#when I was in counseling (post-diagnosis) I mentioned it but I was focused on my anxiety at the time | Explore Tumblr Posts and Blogs

chibisquirt · 4 years

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You don't have to answer, but if you wouldn't mind. What are some things you've learned about ADHD from Tumblr that are applicable to you, or others you may now? I've been reading more on it and how it manifests in girls/women and was curious when I read your rb on that post about Grammarly

I don’t mind at all! Fair warning: this is gonna be LONG.

I’m going to start by repeating something I mentioned in that post: I was diagnosed in third grade, which was over two decades ago. I had my diagnosis halfway through elementary school, much less high school and two rounds of college. So a lot of the old information about ADHD I learned as a young person, and those things are worth exploring, too.

Example: It’s not that I’m not listening, Mrs. Nock, it’s just that if I try to keep my hands still, then the only thing I will retain from the lesson will be keep your hands still and not the things you trying to teach, which are supposedly important!

(Mrs. Nock was the one who said to me, “I believe you believe you’re paying attention.” Yes, it’s been fifteen years. Yes, I’m still mad. If you can’t have basic respect for your students, don’t teach.)

I figured out half on my own, half because of the counselling that if I had a fidget tool that didn’t require words I would pay better attention than if I tried to sit still. (I still remember being mocked by my dad for fidgeting well after making that discovery, though. Apparently diagnoses should only inform compassion when they’re his.) On the same lines, I also figured out that music in the background wouldn’t work for me if it had words, and television is too distracting for me to use at all. (I have a friend, though, whose ADHD works the opposite way: he has difficulty focusing if there isn’t a television in the background. Yes, both are valid.)

So, the Classics:

I always had trouble with organization and cleaning, had trouble with schedules and calendars and managing my time. Those are the things they’ll warn you about, the things they’ll tell you in counselling are natural and normal things for people with ADHD to have trouble with. Trouble paying attention, sure. Trouble sitting still. Procrastination. Got it.

But if you turn those traits around and re-frame them, they become a new set of symptoms. Adaptations for these new symptoms are more personal and universally applicable in my life, and therefore, to my mind, more useful.

Take Procrastination. (No really: please take it.) That just means “putting it off until tomorrow,” and there are lots of reasons to do it: “don’t have the tool I need” is one of the biggies, “want to conserve steps” trips me up a lot, “I still have time to get to it” is HUGE for me... But a lot of times, these are just superficial reasons. The re-framed symptom is, Trouble making yourself do things you don’t want to do.

ADHD is an executive function disorder. That’s a phrase I first learned on Tumblr, by the way; it may have been mentioned by one of my earlier counsellors, but it definitely wasn’t taught.

This is why soooo many of us have struggled with the perception (including self-perception) that we’re lazy! But no one tells the kid in the wheelchair he’s just lazy for not playing basketball. (Okay, they totally do. People are terrible. Ignore that, stick to the point.) I reframe this the way I do because acknowledging this as a symptom, taking the blame out of it, makes it easier to find adaptation.

Now, this is a personal post. YMMV. But I have an easier time managing my conduct if, instead of calling myself lazy a procrastinator, I say, “I keep not doing that --> oh it’s because I Don’t Wanna --> how can I con myself into doing it?” (Strategies include bargaining, making it easier, powering through but then allowing yourself to stop afterwards, just acknowledging that I Don’t Wanna and allowing that to be valid...) Procrastination is an action, but “executive function disorder” is a disease and “I Don’t Wanna” is its trigger, just as much as an allergy and a clump of ragweed are. “Procrastination” is a powerful sphynx against which I’m helpless, but “I Don’t Wanna Disease” lets me start cultivating my metaphorical catnip and researching the answers to common riddles.

And while we’re talking about procrastination--and trouble with deadlines, and schedules in general--let’s talk about Time Insensitivity. Missed deadlines and perpetual lateness (perpetual) are external actions, just like procrastination, and they can have all sorts of explanations.

(Shoutout to Mrs. Pollack, who looked around a classroom containing thirteen-year-old me, and, knowing full well that I was chronically tardy, declared that “anybody who’s always running late, deep down, they just doesn’t care about anybody else’s time.” Great job with calling the thirteen-year-old a heartless bitch, Mrs. Pollack! As you can tell, I definitely forgot it very quickly, and didn’t at all have a self-critical breakdown about it, periodically revisiting the question of my own inherent selfishness for years!!!)

But ignoring the external actions, let’s take a compassionate look inside the head again. Executive function includes regulation of, and awareness of the passing of, time. Again: you can’t play the basketball with no legs. We literally do not realize what time is doing. Sometimes we do--if we devote enough of our attention to it, which may be a large amount for some, a small amount for others, or a variable amount for the same person. But our brains literally don’t process it the same way.

But hold on a minute--let’s go back to that analogy. Because actually, people with no legs can play basketball! It’s just that you have to use the adaptation of wheelchairs to do it--and that’s an adaptation for the game and for the players.

I use alarms. I’ve recently seen a post about audio memos as alarms. There are people who just slap clocks everywhere. When I was forced to work in a kitchen with no clocks, I used the multi-setting timer and set it for like four hours so I would know if I was keeping on schedule. I also chose a job environment where much of my shift is the same as itself, and rigid punctuality isn’t enforced--that’s adapting my environment, instead of myself. There’s all kinds of adaptations. But you have to know you have the condition before you can compensate for it.

Here’s a fun little story: when I was... oh, eleven? Twelve? My Quaker Meeting’s youth group (#7 whitest phrase I’ve ever written) went to the museum together. One of the stops was in the children’s section, there was a... a pegboard, I think? With some kind of problem on it. A puzzle. Me and a couple others sat down at it, and it took me a while, but eventually I solved it, and I looked up.

I blinked. “Where is everybody?” I said.

“They left,” said my mom. “Half an hour ago.”

I was stunned. “Half an hour ago?! But I couldn’t’ve spent more than ten minutes on this!”

