Cognitive Behavioural Therapy Delivers Relief

A substantial evidence base supports the efficacy of problem-specific cognitive-behavioral interventions for a variety of childhood and adolescent anxiety and depressive disorders. Unlike other psychotherapeutic techniques that have been applied to these disorders, CBT is consistent with a perspective that values empirically supported problem-focused treatments. CBT presents a logical theoretical framework to guide practitioners through assessment of specific problem domains, the delivery of problem-specific treatment interventions, and well specified outcomes to monitor treatment progress. However, CBT is not simplistic. Helping children, adolescents, and parents make rapid and difficult behaviour change over short time intervals [three to six months] requires considerable expertise and training.

“Cognitive-Behavioral Psychotherapy for Anxiety and Depressive Disorders in Children and Adolescents: An Evidence-Based Medicine Review”                  SCOTT N. COMPTON, PH.D., JOHN S. MARCH, M.D., M.P.H., DAVID BRENT, M.D., ANNE MARIE ALBANO, PH.D., V. ROBIN WEERSING, PH.D., AND JOHN CURRY, PH.D.                                                                                                                        J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY, 43:8, AUGUST 2004

For more information about anxiety and depression visit the Anxiety and Depression Association of America ADAA website

www.adaa.org/understanding-anxiety

To find out more about our professional counselling and support services in Durham Region or to schedule an initial assessment  Contact us today!

I Throw Up Almost Every Time I Eat – What Can I Do?

This post is primarily a compilation of negative thoughts about eating, body image, binging and purging shared by many who are/were struggling with disordered eating behaviours.

The way ‘It’ see’s eating

Imagine… every time you bring a mouthful of food to your mouth… hearing the following echoing with every chomp, swish and swallow. Even after it goes down the constant ringing of the voice always saying…

*************

“you pig, why would you do that”

“oh look who messed up again, shocker”

“Oh really another candy bar, well you’re already FAT… go ahead eat it fat ass”

“have another, it won’t do any more damage than you’ve already done, you’re going to throw it up anyways”

“wait where are you going to throw up so no one knows/will hear”

“do you have perfume/gum nearby so no one can smell the vomit on you after”

“I’m so proud of you for figuring out which finger works best”

“don’t you dare get it on your clothing, people would be disgusted with you and your gross throwing up”

“ahh see there you go, now you don’t have to feel guilty for eating now that it’s all out of your system… but aren’t you a little hungry again, maybe go have some more to eat, just do it again… it was easy the first time”

“okay so you’ve already done it twice today… just do it once more, then that’ll be the last one”

“if they keep asking why you go to the washroom after every meal just blame it on PMS, depression or something”

“okay so if I go do it on my lunch break that’ll leave me 5 minutes after eating, and I’ll go to the far washroom that no one ever goes to that way no one will hear me”

“you better hurry and do it quick, you know the longer it stays in you the more you’ll absorb, god forbid you need any more layers of fat on you”

“my favorite thing to throw up after anything I eat is ice cream, it comes up nice and smooth”

“think, if you do this for just a few more weeks you’ll be able to fit in and actually look normal”

“who cares if people want you to stop, it’s your body not theirs, you’re doing no harm to them, why are they being so selfish, let me make my own decisions”

“never give up on doing this, or you’ll never be worth anything”      

*************

… pretty serious things to be hearing ‘It’ or that negative voice constantly tell you. Most people eat three meals a day with a few snacks and barely consciously think about what they consume. To someone with bulimia, it comes down to the moment the food touches your lips you start calculating how fast, where and how you can go unnoticed when getting it out. Crazy how ‘It‘ makes it seem like without the bulimia you’d be nothing.

If you or someone you love struggling with an eating disorder or even if you feel you have disordered eating patterns, I encourage you to find a therapist to assist you with your recovery / change process. For more information  Contact us today!

 

Photo credit 1: anatheme from morguefile.com
Photo credit 2: taylorschlades from morguefile.com

Do You Feel You’re Not Getting Anywhere?

How often do we feel frustrated and alone, like no matter what we try life doesn’t seem to get any better. We might change this or that behaviour, for at least a short while, only to end up back in the same situation. We can gradually or not so gradually get more down, hopeless and tried as we seem to return to the same ‘rut’. I heard once the only difference between a rut and a grave is the depth?

