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How to Discuss Difficult Topics with Children by Rebecca Spooner MA, LPC

In today's world, we have the ability to readily access the latest news about events occurring within our communities and across the globe. While there are many benefits to the accessibility of information, news on the latest tragedies across the world can oftentimes be a source of anxiety for many, including children.

A desire to shield children from difficult news may lead some to shy away from these topics, but children are often already exposed through peers, television, the internet, and various social media platforms. Creating conversations with children about traumatic events such as community violence, natural disasters, or foreign conflicts, provides an opportunity for increasing understanding, correcting misperceptions, and providing reassurance. Such conversations can play a role in helping children learn to cope with the events that occur in the world around them. 

The following article published by The American Psychological Association provides some helpful information on how to facilitate these conversations with the children in your life. 

“How To Talk To Children About Difficult News”

“Children's lives are touched by trauma on a regular basis, no matter how much parents or teachers try to keep the "bad things" away. Instead of shielding children from the dangers, violence or tragedies around us, adults should talk to kids about what is happening. 

The conversation may not seem easy, but taking a proactive stance, discussing difficult events in age-appropriate language can help a child feel safer and more secure.

As much as adults may try to avoid difficult topics, children often learn or know when  something sad or scary happens. If adults don’t talk to them about it, a child may overestimate what is wrong or misunderstand adults’ silence.  So, be the first to bring up the difficult topic. When parents tackle difficult conversations, they let their children know that they are available and supportive.

Guide the conversation

Think about what you want to say. It’s OK to practice in your head, to a mirror or with another adult. Some advanced planning may make the discussion easier. You won’t have to think about it off the top of your head.

Find a quiet moment.

Perhaps this is after dinner or while making the next day’s lunch.  This is time and place where your children can be  the center of your attention.

Find out what they know. 

For example, there was a shooting at a school or a bomb set off in another country. Ask them "What have you heard about this?" And then listen. Listen. Listen. And listen more.

Share your feelings with your child.

It is OK to acknowledge your feelings with your children. They see you are human. They also get a chance to see that even though upset, you can pull yourself together and continue on.  Parents hear it often: Be a role model. This applies to emotions, too.

Tell the truth. 

Lay out the facts at a level they can understand. You do not need to give graphic details.

For young children, you may need to have the conversation about what death means (no longer feel anything, not hungry, thirsty, scared, or hurting; we will never see them again, but can hold their memories in our hearts and heads).

Say, "I don’t know." Sometimes the answer to the question is "I don’t know." "Why did the bad people do this?" "I don’t know" fits.

Above all, reassure. 

At the end of the conversation, reassure your children that you will do everything you know how to do to keep them safe and to watch out for them. Reassure them that you will be available to answer any questions or talk about this topic again in the future. Reassure them that they are loved.

Take care of yourself

Talking about and experiencing difficult news and tragedies can be exhausting. Don’t forget to take care of yourself: 

Turn off the news.

Take a break.

Engage in physical activity.

Do something that will lift your spirits and those of your family. 

Seek professional help

These tips and strategies can help you guide your children through the current crisis. If you are feeling stuck, overwhelmed or your child shows persistent signs of stress or agitation, you may want to consider talking to someone who could help. A licensed mental health professional such as a psychologist can assist you in developing an appropriate strategy for moving forward. To find a psychologist in your area, visit the Psychologist Locator”

Additional resources

Disaster Distress Hotline - SAMHSA.gov

Listen, Protect, Connect – Psychological First Aid for Teacher & Students (PDF, 2MB) - Ready.gov

Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event – a guide for parents, caregivers, and teachers (PDF, 300KB) - SAMHSA.gov

Helpful Hints for School Emergency Management: Psychological First Aid for Students and Teachers: Listen, Protect, Connect – Model & Teach (PDF, 430KB) - U.S. Department of Education

Explaining the News to Our Kids - CommonSenseMedia.org

Children & Grief: Guidance and Support Resources - Scholastic.com

The Road to Resilience - APA.org

How to talk to children about difficult news. 2015, November. Retrieved from https://www.apa.org/helpcenter/talking-to-children.

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Helpful Information to Assist in the Transition from Summer to School By Randall Rubida, MFT

Easing a Child’s Summer to School Transition https://www.psychologytoday.com/us/blog/abcs-child-psychiatry/201608/easing-child-s-summer-school-transition. Internet Retrieval 8/22/19.

Summer is coming to an end.  For many, that means no more late nights playing video games or watching movies, being at the pool all day, or simply having the freedom to do what we want.  School means that we have to jump back into the routine: getting up at 6 am, completing homework after school, eating dinner at a certain time and of course, having a set bedtime.  Many children and adolescents handle this transition quite well.  But others may find this transition to be extremely challenging.  Being proactive and taking a few steps to support your child during the transition can help them start the school year off positively.

The following article from Psychology Today may be helpful:

Sleeping and Waking

One of the more difficult transitions is getting up early, ready to meet the day.  The several hour difference from a summer bedtime to a school bedtime can be a challenge.  A good intervention would be to move your child’s bedtime earlier by 30 minutes over the course of several days to prepare them for the earlier school wake time.  An added suggestion would be to not have them go to bed with their phones.  This prevents that late night texting and other forms of social media.

Family Meals

Family meals are a good idea in general, but this is often lost during the summer as children and parents go off in a million directions.  As the new school year approaches try letting the family know that family meals are back on.  Consider making “family favorite” meals to increase your family’s buy-in.

Restarting Routines

Sometimes summer means structured routines like chores or lessons become a little more relaxed.  Bring back these routines before the start of the school year can assist in rebuilding that sense of structure and predictability.

School Anxiety

For many children the beginning of a new school year is not an exciting time.  The disappointment that summer is over or the fear of starting a new grade can be challenging.  But for some children this level of anxiety can be more severe.  Talking to your child about what specifically is causing them anxiety can lead to a discussion about possible solutions.

The goal of all these steps is to help your child start school on the right foot.

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Thoughts Give Us Feelings  by Sarah Kunkel MS, LPC, CAADC -Contribution by Joseph H. Lucas PsyD

Human emotions or feelings are caused by thoughts.  The fact is that every emotion is preceded by a thought regardless of the situation.  There are two types of thoughts that we should be aware of:  Conscious thoughts (manual thoughts) and automatic thoughts.  Sarah Kunkle, LPC provides some very interesting insights into how we can be in charge of our thinking, which ultimately allows one to be in charge of their emotional state.

Imagine enjoying your afternoon lunch break by taking a stroll through the nearest shopping center. It’s a beautiful sunny day, you have your favorite iced coffee in hand and you’re peering through the windows of each shop you bypass. As you’re mindlessly walking down the sidewalk, you see one of your favorite coworkers, Jane, sitting at an outdoor table about 10 yards away, eating her lunch. You haven’t seen Jane since she returned from vacation, and you’re wondering how she is and how her time off was. So out of excitement, you wave and happily call out “Hey Jane!” But...Jane doesn’t answer you. She doesn’t even look up from the sandwich placed in front of her. So now you are standing there like a statue, feeling awkward, disappointed and confused because you assume the worst, “I must have done something, Jane is upset with me.”  Now, instead of catching up with your friend, you quickly turn around and head in the opposite direction, still wondering what you did wrong.

Let’s pause for a second and run through this scenario again and notice the patterns. You see a friend eating her lunch nearby. You think to yourself, “I want to talk to her!” You feel happy and excited to catch up, therefore you try to get her attention. When Jane doesn’t respond, your thought changes to “I did something wrong,” which makes you feel sad. You, therefore, decide to walk away.

BUT, what if you didn’t cause Jane to be upset? What if she didn’t purposefully ignore you? What if there was another reason for her behavior?

The moment you realized Jane didn’t answer you, an automatic thought popped into your head. This thought caused you to feel sad, which prompted you to walk away.  So what if you intentionally thought about the situation in a different way? When you noticed Jane didn’t respond, what if you said to yourself “she must not have heard me” or “maybe she doesn’t recognize me”. How do you think you would feel? Instead of being sad, perhaps you are more understanding or even feel silly! Do you think you would still walk away and just not talk to Jane? Probably not! You would likely be more inclined to walk closer to her and get her attention. This is because you have the power to change your thoughts! If we can control our thoughts, that means we can also control our feelings and behaviors!

All-day long we are thinking and have a flow of both conscious (on purpose) and automatic thoughts (not on purpose). Automatic thoughts pop up very quickly in response to a stimulus. Automatic thoughts can be beneficial and give us clues of how to respond to a situation, but they can also be hurtful to us and lead to patterns of even more unhelpful thoughts, emotions, and behaviors. In the above scenario, we had an automatic thought about why Jane didn’t respond to us. The automatic thought caused emotions of sadness and led to us avoiding Jane all together. But when we took a moment to notice the unhelpful thought and changed it to something different, we also changed our emotions and behavior.

We have so much power when it comes to our emotions and behaviors, but that process starts with the ability to catch, check and change our unhelpful automatic thoughts. If we can make it a habit to notice when our thoughts are causing unwanted emotional responses, we can strengthen us ability to form more desired behaviors.

