Given recent violent events, the tenor of political discourse and the deep divide within our country, I've been searching for a way to better understand what is going on and how to move forward personally and professionally.
I recently came across an article called "Can We Have Compassion for the Angry?" by Laura L. Hayes, Ph.D on Slate.com from 2016.
I love how she differentiates amongst people who are struggling with mental health issues and people with anger issues. I also think it is important to highlight the link between unregulated anger and rage, and the connection to violence.
I've had my share of rageful "conversations" on Facebook, and I find it incredibly helpful to remember that the true issue in play is anger. Unregulated anger and rage is a major issue in our society and one, I believe, few people consider as an significant issue.
According to Dr. Hayes:
"An adult who is able to effectively regulate anger uses it to alert himself to a problem situation. Managed well, it is an extraordinarily effective warning system. Unregulated, impulses are stronger, and thinking is less clear. The poorly regulated adult with enhanced reactivity, impulsivity, and a constant state of fight or flight sees in every interaction the potential for being harmed and the necessity to defend himself. The angrier he feels, the less clearly he will think. His reactions will often be out of proportion to the situation, and he will be prone to violence. Because he sees the world as a constant source of danger, he externalizes blame, to his spouse, children, neighbors, government, and 'others' in race, nationality, religion, or culture. Angry, blaming, aggressive, and unable to modulate his emotions, he can become a danger to others."
"Violent crimes are committed by people who lack the ability to regulate and modulate their response to perceived danger. This is not a hypothesis; it is a fact. The individual who lacks the essential skill of using more sophisticated reasoning, perspective-taking, and emotional stabilization to regulate his more primitive fear and aggressive impulses will fall into the pattern of aggressive overreaction again and again, often with escalating levels of violence.
In the end, it is helpful for me to remember that these reflections are just thoughts and feelings we have about ourselves, others and the world. Our brain, self-empowerment and discipline are much stronger, more resilient and adaptable to change, and more powerful than our automatic thoughts and emotional reactions. We are able to change our responses to these provocations.
Dr. Hayes recommends mindfulness as a tool to self-soothe:
The process of mindfulness is often described as nonjudgmentally bringing awareness to the present moment. One can be mindful about an infinite number of things, so there are many ways to approach it. Often instruction begins with exercises of breath and/or attention to what is happening in the present moment in the mind and body.
For me personally, the next time I see Facebook's algorithm throw me a contentious political or religious dead-end dialogue doomed to fail, I'm going to conduct a quick breathing exercise and throw the below meme onto the discussion:
#anger #rage #issues #mindfulness #thinking #thoughts #reframe #deflection
Below I've included text from the article, "Why Cognitive Behavioral Therapy Is the Current Gold Standard in Psychotherapy."
This link is a recent research opinion article within the field of cognitive behavioral therapy and, to me, has a lot of diverse considerations and implications.
I think the article highlights the importance of considering differences amongst providers -- certification, adherence to fidelity within treatment, resilience and more. But, even more important, I read this research as acknowledging where we are as a field. By accepting CBT's scientific basis, years of research and structured modality, I do not see it as diminishing or "throwing shade" at other modalities.
There are a lot of skilled practitioners with diverse modalities within the psychotherapy field and most do important, passionate work. I think this truth will remains irregardless of background -- CBT, analytic, ISTDP, etc. -- or conceptualization of the human condition. Instead, I read this article as a consolidation of numerous scientific efforts within the field of psychology. CBT is not a panacea, but it's a good marker in our evolution in what we know works in therapy.
As practitioners, let us continue to join together to improve our services for our clients, and remember that difference is NOT deviant.
A few key highlights I found interesting:
Cognitive behavioral therapy:
"(1) ... is the most researched form of psychotherapy. (2) No other form of psychotherapy has been shown to be systematically superior to CBT; if there are systematic differences between psychotherapies, they typically favor CBT. (3) Moreover, the CBT theoretical models/mechanisms of change have been the most researched and are in line with the current mainstream paradigms of human mind and behavior (e.g., information processing)."
"...there is clearly room for further improvement, both in terms of CBT’s efficacy/effectiveness and its underlying theories/mechanisms of change."
"...although CBT is efficacious/effective, there is still room for improvement, as in many situations there are patients who do not respond to CBT and/or relapse. While many non-CBT psychotherapies have changed little in practice since their creation, CBT is an evolving psychotherapy based on research (i.e., a progressive research program). Therefore, we predict that continuous improvements in psychotherapy will derive from CBT, gradually moving the field toward an integrative scientific psychotherapy."
David D, Cristea I and Hofmann SG (2018) Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Front. Psychiatry 9:4. doi: 10.3389/fpsyt.2018.00004
#cognitivebehavioraltherapy #cbt #psychotherapy #research #goldstandard
For me, the end of the year is a time of reflection, appreciation and gratitude. It's when I carve out time to be proud of myself and my accomplishments of the year. It's when family rejoins, and tradition and ritual come to a focus. During this process of reflection, I find it natural to reflect on areas for growth, development and change.