“I promise you, it was half an hour.”

“Why didn’t you call me?? Why didn’t you say my name?”

“We did. Several times.”

To this day, I will swear myself blind that I never heard a thing.

Hyperfocusing. They’ll tell you about the problems focusing; oh yes. They’ll tell you allll about that one. But they won’t tell you about the flip side of it. They won’t tell you about the times when the rest of the world falls away, and the only two things in the world are you and whatever problem you’re trying to solve.

D’y’know what, I bet that’s the reason I test well. I just realized this now, phrasing it like that, but--I’ve always tested well, even when my actual practical applications of things are mediocre I do well with the classroom testing on it. I scored a 39 on the MCAT, back when it was out of 45 and not whatever it is now. (To those with the plain good sense not to want to be doctors: that’s pretty good.) And I just bet it’s because, once I get focused on solving the problems, the other problems--nerves, intrusive thoughts, anxiety--just don’t have room to get in. Hyperfocusing can be a superpower, if you can harness it.

But it can also blind you to everything else. And it works in smaller ways, too: once I think I understand something, it is very difficult for me to perceive information that contradicts that understanding. I still get the map of the Elflands backwards every time I read The Goblin Emperor, just because I pictured it one way, and every indication in the text that it was the other way just fell on deaf ears.

And this one leads right into the next, which is Rejection Sensitivity Disorder. RSD is hyperfocus, but it’s hyperfocus on how everyone must hate you. It’s delightful! I’ve been diagnosed with anxiety and depression, as well, and I do have both of those things, but for my money, I think that this one symptom of ADHD--which no doctor has ever even mentioned to me--has hurt me more than both of those conditions combined.

The last one I’m going to bring up is Auditory Processing Disorder. Now, I’ve gone and gotten re-diagnosed twice in my life, and the last time was just a few years ago, so they actually used this one in the test. The psychologist told me about it, she just didn’t use the phrase Auditory Processing Disorder, and she didn’t tell me that it was its own symptom--she just used it for the test.

What she did was, she gave me two hearing tests, one to test whether or not I could hear, and then the other a list of words that all sounded alike, and I had to mark which one I was hearing. The second part of that was very long, and very boring, and despite scoring perfectly on the first test, I got several wrong on the second. I was actually surprised by that; I at no point suspected I had heard any of them wrong. When she gave me the test, told me this was proof by contradiction, that we were ruling out hearing loss as an alternative explanation for my difficulties. It was only after the test was done that she explained that the pattern I showed was actually part of the diagnosis of ADHD; that we get bored, and stop really paying attention, and that we don’t even know we’re doing it.

...Okay, but you couldn’t have mentioned the part where I also do that every day in real life, lady?!?! It’s not just when we’re bored, it’s not just for long processes. I do this all the time. I actually tell people now that “I actually have a neurological condition that makes it hard for me to hear; I can tell that you’re speaking, but I can’t tell what you’re saying.”

This is 100% true. It is a neurological condition.

We label this a condition, but as a society, we don’t treat it that way. Society treats it as yet another excuse. It’s not. You’re not lazy, stupid or crazy. Neither am I.

I have a condition. Acknowledging that is the first step of treatment. Not five thousand sticky notes, not binders or filing systems or even taking all the doors off the cupboards (although I definitely plan to do that one as soon as I possibly can). Not counselling sessions with so many different people I can’t even name them all, for the love of god please understand that you can’t just fix it with pills.

(Although mad props to the people who thought Concerta would magically solve me at the age of nine! Spoiler alert: it did not do that! But it did mean that my parents felt comfortable blaming me for all my failures again, so it did at least some of what it was designed for, I guess. :) )

I have spent the last few years re-understanding my ADHD it as is: a neurological condition, a disability, and a simple fact of life. A starting place, instead of yet more proof of my own inherent insufficiency. And you know what? When you take the blame and self-hatred out of the diagnosis--when you stop cursing it as the cause of all your problems and start trying to work with it, instead--it gets a lot easier to manage.

#laexploradoraaa

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beerecordings · 5 years

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This might be a bit much to ask but . . . What exactly ARE all the different kinds of therapy? Or at least the common ones? I’ve only ever heard of CBT.

okay so I saved this for the night before my Intro to Counseling final so I could actually use this as review hahaha. this isn’t exhaustive, though, these are just some of the forms we talked about in class. and hopefully I don’t get anything wrong or I’m going to be missing points on the final tomorrow lmaoo

Important note first tho: the most important factor in therapeutic success is not the techniques or even viewpoint employed. It is the client-therapist relationship. You need to find a therapist you can trust who doesn’t seem crazy or ridiculous to you - which ties in to their therapeutic model, but is not dependent on it. Okay? Okay. Don’t be afraid to try out a therapist just because they’re not the exact type that seems right to you. Most therapists function using multiple models and techniques anyway :) Also some of these are more empirically-backed up and reputable than others lol

Okay so yes CBT therapy or Cognitive-Behavioral Therapy! There’s a reason you’ve only heard of this one - it’s popular, effective, and empirically-backed-up more than almost any other therapy because it relies on techniques which are easily empirically tested. CBT looks at the problematic behaviors present in the client’s life, investigates the cognition behind it, and seeks to change the cognition so that the behavior will change. They often use homework and exercises in changing cognition, so the client’s dedication is vitally important.

CBT was derived from early Behavioral Therapy, which does not focus on changing the cognition but merely the behavior. This might sound a little shallow, but it can be very helpful sometimes. You can change precursors to the behavior (driving past the bar makes me want to drink, so I take another route home) or consequences to the behavior (I give my child a popsicle to calm her down when she’s crying, but now I’m going to stop rewarding her). Behavioral therapy functions on the assumption that every behavior is the result of operant or classical conditioning - rewards and punishments in the environment have shaped all behavior. Behavioral therapists help clients set goals and then find concrete ways to work towards them. It is home to treatments such as progressive muscle relaxation, systematic desensitization, and several off-shooting therapeutic models such as DBT, CBT, and mindfulness training.

