The recent celebrity suicides have hit me pretty hard especially as someone who has lost to suicide.
I connect to those left behind. When we have losses like this, for me, suicide loss acts as a cheese grater on my soul, slowly peeling back my own layers of grief. I imagine what those left behind face and are enduring, and, no matter how hard I try to forget, the losses always bring back memories, thoughts and feelings of those I've loved and lost to suicide.
In my time at Didi Hirsch's Suicide Prevention Hotline, I remember staff would talk about call volume spiking, and the need for more counselors to come in to support the many callers who connected to the recent celebrity suicides. These deaths, and the media coverage of the events, always reminds us of our own and others pain.
If you are someone who is struggling with suicidal thoughts, depression or has lost someone to suicide, this will be a difficult time. Please treat yourself well. Reach out to a friend, a loved one. Take that walk or extra time in the gym. Be gentle and kind to one another. It is a good time to invest in ourselves.
If you need additional supports, I've included the below from my depression and suicide webpage as a reminder of resources for you during this difficult time.
If you are struggling with thoughts of suicide or planning to kill yourself, PLEASE take a moment, a breath and remember that if you can delay suicidal impulse, research shows the impulses WILL decrease. There are some incredible volunteers and paid staff that would love to talk with you about what you are struggling with. Please reach out to the National Suicide Prevention Hotline (1-800-273-8255).
From my website:
Losing a loved one, family member, friend or even an acquaintance can be devastating. The feelings are complex, the thoughts overwhelming. Everything seems to trigger memories of the person gone, and all memories seem tainted by the nature of death.
The process of losing someone can make us feel alone. Grief, loss and bereavement are incredibly difficult things to experience, but there are many amazing people and organizations out there for support:
American Foundation for Suicide Prevention's I've Lost Someone
American Association of Suicidology's Suicide Loss Survivors
West Los Angeles-based Didi Hirsch's Survivors After Suicide are great places to start.
#suicide #prevention #call #celebrity #support #suicidal #ideation #intent #empathy #love #connection
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
(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.
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
ON Relationships and love
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
Men, anxiety and psychotherapy
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
A little bird told me ...
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
3 Quick Ways to Improve Your Mood
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.
Shout Out to Veterans
My grandfather was an United States Navy Lieutenant Commander in the Pacific during World War II. One of my best friends, Army 82nd Airborne during OEF/OIF.
I can't imagine signing over my life to the unknown, and deeply respect their devotion to our Nation.
I've worked with veterans at the West Los Angeles Veterans Affairs as a volunteer and intern. I spent three years working at DMH's Veterans and Loved Ones Recovery (VALOR) program helping VA healthcare eligible and ineligible move forward in their lives. In my full-time position, I am still helping veterans link and engage with the VA.
This weekend is a reminder to me to celebrate their discipline, commitment and experiences. They deserve better.
Here's a portion of a piece I wrote a few years ago:
"Many homeless veterans have been through a great deal. Despite the adversity, they continue to demonstrate remarkable agility. I have seen them survive on jetties in Long Beach, in the iceplant on the sides of our freeways, and other areas not meant for human habitation. The odds of success are clearly stacked against them. Yet, after developing a trusting relationship with homeless veterans, I have seen them become more open to changing their lives. In fact, I have seen some of the most hopeless thrive once housed. To me, it is another reminder of our human potentiality. As a wise instructor once told me, “Your view of your clients as being either weak or strong is often a reflection of how you look upon yourself ... choose strength.”
Raising a small child brings all sorts of challenges. Lately, I've found myself waking up early and preparing lunches. During these pre-dawn hours, I've fallen in love with a number of podcasts and listen to them regularly.
As a certified Cognitive Behavioral Therapy, CBT therapist in West Los Angeles, I was highly impressed by Alix Spiegel and Lulu Miller's first episode of Invisibilia, "The Secret History of Thoughts". It was a compelling exploration of our thoughts and an interesting analysis of mental health's view of thoughts.
The contrast of psychoanalysis, cognitive behavioral therapy and mindfulness and meditation was useful and relevant not only for people experiencing symptoms like depression or anxiety, but also a good reminder for me as a therapist.
Check it out and let me know what you think.
Mental Health and Therapy Writer. As featured on Huffington Post, Vox Media and elsewhere.