Take Control of Anxiety

Millions of adults suffer from anxiety disorders, according to the Anxiety Disorders Association of America. Some individuals will begin anti-anxiety medications for the first time while many sufferers are now dependent on anxiolytics, like Xanax, to fall asleep and manage anxiety throughout the day. As a therapist who treats anxiety and mood disorders, I know how helpful antidepressants and anti-anxiety medications can be. Without these pharmacological interventions, many would suffer serious and disabling symptoms. One problem I’ve observed, is that because of the ease of medication, anxiety sufferers fail to learn the skills that can help them take control of their symptoms, leaving them unprepared down the road. For those willing to make some lifestyle changes,  I offer these helpful tips.

• Learn to breathe –  People prone to anxiety tend to take rapid, shallow breaths that come directly from the chest. This type of breathing is called thoracic or chest breathing which can upset the oxygen and carbon dioxide levels in the body, resulting in increased heart rate, dizziness, tingling sensations, muscle tension, agitation and other physical sensations. These strange body sensations that anxiety sufferers experience lead to more anxiety and the concern that something bad is happening to the body. Learn to replace shallow breathing with diaphragmatic breathing. It does work, however you need to practice this and don’t give it up when your symptoms disappear.  Proper breathing slows down or stops the fear response, but you need to make it a habit. Keep it simple in the beginning, a few minutes at a time and several times a day until you get the hang of it. You can google this on your own or use this link to learn how to practice abdominal breathing.
• Meditation - Learn to meditate by taking a class, private instruction or by using a guided meditation tape.  You don’t need to meditate for an hour to see benefits, ten minutes daily can support your emotional health. Mindfulness is a wonderful practice to help with generalized anxiety disorder or GAD. I found this helpful, how-to on the Psychology Today Blog.
• Progressive Muscle Relaxation – Fear, dread, rumination and the attendant muscle tension can all be reduced by learning PMR.  Once you learn this relaxation response and have some practice under your belt, you can combat anxious thoughts by remembering how you felt during your relaxation session.  When you begin worrying, remind yourself it’s just your “worry brain” and this is your cue to practice the relaxation techniques.  You can learn about PMR here.
• Rumination – If you are tormented by problems and issues, commit your worries to paper then put it in a desk drawer or box to be dealt with at a later time.  The goal is to contain the problems, if even temporarily, to quiet the mind.
• Challenge your thoughts - Thought-stopping is a helpful cognitive therapy technique for interrupting disturbing thoughts and ruminations.  In order for this to be effective, you must do this every time you feel interrupted by persistent thoughts. When you stop an automatic thought, you then replace it with a more realistic, rational thought.  You may need to do this hundreds of times daily, just so you know.  To learn more about thought-stopping visit about.com or WebMD.
• Make a plan – Sometimes it helps to set a timer and plan a “worry” session.  This begins with identifying the issue, then prioritizing and taking care of only what is necessary. What needs to be addressed now?  Next, determine a time when you will revisit the issue (next week, next month) then record the scheduled time in your calendar.  If the issues bubbles up before that time, and it likely will,  say stop (because you’ve already put in the fret-time) and distract yourself with other thoughts.
• Identify triggers –  Triggers are people, thoughts or situations that send anxiety sufferers into panic mode. Making the choice to eliminate triggers as well as working through problems or dilemmas in a logical, productive way can reduce the impact of a particular trigger.
• Find the funny - Whatever it takes, find a way to laugh.  Laughing discharges tension.  In therapy, I often make this a treatment goal and suggest that my patients make time for play and fun.  Many adults have a tough time with this, so it’s important to help fun-deprived people explore any resistance to fun and relearn this long-forgotten aspect of themselves.
• Lifestyle and chemicals - Remove them (not fun, I know), but you will feel better if you reduce or eliminate coffee, alcohol, tobacco and sugar.  Many drink to relax and reduce anxiety, but is actually a depressant which leads to mood and anxiety problems.
• Exercise regularly – The Mayo Clinic suggests exercising on most days of the weeks to improve health and emotional problems. Walking, dancing, yoga and tai chi are all good choices to support emotional health
• Improve your diet – Eat a healthy, balanced diet. Proper nutrition and eating before blood sugar tanks is key to warding off anxiety and potential related problems such as heart palpitations and hyperventilation. According to this article in Psychology Today, Omega 3 fatty acids may play a role in reducing anxiety, so power up the nutrition.
• Learn to self-soothe – Read a good book, enjoy a hot bath, call a friend, dance, play a game or listen to music to help you manage your anxiety. Load your iPod and playlists with relaxing tunes for chill time.  A bookshelf favorite of mine, and I love to loan, is 50 Ways to Soothe Yourself Without Food  by Susan Albers, PsyD. This book is not just for individuals with eating disorders, and is packed with healthy, helpful actions that support positive self-esteem and increase control over many symptoms including anxiety.
• Aromatherapy – Essential oils have a molecular structure that makes it easy for them to enter the olfactory system, via the nose, which signals the limbic system to release important neurochemicals that affect mood and relaxation. Some helpful oils to support relaxation are lavender, orange, bergamot, frankincense, sandalwood, clary sage, vetiver and rose. A favorite book AromaYoga by Tracy Griffiths and Ashley Turner  is a wonderful resource for anyone interested in learning about essential oils and how to enhance their yoga and wellness practice.
• Get plenty of  restful sleep – The effects of poor sleep quality and insomnia can compound over time interfering with coping abilities and increasing anxiety.