The poem below, written by Portia Nelson, conveys these very sentiments and walks the reader through five ‘chapters’ in order to signal a flicker of hope somewhere on the road of life.

There’s a Hole in My Sidewalk (five chapters)

                     1

“I walk down the street.
There is a deep hole in the sidewalk.
I fall in.
I am lost… I am helpless.
It isn’t my fault.
It takes forever to find a way out.

2

I walk down the same street.
There is a deep hole in the sidewalk.
I pretend I don’t see it.
I fall in again.
I can’t believe I am in the same place.
But, it isn’t my fault.
It still takes me a long time to get out.

3

I walk down the same street.
There is a deep hole in the sidewalk.
I see it is there.
I still fall in. It’s a habit.
My eyes are open.
I know where I am.
It is my fault. I get out immediately.

4

I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it.

5

I walk down another street.”
Portia Nelson, There’s a Hole in My Sidewalk: The Romance of Self-Discovery

I think most of us want to believe we can change, that things will improve, and that one day we will reach that illusive better place? While there are certainly no guarantees and we really don’t know anything for sure about the future, what is life without hope? How do we, in the face of severe difficulties, loss, pain and grief, manage to hold onto hope? What can we do to regain a sense of hope we may have one had?

These and other questions strike a nerve in our spiritual being. Who am I? Why be good to myself and others? What does the end of life really mean? Almost all people will contemplate questions like these, pondering issues that do not seem to be answerable by science; at least not yet anyway. This is both a frustrating and exciting element of human life. This is where faith and one’s belief system becomes essential. Our task is to examine our hearts and minds, our emotional selves and seek to discover an improved understanding of ourselves and the amazingly contradictory world we live in.

A journey that doesn’t include the unknown is not really much of a journey at all. Imagine a trip with no surprises, no unexpected discoveries, whether this is an actual holiday or the challenging journey in a close relationship. As we said to our children in preparation for our adventures, “let’s find a way to look forward to and enjoy the journey”.   Rather than being a burden, this attitude seemed to improve our ‘getting along’ and each leg of the trip a more enjoyable and exciting adventure.

Cognitive shifting can help us see situations a bit more positively and in a way that helps us achieve a more balanced emotional state. We can change our thought patterns about almost any event or situation when we are determined to stop falling into the holes in the sidewalk.

 

 

Photo credit 1: willybearden from morguefile.com
Photo credit 2: quicksandala from morguefile.com
Oshawa therapist, durham region counseling

ALIENATION WATCH – THE LESSER SPOTTED ALIENATION AWARE PROFESSIONAL

Posted on 14/11/2014 by karenwoodall

This week I have been confronted with the dearth of alienation awareness and expertise in the UK field of family services. This is not a surprise to me but what has been surprising if not alarming is the emergence of a new type of professional, the lesser spotted professional if you like (it is coming up to the weekend, humour me).

This lesser spotted professional is someone who for the sake of a few hours training could be the alienation aware professional who knows what to do and how to do it. That this person remains ignorant, not only of what they don’t know but what they do know, is both astounding and terrifying to me in equal measure. This week, on wading through yet another case file, I became aware that the case, which has been bouncing back and forth twixt professionals in public and private law, was actually beautifully described in a section 7 report some SIX YEARS ago. The problem is that the social worker, who wrote so eloquently about the child’s campaign of dislike and hatred, the fused indignation of the child and parent, the furious and unrelenting denigration of the rejected parent, had not the first idea of what she was looking at. And so, concluded, in a pitiful and damning ending to her sixty page description of a severe case of alienation that, the child is the subject of a contact dispute in which both parents are to blame and the child should be left with the preferred parent with no contact now or in the future to the parent rejected by the child. Grim reading. Parentectomy due to lack of awareness of the professional charged with analysis. Little wonder parents in the UK go mad, get bad or simply end their lives because of the intolerable ineptitude of the people charged with safeguarding our children.

