Here is a list of what I feel are the most important therapy and psychology handouts to have. This list ebbs and flows as more resources are added.
Therapist Resources for Your Journey
Without Trust, Your Relationship Will Not Survive the Year
In many relationships, a recurring concern is the lack of trust, leading to the common question, “Why don’t you trust me?” This reflects a fundamental problem in a relationship without trust, where cycles of doubt and misunderstanding erode the bond between partners. Addressing this lack of trust is essential for a secure and healthy connection.
[Read more…] about Without Trust, Your Relationship Will Not Survive the YearConsequences of Not Having Personal Boundaries
We all want to be fair, kind and loving to the people that we care about. Sometimes that means going out of our way for them. At other times, it means putting up with a certain amount of crap. In the long run, we hope and bet on the odds that it’s worth it for our relationship to have a little give-and-take. However, giving out love without any personal boundaries can be extremely dangerous and carries extreme risk to our own sense of self and others.
[Read more…] about Consequences of Not Having Personal BoundariesWait, I’m not Crazy?! Adults Who Grew Up in Dysfunctional Families
If you grew up in an unhealthy or dysfunctional family, it has drastically and permanently altered the course of your life. It is absolutely vital to understand how, specifically, this affects you so that you can stand a chance to change patterns of unhealthy choices and behaviors that plague you and your adult life. Left unchecked, these patterns can drastically sabotage everything you hold dear in this life.
[Read more…] about Wait, I’m not Crazy?! Adults Who Grew Up in Dysfunctional FamiliesWhy Do I Keep Choosing the Wrong Person?
We often ponder why we find ourselves in challenging relationships that “go sour” despite their initially “promising” nature. Frequently, we find ourselves choosing the wrong person repeatedly, puzzled by this pattern. Often, we blame the other individual, believing the world is filled with “wrong people,” leading us to think we should either “avoid relationships altogether” or just “tolerate the situation.”
Empowering Adult Children to Conquer Task Completion Challenges
Adult Children have difficulty in following a project through from beginning to end. They may have great beginnings, but then have problems with full follow-through, because they are doing several things at once and trying to do everything. They have problems pacing themselves, and their activities, tending to become exhausted with all that they have to do.
The real problem is that they are not procrastinators in the usual sense. They came from homes of an awful lot of promises. No one took time to sit down and say “that is a good idea.”
[Read more…] about Empowering Adult Children to Conquer Task Completion ChallengesNavigating Normalcy: The Struggle of Adult Children
Adult Children never feel that they know what normal is. They think they know; in fact, they believe that they know it better than anyone else, but they are never really sure. Such individuals are actually very practical people who have learned to survive in life on instinct. However, this leaves them feeling insecure about what is really the right way of doing things.
They simply have no experience with what is normal. Growing up, they never had the freedom to ask, so they never know for sure. Their goal in life is to keep others from finding out that they don’t know. Instead, they have to guess all the time, which ends up being hard, lonely work. They missed out on the discussions with their parents about how to handle things. They have no frame of reference for what is ok to say and to feel.
[Read more…] about Navigating Normalcy: The Struggle of Adult ChildrenRelationship Red Flags and Warning Signs
Researchers have identified specific patterns that put the relationship at risk of ending. Ask yourself where you would rate yourself and your partner. See if you can change your response style to improve things.
[Read more…] about Relationship Red Flags and Warning SignsUnderstanding Relationship Health: A Guide to Strengthening Your Bond
In every relationship, navigating the journey of togetherness involves understanding and managing various emotional and practical aspects that contribute to what we call relationship health. As a Certified Gottman Therapist, I’ve witnessed first-hand how identifying and addressing specific areas within a relationship can lead to profound improvements in how couples connect, communicate, and commit to each other. Let’s delve into some key areas that are vital to strengthening your bond.
[Read more…] about Understanding Relationship Health: A Guide to Strengthening Your BondUnderstanding Your Partner: Unveiling the Mystery of Unshared Emotions
Why doesn’t my husband share his emotions? This question, often whispered in the quiet corners of our minds or during heartfelt conversations, reflects a common yet deeply personal concern among many partners. The silence that greets us when we seek to connect on an emotional level can feel both puzzling and isolating. But beneath this silence lies a complex world of feelings, beliefs, and, most intriguingly, meta-emotions.