The following article:

The goals and techniques of Cognitive Behavioral Therapy:

by Barbara Crăciun Titu Maiorescu- University, Bucharest, Romania and

 Manuela Răscol-National R&D Institute for Food Bioresources, Bucharest, Romania

“Abstract According to Beck's model, maladaptive cognitions include general beliefs or schemas about the world, the self, the others, and the future of a person, giving rise to specific and automatic thoughts, most of the times negative in certain situations. The model proposed by Beck argues that therapeutic strategies aimed at changing these maladaptive cognitions lead to changes in the direction of decreasing emotional stress and problematic behaviors (Clark, & Beck, 2010). The goal in cognitive-behavioral therapy is to change patterns of thinking or behavior that are behind people's difficulties, and so change the way they feel (Wright, & Davis, 1994). Keywords: Cognitive Behavioral Therapy, depression, therapeutic strategies, Socratic dialogues, action plan Corresponding author: Manuela Răscol Phone number: - E-mail address: manuela.rascol@gmail.com Crăciun, B. & Răscol, M. RJCBTH 2 I. INTRODUCTION The goal in cognitive-behavioral therapy is to change patterns of thinking or behavior that are behind people's difficulties, and so change the way they feel (Wright, & Davis, 1994). A broad research conducted in 2012 that examined 269 meta-analyses has shown the importance of cognitive-behavioral interventions for a variety of issues, including: depression and dysthymia, bipolar disorder, anxiety disorders, somatic symptom disorders, eating disorders, insomnia, substance abuse disorders, schizophrenia and other psychotic disorders, personality disorders, aggression, criminal behaviors, general stress, stress due to general medical conditions, chronic pain and fatigue, stress related to pregnancy complications and female hormonal disorders. Also, a series of meta-analyses examined the efficacy of CBT for various problems in children, young and elderly (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012). Although cognitive-behavioral approaches differ from one another, they share the following features:  The existence of a relationship based on collaboration between the client and the therapists (Bachelor, 1995);  The concept that psychopathological disorders are due to cognitive distortions or maladaptive cognitions (Kovacs, & Beck, 1986);  The therapeutic process is focused on changing cognitions for the desired restructuring at the level of affective processes and behavior (Samoilov, & Goldfried, 2000);  The time-limited nature and psychoeducational approach to which there is included the use of well-structured problem-solving strategy (Hayes, 2012). Also special attention is paid to the achievement of homework, the client being assigned the responsibility of change, playing an active role in the psychotherapeutic process (Beck, 2011). 

II. CONTENT THE ROLE OF COGNITIVE BEHAVIORAL THERAPY IN DEPRESSION Beck (1987, 1979, and 1988) considers that the negative and distorted way of thinking is the foundation for depression. In 1987, the quoted author wrote about the so-called cognitive triad that leads to depression. The first element of the cognitive triad refers to the fact that the subject has a negative image of his or her own person. The client minimizes his qualities and accentuates his flaws, considering that his flaws prevent him from being happy. The second element of the triad consists in the tendency of the subject to negatively interpret the life events by selectively extracting only those elements that come to confirm their Cognitive Behavioral Therapy & Depression RJCBTH 3 conclusions (the selective abstraction process). The third element concerns the pessimistic vision of the depressed about the future. He believes that his problems and difficulties will continue indefinitely, anticipating only misfortunes and failures for the future (Beck, 1979). Depressive people generally set rigid, perfectionist, impossible targets. Their negative expectations are so strong that even when they are successful they expect failures in similar actions they will undertake in the future (Holdevici, & Crăciun, 2015). 

The negative thoughts of depressed people are centered around disasters, irreversible losses and failures, which gives them sadness, disappointment, and apathy. The cognitive approach focuses on the specific problem area and the reasons the subjects invoke for their depressive state. Thus, some of the behavioral symptoms of depression are: inactivity, withdrawal, and avoidance. Clients say they are too tired to do something, they will feel even worse if they try and fail whatever they want to do (Beck, 1998). The therapist will use the Socratic dialogue, asking those questions such as: “What happens if you try to do this?”, “How do you know that it is useless to try?” etc. The therapeutic strategy will consist of establishing a program that will include gradual activities that will be performed by the client. In the beginning, we draw easy tasks that are likely to be successful and which will contribute to forming a more optimistic attitude of the subject. The therapist will convince the client that if he does something he will feel better than if he does nothing (Mor, & Haran, 2009). A difficult situation is where some of the depressed clients develop suicidal thoughts. In such cases, the therapist will help them find alternatives to the situation they are part of (in addition to giving up life) and to split complex issues into some smaller ones, prone to be easier to solve. For example, you can ask the client to compile lists of the reasons for living and of the ones to die. Next, we can identify alternative ways of seeing problems and solving them constructively.

 A particular feature of the depressed client is the inclination towards self-criticism. The attitude of inadequacy, weakness and lack of accountability are at the basis of the person's selfworth. The therapist will ask the client the following questions: “If I make such a mistake, do you despise me as much as you despise yourself?” The absolutism of categorical imperatives that generate depression and negative selfimage will also be highlighted and examined. Depressive subjects also claim that they feel a lot of suffering and that nothing can make them better (Young, Weinberger, & Beck, 2001). In such situations an effective strategy may be the use of the sense of humor, made in connection with the experiences or behaviors of the client. If the client manages to amuse himself a little, this may be an antidote to the state of sadness. Crăciun, B. & Răscol, M. RJCBTH 4 Another particular feature of depressed people is that they tend to exaggerate the importance of external problems, demands and pressures. Subjects feel surpassed by how many things they have to accomplish and think they will never be able to carry them out (Beck, 1991). After discussing the issues that trouble them, clients start to realize that they tend to amplify their personal difficulties. As a result of the therapeutic treatment, clients gain a new perspective on their existence and the tasks they have to accomplish with the therapist, they can make a list of responsibilities, prioritize and develop realistic action plans (Beck, & Dozois, 2011). Since the implementation of these action plans is often inhibited by disruptive negative thoughts, the therapist will help clients identify and modify them through cognitive strategies. After learning to fight against their doubts by fighting them during the psychotherapy session, clients will be helped to apply the new cognitive and behavioral skills to real life situations. 

III. CONCLUSIONS Cognitive therapy is a short, time-limited intervention focused on current events, although some aspects of the client's life history can be addressed in the course of the action in certain situations (Beck, & Beck, 1995): - When the client has an imperative need to talk about his past; - When the therapist considers that past data is essential to highlight how basic dysfunctional beliefs have been formed and structured. The goals of the therapeutic process involve reducing symptoms, solving client’s problems and preventing relapses. The therapeutic relationship in cognitive therapy is warm, empathetic, non-evaluative and based on trust. The therapist does a conceptualization of the case, is active, creative and guides the client during the Socratic dialogue towards self-discovery and the use of cognitive and behavioral problem-solving techniques. The role of the cognitive therapist is a catalyst that helps the client understands how thoughts, attitudes and beliefs influence their thinking and action. The therapist will act by correcting the clients' cognitions, which will facilitate the change process and help him form new habits (Beck, 1979; Raue, & Goldfried, 1994). The client will also play an active role during the therapeutic process, presenting the problems he/she wants to work with, identifying and modifying cognitive distortions, understanding the essential elements of therapy and carrying out homework. The therapist and the client will work together to conceive assumptions that will then be tested to confirm or invalidate their veracity. Beck (2005) is of the opinion that it is more effective for the patient to discover by himself alternative ways of thinking than to be suggested Cognitive Behavioral Therapy & Depression RJCBTH 5 by the therapist. Finally, clients learn to become their own therapists, able to restructure their dysfunctional thinking style, solve their problems, and prevent possible relapses. Homework or “action plan�� is structured according to the specific issues of each client, the goal of which is to teach clients new problem-solving skills and to test their beliefs in new life situations (Beck, & Dozois, 2011). Regardless of the issues addressed, the therapist will help the client to come to alternative interpretations of life situations that disturb him/her. For example, a depressed student can assess the situation where the assistant does not ask him to speak at the seminar, saying: “He thinks I'm stupid and I have nothing interesting to say; of course he is right because all my colleagues are smarter and better prepared than I am... I felt inferior to others”.

 Under the guidance of the therapist, the client will find other possible explanations for the assistant's behavior: he is rushing; he already knows the point of view of the student in question; he wishes to test the level of training of other students etc. In this example, dysfunctional thoughts and beliefs will be debated and replaced by some realistic alternatives. In cognitive-behavioral approach the client's involvement and motivation represent basic arguments in the success of the therapy.

 References Bachelor, A. (1995). Clients' perception of the therapeutic alliance: A qualitative analysis. Journal of Counseling Psychology, 42(3), 323. Beck, A. T., & Dozois, D. J. (2011). Cognitive therapy: current status and future directions. Annual review of medicine, 62, 397-409. Beck, J. S., & Beck, A. T. (1995). Cognitive therapy: Basics and beyond (No. Sirsi) i9780898628470). New York: Guilford press. Beck, A. T. (1979). Cognitive therapy and the emotional disorders. Penguin. Beck, A. T. (1991). Cognitive therapy: A 30-year retrospective. American psychologist, 46(4), 368. Beck, A. T. (2005). The current state of cognitive therapy: a 40-year retrospective. Archives of general psychiatry, 62(9), 953-959. Clark, D. A., & Beck, A. T. (2010). Cognitive theory and therapy of anxiety and depression: Convergence with neurobiological findings. Trends in cognitive sciences, 14(9), 418-424. Hayes, S. (2012). Cognitive behavior therapy. W. T. O'Donohue, & J. E. Fisher (Eds.). Chichester, UK: Wiley. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive therapy and research, 36(5), 427-440. Crăciun, B. & Răscol, M. RJCBTH 6 Holdevici, I., Crăciun, B. (2015). Psihoterapia tulburărilor emoţionale. Editura Trei, Bucureşti. Kovacs, M., & Beck, A. T. (1986). Maladaptive cognitive structures in depression. Essential papers on depression, 240-258. Mor, N., & Haran, D. (2009). Cognitive-behavioral therapy for depression. Israel Journal of Psychiatry and Related Sciences, 46(4), 269. Otto, M. W. (2000). Stories and metaphors in cognitive-behavior therapy. Cognitive and Behavioral Practice, 7(2), 166-172. Raue, P. J., & Goldfried, M. R. (1994). The therapeutic alliance in cognitive-behavior therapy. The working alliance: Theory, research, and practice, 173, 131-152. Samoilov, A., & Goldfried, M. R. (2000). Role of emotion in cognitive‐behavior therapy. Clinical Psychology: Science and Practice, 7(4), 373-385. Young, J. E., Weinberger, A. D., & Beck, A. T. (2001). Cognitive therapy for depression. Clinical handbook of psychological disorders: A step-by-step treatment manual, 3, 264-308. Wright, J. H., & Davis, D. (1994). The therapeutic relationship in cognitive-behavioral therapy: Patient perceptions and therapist responses. Cognitive and behavioral practice, 1(1), 25-45 “

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Common Meditation Myths

By LaTasha Thomas, MS, LPC

Meditation is one of the most common ways one can practice a mindful lifestyle. However, misunderstanding sometimes prevents some from exploring this empirically tested tool with benefits, such as: reduced symptoms of anxiety and depression, improved concentration and memory, as well as an increased ability to emotionally regulate.