However, over the years as I've progressed through my experience as a certified Cognitive Behavioral Therapy, CBT therapist in West LA, I've noticed difficulty in executing some of the New Year's goals I set for myself. I know I am not alone in this. Much has been written about the importance of setting SMART (Specific, Measurable, Attainable, Relevant and Time-bound) goals. In thinking about my past goals and in remembering discussions with friends and family, identifying goals is rarely the main barrier.
Too often I think our year-end reflections get filtered through a negative filter. Instead of dwelling on my accomplishments and successes, I tend to set goals that tap into my perceived inadequacies and dissatisfactions over the past year. Sadly, the outcome of this type of filtration is that I leave myself with a sense that I am, and/or my life, just isn't good enough.
Goals of this nature can become a checklist of tasks I "need" to or "must" do, and become a basis for my own feelings of inadequacy, lack of confidence and esteem, and tend to gain momentum throughout the year. Conducted through this lens, in the generation of goals, I struggle to finalize a thorough list of SMART goals and commit to executing them.
If you are someone who is able to carve out SMART goals for yourself, hold yourself accountable throughout the year and move forward in creating your ideal self and environment without distress, BRAVO! Keep up the excellent work!
However, if you find yourself struggling to set SMART goals or executing change within your life, I have a proposal for you.
In a prior post, I recommended:
We all drift from our good-enough selves. Being adaptable, resilient and committing time to reconnecting with our passions, purpose and cultivating a process to do so is most important.
Similar to the above quote, it is important to remember that we all drift from our true intentions and goals -- each and every one of us. Therefore, it is not helpful to berate ourselves for this sort of drift.
It has been much more helpful to think about the times in my life when I have lived according to my desired goals -- going to the gym on a regular basis, cultivating meaningful relationships, treating loved ones in a loving, compassionate manner -- and reflecting on how I was feeling at those times, what I was thinking in those moments and factors that led to drifting away from those ideal behaviors.
Typically, I find that when I cultivate such compassion for myself, I'm in a much better position to share compassion and nurturance with the world and others.
If you are interested in working on your goals in 2018 and think a therapist might be helpful in keeping you on track, please contact my West Los Angeles psychotherapy practice today for a consultation.
#goals #newyear #change #psychology #inspire #reflection
I believe being in an intimate, connected and committed relationship is one of the most difficult things to do on the planet. Divorce rates in California have been estimated to be as high as 60%.
In my Master's in Social Work coursework at University of Southern California, one of my favorite courses was Couples Therapy -- the interplay of seen and unseen dynamics, complexity of internal and external factors on the relationship, historical intimate relationships playing out in the present. Relationships are as fascinating as they are challenging.
One of the biggest challenges in my own marriage has been cultivating a shared story that carves a path of true North. Esther Perel's Where Shall We Begin has been incredibly helpful in seeing my marriage, and all of my intimate relationships, differently.
I think her ability to highlight the shared stories of humanity and relationship are so calming and reassuring, they bring us to a place of sameness, safety and support. From NPR, quote is specific to her new book on infidelity:
When you pick a partner, you pick a story, and that story becomes the life you live. ... And sometimes you realize, after years of living those parts of you, that there are other parts of you that have virtually disappeared. The woman disappeared behind the mother. The man disappeared behind the caregiver. The sensual person disappeared behind the responsible person.
I highly recommend listening to Perel's podcast as a portal to seeing you and your relationship differently. As an entry into the podcasts, as a self-defined heterosexual, hypermasculine male, I found Season One, Episode Five and Season One, Episode Seven to be most relevant.
Learn more about my Cognitive Behavioral Therapy psychotherapy practice.
#couples #therapy #masculinity #relationships #intimacy #love #support #psychotherapy #psychotherapist
I love thinking the majority of my thoughts are worthless without action. That I am an observer of, not subjected to, the electrical storm within my mind. A growing gale nurtured through my focus and attention.
I love thinking I can choose to engage and ignore my thoughts -- to give life to my deepest passion and exile my darkest anxiety. These are things I focus on within my West Los Angeles psychotherapy practice.
"...5% of our thoughts are actually meaningful and relevant..."
What an empowering reminder.
Here are a few of my favorite quotes from the Forbes article "A Better Way to Deal With The Negative Thoughts In My Head."
Shannon Kolakowski, PsyD notes:
“Defusion is the process of noticing your negative or anxious thoughts, such as ‘I'm going to be alone forever,’ and then responding to it with openness and curiosity as a distant observer,” says Kolakowski. “Rather than accept your thought as the ultimate truth, you recognize that thoughts will come and go, but you don't have to believe them or act on them. You become an observer, saying to yourself ‘I'm having the thought that I'm going to be alone forever,’ and then try to explore that thought with curiosity."