[Read more…] about Understanding Your Partner: Unveiling the Mystery of Unshared EmotionsThe No-Nonsense Guide to Improving Your Relationship: The 5:1 Ratio Unpacked
You might be wondering, “What’s the secret to a long-lasting relationship?” Well, it’s not just luck or chemistry—it’s a science. Research from Dr. John Gottman, a leading expert on relationships, has identified a simple but powerful formula: the 5:1 ratio of positive to negative interactions. This isn’t just a feel-good concept; it’s grounded in rigorous scientific study. The essence is straightforward: for every negative interaction you have, aim for at least five positive ones. When you get this balance right, your relationship can thrive.
[Read more…] about The No-Nonsense Guide to Improving Your Relationship: The 5:1 Ratio UnpackedUnderstanding Emotional and Verbal Abuse: How Therapy Can Help You Heal
Emotional and verbal abuse is a topic that doesn’t get nearly the attention it deserves. Unlike physical abuse, the scars aren’t easily seen, but they cut deep. Many people don’t even realize they’re caught in an abusive cycle until it’s caused significant emotional damage. This form of abuse thrives in secrecy and ambiguity, making it difficult to understand and confront. But don’t worry, we’re going to demystify it for you, explain why it’s so problematic, and, most importantly, show you the role therapy can play in healing.
What Emotional and Verbal Abuse Looks Like
Ever heard the phrase, “Sticks and stones may break my bones, but words will never hurt me?” Well, whoever coined that phrase didn’t know much about emotional and verbal abuse. Whether it’s constant belittling, manipulation, or psychological torment, this form of abuse seeps into your thoughts and reshapes your sense of self. There’s no one-size-fits-all pattern, making it difficult to identify. Think of it as a chameleon, adapting its colors to blend into your everyday life, making it hard to pinpoint but easy to feel its impact.
The Agonizing Cycle of Pain and Struggle
Imagine carrying a backpack filled with bricks. At first, you might think you can manage, but the longer you carry it, the heavier it becomes. The same goes for emotional and verbal abuse. The weight of derogatory comments, manipulation, and humiliation gradually crushes your spirit. Over time, victims find themselves trapped in a fog of self-doubt, confusion, and anxiety. Simple decisions become agonizing. You second-guess your worth, question your perceptions, and even doubt your sanity. Why? Because someone you trusted is playing puppet master with your emotions.
The Deceptive Nature of Emotional and Verbal Abuse
Why do people fall into this trap? Why don’t they “just leave”? Band-Aid’s not going to fix something that requires surgery, and the same goes for escaping abuse. Victims often stay because they’ve been manipulated into believing that the abuse is their fault or that the abuser will change. Plus, emotional and verbal abuse is often dished out in small doses, interspersed with moments of affection, creating a vicious cycle that leaves victims clinging to the hope of happier days.
The Benefits of Therapy for Emotional and Verbal Abuse
Seeking therapy isn’t a sign of weakness; it’s a step toward empowerment. In the same way, you’d consult a doctor for a physical ailment or a therapist for emotional wounds. Working with a therapist gives you a chance to dissect the complexities of emotional and verbal abuse in a safe space. They provide tools to identify abuse, establish boundaries, and initiate a healing process. Therapy helps you unload that backpack of bricks and fill it instead with resilience, self-worth, and a sense of peace.
Take Action: Your Path to Healing Starts Here
So, what’s stopping you from taking that first step? False solutions and fear of judgment often paralyze victims. Let’s dispel that myth right now. Your well-being is too important to leave in the hands of anyone who doesn’t have your best interests at heart. Reach out to a therapist experienced in treating emotional and verbal abuse. Your future self will thank you.
The road to healing is within reach. Don’t walk it alone; let a therapist guide you to a life of emotional well-being and self-worth. Reach out today because you don’t have to carry that weight anymore.
The 3 Essential Steps for Transforming Your Relationship Today
I can’t tell you how many times I’ve seen couples stroll into my office, thinking a few tips and tricks are going to fix years of relationship decay. It’s like putting a bandaid on a bullet wound and expecting to walk it off. Spoiler alert: you can’t. That’s because genuine transformation is way different from merely having information. I’ve seen people miss this crucial point over and over, often when it’s far too late to reverse course.
