EMDR Therapy
IdentityIntakeCoordinator

EMDR Therapy

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Eye Movement Desensitization and Reprocessing (EMDR) therapy is an approach to psychotherapy that was created to help people heal from symptoms of trauma and psychological distress caused by upsetting life experiences. EMDR is performed by a mental health professional like a therapist, counselor, social worker or psychologist, who has been formally trained in EMDR therapy and its techniques. At Identity Counseling Psychology, our therapy practice located in Ann Arbor, MI, we offer both traditional talk therapy for issues relating to trauma, as well as EMDR therapy as a form of treatment. IDENTITY clinician Jaymin Cox, LMSW, CAADC, specializes in trauma counseling and has been trained in EMDR therapy. Check out Jaymin’s profile to learn more, or contact us today to schedule an intake. 

What is EMDR Therapy?

EMDR stands for Eye Movement Desensitization and Reprocessing, and it’s a unique form of psychotherapy that was created to treat symptoms of trauma, although it doesn’t require patients to talk about the traumatic experiences that they’ve endured. EMDR has been highly beneficial for patients dealing with trauma and PTSD, as opening up about the surrounding events or memories tends to be a painful, slow-moving, and sometimes impossible feat.

The goal of EMDR therapy is to help patients fully process negative past experiences and sort out the feelings, memories, and triggers attached to those experiences so that they can heal in a healthy way. EMDR is an integrative style of therapy, in which practitioners use bilateral stimulation, such as eye movements, sounds, or taps, to divert the attention of patients while they recall painful or traumatic memories. Exposure to trauma in this indirect way alleviates its intensity and allows it to be worked through and addressed in a safe setting. Processing past psychological pain is an important step that makes room for healthy healing and coping moving forward.

EMDR sessions follow a specific sequence of phases, which can generally be completed within 4-8 sessions. The therapist and patient can then reevaluate whether more treatment is necessary or wanted. EMDR can be used as a stand-alone therapy or alongside other forms of treatment.

What Does EMDR Therapy Treat?

EMDR therapy is particularly effective for those who struggle to talk about their past experiences. It was originally designed to treat post traumatic stress, but EMDR can be used to address any adverse experiences or negative memories that may be impacting or leading to mental health concerns. 

Therapists have been known to use EMDR for issues like:

How Does EMDR Therapy Work?

In EMDR therapy, patients are helped to identify and work through the negative memories or experiences that cause them distress in order to make room for proper healing. There are eight phases in EMDR therapy, which consist of the following steps:

1. History and treatment planning

This phase involves the therapist and the patient reviewing the patient’s past experiences, current concerns, and future goals, as well as identifying the target memories and events that may be traumatic and need to be fully processed. 

2. Preparation

During this phase, the therapist will explain the treatment process and establish trust with the patient. The therapist will also go over coping strategies for any distress or overwhelming feelings that may arise during the treatment. Stress management and coping techniques may include things like deep breathing or mindfulness exercises.

3. Assessment

In this phase, the patient brings the target event to mind and discusses his or her associated negative thoughts, beliefs, and even physical sensations when thinking about the event. The therapist records and evaluates these observations. The therapist and patient together then pick a more positive and desirable cognition or belief related to the event. They discuss, measure and record how true the new, healthier association feels to the patient.

4. Desensitization

Desensitization is the phase where the bilateral stimulation occurs. The client thinks about the target event while the therapist administers sets of side-to-side eye movements, sounds, or taps. This stimulation diverts the client’s attention while they are simultaneously giving attention to the target memories. The therapist breaks periodically to check in on the patient and evaluate how they’re feeling. The sets of eye movements, sounds, or taps are repeated until the event feels less disturbing. 

5. Installation

This phase is used to strengthen positive and healthy replacement cognitions related to the event. The desirable beliefs and associations that were previously discussed are the target of the bilateral stimulation in this phase. The therapist again checks in with the client periodically to measure how true the healthier cognitions feel as the bilateral stimulation continues. 

6. Body scan

In this phase the therapist and the patient check in to see if the patient is now able to   bring up memories of the traumatic event without experiencing psychological distress or any negative feelings that aren’t relevant or healthy. If the patient is still not able to process the memory without experiencing unhealthy physical tension or emotional disturbances, continuation of the bilateral stimulation may be deemed necessary. 

7. Closure

Closure is a phase that occurs at the end of every session, even if the target event is not  fully processed. This is important because EMDR therapy can take several sessions to complete, and the patient must always reach stabilization before a session is over and they leave therapy, as bilateral stimulation can be overwhelming, especially at first. Reaching closure can include calming exercises, guided imagery, or discussion of the session. 

8. Reevaluation

This phase occurs at the beginning of every session, and it consists of evaluating and measuring the residual distress related to the target event that may still be in place, as well as evaluating and measuring the perceived accuracy of the new positive beliefs related to the target event. If the client is still experiencing unhealthy levels of disturbance, the session resumes with desensitization. If healthier beliefs are accepted, the patient is ready to move on. Both the patient and the therapist assess the progress that has been made. 

How IDENTITY Can Help

Identity Counseling Psychology is a psychotherapy practice in Ann Arbor, MI that specializes in counseling for issues related to trauma. Our therapists are passionate about tailoring therapy services to the individual needs of the patient, and this might include techniques like EMDR. Jaymin Cox, LMSW, CAADC offers EMDR therapy at IDENTITY, and is trained in trauma counseling and EMDR techniques. EMDR operates under the theory that disturbing memories, events, or experiences can lead to unwanted mental health symptoms, and that processing trauma is important to make room for healing. However, this is often difficult without the help of a mental health professional. If you are dealing with symptoms of trauma, but struggle to discuss or relay painful emotions, EMDR therapy might be a good fit for you. Contact us today to learn more or to schedule an appointment.

It is important to note that due to the nature of EMDR therapy and its potential for producing vivid visual imagery and/or body sensations, the clinicians at IDENTITY cannot engage in this therapy with anyone who dissociates or has a dissociative disorder at this time. If you are interested in EMDR, but are unsure if you dissociate, please talk to your therapist. All EMDR clients will be screened for dissociation prior to beginning treatment. 

Seasonal Affective Disorder
IdentityIntakeCoordinator

Seasonal Affective Disorder

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Identity Counseling Psychology is a counseling and psychotherapy practice in Ann Arbor, Michigan offering therapy services for a wide range of mental health concerns. The therapists at IDENTITY specialize in treating patients with depression and categories of depression, including seasonal affective disorder. If you live in the Ann Arbor area and are struggling with seasonal affective disorder or other forms of depression and would like to seek help, contact us today to learn more about our services and clinicians or to schedule an intake appointment. 

What Is Seasonal Affective Disorder?

Seasonal affective disorder (SAD) is a type of depression that’s affected by seasonal changes in the weather. SAD is also commonly referred to as “seasonal depression” or “winter blues” and is characterized by cyclical depressive episodes that are triggered by seasonal shifts around the same time every year. For most people with this disorder, symptoms begin in the fall and continue through the winter, leaving them with feelings like low energy and moodiness until spring. For a much smaller number of people, symptoms begin in the spring and continue through the summer. 

It’s normal to feel a bit sluggish sometimes during the winter months, and when the days become shorter, colder and darker, people tend to slow down their busy lives and spend more time inside. But for people with seasonal affective disorder, winter brings about depression-like symptoms that are significant and persistent, causing disruption in their everyday lives and impairing their ability to function normally. 

How common is seasonal affective disorder?

Throughout the United States, the prevalence of SAD varies by region. For example, states in the Northeast, where daylight hours are shorter during the winter, have much higher rates of seasonal affective disorder compared to states in the Southeast that are closer to the equator. In New Hampshire, studies have shown that SAD affects almost 10% of the population, whereas in Florida, under 1.5% of people reportedly experience SAD. Overall, seasonal affective disorder is said to impact around 6% of Americans, with women being more likely than men to experience symptoms. 

How does SAD impact mental health?

As with other forms of depression, seasonal affective disorder should be taken seriously, and it has the potential to worsen over time, leading to harmful mental health outcomes if left untreated. Mental health complications that can occur as a result of SAD include:

If you’re struggling with the symptoms of SAD, you are not alone and you don’t need to just “tough it out” or “brush it off” until the spring. SAD is a mental health disorder with diagnosable symptoms and a variety of treatment options. If SAD is impacting your life, consider reaching out to a mental health professional to help you better manage and cope with your symptoms. 