There is an abundance of evidence that suggests that anxiety disorders run in families. Whether nature, nurture or some combination, left untreated, anxiety can worsen leading to impaired daily functioning including school, work, social activities,  relationship problems, panic attacks and even agoraphobia. People who suffer from an untreated anxiety disorder often tend to suffer from other psychological disorders, such as depression, and they have a greater tendency to abuse alcohol and other drugs. Common signs of anxiety include:  restlessness, difficulty concentrating, fatigue, irritability, muscle tension, sleep disturbances and changes in personality such as isolation. No need to suffer in silence.  Ask for help. Therapist in New York City for anxiety and depression and stress, psychotherapist New York for eating disorders and addiction therapy Manhattan, New York Psychologist for anxiety treatment, CBT therapy for anxiety, therapist for anxiety attacks panic New York NY

Mindfulness in Every Bite

Mindfulness is being used by therapists, psychologists and MD’s to treat many physical and psychological problems including anxiety, stress, PTSD, depression, chronic pain, borderline personality disorder (BPD), addictions and eating disorders (ED’s). Therapists who work with complicated disorders such as ED’s find that patients often show an incomplete response to treatment, revealing a need for additional interventions to provide support, skills, and ultimately, symptomatic relief. Eating disorders are associated with significant dysfunction and/or distress including anxiety symptoms, mood disturbance, substance abuse, and physical complications. The most widely researched treatments for eating disorders are based on cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT) and interpersonal therapy, which all have strong empirical support for success in the treatment of BED and BN. Mindfulness-based interventions are well-suited to address disordered eating, particularly Bulimia Nervosa (BN) and Binge Eating Disorder (BED), as a stand alone treatment or an adjunct to other forms of ED treatments.

What is mindfulness? The practice of mindfulness provides individuals with a heightened ability to simply “have” and “observe” emotions, feelings, behaviors and experiences and to disengage from automatic and often dysfunctional reactivity.  The result is a more balanced sense of self which allows the practitioner to develop a healthier, more balanced relationship with their bodies and their eating. Individuals become more mindful of the enjoyment and satisfaction that can be obtained from the quality of food, rather than the quantity, which also appeals to chronic dieters.  To learn more about how to practice mindfulness visit DukeHealth.org and enjoy these articles from The New York Times Mindful Eating as Food for Thought and The Wall Street Journal Putting an end to Mindless Munching

Reconnecting – Emotionally Focused Therapy for Couples

If you’d like to improve communication, increase intimacy and closeness, stop fighting and renew the spark of earlier feelings, then Emotionally Focused Therapy can work for you!

What is Emotionally Focused Therapy for couples? Emotionally Focused Therapy (EFT) is a short-term psychotherapy method for couples, and considered one of the most effective approaches to marriage and couples therapy. The goal of EFT is the reconnection between partners and is based on well-tested theory and decades of research and clinical practice.

How does EFT work? EFT focuses on what makes relationships distressed and provides a map to heal the patterns and wounds that are a destructive force in many relationships. EFT helps couples by working to strengthen attachment bonds which leads to an experience of belonging, comfort, safety and acceptance with each other. As this happens, couples feel increasingly confident in their ability to effectively solve problems, resolve negative repetitive fights and patterns, dissolve feelings of distance and disrespect and learn effective ways to lovingly work together to face future challenges.  EFT is effective because it builds  and supports emotional responsiveness in couples which leads to feelings of connection, safety, security and happiness.

What is the course of treatment with EFT therapy? EFT is a short-term therapy experience unlike typical relationship counseling that can last for years. In EFT, research studies show that over 70% of couples improved their relationship, moving from distressed to happy in 15 – 20 sessions.  Over 90% of couples experienced significant improvement in their relationship.

EFT was developed by Sue Johnson and Les Greenberg and is based on John Bowlby’s Attachment Theory and research.   

What four leading experts say about EFT:

“EFT is a proven road map to the process of change in couples therapy.”  John M. Gottman, Ph.D., world-renowned marriage expert, cofounder of the Seattle Marital and Family Institute, Professor of Psychology, University of Washington, and bestselling author of The Seven Principles for Making Marriage Work. (www.gottman.com)

“EFT is one of the best documented, most substantive and well researched approaches to couple therapy.” Alan S. Gurman, Ph.D., Emeritus Professor of Psychiatry and Director of Family Therapy Training, University of Wisconsin Medical School, and a leading authority on the clinical practice of couple therapy.

EFT is “one of the few approaches to marital therapy that has been proven to be effective.”  Jay Lebow, Ph.D., LMFT, ABPP, Past President, Division of Family Psychology, American Psychological Association (www.apa.org); Research Consultant, The Family Institute, Northwestern University (www.family-institute.org).

“Rigorous studies during the past fifteen years have shown that 70 to 75 percent of couples who go through EFT recover from distress and are happy in their relationships. The results appear lasting, even with couples at high risk for divorce.”  Dr. Sue Johnson, Professor of Clinical Psychology, University of Ottawa; Director of Ottawa Couple and Family Institute and International Centre for Excellence in Emotionally Focused Therapy (www.iceeft.com); Research Professor, Alliant University (www.alliant.edu). New York City therapist Kimberly Seelbrede provides couples therapy, marriage counseling, relationship counseling, couples counseling, pre-marital counseling, singles and couples workshops, help with divorce, relationship guidance, healing from infidelity as well as help with dating, love and communication skills. Kimberly Seelbrede provides individual therapy in New York City, counseling, grief and bereavement counseling, substance abuse counseling, addiction therapy,  support for individuals and couples coping with infidelity, life transitions, plus support for couples facing intimacy issues following prostate cancer, breast cancer, sexual problems including impotence (erectile dysfunction [ED]). She also provides family therapy, psychotherapy, divorce counseling, counseling for affairs, drug abuse, stress management, communication skills, EMDR therapy in New York and Emotionally Focused Therapy 

Are We Okay?

Many couples begin relationship counseling because of sexual desire problems.  In fact, most couples experience desire problems at some point in their relationships. There are often biological, psychological and social reasons behind desire issues that make sex less than sizzling for couples. Many with low sex drive may actually have performance and anxiety-related difficulties. Other desire-sapping problems include hormonal deficiencies (low testosterone, estrogen), medication side effects (antidepressants, antihypertensives), unresolved anger and general physical problems related to aging. These are real problems that may be resolved by visiting your primary care physician or talking with a therapist who can help you sift through the issues and make a medical referral if necessary. Okay, so you’ve pretty much ruled out any emotional and physical problems that may have contributed to your lack of desire, and you and your sweetheart still aren’t feeling the heat.  What if you are a happy, healthy couple who experiences desire problems? This article from Psychology Today offers an interesting view of the issue that may lay to rest the notion that there is something “wrong” with you and your beloved.

