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Don’t Let a “Shame Attack” Get The Best of You

By UB’s Joyce Marter, LCPC, for PsychCentral

One of my friends, who is a therapist, accidentally drunk-dialed her male client (rather than her ex-boyfriend) and played a love song into his voicemail after saying she missed him. The next morning, her client politely called her to alert her of the error. Her emotional response at that moment is what is called a, “shame attack.”

We all have shame attacks. They suck. 

Some are short and minimal. Like the therapy session that I conducted and accidentally dropped and an Altoid into my cleavage while making a very serious psychological interpretation—my client and I burst out laughing and I forwent searching for it…

Some are intense and haunting. Like the time my stiletto got caught on a cord while I was saying hi to my husband who was deejaying on the stage at our children’s school benefit—resulting in my backwards fall into the shrieking crowd, taking a folding table and much sound equipment down with me…

Shame attacks can occur after the following:

  1. Substance induced disinhibition or sloppiness. (See above.)
  2. A mistake, accident or error. I once dropped a rental movie into a mailbox on the street and put my mail into the video store’s return slot. In my defense, it was early morning and  I was not properly caffeinated—and, when I called to get the situation corrected I learned I was not the first to have done this…
  3. Self-disclosure. One therapist who works for my practice said she experienced a “shame attack” after disclosing personal information about her own psychiatric treatment during a training I facilitated. (BTW, I love when therapists admit that we have issues too. Quite simply, it is what brought us to the field and gives us the ability to help others—nothing to feel shame about.) As long as what you said was authentic and true, there is nothing for which to feel badly. Social anxiety is a projection of our own self-loathing.
  4. Sexual impulses. Flirtation. Advances. Verbalizations. Actions. Sometimes it is hard to admit what we want, especially if unreciprocated. Understand sexuality is intensely personal. We all have needs and perhaps we all feel silly about them sometimes.
  5. Regressive behaviors. I once (okay, more than once) yelled something ridiculous and childish at my husband when the doorbell rang and my neighbor and his daughter were at the door. I went from five years-old and psychotic to 41 and composed in five seconds. My neighbor was nice enough to pretend he didn’t hear a thing, but we both knew he saw my less-evolved self. We all act like babies sometimes. Reflect on why those old parts are getting triggered and seek the help of a good therapist.

How to recover:

  1. Remember, you are human and nobody is perfect. Nobody expects you to be perfect (except for yourself and maybe your mother, LOL.)
  2. Understand, mistakes happen for a reason. They help us learn and grow.
  3. Make amends whenever needed. Take responsibility for yourself for poor behaviors and apologize. If you are having multiple substance-induced shame attacks, get help through treatment, therapy and/or a 12-step program.
  4. Forgive yourself. In moments of quiet, prayer or meditation, express forgiveness and compassion to yourself just as your would extend to others whom you love.
  5. Learn from mistakes. They are messages that something needs to change in your life (like you need to slow down, take better care of yourself, etc.)
  6. Understand, “This too, shall pass.”  Zoom out and look at your life from a greater perspective. Did anybody die? Is it the end of the world? Remind yourself you will feel better about the shame-triggering event with each day that passes.

When I look back at the things I have felt shame about, most of them don’t matter a wee bit.  And shame is a heavy burden to carry you need to purge the ickiness to make room for joy. 

Breathe in, breathe out and let it go. 

Watch this free webinar: The Psychology of Success

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Learn More About Anxiety and The Symptoms of a Panic Attack

By UB Therapist Leslie Holley, MA, LCPC

As a psychotherapist at Urban Balance one of my specialities is anxiety. I have worked with many clients presenting with generalized anxiety, social anxiety, and illness anxiety to name a few. Anxiety can have a wide variety of symptoms and some of them may be physical. Here are some common symptoms:

• aches and tense muscles

• trouble falling asleep or staying asleep

• feeling on edge, “keyed up”

• being angry or irritable

• worrying about everyday decisions for several days in a row

• feeling like something bad is going to happened

• difficulty concentrating

The key symptom for moderate to severe anxiety is constant worry. People with this type of anxiety worry often about current and future life events. Symptoms can cause the worrier to feel as if their thoughts are debilitating and they may find it hard to complete simple, everyday tasks. These clients may avoid certain places or things and pull away from other people and become more isolated. It is also typical to have someone with extreme anxiety have trouble with assertive communication and present more passive in work and social interactions. Their focus is on what isn’t going well and what could go wrong.

Some people with anxiety also experience panic attacks. It is important to note the difference between anxiety and a panic attack. Some of the symptoms for a panic attack include:

• trembling or shaking

• difficulty catching your breath

• heart pounding

• dizziness

• sweating

• feeling fatigued

• tingling in arms, hands, and legs

To reduce anxiety symptoms it is important to first recognize and accept the symptoms, which can be hard for many clients. Many people who suffer with anxiety have a lot of shame around their symptoms so acceptance is the first step. Counseling is a great tool to support clients and educate them on how they can live with anxiety. Additionally, physical activity, eating healthy meals, and following a strict sleep routine can help reduce symptoms. There are also many smartphone apps to help clients practice relaxation techniques that can be done in the shower, at night before bed, or during the morning commute to work. Anxiety doesn’t have to take over someones life and with support and practice can be managed.