What Are the Symptoms of Seasonal Affective Disorder?

In most cases, SAD symptoms emerge during late fall, persist and worsen throughout the winter, and go away during the spring. Symptoms of seasonal affective disorder are similar to those of clinical depression, but include some common identifiers that are unique to winter SAD.

Symptoms of winter SAD often include: 

  • Changes in appetite
  • Decreased self-esteem
  • Difficulty concentrating
  • Cravings for foods high in carbohydrates
  • Fatigue
  • Feeling depressed for most of the day, nearly every day
  • Hopelessness
  • Increased irritability 
  • Loss of interest in activities that you once enjoyed
  • Oversleeping
  • Poor mood
  • Relationship problems 
  • Sense of heaviness in arms and legs
  • Sluggishness 
  • Weight gain

What is summer SAD?

Although the majority of people with seasonal affective disorder experience their symptoms in the fall and winter months, there is a small subset of people who struggle with summer SAD. Summer SAD looks a bit different, and symptoms begin in the spring and persist throughout the summer. Aside from the same depression-like symptoms that occur with winter SAD, symptoms of summer SAD tend to manifest as the following:

  • Agitation
  • Anxiety
  • Decreased appetite
  • Insomnia
  • Irritability
  • Feelings of mania

What Causes Seasonal Affective Disorder? 

The exact causes of SAD are still unknown, but researchers are able to point to several factors that likely come into play. These include:

  • Circadian rhythm – Your circadian rhythm is your body’s biological clock and it regulates important functions like sleep, energy, hormone levels, appetite and body temperature. Disruption of this clock is a known trigger of depression. Your brain keeps track of the amount of sunlight you get each day and uses this information to set your internal clock. The reduced level of sunlight in the fall and winter months can throw your body clock out of sync, leading to feelings of depression.
  • Serotonin – Reduced sunlight can also cause a drop in your levels of the neurotransmitter, serotonin. Serotonin is a chemical in your brain that affects mood, behavior, and stress response, and lowered levels of serotonin is a known cause of depression.
  • Melatonin – Melatonin is a chemical that regulates sleep patterns and mood. Reduced sunlight in the winter months can disrupt the balance of your body’s melatonin levels and impact sleep and mood, which both play a large role in depression.
  • Gender – Seasonal affective disorder is diagnosed more often in women than in men.
  • Age – Seasonal affective disorder occurs more frequently in younger adults compared to older adults.
  • Proximity to the equator – SAD is more common among people who live far from the equator due to the decreased sunlight and shorter days during the winter months.
  • Family history – Having a history of depression in your family, especially of seasonal affective disorder specifically, is known to be a risk factor for developing SAD.  

Treatment for Seasonal Affective Disorder

Below are some of the common treatments that work well for seasonal affective disorder. The treatment plan that works best for you may include more than one approach. 

Light Therapy for SAD

Light therapy, or phototherapy, is one of the first line treatments for seasonal affective disorder, and it has proven highly effective in reducing symptoms for those with winter SAD. Light therapy treatment involves exposing oneself to bright light via a special device called a light box. A light box mimics natural outdoor light, which is known to help balance the body’s circadian rhythm and increase chemicals in the brain that directly impact mood. During the fall and winter months, when the days are darker, shorter, and colder, we experience a significant reduction in our exposure to natural sunlight and thus all of its antidepressant benefits. Light therapy sessions generally last about 10-15 minutes at first, and then gradually increase depending on the severity of the symptoms. Light therapy is a popular treatment option because people generally start seeing benefits in just a few days to a few weeks, and it has few known side effects.

Research on light therapy is rather limited, and we don’t recommend purchasing a light box or beginning light therapy sessions without talking to your doctor first and making sure that light therapy is a safe and effective treatment option for you. 

Psychotherapy for SAD

Psychotherapy, or talk therapy, is another popular treatment option for seasonal affective disorder. Psychotherapy is conducted by a licensed mental health professional, like a counselor, therapist or psychologist, and consists of weekly sessions in which the therapist and the patient work together to set individualized goals and reduce the harmful impact that SAD symptoms may be having. Psychotherapy has proven to be very beneficial for people with depression, and a variety of therapeutic approaches and techniques are known to be successful in treating SAD.

Psychotherapy can help SAD patients through…

  • Cognitive Behavioral Therapy (CBT), a form of talk therapy in which patients learn to identify and change negative thought patterns and behaviors that may be making them feel worse
  • Offering healthier, more positive ways to cope with SAD symptoms
  • Reducing harmful coping mechanisms, such as avoidance behavior, through techniques like exposure therapy and setting small, attainable goals
  • Mindfulness and relaxation exercises like deep breathing and meditation that reduce distress 

Self-help tips for coping with SAD

There are some lifestyle changes that you can make on your own to help prevent and improve symptoms of SAD. Some of these include:

  • Stay active and get regular physical exercise
  • Try to spend some time outdoors each day, even on cold or cloudy days
  • Brighten your environment by opening blinds or sitting closer to windows and skylights 
  • Maintain a healthy and regular sleep schedule
  • Do not turn to alcohol or recreational drugs for relief 
  • Keep an active social life and make a conscious effort to connect with friends and loved ones when you’re feeling down 
  • Make healthy, nutritious choices for meals and snacks
  • If you can, plan trips to sunny, warm locations during the winter

How IDENTITY Can Help

Identity Counseling Psychology is a psychotherapy practice in Ann Arbor, MI that offers counseling services to adults, adolescents, children, and families. The therapists at IDENTITY specialize in treating depression and categories of depression, including seasonal affective disorder. If you live in the Ann Arbor area, and you or someone you love is suffering from symptoms of depression, contact us today to schedule an intake appointment. 

Strategies for Dealing with Social Anxiety
IdentityIntakeCoordinator

Strategies for Dealing with Social Anxiety

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Identity Counseling Psychology is a counseling and psychotherapy practice in Ann Arbor, MI that treats a variety of mental health concerns in children, teens and adults. Our team of therapists specializes in counseling for anxiety disorders including social anxiety. To learn more about our services or how therapy can help you or a loved one who’s struggling with social anxiety, contact us today. To find out more about our licensed clinicians and their specialty areas, check out our team page. 

What Is Social Anxiety?

It’s normal to feel nervous in certain social or performance situations, like how going on a first date or giving a presentation may cause butterflies in your stomach. It’s also normal to at least sometimes worry a bit too much about what others think of you. So what sets Social Anxiety Disorder, also known as Social Phobia, apart from typical nervousness? 

In social anxiety disorder, anxiety is severe and persistent, and everyday interactions cause significant feelings of fear, embarrassment and self-consciousness. Social anxiety disorder is characterized by avoidance of social and performance situations where a person might be judged, criticized or rejected, and it can be so serious that it interferes with daily routines, work, school, and important relationships.

People with social anxiety almost always experience physical symptoms, and worry about appearing visibly anxious when their anxiety is triggered. These physical symptoms might include things like blushing, stumbling over words, sweating, or rapid heart-rate, and can develop into a full-blown panic attack. People dealing with social anxiety usually know that their reactions are unreasonable, and want to control them so that they can be more social, but feel powerless against their anxiety.

Common situations that can trigger social anxiety might include:

  • Going on dates
  • Job interviews
  • Parties
  • Public speaking
  • Business meetings
  • Reading aloud in class
  • Meeting with an authority figure
  • Being the center of attention

What Are the Symptoms of Social Anxiety Disorder?

It’s important to note that everybody is different and it’s normal for comfort levels in social situations to vary depending on factors like personality and life experience. Some people are naturally more reserved and shy, especially during childhood, and this isn’t necessarily a sign of social anxiety disorder or that a child will one day develop social anxiety. On the other hand, some people are naturally more outgoing and extroverted, and these people can have social anxiety too.

Behavioral Symptoms

People with social anxiety disorder tend to have lower self-esteem and put a lot of energy into avoiding their triggers. As a result, social anxiety commonly manifests in the following behaviors:

  • Apologizing often
  • Avoiding situations where you  might be the center of attention
  • Avoiding smiling at people or making eye contact 
  • Finding excuses to leave a situation, like going to the bathroom 
  • Keeping conversations focused toward others rather than yourself
  • Leaving social situations abruptly
  • Mentally checking out of situations, or daydreaming
  • Not contributing or saying very little in conversations
  • Seeking frequent reassurance from others
  • Spending excessive amounts of time preparing for social situations
  • Trying to blend in or not draw attention to yourself
  • Using alcohol to cope in social situations 

Physical Symptoms

Physical symptoms can, and often do, accompany social anxiety. These might include:

  • Blushing
  • Dizziness
  • Fast heartbeat
  • Feeling that your mind has gone blank
  • Lightheadedness 
  • Muscle tension
  • Nausea
  • Shaky voice
  • Shortness of breath
  • Sweating
  • Trembling
  • Upset stomach

How Does Social Anxiety Affect You? 

