CBT :: Coaching + Therapy Techniques For Changing Thoughts And Behaviors

We all need a little help sometimes, even when we have awareness of our challenges and difficulties. It's really hard for many to ask for help, so I thought I'd share some useful techniques that I use in my own private practice. CBT techniques are very helpful tools to be used in therapy, coaching and useful when applied to everyday life situations. What follows are some of the most common CBT techniques that I use with my therapy and coaching clients. 

  1. Journaling-This technique gathers information and data about habitual thoughts, emotions and moods. Included in journal entries can be: time of day, the source or trigger, the intensity of the feeling state and the response or action taken. You can add more helpful and adaptive coping responses that might be considered in the future.

  2. Catastrophizing-This tendency is to go immediately to an irrational thought that something is far worse than it actually is. Catastrophizing generally takes two different forms: making a catastrophe out of a current situation or a future situation. Step one is to identify when your are doing this. Next, use your smartphone or journal to write the thoughts down throughout the day and add a corrective statement to counteract the negative belief. 

  3. Cognitive Distortions-Alone or with a therapist, you practice identifying harmful or negative thoughts that are automatic for you, then challenge these

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Healing From Trauma :: Reclaim Your Identity

Traumatic experiences change the brain and it does so in an effort to protect us from future negative experiences. However, trauma and its symptoms do not have to hold us in its grip forever. As you continue to think, talk, re-tell and act on your experience(s), you reinforce your attachment to what happened, which exacerbates your symptoms and you loop on the upsetting memory and trauma responses. 

The body is designed to heal. We now know that the brain has an amazing capacity to heal by creating new neural pathways. This process is called neuroplasticity. When people are finally able to regain control over their thoughts, behaviors, responses and lives, the brain's limbic system, parasympathetic and vagus nerve system can normalize. 

Unfortunately, most who have suffered trauma want to heal, and yet struggle with allowing and accepting feeling "well" and "whole." This seems counterintuitive, however the underlying instinct is to remain vigilant as if the nervous system signals that it is "unsafe” to heal and be well. If one relaxes into safety and wellness, then

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Difficult People :: Saving Yourself From Crazy Makers

Have you reached the end of your rope with the crazy makers in your life? I have them in my life as well, and even with psychological training, they frequently throw me off-course. Sometimes you can't escape them. They are your ex, colleagues, friends, lovers or family members, sometimes you have to co-parent with them. Perhaps you must have regular contact with them, leaving you with feelings of dread and terror, and even physical symptoms. Crazy makers drain your energy and consistently engage in controlling, destructive, manipulative and reckless behaviors, leaving a path of destruction in their wake.

They set traps for you, you can't win. They create drama, and then more drama. Their behaviors show up as excessive negativity, anger, aggression, addictions, recklessness, splitting (extremes of good/bad), envy/jealousy, grandiosity, trap-setting, gaslighting and sabotage. They may already have an actual psychiatric diagnosis such as Histrionic, Borderline, Narcissistic or Antisocial Personality Disorder, and behaviors related to trauma, abuse and substance abuse. You experience fatigue and overwhelm from being in their negative vibration and the practical aspects of cleaning up their messes. You may even wonder if you are the crazy one as they engage in projection, shaming and blaming behaviors. Essentially, they play the victim, turning things around in a nanosecond. What follows are some important things to remember:

  • If you're co-parenting, seek professional counseling to support you and your children.

  • Develop healthy boundaries. Crazy makers will continually pull you back in to their web--they charm and manipulate. Learn to notice when you are being played. The trauma bond is

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#shrinkthinks :: Your Shadow Side

Embrace it and be free.

One does not become enlightened by imagining figures of light, but by making the darkness conscious. The latter procedure, however, is disagreeable and therefore not popular. -Carl Jung

We avoid our shadow selves by projecting onto others what we most reject about ourselves. We "split-off" or dissociate important aspects of ourselves, our unconscious thoughts, impulses, feelings and drives. In doing so, we develop as poorly integrated humans, out of balance, creating more acceptable (or so we imagine) "personas of light." To our detriment. Our repressed shadow self can become a destructive force, unconsciously driving our behaviors, our lives. What are your fears about connecting to your shadow?