 

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Listening Exercises to Help See Life Better

Listening to Guided Relaxation Exercises

I am a big fan of listening to guided imagery and relaxation exercises for my clients. Whether you are having difficulties with anxiety, self-esteem, phobias, stress, depression and even weight loss, there is a plethora of scripts and audio bytes out there in cyber land.
So what is guided imagery?
It is usually a written script or audio that directs one to imagine, focus and/or project certain feelings or settings in our minds. It can help people’s body and mind relax, sleep better, calm down before or after something troubling or help coach the soul to a more positive place. I’ve compiled several audio clips that I have used in the past for clients. I would definitely recommend checking out some of the websites beyond the audio clips to find out more about this topic and other relaxation exercises.
Tips before starting guided relaxation:
Make sure you are in a comfortable position, preferably laying down. A quiet setting, minimal distractions, cool temperature and remember to turn off your phone (unless you’re using it for these exercises- then lock incoming calls/texts/notifications!) Some of these audio clips might have videos, but don’t watch them! It is best to lay back and close your eyes, only listening to the sounds and prompts.

Progressive Muscle Relaxation

Progressive Muscle Relaxation (PMR) is systematically tensing and releasing certain muscles in the body, creating a sense of relaxation. These are great to use for anxiety, stress and looking to become more relaxed before sleep:

Guided Visualization

These types of visualization often leave people in a calm or relaxed state. They typically use prompts to imagine being in a certain setting, like a forest or beach, and guide you to focus on the five senses- touch, sound, taste, sight and smell. They can also prompt you to feel certain ways, such as warming parts of your body (my personal favorite!) or “floating” on a cloud. I would recommend these audio clips for people looking to sleep better, start their day off in a more peaceful manner, or unwind after a stressful day. This is also good for people with anxiety and depression:

Mindfulness Meditation 

Mindfulness is a term used to be more present in our thoughts, so these audio clips will help guide you to think and do so. Focusing on breath, sounds and current feelings are the core of these exercises. I’d recommend these for people having troubles with anxiety, OCD, phobias, or in a heightened state of emotion.:
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Get Healthy, Get Married

This article was written by UB therapist  Bridget Levy, LPC.

In a lecture by health psychologist Dr. Tamara Sher, she focused on how marriage and long-term relationships affect our physical health. Dr. Sher spoke about her research findings, which included why not having a long term relationship can be detrimental for health, the different ways men and women benefit from relationships, the effects of marriage/relationship change and how to have a healthy argument. Here are some interesting facts and findings I learned from Dr. Sher that may surprise you.

  • Change in cause of death: A century ago, the top 4 causes of death were small pox, measles, TB and the flu. Today, the top causes are heart disease, cancer and respiratory diseases. This change not only reflects advances in medicine, but also that there are now behavioral and social components to why many die. Stress triggers the production of small proteins called cytokines, which cause inflammation that can become a risk factor for heart disease.
  • Living alone: Those who live alone have worse hearts and are more likely to have heart disease. The quality and amount of social support (friends, family, coworkers etc) is essential. In fact, social support has been found to be as predictive of good health as smoking is predictive of poor health! Socially isolated men have an 82% higher risk of dying from heart disease than men with strong social ties.
  • Marriage benefits for men: Married men eat better, exercise more and are less likely to engage in risky behaviors than those who are unmarried, divorced or widowed. They are also more likely to get regular doctors check ups and have a higher standard of living. 66% of married men say their main source of support is their spouse. Men who get married over the age of 25 get more benefits from marriage than those who marry before 25. Marriage is better for men’s physical well being than it is for women.
  • Marriage benefits for women: Married women gain emotional stability and get value from being in the care-giver role. Women in happy marriages are thinner, gain less weight across time, have lower cholesterol and exercise more. The quality of the relationship matters more for women than men. Women tend to be the “barometer” of how healthy the relationship is. It’s more important for women to feel that they can express their feelings in their marriage than it is for men. In fact, women who can express their feelings in their marriage are 4 times less likely to die than those who feel they can’t!
  • Divorce, widowed and remarriage: Divorce causes immediate health effects. Becoming widowed causes health decrease later on. There is strong evidence that among those who have been divorced or widowed those who remarry have better health.
  • How to have a healthy argument: Dr. Sher suggests that having a healthy argument requires 2 things. 1) The speaker needs to get the listener to listen. Screaming, nagging, and attacking won’t do it. It’s all in the delivery and timing! 2) The listener needs to help the speaker express his or her feelings, be supportive and engage in active listening (even if you disagree with your partner!)
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Get Things Done Now

By Margarita Tartakovsky, M.S. for Psych Central quoting UB’s Joyce Marter.

Therapists often wear many hats. And that’s just in their private practices. Many also teach, write, supervise students and give media interviews. They have families and many interests outside of psychology.

“With 6 kids, ages 16 to 5, a husband and home to care for, a private practice, and my many ‘side jobs,’ including running a non-profit, speaking, writing for my website, blog, and other people, doing some legal consultation, and writing a book, I like to say my life is ‘full,’” said Christina G. Hibbert, PsyD, a clinical psychologist and expert in postpartum mental health. She’s also active in her church and has commitments on Sundays and Wednesday evenings every week.

Joyce Marter, LCPC, a therapist and owner of the counseling practice Urban Balance, also has a lot on her plate. “I am a wife, a mother, a psychotherapist and owner of a group practice with nearly 50 therapists and five locations, a writer with a book in development, a public speaker, the Vice President of the Board of the Illinois Mental Health Counselors Association, and frequently serve as a psychological expert in the media.”

That’s enough to make anyone’s head spin. In addition, Marter takes her kids to and from school, eats dinner with her family, has an active social life, vacations for at least six weeks every year and gets eight hours of sleep per night.

So what’s their secret? Below, Marter, Hibbert and other therapists spill the details on living a fulfilling life and getting things done.

1. They know their priorities.

Hibbert knows what matters most to her, and she focuses on those things first and foremost. “[This] allows me to prioritize my time and helps me know when to pull back from other things. If any of my top priorities are out of shape, I push off the others until things are in order again.”

Her top priorities are: “My relationship with God, my relationship with my husband, and my role as a mother and relationship with my kids.” Her work comes next. But this also has to match her mission: “to learn all I can and teach what I learn.”