Social anxiety disorder, when left untreated, can significantly impact your life. Social anxiety symptoms tend to be very disruptive and can interfere with daily routines, performance at work or school, and interpersonal relationships. Social anxiety also has negative mental health consequences, as people with the disorder are at an increased risk for developing clinical depression and substance use disorders.

Harmful effects of social anxiety can include:

Self-Help Strategies for Dealing with Social Anxiety

Although social anxiety disorder generally requires help from a mental health professional like a therapist or counselor, there are some strategies that you can employ on your own to reduce symptoms, improve coping abilities, and overcome personal hurdles. Treatment isn’t always available or affordable, and if you or someone you love is struggling with social anxiety, we recommend the following self-help strategies to deal with social anxiety disorder in a healthy and effective way. 

Ask for Help with Getting Help

Sometimes, having social anxiety can make it especially difficult to seek professional help. Reaching out to strangers can be very tough for someone with social anxiety, but there are ways around this. Fear shouldn’t stop you from getting the help that you deserve for your mental health needs. If your social anxiety is keeping you from starting counseling, we recommend:

  • Asking a supportive family member or friend to contact a therapist or psychologist for you first. They can even help you set up your first appointment.
  • Writing an email to the mental health professional that you’d like to meet with instead of making a phone call. This tends to be easier for people with social anxiety. (At IDENTITY, we make it easy to write a quick online message to set up an appointment with any of our therapists through our contact page.)
  • Finding a therapist who practices online therapy. In recent years, more and more counseling practices offer online therapy. There are also apps and platforms to help you find exactly what you’re looking for in your online therapist. 

Self-Care

Self-care is always important when it comes to managing your mental health. There’s so much that you can do to care for your emotional and psychological well-being, but below we’ve narrowed down some of the best self-care strategies for social anxiety disorder in particular.  If you have social anxiety, consider making time for following self-care steps:

  • Join a local or online support group for people with social anxiety 
  • Get regular physical exercise in a way that you enjoy 
  • Limit alcohol and caffeine intake 
  • Create healthy sleeping habits
  • Read a book about social anxiety 
  • Practice mindfulness techniques, such as deep breathing or yoga 
  • Volunteer in your community
  • Perform random acts of kindness for others
  • Make time for hobbies that help you relax

Practice Your Social Skills

Knowing that you’re prepared and have put in the work is always a good way to reduce anxiety. We recommend applying this mindset to your social life. Start by thinking about your recent social encounters. Try to Identify the social skills that could use the most improvement or that you most commonly avoid. Below are some strategies for practicing and developing your social and communication skills:

  • Assertiveness – Many people with social anxiety have low self-confidence and lack assertiveness when communicating with others. Learn to become more assertive by making a point to practice communicating your needs in a calm and relaxed way that respects the needs of others. Usually, this takes the form of “I” statements, like “I feel disrespected when you interrupt me in meetings.” 
  • Nonverbal communication – People with social anxiety often adopt a “closed-off” stance in social situations and are reluctant to make direct eye contact or start conversations with others. They usually do these things without even realizing it, and aren’t aware of how it may be received. Practice relaxed posture, eye contact, and holding your hands at your sides to help you appear more confident and approachable in social situations. 
  • Verbal communication – Learning how to converse well with others can be very beneficial in reducing social anxiety symptoms. Practice joining in group conversations by listening first and then making a comment about what’s already being discussed. For example, “Are you talking about the midterm exam? I couldn’t figure out the extra credit question either.” It’s also important to practice being a good listener, asking open-ended questions, and sharing stories about yourself.

Tell Others About Your Social Anxiety

Your close friends and family may already know or have an idea that you have social anxiety, but it can be therapeutic, cathartic, and helpful in everyday life to share with others about your condition. If someone is important to you, talking with them about your symptoms and experiences can help them gain a better understanding of what you’re going through, and in turn, build a deeper and stronger connection between the two of you. If you’re feeling nervous to tell a friend or loved one that you have social anxiety, try to arrange a time where you can sit down and talk quietly and uninterrupted. You can also make a list of bullet points that you feel are important; this will help you if you tend to freeze up or your mind goes blank when you’re feeling nervous. 

It can also be beneficial to talk to your employer about your social anxiety so that you can receive accommodations or support that you might need in the workplace.

How Can IDENTITY Help?

Social anxiety disorder is a chronic mental health condition, but it does respond well to treatment. Treatment from a mental health professional like a therapist, counselor, or  psychologist has been known to greatly reduce symptoms, improve confidence, and increase the quality of life for those with social anxiety.

Psychological counseling or psychotherapy, has proven to be very beneficial, and many forms of therapy are known to be effective. Cognitive Behavioral Therapy (CBT) is the most popular approach for social anxiety, as it works by helping patients identify and combat the incorrect and negative beliefs about themselves that actually worsen their social anxiety. In therapy, the clinician and the patient work together to help the patient improve their coping skills and develop stronger self-confidence, engaging in exercises like social skills training, role-playing, and exposure therapy. 

IDENTITY is a psychotherapy practice located in Ann Arbor, Michigan that specializes in treating social anxiety disorder. Our licensed therapists are experienced in helping patients overcome and cope with social anxiety, and are passionate about seeing clients achieve growth and accomplish their goals. If you’re in the Ann Arbor area and you or someone you love is dealing with social anxiety, contact us today to schedule an intake or learn more about our counseling services. 

How Does Acceptance and Commitment Therapy Work?
IdentityIntakeCoordinator

How Does Acceptance and Commitment Therapy Work?

acceptance-commitment-therapy-identity-ann-arbor

Identity Counseling Psychology is an Ann Arbor counseling and psychotherapy practice specializing in therapy for anxiety disorders, clinical depression, grief, trauma, relationships, substance abuse, panic attacks, self-esteem, identity, motivation and more. Our licensed therapists are passionate about helping patients live their most fulfilled lives, and our team is experienced in a variety of therapeutic approaches, techniques and frameworks, including Acceptance and Commitment Therapy (ACT). If you’re interested in starting counseling or learning more about how ACT can help you or a loved one, contact us today. 

What is Acceptance and Commitment Therapy?

Acceptance and commitment therapy is a modern form of psychotherapy, or talk therapy, performed by a licensed mental health professional like a therapist, counselor, psychologist, or social worker. ACT is an action-oriented approach to therapy, using mindfulness techniques to help patients develop psychological flexibility and live a life that’s more in line with their goals and values.

ACT is a unique approach to counseling because it doesn’t consider patients with psychological distress or symptoms of a mental health disorder to be pathological. Patients of ACT are not viewed as flawed or damaged, and the goal of therapy is not to “fix” them. Rather than trying to control, relieve, change or avoid a negative emotion or the side effect of a mental health condition, ACT seeks to help patients accept and learn to live with the uncomfortable cognitive patterns that other therapies try to get rid of or reduce. ACT encourages self-love and empathy for all of one’s emotions and experiences, no matter how troubling or potentially destructive they may seem, giving patients the chance to move on with their lives and thrive as the person that they are. 

What Does Acceptance and Commitment Therapy Treat?

ACT can be offered as individual counseling, couples counseling or group counseling, and as both long-term and short-term treatment. Acceptance-commitment therapy can be helpful for a wide range of clinical populations and mental health concerns. Unlike most modern forms of therapy, symptom reduction isn’t the goal when it comes to ACT, although it is almost always a byproduct. 

One objective of the acceptance-commitment approach is to help patients stop viewing their unwanted thoughts and feelings as “symptoms” of a disorder. Instead, they’re encouraged to start viewing distress, in whatever form it may come, as an uncomfortable, but harmless and temporary event in their minds, separate from who they are as people. Therapists practicing ACT know that once a mental health struggle is labeled as a “symptom,” there’s a subsequent struggle to fix or get rid of that symptom. In ACT, the goal is to accept the struggles that we have without allowing them to create even more struggles or hold us back from being who we want to be. 

Acceptance and Commitment Therapy has been used effectively to help treat the following mental health concerns:

How Does Acceptance-Commitment Therapy Work?

