Category Archive: Therapy

Mar 12

Acceptance and Commitment Therapy Part 3: Present Moment Awareness

I hope you have a few minutes to engage in a few exercises with me…. First, I’d like you to take 1 or 2 minutes to imagine that you are sitting on a white sand beach looking at the ocean, watching the waves roll onto the shore. Set your phone timer if that would be …

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Feb 09

Psychopharmacologist

I am not a psychopharmacologist. A patient who I have been seeing for almost a year and who has been depressed throughout that period came in to see me today and we talked about her mood over the last couple of months. She has been markedly less depressed, and I was congratulating myself on the …

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Aug 21

Bay Area Groups for Bipolar

Readers of this blog who live in the Bay Area may be interested in two groups that are starting this fall. Both of them are led by excellent clinicians and should be valuable to people with bipolar. Colleague and friend Descartes Li will be leading one of them. He describes the group this way – …

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Jul 02

Mindfulness for Depression -Research Update

Mindfulness has received a lot of attention recently as an approach to improving mental health in a number of conditions. But is it really effective as part of a strategy for treating serious depression? And, if so, how can we best incorporate it into treatment, given the great difficulty that many people with depression have …

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Jun 13

Acceptance and Commitment Therapy Part 2: Defusion

Defusion is one of the six core processes that make up Acceptance and Commitment Therapy (ACT). These core processes, which also include acceptance (click here to review this process as described in Part 1), present-moment awareness, self-as-context, values, and committed action, are aimed at cultivating psychological flexibility, or the ability to have all of our …

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Apr 13

Acceptance and Commitment Therapy Part 1: Acceptance and Willingness

I recently attended the Anxiety and Depression Association of America conference in Philadelphia, where I offered a two-hour workshop on Acceptance and Commitment Therapy (ACT) and deepening experiential practices in ACT sessions (largely based on the book The Big Book of ACT Metaphors: A Practitioner’s Guide to Experiential Exercises and Metaphors in Acceptance and Commitment …

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Sep 22

Parity is What We Want

Parity is What We Want

An overwhelming majority of Americans want parity. A large study found that almost 90% of Americans reported that mental health and non-mental health care were equally important to them in terms of their overall well-being. At the same time nearly a third of those Americans surveyed felt that mental health care was inaccessible and 40% felt …

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Aug 07

Distress Tolerance

Distress Tolerance

In A wonderful young woman we have been seeing for a few months asked for some recommendations for skills to help her deal with her experience of moments of overwhelming negative emotions that often seem to come out of nowhere. This post is a relatively quickly pulled together document derived from Marsha Linehan’s Dialectical Behavior Therapy. Think …

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Aug 02

DBT for Bipolar Group

DBT for Bipolar Jenifer Culver

We are very happy to pass this information on about a great group for people with bipolar being offered in the bay area by an expert in the psychosocial treatments for bipolar: Dr. Jenifer Culver. Dialectical Behavior Therapy (DBT) Skills Group for Individuals with Bipolar Disorder in Los Altos, CA. The Next group begins September 2015. …

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Aug 01

UCSF Bipolar Group

Bipolar Group

The UCSF bipolar psychoeducational group starts on September 14, 2015. This group is lead by bay area bipolar expert Descartes Li, MD.  It runs for 8 sessions, Mondays 12pm to 115pm. Most commercial insurance is accepted. Dr. Li describes this group as “an advanced class about bipolar disorder for people who have bipolar disorder.” For regular …

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Jun 30

Prefrontal Cortex and Limbic System

Prefrontal Cortex and Limbic System

A very bright young man who has a great potential as the therapist but who is wrestled with chronic depression for years and has developed a pattern of avoiding doing things that he knows he has to do in order to move ahead with his life led me to talk again about the relationship between depression, …

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Jun 14

Chronic Insomnia Treatments

chronic insomnia treatments

A recent study confirms that cognitive behavioral therapy is effective for chronic insomnia and is often more effective than medications. “What surprises us is that there isn’t more awareness of this treatment’s effectiveness and that there haven’t been more attempts to make the treatment more available to patients,” James M. Trauer of the Melbourne Sleep …

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Apr 09

Mentalize

Sometimes a word just seems to show up everywhere.  This past week the word “mentalize” has come up in conversation a number of times.   A colleague who is looking for a referral for therapy says that she needs someone who can “mentalize well.”  One of my patients who just completed a DBT-based treatment program says that …

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Mar 23

Attentional Bias Modification Prevents Depression

Attentional Bias Modification

A middle-aged nurse wrestling with depression said she want to do “everything” that she possibly could to improve her mood. She doesn’t have access to therapy through her insurance, and she’s already vigorously pursuing mindfulness practice, but her request reminded me of an article I recently read on Attentional Bias Modification as both a possible …

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Feb 25

CBT for Insomnia Reduces Suicidal Thoughts

CBT for Insomnia

CBT for insomnia (CBTi) is clearly preferable to taking sleeping medications for most people. Studies show that cognitive behavioral therapy is associated with greater improvements in sleep quality than sleeping medications, and that those improvements are more durable, and, particularly in the elderly, sleeping medications are associated with significant adverse effects, including an increase in mortality. But …

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Jan 18

Through the looking glass 2 – Meeting the Therapist

The last blog posted some three hours ago jumped over this one, much as thoughts are given to do in my head. This, in fact is a description of me meeting the therapist for the first time. My earnest apologies. Maestro, the music if you please. …My wife, caught up in a Maelstrom of hypomania, seeks and …

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Jan 18

THROUGH THE LOOKING GLASS: 2 – Depression Assessment

Cartoon

  …I’m returning to do the test suggested by my therapist in our previous meeting – the Beck Depression Inventory II. Tremendous. Doing a test sounds like something you see in those silly magazines that tell you how good a lover you are are some such other rubbish, but apparently this test is rather serious. So I …

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Dec 15

Through the door 1 – Therapy needed

A few years back and I am living in Paris with my Irish wife who works for a large International think-tank based in the city. I work in London and return to Paris on weekends via Eurostar. I have had many ‘episodes’ in the past, but for a while now I’ve been free of them. But I …

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Nov 12

Art Therapy – Lyndsey

art therapy

When I was in the hospital, one of the activities they provided for patients was art therapy.  I sat in a room, silent and bewildered as I was, and methodically glued tiny pieces of glass mosaic tiles on a black wrought iron trivet frame.  I called it my Crazy Trivet ever after, and it was …

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Nov 09

I Can’t Stand It! (ACT)

ACT

This week began with me spending three or four hours writing up a summary of Acceptance and Commitment Therapy (ACT) for one of the people I saw two days ago.  For those of you who haven’t heard the term, ACT is the “hot” new approach to therapy (although much of it dates back thousands of years to …

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