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In many cases, grief occurs when someone has already suffered a loss. But grief can also result from a loss that is impending but hasn’t yet occurred. When this happens, it’s referred to as “anticipatory grief” or “preparatory grief.” Anticipatory grief commonly affects individuals who are expecting to lose someone or something important in […]
In many cases, grief occurs when someone has already suffered a loss. But grief can also result from a loss that is impending but hasn’t yet occurred. When this happens, it’s referred to as “anticipatory grief” or “preparatory grief.”
Anticipatory grief commonly affects individuals who are expecting to lose someone or something important in the near future. For example, you may experience anticipatory grief if:
Like the other types of grief, anticipatory grief can lead to sadness, irritability, anger, anxiety, fear, guilt, and other intense emotions. However, it’s important to remember that anticipatory grief can also serve a beneficial purpose—it can motivate you to address unresolved issues and process your thoughts and feelings before the event in question occurs.
If you think you may be experiencing anticipatory grief, we invite you to schedule an appointment with one of the skilled therapists on our team. We’re highly experienced in treating the many forms of grief, and we’ll provide you with the tools and tips you need to move forward with your life. Contact us today.
“Double depression” – What is it and how is it treated? Double depression, as the name implies, is a complex interplay between two distinct forms of depression: Major Depressive Disorder (MDD) and Persistent Depressive Disorder (Dysthymia). It represents a challenging clinical scenario where the acute symptoms of MDD are superimposed on the enduring low-grade depressive […]
“Double depression” – What is it and how is it treated?
Double depression, as the name implies, is a complex interplay between two distinct forms of depression: Major Depressive Disorder (MDD) and Persistent Depressive Disorder (Dysthymia). It represents a challenging clinical scenario where the acute symptoms of MDD are superimposed on the enduring low-grade depressive state of Dysthymia.
Identifying Double Depression:
One of the key challenges in addressing double depression is recognizing it. The chronic nature of Dysthymia may lead individuals to believe that their low mood is “normal” for them, making it difficult to discern the acute exacerbation of MDD. Therefore, a comprehensive evaluation is essential for an accurate diagnosis.
Impact on Daily Life and Functioning:
Double depression can significantly impair an individual’s daily functioning and overall quality of life. The persistent low-grade symptoms of Dysthymia can create a baseline of dissatisfaction and hinder the individual’s ability to experience joy or motivation. When the acute symptoms of MDD emerge, they compound the distress and dysfunction.
Challenges in Diagnosis and Treatment:
Diagnosing double depression requires a keen understanding of both MDD and Dysthymia, as well as the ability to differentiate them from other mood disorders. The treatment approach must be equally sophisticated, addressing the acute symptoms of MDD while also targeting the underlying dysthymic features.
Treatment for Double Depression
Effectively managing double depression necessitates a comprehensive and integrated approach:
1. Comprehensive Evaluation and Diagnosis:
Accurate diagnosis is the foundation of effective treatment. A mental health professional will conduct a thorough assessment to determine the severity of both MDD and dysthymic symptoms. This evaluation enables the development of a tailored treatment plan.
2. Combining Treatments for MDD and Dysthymia:
Double depression demands a multifaceted treatment strategy. To address the acute symptoms of MDD, antidepressant medications may be prescribed. These medications aim to provide relief from intense sadness, hopelessness, and other acute symptoms.
Simultaneously, psychotherapy plays a pivotal role in managing both components of double depression. Cognitive-Behavioral Therapy (CBT) can help individuals reframe negative thought patterns and behaviors associated with MDD. It also equips them with practical tools to navigate the enduring low mood of Dysthymia.
3. Long-Term Management and Relapse Prevention:
Managing double depression is not a short-term endeavor. Even when the acute symptoms of MDD improve, ongoing therapy and medication management may be necessary to prevent relapse. Maintenance treatment can help individuals sustain their progress and lead fulfilling lives despite the challenges posed by double depression.
In conclusion, the landscape of depressive disorders is diverse, with each type requiring its unique approach to assessment and treatment. Understanding the nuances of these conditions empowers mental health professionals to offer personalized care that maximizes the chances of recovery and improved well-being. Double depression, while complex, can be effectively managed through a comprehensive strategy that addresses both acute and chronic aspects, offering individuals hope and a path toward a brighter future.
-Claudia Coxx, LMSW
Claudia Coxx is a clinical therapist at Marsh Psychology Group specializing in mood and anxiety disorders. She can be reached at 248-860-2024 or ccoxx@marshpsychologygroup.com.
