Sitting with Emotions I regularly work with clients who are trying to avoid and push away feelings of sadness, anger, loneliness — so-called “negative” emotions. On the one hand, I can entirely relate with this draw and have experienced it myself. However, the more I’ve learned to sit with these emotions, and witnessed others sit with them, the more important …
Tools for Change
In my previous post I outlined the idea of “stages of change,” here I want to focus on some of the tools for change. In the picture below you will they the stages of change lined up with appropriate tools for change. Some of the tools are appropriate in more than one stage and, in general, the activities that support …
Ready for Change?
Getting Ready for Change The process of getting ready for change has been the focus of the research of James Prochaska for the last 40 years. James O. Prochaska and Carlo Di Clemente, developed the Transtheoretical Model for change (TTM), which is the most widely accepted framework for understanding change in the mental health and substance use treatment communities. They found …
Nature and Wellbeing – Gina
Nature and Wellbeing Many patients I work with speak of the value that nature plays in their lives and I can say that I also strongly relate to the value it plays in my own. Through personal experience and repeated accounts from others, I have seen how nature can improve moods, increase feelings of connectedness, and impact thought patterns. More …
Treatment Controversies
Treatment controversies abound in psychiatry. An earlier post about a conversation I had with a patient’s therapist in which it seemed that both therapist and patient agreed that being encouraged to come in for an early appointment was a kind of punishment, sparked an interesting dialog with one of this blog’s many dedicated readers. The reader wrote – As one who has experienced that …
Sadness Benefits
Are there sadness benefits? It often seems as though the work I am supposed to do is to eliminate all negative emotion on behalf of the people who come to me for psychiatric help. But is that possible, and if it were possible would it be a good thing to do? Are there sadness benefits that would be lost if …
Shame and Guilt After Mania – Gina
Addressing Shame and Guilt After a Manic Episode I have witnessed the immense pain caused by the shame and guilt experienced by people with bipolar disorder following a manic episode. After a manic episode, most have engaged in behaviors that they regret. The resulting shame and guilt can contribute greatly to symptoms of depression that follow an episode. Understanding techniques …
Boost Creativity by Walking
“How can I get my creativity back?” One of my patients, who has been wrestling with depression for quite a while, asked me if I could think of anything that might help give her creativity a boost. My quick, off the cuff, reply was “go running again” (she was an avid runner before she got depressed), in part because of …
Impulsivity – Gina
Impulsivity is something everyone has experienced. We have all had moments when we have said something impulsively that we regret or have gotten carried away with an idea. Sometimes the consequences of an impulsive action are minimal. But that is not always the case. Impulsive decision-making is more common in people with bipolar. And this increase is not just something seen …
Avoid Intimidation
Rick Hanson has written an elegant and timely newsletter article about how to avoid intimidation and fear from paper tigers and media demagogues. I love his weekly email newsletters and it is again time to encourage readers of this blog to sign up. Here is the link. One of Rick’s themes, elegantly outlined in this most recent article, is how …
Cognitive Recovery from Mania
Cognitive recovery from mania or depression seems to lack behind the improvement in mood symptoms. In our experience full cognitive recovery may take up to three months after the mood symptoms have remitted. One way of thinking about this is that an episode of mania, or depression, upsets the normal function of the brain and it takes a while for …
Pace Yourself for More Manageable Moods
I have been doing a lot of thinking about how to pace yourself so that you can capture some of the energy and creativity associated with being mildly energized while not getting so involved that you burn out or edge into full-fledged mania. There’s nothing quite so exciting as entering a time of increased energy and ideas after a long …
Hope and Self Efficacy – Gina
Believing you can create change in your life is the foundation for successfully making the change. Self efficacy is the sense that you can make change and thus hope and self-efficacy are intimately connected. Often people with bipolar or depression are overwhelmed with feelings of hopelessness. They feel stuck and unable to manage their moods. And yet a great deal of research shows …
Positive Emotions
We had a wonderful conversation (see the conversations tab on this site) with two smart young UC Berkeley graduate students in psychology (Janelle Capnegro and Erica Lee) who have developed an intervention designed to help people with bipolar regulate and develop positive emotions. It started us thinking about emotions in terms not only of how positive or negative the emotions …
Sustained Attention and Denial
What to do when a loved one is refusing necessary medical care? Is an “intervention” the answer, or can sustained, loving, attention accomplish the same goals?
Happy Acts by Gina
The Happy Acts Challenge Did you know that giving can activate the reward centers of the brain? We think regularly about techniques to support us in managing our mood including exercise, eating healthy, regular sleep routine, etc. Is giving back or volunteering also on your list? If not, you should consider it. Researchers are finding that areas of the brain …
Interpersonal Effectiveness and DEAR MAN
For many people with depression, it can be hard to find an assertive, but not hostile, way of dealing with conflict. Marsha Linehan’s Dialectical Behavior Therapy (DBT) addresses many practical problems such as this with straightforward answers. This comes from the “Interpersonal Effectiveness” module of DBT. The acronym to remember is DEAR MAN: Describe Describe the situation in as objective …
Hamster Brain
A young woman who has been making good progress tackling the problem of severe depressive episodes suddenly is having trouble managing the opposite end of the mood spectrum. She gets energized and is consumed with getting stuff done. She is unable to stop until she is exhausted and she crashes. I call this state of mind “hamster mind” because it is like the …
Coping with Political Uncertainty
Many of the people that I work with on a regular basis have been experiencing symptoms of depression and anxiety related to the recent election results. Unfortunately, mental health professionals are no better as news analysts than the so-called professionals. I have been struggling a little bit trying to figure out what to say to these people. Coping with Political …
Friends and Purpose
Maff Potts spent his professional life working with charities for the homeless in England. But he was frustrated that all of his work did not seem to be changing outcomes for the people he was working with. The result of his reassessment is a program that focuses on addressing what Maff feels are the two psychological problems that bedevil the homeless… …