Thoughts on Therapy

Technology and Family Life

2009-08-11T08:22:00.001-07:00

Do you rely on your daughter's status updates on Facebook or Twitter to know how she's feeling today?

We already know too much time spent on video games deprives a child the opportunities to develop crucial social skills. But are we setting enough limits on texting and other online activities for our kids? And, more importantly, how are we adults doing in modeling good behavior for our children?

In our quest to reach out to connect with the world through technology, must face-to-face interaction with those closest to us be sacrificed?

clipped from www.nytimes.com

Technology has shaken up plenty of life’s routines, but for many people it has completely altered the once predictable rituals at the start of the day.

This is morning in America in the Internet age. After six to eight hours of network deprivation — also known as sleep — people are increasingly waking up and lunging for cellphones and laptops, sometimes even before swinging their legs to the floor and tending to more biologically urgent activities.

Mr. Gude, an instructor at Michigan State University, sends texts to his two sons to wake up.

“We use texting as an in-house intercom,” he said. “I could just walk upstairs, but they always answer their texts.”

Weekday mornings have long been frenetic, disjointed affairs. Now families that used to fight over the shower or the newspaper tussle over access to the lone household computer — or about whether they should be using gadgets at all, instead of communicating with one another.

Group Therapy for Women

2009-08-04T10:10:00.001-07:00

What does it mean to be a working woman with a family?

You work hard in a job that may or may not pay you well, and you sometimes wonder if sexual discrimination/harassment is alive and well at your workplace. When you come home you've got to fulfill your roles as a mom and wife, fixing dinner for your husband/partner and reading to your children at bedtime. Every time when your mom/sibling calls to complain about their lives, you step into the role of a good daughter/sister and offer them your best support. When a friend is sick or going through a bad breakup, you run to their rescue.

You make sure every detail in others' lives is taken care of, even when you don't always get thanks.

Everyday, millions of working women in America are struggling to keep up with the demands of work and family. Symptoms of anxiety and depression often develop, along with feelings of "I'm not good enough" or "what is the purpose of my life?"

The good news is, you don't have to suffer alone. Come meet with a group of women who face challenges like yours. I am starting a therapy group for women in Bellevue, WA. You'll find strength from group bonding, practical advice on keeping your life together, skills to combat stress and negative emotions, and renewed energy so you can thrive and grow. I'm keeping the group size small (no more than 6) for maximum therapeutic benefits.

Details are as follows:

Finding Work-Life Balance - Group Therapy for Women
When: Fridays, 5pm to 6:30pm
Where: 9 Lake Bellevue Dr, Suite 217, Bellevue, WA 98005
Cost: $25 per session
Call (206) 280-3591 or email ling@passagescounseling.com for a free screening and consultation.

Depression: A Mistaken Disease

2009-08-02T21:01:00.001-07:00

Is there a biological basis for depression? Certainly, according to Dr. Mark Rasenick, a professor of physiology, biophysics and psychiatry at the University of Illinois Chicago (an excerpt of his recent article follows). Even then, he contends that we know too little about the disease to even begin to treat it effectively, let alone stem its rising tide in the global population.

I share his sentiment that the medical professionals erroneously see medication the magic bullet to cure depression. Yet one needs to interpret with caution his assertion that depression is a "biological, medical problem" that often requires "long-term treatment." The relationship between biological and emotional aspects of depression remains a chicken-and-egg puzzle: does one feel depressed because of a chemical imbalance in the brain, or does feeling depressed lead to such imbalance?

clipped from www.chicagotribune.com

Depression impairs 15 million Americans each year. That's more people than are affected by cancer, AIDS or coronary heart disease. Women are twice as likely as men to suffer from depression.

I study how the brain works on the molecular and cellular level, and I am especially focused on the biology of depression. I can tell you that depression is as real as any other disease.

We still don't have a clear understanding of the biological basis of the causes of depression or the best ways to treat it, whether with medication or other methods.

those with heart diseases are treated with compassion while those with psychiatric disease are ignored or scorned. Most people -- including far too many doctors -- don't fully understand it. They think you can just snap out of it with positive thinking or a couple of weeks' worth of medicine. It won't happen. Not for those with major depression. It is a biological, medical problem that can be helped only with well-managed and often long-term treatment.

Not Just an Addiction Problem

2009-07-30T08:10:00.001-07:00

Ever wondered why addictions -- to drugs, alcohol, the Internet, shopping, etc -- are so hard to kick? Why expensive drug treatment programs so frequently fail to deliver their promised results?

The answer lies in the fact that addictions are but people's desperate way of coping with their deeper psychological problems, most often depression and anxiety but may include schizophrenia and other forms of psychosis as well. When substance abuse professionals focus on the person's dysfunctional behavior and ignore the underlying pain (even worse, downplay the pain by believing that the depression will go away once this person is off drugs), the chances of relapsing are extremely high.

It's time we pay serious attention to the use of substances for self-medicating reasons. I'm not denying the presence of substance-induced psychological problems. But contrary to what established institutions such as AA say, addiction is NOT a disease but a failed solution to overcoming a disease.

clipped from www.washingtonpost.com

Experts Challenged by Mental Illness Mixed With Addiction

In the often separate worlds of mental health therapists and substance abuse counselors, professionals began realizing in the mid-1980s that large percentages of the people they were seeing -- sometimes 50 percent or more -- suffered from both mental illness and addiction to alcohol or drugs.

And treating just one affliction wasn't helping.

Hence the term "co-occurring disorders," or "dual diagnosis."

The federal government estimates that about 7 million U.S. adults suffer from co-occurring disorders and that more than 90 percent of those people are not getting the right treatment.

Anderson said, "The mix of substance abuse and mental health problems really does complicate things." Those with co-occurring disorders, she said, "end up being marginalized in society. Because they have mental illness, they can't handle alcohol or drugs. They get criminalized. They can't get housing, they can't get jobs. What's left for them?"

Do Drug Rehab Clinics Work?

2009-07-23T07:29:00.000-07:00

One of the few TV programs I watch is "Intervention." Each episode features a person with an addiction, usually to a drug such as meth, heroin, or alcohol. In a typical, formulaic reality-TV fashion, you follow this person in his/her day-to-day living. The show climaxes when the family arranges an intervention to try to get the person to pack up right away and check into a treatment facility.

(By the way, don't you agree reality TV is totally junk yet curiously addictive at the same time? Hmm, I'm addicted to watching others being addicted. Such a paradox of life.)

