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

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Mental Health Blog

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I have decided to skip the usual list of links to major mental health websites. If you are looking for those, I highly recommend you start from the site of Michigan Mental Health Network . This site encompasses everything you may want to know about mental health in Michigan and beyond. It contains a directory of therapists, clinics and support groups in Michigan; an excellent list of links to mental health websites; and interesting articles for professionals and lay persons alike.

Another excellent resource is the website The guide to self help books. It contain a directory of books, arranged by different topics in self help, personal growth and self improvement areas.

I will dedicate this space to less known resources, that touched me deeply and influenced my life and my professional work.

This blog is not a substitute for professional advice on diagnosis or treatment of a mental health condition. Please consult with a professional before trying any of the ideas presented here.

If you have more recommendations along those lines, email me at mchll.samuel@gmail.com I’ll be more than happy to add them.

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Finding Joy in life

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I have recently discovered a website called The Big Joy Project. This website is funded by a nonprofit and its goal is to bring more joy into peoples’ lives. The Website uses small and easily practiced exercises taken from positive psychology to help us find joy in our everyday lives. It is a small investment of time with a significant payback. The Website is https://ggia.berkeley.edu.  I highly recommend checking it out.

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Sorrywatch – How to Apologize

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This post references a website  https://sorrywatch.com/

All relationships need maintenance, whether intimate relationships, close friendships, acquaintances or relationships with colleagues. Part of developing relationships, especially intimate ones, is to be able to get over disagreement, difficulties and harsh words that were said in the heat of the moment.
The website referenced above, compiles stories about apologies. Many of the posts describe deplorable situations where corporations or individuals made the situation worse by issuing a clumsy or mishandled apology. The “apology” was sometimes more hurtful than the original offense. The negative can be instructive, and at times amusing. There are also positive stories where an apology was well handled, and the difference is obvious.
The website also provides guidelines to a good apology. It is surprising how many people ignore the obvious.

To paraphrase those steps:

  1. Take responsibility for your words, or actions. Say “I apologize” instead of  a vague sentence ” I am sorry this happened”
  2. Acknowledge exactly what you are apologizing for. Do not let it be unclear.
  3. Show empathy and understanding why what you did was hurtful.
  4. Be careful not to provide excuses. Explanations, as long as they are honest and respectful of both sides, are OK
  5. Commit to not do it again. If it is something that can be corrected, do so. 

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techniques to enhance creativity

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Creativity is a critical skill in life.

We tend to think of creativity in the realm of the arts, the novel written by a great author or a song by a gifted musician.

Creativity is a much broader concept and is important not only in creating new works of art but in problem solving and in how we face the everyday challenges in our lives.

Note that I called creativity a skill. We often think of creativity as a gift, as something we either have or don’t have, but creativity can be developed and learned. 

Research into the creative process has found a number of techniques that can help unearth and develop our creativity.

The techniques have two main directions:

  1. Techniques that force us to see the world in a new way, that force us out of our mental rut.
  2. Techniques that help us tap into our unconscious, where thoughts are far less constrained, think of how wild your dreams can be, unfettered by reality.  

First let’s focus on techniques researchers have studied to help us get out of our mental rut. These techniques are meant to help us get out of our fixed thought process that impedes creativity. They are exercises designed to break our established ways of thinking

1.  Generic parts techniques. Think about common objects in terms of their parts – naming those parts without allusion to their regular use.

2. Pay attention to sensory properties of objects-especially visual ones, and particularly those aspects that we normally ignore. Force yourself to notice.

3. Prime with a task that requires creativity -for example,  come up with 6 alternative uses for common objects.

4. Perform a set of tasks in an unusual order, breaking habits where possible.

5. Cultivate an open mind. Allow yourself to think with minimal rules and constraints. This last suggestion is to some degree a restatement of creativity. It is worth stating because we are often not aware of the constraints we put on our thought process.

The second set of techniques are geared towards helping us tap into our subconscious which is not as policed by rules and regulations as our conscious thought is.

  1. Sleep on a problem. Invite a dream that could illuminate the problem in a new way.
  2. Let your mind wander. Distract yourself deliberately. Take a break and do something entirely different.
  3. Step outside of your comfort zone. Do novel activities you have never done before.
  4. Imagine the problem far in the distance, either in time or space.

