updated explanation: How I work ~ what is multi-modal, holistic, cognitive behavioral therapy?

Cognitive-Behavior Psychotherapy (CBT, also known as CBE – cognitive, behavioral, emotional) focuses on the thoughts, feelings, physical symptoms & behaviors that comprise an area of emotional, relational, and life difficulty. Controlled clinical trials of treatment for Anxiety & Mood disorders demonstrate that CBT decreases symptoms in 60-80% of sufferers. Research comparing CBT to psychotropic drugs for anxiety and mood problems repeatedly show that therapy is equally effective but more comprehensive and long term: Drugs change your brain chemistry, with some unwanted side effects, but do not change your circumstances nor the origin of anxiety, mood, or relationship problems. New behaviors as developed through CBT also change brain chemistry and therapy helps you address the cause(s), not just the symptoms. In acute situations, research shows that combining drugs with therapy is the most effective treatment.

The goals of CBT are to:

• recognize maladaptive patterns of thinking/acting

• decrease the intensity & frequency of problematic symptoms

• increase coping skills, change feelings and behaviors

• prevent relapse

What is multi-modal, holistic therapy?

 Multimodal therapy allows individualization of approach and techniques defined by what each client needs. Dr. Orion’s application can incorporate brief therapy approaches, individual or couples work, CBT, mindfulness and relaxation, traditional talk/insight therapy (psychodynamic), solution focused techniques, family systems theory, sex therapy, and clinical humanistic psychology. Holistic means we address the whole of your life – physical, mental, emotional, spiritual, cultural – as needed, in relation to the problems and issues you present, rather than just focusing only on specific symptoms with a single approach. It’s body, mind, & spirit; it’s bio-psycho-social.

 A whole person is more than behaviors and thoughts, but maladaptive thoughts, feelings, and behaviors can impair lives and relationships. People suffering from such impairments also need to clarify, heal, express, tolerate, and share emotions. Emotional closeness is the essence of intimacy and a vital part of any significant relationship whether between parent and child, family members, friends, or adult partners. Using CBT to address behavior and thinking patterns is often a necessary component in further developing emotional and relationship health. Sexual health is more than the absence of disease; relationship health is more than the absence of conflict.

Psycho-education is yet another important component of most clients’ therapeutic experience. Everyone in this complex society and stressful demanding world needs information on a variety of topics including the process of change, relationships, brain function, physiology, nature and instinct, and how culture has and does impact our selves, families, and relationships. Many people also, or instead, need other kinds of help, including understanding and differentiating from family of origin influences and experiences, and with problems that may NOT require a comprehensive CBT program. Multi-modal, holistic approaches allow for such individualized, yet expert, treatment.

Practice random kindness…

A client told me a story today that made me think of the saying practice random acts of kindness. You just never know what people may have been going through in life, or this day, so its best to practice kindness as often as possible.

How crazy would this be: the receptionist who answers the phone at a hearing aid facility talks too fast and doesn’t listen to the caller even when the caller states that they are hard of hearing?

Crazy is too often true but this story is even worse – the receptionist hung up not once, not twice, but three times on my client, a disabled man who wears two hearing aids!

This client, we’ll call him Joe (not his name), had lost one of his custom made, expensive hearing aids which is why he was calling. He was quite worried and obviously having even more trouble hearing without one of his aids. When the woman answered the phone, she spoke rapidly and Joe asked first if he had reached “the hearing aid place”. Instead of answering yes or no, and surmising that the caller has at the least, a hearing problem, the receptionist rattled off several sentences that Joe could not understand. He then asked her to please speak more slowly – and can she just say yes or no if he has reached the right place? Again, she rattled off several sentences that he did not understand. When he tried to explain that he has a phone for the hearing impaired and if she speaks more slowly he can adjust the receiver – she continued to talk over him without listening.

Keep in mind – she’s answering the phone at a place that makes hearing aids….

As the woman continued to talk over Joe, he raised his voice and said – hold on, hold on, please hold on…and she hung up on him! This was very upsetting to him, but he dialed the place again. When she answered he said – if this is the hearing aid place, i think im the person you just hung up on…and she hung up on him again without a word!