The main goal of Acceptance and Commitment Therapy is to help patients develop psychological flexibility, which can be defined as “the ability to be present, open up, and do what matters.” In ACT sessions, patients focus on three key processes: letting go of emotional control, acceptance of unwanted private experiences (thoughts, memories, emotions, cognitive patterns, etc.), and commitment toward living a life in line with their core values. 

Letting Go of Emotional Control

ACT begins with the patient confronting their own agenda of emotional control. Most patients come to therapy in hopes of learning to control painful feelings and fix unwanted emotional responses, having failed in their past attempts to do so. The therapist encourages the patient to examine the ways in which they’ve tried to cope with, avoid or find relief from the mental health issue that they came in for. What are the strategies they have used to gain emotional control? 

The therapist and the patient run through the list together, making note of the strategies that can be harmful if used long term, and confronting which strategies actually end up making the patient feel worse than the unwanted emotion itself. They then take a realistic look at the efficacy of the emotional control strategies that may seem harmless. Have they helped consistently? Have they helped significantly? Are they worth the time, energy and money that the patient has put into them? How do they impact the patient’s quality of life? 

Some examples of strategies to control emotional discomfort might include:

  • Therapy that aims to change unwanted cognitive processes
  • Antidepressant / anti-anxiety medication
  • Drinking alcohol before bed 
  • Not opening up to new people 
  • Avoiding social events
  • Therapy that analyzes one’s childhood
  • Blaming genetics, parents, or upbringing for mental health issues
  • Deep breathing
  • Watching TV
  • Eating
  • Gambling
  • Smoking cigarettes
  • Self-harm
  • Ruminating
  • Chastising oneself

When patients come to the realization that their attempts at emotional control are part of the problem, not the solution, they become more open to the idea of letting go and learning to accept themselves as they are. In ACT, patients learn that when they resist emotional discomfort, not only do they become distressed by the distress itself, but they also do whatever they can to make the feeling go away, regardless of the long term costs. 

Mindfulness

There are six core principles of ACT used to help patients develop psychological flexibility. The first four principles are techniques based in the practices of mindfulness. 

Defining features of mindfulness that are important to psychological flexibility and ACT include:

  • Living in the present moment
  • Engaging fully in what you’re doing rather than getting lost in thought
  • Bringing awareness to your here-and-now experience and accepting it with openness 
  • Calmly acknowledging your thoughts, feelings, and bodily sensations
  • Allowing your feelings to come and go as they are, letting them be instead of trying to control them

Values Clarification

The last two core principles of ACT employ exercises in something called values clarification, which helps patients remember the values that are most important to them in life. Once a patient defines their values, they can learn to use them as a compass, pointing them in the right direction when painful emotions or coping mechanisms begin to lead them astray or cloud their judgement. Making a commitment to acting in line with these values allows patients to take purposeful action in their lives and behave in ways that reflect them at their core, rather than in ways that are a response to their psychological discomfort.

For example, a patient seeking anxiety treatment may list “spending meaningful time with family” as one of their core values. The next time they’re invited to a triggering family gathering, they’ll still feel anxiety, despite their time in ACT. Maybe they’re scared of being judged by their parents, or maybe they’re worried about being compared to their siblings. This anxiety will still come up, but now, instead of allowing it to guide their decision making, they’ll remember their commitment to their core values and attend the family event despite their discomfort. In the past, the patient may have decided to drink a few beers before the event to take the edge off, or make an excuse and stay home. But in ACT, patients find the inner strength and willingness to accept and feel unwanted emotions so that they can live a life that reflects what they value. 

Six Core Principles of ACT

The following principles are employed throughout Acceptance and Commitment Therapy with the goal of helping patients reach a state of psychological flexibility. Through mindfulness and values clarification exercises, these principles encourage them to accept their truths and live more fulfilled, purpose driven lives.

  1. Cognitive Defusion – Defusing threatening or uncomfortable thoughts, memories, and cognitions by recognizing them as nothing more than an ever changing stream of pictures, words and sounds that exists in the mind. Understanding their temporary and harmless nature disarms them, and they’re no longer seen as threats that must be obeyed, or objective truths and facts about one’s character.  
  2. Acceptance – Making room for unpleasant emotions, sensations, urges and cognitions, allowing them to come and go without struggle or analysis. 
  3. Contact with the present moment – Bringing full awareness to the present moment with openness and receptiveness to whatever it is that one experiences.  
  4. The Observing Self – Observing thoughts and feelings as something separate from one’s true self and not part of the essence of what makes them who they are. 
  5. Values – Clarifying what’s most important to someone in their life, and what sort of person they want to be. 
  6. Committed Action – Setting goals and taking action that is guided by one’s core personal values. 

How IDENTITY Can Help

Identity Counseling Psychology offers psychotherapy services in Ann Arbor, MI to adults, teens, kids, and families for a variety of mental health issues. Our therapists are trained in mindfulness techniques and a variety of therapeutic approaches, including Acceptance and Commitment Therapy. If you think that you or someone you know might benefit from ACT, mindfulness, or a multimodal approach to therapy, contact us today to set up an intake appointment or learn more about our practice.

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6 Steps to Beating Depression
IdentityIntakeCoordinator

6 Steps to Beating Depression

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Many people struggling with depression feel stuck, unsure of what to do or how to move forward. Counseling, medication, and mental health programs are not always available or affordable, and taking big steps can feel even more difficult for someone with depression. Identity Counseling Psychology is a counseling and psychotherapy practice in Ann Arbor, Michigan, made up of a group of licensed therapists who specialize in treating people with depression. While counseling has helped many people dealing with depression to cope with and find relief from their symptoms, there are some key steps that you can take on your own to start feeling better. 

In his book, “The Depression Cure: The 6-Step Program to Beat Depression without Drugs,” clinical psychologist, Dr. Stephen Ilardi, introduces and explains his 6-step Therapeutic Lifestyle Change (TLC) program for treating depression. We see great value in his approach, and have outlined Dr. Ilardi’s 6 keys to battling depression below. We also provide real life ways that you can implement these 6 steps into your life to help you take action against your depression and start feeling like yourself again. Although these steps can be taken on your own, Dr. Ilardi recommends checking with your doctor before making any major lifestyle changes. If you are battling depression and want to move forward, try these tips to start taking action and recovering from your depression. 

1. Create Healthy Sleeping Habits

One step that you can take to start feeling better if you’re going through depression is to create better sleeping habits. Sleep and mood are highly interconnected, and sleep disruption is a known trigger for depression. Even for those who don’t have a mental health disorder, a few nights of poor sleep can have negative consequences, like feeling cranky, pessimistic or worn out. Consistent sleep deprivation or disruption can be even worse, causing confusion, brain fog and other serious physical and mental health problems. Despite how important it is, most people don’t usually get a good night’s sleep, sleeping only 6 hours per night instead of the suggested 8 or 9 hours. Poor sleeping habits often lead to increased caffeine use, which only harms the sleep cycle even more, as caffeine makes it harder to fall asleep. 

Once depression takes hold, it can be difficult to move forward and make progress in getting better, especially because poor sleep can not only cause depression, but depression can also hurt our ability to fall asleep, stay asleep, and partake in the deep, quality sleep that we need to function at a high level every day. If you are experiencing depression and it’s been affecting your sleep, we encourage you to try some of the following habits that promote healthy sleep:

  • Only use your bed for sleeping
  • Create a consistent sleep schedule 
  • Avoid napping during the day
  • Keep a cool, dark bedroom
  • Avoid caffeine after the morning
  • Avoid alcohol at night
  • Try not to think about stressful or upsetting things before bed

2. Engage in Physical Exercise

There are over a hundred studies documenting the significant antidepressant effects of physical exercise. For many Americans, modern life is far too sedentary. Between commuting there, sitting all day through work or school, and commuting home, it’s hard to find time for substantial physical activity. Even if you don’t have depression, the benefits of exercise are worthwhile.  And if you do have depression, physical exercise is even more important to add to your routine. A lot of the chemical changes in the brain brought about by popular antidepressant medications to correct depression-related chemical imbalances can also be brought about by physical exercise.

Exercise changes the brain’s chemistry by increasing activity levels for important neurochemicals like dopamine and serotonin. It also increases the brain’s production of an important growth hormone, called BDNF, which is known to decline during depression. After regular physical exercise, people typically experience positive results like increased energy that are also helpful in overcoming depression.