One does not become enlightened by imagining figures of light, but by making the darkness conscious. The latter procedure, however, is disagreeable and therefore not popular. -Carl Jung

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Turmeric Elixir :: Body + Soul Love

I love experimenting with new recipes and especially healing tonics using teas, spices and essential oils that soothe and comfort. So, I was very excited to finally receive my copy of Whole Beauty by the lovely Shiva Rose (I'm addicted to her Glow Face Balm!), and after enjoying her luxurious, holistic practice rituals, I've decided to share her yummy Turmeric Golden Milk recipe. As someone who also struggles with an autoimmune issue, I watch my diet and do my best to avoid irritants and inflammatory foods. If you're feeling the need for self-care after a long and harsh winter, personal or professional burnout, or any personal struggle, I recommend her gorgeous book as an offering to yourself--a little TLC. Enjoy this recipe from Shiva Rose!

  • 1/8 teaspoon turmeric

  • 1/2 cup water

  • 8 ounces milk, preferably raw or any kind of milk or nut milk that you like

  • 2 tablespoons almond oil

  • Raw honey to taste

  • 1/8 teaspoon cardamom or ghee (optional)

  • 1/8 teaspoon ground black pepper (optional)

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Engage Your Vagus Nerve :: Breathing Techniques For Relaxation And Insomnia Relief

Concerns about the long-term impact of chronic stress, depression, anxiety and insomnia is a topic of concern for many of my coaching and therapy clients. A few stressful, sleepless nights can easily spiral into a regular problem as clients begin to develop a negative relationship with bedtime and sleep. Many will seek the help of a psychiatrist to obtain prescription medications in an effort to break the cycle. Not a bad option in the short-term, but less than ideal as a long-term solution. I always recommend lifestyle modifications and attempts at simple changes in the environment first. Before we move to information about engaging your vagus nerve and the relaxation response, let's clear the path to create an optimal environment for sleep. 

How can you modify your environment to promote better sleep? In addition to dimming the lights and reducing evening electronic stimulation, some helpful evening rituals include the following:

  • meditation

  • focused breathing

  • biofeedback

  • guided imagery

  • progressive muscle relaxation

  • restorative yoga

  • gentle stretching to release tension in the body

  • a warm bath

  • a soothing warm drink such as milk, nut milk or non-caffeinated tea 

  • herbs and homeopathic support 

How are you breathing during the day? You may not be aware that throughout your busy day, your breathing has become shallow. Your thoughts likely contribute

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Your Erotic Life :: Do You Need Sex therapy?

Tell me more about your erotic life. I think it's important. As a sex-positive therapist, I am open to conventional partnerships as well as alternative lifestyles, identities, and gender expressions. It's all just normal expressions of love

  • Are you craving more exploration, surprise, mystery, novelty, excitement, desire and passion?

  • Does your partner feel like a child or parent, thus decreasing desire?

  • Do you struggle with sharing sexual concerns with your partner, especially your sexual desires and needs?

  • Are you struggling alone with personal sexual issues?

  • Do you worry about the frequency or lack of sexual frequency in your relationship?

  • Do you feel turned-off when your partner wants sex? 

  • Does your partner struggle with sexual dysfunction?

  • Do you feel sexually unfulfilled?

  • Are you struggling to heal from a boundary violation, sexual or emotional infidelity?

  • Is your relationship longterm, and you're feeling more like roommates than lovers?

  • Are you a new parent and having trouble with life/balance or feeling romantic and sexual again?

  • Are you having hormonal or drug-related side effects or chronic pain and medical concerns?    

For many reasons, sexuality changes throughout our lifetime--this is normal. It's important however to be able to openly discuss

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Therapist Or Coach :: What's The Difference?

When you are feeling stuck, overwhelmed or challenged by a particular situation, or life in general, you may be considering seeking professional help. There are so many available and effective choices to help you move forward with your life and in your online research, you may have stumbled upon outstanding sites such as Psychology Today. It is likely that you also feel overwhelmed with the many options--therapy, mentoring, life coaching, relationship support and groups for example. It's also important to understand your needs at this point in your life. Are you stuck deep in the mud, or are you perched and just about ready to take flight but in need of a little support?  