Psychoanalytic Therapy, to start nearer the beginning, is that Freudian stuff and it’s the worst. The therapist is very much the expert and will tell the client what it is that they are experiencing, even using dreams and other sub-conscious processes as the basis for their assumptions. This version of therapy is what allowed Freud to convince multiple women that they had not been sexually assaulted as children and to dismiss many of their issues as female hysteria. It focuses on the sexual stages of development (which Freud made up and which have been empirically disproven). This form of therapy is not in use anymore, at least in that same original form, but it bears mentioning because it is the sexist old grandpa of pretty much any other form of therapy we use today.

Adlerian Therapy is another old-timer, but much warmer and still in use today. It focuses heavily on early childhood memories, and may ask the client to recreate them using sandbox models or through story-telling. It has a large social focus, encouraging clients to make friends, establish healthy intimacy, and contribute to society as its three main goals. The therapist is the expert in this relationship and happily offers suggestions for ways to develop social interest and encourage self-understanding through childhood development. They will challenge and confront irrational beliefs, but are always very encouraging and ask clients to define themselves in their own context.

Feminist Therapy assumes that the cause of people’s problems is society, not necessarily shaping. They do not like traditional forms of diagnosis because, to them, the problem is not that you have depression or anxiety or BPD or whatever you would traditionally be diagnosed with - the problem is that the system is unjust, and your reaction is an outcry against it. Therefore they encourage social action, social skills training, and power analysis as part of their treatment plans. In feminist therapy, the therapist and client have a completely egalitarian relationship, meaning the therapist is not the expert, but equal to the client. To demonstrate this, the therapist is likely to self-disclose (talk about themselves and their issues and struggles) and work hard to relate to the client. Feminist therapy seeks to show people of all genders, races, cultures, nationalities, sexual orientations, and more the ways that power plays a role in their life and how they can live defending others and themselves.

Person-Centered Therapy is related to the positive psychology movement, so one of its goals is to always see the client in an extremely positive regard! Even when the client does something wrong, the therapist assumes that they were doing the best they could at the time with the mental and emotional resources they had. This model strives for self-actualization: being able to have deep and trusting relationships, accepting that fact that anxiety is a part of life, and being able to be spontaneous and creative! They hold clients in the warmest regard and do not like traditional diagnosis either, because they do not seek to be the expert in the therapy room and make the client the expert. They are present-focused and do not emphasize technique but relationship.

Post-Modern Therapy is kind of out there, I’ll tell you right now. This therapy functions on the viewpoint that reality is always subjectively defined, and seeks to meet the client exactly where they’re at without challenging even irrational beliefs or practices. They don’t use specific techniques, but seek to build up a strong relationship, empowering the client to find solutions based on their own personal view of reality, and have little interest in the causes or history of problems, only in their solutions. They may use strong metaphorical language and can develop a whole personal system of speaking with the client that allows them to express themselves in their own unique terms. Often this therapy is very positive and encouraging, but can be seen as a little… what’s the opposite of concrete? Whimsical, perhaps. Still, some people really find power in it.

Existential Therapy, though? Oh, no. Existential therapy will challenge you and your irrational beliefs. Existential therapy will challenge every belief that you have and every system it hooks up to - your morality, your religion, your life outlook, and on and on. Existential therapy wants clients to see the ways they have taken on irrational and dysfunctional thoughts and behaviors from others and destroy those irrational and dysfunctional thoughts. Once they’re gone, the client can begin rebuilding a system they actually truly believe in. These guys are intense too - they embrace the fact that life causes anxiety, involves pain, and will one day end in death. They seek to help clients deal with that by taking control of their own fate and creating their own meaning in an otherwise meaningless world. The therapeutic experience is meant to be intense, with the deepest part of the therapist meeting the deepest part of the client, and both of them coming out of it changed.

And lastly, Family Therapy is, as you may have noticed, designed for families and relationships! It’s great because it does not assume that the individual is the problem, but that there is dysfunction within the whole system which needs to be addressed. This is great especially for young kids with disorders such as ADHD - family therapy does not allow parents to go “here is the problem child, fix it” and walk away. It requires the whole family to become involved in the dysfunction in the home. Sometimes called Marriage and Family Therapy, this idea is sometimes strange to Westerners, who are used to seeing a single person as a diagnosable problem, but it’s very effective across cultures. Usually the whole family or both members of the couple are invited into the therapy room and the therapist serves as facilitator between them. That being said, there are actually versions of family therapy which work only with the individual, but they always assume that there are other forces acting on the person which are changing their behavior. Family therapists work to help you change your family or relationship environment, but if that is not possible they may help you to cope or even to escape.

But like I said, the relationship and trust with the therapist is what’s most important! Still, I hope this helps people to see just how cool, varied, and unique the therapeutic experience can be, and empowers them to seek the model which will work right for them :)

Wish me luck on my test!

#there's like nine of the most popular ones here #psychology #therapy #counseling

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thescholarlystrumpet · 4 years

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hey! i saw you on naamahdarling's post about therapists and was just wondering what sort of education program you went through? i've decided i want to become a therapist and am taking prereq classes for grad school applications, and i'm just a bit overwhelmed by all the options out there. :O my dream is to go into a program that does both art therapy and clinical counseling, but even outside of that, there's a lot to choose from and ahhhh. thanks in advance if you have thoughts!!

Hello!

I should first mention that I went the roundabout way and didn’t start grad school until later in life. I loved my undergrad Psych classes so much, I ended up tacking on Psychology as a minor. However, after college, I went through a Recession, a cross country move, a huge personal breakdown, and years of my own therapy.