Do you feel that meditation is difficult? Do you wonder where you will find the time, in an already busy day, to meditate? Do you believe that meditation has to be spiritually or religious based?

If you answered “yes” to any of the above questions, you may benefit from the following article, where common myths of meditation are discussed in further detail by Deepak Chopra, a world renowned Medical Doctor, author and mindfulness practitioner.

7 Myths of Meditation

By Deepak Chopra, M.D

In the past forty years, meditation has entered the mainstream of modern Western culture, prescribed by physicians and practiced by everyone from business executives, artists, and scientists to students, teachers, military personnel, and – on a promising note – politicians. Ohio Congressman Tim Ryan meditates every morning and has become a major advocate of mindfulness and meditation, as he describes in his book, A Mindful Nation: How a Simple Practice Can Help Us Reduce Stress, Improve Performance, and Recapture the American Spirit. Despite the growing popularity of meditation, prevailing misconceptions about the practice are a barrier that prevents many people from trying meditation and receiving its profound benefits for the body, mind, and spirit. Here are seven of the most common meditation myths dispelled.

Myth #1: Meditation is difficult.

Truth: This myth is rooted in the image of meditation as an esoteric practice reserved only for saints, holy men, and spiritual adepts. In reality, when you receive instruction from an experienced, knowledgeable teacher, meditation is easy and fun to learn. The techniques can be as simple as focusing on the breath or silently repeating a mantra. One reason why meditation may seem difficult is that we try too hard to concentrate, we're overly attached to results, or we’re not sure we are doing it right. In our experience at the Chopra Center, learning meditation from a qualified teacher is the best way to ensure that the process is enjoyable and you get the most from your practice. A teacher will help you understand what you’re experiencing, move past common roadblocks, and create a nourishing daily practice.

Myth #2: You have to quiet your mind in order to have a successful meditation practice.

Truth: This may be the number one myth about meditation and is the cause of many people giving up in frustration. Meditation isn’t about stopping our thoughts or trying to empty our mind – both of these approaches only create stress and more noisy internal chatter. We can’t stop or control our thoughts, but we can decide how much attention to give them. Although we can’t impose quiet on our mind, through meditation we can find the quiet that already exists in the space between our thoughts. Sometimes referred to as “the gap,” this space between thoughts is pure consciousness, pure silence, and pure peace. When we meditate, we use an object of attention, such as our breath, an image, or a mantra, which allows our mind to relax into this silent stream of awareness. When thoughts arise, as they inevitably will, we don’t need to judge them or try to push them away. Instead, we gently return our attention to our object of attention.In every meditation, there are moments, even if only microseconds, when the mind dips into the gap and experiences the refreshment of pure awareness. As you meditate on a regular basis, you will spend more and more time in this state of expanded awareness and silence.

Be assured that even if it feels like you have been thinking throughout your entire meditation, you are still receiving the benefits of your practice. You haven’t failed or wasted your time. When Chopra Center co-founder Dr. David Simon taught meditation, he would often tell students, “The thought I’m having thoughts may be the most important thought you have ever thought, because before you had that thought, you may not have even known you were having thoughts. You probably thought you were your thoughts.” Simply noticing that you are having thoughts is a breakthrough because it begins to shift your internal reference point from ego mind to witnessing awareness. As you become less identified with your thoughts and stories, you experience greater peace and open to new possibilities.

Myth #3: It takes years of dedicated practice to receive any benefits from meditation.

Truth: The benefits of meditation are both immediate and long-term. You can begin to experience benefits the first time you sit down to meditate and in the first few days of daily practice. Many scientific studies provide evidence that meditation has profound effects on the mind-body physiology within just weeks of practice. For example, a landmark study led by Harvard University and Massachusetts General Hospital found that as little as eight weeks of meditation not only helped people experience decreased anxiety and greater feelings of calm; it also produced growth in the areas of the brain associated with memory, empathy, sense of self, and stress regulation. At the Chopra Center, we commonly hear from new meditators who are able to sleep soundly for the first time in years after just a few days of daily meditation practice. Other common benefits of meditation include improved concentration, decreased blood pressure, and enhanced immune function. See the article Why Meditate? for more benefits of meditation.

Myth #4: Meditation is escapism.

Truth: The real purpose of meditation isn’t to tune out and get away from it all but to tune in and get in touch with your true Self – that eternal aspect of yourself that goes beyond all the ever-changing, external circumstances of your life. In meditation you dive below the mind’s churning surface, which tends to be filled with repetitive thoughts about the past and worries about the future, into the still point of pure consciousness. In this state of transcendent awareness, you let go of all the stories you’ve been telling yourself about who you are, what is limiting you, and where you fall short – and you experience the truth that your deepest Self is infinite and unbounded. As you practice on a regular basis, you cleanse the windows of perception and your clarity expands. While some people do try to use meditation as a form of escape – as a way to bypass unresolved emotional issues – this approach runs counter to all of the wisdom teachings about meditation and mindfulness. In fact, there are a variety of meditation techniques specifically developed to identify, mobilize and release stored emotional toxicity. If you are coping with emotional upset or trauma, we recommend that you work with a therapist who can help you safely explore and heal the pain of the past, allowing you to return to your natural state of wholeness and love.

Myth #5: I don’t have enough time to meditate.

Truth: There are busy, productive executives who have not missed a meditation in twenty-five years, and if you make meditation a priority, you will do it. If you feel like your schedule is too full, remember that even just a few minutes of meditation is better than none. We encourage you not to talk yourself out of meditating just because it’s a bit late or you feel too sleepy.

In life’s paradoxical way, when we spend time meditating on a regular basis, we actually have more time. When we meditate, we dip in and out of the timeless, spaceless realm of consciousness . . . the state of pure awareness that is the source of everything that manifests in the universe. Our breathing and heart rate slow down, our blood pressure lowers, and our body decreases the production of stress hormones and other chemicals that speed up the aging process and give us the subjective feeling that we are “running out of time.” In meditation, we are in a state of restful alertness that is extremely refreshing for the body and mind. As people stick with their meditation ritual, they notice that they are able to accomplish more while doing less. Instead of struggling so hard to achieve goals, they spend more and more time “in the flow” – aligned with universal intelligence that orchestrates everything.

Myth #6: Meditation is a spiritual or religious practice.

Truth: Meditation is a practice that takes us beyond the noisy chatter of the mind into a place of stillness and silence. It doesn’t require a specific spiritual belief, and many people of many different religions practice meditation without any conflict with their current religious beliefs. Some meditators have no particular religious beliefs or are atheist or agnostic. They meditate in order to experience inner quiet and the numerous physical and mental health benefits of the practice – including lowered blood pressure, stress reduction, and restful sleep. The original reason that Deepak Chopra began meditating was to help him stop smoking. Meditation helps us to enrich our lives. It enables us to enjoy whatever we do in our lives more fully and happily – whether that is playing sports, taking care of our children, or advancing in our career.

Myth #7: I’m supposed to have transcendent experiences in meditation.

Truth: Some people are disappointed when they don’t experience visions, see colors, levitate, hear a choir of angels, or glimpse enlightenment when they meditate. Although we can have a variety of wonderful experiences when we meditate, including feelings of bliss and oneness, these aren’t the purpose of the practice. The real benefits of meditation are what happens in the other hours of the day when we’re going about our daily lives. When we emerge from our meditation session, we carry some of the stillness and silence of our practice with us, allowing us to be more creative, compassionate, centered, and loving to ourselves and everyone we encounter.

Retrieved from

https://www.huffpost.com/entry/meditation-myths_b_2823629?utm_hp_ref=mostpopular

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The Emotional and Health Benefits of Petting Pets by Kristen M Gaughan, MS, LPC

Edits by Joseph H. Lucas, PsyD

It has long been stated that pets are great to have around. Who doesn’t enjoy time with Fido the dog or Fluffy the cat? Spending time with our beloved pets may come naturally to some, but science suggests it’s much more. In fact, research suggests that spending more time with animals increases beneficial oxytocin and decreases the stress hormone cortisol, respectively. The benefits of spending time with our beloved pets and animals in general is not a hobby or necessarily a past time, but can is shown to have significant emotional and health benefits. Believe it or not, spending time with animals can actually be considered self care.

Today, many places, including colleges and universities, are bringing this self-care technique to the masses. In the following article from Washington State University entitled “Stress reduction benefits from petting dogs, cats,” the many benefits of petting cats and dogs is explored with the investigation of the effects on 249 university students.