Coaching For Success

Whether it’s falling in love, finding your dream job, losing weight, earning more money, enhancing your communication style or reaching your potential, enlisting the support of a life coach can help you define and reach your goals. Who chooses a life coach over a therapist? Many clients opt for the coaching model rather than the therapy model because they don’t feel they need therapy. For these clients, action and positive results are desired, and quickly!  Having a coach help you uncover blocks, as well as encourage, support and guide you is a powerful resource. Few regret the choice to hire a life coach.

Using communication, honesty, accountability and identifying the goals that really inspire you, life coaching helps you move beyond self-limiting thoughts and behaviors and towards your vision of how you would like your life to unfold. I support my life coaching clients to move through self-defeating thoughts, negative self-concepts and other obstacles that interfere with success and happiness. Your coaching program is customized to meet your needs and lifestyle, on your terms.

How the coaching process works: 

Winter Gloom Is Upon Us

Seasonal affective disorder occurs when a lack of sun disrupts the body’s circadian and serotonin cycles. It is a real form of depression. Seasonal affective disorder is considered a form of recurrent major depressive disorder by the American Psychological Association (APA).  It usually begins in the fall, with symptoms worsening during the winter months, and improving in the spring and summer.  People often seek the help of a therapist or enter psychotherapy in an effort to ease their symptoms. Many often turn to medication and alternative treatments such as light therapy.  If you’re feeling sad and blue this season, learn more about getting the help you need and some available options.  Read more from The Doctor Will See You Now New York, NY therapist for anxiety, phobias, emdr, social anxiety, depression, ocd, self-esteem, relationship problems, couples therapy, sexual problems, addiction therapy, psychotherapy for adolescents, teens psychologist, manhattan, downtown, upper east side

Crisis Therapy and Counseling for Individuals and Couples

A crisis is defined as a situation or event where the person feels overwhelmed and/or is unable to cope. In crisis counseling, a therapist works to provide mental health support to his/her client. The events that trigger this crisis can run the gamut from developmental issues (such as going through puberty), accidents, marital issues, infidelity,  job loss to the death of a loved one. Crisis counseling can help individuals deal with the crisis by offering assistance, support and much needed guidance.

Solution Focused Brief Therapy

“What might your life look like if you didn’t have this problem?”

Solution focused brief therapy (SFBT), often referred to as simply ‘solution focused therapy’ or ‘brief therapy’, is a type of talking therapy that is based upon social constructionist philosophy. It focuses on what clients want to achieve through therapy rather than on the problem(s) that made them seek help. The approach does not focus on the past, but instead, focuses on the present and future. The therapist/counselor uses respectful curiosity to invite the client to envision their preferred future and then therapist and client start attending to any moves towards it whether these are small increments or large changes. To support this, questions are asked about the client’s story, strengths and resources, and about exceptions to the problem.

Solution focused therapists believe that change is constant. By helping people identify the things that they wish to have changed in their life and also to attend to those things that are currently happening that they wish to continue to have happen, SFBT therapists help their clients to construct a concrete vision of a preferred future for themselves. The SFBT therapist then helps the client to identify times in their current life that are closer to this future, and examines what is different on these occasions. By bringing these small successes to their awareness, and helping them to repeat these successful things they do when the problem is not there or less severe, the therapists helps the client move towards the preferred future they have identified.

Solution focused work can be seen as a way of working that focuses exclusively or predominantly at two things. 1) Supporting people to explore their preferred futures. 2) Exploring when, where, with whom and how pieces of that preferred future are already happening. While this is often done using a social constructionist perspective the approach is practical and can be achieved with no specific theoretical framework beyond the intention to keep as close as possible to these two things.

~Wikipedia

One of the main tools of solution-focused therapy is the “Miracle Question.” In this query, a therapist will ask a question designed to hone in on a feasible, effective solution. The client will be asked to imagine how he would feel if he woke up to find that his problem was gone. This question leads to an exploration of what steps the client would take and what changes could be observed if this “miracle” occurred.

Kim Seelbrede is a psychotherapist, EMDR therapist and integrative yoga therapist with a private practice in New York City, downtown near Union Square/Flatiron and on the Upper East Side of Manhattan.

I provide therapy, EMDR, hypnotherapy, mind/body techniques, coaching and stress management for individuals, couples and groups. I help clients overcome obstacles such as conflicts and lifestyle habits that are preventing them from healthy and satisfying relationships, enhanced self-esteem and happiness.  My specialities include: anxiety; phobias; depression; relationship issues; marriage counseling,  career issues; stress management; coping skills; performance enhancement for career and performance; creative blocks; bereavement and loss; post traumatic stress disorder (PTSD); addictions and substance abuse recovery support; codependency; smoking cessation; weight issues; pain management; major life transitions.

I am a licensed psychotherapist/therapist in NYC. My professional credentials include a graduate degree from New York University, post-graduate psychodynamic psychotherapy training, advanced EMDR training from EMDRIA,  integrative yoga therapy training from the Urban Zen Foundation. You can follow Kim Seelbrede’s psychology, yoga and health-related tweets on Twitter or friend her on Facebook. Kim Seelbrede offers adjunctive EMDR, meditation and yoga therapy to medical and mental health professionals in New York City. www.kimseelbrede.com

CBT Therapy: Behavior and Thought Changing Therapies That Work

Gaining insight and self-awareness does not always lead to change, therefore cognitive behavior therapy (CBT) is a useful technique. therapist in New York City Kimberly Seelbrede

Cognitive-behavioral therapy is a type of treatment that involves evaluating the way a client thinks and feels from situation to situation, with the goal of helping him/her identify faulty thinking patterns that were learned earlier in life. Cognitive-behavioral therapy includes assignments, tasks and strategies designed to help the client re-evaluate his/her core beliefs and thought patterns, allowing for a more informed decision as to whether these beliefs are accurate.

