Nick Holt, LCSW | CBT Therapist for Men | West Los Angeles
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Nick Holt, LCSW

CBT Therapist in West Los Angeles | Men’s Mental Health | A-CBT Diplomate
Serving the West Los Angeles neighborhoods of Sawtelle, West LA, Santa Monica and Brentwood

What to do with Worry?

7/19/2016

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This post was originally featured on WellnessUniverse.com.

I recently became a Diplomate in the Academy of Cognitive Therapy (ACT). The ACT is the only cognitive behavioral therapy (CBT) certifying agency in the world.

Joining this elite group of therapists is quite an honor. There are many therapists in the world that can say they are CBT trained but only 750 people in the world can say that they are CBT certified.

One of the greatest benefits of being an ACT Diplomate is joining their ListServ. Some of the most prestigious CBT therapists in the world are on this list and share their perspectives on a daily basis. Unfortunately, much of this information does not get outside this small network and the clients they work with.

In a recent ACT ListServ email from Reid Wilson, Ph.D., Dr. Wilson shared some helpful videos about anxiety relating to his new book Stopping the Noise in Your Head. I thought the videos were fun and demonstrate important concepts in CBT.

About Dr. Wilson: He has spent much of his 30+ year career providing free or inexpensive ways to help people combat anxiety and worry, and encouraging them to seek CBT services when appropriate.

In promoting his new book, Stopping the Noise in Your Head, he released a free video series called Noise in Your Head, which follows a young woman, Susan, in her struggles with anxiety.

Here are a few of the highlights from each video:

  1. Meet Your Competitor: Anxiety

    This video normalizes much of the negative and worrisome thinking we experience in our daily lives. It introduces the importance of having an outcome strategy and personal characteristics like grit, trust, and courage.

  2. ​Ditching Content, Welcoming Uncertainty

    Susan discusses how easy it can be to get lost in worry and end up in obsessive, negative thinking. Instead, she suggests acknowledging the worry, uncertainty, and discomfort in the imperfection of our daily lives.


  3. Willingly Seek Out Discomfort

    Susan continues her battle against anxiety by recommending different strategies to cope with anxiety. It’s okay to be scared!

  4. Do the Opposite

    Susan talks about doing the opposite of what anxiety needs — seeking out discomfort! She explores a number of other strategies as well.

  5. Get Scared, Score Points

    Susan pushes herself to confront a situation that scares her. She imagines the experience, acknowledges her emotions, supports herself, and conducts other strategies to face her greatest fear.

  6. Living with Anxiety

    Susan faces down anxiety in his most desperate form. She finishes the series by finding a place for him in her life.
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Mental Health: Part of a Balanced Lifestyle

8/1/2014

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This post was originally featured on HuffingtonPost.com

Being an eager, determined, and active male within my personal and professional roles, I understand the inherent challenges when it comes to living and maintaining a balanced lifestyle. It is also a frequent complaint encountered within my role as a therapist working with men. These conversations often start off like this:

"I'm functional. I have a good paying job, I'm dating, having sex, I'm happy. I'm close with my family and have quite a few close friends. I eat well, I exercise, take good care of my body, and I like myself. I maintain an active lifestyle and seek out new opportunities for growth and personal development. There's nothing wrong with me, so why should I consider seeing a therapist?"

There are many ways to answer this question. For the purposes of this article, I focus on two responses.

1) Few of us fall into this ideal on a consistent basis.

Yes, fundamentally and cognitively, we know exercise, diet and nutrition contribute to better mental states. That nature provides us the opportunity to connect with our spirituality, to rejuvenate, and relax. We know giving back to society, mentorship and volunteering reap deep intrinsic rewards. We understand management of stress is vital, and to do so, we need to carve out time to play, be creative and relax. We've heard the importance of healthy and intimate relationships; of the benefits afforded to processing and exploring recent events and stress. But really, who has time to do this?!?

Too often, we have competing interests in our day-to-day lives. With pressures coming from employment, peers, family, household chores and more, our daily tasks often become hasty, triaged decisions based in reaction rather than prevention.

This makes sense. The Organization for Economic Cooperation and Development (OECD) is a forum where member countries discuss issues and policies relating to economic growth, prosperity and sustainable development. The OECD reports people in the United States of America (USA) work more hours per year, and have more employees working "very long hours" than the average nation. Collectively, the USA ranks 33rd out of 36 nations when it comes to "time devoted to personal care and leisure," an outcome which contributes to poor physical and mental health.

Furthermore, our society reinforces a minimized view of such therapeutic activities and encourages other means of support instead. Roger Walsh states, "(these activities) require considerable and sustained effort, and many (individuals) feel unable or unwilling to tackle them. (Individuals) often have little social support, little understanding of causal lifestyle factors, and a passive expectation that healing comes from an outside authority or a pill." He identifies advertising as a main method of refocusing us onto more economic, and easier, ways of soothing these desires. These mechanisms include "self-medicating" via alcohol, nicotine, unhealthy food and other compulsions, which, at a certain point, become unhealthy and suffer from the psychological concept of habituation, the perceived benefits yielding less and less relief over time. These societal messages are further reinforced by many of our friends, family, employers, co-workers and many others.

What can we do?

Stress exists in all of our lives. It is not a question of if we will experience stress, but rather how we will deal with it. My colleague Ken Howard, LCSW recently listedsome warning signs when it comes to your lifestyle. Here's what I think:

2) Seeing a therapist can be helpful in moving from reaction-based decision-making to a more proactive approach. In doing so, we create an environment for preventative health care and move toward a more balanced lifestyle.

