Cognitive Therapy Basics

People who suffer from panic attacks experience symptoms such as heart palpitations, sweating, loss of control, feelings of impending doom, disorientation, and feeling trapped. Although those who suffer from this disorder feel debilitated, it is one of the most manageable syndromes to treat through the use of cognitive-behavioral therapy.

When people first come for cognitive-behavioral therapy, they may indicate that they have received prior counseling, have made innumerable visits to doctors, and have been treated in emergency rooms for symptoms associated with their anxiety. Patients are usually desperate for answers to alleviate their on-going struggle with panic. Patients are relieved to know that their symptoms are treatable through the use of cognitive-behavioral therapy. Often, patients feel that they are going crazy, although they need to be reassured that having “crazy” feelings is a cognitive distortion and is vastly different from those who might be considered clinically crazy.

Most individuals know the time-frame when they first started experiencing panic attacks. There may have been triggering events that fostered the emergence of panic. The patient may be unable to make an association between the panic and a painful triggering experience. Factors such as a significant illness, job stress, family abuse/ trauma, losing a loved one, and lacking emotional expressiveness may create conditions ripe for panic. Once a panic attack erupts, further attacks usually follow if an individual is not aware of the cycle of self-defeating thinking and behavior which sustains the panic process.

The key to curtailing panic is to help people understand that it’s the secondary symptoms that keep the panic alive. In other words, it’s the “panic over the panic” that sustains the panic pattern. With cognitive-behavioral therapy, recovery involves educating the sufferer on ways to respond to their self-defeating thought processes during the onset of their attack. For example, let’s say that you are taking a mid-term exam during college. You open up the test booklet and immediately react by saying, “Oh my God, none of this material looks familiar; there’s no way that I can pass this test; if I flunk this test, I might fail this course for the semester; if my parents find out, there’s going to be hell to pay!” In contrast, you can learn to respond rationally by saying, “Wow, some of this stuff doesn’t look familiar; just take some deep breaths and relax; I guess I better survey the whole test, answer the questions that I can and then go back and work on the other one’s; I can tackle this test, I just need to relax and be patient!”

How one responds to panic determines whether it subsides. Those who fight with their panic by “awfulizing” about their symptoms, intensify their panic. They may say, “Oh my God, here come those unbearable feelings again – I feel like I’m going to die!” However those who accept their panic and respond rationally with thoughts like, “Here comes that panic again – just calm down and take those deep breaths and it will eventually subside. These feelings won’t last forever, they are time-limited – they’ll be gone soon.”

Learning through cognitive-behavioral therapy to go “down stream” with panic is important to its eradication. Those who “catastrophize” about their symptoms intensify panic attacks. Learning to rationally respond to panic diminishes its effect. Trying to figure out what caused an individual’s panic is not necessary to treat it. What is essential is teaching those who suffer from panic to respond with positive self-talk.

People who experience panic attacks tend to feel ashamed of their problem. It is important for sufferers to understand that they are not alone – anxiety is apart of the human condition. Anxiety and panic is not unusual and those who experience it need to learn to be more open and expressive with all of their feelings. Sharing a wide range of emotions with those you can trust is essential to the healing process. Those who hide panic as a shame-based pattern set themselves up to repeat it. When those we trust are aware of our authentic self, which includes our vulnerability, our anxiety problems tend to fade in significance.

Paradoxical interventions can be helpful in dealing with panic disorder. Having a patient schedule a panic time and encouraging them to perseverate can bring humor and assist in breaking the panic cycle. A ruminating patient might be asked to conduct cardiovascular exercises during panic-related chest tightness to try to lighten the moment and break the cycle of suffering. Cognitive-behavioral therapy is a structured, pragmatic approach which assists people in addressing the symptoms of panic by learning to respond to the disorder with a positive approach to their thinking.

Those who work in the field of healthcare have known for some time that a connection exists between our underlying beliefs and thoughts and the functioning of our bodies. Dr. Herbert Benson, in his 1970’s landmark book, The Relaxation Response, articulated the concept that stressors can trigger a “fight or flight response”, an inner startle response that indicates we are about to experience an unpleasant event. Although there is a healthy fear that protects us from harms way, many times how one interprets stressful events and one’s ability to manage it, can affect the immune systems functional capacity. There is now sufficient research to validate Benson’s work, that relaxation techniques such a meditation, can have a direct link to minimizing the effect of a wide range of disorders such as high blood pressure, irritable bowel syndrome, back problems, neurological pain, and headache problems. Relaxation strategies calm the sympathetic nervous system, making it easier for the body to heal.

