Effective Psychotherapy

Recommended book:

Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life

This book is a valuable introduction to the concept of mindfulness. The book teaches to value and savor the present. This approach can help deal with stress and the practice of mindfulness has been shown to increase ones quality of life.

Dr. Zinn brought the concept of mindfulness from Buddhist meditation, and has shown how it can be applied as a basic technique for improved well being and stress relief.

Mindfulness means the ability to live in the present moment, to be absorbed completely, fully aware of each thought, feeling or sensation that arises. This awareness implies a nonjudgmental attitude towards our flow of thoughts, even unpleasant sensations or mental events.

The mere act of watching our mind,  allows us to distance ourselves from our emotions. This enables us to gain a better perspective on our challenges.  Through mindfulness  we realize that our emotions are just that, not the ultimate truth about reality. The common thought distortion “I feel, therefore it is reality” loses its hold on us.

Living in the present means that we do not dwell on the past, or think anxiously about the future . Many people believe that if they immerse themselves in painful emotions, it will provide them an insight and ultimately lead to inner transformation. Delving into the past must be done with care, as it may  strengthen and reinforce  the neural pathways of pain and depression.  This reinforcement may lead to further deepening of the depression and pain, as opposed to the hoped for alleviation. Mindfulness offers an additional method for dealing with ones challenges.

Studies have shown that practicing mindfulness is a good tool for stress management, depression management, and  it leads to better quality of life, enhance creativity, and can  improve chronic pain and other medical conditions.

Deficiency in vitamin D is linked to depression, Parkinson disease and to cognitive decline according to a new article in Scientific American. According to the article, about three quarters of the population in the USA suffer from vitamin D deficiency. Here, in Michigan, the percentage may be even higher because of the lack of sunlight.

If you suffer from depression, it would be prudent to ask for a blood test, to determine whether your blood levels are within normal limits. Do not take extra supplements of Vitamin D without consulting your primary care physician, as it can be toxic in large doses.

The original article can be found here.

Depression contributes, and is maintained by common distorted thought patterns.

This checklist is taken from the Wikipedia, “Feeling Good” book  and other sources, with some changes and additions. As you go through this list try to  identify these patterns that you tend to use. It may be an  eye opener: You will realize that what sounded like “the reality”,  is indeed very subjective. This is the first step to start controlling those thought patterns, and influence your mood. You may want to keep track of these thought patterns in a journal.

1. Black and white thinking – No shades of grey. Thinking of things in absolute terms, like “always”, “every”, “never”.     If it is not perfect, it is a failure.
2. Overgeneralization – Taking isolated cases and using them to make wide generalizations. Generalization from one detail , or aspect of a situation, to the whole situation.
3. Mental filter – Focusing almost exclusively on  negative or upsetting aspects of an event while ignoring other positive aspects.
4. Disqualifying the positive – Continually deemphasizing  positive experiences.
5. Jumping to conclusions – Drawing negative conclusions  from little  evidence. Two specific subtypes:
   • Mind reading – Assuming you can read the feelings and thoughts of others. You know for sure what other people think of you, and of course is it negative.
   • Future reading –  Catastrophizing.  You expect the worst possible outcome, however unlikely. You ruminate about “What if”.
6. Magnification and minimization – Distorting aspects of a memory or situation through magnifying or minimizing them such that they no longer correspond to objective reality.  If you are depressed, often the positive characteristics of other people are exaggerated and negative characteristics are understated. The reverse  happens when you think about yourself.
7. Emotional reasoning – Accept your emotions as a valid evidence.  ”I feel therfore it is true”. If you feel stupid , than you are  stupid.
8. Should statements – You know the way things “should” be.  You have rigid rules which  always apply, no matter what the circumstances are. Using “should” statement  leaves you and others feeling preasured, guilty, and on the long run  jeopardizes any motivation for change. It does not allow you to be flexible and adapt to  changing circumstances.
9. Labeling –  Rather than describing  a  specific behavior, you assign a negative  label to yourself.  it is not the action that was a mistake, you are the mistake. Frequntly, you judge others as harshly as you judge yourself.
10. Personalization - Attribution of personal responsibility and guilt to yourself   for events over which you have no control.
11. False expectations: Assuming that other people should be able to read your mind, without any need of your part to express your emotions and needs.  Assuming that your happiness depends on somebody else.