Fifteen years ago this man was a working truck driver, transporting goods that you and I count on, when in winter he had a terribly serious accident. He has since had some memory, comprehension, and hearing problems. It also took him a couple of years to regain the ability to walk or have feeling in several areas of his body. He has never been able to work or live a full life since.

People who experience such traumas have long lasting affects to their emotions as well – easily set off panic, anxiety, fear, and memories of their trauma; your basic post traumatic stress disorder. Something as “simple” as being rudely dismissed and hung up on when trying to call for help – sets off anxiety and even memories of his life threatening accident.

My client’s wife, also an older woman with some disabilities of her own, called the hearing aid place a third time and was able to speak to the physician who makes the hearing aids. When she explained what had happened, the physician said – “The receptionist told me that Joe was rude to her. I know he has hearing problems but she’s new – there’s two sides to everything.”This cavalier attitude made Joe feel betrayed by a practitioner who had worked with him for a long time and usually understands.

It also suggests that he will not do much to retrain this new receptionist – who needs to perhaps realize that people calling a hearing aid place, may be hard of hearing.

The practitioner obviously did nothing about it that day. Joe called the next day to inform the physician that the hearing aid had been found and to ask if it should be brought in for adjustment so Joe wouldn’t lose it again. The receptionist hung up on him the minute she heard Joe’s voice!

What happened to common courtesy? Any patience or compassion? Is “the customer is always right” completely outdated?

Joe told me he thought about his phone call “for several days” trying to learn how he had acted so badly as to “deserve” such treatment. His wife confirmed for him that he had likely done nothing at all wrong. I agree and I’ve worked with Joe for nearly a year.

I hope we’ve all had the experience of our day improving because someone smiled at us or had a kind word to say. I know I have. Unfortunately the opposite is also true.

Fortunately, Joe has gained some wisdom and strength during his years of recovery and rebuilding life. Despite his ruminations, and the usual feelings he has of being isolated, left out, misunderstood, and a bother because he always has to ask people to slow down when speaking, he was able to go on with relative stability and whatever joy he is able to experience.

No thanks to a young receptionist who needs to learn manners at least – and to practice kindness more than randomly, at best.

Who knew – therapy is better for you than money!(And may help you earn more!)

Two recently published research reports show that people are feeling more stressed than ever and have less money for counseling and other health supporting activities. Groups are cited as economical and effective to keep on track and get ahead despite difficult world times.

Further, individuals who participated in 12 weeks of private and/or group sessions reported significantly higher rates of both happiness and success in their lives, than did the group who received a pay raise or significant sum of money.

THRIVE women’s group has one or two spaces available.

Beginning TUESDAY JANUARY 19 meet EVERY OTHER WEEK

Members commit to 9 (nine) group meetings and confidentiality.

$40 per session – one third the cost of a 1 hour therapy session!

Sign up requires advanced payment of at least 2 sessions unless other arrangements are made. Pay for the entire series at once – get a $40 discount – the equivalent of one free group!

So far the group is a fantastic mix of progressive, intelligent women, gay and straight, married and single, ages ranging from 30 – 70, in various professions. All are seeking to:

MEET NEW PEOPLE

IMPROVE LIVES AND RELATIONSHIPS

GIVE AND RECEIVE SUPPORT/MOTIVATION

SHARE STRATEGIES

GET NEW INFORMATION AND PROFESSIONAL GUIDANCE

Start the new year – and decade – by taking action that will create lasting life changes in a comfortable, supportive, and interesting way!

Rhea Orion Dyer PhD(c), MEd, MFTi, CSC                                    Napa 707-255-4775

lovehelp@me.com holisticounseling.org

10 positive thoughts for the holidays

Allow yourself a chance to savor the moment.

Optimism isn’t just a shift in perspective – it’s bravery.

Only you can decide the path worth taking.

Don’t wait for your mood to change – take action despite it.

Approach gifting as an opportunity to honor people you love.

Rather than search for a miracle food, strive for a varied and delicious diet; enjoy treats in moderation.

You can’t grow without pushing your limits.

Stop worrying about getting sick ~ focus on your health instead.