In Barbara Levine’s book, Your Body Believes Every Word You Say, she explores how our thoughts and underlying beliefs about our physical maladies affect our auto-immune system which regulates our ability to ward off illness, manage pain, and promote healing. In other words, legitimate pain from various illnesses and somatic complaints can be intensified by the kind of messages we tell ourselves. Spontaneous self-defeating thoughts such as, “What’s the use, my body will always betray me and never get better.” can reinforce the pain cycle of making things worse. People with such chronic self-defeating reactions have been shown to create inner chemical changes and constricted blood flow which further erodes the individual’s ability to manage pain. How we respond to our bodily disorders, in terms of core beliefs and inner dialogue, may affect the outcome of our health. 

 Some time ago, I attended a presentation by psychiatrist M. Scott Peck. He talked with mental health providers about his struggles with neck pain, a problem that had plagued him for years. An operation resolved some of his pain, but he felt that there might be some negative underlying belief that was also contributing to the problem. He ultimately concluded that he was a conflict-avoider, lacking the ability to appropriately assert himself, refusing to “stick his neck out.”

 Physical illnesses can be intensified by self-defeating underlying thinking that is a metaphor for the chronic condition experienced. For example, people with back pain may at times lack the “backbone” to express their thoughts and feelings courageously. Individuals with gastrointestinal problems may not be unable to “stomach” certain intolerable thoughts and feelings. People with headache syndromes may experience beliefs and thoughts about events that make them want to say, “Life is making my head hurt.” Eating disordered people may experience core assumptions such as, “I’m so angry that I could just vomit, or if I monitor my weight and eating habits, at least it’s one area in my life that I can control!” People with neurological pain such as inner ear disorders may exacerbate their pain by experiencing thoughts of panic such as, “Oh my God, here it comes again, that nasty, annoying pain. I’ll never get over this because the volume in my life is turned up too high.” 

Anxiety, panic, and depression are typical characteristics associated with physical pain. The more effectively one manages these symptoms, the less troublesome the pain may be. Learning to cope with anticipatory anxiety by rationally responding, “Ok, I know that this pain can be troublesome, but when it comes I will do my deep breathing and manage just fine!”, or dealing with panic, “When a wave of pain comes, I’ll just go with it. It’s not a big deal, my scary feeling are time-limited, they’ll be over soon”), and managing depression, “Just because I feel awful doesn’t mean I can’t do things to stay active and make me feel involved” are important ways of adaptively responding to pain

The following ideas are some guidelines for managing pain more effectively

·         Try to get you pain in perspective. Make a realistic appraisal. “In the scheme of things, how bad is my condition?

·         Don’t fight with your symptoms, it only makes them worse. The more you accept your symptoms, the more they are likely to diminish

·         Use various activities to refocus away from your pain. Dwelling on pain makes it more    painful. Stretching, music, swimming, meditation, and other activities are important

·         Seek a multidisciplinary approach to your problem, if necessary. Get a team of healthcare specialists, including a quality physician, psychotherapist, physical therapist, message therapist or other providers of pain management

·         Develop a solid support system of family and friends. Also, there are many support groups in our community for people suffering from a variety of physical ailments

·         Remember, that the things we tell ourselves have an impact on our physical and emotional well-being.

Those who work in the field of healthcare have known for some time that a connection exists between our underlying beliefs and thoughts and the functioning of our bodies. Dr. Herbert Benson, in his 1970’s landmark book, The Relaxation Response, articulated the concept that stressors can trigger a “fight or flight response”, an inner startle response that indicates we are about to experience an unpleasant event. Although there is a healthy fear that protects us from harms way, many times how one interprets stressful events and one’s ability to manage it, can affect the immune systems functional capacity. There is now sufficient research to validate Benson’s work, that relaxation techniques such a meditation, can have a direct link to minimizing the effect of a wide range of disorders such as high blood pressure, irritable bowel syndrome, back problems, neurological pain, and headache problems. Relaxation strategies calm the sympathetic nervous system, making it easier for the body to heal.

