Psych Central Professional For mental health, psychiatric and psychological professionals. Fri, 27 Nov 2015 13:47:29 +0000 en-US hourly 1 20 Things to Consider Before Marriage Fri, 27 Nov 2015 13:47:29 +0000 http://5.423 Pre-marriageIt is hard to know if a person will be a good fit as a spouse. It is even harder to stop and evaluate a potential spouse from a logical, non-emotional point of view. Yet this is precisely what needs to be done.

Friends and family can be helpful in pointing out some concerns but their excitement for the couple may cloud judgement. Even the best premarital counseling can’t detect all of the potential pitfalls. Instead, present these questions to a couple and have them individually answer. This can provide a more realistic viewpoint and offer some areas of discussion prior to marriage.

  1. Are there frequent arguments over nothing?
  2. Do you or your partner use biting sarcasm to confront issues?
  3. Are you staying in the relationship out of fear?
  4. Do you have few areas of common interest?
  5. Are either you or your partner overly dependent on your parents?
  6. Is there any sign of physical, sexual, or verbal abuse?
  7. Do you avoid discussing sensitive topics to prevent an argument or because you are afraid of their reaction?
  8. Does your partner frequently complain about unreal aches and pains?
  9. Does your partner make excuses for not finding a job?
  10. Are you or your partner involved in any addiction such as alcoholism, drug use, gambling, or pornography?
  11. Does your partner avoid contact with others and prefer to be alone?
  12. Do you find yourself always doing what your partner wants to do?
  13. Does your partner harm themselves or have extreme irrational fears, bizarre behavior, or inability to be affectionate?
  14. Is your partner overly jealous, questioning you all the time about your whereabouts?
  15. Is your partner overly critical and demanding that you adjust to their expectations?
  16. Are you and your partner dishonest about your sexual past?
  17. Do you have an uneasy feeling about the relationship?
  18. Are your parents or friends strongly against the relationship?
  19. Do you have a feeling of settling for less than the best?
  20. Is there spiritual harmony?

Answering yes to a few of these questions does not mean the marriage is doomed.  Rather, it signifies a need to better evaluate the situation and seek additional counsel.  Some of these issues can be resolved quickly, allowing the foundation of the marriage to be even stronger.

However, if “yes” answers were given to numbers 3, 6, 10, or 13, please seek individual professional help immediately. Those issues are more long term in nature and marriage will not fix the problem, it will only make it worse.

Christine Hammond is the award-winning author of The Exhausted Woman’s Handbook available from Amazon, Barnes & Noble and iBooks.

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How to Get Your First Client Part 2 Fri, 27 Nov 2015 13:05:08 +0000 computer

In the first part of this series, we discussed getting some basics set up so that you get referrals. We covered what doesn’t work what does work, and how to build a marketing flow.

As you start to meet more people, your practice will grow. It’s amazing because the more that you get breakfast with referral sources, the more that you get to know each other. The more that you develop that relationship with that person, the more trust there is, like authentic trust, not just like fake trust where they don’t know you but you just like each other.

When you know someone and you like them, and then someone comes to you and says, “You know what? I need counseling.” That person’s going to then refer them to the people they know and trust. They are at the forefront of their mind, not the random person that just sent one letter.

Getting Doctor Referrals

If you have a new doctor that refers someone eventually, follow up with them. If you don’t have your first client yet, get out and network. If you can’t speak to people, attend Toast Masters and learn. Doctor referrals work pretty much the same. A doctor will usually refer to the same person, because they have limited time. The easier you make it for them, the better.

How to Network

Here are the basic steps:

  • Find someone who has a similar Business Avatar (Ideal Client)
  • Hear their story and get to know them as a person.
  • What’s your personal story?

How to Develop Your Story

Your story is the best thing to make yourself stand out. No one can out-do you in that area. Why did you go into counseling?

A while ago, I was doing private practice consulting with someone that told me they used to weigh 400 pounds, at the time of our consulting they weighed under 200.

His story was:

“I used to be overweight and I changed my lifestyle and I want to help you do that too.”

He’d found his story. He’d found his niche as to what worked for him and what was his story.

There was another guy, he had a near-death experience where he was pronounced dead. Then he went from being a corporate banker to being a counselor. In the front page of his website he says his story:

“I was pronounced dead and I had a lifestyle change where I went back to school to become a counselor to help the world. I used to make six figures. Now, I’m a counselor. I just want to help people. I feel like life is too short.” He told his story and then he had specific niches around lifestyle changes about trying to help better the world.

The more that you can articulate what’s your story in a really short, almost Twitter style, 140 characters or elevator speech, whatever words you use, the easier it is for people to help refer to you.

For Mental Wellness Counseling:

“We help angry kids, frustrated parents and distant couples… and just about everyone else.”

Keys to Practice Marketing: Techniques That Work

At Mental Wellness Counseling, we help people across the life span. We have an infant mental person who works with infants and preschoolers and parents all the way up to someone that works with people that are empty nesters or they’re living post-divorce after being married for 50 years.

We say we help angry kids, frustrated parents, and distant couples… and just about everybody else because people remember them. They remember who we help and it’s just straightforward. I don’t have to explain it. It’s just easy to understand.

The other thing is once you’ve got your website going, making sure that you’re really trying to rank high (here’s a video about keywords).


Keyword Marketing Examples

For example, in Mental Wellness Counseling’s website we often say: “Mental Wellness Counseling, a Traverse City Counseling practice.” We only have one location but by saying Traverse City Counseling, that’s something that someone is going to google. We routinely rank usually number 1 in our area.

That is a great way to be able to rank higher in Google is writing a lot of things around your keywords. Maybe you write articles about angry kids, maybe you write about five ways to help your marriage today. Maybe you talk about how to get through the six weeks post-pregnancy, when you’re not having sex and you’re feeling disconnected and you’re dead-tired and I’m just talking about that because we have a new baby. I oftentimes am tired. How do you stay connected to your spouse?

So, creating articles that people want to share (sometimes known as content marketing) is going help you rank higher in Google, but it’s also going to get your name out there a lot more. All right.

Networking and telling your story is the next clear step in getting more referrals. In the final blog post in this series, I’ll be covering how to make referring to you easier!

At the computer photo available from Shutterstock

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How To Get Your First Client Part 1 Thu, 26 Nov 2015 13:02:47 +0000

I recently conducted a survey of my audience on Practice of the Practice. I found that 51% of people are either about to start a private practice or have just started a private practice. I remember when I first started how tough it was to figure it all out. Here are a few tips I learned along the way.


How To Get Your First Counseling Client?

So, today what I wanted to talk about is your very first client. A lot of what we’ve talked about has been more advanced things. When you have a practice that starts to plateau or those sorts of things. I recently got an email, it said, “All that you share is great and all, but what about my first client? Like I haven’t had a client yet. What I do?”

I’m assuming that you’ve already started. You’ve filed your LLC paperwork, you have a location — a location that hopefully, is one that you’re paying either by the session or as a percentage of what you bring in, not just going in and renting a space and hoping that it works.

I mean, very low risk that you have a counseling phone number, you’ve got your counseling website, you’ve got your counseling business cards — that you’ve got all that done. Now, what?

Let’s talk about some things that you can do to bring in that very first client.

I remember my first client. I received a referral from my therapist friend, Monica Lieser (who was in Podcast Episode 35). She actually gave me my very first client in private practice. I remember that day. I had been hustling and talking to people and networking and getting to know people.

When Nothing is Working

Nothing was working. It had been months and I was in a group practice. I thought to myself, “I don’t know what else I can do?” I wasn’t on insurances because I was a new graduate. I didn’t have those years of experience that you need in Michigan. The people that have called have insurance and want insurance and I didn’t know all about how to talk about private pay counseling and all that.

Monica, was seeing this couple and she referred the husband from that couple to me. For me, to be able to have that very first client and build that confidence was a key step. When I opened Mental Wellness Counseling, I still remember my first client that followed through with me. It’s such an awesome moment.

How to Improve Private Practice Marketing to Get the First Client

When you have no one,  what do you do? There’s a number of things that we’re going to talk about in kind of really big chunks.