“College is stressful. Students have classes, papers, and exams. But they also often have work, bills to pay, and so many other pressures common in modern life.

Many universities have instituted "Pet Your Stress Away" programs, where students can come in and interact with cats and/or dogs to help alleviate some of the strain.

Scientists at Washington State University have recently demonstrated that, in addition to improving students' moods, these programs can actually get "under the skin" and have stress-relieving physiological benefits.

"Just 10 minutes can have a significant impact," said Patricia Pendry, an associate professor in WSU's Department of Human Development. "Students in our study that interacted with cats and dogs had a significant reduction in cortisol, a major stress hormone."

Pendry published these findings with WSU graduate student Jaymie Vandagriff last month in AERA Open, an open access journal published by the American Educational Research Association.

This is the first study that has demonstrated reductions in students' cortisol levels during a real-life intervention rather than in a laboratory setting.

The study involved 249 college students randomly divided into four groups. The first group received hands-on interaction in small groups with cats and dogs for 10 minutes. They could pet, play with, and generally hang out with the animals as they wanted.

To compare effects of different exposures to animals, the second group observed other people petting animals while they waited in line for their turn. The third group watched a slideshow of the same animals available during the intervention, while the fourth group was "waitlisted."

Those students waited for their turn quietly for 10 minutes without their phones, reading materials, or other stimuli, but were told they would experience animal interaction soon.

Several salivary cortisol samples were collected from each participant, starting in the morning when they woke up. Once all the data was crunched from the various samples, the students who interacted directly with the pets showed significantly less cortisol in their saliva after the interaction. These results were found even while considering that some students may have had very high or low levels to begin with.

"We already knew that students enjoy interacting with animals, and that it helps them experience more positive emotions," Pendry said. "What we wanted to learn was whether this exposure would help students reduce their stress in a less subjective way. And it did, which is exciting because the reduction of stress hormones may, over time, have significant benefits for physical and mental health."

Now Pendry and her team are continuing this work by examining the impact of a four-week-long animal-assisted stress prevention program. Preliminary results are very positive, with a follow-up study showing that the findings of the recently published work hold up.

They hope to publish the final results of that work in the near future.”

https://www.sciencedaily.com/releases/2019/07/190715114302.htm

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What is Neurofeedback and How Does It Help? By Natalie Fleischacker, Psy.D.

Edits provided by, Joseph H. Lucas, PsyD

It was previously believed that our brain was a fixed and hard-wired organ, incapable of change or growth. We now know that our brain is constantly changing, both functionally and anatomically. New brain cells are continually being born, and new connections between those brain cells are generated. These changes in neural connections are called “neuroplasticity.” In general, neuroplasticity is a way for your brain to fine-tune itself for efficiency. Neurofeedback is a non-invasive treatment that harnesses neuroplasticity and retrains the brain to perform at an optimal level and balanced state.

Our brain consists of billions of brain cells, or neurons, that communicate with each other. The messages sent between neurons essentially control our emotions and our behavior. As our brain cells communication, tiny electrical pulses emanate, which are displayed in the form of brainwaves. A host of information can be revealed through brainwaves, such as mood states, thought habits, stress levels, and overall brain function. By changing brain activity, or by changing how one area of the brain talks to another, we can improve attention, better control emotions, and modify behavior. This is where neurofeedback comes in. Neurofeedback actually changes the brains electrical functioning (brain waves) thus improving, cognitive processing, emotional regulation, mood, attention, executive functions and has been shown to improve brain stabilization thus improve outcomes for substance abuse dramstically.

Neurofeedback is a way to train our brain activity. It is based on a specific type of learning called ​operant conditioning. ​According to this principle, behavior that is followed by positive consequences (a reward) is likely to be repeated, and behavior followed by negative consequences is likely to weaken (Skinner, 1938). Thus, operant conditioning reshapes behavior through learned consequences, either negative or positive. With neurofeedback, this is accomplished by ​pairing information about brain activity with positive outcomes and rewards. For example, brainwave patterns are monitored through EEG sensors that are placed on the scalp. This “feedback” is then provided through a catalyst such as a video game. When an optimal level of brainwave functioning is produced, the individual is rewarded by gaining points in the video game. When brain activity becomes dysregulated, the individual will not score points. After repeated exposure to this positive feedback, our brain learns to improve brain waves that enables the patient to achieve an optimal and regulated state.

Many different psychiatric and neurocognitive disorders are marked by specific patterns of brain activity. Neurofeedback can be used to alter these dysfunctional brainwave patterns, thus decreasing symptoms. For instance, a child with Attention-Deficit/Hyperactivity Disorder (ADHD) tends to have increased very low frequency theta brainwaves and fewer high frequency beta brainwaves in certain areas of the brain (Monastra, 2002). Neurofeedback can change these problematic electrical neuro-functioning. Over the course of neurofeedback training, the child would be rewarded each time he/she demonstrates beta waves. Through this process of operant conditioning, the child’s brain learns to increase beta waves and suppress theta waves on a regular basis. Moreover, studies exist that demonstrate that thePositive changes achieve through Nuro feedback are maintained 10 years after treatment (Lubar et. al)

Neurofeedback has been effectively used in the treatment of anxiety, depression, ADHD, Autism Spectrum Disorders, sleep disorders, concussions, Epilepsy, Substance Use Disorders) and more. There is not only a solid body of research showing it to be an effective treatment, research also supports the long-term benefits of neurofeedback (VanDoren, 2018). The significant improvement in cognitive, social, emotional, and behavioral functioning through neurofeedback has generated much interest among scientific communities, which has led to the continuation of empirical research.

References

Skinner, B. F. (1938). ​The Behavior of organisms: An experimental analysis​. New York: Appleton-Century.

Monastra, V, Monastra, D., George, S. (2002). The Effects of Stimulant Therapy, EEG Biofeedback, and Parenting Style on the Primary Symptoms of Attention-Deficit/Hyperactivity Disorder.​ Applied Psychophysiology and Biofeedback. ​27: 231-249.

VanDoren, J., Arns, M., Heinrich, H., Volleybrecht, M., Strehl, U., Loo, K. (2019). Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. European Child & Adolescent Psychiatry.​ 28: 293-305.

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The Sun is Rising on 2019!  Have an amazing year!

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The Drama Triangle - by Latasha Thomas, LPC

The Drama Triangle

Have you ever felt as if you are going round and round in a relationship, whether it be with your child, significant other, friend, or co-worker?  If so, you may be caught in the Karpman Triangle, otherwise known as the “drama triangle”.  The drama triangle is a concept based in family systems therapy that draws attention to dysfunctional ways of being that get in the way of effective communication and lasting connections.  

Most of us enter the drama triangle from the standpoint of the “Victim”.  This normally occurs when one’s expectations go unmet, whether they be spoken or unspoken.  As a result, this person may experience feelings of entitlement which ultimately leads to anger and resentment, starting the shift into the “Persecutor” role.  

As a result of the feelings of anger and resentment experienced in the “Victim” role the “Persecutor” then acts out in an abusive manner, which can be mental, verbal, emotional, or physical. They may withdraw love, sex, or money. Possibly becoming passive aggressive and using guilt as a way to control and manipulate others.  At some point, this person starts to feel remorseful for their less than favorable behaviors and experiences feelings of guilt and shame.  

In order to correct their wrongs they move into the “Rescuer” role. This is where they attempt to make everything right again. Possibly by supplying gifts, favors, praise, and over the top gestures.  If and when these attempts at reconciliation are not accepted the person feels abandoned, resulting in self-pity, starting the cycle all over again.  

Breaking free of the drama triangle is done by:

Taking personal responsibility for your own feelings and actions. This includes keeping your expectations in check and being vocal about needs and desires.

Boundaries. Clear, realistic, and repetitive.

Negotiate/Compromise. Knowing what is a non-negotiable and what can be fluid in nature.  

If anything about the drama triangle resonates with you, reach out to your clinician to further explore ways to empower yourself to recognize when triggered so you have the ability to make the choices that support healthy communication and connection.

Weinhold, B. K. & Weinhold, J. B. (2014) How to Break Free of the Drama Triangle and Victim Consciousness. Colorado Springs, CO: CICRCL Press.

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IS IT MORE THAN JUST THE WINTER BLUES?   By Dr. Natalie Fleischacker

IS IT MORE THAN JUST THE WINTER BLUES?

As the sun begins to set earlier and the winter days get colder, some look forward to snowflakes, icicles, and curling up with a mug of hot chocolate. But for millions of people, winter brings debilitating symptoms of depression that can go way beyond feeling sad. Seasonal Affective Disorder (SAD) is thought to affect roughly five percent of the country, with another 10 to 15 percent having a milder variation of SAD (Melrose, S., 2015. Seasonal affective disorder: an overview of assessment and treatment approaches. Depression Research and Treatment, 2015). Symptoms can include not only depression, but changes in appetite, weight gain, irritability, anxiety, sleep abnormalities, muscle aches and difficulty concentrating.SAD can be tricky to diagnose because many of the symptoms are also found in numerous other psychological disorders. However, there is at least one defining element in every case of SAD; seasonal change. Individuals with SAD typically experience an onset of symptoms in the late fall, which become progressively worse through the winter months. By the spring, symptoms begin to dissipate and individuals return to their baseline level of functioning. Although we have not yet discovered exactly what causes SAD, research has shown a connection between natural light and the brain’s production of serotonin. Serotonin is a chemical that plays an important role in regulating mood. There is evidence that the amount of serotonin in certain regions of the brain declines during the winter, and that bright natural light is associated with higher concentrations of serotonin (European College of Neuropsychopharmacology (ECNP). "Biochemical cause of seasonal depression (SAD) confirmed by researchers." ScienceDaily, 20 October 2014). In regards to treatment, numerous controlled studies have shown cognitive-behavioral therapy to be extremely valuable in not only helping people with SAD, but also in the prevention of subsequent episodes. 

