Tag Archives: guest post

Guest Post: Journey of an Anxiety Specialist

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 I’m so grateful for this post from my dear friend and anxiety specialist, Dr. Marianne Stout. 

(My apologies for the awkward line breaks; I’m still not very proficient with WordPress!)



In my training as a therapist I became interested in working with anxiety disorders
after encountering many clients with anxiety and having no idea how to treat them.
Simply talking about one’s fears or worries did not lessen their symptoms and the
worry, panic attacks, obsessions, and compulsions continued. Many people also
reported that it felt pretty good to explore their relationships with friends and
family, but that while this helped those relationships, it did not stop the anxiety. I
was doing something wrong and I felt incompetent as a practitioner since I could
not help. At the same time I had friends in other psychology programs who were
learning specific skills for treating anxiety and I wanted to know what they knew.
They were using cognitive behavioral therapy (CBT) to treat anxiety disorders such
as generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, and social anxiety, but I did not know specifically how they did this.

CBT was developed by Albert Ellis and Aaron Beck and is a heavily researched
theoretical approach to treat a host of psychological disorders by aiming to change
behaviors or challenge maladaptive thoughts and thus influence emotions. The
theoretical premise is that thoughts, feelings, and behaviors are directly related and
thus someone with panic disorder may say, “I must sit in the back of the classroom
so I can easily escape if I begin to have a panic attack.” The belief is that sitting in
the back or escaping will keep them safe and avoid the embarrassment of having a panic attack in front of fellow students. The behavior is sitting away from others or
physically removing themselves from the situation when their heart begins to race,
their breathing increases, their chest tightens, they feel nauseous, or any of the host
of symptoms that occur during a panic attack. The subsequent feeling could be fear
of dangerous panic attacks, fear that they are “crazy,” or sadness that they cannot
enjoy a class they are interested in like other students. The work of a CBT counselor
would be to work with a client to expose them to anxiety inducing behaviors at
a gradual pace. This may mean having them sit in the second to last row in the
classroom and eventually lead up to them sitting in the front row or having them
stay in the room during a panic attack. A CBT approach would also challenge the
maladaptive thinking that panic attacks are dangerous (they are uncomfortable,
annoying, and tiring, but not dangerous) or that it would be embarrassing to have a
panic attack in front of others (classmates would likely be sympathetic).

In my fifth year of graduate school I began a practicum working under an anxiety
specialist, Diana Damer, PhD. While she used CBT to treat anxiety disorders, she
also incorporated an interpersonal approach exploring underlying relationships and
issues contributing to anxiety and explored the relationship between the client and
therapist. Research shows that regardless of theoretical orientation, the therapeutic
alliance, or relationship between therapist and client, is an important predictor of
success in treatment outcomes (Krupnick et al., 1996). This approach made sense
to me. Treating symptoms of anxiety as well as their underlying causes seemed very
effective and still acknowledged that the client was a relational being.

Since that time I completed my internship, post doc, and became a licensed
psychologist specializing in anxiety disorders. I have also come to include
acceptance and commitment therapy, which has a strong focus on meditation,
in my work as it can be difficult to ask someone to sit with the discomfort of
anxiety without giving them the tools to cope with said discomfort. I have begun a
meditation practice for myself and while I may go weeks without meditating, I find
that when I do life seems to make more sense. A wonderful book that understands
and treats anxiety in a way very similar to my own practice is Panic Attacks
Workbook by Dave Carbonell. Dr. Damer, another colleague, Thomas Smithyman,
PhD, and I recently opened a private practice focusing on anxiety disorders (http:/
/www.anxietyaustin.com) and it has been wonderful to work with like minded
psychologists who are as energized by the treatment and understanding of anxiety
as me. We welcome other professionals in the community who focus on anxiety
disorders to come to our Friday meetings and are always looking for new ways to
engage with the community on this topic.

References
The role of the therapeutic alliance in psychotherapy and pharmacotherapy
outcome: Findings in the National Institute of Mental Health Treatment of
Depression Collaborative Research Program.
Krupnick, Janice L.; Sotsky, Stuart M.; Simmens, Sam; Moyer, Janet; Elkin, Irene;
Watkins, John; Pilkonis, Paul A.

Journal of Consulting and Clinical Psychology, Vol 64(3), Jun 1996, 532-539.

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Guest Post: Reflecting on Reflection

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by Lexie

This month as I dedicated time to self-reflect, I felt much more in tune with my soul, just as I hoped. It has been very rewarding and something I seek to continue on. I find myself paying special attention to how certain situations and actions make me feel, recognize what all I’m blessed with, what I am seeking more of, and goals on how to get there.

I especially love the topic to ponder, what is my gift to give to this world? In the self-discovery workshop I attended, Jane spoke about with every gift you must also recognize there comes a challenge. A friend of mine recently told me she felt I was gifted in friendships. What a great compliment! However, setting boundaries and saying ‘no’ (without guilt!) is a challenge I have been facing for some time, especially recently as my focus has shifted to myself and family. Finding a healthy balance sure is hard, isn’t it?