I'm always astounded by the sheer beauty and luxury of these treatment centers in Intervention. Quite inevitably they're in sunny places such as Florida or California, sometimes by the beach, always spa-like. They look like the perfect place to spend my honeymoon.

In real life it costs tens of thousands of dollars to check into one of these places for a month. And no one knows for sure whether these treatment programs work because these clinics are rather secretive about their success rates. Post-treatment or aftercare services are scarce; follow-ups with their patients 3, 6, or 12 months on are practically non-existent. But anecdotal evidence suggest that patients don't stay sober for long after discharge.

In the words of Thomas McClellan, chief executive of the nonprofit Treatment Research Insititute in Philadelphia (which I quote from the New York Times, Dec 23, 2008), "You go to Shady Acres for 30 days . . . And then you're discharged and everyone's crying and hugging and feeling proud -- and you're supposed to be cured. It doesn't really matter if you're a movie star going to some resort by the sea or a homeless person. The system [of drug rehab] doesn't work well for what for many people is a chronic, recurring problem."

Imagine spending a month at a rehab center in a picturesque setting. You make new friends, you have wonderfully supportive staff, you have a daily routine that comprises physical exercise, counseling, endless walks on the beach. You may even cultivate a passion for gardening. Then you say goodbye to this fairy-tale setting and return to real life that is your family, your community. Your teenager is still giving you an "f-you" attitude (or, if you're the teenager, your parents are still driving you crazy), you're still stuck in a dead end job, and every social gathering you go to has no lack of booze to take you right back to where you were a month ago.

You get the idea. You really can't expect addicts to break their habit without changing (a) their environment and (b) their response to the stressors in their environment. Most drug rehab programs would have you believe that addiction is a disease. Yes, we know about the hereditary factors that predispose some people to addiction, and that prolonged drug use can have profound impact on the brain chemistry and structure. I also agree that detox is often a necessary first step to recovery. So I'm not arguing against the biological and physiological dimensions of substance abuse and addiction.

But seeing addiction as a disease keeps us focused on treating the individual person, neglecting the ecology (such as family dynamics) that maintains the disease or the person's psyche that prevents him/her from using adaptive coping skills. An important skill to learn, for example, is emotional regulation. A person without this capacity is likely to want to escape from them whenever they threaten to overpower this person. In the quest to escape one's emotional pain, if the spa-like comfort house by the beach is not within reach, the bottle (or syringe) would once again look immensely promising.

The Pain of Avoidance

2009-07-21T07:46:00.000-07:00

In a comment to my previous post, a reader of this blog recently shared that she tried to avoid stress as much as possible to alleviate her physical (and perhaps emotional) pain.

I bet that's what most of us do. It's instinctual, isn't it? We stay away from things we don't like. That's perfectly fine with tangible things -- objects, persons, places, a third slice of that sinfully decadent chocolate fudge cake-- that we can physically remove ourselves from. This often doesn't happen so easily with non-tangible things such as memories of the past and anticipation of the future. That's right, we can't avoid our thoughts and feelings.

Classic Psychology 101 exercise: for the next 30 seconds, think of anything but a white bear.

Chances are, you couldn't think of anything else but the white bear. One strategy to "succeed" in this exercise is to substitute the thought of the white bear with, say, that of a pink elephant. In real life, however, substitutions are not always healthy and adaptive. Just look that how many people you know who abuse drugs and alcohol to avoid dealing with their pain or grief. Or those who immerse themselves in work to avoid having to deal with the emptiness they would otherwise feel in their lives.

The fact is, the more we try to avoid a thought or feeling, the more we inadvertently become slaves to it, giving it more power while we continue to run and hide from it in fear.

But why do we run in the first place? We willingly bear with the pain of a vaccination shot because we know it'll benefit us. The thought, "It's good for me" is a judgment that leads to our decision to stay still in the doctor's chair and let him prick our arm with the needle. It also helps to know that no matter how much it hurts in the moment, the pain will go away.

With psychological distress, it's hard to imagine how it can be good for us, let alone know when it'll end. It seems the only option is to keep it at bay for as long as we can. But let's back up to the point we start to think, "This is bad." If we're able to look at an event or an emotion without judgment or attaching a value to it, what would happen?

Suppose you lose sleep tonight. Does it help to have the thought that you have an important meeting first thing in the morning and you should get some sleep? Suppose you feel depressed because you lost your job. Do you feel better or worse when you start thinking, "But I still have my house, I'm better off than most people, I shouldn't feel depressed"?

The problem with avoidance is that it adds to the very pain we're trying to overcome. Instead of wishing for the pain to go away, you may want to practicing mindfulness. This helps you relate to your pain in a different way, so you don't feel powerless against it.

Notice the frustration, sadness, or other negative feelings and thoughts as they come up as if you're watching a movie. Your mind is the silver screen on which fleeting images are projected.

Notice that these are thoughts and feelings inside of you, not reality itself.

Notice without judgment. Let go of the should's and must's.

Notice the urge to want to push these unpleasant feelings away, but just let it be. You don't have to act on this urge.

Notice that you're drifting in and out of your thoughts and feelings, and tell yourself it's okay.

Notice that you're probably beating yourself up because you're "not doing a good job" meditating or noticing, then let your "good job" judgment go.

Be curious and compassionate as you stay present with your thoughts and feelings.

Smell the Roses (or Coffee)!

2009-07-19T23:44:00.001-07:00

Who hasn't taken a trip down memory lane with a mere whiff of a familiar scent? Whether it's the woodsy smell of some old furniture that reminds you of your wonderful time in grade school, or a particular cologne that fills you with the bittersweet memories of an old lover, scents have a powerful way of stopping us in our tracks and at times filling us up with rather intense emotions--good or bad.

Yes, it's not just the information that we recall with a scent, but more importantly the emotions that go along with the memory.

According to the following article, scents go straight to the limbic system in the brain, the very place our emotions are triggered. Is it any wonder why aromatherapy is so effective in calming nerves and revitalizing one's energy? Of course, it helps that when we smell something pleasant, we take in slower, deeper breaths--often the very action that soothes us and clears our mind.

So take your time when you wake up tomorrow and smell the rich, textured layers of your coffee. And let the world stand still for you for a minute.

clipped from www.care2.com

according to psychologist Rachel Herz, a Brown University professor who studies the psychology of smell. “A person may have no emotional reaction to seeing a photo of a loved one who died,

but that person may unexpectedly encounter the same smell particular to the loved one’s study–a combination of cigarettes and books, for instance–and feel like weeping.” She notes that “those who lose their sense of smell because of accident or illness also report a loss of emotional richness and, over time, a loss of emotional intensity toward life. Experiences are flatter, they report.”