So, the first big chunk is private practice marketing. How do you get your name out there? Now, I would say Psychology Today, in most communities is a really good resource because Psychology Today, when you google, almost any city, it’s the first or second thing that comes up: their therapist finder.

What Doesn’t Work in Setting Up a Counseling Private Practice

  • Letters: The letters where they say: “Hi! I’m new to the area. Or I just opened my practice.” From people I’ve talked to and from personal experience that really doesn’t work very well.
  • Nothing in Person: Lack of in-person appointments where you go meet with a doctor for 10 minutes, you go meet with a pastor and you meet with some lawyers. You meet with business people, just to shake to hands, introduce people — the kind of people that you want either as clients or you want referring to.

The Specific Private Practice Networking Strategy

Once you do that, you’re going to have an idea of the maybe 50 people that you go meet. That you figure, if you meet one person a day for 10 weeks, that’s 50 people over the business week. That’s like if you’re not seeing people you might as well be networking like it’s a full-time job.

You go shake hands, you meet people, and you talk to them.

From those 50 people, who are the 10 with whom felt you really connected?

Who were the people that you enjoyed talking to?

I think about who have been my biggest referrals?

My own doctor has been one of my biggest referrals. The pastor that married my wife and I — he, for a long time, was a big referral but he ended up moving to a different city so your referrals sometimes leave.

Then the rest are just kind of a handful of people that I tend to connect with here and there.

As you take these steps, you’ll begin to get the flow of referrals.

Handshake photo available from Shutterstock

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Goodbye, Ms. Singleton Wed, 25 Nov 2015 13:01:48 +0000 I walk out of her room with a heavy heart. Her bed lies empty in the glow of the hot August sun creeping in through the blinds. Earlier, I had asked the CNA standing outside attending to the medicine cart, about Ms. Singleton. She had told me matter-of-factly, “She died last night in her sleep.”

I sit down on the plush sofa that lines the wall of the nursing home passageway. This one is my favorite – I sit and write notes on it, reflect about life, catch a moment’s breath from my busy day to exchange texts with colleagues and friends, and also daydream occasionally on it from time to time. Today there are tears in my eyes. Why can’t I control them? Why am I losing my focus as a clinician?

`I Am Your Psychologist’

I first saw Ms. Singleton almost five years ago. I was new to the practice and this was my first visit inside a nursing home in America. There she was, my second patient for the day, lying down on the bed with a pearly smile on her face. I had asked her my regular intake questions. She had answered all of them with her smile in place. Now and then, she had looked up into my eyes and asked me about what I do. “Are you a priest?” “No, Ms. Singleton, I had replied, I am your psychologist.”

Since that day, I had seen her everywhere in the nursing home. At the ripe old age of 95, she still did her own laundry every day.

She was also a bit delusional and called the police a couple of times because she thought 9-11 was an inside job done by Mr. Bush, our 43rd President. She could be very stubborn at times, not wanting to talk to me or to anyone for that matter.

She would tell me about her daughter and her son-in-law, and how hard it was for them to drive to see her anymore. She would narrate to me incidents from her childhood in Alabama, where her ancestors had been sharecroppers for generations.

She would tell me about her dreams, and even about her nightmares. She would often pause in the middle of a sentence to look up into my eyes, and say, “Doc, don’t fret over me. I’ll be okay.” She was proud, she was temperamental, she could be a pain in the butt sometimes, but she always wore that trademark smile of hers in place.

When I went to visit my folks in India last year, she was very depressed. She told me that she thought I would never come back to see her again. When I came back and saw her, she was relieved to no end, and gave me that million dollar smile of hers in no mean measure.

I am still sitting and thinking of her. I am feeling a deep pain somewhere in my heart today. I slowly wipe away my tears as I see the unit nurse walk up to me, “Doc are you ok? We need you to see Ms. Keith in Rm. 208. She is talking about killing herself.”

As I rise up to go to my patient’s room, I say a little prayer in my heart, “Goodbye Ms. Singleton. Hope you are smiling that heavenly smile of yours through all the clouds up there. “ And I swear I can hear a wavering 95 year African-American lady’s voice somewhere in the distance, “Doc, don’t fret over me. I’ll be okay. The show must go on……”

Elderly woman photo available from Shutterstock

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The Two Sides of Alcohol Wed, 25 Nov 2015 05:00:27 +0000 http://7.89 bottlesofalcoholThe following speech, written my Mississippi state senator, Noah S. “Soggy” Sweat, Jr., in 1958, describes the contrasting views of alcohol, which have always existed and still exist today (Goodwin, 1981).

“My friends, I had not intended to discuss this controversial subject at this particular time. However, I want you to know that I do not shun controversy. On the contrary, I will take a stand on any issue at any time, regardless of how fraught with controversy it might be. You have asked me how I feel about whiskey. All right, this is how I feel about whiskey:

If when you say whiskey you mean the devil’s brew, the poison scourge, the bloody monster, that defiles innocence, dethrones reason, destroys the home, creates misery and poverty, yea, literally takes the bread from the mouths of little children; if you mean the evil drink that topples the Christian man and woman from the pinnacle of righteous, gracious living into the bottomless pit of degradation, and despair, and shame and helplessness, and hopelessness, then certainly I am against it.

But, if when you say whiskey you mean the oil of conversation, the philosophic wine, the ale that is consumed when good fellows get together, that puts a song in their hearts and laughter on their lips, and the warm glow of contentment in their eyes; if you mean Christmas cheer; if you mean the stimulating drink that puts the spring in the old gentleman’s step on a frosty, crispy morning; if you mean the drink which enables a man to magnify his joy, and his happiness, and to forget, if only for a little while, life’s great tragedies, and heartaches, and sorrows; if you mean that drink, the sale of which pours into our treasuries untold millions of dollars, which are used to provide tender care for our little crippled children, our blind, our deaf, our dumb, our pitiful aged and infirm; to build highways and hospitals and schools, then certainly I am for it.

This is my stand. I will not retreat from it. I will not compromise.”

Reference:  Goodwin, D.W. (1981). Alcoholism: The Facts. New York: Oxford University Press

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BCBA Exam Study Topics: Intervention Strategies Tue, 24 Nov 2015 21:38:29 +0000 http://3.552

More BCBA Exam Study Info….

This post will be addressing some examples of intervention strategies that a Board Certified Behavior Analyst (BCBA) might use while working to help an individual increase his skills or decrease certain types of maladaptive behavior (Cooper, Heron, & Heward, 2007). See Cooper, et. al. (2007) for more information on the following topics.

Differential Reinforcement of Lower Rates (DRL):

  • Reinforcement on a full-session DRL schedule is provided when responding (specific target behaviors occur) during an entire session is equal to or less than a predetermined level (criterion).
  • On an interval DRL schedule, the session is separated into equal intervals (amounts of time) and reinforcement is provided at the end of each interval in which the number of responses during the interval was equal to or less than a predetermined level (criterion).
  • Reinforcement on a spaced-responding DRL schedule looks at the interresponse time (IRT). Reinforcement is only provided when the IRT (time between instances of the behavior/response) is at a minimum amount of time. Increasing IRT between instances of the behavior decreases the overall frequency or rate of the behavior leading to lower rates of the behavior.

Noncontingent Reinforcement (NCR):

  • NCR is when stimuli that are known to have reinforcing properties are presented on a fixed-time (FT) or variable-time (VT) schedule regardless of the behavior of the individual.
  • 3 procedures of NCR
    • Positive Reinforcement (ex: providing attention)
    • Negative Reinforcement (ex: providing escape from tasks)
    • Automatic Reinforcement (ex: without social mediation; sensory experiences)
  • An NCR schedule may serve as an abolishing operation (AO) in regards to decreasing the likelihood of engaging in problem behavior. Since the individual will already be receiving the reinforcement they were receiving for problem behavior, they may have less motivation for engaging in a maladaptive response.

Reference: Cooper J.O, Heron T.E, Heward W.L. (2007). Applied behavior analysis (2nd ed.) Upper Saddle River, NJ: Pearson.