At Marsh Psychology Group, we understand that anxiety can be overwhelming. We also believe that you have the strength to conquer it. Our dedicated team of experienced anxiety therapists is here to guide you on a journey towards a more peaceful and fulfilling life. What is Anxiety? Anxiety is a common and natural response to […]
At Marsh Psychology Group, we understand that anxiety can be overwhelming. We also believe that you have the strength to conquer it. Our dedicated team of experienced anxiety therapists is here to guide you on a journey towards a more peaceful and fulfilling life.
Anxiety is a common and natural response to stress, but when it becomes unmanageable and starts affecting your daily life, it’s time to seek help. Our anxiety therapists are trained to recognize the nuances of anxiety, helping you understand its underlying causes and triggers.
Marsh Psychology Group serves as your partner in conquering anxiety. We provide a safe and empathetic space for you to express your concerns and fears. Our experienced anxiety therapists will work with you to develop personalized treatment plans that cater to your unique needs.
Therapy is a powerful tool for managing and overcoming anxiety. Our anxiety therapists use evidence-based approaches to equip you with practical strategies for coping with anxious thoughts and feelings. You’ll learn to regain control over your life and build resilience against future challenges.
There’s no one-size-fits-all solution for anxiety. Our anxiety therapists customize each treatment plan to ensure it aligns with your goals and preferences.
Don’t let anxiety hold you back from living your best life. Our anxiety therapists at Marsh Psychology Group are ready to help you understand and conquer your anxiety. Take the first step towards a brighter future and contact us today. Your journey to a more peaceful and fulfilling life starts here.
If you have any further questions or would like to schedule an appointment with an anxiety therapist, please reach out to us. We’re here to support you every step of the way.
Part I: Understanding Different Types of Depression and How They Are Treated
Depression is something many of us have heard about, and it’s more common than you might think. But did you know that there are different types of depression, each with its own features and ways of being treated? In this article, we’ll explore these various types.
Types of Depression:
1. Major Depressive Disorder (MDD):
This is what often comes to mind when we think of depression. It’s when someone feels intensely sad, loses interest in things they used to enjoy, struggles with sleep and eating, and often feels worthless. It is not merely a fleeting case of the blues but a pervasive and often debilitating condition.
Individuals with MDD may find it challenging to engage in their daily lives, affecting their work, relationships, and overall quality of life. Treatment for MDD typically involves a combination of psychotherapy and pharmacotherapy.
2. Persistent Depressive Disorder (Dysthymia):
Persistent Depressive Disorder, also known as Dysthymia, presents a different facet of depression. Unlike the acute onset of MDD, Dysthymia is characterized by a chronic, low-grade depressive state that persists for at least two years. It may not be as severe as MDD, but its chronicity can lead to substantial impairment in daily functioning and a pervasive sense of dissatisfaction.
3. Seasonal Affective Disorder (SAD):
Seasonal Affective Disorder, or SAD, exhibits a unique pattern of depressive symptoms that occur seasonally, often during the winter months when there is reduced exposure to natural sunlight. This condition underscores the influence of environmental factors on mood regulation.
Comprehensive Therapeutic Approaches:
1. Psychotherapy:
Psychotherapy remains a cornerstone in the treatment of depression across its various forms. Its flexibility allows therapists to tailor interventions to the individual’s specific needs.
– Cognitive-Behavioral Therapy (CBT): CBT is an evidence-based approach that focuses on identifying and challenging negative thought patterns and behaviors. It equips individuals with practical coping strategies and skills to manage depressive symptoms effectively.
– Interpersonal Therapy (IPT): IPT concentrates on improving interpersonal relationships and communication. It helps individuals identify and address conflicts or difficulties in their interactions with others, which may contribute to their depressive symptoms.
– Dialectical Behavior Therapy (DBT): DBT is particularly beneficial for individuals with mood disorders and emotional dysregulation. It emphasizes mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance.
2. Pharmacotherapy:
Antidepressant medications play a crucial role in managing depression, especially in cases where symptoms are severe or significantly impacting an individual’s functioning.
– Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs are a class of antidepressants that increase the availability of serotonin in the brain. They are often considered a first-line treatment due to their effectiveness and relatively mild side effects.
– Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): SNRIs, like SSRIs, affect neurotransmitters in the brain and are another option for individuals with depression.
