Ann Arbor therapist offers counseling, helping clients achieve satisfying life.

Counseling for Individuals and Couples

Category: emotional intelligence (Page 1 of 4)

Real Fairy Tales for Strong Girls

Most of us are familiar with a specific type of fairy tale involving young women. In these tales, such as sleeping beauty, you will find a princess with arrested development that her sole purpose in life is to find the prince and marry him. The poor girls in those fairy tales are essentially helpless. those damsels in distress depend for their survival on men, either in the shape of dwarves or a dashing young prince.

I have found a collection of original fairy tales from many countries and many cultures. Their content was not modified in any way. These fairy tales portray a strong feminine hero. The heroines are strong, smart and brave. These are tales of women who take their destiny into their own hands.

Maybe the fairy tales that have been passed down to us have been filtered to suit today’s gender roles. This book shows that there is a much broader range of portrayal of women in traditional tales.

I wish I had known about this book when I raised my children. Even more so, I wish I had known about it when I grew up.

Fearless Girls, Wise Women & Beloved Sisters: Heroines in Folktales from Around the World/ Kathleen Ragan  ed.

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How to manage anger and frustration effectively

Anger is a very common emotion that most of us deal with. Anger exists for a reason. In certain cases when fighting for survival it can serve a useful purpose. However, in most cases in our modern lives anger is a corrosive emotion which tends to harm ourselves and others.

There are many common suggestions that are prevalent and widely accepted in dealing with anger. They tend to focus on the concept of letting off steam. The analogy of a vessel under pressure that may explode if the steam is not released. This concept is enticing. Many people tried and used non harmful aggressive behavior such as hitting a punching bag or screaming into a pillow. A detailed review of research reported in American Scientific Mind refutes the usefulness of this approach.

While this seems counter intuitive, the explanation is that anger is a form of arousal. Activities such as punching or screaming do not release the anger, they reinforce the arousal. A better approach is to engage in activities that reduce arousal. Some possibilities are deep breathing, listening to calming music or calming physical activity such as Yoga and Tai Chi. There are subtleties in engaging in more strenuous activities. Jogging was found to be unhelpful, possibly because of the repetitive nature of the activity, that allows for rumination.  Group sports tended to be beneficial, possibly because of the need for cooperation and empathy, and because you need to be completely engaged.

So when rage overtakes you avoid the common myth of letting off steam, you are not a pressure cooker, and engage in calming activities.

According to Feeling Angry? Chilling Out Helps More Than Blowing Off Steam by SOPHIE L. KJAERVIKBRAD BUSHMAN in Scietific American Mind April 8 2024.

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Psychedelics as a Promising Therapy

Recently there has been renewed interest in the use of psychedelics to improve mental health and wellbeing. Psychedelic plants have been used for centuries in many cultures for healing and for spiritual purposes. While these materials have been banned in the United States for a number of decades, there is a growing understanding that they have therapeutic value. There is now a movement to enable the controlled and careful legal use of these substances. Indeed, Substances, such as psilocybin and LSD, have been found to be effective in treating PTSD and severe depression. Strangely enough, they seem to help with addiction mitigation.

There are now phase 3 clinical trials taking place in major hospitals across the country. Clinical trials have shown remarkable results, with significant reductions in anxiety and depression, and improvements in overall well-being. Patients report a change in their world view. The therapeutic effects of psilocybin seem to last long after the experience itself, providing long lasting relief of symptoms and benefits that were not attained through medication or talk therapy.

I’d like to stress that I am not talking about recreational or casual use of these substances, nor do I recommend that. I am talking about deliberate use of these substances in a therapeutic setting.

Typically the process includes a few sessions of a preparation for your journey. Those sessions will help you set the intention. The therapist will be present in the room to help you during your journey. Later, the therapist will work with you to integrate those experiences and insights into your own life .

Successful “journey” requires attention to both set and setting.

Setting means the setting you are in. You should feel completely safe, supported and comfortable. The music should be right for you. A trained professional will be present to assist you.

“Set” is a harder concept to explain. It means the attitude, or intention, you bring to the experience. It also means your situation in life and your past life experiences. More specifically, what you want to get out of the experience. You need to be clear to yourself. This intent is one of the things you should discuss with a therapist before embarking on the journey. The more you know what you need, the more likely that your needs are going to be met. You should not embark on a journey if you are agitated or in a bad place. That might cause you to experience a nightmarish trip.