When I finally realized I actually did want to be a therapist, I was already working full time in another field. I needed to keep working so that limited my options to schools that offered weekend and evening classes. I chose my program based on that criteria and based on the fact that the school was very LGBTQ+ friendly. It was also very Psychodynamic in focus, which fits my own preferences (though I’ve also developed a great appreciation for DBT). It would have been a two year program but in order to keep my sanity, I couldn’t always keep a full class load so I finished in 3.

I got my MA in Psychology with a focus in Counseling and 300+ hours started toward an LMFT (Licensed Marriage and Family Therapist). After graduation, I registered with the Board of Behavioral Science to become an Associate (used to be called Intern). It takes 3000 total hours of experience - including 500 specifically with couples, families, or children - in order to get licensed. I also had to take a Law and Ethics exam after graduation. Now that my hours are complete, I submitted them for approval and will hopefully get permission to take the final licensing exam in the next couple months. 🤞🏻🤞🏻

Now, this is all state-specific for CA so I can’t tell you exactly what other programs might entail. LMFT is the license I’m getting because it’s what my school offered and I LOVED my school. The other options out here are LPCC (Licensed Professional Clinical Counselor) and LCSW (Licensed Clinical Social Worker).

Any of these licenses can be used to practice therapy. An LCSW, to my knowledge, will get more education on community resources and brief therapy because Social Work tends to focus on helping with the immediate crisis and then reintegrating the individual back into society. LPCC and LMFT tend to get more training on longer term individual and family therapy. An LPCC, to my knowledge, would tend to specialize more in diagnosis and treatment of the individual and (unless something has changed) they cannot start accumulating their 3000 hours until after graduation.

LMFT specializes in interpersonal treatment with a focus on our ability to work with families/couples as well as the individual. We start our hours before graduation and continue them after. We can do short term/brief therapy and crisis counseling, too. Just like an LCSW can do longer term one on one therapy.

Since you specifically mentioned wanting to do art therapy, I’d start with that when it comes to looking for grad schools. Is there one with a specific focus on art? If you find a school you love that doesn’t have that specific focus - that’s ok. You can always add on, later. Even once licensed, therapists have to take Continuing Education classes yearly. So, you might find a certification program in Art Therapy later. I intend to get certified in several specialized areas when I can afford it.

You’ll generally need to complete an amount of hands-on experience hours while you’re in grad school in order to graduate. Depending on what your school offers, you can look for a site that may be open to training you in Art therapy.

Here is where it might make a difference if you go for a Masters in Social Work versus a Masters in Psychology. From what I know, most Social Work programs only have very specific training sites where you can work while you’re in school. The upside of the Social Work degree is that you start working hands-on faster, you get more hours accumulated right away, and you’re more likely to get paid as an intern. The downside is the limitation of where you’ll work and having less control over the focus of what you do while in school (again, this is to the best of my knowledge based on the stories of friends in social work).

As an LMFT, I got to choose my site and I ended up really, really happy with the decision I made. Some of my friends were not so lucky and were very happy when their in-school hours were done so they could leave.

I know I just wrote an entire novel that may not have actually given you a lot of answers. 😬Basically, my greatest advice would be to weigh your options carefully and choose what feels right. If you like your school, you will automatically make the most of the experience. If you enjoy the site where you’re working, you will learn and grow there.

Some questions to ask yourself:

Am I staying in state? If not, where would I be comfortable living for the next few years?

Will I be working full time while in school?

Do I have a favorite modality? (Psychodynamic, CBT, etc.)

What other focuses are important to me? (Trauma, LGBTQ, etc.)

How much debt am I comfortable taking on?

Hope this helps? Feel free to message me privately if you want details about my specific school. 👍🏻

#strumpet rambles #ask box #becoming a therapist #i miss my job

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the-astounding-aspie · 5 years

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Q&A Post #1

As I mentioned in my last post, a post I made on the aspergirls subreddit recently has prompted some very interesting conversations, and I wanted to share some of the questions and answers that I found particularly interesting.

Please note, I am in no way any kind of expert. I’m just an aspie who wants to add her voice to the other aspergirls out there trying to spread not just awareness but acceptance. Any advice I give anyone is purely based on my own experiences, but I am here to listen and try to help anyone who asks.

Question: Why did it take me so long to finish college?

It took a while for a lot of reason. I would say the main reason is that I didn't know I was autistic and was not in any way prepared to go off and live in a dorm. I never went to class. In fact, I rarely left my room at all except to get food. Flunked my first semester (fall 2007), went back home and to community college.

Also, I didn't really know what I wanted to do. Expecting an 18-year-old to decide what career they want is absurd. And I didn't realize that the time that my major and my degree didn't have to define the rest of my life. I didn't know how common it is for people to end up in a job that has little to no connection to what they studied in undergrad.

So I didn't have the social skills, I was not independent, and have NO mental health diagnosis AT ALL. It wasn't until the following fall (2008) when I returned to Radford and had what I now know to be a huge meltdown/breakdown that mental health became something I was aware of. I was stressed out and angry all the time and I realized I was being really mean, which is very out of character for me. I went to the student counseling center and was diagnosed with ADD and depression. The counselor point blank told me that I could go home or be hospitalized but that I should not continue with the semester. Went home, saw psychiatrist, and went through the long process of figuring out which cocktail of medication helped me to feel well.

Spring semester back at community college. Fall (2009) semester back at Radford. Grandfather died, then aunt died a month and a day later, then my mom's best friend died two months after that. Teachers wouldn't believe me. I missed too much class and too many assignments and was given failing grades so low that there was literally no way I would be able to bring my GPA up high enough to get me off of academic probation in the time I would be required to do so. Radford now off the table for good.

I think at this point I was living off campus is various unhealthy relationships and roommate situations (none of which ended well. Tried living alone and ended up in the hospital after ODing in spring 2010) Found some tolerable roommate situations to get me through at the new river community college and finish up a general studies associate degree (summer 2010, age 21). I kept on taking classes at the community college though, focusing on early childhood education as I worked as a nanny. Lived with my (now ex-)best friend and had a pretty good couple of years.