In Barbara Levine’s book, Your Body Believes Every Word You Say, she explores how our thoughts and underlying beliefs about our physical maladies affect our auto-immune system which regulates our ability to ward off illness, manage pain, and promote healing. In other words, legitimate pain from various illnesses and somatic complaints can be intensified by the kind of messages we tell ourselves. Spontaneous self-defeating thoughts such as, “What’s the use, my body will always betray me and never get better.” can reinforce the pain cycle of making things worse. People with such chronic self-defeating reactions have been shown to create inner chemical changes and constricted blood flow which further erodes the individual’s ability to manage pain. How we respond to our bodily disorders, in terms of core beliefs and inner dialogue, may affect the outcome of our health. 

 Some time ago, I attended a presentation by psychiatrist M. Scott Peck. He talked with mental health providers about his struggles with neck pain, a problem that had plagued him for years. An operation resolved some of his pain, but he felt that there might be some negative underlying belief that was also contributing to the problem. He ultimately concluded that he was a conflict-avoider, lacking the ability to appropriately assert himself, refusing to “stick his neck out.”

 Physical illnesses can be intensified by self-defeating underlying thinking that is a metaphor for the chronic condition experienced. For example, people with back pain may at times lack the “backbone” to express their thoughts and feelings courageously. Individuals with gastrointestinal problems may not be unable to “stomach” certain intolerable thoughts and feelings. People with headache syndromes may experience beliefs and thoughts about events that make them want to say, “Life is making my head hurt.” Eating disordered people may experience core assumptions such as, “I’m so angry that I could just vomit, or if I monitor my weight and eating habits, at least it’s one area in my life that I can control!” People with neurological pain such as inner ear disorders may exacerbate their pain by experiencing thoughts of panic such as, “Oh my God, here it comes again, that nasty, annoying pain. I’ll never get over this because the volume in my life is turned up too high.” 

Anxiety, panic, and depression are typical characteristics associated with physical pain. The more effectively one manages these symptoms, the less troublesome the pain may be. Learning to cope with anticipatory anxiety by rationally responding, “Ok, I know that this pain can be troublesome, but when it comes I will do my deep breathing and manage just fine!”, or dealing with panic, “When a wave of pain comes, I’ll just go with it. It’s not a big deal, my scary feeling are time-limited, they’ll be over soon”), and managing depression, “Just because I feel awful doesn’t mean I can’t do things to stay active and make me feel involved” are important ways of adaptively responding to pain

The following ideas are some guidelines for managing pain more effectively

·         Try to get you pain in perspective. Make a realistic appraisal. “In the scheme of things, how bad is my condition?

·         Don’t fight with your symptoms, it only makes them worse. The more you accept your symptoms, the more they are likely to diminish

·         Use various activities to refocus away from your pain. Dwelling on pain makes it more    painful. Stretching, music, swimming, meditation, and other activities are important

·         Seek a multidisciplinary approach to your problem, if necessary. Get a team of healthcare specialists, including a quality physician, psychotherapist, physical therapist, message therapist or other providers of pain management

·         Develop a solid support system of family and friends. Also, there are many support groups in our community for people suffering from a variety of physical ailments

·         Remember, that the things we tell ourselves have an impact on our physical and emotional well-being.

Hypnose (or hypnosis) has been accepted for a long period of time as a mental state which is very similar to sleep. Induced by suggestion, this practice has allowed therapists and other specialists to enter ones subconscious. Today, we know much more facts about hypnosis and hypnotherapy. There is no more room for controversies or prejudice, given how useful hypnose really is.If you are curious about finding out more about this subject, then you should definitely keep on reading. You will be informed about how powerful can suggestions be for a person who is about to be hypnotized, but also how important is to be genuinely relaxed before the hypnose session. The Internet is also a pretty good source of information, with hundreds of specialized websites tackling this very interesting subject. It all depends on how much are you interested in finding out.There is another fascinating fact about hypnose. Even though most people prefer going to a trained hypnotist for a session, there are probably just as many who induce this mental state by themselves. Self-induced hypnose is practiced by people from various corners of the world, starting with a state of relaxation and different suggestions. This is the only way to reach the subconscious mind and experience a unique state where peripheral consciousness is reduced to a very low level.Being under hypnose means that all of your senses will be modified. Memories might be brought back to you. You might experience new thoughts or old emotions. No one can tell for certain what is going to happen while you are hypnotized. Interesting experiments have been made to demonstrate that hypnose can be used to cure various medical conditions, including spastic colon or different skin conditions. In some cases, it has been proved that hypnosis might be used instead of substance-induced anesthesia. As the number of people suffering from different phobias increased, hypnose started to be perceived as one possible treatment. It did not take too long for hypnosis to enter the list of recommended treatments. Nowadays, fobi and other anxiety disorders are successfully treated with hypnose sessions. While they are under the state of hypnosis, phobic persons are instructed to recall any event or situation that may have triggered their fobi. They use their experience to relate these events or happenings to the predispositions of the person. Using all of this information, one might provide the person suffering from a certain phobia with very important suggestions.There are millions of people out there who have been diagnosed as suffering from fobi. Some are afraid of how they will deal in social situations, thus having what is known as a social phobia. Others are terrified of spiders, dogs or flying. Many people will not even dare to go on an elevator or sit on the top of a building, being scared of heights. When such fears prevent them from functioning normally, the term of fobi can be definitely used. Fortunately, there are different types of treatment out there and not only hypnose. Cognitive behavioral therapy is starting to become more and more popular, offering incredible results.Suffering from a fobi can make you change your life. Do not take such a turn and seek out for help. Use the Internet to discover more information about different phobias, search for ways to overcome your fears. Talk with a therapist about your fobi, learn about self-induced hypnosis and you will be alright in no time!