[Image Credit: Author: jolopes via Fotalia]

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5 Important Tips for Prelicensed Therapists in Private Practice Tue, 24 Nov 2015 15:00:15 +0000 http://4.691
  • Guest post by Rachel Moore, MA, MFTI. A huge thank you to Rachel for sharing these amazing tips.
  • 5 Important Tips for Prelicensed Therapists in Private Practice

    Being a prelicensed therapist can be hard. In many states, after completing your master’s degree, you are required to work in a supervised environment for a few thousand hours before being allowed to sit for marathon licensing exams. Whew!

    For many of us, therapy also is a second career. It can be humbling to be a middle-aged “intern,” with all that word implies. It is also disheartening, in my opinion, that many therapy internships are unpaid.

    That’s why a private-practice internship can be a good option for prelicensed therapists. Private-practice interns can earn money and also build up a clientele that may carry over after they’re licensed.

    I have been registered with the Board of Behavioral Sciences in California as a Marriage & Family Therapist Intern since 2013. I earn my hours at a nonprofit agency as well as private practice.

    There are a few important things to know if you are a prelicensed therapist considering private practice or if you are at a private practice now:

    1. Find a Good Fit

    After you’ve graduated and waited for the state to process your internship registration, it can feel like the pressure is on to start earning hours right away. It is important to choose your internship site carefully, however, especially when it comes to private practice.

    As a friend and fellow prelicensed MFT puts it: “One thing I found to be a big deal was choosing a practice that is in the area of town that you want to work. I know that sounds obvious, but I think it can be tempting to take whatever private-practice opportunity you are presented with.”

    Besides location, a good connection with your supervisor is vital. “It’s so important to find someone that encourages you and is willing to work with you and teach you, versus someone who is demanding and adds too much pressure,” my MFT intern friend says. “I would say make sure your supervisor is not just about the money.”

    How do you find a good supervisor? Here are some questions to ask a potential employer: What is your purpose in having an intern? Have you had other interns before; what has that experience been like? What do you expect of your interns (for example, how many clients do you want an intern to have within the first 6 months)? How will I get clients; will you give me referrals or do I need to generate most or all of them myself? What will my pay structure look like? (In California, private-practice interns must also be employees and receive the equivalent of minimum wage for the hours they work.)

    Some of the places private-practice internship opportunities can be found are Craigslist (really!), online job boards, school connections, Facebook groups for therapists, and a helpful website that launched recently:

    2. Know the Rules

    It’s key to know what all of the rules are in your state for prelicensed therapists. For example, California has something called the “6-year rule” for Marriage & Family Therapist Interns. This means the state board won’t accept internship hours that are more than 6 years old (there are certain exceptions regarding hours earned during school).

    If you take longer than 6 years to complete your hours, you must apply for a second (subsequent) intern registration number to continue accumulating hours. However, you are not allowed to work in private practice in California if you have a subsequent intern registration number. This can be heartbreaking for prelicensed therapists who have to walk away from their practices.

    It is important to make sure you know your state’s rules and expectations before you start building your private practice, and these rules can be easily found online through your state’s licensing board.

    3. Decide If You Also Want to Work at an Agency

    Most of the hours I’ve earned so far have been from my volunteer internship at a local nonprofit hospice. I love the work there, and I’m able to arrange my schedule and appointments around my private-practice job. The downside of working at hospice is I don’t get paid (fortunately, my husband’s income covers most of our expenses).

    A prelicensed social worker friend of mine has found an internship at a hospital that does pay her. She says this is helpful because she’s able to build her clientele at private practice without having to rely on private-practice work as her only means of financial support.

    I personally only know of one prelicensed therapist who works full time at a private practice. In most cases, a private-practice internship will help you build a client base but it probably won’t pay all your bills. It’s important to decide what your purpose will be for working in private practice.

    4. Mind Your Marketing

    I love doing marketing. I know that’s not a typical thing for a therapist to say. I like connecting with people, though, and when I can use my creativity to do that it feels even better.

    We need to let our ideal clients know about us if we’re going to work with them. It’s as simple as that. I don’t want to convince people who wouldn’t be a good fit that they should see me, but I do need to be visible enough that my ideal clients will find me.

    One of the things I’ve done to help myself and other clinicians is create a marketing group for fellow healers. We meet about once a month to share ideas and support. I encourage you to reach out to others. Marketing isn’t scary, although it can sometimes feel scary to put yourself out there. It helps to know you’re not alone.

    Check with your state’s rules about how to market yourself as a prelicensed therapist. For example, in California we must spell out “Marriage & Family Therapist Intern” if we use the initials “MFTI” in our advertising. Also, your supervisor may be obligated to provide certain marketing materials such as business cards and a website.

    A couple of popular online therapist directories are Psychology Today and Good You may also consider creating a Facebook page and/or a Twitter account. Again, please be mindful of the advertising rules in your state.
    There are many good resources out there, including, to help prelicensed and licensed therapists with business issues and marketing. I also recently heard Casey Truffo, creator of Be a Wealthy Therapist, say it’s good to network with other businesses your ideal clients use. For example, I like to work with artists, so it might be good for me to put up a flier at my local art supply store.

    5. Don’t Give Up!

    As one of my now-licensed MFT friends puts it: “Be reasonably humble but don’t short-sell yourself. Lots of interns can be better therapists than people who’ve been licensed for years. They’re inspired, motivated, and have often had the most recent training.”

    If you’re feeling like private practice isn’t for you, please go back to tip No. 1 and see if there might be an internship site that is a better fit. Or if you’re not getting the amount of clients you want, understand that ebb and flow is a normal part of private practice. Look again at tip No. 4 and see if you can ramp up your marketing with the support of your supervisor.

    This is your time to learn and grow, and it’s OK to be unsure or make mistakes. Let your experiences as a prelicensed therapist serve you and allow you to feel more empathy with your clients who may be struggling through similar life transitions.

    Working as a prelicensed therapist in private practice can be scary, exciting, and richly rewarding. Please feel free to comment if you have questions or want to share your experiences. I wish you all the best in your current and future work!

    unnamed (1)Rachel Moore, MA, MFTI, is a registered Marriage & Family Therapist Intern in San Diego who works in hospice and private practice. Rachel was a newspaper copy editor for 14 years in her former life. She now specializes in helping artists, writers, and musicians overcome creative anxiety and increase self-esteem. If you are interested in Rachel’s groups and upcoming events or would like more information about her therapy services, please visit:


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    How to Survive the Holidays with an Addict Tue, 24 Nov 2015 14:23:24 +0000 http://5.418 AddictAddicts plus holidays usually equal disaster. This is because addicts have a tendency to divide family at a celebration, not unite. Relatives fall into one of three categories: those who see the addiction and have no tolerance, those who see the addiction and tolerate it, and those who don’t see the addiction at all.

    An addict will take the path of least resistance and be charming with the last two categories while ignoring the first. This divides the parties’ even further causing tension amongst the relatives. When the bickering starts, the addict slips away having made the celebration about them without receiving any direct confrontation. In the end, only the addict is satisfied.

    But it doesn’t have to be that way again. There is a better way of surviving the holidays with an addict.

    Sensible expectations. Review the addict’s past behavior during celebrations. Take notice of any discernable pattern. This is the best estimate as to how the addict will behave in the future. Don’t set expectations that somehow things will be different this year that type of thinking will only lead to disappointment. Rather, see the pattern for what it is and expect the manipulation, excess, arrogance, deceitfulness, and rudeness. Then, determine what will and will not be tolerated.

    Secure consensus. Discuss the expectations with each attendee, including those who follow into the second two categories. The first category will be willing to set boundaries. The second category will go along to keep the peace. But it will not be possible to get the last category to see things differently. Instead, help them to understand that the first two categories have made a decision and everyone would appreciate their silence on the matter.

    State boundaries. Prior to the event, have a discussion with the addict about the expectations. Let them know a consensus has already been reached and there will not be any lenience. This discussion is likely to spark anger in the addict. They will be furious that a conversation about them is happening behind their back. Stay calm, don’t respond with any emotion. Use only logic, simple statements, and limit the dialogue time. They will test what is being said by confronting the last category of relatives, so prepare them ahead of time.

    Snub self-centeredness. During the celebration, the addict will act as if nothing is wrong and attempt the same old pattern again. Pull them aside and gently remind them of the boundaries. Then immediately change the group conversation to something everyone enjoy or suggest a group game. Playing a game together keeps the addict from making the conversation about them or their interests. This simple act can highlight the addictive behavior even further as the addict continues to seek attention. By the end of the event, some of the second category of relatives will have moved to the first group.