January 2012 I met my husband through a dating app. He encouraged me to try again to get a BS, I wanted to study elementary education (which is what I entered Radford to study in 2007 but got freaked out when I realized I didn't want to be a teacher and had not done the research to realize what other jobs that degree is relevant to). I enrolled at the local community college (after I had moved to another city when moving in with my husband) and was started taking classes there right after we got married in August 2013. October 2013 my mom was diagnosed with cancer. She died 3 weeks to the day later. I finished out the semester and ceased functioning altogether for about a year. It was through grief counseling, maybe 6 months to a year after she died (? Sometime in 2014) that I finally found out that I have Aspergers.

Knowing I'm autistic changed a lot of things for me. It gave me the confidence to try again because it made me feel like my past 'failures' weren't all my fault. (All my life I had been told that I was smart but lazy. Depression was met with questions like what happened? anxiety with what's wrong?) I choose liberty online because it's more affordable than JMU, and because their religious expectations make it easy for me to understand exactly what they want from me.

I wrote that reply 6 days ago, and I’m not going to let myself analyze it and change it up, but I am glad that I took the time to write it out. I’ve never done that before, and it has lead to a lot of self-reflection.

#actually autistic #ama #q&a #autism #do i look autistic yet #story #reflection #challenge #aspergirl #the struggle is real #failing #success #perservance #resilence #don't give up #screw up #try again #so much debt #student loans for years

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psychologist-north-lake · 5 years

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Why is happiness so difficult? 10 reasons, 10 solutions

Most of us are happy with the error. This is because we grew up on the belief that life is supposed to make us feel comfortable. We have learned to avoid pain like plague, because negative events cause negative emotions, and negative emotions are not intended to feel. The result is that we feel pain and fail at the first signs of stress because the wheels of emotional training have never stopped.

Although there are roadblocks to happiness, the good news is that it is all in our control. Here is a look at thieves shared happiness and how to change them in order to feel better.

1. Fear

Fear of change is natural. Staying mired in misery, is not. Common causes include fear of the unknown, failure, what people might say, and risking our safety blanket in the name of safety and predictability.

Fear afflicts many clients of the treatment: staying in a self-fulfilling profession because “this is what my parents did to provide the family”, or sticking to unhappy relationships because it is “better than being alone”, and stalling in a creative project because “what would the naysayers say if they failed?

It takes courage to get out of your comfort zone, but your comfort zone is also a danger zone. One of the biggest remorse for death is to restore whatever. Topping the list is the fear of criticizing others. Get advice from the ex-wife:

"You won't have to worry too much about what other people think of you if you realize that they rarely do so." - Eleanor Roosevelt

2. The chase of self-esteem

“It has become self-evident in our culture that we need to be highly respected in order to be happy and healthy. But as research begins in clarification now, the need to positively assess ourselves comes at a heavy price. The main problem is that obtaining a high degree of self-esteem It requires a feeling of privacy and above the average. To be called an average is considered an insult in our culture. This need to feel the superior results in a social comparison process in which we constantly try to blow ourselves up and put others in their place. "- Dr. Christine Neve

The problem is that once our self-esteem collapses, as it is inevitably, we begin to absorb negative emotions and prepare for our feelings of anxiety, depression, and lack of merit.

What is an antidote?

Developing self-compassion.

Empathy for oneself means seeing ourselves realistically, as infallible as the next man or person. Feelings of complacency about self-compassion are very stable because they are based on our own subjective values.

Research has shown that compassion provides the same benefits as high self-esteem, such as reducing anxiety, depression, and high happiness. However, it is not associated with the negative effects of self-esteem such as social comparison, defense, or narcissism.

3. External rewards

Happiness is an inner work. Sure, a shiny new car, elegant fossils and a European vacation can make life better, but they are temporary fixes. Sometimes we move away from our minds in search of happiness so that these outward endeavors block our path. The best things in life are created and developed - good and close relationships, positive experiences and loving memories. Material goods will not overwhelm us with feelings of good sense and meaning.

4. "When you reach this goal ..."

Life does not respect the ideal time. Waiting for the future is to sit anxiously as the world passes. We postpone our happiness until a future time when everything is OK. Only this time never comes.

Some believed that happiness should be earned, and suffering now means that we can cash in our karmic sunlight tomorrow. The truth is that happiness is not mystical or destiny. Anxiety therapy agents often self-sabotage when things begin to search because they believe that if they take emotional wellness for granted, the Gods of Happiness will strike them. Protective Anxiety is a waste of time if there ever was.

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As a child I have always looked forward to highlights: high school graduation, independent living, marriage, travel, parenting, etc. Then I woke up one day in my twenties and realized that I was living "the future". Despite the highlights, there have always been barriers. Once one of the challenges was overcome, the next challenge was knocking on my door. This realization has forced me to be a deficient reality, known as "here now". It's very easy to get involved in tomorrow's game. And every precious moment of the day passes by us.

5. Negative thoughts

The critical psychological lesson is learning that our thoughts shape our emotions, not the other way around. It is common to think that we cannot help our feelings, but this is simply not true. Negative thoughts can seem automatic as they become ingrained in our thinking process. The complexity of things is that many of our thoughts are unconscious.

One of the best ways to combat chronic negative thinking is to visit a therapist. A skilled therapist will help you uncover your unconscious thinking process so that these thoughts are brought into consciousness, examined and dealt with.

For example, you may have had many ideas when reading, "Visit a therapist." Perhaps you have had a negative counseling experience in the past, or your immediate idea was, "Here we go again, someone tells me I'm crazy, and I need to fix, or other thoughts that sparked a negative correlation. If you find yourself interacting with the same people and situations over and over again, it is Your subconscious thoughts will likely block your way.

The sister-to-be uncovered by unconscious thoughts is a treatment technique called Cognitive Behavioral Therapy (CBT).

The quality of our thoughts means everything to happiness.