There is no question that you need to get help for agoraphobia. Agoraphobia can drag on for years. It can be depressing to watch life pass you by.

Despite how badly you may feel right now, it is very possible to overcome this condition, so remain positive. You must make the move to get proper help though.Help Is Effective

Whatever you think right now, there is lots of help these days which will make you feel so much better. It will get rid of the dark cloud that’s constantly hovering over you.

You may be required to take medicine to help calm some of what you’re feeling. Cognitive behavioral therapy along with medication is effective. Your doctor will provide tasks to accomplish.

You will be actively involved and participating in your recovery. You’ll need to report everything to your doctor. As you progress and start feeling better, your tasks may increase.

This is fine, because by this stage, things are looking up for you already. By practicing, you get better and more confident. The dark cloud above you is all but gone! Imagine how happy you’ll be feeling!Encountering Problems

Occasionally, you might have a bad day. This does happen, so don’t worry, although it can be upsetting. That’s alright. Just remember to carry on with the good work you’ve done up to this point.

Getting well does take time and effort, so you need to be patient and focused. Put any ‘bad days’ behind you and get right back into the thick of things!Alternative Methods

You can get help for agoraphobia by using other methods too. Some successful drug-free methods include PureCalm, a herbal remedy that’s been effective for many, The Linden Method and Panic Away programs.

There are many other options as well. You can try a holistic approach or hypnosis, for example. However, whatever you choose, try to have some form of therapy as well for the best benefit.

It’s easy to look for excuses and put things off. Having a therapist means you have to ‘report’ to someone. Be honest. It’s for your benefit. With a strict and planned program, you will make tremendous strides.

Moving Beyond Chemical Dependency

How to Manifest the Life of Your Dreams Using Hypnosis & Mindfulness

(The Three Rules of Sobriety)

By DLScott CtHA / CDP

               What we focus our attention on is what we get.  I have been a hypnotherapist and Chemical Dependency Counselor for over 18 years. I have taught from both a traditional abstinence view point of treatment utilizing standard 12 step methods to change your life, and a harm reduction view point utilizing cognitive behavioral therapy and mindfulness techniques that help a person move beyond the active use of drugs, utilizing the principles of harm reduction and clinical hypnosis.

               As a chemical dependency counselor I have had thousands of clients walk through my doors, and immediately tell me what they don’t want, “I don’t want to use drugs, alcohol, (fill in the blank)”. When I ask them the simple question, then what is it that you do want, I initially get a blank stare, and a confused “I just told you, I don’t want to use (fill in the blank).”

               If I were to tell you right now, don’t think of the New York Harbor with the Statue of Liberty. I would bet my life savings on the fact that you are either visualizing an image of the Statue of Liberty in the New York Harbor, or you are trying hard to keep that image out of your head.

               You see the brain does not really get the concept of no, or don’t. What it gets is “Statue of Liberty – New York Harbor” and then those images come into view. In the same way, when someone comes to me and says, “I don’t want to take drugs”, what the brain does is creates images of drugs, and what it feels like to take those drugs. The first thing I do when someone comes to me is to explain three simple rules.