This little known book describes the inner experience of depression, in a very sensitive and authentic way. Its charm lies in the fact that in spite of the very real description of depression, It is full of hope. for
In the beginning Lea, The main character, is in her deepest moment of despair. The world seemed bleak, senseless and cruel. She feels complete alienation. Her pain was so great, that she tried to jump from a bridge, in a futile attempt to commit suicide. An alien caught her and saved her life.
The first step to her recovery was numbing her emotional pain. The alien temporarily numbed Lea’s pain and locked her in a house, in order to protect her. (Fantasy equivalent to psychotropic medication? Hospitalization?) Lea felt better, though numbed. She knew that the numbness was a temporary relief, a crutch to support her during the process of recovery.

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Many people use a  journal to enhance their well being and cope with variety of mental health challenges.  A journal can have a wide variety of uses. The Journal can enhance a persons creativity. The Journal may also be helpful in managing the writers emotions. The Journal may be a useful tool in delving into, and coming to terms with ones past.

One technique is recommended in  The Artist’s Way: A Spiritual Path to Higher Creativity [10th Anniversary Edition].

The instruction provided in the “Artists Way”   is  to write what ever comes to mind. You should let the written words pour out in a stream of consciousness with no regard or concern for literary value. The method is based on the assumption that no one will ever see your journal so you are free to write whatever comes to mind. In fact you are advised not to look back and reread what you wrote. It is the act of uninhibited writing that is therapeutic. This technique was initially developed to enhance creativity. Clinical experience shows that it support mental health as well.

People that are depressed should be cautious using this method. For some, it can be beneficial. Others may find that this method exacerbates their depression . They may use the free flowing journal to dwell on minor faults  and sorrows. These people may benefit more from a more structured way of journaling.

One of the simplest structured forms of writing a journal to help alleviate depression is, at the end of the day, to write down three things that you are grateful for.  It is important to persevere and to write down three real things that are unique; not to repeat oneself day after day. As simple as this may sound, studies have shown a beneficial effect of this method. It gradually alters the way we perceive our world.

Psychotherapy does not have to always be  a serious endeavor. Sometimes  laughter can be more effective than tears. Loretta Laroche is a clinical psychologist, and a stand up comedian; an unusual combination. Her CD’s and DVD’s teach the basics of cognitive behavioral therapy and existential therapy through a humorous examination of her own life. Very uplifting, lots of common sense, gives a great perspective on life. An effective audio antidepressant.

How to Be A Wild, Wise, and Witty Woman 4-CD: Making the Most Out of Life Before You Run Out of It

Life Is Short, Wear Your Party Pants

Or – What Would You Say to the Person on the Roof?/ Avshalom C. Elitzur, PhD

Hello, Ron. I am here to talk to you. I hope I will be able to speak in favor of the side within you that still wants to live.

In any court of justice, even in a totalitarian state, every person is entitled to a defense, whereas you have appointed yourself as prosecutor, judge and executioner, all in one. I, therefore, demand the right to speak in your defense.

First of all, let me say that I understand that you are now at the very limit of the human capacity for endurance. The pain you are feeling is huge. I truly believe that your suffering is extreme and that the situation feels absolutely unbearable. It is a suffering that cannot be overcome, laid aside or forgotten. This unbearable suffering, this inhuman pain, must be stopped. Perhaps you also feel tired and weakened from the fight against forces that are too strong for you, against the ill-luck and the cruelty of your life.

I acknowledge your deep pain. I accept your feeling of no solution. I accept that you feel at the end of the road. Every human being may arrive to a point when one says: That’s it! I can suffer no more! I accept that you have reached this point.

Even so, I will try to speak for another way of viewing things. I believe that this different voice also deserves a say.

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Social anxiety can reduce you quality of life, not let you achieve your full potential, and ultimately lead to depression. What results is a vicious cycle – the more anxious you are, the more barriers you will encounter in your life, the more depressed you become, which ultimately contribute to your anxiety. I recommend this self-help book. It is part of a serie published by Oxford University Press. All the books adhere to cognitive-behavioral approach. They come in pairs – one for the client, one for the therapists. All those I have seen so far, were excellent.If you read this book, and work along its guideline, you may not even need to see me. And if you do, it will shorten the treatment and make my work easier.

There are two kinds of light therapy for depression: Light box, and Dawn simulator.
Most people know about the light box; those you can find anywhere on the web. I would like to recommend the less well known device, called Dawn Simulator (or sunrise simulator). Dawn simulator slowly lights a bedside lamp to simulate dawn. This simulates sunrise and tells your brain that it is time to get up and start the day. Absolutely no side effects, and it is amazingly effective. It has been shown  in studies to improve seasonal depression. It certainly can help you start your morning in a different tone. You can find very expensive ones on the internet, that contain also a lamp, a radio, and an alarm clock built in. Assuming you already have all of these, you may want to buy the most inexpensive on the internet. It is just as effective as any other.

Dawn simulator