Marter takes a similar approach. She starts off with a vision for her personal and professional lives. (For instance, you can create a vision board, she said.) “Then we need to align our priorities and intentions to support that vision. We need to focus our energy on the things that provide meaning, value and life energy and let go of the things that don’t.” She then sets clear goals and firm boundaries around her time, such as her work hours.

2. They have a formula for their days.

“It has taken me many years and several iterations to find a formula that worked for me,” said John Duffy, Ph.D, a clinical psychologist and author of the book The Available Parent: Radical Optimism for Raising Teens and Tweens.

He sees clients either three or four days a week from late morning into the evening to accommodate his clients, many of whom are teens. “I work fairly long hours those days, but I enjoy the work.” The other days he works on his next book or with the media. For instance, he’s been on the Steve Harvey Show multiple times.

3. They protect family time.

Clinical psychologist Ryan Howes, Ph.D, wakes up early to make breakfast for his sons and drop them off at school. He comes home around 6 p.m. to have dinner with his family and eventually put his boys to bed.

“After the boys’ bedtime I enjoy the evening with my wife, which includes checking in with each other, talking about our future plans, and watching some reality TV cooking shows.”

Duffy also “[protect[s] nights and weekends for my wife, son and friends.”

4. They delegate.

When Hibbert needs more time to accomplish projects after school, she asks her older kids to watch the younger ones. She asks her husband to help with grocery shopping and dinner several nights a week. She also has a housekeeper come once a week. “[This] is one of the best things I’ve ever done for myself!”

Marter outsources anything that doesn’t “provide personal meaning or value to me. In my business, I delegate the responsibilities that are not my strengths or passion.” At home, she outsources house cleaning and grocery shopping. This way she has time for what’s most important, such as hosting her kids’ play dates.

5. They have pets.

Having a dog actually makes my life more productive,” said Jeffrey Sumber, M.A., a psychotherapist, author and teacher. “I’m responsible to make sure he is well fed, walked and properly taken care of but this also helps punctuate activities in my day and organize tasks around set breaks in my process.”

6. They use activities to ground them.

Sumber uses the walks with his dog to map out his days and intentions.

It is often during my morning walk with Tashi that I run through my day in my mind, determining priorities and goals and create a visual for how the day will ideally play out. This walking meditation is functional as well as intentional and sets me off on a conscious trajectory into my day.

He also finds focus while making his morning coffee.

I also enjoy the process of my morning coffee. I grind the beans, pull the espresso shots and mix the Americano to my personal perfection. This takes me 10 minutes every morning and I might as well be repairing the space station tethered in deep space…I am very focused.

As I sip the coffee, I ease into my morning by sifting through emails (mostly deleting) and then send personal birthday messages to Facebook friends. I typically take time to prepare meals for the day and then set off to work.

Deborah Serani, Psy.D, a clinical psychologist and author of the book Living with Depression, uses her senses to switch gears and get things done.

My typical day has me in the role of clinician, homemaker, professor, writer and woman. I know the metaphor of wearing “different hats” gets tossed around in shifting roles, but for me, it’s more of what’s in my hands that helps me get things done.

It’s as if my sense of touch transforms me into who I next need to be. My appointment book helps me shift into clinician mode. As soon as I touch it, I can feel myself move into a professional posture.

I have a home office, so in between patients, when I walk back into my home and I touch the doorknob, I’m into homemaker mode – cooking, doing laundry or tidying up the place.

When I pick up my lecture notebook, I’m into professor mode and readily head off to the local university to teach. And if I’m sitting at the keyboard, I easily shift into writer mode.

When I return home and settle into comfy clothes, I become just a woman again -connecting with my family and myself. I’ve always been a very sense-oriented person, and have found using touch as both a cue for change and a grounding way to cement my identity.

7. They stay fully present.

Howes focuses on being present in all his activities:

Freud said “love and work are the cornerstones of our humanness.” I agree with that and try to make the most of both. I do my best to be fully present when I’m wearing either hat. I want to engage with my family, regardless of what is happening at work, and be fully present with my clients, regardless of what is going on at home. On my best days, I’m able to do both.

8. They practice self-care.

Marter always makes time for self-care, which helps her be more productive in other areas of her life.

I prioritize self-care (like rest, meditation, exercise and fun) so that I have the energy to manage all my responsibilities. I practice gratitude and positive thinking to facilitate the energy and confidence I need to achieve my dreams. I tap into my support network (friends, family, therapist, coach, colleagues, mentor, etc.) for feedback, wisdom and support in helping make my life vision a reality.

Hibbert practices her self-care routine first thing in the morning.

On a day-to-day basis, one of the best things I do is wake up before my kids so I can enjoy an hour just for me. I exercise, meditate, and study scriptures to start my day right. When I miss this time, life just doesn’t seem to run as smoothly.

The morning also designates self-care for Duffy. “I work out, meditate when I can, and get to the office early. I eat breakfast there, page through the paper, and clear my mind for a while before the chaos begins!”

Hibbert prioritizes sleep, which is crucial to her productivity and well-being.

For me, the other big key to getting anything done is sleep. If I’m not sleeping well (and I’m not a great sleeper in general), I can’t function well. I get grumpy and overwhelmed too easily. So, I focus on getting to bed as early as I can so I can get up early, and I try to “sleep in” on weekends, when I am given the chance.

When he has the time, Howes strums his guitar, plays hoops, or works on “creating the world’s next great pasta sauce.”

9. They pay attention to their energy levels.

Sometimes Marter lets her energy guide the projects she works on. “When I occasionally experience an ebb of energy, I let myself rest or do the tasks that are easy for me. When my energy is high, I make a concerted effort to carve out time to tackle tasks that are high priority but low urgency like writing my book.”