Cognitive-behavioral therapy also includes specific elements aimed at changing behavioral responses. CBT incorporates stress reduction techniques and goals and may include exercises in relaxation, visualization and meditation/mindfulness. CBT therapy also provides concrete solutions for problem solving, time management and increased attention span and focus. CBT can be very helpful for clients who wish to lose weight, begin dating or change careers by helping them with time management skills, goal establishment and support for uncovering self-defeating habits and patterns that will interfere with progress.

Cognitive-behavioral therapy is evidence-based and supported by a large body of research indicating it is quite effective in treating a variety of emotional problems. CBT may be integrated into other types of therapy for greater treatment success.

More about CBT 

Cognitive behavioral therapy (or cognitive behavioral therapies or CBT) is a psychotherapeutic approach that aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure. The title is used in diverse ways to designate behavior therapy, cognitive therapy, and to refer to therapy based upon a combination of basic behavioral and cognitive research.

There is empirical evidence that CBT is effective for the treatment of a variety of problems, including mood, anxiety, personality, eating, substance abuse, and psychotic disorders. Treatment is often manualized, with specific technique-driven brief, direct, and time-limited treatments for specific psychological disorders. CBT is used in individual therapy as well as group settings, and the techniques are often adapted for self-help applications. Some clinicians and researchers are more cognitive oriented (e.g. cognitive restructuring), while others are more behaviorally oriented (in vivo exposure therapy). Other interventions combine both (e.g. imaginal exposure therapy).

CBT was primarily developed through a merging of behavior therapy with cognitive therapy. While rooted in rather different theories, these two traditions found common ground in focusing on the “here and now”, and on alleviating symptoms. Many CBT treatment programs for specific disorders have been evaluated for efficacy and effectiveness; the health-care trend of evidence-based treatment, where specific treatments for symptom-based diagnoses are recommended, has favored CBT over other approaches such as psychodynamic treatments. In the United Kingdom, the National Institute for Health and Clinical Excellence recommends CBT as the treatment of choice for a number of mental health difficulties, including post-traumatic stress disorder, OCD, bulimia nervosa, and clinical depression, and for the neurological condition chronic fatigue syndrome/myalgic encephalomyelitis.

The particular therapeutic techniques vary within the different approaches of CBT according to the particular kind of problem issues, but commonly may include keeping a diary of significant events and associated feelings, thoughts and behaviors; questioning and testing cognitions, assumptions, evaluations and beliefs that might be unhelpful and unrealistic; gradually facing activities which may have been avoided; and trying out new ways of behaving and reacting. Relaxation, mindfulness and distraction techniques are also commonly included. Cognitive behavioral therapy is often also used in conjunction with mood stabilizing medications to treat conditions like bipolar disorder. Its application in treating schizophrenia along with medication and family therapy is recognized by the NICE guidelines (see below) within the British NHS.

Going through cognitive behavioral therapy generally is not an overnight process for clients. Even after clients have learned to recognize when and where their mental processes go awry, it can in some cases take considerable time or effort to replace a dysfunctional cognitive-affective-behavioral process or habit with a more reasonable and adaptive one.

~Wikipedia

Kim Seelbrede is a psychotherapist, EMDR therapist and integrative yoga therapist with a private practice in New York City, downtown near Union Square/Flatiron and on the Upper East Side of Manhattan.

I provide therapy, EMDR, hypnotherapy, mind/body techniques, coaching and stress management for individuals, couples and groups. I help clients overcome obstacles such as conflicts and lifestyle habits that are preventing them from healthy and satisfying relationships, enhanced self-esteem and happiness.  My specialities include: anxiety; phobias; depression; relationship issues; marriage counseling,  career issues; stress management; coping skills; performance enhancement for career and performance; creative blocks; bereavement and loss; post traumatic stress disorder (PTSD); addictions and substance abuse recovery support; codependency; smoking cessation; weight issues; pain management; major life transitions.

I am a licensed psychotherapist/therapist in NYC. My professional credentials include a graduate degree from New York University, post-graduate psychodynamic psychotherapy training, advanced EMDR training from EMDRIA,  integrative yoga therapy training from the Urban Zen Foundation. You can follow Kim Seelbrede’s psychology, yoga and health-related tweets on Twitter or friend her on Facebook. Kim Seelbrede offers adjunctive EMDR, meditation and yoga therapy to medical and mental health professionals in New York City. www.kimseelbrede.com

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Psychodynamic Psychotherapy: Past And Present

As long as a man stands in his own way, everything seems to be in his way. ~Ralph Waldo Emerson

Psychodynamic psychotherapy, often called “psychoanalytic” or “dynamic” therapy is based on the premise that past experiences shape the present. According to the psychodynamic therapy model, the way in which an individual solves relationship issues early on can profoundly influence the formation of that individual’s adult personality.

At any early life stage, a person may have become “stuck” in a way of reacting or problem solving that is maladaptive in the present. As an adult, these same limiting patterns and dynamics often play out, getting repeated reflexively and automatically. These patterns interfere with the client’s ability to have healthy, intimate relationships with others as well as demonstrate resilience in the face of rejection. Unresolved development issues can prevent the individual from fully and spontaneously experiencing his/her true feelings which can lead to dissatisfaction in many areas such as relationships and career. Despite an individual’s mature exterior and successes in many areas of life, their rigid and repetitive patterns interfere with personal growth and the ability to lead a passionate, fulfilling life. Psychodynamic, insight-oriented therapy seeks to make conscious many of these patterns of behaviors that have previously been out of awareness for clients.  Some of the newer types of psychodynamic therapies are relational analysis, self psychology and object relations therapy.

Psychodynamic psychotherapy is a form of depth psychology, the primary focus of which is to reveal the unconscious content of a client’s psyche in an effort to alleviate psychic tension. In this way, it is similar to psychoanalysis, but psychodynamic therapy tends to be briefer and less intensive than psychoanalysis. It also relies on the interpersonal relationship between client and therapist more than other forms of depth psychology. In terms of approach, this form of therapy also tends to be more eclectic than others, taking techniques from a variety of sources, rather than relying on a single system of intervention. It is a focus that has been used in individual psychotherapy, group psychotherapy, family therapy, and to understand and work with institutional and organizational contexts.