The question for me is why do our family services know so little about Parental Alienation and, when they do know something about it, (which clearly the author of this report does, she described it so perfectly) why do they not want to find out more about it. Why, for example, did this social worker, on hearing a child say ‘I wish he would just die’ and ‘I would kill him if I could’ not consider that to be concerning? Why, when a child says that her father should be ‘shot and thrown into the river’ does a social worker not decide that this requires further examination? Why do social workers and other family workers not realise, when they see a child who is utterly determined to uphold the aligned parent’s perspective – to the point of delusion – go on to conclude that this is just a contact dispute. What sort of mind block prevents professionals in family services from understanding the reality for alienated children? Politics? Discriminatory practice? Or simple ‘he said/she said’ fatigue? Whatever it is it is causing our children to become stuck in the most appalling circumstances within the court process, subjected over and over again to professionals who are well meaning but unskilled in the field and to a flimsy court management process which aids and abets institutionalised abuse of children which frankly appalls me.

Parental Alienation is NOT a simple contact dispute, it is, in severe cases, child abuse, nothing more nothing less. In less severe cases, hybrids perhaps or those which are created by naive alienators, it is all too easy for it to trip into child abuse and should always be approached as a case where children are at risk.

And lest you think this is just an all out attack on family support services, let me tell you that I have worked in cases where social workers and CAFCASS officers have approached the problem as a child protection issue. Where those people have really ‘got it’ from the outset and we have worked together to tackle the problem immediately and systemically, bringing change for child rapidly and effectively. Those people are like gold dust (you know who you are) and I salute each and every one of them for there are, in this country, some brave and fearless people who make a massive difference. If only there were more.

The reason there are not more of these people is perhaps answered in the arguments which are raging between parents and state services up and down this land of ours. From the islands to the highlands from the borders to the metropolis, parents are campaigning to have Parental Alienation recognized by the people who serve our families. Pleas which are falling on deaf ears mostly and which receive dismissals and derisory commentary from those who profess to be in the know and who are most certainly in power. How and why is alienation ignored is the question being asked, when is the question I am asking, when will family services recognize the problem of children who are stuck with an angry, vengeful and determinedly alienating parent is not just a contact dispute but a case of child abuse which must be stopped.

That question is one which rattles around my brain as I read through the teeth grindingly painful accounts of social work interactions with families where alienation is alive and kicking. When social workers describe a child who has been ‘spousified’ and who is being used as a confidant and a replacement partner but see nothing to be concerned about in that. When social workers listen to children parroting angry words and untruths about a parent they think deserves to be kicked out forever and hear nothing wrong in that. And when social workers speak only of contact disputes instead of child abuse in the face of those things , the answer to the question appears to be never.

The problem in my view lies in the institutionalised acceptance of disposable parenthood and the notion that family separation is normal and simply something that causes a bit of an upheaval for a while but everyone gets over it eventually. Far from getting over it however, there is a significant cohort of people for whom getting over is not possible and for whom an alternative reality is revenge, cold blooded or otherwise or a definite and distinct unhingement from normal behaviors. And the truth is that everyone goes a little bit mad when they separate. It is after all a most unpleasant and terrifying experience. What everyone doesn’t do however, is hook their children up to their revenge making machine and drop them hook line and sinker into the shittiest parts of adult rage. Most reasonably healthy adults know that this stuff is not for their children. Most people, however mad they go, manage not to take their children with them.

But a significant number of people do and this is where being able to understand this group and differentiate them from the rest of the general family separation cohort is vital for family services. In this group are people with personality disorders, people with rage problems and people with enmeshment and other issues that cause an inability to tell the difference between their own feelings and those of their children. It would seem like basic social work practice to me to be able to recognize those people but judging by the reactions of social workers when confronted with them and by their behaviours, it is easier to not see the reality than see it, name it and deal with it.

And perhaps that last sentence says it all because dealing with it appears to be beyond the capability not only of those who support the family but those who assess the family and those who make judgements in family courts. Clearly recognizing problems is one thing but doing something about it is quite another, perhaps it is this which leads social workers and other family professionals to act like the three wise monkeys when they are confronted with parental alienation, if they see it and hear it but manage not to speak of it, will anyone notice or even really care (apart from the rejected parent who can so easily be picked off with the accusation that they are simply an aggrieved parent who did not get what they wanted in court).

Which leaves us with a generation of children and their families who have been torn apart by parental alienation, who have turned to the courts for assistance and found none and for whom the future looks very bleak indeed.