Melrose, S. (2015). Seasonal affective disorder: an overview of assessment and treatment approaches. Depression research and treatment, 2015.

Serotonin findings are discussed in this article:

European College of Neuropsychopharmacology (ECNP). "Biochemical cause of seasonal depression (SAD) confirmed by researchers." ScienceDaily. ScienceDaily, 20 October 2014.

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Codependency:   A Complicated yet Common Issue. - by Kristen Gaughan, MS, LPC

Symptoms of Codependency

When many people hear the word codependency, they believe it means that someone is simply dependent on their partner.  While there is a morsel of truth to that idea, codependency is so much more.  It is a very complicated set of issues that may or may not relate to loving someone with an addiction.  Although the concept of codependency came from the addiction field, the reality is that the term is much more applicable to the general population that must of us would have believed.   The good news is, despite it’s complicated nature, there is help for codependency.   But what is it exactly?  Am I codependent? Is this an issue that I need to be concerned with?  To better understand this complicated concept, this article, “Symptoms of Codependecy” by Darlene Lancer, JD, MFT can bring some clarity.

“Codependency is characterized by a person belonging to a dysfunctional, one-sided relationship where one person relies on the other for meeting nearly all of their emotional and self-esteem needs. It also describes a relationship that enables another person to maintain their irresponsible, addictive, or underachieving behavior.

Do you expend all of your energy in meeting your partner’s needs? Do you feel trapped in your relationship? Are you the one that is constantly making sacrifices in your relationship? Then you may be in a codependent relationship.

The term codependency has been around for decades. Although it originally applied to spouses of alcoholics (first called co-alcoholics), researchers revealed that the characteristics of codependents were much more prevalent in the general population than had previously imagined. In fact, they found that if you were raised in a dysfunctional family or had an ill parent, you could also be codependent.

Researchers also found that codependent symptoms got worse if left untreated. The good news is that they’re reversible.

The following is a list of symptoms of codependency and being in a codependent relationship. You don’t need to have them all to qualify as codependent.

-Low self-esteem. Feeling that you’re not good enough or comparing yourself to others are signs of low self-esteem. The tricky thing about self-esteem is that some people think highly of themselves, but it’s only a disguise — they actually feel unlovable or inadequate. Underneath, usually hidden from consciousness, are feelings of shame.Guilt and perfectionism often go along with low self-esteem. If everything is perfect, you don’t feel bad about yourself.

-People-pleasing. It’s fine to want to please someone you care about, but codependents usually don’t think they have a choice. Saying “No” causes them anxiety. Some codependents have a hard time saying “No” to anyone. They go out of their way and sacrifice their own needs to accommodate other people.

-Poor boundaries. Boundaries are sort of an imaginary line between you and others. It divides up what’s yours and somebody else’s, and that applies not only to your body, money, and belongings, but also to your feelings, thoughts and needs. That’s especially where codependents get into trouble. They have blurry or weak boundaries. They feel responsible for other people’s feelings and problems or blame their own on someone else.Some codependents have rigid boundaries. They are closed off and withdrawn, making it hard for other people to get close to them. Sometimes, people flip back and forth between having weak boundaries and having rigid ones.

-Reactivity. A consequence of poor boundaries is that you react to everyone’s thoughts and feelings. If someone says something you disagree with, you either believe it or become defensive. You absorb their words, because there’s no boundary. With a boundary, you’d realize it was just their opinion and not a reflection of you and not feel threatened by disagreements.

-Caretaking. Another effect of poor boundaries is that if someone else has a problem, you want to help them to the point that you give up yourself. It’s natural to feel empathy and sympathy for someone, but codependents start putting other people ahead of themselves. In fact, they need to help and might feel rejected if another person doesn’t want help. Moreover, they keep trying to help and fix the other person, even when that person clearly isn’t taking their advice.

-Control.  Control helps codependents feel safe and secure. Everyone needs some control over events in their life. You wouldn’t want to live in constant uncertainty and chaos, but for codependents, control limits their ability to take risks and share their feelings. Sometimes they have an addiction that either helps them loosen up, like alcoholism, or helps them hold their feelings down, like workaholism, so that they don’t feel out of control.Codependents also need to control those close to them, because they need other people to behave in a certain way to feel okay. In fact, people-pleasing and care-taking can be used to control and manipulate people. Alternatively, codependents are bossy and tell you what you should or shouldn’t do. This is a violation of someone else’s boundary.

-Dysfunctional communication.  Codependents have trouble when it comes to communicating their thoughts, feelings and needs. Of course, if you don’t know what you think, feel or need, this becomes a problem. Other times, you know, but you won’t own up to your truth. You’re afraid to be truthful, because you don’t want to upset someone else. Instead of saying, “I don’t like that,” you might pretend that it’s okay or tell someone what to do. Communication becomes dishonest and confusing when you try to manipulate the other person out of fear.

-Obsessions.  Codependents have a tendency to spend their time thinking about other people or relationships. This is caused by their dependency and anxieties and fears. They can also become obsessed when they think they’ve made or might make a “mistake.”Sometimes you can lapse into fantasy about how you’d like things to be or about someone you love as a way to avoid the pain of the present. This is one way to stay in denial, discussed below, but it keeps you from living your life.

-Dependency.  Codependents need other people to like them to feel okay about themselves. They’re afraid of being rejected or abandoned, even if they can function on their own. Others need always to be in a relationship, because they feel depressed or lonely when they’re by themselves for too long. This trait makes it hard for them to end a relationship, even when the relationship is painful or abusive. They end up feeling trapped.

-Denial. One of the problems people face in getting help for codependency is that they’re in denial about it, meaning that they don’t face their problem. Usually they think the problem is someone else or the situation. They either keep complaining or trying to fix the other person, or go from one relationship or job to another and never own up the fact that they have a problem.Codependents also deny their feelings and needs. Often, they don’t know what they’re feeling and are instead focused on what others are feeling. The same thing goes for their needs. They pay attention to other people’s needs and not their own. They might be in denial of their need for space and autonomy. Although some codependents seem needy, others act like they’re self-sufficient when it comes to needing help. They won’t reach out and have trouble receiving. They are in denial of their vulnerability and need for love and intimacy.

-Problems with intimacy. By this I’m not referring to sex, although sexual dysfunction often is a reflection of an intimacy problem. I’m talking about being open and close with someone in an intimate relationship. Because of the shame and weak boundaries, you might fear that you’ll be judged, rejected, or left. On the other hand, you may fear being smothered in a relationship and losing your autonomy. You might deny your need for closeness and feel that your partner wants too much of your time; your partner complains that you’re unavailable, but he or she is denying his or her need for separateness.

-Painful emotions. Codependency creates stress and leads to painful emotions. Shame and low self-esteem create anxiety and fear about being judged, rejected or abandoned; making mistakes; being a failure; feeling trapped by being close or being alone. The other symptoms lead to feelings of anger and resentment, depression, hopelessness, and despair. When the feelings are too much, you can feel numb.

There is help for recovery and change for people who are codependent. The first step is getting guidance and support. These symptoms are deeply ingrained habits and difficult to identify and change on your own. Join a 12-Step program, such as Codependents Anonymous or seek counseling. Work on becoming more assertive and building your self-esteem.”

Retrieved 1/21/2019:  https://psychcentral.com/lib/symptoms-of-codependency/

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Gambling Addiction:  A Reality in Today’s World by Kristen M Gaughan, MS, LPC

With the options for gambling exponentially increasing, the possibility for one to acquire a gambling addiction increases as well.   Whether it’s scratch off tickets and casino gambling on a mobile phone, the Monday night bingo game at a church, or raffle tickets for a school fundraiser, gambling is everywhere.   While the field of psychology once saw gambling as a compulsive behavior that does not rise to the level of addiction, this is no longer the case.  Gambling, like any other addiction, can create ruin in many areas of one’s life.  That is why it is essential for an understanding of gambling addiction and its consequences to become commonplace in our culture.  Although gambling can be a leisure activity for many, it can be a devastating experience for a select group of people.   It is time to identify gambling addiction as a genuine problem and give those with this disease the support they need to enter into treatment and gain the recovery that will allow them to take back control of their lives.  The following article by Ferris Jabr in Scientific American entitled, “How the Brain Gets Addicted to Gambling”, can help to shed some additional light on this subject.

“When Shirley was in her mid-20s she and some friends road-tripped to Las Vegas on a lark. That was the first time she gambled. Around a decade later, while working as an attorney on the East Coast, she would occasionally sojourn in Atlantic City. By her late 40s, however, she was skipping work four times a week to visit newly opened casinos in Connecticut. She played blackjack almost exclusively, often risking thousands of dollars each round—then scrounging under her car seat for 35 cents to pay the toll on the way home. Ultimately, Shirley bet every dime she earned and maxed out multiple credit cards. “I wanted to gamble all the time,” she says. “I loved it—I loved that high I felt.”

In 2001 the law intervened. Shirley was convicted of stealing a great deal of money from her clients and spent two years in prison. Along the way she started attending Gamblers Anonymous meetings, seeing a therapist and remaking her life. “I realized I had become addicted,” she says. “It took me a long time to say I was an addict, but I was, just like any other.”

