Picture a therapist seated behind a couch. A client staring at the ceiling, talking about childhood while someone nods and takes notes. Years of it, with no clear endpoint. That image sticks in our collective imagination when it comes to psychotherapy. But I haven’t experienced that as a therapy client in my life, and I certainly didn’t enter the field to provide this form of therapy.

Cognitive Behavioral Therapy is close to the opposite of that picture. And the gap between what most men imagine and what CBT actually is might be the only thing standing between them and getting some help.​

It Has a Point

CBT is structured. We’re not wandering. While we may discuss your history and childhood may be a topic, the goal is to mutually agree on what’s actually driving the problem — the patterns of thinking and behavior that are running underneath whatever brought you in — and then work on it collaboratively and directly. You’ll usually know what we’re doing and why. That structure isn’t rigid, but it means your time isn’t being spent circling.

You’re Not a Patient Being Analyzed

CBT is collaborative. You’re not lying back while someone interprets you. You’re working alongside me on a problem, and your intelligence, practice and empowerment is an asset in that work — not something we have to get past. For men who are used to solving things, this tends to land better than open-ended exploration. It respects how you already operate.

The Premise Is Simple

Here’s the core idea: how you think shapes how you feel and what you do. Most of the time we’re not aware of the thinking — it runs automatically, built up over years, and we experience its output as just “how things are.” CBT slows that down. We look at the automatic thoughts and beliefs that are steering the ship, test whether they’re actually true, and adjust the ones that aren’t serving you. When the thinking shifts, the feeling and the behavior tend to follow. More times than not, situations are more complex than we label in our minds.

You Arrive at It Yourself

This part matters, and it’s where good CBT separates from the mechanical version. I’m not here to tell you what’s wrong with you. My job is to ask the right questions — the ones that slow you down long enough to notice something you’ve been moving too fast to see. The insight you reach on your own sticks in a way that someone else’s observation never quite does. That’s not a technicality. It’s the difference between being told something and actually knowing it.

It Gives You Tools You Keep

The goal of CBT isn’t to make you dependent on therapy. It’s to teach you to do this yourself. You walk away with actual tools — ways of catching a distorted thought, interrupting a pattern, responding differently under pressure — that keep working after our work together ends. Which brings me to the last point.

It Ends

I’m not interested in making you a lifelong client. Most CBT work is time-limited by design. We define what you’re here to work on, we work on it, and when you’ve got what you came for, you go live your life. That’s the whole point.

Why the Credential Matters

CBT is having a moment — which means a lot of therapists now list it as something they do. Not all CBT is the same. I’m a Diplomate of the Academy of Cognitive and Behavioral Therapies, one of fewer than 750 in the world. That designation means my competence in the model has been reviewed and verified against peer standards. It’s not a line on a website. It’s the difference between someone who took a workshop and someone who has actually built their practice around this.

If you’re in West Los Angeles — Sawtelle, Brentwood, Mar Vista, Westwood — and something here made more sense than the couch-and-ceiling version you’d been carrying around, that instinct is worth following.

Free consultation. No pressure. Just a conversation to see if this fits.


Nick Holt is an LCSW and A-CBT Diplomate in private practice on the Westside of Los Angeles. He has spent over a decade as a social worker serving LA County’s most forgotten and most impaired — the people the system failed repeatedly. He has also been a son watching his mother through a long and difficult end, a father, a surfer, a drummer, and someone who has broken his neck and come back from surgical repair of his shoulder. He works with men, caregivers, and high-functioning individuals who are ready to stop managing alone. Free consultations at nickholtlcsw.com.

2019 brings many of the challenges from 2018 with it, but also a number of positive developments.

I am honored to report my private psychotherapy practice in West Los Angeles, CA 90025 is FULL as I've received 10+ referrals since late December. I have started a waiting list but I continue to support individuals in linking to other certified Cognitive Behavioral Therapy practitioners, and other services most appropriate to their situation, in the area.

My heart is full with appreciation to those reaching out for support. I fully recognize and connect with the privilege of supporting individuals during immense moments of vulnerability and honesty. I also grasp the tremendous disappointment in contacting someone in hopes of developing a therapeutic alliance and learning of their unavailability. This is why I think it is vital to post this update.

I think the recent amount of referrals is reflective of the time of history we are in, the impact of our stressful and complicated lives, and the demonstrated inner strength, curiosity and empowerment of those reaching out. My hope is that it is also a symbol of decreased stigma in seeking out support for what each of us experiences in our respective journeys. I truly believe mental health symptoms are part of our unique humanity, and therefore the significance is not 'if' we are having challenges but 'how' we are attending to ourselves.

May you keep pushing in 2019 for consistency, contentment and compassion in your support for yourself, loved ones, colleagues and acquaintances. I wish you success in your maintenance of the self-discipline and commitment required to continue your exercise, diet, relationship and routine goals. May we continue to replenish ourselves and radiate our emotional energy outwards to others.