Like seeing a doctor for regular check ups and evaluations, seeing a trained mental health professional on a regular basis can be a great way to maintain consistency in perceiving, evaluating, interpreting and responding to the overwhelming complexity making up our daily lives. In fact, with many mental health symptoms seen in primary care physician settings, there is a push within the field to integrate mental health treatment earlier and more often in physical health treatment as well. Very few of us are allowed the conversational space required to explore the deep cognitive and emotional impact of our daily lives, not only on our minds but also on our bodies.

Now what?

Given the challenges outlined by Walsh, being proactive over your lifestyle is imperative. In order to move toward a more proactive view of your lifestyle and healthcare, I believe integrating mental health treatment or coaching into one's schedule is vital. Prior to a mental health evaluation, it is important to have specific goals in mind. For example, if you are stuck, one goal could be to gain clarity. Other helpful hints in searching out a therapist include interviewing your therapist to ensure they are competent in approaching your unique situation (some great sample questions here), and to establish mutually agreed upon goals prior to beginning treatment. There are exceptional treatment protocols in the field of mental health including resolving uncertainty via Motivational Interviewing and Cognitive Behavioral Therapy, as discussed in my last post.
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What Neil deGrasse Tyson Can Teach You About Mental Health

7/6/2014

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This post originally appeared on HuffingtonPost.com

As a mental health professional, I can't help but think about how my favorite TV shows, books and music apply to healthy mental living. For instance, I am a big fan of Cosmos: A Spacetime Odyssey. The images are striking. The writing, brilliant. It taps my imagination, and reinforces my thoughts and beliefs via scientific research and theory.

In a recent episode called "Unafraid of the Dark," I was struck by a discussion about how the factors that influenced the advancement of science and humanity parallel the tenets of a healthy philosophy for daily living.

Here is the excerpt:

It was the work of generations of searchers who took five simple rules to heart:


  • Question authority. No idea is true just because someone says so, including me.

  • Think for yourself.

  • Question yourself. Don't believe anything just because you want to. Believing something doesn't make it so.

  • Test ideas by the evidence gained from observation and experiment. If a vagrant idea fails a well designed test, it's wrong. Get over it.

  • Follow the evidence, wherever it leads. If you have no evidence, reserve judgement. Remember, you could be wrong. Even the best scientists have been wrong about some things: Newton, Einstein, and every other great scientist in history. They all made mistakes. Of course they did. They're human. Science is a way to keep from fooling ourselves and each other.

You can use deGrasse Tyson's five simple rules to encompass a broader view of personal growth, too. Taking them to heart can help us be more scientific in our thinking, which can lead to a more empathic understanding of ourselves and others in our daily lives.

For instance, I connected deGrasse Tyson's first three points to the biases we hold in our daily lives. As briefly discussed in my last blog, cognitive distortions (or biases, a slightly less judgmental word) are always in play. It is not a question of if we are biased in our thinking, but rather a question of if we are aware of such a bias influencing our thinking, e.g. personalization, emotional reasoning, etc.

A tool for all of us to better examine our thinking, and how our thinking influences our moods and behaviors, is Cognitive Behavioral Therapy (CBT). From its inception, CBT has become the most widely researched and evidence-based form of psychotherapy. In some cases, research has demonstrated its being as effective as psychotropic medication.

As Tyson talked about his fourth and fifth points, the frame of CBT was screaming through my mind. Some of the ways CBT provides a more structured and scientific approach to our thoughts, feelings and actions includes identification and evaluation of feelings, "automatic thoughts," intermediate beliefs and core beliefs, role playing, behavioral experimentation, examining the evidence, and many, many other mechanisms.

The most important portion of Tyson's commentary is the fifth point. Tyson talks about how "even the best scientists were wrong about some things," and it's similar to how we can and should move forward once we accept the inevitability of our own errors.

We do not achieve growth in our lives without missteps along the way. Ideally, acknowledging this will help soften our own tender approach and playful response to adversity in our lives when it comes. If we can't acknowledge our missteps, a real danger emerges in which we believe ourselves to be unequivocally right. In doing so, we often lose empathy towards ourselves or others.

Research demonstrates what happens when we lose empathy in our relationships, and communicate with vehicles such as criticism, contempt, defensiveness and stonewalling. The effects can be devastating on marriages, leading to a host of negative effects like lack of communication, emotional flooding, withdrawing from the relationship, even leading to affairs (1).

By better examining our thinking through a more scientific process and softening our internal and external response to failure, we are better able to continue our journeys in personal growth in order to advance ourselves, those around us and, hopefully and ideally, mankind.

Reference:

(1) Gottman, John M., and Nan Silver. (1999). "How I predict divorce," in The Seven Principles for Making Marriages Work (Chapter Two, 25-46). New York: Three Rivers Press (Random House, Inc.)
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    Nick Holt

    Mental Health and Therapy Writer. As featured on Huffington Post, Vox Media and elsewhere.

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Nick Holt, LCSW, A-CBT, BCD
​CA BBS #67195

​Psychotherapy
  Cognitive Behavioral Therapy
  Therapy for Men by a Male Therapist
​  Caregivers and Family
​  Depression and Suicide

  Evening and Weekend Therapy
  Psychotherapy in West Los Angeles
  Self-Pay & Out-of-Network Therapy
About Me
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Contact Me
  FAQ

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​West Los Angeles*
Nick Holt, LCSW, A-CBT, BCD
2001 S Barrington Avenue
Suite 312
​Los Angeles, CA 90025
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(310) 439-9144
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  • Psychotherapy
    • Psychotherapy in West Los Angeles
    • Cognitive Behavioral Therapy
    • Men's Mental Health
    • Depression and Suicide
    • Therapy for Caregivers
    • Evening & Weekend Therapy in West Los Angeles
    • Self-Pay & Out-of-Network Therapy
  • About Me
    • Blog
  • Contact Me
    • FAQ