– Atypical Antidepressants: This category includes medications with diverse mechanisms of action. They may be prescribed when other antidepressants are not effective or cause intolerable side effects.
3. Lifestyle Modifications:
Encouraging individuals to make positive lifestyle changes can significantly impact their experience of depression.
– Exercise: Regular physical activity has been shown to release endorphins, which are natural mood lifters. Exercise also promotes overall well-being and can help alleviate depressive symptoms.
– Diet and Nutrition: A balanced diet rich in essential nutrients is crucial for optimal brain function. Omega-3 fatty acids, found in fish and certain nuts, have been associated with improved mood.
– Sleep Hygiene: Maintaining a consistent sleep schedule and creating a conducive sleep environment can help prevent sleep disturbances associated with depression.
4. Alternative Therapies:
While not typically considered primary treatments, some individuals find relief from depression through alternative and complementary therapies.
– Mindfulness Meditation: Mindfulness practices, such as meditation and deep breathing exercises, can help individuals manage stress and improve emotional regulation.
– Acupuncture: Some people report reduced depressive symptoms with acupuncture, although its effectiveness varies from person to person.
– Herbal Supplements: Certain herbal supplements, such as St. John’s Wort, have been studied for their potential antidepressant effects. However, it’s essential to use caution and consult with a healthcare provider before trying any herbal remedies, as they may interact with other medications.
– Light Therapy: Light therapy, or phototherapy, involves exposure to a bright light source that replicates natural sunlight. This therapy is particularly effective in mitigating the symptoms of SAD and restoring a more stable mood.
In conclusion, depression is a very real and treatable ailment. Often it requires a combination of the above approaches. Consulting with a mental health care provider is the first step toward healing.
– Claudia Coxx, LMSW
Claudia Coxx , LMSW is a clinical therapist at Marsh Psychology Group. She can be reached at 248-860-2024, ccoxx@marshpsychologygroup.com or https://marshpsychologygroup.com/claudia-coxx-lmsw/.
Depression and Anxiety treatment- DBT
Dialectical Behavior Therapy (DBT) is a form of cognitive-behavioral treatment developed by Marsha M. Linehan, initially aimed at treating individuals with borderline personality disorder. It has, however, proven effective for treating a range of other conditions, notably depression and anxiety.
DBT incorporates the standard cognitive-behavioral techniques for emotion regulation and reality testing while integrating new strategies like mindfulness, acceptance, and focusing on dialectics – the process of finding balance, avoiding extremes, and synthesizing opposite concepts. These components collectively make DBT an innovative and comprehensive approach towards managing depression and anxiety.
Acceptance:
In terms of depression, DBT focuses on the acceptance and change dialectic. The goal is to help patients accept their experiences and feelings while working to change their negative thought patterns and behaviors. By doing so, they can break free from the cycle of depression. DBT provides tools to manage painful emotions and decrease conflict in relationships, elements often associated with depressive disorders.
Emotional Regulation:
DBT’s emphasis on emotional regulation is particularly useful in dealing with anxiety. Techniques such as mindfulness help patients focus on the present, alleviating worries about the future. Anxiety often stems from an overactive fight-or-flight response, and DBT aids in calming this response, allowing individuals to better manage their reactions to stressors.
Treatment:
A typical DBT treatment for depression and anxiety involves individual therapy, group skills training, phone coaching, and therapist consultation. The group skills training is essential as it teaches behavioral skills in four modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
Mindfulness:
Mindfulness, the core skill, teaches individuals to be fully present in the moment, thereby helping to manage depressive rumination and anxious preoccupation. Distress tolerance equips individuals with crisis survival strategies and the ability to accept and tolerate distress. Emotion regulation focuses on identifying and managing emotional reactions – an essential skill for anyone battling depression or anxiety. Interpersonal effectiveness helps patients navigate relationships and social situations, which can often be a source of stress and trigger for depressive or anxious episodes.
DBT’s effectiveness for treating depression and anxiety is backed by multiple scientific studies. In these studies, DBT has consistently shown to reduce symptoms of depression and anxiety, improve emotional regulation, and enhance overall quality of life.
While the journey to recovery can be challenging, DBT equips individuals with the tools and strategies to navigate their path. It’s a comprehensive, evidence-based therapy that brings hope to those struggling with depression and anxiety. This therapeutic approach helps individuals find balance, improve emotional resilience, and ultimately lead a life worth living.