Margo Valentine Lazzara

writes that scents “trigger memories because of their quick access to the limbic system in the brain. It is here that scents will evoke an emotional response, such as hunger or sexual appetite. They can help you recall long- and short-term memories. If a particular scent stirs up past or painful emotions and memories and causes you suffering, then you might want to avoid this specific scent.

Unexplained Pain? It Could Be Depression

2009-07-17T08:35:00.000-07:00

Every now and then, when we experience shoulder tightness or backaches, we know it's stress related. But do you know that depression can similarly cause pain in our body?

According to a recent study reported in Science Daily, about 73% of pain and other bodily symptoms seen by doctors in general practice have no physiological causes. Symptoms that cannot be explained in medical terms or cannot be attributed to organic origins are known as somatoform symptoms. Contrary to popular belief, the patient is not imagining the physical sensations; indeed the pain is real and can cause clinically significant impairment in one's daily functioning.

In this study of 308 patients, the researchers found a significantly higher incidence of somatoform pain in patients who are depressed or have had depression in the past year, compared with patients without depression.

I'm reminded that in many cultures, depression can look very different from that as described by the Diagnostic and Statistical Manual (DSM-IV-TR). The DSM includes feelings of emptiness, worthlessness, excessive guilt, and thoughts of death amongst its criteria for major depression. The affective (feelings) and cognitive (thoughts) dimensions of depression may not play a prominent role in non-western cultures. For example, depression among the Chinese population often manifests in the forms of bodily aches, digestive difficulties, and obstruction of the flow of qi (energy) within the body.

If you're experiencing discomfort or pain in any part of your body for which your doctor is unable to determine any medical causes, do some research online or talk to a mental health professional to see if there could be underlying psychological issues.

It's All in the Head: Psychotherapy Changes Brain Activity

2009-07-16T07:24:00.001-07:00

Medication or psychotherapy? Pharmaceutical companies would have us believe that depression and anxiety disorders cannot possibly be lifted if we don't address the underlying neurochemical imbalance with medication. Yet increasing evidence indicate that receiving counseling and therapy brings about similar changes in the brain that are associated with improved mood and functioning.

I'm really excited about findings like this. To be sure, I'm not advocating that we do away with medication altogether. Medication may indeed be necessary to treat psychotic symptoms or severe depression. But I am hopeful this and other studies will get us to think twice before we reach out for that bottle of Adderrall or Concerta for ourselves or our kids.

clipped from www.psychologytoday.com

The Biology of Psychotherapy

growing evidence from brain imaging research suggests that the form of therapy known as cognitive behavioral therapy, or CBT, produces changes in the brain similar to those produced by medications when they work.

Cognitive behavioral therapy emphasizes the role our thoughts play in how we feel.

Obsessive-compulsive disorder (OCD) is characterized by anxiety-laden intrusive thoughts and accompanying repetitive behaviors that are meant to reduce the anxiety.

In a study that compared CBT to Prozac, researchers used a brain-scanning technique called positron emission tomography to measure the rate of glucose metabolism in the OCD brain after Prozac treatment alone and after therapy treatment alone. The results were essentially identical: both interventions decreased the rate of glucose metabolism to levels seen in healthy people without OCD, and the rate of the decrease seemed proportional to the degree of improvement in their OCD symptoms.

The Power of Negative Thinking?

2009-07-08T22:01:00.001-07:00

An interesting article that reflects a basis premise of mindfulness and other modern therapeutic approaches: the more we fight the demon, the bigger it becomes. So let's just sit with it, instead of acting on the urge to confront, challenge, and change it.

clipped from www.time.com

Yes, I Suck: Self-Help Through Negative Thinking

A Million Little Pieces by James Frey (center) is displayed amongst other self-help, recovery books, at a Borders Book store.">

A study just published in the journal Psychological Science says trying to get people to think more positively can actually have the opposite effect: it can simply highlight how unhappy they are.

unfavorable thoughts about ourselves intrude very easily, especially among those of us with low self-esteem — so easily and so persistently that even when a positive alternative is presented, it just underlines how awful we believe we are.

The paper provides support for newer forms of psychotherapy that urge people to accept their negative thoughts and feelings rather than try to reject and fight them. In the fighting, we not only often fail but can also make things worse. Mindfulness and meditation techniques, in contrast, can teach people to put their shortcomings into a larger, more realistic perspective. Call it the power of negative thinking.

Quotes of the Day

2009-07-07T14:45:00.000-07:00

"Continuing to approach things in the same way is just more of the same of something that is not working, which is the exact definition of a problem."

-- Steve de Shazer

"Insanity is doing the same thing over and over again and expecting different results."

-- Albert Einstein

Do Something Different

2009-07-06T12:27:00.001-07:00

Two parents saw a therapist because they didn't know what to do when their son threw temper tantrums. The therapist said, "The next time he throws a temper tantrum, instead of doing what you used to do to try to calm him down, I want each of you to do something different. I won't tell you want to do, it's up to you to decide." As you can imagine, the parents left the session uncertain if this was going to work (and whether they went to the right therapist!). But when Junior threw a temper tantrum the next day, Mom broke into a song and Dad gave him a dime. After some time, Junior stopped his tantrums altogether.

This story was told by Steve de Shazer, founder of the solution-focused approach. How did that happen?

We often get locked in negative cycles of communication (Junior's way of communication was through his temper tantrums) as tension escalates and power struggle ensues. Like actors in a play, we all follow a script that plays itself out over and over again as each participant's behavior becomes predictable. Typically, the script says, "Stop the other person from doing what he/she is doing." Or, "Try harder so they'll get your message." When we do something unpredictable and uncharacteristic of ourselves in such a situation, we throw the other person a curveball that invites a different response. In many situations, this breaks the negative exchange.

Remember when you were having a fight with your best friend, and one of you made a silly, irrelevant remark that made you both break into uncontrollable laughter? That's the power of the unpredictable response.

Bottomline: If it ain't working, do something different. It doesn't matter as much what you do, as the fact that you're changing up something.

Plants Help Your Kids Cope with Stress

2009-07-04T15:32:00.001-07:00

clipped from www.psychologytoday.com

The Healing Power of Nature

A bit of green may calm a child's frayed nerves. Rural children who have access to nature seem better equipped to handle stress than kids in a room without a view. What's more, children who are the most vulnerable to stress benefit the most from adding greenery to their lives.