All of these clinicians lead fulfilling professional and personal lives. They know their priorities and do their best to protect them. They manage their time effectively, know when to delegate and make sure to be completely present at every point.

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How Change Happens in Therapy

By Margarita Tartakovsky, M.S. for Psych Central quoting UB’s Joyce Marter.

Change is pivotal in therapy. In fact, it’s the reason people seek professional help in the first place, according to Deborah Serani, Psy.D, a clinicial psychologist and author of the book Living with Depression. Sometimes, they want to change themselves. Other times they yearn to change others.

“I’m still surprised at the number of people who come to therapy to learn how to get someone else to change,” said Ryan Howes, Ph.D, a clinical psychologist and author of the popular blog “In Therapy.” “They want to know how to get their boss to talk to them differently, or want their wife to appreciate them more, or want their friends to be more considerate.”

Of course the only person you can change is yourself. That includes changing your beliefs, behaviors, reactions and patterns. As therapist Joyce Marter, LCPC, said, “In therapy, change may mean letting go of dysfunctional relationship patterns, irrational beliefs and self-sabotaging behaviors and then replacing them with a more positive, conscious and proactive mode of operation that leads to greater happiness, wellness and success.”

Why is Change so Hard?

According to clinical psychologist Christina G. Hibbert, PsyD, change is difficult because most people don’t know how to change, or we’re just not ready. She believes there are six stages of change, which are part of the “transtheoretical model of change.” This model demonstrates that change isn’t linear but a spiral. She said:

Most people spiral up and down the six stages of change several times before they actually make change that lasts. That’s just part of the nature of change.

As I always say, “As long as you’re in the spiral, you’re making progress. It doesn’t matter whether you’re spiraling up or down, what counts is that you keep on working.” Teaching this to my clients helps them see they’re actually doing better than they think.

(Hibbert explains the model in this post.)

Sometimes change isn’t really what you want. Howes gave an example of a husband who thought he wanted his wife to change.

I’ve worked with couples who claimed to want changes from their partner, but when change happens they want the old familiar dynamic back. A husband wants his wife to be more social, for example, but when she branches out he feels jealous and wants the homebody back. I encourage couples to be clear about the change they ask for, and prepared for that change to occur.

We also gravitate toward the familiar, and fear the unfamiliar, said Marter, owner of the counseling practice Urban Balance. “Change can be scary because people fear the unknown, perceived loss of relationships or the risk of failure.”

Howes quoted the common saying: “The devil we know is better than the devil we don’t.”

Some people hyperfocus on external changes. “I’d say that so many of us struggle with external change because we secretly hope we can bypass the true work which is changing how we feel inside,” said Jeffrey Sumber, M.A., a psychotherapist, author and teacher. Put another way, “when we place too much concern in things looking different then we tend to overlook the deeper need to shift our internal climate.”

Change is tough because it also takes time. According to Serani, “It takes time to discover patterns that create undesirable thoughts and behaviors. It also takes time to understand what issues get in the way of achieving your goals once you know what you need to change.”

Naturally, resisting change is normal, Marter said. “Breaking through defense mechanisms and developing the tools to think and operate differently is a process with ups and downs.”

While change is difficult, it’s to be expected. “I think we need to recognize the inevitability of change. We are all changing in some way or another, every day,” said clinical psychologist John Duffy, Ph.D, author of the book The Available Parent: Radical Optimism for Raising Teens and Tweens.

How Therapists Facilitate Change

“I try to teach clients to be like a super-sleuthing detective. I want them not to just crave change, but to be immensely curious about it,” Serani said. In fact, she believes that “enthusiastic curiosity” helps us develop insight and replace old behaviors with new ones much faster.

Healthy change, she said, happens when we ask key questions, such as “Why isn’t this new technique working? What’s getting in the way? How can we make it work better?”

Hibbert, an expert in postpartum mental health, helps her clients learn how to change. “My job as a psychologist is to provide the ‘how’ so the client can get to work. I’ve seen many people make amazing changes, so I know it’s possible. You just have to believe it’s possible for you.”

Howes helps clients gain a clearer understanding of the trade-offs of change.

As pessimistic as it might sound, I try to help people know that change means trading in one set of problems for another. Sure, there may be some clear benefits to change, but there is always a different set of hardships to endure.

Just ask the people who win the lottery. Financial problems are solved, but a host of new problems emerge. If they’re informed and prepared for their new set of problems, change may be welcomed instead of dreaded.

Change is an inside job. Marter quoted Eckhart Tolle, author of The Power of Now, who said: “If we get the inside right, the outside will fall into place.” She explained:

Many people think if they have the perfect job, house, relationship, or body, they will finally be happy. Through therapy, I help clients make internal changes – such as detachment from ego, focus on essence, silencing the inner critic, practicing positive thinking and gratitude – that lead to positive change in life.

Marter teaches her clients to recognize that it’s “inner forces” that determine their lives, not external ones. This way “they feel empowerment to enact positive change in their lives, both personally and professionally.”

Plus, she teaches them to practice assertive communication, which includes “asking for what they need, setting healthy limits and boundaries and saying no to old patterns that are no longer serving them.”

Sumber also helps his clients transfer the focus from external change to internal transformation.

I work with clients to release their expectation of external manifestations and allow for a shift in their conscious awareness of who they are and why they are doing what they are doing. Most clients are surprised in the end to find that things have indeed shifted externally as a result.

Duffy helps clients foster self-awareness, which he views as a requisite “for satisfactory, proactive change. Otherwise, we are simply reacting to life, and often feel we are victim to it.”

Real change requires work and effort. As Serani said, “toxic tendencies or undesirable thoughts don’t happen overnight. They are created and cultivated over time. And the same goes for change. It doesn’t happen overnight either.”