Although psychodynamic psychotherapy can take many forms, commonalities include:

• An emphasis on the centrality of intrapsychic and unconscious conflicts, and their relation to development.
• Seeing defenses as developing in internal psychic structures in order to avoid unpleasant consequences of conflict.
• A belief that psychopathology develops especially from early childhood experiences.
• A view that internal representations of experiences are organized around interpersonal relations.
• A conviction that life issues and dynamics will re-emerge in the context of the client-therapist relationship as transference and counter-transference.
• Use of free association as a major method for exploration of internal conflicts and problems.
• Focusing on interpretations of transference, defense mechanisms, and current symptoms and the working through of these present problems.
• Trust in insight as critically important for success in therapy.

~Wikipedia

Latest Research in Psychotherapy:

The premier journal in psychology, The American Psychologist, published (February, 2010) an article by University of Colorado researcher Jonathan Shedler, Ph.D. that challenges prevailing thinking about psychotherapy by using multiple sophisticated meta-analyses of psychodynamic therapy and other psychological and pharmacological treatments.  In “The Efficacy of Psychodynamic Psychotherapy,” Shedler states ”Empirical evidence supports the efficacy of psychodynamic psychotherapy. Effect sizes for
psychodynamic psychotherapy are as large as those reported for other therapies that have been actively promoted as “empirically supported” and “evidence based.” Additionally, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends.” Here is a link to Shedler’s article: http://www.apa.org/pubs/journals/releases/amp-65-2-shedler.pdf.

Kim Seelbrede is a psychotherapist, EMDR therapist and integrative yoga therapist with a private practice in New York City, downtown near Union Square/Flatiron and on the Upper East Side of Manhattan.

I provide therapy, EMDR, hypnotherapy, mind/body techniques, coaching and stress management for individuals, couples and groups. I help clients overcome obstacles such as conflicts and lifestyle habits that are preventing them from healthy and satisfying relationships, enhanced self-esteem and happiness.  My specialities include: anxiety; phobias; depression; relationship issues; marriage counseling,  career issues; stress management; coping skills; performance enhancement for career and performance; creative blocks; bereavement and loss; post traumatic stress disorder (PTSD); addictions and substance abuse recovery support; codependency; smoking cessation; weight issues; pain management; major life transitions.

I am a licensed psychotherapist/therapist in NYC. My professional credentials include a graduate degree from New York University, post-graduate psychodynamic psychotherapy training, advanced EMDR training from EMDRIA,  integrative yoga therapy training from the Urban Zen Foundation. You can follow Kim Seelbrede’s psychology, yoga and health-related tweets on Twitter or friend her on Facebook. Kim Seelbrede offers adjunctive EMDR, meditation and yoga therapy to medical and mental health professionals in New York City. www.kimseelbrede.com  therapist, psychotherapist, psychologist new york city, nyc therapist and therapy for depression, anxiety, addictions, self-esteem, sexual problems, phobias, panic attacks, trauma, emdr therapist

Light Therapy for Seasonal Affective Disorder SAD

More than 8 million people live in New York City and some of them are SAD, all winter long.  As the October leaves begin to change and glide from their branches the days become increasingly shorter and darker. This is when many people begin to feel the nudge of Seasonal Affective Disorder or SAD. This is the season when many seek the help of a mental health professional such as a psychotherapist or psychologist. Yes, the holidays ignite issues for people such as loss and family conflicts, but for many, the depression and lethargy are the result of insufficient sunlight. To make matters worse, many of us leave for work early in the morning when it is dark, have lunch in the conference room and return home in the evening.  Some never see the light of day and office lighting is never a replacement for natural light.

So what is SAD or Seasonal Affective Disorder?

According to the Mayo Clinic, SAD is “a type of depression that occurs at the same time every year.” Symptoms of SAD include depression, hopelessness, anxiety, loss of energy, social withdrawal, appetite and sleep changes, disinterest in sex, immune system suppression and lack of interest in normal activities.

How can you differentiate SAD from other types of depression?

Symptoms of SAD tend to come back year after year (Fall), with mood and energy levels returning to normal when the season ends (Spring). There is a pattern to the dips in mood and energy that people experience seasonally. Friends and family may notice changes in loved ones and women or those with a biological relative diagnosed with SAD are more vulnerable to developing the disorder. It is important to note that changes in mood are not necessarily connected to situations (the loss of a job, or a disruption in a relationship would make anyone sad during the winter, for example).

What causes SAD?

The 24-hour sleep-wake cycle also known as the circadian rhythm, is controlled by the regular rise and fall of hormones, especially melatonin. Melatonin is known as the master sleep hormone and is produced in the pineal gland. Our overall pattern of sleep-wake depends on the proper functioning of the internal circadian clock, which lies deep in the brain. This circadian clock works in concert with photosensors in the eyes to sense darkness. At night, the body begins to secrete melatonin, which is one of the natural factors that cause sleep. Melatonin continues to be secreted throughout the night. As the sun rises, melatonin secretion slows and the wake cycle begins. According to research, people with SAD, like those with most other types of depression may have low levels of neurotransmitters, including serotonin (a precursor to melatonin) dopamine and acetylcholine. Some research suggests that the change in serotonin levels may result from reduced levels of vitamin D (which we get from sun exposure).

What kind of help is available if you suffer from SAD?

If any of the symptoms listed above seem familiar to you, and they tend to occur during the darker months of the year then you may need seasonal help.  There are a number of options and what is best for you may depend on the severity of your symptoms and your particular situation. Recommended treatments include working with a therapist, medication and/or light therapy and lifestyle changes that support health, hormones and mood.  Some examples are as follows:

• Psychotherapy to help you identify and change negative thoughts and behaviors, as well as help you develop healthy ways to cope with seasonal affective disorder symptoms such as depression, anxiety and stress.
• Antidepressant medications may be prescribed to treat SAD, particularly if symptoms are severe.  See your medical doctor or a psychiatrist to discuss medication as an option.
• Light therapy (or phototherapy) involves using a special light box to mimic outdoor light.  Some insurance companies will cover the cost of purchasing a light therapy lamp. It’s very important to have medical supervision when using light therapy.
• Get sunlight on your lunch hour by going for a walk.
• Keep window treatments open and sit closer to the windows if possible.
• Make sure you are exercising regularly and eat a balanced diet with plenty of omega-3 fatty acids for mood support.
• Supplement your diet with vitamin D3 to make up for inadequate or inconsistent sunlight.
• Consider adding mood-boosting activities such as yoga, meditation, acupuncture and massage therapy.