Using these substances sends you on a journey similar to dreams, but more powerful. As with dreams, you gain access to your unconscious, with less inhibition, more creativity and introspection.

Clients have told me in the past about visions they had while on psychedelics, that gave them insight about their life, even changed the course of their lives.

Caution – psychedelic substances are not recommended if you , or a first degree relative, has had a psychotic break of any kind. This may make your condition worse and bring about psychosis. Some medications are not compatible with these substances. You need to check with a health care professional.

Disclaimer: I do not recommend using these plants for recreation, or on your own. If you feel you can benefit from such a treatment, look for a medical facility where those studies are done, so it can be done responsibly. Sorry , I cannot be your guide on your trip, as I abide by the law. But if you had a meaningful experience, I’ll be more than open to work on it with you.

If you want to know more about the subject, you may want to consult these books:

How to change your mind/Michael Pollan

The Psychedelic Explorer’s Guide: Safe, Therapeutic, and Sacred Journeys/James Fadiman

The Psychedelic Handbook: A Practical Guide to Psilocybin, LSD, Ketamine, MDMA, and Ayahuasca (Guides to Psychedelics & More) Guides to Psychedelics & More A Practical Guide to Psilocybin, LSD, Ketamine, MDMA, and DMT/Ayahuasca/ Rick Strassman

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Dreams can change your life

Well, if you listen to them.

In today’s modern hectic world, many people suffer from difficulty sleeping. There is much focus on “sleep hygiene” in order to improve sleep quality. What is often less discussed is the importance of dreaming. Many substances that people take to help them sleep, such as sleeping pills , alcohol, cannabis, and many common medications actually tend to suppress dreams.
There is no consensus in the academic community on the role of dreams. It is clear today, though, that dreams are not just random firing of neurons as we sleep. Many, or even most cultures recognized the importance of dreams and often seek to understand the message and the guidance contained in them. In our highly driven western culture, sleep and the dreaming that goes with it, are often viewed as a necessary waste of precious time in service of alert wakefulness. We forgot to listen to our dreams.
Many researchers view dreams as a way that we process our daytime experiences. Dreaming is often viewed as a healing process, where our deepest concerns are worked through. Sometimes in individuals with PTSD this mechanism may go into overdrive. The nightmares brought on by the trauma may make people fearful of falling asleep. In therapy there are methods to assist with this problem. People can learn lucid dreaming. They gain some control over their dreams, as paradoxical as it sounds. They learn to change their nightmares inro something else.
In therapy dreams may be used as a window into parts of ourselves that we are less conscious of. Because dreaming is a less tightly controlled form of thought, the dream may become a creative synthesis that can help us find a way forward in life. This message from our deeper consciousness may be somewhat cryptic but with thought and care the meaning may be unraveled. A trained therapist can assist you in this journey. Dreams can help you in the process of healing, personal growth and transformation.

Dreamwork enables individuals to access parts of themselves that may be hidden or suppressed, providing a platform for exploring unresolved emotions, traumas, fears, and desires. By engaging with dreams, clients can gain valuable insights, increase self-awareness, and develop a deeper understanding of their inner world.

Dream work can take various forms within psychotherapy. Therapists usually encourage clients to keep dream journals, recording their dreams upon awakening. This practice helps individuals establish a stronger connection with their dreams and enhances their ability to recall and analyze dream content. Sharing dreams in therapy sessions allows therapists and clients to collaboratively explore dream symbols, patterns, and themes, fostering a deeper understanding of the client’s psyche.

Interpreting dreams requires a delicate balance between objective analysis and subjective exploration. While there are universal symbols and archetypes, the meaning of dreams is highly personal and unique to the dreamer.

Dream work can also involve techniques such as active imagination, where clients engage in a dialogue with dream figures or symbols, allowing for a deeper exploration of their significance. Creative methods like drawing, painting, or sculpting dream images can provide additional channels for self-expression and insight.

The benefits of dream work in psychotherapy are numerous. It can help individuals gain clarity and perspective on their life challenges, uncover unconscious patterns that may be holding them back, and facilitate the integration of conflicting aspects of their personality. Dream work can also be a powerful tool in trauma therapy, allowing for the gradual processing and resolution of traumatic experiences in a safe and controlled environment.

Based mostly on Rubin Naiman presentation on dreams at IASD conference and his book “Healing Night”.