Don’t believe everything you hear; life has goodness. Connect with gratitude.

No one knows what the future will bring – put your energy into now.

I’ll be doing my best to follow this advice! Happy Holidays to all!

Rhea

couples here on earth

Are men from mars, women from venus? April 1, 2008 — Functional magnetic resonance imaging of men and women here on earth who are under stress showed neuroscientists how their brains differed in response to stressful situations. In men, increased blood flow to the left orbitofrontal cortex suggested activation of the “fight or flight” response. In women, stress activated the limbic system, which is associated with emotional responses.

Many other things may contribute to stress responses in all people, but the results here are interesting and may indicate why some couples argue. A question, request, or perceived criticism or threat in a conversation or daily activity is a form of stress. If the man in this hypothetical couple feels threatened or stressed by the topic or situation – his reaction may be to defend himself and somehow run away from the issue, for example by changing the subject or shifting the focus away from himself – fight and/or flight. Meanwhile the female is responding emotionally to this evasion and denial. Result – argument…

In general – the study may suggest that keeping stress down in our lives will reduce the anxiety in some people who feel always a little on edge – on that fight or flight response line about many things in their day. Or, because of a general level of stress, emotions are just under the surface, can erupt, and play a larger role in behaviors than may be effective or appropriate.

STRESS-REDUCING TIPS: There are several easy, practical things people can do to reduce the amount of stress in their lives. (1) Be realistic and don’t try to be perfect, or expect others to be so. (2) Don’t over-schedule; cut out an activity or two when you start to feel overwhelmed. (3) Get a good night’s sleep. (4) Get regular exercise to manage stress — just not excessive or compulsive exercise — and follow a healthy diet. (5) Learn to relax by building time into your schedule for reading or a nice long bath.

Tips for the lovelorn and love-worn

Valentine’s Day can cause anyone to reflect on their love life – or perhaps the fact they don’t have one. It’s hard to avoid the commercialism in our culture, which creates pressure to participate in ritual expressions of romance. If Hallmark has the card for you, and your kisses begin with Kay, you may feel no discord between your life and the expectations portrayed in our society. If you have no person of romantic interest in your life, perhaps you are well enough on your own, and someone like your mother or dear friend feels special because you bring them a valentine. The largest percentage in history of adults in our culture are now living alone – and liking it. If you are among this group, you are likely figuring out new and expanded ways of celebrating love and caring. If you’re among the millions of people who are lonely or millions of couples who feel they’ve lost the spark – you’re actually not alone! When the pressure to share romance makes you want to change life’s channel, here’s a few tips for finding new valentines, or warming up the connection to the one you have. For the Love Lorn (single and lonely)~Don’t isolate yourself! Get out and meet people: 

• Spend time with groups of friends where everyone is not a couple and other single folks may visit.  
• Make yourself get involved with interest groups such as hobbies, politics, arts, outdoor activities, book discussions, movie goers, pet owners, gardeners, LGBT, poly, etc.
• Research and try out spiritual groups or church groups.
• Volunteer in organizations that interest you. You’ll meet like minded people and feel good helping others.
• Keep yourself in reasonable shape and take care of your appearance like it matters – to YOU! 
• Give a valentine to someone else who is lonely or alone – of any age or gender. Sharing love doesn’t have to mean sharing lust or romance.
• If you have lingering depression, low self-confidence, or find yourself repeatedly alone or in bad relationships, check in with a counselor. Many people need help with these problems in living.

For the Love-worn 

 

Many couples are too busy and romantic distance has become habit. It may not be easy to snap back into place! If you want a gourmet meal, it takes planning and time. If you want a romantic evening, it takes planning and time. 