Whether your struggles are recent or longstanding, you may be challenged by many of the following: low self-esteem, depression, severe anxiety, residual trauma(s), family of origin issues, addictions, eating disorders, intense emotions and relationship struggles. When you're managing any of the above, it makes it very difficult, if not impossible to move forward using the help of the life coaching strategies that require action and accountability. Coaching is an elegant model for individuals who are healthy enough or who have resolved obstacles and conflicts that enable them to feel strong, deserving and able to receive

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EMDR Therapy :: A Brief Explanation

EMDR Therapy or Eye Movement Desensitization and Reprocessing is a highly-successful and powerful healing technique that very effectively helps people who suffer from anxiety, panic, chronic sadness, negative self-concepts, trauma, disturbing memories and thoughts, PTSD or post traumatic stress and many other emotional problems. Until recently, psychotherapists and psychologists have used some combination of talk therapy and CBT in their efforts to help people overcome distress and suffering. While nothing beats the support of another human who is able to listen and be present during suffering, many of these traditional techniques do not resolve client symptoms or support healing at the level of the nervous system in the way that EMDR does. EMDR is considered a breakthrough therapy because of its ability to bring quick and lasting relief for most types of emotional distress. 

EMDR therapy uses bilateral stimulation, right/left eye movement, or tactile stimulation which activates opposite sides of the brain. As troubling images, feelings and self-concepts are processed by the brain using bilateral eye-movement patterns, resolution of the issues

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Self-Care :: Support For Traumatic Stress + Loss

Whether you're struggling to manage challenging life-events, a trauma or accident, loss and grief or any kind of transition that causes you distress or destabilization, it's helpful to understand that your feelings, emotions and behaviors are a normal reaction to extreme or disturbing events. As a psychotherapist who uses EMDR therapy, supportive work and a focus on helping clients develop healthier coping skills, I'm happy to share tips to support you as you move through difficult times. What helps?

  • Allow yourself to acknowledge and accept that you're experiencing something difficult and that your reactions are normal, but that you can manage. Remind yourself about how you've handled difficult situations in the past. What healthy skills did you call upon previously to help you cope during stressful times?
  • Ask for help. This is hard for many, but people can be quite kind when it comes to supporting others. This also requires that you allow yourself to receive help and manage feelings of shame related to needing help.
  • Take exquisite care of yourself, when you can. Show self-compassion and practice self-care. Giving yourself permission for a "time out" can help you feel stronger and more resilient
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Boundary-Setting Mantra :: Sanity During The Holiday Season

The holiday season is one time of year that leaves many of us feeling vulnerable to stress and feelings of overwhelm. The season brings windows dressed with cheer and reminders of other people who appear carefree and happy, while many face the reality of family dysfunction, unrealistic expectations, loneliness, dark days and seasonal affective disorder, poor eating and drinking habits and loved ones who are no longer with us. Perhaps the seemingly happy folks are drunk, it's hard to know for sure. That said, social media now contributes a new platform for us to compare our own lives with the experiences of others, leading to even more isolation and despair. It is also a time when we may do less self-care than usual--at a time when we actually need a little more TLC.

This leads quite natural to the topic of boundaries. Who wants to be the bad guy and say no, right? Sometimes "no" is best for all. The holiday season is a perfect time to learn and practice self-protection. Boundary-setting is very much a learned skill that takes practice and often requires giving yourself permission to put yourself first. Do you know what you need? it's important to know your needs and to identify your own physical and emotional limits. Overload cues present to us in different forms. For some, it's a feeling or nudge

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Depression :: What's New And What Helps

It's the time of year when individuals vulnerable to mood difficulties begin to experience symptoms of depression. Therapists who treat depression and anxiety see an increase in requests for psychotherapy evaluations and treatment as the days become shorter and there is less available sunlight. If you're considering medication for depression, you've likely tried other things including: psychotherapy or talk therapy, exercise, sunlight, anti-inflammatory diets, supplements (SAMe, St John's Wort), extra B vitamins, fish oil and meditation or mindfulness, yet you're still struggling with symptoms. Depression is a complicated matter because there are many reasons people become depressed and different expressions of depression including: major depression, seasonal affective disorder (SAD), reactive depression, bipolar disorder, psychotic depression, premenstrual dysphoric disorder and postpartum depression, as examples.  

