"You Want to Zap My WHAT!?" Electroconvulsive Therapy, Transcranial Magnetic Stimulation and Memory

Monday, April 27, 2015 by Meg   •   Filed under Treatment Techniques

When people think of Electroconvulsive Therapy (ECT), they usually envision something pretty archaic. A One Flew Over the Cuckoo’s Nest style lab complete with sadistic doctors in lab coats and patients strapped to tables prepared to have their brains scrambled. Or they picture that whole lobotomy thing with ice picks up the nose. 

Except…that’s not at all what it is, though there are probably those who would embrace lobotomy treatments if it meant the depression would cease altogether. (For a great insight into ECT and recovery check out Will I Ever Be the Same Again? Transforming the face of ECT.)

So let’s get into this. 

Disclaimer: I have never been involved in administering ECT, though I have worked with a few outpatient and inpatient clients who have undergone this procedure. I’m a smart girl, but treating a handful of people who have undergone ECT does not make me a expert on this particular treatment. 

I wish it did. I’d be an expert on Every Damn Thing. 

What I can offer you is what I saw, answer the questions that my patients had, give you some background on what ECT is and what it isn’t and tell you about another less invasive treatment using magnets.

Uh...magnets?

That's right folks. Prepare to be fucking amazed....  continue reading

How To Deal With Intrusive Thoughts: Cognitive Behavioral Therapy and "What If?" Thinking

Monday, January 19, 2015 by Meg   •   Filed under Treatment Techniques

What-if thinking is an exercise described in detail by Dr. David Burns in When Panic Attacks1. For those who suffer with anxiety or panic attacks, this exercise can be immensely helpful with getting to the root of a scary thought pattern.  

I know, it sounds very Freudian, but I promise we won’t blame it all on your mother or sexual attraction to your father.

Freudian slip = when you say one thing but mean a mother…I mean another!! 

Why Getting To The Root of a Problem Matters

The underlying meaning to these patterns is sometimes important because there may be a deeper-rooted fear for certain negative thoughts. While someone with an overactive nervous system may feel anxious about all kinds of different things, someone with a deeper fear may have it manifest in a series of thoughts that are seemingly related, but not obvious in their root. If you can change that original underlying thought--which may be closer to a belief--you can avoid other thoughts cropping up later....  continue reading

How to Cope With Intrusive Thoughts: Cognitive Behavioral Therapy, Talking (To Yourself) and the Benefit of Defensiveness

Friday, October 24, 2014 by Meg   •   Filed under Treatment Techniques

In When Panic Attacks1Dr. David Burns notes that role playing can be a great exercise to organize ideas and hear the absurdity of irrational scary thoughts. Debating anxiety-producing thoughts out loud may be of even more assistance for people who prefer to learn by listening to lectures or other types of auditory cues. 

This post will be short as there are only a few techniques that are related closely enough to justify putting them together. Because no matter which type of cognitive behavioral therapy practices you're into at the moment, they just don't compare to yelling at yourself or someone you love like a tweaked-out Gilbert Gottfried....  continue reading

Deep Breathing: You're Doing it Wrong.

Monday, October 20, 2014 by Meg   •   Filed under Treatment Techniques

It usually goes down something like this: someone comes in and says, “I heard deep breathing is supposed to help with anxiety, but it  makes me feel worse.”

Red flag number one.

They go on. “Sometimes, even if I feel okay to begin with, I feel dizzy or like I am about to pass out when I start taking deep breaths.”

Even though panic and anxiety can cause dizziness, tunnel vision and lightheadedness, I count this as red flag number two if it seems to be made worse by the breathing. 

From me, it takes two words to see if I am right: “Show me.”

After years of clinical practice, one thing is clear: you people have no idea how to breathe. This is especially true in those who have a history of trauma (due to bodily disconnection or dissociation) and those with overactive sympathetic nervous systems (such as those with anxiety disorders or depression). And deep breathing done the wrong way can actually make anxiety symptoms worse instead of alleviating them....  continue reading

Stop Being Mean (to yourself): 8 Ways to Reduce Scary or Intrusive Thoughts

Wednesday, October 15, 2014 by Meg   •   Filed under Treatment Techniques

Cognitive Behavioral Therapy (CBT) is a cornerstone in the treatment of depression, anxiety disorders and even other therapies such as Dialectical Behavioral Therapy which is often used to treat personality disorders. The premise is simple: by altering the way people think, we can change their responses and the way they end up behaving. 

Sounds good, right? 

While there are numerous tactics for addressing negative or racing thoughts, some are more popular than others. So today, I wanted to offer you a quick and dirty list of some of my favorite types of CBT practices. 

But first we need a thought to challenge. Let’s say your recurrent negative thought is, “I’m a terrible mother. Everyone else does it better.”

We’ve all been there, right? So how to combat this?...  continue reading

What is Dialectical Behavioral Therapy? The Features of DBT, Radical Acceptance, and Coping with Pee

Monday, October 13, 2014 by Meg   •   Filed under Treatment Techniques

Dialectical Behavioral Therapy (DBT) has been a growing phenomenon in the psychotherapy world. And as this movement becomes more popular in the general population, I have been getting more and more questions about it.

“So….DBT is like Cognitive Behavioral Therapy…but it isn’t?”

Pretty much. There are a number of great books on it, including Calming the Emotional Storm: Using Dialectical Behavior Therapy Skills to Manage Your Emotions and Balance Your LifeDBT Made Simple: A Step-by-Step Guide to Dialectical Behavior Therapy, the DBT Skills Training Manual, Doing Dialectical Behavior Therapy: A Practical Guide (Guides to Individualized Evidence-Based Treatment)Dialectical Behavior Therapy for Binge Eating and Bulimia, and, as a clear winner for the longest title on the planet, The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance. 

But before you run out and buy those, I invited a friend of mine to tell you all about DBT and illustrate some key concepts for you. Welcome to the world of Dialectical Behavioral Therapy....  continue reading