Ten years ago the idea that someone could become addicted to a habit like gambling the way a person gets hooked on a drug was controversial. Back then, Shirley's counselors never told her she was an addict; she decided that for herself. Now researchers agree that in some cases gambling is a true addiction.

In the past, the psychiatric community generally regarded pathological gambling as more of a compulsion than an addiction—a behavior primarily motivated by the need to relieve anxiety rather than a craving for intense pleasure. In the 1980s, while updating the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association (APA) officially classified pathological gambling as an impulse-control disorder—a fuzzy label for a group of somewhat related illnesses that, at the time, included kleptomania, pyromania and trichotillomania (hair-pulling). In what has come to be regarded as a landmark decision, the association moved pathological gambling to the addictions chapter in the manual's latest edition, the DSM-5, published this past May. The decision, which followed 15 years of deliberation, reflects a new understanding of the biology underlying addiction and has already changed the way psychiatrists help people who cannot stop gambling.

More effective treatment is increasingly necessary because gambling is more acceptable and accessible than ever before. Four in five Americans say they have gambled at least once in their lives. With the exception of Hawaii and Utah, every state in the country offers some form of legalized gambling. And today you do not even need to leave your house to gamble—all you need is an Internet connection or a phone. Various surveys have determined that around two million people in the U.S. are addicted to gambling, and for as many as 20 million citizens the habit seriously interferes with work and social life.

Two of a Kind

The APA based its decision on numerous recent studies in psychology, neuroscience, and genetics demonstrating that gambling and drug addiction are far more similar than previously realized. Research in the past two decades has dramatically improved neuroscientists' working model of how the brain changes as an addiction develop. In the middle of our cranium, a series of circuits known as the reward system links various scattered brain regions involved in memory, movement, pleasure, and motivation. When we engage in an activity that keeps us alive or helps us pass on our genes, neurons in the reward system squirt out a chemical messenger called dopamine, giving us a little wave of satisfaction and encouraging us to make a habit of enjoying hearty meals and romps in the sack. When stimulated by amphetamine, cocaine or other addictive drugs, the reward system disperses up to 10 times more dopamine than usual.

Continuous use of such drugs robs them of their power to induce euphoria. Addictive substances keep the brain so awash in dopamine that it eventually adapts by producing less of the molecule and becoming less responsive to its effects. As a consequence, addicts build up a tolerance to a drug, needing larger and larger amounts to get high. In severe addiction, people also go through withdrawal—they feel physically ill, cannot sleep and shake uncontrollably—if their brain is deprived of a dopamine-stimulating substance for too long. At the same time, neural pathways connecting the reward circuit to the prefrontal cortex weaken. Resting just above and behind the eyes, the prefrontal cortex helps people tame impulses. In other words, the more an addict uses a drug, the harder it becomes to stop.

Research to date shows that pathological gamblers and drug addicts share many of the same genetic predispositions for impulsivity and reward seeking. Just as substance addicts require increasingly strong hits to get high, compulsive gamblers pursue ever riskier ventures. Likewise, both drug addicts and problem gamblers endure symptoms of withdrawal when separated from the chemical or thrill they desire. And a few studies suggest that some people are especially vulnerable to both drug addiction and compulsive gambling because their reward circuitry is inherently underactive—which may partially explain why they seek big thrills in the first place.

Even more compelling, neuroscientists have learned that drugs and gambling alter many of the same brain circuits in similar ways. These insights come from studies of blood flow and electrical activity in people's brains as they complete various tasks on computers that either mimic casino games or test their impulse control. In some experiments, virtual cards selected from different decks earn or lose a player money; other tasks challenge someone to respond quickly to certain images that flash on a screen but not to react to others.

A 2005 German study using such a card game suggests problem gamblers—like drug addicts—have lost sensitivity to their high: when winning, subjects had lower than typical electrical activity in a key region of the brain's reward system. In a 2003 study at Yale University and a 2012 study at the University of Amsterdam, pathological gamblers taking tests that measured their impulsivity had unusually low levels of electrical activity in prefrontal brain regions that help people assess risks and suppress instincts. Drug addicts also often have a listless prefrontal cortex.

Further evidence that gambling and drugs change the brain in similar ways surfaced in an unexpected group of people: those with the neurodegenerative disorder Parkinson's disease. Characterized by muscle stiffness and tremors, Parkinson's is caused by the death of dopamine-producing neurons in a section of the midbrain. Over the decades researchers noticed that a remarkably high number of Parkinson's patients—between 2 and 7 percent—are compulsive gamblers. Treatment for one disorder most likely contributes to another. To ease symptoms of Parkinson's, some patients take levodopa and other drugs that increase dopamine levels. Researchers think that in some cases the resulting chemical influx modifies the brain in a way that makes risks and rewards—say, those in a game of poker—more appealing and rash decisions more difficult to resist.

A new understanding of compulsive gambling has also helped scientists redefine addiction itself. Whereas experts used to think of addiction as dependency on a chemical, they now define it as repeatedly pursuing a rewarding experience despite serious repercussions. That experience could be the high of cocaine or heroin or the thrill of doubling one's money at the casino. “The past idea was that you need to ingest a drug that changes neurochemistry in the brain to get addicted, but we now know that just about anything we do alters the brain,” says Timothy Fong, a psychiatrist and addiction expert at the University of California, Los Angeles. “It makes sense that some highly rewarding behaviors, like gambling, can cause dramatic [physical] changes, too.”

Gaming the System

Redefining compulsive gambling as an addiction is not mere semantics: therapists have already found that pathological gamblers respond much better to medication and therapy typically used for addictions rather than strategies for taming compulsions such as trichotillomania. For reasons that remain unclear, certain antidepressants alleviate the symptoms of some impulse-control disorders; they have never worked as well for pathological gambling, however. Medications used to treat substance addictions have proved much more effective. Opioid antagonists, such as naltrexone, indirectly inhibit brain cells from producing dopamine, thereby reducing cravings.

Dozens of studies confirm that another effective treatment for addiction is cognitive-behavior therapy, which teaches people to resist unwanted thoughts and habits. Gambling addicts may, for example, learn to confront irrational beliefs, namely the notion that a string of losses or a near miss—such as two out of three cherries on a slot machine—signals an imminent win.

Unfortunately, researchers estimate that more than 80 percent of gambling addicts never seek treatment in the first place. And of those who do, up to 75 percent return to the gaming halls, making prevention all the more important. Around the U.S.—particularly in California—casinos are taking gambling addiction seriously. Marc Lefkowitz of the California Council on Problem Gambling regularly trains casino managers and employees to keep an eye out for worrisome trends, such as customers who spend increasing amounts of time and money gambling. He urges casinos to give gamblers the option to voluntarily ban themselves and to prominently display brochures about Gamblers Anonymous and other treatment options near ATM machines and pay phones. A gambling addict may be a huge source of revenue for a casino at first, but many end up owing massive debts they cannot pay.

Shirley, now 60, currently works as a peer counselor in a treatment program for gambling addicts. “I'm not against gambling,” she says. “For most people it's expensive entertainment. But for some people it's a dangerous product. I want people to understand that you really can get addicted. I'd like to see every casino out there take responsibility.”

This article was originally published with the title "Gambling on the Brain"

Retrieved 10/31/2018:

https://www.scientificamerican.com/article/how-the-brain-gets-addicted-to-gambling/

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Welcome to Mindfulness by Latasha Thomas, LPC

In a world full of distractions at our fingertips, such as: email, text messaging, and social media, one can find it difficult to remain focused.  The majority of us walk around in a daze.  Aimlessly moving from one task to the next, missing out on the beauty of life. Whether that is a majestic sunrise, the trees changing colors as fall approaches, or the sound of our child’s excitement when they complete a task for the very first time; most of us are numb to the experiences of life.   

The ancient practice of mindfulness helps in the cultivation of present moment awareness which may contribute to improved concentration and focus, as well as an increased ability for emotion regulation.

Jon Kabat-Zinn defines mindfulness as “paying attention, in the moment, non-judgmentally”, and believes that its practice is “meant to serve as an effective counterbalance to all of the ways we get pulled out of ourselves and wind up losing sight of what is important”.

Watch Jon discuss mindfulness and some of its benefits.  

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“The Game, the Brain and the Scary Truth” -by Joseph H. Lucas PsyD

 Aaron Hernandez Had Severe C.T.E. When He Died at Age 27

The Game, the Brain and the Scary Truth

- by Joseph H. Lucas PsyD

 For many football players across the country Mini Camp or summer practice will soon begin for “Pop Warner” through College and even the National Football League (NFL).  Though many parents, coaches, athletic trainers and team physicians will be focused on ensuring players safety from heat exhaustion.

 The most publicised and perhaps most important aspects of the game, “Player Safety” will be put to the test.  The terms “Player Safety” and “Heads Up Football,” mean brain safety.  Through the promotion “correct” tackling technique which is not leading and tackling with the crown of one’s helmet and the teaching of “better tackling techniques,” such as tackling with your “head up looking straight ahead at your target,” safer football’s goal is for players to sustain fewer concussions and Mild Traumatic Brain Injury (MTBI).  

 We now know the dangers of head injuries in sports and any of life’s arenas can have immediate and life-altering effects.  For instance, Twice concussion syndrome (sustaining a significant concussion, before the sequela or adverse neurological and neuropsychological symptoms for the initial concussion have abated) can lead to death and/or permanent brain damage.  The latest brain research and cadaver brain studies indicate that multiple concussions and MTBI can lead to Chronic Traumatic Encephalopathy (CTE), an inorganic and devastating brain “disease” that ultimately leads to death.