“Creating a new relationship with your thoughts is freeing,” says Kolakowski. “You may not be able to control what thoughts pop up, but you can control how you respond to them. And you can control what action you take."
Ajahn Amaro notes:
“We tend to think that our thoughts are oppressive,” says Amaro, “and that therefore we should make them go away…Oftentimes meditation instruction is about stopping your thinking, as if thoughts are a kind of brain disease, an infection, an intruder. But the very act of pushing them away, and adopting the sense that they’re intrinsically intrusive, actually makes them more powerful. Rather than relating to them in that way, there’s another attitude we can have toward them—not taking them personally.”
He adds that the vast majority of our thoughts are, at best, random, and at worst, destructive. “One of the first things I emphasize when teaching,” he says, “is that 5% of our thoughts are actually meaningful and relevant, and 95% are replaying movies, music, and recollecting. It’s mostly just debris. I often encourage people to look at it like listening to neighbor’s radio–you understand the content, you can hear the words; you might sometimes get excited about an ad, or a talk show. But you don’t really care on a personal level. You relate to your neighbor’s radio in a non-personal way—we can have the same relationship to activity of the mind. It doesn’t have to make a big story around the thoughts. It’s an attitudinal shift.”
#thoughts #thinking #shift #mindfulness #meditation #anxiety #givelife
It took me a long time before I realized the depths of my anxiety. For much of my life, I self-managed my discomfort by doing -- sports, hobbies, education, friends, family, writing and more. My checklist of "to-do's" helped regulate an early experience of feeling out-of-control, and gave me a sense of empowerment over my life.
It has taken me even longer to breakout my nuanced thoughts and feelings encompassing my anxiety. I am still learning, and still reminding myself of the importance of psychotherapy. Psychotherapy can be an important space of safety for exploration, understanding and compassion, and in rekindling my awareness and intention.
With clients, I sometimes share a lighthearted prompt: "I'm not only the hair club president... (I'm also a client)." It's meant to be a reminder that mental health and psychotherapy is not only about knowing but remembering.
We all drift from our good-enough selves. Being adaptable, resilient and committing time to reconnecting with our passions, purpose and cultivating a process to do so is most important.
We (men) struggle to do this, and this is one of the reasons why I love working in the field of Men's Mental Health in West LA.
It is hard enough for men to care for their physical vulnerabilities, let alone exposing our emotional selves. From a young age, boys are encouraged to "suck it up" and "walk it off." Messages of repressing pain and discomfort still permeate our culture.
Unfortunately, there is a consequence to this. Learn more about the challenges of men seeking support:
Studies show that men who equate seeking assistance with weakness, or the appearance of not being able to handle their own problems, experience more soured relationships with their significant others, higher rates of debilitating illnesses, and earlier death.
Let us remember to take good care of ourselves and one another. If you have any questions, please do not hesitate to reach out. I am happy to share my perspectives.
#men #masculinity #love #caring #anxiety #psychotherapy #thoughts #feelings #empowerment #reachingout #trust
I was talking with someone today about how difficult our lives can be. Our conversation intensified as we entered the specifics -- working, families, politics, exercise, hobby, income, retirement, safety.
As we hit a high point in the conversational anxiety, a small Finch plops down on the chair in front of us, stares into our eyes, flicks his wings and barks at us before flying off.
In that moment, he understood so clearly what we needed.
Here's one of my favorite #breathing exercises I use to reconnect with myself in times of #distress:
According to the people I learned this from, if you wish to gain energy, take longer inhales and shorter inhales. For less energy, breathe shorter inhales and longer exhales.
#grounding #love #earth #stillness #letgo #peace #breathe
-- Enjoy your day
I've spent a large part of my life living within core beliefs of not good enough, inadequacy and incompetence.
Out of an almost obsessional pursuit to disprove these internal fallacies, I have been driven to do more, hold myself to "higher" standards and take full responsibility for many neutral-negative encounters I have. As I reflect on a lifetime spent in this default mode, I recognize it's had a significant impact on my contentment, confidence and self-compassion.
In my personal life, I've had moments of desperately seeking validation from the external world, which rarely comes. It's taken a long time to build reserves from within, find peace with uncertainty and be confident within my voice.
I know these thoughts and beliefs have distanced me from others -- "less people around me, the less 'burdens' to take on" -- and framed many encounters as a way to get my needs met rather than just sharing space and connection.
I LOVE this piece. It's short but addresses these traits in direct way and acknowledges the impact of highly competent traits in the workforce and in our personal relationships.
