Digital mental health tools: how do they work?

22 Aug

Teaching cognitive behavioral tools for mood management has been a large part of my psychotherapy practice since I began over 10 years ago.  Some of the most effective tools are relaxation techniques that work to help people manage a wide range of common mental and physical health symptoms, including anxiety/worry, self destructive thinking habits, panic attacks, insomnia, depression and chronic pain.  During psychotherapy, patients learn how and why these tools work, followed by demonstrations and practice in session, followed by homework for review in between appointments.  Innovative developments in technology have given people helpful tools to support what they are learning in psychotherapy, including the ability to measure and track their body’s physiological functioning with wearable devices. A variety of mental health focused mobile apps can work as supportive guides for relaxation, cognitive restructuring, and mood management. Some apps are built as digital games, based on research findings that suggest “gamifying” a scientifically-supported mental health intervention offers measurable mental and behavioral benefits for people with relatively high levels of anxiety.  Mental health professionals now have a wide range of supplemental digital tools to choose from to support their patient care, as well as individuals aiming for increased mental wellness.  Discuss with your mental health provider which digital tools best match the work you are doing together; if she/he is not familiar with any, aim for those utilizing evidence-based practices developed by health professionals, and steer clear of those making dubious health claims.  While the latest ‘best mental health apps’ lists are a great place to start, ultimately the ‘best app’ is one that is a scientifically supported one that you feel you can use with ease and consistency.

What makes these tools so effective and how do they work?

Relaxation techniques improve the mind and body’s physiological functioning and health.  Panic and other physical symptoms of stress are caused by the body’s  automatic reaction to perceived fear.  “The Stress Response” occurs when chemicals flood your body that prepare you for “fight or flight.” While the stress response is helpful in true emergency situations where you must be alert and ready to act, overall exhaustion can occur when constantly activated.  Relaxation strategies work to elicit “The Relaxation Response”, which rebalances your body’s physiological system by: deepening your breathing, reducing stress hormones, slowing down your heart rate and blood pressure, and relaxing your muscles. In addition to its calming physical effects, research shows that the relaxation response also increases energy/ability to focus, fight diseases, relieves aches and pains, heightens problem-solving abilities, and boosts motivation and productivity.

Cognitive techniques such as thought records and mood trackers reduce anxious, depressive or self-destructive thinking habits.  Worry, panic and fear are all normal and automatic human responses to real or imagined threats to safety. Self-evaluative thoughts play an important role in motivating us to identify errors and take action for improvement.  All of these types of thoughts work as a natural alert system, compelling us to make necessary changes that can remove us from harm’s way, decrease harmful behaviors or increase healthy behaviors. While sometimes these thoughts work in our best interest, they can also be hazardous to our mental and physical state of health if left poorly managed.  Automatic thoughts of worry or self-criticism can become distorted and irrational when left unchecked, and actually prevent us from being able to function optimally in our daily lives. Learning to refute and manage irrational thoughts is an important step in healthy coping when faced with uncontrollable circumstances.

Professional mental health treatment by trained experts remain an essential part of diagnosing and treating mental illness.  There is no substitute for understanding the myriad composition, history and progress of an individual’s mental health symptoms.  A person’s mental health can erode suddenly and sometimes without warning; dangerous progression of symptoms can be avoided with timely and appropriate professional care. 

 

 

Gen-Y’s tech twist on engagement, weddings and parenthood

18 Aug

While Gen-Y is still getting married at much lower rates than previous generations, some millennials are finally beginning to grow up, entering the world of marital engagements, wedding planning, and parenthood. True to form, their choices reflect advancements that set them apart from Gen-Xers, who were the first to utilize technology to chronicle their love stories on websites like theknot.com, build wedding registries online, gift personalized CDs with digitally remastered music as wedding favors, show spliced video montages of the bride and groom’s childhood at wedding receptions, and research honeymoons on websites like tripadvisor.com. As a card carrying member of generation X, I can proudly say we thought we were so cutting edge! Our kids were the first to be born with smartphones and tablets in their hands, and we posted their baby pictures on our social media pages and texted them to their grandparents. But time nor technology stands still, and Gen-Y has begun to put their own tech twist on engagements, weddings and baby plans. As a mental health treatment provider and consultant who works almost entirely with millennials in the San Francisco Bay Area, I have taken note of the following trends:

Their romantic relationships have an online life of their own. As the saying goes, no one really knows what happens behind closed doors, but in the personal lives of millennials, we can certainly take a look at their online activity to see what they’d like us to believe about their relationship status and history. The internet has become their forum of choice for chronicling romantic highs and lows, functioning as a means to gain public support, air grievances, compete for attention, and display markers of success (not to mention deleting away failures.) From public playlists on Spotify, hashtags on Twitter and Instagram, Pinterest boards and Facebook’s ‘Relationship Status’ updates, Gen-Y leaves little to the imagination when it comes to sharing their stories of romance.

They crowd source their decisions when it comes to navigating relationships. Millennials are used to solving problems fast, arriving at optimal solutions with the least resistance possible. Millennials have been groomed to work in competency-based teams, and this concept is frequently used for managing their personal lives too. They prefer to avoid conflict, and are more comfortable than previous generations relying on others to help them make decisions. Jeff Snipes, CEO of Ninth House, a provider of online education, including optimizing team effectiveness, says a hierarchical, leader-oriented team was more appropriate for earlier generations: “Traditionally if you worked up the ranks for twenty years and all the employees were local then you could know all the functions of the workplace. Then you could lead by barking orders. But today everything moves too fast and the breadth of competency necessary to do something is too vast.” When faced with life-changing decisions about relationship commitment or endings, Gen-Y seeks the opinions of their team of friends, family and experts to help them navigate and solve problems. When problems are deemed too private to share, websites like popular sites like Whisper and Secret are put to use by millennials as a way to air their private thoughts, share their hidden behaviors and ask for advice completely anonymously, so there is no threat to their carefully constructed online image.

Their engagement stories, weddings and honeymoons reflect their brilliance and investment in personal branding. While previous generations aimed to establish their worth and reputation through self-improvement, author Dan Schawbel of Me 2.0: Build a Powerful Brand to Achieve Career Success points out that Gen-Y has discovered that in the dawn of the internet, admiration and success comes from self-packaging through a carefully concocted personal brand. From the days of Myspace to Tumblr, millennials have grown up managing their self image like celebrity publicists. Gen-Y has turned self-portraits into a way of life- ‘selfies’ have become one of the internet’s top forms of self-expression. Their overall online presence has been a way to uniquely distinguish themselves from everyone else, and they are highly invested in making their relationship milestones ideally memorable as part of their personal brand. Whether they capture and share these milestones via Snapchat’s Our Story, Instagram, Twitter, Facebook, or personal blogs, millennials are sure to control how the world sees their love stories unfold through brand management. One San Francisco Bay area millennial shared with me she got engaged via FaceTime, since her long-distance boyfriend was living in abroad and couldn’t wait to pop the question. To his credit, her (now fiance) also created an iMovie that he shared with her, depicting him staged in funny scenarios accompanied by a personalized musical score that specially captured their romantic history.