Adapted from:

  1. Tony McCaffrey: Innovation Relies on the Obscure. A Key to Overcoming the Classic Problem of Functional Fixedness. Psychological Science March 2012 vol. 23 no. 3 215-218

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What I have learned from my clients

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An unscientific survey of those around us shows that people are stressed. Accelerated change in all walks of life is challenging and disorienting. New means of communication seem to reduce our actual interpersonal communication and lead to more isolation and splintering into ever more opposed and self reinforcing groupings.The political turmoil affects us.  Many of us feel stressed and angry, often finding it hard to get a good night’s rest.

In order to relax, if we are to avoid the fleeting and ultimately defeating respite found in the medicine cabinet or a bottle, we need to find a means of relaxation within ourselves. 

One of the challenges of relaxing the mind is the constant background chatter that we experience. This chatter can also make it difficult to fall asleep. Many well known methods for relaxation teach, over time, how to quiet this chatter. 

An alternative approach, which may be easier and more accessible for some, is to lean into the chatter, but to redirect it.

Focus the mind on a subject, particularly an activity that you are interested in. Go into the most minute painstaking detail in planning something you like to do and even problem solving. This type of approach helps in two ways, it redirects the anxious chatter supplanting it with other thought patterns and it focuses us on something we enjoy, which is ultimately calming.

For example, I have clients who enjoy cooking who will plan out elaborate and detailed meals . These meals may or may not come to fruition, the planning is an end in itself.

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Real Fairy Tales for Strong Girls

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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

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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. KJAERVIK, BRAD BUSHMAN in Scietific American Mind April 8 2024.

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How to Change those Annoying Habits

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Most of us are looking for an effective and easy way to change our bad habits and improve our lifestyle. We would like to eat a more healthy diet, exercise more and save more money. There are many other behaviors and habits that we know are damaging to our health or psyche such as smoking or doom scrolling, but behavior change is difficult.

There are a few effective methods that have been documented to help. Many of the methods described below are taken from the book  “The willpower instinct” by Dr. Kelly McGonigal.

  • Set yourself a clearly defined target. You can’t change everything at once. Set realistic, short term goals. Allow yourself baby steps, and accept that there will be relapses.
  • Understand what is motivating you to make the change. Be honest with yourself. If you better understand the motivation, you have a better chance of changing your behavior. The motivation has to be internal, external motivation tends to fizzle.
  • There is an evidence based  theory that sees willpower as a muscle that needs to be trained. Make it a point to change something small and insignificant in your life. Make a change that does not require a great act of will, just a change. For example, always open doors with your left hand. You will be surprised how the ability to change one small habit influences the way you can change more important habits.
  • Imagine the situation that you find tempting, and imagine how you are going to cope with those situations.  Imagine yourself failing to cope with temptation, how would that make you feel? It is counterintuitive, but actually imagining your failures will help you prepare better for them.
  • When you have an uncomfortable emotion that drives a bad habit, don’t try to avoid the emotion. Learn how to “surf” uncomfortable emotions, rather than trying to distract yourself. Pay attention to your emotions, stay with them. Feel like you are surfing the wave of emotions, and let is subside.
  • Document your progress. Document on paper,  on your cellular device  or elsewhere. Examples are documenting   what you have eaten, how much you exercised, or how much you spent and on what.  Pay attention to what time of day, or situations, are more challenging for you. There are numerous sites and apps that let you enter this type of information , and get support and advice from other users.
  • Many bad habits are driven by high levels of stress. When you feel stressed, instead of reaching for that quart of ice cream,  learn positive stress reduction techniques. Examples of stress reduction techniques are deep breathing, meditation and yoga. Experiment and see what works for you.
  • Try and spend at least 5 minutes a day walking outside, preferably in a green space.
  • Make sure you get enough sleep. Try to eat nutritious food. If you are sleep deprived, or your blood sugar runs low, you are the worst version of yourself.
  • When possible,  avoid situations that trigger the behavior you want to change.
  • Group support is helpful for those that feel comfortable with that.

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Psychedelics as a Promising Therapy

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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

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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

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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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