1)                     The Rule of Attention – what you put your attention on is what manifests in your environment.  Think about that, some people like to call it the law of attraction, and claim that what we focus our thoughts on is what we attract into our lives. I like to think of it as the fact that we live in a world where we are surrounded by literally millions of options, events, people, and activity in our lives. We don’t have to worry about attracting something into our lives, it is probably already there, and whether you are paying attention to the event or thing is what is really important. As an example, my partner and I use to be avid scuba divers, we LOVED to scuba dive. It was something that filled us, made us happy, and made our lives exciting. We were diving on the average of three to four times per week. We were also bumping into at least four or five other divers on a weekly basis. Where ever we went, out shopping, or just having coffee at a our local Starbucks, we were constantly noticing and interacting with other scuba divers.  Now does that mean that we were attracting those divers into our lives, or were we paying attention to what was already around us? The same rule applies if you are an active drug or alcohol user. You are focused on your use, either the benefits; stress relief, detachment from emotions, ability to feel more social; or the consequences such as hang over’s, loss of jobs, loss or friends and relationships, legal issues, etc. It is also probably true that you hang out in bars or clubs, or dealers houses, where there are many other people who use your drug of choice. We just have to focus our attention on the thing, and as we notice it in our environment, we interact with it.

No matter what the situation the rule is the same. If you are angry with someone, if you are unhappy about your job, relationship, whatever it might be for you, I will guarantee you that more of reasons to focus on those things will continue to show up, these are the circumstances you will notice in your environment. If you are happy about your job, if you experience good friends, relationships, a nice place to live, and your focus is filled with these images, these are the circumstances and events that you will notice and experience in your environment.

However you want to look at it, we are surrounding ourselves with, (literally manifesting into our lives), our focus of attention.  So I ask you the question, what are you paying attention to? Are you paying attention to the fact that you are an active drug user, that you have constant cravings and urges re: your drug use, or are you focusing your attention on what you would like your life to be about, the more positive features in your life. What would your life be like if you were to wake up, and immediately greet the day with a list of all of those things in your life that you are grateful for. How different would it be for you, if you simply made it a daily habit of waking each morning and naming three things in your life that you really are grateful for, such as friends, a special relationship, and a roof over your head, your job, etc? Naming off three things, and then allowing yourself to contemplate how wonderful it is that you have those things in your life.

When I give this tool to clients, I usually hear the same responses, “you just don’t understand, I am addicted to drugs, I have no control over the drugs, and can’t stop the urges or cravings”.

You are absolutely correct. You have no control over the thoughts that go through your brain, what you do have control over is the fact that you don’t have to buy into every thought or craving that comes up.

2)      The Rule of Detachment: You are not your thoughts; you are not your body. Rene Decartes, (1596 – 1650), a Christian philosopher, made the famous statement, “I think therefore I am”.  WRONG!!!!!! Your brain is a powerful and marvelous tool, that has millions of thoughts flowing through it every day, thoughts about what you are going to have for dinner, thoughts about things from the past, and worries of the futures, but none of these thoughts are the real you. You, the real you, is the observer of these thoughts, in many cases the reactor to these thoughts, but you are not these thoughts. Think about your car. If I were to ask you to go get into your car, turn on the ignition to start the motor, put the car in gear, take off the brake and then get out of the car, what would happen? The car would start moving forward and continue on an erratic path until it crashes into something. The car has no driver; it is simply being moved by the engine. Now think of your body, as the body of the car, and think of the engine of the car as your brain. Just because the car is able to move with the power of the engine, it still needs a driver to guide it. Your body can move around with the power of the brain, but it still needs you, the driver, to guide it through life.

                      The most important thing that I can teach a new client is the ability to witness

 and observe their thoughts without reacting to every thought that goes through their  brain and that includes the thoughts we call urges and cravings. A simple way to detach from your thoughts is to practice mindfulness meditation. This can be accomplished in  many ways, but the way I prefer is to take about6 10 minutes, twice a day, and just count your breathing, starting with the in breath as one, the out breath as two, the in breath as three, and the out breath as four, continuing this until you reach the count of ten.  What you will and should find is that it will be hard to continue to focus on your          breathing, because your brain will do exactly what it was created to do, it will continue to churn out thoughts.  What you will also begin to discover that is you continue to practice this exercise; you will start recognizing quickly that you are  aware of these constant thoughts, and that will give you the ability to let go of them of or detach from them. Learning to do this will allow you to recognize an urge or a craving, and then do whatever it takes to move on to something else, perhaps performing a task that you really would benefit from.