They’re comfortable resisting tradition, understanding that ‘following the rules’ doesn’t necessarily bring ‘happily ever after.’ Author Paul Hudson of Elite Daily, The Voice of Generation Y observes that millennials are far less likely than past generations to buy into the notion that marriage is the gateway to a future of stability and happiness. Harry Benson, research director at the Marriage Foundation, describes the strong link between parental divorce and a reluctance to get married. “If your parents split up then most people are more likely to be quite skeptical about the value of marriage,” he explains. “So as there’s rising divorce rates, you can imagine how when the next generation appears, people will be more dubious about marriage.” Bobby Duffy, leading market researcher on generational analysis, says there are also far more financial pressures on millennials than previous generations. They have more educational debt in a less stable economic climate, and face an incredibly buoyant housing market. According to CNNMoney, twenty-somethings are transitioning into adult life at a more gradual pace, opting to cohabitate and co-parent without traditional marriage at a much higher rate than previous generations.

They anticipate their babies’ future in a world where technological identity matters. One website says it all:awesomebabyname.com, a new online tool that allows parents to choose a name for their child based on website domain availability. Yes people, this is happening. I heard it first a few months ago when a pregnant patient of mine found out she was having a girl, the first thing she and her cohabiting boyfriend/expecting father-to-be did was buy website domains and establish email accounts in her name. Of course, now there’s an app for that! “It’s important to give your children a fighting chance of having good SEO (Search Engine Optimization) in the 21st century,” says Finnbar Taylor, who created this website together with Karen X. Cheng. “We use search engines all day long to answer our questions and find things, including people. Imagine being called John Smith and trying to get a ranking on Google search. It’s important to give your child a unique name so that people, like potential employers, will be able to find them easily in the future.”

Granted, millennials are still in their 20’s, a time when it’s still developmentally common to be preoccupied with self-image, and an idealized future that looks different than previous generations. The question is, as Gen-Y ages, which of these trends, if any, will change?

Dr. Christina Villarreal is a clinical psychologist in the San Francisco Bay Area, CA. She produces web articles, televised and print/web interviews on current issues in mental health and tech culture. She offers consultation and strategy to start up founders and employees.

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DJs and Mental Health: Electronic Music’s Last Taboo

12 Aug

DJs and Mental Health: Electronic Music’s Last Taboo

This article was featured in djbroadcast.net, an international platform for music, art & lifestyle.  Thank you author Dan ColeEditor In Chief at Blueprint Media BV for this well-written and timely article, and for bringing this topic into the light for the music community. I appreciate the mention and inclusion in your writing.

“The challenges of being an on-the-road performer are often popularized in modern culture; more so than they are discussed by real life musicians. One only has to refer to the likes of DJ Ickarus (aka. Paul Kalkbrenner) in Berlin Calling, who succumbs to a mental illness as a consequence of the rock & roll lifestyle he adopts.  Or there’s Frankie Wilde in ‘It’s All Gone Pete Tong’, who struggles with addiction, loss of hearing and arguably, loss of self-identity. Yet, as we happily grimace at these fabricated, big screen purveyors of dance music, mental health issues in real life are no laughing matter. One in four of us will struggle with mental health issues at some point in our life. It’s something however that a very small segment of the DJ community has spoken openly about. So how prevalent is it among the touring DJ scene, and why does it appear to be the last taboo to be broken? We spoke DJ veterans Joost van Bellen and Jeremy P. Caulfield to shed some insight on this sensitive subject.”

Aim For the Stars
Towards the end of Dom Phillips’ 2009 book, Superstar DJs Here We Go! (The Rise and Fall of the Superstar DJ), is the story of Sasha, and how, during the peak of his career, he struggled to deal with the pressure the industry was putting him under to release music. Following the success of several singles and countless mixes, he was still yet to release an album – a record he consistently confirmed was coming out. ‘Muzik magazine went over to New York to interview him. Sasha proved elusive,’ Philips wrote. ‘The eventual feature was entitled The Lost Weekend. Last time Muzik sees him in New York, he’s half underneath his bed at the Soho Grand Hotel, waving a two-litre bottle of vodka in one hand and a bin in the other.’

While we might otherwise laugh at the rock & roll clichéd actions of Sasha at this point in his career, it is clear that these were not the actions of a healthy person. Massively overwhelmed due to an exhaustive schedule and pressure from a baying audience, Sasha’s actions became irrational, and his actions, unsound. These idiosyncratic, patterns on behaviour are characteristic of many artists within the musical sphere. When the pressure is on, and fatigue sets in from over-work then one’s own mental health can begin to suffer. This is especially prevalent when there is an ease of access to excess alcohol and drugs.

“…At one point, after a pretty exhausting tour,
I came back and it just wouldn’t stop –
the anxiety stayed…”

Confiding in the Press
DJs are bearing more than ever in progressively candid interviews with press and media. Quite often an artist will talk about their childhood, liaisons and drug use. Yet very rarely will they talk about some of the mental challenges that have had to tackle. Topics of which can be perceived to be extremely personal. There are a rare few who have gone against the tide. Dutch DJ Laidback Luke is one of them.

“I’ve had burnout twice in my life; I had a burnout when I was 20 and I had a burnout when I was 30,” Laidback Luke confides to online publication, OnlyTheBeat. For a mini-documentary entitled, My Son The DJ, the Dutch DJ elaborates further regarding the latter incident. In 2010 Laidback Luke had the most international bookings out of all Dutch artists (150 in one year) – this inordinate touring schedule, combined with the breakup of his marriage lead to this second period of burnout. “I was in the bus enjoying my time off and I all I wanted to do was fucking scream inside of the bus because I was just getting crazy,” he explains. This is the response of someone who is not just suffering from physical fatigue, but from something more complex, and sometimes misunderstood; nervous exhaustion.

When we’re ill we can see the doctor, or simply take some medication, but matters of the mind are much more difficult to fix. German house DJ, Motor City Drum Ensemble, was honest enough to talk extensively about his anxiety problems in a recent Resident Advisor documentary. “At one point, after a pretty exhausting tour, I came back and it just wouldn’t stop – the anxiety stayed,” he candidly admits. The realisation of such, actively lead to the DJ cutting down on his touring commitments, in order to improve his health.