6. Comparison

Have you ever shouted Instagram and thought, "Wow, if only my life is such and such, then I would be really happy"?

We have bombed by reminding us that our best breath is waiting in the wings. The thing is that we are seeing modified reality. Example: As I was writing this article I was motivated. So she went out and started taking pictures to post on social media. When I checked my self-consciousness, I had to admit I was more interested in reaching my followers' number, rather than providing value to my fans. Instead of feeling grateful that I was able to write for great websites like Huffington Post and Psychology Today, I was chasing more readers, more likes, more hearts and more posts. The comparison really is a thief of joy.

7. Live in the past

Few things are more sad than seeing someone stuck in an endless cycle of repeating their glory days. As the saying goes, "Young people get lost on youth." The thing in the past is that we will come back and change the miserable parts if we can. Regreting what you did or didn't do is useless because you were a different person at the time. Plus, we are constantly developing.

With the exception of John from high school who will happily present you a beer in exchange for listening to that time, he has had great success in the game in the last seconds of the fourth quarter. Or how his life was distorted because of that miserable wife who turned his children against him and took him to the cleaners during the divorce.

8. Loose borders

Healthy limits are the key to happiness. Without a plan of who we are, who we are, who we are and what we want in our lives, we cannot simply manage time and emotional energy.

For example, let's say you and your family traveled through the city to visit people for Sunday dinner. After sweets, the mother does not want you to leave, although your children are weird. When my mom pushes the boundaries that negatively affect your family, keep steadfast, but you love: “I appreciate the time I spent today, but as I mentioned earlier, sleep is at 8:00 pm. We have to go.”

My mom might see the border as a challenge, and an invitation to push your buttons. Hold your land and impose "second level" limits, if necessary. For example, leave without getting involved in any other conversation, turn off your mobile phone, and do not allow yourself to plead guilty to repeated pleas to make an exception because it is a "special occasion".

9. Neglecting gratitude

There is a wide range of reasons why we are grateful for daily practice - research has shown that feeling grateful has many positive effects such as improved health, better immune systems, feelings of communication, and higher levels of cooperation.

When we watch what we do not have, we waste our emotional energies. Focusing on our shortcomings, rather than our blessings, means overlooking the fact that most things in our lives are very good.

Try thinking about three things each day that you feel grateful for or keep gratitude notes. These cute little deeds only take minutes, but the difference in outlook and positive emotions can make a big difference.

10. Forget about the process

Sometimes we make life more difficult than necessary. Happiness is not a means to an end, because there is no happy face. We certainly experience happy moments and happy memories, but life revolves around the journey and enjoys the steps along the way. When we give up our limited view of happiness, we accept that life is full of distractions and flows where some days are wonderful, others are good, others are bad. that's good. The cultivation of happiness is as much a matter of treating adversity as it is about embracing beauty in the moments of everyday life.

Source:

https://thepsychologyhub.com.au/

https://thepsychologyhub.com.au/babies-infants-and-early-childhood/

https://thepsychologyhub.com.au/childhood-and-adolescence/

https://thepsychologyhub.com.au/adults-and-families/

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ceruleantrolls · 7 years

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Therapists and pales-for-hire: they aren't the same

As written by Noru. Not sure if it's an actual article or just one his blog posts.

The terms I used in the title are, in fact, in themselves partially wrong. Therapy is a broad term, and can refer to quadrants therapy, counseling, social workers, etc., but for simplicity’s sake, the kind of therapy that we will mostly be talking about is the kind where you talk one-on-one to a qualified psychotherapist, though there will be some overlap with: Counselling (similar to psychotherapy, but for a much shorter time and for more short-term or skin-deep problems, as opposed to longstanding psychological issues), and psychiatry (medical professionals who are qualified to diagnose mental health conditions and disorders and prescribe medication, and sometimes still provide psychotherapy, but not often).

Pales-for-hire, as I call them -- the more popular term as I've heard it is palewhore, but that label is derogatory and, quite frankly, a rude way to refer to someone you've just paid to pretend to be your moirail for 45 minutes -- are, as I've just mentioned, people who you pay to receive the pale experience, as it were.

The key difference between the two is that one of them is a qualified professional, and the other is not. This isn't to say that hiring a PFH (as I’ll now call them, since pales-for-hire is a mouthful) can’t be beneficial to your mental health, or that they don't know what they’re doing. To explain, I've heard some say that a PFH is just a cheap brand of therapist, which is true if you consider painkillers to be a cheap brand of actual prescribed medication. I'm guessing you don't, but if you do, I demand that you immediately book a doctor’s appointment, if you can afford it; if not, ring me up and I will personally give you financial assistance because you might have a whole host of horrible health problems lying dormant that could be prevented just by telling your doctor you've had a pain in your gut that might be, I don't know, a kidney stone or something that definitely can't be solved by painkillers.

Anyway, a PFH can help you sometimes, the same way a painkiller can alleviate symptoms of an illness. We've established that. This is especially the case if your problem is only temporary, like a breakup that makes you feel like you really need a hug, or you got fired and need a good papping before you go nuts and kill your git of a boss. If you have a long-term problem or mental health problems, however, the PFH is probably not equipped in the slightest to help you deal with that, just as painkillers will not cure a disease.

Remember, to become a therapist you need at least a masters degree, but to become a PFH you do not, and there are some people who are so ill-informed about mental health issues they might actually make your problems worse. Ever had a friend who told you to deal with your problems by telling you to just ‘cheer up, frowny face’? That's the kind of person you might encounter while paying for a PFH’s services. While they may be naturally empathetic and excellent shooshpappers, they simply aren't qualified to help you with your depression or PTSD, or any of the more ‘complicated’ diagnoses like schizophrenia or autism spectrum disorder.