Sincerely,
Claudia Coxx, MSW, LMSW
248-860-2024 Ext. 505
Office Hours: Tu 3p-6p, W-Th 11a-7p; Fri 11a-5p; Sat 10a-1p
EMDR Phases 5-8 Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach that works to reduce distressing emotions which are linked to traumatic memories. EMDR treats mental health conditions, often anxiety, depression or other symptoms, which occur because of those memories we have stored from traumaticevents. In my […]
EMDR Phases 5-8
Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach that works to reduce distressing emotions which are linked to traumatic memories. EMDR treats mental health conditions, often anxiety, depression or other symptoms, which occur because of those memories we have stored from traumaticevents.
In my first and second articles on the phases of EMDR we looked at Phases 1&2-Client History/Treatment Planning and Preparation and then we explored phases 3&4-Assessment and Desensitization.
If you would like to read the articles on phases 1&2 and 3&4, please find them on the Marsh Psychology Group website, https://marshpsychologygroup.com/blog/
We will now look at Phases 5-8.
Phase 5: Installation. Once the desensitization therapy sessions are complete, the client will likely feel more positive about the memory. Clients often report they feel the memory is farther away or it just isn’t upsetting anymore. In theinstallation phase these positive emotions and thoughts are “installed.”
In this phase, the client connects and strengthens a positive belief with the target event until it feels completely true. This is done by having the client focus on the positive belief or thought while continuing with bilateral stimulation. The primary objective is to create positive cognitions and associations with the memory.
Phase 6: Body Scan: During the body scan, the client is asked to hold in mind the target event and the positive belief while scanning the body from head to toe. If there are any lingering negative emotions or thoughts, the therapist will ask the client to focus on those sensations while continuing with bilateral stimulation. The goal is to help the client become more aware of their body and any emotions or thoughts affecting them.
The next and last two phases ensure safety for the client both at the end of the current session and at the beginning of the next session.
Phase 7: Closure: Every session of reprocessing ends with the seventh phase, closure, in which the client is assisted to return to a state of calm in the present moment. This phase occurs whether the reprocessing is complete or not. Reprocessing of an event is complete when the client feels neutral about it andreports a disturbance level of zero, and the positive belief feels completely true. The body is also completely clear of disturbance.
Phase 8: Reevaluation: Reevaluation is how each new session begins after reprocessing. The client and therapist discuss recently processed memories to ensure that distress is still low, and that the positive cognition is still strong. If that is true, the client and therapist will move back to the assessment phase to begin working on the next memory.
If you have experienced trauma of any kind and feel you could benefit from EMDR to reduce symptoms and to improve quality of life, feel free to reach out to me at Marsh Psychology Group.
Carol Van Kampen, LMSW is an individual private practice psychotherapist who specializes in anxiety, depression, grief, and trauma treatment at Marsh Psychology Group. Carol is EMDR trained. Contact her at marshpsychologygroup.com
cvankampen@marshpsychologygroup.com
” https://marshpsychologygroup.com/carol-van-kampen-lmsw/
Resources: https://www.emdria.org/public-resources/the-eight-phases-of-emdr-therapy/
Navigating the Delicate Terrain: Things to Say to Someone Going Through a Mental Health Crisis As a licensed social worker, I understand the importance of offering support and guidance to individuals facing a mental health crisis. When interacting with someone experiencing such a crisis, it is crucial to remain empathetic, compassionate, and patient. […]
Navigating the Delicate Terrain: Things to Say to Someone Going Through a Mental Health Crisis
As a licensed social worker, I understand the importance of offering support and guidance to individuals facing a mental health crisis. When interacting with someone experiencing such a crisis, it is crucial to remain empathetic, compassionate, and patient. Here are some key phrases and ideas to help you provide support and reassurance during these difficult moments.
1. “I’m here for you.”
Let the person know that they are not alone. Express your availability, both physically and emotionally, to provide support. This simple statement can be incredibly powerful in assuring someone that they have a shoulder to lean on and someone to listen to their concerns.
2. “I care about you.”
Sometimes people going through a mental health crisis might feel as if nobody cares or understands their pain. Letting the individual know that you genuinely care about their well-being helps create a sense of safety and trust. This statement provides reassurance that they are valued and not alone in their struggles.
3. “It’s okay to feel this way.”
Validate their emotions by acknowledging that it is normal to experience feelings of distress, anger, sadness, or fear during a crisis. Avoid attempting to dismiss or minimize their emotions. Instead, show acceptance of their feelings, emphasizing that it is a natural part of the healing.