For every story of someone who’s managed to acknowledge their health problems, there are countless examples of those who haven’t. Just take the tragic story of US house producer Gemini, aka. Spencer Kincy. Luke Solomon talks about Kincy’s problem in a Resident Advisor Exchange podcast, during which he describes how Kincy has ‘decided to opt out of society, to not have a fixed abode, not be a part of the music industry anymore and he doesn’t want to be a part of this world anymore – that’s his choice and mental illness and that, are a factor.’ Although, this is a very drastic example, it only goes to highlight the extent to which mental illness can impact an individual’s life. Something, which were it not to have been brought to our attention, could have easily slipped under the radar.

Expander
Dr. Christina Villarreal, a Mental Health Examiner in Oakland, talks about the psychological issues celebrities can struggle with at various points in their career, in an article for The Examiner. Villarrea
l lists the following points:

- No Privacy – a suffocating environment can lead to individuals acting out in an uncharacteristic manner, such as ‘unsavoury sexual appetites, volatile outbursts or uncontrolled substance abuse.’
- Loss of Self-Sense – this can cause individuals ‘to make choices that no longer reflect their true self.
- Loss of challengesa problem that can cause those who’ve become successful, to consistently seek new challenges and ways of becoming even more successful.
- Imposter syndromea problem that can lead to inadequacy, when an individual feels that they might not be up for the job.
- Quest for media spotlight immortalitya prevalent problem leading to artists going to the utmost limits to ensure that they remain as famous forever.

You can apply any one of these issues to a certain number of DJs. It’s clear that when Sasha was pushing himself around the time of Xpander, as stated at the start of the article, that that lack of privacy and loss of self-sense, was putting a huge strain on the Welsh DJ.

Leading dance music journalist Marcus Barnes, writing on the health issues that touring DJs need to be wary of, consulted senior NHS nurse, Jacqui Jedrzejewski, when writing a similar article for the online outlet, Meoko. As well as various physical ailments, such as back issues and tinnitus, Barnes states that consistent touring, alongside effects of jetlag, can lead to  wide-ranging effects on an individual’s physical and mental wellbeing.’Barnes also refers to the problems of depression, upon which Jedrzejewski states that:

‘Becoming isolated from friends, or the world in general and feeling alone or misunderstood can quickly lead to depression.’

I spoke with Gordon Shippey, a US based psychotherapist and counselor about the perils posed to those exposed to excess fame. “Having an adoring fanbase near at hand can cause problems. One credible explanation for why we see stars acting badly, is that in their fans’ eyes, they can do no wrong. A big part of narcissism is the inflated sense of self-importance. But for people who are legitimately famous, that sense is reinforced by their fanbase.”

“I know DJs who get anxiety attacks and depressions; who get paranoid even when playing at a club or festival”

Pandaogen
Joost van Bellen is a revered and legendary DJ from the early days of dance music in The Netherlands. Known throughout the country as one of the instigators of the Dutch electronic music movement, the 54-year old DJ helped established the RoXY club in Amsterdam, which laid the groundwork for the current wave of
underground Dutch and techno.  He recently wrote a book – a work of fiction – about the perils of fame, entitled Pandaogen, from the perspective of a fashion model. “Success and fame would bring happiness, but she loses her friends and herself along the way to the Holy Grail,” explains van Bellen. “It can happen to DJs too, there is actually a DJ in my book who is my nightmare reflection in a mirror.”

Haven spoken previously about his concerns regarding the health implications brought on my excessive DJing, DJBroadcast caught up with the influential Dutch DJ to take his perspective on the whole situation.

 

“I know DJs who get anxiety attacks and depressions; who get paranoid even when playing at a club or festival,” he explains. “But most of them will be waving they’re hands in the air when they are back in that DJ-booth like nothing is wrong.” Is this a sign of denial, or do DJs not want to let on that this perceived notion them of having a good time is actually a fallacy?

As well as hosting the regular Rauw nights at Amsterdam’s Trouw, van Bellon is still doing two to three shows every week. He used to do a lot more; something which took its toll on his own mental heath.

“I’ve been there: saw things which were not there because of exhaustion and light effects in clubs. I had trouble breathing properly, got hyperventilation attacks and saw the world around me spinning like a merry-go-round.”

So if it is happening, then why does it come across as being so taboo? “You might feel like shit but you always have to be happy and pretend it’s a great party,” he states. DJs, are in a sense, becoming actors, and pretending that everything is fine. Until, that is, when it all goes terribly wrong.

Faking It
Jeremy Caulfield went into semi-retirement recently. The Canadian DJ, producer and label owner moved from Toronto to Berlin a few years ago, after establishing himself as a force to be reckoned with among his fellow tech-house and techno DJ peers. His label, Dumb-Unit, was established at the turn of the century, giving rise to the likes of Butane and Mike Shannon.

Caulfield however called time on his DJing, after recently becoming a father, in addition to taking on the management of a new Berlin-based café and bar, Aunt Benny, which he runs with his wife and brother-in-law. He could see that, if he carried on with the way things were, it wouldn’t work out too well for him. He’s now opted to focus on being a dad and looking after his business – he’ll still take the occasional booking though, but only if it’s for the right reasons; the reasons why he started DJing in the first place.

Fans of Caulfield might have seen this coming. In a 2009 Resident Advisor article, Caulfield expressed his growing weariness of international touring.

‘Years before—on my first tours—I was excited to be in Europe, to visit the sites and to take in the culture. But lately I had not been feeling very inquisitive. My TV intake began to rise, I was getting into the salted peanuts a lot earlier and seeing a town consisted of a pre-gig excursion to the hotel bar. The original sheen had faded.’

Now out of the rat race Caulfield looks back with an objective eye. “I wouldn’t say that I was going nuts yet, but I could see that it was wearing me out,” Caulfield explains. “While I have regrets of not fulfilling my duties, I’m quite happy that I ended it – even though I’ve moved into something even more stressful.”

“…You become a sociopath to some
degree because you have to
maintain this persona…”

 

As we discuss his experiences, the conversation inevitably came to the subject of ‘loss of self sense,’ as Villarreal described it. “I think after a while you become a sociopath to some degree because you have to maintain this persona,” he says, about the constant need to put the ‘DJ act’ on when meeting people.

“I pulled all my [social] accounts when I retired,” Caulfield continues. “On a narcissistic level, it’s an epidemic, so pulling my Facebook account was a real personal vindication and was one of the most beneficial things for my health.”

“Narcissism is entwined within the fabric of the scene. As a DJ you are projecting yourself to a younger crowd and when you start getting out of touch with that and you can no longer trust your own instincts about what is good and what is cool, that its time to relinquish a bit.”

At what point, after you’ve been promoting yourself and talking-up your own work, do you actually begin to believe the hype you’ve created about yourself? Social media only inflates the DJ-super-ego. Even though, as I discuss with Caulfield, DJs rarely have anything interesting to say.