Individuals who wish to begin light therapy should do so under medical supervision as light therapy may trigger hypomania or mania in some people with undiagnosed or diagnosed bipolar disorder. As an important precaution, patients with Bipolar I disorder who use light for depressed cycles are at risk for switching to full-blown manic episodes and should be on a mood-stabilizing drug while using light therapy.

More about full-spectrum lamps

Light therapy for Seasonal Affective Disorder and circadian-rhythm disorders involves sending visible light through the eyes so that it reaches, and triggers, the pineal gland. The sun is the ultimate source of full-spectrum light, which means it contains the spectrum of light, from infrared to ultraviolet. Generally speaking light therapy involves the use of equipment that sheds either full spectrum or bright white light.  In most cases, the purpose of light therapy is to increase the amount of light to which we would otherwise be exposed. Bright light therapy consists of looking at special broad spectrum lamp, generally in the early morning hours. One should not stare directly into the lights because of possible eye damage. One popular brand isVerilux many other light boxes can be found on Amazon.

Reverse Seasonal Affective Disorder or Summer Depression

Rarely, some individuals experience summer depression which is an annual relapse of symptoms that occurs in the summer rather than winter. During that period, the depression is more likely to be characterized by insomnia, decreased appetite, weight loss, and agitation or anxiety. Patients with such “reverse SAD” may benefit from the use of an antidepressant combined with a mood stabilizer. In still fewer cases, a patient may experience both winter and summer depressions, while feeling fine each Fall and Spring, around the equinoxes.

Information from the Center for Light Treatment and Biological Rhythms – Department of Psychiatry at Columbia University

The Center for Light Treatment and Biological Rhythms is a unique clinical program in the United States, with its coordinated focus on circadian rhythm, mood and sleep disturbances.

• Establish normal sleep onset time for people who cannot fall asleep until it is too late, or have trouble waking up because of fragmented sleep
• Relieve winter depression (seasonal affective disorder, or SAD, or the milder winter doldrums or winter blues)
• Alleviate symptoms of unipolar and bipolar depression, whether or not the depression is seasonal
• Increase daytime alertness and reduce slumping in the afternoon and evening
• Substitute light therapy for drugs during pregnancy
• Improve cognitive performance, mood and sleep in adult attention deficit hyperactivity disorder
• Work effectively when drugs have not worked, worked only partially, or cannot be tolerated
• Work effectively in conjunction with antidepressants and mood stabilizers

Outpatient services begin with an extended diagnostic evaluation session in which an individualized treatment regimen is generated to follow at home. Over six weeks, we actively monitor progress and, if necessary, hone the treatment regimen to achieve maximal response. Many of our patients are referred by their primary mental health provider. In those cases, we work as a team to coordinate treatment. We work with outpatients across the country and abroad as long as they can visit New York for the evaluation workup. The Center also offers services to inpatients at Columbia University Medical Center.

Light Therapy for Depression - New York Times Health Blog

Hear about Dr. Terman’s research on National Public Radio.

Department of Psychiatry – Columbia University Center for Light Treatment and Biological Rhythms

1051 Riverside Drive, Unit 50, New York, NY 10032,  email at: doctors@columbia-chronotherapy.org

Resources on the web:

http://www.nami.org/Content/ContentGroups/Helpline1/Seasonal_Affective_Disorder_(SAD).htm

http://www.mayoclinic.com/health/seasonal-affective-disorder/DS00195

Read more about light therapy and the treatment of depression

Light Therapy For Depression

New York Times by Roni Caryn Rabin (reprinted)

Life Coaching vs Therapy

You may be searching the internet looking for help and support for your relationships, career, self-esteem, self-defeating behaviors, habit problems, stress or life satisfaction. Clients ask me to explain the difference between life coaching and therapy, and while the two may overlap, they are different.  Most psychotherapists or therapists tend to focus on developing self-awareness and understanding feelings, behaviors and past experiences.  Certain types of therapy such as CBT or Cognitive Behavioral therapies focus less on understanding the root of a problem and instead address changing behaviors. I’ve had psychotherapy patients tell me that they’ve spent years in therapy talking about feelings and past events and still feel “stuck.” They are “therapy-weary” and anxious to put the past behind them and move forward in their lives.  Life Coaching is action-oriented and goal-oriented in a way that seeks to empower the client to take charge and move through obstacles.

It’s not so simple for many.  Not all, but some life coaches are qualified and able to help clients understand feelings, patterns, behaviors and actions. This is often important because when clients have “blocking beliefs” about change, growth, success, abundance and so on coaching efforts towards setting goals, creating a plan of accountability and motivating the client will met with resistance and self-sabotage.  Even high-functioning, successful individuals in good mental health may have some mild mood and anxiety difficulties as well as defense mechanisms that interfere with achieving even greater levels of health and happiness.  A good life coach should be able and prepared to address a range of issues, and yes, even past difficulties that arise from time to time.

What should your life coach be prepared to help you with?

• addressing your beliefs, feelings, thoughts and behaviors
• help you as a healthy individual find success and happiness
• challenge yourself
• help you shift unhelpful patterns of behaviors
• break the cycle of negative thoughts and distortions (I can’t do this) and the feeling state that accompanies these thoughts
• learn positive thoughts and beliefs that lead to positive change in behaviors (sometimes you have to take action first then circumstances change as opposed to waiting for circumstances to be ideal before taking actions)
• identify when you get in your own way or fall back on self-sabotaging behaviors by uncovering “blocking beliefs” (I don’t deserve to be happy, if I move forward I’ll lose something or I’ll be punished in some way if I gain success, for example)

More about life coaching for celebrities, high-profile individuals and creative people

And I’d Like to Thank My Coach 

Need Therapy? A Good Man Is Hard to Find

Self-Help Tips for Managing Fear and Anxiety

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Symptoms of fear and anxiety run the gamut from vague, gnawing uneasiness to full-blown phobias. We use many strategies to manage anxiety often without knowing that we are engaged in behaviors that serve to reduce anxious feelings. If you are someone who could benefit from some helpful, self-soothing rituals give these mind-body tips a try. Many of my psychotherapy patients have reported success making a few simple lifestyle changes.