So, if you’re really invested in turning your relationship around, here’s what you need to be doing:
[Read more…] about The 3 Essential Steps for Transforming Your Relationship TodayUnderstanding the Conflicted Parts of Ourselves (with IFS)
The primary tool I use to help people who struggle with internal conflict is known as Internal Family Systems (IFS). It has nothing to do with family therapy. More accurately, it’s not unlike being a wildlife observer. A really good one. Who has also read Clan of the Cave Bear. You’ll understand it all in a moment.
First, imagine a wildlife observer sitting down in a field, taking notes in his journal. He’s intent on learning more about the animal kingdom. After sitting still for a few hours, he notices a small squirrel innocently wandering around, looking for nuts. Without warning, a lion suddenly pounces out of the bushes in an attempt to eat the squirrel.
With a rush of adrenaline, The Poor Wildlife Observer immediately reacts. In a flash, he jumps up and tosses his clipboard and papers in the air as he rushes towards the lion in a panic. He waves frantically and yells at the top of his voice: “Bad lion! Shoo! Shoo! Go away!” He’s desperately trying to save the poor innocent squirrel. Startled by all of the commotion, the lion hesitates, and reluctantly backs off. The Poor Wildlife Observer picks up the little squirrel, cradles it in his arms and gives it a gentle caress as if to say that everything is going to be all right.
This is not the right approach to self-awareness.
Compare this with the behavior of The Good Wildlife Observer. He notices the squirrel and sees the lion pounce. However with this encounter, he does not react to what he sees. Instead, he allows the entire interaction to take place. Undeterred by the protests of the innocent little squirrel, the lion proceeds with his midday snack. The Good Wildlife Observer simply nods, picks up his clipboard, and with slow, deliberate action begins to write: “Lion exhibits squirrel-eating behavior. Interesting,” and shrugs.
The difference between the two wildlife observers is that one reacts, while the other one reflects. When we react to our thoughts and emotions, we don’t really notice what’s truly going on deep inside of ourselves. Reflection allows us to notice, observe and accept what is. You can’t change what you don’t notice, and over time, you’ll be able to choose to act rather than react. Acceptance and curiosity allows us to access a deeper, more complete picture of our emotional landscape.
This is one of the essential components in Internal Family Systems (IFS).
Introducing IFS
Internal Family Systems (IFS) is a type of therapy that helps people understand and manage their complex emotions, thoughts, and beliefs. An essential component of this is that each person is made up of different “parts”, all of whom may have different goals, objectives and motivations. Understanding how they work and not working against them is the first step towards healing emotional wounds.
All About this IFS “Part” Nonsense
A client once expressed her concern over exploring her various “parts”. She didn’t want to buy in to this “touchy feely nonsense” without some understanding of how it works. Which is perfect, as I love it when clients want to understand how to use these tools better.
I suggested that she look at it like the situation with Ayla doing mathematics in Clan of the Cave Bear. For Ayla, learning to count was simple; in fact, she could count past ten even though she only had ten fingers. Her peers were dumbfounded; they were still stuck on the literal concept of not comprehending what fingers had to do with numbers. However, Ayla knew that her fingers were representative of a concept, specifically mathematics.
In the end, it doesn’t really matter whether or not we actually have different “parts” of ourselves or if we’re just using this as a way to represent our conflicting feelings and thoughts. It’s effective and incredibly illuminating to understand ourselves in this new light.
How to Effectively Sabotage Your Relationship
In 1944, the ClA wrote a handbook on how to sabotage an company’s productivity. This secret (now declassified) pamphlet was called “The Simple Sabotage Field Manual” and has several surprising similarities to how couples unsuccessfully communicate.
[Read more…] about How to Effectively Sabotage Your RelationshipEnhancing Closeness thru Vulnerability
Research has revealed that a very powerful predictor of relationship stability is whether couples spend time getting to know each other or not. One way to do this is to ask open-ended questions. An open-ended question is a question that can’t be answered by a simple “yes” or “no.” It is a question such as, “How would you like our life to change in the next five years?”
The ultimate goal is to change the way the two of you “move through time” together.