The Wild Card
Bill Hicks famously said, “I want my rock stars dead,” and in a weird way, we do actually want to see our idols suffer, due to our sycophantic relationship with celebrity and media. There’s a collective ‘sigh’ when our favourite drug-addled musician cleans up, because we worry that the music quality might suffer. Or we drop our shoulders when we read that a DJ we adore doesn’t drink. How can we relate to someone who isn’t as decadent as us?

We are naturally drawn to the eccentrics; the Sven Väths, Squarepushers, deadmau5s – in this world. Some of these wild cards might not have the best grip on reality, but then again, that’s what makes their art so great. “You don’t have to be mentally healthy to be an artist,” Caulfield explains. “Just make sure its not killing you or hurting anyone else around you.” Caulfield makes reference to Danny Tenaglia’s ‘breakdown’ in 2012, in which he took to social media to resign from DJing. During his online rant the US jock complained about how poor he was (‘many people think I am wealthy but I assure I am not’) and that he was intending to move out of his NY loft. Of course this didn’t happen and his resignation was short-lived, but there it was; a breakdown made public through the internet – for all to see.

In all areas of art, we are drawn to those whose eccentricities are exuburated by their individual neuroses: Vincent van Gogh, Daniel Day Lewis, Kurt Cobain. As Joost van Bellen said, “you have to be a little twisted to be a good DJ.”

The Last Taboo
It’s clear that more than likely, some of our favourite DJs have exhibited some of the pior listed traits about irrationality, dependency and depression. Yet, the topic at hand seems to have been ignored in conversation.

While researching the article I reached out to many artists for their opinion and almost all of them declined to comment. This as much didn’t come as a great surprise. While reading Barnes’ Meoko article I saw that Elite Force, aka. Simon Shackleton, had commented on the piece heavily, so I decided to reach out to get his opinion on the situation. “Generally people are very guarded about this side of things,” he told me. “There’s so much smoke and mirrors when it comes to this profession, and honest responses would probably be seen as a sign of weakness by many people.”

“…There’s so much smoke and mirrors
when it comes to this profession…”

Again, there was that reference to avoiding public displays of weakness. Caulfield also touched upon this during our conversation. “No one wants to be a downer,” Caulfield explains. “In these days people who are downers get scuttled under the carpet, this relates to drug usage too.”

Caulfield thinks that the image of the troubled DJ might also have a detrimental impact on their career, which is why people stray away from the topic. “The legitimate side of dance music, where it has moved to now, i.e. big money and business, has grown and any sign of weakness is deemed to be bad. People often will look for a way to take advantage of that.”

All of this, he explains, is tied together through the intricate web of social media. Once someone becomes more open through social media, then their message spreads like wildfire through the music community. Just look at Tenaglia.

Breaking The Habit
The DJ community has become very open when discussing their nefarious habits, such as drug abuse, sexual promiscuity and other on-the-road mishaps. Yet the only way to break the taboo surrounding mental health issues, is to discuss them freely, in an environment free from judgement. Is the electronic music scene ready for that? We can hope that our scene that was born out of open tolerance and liberty, can also embrace the needs of its more challenged participators.

The elements of conceitedness and for all practical purposes, machoism, need to also be addressed. We can’t carry on expecting that DJs live this party-hard, facile style-of-living. By allowing them to be more open and honest, we might even help ourselves approach reality with a fresh perspective. One individual in particular we can point to is Seth Troxler. From his extremely candid interview with Resident Advisor about the problems of holding down relationships, to his RBMA lecture which touched up upon the issues of holding it together, Troxler has been a luminary among the DJ community about discussing real-life problems.

We also need to address our own expectations and understand what effect they have on those we look up to. At some point we should have said, “hey Sasha, Xpander was really cool. I don’t care if you do another album or not, just be who you are.”

Going out, partying and dancing, are forms of escapism; an attempt to temporarily detach ourselves from reality. But how do DJs indulge in escapism and what happens when they need a break? No wonder there’s this perpetual relationship with DJs and drugs. This should be a warning sign, that we need take this issues more seriously.”  – author  Dan Cole, editor-in-chief, djbroadcast.net

 

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Hacking Social Isolation, published on TechCrunch.com

25 Jun

Hacking Social Isolation, published on TechCrunch.com

This article was written for TechCrunch.com‘s #Love column, which is a special column focused on digital matters of the heart.  Thank you Jordan Crook, TechCrunch tech journalist for the opportunity to contribute my writing.

Tech in dating: decoding the social rules of text, online dating & social media

1 Jun

Let’s face it: flirting, finding love and managing relationships have always been complicated, but with the involvement of countless forms of technology now impacting every little step of the way, the social rules of love and sex have only gotten more confusing. The role of tech in dating is a primary topic in psychotherapy sessions I conduct with young singles in the Bay Area of California- the world’s hub and backbone of tech culture. Part of my role as their clinical psychologist is to help them decode and navigate the emerging social rules of text, online dating and social media to help them achieve fulfilling relationships. I recently spoke withTech Crunch journalist Sara Buhr, who was investigating dating trends among people immersed in the tech industry. Some of the questioned she asked of me were: How are the norms and expectations different? Are young men in tech less likely to follow traditional social rules of dating? How has the proclivity toward using dating websites changed the dating game? This article was born from that conversation, and aims to illuminate the challenges of social connection in the 21st century.

So what do we already know? If you want to communicate personally with anyone these days, you’ve got to text them. Casual, easy and non-threatening, text messaging is upending today’s dating culture. The cellphone is the gateway: swiftly and radically changing the way people interact, meet and move forward (or not) in a relationship. According to a report released in 2013 by Nielsen based on actual phone bills of mobile contract subscribers, about 764 text messages per person were sent/received each month in the USA in 2012, compared with about 165 mobile calls per month. A new survey of 1,500 daters provided to USA TODAY reveals how deeply mobile technology has rocked the dating world. The daters, ages 21 to 50, give even greater insight into mobile behaviors and a new range of dating questions: Do you check your phone during a date? How soon must you reply to a text? Should a friend call or text you to see how the date is going?

Among the findings:

•Approximately one-third of men (31%) and women (33%) agree it’s less intimidating to ask for a date via text vs. a phone call.

•More men (44%) than women (37%) say mobile devices make it easier to flirt and get acquainted.

Texting is kind of an ongoing conversation. It does make it easier to flirt. Maybe you’re talking every day,” says Alex Pulda, 27, who works in product research in San Francisco. “It’s not like text conveys a ton of emotion, but you are getting a little more comfortable with each other.” Pulda says he texts for everything, including dates. “I don’t love phone calls,” he says. “They have all the downsides and don’t have the benefit of face-to-face communication. It’s kind of this in-between. And part of it is, it’s a lot more work than a text.”