• Sip chamomile tea or a blend of natural, non-stimulant teas created to calm frazzled nerves. The ritual of preparing a cup of soothing aromatic tea can begin the relaxation process by replacing anxiety with a sense of calm and control over emotional states.
• A drop of lavender oil applied to inner wrists, the back of your neck and shoulders or simply inhaled works well. There are many other essential oils that can be used to calm your nerves such as orange, rose, sandalwood, nutmeg, patchouli, clary sage and ylang-ylang, to name but a few. My favorite Young Living proprietary blends are Peace and Calming and White Angelica. The olfactory system and smell is the only one of the five senses directly linked to the limbic lobe which is the emotional control center of the brain. Targeting this area of the brain reduces anxiety, depression, fatigue and stress. Essential oils have long been appreciated for their uplifting, calming, and clarifying effects on emotional wellness.
• Many are never without Bach Flower Rescue Remedy. Definitely worth a try!
• Mantras and affirmations can be helpful for many people. Keep it simple. (I am well – I’m okay)
• Breathe and breathe consciously. Controlled breathing exercises such as inhale – exhale – pause or inhale – pause, exhale – pause helps regulate the parasympathetic nervous system (that’s the fight or flight response). Breathing exercises do not work with all anxious people, in fact, some people become more anxious as they focus on their body. For those individuals, guided imagery is a more helpful response.
• Grounding. Sit in a comfortable position with relaxed arms. Close your eyes and notice your breathing. Allow your breath to soften and relax. Imagine your body as a majestic tree, solid like the strong trunk of the tree. Feel your feet firmly planted on the ground. Imagine your legs growing roots moving down deep into the earth. Notice how rooted and anchored you feel. You feel solid and strong, able to handle any stress. As upsetting situations arise return to this place of feeling grounded and safe. Visualize your body as a majestic, firmly rooted tree. If the tree imagery does not work for you use the grounding cord technique. Imagine as you sit quietly that a cord or sturdy rope drops from the base of your spine and connects to the rock beneath the surface of the earth. This is your grounding cord. Continue to breathe deeply and notice the sense of calm and stability that your grounding cord provides. Some days, depending on the stressors, you may need to make your grounding cord thicker or your tree roots broader.
• The amino acids GABA and L-Theanine have been clinically proven to help reduce stress, anxiety and panic attacks. Some individuals find relief using adaptogenic herbs such as Holy Basil and Ashwagandha which helps rebuild depleted adrenal glands, so you can fight chronic anxiety brought on by adrenal burnout. The holistic stress relief herbs Lemon Balm and Skullcap can be helpful as well. It is important to work with a holistic doctor when using these powerful, holistic remedies and should never replace medication in individuals diagnosed with a serious mental health disorder such as Bipolar Disorder or Major Depressive Disorder.
• A skilled psychotherapist can work with you using hypnotherapy, guided imagery, biofeedback or EMDR. Guided imagery is a wonderful tool for those who wish to escape being “in” the body. Some are able to find peaceful, soothing images on their own while others may need the helpful support of a DVD or taped guided imagery session.
• Cognitive behavioral therapy is used by therapists to expose clients to anxiety-producing situations with the goal of managing and replacing the terrifying sensations that accompany fear with a sense of mastery. Rational thinking helps replace the unhelpful dialogue that we often have with ourselves (is this or that really going to happen?). CBT teaches you how to think differently about anxiety-producing situations.

Sometimes, we can’t do it alone and may need medication. It is not a sign of weakness or failure to ask for help in this way. Antidepressants such as SSRI’s (Zoloft, Prozac, Lexapro) are very helpful for generalized anxiety disorder GAD, panic disorder and phobias. If fear and anxiety have spawned a full-blown phobia (you can’t drive a car) or agoraphobia (you can’t leave your house), it may be time to try medication to get you back to your life. Xanax can be used short-term (just know that anxiety comes back with a vengeance in a few hours) and beta blockers are helpful for performance anxiety and public speaking. While medications are helpful options, they do not get to the root of fear and anxiety.

Talking with a therapist trained to help you identify anxiety and the conflicts that drive some of your symptoms works. Therapy helps many, yet self-expression does not always lead to change. That’s when adding some of the action-oriented steps listed above offers a balanced, supportive approach to managing stress and anxiety. Suffering in silence should never be an option.

Kim Seelbrede is a psychotherapist, EMDR therapist and integrative therapist with a private practice in New York City. In her Manhattan therapy practice, Kim has experience addressing the following concerns: relationships, marital difficulties, divorce, parenting, career, professional performance enhancement, anxiety, panic disorder, OCD, depression, loss/grief, adolescent psychotherapy, underachievement, perfectionism, identity issues, LGBT, body image, eating disorders, addiction, substance abuse, sexuality, PTSD, trauma, stress reduction, transitions, life purpose, health concerns, women’s issues, therapy for men, pain management and wellness. Kim Seelbrede has advanced training in EMDR therapy and Brainspotting and uses it with clients who prefer to work in this way, or when she feels it is a technique that will be helpful for the client. Clients include CEOS, senior executives, entrepreneurs, financial analysts, performers and creative individuals with a focus on helping them identify and remove barriers to success and happiness. Kim Seelbrede offers adjunctive EMDR, meditation and yoga therapy to medical and mental health professionals in New York City. To learn more about her psychotherapy approach, visit her therapy website at www.kimseelbrede.com call 646.248.9196 or email.