Many parents across the country may be considering or even acting upon not allowing their children to participate in football due to the inherent dangers that the game presents to their children’s brains.  Our brains control every organ and process in our body; from our heart rate, blood pressure to thoughts and emotions, even creativity, it is not surprising that parents may balk when signing the consent or permission to play form.

 Perhaps the sport that has arisen to “America’s New Pastime,” but increased awareness of the dangers that lurk inside each and every game, and the lack of evidence to support the fact that tackling with “heads up” is reducing any or immediate or long-term term brain damages, would make this parent get “writer's cramp” when it would come to sign the parental consent form to play football.  You may ask why would an ex-high school cornerback and quarterback make such a blasphemous statement?  Then, I direct you to read the disturbing and sobering article regarding Aaron Hernandez, who at just 27  years old was posthumously diagnosed with Chronic Traumatic Encephalopathy (CTE).  The Ex-New England Patriot and All-Pro Football Player died of a suicide inside the walls of a prison and it is not doubted in my mind that his murderous behavior turned suicidal; both most definitely due to playing football and sustaining multiple concussions and MTBI.”  So read on and hold on for the ride and I warn you, you made need a box of tissues.

 “BOSTON — The brain arrived in April, delivered to the basement of the hospital without ceremony, like all the others. There were a few differences with this one — not because it was more important, but because it was more notorious.

It went to the lab outside the city, instead of the one in Boston, where most of the examinations are performed these days, because it was less likely to attract attention that way. Instead of being carried in through the service entrance, it was ushered in secretly through the underground tunnel system. The brain was given a pseudonym, and only three people knew how to identify it.Other than that, the brain came alone and disconnected from its past, unattached to its celebrity. The sordid details of the man’s rise and fall, the speculation over what went wrong, the debate over justice — all that was left behind for others to assess.

It was just a brain, not large or small, not deformed or extraordinary in appearance, an oblong and gelatinous coil weighing 1,573 grams, or about three and a half pounds, just carved from the skull of a 27-year-old man. The coroner took special care, and it arrived hours later in near-perfect condition.

“They handled everything beautifully,” the neuropathologist said.

The laboratory was a 30-minute drive from the prison where the man hanged himself a night or two earlier. His name was familiar to the scientists, just as he was to people throughout New England and many around the country. Now his brain was about 30 miles north of where the man had most recently worked, in Foxborough, Mass.

They expected a normal brain because of the man’s age.

“I didn’t equate his behavior with the disease,” the neuropathologist said. “I just thought that’s who he was.”

On the table, the brain appeared healthy. The meninges, the layers of translucent membranes that coat and protect the brain, still enveloped it. The brain had a healthy sheen.

The brain was sliced into sheaths, maybe a half-inch at a time, starting at the front. That was where the first inkling came that this was not just another 27-year-old brain. Even to the naked eye, the cross sections had substantial gaps in the tissues — fluid-filled ventricles that expanded as the brain tissue itself shrank. A cross section of a healthy 27-year-old brain looks robust, fleshy. This one was hollowed by boomerang-shaped caverns.

“The reason the skull grows is to make room for the growing brain,” the neuropathologist explained. “Everything is packed really tightly. Nature doesn’t leave any gaps.”

The septum pellucidum, a small membrane between the two halves of the brain, was atrophied to the point that it looked withered and fragile, even perforated. When the neuropathologist later went to look for others in a similar condition, the youngest comparable example was a 46-year-old boxer.

The fornix, a C-shaped bundle of nerves, was similarly deteriorated, stripped of its relative heft. The hippocampus, too. Even some of the most famously diseased brains that the neuropathologist had explored, from men who had died decades later, did not have such obvious signs of destruction when examined by the naked eye.

But only under a microscope could the disease be diagnosed with certainty. Wafer-like tissues were immunostained, using antibodies designed to discolor a specific protein — in this case, tau, which clumps and spreads, killing brain cells. That is where the full scope of the damage was apparent.

Tau, stained brown, appeared like bursts of fireworks in the frontal cortex, the part of the brain that controls decision making, impulse and inhibition. The neuropathologist could see it spreading through the brain. It was in the amygdala, the part of the brain that regulates emotions like fear and anxiety, and the temporal lobe. She spotted “a perfect demonstration” of lesions around the tiny blood vessels, a telltale sign. She found previous microhemorrhages and astrocytic scarring around the ventricles.

She declared the case Stage 3 on her own scale of severity, which goes from 1 to 4. It was the most damage she had seen in anyone that age. Among the hundreds of other brains she had examined and graded, the median age of a Stage 3 brain from \his profession was 67. Now she had one that was only 27.

What made the brain extraordinary, for the purpose of science, was not just the extent of the damage, but its singular cause. Most brains with that kind of damage have sustained a lifetime of other problems, too, from strokes to other diseases, like Alzheimer’s. Their samples are muddled, and not everything found can be connected to one particular disease.

This one looked as if it had been lifted from the pages of a textbook devoted to just one disease.

“It’s rare for us to get a brain of a person this young in such good shape,” the neuropathologist said. “It is a classic case. And it tells us a lot about the disease.”

The brain is no longer a brain, in function or form, because it has been sliced into pieces. Those pieces have been numbered, archived and stored. Scientists still study it, probably will for years, because it is such a perfect, fascinating specimen.

The neuropathologist and her closest associates kept this all to themselves for months, though, until the man’s family agreed to let the results go public. In September, the news came out and the headlines returned, but the neuropathologist did no interviews. She released only a short statement confirming the results of the examination.

“I didn’t want to contribute to the sensationalism,” she said.

But science cannot advance without the cumulative power of research, which was why she was in a university ballroom on Thursday, in front of more than 150 neurologists, pathologists and other scientists.She stood in the dark and put a PowerPoint presentation on the screen, several dozen slides of images showing an immensely atrophied young brain, the mind of a former star in his field who was also a convicted murderer. “He had beautiful pathology, if you can call it beautiful,” the neuropathologist had said earlier.  The particulars of the damage that the neuropathologist detailed — the tangled tau proteins, the battered frontal cortex, the shrunken tissues and the enlarged ventricles — have long become familiar to those paying attention to brain science. They are the things that threaten the long-term future of the industry in which the man worked.This is where his job faces the most scrutiny — under the microscope in darkened labs and in the scientific presentations at academic conferences.

“It’s scientifically interesting,” the neuropathologist said. “To me, it’s a fascinating brain.”

Retrieved 11/14/2017 from: https://mobile.nytimes.com/2017/11/09/sports/aaron-hernandez-brain-cte.html?smid=tw-share&referer=

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What is the Purpose of Psychological Testing and Evaluation? Natalie Fleischacker, Psy.D.

The term “psychological testing” can sound intimidating, and many people are unsure of what such testing entails. In many ways, psychological testing and assessment are similar to medical tests. When a patient is having physical symptoms, a primary care physician may order X-rays or blood tests to understand what’s causing those symptoms. The physician will use the test results to help inform a treatment plan. Psychological evaluations serve the same purpose. Psychologists use tests to measure and observe a client’s behavior in order to arrive at a diagnosis and guide treatment. Although the symptoms of a psychological issue are usually obvious, such as when a child experiences academic or social problems at school, or when an adult struggles to maintain personal and professional relationships, the cause of the problem is not always clear. Psychological evaluations provide a deeper, more complete understanding of the problem that can be gained from a brief office visit. The additional information derived from psychological testing is sometimes needed in order to design the best approach to address the problem.

Psychologists administer tests and assessments for a wide variety of reasons. Children experiencing difficulty in school may undergo testing for learning disabilities. Neuropsychological testing assesses cognitive skills to diagnose conditions such as ADHD, Autism Spectrum Disorders, or Dementias. If a person is struggling at work or school, or in personal relationships, psychological tests can help gain a deeper understanding of contributing factors such as poor anger control, interpersonal deficits, or personality characteristics. Other tests evaluate whether clients are experiencing emotional disorders such as depression or anxiety.

A mental health assessment could stir up a variety of emotions. Depending on the reasons for a psychological evaluation, an individual may feel resentful, hostile, afraid, or anxious. These are all common reactions to someone evaluating how you think and feel. Remember, psychologists, are here to help you work through problems, not judge you.  In essence, the results of a psychological assessment provide a snapshot of one’s emotional/cognitive state, which can serve as a vital step in providing clarity of diagnosis and treatment planning.

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Asperger’s/ASD vs. Schizoid Personality Disorder by Joseph H. Lucas PsyD, ABSNP, CCBT

Today I'm discussing the diagnostic differences between Autism Spectrum disorder-Asperger's disorder and Schizoid Personality disorder. Although these two disorders share comorbidity, they are categorized as distinctly different disorders in the DSM-V. In understanding the differences between the two aforementioned disorders the following article may be helpful. I am providing insights into these two similar disorders because I have treated individuals with both disorders and there are real differences between the two. Specific diagnosis and greater specificity with regards to diagnostic classification, typically, in most cases, results in far superior treatment. However, without significant psychological testing with both quantitative and qualitative measures, it is very difficult for the average practitioner and physician to distinguish these two severe disorders. The following article from April 15, 2014, by Climbing the Cinder Cone may be helpful.

“Making diagnoses can be tricky business. In the medical world, even with all the lab tests and imaging currently available, physicians frequently have a hard time pinpointing the best label (never mind the best treatment) for a set of symptoms. Diagnoses are even squishier in the mental health world, where labels are based primarily on how an individual behaves and feels; lab tests and imaging are rarely used.

Elsewhere in this blog I’ve documented how the diagnoses for our son Nathan changed over time. In his late teens, the notion that he had Aspergers took hold. Psychological tests at his high school qualified him as “autistic-like”; the psychiatrist who finally provided an official Aspergers diagnosis said of Nathan, “He has it, in spades!”