Similarly, there are services that you should not ever expect your therapist to provide that a PFH can. You can ask your therapist to be open about themselves and tell you things about their personal life if they are relevant, and you can ask them to adopt a casual tone and vocabulary when talking to you so they seem less imposing, but therapists are not your friends, let alone your moirail. Neither are PFHs, technically, but you pay them for the illusion that they are, whereas with therapists you should always be aware that the person is no more your friend than your doctor is, unless you don't have a doctor, in which case I refer you to my third paragraph again.

Furthermore, while you can cry and feel free to be as open about yourself as you want in therapy, like you might tell your doctor about the rash you have in a very strange place, it's inappropriate to sit down with your therapist on a pile of cushions and hug them for an extended length of time. That kind of physical contact is simply not appropriate -- not for you, and not for the therapist. In fact, getting personally involved with your patient is against the law and if your therapist starts entangling themselves in quadrants or quadrant-like behaviour with you, that is enough grounds for you to at least change to another therapist.

Think of it this way: if your therapist started flirting with you in a session, would it be appropriate behaviour? No. Then it is the same thing with papping and other related behaviors. The relationship between patient and therapist is supposed to be focused entirely on working through the patient’s issues, and the anything the therapist does should be in pursuit of that goal and not of their own desires. The therapist can be a blank slate for you to throw words at, or a friendly presence through which you work out your personal problems, but they are not actually your friend (though they should like you or at least be neutral about you; if they don't, it probably won't be very beneficial for you to work with them.)

To summarise:

PFHs are helpful sometimes, but are not a long-term solution if you have long-term problems or actual mental health issues, and are not qualified to help you with (or diagnose you with, or provide prescriptions for) your mental health problems. That is the job of a therapist (or, with regard to diagnosis and prescription, a psychiatrist). They are somewhat similar to counsellors, except they are not qualified professionals but are the person to look for if you need something similar to a moirail at that point in your life;

Therapists have degrees and are qualified to handle your bigger problems or your mental health issues -- they know the techniques and have the background knowledge to do so -- and are the only ones able to refer you to psychiatrists as to get you prescription drugs should you need them, but are not your friends or moirails and should be treated accordingly.

Therapy, all its associated branches, and PFHs are both valuable services that can help an individual, but confusing the two can lead to more harm than good. Additionally, these services are looked down upon by the government for showing ‘weakness' or being ‘unnecessary’, but these are falsehoods propagated by a government that encourages mental instability in those of higher hues and dismisses the problems of mid and lower hues, which only makes an already chaotic and frightening world even more so. You should never be ashamed for having flaws and weakness, and NEVER ashamed of mental health problems or disorders, and if you ever seek help -- whether it is through the temporary balm of a PFH, or the professional help of a psychotherapist -- know that there is absolutely nothing wrong with doing so.

#Noru #SSometimes I entertain the idea of running a blog as though he were running it #Just for fun #GGive an idea of what he talks about when he's online #Writing #headcanons

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realselfblog · 6 years

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The Consumer and the Payor, Bingo and Trust: My Day At Medecision Liberator Bootcamp

To succeed in the business of health information technology (HIT), a company has to be very clear on the problems it’s trying to address. Now that EHRs are well-adopted in physicians’ practices and hospitals, patient data have gone digital, and can be aggregated and mined for better diagnosis, treatment, and intelligent decision making. There’s surely lots of data to mine. And there are also lots of opportunities to design tools that aren’t very useful for the core problems we need to solve, for the clinicians on the front-lines trying to solve them, and for the patients and people whom we ultimately serve.

At the end of each day, the HIT company has to remember that at the end of a digital transaction, there’s a person. That individual could be a member of a health plan, a nurse, a physician, a grandparent-caregiver tapping into her grandchild’s medical portal…all people, with different abilities to read and comprehend data, values, and incentives.

Earlier this week, I spent a day with Medecision’s digital health team, aka ‘the Liberators.’ My role in the event was to provide a through-line from introductions to trend-weaving what I heard and learned at the end of the day. In the middle of the day, I spoke about trends in health care focusing on the patient: as a payor, as im-patient, as digital, as a consumer, and as political.

As a payor, the insured patient in 2019 is likely to be managing a high-deductible health plan, responsible for first-dollar costs until s/he reaches that threshold. As such, health care spending feels like a retail event, prompting the patient-as-payor to ask, “what’s the price?” “What’s the value?” “What’s the product?” “What are the alternatives?” Even though price transparency has gone live online among more hospitals, this start-up phase is still heavy-lifting and confounding for people to understand. Health care costs continue to be the top pocketbook issue for most families in the U.S. across income cohorts.

As that payor, expecting retail service, patients are im-patient. Why can’t appointments be made online like I do with restaurants on OpenTable? What’s so hard about getting me my lab test on the day or next-day after I provide my sample? Health care surely doesn’t feel like the best retail experience, and that’s especially true for health plans. I shared the Temkin Group’s data on customer experience (shown here), where our favorites are found in grocery stores, fast food joints, and retailers. Health insurance plans? Not so much.

Patients are also digital: smartphones are fairly ubiquitous (although we must remember that not all people can afford data plans – my mantra, that connectivity and broadband are a social determinant of health). This means people (with connectivity) want work-flows for health care the way they conduct their financial affairs, social networking, travel planning, and way-finding. People are omni-channel, too, so health care must think like a retailer in reaching people wherever and however they want to be reached: online, via email, via text, phone call, and even via snail mail for some (albeit increasingly fewer) patients.

Patients are consumers, at the end of the day. As payors, digital beings, im-patient people demanding service levels they experience elsewhere — outside of healthcare.

Finally, patients are political. Health care was the top issue driving voters to the 2018 mid-term elections. Health care will also be top-of-mind among voters in 2020, who are becoming more aware of the risks of losing coverage. This week, the level of uninsured people in America rose to a four-year high, with the erosion of support for the Affordable Care Act by President Trump and Congress over the past two years. Growing concern for losing coverage for pre-existing conditions has become mainstream across political parties.