    Surviving the holidays with an addict is all about strategy. Don’t allow their addiction to become the center of the celebration again this year.

    Christine Hammond is the award-winning author of The Exhausted Woman’s Handbook available from Amazon, Barnes & Noble and iBooks.

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    How to Create Happier Relationships Through Couples Counseling Part Two Tue, 24 Nov 2015 12:56:39 +0000

    “A happy marriage is a long conversation which always seems too short.”
    Andre Maurois

    The first installment on this topic revolved around creating new principles, goals and objectives that gives the couple a chance for success in finding the underlying causes that create the rift in their relationship.

    We also discussed the primary role for the therapists in guiding the conversation in session to help couples improve communication and review how the couple was progressing in sustaining the new principle, goals and objectives to breathe new life into the relationship.

    In Part 2, we’ll review the importance of the individual behaviors in the relationship and the effort, time and compromises one must be willing to make.

    When an individual reaches out in therapy to upgrade his/her relationship, that person must respect his mate and be honest with himself.

    Time, Trade offs and Compromises

    To create the relationship you really desire, there will be some difficult trade offs and tough choices for each person.

    The first trade off will be time. It simply takes time to create a relationship that flourishes: time to be together, time to be with family, time to play, coordinate, nurture, relax, hang out and plan. This time will encroach on some other valuable areas – your personal or professional time.

    The second compromise is comfort. That means emotional comfort, like going out on a limb to try novel ways of thinking or doing things, listening and being curious instead of butting in, speaking up instead of becoming resentfully compliant or withdrawing

    At the beginning, there will be emotional risk taking action, but you will never explore different worlds if you always keep sight of the shoreline. In addition, few people are emotionally comfortable being confronted with how they don’t live their values or being confronted with the consequences of their actions.

    The other comfort that will be challenged is energy comfort. It simply takes effort to sustain improvement over time: staying conscious of making a difference over time, remembering to be more respectful, more giving, more appreciative etc. It takes effort to remember and act.

    The other effort is even more difficult for some people: that is improving their reaction to problems.

    For example, if one person is hypersensitive to criticism and his/her partner is hypersensitive to feeling ignored, it will take effort to improve their sensitivity instead of hoping the partner will stop ignoring or criticizing.

    In all these areas, there is generally a conflict between short-term gratification and the long-term goal of creating a satisfying relationship.

    The blunt reality is that, in an interdependent relationship, effort is required on the part of each person to make a sustained improvement. It is like pairs figure skating – one person cannot do most of the work and still create an exceptional team.


    • You can’t create a flourishing relationship by only fixing what’s wrong. But it’s a start.
    • Grace under pressure does not spring full-grown even with the best of intentions – practice, practice and more practice. Practice the right things and you will get there.
    • Love is destroyed when self-interest dominates.
    • If you don’t know what you feel in important areas of your relationship, it is like playing high stakes poker when you see only half your cards. You will make a lot of dumb plays.
    • The possibility exists that we choose partners we need but don’t necessarily want.
    • To get to the bottom of a problem often means you first accept its complexity.
    • Trust is the foundational building block of a flourishing relationship.
      You create trust by doing what you say you will do.
    • It’s impossible to be in a highly inter-dependent relationship without ever being judgmental or being judged.
    • If you strive to always feel emotionally safe in your relationship and get it, you will pay the price by becoming dull
    • If neither of you ever rocks the boat, you will end up with a dull relationship
    • Knowledge is not power. Only knowledge that is applied is power.

    Most of the ineffective things we do in relationships fall into just a few categories:

    • Blame or attempt to dominate
    • Disengage/withdraw
    • Resentful compliance
    • Whine
    • Denial or confusion.
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    Financial Planning in Private Practice with Mary Beth Storjohann Mon, 23 Nov 2015 22:17:21 +0000 http://4.674 descarga (14)

    Maybe you have your tax planning, retirement, disability coverage and cash flow all figured out. But if you don’t, this is for you. This is to encourage you to start learning, even in baby steps. I (Kelly) used to find this stuff intimidating. So I’ve reached out for support and every year, it gets better. I don’t feel so fearful and I know what is currently going on in my business while I am reaching new personal and professional financial goals.

    This podcast is all about the common misteps therapists make in private practice and what they can do to ensure a stable financial future.

    Thanks to Mary Beth Storjohann, CFP, Founder of Workable Wealth for this interview. Mary Beth also provides support in our bootcamp as well and we appreciate her so much!

    Ps. Pardon our appearance – it was super hot!

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    How to Create Happier Relationships Through Couples Counseling Part One Mon, 23 Nov 2015 18:56:07 +0000 Couples are often uncertain what to expect from the process of couples therapy. Most couples approach therapy with the notion that each person will describe their distress and somehow the therapist will assist them to create a happier, more functional relationship.

    However, most people hope their partner will do most of the learning in problem areas.

    What is soon discovered is that the therapist does not have a magic wand and one has to look within themselves to find answers to the problems within the relationship for effective healing.

    Guidelines That Can Make Counseling More Effective

    Experienced therapists have evolved principles, goals and objectives that give them the greatest chance for success in finding the underlying causes of the rift in the couple’s relationship. The primary role for the therapists is to help couples improve communication as well as set goals and objectives for the couple to discuss and ponder:

    • The kind of life they want to build together
    •  The kind of partner they aspire to be in order to build the kind of life and relationship they want to create.
    • Reviewing individual blocks to becoming the kind of partner they aspire to be.
    • The skills and knowledge necessary to do the above tasks.
    • A vision of the life you want to build together
    • To have a life separate from your partner because you are not joined at the hip
    • The appropriate attitudes and skills to work as a team
    • The motivation and patience to persist
    • Time to review progress. To create the relationship you really desire, there will be some difficult tradeoffs and tough choices for each person.

    Important Concepts for Couples Therapy and Relationships

    The following concepts can help couples identify areas of focus to work on outside the sessions. Real healing comes from the amount of work the couple is willing to put in separately and together putting into practice what was shared in session.

    Attitude is Key

    When it comes to improving your relationship, your attitude toward change is more important that what action to take.

    Identifying what to do and how to do it is often easy to identify. The bigger challenge is why you don’t do it.

    How to think differently about a problem is often more effective than just trying to figure out what action to take.

    Your partner is quite limited in his/her ability to respond to you.

    You are quite limited in your ability to respond to your partner.

    Accepting that is a huge step into maturity.

    The definite possibility exists that you have some flawed assumptions about your partner’s motives and that he/she has some flawed assumptions about yours. The problem is most of the time we don’t want to believe our assumptions are flawed.

    Focus on Changing Yourself Rather than Your Partner

    Couples therapy works best if you have more goals for yourself than for your partner. Problems occur when reality departs sharply from our expectations, hopes, desires and concerns. It’s human nature to try and change one’s partner instead of adjusting our expectations. This aspect of human nature is what keeps therapists in business.

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    Psychology Of How War With Islamic State Becomes A Just War Sun, 22 Nov 2015 12:57:48 +0000

    Do leaders use psychology when justifying military action to their electorate?

    A leading authority on deciding whether a war can be ‘just’ explains whether the Western fight against Islamic State, is indeed a ‘Just War’ and to what extent psychology is involved in how we get involved in ‘just wars.’

    Is this battle being sold by politicians to the public as ‘just’ or ‘moral’, exploiting the understandably strong emotions in the wake of the Paris atrocities, when, in fact, a more dispassionate analysis might suggest it’s still possible such a conflict could escalate into an unjust war?

    Do we need to understand the psychology of anger and rage about the terrible and murderous attacks in Paris in order to see through the propaganda from both sides, and come to a clear conclusion?

    Does an attempt at a more reasoned analysis about a war against Islamic State seem provocative and unfeeling, when our emotions are understandably heightened following the sorrow and grief of the Paris victims?

    Does the natural need for retaliation and revenge involve a psychological reaction to feeling vulnerable?

    Do we seek military solutions to re-establish a sense of power and control? But might the craving for a temporary ‘psychological fix’ end up causing more problems, and yet even more innocent victims, on both sides, in the longer term?