Nathan has been through a few mental health professionals since then. All of them seemed to be on board with the Aspergers diagnosis, although the emphasis of their treatment was on Nathan’s depression, which had reached crisis levels (0r depths).

Nathan started seeing his latest psychologist (Dr S) last July. I gave my input in the first session, and subsequently sat in the waiting room during their monthly sessions. By February’s appointment, I decided it was time to ask Dr S about his impressions, and whether there were adjustments we should make in supporting Nathan’s journey through life.

Dr S asked me what I saw as Nathan’s challenges. I replied, “Blah blah blah his depression, and blah blah blah Aspergers…”

Dr S interrupted me. “Oh, I don’t see any signs of Aspergers. I think Nathan has schizoid personality disorder. Have you ever heard of it?” I shook my head. He then showed me the diagnostic criteria for this scary-sounding label.

“Wow, that does seem to fit him!” I said.

Dr S turned to Nathan. “Are you curious about this?”

Nathan grimaced. “Not really.” He declined to read the diagnostic criteria.

Dr S told me two major things about schizoid personality disorder. First, it would be pointless to try to get someone with Schizoid PD to socialize if s/he doesn’t want to. Second, he said people with Schizoid PD rarely hold jobs.

I left his office trying to wrap my head around this new framework for Nathan’s condition. My new task was to find out more about Schizoid PD. I also wondered how common it is for the diagnosis to be switched with Aspergers or autism spectrum in general. The following is what I have found.

First, it helps to know what a personality disorder is.  This summary from the Mayo Clinic is in plain language (compared to the others I found):

A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and to people. This causes significant problems and limitations in relationships, social encounters, work and school.

In some cases, you may not realize that you have a personality disorder because your way of thinking and behaving seems natural to you. And you may blame others for the challenges you face.

Among the better-known personality disorders are the paranoid, narcissistic, and antisocial personality disorders.

Like all personality disorders, Schizoid PD doesn’t become evident until the teen years or early adulthood. It is more common in males, and is thought to affect 1 – 5% of the population.

Here is a summary of Schizoid PD symptoms, copied from this link to Psychology Today:

The schizoid personality rarely feels there is anything wrong with him/her; symptoms are an indifference to social relationships and a limited range of emotional expression.

Takes pleasure in few, if any, activities

Does not desire or enjoy close relationships, including family

Appear aloof and detached

Avoid social activities that involve significant contact with other people

Almost always chooses solitary activities

Little or no interest in sexual experiences with another person

Lacks close relationships other than with immediate relatives

Indifferent to praise or criticism

Shows emotional coldness, detachment or flattened affect

Exhibits little observable change in mood

It is important to know that Schizoid PD is not schizophrenia, and it isn’t schizoaffective disorder. Both of those involve psychotic symptoms such as hallucinations and delusions. People with Schizoid PD are in touch with reality. That being said, there does seem to be a relationship between Schizoid PD and schizophrenia: they turn up in the same families, and individuals with Schizoid PD may be more likely to develop schizophrenia than the general population. Another condition, called schizotypal personality disorder, has similarities to Schizoid PD but (from what I gather) involves more fear and eccentric behavior.

Other informative links about Schizoid PD are from Wikipedia (lots of detail here!) and the Mayo Clinic. It was disturbing in the latter link to read that one of the risk factors for Schizoid PD is “having a parent who was cold or unresponsive to emotional needs.” I immediately thought of the times I was understated or annoyed in reacting to Nathan’s many meltdowns. Ah, parental guilt! The Wikipedia entry softens this somewhat by saying that the link to parental aloofness is a hypothesis, not a certainty.

Speaking of guilt, I found a website called Out of the FOG, which provides support for family members of someone with a personality disorder. FOG stands for Fear, Obligation, and Guilt – common reactions for those dealing with such a person. Anyway, if you follow the OOTF link above, you’ll see a list of 30 traits that are common in people with Schizoid PD, and toward the bottom of the page is the official diagnostic criteria from the DSM (Diagnostic & Statistical Manual of the American Psychiatric Association).

It appears there are no really great treatments for Schizoid PD. Psychotherapy may help, if the individual decides s/he wants to make progress in coping with society. Medications can be prescribed for some of the symptoms that go along with the disorder, such as depression and anxiety.

As for a diagnosis switching between Aspergers and Schizoid PD, it seems to be a fairly common occurrence. A book about Aspergers published in 2007 that I found on our bookshelf says that some researchers believe Aspergers and Schizoid PD might be the same thing. This article by Barbara Nichols from October 2013 talks about the differences but also says some believe Schizoid PD may be on the autism spectrum. The controversy continues. (The nifty diagram (with teeny-tiny print) at the top of this post was taken from this article).

Internet forums are a good way to find out what others have to say. Here are links to three forums on the topic of Aspergers vs Schizoid PD. This one from Wrong Planet gets into other diagnoses besides Schizoid PD that may come up in the Aspie community. The explanation given by Anasthasia in this Psych Forum is one of the clearest I’ve come across. Among other things, she says that an Aspie struggles with reading social cues; a Schizoid can read them but doesn’t care to. This thread in a forum on CosmoQuest gets off-topic, but was notable to me for posing the idea that Schizoids can change their sociability with a lot of will power, but Aspies are wired differently and therefore cannot.

One last link about the differences: for those of you who watch the BBC “Sherlock” series (with Benedict Cumberbatch), here is someone of the opinion that Sherlock has Schizoid PD, not Aspergers. Which diagnosis do I think fits Nathan better? I’m still a little confused, but the balance is tipping towards Schizoid PD. Sadly, I won’t be able to ask Dr S any follow-up questions: he passed away suddenly 13 days after Nathan’s February appointment. Nathan, who dislikes almost everyone, seemed to be fine with Dr S and their sessions. He expressed surprise but no other emotion on learning of his therapist’s passing.”

Retreived 11/13/2017: https://climbingthecindercone.com/2014/04/15/aspergers-or-schizoid-personality-disorder/

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Neurofeedback is a Great Treatment for Smoking Cessation

Stop Smoking With Neurofeedback

Can Neurofeedack Help You Stop Smoking ?

According to statistics there are about 10 million adults who smoke cigarettes in Great Britain. Every year over 100,000 smokers in the US die from smoking related causes like lung cancer, heart diseases, COPD (chronic obstructive pulmonary disease) and many more.

Nicotine stimulates the brain and when the blood level of nicotine falls the smoker can get withdrawal symptoms such as:

·       Anxiety

·       Craving

·       Restlessness

·       Headaches

·       Hunger

·       Irritability

·       Difficulty with concentration

These symptoms are relieved by the next cigarette. That is why smokers have to smoke regularly to feel normal.

Can Neurofeedback help with Smoking Cessation?

This recent study (2015) showed that there is greater connectivity between certain brain regions in people who successfully quit smoking compared to those who tried and failed. Researchers, using  fMRI (functional magnetic resonance imaging), observed that the 44 smokers who quit successfully had something in common:

Before they stooped smoking they had better synchrony between the insula (the part of brain responsible for urges and cravings) and somatosensory cortex (the centre of the sense of touch and motor control).

Joseph McClernon, the senior author of this study, noticed that “the insula, a large region in the cerebral cortex, has been the subject of many smoking cessation studies that show this area of the brain is active when smokers are craving cigarettes”.

This opens the opportunity for researchers to use Neurofeedback training to increase connectivity between insula and somatosensory cortex in smokers to be more like those who quit successfully. It seems that better connectivity between those two regions of brain can help to quit smoking and Neurofeedback training offers a possibility to increase that connectivity.

There are already case studies that give very promising predictors that Neurofeedback training can truly help to quit smoking.

From this site Paula, 27: “Within one month I stopped smoking cigarette and cannabis, it just wasn’t so pleasant anymore. As a result of the neurofeedback I was already relaxed (that’s what I needed the smoking for). And if I smoked, the relaxed feeling got even less, so it was logical to stop smoking now.
Not long after that, I totally quit drinking alcohol and all this without any effort.
At this moment, after 5 months, I still don’t drink or smoke cigarette or cannabis anymore and I don’t miss it and that is the difference with how I felt in the past when I tried to stop”.

Another single study case is described by Dr Ron Kerner here: He had a patient 49 years old man who smoked 2 pack of cigarettes every day. With Alpha-Theta Neurofeedback Training he reduced his smoking down to 1/2 pack per day. Additionally to this training the patient had begun self-monitoring which was based on recording his reason for smoking each cigarette before he smoked it. This approach enhances awareness and enables  the smoker to focus on their smoking behaviour and frequency.

Neurofeedback and Smoking

In the book Clinical Addiction Psychiatry (2010) Siegfried Othmen and Mark Steinberg explain that Neurofeedback training can help you to prepare yourself for a drug-free existence and train your brain to function without nicotine. Neurofeedback alters the brain reward circuitry so that the association between pleasure, satiety and nicotine is reduced. The results from effective Neurofeeback training will help you feel joy on a daily basis and maintain sobriety.

It is quite apparent to many smokers that their brains function better when they smoke. These people give up smoking at some considerable cost to themselves and perhaps to their relationships and work performance as well, therefore at the beginning of smoking cessation, your brain will be trained so that nicotine no longer offers performance improvement. Later on the main task will be to cessation of smoking. This approach is very successful  in work with marijuana smokers. Patients sometimes are more surprised than clinicians that they are able to give up marijuana unintentionally after they start Neurofeedback training. They report that they forgot to use! The same has been reported for nicotine addiction.