Positive change is a process that ebbs and flows. But it’s worth it. Change is “an essential part of healing and development,” Marter said.

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Doing Self-Care the “Right” Way

By   for  Psych Central quoting UB’s Joyce Marter.

In our society self-care is largely misunderstood.

Its narrow and inaccurate perception explains why many of us — women in particular — feelguilty about attending to our needs. It explains why many of us stumble around drained and depleted.

However, self-care offers a slew of benefits. And it feels good to nourish our needs.

Below, experts dispel seven of the most common myths surrounding self-care.

1. Myth: Self-care is all or nothing.

Fact: Many people believe that self-care means spending an entire day of pampering or “it’s not worth it,” said Anna Guest-Jelley, a body empowerment educator, yoga teacher and founder of Curvy Yoga. However, while pampering is a great way to nurture yourself, it doesn’t define self-care.

“I believe that self-care is really found in the small moments of life – when you choose to take a deep breath because you notice you’re feeling stressed, or when you give yourself three minutes before bed to sit quietly and reflect on your day.”

2. Myth: Self-care requires resources that you don’t have.

Fact: Self-care is often viewed as a luxury that many of us have neither the time nor the money to enjoy. “Self-care does not need to involve an expensive spa or tropical vacation, nor does it need to take hours of your day,” according to Joyce Marter, LCPC, a therapist and owner of the counseling practice Urban Balance.

For instance, self-care can be “10 minutes of mindfulness meditation a day or doing some stretching or taking an Epsom salt bath,” she said. These simple practices “can go a long way in rebooting your mind and body.”

3. Myth: Self-care is optional.

Fact: Running yourself ragged can lead to unhealthy habits, because our needs can’t go unmet for too long. “If you choose not to create room for self-nurture or rest, it will elbow its way in, often in forms that feel less than self-caring in the moment,” according to Ashley Eder, LPC, a psychotherapist in Boulder, Colo. These forms include compulsive behaviors such as overeating and even symptoms of depression, she said.

If you find yourself turning to these kinds of habits, explore the needs you’re meeting with them. And “offer yourself that choice directly instead of through these backdoor behaviors.”

4. Myth: Self-care is unfeminine.

Fact: The media perpetuates messages that femininity is “other-focused and self-denying,” Eder said. We typically see female protagonists focusing on everyone else’s needs, listening to others instead of speaking and playing a supporting role, she said. Care-taking is portrayed as a woman’s job.

“This only makes sense in real life if you want the star of the play to be a man. It does not work for a woman to play a supporting role in her own show.”

If you notice that your needs are going unmet, “try asking yourself who the main character in your life is right now, and whether you would like to stick with that or change it.”

5. Myth: Self-care is anything that soothes you.

Fact: Many people turn to alcohol, TV marathons, smart phone games and food to soothe their stress and unwind, Marter said. But these habits are the opposite of self-care. “Self-care practices need to support health and wellness and should not be addictive, compulsive or harmful to your mind, body or bank account,” she said.

6. Myth: We have to earn the right to practice self-care.

Fact: “Our lives are organized culturally with an emphasis in the first third of our lives on education, the second around career and family development, and the last third for leisure,” said Sarah McKelvey, MA, NCC, a psychotherapist with a private practice in Centennial, Colo.

This creates the notion that we can only take good care of ourselves after we’ve accomplished certain goals. Yet it is self-care that gives us the energy and nourishment we need to achieve great things.

7. Myth: Practicing self-care means making a choice between yourself and others.

Fact: “When we are not taking care of ourselves, we end up in a cycle of deprivation in which the activities of our day deplete our energetic and emotional reserves,” McKelvey said. We become frustrated, cranky and needy, she said. We look to others to nourish our needs and replenish those reserves.

“Ironically, all of our efforts of sacrifice make us vulnerable to actually ‘being selfish.’” Yet, when we’re meeting our needs, we have more energy to give to others. “There is nothing greater to offer the world than your inspired and well-nourished self.”

Self-care is an important part of our lives. It is the basis for our well-being.

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Beating Stress: Advice from the pros

By Margarita Tartakovsky, M.S. for Psych Central quoting UB’s Joyce Marter.

None of us is immune to stress — not even the professionals who help others cope with theirs. In fact, sometimes it’s just as hard for clinicians. “I wish I were [an] expert at dealing with stress management. I find that I’m far better at guiding people to manage their stress than I am at taking my own advice, and managing my own,” said John Duffy, Ph.D, a clinical psychologist and author of the book The Available Parent: Radical Optimism for Raising Teens and Tweens.But that’s why it’s so important to have an assortment of tools and techniques at your disposal. This way, when stress strikes, you have an army of options to deal with it healthfully.

Below, Duffy and other clinicians reveal how they reduce and manage their stress.

Before you can deal with stress, you need to recognize that you’re actually stressed out, which isn’t always obvious. “In order for me to de-stress, I need to acknowledge my stress-state in the first place,” Duffy said. For warning signs, he zeroes in on his body. “I have certain tells, like tapping my feet or slipping into a headache.”

Duffy de-stresses by writing, exercising and being with loved ones.

I write to de-stress, and this is highly effective for me. I get lost in that creative process, especially if I can get into the flow of it, and stress is a non-factor.

I can say the same for exercise. When I am running or working out, it is incongruous with stress for me.

Perhaps the best day-to-day stress manager in my life is spending time with my family and friends. And I know that if I’m laughing, I’m good.


Deborah Serani
, Psy.D, a clinical psychologist and author of the book, Living with Depression, focuses on soothing her senses, and sneaks in moments of self-care, even on the busiest of days.