Nancy Wells, an environmental psychologist at Cornell University, assessed access to nature in the households of 337 children in grades three through five. She noted the number of houseplants, the amount of greenery seen from windows, and if the yard had grass, dirt or concrete.

Wells and her team also interviewed children and their parents to rate the kids' stress levels and also gave a standardized stress test. Even when controlling for income and socioeconomic status, the more green a child saw, the better he or she seemed to cope with adversity.

And in a previous study, Wells found that children who were surrounded by nature have longer attention spans.

Therapy - Luxury or a Necessity?

2009-07-01T14:38:00.000-07:00

We're halfway through 2009. Despite the occasional break of uplifting news--some hint of recovery in the housing market, stabilization of oil prices, the slow but certain withdrawal of our troops from Iraq--the mood is still sombre overall on the economic front.

While the debate over health care reform is still going on, everyday thousands of people across the country are losing their jobs--and their health insurance. You may know of someone, a friend of a friend perhaps, who is now struggling to keep up with the mortgage after having been pink-slipped a few months ago, and is only one illness away from bankruptcy.

Even those fortunate enough to keep their jobs are not spared from the mental agony of wondering, "Will I be next?" That is, if they have a moment to pause between the multitude of tasks they now have to cover with their company's downsizing.

The irony of it all? At a time when the population's mental health is on the decline, when marriages are crumbling due to financial stress, when family cohesiveness is giving way to distress, tension, and chaos, people are putting off seeking therapy because they can't afford it.

You know what eventually happens when you keep ignoring an aching tooth. You woundn't wait till your car goes up in smoke before you take it to a mechanic for a routine check-up. So why would you put your mental health on the line?

To be sure, psychotherapy, like other services in the healthcare industry, can be costly. But there are ways to get the services you need--in times of need. Many therapists (including myself) offer a sliding scale fee for clients who can't afford their full fee. Others offer variations of individual psychotherapy, such as group counseling, at a lower fee. Most therapists are also flexible in their scheduling: if paying $100 per week to see your therapist is not within your ability, negotiate to have bi-weekly sessions or shorter sessions.

Many good directories exists that allow you to check out the therapists practicing in your area. The good news is that you don't have to register or pay a fee to use these databases. Feel free to shop around on directories such as psychologytoday.com and goodtherapy.org. Or find out if your local church or synagogue offers free therapy services.

I believe that therapy should not be entitled to the rich. Everyone should have access to therapy when they need it.

Mistakes Are D-E-L-I-C-A-T-E

2009-06-29T07:04:00.000-07:00

Since I recently wrote about perfectionism, I thought I'd share some useful tips on how we can prevent perfectionism in children. According to family psychologist John F. Taylor, Ph.D., the trick is to encourage a healthy attitude toward mistakes in young children. Using the acronym DELICATE, he suggests that parents and teachers use the following statements when a child gets discouraged when he/she makes a mistake.

And what's to stop us grownups from saying these to ourselves too?

"Your mistakes are ... "

Decreasing --

"Look how far you've come"

"Things will get easier as you continue to practice"

Expected --

"That's why pencils have erasers"

"Everybody makes mistakes; nobody is perfect"

Learning Tools --

"Success means any forward progress"

"What can you learn from this experience for next time?"

Incompletions --

"You didn't run out of talent; you just ran out of time"

"You're just not done with it yet; we'll work on it again later"

Caused --

"Let's see what's giving you the trouble here"

"Every mistake has a cause"

Accidental --

"You can't make a mistake on purpose"

"All mistakes are just accidents"

Temporary --

"You're just not ready for this right now"

"This doesn't mean that you can't do it better later"

Effort Proofs --

"Mistakes only prove you're trying"

"Mistakes are benchmarks on the path of effort"

(Special thanks to John F. Taylor, Ph.D. for permission to reproduce his material. Dr. Taylor is an expert on parenting children with ADD and chronic misbehavior. You can visit his website for more information.)

So You Think They Noticed?

2009-06-26T07:49:00.000-07:00

Ever made a verbal gaffe in a presentation at work and thought to yourself, "I must have looked stupid"? Or had a date who burped loudly in a classy restaurant and you thought, "Great, I'll never be able to show my face here again"?

In social psychology, the "spotlight effect" refers to our tendency to overestimate the amount of attention people pay to our actions--especially the embarrassing ones. Oftentimes it's all just in our mind. So don't fret over the mismatched socks.

clipped from www.psychologytoday.com

Did everyone see me do that?

We often feel that everything we do is under a social microscope. For example, we worry that everyone will notice the awkward statement that we make during an important conference call or that everyone was focused on our appearance on a "bad hair day." Are such worries justified or are we just being too sensitive when such thoughts cross our mind?

Cornell undergraduates were asked to wear a Barry Manilow t-shirt.

At the end of the study, the shirt wearer was asked to estimate what percentage of the other students would remember their shirt, and they expected that nearly half of the students in the room would be able to recall their embarrassing shirt. However, in actuality when the others students were asked to identify the shirt, less than a quarter of them could do it. On average, people expected that twice as many people would recall the shirt as they actually did.

A Little Conversation About Feelings

2009-06-25T07:34:00.000-07:00

Wednesday. 3pm. Alone in staff lounge, savoring lunch at long last. Colleague (non-counseling staff) walks in.

Colleague: How are ya?

Me: Exhausted, but good. Just came out of a very intense session with a family. It all went well, but I'm just mentally drained.

C: Yeah?

M: Do you sometimes feel this way in your work? (Read: I'm too tired to talk, but I want to have a conversation with you. How about you tell me about your work?)

C: Thankfully I don't deal directly with clients. But I do feel this way in my own family. I've got a husband and a teenage kid.

M: I see.

C: And I used to feel so overwhelmed by my feelings about things at home. It got so bad I sometimes just wanted to hit somebody. My husband, who's trained in martial arts, would let me take it out on him, so I'd punch him repeatedly on his arm and scream. And then I'd say, "Why doesn't that make me feel better?" And I'd actually feel much worse than before because I couldn't make my bad feelings go away.

M: ...

C: Then, over time, I came to realize that my feelings are just that--feelings. Just because I have a feeling about certain things, my feelings don't define these things. Feelings and reality are not the same.

M: Yup. Your feelings about a past event, a person--anything--may come and go, even if the object is still there. And you may have a different feeling about the same object in the next moment.