    Who Decides a War is Just?

    Nicholas Fotion, professor of philosophy at Emory University in Atlanta has published a book entitled, “War and Ethics – a New Just War Theory,” published by Bloomsbury Atlantic and a chapter entitled ‘Just War Theory’ in the ‘Encyclopaedia of Applied Ethics.’

    Professor Fotion points out arguments over whether a war is just seem to have existed perhaps as long as wars have endured.

    In a sense, both sides always believe their fight is ‘moral’ or just, but who, in fact, is right when it comes to deciding that a war is ‘just’, and how can we work this out definitively for ourselves?

    Professor Fotion argues that attempts to define a ‘just war’ date back to Confucius (552–479 BC). In a surprisingly prophetic analysis, which appears to have anticipated current parts of the Middle East conflict, when asked what to do if a rebellion break outs in a province of a country, Confucius declared that an emperor should dispatch virtue rather than soldiers.

    The ancient Chinese philosopher was arguing that a ‘just’ response to a conflict requires a coherent analysis as to causes.

    Confucius was contending that as rebellion most likely was triggered by exploitation and brutality from local leaders, the remedy then was not to inflict even more harm by crushing the rebellion, but rather, to replace bad rulers with virtuous ones.

    Deciding whether Western military intervention in the Middle East is just, partly hinges on your view of whether the West installs one bad leader after another, with little concern on the impact on local populations. Or whether in the long run, corrupt governance is replaced with better.

    This outcome of such warfare crucially determines whether battles like this are ‘just.’

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    How to Handle a No Show Sat, 21 Nov 2015 11:36:35 +0000

    We’ve all had no shows or late cancellations. How should you handle this?

    At the heart of a no show is the question “What are we worth?”

    Whether you have a full private practice or a struggling one, ultimately, that time that you set aside for that person you didn’t take on new clients. Even if you’re not busy, you had the potential to take someone on during that time. What’s the standard you want to set for yourself?

    I charge my full rate if someone no-shows, unless there is a car accident or someone’s really sick.  I have the 24-hour notice clause that they have to give me at least 24-hour notice so that I can try to fill it.  At the heart of it is that I could have filled that counseling session with somebody else and so why would I get $20 for showing up, for being here or for keeping that spot open if I could have filled it with a full rate client?

    Accountability of a Counseling No Show

    I found that I have a very low no show rate when someone does have to pay for their no show or their late cancellation. Now, there are times where someone calls the morning of. You can choose whether you’re going to be completely rigid and completely consistent or not. I don’t do it like based on client. “Oh, I like that person or not.” That’d be obviously unethical.

    I think that there are situations when people say the week before, “Oh, my daughter might have volleyball that night. We’re going to have to let know.” Then you know ahead of time, “Okay, they might cancel the last minute or they might not.”

    You then take on that risk, as well. I think charging the full rate really helps the client realize that you are busy or you have the potential to be busy and that someone else could have had that session.

    Logistics of a No Show Policy

    The way the logistics work is within my intake, I mention it. I also have it in my intake paperwork that they sign off that they’ll be charged the full rate. I don’t keep a credit card on file. Some people do that, but overall it’s seen as a best-practice to not keep it on file.

    If someone then no shows, then in the next session, I charge. I may also email them ahead of time. If it’s a brand-new client, though, I don’t charge them for that because if you think of it from a sales perspective, you don’t want to start that therapeutic relationship or that business relationship on the wrong foot. 

    I may mention that I just wanted to let you know that typically with that no show or in the first session you need to cancel the hour before, I will have to charge you that full rate in future sessions. I just wanted to remind you of that and I’ll waive that this first time because you just don’t want to start that therapeutic relationship on the wrong foot and you don’t want to start them being double out-of-pocket even though you could have filled that session.

    Why it Works

    I found that when someone has to pay for that no show, it really reminds them, especially the teenagers with whom I work. I’ve had teenagers that just totally flaked out and their parents say, “You have to pay the full rate. I’m not going to pay it.”

    Then, maybe that teenager had to work for a number of hours–it might even equal a full day’s work that they are paying. As a result, they take counseling a lot more seriously. I mean, if you no show on a doctor, you no show on a plumber or you no show on your furnace person, you have to pay him.

    Here are some quick tips to improve your no show/late cancellation policies:

    • Have your policy in your welcome email
    • Have a written policy on the intake
    • Charge your full rate
    • Make it easy to pay via online payment
    • Practice your explanation
    • Tell yourself, “Every medical professional does this.”

    Why would we change and change our expectations for people that are coming to us that want to reach their goals? Why would we be less holding them accountable? Those are my thoughts on no shows.

    Man looking at his watch photo available from Shutterstock

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    Attachment Trauma Sat, 21 Nov 2015 07:26:45 +0000 http://7.84 teddybearDuring the early developmental years of an infant and young child’s interpersonal life is the need for intersubjectivity.  Intersubjectivity involves the infant and parent’s discovery of each other, and the development of the self in relationship with the other.  The intersubjectivity experience in a securely attached child is what creates an integrated self.  Without a secure attachment relationship with a parent then a person develops a fragmented self, incapable of properly engaging in healthy interpersonal relationships.  Primary intersubjectivity involves a here-and-now person-to-person relationship.

    Affect (emotional) attunement is shared affect and is one component of intersubjectivity between two persons.  Two other components of intersubjectivity are shared attention and shared intentions.  Both parent and child are involved in a congruent state of experience.  Attunement creates connection between the two individuals by ensuring that each person feels a co-occurring experience of acceptance, value, and enjoyment.  In order for a child to develop well, he needs to have a positive impact on the important people in his world.

    When a child is neglected, ignored, and not attuned with in some way then he/she feels and concludes that “I am not interesting, not special, and not lovable.”  This is the end result of attachment trauma.  When this experience recurs over and over again the child develops a deep sense of shame and rage.  Over time, when a child does not have sufficient restorative or correcting experiences with the parent, the shame never gets resolved and the child develops neither the ability to experience guilt nor empathy.

    When a child has been subject to attachment disruption, neglect, or abuse, then he has not learned how to trust others, how to love, and how to develop an integrated self.  He has deep seated shame that permeates his sense of self, which if not corrected, can develop into psychopathology.  Children and adults who do not have healthy intersubjectivity with a parent, particularly a mother, as a young child, are incapable of experiencing remorse when they hurt others.  Guilt and empathy emerge only within the context of attachment security.

    If you are a foster parent, therapist, step-parent, or some other significant person in a child or adult’s life who suffers with attachment trauma, be prepared to understand that your life will be difficult.  The person suffering with attachment trauma cannot have a healthy relationship with anyone, particularly someone in a close, intimate context.  Be prepared to realize that the suffering person will display the following behaviors:

    • Have a strong need to be in control at all times
    • Will resist comforting, affection, and experiences of mutual enjoyment
    • Will be highly manipulative causing others (and yourself) to doubt your good intentions
    • Will use people like objects and will use people for what they can give to them (are very utilitarian in relationships)
    • Can be extremely oppositional
    • Have no sense of guilt, remorse, or regret for wrongdoing
    • Will sabotage all or most events involving enjoyment with others or between others
    • Will steal, lie, bully, hurt, and destroy
    • Cannot connect to others emotionally and can easily walk away from significant relationships
    • Have no insight
    • Cannot feel sadness, but rather, feels self-pity and pouts
    • Is very manipulative

    If you are involved with a person exhibiting the above listed traits, then be warned to educate yourself and arm yourself with knowledge and personal therapy so that you will not personalize or react to this person in ways that will cause you to lose your own sense of self.  Make sure you have resolved all of your own childhood attachment issues with your own parents.

    When raising a child with attachment trauma, it is important that you run a tight ship and keep the child in close proximity to you at all times, always providing empathy, strength, humor, kindness, and firmness.  Be aware that other people will not understand the continual manipulation strategies the child uses and will most likely question your parenting.  It is important for you to be strong enough to understand that other people just have no idea about the nature of the work you must constantly accomplish in order to raise a child with attachment trauma, and you must realize that in many ways you stand alone.  In fact, others may openly challenge you, believing that you are too hard on the child; this happens because of the masterful manipulators these individuals are.