Millennials’ love of texting is rubbing off on other generations, suggests Naomi Baron, a linguistics professor at American University in Washington who has studied electronically mediated communication in five nations, including the USA. She says telephone calls are often thought of as an intrusion, while texting affords a way of “controlling the volume,” a term she uses to describe the sense of control that text gives users that they can’t get with a voice conversation. “We tell ourselves we don’t want to disturb someone. Sometimes it’s true, but more often, it’s because we can’t get them off the phone,” she says. In texting, “we don’t have to talk to people or listen to what another person has to say. We decide how we want to encounter or whether we want to encounter other people. Technology gives us tools for controlling our relationships.” In the modern world of dating, it’s becoming increasingly difficult to know how our electronic messages are being perceived and paced by others.

It’s not uncommon (and quite the norm) for my patients to save texts, tweetsstatus updates and Gchats to discuss and analyze during our psychotherapy sessions. These digital exchanges are often at the root of their increased anxiety and worry, social tension, and depressive symptoms such as decreased concentration and irritability at work and other important areas of functioning. Life coach Debra Smouse explains “when a response [from others] doesn’t come, we begin to worry. When we don’t hear back, our minds start to spiral, creating crazy scenarios and we begin to believe that something is wrong. We know logically that a friend may have left his or her desk or a colleague may be on a call, but when we’re on the other end and stress hits, an unanswered chat box is discomforting, and logic goes out the window.” [Technologies like Gchat] “make us think that because the technology is ‘instant’ and free, people should respond instantly — and there’s something wrong when they don’t,” adds Alex Soojung-Kim Pang, author of “The Distraction Addiction.”

It’s not just the frequency and pace of our electronic messages that are difficult to decipher. The content of these exchanges can also be equally confusing in the context of modern dating (a.k.a ‘hanging out‘), getting to know each other, (a.k.a ‘internet stalking‘) and sex (a.k.a ‘hooking up‘.) Ambiguous, common messages like “what’re you up tonight, anything fun going on?”, “I’m out drinking with some friends if you’re around”, and “hey” are all commonplace in the current dating marketplace, can make it difficult for people to gain traction towards building a committed relationship. The normalization and proclivity toward using dating websites in recent years contributes to a pattern of non-comittal social ties. Mobile apps like Tinderokcupid and plenty of fish supply people with a never-ending source of new social opportunities. The problem is that “young people today don’t know how to get out of hookup culture” Donna Freitas explains, author of the forthcoming book, “The End of Sex: How Hookup Culture is Leaving a Generation Unhappy, Sexually Unfulfilled, and Confused About Intimacy.” “Dodging vulnerability cheats us of the chance to not just create intimacy but also to make relationships work”states Brené Brown, a University of Houston researcher whose work focuses on the need for vulnerability and what happens when we desensitize ourselves to it.

In this light, people can utilize psychotherapy as a way to build social skills to help them find, evolve and navigate romantic relationships. Dean, a Millennial who writes about her generation (generally born 1982 to 2000) says, “We really see this generation as having a huge handicap in communication. We have our heads down in our smartphones a lot. We don’t know how to express our emotions, and we tend to hide behind technology, computers and social media.” she says. With diminished opportunity for healthy social relationships, this generation is at increased risk for anxiety, depression and isolation.

As a mental health professional, I help people identify the relationship between their thoughts, feelings and behaviors that are leading them to feel ‘stuck’ in unfulfilling social patterns. It’s a slow process- teaching pacing and managing expectations are key to lasting progress. Participating in psychotherapy can help people increase their ability to establish and maintain fulfilling relationships. With these relationships come the superior health benefits of physical contact and emotional intimacy, love, trust and not-so-cyber sex.

Cohabitation: a generational trend that’s here to stay, but does it work?

30 Apr

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Once in a while a treatment issue pops up so frequently among young adult patients in my psychotherapy practice, I begin to feel like it’s a generational trend, or perhaps specific to living in the Bay Area.  More and more people are struggling to make their romantic relationship work while cohabiting.  Like many desirable urban areas, Bay Area rent prices continue to soar with no end in sight.  In spite of having well-paying jobs, many young adults are weighed down with hefty student loans, and have learned to enjoy an expensive lifestyle where smartphone bills, an expectation of recreational travel, eating out, and ‘networking over drinks’ are the norm.  Many couples start moving in together in their mid-twenties, reasoning “it’s too early to get married, I need the freedom to make life decisions and consider what’s best for me before settling down” or “we were staying at each other’s places all the time anyway, it made sense to save money on rent and get a place together- living together will give us a chance to see if our relationship will work before making bigger decisions about engagement or marriage.”  Cohabitation among young adults appears to be here to stay, but does it work?

Cohabitation in the United States has increased by more than 1,500 percent in the past half century. In 1960, about 450,000 unmarried couples lived together. Now the number is more than 7.5 million. The majority of young adults in their 20s will live with a romantic partner at least once, and more than half of all marriages will be preceded by cohabitation. This shift has been attributed to the sexual revolution, the availability of birth control, and in our current economy, sharing the bills makes cohabiting appealing.  In a nationwide survey conducted in 2001 by the National Marriage Project, nearly half of 20-somethings agreed with the statement, “You would only marry someone if he or she agreed to live together with you first, so that you could find out whether you really get along.” About two-thirds said they believed that moving in together before marriage was a good way to avoid divorce.  Premarital cohabitation allows couples to experience a “trial run” before making the real commitment of marriage.  Following this logic, those who cohabit before marriage are more prepared for marriage having already lived together, and reducing their risk of divorce.  Research studies have shown however that premarital cohabitation should be considered with caution if marriage is the desired outcome, particularly for serial cohabiters.  “People who live with multiple partners have higher divorce rates. If you’ve only lived with the person you are going to marry, you have no greater chance of getting divorced than a couple who hasn’t lived together” says Sharon Sassler, a professor of policy analysis and management at Cornell University who has extensively studied cohabiters.

Couples who opt to live together before marriage, engagement or otherwise clearcut commitment, tend to be less satisfied with their marriages and more likely to divorce than couples who do not. These negative outcomes are called the cohabitation effect.  Researchers originally attributed the cohabitation effect to selection, or the idea that cohabiters were less conventional about marriage, and therefore more open to divorce. As cohabitation has become a norm, however, studies have shown that the effect is not entirely explained by individual characteristics like religion, education or politics. 

What contributes to the cohabitation effect? 

Relationship inertia.  Some couples who would not (and likely should not) have gotten married do so because they were already living together. The threat of having to separate complicated living arrangements and shared belongings may be enough to keep some couples together.  Some couples may find themselves on a path toward marriage because it seems more palatable than the alternative.