C: Exactly. Having a feeling about something doesn't meant I have to act on it. Sure feelings sometimes guide action, but by way of rational thought.

M: And you are more than your feelings. Your feelings are but one of the many parts of you.

Then somehow the subject shifted to "husbands," the contents of which I shall not spill here. But deep down, I was grateful to Colleague for that wonderful reminder. It was exactly what I needed in that moment (besides food).

Perfectionism

2009-06-24T07:29:00.000-07:00

A fellow counselor and I were discussing perfectionism just the other day. To be exact, we were talking about our perfectionism. Or, shall I say, how we're tormented by our desire to get everything just the way we want it to be, no more, no less.

There is a certain paradox about two self-proclaimed perfectionists lamenting how they lives are imperfect because of their obsession with perfection. Think of it, if you have to put all your mental energy into bringing a piece of work to perfection, agonize over the little details so much you miss the joy of creating this work in the first place, and the only way you can be satisfied is if the work meets all your expectations of what you want it to look like, how much energy is left for the other aspects of life?

But then, isn't perfectionism what makes us competent individuals? Isn't this what some of our parents and teachers taught us to become, to "keep trying until you succeed," to "keep practicing so you get better each time"? Isn't perfection what the media insidiously and relentlessly goad us to pursue, with commercials that bombard us with images of flawless faces or cellphones with ever-faster 3G connection?

A professor once said, "Perfectionism is like the the most westerly point. You can head west, and even feel compelled to do so, but you'll never get there. Wherever you are, there's always a point further west."

Ok, I get it. And I've thought of a perfect solution for my perfectionism. For today, I'm going to deliberately make a perfect mistake. I'll obsess for the next hour what it's going to be, how and when I'm going to execute it. It'll be so perfect it'll bring a smile to my face every time I think about it. And maybe I'll blog about it tomorrow. Perfect.

Bad Relationships Increase Work Stress

2009-06-23T08:28:00.001-07:00

How many times have you heard a friend lament about their being single, something along the lines of, "Work is killing me! Oh if only I could have a loving partner to come to home to every night..." (Or, how many times have you caught yourself thinking that?) Read on...

clipped from www.sciencedaily.com

Partner Relationship As A Buffer Against Stress

A good partner relationship can act as a buffer for those exposed to work-related stress.

Women with a poorly-functioning relationship experienced more anxiety, mental stress reactions and sleeping difficulties than women who had a good relationship. Men who had a mediocre relationship had a higher incidence of depression, anxiety, psychological and somatic stress reactions than men with worse or better relationships.

One explanation can be that people living with a mediocre relationship take more responsibility to improve the relationship, while those with poor relationships just admit it, and don't feel they can do anything about it.

After having been exposed to stress, the body must recover and recharge itself. If there is no opportunity to recover

, the body's reserves are emptied, and poor health ensues. The same principle applies when a person takes work home

or has recurring quarrels and problems in his or her relationship.

Affordable Therapy

2009-06-21T14:44:00.000-07:00

Does one need to be in long-term therapy before one sees the results?

Absolutely not. People often look for long-term therapy to work on deep-seated issues such as childhood abuse, trauma, and family-of-origin issues. But these are by no means the only way you can alleviate your present psychological problems. There are alternatives to dwelling on the past and exploring how historical factors led a person to his/her present predicament. After all, history is static: you cannot do anything to change it. Instead, you want to ask yourself, "Given what has happened, how do I move on?" This is like being dealt with a hand at poker that is far from perfect--the challenge is to play as good a game as you can with what options are available to you.

Solution-Focused Brief Therapy (SFBT) helps you maintain a forward-looking perspective by focusing on how you want things to be different and how to get there. It helps you take stock of your strengths (including a desire to change) and explores ways to develop these strengths so you reach your goals. Often, even without your awareness, elements of your desired outcomes are already present in your life. They become the ongoing basis for change and, with the help of a therapist, become amplified so that bigger changes can take place.

Establishing clear and specific goals is vital to the success of SFBT. Compared with therapists who adopt a psychodynamic tradition (think Freud), SFBT therapists are also more directive in keeping the focus on goals and how to reach them. Though SFBT tends not to set a limit on the number of sessions, the course of treatment is usually six sessions or less, simply because the approach is dynamic, focused, and goal-driven.

Though some poo-poo SFBT as a Band-Aid solution to psychological distress because it doesn't "get to the root" of the problem, research has shown impressive support for its efficacy. Maybe SFBT won't help you work through your feelings of abandonment and other childhood wounds, but it helps you to begin creating changes in the present so your unfinished business from your past no longer gets in the way of living a fulfilling life.

What does SFBT treat? The sky's the limit, though it's best suited for adjustment problems, stress, anxiety, depression, substance abuse, relationship problems (couples and family), and trauma.

If you're looking for a therapist but are skeptical about throwing in thousands of dollars for long-term treatment, Solution-Focused Brief Therapy may be the perfect answer for you.

SFBT Summer Special: 6 sessions for $400! Call (206)280-3591 or email me to schedule a free 30-minute consultation to find out if SFBT is right for you.

Simple Ways to Improve Sleep

2009-06-19T11:28:00.000-07:00

Do you know:

- 25% of Americans experience occasional sleep problems
- 10% of the nation's population suffer from chronic insomnia
- Americans spend millions of dollars a year looking for a cure to their sleep problems, including prescription drugs, mattresses, and sound machines?

Before you fork out your hard-earned money to improve your quality of sleep, here are some simple, low-cost way that may help:

1. Create an Environment Conducive to Sleep

People tend to overlook the importance of having a conducive place to sleep. Get dimmers for your lighting, light-proof blinds, a CD player to play soothing music. Spray a calming scent if you want to, but no candles because you'll probably lay awake worrying about whether it's going to catch a fire. Absolutely no TV, computer, or even cellphones. Electronic equipment emits small amounts of energy that may interfere with your brain waves. Even the sight of them can be a stark reminder of the tasks you've not completed in the day. If you can't move them out of your bedroom, cover them with scarves or other soft fabric before you start your bedtime routine. Avoid watching TV, eating, or web-surfing in bed. (Some even discourage reading in bed.) You want to prime your mind to think "sleep" when your head hits the pillow.

2. Establish a Relaxing Bedtime Routine

You know you get drowsy after a carb-laden meal in the day, but it really doesn't improve your quality of sleep because your internal organs are working hard to digest the food. So try to have your dinner at least two hours before bedtime, and preferably a light meal at that. If you do snack at night, stick to proteins such as nuts. Start winding down mentally 30 minutes before bedtime--read a calming book (on a comfy chair by the bed), put on soft music, practice meditation or muscle relaxation.