    To help these children (and adults), you must provide the attachment experiences that they did not have in those early developmental years.  You do this by holding them accountable, mirroring (reflecting) their words and behaviors consistently, and by not allowing them to manipulate you or others.  You must be willing to call them on their manipulations and behaviors and teach them how to interact in a family in a healthy way.  This job is tough and requires consistent love.  Never yell at them or look at them without empathy.  If you are unable to do this momentarily then remove yourself from the situation until you are ready to do so.

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    Recognizing Symptoms Leading to Relapse Thu, 19 Nov 2015 12:27:19 +0000 Even though it is up to the individual to maintain the disciplines that insure sobriety, other people can help.

    Nearly every person close to an alcoholic is able to recognize behavior changes that indicate a return to old thinking.

    Often these individuals and fellow A.A. members have tried to warn the subject, who by now, may not be willing to listen. He/she may consider it nagging or a violation of his/her privacy.

    Warning signs abound. Most alcoholics, if approached properly, are willing to go over an inventory of symptoms periodically with a spouse or other confidante.

    If the symptoms are caught early enough and recognized, the alcoholic will usually try to change his/her thinking, to get “back on the beam” again.

    A weekly inventory could prevent some relapses. This added discipline is one, which many alcoholics seem willing to try.

    Following is a list of common symptoms leading to “dry-drunk,” to possible relapse or, to what A.A. commonly calls “stinking thinking.”

    • Exhaustion – Some people allow themselves to become overly tired or in poor health. Some alcoholics are also prone to work addictions; perhaps they are in a hurry to make up for lost time. Good health and enough rest are important. If you feel good, you are more apt to think well. Feel poor and your thinking is apt to deteriorate. Feel bad enough and you might begin thinking drinking couldn’t make it any worse.
    • Dishonesty – This behavior begins with a pattern of unnecessary little lies and deceits with fellow workers, friends and family. This symptom is called rationalizing – making excuses for not doing what you do not want to do, or for doing what you know you should not do.
    • Impatience – The individual thinks that things are not happening fast enough or others are not doing what the alcoholic wants them to do.
    • Argumentativeness – Arguing small and ridiculous points of view indicates a need to always be right. “Why don’t you be reasonable and agree with me?” It could be looking for an excuse to drink?
    • Depression – Unreasonable and unacceptable despair may occur in cycles and should be dealt with and talked about.
    • Frustration – This reaction is directed at people and also because things may not be going the person’s way. Remember – everything is not going to be just the way you want it.
    • Self-Pity – “Why do these things happen to me?” “Why must I be alcoholic?” Nobody appreciates all I am doing (for them)!”
    • Cockiness – A feeling of “I’ve got it made and no longer fear alcoholism”–could lead to going into drinking situations to prove to others they have no problem. Do this often enough and it will wear down defenses
    • Complacency – “Drinking was the farthest thing from my mind.” Not drinking is no longer a conscious thought. It is dangerous to let up on disciplines because everything is going well. To have a little fear is always a good thing. More relapses occur when things are going well than otherwise
    • Expecting too much from others – “I’ve changed; why hasn’t everyone else?” It’s a plus if they do, but still your problem if they do not. They may not trust you yet and may be still looking for further proof. You cannot expect others to change their lifestyles just because you have.
    • Letting up on disciplines – Prayer, meditation, daily inventory, A.A. attendance. Either complacency or boredom can be a cause. An alcoholic cannot afford to get bored with the program. The cost of relapse is always too great.
    • Use of mood-altering chemicals – The person may feel the need to ease things with a pill and the doctor may go along with it. Chemicals other than alcohol may not have been a problem in the past, but people can easily lose sobriety starting this way. It is about the most subtle way to have relapse. The reverse of this situation is true for drug-dependent people who start to drink.
    • Wanting too much – It’s important not to set goals too high and to take one step at a time and keep long distance goals flexible.

      ]]> 0 Having a Nervous Breakdown? Thu, 19 Nov 2015 10:36:37 +0000 http://5.412 Nervous BreakdownOne minute everything seems fine. Then in a flood of intense emotion and erratic thoughts, it all changes. Life becomes a distorted kaleidoscope, with nothing familiar from before. Even speaking is difficult. It is impossible to explain what is happening because the event is so unlike anything experienced prior.

      In the past, the term nervous breakdowns described such an event. But this is not a diagnosable disorder; rather it is a cultural euphemism. Instead there are three main possibilities for the condition described above. Each has unique characteristics and very different treatments.

      Panic Attack. One possibility is a panic or anxiety attack. For a person never experiencing this event, it can seem similar to the symptoms of a heart attack. The sudden onset of intense fear usually reaches a peak within minutes. Initially, most are unable to identify the fear that caused the event. It is only after some counseling that the trigger can be recognized and properly addressed. Other symptoms include:

      • Pounding heart
      • Sweating
      • Trembling or shaking
      • Shortness of breath
      • Feelings of choking
      • Chest pain
      • Nausea
      • Dizziness
      • Chills or heat sensations
      • Numbness or tinging sensations
      • De-realization or depersonalization
      • Fear of losing control
      • Fear of dying

      It is important to rule out a medical condition first, so see the help of a physician immediately. Once the physical symptoms have subsided and there is no finding other than a panic attack, seek the help of a counselor to discover the cause. Untreated attacks can lead to an increase in the duration, frequency and intensity.

      Manic Episode. Another possibility is a manic episode which may or may not be part of Bi-Polar Disorder or another type of depression. Unlike a panic attack, periods of mania tend to be longer lasting and have less panicky physical symptoms. Rather, the episode creates a larger than life impression. For a person experiencing this for the first time, it can increase anxiety so some of the symptoms of a panic attack could also be present. The main characteristics of mania are:

      • Intense feelings of euphoria
      • Fast speech, talkative
      • Racing thoughts
      • Impulsive and “high-risk” behaviors: shopping, gambling, sex
      • Insomnia or feels rested after three hours of sleep
      • Ideas of grandeur: can do anything
      • Easily distracted
      • Increase in goal-directed activity
      • Discernable pattern of episodes

      It is best to see a psychiatrist to get a proper diagnosis of manic depression. The good news is that this condition is can be successfully treated with medication. This is a brain chemistry issue and not a manifestation of intense fear or anxiety.

      Brief Psychotic Episode. The last possibility is a brief psychotic episode. While the name may sound a bit intimidating, the condition is more common than realized. This does not mean a person has a psychotic disorder, although it might be an indicator of one. Usually this lasts for a couple of hours to several days but not longer than a month. It has the following symptoms:

      • Delusions (beliefs without any basis in reality)
      • Hallucinations (hearing voices or seeing things that are not actually present)
      • Disorganized speech
      • Severely disorganized or catatonic behavior
      • No discernable pattern of episodes

      To receive the best diagnosis, it is good to be treated in a mental facility for this condition. A combination of medication and rest might be just what is needed. Anyone can have a one-time episode; it is not a sign of weakness in any way.

      Christine Hammond is the award-winning author of The Exhausted Woman’s Handbook available from Amazon, Barnes & Noble and iBooks.

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      Geopolitics and the Psychopath Wed, 18 Nov 2015 12:11:11 +0000

      “A small proportion of people who suffer from psychologically abnormal personalities have, throughout history, had an immeasurable detrimental impact on our societies, our politics and our world. Enabled by their ruthlessness to readily acquire positions of power, they have long dominated the psychologically normal majority of the world’s population.”
      Ian Hughes

      In the aftermath of the Paris massacre, I find myself pondering the surreal state of the world and the myriad humanitarian disasters and violations of international law infiltrating the globe.

      War crimes in Iraq, Gaza, Syria and Libya accompanied by air strikes, bombing raids and regime changes have become routine.

      The genocide in Yemen, albeit a humanitarian catastrophe, receives little media attention.

      U.S. led propaganda and harsh sanctions have economically destabilized Venezuela, conceivably as a prelude to invasion.

      Governmental looting of pensions and savings has begun, devastating retirees and their surviving spouses while corporate moguls earn 380x more than the average wage earner.

      It has always been this way irrespective of ideology, theology, or philosophy. The brutality of war and suffering are historical realities.