Conflicting agendas.  Researchers discovered that in heterosexual relationships women were more likely to view cohabitation as a step toward marriage, while men were more likely to see it as a way to test a relationship or postpone further commitment.  This gender asymmetry was associated with negative interactions and lower levels of commitment even after the relationship progressed to marriage.  There is a dearth of information on same-sex couples who choose to cohabit; their circumstances should be distinguished from heterosexual couples since same-sex relationships continue to be impacted by discriminatory laws prohibiting same-sex marriage in the United States.

Sunk costs and cognitive dissonance.  How do these concepts apply?  The more time and energy people invest into a relationship the harder it becomes to end the relationship, even if cutting their losses will save them more heartache in the future.  Further, people tend to strive for consistency between their feelings, behaviors and circumstances.  Even if there are plain signs a relationship is no longer rewarding or even functional, living together can lead people to adjust their views so that their current living arrangements continue to ‘make sense’.  

Decreased opportunity to meet other (potentially better suited) partners.  Couples who live together are likely spending more time together, narrowing their exposure to other people who frankly might be a better match, romantically.  Some people end up investing years of their 20’s and 30’s into relationships that might have lasted only months had they not been living together.  

 

One thing men and women do agree on, however, is that relationship standards for a live-in partner are lower than they are for a spouse.

Young adults in psychotherapy treatment illuminate the dilemma of cohabitation:

“It’s true, I make about 30 thousand dollars more annually than my girlfriend does. But I don’t think I’d be ready to pay more of our bills than she does, unless we were married…but we’re not, we’re living together.”  James, age 29

“My [live-in] boyfriend doesn’t like that I go out and stay out so late drinking with my friends.  It’s like he expects me to stay in, just because he’s tired from working all the time.  Why shouldn’t I go out and have fun with my friends? I think once I’m actually married to him things will be different, I’ll want to do different things when I’m married. I’ll be thinking about having kids, and my friends will be married too.”  Audrey, age 27

“Everything is going really well with my girlfriend, we’ve been living together for almost a year now.  Except she has made it very clear she wants to move back East to be close to her family once she’s married and ready to have kids. Her mind is made up. But my career in tech is growing here, the company I founded is based here in Silicon Valley and my family is here too.  So what should I do doc?  Enjoy our relationship for now since we’re so young? Or break it off now rather than avoid the inevitable?”  Mark, age 26

What is the impact of the cohabitation effect on one’s mental health?  Dr. Lloyd Stockey, a board certified primary care physician at Kaiser Hospital’s flagship medical center in Oakland, California weighs in on the topic. “[Cohabitation] is like a lease or practicing to see if you really want to commit. Unfortunately, it sets the bar low. There’s no real commitment with living together. It’s an opt out clause, and it’s never equal. It’s a roommate situation after 2 years.  Everyone ‘goes for self’ when cohabiting. Career, freedom, and personal success comes before commitment and family. The younger generation thinks it’s commonplace to upgrade partners, and is satisfied being single parents.  The landscape has changed. There’s blurring in gender roles, household leaders, finances, and expectations. Playing house is exactly what it is. It’s monopoly money. Looks good on paper and everyone is playing, but not worth anything when the game is over.  Codependency and living arrangements cause a majority of adjustment disorders and depression in family medicine. It’s messy in a lot of ways. It’s just like Facebook says–single, married, or it’s complicated.”

The bottom line: cohabitation is here to stay, and there are things young adults can do to protect their relationships from the cohabitation effect. Meg Jay is a clinical psychologist at the University of Virginia and author of “The Defining Decade: Why Your Twenties Matter — and How to Make the Most of Them Now advises – it’s important to discuss each person’s motivation and commitment level before opting to move in together, and view it as an intentional step toward, rather than a convenient test for marriage or partnership. It also makes sense to anticipate and regularly evaluate constraints that may keep people from leaving the relationship.  Couples who communicate openly and regularly will likely reduce ambiguity about their partner’s commitment, and have realistic expectations about the future of their relationship.  Sassler says the takeaway from her research at Cornell is that couples need to talk about situations such as the possibility of pregnancy, whether they’ll split household expenses evenly, and general expectations about gender roles. 

Understanding the role of cohabitation in the success and failure of relationships has far-reaching implications for generations to come.  Recent estimates suggest that about 33% of all children of unwed parents are born to parents in a heterosexual cohabiting relationship, and more than 50% of all children born in the United States will live in a house headed by at least one unwed parent.  Those who contemplate cohabiting can benefit from educating themselves about the benefits and risks, and utilize resources on how to make a smooth and successful transition to cohabitation (couples workshops, relationship books, working with a family/couples therapist).  Whether or not people subscribe to traditional societal expectations for marriage, choose to cohabit or not, my aim for the individuals in my psychotherapy practice is that they become better equipped at participating in happy, functional and rewarding romantic relationships.

Dr. Christina Villarreal is a licensed clinical psychologist in the Bay Area, CA.  She has a private psychotherapy and forensic assessment practice with office locations in Rockridge and San Francisco.

 

 

Dr. Villarreal has added a second office location in San Francisco’s Financial District

6 Feb

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I will be opening up a new psychotherapy office in the financial district of San Francisco beginning March 1st, 2014! This office will be a second location for me, as I will continue to see patients in Market Hall, located in the Rockridge area of Oakland. My new office address is at 220 Montgomery, located in the historical landmark Mills Tower Building, regarded as the city’s second skyscraper after the Chronicle Building and home to several major financial firms including the New York Stock Exchange. Please pass this update to anyone who might be interested in psychological services, including psychotherapy and forensic assessment.

Freshman year college survival guide: 20 tips for success

17 Oct

The autumn season for many young people is an exciting time of year. Seniors in high school are excitedly anticipating next steps in their educational paths, contemplating their college selection and admission possibilities. Freshman in college are in the throes of their first term/semester, scrambling to survive and balance their newfound independence, educational demands, and social development. In my practice as a clinical psychologist I treat young people as they learn to navigate these important life transitions.

One of the questions I am asked most often by young people is “How did you make it through college successfully and get in to graduate school? How did you become a clinical psychologist with your own private practice? I also receive emails from young people all over the country hoping I might share with them helpful advice on building a prosperous career in psychology. Many of them do not have role models to approach for guidance, particularly young people of color and/or those who may be the first generation to attend college in their family or community.

An excerpt from a message I recently received:

Dear Dr. Villarreal,
I am a senior in high school in Utah. Since I was in 8th grade I was interested and fascinated with psychology. I am still interested now that I’m a senior. I want to be a clinical psychologist and I came upon an interview that you did on YouTube and you really stood out to me. I am also a Hispanic female, therefore you were really inspirational to me! I had some questions about how you chose your undergraduate school. This seems to be the only thing I am worried about and I don’t exactly know what I should be looking for. Also, I know that I want to open my own private practice in the future and I wanted to know how you started yours. Thank you so much for you time.