3. Help Your Body Relax

Focus your mind on your here-and-now experience in your body. Apply a scented lotion all over your body before you change into your PJs, and enjoy the feeling of stroking your own skin. If you sleep with a partner, give each other a massage. Practice deep, slow breathing. Think "in" as you inhale, feeling the breath work its way down to your diaphragm, then think "out" as you exhale. Feel the soft touch of your Egytian cotton bedsheets on your skin and the mattress gently propping your body up. Trust that your bed will hold you through the night, so your body doesn't have to support itself the way it does in the day. If a worrying thought comes into your mind, notice it, and let go. You can deal with it tomorrow. Then gently return your focus on your bodily experience. You may find it helpful to play an audio recording of guided relaxation to help you relax your various muscle groups.

4. Change Your Lifestyle

Exercise regularly, reduce your intake of caffeine, tobacco, alcohol, and sugar. Drive in the slow lane. Make time for friends and family. Resist the urge to multi-task. Cultivate a new hobby.

5. Cultivate Compassion Toward Yourself

We are often our own harshest critics. Allow yourself to make mistakes. Instead of chiding to yourself, "I should be asleep by now!" give yourself permission to lose sleep. You may find that removing self-criticism will at once alleviate the pressure and anxiety that are stopping you from falling asleep.

Do you know of other ways to help you sleep better? Feel free to comment or email me with your tried-and-tested tips.

The Problem with Diagnoses (Part 2)

2009-06-18T06:37:00.000-07:00

In yesterday's blog, I wrote about how inclusions of mental disorders shift with different editions of the Diagnostic and Statistical Manual (DSM), and how this process is influenced by the marketing efforts of pharmaceutical companies and other lobbying groups. A few hours after publishing the post, I came across an article online that illustrates perfectly how arbitrary definitions of mental illnesses is. (And, if I may say so, how institutions such as the APA oppress the working poor, the have-nots in the society--but I'll save that discussion for a later blog.)

To be sure, the DSM is not all bad. It gives us the language to communicate with other professionals (and yes, insurance companies too) when discussing client needs and in coordinating services. Many people also feel relieved about being able to name their condition and understand that the condition is only a part of themselves ("I'm not crazy; I have bulimia.").

For others, a diagnosis especially one of a personality disorder, is not unlike a life sentence and even a convenient excuse to NOT try to change their behavior ("I'm borderline, don't expect me to behave rationally!"). It may also affect how others perceive them. Human beings are consistently looking to filter information--it's what keeps us from being overwhelmed and confused by the barrage of stimuli around us. However, what happens when we name something is that we tend to look at it out of its context and attach permanent characteristics to it. Similarly, when we hear about a mental disorder in a person, the person's other characteristics (e.g., of a loving mother) may fade into the background.

With adolescents who persistently defy authority and break rules, it is not uncommon to find dysfunction in the family; labelling the teen as "oppositional defiant" may unduly place shift the focus away from the family to the offending youth. Family members often fail to see the role they play in creating or maintaining the unwanted behavior and thus miss out on the opportunity to help create lasting changes in the adolescent by changing the dynamics in the family system.

Therapy is a meeting of two or more people, each with his/her rich characteristics and unique qualities. No one deserves to be seen through the tunnel vision offered by the label of a mental disorder.

Feeling Bitter? You Could be Mentally Ill

2009-06-17T07:12:00.001-07:00

What's worse than having lost our jobs, our homes, our 401(k) in the recession, while the top execs at financial institutions get away with big bonuses straight out of our pockets? How about being told we've got Post Traumatic Embitterment Disorder? American Psychiatric Association (APA) is considering including bitterness in its Diagnostic and Statistical Manual of Mental Disorders (DSM).

clipped from www.psychologytoday.com

Bitterness: The Next Mental Disorder?

that some psychiatrists are urging it be identified as a mental illness under the name post-traumatic embitterment disorder.

But when justified anger at such incompetence is discussed as a sign of mental illness, it is borderline insulting, especially because half the reason for the discussion is to ensure that drug companies—anxious to prod their faltering revenues—can promise relief from the alleged disorder with yet more pharmaceuticals.

Imagine, if you will, the inevitable ads: "Think it's just bitterness from job loss, foreclosure on your home, or that nonexistent pension for which you've been saving all your working years? It may be 'post-traumatic embitterment disorder,' a mental illness that some doctors think is due to a chemical imbalance . . ."

as usual

the APA

has ignored or shunted aside most of the explanatory context, to pathologize the individual in all of her or his frustrated grievance.

The Problem with Diagnoses (Part 1)

2009-06-17T00:21:00.000-07:00

Let's picture what typically happens when you seek therapy. You call around various therapists, make an appointment with one of them who accepts your medical insurance, and you show up for the initial assessment. What you may or may not know is that your therapist will then have to diagnose you with a mental disorder and provide this, along with other information such as your treatment plan, to your insurance company in order to be paid for the services provided to you.

What's wrong with this picture?

To make a diagnosis of a mental illness, mental health professionals such as psychiatrists and therapists rely on the Diagnostic and Statistical Manual of Mental Disorders (DSM). The current manual (DSM-IV-TR) lists categorically 297 conditions ranging from schizophrenia to substance abuse, from panic disorder to paranoid personality disorder. Almost every disorder carries a set of criteria one needs to meet to justify its diagnosis.

Herein lies the problem: definitions of what is "normal" change with every new edition of the manual, as a result of new research findings and greater awareness, as well as lobbying efforts and political factors. A strong cultural bias exist. Case in point: "homosexuality" was considered a mental disorder (read: needs fixing) until 1987 edition of DSM.

A related problem is that it isn't always clear which diagnosis fits you best, so your therapist may have to do some guesswork or fill in some information gaps just to fit you into a diagnostic category.

Insurance companies also dictate what conditions they do and do not cover. Most do not cover treatment of relational problems such as that within a couple of between a parent and child. This means that if you're seeking couples therapy, chances are your therapist will have to diagnose you or your partner with a mental disorder such as depression or anxiety in order to fulfill insurance requirements.

Lobbying efforts from pharmaceutical companies can dictate the prevailing diagnoses. We saw how, beginning in the late 1990s, children formerly diagnosed with ADHD were increasingly being labelled bipolar, thanks in large part to aggressive marketing efforts by the makers of anti-psychotic and anti-depressant drugs to family doctors and child psychiatrists.