“If someone (in the workforce) is doing more than his fair share, compensate him for it. If not, he may ultimately leave and seek recognition elsewhere. Similarly, in our personal relationships, we should recognize that just because our high-ability partners can do something for us, doesn’t mean that we should let them. And if they do help us, we should recognize it and thank them for it. Otherwise, they too may end up feeling burdened by us, and less satisfied—and that should be the last thing we want to do to a good employee or a good partner.”
#competence #work #relationships #burden #incompetence #inadequacy #therapy #therapist #beliefs #ocpd #perfectionism
I'm excited to share my brand new private practice brochure! I just spent a few solid hours working with the amazing staff at FedEx to finish.
Fun cultural fact: If you Google, "to see if working together would be a good fit" with quotations, 90% of websites listed are from therapists. Apparently, we're the only ones who use that phrase.
Learn more about my certified Cognitive Behavioral Therapy West Los Angeles psychotherapy practice.
#therapy #therapist #westla #westlosangeles #90025 #cbt
Emotions are part of our daily lives. The breadth of feelings within the human condition are what makes life interesting, exciting and dynamic. Our experiences influence our moods, and our thinking plays a big part in how we feel.
Unfortunately, life is not always positive. For many of us, it is only a matter of time before we are confronted with relational, social, career-related and familial changes. These adaptations are normal, but create certain emotional states. Depending on our prior experiences and beliefs about ourselves, the world and others, our biased reactions may become distressing. This stress becomes problematic when it does not improve, increases in consistency, and impacts our social, occupational and other important areas of our lives.
Major Depressive Disorder affects over 16 million people in the United States. Typical reactions include issues with sleep, appetite, weight changes, loss of energy, interest in daily activities and pleasure, decreased focus or concentration, thoughts of suicide and more. If you find yourself stuck in a cycle of depression, self-help techniques may not be enough. It can be difficult to find appropriate social supports and tools to reframe many of our negative thoughts.
If you find yourself struggling with your symptoms, I recommend finding a certified Cognitive Behavioral Therapist in your area.
According to the Beck Institute, “Cognitive Behavioral Therapy (CBT) is a time-sensitive, structured, present-oriented psychotherapy directed toward solving current problems and teaching clients skills to modify dysfunctional thinking and behavior.” For mild and moderate depression, CBT has been shown to be as effective as psychotropic medication.
Depressed mood is part of our lives, but suffering doesn’t have to be.
Here are 3 ways you can try to improve your mood:
1. Increase your awareness of your thoughts, feelings, behaviors and situations when negativity seems strongest.
I know it’s overly simplistic, but just because you think something doesn’t make it true.
In our culture, we confuse thoughts and feelings, and are likely to believe our thoughts are biologically ingrained and incapable of change. CBT labels these reflexive thoughts as “automatic thoughts.”
To combat the distress created by automatic thoughts, beginning a process of observing our thinking and feelings in a non-judgmental manner and paying attention to situations when we are more sensitive to negative emotions is imperative. This practice deepens our awareness of our thoughts, connects them with specific situations, triggers and themes, and can improve our confidence in managing our own internal pain.
2. Deepen your commitment to yourself and people who make you feel good.
When it comes to depression, the best cures are action and increasing social supports.
But this is the insidious nature of depression. When we do not have the energy, interest, sleep or concentration to engage and connect with activities or supportive loved ones, we don’t do it. If we continue not to do something, we feel worse and become more likely to avoid the task. This sort of self-defeating emotional reasoning — “I feel, therefore I am/think…” — can be a significant impediment in moving forward in our lives.
Empowering ourselves by committing to a goal of activity and supportive connection is a disciplined way of exercising self-care and self-compassion. Both of these concepts are vital in combating depressive episodes.
3. Practice daily self-care and self-compassion.
I know it sounds simplistic and contrived, but you have to regularly take care of your physical and mental health. But don’t worry, it’s a lot easier than you think.
Self-care might include exercise, spending time with supportive others, in nature and by yourself, psychotherapy, nutrition, personal training, massage, intentional nothingness (e.g. being intentional in doing nothing), coping cards, reading and many more activities.
Self-compassion might include treating yourself with love and kindness, decreasing self-blame and self-loathing, increasing emotional tools and coping mechanisms, and more.
Rather than thinking of your depressed mood as being representative of you, try thinking of it as a cue or reminder that it’s time for some self-care and self-compassion.
And with that, I’m off to spend some time with my family outdoors. Here’s hoping you find something to rejuvenate, recharge and refresh yourself today.
Nick Holt, LCSW is a certified Cognitive Behavioral Therapy, CBT therapist in West Los Angeles, California. As an BBB Accredited Business, he runs an intentionally small, part-time private practice for clients looking for targeted mental health treatment and support on weekends and evenings. His specialties include treatment for depression, anxiety, trauma, grief and loss for survivors of suicide, and support for suicidal ideation.
Mental Health and Therapy Writer. As featured on Huffington Post, Vox Media and elsewhere.