 

• Plan some time to be private together. Turn off phones, TV’s & computers. Send kids to grandma’s, or get a room.
• Schedule a realistic amount of time to get relaxed, prepared, and be together. STICK to that schedule.
• Ritualize the space & the shared time alone: clean, set out candles and flowers, choose music that is relaxing, romantic, or sexy – whichever you need most! Have special foods, snacks, wine, or drinks ready for the occasion. 
• Keep in reasonable shape and take care of your appearance – like it matters to YOU! Then dress to impress your partner!
• If you drink, do so moderately – too much alcohol ruins the recipe.
• If you have aches and pains, a disability or chronic illness, take a pain reliever or your medications, and prepare the space for your comfort and abilities.
• Choose, focus, and allow: Choose to really be here now; focus on the sensual – scents, tastes, touch, sounds, sights; allow yourself to relax and enjoy.
• Communicate: Say what’s in your way, respond to what’s great, say what you want, show your interest. Listen with all your senses to your partner. See into each other’s eyes.
• Breathe and reboot: Breathe deeply. When those inevitable thoughts of stress keep entering your mind – keep rebooting right back with – breathe, choose, focus, and allow!
• Go slow! It’s not a race to the finish, but a savoring of the flavors. Wolfing down a gourmet meal is a waste!
• If you can’t keep the stress away, or reconnect and enjoy no matter what you try – check with a relationship counselor. Many partners need help getting out of a love-worn rut.  

21 days to resolution

Does your new year resolution fizzle out like flat champagne? Try the 21-day plan. Fitness experts have noted that exercising for 20 minutes, for 21 days in a row, is enough to create a habit for lasting change. 20 minutes isn’t an overwhelming commitment, so it’s achievable and realistic. 21 days – three weeks – doesn’t seem like a long time to do something every day. It is long enough, however, to develop the pattern for a new habit, and to show initial results. Results that are measurable, rewarding, and motivating. After the 21 days, it is therefor easier to continue with new habits even if not on a daily basis.  Neuroscience shows that the brain continues to grow and respond to changes in behavior, a fact which supports the 21-day plan. If fitness or weight loss isn’t your resolution, try it with some other activity you’ve been wanting to fit into your life. I have 4 days left on a fitness plan, and I can tell you it works! I’ve lost inches, gained strength and energy, and I’m getting more done in all areas of my life. Next I’m going to write for 20 minutes a day, for 21 days in a row. Maybe I’ll get that book written –  at 20 minute intervals!

No time for meditation? Try MINI-TATING…

   TOOLS FOR THE JOURNEY

“MINDFULNESS” or being mindful of the moment you are in, the tasks you are doing, is an ancient idea with roots in the East, but not easy for most Westerners. Meditation is a mindfulness practice and has been proven to postively effect physical and mental health as well as precipitate lasting life changes. The meditative process of “emptying the mind” is not, however, something most people in our culture can do even for a few moments, let alone for 20 minutes to an hour, as may be considered normal for traditional meditation.

Recent brain science shows that shorter and more natural exercises of mindfulness are equally powerful and may be more effective – because people do them! Making time for a manageable meditative exercise several days a week can help control the symptoms of mental and physical ill-health by ameliorating mental and physical stress, helping to solve problems, motivating behavior changes – in general bringing a greater sense of peace and well-being. Like any type of practice, the more or longer one does it, the more ability one has to use the skill whenever one wants ~ even when you are not in your designated quiet spot!

Triggered off by a situation at work or home? If you’ve practiced mindfulness at other times, you’ll be more able to take a few breaths and speak some thoughts to yourself; your body will calm down and you can deal with the situation in a more positive way – to your own lasting benefit. 

Nervous, anxious, or uptight in academic, professional, romantic, or sexual situations? If you’ve learned mindfulness, you can take a breath, return to that calmer place, and focus on the current challenge, activity, and experience feeling more confident and in control. 

You don’t have to know all the answers or what to do – you only need to really BE here, each moment. This allows your inner self – which does know, or can find out, what to do – to help you handle things better on the spot.

Each moment is, after all, the only time and place we truly are and CAN be.

Over time, you will likely discover that you don’t get triggered off as easily, or as often. How great would that be? And – mini-tating is FREE!

It may take more than a mindfulness practice to change your life, and help your inner self develop – you may need additional support, information, new experiences, or counseling to deal with many kinds of pre-existing problems. But the fact is – mindfulness practices change brain chemistry and autonomic body functions and improve self control. Without the side effects of drugs – and with the benefit of knowing – it’s YOU creating the changes in your life.

Sound compelling?