[Read more…] about Enhancing Closeness thru VulnerabilityGeneralized Anxiety Disorder
The key element behind this type of anxiety and worry is an intolerance of uncertainty. Over time, our excessive worry becomes persistent, repetitive and uncontrollable. We rush around trying to find solutions, yet we never end up finding any sort of relief.
When we worry, we tend to predict that bad things will happen to themselves or other people. These fears may even be based on real events. We try to figure out one or more solutions to what we fear will happen. However, since the “bad” event still hasn’t actually happened yet, we never end up being able to use our solution. As a result, we still continue to feel uncertain and anxious.
Adapting Cognitive-Behavioral Therapy (CBT)
Cognitive-Behavioral Therapy (CBT) uses a specific cognitive model in order to understand, interpret and effectively work with Generalized Anxiety Disorder (GAD). The cognitive model of GAD consists of four essential parts:
- Intolerance of uncertainty
- Beliefs about worry (positive & negative)
- Poor Problem Orientation
- Cognitive & Emotional Avoidance
Part 1: Intolerance of Uncertainty
When we can’t handle uncertainty, we tend to become intolerant of it. This intolerance tends to set us up for developing Generalized Anxiety Disorder (GAD) as well as maintaining the disorder once it starts.
People without GAD may not like uncertainty, but they generally tolerate it. They tend to believe that if bad things happen to them, they’ll be able to cope.
GAD clients have a different perspective! They believe it is unacceptable to have any uncertainty. They fear that experiencing any uncertainty or ambiguity will actually cause more problems. There is even a believe that they would be irresponsible of they don’t try to eliminate any uncertainty.
Part 2: Beliefs About Worry (Positive & Negative)
Generalized Anxiety Disorder (GAD) clients suffer from dysfunctional beliefs about how worry works. They tend to have extreme views on how helpful or harmful worry is.
People with GAD might feel that worrying ahead of time can prepare them for anything that happens to them (extreme positive belief). Or they might feel that it is dangerous to experience worry and that any worry is uncontrollable (extreme negative belief). It’s the extreme beliefs that are the actual danger themselves, as they add fuel to the fire to make us worry more.
Part 3: Poor Problem Orientation
Those with General Anxiety Disorder tend to view any problems as threats. They aren’t very confident in their ability to come up with any solutions. This mindset sets them up to always expect a negative outcome when they attempt to solve any problem. As a result, they overcompensate by trying to create a perfect solution.
But, when you combine a Poor Problem Solving Orientation with an Intolerance for Uncertainty, this is what happens:
- You’ll keep trying to come up with a solution that you are certain will work.
- Yet the problem is still in the future, so you won’t be able to implement the solution at the moment.
- The result is that you can’t be certain that your solution will work, so you’ll continue to worry and come up with more solutions without actually choosing one.
Part 4: Cognitive & Emotional Avoidance
Ironically, worry itself is a way for us to avoid certain things. We don’t want to think of what things will look like if something goes bad. We start to imagine “worst case scenarios” and experience very distressing feelings. As a result, clients with Generalized Anxiety Disorder use worry as a way to avoid these thoughts and emotions.
The Benefits of Cognitive-Behavioral Therapy (CBT)
I’ve had many other counselors over the years and I chose you because of your focus on CBT (Cognitive-Behavioral Therapy). I really relate to your more analytical, organized, solution focused approach verses just letting me talk and you listen. It feels more pragmatic.
– Client review
Cognitive-Behavioral Therapy (CBT) is one of the major tools used in psychotherapy. CBT assumes that the way that people perceive situations is more closely connected to their reaction than the situation itself.
Simply put, a therapist’s job when using CBT is to help clients identify the thoughts that pop up into their minds, evaluate, and respond to them. The assumption is that when clients are able to do this, they feel better and can act in accordance with their values and goals. One critical concept underlying all aspects of CBT is that just because you think something doesn’t necessarily mean it’s true.
Evidence-Based Treatment
CBT is evidence-based. This means that it is backed by research to be an effective treatment. However, it’s worth noting that any type of therapy (such as CBT) cannot be “evidence-based” without listing what disorder it is effective in treating. For example:
- CBT is an evidence-based treatment for Major Depressive Disorder. The therapist focuses specifically on the automatic thoughts that have to do with the self, the world, the future.