      Human Evil

      In distress I turn to my chosen field of psychology for answers. I am led to realize that in this geopolitical landscape, driven by the quest for political domination and exploitation of world resources, it is increasingly imperative that the layperson acquires a basic psychological comprehension of human evil, in order for any of this to make a modicum of sense.

      In “Religion Within the Boundaries of Mere Reason” philosopher Immanuel Kant makes the claim that evil is innate to the human species. According to Kant, self-conceit is the designated egoistic trait responsible for moral corruption.

      An extreme propensity for evil has been referred to by psychiatrist Hervey Cleckley, in his seminal book “The Mask of Sanity,” as a neuropsychiatric defect that fuels the need to destroy. Cleckley’s psychological perspective identifies a measure for evil as psychopathology.

      Wikipedia defines psychopathy as a personality disorder characterized by enduring antisocial behavior, diminished empathy and remorse and disinhibited or bold behavior.

      They are conscienceless and calculating and ruthlessly driven to acquire power and control. Psychopaths command compliance and obedience so as to actualize their agendas.

      Accordingly, they are encouraged by the absence of critical thought, and the reliance on primitive psychological defenses of those they seek to control. Moreover, research using positron emission tomography (PET) indicates that one of the primary causes of psychopathic behavior is believed to be neurological abnormalities in the frontal lobe of the brain.

      Cleckley purports that psychopaths present with a visage of normalcy.

      According to Cleckley the psychopath has the uncanny ability to conceal this ‘neuropsychiatric defect,’ stating, “they are disarming not only to those unfamiliar with such patients but often to people who know well from experience their convincing outer aspect of honesty.”

      We are deceived, even deluded by, the psychopath’s disguise of virtue, his glibness, ostensible calm, status and charm. The psychopath’s veneer of normality can be so seamless it becomes implausible to consider the malevolence behind the mask, even for trained clinicians.

      Political Ponerology

      Political Ponerology, coined by psychiatrist Andrzej Łobaczewski, is the study of institutional and government systems comprised of high-ranking officials presenting with psychopathic traits.

      Łobaczewski’s investigations focus on government in which absolute political power is held by a psychopathic elite and explains how an entire society can be ruled and motivated by purely pathological values.

      Łobaczewski emphasizes how psychopathic leaders’ “special psychological knowledge” of normal people enables them to manipulate and assert a hypnotic power over the masses. He explains, psychopaths have studied us and their ability to use our emotions against us deteriorates our cognitive abilities.

      B.F. Skinner’s work with operant conditioning tells us that what we learn is impacted by reinforcement and punishment/unpleasant consequence.

      A pattern of intermittent reinforcement establishes unpredictability and confusion. The psychopath capitalizes on this phenomenon. The victim’s mind scrambles in an effort to mitigate the distress and return to internal consistency.

      Eventually, cognitive dissonance sets in and the desperate urgency to discern a rhyme or reason becomes a driving force. At this point, the duped masses are caught up in an addictive cycle and come to view the psychopathic tormentor as the redeemer. Lobaczewski contends, the psychopath’s evil motivations masked by a humane ideology, further exacerbate confusion.


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      My Favorite Strategy for Overcoming Your Fear of Documentation Wed, 18 Nov 2015 11:10:37 +0000 http://4.647 A huge thank you for Dr. Maelisa Hall for this guest post!
      I’ll bet no one’s ever explicitly told you “Documentation is scary.” Leonardo da vinciHowever, most therapists fear documentation.

      Whether that’s fear of being subpoenaed, fear of being audited, or even fear of having your lack of notes “discovered.”

      We are taught to fear documentation. Through not talking about it, through lack of training and through poor supervision. You are implicitly told your documentation probably isn’t good enough but don’t ask too many questions or you might be reported to the licensing board.

      Well, I am here to change all that. First of all, we’re talking about it! And that’s half the battle. Now, I have some easy tips for you to overcome your fear.

      One of the best ways I’ve found to do this is by discovering exactly what is going on and tackling it head on.

      Take a moment to stop and reflect on what it is like when you sit down to write notes. Picture one of your clients. Picture yourself right now, about to start typing (or writing).

      How many notes do you need to write? It may be a long list of catch up or it may simply be 1-2 notes for a recent client.

      Now consider this: How do you feel? Are you nervous, resentful, anxious? Overwhelmed?

      If so, take a moment to write down what those feelings are and why. Did you have a prior negative experience with documentation? Were you chastised by a supervisor or overwhelmed by paperwork requirements at an agency?

      We all know that when people are emotionally triggered in a negative way they have difficulty solving problems and thinking rationally. Think about what that means for writing notes!

      When we associate documentation with everything that’s negative we will inherently have more difficulty writing quality notes and making clear decisions about what to include. Acknowledging these past negative experiences is crucial to creating a new reality and forming a different relationship with documentation.

      Now I want you to take a few moments and reconsider that same situation of sitting down to write notes. This time imagine yourself as a “writer.” You do this for a living because you love it. You are creating meaning from people’s stories. You have the privilege of writing out their journey with you. Your fingers fly with ease. In this scenario, were you able to put yourself in that role? Could you see yourself as confident and competent? Did it feel different?

      Now let’s apply this to your everyday (work)life.

      Perhaps there is an area in which you feel more confident. For example, maybe you have trouble staying on top of writing notes but you are very comfortable with your policies and procedures. Identify and acknowledge this! Write out your strengths, everything you’re good at clinically. How can this apply to your documentation?

      For example, if you’re really good at building rapport you can bring that into your documentation by creating an awesome intake session. You’re probably able to easily navigate the conversation and make people feel comfortable so it’s not just a session about signing forms.

      I call that creating a conversation out of your paperwork. And that’s really all documentation is- the written versions of the conversations you have with your clients.

      So let’s change our experience of documentation by actively making it a more positive experience. I challenge you to share this with a colleague. The more we talk about our experiences and share information, the more we will create that positive reframe.

      Who knows… you may discover documentation isn’t so scary after all.


      unnamedBio: Dr. Maelisa Hall specializes in teaching therapists how to connect with their paperwork so it’s more simple and more meaningful. The result? Rock solid documentation every therapist can be proud of! Check out her free online Private Practice Paperwork Crash Course , and get tips on improving your documentation today.

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      Why Loneliness Is Worse Around the Holidays Wed, 18 Nov 2015 10:06:46 +0000 http://5.409 LonelinessFeeling lonely is bad enough but add the holidays to the mix and instead of helping, the feeling intensifies. This strange phenomenon tends to isolate even further and can bring about a deeper depression. In some cases, the hopelessness many lead to suicidal thoughts.

      The contrast is shocking. Everyone else seems to be happier. There is extra stuff crowded the store isles with bright and cheerful colors screaming “buy me”.  The aroma of scented candles and flavored coffee permeates the air. The music is loud and joyful with new versions of familiar lyrics.  The traffic is busy. Lights are flashing, decorations are hung, and the excess of delicious food and drink dominate the atmosphere.

      On the surface, no one else seems to be lonely. Feelings of alienation magnify, thoughts become stale, and life seems more like a movie happening to someone else. The conclusion is that it is better to be alone then fake happiness. Or worse, that life is not worth living. This is not the place to stop. There are some small changes that can be made to relieve the loneliness before it escalates.

      Examine the perspective.  Everything is not what it seems.  The reality is that many others struggle this time of year financially, emotionally, physically, mentally, and even spiritually. Depression rates are higher due to the extra demands on time, energy, work and family. Being honest about the feelings is healthy and talking to someone is essential. Instead of surviving yet another party, invite one person out for coffee who seems to be isolating as well and talk. They might have the same perspective. Or if the depression worsens, speak to a professional counselor to gain a different perspective.

      Establish boundaries.  One of the causes of loneliness is a lack of appropriate boundaries.  How?  Examine a playground for a moment.  Several studies have shown that a playground without a fence causes children to hover around the equipment.  In contrast, a playground with a fence away from the equipment frees the children to run around yet still remain within the confines of the fence.  If the fence is too close to the equipment, the fence becomes part of it and is climbed over.

      Good boundaries are the same way; they exist but are neither too restrictive nor too distant to be effective.  Some friends and family tend to be too intrusive resulting in a desire to run away instead of engaging in relationships. There is nothing wrong with deciding ahead of time what will and will not be discussed or done.  The boundaries create a safe guard. Just make sure someone is invited into the playground.