Thank you for letting me share this experience with you! I hope you can find time for yourself amidst the daily obligations and distractions that surround us all.

*Update on my lab, Niko: the vet called today to report there was no bacteria/infection shown on the blood culture so we are unsure (still) of the cause of his swollen lymph nodes. Niko is getting lots of special attention these days with walks, canned food, and kisses. Thanks for the comments and love!

Guest Post: What You Focus on Expands

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by Lexie

The other day, I read an article on Oprah.com about her journaling styles throughout the years.  It looks like Oprah also practices gratitude in her daily reflections which has to mean I’m onto something here, yes?:   😉

“In my 40s, I got wiser. I started using journals to express my gratitude—and watched my blessings multiply. What you focus on expands.”

This week has been an emotional roller coaster as my furry friend, Niko, suddenly developed huge swollen lymph nodes and my vet prepared me for the worst.  Lymphoma.  He kept Niko for a couple of hours to do a biopsy and blood work and in the meantime, I tried to keep it together.  Niko has been a huge part of my life for the last 11 years.
Practicing gratitude leading up to this really helped me cope.  I felt so very fortunate that my husband was in town and not traveling like he typically does.  Those hugs were much needed.  He walked Niko slowly around the neighborhood each day and helped me clean up accidents in the house that were caused by Niko’s medication.  It was heartbreaking to watch yet comforting to know we were in this together.
Results from the tests came back with questions still unanswered so we went in for additional testing.  As I left the vet for the third time and drove us back home, I started adding up the vet bills in my head.  It suddenly occurred to me that the commission check I received the week prior was within $2 of the vet bills all combined.  Isn’t that something?  The money was all there, preparing me financially for this week.
I’m still in awe of how extremely blessed I am during such a challenging time.  The biggest blessing of all?  Niko’s swollen lymph nodes have significantly gone down today after experimenting with some antibiotics, which is very encouraging that this could just be an infection, not cancer (going against all odds of what the vet has witnessed in his profession).
Maybe we do have control on our blessings multiplying or maybe it’s merely being more aware of the things we should be thankful for.  All I know is that I’m hugging my little family closer these days and am thankful for the time we have.

Guest Post: Questions to Ponder

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by Lexie

“Learning without reflection is a waste, reflection without learning is dangerous.” – Confucius

Self reflection hasn’t been as natural of a process as I thought it would be for me.  I have kept a journal off and on throughout my life, however, in the past I only tended to journal when there was drama around me.  Now that I’m in my 30s (and thankfully my relationships have matured), I’m discovering that it’s a challenge to find things to reflect about.  Life is good; what is it exactly that I’m seeking? 

I do believe that the simple daily exercises of practicing gratitude and jotting down basic insights is a good start, but there are days that I want to dig deeper. 

Today, I stumbled upon a list of questions to prompt self reflection and wanted to share some of my favorites:

  • What are my most important values?
  • What does it mean to choose?  To live proactively?
  • Who am I at my best?
  • Who am I at my worst?
  • Who am I becoming?
  • What am I avoiding or resisting?
  • What would I do if I were ten times bolder?
  • What am I most grateful for?
  • What am I settling for?
  • If I knew I would die a month from now, what would I do?
  • What is my gift to give to the world?


Read the entire article here.  (it’s a goodie!)

What about you?  Are there specific questions or exercises that you practice in your self reflection time?

Guest Post: Gratitude = Happiness?

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I recently read the book Have a Little Faith by Mitch Albom and the chapter on Happiness really caught my attention. In short:

I knew depression was real, and in many cases required medical attention. I also knew we overused the word. Much of what we called “depression” was really dissatisfaction, a result of setting a bar impossibly high or expecting treasures that we weren’t willing to work for.

To these people, unhappiness was a condition, an intolerable state of affairs. If pills could help, pills were taken.

But pills were not going to change the fundamental problem in the construction. Wanting what you can’t have. Looking for self worth in the mirror.

What makes a man happy?

Be satisfied.

Be grateful. For what you have. For the love you receive. And for what God has given you.

That’s it.

Week 1 into self-reflection and I seem to be consistently (or inconsistently, if you will) hitting my goal of alone time every other day. I have found writing my thoughts keeps me focused and accountable rather than let my mind wander aimlessly. When I am lost on where to take my focus, I come back to what I’m thankful for that day and make a list:

gorgeous fall weather in KC
my beautiful, healthy, unconditionally loving pups
hubs, home today (and the entire week). no travels. hooray!
a yummy bottle of pinot noir, on sale
my skinny black pants still fit!
time to squeeze in a workout to continue to fit into those pants
sweet clients that make me laugh and my job enjoyable
pork chops and asparagus on the grill. dinner for two.

How blessed I am! What are you thankful for today?