Effective physical activity can include:

  • Running
  • Walking
  • Biking
  • Jogging
  • Weight lifting
  • Boxing
  • Swimming

3. Keep Your Mind Occupied

Depression is closely linked to a toxic thought cycle called rumination. Rumination is the habit of dwelling on negative thoughts or memories and going over them again and again in your mind. While we all can undoubtedly benefit from self-reflection and learning from our mistakes, excessive or chronic rumination can become incredibly painful and plays a large role in depression. Some depressed people spend hours per day ruminating, going over the same unbearable thoughts, causing their depression to spiral even more out of control. 

You can only ruminate when your mind isn’t otherwise occupied, and any stimulating or engaging activity can work to interrupt unhealthy rumination. Spending time alone is the biggest risk factor for rumination, and everyday situations like getting stuck in traffic, feeling bored at work or school, watching mindless television, or eating a meal alone can lead to unchecked and dangerous rumination.

Most people aren’t aware of their rumination and don’t realize that they do it, how often they do it, or that others do it too.The best ways to avoid harmful rumination are to recognize when you’re ruminating and try to shift your attention, and to set yourself up for success by limiting your triggers or situations that put you at risk. For example, if you know that your mind often wanders during your drive to work, make a playlist of your favorite music to listen to during the ride. 

Engaging activities that can interrupt rumination might include:

  • Listening to music
  • Listening to a podcast
  • Playing an interactive game
  • Conversing with a loved one
  • Watching videos or reading books about your passions and interests
  • Social interaction, especially in a group setting

4. Maintain Social Connections

People who lack supportive social connections are at an increased risk for depression and tend to have a harder time coming out of depression. In today’s fast-paced world, it can be hard to block out time for meaningful social bonds, and we often end up spending far too much of our leisure time alone. This can be due to increasingly demanding work schedules and competitive office environments, and it can also have to do with technology, which without a doubt promotes social isolation, getting worse with each new invention and upgrade. Now we can have our groceries delivered instead of going to the grocery store, and can access thousands of movies and TV shows through streaming services instead of going to the movie theater. Technology is multiplying our opportunities to be alone everyday, and this can be especially harmful for someone with depression. 

Depression causes people to withdraw even further than they already may have from those around them, leading to feelings of loneliness and diminishing their support systems for recovery. It’s human nature to self-isolate and take time for rest when feeling unwell. Most of the time, for example if you have the flu or a virus, taking some time away would be helpful and lead to recovery. However, when it comes to depression, being alone makes things worse, and is only an obstacle in getting better. 

Here are some helpful steps you can take to build yourself a social support system and start making meaningful connections:

  • Give to those in need
  • Become a pet owner
  • Get involved involved in your religious community
  • Volunteer in your community
  • Join a sports team
  • Get to know your coworkers outside of the office 

5. Increase Your Sunlight Exposure

Millions of Americans and Europeans, especially those living in northern latitudes, suffer from Seasonal Affective Disorder (SAD). SAD is a condition that causes people to become depressed during the winter, and it’s triggered by reduced exposure to sunlight during the shorter, cloudier days of winter.

The reason that less sunlight exposure can cause depression is because your brain keeps track of the amount of light you get each day and uses that information to set your body clock. When you don’t get enough exposure to bright light, your body clock gets out of sync, throwing off circadian rhythms that regulate important biological functions like energy, sleep, hormonal levels, body temperature and appetite. The disruption of these rhythms is harmful and can trigger depression.

Bright light stimulates the brain’s production of the neurotransmitter, serotonin, which affects mood, stress response, and behavior. People who work from sunrise to sunset don’t get enough natural sunlight, which is significantly (over a hundred times) brighter than indoor lighting. As little as 30 minutes of natural sunlight can be beneficial in resetting your body’s clock and getting back in sync. However, this isn’t always realistic. We’ve listed some tips below for getting the important benefits of bright light that our bodies need in general, and especially in order to recover from depression.

  • Try spending at least 30 minutes outside each day 
  • Start using a light box
  • Take a Vitamin D supplement 

6. Consume More Omega-3 Fatty Acids

There are certain fat molecules that the brain needs to function at its best. Our bodies make some of these fats on their own, but others can only be acquired through what we eat. Among the most important of these dietary fats are omega-3 fatty acids, which are mainly found in nuts, leafy greens, fish, and wild game. Sources of omega-3 fatty acids have been on the decline over the years, and with the popularity of grain-fed fish and cattle, there are less and less easy ways to get enough of this important fat. This trend has been harmful, as those who don’t get a sufficient amount omega-3s are at an increased risk for depression and other mental illnesses.

Clinical research has shown that using omega-3 supplements to help treat depression can be extremely beneficial. The human brain needs a steady supply of omega-3 fatty acids to function properly anyway, but if you have depression, increasing your intake of omega-3s can be key to recovery and prevention. You can do this by:

  • Making conscious diet choices
  • Taking a fish oil supplement
  • Taking a plant-based DHA/EPA supplement

Common Anxiety Issues in College Students
IdentityIntakeCoordinator

Common Anxiety Issues in College Students

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Anxiety is one of the most common mental health concerns facing college students today. While experiencing some anxiety during the numerous transitions involved in going away to college is undoubtedly normal, many college students in the United States report feeling overwhelming amounts of anxiety, which can be dangerous and unhealthy. 

Anxiety is characterized by the tendency to: 

  • Worry excessively
  • Feel afraid
  • Experience a sense of panic

There are many factors that can contribute to these feelings for college students nowadays, and major lifestyle changes alone, like going to college, are known to exacerbate the effects of a mental health condition. There are some specific issues that are especially widespread on college campuses right now that seem to be triggering and adding to this rise in anxiety among college students. Below, we discuss some of the most common anxiety issues that are facing college students today.

If you’re struggling with anxiety on campus, you may benefit from the help of a mental health professional. Please do not be afraid to seek help and talk to someone about what you’re going through. Almost all colleges and universities have some form of counseling available on campus to help students with mental health issues. Campus counseling centers can either help treat students or provide an appropriate referral.

Sleep Disruption

Sleep disruption and anxiety go hand in hand, and poor sleep is one of the biggest contributors to anxiety disorders among college students. There are many factors that can significantly impact sleep in college. Aside from things like cramming for exams and partying late at night, even simply living with a roommate for the first time can have negative effects on a student’s sleep cycle. 

The following are some common causes of sleep disruption in college students:

  • Worrying
  • Phone or laptop use before bed
  • Drinking excess caffeine
  • Inconsistent sleep schedule
  • Pulling all-nighters

Some tips for practicing better sleeping habits in college include setting a consistent bedtime and wake-up time each day, limiting caffeine in the evenings and alcohol in general, putting away all electronics an hour or two before bedtime, and avoiding spending time in your bed for activities other than sleep, such as studying. 

Financial Stress

It’s common knowledge that college is getting more and more expensive, but not everyone understands how significantly the financial burden of paying for college affects college students today. Most students leave college with extreme amounts of debt and only entry-level salaries, leaving them in a stressful situation for years after graduation. This predicament has become a source of dread and anxiety for many college students, so much so that the anxiety caused by this financial burden often overrides the happiness and pride that should be associated with graduating from college.

Financial stress is also a source of anxiety for students whose parents pay for college, as this puts an added pressure on them to do well, finish on time, and get a high-paying job. These students experience anxiety surrounding the looming fear that their parents “spent all this money on their education for nothing” or that their parents “wasted their money on them.” Relying on their parents to pay for college can also delay development of important life skills relating to emotional and financial independence for college students, leaving them unprepared and anxious for the “real world” that lies ahead. 

The financial stress associated with paying for college can also make it harder for college students to find the time and space in the budget for doing the things that make them happy. Seeing a movie, going out to eat with friends, joining a gym, these are all things that can help college students cope with or reduce anxiety, but they are hard to do for students who are on a strict budget due to the cost of college, or who have to spend their free time working at a job. 

Loneliness

Loneliness is a common problem for college students, especially for freshmen. One of the biggest sources of loneliness for college students comes from homesickness. Homesickness is defined by functional impairment or feelings of distress caused by an anticipated or actual separation from home and attachments, such as parents, siblings or pets. People who suffer from homesickness often experiences bouts of anxiety, sadness, worry and nervousness and can’t shake their preoccupation with thoughts of home and family. Homesickness is one of the leading causes of loneliness for students who are away at college, especially when they’re first adjusting to the change. 