- CBT is an evidence-based treatment for Panic Disorder. The therapist focuses on the automatic thoughts that have to do with the catastrophe that the client is afraid will happen if a symptom gets worse.
- CBT is an evidence-based treatment for Obsessive-Compulsive Disorder. Here, a CBT therapist doesn’t focus on automatic thoughts; rather, the focus is on the beliefs that the client has about their obsessive thinking and about their ritualistic behavior.
Where Therapists Get CBT Wrong
Many therapists jump into CBT without understanding the fundamental concepts and techniques, and apply a scattered “try, try again” approach with techniques. In fact, when working with clients it is critical to delay introducing CBT techniques until they have demonstrated two essential things first:
- That your client believes and “buy in” to the cognitive model (that “thinking influences how we feel and what we do”) and that by evaluating their thinking, they can feel and act better.
- Clients should also be able to demonstrate to you that they can use the list of socratic questions (see below) and have filled out any related worksheets with you during/in-session. Otherwise, any assignments you give will be half-believed, half-accomplished and will be unlikely to make any material change in their cognition between sessions.
Action Plans (“Assignments” or “Homework”)
It’s just not enough to come in and talk for 50 minutes a week. The way that people get better is by making small changes in their thinking and behavior every day. That’s why action plans are so crucial. Research consistently demonstrates that CBT which includes action plans is more effective than CBT that doesn’t.
Most people don’t like homework, so “assignments” or “action plans” are used instead. However, I’ve found that the following question helps to identify clients who are more likely to follow through with CBT assignments (i.e, those who don’t choose the third answer):
- How do you prefer to spend your time in-between sessions?
- I prefer reading assignments
- I prefer written assignments
- I prefer to just reflect and think on what was discussed in session.
Assignments entail some kind of responding to the client’s negative thinking and behavioral change. If in doubt, you can ask your client, “What do you think is most important to remember this week? What would you like to do about it? What would you like to remember?” At a minimum, clients should be assigned the following activities in-between sessions:
- Read coping cards or therapy notes everyday
- Implement solutions to problems
- Monitor experiences so that they can notice important automatic thoughts
- Respond to their negative cognitions
- Practice new behavioral skills
Cognitive Conceptualization
To be an effective therapist, you have to continuously conceptualize clients’ experiences. You must understand what the client’s specific problem is and decide on a treatment technique, such as:
- Evaluating their thoughts
- Identifying and modifying their beliefs
- Doing problem solving
- Teaching skills to regulate emotions
- Change their behavior
- Decrease their physiological arousal
- Acceptance of the problem and changing their focus
In the end, people’s reactions always make sense once you understand what they were thinking. That’s the hallmark of CBT.
Understanding Thoughts, Emotions and Behaviors
For example, think of a recent situation in which you felt at least a little distressed. Or where you engaged in an unhelpful behavior, or noticed a change in your body. With CBT, we ask ourselves:
- What was the situation? Or what were you thinking about, remembering, experiencing or predicting?
- What went through your mind? (Automatic Thoughts)
- How did you feel emotionally? What was your reaction? (Emotions)
- Did your body react? If so, how? (Physiological)
- What did you do? (Behavior / Coping strategy)
The resulting behaviors can tell us what kind of strategies a person has developed to survive in life. These patterns tend to be consistent and, at times, dysfunctional.
Understanding Core Beliefs
Initially, your work with a client will focus on evaluating and modifying their thoughts and/or beliefs. As sessions progress, you might begin to focus on clients’ deeply held beliefs, which are referred to as Core Beliefs. Core beliefs prevent you from gathering evidence to contradict your analysis of a situation. You can identify these beliefs as they are always active (24 hours a day, 7 days a week) and act as a “lens” where whatever happens to you gets filtered through it.
There are three primary categories of Core Beliefs:
- Helplessness
- Ineffective in getting things done
- Ineffective in protecting ourselves
- Ineffective as compared to other people
- Unloveability
- Worthlessness (belief that you are morally bad)
How Client Cope with their Core Beliefs
People cope with their Core Beliefs by using Assumptions or “Rules for Living”, regardless of whether they create more problems than they solve. Coping Strategies are the characteristic ways that clients behave in order to protect themselves from the activation of their core beliefs.