At every step along my journey through college and graduate school I benefited from peers, teachers, and supervisors who helped guide me towards success and taught me to tap into the essential motivation and stamina it takes to overcome the inevitable challenges, setbacks and failures along the way. According to American College Testing (ACT), one in every four college students leaves before completing their sophomore year and nearly half of all freshmen will either drop out before obtaining a degree or complete their college education elsewhere. The tips in this article serve as a guide to surviving your first year of college with improved odds for success. Developing the right tools, skills, and habits early on can help you not only succeed in college and your future career, but in managing a well-balanced life.

  1. Attend freshman and campus orientations. It is extremely tempting to skip some of the long-winded freshman year orientations that take place at the beginning of the school year. Even if you don’t hear any new information, these gatherings are an excellent opportunity to ask questions, meet other like-minded peers, and commit newly learned information to memory.
  2. Make an effort to befriend roommates and others in your residence hall. The people you live with your freshman year are all likely going through similar transitions and emotions as you, and can be huge source of support as you adjust. This built in network of people serves not only as a team to problem solve day-to-day challenges, but will open up continued opportunities for social support.
  3. Stay on campus as much as possible your first year. Frequent trips home to eat or do laundry, off campus jobs, or maintaining romantic partners from home can stand in the way of fully adjusting to college. The more time you spend acclimating to your campus and new peers, the more comfortable you’ll be in your new environment and the more likely you are to thrive there.
  4. Get organized. In high school, teachers typically lead you through all the homework and due dates. In college, professors hand out a course syllabus and/or post the assignments online for the entire term/semester and expect you to prepare independently. While digital devices are a great way to get organized, maintaining a hard copy calendar is also extremely helpful for mapping out a ‘master timeline’ for completing all your readings, assignments, tests, and other important events. While good grades might have come naturally to you in high school, you will have to develop a new set of organization and study habits to survive your new educational setting.
  5. Become an expert on course requirements and due dates. Professors spend hours preparing course syllabi and calendars so that you will know exactly what is expected of you, and when. One of my most memorable failures (that thankfully I can laugh about now) is when I didn’t realize that a freshman course final exam was only ‘optional’ for those people who’d earned a certain number of points by the end of the semester. Don’t get burned by finding some things out too late!
  6. Commit to a study area and time schedule. With a never-ending calendar of social opportunities, campus events and parties it’s very easy for unstructured ‘study time’ to fall by the wayside. As early as possible, carve out specific times in your schedule to complete your readings and studying. Set realistic deadlines for yourself and stick to them. Choose a place with as few distractions as possible and make a commitment to going regularly. Selecting study partners is also important- decide early on which of your peers are better as study partners and which are better reserved for socializing only.
  7. Seek a balanced life. College life is an ever-changing mix of social opportunities, academic demands, and self-care. Try to prioritize what’s most important to you in advance and then make your choices accordingly. Peers can be extremely influential in your daily habits so try to surround yourself with like-minded people who will help you maintain a balance that’s well-suited to your personality and abilities.
  8. Attend class regularly. Avoid the temptation to sleep in or go late to that 8 am class. Without parents or attendance requirements to keep you on track, it’s a slippery slope when you start giving yourself permission to skip classes. Even if your professor is simply reviewing a powerpoint presentation that is available online, you’ll miss the exposure to auditory learning which will help you perform better on exams and assignments. You also risk missing vital information from professors about what to expect on exams, changes in due dates, etc.
  9. Connect with students in your classes. Aim to meet at least one new person in each of your classes and exchange contact information with them. Everyone appreciates someone else making an effort to say hello, so try to overcome feelings of shyness. These connections will serve as an important resource when you have to miss a class or need to build or join a study group down the road.
  10. Visit your professors during their office hours. Speaking as a professor, I can assure you there are only benefits to getting to know your professors, especially if later in the semester you run into some problems and need to ask for extensions or planned absences. Professors maintain office hours for the sole purpose of meeting with students to help them troubleshoot and succeed in their course.
  11. Meet with your academic adviser at least twice a year. This is the person who will help you with course conflicts, adding and dropping courses, planning out your terms/semesters, and selecting majors and minors and their requirements. Your academic adviser can play an integral role in leading you towards a timely graduation. Don’t be afraid to request another adviser if you don’t click with the one assigned to you.
  12. Don’t feel pressured to decide on a career right away. Even if it seems like everyone else knows what they’re doing with their lives, try to resist committing prematurely to a specific career path if you feel undecided. College is a time for you to explore what you enjoy learning in greater depth. It may take a few different directions before you have a greater sense of how you’d like to spend your time once you graduate. Further, just because it feels like a struggle to succeed in a given area, don’t give up easily. Trust your attraction to a particular area of study. Passion is the fuel for hard work and determination, which will allow you to succeed over time.
  13. Consider joining student organizations. A big hurdle for a lot of new students is the combination of homesickness and a feeling of not belonging, particularly for students of color, sexual minorities and those living far from their regional home. Look into joining student organizations, clubs, sororities or fraternities, or sports teams. You’ll benefit from much needed social support, learn new skills, and feel more connected to your school.
  14. Don’t be afraid to enlist extra help. One of the biggest mistakes students can make is not securing extra help early on, before becoming overwhelmed and lost. Take advantage of the study resources on campus- most have learning labs and tutors available, or consider joining/forming a study group. Don’t feel ashamed for needing extra resources or support. Every successful professional (including myself) got there by adopting a ‘do whatever it takes’ approach to achievement. College is a humbling time for just about everyone at one point or another. Make an effort to shift your focus away from evaluating yourself by the grades you earn. Instead, look for upward growth as a marker of success. My own college transcripts definitely reveal a slow and humble start, with steady improvements along the way.
  15. Stop comparing yourself to everyone else. Everyone learns in different ways, and at different paces. Everyone comes from different backgrounds with a wide range of life experiences, making college easier or harder, depending on their origins. If I’d given up after realizing other people were learning faster than me, or earning higher grades than me, I definitely would NOT have succeeded in earning a Ph.D. I wasn’t the smart kid who earned straight A’s, and I had to work much harder and longer than many of my peers to achieve passing grades. I made a lot of mistakes and faced a fair amount of setbacks along the way. Eventually college got easier, even though the courses got harder because I became more familiar with what study habits worked best for me. In spite of those challenges and setbacks, I continued to pursue my long term goal of becoming a licensed clinical psychologist. Accept early on that it may take you longer than expected to reach your goals, and the path you take to get there may be different from those around you. Keep asking for help, but be prepared to work harder than others around you if you expect to see successful, competitive results.
  16. Take responsibility for yourself and your actions. Try not to waste time placing blame on others for problems you face along the way. Move on and take the attitude that no one else is worth losing sight of your goals. Part of being an adult means taking responsibility for what happens to you, regardless of how you got there.
  17. It’s normal to feel overwhelmed. College is a time of tremendous change and ongoing challenges. Expect to have moments when everything seems too difficult to continue, or feeling like everyone else seems to be getting along better than you. Take a break and wait for those moments to pass; they will. Just keep moving forward and take one day, one week at a time.
  18. Make time for self care. Be sure to set aside time and activities that help you relax and take the stress out of your day or week. Whether it’s spending time with friends or communicating with family for support, engaging in your favorite type of exercise or hobby, or having downtime watching your favorite television shows or movies, be good to yourself. It will feel like you don’t have time to relax! But by doing so you will recharge and have better focus when you return to your studies.
  19. Maintain healthy eating and sleeping habits. Adequate sleep and nourishment are essential for maintaining your mood and energy level. While college dorms and apartment settings are great places to socialize with your peers, they aren’t always conducive to maintaining good health habits. Make a concerted effort to develop and maintain realistically healthy dietary and sleep habits. Freshman are especially vulnerable to gaining weight from unrestricted junk food and alcohol consumption. Aside from taking a negative toll on your physical health, don’t underestimate how these bad habits can affect your mental health as well. Even if you are the envy of your friends because you’re less prone to alcohol hang-overs or weight gain, poor health habits will eventually take a toll on your mental functioning and consequently your ability to thrive at your highest potential.
  20. Seek professional help when you need it. Familiarize yourself with your college’s health resources and counseling centers. If you become sick, or notice ongoing feelings of isolation, anxiety or depression, don’t wait for things to worsen before taking advantage of the many services these offices provide for students. You don’t have to face these issues on your own. Consider asking a friend to go with you if you feel reluctant to go alone or offer to go with a peer who may be struggling. Keep a list of emergency hotlines for handling crises such as experiencing suicidal thoughts, sexual violations or violence.