4. “You don’t have to go through this alone.”
Encourage the person to seek professional help. As a supportive friend or family member, there is only so much you can do. A mental health professional is trained to provide appropriate coping strategies, therapy, and, if needed, medication management. Encourage them to reach out for help and let them know you will support them in finding the appropriate resources.
5. “Take your time.”
In a mental health crisis, it is essential to give the person the time and space they need to process their emotions. Avoid pressuring them to “snap out of it” or “get over it.” Instead, emphasize that healing is a journey that takes time and patience.
6. “What can I do to help?”
Offer specific forms of assistance that might alleviate some of the burden they are facing. This could include helping with daily tasks, offering to find mental health resources, or simply being there to listen. By asking how you can help, you are giving the person a sense of control and agency in their situation.
7. “You’re not a burden.”
When someone is going through a mental health crisis, they may feel guilty or believe they are causing trouble for those around them. Reassure them that their feelings and experiences are not a burden on you or anyone else. Emphasize that you are there to help and support them in their journey towards healing.
8. “You are strong and resilient.”
Remind the person of their inner strength and resilience. This can help foster a sense of hope and confidence that they can overcome their current challenges. Share examples of times when they have faced adversity and emerged stronger.
9. “You matter.”
People in crisis can often feel hopeless or like they don’t matter. Reiterate the importance of their life and existence, emphasizing their unique qualities and the positive impact they have on others.
Approaching someone going through a mental health crisis requires empathy, patience, and compassion. Keep these phrases in mind when offering support, but remember that every individual’s experience is unique. Tailor your approach to their specific needs, and most importantly, be a consistent presence in their life as they navigate the complex road to recovery.
Sincerely,
Claudia Coxx, MSW, LMSW
248-860-2024 Ext. 505
Office Hours: Tu 3p-6p, W-Th 11a-7p; Fri 11a-5p; Sat 10a-1p
Detachment When we hear the word detached, we might immediately think of the negative connotation – someone who is not engaged in their life or with the world around them, unfeeling and cold, cut off from their emotions and from others. None of that sounds particularly healthy. But learning to use detachment effectively and […]
When we hear the word detached, we might immediately think of the negative connotation – someone who is not engaged in their life or with the world around them, unfeeling and cold, cut off from their emotions and from others. None of that sounds particularly healthy. But learning to use detachment effectively and intentionally can bring about positive change.
There are infinite possibilities when it comes to situations in which detachment could be beneficial. Here are a few areas to consider:
Detachment from unhelpful thoughts
The mind is constantly doing its job – thinking. In fact, we experience 80-90,000 thoughts each day. We usually assume each of these thoughts is useful and true, but our thoughts are not facts. Often, what we think is not worth paying attention to at all.
For example, imagine you reach out to an old friend and are waiting to hear back. Your mind might start having unhelpful thoughts:
‘They probably don’t want to hear from me’
‘No one ever wants to be my friend’
‘I shouldn’t have contacted them after so long’
None of these thoughts are facts, nor are they helpful in the moment. If you allow them to continue as usual, it becomes easy to attach to them and start to believe them.
Learning to detach from our thoughts in the moment starts with being more aware of what is happening in our mind. Begin to recognize your thoughts and decide if they are helpful and truthful. If not, try observing them without putting any value on them. Try using the phrase ‘My thoughts are telling me ___’ before the thought. Remind yourself ‘that is just a thought and thoughts are not facts.’ Another strategy involves imagery. Imagine your thoughts coming and going, drifting in and out of your mind, like watching clouds drift across the sky. Meditation is also an effective way to practice detachment from thoughts because it teaches us to stop paying attention to our thoughts in the moment.
Detachment from an outcome
When we care about something, attachment is natural. If you interview for your dream job, you will likely experience strong emotions about it and focus your thoughts on how much you want the job. The more we care about something, the more we want to control the outcome. So, it can feel counterintuitive to work on detaching in these situations. While attachment is natural, it is not always helpful, because we cannot control what happens. When we try to control, or make something happen, we will inevitably face resistance when things do not work out as we hoped. Resistance makes things more difficult. If you do not get the job offer and you were attached to the idea, you will likely have a much more difficult time accepting the outcome. Using detachment, we can acknowledge how we are feeling (how desperately we want the job), while also letting go of the desire to control the outcome. This involves an intention to trust that we can handle whatever outcome we face. Focusing on trusting ourselves to cope with the things we cannot control allows us to let go of unhelpful attachment to outcome.