Because depression can be a challenge to treat, it's unlikely that one form of treatment will address all the symptoms of depression. For instance, individuals with a milder form of depression may respond positively to lifestyle changes such as exercising several times a week, yoga, meditation, supplements for brain and gut health, dietary changes, education about depression, connecting with friends and families and taking steps to avoid isolation. Working with a depression expert can help you develop skills to cope better, in addition to the connection that you develop with another human during the psychotherapy hour. Counseling

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The recent presidential election and divisiveness has activated and triggered many individuals who have unresolved trauma(s). As a Psychotherapist and trauma therapist with a private practice in New York City, I can share that many men and women have sought counseling to deal with trauma symptoms that have recently surfaced as a result of the accusations of sexual assault and boundary violations revealed during this recent election cycle. Clients state that they now feel empowered and sufficiently supported by others and the community at large to begin to tell their personal stories of rape, assault, boundary violations and inappropriate behaviors. Some have never shared their stories--not with trusted friends or even family members. For many, being in the presence of another, to receive their experience, help hold their fear and terror and help sort out confusion and reality can be extremely healing. Some who have suffered in silence will need more support. EMDR therapy is a therapy modality that can successfully heal these experiences from a neurological standpoint, as well as reduce the impact of painful memories, distorted self-concepts and further support healing the body. 

Many patients seek EMDR therapy following slow progress with traditional psychotherapy or when they feel they have not benefitted from traditional talk therapy, hypnosis or CBT. As a licensed psychotherapist in New York City, EMDR has become my technique of choice to treat a variety of concerns. After years of integrating it into my practice, I've experienced extraordinary success

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There are many forms of treatment that successfully help clients heal from addictions, compulsions, anxiety, unhealthy relationship dynamics, self-esteem problems and other behavior difficulties. Some of the most helpful therapies include: CBT or Cognitive Behavioral Therapy, DBT or Dialectical Behavior Therapy, interpersonal psychotherapy, 12 Step programs and body-oriented therapies such as Somatic Experiencing (SE) and EMDR Therapy. As an integrative psychotherapist, I have great respect for these psychotherapy modalities, and have had real success using some combination with my own clients. I find EMDR therapy to be the most effective form of therapy to address alcohol use, substance and behavioral addictions, compulsions, eating disorders and any underlying traumas that may have contributed to using substances and maintaining these behaviors. 

Dr. Robert Miller developed a protocol called the Feeling State Addictions Protocol or FSAP that uses EMDR therapy to focus on a very important piece of alcohol and other addictions. Pleasure. Mainly, that people rely on substances or behaviors because of the intense positive feeling it gave them initially and continues

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Therapy And Counseling :: Which Type Of Therapy Do You Need

You've decided that it's just too difficult trying to manage things on your own and now you're  ready to reach out for a little help, but web research has you completely overwhelmed. Understandable! Finding a therapist can be difficult especially if you don't have the benefit of a referral from a trusted friend or colleague, and you're likely unsure of the type of counseling that would best suit your needs. Sources such as Psychology Today and GoodTherapy can provide profiles of therapists in your area, as well as list the expertise of the counselors, psychotherapists, psychologists and psychiatrists. Professionals tend to specialize in many areas such as: grief and loss, aging, adolescent concerns, transitions, crisis counseling, anxiety, depression, addictions, alcoholism, stress reduction, trauma resolution, marital and relationship difficulties, family concerns, spirituality and more. To make your search a little less daunting, I've included a partial listing of psychotherapy modalities that licensed psychotherapists and psychologists use with their clients.