Here last year's New Year post. I still feel similar. If it's possible, maybe a bit more grateful -- https://goo.gl/BgMYPe

I had the immense pleasure of catching Dr. Susan David on Mental Illness Happy Hour "Judging Our Feelings" this past week.

She has a wonderful conversation with Paul -- starting at 21 minutes -- about thoughts, feelings and ways of approaching a healthier, more consistent lifestyle. She touches on many vital concepts, which are emerging with greater and greater scientific support.

Two key concepts and reminders I took away from the podcast:

• Thoughts and feelings are "data not directives." You are not subjected to your thoughts and feelings and does not represent our entirety in a given moment. Rather, thoughts and feelings are "a sign post," which provides us with an opportunity of doing things differently.
• Our world view and how we live our lives are simply stories we tell ourselves. Instead of asking if the story is right or wrong, a better question is to wonder if the story is congruent with our desired life. Is our story serving our ideal self? What are steps we can take to better align our ideal and current self? Is our story a prison or is it serving us? "Discomfort is the price of admission to a meaningful life."

Have you listened to this podcast already? If so, what were some of your takeaways?

So many beautiful possibilities in this chat. I highly recommend it.

#thoughts #feelings #mentalhealth #support #love #compassion #beauty

(Post originally featured on Rodale's Organic Life. Now found here.)

I'm honored to have been featured!

8 Little Ways To Build Mental Strength Every Single Day
By Shelby Deering

​Simple steps to becoming a more resilient, mentally tough person.

You don’t have to be the Dalai Lama or Oprah to achieve mental clarity and toughness. With some practice and armed with tips and tricks, you can find mental strength and in turn, improve your thinking patterns.

We asked a gamut of mental health pros—a therapist, a mindfulness coach, and an Olympian—to weigh in on what methods lead to better mental strength. They all have gone on personal journeys to discover their own mental toughness.

Nick Holt, LCSW, a certified cognitive behavioral therapist, shares that he is a “professional and personal survivor of suicide,” facing substance abuse and mental health challenges since he was a child. Lara Jaye, CEO of Lara Jaye LLC, is an author, speaker, and mindfulness expert who once dealt with depression, a marriage that was falling apart, and substantial health issues. Joanna Zeiger, PhD, is a professional triathlete and Olympian who says that she’s not a “natural” and lived an athlete’s life littered with injuries and unmet goals.

What do these three have in common? They dug deep and uncovered grit and determination to reach their versions of mental strength. Here are 8 practices you can start doing today to build up your own.

Increase Your Awareness Of Your Thoughts

Mental strength is important, says Holt, because “the world is full of uncertainty, change, and negativity.”

“In empowering ourselves to have a more connected, disciplined, and resilient existence, we increase the likelihood of having more contentment, support, and intimacy in our lives,” he says. And all that mental strength often starts with something that is equal parts simple and challenging—awareness.

“Personally, it’s taken me a long time to connect to many of my thoughts and feelings,” Holt says. “For the majority of my life, many of my thoughts and feelings passed by without much attention. They were fused into my daily behavior. These thoughts and feelings guided my life without much consideration of the validity or usefulness of them.”

Now Holt harnesses their power by observing his own life experiences, especially when negative situations occur. “As you enter this new level of connectedness to yourself, your thoughts, and your body, you enter a path of improving your confidence and self-esteem. You become more disciplined, experience more comfort within discomfort, and ultimately, become more mentally tough,” says Holt. (Here’s how to quit your negative thinking once and for all.)

Jaye believes that awareness starts by “silencing the mind chatter.” She says, “Become aware of the radio station that is running in the background. How are you talking to yourself? What do you really believe about yourself? Journal your thoughts.

Practice Visualization

Visualization is a technique commonly applied by athletes, something that Zeiger writes about in her book, The Champion Mindset. But it’s a method that’s not limited to athletes.

“I cannot emphasize enough the importance of visualization,” she says. “Visualization is an opportunity to mentally practice a situation so when the situation arises you are ready to conquer it. Most of the time, people use visualization to imagine perfect scenarios. In sports, it would be the perfect race, and in business, it could be closing an important deal and going over the conversations and actions that would lead to the deal being made. These types of visualizations, where everything occurs smoothly, are important rehearsals that can instill confidence.”

She adds that visualization can result in mental preparedness for whatever may happen, saying, “Most situations in life do not go smoothly. So, imagery during visualization does not only have to be just about success, but also how to handle glitches. I call these ‘disaster scenarios.’ At some point, disaster will strike, and you will be empowered through your imaginary practice to figure out how to navigate the difficulty.”