Detachment from a difficult situation as it is happening
What can we do when we are in the middle of a situation and our thoughts and emotions are interfering with our ability tomake sound decisions? You guessed it- detach. For example, if we are in an argument with our spouse, we will likely feel triggered in some way. Maybe our body is in fight or flight, maybe we feel anger and want to lash out, or want to shut down and give the silent treatment.
If we act on any of these impulses, we are not acting in a way that is beneficial to ourselves or the relationship. Detaching from the situation can give us time to calm our nervous system and get centered, to process our emotions, and consider how we want to respond. Communicating the need to detach and takingtime alone to reflect before continuing a discussion can lead to a much better outcome.
Detachment from codependent patterns
Many of us find ourselves in codependent patterns in our relationships. Codependency causes us to be more focused on the needs of others than on ourselves, and underneath this we believe we can control the problem (or person) – and need to in order to be safe. This is often the case in relationships with someone who has an addiction or other mental illness. When our loved one is engaging in behavior that is harmful, we want to be able to stop the behavior, and try to control it as a result. This can take on many forms, including obsessing about it, worrying, monitoring/managing the other person, changing our own behavior, and ignoring our own needs.
One of the easiest ways to step out of this pattern is through practicing detachment: shifting our beliefs to accept we cannot control another person, and it is not our job to try. The addiction recovery field has been teaching the concept of ‘detaching with love’ for decades (Beattie, 1992).
We can begin to accept the premise of detachment by learning to focus on our own needs. When you find yourself focused on the other person: – their behavior, emotions, or needs – bring focus back to yourself. Ask yourself ‘What am I feeling and why?What do I need most right now?’ Then, do something to take care of yourself based on those needs.
As with most change, this will likely feel uncomfortable at first. With practice, detaching with love and focusing on yourself will become easier.
Learning to detach with intention and purpose is a process that takes time. A trained mental health professional can provide support and guidance for adopting these concepts in a way that benefits you as an individual.
-Laura Gross, LMSW
Laura Gross is a Clinical Therapist with Marsh Psychology Group
You can contact her at:
lgross@marshpsychologygroup.com
Beattie, M. (1992). Codependent No More. Center City, Minnesota: Hazelden.
EMDR-Phases 3&4 Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach that works to reduce distressing emotions that are linked to traumatic memories. EMDR treats the mental health conditions, often anxiety, depression or other symptoms, which occur because of the memories we have stored from these traumatic […]
Eye movement desensitization and reprocessing therapy, commonly known as EMDR, is a mental health therapy approach that works to reduce distressing emotions that are linked to traumatic memories. EMDR treats the mental health conditions, often anxiety, depression or other symptoms, which occur because of the memories we have stored from these traumatic events.
In my first article on the phases of EMDR we looked at Phases 1&2-Client History/Treatment Planning and Preparation. Now we will look at Phases 3&4-Assessment and Desensitization.
Phase 3- Assessment
In phase three the client and therapist will work together to identify
the target memory that triggers emotional distress. This includes what incident caused the trauma? (Was it sexual assault, an accident, the death of a relative etc.?),and what is the most consistent image associated with the memory?
The first step is for the client to select a specific image or mental picture from the target event that best represents the memory. Then the client chooses a statement that expresses a negative self-belief associated with the event. Common negative cognitions could be statements such as, “I am helpless,” “I am worthless,” “I am unlovable,” “I am dirty,” “I am bad,” etc.
During phase three of EMDR therapy, a positive belief is also chosen to help counteract the negative emotions caused by the trauma. The client will pick a positive self-statement that he would rather believe. This statement could be “I am worthwhile/lovable/a good person/in control” or “I can succeed.”
The therapist will then ask the person to estimate how true the positive belief feels using the 1-to-7 Validity of Cognition (VOC) scale. “1” equals “completely false,” and” 7″ equals “completely true.” It is important to give a score that reflects how the person “feels,” not” thinks.”
During the Assessment Phase, the person identifies the negative emotions (fear, anger) and physical sensations (tightness in the stomach, headache) he or she associates with the target. The client also rates the level of disturbance, but uses a different scale called the Subjective Units of Disturbance (SUD) scale. This scale rates the feeling from 0 (no disturbance) to 10 (worst) and is uses this score to assess the disturbance that the client feels throughout the processing.