Once this rule is integrated into the client’s life, it is time to start looking at how you can start gaining the same benefits that you once got from active drugs or alcohol, using other behaviors.   

Most people use drugs or alcohol to obtain stress relief, to become more relaxed in social settings, to avoid unwanted or negative emotions, or simply to make themselves feel better. The problem is that, although the substances start out accomplishing these benefits, they also cause consequences that begin to far outweigh the benefits.

3)      The Rule of Deliberate Creation – The brain knows no difference between a real or an imagined event. It simply reacts to the images that are it contains. The idea of “Don’t think about drinking, or don’t think about using drugs”, simply creates an image in your brain of using alcohol, or using drugs. This image causes familiar feelings of being high which lead to urges and cravings towards the alcohol or drug.

            With hypnosis, the client is lead into a very relaxed state of focused awareness

In which the conscious portion of the brain is bypassed and the subconscious portion of the mind is allowed to take charge. One of the duties of the subconscious portion of the brain is to protect and heal the body. It is this portion of the brain which is in charge of our autonomic functions such as blood flow, respiration, maintaining healing and health, such as healing wounds and correcting illnesses.

            Think of the brain like a powerful computer, and like any computer it works best when the programming is kept clean and free of virus’s. When the subconscious portion of your mind is filled with images of lack, low self worth, and low self esteem, these images act like a virus in your computer. They are written in the same language of the rest of the program, but because they create negative feelings, and negative focus in your life, the result is that you begin experiencing more and more negative events in your life. As I said before; we are surrounded by hundreds of events and circumstances in our lives, but due to the focus of our thoughts, we will experience those events and circumstances that correspond with our feelings created by the images in our brains. The outside events may not exactly match the details of the images, but the event will be sufficient to cause the same type of feelings. How many times have you heard yourself say, “Why do these types of things always happen to me?”

            Simple and effective clinical hypnotic techniques can clean up the old programming, old images, and replace them with powerful new programs and images that promote health, happiness, prosperity, feelings of well being, and the motivation to create and live the type of life that you have always dreamed of.  

Most people starting use drugs or alcohol to fit in, to feel better about themselves, to cover over those subconscious images and programs that have held them back. By using the power of hypnosis people are finding that they can achieve those benefits from the inside, and when you can do that, you no longer have to rely on a substance outside of yourself. The motivation to continue the use of drugs begins to simply fade from your life, and you easily and effortlessly Move Beyond Chemical Dependency.

Four main types of dissociative disorders are currently identified and recognized by the psychiatric community. While certain symptoms are common between each type, each disorder has its own specific dissociative signs not shared with the other three. These disorders can also be comorbid with other mental illnesses and conditions, including one or more of the other dissociative disorders. Patients with any of the four types may experience loss of memory, detachment, anxiety, depression, and a distorted sense of one’s self or of others.The first type is called “Dissociative Amnesia”. While all four disorders may involve some degree of memory loss, Dissociative Amnesia is characterized by a loss of memory that is atypical. Sometimes this amnesia will occur directly after a traumatic event, but more often the memory loss will not be noticed until later, so the cause of the amnesia may not be readily apparent. Sufferers may not be able to recall events or people during a certain period of time after a trauma.An illness which is frequently comorbid with the amnesia described above is “Dissociative Identity Disorder”, also known as DID. This disorder was previously referred to as “Multiple Personality Disorder“. With DID, a person may take on several completely disparate personalities to respond to different circumstances, particularly in times or situations of great stress. While it is not always the case, these alternate personalities can be so unlike the person’s true identity that they may have singular voices, dissimilar memories or even be of the opposite gender from the person’s actual physical sex.The third dissociative condition is known as “Dissociative Fugue” which shares characteristics of both the two aforementioned conditions. A person suffering from this disorder may suddenly leave his or her life and take up a new identity in the new surroundings – for hours or even months – before just as suddenly returning to their senses, usually without any recall of the events that took place within the fugue state and without knowing how they came to be in the new place.Finally, there is “Depersonalization Disorder”. This condition causes a person to feel detached, as though they are watching themselves from a removed distance, almost as if they were merely watching a character on television. The lines of reality may be blurred, and objects, other people or even time itself may seem to stretch out of proportion. Depersonalization can be momentary or it can occur off and on throughout a patient’s lifetime.Treatment for any of the four  dissociative disorders most likely will include psychiatric counseling of some kind. Therapy can help a person trace the origins of their condition and find better ways to cope. Cognitive Behavioral Therapy helps a dissociative person replace negative responses with positive ones. Another way to manage these dissociative disorders is  using creative arts therapy, where a person who has trouble articulating their feelings may instead use some form of artistic expression, like sculpture or poetry. Treatment may consist of medications such as anti-anxiety medications or anti-depressants.