I have so many things I do when I’m stressed out. I’m a very sense-oriented person, so my de-stressing toolkit involves cooking, gardening, painting, meditation, yoga, catnapping, taking a walk, listening to music, lingering in the fresh air of an open window, a lavender-scented bath or nursing a cup of chamomile tea.

I have to say that I truly make “time for me” a significant priority, even if it means sitting in my car for just a few minutes during a busy day with the sunroof open, my seat tilted back just right, the radio playing soft jazz while I sip a warm latte. Just don’t bother me should you spot me in the Starbucks parking lot, okay?

Jeffrey Sumber, M.A., a psychotherapist, author and teacher, takes a meditative – and humorous — approach to stress.

When I’m stressed out I like to cook really healthy food. I like to spend time at Whole Foods getting super clean ingredients and then I like to chop vegetables, make sauces, etc., until I have a great tasting, healthy dish to enjoy.

The process is meditative and ideal for me on practical levels as well! Then I take a picture of the dish and post it to Facebook so my friends are jealous.

I also like to take the dog for a long walk so I can sort of zone out while he enjoys his exercise.

Ryan Howes, Ph.D, a clinical psychologist and author of the blog “In Therapy,” approaches stress like he does therapy.

My best protection from stress is the therapy frame: the boundaries of time, place, and role that give structure to therapy. For example, I do my best to begin and end sessions on time so I have 10 minutes each hour to write a note, return a phone call, eat a snack, and strum on the guitar I’ve had sitting by my desk for the past decade. Those 10 minutes are my time to recharge, refresh, and prepare for the next session.

I’m not rigid about this. Sometimes a session needs to run a few minutes long, but I try to hold tight to that boundary because I know it benefits me and my clients in the long run.

I also try to leave work at work by completing my notes, phone calls, and business busywork at the office.

Howes also has a variety of outlets that help him deal with stress. Seeing his own therapist is a major one.

When I’m away from work, I have my family, friends, basketball league, running, writing, and my endless quest to create the perfect tomato sauce. I’ve tried 200 recipes and I’m not there yet.

I’m also in therapy and will continue therapy as long as I’m seeing clients. I ask other therapists to do the same, or at least seek regular consultation or supervision. I believe outlets like this and feedback on your work is essential.

For Christina G. Hibbert, Psy.D, a clinical psychologist and expert in postpartum mental health, daily habits are vital in staving off stress, and coping with it.

As a psychologist and mom of 6, I must admit I feel stressed more often than I’d like. The good news is that, over the years, I’ve learned to see stress coming and tackle it before it gets out of hand.

As a wise person once said, “…calm is something you must go after, whereas stress comes after you” (Judith Orloff, MD). Stress certainly comes after me, so I seek the “calm” in the following ways.

My daily habits help the most, to both prevent and manage stress. These include: morning exercise, scripture study, meditation, and prayer; putting foods in my body that give me energy; and getting to bed in time to get a good night’s sleep (when my kids will let me!).

I also take a daily “rest” before my kids get home from school (or if they’re home, I make them rest too), so I can lay down, take a nap, read, or just unwind for a bit.

For stressed out muscles, I get a deep tissue massage at least once a month, and I’m a big fan of a hot bath on a cold day.

Hibbert turns to cognitive-behavioral techniques to cope with distorted thinking, which only exacerbates stress.

When stress levels rise, I use cognitive-behavioral techniques to manage my thinking—one of the best tools I’ve ever learned for stress management (check out my article on “Thought Management”). This helps me see what my mind is saying and gives me the opportunity to turn it into something more realistic.

She also uses stress as important information to scale back on commitments and focus more on savoring life.

I tend to be “all-or-nothing,” so I also examine my commitments and start saying “no” a little bit more. Mostly I take stress as a sign that I am doing too much. It’s a great warning signal that I need to go back to the basics again—to slow down, let love in, let go of “doing” so much and just “be” for a while.

When stress gets so overwhelming, it’s paralyzing. Joyce Marter, LCPC, a therapist and owner of the counseling practiceUrban Balance, uses a tip from Alcoholics Anonymous (AA).

I know that in AA, they talk about “doing the next right thing.” When I get stressed out, I sometimes become almost paralyzed with feelings of overwhelm. I find that doing anything proactive, even something simple like straightening up my space, will make me feel better. Once I gain momentum, I tackle the things that need to be addressed to alleviate the stress.

Like the other clinicians, Marter also has a collection of tools, which includes cranking up self-care, calming uneasy thoughts and putting stress into perspective.

I increase self-care, such as exercise, proper nutrition and rest.

I practice mindfulness techniques, such as deep breathing and meditation, to ground me in the present. This helps me to stop obsessing about the past or worrying about the future, and to realize that basically everything is okay in the present moment.

I silence my inner critic and replacing that voice with a positive mantra, such as “I am only human and am doing the best that I can.”

I take everything off my plate that isn’t imperative and delegate what I can.

I share with my core support system and ask them for help.

I try to remember that stress ebbs and flows and “this too shall pass.”

I try to “zoom out” and gain perspective. If it isn’t a matter of life and death, I try not to be too serious and remember to see the humorous aspects that exist in most situations.

I try to detach from ego and focus on my essence — meaning rather than defending my sense of self (which can be very stressful), I try to let go and live life from a deeper, wiser, spiritual entity within.

Stress is inevitable. And when it strikes, it can feel like you’re being attacked from all sides. That’s why having healthy tools to turn to is critical. Maybe the above techniques resonate with you. Or maybe they help you brainstorm your own set of de-stressing activities. Either way, having a plan to prevent and handle stress can be the difference between falling from a cliff and tripping over a pebble in your path.

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Ending Therapy the Right Way

By Margarita Tartakovsky, M.S. for Psych Central quoting UB’s Joyce Marter.

