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Stress, Happiness,
Modern Life & Therapy
 ARE WE THERE YET?
The question of when therapy is finished is tied to how therapy began. Sometime within the first few sessions therapist and client(s) should agree on goals for their work and have a discussion of what it might look like when those goals have been achieved. If the work to be done is short-term and solution-focused, an agreed upon number of sessions might also be a part of the initial discussions.
For more complex issues, it might be difficult to target a specific number of sessions. Smaller, more measurable goals may be set within the context of the larger therapeutic experience. In all cases, however, a satisfying termination of therapy is a negotiable part of the process. This leaves open the possibility of returning for “check-ins.”
Good, successful therapy encourages growth and openness to life. In that sense, therapy is never finished — it just doesn’t all have to take place in the therapist’s office.
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 WHAT CLIENTS CAN EXPECT FROM THEIR
THERAPISTS
Many people have preconceived notions of what to expect from psychotherapy. These notions come from anecdotes from friends or family, TV or film portrayals, or their own experiences. While there are many different techniques and approaches to psychotherapy, there are also basic standards that clients can expect — no matter what style of therapy is utilized by the therapist.
First of all, one should expect his or her therapist to be fully trained and licensed. Secondly a skilled therapist will do the utmost to maintain confidentiality unless required by law or by a patient’s insurance plan to do otherwise. (This should definitely be discussed in the first session). In addition, one can expect to find an empathic listener who will create an environment of safety and positive regard for the client. Psychological growth can be best accomplished in an atmosphere where there is confidence in the therapist, and where there is a sense of trust and mutual respect.
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 WHAT THERAPISTS HOPE THEIR CLIENTS
BRING TO PSYCHOTHERAPY
Clients who seem to make the most of their psychotherapy experience bring a sense of curiosity to the work. People who want to know what “makes them tick” and who question their behavior and actions can use psychotherapy to discover more about themselves. Clients can make good use of therapy by thinking and working between sessions, and coming to each new session with a sense of what is most important to discuss/work on that hour.
It is also important to have realistic expectations of what therapy can do. Therapy should help you identify core issues, which can be worked on in situations where those issues are activated. Therapy can help broaden your life experiences. Clients who take responsibility identifying what they need to work on and who are active in their therapy make the best progress. Remember therapy doesn't “cure” us of life’s difficulties — it helps us to learn, grow, and mature psychologically. Therapists don’t “give out”answers — they are partners on the path to greater psychological knowledge.
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 OBSESSIVE COMPULSIVE DISORDER (OCD)
Obsessive Compulsive Disorder is an anxiety disorder that is characterized by two components: 1) persistent and recurring thoughts that are distressing and disruptive; and 2) repetitive behaviors called compulsions or rituals that must be performed in order to alleviate the anxiety caused by the obsessive thoughts.
An example of OCD behavior would be a person who worries incessantly about setting the house on fire. In order to calm the anxiety produced by this obsession, this person will engage in the ritual of checking the house repeatedly to make sure that he/she turned off the stove and all other appliances. As the cycle of obsessing and checking continues, the person often experiences depression, shame, and more anxiety.
Cognitive-behavioral therapy is often the treatment of choice for this disorder. For some, this form of intervention is sufficient. For others, medication in conjunction with therapy yields the best result. Obsessive Compulsive Disorder is treatable. Getting the appropriate kind of help can greatly improve the quality of life for someone suffering from this disorder.
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 POST-TRAUMATIC STRESS DISORDER
Post-Traumatic Stress Disorder (PTSD) is the name psychiatry has given to the reliving of terrifying experiences that hinder a person's sense of predictability and invulnerability. Following major trauma such as war, physical and sexual assaults, and accidents, the body goes into “psychological shock” as a way to manage the overwhelming thoughts, feelings, or images that result from the trauma. This may include hyper-arousal, intense emotional reactions, sleep problems, memory disturbances, and learning difficulties. While these reactions may be adaptive in the short term, if the symptoms persist and are severe, recurrent, and interfere with everyday functioning, professional help may be needed to better cope with the trauma experience and restore a sense of safety and well-being to the person’s life.
The immediate need for someone who has experienced a major stressor is to assure their physical safety, to encourage their disclosure of the traumatic events, and to educate them of the physical and psychological effects of trauma so they do not think they are "going crazy." Early support and intervention may prevent delayed reaction and lessen the severity of symptoms experienced.