Four main types of dissociative disorders are currently identified and recognized by the psychiatric community. While certain symptoms are common between each type, each disorder has its own specific dissociative signs not shared with the other three. These disorders can also be comorbid with other mental illnesses and conditions, including one or more of the other dissociative disorders. Patients with any of the four types may experience loss of memory, detachment, anxiety, depression, and a distorted sense of one’s self or of others.The first type is called “Dissociative Amnesia”. While all four disorders may involve some degree of memory loss, Dissociative Amnesia is characterized by a loss of memory that is atypical. Sometimes this amnesia will occur directly after a traumatic event, but more often the memory loss will not be noticed until later, so the cause of the amnesia may not be readily apparent. Sufferers may not be able to recall events or people during a certain period of time after a trauma.An illness which is frequently comorbid with the amnesia described above is “Dissociative Identity Disorder”, also known as DID. This disorder was previously referred to as “Multiple Personality Disorder“. With DID, a person may take on several completely disparate personalities to respond to different circumstances, particularly in times or situations of great stress. While it is not always the case, these alternate personalities can be so unlike the person’s true identity that they may have singular voices, dissimilar memories or even be of the opposite gender from the person’s actual physical sex.The third dissociative condition is known as “Dissociative Fugue” which shares characteristics of both the two aforementioned conditions. A person suffering from this disorder may suddenly leave his or her life and take up a new identity in the new surroundings – for hours or even months – before just as suddenly returning to their senses, usually without any recall of the events that took place within the fugue state and without knowing how they came to be in the new place.Finally, there is “Depersonalization Disorder”. This condition causes a person to feel detached, as though they are watching themselves from a removed distance, almost as if they were merely watching a character on television. The lines of reality may be blurred, and objects, other people or even time itself may seem to stretch out of proportion. Depersonalization can be momentary or it can occur off and on throughout a patient’s lifetime.Treatment for any of the four  dissociative disorders most likely will include psychiatric counseling of some kind. Therapy can help a person trace the origins of their condition and find better ways to cope. Cognitive Behavioral Therapy helps a dissociative person replace negative responses with positive ones. Another way to manage these dissociative disorders is  using creative arts therapy, where a person who has trouble articulating their feelings may instead use some form of artistic expression, like sculpture or poetry. Treatment may consist of medications such as anti-anxiety medications or anti-depressants.

Eating disorders are a troublesome problem, usually with an onset during adolescence. Although typically associated with teenage girls, there has been a steady increase in the number of boys affected by this disorder. Whether the individual is anorexic or bulimic, the common thread is a fascination and fear with the notion of gaining or losing weight.

Those who are anorexic or bulimic tend to have common behavioral characteristics related to their disorder. Although each case is unique, eating disordered children often suffer from obsessive-compulsive behavior, issues of power and control, perfectionistic tendencies, depression and anxiety, and thwarted rage and anger.

A multidisciplinary approach consisting of outpatient or inpatient therapy, medication management, family counseling, nutritional assistance, and regular monitoring by the child’s physician is imperative. Cognitive-behavioral therapy, coupled with family systems treatment and psychiatric intervention appear to work most effectively in assisting youngsters in managing the disorder.

Children who are anorexic have a fear of gaining weight. The anorexic will crave food, by will refuse to eat or retain it because of an intense fear of weight gain. The behavior of an anorexic may be characterized by a pattern of social withdrawal, rigorous exercise, and ritualistic eating patterns. Body misperception is a core feature of the anorexic. As they look out of the lenses of their disorder, being excessively underweight appears normal. Teenage anorexics will look in the mirror at 90 pounds and tell you that they look fat.

Those who are bulimic use various mechanisms to control their weight. The most frequent pattern is the ritualistic binging and purging cycle along with the use of various diuretics and laxatives. Adolescents may fluctuate between the presenting symptoms of bulimia and later manifest the patterns of anorexia. Both eating disorders are extremely dangerous and can be life threatening. The effect on the child’s health cannot be underestimated.