Politics underpin what’s happening in health plans in the public sector, and I spoke a bit about Medicare and Medicaid. The latter is the place to look, across the fifty State Governors, for Medicaid expansion (or not); growing integration of behavioral health to deal with depression, anxiety, and the opioid crisis; and greater attention to the social determinants of health and long term social supports (LTSS). You can see the latest Medicaid demonstration waiver data from a Kaiser Family Foundation analysis done January 9, 2019 shown in the bar chart.

To that point, during the day, two Medecision Liberators played out a scenario for complex cardio management. In the role play, a patient-persona was speaking with a call center associate. In the conversation, the plan member asked how the associate knew so much about them. Further into the conversation, the member said she needed to hurry off the call to get to her bingo game in time.

That conversation raised two important points and opportunities to drive health outcomes: first, on the issue of privacy and trust, as the member questioned just how the associate knew so much about her. That’s an opportunity to forge a bond of trust between the member and the health plan or provider, to discuss how bringing various data together can help paint a picture of her whole life and help her achieve better health.

The second item — the bingo game — presented an opportunity to discuss social supports, transportation to the event, and what the member might be snacking on during bingo. If it turns out she loves the salty snacks or M&Ms, the health coach has an opportunity to counsel the member on the impact of salt on her heart health, and suggestions for some healthier snacking.

This kind of conversation is inherent in the values that Health New England’s Lisa Holland discussed in the context of HNE’s customer promises for the organization: quality, thoughtfulness, and humanity.

The Medecision Liberators collaborated in a brainstorming exercise about social determinants of health, generating important insightful questions they would ask people about their lives to un-earth opportunities to address social supports. A few of these questions were:

What’s your most challenging daily activity?

Walk me through your typical day.

Do you have someone you can rely on if you need help?

What does living independently look like to you?

Do you have access to healthy food?

What did you do for entertainment today that gave you pleasure?

Can you read?

That led me to end the day’s trend-weaving quoting one of my favorite JAMA columns from the recent past: that Value-based payments require valuing what matters to patients, co-written by Dr. Joann Lynn, Dr. Aaron McKethan, and Dr. Ashish Jha. This has become a pillar in my thinking about the role of respect and trust in health care between patients (as payors, consumers, self-carers and caregivers) and health care organizations. They ask and answer: “How can a care system be structured to deeply respect the myriad differences among patients when disabilities or advanced age makes those differences especially important? The answer is that the delivery system must proactively help affected people articulate their priorities and goals.”

Health Populi’s Hot Points: The theme of trust was mentioned throughout the day, across a wide range of discussion topics. I noted in closing that this week also convened the World Economic Forum in Davos, during which Edelman annually updates their Trust Barometer. This year’s survey found that globally in 2019, the most trusted institution for consumers is the employer: both for ensuring a job for “me,” as well as for being a good corporate citizen in the community locally and in the larger world, in sustainability and responsibility.

This behavior drives trust, which we learned is the most important driver behind peoples’ engagement in health — a key finding in the first Edelman Health Engagement Barometer conducted in 2008. Eleven years later, trust as a health engagement requirement is even more important in light of our AI-enabled health care world.

We remember that at the end of every health IT transaction, there’s a person: a plan member, a consumer, a doctor, a caregiver.

“We are all the same,” a doctor’s essay in JAMA noted this week. Dr. Mandy Maneval, a family practitioner in Mifflintown, PA, wrote:

It strikes me that so many of life’s moments are dichotomies of health and disease, life and death, joy and sorrow. As a family medicine physician, this mirrors my everyday life. I often leave one patient’s room after giving bad news and immediately enter the next room to see the happy parents of a newborn. Navigating the full spectrum of human emotion is simultaneously exhilarating and exhausting. There are days when I feel like a hero and others when I cannot do a thing right…Connecting deeply through our shared humanity, no matter our differences, is one of the most precious gifts we offer and receive as physicians. We are all the same.

That works for physicians, and it works for all of us in the health care ecosystem. I thank Medecision for the opportunity to participate in this day of insights, team-building, and real human connection.

That last sentence was going to be the conclusion of this post. But just in time, on cue as this post was being scheduled on WordPress, an article titled A Framework for Increasing Trust Between Patients and the Organizations That Care for Them arrived in my inbox from JAMA published on 24th January 2019. Dr. Thomas Lee and colleagues explained:

Trust matters in health care. It makes patients feel less vulnerable, clinicians feel more effective, and reduces the imbalances of information by improving the flow of information. Trust is so fundamental to the patient-physician relationship that it is easy to assume it exists. But because of changes in health care and society at large, trust is increasingly understood to be at risk and in need of attention.

The authors outline potential approaches to increase trust between patients and health care organizations, which include:

As a first step, leadership should acknowledge that trust is foundational and a trusting environment essential for good health care

Measuring trust should be a standard part of evaluating patient care experiences, including those with health plans

Transparency of patient care experiences should be part of measuring, monitoring and continually improving quality and safety

Boards and leadership should routinely examine data that reflect on patient and staff trust, and include these in reward plans

Standards, training and accountability systems should be developed for clinicians and for teams

Relationships between patients and clinicians should be structured such that patients can make choices reflecting their personal preferences: this recognizes that patients know more about what matters to them and how they are doing

Health systems should insure needs of patients for a navigator or translator are met

Finally, patients should be actively engaged in designing solutions to the erosion of trust.

This article is free from JAMA’s usual paywall, so please click on the link above to access the entire discussion. These doctors who crowdsourced the recommendations really understand that it’s good to know about patient’s love of bingo, taste for salty snacks, and social support systems…and patients really do want to be part of their own planning and care.

The post The Consumer and the Payor, Bingo and Trust: My Day At Medecision Liberator Bootcamp appeared first on HealthPopuli.com.

The Consumer and the Payor, Bingo and Trust: My Day At Medecision Liberator Bootcamp posted first on http://dentistfortworth.blogspot.com

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maxihealth · 6 years