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Eating Disorders :: Mindfulness Or Distractions--What Works Best

As a therapist who treats clients with Eating Disorders, I am constantly reminded of the need for an integrative treatment approach and psychotherapy that addresses the complexities that ED's present for clients. Does Mindfulness help or hinder eating disorder recovery? The best answer may be that it depends on the nature of the eating disorder, and the stage of treatment. This is a much-debated topic within the ED treatment community.

Mindfulness, in addition to DBT Skills can be incredibly helpful for patients and clients in recovery, and in many aspects of their lives, especially when trying to manage powerful emotions and regulate mood. Some clients have reported that attempts at mindfulness early in recovery, especially during meals, creates intolerable anxiety and distress that interferes with the process of eating. Clients with Anorexia Nervosa find that distraction is the most helpful way to eat. "Thinking" about what's being consumed and eaten in early ED recovery is described as excruciating by clients. Distraction allows them to "pair" an enjoyable activity with mealtime, which is a very different experience than meals with the demand that they be "mindful" of excruciating feelings of fullness and any other sensations.

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Holiday Chaos Survival Tips For Couples :: Because Murder Is Not An Option

As a therapist who enjoys providing marriage and couples therapy, I've made the observation that partners struggle to work as a team during the busy, stress-filled and conflict-ridden holiday season. Feeling torn with competing interests such as family needs, travel and extra demands on time and energy can bring many to exasperation and exhaustion. If you tend to suffer because of your "people pleasing" nature and an inability to say NO, protecting your boundaries or creating healthy boundaries for yourself (perhaps you're new at this?) can be a real challenge.

Don't suffer in silence, or loudness. Many couples and partners enter marriage and family counseling after the holiday season because they feel disconnected, hurt and misunderstood, in addition to a range of other experiences, including losing once-enjoyed intimacy. Being in the company of family and friends can trigger feelings of resentment, reignite old wounds as well as highlight family of origin issues--leaving even high-functioning couples feeling de-skilled and in need of help to sort through the chaos.  

So, how do you reconnect after fighting, communication problems and hurt feelings? Having some simple tools at your ready can help you avoid the downward spiral. What follows are

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#shrinkthinks DBT Quick Reference :: Holiday Survival Skills For Anxiety, Addiction Triggers, Emotions And Problem Behaviors

Many of my psychotherapy patients ask for a Dialectical Behavior Therapy or a DBT cheat-sheet to have handy because... life happens, it's easy to feel overwhelmed, and it's hard to remember what to during those challenging moments! This is a basic list to remind you that you DO have other options at your disposal to help you better manage your relationship problems, trauma symptoms, addiction and eating disorder triggers, anxiety, depression, self-harm urges, relationship challenges, stress and strong emotions. With the holiday season comes lots of stress--and with no shortage of emotional triggers--people struggle with: alcohol and food in abundance, family stressors and memories that reignite feelings of anger, loss, sadness, longing and loneliness.

Even though situations and stressors are present, DBT can help you make healthier choices for yourself! A good place to start is to remember to focus, breathe and be mindful. When the skills don't work

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#shrinkthinks On EMDR :: Voice Of The Patient

If you're curious about how EMDR psychotherapy can help you resolve trauma, negative experiences and other challenges, please enjoy this short YouTube video that includes the voices of clients who now experience freedom and hope as a result of their EMDR treatment. Not just for trauma resolution, EMDR psychotherapy is an effective treatment for a variety of concerns including: eating disorders, addictions, compulsions, phobias, guilt, depression, anxiety, shame, negative self-concept, performance problems, self-sabotage, feeling "stuck" and more. You can learn about EMDR, or find an EMDR therapist by visiting EMDRIA and by watching this video.

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You Were Meant To Love

“Life will break you. Nobody can protect you from that, and living alone won't either, for solitude will also break you with its yearning. You have to love. You have to feel. It is the reason you are here on earth. You are here to risk your heart. You are here to be swallowed up. And when it happens that you are broken, or betrayed, or left, or hurt, or death brushes near, let yourself sit by an apple tree and listen to the apples falling all around you in heaps, wasting their sweetness. Tell yourself you tasted as many as you could.”

~Louise Erdrich, The Painted Drum

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