Most of these take the form of an “if…/then…” format. For example, “If I don’t trust people, then I’m going to be ok. But if I do trust them, I’m going to be hurt, and therefore proven unloveable.” Therapists help clients evaluate these conditional assumptions by exploring both the positive assumption that helped them cope with their core belief, as well as any negative counterparts to their assumptions.
Modifying Core Beliefs
Using what CBT therapists refer to as the “downward arrow approach”, you identify a core belief through automatic thoughts by asking, “If your automatic thought were true, what would that mean? And especially, what would that mean about you?” This can be time-consuming and challenging as clients often express their core beliefs as automatic thoughts. You can also explore how the client has coped with these core beliefs all their life, examine what kind of behavioral strategies they have developed to get along with in life, and identify some consistent patterns of behavior that are, at times, dysfunctional.
Core beliefs can’t be worked on during the initial steps of therapy until the client is in agreement with the critical concept above (thoughts are not necessarily true). Also, questioning one’s core beliefs questions a client’s core self, which can be very uncomfortable; this requires trust in the therapeutic relationship to be solid and established.
Cognitive Distortions
Cognitive distortions are often the blueprint with which we explain and comprehend what happens to us in life. With CBT, it’s not essential to label the cognitive distortion, but it can be helpful to give clients some cognitive distance from their emotionally charged thoughts. Some common distortions include:
- All-or-nothing thinking: You see things only in two categories. Things are black or white, with no shades of grey. “I have to do a great job on everything.”
- Fortune-Telling: You make negative predictions about what will happen when other outcomes are more likely. “I’ll always have trouble figuring out my thoughts.”
- Labeling: You put a globally negative label on yourself. “I’m a failure for making a mistake.”
- Emotional reasoning: You believe something must be true because it “feels” true. “I must be incompetent.”
- Selective abstraction: You pay attention only to the negative aspects of situations instead of considering the entire experience. “I made so many mistakes”.
- Overgeneralization: You draw a general conclusion based on a small amount of evidence. “I do everything wrong.”
- Mind reading: You are sure you know what others are thinking. “They probably think I’m foolish.”
- Personalization: You take others’ actions personally when they actually have other intentions. “They did that to me on purpose.”
- Imperatives: You have an unreasonably rigid idea about how you or others should or must behave. “I should always do my absolute best.”
- Magnification and minimization: You magnify the negatives or minimize the positives. “I’m no good at figuring out what to do.” “It doesn’t matter that I have good common sense.”
Adapted from Cognitive Behavior Therapy: Basics and Beyond (J. Beck, 2011)
Responding to Dysfunctional Cognitions
Cognitive-Behavioral therapists tend to challenge these thinking errors using a variety of techniques, including Socratic Questioning, Behavioral Experiments, Labeling of Cognitive Distortions, Cognitive Challenging/Refocusing/Reframing, Exploration of Coping Patterns, Exploration of Thoughts and Emotions, Interactive Feedback, Role-Play/Behavioral Rehearsal, and using Analogies and Metaphors.
Of these, the most important is Socratic Questioning, where clients learn how to evaluate thoughts and beliefs by gathering evidence, developing alternative explanations, de-catastrophizing, and using other Socratic questions, such as:
- What’s the evidence?
- What’s the evidence on the other side?
- What’s another way of looking at this situation?
- If the worst happens, how could you cope?
- What’s the best outcome?
- What’s the most realistic outcome?
- What’s the effect of changing your thinking about this?
- What would you tell a friend who was in the same situation?
- What do you think you should do?
How to End Every CBT Session
The single most important question to ask your client at the end of each CBT session is, “How likely are you to do your assignments (action plan) this week?”
- If your client responds saying 90-100%, you’re all set for success.
- If they say 75%, your client will do some of the assignment, but just before the session just to please you.
- If they say 50%, they’re not going to do it, but they don’t want to tell you.
To reach 90%, make certain the action plans are easier, or make parts of the action plan optional. You can ask yourself, “What are the practical problems (or automatic thoughts) that will get in my way?” Once you’ve addressed these and revised your action plan, you can then ask yourself, “NOW how likely am I to do the action plan this week?”
How to Get Divorced in 4 Easy Steps
Learn how to recognize and counteract the harmful communication patterns that are common in failed relationships.
[Read more…] about How to Get Divorced in 4 Easy Steps