Kim holds a master’s degree in social work from New York University (MSW) and received advanced post-graduate training inpsychodynamic psychotherapy and cognitive behavior therapy (CBT)  from New York University. Kim uses an eclectic approach which draws from attachment theory, object relations theory, self-psychology, ego-psychology, family systems, CBT, crisis counseling and solution-focused therapy with her clients as needed. Kim has pursued advanced education in the fields of psychology, wellness and complementary health care for nearly 10 years.  Kim draws from extensive education and life experiences including training from the Urban Zen Integrative Therapist Program (UZIT) during which she completed clinical rotations working directly with cancer and surgical patients at Hope Lodge and at Beth Israel Medical Center and has studied nutritional theories from leading experts in the field. Kim Seelbrede is an integrative healthcare blogger for the Urban Zen Foundation.

In her separate integrative therapy practice Kim Seelbrede works with healthy clients as well as clients facing and managing health challenges. Kim collaborates with health care providers and can provide support with the following techniques:  gentle yoga movement, restorative yoga poses, stress reduction, breath awareness (pranayama), controlled breathing techniques, guided imagery, meditation, nutrition, essential oil treatment (aromatherapy), Reiki, life coaching and contemplative care. All of these unique integrative therapy modalities provide a gentle and balanced approach to the following concerns:  pain, anxiety, nausea, insomnia, digestive issues, fatigue and serious chronic illness. Please email or call Kim 646.248.9196 with questions or to arrange a consultation in her Manhattan office. For more information about her holistic integrative therapy practice visit her at www.nyintegrativetherapy.com  follow Kim Seelbrede’s psychology, yoga and health-related tweets on Twitter or friend her onFacebook.

Kim Seelbrede offers adjunctive EMDR, meditation and yoga therapy to medical and mental health professionals in New York City. 

When Talk Therapy Fails PTSD and Trauma Patients

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In order to understand EMDR, one needs to be clear about how trauma can affect the brain. When an individual experiences a traumatic event or multiple traumas they may develop Post Traumatic Stress Disorder (PTSD) as a response to the overwhelming events. When this occurs, the brain fails to successfully process the trauma leaving it “stuck” in the central nervous system. This often leads to numbness, severe anxiety, depression, insomnia, addictions and physical complaints for the sufferer. In everyday life, the body fails to recognize that the person is now safe and it reacts as though the danger is current, leaving the individual in a state of arousal. EMDR as a treatment is unique because it facilitates the processing of trauma information that has become “stuck” in the central nervous system. EMDR calms the nervous system and lessens anxiety. Brain scans have actually captured information transferring from one side of a brain to another as a person experiences an EMDR session. The same cannot be said for other forms of therapy. Historically, we have used talk-based therapies, CBT or drugs to ameliorate the symptoms associated with PTSD. Talk therapy and the relationship with the therapist may be supportive for the duration of the treatment, but often, the brain will begin to loop back into the trauma and the whole cycle will begin again.

We now know that individuals with PTSD have limbic systems that are more active then non-PTSD therapy patients. Psychotherapy or talk therapy may not decondition the limbic system. These individuals experience extreme frustration as they work diligently in sessions and experience little symptomatic relief. Additionally, the retelling of their trauma experiences often leaves them retraumatized and vulnerable. EMDR as a treatment “calms” the nervous system and does so in a way that traditional psychotherapy cannot. With respect to the neurobiology of trauma we now know that early childhood trauma causes “synaptic pruning” which predisposes a person to developing PTSD.  A traumatic event “freezes” the integrative processes of the brain; the information is then stored in a fragmented form in the right side of the brain. Many individuals with trauma histories have lost the capacity to analyze and categorize arousing information because they can’t always “talk” about it and the left hemisphere is then “locked out” of the process. In short, the person attempting to talk their way to healing cannot utilize language in a way that allows them to gain the necessary distance from the painful stimulus. EMDR uses specific protocols to create distance so that the trauma can be reprocessed and fully integrated into both hemispheres of the brain. The grip of hyper-arousal and body tension is now lessened for the patient and the nervous system is calmed.

After successful EMDR treatment the original trauma targets are less activating for patients. In short, their brains are less geared to traumatic stimuli and better able to attend to more neutral stimuli moving forward. In my opinion, the real beauty of EMDR treatment lies in its ability to provide the nervous system with calming, supportive experiences and images that serve the patient well after treatment has ended. The patient is now empowered with the capacity to self-soothe and call upon nurturing and supportive images. Feelings of terror and helplessness are replaced with positive emotions and the new belief that one has power and efficacy in the here and now. When it comes to un-freezing trauma, the powerful combination of a supportive therapist and the wisdom of mind/body integration may provide superior treatment.

To learn more about how EMDR can treat trauma-related symptoms, as well as performance issues, addiction, substance abuse, depression, nightmares, fears, anxiety, panic disorder, eating disorders, health concerns, insomnia, sexual & emotional abuse issues and relationship problems visit this page. Call Kim Seelbrede at 646.248.9196 or email her to arrange a consultation for EMDR treatment in New York City.

Kim Seelbrede is a psychotherapist, EMDR therapist and integrative yoga therapist with a private practice in New York City, downtown near Union Square/Flatiron and on the Upper East Side of Manhattan.

I provide therapy, EMDR, hypnotherapy, mind/body techniques, coaching and stress management for individuals, couples and groups. I help clients overcome obstacles such as conflicts and lifestyle habits that are preventing them from healthy and satisfying relationships, enhanced self-esteem and happiness.  My specialities include: anxiety; phobias; depression; relationship issues; marriage counseling,  career issues; stress management; coping skills; performance enhancement for career and performance; creative blocks; bereavement and loss; post traumatic stress disorder (PTSD); addictions and substance abuse recovery support; codependency; smoking cessation; weight issues; pain management; major life transitions.

I am a licensed psychotherapist/therapist in NYC. My professional credentials include a graduate degree from New York University, post-graduate psychodynamic psychotherapy training, advanced EMDR training from EMDRIA,  integrative yoga therapy training from the Urban Zen Foundation. You can follow Kim Seelbrede’s psychology, yoga and health-related tweets on Twitter or friend her on Facebook. Kim Seelbrede offers adjunctive EMDR, meditation and yoga therapy to medical and mental health professionals in New York City. 

Kim Seelbrede offers adjunctive EMDR, meditation and yoga therapy to medical and mental health professionals in New York City.