Social media and technology can also contribute to loneliness in college students, in more ways than one. First of all, social media can get in the way of students, especially freshmen, developing strong relationships with their classmates. Texting and facetiming old friend groups from back home can take away from college students putting time and energy into meeting new people around them in the real world. It can be tempting to stay within the comfort zone of the friends that you grew up with, especially with the ease and instant gratification of social media and modern technology.  But, it’s important for college students to break old habits and branch out when adjusting to their new environment. And, for students coming into college with social anxiety disorder or generalized anxiety disorder already, Netflix, social media and online gaming can become comfortable escapes that hinder their chances of forming meaningful relationships with their peers in real life. 

Academic Pressure

Academic pressure is another major source of anxiety among college students. Academic pressure can lead to generalized anxiety disorder, perfectionism, and test anxiety. Perfectionism, which can also cause or worsen anxiety disorders, is increasingly common in today’s college students. Perfectionism is defined by the need to be or appear perfect in one or more aspects of life. 

Often students feel this pressure to be perfect from:

  • The competitive environment fostered on many college campuses 
  • Financial stress from scholarships or strict parents
  • Comparing themselves to their peers on social media 

Even though some people view perfectionism as a positive trait, especially when it comes to academics and education, it can actually lead to mental health disorders, like anxiety and obsessive behavior, that end up making it more difficult for students to achieve their goals. 

Test anxiety is another big mental health concern for college students that can stem from academic pressure. Test anxiety is a type of performance anxiety that can be caused by fear of failure. Colleges have become increasingly competitive, and the added pressure to be the best can lead to test anxiety in college students.

Test Anxiety can activate the body’s fight or flight response, causing symptoms like:

  • Sweaty palms
  • Nausea
  • Racing pulse 
  • Dread
  • Shaky voice
  • Knots in the stomach

These symptoms end up making it harder for students to succeed and achieve their goals, and for students with chronic test anxiety, therapy, as well as relaxation and mindfulness techniques can be very beneficial.

Social Media

Social Media has become one of the most common anxiety issues for today’s college students. Having constant access to a highlight reel of what their peers are doing can cause extreme anxiety and self-comparison among adolescents. Everyone shows their best selves on social media, so for students who are struggling academically, socially, or with their body image, comparing themselves and feeling lesser-than is inevitable when looking at the pictures and videos of peoples’ greatest, most showoffable experiences. There is also worry that comes along with seeing that you’re being excluded, or feeling like you’re not living life to the fullest or experiencing college to the extent that you should be based on what “everyone else” is doing. In these ways, anxiety and worry become compounded by social media use. 

For students who already have anxiety, the positive reinforcement of getting “likes” and instant feedback on social media can help put their minds at ease, but negative feedback, lack of feedback or comparison to others, all which are bound to occur on social media, can actually end up causing more anxiety. Students prone to anxiety can also feel anxious from being disconnected for too long when trying to stop using social media. Often, students tend to make the connection on their own that social media is exacerbating their anxiety, leading them to try to take breaks from or “quit” social media altogether. This, due to social media’s addictive nature, can lead to more feelings of fear and worry about being disconnected from the world. 

How Therapy Can Help

Identity Counseling Psychology is a counseling and psychotherapy practice in Ann Arbor, Michigan that specializes in working with college students and helping patients manage anxiety. Our licensed counselors are experienced in treating anxiety and are passionate about helping students navigate the college experience and cope with academic concerns. If you’re a student seeking counseling in the Ann Arbor area, contact us today for an intake. Our office is located in the heart of Ann Arbor, next to Bearclaw Coffee, where Washtenaw Ave and Stadium Blvd split. 

Psychodynamic Therapy
IdentityIntakeCoordinator

Psychodynamic Therapy

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What Is Psychodynamic Therapy?

Psychodynamic Therapy is a longstanding form of psychotherapy, or talk therapy, performed by a mental health professional like a therapist, psychologist or counselor. Psychodynamic Therapy aims to help patients become more self-aware, confront inner conflict, and understand the foundation and formation of their psychological processes and behavioral patterns. Unlike more goal-oriented therapeutic approaches, Psychodynamic Therapy is open-ended and less structured, allowing the patient to lead the conversation and explore their emotions, relationships and past experiences in an authentic and uninhibited way. 

Psychodynamic Therapy is rooted in Freud’s 19th century theories of psychoanalysis, and although it looks much different in modern practice, Psychodynamic Therapy still uses techniques informed by Freudian thought and psychoanalysis today. Psychodynamic Therapy’s unique focus on understanding how and why psychological issues and dysfunctional patterns were developed in the first place, rather than simply on trying to cope with and change them, has been beneficial to many patients over the years, especially when it comes to seeing long-term results and overcoming trauma. 

What Does Psychodynamic Therapy Treat?

Psychodynamic Therapy has been helpful for many patients, as it addresses a variety of factors that are known to cause or exacerbate mental health problems. Through the exploration of topics such as early childhood experiences and attachments, current relationship issues, coping and defense mechanisms, and distressing  feelings, urges and thoughts, Psychodynamic Therapy allows patients to get to the root of and move past the hurdles in their lives.

Psychodynamic Therapy has been known to reduce symptoms for the following mental health issues:

Psychodynamic Theory

Although Psychodynamic Therapy has been updated and simplified over the years, the theories and core concepts that support it can be traced back to Sigmund Freud’s theories of psychoanalysis. While not all of Freud’s ideas are still relevant in today’s practice, a handful of his core theories are central to Psychodynamic Therapy and inform its most popular techniques.

The Unconscious

Freud believed that the human mind has multiple levels. There’s a conscious level of the mind, which contains the things that we can remember and are aware of, and there’s an unconscious level of the mind, which contains the things that we cannot remember and are unaware of. According to Freud, the unconscious mind holds things like our early memories, our gut instincts, our deepest urges, fears and desires, our patterns of thought and behavior and our psychological processes that were developed during childhood. 

Psychodynamic Therapy places a large emphasis on the unconscious mind, where we tend to push feelings and thoughts that are too painful to face, and memories and beliefs that we might be ashamed of. However, these emotions and impulses still affect us and influence our behavior even though they are outside of our awareness. For example, a person might avoid romantic relationships that bring up painful memories of their parents’ divorce without realizing they’re doing so, keeping them from reaching important milestones in their lives like starting a family or falling in love. A trained Psychodynamic Therapist knows how to recognize these patterns of behavior and help patients confront the contents of their unconscious mind that might be holding them back from reaching their full potential. 

By encouraging open discussion and reflection, the Psychodynamic Therapist is able to pinpoint important themes and topics in a patient’s life, probing them with follow up questions and opening up their minds. The goal in Psychodynamic Therapy is to make the unconscious conscious, helping patients to take back control over the harmful feelings and dysfunctional patterns that have been holding them back. For catharsis, or relief from psychological distress, to occur, the client must gain the self-awareness to confront unresolved conflicts, repressed emotions, and maladaptive behaviors. 

Inner Conflict (Id, Ego and Superego)

Resolving inner conflicts is a major goal in Psychodynamic Therapy. Oftentimes, inner conflicts exist in the unconscious mind without our knowledge, but still manifest in our everyday behavior and emotions, taking a toll on our mental health. Freud theorized that there are three components of the human mind, two of which are constantly acting in opposition to each other, and one of which is meant to mediate that opposition.

  • The Id – Freud theorized that the Id is the most primitive part of our mind. The Id resides in the unconscious mind, containing things like repressed desires, shameful memories, sexual drive and aggressive urges. The Id is motivated only by pleasure, and Freud believed that it was the only active part of the human mind during infancy and very early childhood.
  • The Superego – According to Freud, as children grow and begin to experience the world, they eventually develop the Superego. This is our moral conscience, and it enforces the psychological processes that are necessary to exist in civilized society. The Superego contains our value system, feelings of guilt, knowledge of right from wrong, and the standards to which we hold ourselves and others. 
  • The Ego – Freud held that the Id and the Superego are in constant conflict, and the Ego is the mediator between the two. The Ego allows for rational decision making and drives the ability to satisfy the impulsive needs and urges of the Id in a way that is acceptable to the Superego. For example, if we are upset at work and our impulse is to cry, but we know that crying in the office is considered unprofessional, we might decide to go to the bathroom and take a moment to cry privately, returning to work once we feel better.

In Psychodynamic Therapy, patients examine why they want what they want and how they behave to get there, taking a more objective look at their own processes for dealing with conflict and satisfying or coping with the urges of the unconscious mind.

How Does Psychodynamic Therapy Work?