(On a separate note, I shudder to think that many of these drugs have not been shown to work on children; in fact emerging evidence suggests that they may cause more harm in the long run.
If you want to learn more about the controversy, I highly recommend watching the PBS documentary "The Medicated Child.")

We are How We Eat

2009-06-16T07:20:00.000-07:00

A few days ago, I had a tight work schedule (and a long day at that). Anxious to meet my next client on time, I practically slurped a bowl of pho (Vietnamese noodles) in 10 minutes flat during lunch.

"No big deal," I hear you say. "That happens to me a lot." But have you ever noticed how your body felt--how YOU felt--the rest of the day when you did that? Did it help you feel less stressed because you've managed to keep things under control by accomplishing more than if you were to take a leisurely meal? Or did you actually feel more anxious?

For me, I couldn't stay focused almost through the entire day. I felt my anxiety taking over, like I had to keep stepping on the gas in the fast lane. I felt like a hamster on the wheel; I couldn't stop. It seems that when you speed things up hoping to gain control, you wind up losing control. Ironic, isn't it?

What happens when we eat fast is that our stomach and intestines strain to properly break down and assimilate food into our body. This contributes to our stress level both directly through indigestion, bloating, and cramping, and indirectly through failure to absorb essential nutrients.

So, our moms were right when they taught us to chew 20 times before swallowing. Here's why, and a couple of other things that will help relieve anxiety:

- Chewing food 15 to 20 times per mouthful helps relieve anxiety because our teeth and enzyme in the saliva help to break down the food in our mouth and makes the work of our internal digestive system much easier.

- Eat just enough to feel satisfied so you don't overload your digestive system. You don't have to clean out the plate.

- Drink one cup of water with the meal. Drinking too much fluid can actually dilute stomach acid and digestive enzymes, thereby increasing the level of stress on the body system.

You can take it a step further by practicing mindful eating, which involves focusing on chewing, tasting, feeling the texture of the food (and its juices) in your mouth before making a decision to swallow it and finally swallowing it.

I'll write about mindfulness and mindful eating in another article, but for a start, how about eating at a dining table, away from your computer screen or television set?

America's Drug Problem

2009-06-15T07:31:00.001-07:00

In my day-to-day work, I've seen individuals waste their life away on drugs and families broken up because of one (or more) member's drug habit. How much responsibility should we put on the individual who falls to addiction and how much responsibility should we assign to the state? Or to the society who has failed to provide the support these individuals need to cope with their mental health problems?

clipped from www.nytimes.com

Drugs Won the War

This year marks the 40th anniversary of President Richard Nixon’s start of the war on drugs, and it now appears that drugs have won.

First, we have vastly increased the proportion of our population in prisons.

Second, we have empowered criminals at home and terrorists abroad.

Third, we have squandered resources.

We spend seven times as much on drug interdiction, policing and imprisonment as on treatment.

President Obama’s new drug czar, Gil Kerlikowske

wants to banish the war on drugs phraseology, while shifting more toward treatment over imprisonment.

“I don’t see any big downside to marijuana decriminalization,” said Peter Reuter

At most, he said, there would be only a modest increase in usage.

One approach would be for a state or two to experiment with legalization of marijuana, allowing it to be sold by licensed pharmacists, while measuring the impact on usage and crime.

We are What We Eat

2009-06-13T16:42:00.000-07:00

So you've done your meditation, yoga, tried everything your therapist has asked you to do -- and still not able to rid yourself of anxiety? Have you looked at your diet lately?

Of course you know that 5 cups of latte a day is not going to lower your anxiety one bit. Caffeine is a notorious culprit behind generalize anxiety and panic attacks. (And yes, that includes caffeine in your cola and energy drinks.)

But do you know that nicotine is as strong as caffeine in stimulating you physiological arousal? Considering that smokers tend to feel a sense of relief and calm when they light up, it may be surprising to them to know that smoking actually causes constriction of the blood vessels and therefore causes their heart to work harder, resulting in increased stress.

Excessive salt raises your blood pressure, putting strain on your heart and speeding up the process of arterosclerosis. It also depletes your body of potassium, an important mineral in the proper functioning of the nervous system.

Artificial preservatives such as nitrites, monosodium glutamate (MSG), and artificial colorings and flavorings are also responsible for increasing our anxiety. Our bodies are simply not made to process chemicals, and you may even have an allergic reaction to them. Try to eat whole, unprocessed foods and buy organic vegetables and fruits.

Speaking of organic foods, you probably know that a lot of the meat you get in large grocery stores have been fed hormones to promote weight gain and growth. One such hormone, diethylstilbestrol (DES), has caused quite a stir because some believe it causes breast cancer and fibroid tumors. You may want to reduce your intake of red meat, pork, and commercially available poultry, and replace it with organically raised beef, poultry and fish.

According to a Chinese saying, "Disease comes from what we eat." Ok, so they may not have heard about UV rays back when this saying originated, but in many ways this is still true even when we talk about mental well-being, isn't it?

Marriage and Family Therapy

2009-06-12T17:23:00.000-07:00

Everyone's got to have a professional spiel they use from time to time, so here it goes:

Ling Chua, M.A., was trained as in marriage and family therapy at Antioch University Seattle. She is currently a Licensed Marriage and Therapist Associate with the Washington State and has a private practice in Bellevue, WA.

Ling has extensive experience in adolescent therapy as well as couples counseling, individual counseling, and family therapy. Her areas of specialization are as follows:

- Marriage problems
- Parent coaching
- Parent-child relationship problems
- Behavioral problems in children and adolescents
- Addictions and substance abuse
- Anxiety issues
- Depression

- Stabilization of families in crises

Ling uses a variety of treatment techniques in her work, including cognitive-behavioral therapy, narrative therapy, emotion-focused couples therapy, solution-focused brief therapy, and mindfulness based practice. She also offers therapy services in Mandarin.

If you'd like to know if Ling is a good match for you as a therapist, please visit her website at www.passagescounseling.com or email ling@passagescounseling.com to schedule a free initial consultation.

Insomnia - A Modern World Epidemic

2009-06-12T16:48:00.001-07:00

Who would have guessed that a conspiracy exists to keep us all awake at night?

clipped from psychotherapynetworker.com

Sleepless in America

Little is known about the mechanisms, causes, clinical course, co-morbidities, and consequences of chronic insomnia.