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The Challenge of Covid-19

None of us would have chosen this challenge, but here we are. In this strangest of situations, some of us are overworked and traumatized, others are at home, unemployed and worry about their financial situation.

The first thing to do  is to take good care of ourselves. This is easier said than done and it includes the expected list of things:

Make sure to get a good amount and good quality sleep. Make sure to eat well. Exercise. Manage anxiety. Keep your space orderly and clean.  Limit exposure to news and social media.

These are all the usual pieces of advice that we have come to expect, but repeating these advices does not make them happen. What can we do during this lockdown period to try to adhere to these principles, and why is it more difficult than ever?

Most of us have lost the structure that underpins our normal lives, from going to work to visiting people, our lives have assumed an amorphous blob like property. Without structure we gravitate towards things that are easy and give us instant gratification, often not those things that make us healthy and happy in the long term.

Try and build structure into your disrupted life, both physically and temporally.

If you are working from home, try and have a designated work space so work does not intermingle with life. If possible, try and maintain work hours that are distinct from downtime.

If you are unemployed, try and add some structure to your life, learn a new skill if possible, take advantage of the time that has been forced on you to study that thing that you have put off for years.

Keep structure as far as going to sleep and getting up. Avoid the tendency to watch a screen into the late night and then sleep until some time  the next day. Keep a schedule of sleep as if you had some task to wake up for, even though this strikes you as slightly absurd.

Exercise is key and is as simple as taking a walk. We are blessed with wide open spaces, sidewalks and scantily traveled roads that allow us to safely go out. Spring, in spite of its back-sliding is coming. Walking will also help you sleep.

Not being anxious would be unreasonable at this time. The key is to not let anxiety consume you. Watch the minimum of news you need to keep informed, dwelling on every detail of the news cycle induces anxiety and does not make you better informed.

So we are here in this odd time, our lives upended, our routines changed. Being angry at the situation we have been thrown in is useless; looking for someone to blame, a waste of time.

The question is, is there something we can take from this time, something that can be positive.

We have all collectively been forced into what people often call a retreat. Seclusion , lack of many of our usual distractions, a simplification of life. Life being forced back to its bare bones of existence.

Maybe now is a good time for some introspection-is the frenetic pace of your normal life what you need and want. Is there something from this forced seclusion that you can carry back to normalcy when it resumes?

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Where you live matters: “The Geography of Bliss” by Eric Weiner

When I first studied to become a clinical psychologist, I looked at mental health issues as a reflection of the individual’s history. I focused very much on how interactions with important figures in our formative years shape and affect us for years to come.
Later, when I did my degree in social work, I delved more into the ways in which sociological and economical factors affect our personality and the challenges we face.
The “Geography of Bliss” brought me a new perspective on broader forces that shape us as people. I had not paid much attention to the way in which values of the culture we live in determine our level of happiness. In hindsight it is obvious that the culture we live in and grew up in will influence us.
This book describes the journey of a journalist through the world in search of the secret to happiness as a function of geography and culture. He makes an effort to rely on the most current research into happiness and to understand which countries are most happy and which are most miserable and why.
Even the definition and the experience of happiness is rooted deeply in place and culture. The author describes an emotion spanning from the exuberance expressed in the United States (“I am so excited”) to the calm contentment of people in Switzerland.
Happiness comes in different forms in different countries that report a high  level of happiness. There is a basic low level of income that is a fundamental requirement for happiness, enough to ensure a level of food security and health care. Beyond that cultures that engender a high level of happiness take many different forms.
Some of the countries that report the highest levels of happiness are Switzerland, Iceland and Bhutan.
In Switzerland the author traced the high level of contentment to a high level of personal trust between people and to the high level of organization in society. Although for some it can be stifling, on an aggregate level the very orderly society and the high level of predictability made people content.
In Iceland, on the other hand, the small community has a robust safety net and as a society accepts failure as part and parcel of what happens when people take risks and allows them to do so. Icelandic people are less oppressed by the constant fear of failure.
As opposed to the first two examples Bhutan is not a wealthy country. It is a country that takes happiness seriously. They invented the  concept of “Gross National Happiness” in their constitution. They have the practice, taken from the Buddhist tradition, to think about their death as a way to a happier life. This practice helps puts things in perspective, it urges us to put aside the petty and unimportant irritations and to focus on the important things in our lives.
On the other hand, Moldova stood out as a miserable nation. Because of the lack of trust and lack of community. Turns out that happiness is in short supply In a place where  people don’t help each other, .
On the extreme end of wealth, as embodied in Qatar, the old adage rings true: Money doesn’t bring happiness. With no challenges in their lives to motivate them, boredom sets in and material wealth cannot compensate for that.
After reading this book you will not find the secret to happiness, you may not be any happier, but it is a fun and interesting read. For me, it sparked thoughts about the broader forces that shape us.Facebookmail