      Explore the season of life.  If the cause of loneliness is a death, divorce, or other significant life change within the last year, then this is still part of the grieving period.  Any major life event can bring about a difference in how the holidays are celebrated.  It is normal to recall and even miss past festivities. Even when the life change is for the better, grieving over the loss is healthy. Don’t deny it the change. Rather recognize it and welcome it as part of the grieving process.  This begins the process of looking forward to creating new traditions.

      If these steps are not helpful, seek out a professional counselor to work through the loneliness and depression. Any thoughts of self-harm should be dealt with immediately. The National Suicide Prevention Lifeline is available 24/7 at 1-800-273-8255.

      Christine Hammond is the award-winning author of The Exhausted Woman’s Handbook available from Amazon, Barnes & Noble and iBooks.

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      Grateful for Therapy Tue, 17 Nov 2015 13:27:20 +0000 http://4.661 The Gift of TherapyAs a therapist and having done my fair share of time on the couch, I am reminded during this time of thankfulness for the work that is therapy. It is life transforming not only for the client but also for the therapist. I could go on and on but why do that when many therapists are so eloquent with what it is like for them, to be in the presence of profound pain and desire. Thank you to every therapist who shared here. With over 100 submissions, this is just a taste of what was said.

      I see clients who struggle with identity and self esteem issues learn to accept and love themselves for who they are and begin to live the life they desire. – K. Michelle Tapia, MA, LMFT 

      Couples here rebuild their marriage after struggling for so long. Watching the trust grow stronger and their hearts soften is truly a gift. I love being invited to vow renewals! – Kelly Montgomery, LMFT

      As a child custody evaluator I see children and families when things have gotten past broken, with co-parenting boot-camp I have seen significant change in communication and client’s abilities to learn the “business” of co-parenting. Seeing the benefits to the children after helping their parents find their way to a place that is functional, is lifting and makes this work worthwhile. – Nicole Stolar, LCSW, BCD

      I have the privilege of seeing clients shift into their true identities. The beauty of seeing clients come in, seemingly a shell of themselves, transform into beautiful, whole and healthy people is something I can never grow tired of. – Traci Lowenthal, PsyD

      I’ve been a witness to parents feeling empowered, kids feeling heard & seen, and families being able to communicate effectively without lots of conflicts!! – Mercedes Samudio, LCSW, Parent Coach

      I’ve been able to see women recover their hope for the future, rediscover their strengths, and reclaim their stories. – Jessica McCoy, MFT 

      In therapy I allow myself to ‘show-up’ and be fully emotionally present with my clients. That gives my clients permission to show up completely and fully for themselves. It is immense, humbling, and soul changing to witness these transformations. – Karlene S. Haines, LCSW-C

      I’ve seen clients move from fear to fortitude as they decide to end abusive relationships. – Heather Seguin, MFTI

      I get to see families flourish as a cohesive whole instead of fragmented pieces. It gives me hope and happiness to see families start to work so smoothly together. – Carmen Wolf, LMFT

      I have seen couples work through challenges and constant arguments to realize that their relationship is worth saving. Partners have been able to rekindle their love, work together as a team, and discover a new level of amazingness they didn’t even know was possible.  – Erika Labuzan-Lopez, LMFT-Associate, LPC 

      I have seen women learn to love themselves again, and gain the confidence and tools they need to make better decisions about their lives. They grow to understand what they truly want out of their relationships, and learn to ask for things in an entirely different way that draws from their strengths and helps them have more happiness and fulfillment in their relationships. – Alicia Taverner, LMFT 

      I am honored to witness the courage of my clients to face their deepest fear and pain, which allows them to let go of all the self-doubt and defeating behavior! Lanie Smith, Registered Art Therapist

      I’ve seen a client go from looking I’ll from the effects of long term alcohol to having done out patient detox and in a week looking healthier and much calmer!! So exciting to see that physical transformation!!! – Michelle Farris, MFT  

      I’ve have been greatly privileged to witness the inner and outer transformation of clients as they break free from the limiting agendas and expectations of others; to see their strength and courage as they walk away from toxic situations and create the life they want to live and were meant to live. – Lourdes Viado, MFT

      In my experience, therapy can be incredibly transformative for women who want to be in a healthy loving relationship, but continue to get stuck in the same pattern that doesn’t serve them. I’ve seen clients learn to identify their patterns, understand where they come from, and begin to do something different…something that gives them confidence and allows them to have healthy, stable relationships with themselves and their partners. – Chappell Marmon, LCSW 

      I have helped adults learn to move on from traumatic experiences from their childhoods that impacted them in the present. – Lauren Matos, LMHC 

      I have seen children learn to express their feelings, to see their courage as they work through trauma and heal. – April Forella, LMHC

      I have seen men and women, adults and kids, whose lives were controlled by anxiety and panic break free of the fear and live life on their own terms. Nicole Connolly, Ph.D.

      I have seen clients go from hearing voices, not knowing they are internal and feeling terrified, to talking themselves through the steps of testing reality and actually telling the voices they are not real and demanding they go away. The voices lost their power. I’ve also seen clients change relationships with their parents from submission/dominance, fear/rage to self-worth, respect, and calm assertion – as action and not reaction.In both these kinds of growth, the clients were agents of change in their own lives once they internalized their power to cause change – they internalized self-determination they hadn’t even realized they had. – Robin Custer, LICSWA

      I have seen my clients go from hopelessness, stuck in the past to being hopeful and looking forward to a future of living an abundant life. – Patty Behrens, LMFT

      I have seen teen girls and women who are introverted by nature, find their voice and recognize how they quietly influence those around them. In their quiet they roar. – Dr. Joanne Royer

      I love having the privilege to watch moms and kids transform. Moms learn how to make parenting work for them and get creative. While kids connect to their inherent greatness. – Renee Bond, LPCC

      I see clients who are immersed their eating disorders, distanced from the people who love them and totally hating themselves reconnect, learn how to love themselves and how to take care of their emotional and physical needs. It’s incredible seeing people become their real selves, like a film going from black and white to color. – Allison Puryear, LCSW

      Through being a play therapist and giving children a safe person and outlet for their often misunderstood big feelings, I have seen children be able to heal from something challenging or traumatic. I have seen children evolve and bring themselves toward changing or accepting something difficult. The hard work these children do in play therapy is remarkable- I have seen marked improvement in their lives and how they interact in their relationships with their families, peers, and teachers. – Parie Baharian, PsyD

      Time and time again, I see clients shift from feeling consumed by their difficult experiences – their fears, their regrets, their self-criticism – to having a safe distance from them, in which to actually cope and thrive. It’s almost like by virtue of the person’s willingness to explore the issues, they’re standing up to a bully. The bully still goes to their school, but they don’t’ mess with them anymore. It’s inspiring, truly. – Shana Averbach, LMFT

      As a therapist who specializes in working with teens, the most beautiful moment is when teens realize that they actually have a powerful voice and can make dynamic choices to improve the quality of their life. – John Sovec, LMFT

      Some of the most precious and powerful moments in therapy occur when clients can trust themselves, the process, and me, to finally divulge a secret that absolutely no one has ever heard before, perhaps from a time over fifty years ago. It’s a magical moment of freedom. –  Carol Tyler, Ph.D.

      I’ve been honored to witness clients transforming the narratives of their lives from unworthiness to resilience while healing the pain and shame of trauma symptoms. – Laura Reagan, LCSW-C

      I just completed a final session with a couple. Magical. I have seen couples shift from the pain of disconnection and loneliness to the sweet joy of playfully and compassionately having each others back. From hurt to healing. From arguing/shutting down to vulnerable expressions of fear and love. Julie Kyker, MFT

      I think this quote summarizes it the best –

      One of the biggest shifts my practice has caused is an internal a shift in me–from feeling separate from others to realizing more and more with each day, each session, each sentence from a person sitting opposite me, that we are not alone. We are all connected. Like me, my clients suffer. Like them, I struggle. Through connection, we heal. Jean T. Rothman, MA, MFT.

      May I and may all of us never forget that there is hope. There are people that can and will help you and you don’t have to through this life alone. It takes guts but it can be well worth all of it. What are you grateful for?

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