BONUS TIP: Keep track of your spending habits. While a fortunate few of you will have adequate financial support during your college years, many of you will need to learn how to budget your money and spending habits early on. Regardless of your financial resources, it’s important to develop responsible skills in money management- the earlier the better. Avoid succumbing to credit card solicitations on campus or in the mail. The average credit card debt of college graduates is shocking, and can take a staggering number of years to pay off. Familiarize yourself with what options you have in your college’s financial aid center, and plan accordingly.

Final Words of Advice for College Students~ Your college years will fly by before you know it.  Try to hold on to the positive experiences and let go the hardships. Invest in healthy relationships and avoid negative people that can drain you, stress you out, pressure you, or demand more of you than you can afford to give. Don’t be afraid to try new things, go new places, or take new risks! Some of the best experiences I had were the result of taking a leap of faith in myself and my ability to figure something out after the decision/commitment was already made. Roll the dice and bet on yourself to succeed, even if the odds are seemingly stacked against you. Remember that setbacks are NOT failures, they are extended opportunities to learn and grow in new ways. Furthermore, what you learn from those setbacks will prove to be the backbone of your strength and abilities later in life. Forgive yourself for making mistakes. No one else is keeping track like you are; as soon as you get back on the right path, those incidents will fade away as you continue to accrue new achievements. I look forward to hearing your success stories!

Dr. Christina Villarreal is a licensed clinical psychologist and maintains a private psychotherapy and forensic assessment practice in Oakland, CA.

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CBT for Treating Mood Disorders

9 Oct

CBT for Treating Mood Disorders

Among the various psychotherapeutic “talk therapies,” cognitive-behavioral therapy (CBT) appears to be the most effective approach.  CBT is the modality of treatment I use within my psychotherapy practice in the Bay Area, CA.  Like all psychotherapies, much of the success depends on the skill of the therapist as well as the connection one develops with their therapist over time.  What can you expect in a typical session of CBT?

Approach.  CBT focuses on identifying distorted perceptions that people have developed of the world and themselves, revealing how these maladaptive perceptions influence feelings and behavioral choices.  CBT strategies help people adjust these perceptions, and discover new, healthier patterns of thinking. These perceptions, known as schemas, are negative assumptions developed in childhood that can precipitate and prolong mood disturbances.  CBT works on the principle that these schemas can be recognized and altered, thereby changing the response and eliminating disturbance in mood.

  • First, you will learn to recognize depressive and/or anxious reactions and thoughts as they occur, usually by keeping a journal of thoughts, feelings and reactions to daily events.
  • “Homework” may be given in order to practice testing old, negative assumptions against reality, illuminating what may have been previously ignored or overlooked
  • In conjunction with your therapist, you will learn to examine and challenge these maladaptive automatic thoughts and reactions.
  • You will learn to identify how your particular style of thinking has led to patterns of low moods as well as patterns in interpersonal conflicts.  You will learn how to employ new, healthy coping strategies tailored to your special needs.

Over time, CBT can help to rebuild the confidence necessary for you to sustain healthier patterns of functioning.

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Shootings Advice from Oakland Clinical Psychologists

2 Feb

Dr. Villarreal, along with her colleague Dr. Frank Davis, was interviewed by journalist/blogger Zennie Abraham of www.zennie62.com regarding the Newtown Shootings.

sandyhook students, of Newton, CT

[from article produced by Zennie Abraham] “In the wake of the Newton Shootings, many people have a lot of questions. But perhaps the most well-considered one concerns how do we spot a person who might commit such an act before they do it?

To get to that answer, I turned to Oakland and Berkeley-based clinical psychologists Christina Villarreal and Frank Davis, respectively for a talk.

The main reason for Adam Lanza’s murder of 26 people, 18 of them kids, was simple: “access to guns,” is the comment both Dr. Villarreal and Dr. Davis pointed to in our conversation. “There may have been some mental health issues,” speculated Davis. “We have to speculate that there were mental health issues, but as of this time no report has been made (explaining that), Villarreal said.

What To Do If You Think Someone Has A Problem

If you think you know someone who has a mental illness problem that could lead to gun violence, Christina Villarreal and Frank Davis recommend that you talk to the person and also talk to a mental health professional for advice, too.

What About Internet Threats?

Some post threats of life to others on the Internet, but does that count as a issue of concern? Dr. Davis says it does. “I would take the threat seriously,” he said. And Davis also explained that it’s better not to consider such an act as benign. Dr. Villarreal said that it’s also important to make sure parents of children know what they’re accessing online, in order to keep them both from threats and from the possibility that they may be issuing threats via the Internet.

The watchword is to watch. Watch people around you and what they do. Be ready to ask questions of the person you think has the problem.

I would add this: support gun control. We have too many guns in our society, and that has to end.

Stay tuned, Zennie Abraham

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