The goal of EMDR treatment, is for SUD scores of disturbance to decrease while the VOC scores of the positive belief to increase.
Phase 4- Desensitization
Phase four is where the processing of the memory and negative beliefs takes place. The therapist will use some form of Bilateral Stimulation (BLS) to stimulate the mind/brain to process whatever trauma is currently being held in the conscious mind. This usually involves instructing the client to follow hand movements back and forth or hold tappers in each hand.
After a number of eye movements or other form of BLS occur, the therapist will stop and ask, “What are you noticing now?” The client will comment in just a few words what they are noticing. This may be part of the memory, a feeling, or a body sensation. Most of the healing happens while the client is reviewing the memory with the BLS. The therapist will ask the client to continue by stating “Go with that”. The process then continues.
Depending upon the intensity of the response to the trauma, your therapist may adjust the length, speed and type of stimulation used to create the eye movements.
The therapist may have to “circle back” to the original memory multiple times depending on how deep or complex the trauma is, but the process remains the same. The therapist will keep asking the client to hold the memory and the belief and the feelings in mind, while also completing the BLS.
Eventually the memory will feel different. It will have less energy.
The therapist will keep offering BLS until the client is able to grade the memory at a much lower level of disturbance on the 1-10 scale, ideally at a zero –now the memory no longer bothers them. This is the goal of EMDR; to get the client from a point where the memory goes from 8 or 9 out of ten for intensity and unpleasantness, down to a 0-1 out of ten.
During reprocessing, maladaptively stored events are desensitized, integrated, and adaptively stored.
In my third and final segment of the phases of EMDR we will look at phases 5-8-Installation, Body scan and Re-evaluation.
If you have experienced trauma of any kind, and feel you could benefit from EMDR to reduce symptoms and to improve quality of life, feel free to reach out to me at Marsh Psychology Group.
Carol Van Kampen, LMSW is an individual private practice psychotherapist who specializes in anxiety, depression, grief, and trauma treatment at Marsh Psychology Group. Carol is EMDR trained. Contact her at marshpsychologygroup.com
cvankampen@marshpsychologygroup.com
” https://marshpsychologygroup.com/carol-van-kampen-lmsw/
Resources:
https://www.emdria.org/public-resources/the-eight-phases-of-emdr-therapy/
Unless you’ve been living under a proverbial rock, you no doubt are aware that inflation is the highest it’s been in decades. From gas at the pumps to food and utilities, most of us are struggling to make ends meet. And without question, this is causing massive stress. If you are feeling intense stress from […]
Unless you’ve been living under a proverbial rock, you no doubt are aware that inflation is the highest it’s been in decades. From gas at the pumps to food and utilities, most of us are struggling to make ends meet. And without question, this is causing massive stress.
If you are feeling intense stress from the impact of inflation, here are some things you can do:
Be Honest
One of the worst things you can do when feeling stress and anxiety is to pretend you’re not. Be honest with yourself and others about what you’re feeling. The old saying goes, “The squeaky wheel gets the oil.” Ignoring your feelings or pretending they aren’t there will only make them louder and louder.
Get Your Mind Off of Things
Equally important as being honest about your stress is not obsessing over it. You really need to unplug from the stress of the economy and distract yourself with something. Mindless activities are actually a great way to quiet those stressful thoughts. Go for a run. Clean your kitchen. Watch an old movie. Whenever the anxiety begins to creep up, stop and do an activity that will calm you.
Find Joy
It’s important to step back and recognize that no matter how crazy the world gets and no matter how stressed we are, there is still plenty of joy all around us. On our darkest days, the sun still shines. Make sure to spend time each day noticing all of those small things that bring joy and happiness into your life. The perfect latte. A sunset. Your child’s laughter. Be thankful for each and every one of these. Gratitude is the great elixir of stress and sadness.
These are just a few ways you can cope with the stress of inflation. You may also want to speak to someone if your stress turns into unmanageable anxiety or depression. If you’d like to explore treatment options, please reach out to me.
SOURCES:
https://www.huffpost.com/entry/inflation-stress-anxiety-mental-health_l_62d958ade4b0aad58d18015b
https://www.betterhelp.com/advice/general/how-to-prepare-for-inflation-coping-with-financial-stress/
https://www.cnbc.com/2022/05/18/rising-inflation-has-made-people-feel-anxious-here-are-ways-to-cope.html