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 INTENSE FEAR + PHYSICAL PAIN = PANIC DISORDER
Unlike someone who has mild to moderate ongoing general anxieties about life,
the person who has a Panic Disorder has repeated, intense episodes of fear that may be accompanied by chest pain, dizziness, stomach pain, and shortness of breath, mimicking the symptoms of a heart attack. Over two million people in the U.S. report panic attacks, and typically they first appear in young adulthood. It is believed that the panic attacks are associated with an individual's tendency to perceive relatively normal life events as having more catastrophic outcomes or involving danger. The exact cause of Panic Disorder is unknown.
Treatment often involves the use of antidepressant medications in conjunction with cognitive-behavioral psychotherapy. This form of psychotherapy involves identifying thought patterns that lead to misinterpretation of experiences, learning relaxation techniques, and decreasing a person's sensitivity to the often frightening and painful symptoms during the panic attack.
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ARE YOU "STRESS HARDY?"
We are all aware that we are living in a very fast-paced culture. Stressors abound everywhere. As more and more demands are placed upon us, it becomes increasingly difficult to remain calm and focused. Studies have shown that people who possess the following characteristics are more resilient to stress and are considered to be stress hardy:
Commitment: Stress-hardy individuals never lose sight of the passion that motivated them to get into their present situation. They stay committed to family, friends, and career even when things get rough.
Challenge: They look for the opportunity that is created with every change or loss. They can embrace the task in front of them and see it as a challenge they can meet.
Control: They accept the fact that there is much in life they cannot control and are only pro-active about the things they can control.
Compassion: They can listen to others and be empathic. This can diminish stress because understanding the situation of another (a boss or someone with whom they must relate) provides a fuller perspective on a stressful situation.
Cognition: Stress-hardy individuals think positively. They avoid second guessing themselves and ruminating over what they should have done. How "stress hardy" are you?
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 WHAT MAKES PEOPLE HAPPY?
Am I happy? This is a question we all ask ourselves sometime in our life. While most of us can answer this question rather easily, few of us are aware of what factors contribute to happiness. Researchers have studied this question and they should be discussed with the physician who is treating your hypertension. Additional life style changes such as modification of your diet and incorporating stress management techniques which you can learn from Silverside Counseling professionals should also be considered. Research suggests that it's not the events in our life that stress us, but how we interpret those events and this is something over which we have some control.
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INFORMATION OVERLOAD
We all suffer from it! It's hard to know how to protect ourselves from it! Information overload is too much information coming too fast, and often about things we don't need to know. Twenty-four hour television and the Internet contribute to the constant hum of news and information that invades our homes and our lives. What to do? Don't be afraid to turn off televisions and limit what gets into your house. Use your computer as a tool, not as a way of life. Make time every day for some "peace and quiet." Short breaks spaced throughout the day where we stop and relax for five minutes and just slow down without the pressure of television, computers, etc., can help us stay in touch with ourselves and what's really meaningful to us. Refuse to lose yourself in the world's noise, and savor some moments of peace and tranquility.
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 TIME: IS IT OUR FRIEND OR FOE?
Time is immutable; we can't expand, increase, or improve upon it. Because time is a fixed entity, time management is really about attitude and self-management. Many of the world's great religious teachers and philosophers have encouraged us to "live in the moment." By shifting our focus to the present and concentrating on the sensory richness and gifts we do possess, we can let go of the anxieties of the future or the disappointments and resentments of the past. We restore balance, perspective, and a sense of emotional well-being.
Experts on time management divide time into five categories: important and urgent, important but not urgent, urgent but not important, busy work, and wasted time. By utilizing these five categories, we can determine how we are allocating our time and alter our activities to truly reflect our priorities. From this choice comes a sense of living life more as we want, instead of feeling that we are "at the mercy of time."
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 WOMEN IN MID-LIFE
As we as a society continue to feel the necessity to work longer hours, be more productive, and become more technologically savvy, women in their forties and fifties often find that there is an inner voice pulling them in a conflicting direction.
During the fourth and fifth decades of life, women's hormones begin to fluctuate wildly. This period before and just after menopause is called perimenopause. This transition -- which can last up to thirteen years -- is characterized by physical and psychological sensations such as hot flashes, night sweats, fragmented sleeping patterns, depression, anxiety, and irritability.
For many women, this is a time to prioritize what is truly important in their lives. Because stress seems to exacerbate perimenopausal symptoms, it is essential that women take control of their lives and allow time for rest and relaxation.