There are many reasons clients decide to end therapy. According to clinical psychologist Deborah Serani, Psy.D, “Sometimes they’ve reached their goals. Sometimes they need a break. Sometimes the connection with their therapist isn’t there.” Sometimes they notice ared flag. Sometimes they’re about to face a new fear or realize a new insight, said Ryan Howes, Ph.D, a clinical psychologist and author of the blog “In Therapy.”

“Whatever the reason, it’s vital to bring it into your sessions as soon as you feel it,” said Serani, author of the book Living With Depression. Howes agreed. Wanting to end therapy is a critical topic to explore, he said. And it could be as simple as telling your therapist, “I feel like it’s time to end therapy, I wonder what that’s all about?”

Therapy gives people the opportunity to have a positive ending, unlike most endings, which tend to be negative, such as death and divorce, Howes said. An end in therapy can be “more like a bittersweet graduation than a sad, abrupt, or complicated loss. Ideally, you can have a satisfying closure to therapy that will help you end relationships well in the future.”

That’s because our relationship with our therapist frequently mirrors our relationships outside their office. “We often unconsciously recreate dynamics from other relationships with our therapist,” said Joyce Marter, LCPC, a therapist and owner of the counseling practice Urban Balance. “Processing negative feelings can be a way to work through maladaptive patterns and make the therapeutic relationship a corrective experience. If you avoid this conversation by simply discontinuing therapy, you will miss this opportunity for a deeper level of healing resulting from your therapy.”

Tips on Ending Therapy

Below, clinicians share additional thoughts on the best ways to approach your therapist when you’d like to end therapy.

1. Figure out why you’d like to leave. According to Jeffrey Sumber, M.A., a psychotherapist, author and teacher, the best way to end therapy is to delve into why you’d like to leave. Ask yourself: Is it “because I feel disrespected, stuck or incompatible or [am I] actually feeling uncomfortable dealing with certain things that the counselor is pushing me on?” It’s common and part of the process of changing problematic patterns, he said, to feel triggered and even angry with your therapist.

2. Don’t stop therapy abruptly. Again, it’s important for clients to talk with their therapists, because they may realize that their desire to part ways is premature. Even if you decide to leave therapy, processing this is helpful. “A session or two to discuss how you feel and what kinds of post-treatment experiences you may go through will help ease guilt, regret or sadness that often arises when wanting to stop therapy,” Serani said.

Plus, “Honoring the relationship and the work you have done together with some sessions to achieve closure in a positive way can be a very powerful experience,” Marter said.

But there are exceptions. Howes suggested leaving abruptly if there are ethical violations. He reminded readers that you’re “the boss” in therapy:

If there have been significant ethical violations in therapy – sexual advances, breached confidentiality, boundary violations, etc. – it may be best to leave and seek treatment elsewhere. It’s important for clients to know they are the boss; it’s your time and your dime, and you can leave whenever you want. If the violations are serious enough, you may want to tell your therapist’s boss, your next therapist, or the licensing board about them.

3. Talk in person. Avoid ending therapy with a text, email or voicemail, Marter said. “Speaking directly is an opportunity to practice assertive communication and perhaps also conflict resolution, making it is an opportunity for learning and growth.”

4. Be honest. “If you feel comfortable and emotionally safe doing so, it is best to be direct and honest with your therapist about how you are feeling about him or her, the therapeutic relationship or the counseling process,” Marter said.

When offering feedback to your therapist, do so “without bitterness or judgment,” said John Duffy, Ph.D, a clinical psychologist and author of the book The Available Parent: Radical Optimism for Raising Teens and Tweens. “After all, this person will be working with others in the future, and your thoughts may change his or her style, and help them to better serve their clients in the future.”

“A good therapist will be open to feedback and will use it to continually improve,” added Christina G. Hibbert, Psy.D, a clinical psychologist and expert in postpartum mental health.

5. Communicate clearly. “Your best bet is to be as direct, open, and clear as possible,” Hibbert said. Articulate your exact reasons for wanting to end therapy. Hibbert gave the following examples: “’I didn’t agree with what you said last session and it makes me feel like this isn’t going to work,’ or ‘I’ve tried several sessions, but I just don’t feel like we’re a good match.’”

(“’Not being a “good match’ is a perfectly good reason to terminate therapy, since so much of it has to do with a good personality fit and a trusting relationship,” she added.)

6. Be ready for your therapist to disagree. According to Serani, “It is not unusual for a therapist to agree with ending therapy, especially if you’ve reached your goals and are doing well.” But they also might disagree with you, she said. Still, remember that this is “your therapy.” “Don’t agree to continue if you truly want to stop, or feel persuaded to keep coming for sessions because your therapist pressures you to stay.”

7. Plan for the end in the beginning. “Every therapy ends, there’s no reason to deny this fact,” Howes said. He suggested discussing termination at the start of treatment. “Early in therapy when you’re covering your treatment goals, why not talk about how and when you’d like therapy to end? Will you stop when you’ve achieved all your goals? When the insurance runs out? When and if you get bored in therapy?”

Again, therapy can teach you valuable skills to use for your other relationships. According to Marter, “Even if after expressing your negative feelings, you choose to end the therapeutic relationship, you can rest assured that you took good care of yourself by advocating for yourself in a way that was direct and honest. This is a skill you can bring with you to other relationships that are no longer working for you.”

How Therapists React to Termination

So how do clinicians take it when clients end therapy? All the therapists noted that having their clients share feedback on their experiences is incredibly valuable. In short, it helps them improve and grow as clinicians.

But, when there’s no official end to therapy, therapists are left with many unanswered questions. According to Howes:

When a client terminates via voicemail, fades away with a vague “I’ll call you for my next session,” or abruptly announces the end and leaves, I feel loss and am left with many questions.