Psychodynamic Therapy is based on the Freudian principle that our deepest and most formative emotions and memories are buried in our unconscious mind, meaning that without self-awareness and guided self-reflection, we usually don’t even know that they exist are or how they affect us. Psychodynamic therapists encourage open, uninhibited discussion, drawing out painful feelings, early memories and unresolved conflicts during therapy sessions that might have been otherwise forgotten or avoided. This process can take time and requires an especially strong patient-therapist relationship, as the patient won’t achieve true vulnerability until he or she feels comfortable opening up to the therapist. This is why Psychodynamic Therapy tends to last longer than other forms of counseling, usually requiring anywhere from 6 months to 2 years of weekly 1 hour sessions. In Psychodynamic Therapy, the therapist looks for patterns of thought and behavior that recur throughout the patient’s life and points them out to the patient, sharing their insights and encouraging the patient to make relevant connections. By helping patients confront the early experiences, unresolved conflicts, and repressed emotions that impact their present-day lives, Psychodynamic Therapy gives patients the self-awareness to take control of their feelings, reactions and relationships.

Transference

The relationship between the therapist and the patient is uniquely important in Psychodynamic Therapy, as it is used as a mirror through which the therapist can gain insight into how the patient navigates relationships in the real world. Freud theorized that humans learn how to interact with others from their early-life attachments and relationships with their primary caregivers, and that this is then reflected in their adult relationships. 

Transference refers to when a patient projects feelings for family members or loved ones onto the therapist during counseling sessions, and can demonstrate how a patient interacts with others in the  real world. Transference is a useful tool for therapists as they try to understand the early life experiences and psychological processes that affect their patient’s present-day lives. A good Psychodynamic Therapist is aware of transference and looks for patterns in the therapist-patient dynamic that mirror some of the patient’s other interpersonal conflicts. The therapist then shares these insights with the patient to help them become more self-aware. 

Defense Mechanisms

Oftentimes, patients are held back from reaching their full potential because they’ve developed defense mechanisms to avoid dealing with memories or emotions that cause them pain or distress. A Psychodynamic Therapist is trained to recognize unconscious defense mechanisms and help patients break them down so that the underlying issues can be addressed and made sense of.

Below are a few common defense mechanisms:

  • Denial – Refusing to believe a truth or face an emotion that is too painful to accept. 
  • Regression – Returning to an earlier state of consciousness, like childhood, to minimize or avoid distressing situations. 
  • Repression – Subconsciously pushing painful memories or thoughts out of conscious awareness and forgetting that they ever happened or existed. 
  • Sublimation – Channeling the energy from a distressing or painful situation into something else to avoid dealing with the original negative event. 
  • Rationalization- Attempting to logically justify immoral, upsetting, or socially unacceptable behavior to avoid having to deal with the causes for that behavior.

Free Association

Free association is one of the most important parts of Psychodynamic Therapy, and helps set it apart from other therapeutic approaches. Free association refers to how the Psychodynamic Therapist allows the patient to lead the discussion during therapy sessions. This practice encourages the  patient to tap into his or her emotions and thoughts in the most authentic way, and ensures that the therapist is not leading the patient in any particular direction. A patient’s unconscious desires, memories and patterns will not be revealed during therapy unless the patient is able to be fully vulnerable and true to themselves.

Types of Psychodynamic Therapy

Psychodynamic Therapy can come in many forms, including more traditional counseling methods like individual talk therapy and family therapy, and more abstract approaches like art therapy and music therapy.  Below are some common types of Psychodynamic Therapy that differ in style and execution, but are all grounded in the overarching principles of psychodynamic theory.

  • Brief Psychodynamic Therapy – Brief Psychodynamic Therapy tends to last around 25 sessions and enables the patient to examine and address unresolved conflicts, such as childhood trauma, or mental health issues and symptoms, like agoraphobia and somatic pain. 
  • Long-term Psychodynamic Therapy – Long-term Psychodynamic Therapy usually requires at least 2 years of sessions and is meant to change dysfunctional psychological processes that were developed during childhood and are ingrained in a patient’s adult personality, holding them back from reaching their full potential. 
  • Psychodynamic Family Therapy – Psychodynamic Family Therapy tends to be more long-term and addresses chronic problems within a family, emphasizing the importance of exploring relationship issues and patterns of conflict throughout a family history. 
  • Psychodynamic Art Therapy – Psychodynamic Art Therapy can be used in a variety of ways and doesn’t require any artistic talent or experience. Patients can express feelings through the creation of art, discuss the emotions evoked by certain pieces of art, find and discuss personal meaning in pieces of art, and connect pieces of art to different events from their childhood. 
  • Psychodynamic Music Therapy – Psychodynamic Music Therapy can be beneficial for patients with high levels of anxiety or fear who have trouble opening up to a therapist verbally. This approach does not require any musical background or knowledge and encourages self-expression and communication through music. The therapist pays attention to how the patient goes about creating music and the patient can use music as a form of emotional release.

How Identity Can Help

Identity Counseling Psychology is a counseling and psychotherapy practice in Ann Arbor, Michigan made up of a group of passionate, licensed therapists that are trained and experienced in Psychodynamic Therapy. Identity helps adults and adolescents cope with and manage mental health issues like anxiety, depression, stress, trauma, and relationship issues. If you live in the Ann Arbor area and are interested in, or have questions about Psychodynamic Therapy, please contact us today.

How Does Cognitive Behavioral Therapy Work?
IdentityIntakeCoordinator

How Does Cognitive Behavioral Therapy Work?

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What Is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a popular form of talk therapy performed by a mental health counselor or therapist. CBT is a highly structured, goal oriented approach to psychotherapy, meant to help patients problem-solve and work through specific target issues. The goal of CBT is to help patients understand how their thoughts, perceptions and feelings directly impact their responses and behavior in challenging situations.

CBT is based on the principle that our thought patterns shape how we see the world, and when our thought patterns are negative or incorrect, this can lead to unhelpful behaviors and emotional or psychological distress. Through CBT, patients are made aware of inaccurate and harmful ways of thinking so that they can view challenges more clearly and react to them more effectively.

What Does Cognitive Behavioral Therapy Treat?

Cognitive Behavioral Therapy can be a helpful tool for anyone. Not everyone who benefits from CBT has a mental health condition, but it can be used to treat mental health conditions. These can include:

CBT can also help people address emotional challenges, such as:

How Does Cognitive Behavioral Therapy Work?

Cognitive Behavioral Therapy is grounded in the idea that perception is, or at least strongly impacts, reality, and that a person’s beliefs surrounding a challenging situation or experience determine their emotional and behavioral response to that situation or experience. A Cognitive Behavioral Therapist’s goal is to help patients pinpoint inaccurate or dysfunctional thought cycles that may be causing or adding to a distressing challenge that they’re facing, and then encourage them to adjust those thoughts. This can be difficult, as thinking patterns are often deeply ingrained in us and established in childhood. Through CBT, patients are assisted in gradually recognizing and changing harmful cognitive distortions, allowing them to perceive distressing situations more clearly and handle them more confidently in the real world.

Common Cognitive Distortions Addressed in CBT

Cognitive errors, or disruptive, inaccurate thought cycles are often pinpointed and worked through during CBT. Common cognitive distortions that are addressed in therapy include:

  • Viewing the world in extremes – believing that things are black or white with nothing in between.
  • Excessive self-blame – believing that when bad things happen, it must be your fault.
  • Overgeneralizing – believing that if something is true in one setting or one experience, then it must always be true.
  • Taking details out of context – forming conclusions based on isolated (usually negative) details of events or experiences while ignoring the rest of the context and positive aspects.
  • Personalization – believing that the things that other people do and say are always somehow related to you, causing you to take everything personally.  
  • Jumping to conclusions – assuming that you already know the thoughts, feelings and motivations of others without asking them directly, or automatically predicting the worst outcome of a situation or event.
  • Mistakenly seeing situations as catastrophic – expecting disaster or tragedy to strike at any moment and giving greater weight to the worst possible outcome of a given situation.

Changing Automatic Negative Thoughts

Cognitive Behavioral Therapy works by helping patients recognize and change automatic negative thoughts. If people learn negative or destructive ways of thinking at an early age and repeat these thought patterns throughout their lives, they can begin to think this way automatically, regardless of situation or context. When these negative thoughts surface impulsively and are accepted as true, they can have a tremendous impact on a person’s mood, despite not being based in reality.