Eating disorders are fueled by existing media portrayals of “thin is in.” The disorder can also be exacerbated by certain types of rigorous activity such as jogging and dance. I believe there are ballet companies that actually ignore the issue of eating disorders in the process of training their dance students. Eating disorders can also be intensified by parents or peers who draw attention to the adolescent’s weight. Parents or friends who make disparaging comments about weight gain or loss can help trigger or sustain the eating disorder pattern.

Adolescents tend to be resistant to receiving treatment, refusing attempts at therapeutic intervention. Counselors can overcome this obstacle by developing a collaborative, discovery-oriented relationship. I might say, “Let’s work at this together. One of the cardinal features of your disorder is your inability to appropriately evaluate your own weight. If you canvassed five of your friends, what do you think they would say about the nature of your weight?”

I believe that unexpressed anger is at the core of most eating disorders. A child may be saying, “I’ll show you! If you won’t love me for who I am and what I think and feel, I’ll take it out my body and hurt you by doing so.” Often, I tell people that vomiting is a metaphor for “spilling their guts” over pent-up anger and rage.

Parents are usually overwhelmed when they fully recognize that their teenager has an eating disorder. Sometimes parents stay in denial about the nature and severity of their child’s problem and consequently take no corrective action. Here are some recommendations for parents of eating disordered teenagers:

• Seek professional help. Don’t try to handle the problem yourself.

• Promote understanding with your child about any underlying issues of concern.

• Do not become directly involved with your child’s disorder once he/she is in therapy. Keep in touch with the professionals treating your child’s disorder. Comment such as, “What you are doing is hurting the family” are not helpful.

• Create a dialogue with your child on issues unrelated to food and weight.

• Do not establish consequences directly tied to the eating disorder. It only increases power struggles.

• A supportive, affirming attitude should be maintained when dealing with your teen.

• Seek family therapy. Eating disorders are often a metaphor for family relationship problems.

• Expect your child to participate with the family at meal times, but never demand that your teenager eat.

It is imperative that parents understand that an eating disorder involves adolescent power and control. Resist the urge to micromanage the disorder while acknowledging its existence. Minimize household tension and resistance by reserving positive and negative consequences for behaviors outside the domain of the disorder. Try not to get discouraged. Treatment takes time and commitment. There are many supportive programs and mental health providers who can assist you.

Anxiety is one of the most prevalent conditions of the mind today. One of the biggest problems with anxiety is its tendency to strike at the most inopportune moments. Being able to keep your anxiety levels in check will make you a more resilient and confident person.

Fortunately, if your anxiety is not at the rarest form, there are many ways to cope with it that do not need medical intervention, one of being cognitive behavioral therapy. Giving anxiety an all encompassing definition is difficult because of its different effects on different individuals. It does, however, share some common traits.

Anxiety is the feeling of fear we all experience (and I can test to that) when faced with threatening or difficult situations. It helps us to avoid dangerous situations, makes us alert and motivates us to deal with our problems. Everybody knows what it’s like to feel anxious-the butterflies in your stomach before a first date, the tension you feel when your boss is angry, or the way your heart pounds if you’re in danger. Anxiety rouses you to action. It gears you up to face a threatening situation. It makes you study harder for that exam, and keeps you on your toes when you’re making a presentation. In general, it helps you cope.

But if you have an anxiety disorder, this normally helpful emotion can do just the opposite; it can keep you from coping and can disrupt your daily life. Many people still carry the misperception that anxiety disorders are a sign of weakness; a problem that happens because you are weak. They say things like “Pull yourself together!” and “You just have a case of the nerves.” Wishing the symptoms away does not work, but there are treatments that can help and one of them to consider is cognitive behavioral therapy.

Anxiety disorders and panic attacks are not signs of a character flaw. Most importantly, feeling anxious is not your fault. It is a serious mood disorder, which affects a person’s ability to function in everyday activities. It affects one’s work, one’s family, and one’s social life. One of the most proven and tested treatments for anxiety disorder come from cognitive behavioral therapy, behavioral therapy that focuses on behavior in response to those thoughts.

Cognitive behavioral therapy (CBT) is based on the belief that people learn most of their unhealthy ways of thinking and behaving over a long period of time. Using a set of structured techniques, a CBT practitioner aims to identify how you are thinking and how this can cause problematic feelings and behavior. You will learn to challenge negative ways of thinking, which helps you react more positively. This can lead to behavioral changes and then to improved self esteem.