Jaye practices visualization every morning, setting her alarm a half hour before she needs to get up for the day. “I use that time to focus on what I am grateful for in my life, and then I do a 15-minute meditation focusing on my ideal outcome of some specific situation, including how I will feel when it happens. Sometimes I’m creating my life five years down the road, other times, I’m seeing my next speaking gig and what I’m communicating to the audience. Sometimes I’m envisioning myself happy, healthy, and fit, living on a warm beach. Every morning, it resets my mind and body to remember my goal and to feel what it will feel like when it arrives,” says Jaye.

Employ Positive Self-Talk

Positive self-talk is the thing that overtakes those negative thoughts when they creep in. Zeiger explains that when athletes endure long races, there are always rough patches that can easily lead to negative self-talk. “Athletes tell themselves things like, ‘I suck,’ or ‘I should just quit.’”

Anyone can experience similar thoughts, even if they’re not in the middle of a race. Negativity can surface when you’re sitting in traffic, having a disagreement with a partner, or facing a health crisis. “Positive phrases during these times, [such as] ‘This will pass’ and ‘I am a warrior’ will help alleviate the burden of the tough patch,” says Zeiger. “Every day, we are confronted with situations that can cause angst. The way we react will dictate the ability to move forward quickly. Our thoughts are powerful and can change our mood quickly from positive to negative or from negative to positive.”

Come Up With A Mantra And Use It Often

Once you’ve mastered the art of positive self-talk, pick a mantra for yourself and use it often, says Zeiger. It can be a favorite quote or a personal phrase that you’ve devised that just feels right when you say it to yourself.

Having a mantra naturally arise in your thoughts will no doubt take some practice and patience. Zeiger says, “Practice mental toughness. Just because you want to be mentally tough doesn’t mean you will be mentally tough. It takes a lot of practice.”

Be Mindful And Engage All Your Senses

Mindfulness is also something that can lead to more self-awareness. Jaye separates mindfulness from meditation, saying, “People often use meditation and mindfulness interchangeably, but they are different. Meditation is a way to practice being mindful. It’s to engage in contemplation or reflection.”

Jaye recommends using meditation as a way to become more mindful, alongside deep breathing, yoga, walking, spending time in nature, dancing, and eating. “Mindfulness is the basic human ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us,” says Jaye. “To become mindful, you can bring all five senses into whatever you are doing in the present moment.” That means allowing yourself to fully taste your food, slowing down to feel a warm breeze, or quite literally stopping to smell the roses.

Prioritize Self-Care And Quiet Time

Peaceful moments infused with self-care rituals can help you recharge your batteries so you can practice mental toughness the next day. Holt says to practice self-care and self-compassion “daily.”

Holt adds that self-compassion can only be experienced once we choose to be vulnerable. “Vulnerability is the portal that can lead to an appreciation of acknowledgment, empathy, compassion, nurturance, self-care, and much, much more,” Holt says.

Zeiger knows that even athletes need to power down. She says, “Mental toughness is not just about ‘going hard.’ It’s also about knowing when to fold your cards.” And she says not to judge yourself when you need a mental break.

Jaye is an advocate for using silence to get in touch with your true feelings and thoughts. “Be still. Take that quiet time each day to reflect, offer gratitude, meditate, and become mindful of the present moment without judging it,” she says.

Don’t Be Afraid To Experience Emotions

Emotions can undoubtedly be scary at times. None of us really want to face our confidence issues or the unhappiness we experience with a spouse. But Jaye says that it’s essential to feel all those emotions as they come up so you can begin to harness the mental strength you’re thirsting for. “Stop numbing yourself,” she says. “Welcome the emotions and thoughts. Allow your body to feel.”

Jaye also recommends using something called the RAIN Method when you become overwhelmed with emotions.

R: Recognize what you’re experiencing and thinking
A: Accept your emotions
I: Investigate these thoughts and emotions
N: Non-judgement of thoughts and emotions

“Just allow [the emotions] to pass naturally, because what we resist persists,” says Jaye.

Remove Yourself From Negative Situations

And if all else fails and mental toughness seems out of reach, it might be time to simply remove yourself from any negative people, places, or situations that weaken you or affect your thoughts.

Jaye says, “Notice the people and circumstances that are triggering you. Become aware and journal your thoughts.” In this same spirit, Holt says that it’s key “deepen your commitment to yourself and the people who make you feel good.”

“It is hard to be mentally tough if you are doing something you dislike,” Zeiger points out. “If you are stuck in a situation where you are unhappy or hate what you are doing, if at all possible, remove yourself from that situation into something more likable. If it is not possible—for example, you are stuck in a job you dislike and cannot move—make a list of the positives and focus on that rather than the negatives.”

Because at the end of the day, that is the foundation of mental strength. Focus on the positives, cast the negatives aside, and fixate on being the very best version of yourself.

#anxiety #tools #techniques #cognitivebehavioraltherapy #cbt

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

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.