Side Effects of Psychotherapy

I am a therapist and I believe in the power of therapy to alleviate suffering and contribute to people’s quality of life. I have seen it happen many times. In this post I would like to discuss some of the potential risks and  side effects that are not widely discussed.

  1. Dependence: Some clients start to depend on their therapist for every decision they need to make. A related issue is when the client effectively channels the therapist in his everyday interactions with friends and family. When the client overly identifies with the therapist it can lead to awkward social interactions and impedes the quest of the clients in finding their own voice. It is up to the therapist to point out excessive dependence, to explore its meaning and to prevent it.
  1. Reliance on the connection with the therapist as a sole resource to meet emotional needs, instead of expanding a support network. Therapy should help a person improve their social skills, expand their social network and not serve as a substitute.
  2. Not knowing when to terminate therapy: I have heard countless stories about patients wanting to stop therapy, and well-intended therapists have convinced them to stay. My policy is clear. I greatly respect the clients’ wishes to terminate therapy. There are times at which I initiate the discussion on stopping therapy. Similar to the role of a parent, there often comes a point that the client needs to be gently pushed out to stand on their own two feet.
  3. Expense. – This is probably the most recognized issue. .The money that you pay towards therapy, may prevent you from pursuing other activities that could improve your quality of life, and contribute to your growth as a person.
  4. Time – the time and energy you invest in therapy, could have been spent with loved ones, on meaningful activities that could contribute to your quality of life. No, I do not recommend avoiding psychotherapy, if you could benefit from it. I work as psychotherapist because I believe therapy can change people’s life. I had the privilege to witness people’s growth.  There is a large body of empirical evidence that supports the benefits of therapy,  above and beyond what medication alone can offer.

However:

It is OK to gauge whether there is a fit between you and your provider.

It is OK to check from time to time with your provider about the approach, directions, goals and the need for continuation.

It is OK to weigh the benefits of psychotherapy against the cost – what does it prevent you from doing because of the investment in both time and money.

It is OK to see your provider on less than a weekly basis, or as needed – provided it works for both of you.

My policy on terminating therapy is that if a client decides to quit therapy, I do not try to dissuade them unless there is a clear indication of danger.Facebookmail

Recommended: Mental Health Digital Resources

Here are a few digital resources that I have found helpful. This is not an exhaustive list, but I have checked these out and found them to be good.

Wherever possible I looked for free apps. In no case do I have any commercial connection with these recommended sites.

Todoist

For people that suffer from ADD/ADHD , but also for all of us who want our life more organized and efficient.

This website and app helps you organize and prioritize your tasks. The free version is very good. You can pay and get some additional features.

There are many other similar tools. I found this to be the most friendly and useful for the lay person..

DBT (Dialectical Behavior Therapy)   is a collection of practical skills to help you better manage your emotions, stress and hence your life.   This is an app that lists all the DBT skills by modules.  You can create an “emergency list” tailored to your personal preferences.  This app will probably be most useful for people already familiar with this approach.

3. The motivation hacker by nick winter.

A surprising resource – a small book that describes how to set goals for yourself and how to get things done.  This appears to have been written by a geek, not a therapist. The book is based on solid understanding and research, and is better than many others written by mental health professionals.

OK, it is a book and not an app. But it is available  as kindle book and as a regular book. So it is included.

.PTSD coach

For people who suffer from trauma.

esense skin response

Biofeedback is a promising field.  It is based on giving you immediate auditory or visual feedback on a measured response that you cannot normally sense, such as skin conductivity (GSR) or an electrical measurement corresponding to of the tension in your muscles, (EMG). These types of response are related to factors that we would like to learn to control such as stress and hypertension. Research and clinical practice show that with a feedback, you can learn to control these functions. Most are related to the autonomic system – it is a way to reduce the activity of the sympathetic branch (fight or flight) and increase the parasympathetic branch, which induces relaxation.