And all for the sake of a few hours training, a willingness to act and a family court system with enough guts to protect children who are being abused.

The only condition required for evil to flourish is that good people do nothing.

And too many good people, lesser spotted or otherwise are doing nothing at all.

(All readers should note that I am bound by the code of ethics for Experts in the Family Courts as well as by the code of ethics for counselling and psychotherapy. As such each and every case study or reference that I make to my work is heavily disguised to ensure that I do not reveal any of the details of cases I am working on past and present or that any family member with whom I work or professional with whom I am working, could recognize themselves or each other on this blog. As such, my writing refers to real life work but the cases are a patchwork of different elements of cases that I may have or may be working on. I take my responsibilities seriously in the Family Courts, however much I may criticize them and I also take my work as therapist equally seriously. At all times I balance the act of writing and speaking out with my absolute commitment to the rights of families for a fair, just and confidential service. I write because I consider it my duty to raise awareness of alienation and the way in which it is not recognized by family services. Where I see best practice I acknowledge it as I have in this article. I am working for better outcomes for alienated children and their families at all times).

Find more about parental alienation work from Karen’s view at https://karenwoodall.wordpress.com/author/karenwoodall/

Photo credit: quicksandala from morguefile.com

One Young Woman’s Journey Toward Change

There was a time in my life when I was feeling stuck and needed something new. I hated my job, I felt unfulfilled and completely unmotivated to do anything. Then I went to a fundraiser and met a yoga teacher who was promoting her studio and her energy and happiness was palpable! Now let me clarify, at this time I tolerated working out and I had tried yoga before and I sincerely disliked it! I thought for sure I would never try this again. However without thinking too much, I jumped in a class and tried it. My life transformed and I have found myself yet again.

Sometimes we need some transformation in our lives, we need to change to grow and feel again. When life feels the same everyday with no hope of growth, it can feel awful and terrifying! There were three things that this practise of yoga offered me that helped me in my transformation: physical activity, self-awareness and community. We know from several studies that physical activity (and yes this is a very physical practise of yoga!) can prevent physical diseases such as cardiovascular disease, diabetes, cancer, hypertension, obesity and osteoporosis (Warburton, Nichol & Bredin, 2006). However physical exercise and yoga in particular can also help with mental health issues related to self-esteem, mental fatigue, feelings of depression and anxiety (Taspinari, Bas Aslan, Agbuga and Taspinar, 2014). Not only was I now working out to improve my physical and mental health, but now because it was an exercise I connected with and enjoyed, it really helped me in a more meaningful way.

Opportunities for self-awareness are also built into this practise and in this studio. There are so many opportunities to learn about yourself and what you want! Besides the amazing self-awareness workshops available, the practise itself is meditative and helps you look at how you think, behave and feel in your life. With the yoga teachers’ kind words, accepting nature and words of wisdom they transform your practise from a work out to a chance for transformation.

And let’s talk about those people some more! The community of people within this studio are loving, funny, supportive, accepting and were a huge part of my ability to have the courage to transform my life. I took me a year but I was able to find my purpose again and find the courage and strength within me to transform my life. I had settled for a job that I was not happy in, felt no fulfillment in and was not in line with what I always wanted to do with my life. I have always wanted to counsel and support other people and with the support of this practise, studio and family I quit my full time job, went back to school and now have plans for my future that I’m excited about!

So in what areas of your life are you feeling stuck, lost or hopeless? How is this impacting your mental health, physical health, relationships and feelings about your future? What action will you take to take back your life and transform it? Yoga is just one method of transformation. It has worked for me and many others. The great part is that there are many other methods and journeys to transformation and growth.

There are so many things that can help people cope and regain a sense of themselves again – reading helpful books, counseling, reconnecting with friends and family, meditation or joining community groups. However, as I have always envisioned being a counselor and am now furthering my education to become a registered psychotherapist, I really believe and value the immense support and growth a therapist can help people find. A person’s struggles and journeys do not need to be handled alone. Talking with an empathetic, supportive and non-judgemental counsellor can truly change a person’s life and provide a means to transformation.

I encourage you to find your method of transformation today.  Contact us today!

 

Photo credit: Quicksandala from morguefile.com
Photo credit: Giulian from morguefile.com