I’ve found the following practice do-able on a fairly regular basis for busy people who may or may not have experience with other forms of meditation or mindfulness exercises. I call it –

MINI-TATING

Find a quiet place to sit that is comfortable
Relax and close your eyes
Do a body scan – just pay attention, make adjustments to comfort and relax as needed
Take a few deep breaths, then
Focus on breath deliberately thinking the words –
“I’m breathing in…” peace or calm or health or strength- whatever you feel the need to breathe in
“I’m breathing out…” stress or pain or sickness; anger, anxiety, procrastination, fear -whatever you need to breathe out

You can keep it very simple – “In peace, out stress” – or “customize it” for your needs that day

Do that for as many breaths as you can, it may be only a few to start out. You can also try counting breaths in and out, while truly filling your diaphragm down to your stomach and totally emptying it. ANYthing that makes you think deliberately about breathing for at least a few breaths!

Another option is to visualize with these breaths – what color is the air you are breathing in that is peace (for example)? Silver? Gold? Blue? Clear? What color is the air going out that is stress (for example)? Black? Brown? Red? Perhaps you will “decide” – or perhaps, you will just “see” >>> your breath will tell you…

For pain and body stress relief, visualize, as one example, knots untying themselves in your neck, back, shoulders, legs…; or “see” a headache drain away. If you need to take aspirin (or whatever) for bad or chronic headaches or body pain, take it first, then do the visualization. By the time you finish mini-tating, your pain may be eased or gone. You may experience fewer headaches over time, less chronic pain, and may be able to take less aspirin or *medication *(consult your physician).

WHEN YOUR MIND WANDERS – WHICH IT WILL – SIMPLY RETURN YOUR THOUGHTS TO YOUR BREATH AGAIN. Build up how many breaths you can focus on – maybe it’s only ONE at first, or three…it doesn’t matter, just keep working at it. It all helps.

Witness thoughts without judgment.

Allow your thoughts to come and go – a thought parade perhaps. This gives space for new thoughts, ideas, intentions, inspirations, to join the parade. If no new thoughts arrive, fine. No judgement, and no entanglement – keep returning to the breath, or visualizing color, or thinking about positive intentions (see next). If new do thoughts arrive, see what they are!

Before coming back to your day – set an intention:

What do I want to focus on this day? For example, acceptance of where you are in life (or alternately, determination to change); gratefulness; forgiveness; accomplishing a specific thing that day; giving yourself credit; working on one goal; or anything that you need to intend!

The intention can be as simple as – i’m going to be in the moment, focus on doing things as well as I can; or, i’m going to finish one important thing on my list, or I’m going to take care of myself today – the options are endless and up to you.

We can easily get stuck in sad or negative thoughts and feelings, these are common thoughts to have, but don’t ”muck around in the wound.” Once you realize you are doing this, let these thoughts and feelings roll on by and return your deliberate thoughts to your breath, visualizations, intentions, and any new thoughts or directions.

You might even take a few minutes to write down your experience and any new thoughts in a journal after you finish mini-tating.

Setting an intention can also be done at the start of your mini-tation, which may set a tone for thoughts or images you receive and may even help a response or resolution to a problem come to you. Either way, breathe and focus on your intention at least breifly prior to opening your eyes and moving into active life. You’ll find that over time, you do fulfill your intentions.

Spend about 15 minutes as possible each time you mini-tate…if you can only manage to start with 5 minutes – do it. Next time try for 7 minutes, 10, etc. But even if you stop in the middle of a stressful day and do this for 5 minutes – studies have shown that people’s bodies respond by becoming more calm and their minds by working better.

If you have trouble, it gets easier the more you do it. I believe you will find that you come to look forward to MINI-TATING! It’s for YOU! 

Changes are noticeable, immediately and over time, including improved health, greater daily living success, and better relationships. Even if you do this once in a while, it can help to an extent. For best results, like creating any other worthwhile and lasting change, you actually have to DO the excercise with some consistency – even after you are feeling better.

Are you worth 15 minutes of quiet time 3 or 4 times a week, or even daily? If you don’t think so, perhaps you’d better MINI-TATE on that!