The percentage of the population who need less than five hours of sleep per night, rounded to a whole number, is zero.

In fact, thanks to technology, particularly the Internet, there's nothing you can do during the day that you can't do at night.

clipped from psychotherapynetworker.com

Insomnia is exactly what the movers and shakers of our society want for us. The buzz-term used by advertisers and corporate honchos for the monetary windfall of our 24/7 lifestyle is the "attention economy," and there's a perceived need to increase it, which means finding ever-growing numbers of people (consumers) awake and aware of the proliferating Internet-mediated information sources (the "product") popping up on their screens, and ultimately buying something, somewhere, from someone.

clipped from psychotherapynetworker.com

In our own culture, there's an eerie echo of this insatiable striving to rise above our

need for sleep and become

powerhouses.

Impulse Control Problems - When You Never Can Buy Enough

2009-06-12T10:37:00.001-07:00

To buy or not to buy? That is the question we're asking ourselves more frequently these days.

Impulse control disorders come in many forms, including eating disorders, pathological gambling, and addiction to substances. Perhaps a more common, albeit less debilitating, type of impulse control problem is compulsive shopping.

Think back on the last time you bought something you really didn't need and which perhaps costs more than you can afford. You couldn't take the object out of your mind, your excitement level goes way up as you increasing crave for it and anticipate owning it, you may even be experiencing accompanying physiological responses (increased pulse rate and blood pressure). Your experience peaks at the time you sign on your credit card purchase slip and may sustain for a few more hours after you get home to play with your new gadget, put on your new dress, or admire the new painting. You feel an immediate relief as your physiological arousal comes back to normal. That relief, my friend, is what your brain remembers and craves to have happen again and again.

Now how different is that from substance addiction?

clipped from psychotherapynetworker.com

To Buy or not to Buy

You Can Never Get Enough of What You Don't Really Need

by April Lane Benson

All across America, people's shopping habits are changing.

The question of "to buy or not to buy" has become more complex than ever.

clipped from psychotherapynetworker.com

In our consumer-driven economy, we've long been asking material things to do what they really can't: regulate our emotions, improve our social status, and turn us into our ideal selves.

To be sure, even before the downturn, many had raised questions about the psychological consequences of our cultural devotion to materialism. Studies and indicators had found something surprising: that as our economy (and particularly our purchasing) surged from the 1960s onward, our sense of individual and social well-being dropped off sharply.

the more you believe happiness comes from material wealth, the more likely you are to be depressed, distressed, and anxious—and the less actual well-being you're likely to experience.

Why Women Cut (Part 2)

2009-06-12T09:21:00.000-07:00

In part 1 of this series, I mentioned that 70% of people who cut themselves report childhood sexual abuse or other forms of abuse. Yet, not everyone who was abused as a child engages in cutting and other forms of self-injury. Findings from anecdotal and empirical studies show that it is not simply abuse but, rather, abuse in the context of pathological family relationships that places an individual at risk for self-harm. Secure attachment to a caregiver appears to serve as a protective factor. Individual factors that may play a role include: gender, emotional expressivity, and one's ability to bear painful feelings without regression to a more primitive state of mind.

Women who cut generally benefit from therapy directed at helping them work through their trauma. The therapist helps them confront and deal with the emotions and thoughts associated with the abuse. Through exercising compassion toward the self, the client replaces avoidance with awareness. Resolution may or may not involve forgiveness to the perpetrator, but what is important is that the client redefines her relationship with the trauma.

In the treatment for cutting and other forms of self-injury, a therapist may also teach the client more adaptive coping skills to deal with triggers, such as meditation, visual imagery exercises, writing and other forms of artistic expression. Body image work may also be helpful.

Do you have an experience with self-injury and/or its treatment that you'd link to share? I invite you to post your comments or email ling@passagescounseling.com.

Why Women Cut (Part 1)

2009-06-11T23:33:00.001-07:00

What comes to mind when you meet a woman who cuts herself? That she has sadistic tendencies? Or that she is suicidal? Or perhaps seeking attention?

An estimated 70% of people who cut themselves (predominantly though not exclusively women)report childhood sexual abuse or other forms of traumatic childhood experiences. Some researchers believe that when these women cut, they are re-enacting their trauma through an act that symbolizes what was done to them in childhood.

A popular view among researchers and therapists is that because these women had dissociated themselves from their bodies during the abuse, cutting is for them a means to end their dissociative experiences so they may feel alive again. Dissociation often occurs during rape when the victim mentally detaches herself from the horror of the experience and goes into psychological numbness, as if she is only observing the abuse happening to someone else's body. For these women, dissociation can continue to occur when they are flooded with memories of the abuse. With cutting, the physical pain they feel and the sight of their own blood bring them back to their bodily experiences and may ironically be what they need to help them function normally in daily life.

Effective Treatment for Depression in Teenagers

2009-06-11T08:12:00.001-07:00

clipped from www.usnews.com

Prevent Depression in Teens With Cognitive Behavioral Therapy

clipped from health.usnews.com

In cognitive therapy, a person learns to:

Distinguish between thoughts and feelings.

Become aware of how thoughts can influence feelings in ways that sometimes are not helpful.

Learn about thoughts that seem to occur automatically and how they can affect emotions.

Evaluate critically whether these "automatic" thoughts and assumptions are accurate or perhaps biased.

Develop the skills to notice, interrupt, and correct these biased thoughts.

Cognitive behavioral therapy
can prevent teenagers from becoming clinically depressed, even if their parents are depressed, too. That’s great news, because serious depression afflicts 2 million teenagers each year and puts them at greater risk of suicide and depression throughout life.

This latest news, in a depression study just out in the Journal of the American Medical Association, is yet another bit of evidence that cognitive behavioral therapy is a valid treatment for depression.

Welcome!

2009-06-10T23:48:00.000-07:00

Allow me to introduce myself. I'm a counselor who, for 6 years and counting, have been working with troubled adolescents and their families. It is rather ironic that part of my job involves coaching parents to become more effective at setting boundaries with their teens, since as a youth I was a master at violating all boundaries my parents set on me. I guess it's not unlike convicted hackers who are now hired by financial institutions as online security experts.

Therapy changes not just with clients, but therapists too. Over the years I've seen myself grow with my practice. There is so much to learn, whether you are a mental health counselor or a family therapist. As part of my journey of growth, I've started this blog to capture, organize, and share my thoughts about therapy and its related content. I hope you will find it informative and perhaps thought-provoking. You are most welcome to send me your comments =)

Enjoy reading!