What fell short in this therapy? What would have worked better? How could I have been a better therapist for you? What made you feel like you couldn’t discuss this with me? I’m left with no answers for these questions, and that’s difficult. I spend a lot of time reflecting on our work together, but I have no definite answers.

Serani and Marter echoed this sentiment. “Sometimes clients just ‘fizzle out’ without explanation, which has been one of the harder pieces of being a therapist for me because I am very invested in my work with my clients. It causes me to wonder if I did something that bothered them and wished that I knew,” Marter said.

Serani also talked about attempting to understand the client’s decision. “I always want to explore the reasons why. Was it something I said? Was it something I didn’t say? What has happened to make this decision so urgent? I often feel confused, and work hard to make sense of why this has happened.”

Hibbert tries not to take it personally. “Usually clients simply ‘stop coming,’ so it’s not easy to know if they’re just ‘done’ with therapy or if I’ve done something to make them want to leave. When this is the case, I just let it go. It’s their issue, not mine, and I don’t need to stress over it when I don’t know the reasons behind it.”

She takes a similar approach when a client wants to stop therapy because of personality differences. “Only a couple of times has a client verbalized a desire to leave because of ‘personality’ or ‘style’ differences. I can’t say it never stings, but I try not to take it personally. Like I said before, therapy, in large part, is a personality fit, and I can’t fit with every personality.”

When client and clinician are able to have a session (or two) for proper closure, it becomes a great opportunity to reflect on their work together. In fact, for Howes, these are often his most enjoyable sessions.

My goal is to help a client confront life head-on. If they have clear reasons to end therapy and we’ve had the time to talk about it and tie up the loose ends, ending therapy is a great time to reflect on our work, talk about the client’s future, and discuss what has been accomplished and what hasn’t. We can leave with a sense of closure, without lingering questions.

Some of my best sessions have been final appointments where we reminisce about our time together, talk about the client’s future, and I learn how to be a better clinician for others.

Serani described final sessions with mixed emotions. “This is usually an exciting but bittersweet time, where we both feel a loss about the goodbye, but know that leaving is part of the healing process. I’m always sad for me, but happy for my patient.”

Unless there are ethical violations, it’s important to discuss your desire to end therapy with your therapist, in person. As Duffy said, doing so with “respect and integrity will set the tone for other relationship issues you will encounter in life.” It also helps you process your emotions and figure out if you’re leaving too soon. And it gives your therapist valuable feedback that improves their work. In other words, with proper closure, everybody wins.

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Reenergize Your Work, Filling the Downtime Productively

By CareerBliss quoting UB’s Joyce Marter.

Boredom kills — well, not literally. Succumbing to it at work, however, can totally kill your motivation, causing you to (oh horror of horrors) disengage and become all around unhappy. Next thing you know, you’re the guy in the coffee line no one wants to stand behind because you just ooze negativity.

You might be overqualified, underappreciated or, heck, working at a job that’s just too easy for you. Whatever the reason — if boredom has you yawning at work, grab some sort of beverage that will give you a jumpstart (we’re thinking caffeinated, not alcoholic) and beat your boredom once and for all. Don’t sit like a potato!

First thing on the list: your vocab. From here on out, there is no such thing as “downtime,” only “opportunity time,” says Robby Slaughter, productivity and workflow expert and principal at Slaughter Development. Opportunities are meant to be seized!

Check out these awesome boredom busters the next time you find yourself clockwatching, and seize your opportunity!

1. Tell it to your Blog

Start an industry blog—one that shares fascinating, nail-biting insights, commentary and news updates about your job. Even if you don’t grow a huge Bieber-style blog fan base, it’ll help you learn more from others in your industry. To get started, comb through blog directories like BlogHub.com to find fellow bloggers. Google, of course, is your best friend for this.2. Invest a Little Bonding Time with a Coworker

Nothing beats boredom like a stimulating conversation. “With all the virtual communication we have these days with technology, a personal check-in is much appreciated as long as you are not keeping your colleagues from doing their work,” says Joyce Marter, psychotherapist and owner of Urban Balance.

3. Re-energize with Some Midday Meditation or Yoga

Ommmmmm. Even if your company doesn’t offer a fancy gym, you don’t need much equipment to practice a few Yoga poses. Find a quiet spot outside because A few minutes of self-care can clear out the cobwebs and make you more productive at work,” Marter says. Squeeze some time in for exercise on slow days and get away from the hullabaloo.

4. Expand your Virtual Network

Take this opportunity to make some new virtual contacts outside of your office. Cue LinkedIn, your second best friend. Write a killer, personalized LinkedIn message and reach out to experts in your industry. Join a professional group or two and check out their discussions. LinkedIn even offers a “Groups You May Like” feature (hover over the “groups” tab to find it).5. Prep for your Performance Review

If someone were to ask you what your three greatest accomplishments are so far this year, could you answer them? Stay ahead of the curve and keep track of your achievements. This will save you a truckload of time when performance review time comes around. Here’s your handy-dandy to-do list to get you started:

  • Gather all emails and reports that include recognition and positive feedback.
  • Handpick your top achievements over the past year.
  • Keep track of past mistakes or projects where you could have done better.
  • Research your salary and see what others in your position are making.

6. Do Something for Someone Else

You will feel good and look good! “Even volunteering to organize a file room or shared workspace is something that would probably be appreciated and show that you are a team player and invested in your workplace,” Marter says.

7. Brainstorm

Grab your umbrella and create a brain storm — make it rain with your brilliant ideas! “Ultimately, anytime we are not actively working on mission-critical activity we should be doing something to enable us to be better at mission-critical work in the future,” Slaughter says.

Go above and beyond by brainstorming ways to make your job more effective and anything else you can do to help the company’s bottom line.