Often, one can benefit from the support and nurturance of other women during this time of enormous change and confusion. To meet this need, we offer a five-session support group for women going through perimenopause. Please contact Meryl Brownstein at 479-5060 if you are interested in learning more about this perimenopausal women's support group.
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 "THE HOLIDAY BLUES"
As the winter holidays approach, we will again hear about the "holiday blues." Why, during "happy times," are so many of us dealing with feeling "blue?" The holidays, with their focus on families, may remind us that all is not so wonderful in our families. We will have to confront the realities of our lives, which often come with complications and tensions. In addition, perhaps there are no other times that are so filled with conscious and unconscious expectations of how things "should" be. It is easy to endow the holidays with all kinds of expectations.
Solutions? Try to be grateful for what your holidays are, even though you are aware of what they are not. To do that, expectations need to be lessened. We must be open and curious about what is about to take place. Try to reach out to those around you, family or not, with a spirit of celebration that takes into account who people are and what they can offer, not just what they fail to offer. Finally, find ways to make the holiday time meaningful to you, regardless of how others approach these times.
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LIVING WITH UNCERTAINTY
We all know what it feels like to not know what's going to happen in the future. Psychics make their living predicting our future. They try to reduce our anxiety by making us feel we are more in control, even if we are anticipating something painful or difficult. We feel "ready" because we believe it is going to be easier "knowing" than not knowing.
We also like to think that life will continue as it is now and that nothing will ever change. What we can be certain about is this: things always change, and our future is definitely going to be filled with a smorgasbord of wonderful as well as difficult experiences.
How can we be prepared? Predicting the future or pretending that the status quo is permanent are not good solutions. Our reassurance lies in knowing that we are equipped to handle what comes. Good decision-making skills, support from friends and family, and the ability to remain strong, centered, and anchored are tools that provide us with resiliency and allow us to weather any storm.
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 PRACTICING MINDFUL MEDITATION
There are many "active" techniques for reducing stress and achieving health. Mindful meditation (also called insight meditation) is a quiet, almost passive way of letting go of the negative and obsessive thought patterns that often influence us without our even being aware of what is happening.
When practicing mindful meditation, one just sits and notices what they are thinking. The technique is to not judge what thoughts come into one's mind, but to just accept them. For example, as one sits, one might notice that he or she is experiencing fear, followed by anger, or disgust, or happiness, or some obsessive habitual thoughts. The idea is to accept these thoughts and let them pass without assigning meaning or associations to them. Just notice, and observe how they dissipate.
By learning this technique, one can free him/herself of a great deal of suffering and achieve a sense of peace. One can learn that it is not necessary to become a victim of one's thought processes, and that ultimately thoughts are just thoughts. For more information about mindful meditation, call Meryl Brownstein at Silverside Counseling Center.
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 SPIRITUALITY
For many people, faith or spirituality is a source of strength and meaning in their lives. How do these beliefs result in a sense of inner well-being and psychological health? It might be that spiritual beliefs provide a secure sense of identity, thus lowering anxiety and facilitating resiliency under stress. Also, positive emotions of hope, faith, and optimism emerge from spiritual beliefs and practices. These positive emotions contribute to a more relaxed and accepting way of life. Finally spiritual beliefs can provide a feeling of belonging, community and social support in times of need, as well as an opportunity to give to others in their time of distress. Whatever the reason, faith and spirituality can be powerful resources for the healing and change sought in psychotherapy.
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 HOW A HEALTHY DIET AND REGULAR EXCERCISE
ENHANCES OUR MENTAL HEALTH
We all agree that feeling strong and healthy is a worthwhile goal. However, how many of us take the time and energy to make sure we are getting exercise and eating right? Our bodies are designed for walking, running, and stretching. In the days before automobiles and sedentary jobs, people did more of that. We also ate unrefined foods, including more vegetables, seeds, fruits, and grains.
Studies of individuals who engage in regular physical exercise reveal that 30 minutes of aerobic exercise at least three times per week, leads to less depression and anxiety, more restful sleep, higher self esteem, and better mental efficiency.
Eating healthy can also make a difference in how we feel. It has been hypothesized that there is a relationship between mood and physiological well being (e.g. blood sugar levels). Therefore it may be wise to consult with your medical practitioner to make sure your diet is not adversely affecting your mood.
The combination of regular exercise and optimal eating may not only prolong our lives, but may also contribute to richer and more satisfying experiences.
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