Many apps carry the key word biofeedback, nearly all of them have nothing to do with it. Sometimes it is a general relaxation app with nice music. Sometimes it is an app designed to train you to breathe slower and deeper, which will induce relaxation. But you do not need the app for that- you can do it on your own. Breathing is partly voluntary, and certainly you know how to control your breathing if you pay attention to it.

Esense skin response is an actual biofeedback app that  uses the GSR(electrical conductivity of the skin). It does require a pretty large investment for a skin conductivity measurement attachment.

Cognitive diary self help

An app for Cognitive therapy for depression, including a cognitive diary

rejection therapy

A pretty wild approach  designed for people who suffer from social anxiety. Used to be an app, now it is a website. It consists in asking you to put yourself in absurd and embarrassing situations voluntarily. After you do it a few times, and discover that you stayed alive, you will not be so anxious in regular social circumstances. I did not dare to use it, but I believe it to be useful. Comes from the geek community in San Francisco. Essentially, it is a form of exposure therapy.

Succeed socially

A website full of articles, to help the “socially awkward” people function better socially. A bit repetitive, but informative. You can read it on the web for free, or pay and get it on kindle.

iSleepEasy

A serene female voice helps you detach from your day and take the time to relax and sleep, in an array of visualizations and guided meditations. You can control both voice and music tracks. Includes tips for falling asleep. There are many similar apps. I liked this one the best.

. Relax Melodies

A free relaxation and music app.  I liked the option of mix and match nature sounds with music.

Dreamboard

An interesting site for tracking your dreams. Your dreams can give you valuable knowledge about yourself and your life when you listen to them carefully and are able to decipher their code.

TED

A website that  will keep your brain alive.

If you know about any other digital resource that you found helpful, please let me know and I’ll be more than happy to include these.

Healthy Mind

An app designed to enhance your mental health. Relies heavily on mindfulness.

Virtual Hope Box

An app developed by the VA, intended to help people that struggle with suicide ideation.Facebookmail

Reading facial expressions – a help for those with Asperger and all of us

People with Asperger syndrome face many challenges as they cope with life and society. From my professional experience, the most painful area is that of interpersonal relationships. There is often a misconception that people on the autistic spectrum are not interested in other people, in friendships or relationships. From my experience, they actually crave relationship and friendships, as most of us do. Many  times people on the autistic spectrum lack the skills to attain the relationships that they want and need.

One of the reasons that social skills prove to be so challenging is that often people with Asperger do not read facial expressions well. While this skill comes naturally to most of us, people with Asperger tend to lack this innate ability. Luckily this skill can be acquired, if you are willing to invest the time and  effort.

Dr Paul  Ekman dedicated his life to research of  facial expressions in different parts of the world. He found that there are 6 basic emotions for which facial expressions are universal. The universal nature of these expressions indicate that they are most likely  hardwired in us.

Dr. Ekman built an online course dedicated to teaching people to better read facial expressions. There are a few modules to the course. personally, I recommend that those who have trouble reading expressions complete all the modules.

The online Course:

a course in reading facial expressions

The basic book that describes his research:

Emotions revealed/Paul Ekman

An entertaining TV show, that is based on his research. As entertainment it sensationalizes the content, but it is based on his actual work. TV Serie:

Lie to me

 

Full disclaimer: I do not have any business relationships or affiliation  with these programs.

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Permission to be an Introvert

In my clinical practice I often see people who feel they need to apologize for being introverts, at times they see it as a character flaw to be corrected.

Being an introvert is not the same as being socially anxious, socially awkward or lonely. Introverts tend to have fewer friends, but their friendships are often long term and deep. Introverts tend to avoid small talk; but they love to talk about what really matters. Introverts prefer social interaction in small groups, but are capable of dealing with large gatherings when needed.

Introverts can derive great joy from their social connections, but they need time alone in order to recharge themselves.

Introverts enjoy solitary activities, and are not scared to be alone, nor are they bored. They do not depend on other people for entertainment. Introverts tend to have a rich inner world that provides them with stimulation and reward.

Our society tends to value and promote extroverts. Introverts should not shy away from their natural tendencies. Being an introvert is a stable trait and has a recognized genetic component. If you are an introvert embrace your nature and enjoy your strengths.

Recommended book:

Quiet: The power of Introverts in a World that can’t Stop Talking by Susan Cain.

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