In CBT, therapists work with patients to identify any automatic negative thoughts that may be contributing to or exacerbating emotional distress. Patients are encouraged to examine these thoughts compared with evidence from the real-life situations and events that surround them. Then, they must confront whether or not reality supports or refutes their way of thinking, allowing them to take a more objective look at the thoughts that contribute to their negative emotions.

Becoming aware of automatic negative thoughts that are unrealistic and impact your mood is the first step in engaging in healthier thinking patterns. Through goal-setting and practice, CBT therapists aim to gradually adjust how patients think, feel and react in challenging situations, transforming any thought patterns that stand in the way of productive or positive outcomes. By changing automatic negative thought patterns that cause patients distress, that distress decreases and patients can begin to feel better.  

What Does Cognitive Behavioral Therapy Look Like?

Cognitive Behavioral Therapy typically begins with your therapist or counselor learning more about you. This period of gaining background knowledge is less structured, and usually consists of a few sessions in which you’re asked questions about your goals, challenges, present situation and past experiences. Because CBT is goal oriented, it’s important for your therapist to have a deep understanding of you and your concerns in order to determine the best plan of action to make the most out of your sessions.

Steps in Cognitive Behavioral Therapy

Cognitive Behavioral Therapy consists of four core steps.

  1. Identifying challenges in your life. These can vary widely. Some examples could be, divorce, grief, a medical condition, or a mental health disorder. Your mental health counselor might spend some time with you prioritizing these challenges and helping you decide what goals you want to work on.
  2. Becoming aware of how you think and feel about these challenges. Your therapist will encourage you to reflect on and share your beliefs, self-talk, interpretations and perceptions regarding the issues you’ve identified.
  3. Recognizing negative thought patterns and behavior. You will be asked to pay attention to your emotional, physical and behavioral reactions in challenging situations, and reflect on if and how they may be contributing to your distress.
  4. Reshaping inaccurate and harmful thinking. Your therapist will help you confront whether or not your perceptions and thought patterns regarding certain events or situations are accurate and realistic. Established ways of thinking about yourself, your life, and others can be difficult to examine objectively, but a trained mental health professional can help you see things more clearly. Eventually, new, healthier habits and responses can be formed, and with practice, become second nature and replace the old ones.

CBT Learning Tools

There are a variety of tools and techniques implemented by therapists in Cognitive Behavioral Therapy to help teach patients how to identify and adjust harmful negative thinking. These include:

  • Journaling
  • Mindfulness
  • Relaxation
  • Social, physical, and emotional thinking exercises
  • Regular discussion
  • Role-playing activities
  • Gradual exposure to things that cause fear
  • Homework assignments

Homework Assignments

It may sound odd, but homework is a crucial part of Cognitive Behavioral Therapy. Since CBT is a short-term therapeutic approach with a limited number of sessions, homework assignments help reinforce what was learned in therapy. It’s one thing to identify and understand negative thought cycles, but it’s much harder to adjust those cycles and implement new thinking and behavior in the real world. Homework also gives patients the tools to continue bettering themselves and strengthening their positive thinking after they’ve completed their sessions and CBT has come to an end.

Does Cognitive Behavioral Therapy Work?

Cognitive Behavioral Therapy might not cure a mental health condition or make a distressing situation go away, but it does help people cope with challenges in a healthy and constructive way, as well as help improve their confidence and self-esteem. A growing number of mental health professionals are using CBT on a regular basis or have begun incorporating it into their practices alongside other therapeutic approaches.

There is much to learn from CBT, and even if it can’t fix life’s issues, there are many benefits of going through the process. The following are some common positive takeaways for patients after completing Cognitive Behavioral Therapy.

CBT can help patients through…

  • Establishing and meeting attainable goals
  • Letting go of self-blame
  • Facing fears
  • Seeing problems more clearly
  • Challenging assumptions
  • Distinguishing between facts and irrational thoughts
  • Understanding how past experiences shape present beliefs
  • No longer fearing the worst
  • Seeing things from a new perspective
  • Becoming more aware of their moods
  • Avoiding generalizations
  • Focusing on the present
  • Better understanding the motivations and behaviors of other people

How Identity Can Help

Identity Counseling Psychology is a counseling and psychotherapy practice in Ann Arbor, Michigan made up of a group of passionate, licensed therapists that specialize in Cognitive Behavioral Therapy. Identity helps adults and adolescents cope with and manage mental health issues like anxiety, depression, stress, and relationship issues. If you live in the Ann Arbor area and are interested in, or have questions about Cognitive Behavioral Therapy, please contact us today.

11 Ways to Reduce Anxiety Without Medication
IdentityIntakeCoordinator

11 Ways to Reduce Anxiety Without Medication

At IDENTITY, we often see clients who have been on medication before. While there are times when medication may be necessary for psychological health, most people find that they experience side effects and desire to reach a point where they can thrive in life without using medication. It’s common for many of our clients to have the goal of getting off of their anxiety or depression medication. We are passionate about partnering with our clients to achieve this goal.

Below are 11 common ways to reduce anxiety without using medication.

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  • Sweat
    • Exercise—it’s a natural mood booster
    • Go for a walk outside
    • Go swimming
    • Do yard work

  • Fuel your mind

    • Eat more leafy greens, whole grains, and antioxidant rich foods
    • Less caffeine
    • Less alcohol
    • Drink more water

  • Words of affirmation

    • Leave yourself little notes where you know you will see them
      • I can do this!
      • This too shall pass
      • It’s not a bad life, it’s just a bad day

  • Get creative

    • Listen to music
    • Journal your thoughts
    • Paint/draw/color
    • Join a pottery class
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  • Vent it out

    • Talk to someone
      • Friend
      • Trusted colleague
      • Family member
      • Talk with a Therapist

  • Focus on breath and remain present

    • Take a few deep breaths when you feel yourself becoming overwhelmed
    • Calm yourself with positive words of affirmation
      • I can do this
      • I acknowledge my self-worth
      • I love myself
      • I am strong
      • I am brave
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  • Create a peaceful environment 

    • Light your favorite candle
    • Diffuse essential oils—Lavender/Frankincense/Chamomile/Citrus
    • Take a bath

  • Furry friends

    • Pet animals—they are naturally calming
    • Volunteer at your local animal shelter
    • Take your own pet for a walk
    • Snuggle your pet

  • Sleep

    • Use your bed as a place of serenity—only use it for sleep related behaviors
    • Get the recommended 7-8 hours of sleep per night

  • Reward yourself

    • For everything you accomplish/do that you don’t like, treat yourself
      • Go to the movies
      • Watch an episode of your favorite show on Netflix
      • Go out with a friend
      • Buy/make your favorite meal/dessert
Reduce-Anxiety-Without-Medication-Identity-Counseling-Psychology-Ann-Arbor-Michigan-Therapy

  • Unplug

    • Reduce your internet/phone use
    • No Facebook/Instagram/Twitter/Snapchat for a full day
      • If this isn’t “possible”, start with an hour and gradually increase your time away from electronics

We would love to partner with you on your journey towards reducing your anxiety. If you are interested in coming in to begin the process of therapy, or if you have any questions, feel free to contact us via the contact form below!

I Want To Leave My Job, But I Feel Stuck
Identity Counseling Psychology PLLC

I Want To Leave My Job, But I Feel Stuck

  • By Identity Counseling Psychology PLLC
  • July 31, 2017
  • Blog

Have you ever been in this place? Maybe you’ve had this job for a while. Maybe it worked for you before. However, maybe there has been something growing inside telling you that you have something more to offer.

While there is a part of you that knows it would be healthy to leave your job, maybe for some reason you feel paralyzed by the thought of leaving. This situation can contribute to anxiety, depression, mood issues, and even relationship issues.

Let’s dive into some common reasons why we tend to remain complacent with our jobs and continue floating through life when we know it isn’t the best for us.

Leaving my job means changing a part of my identity

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Even if we know we’re in a job that is slowly eating away at us, it is still a part of our identity. We spend a ton of hours at work each week, and after a while it becomes a part of you.

Maybe you’ve spent the last several years developing relationships with other people at work. Finding a new job means making new relationships, establishing a new reputation, and changing a part of our identity. The process of searching for a new career or job is really about becoming more clear about our identity.

Career complacency and “comfort” trick us into staying

Let’s face it. You’ve been in this job for long enough that you can do most of it with one hand tied behind your back. You know exactly what to expect each day, and you know exactly how incredibly bored you will end up a lot of the time. Staying in a job that you despise because it feels like the most comfortable option may be the #1 thing that prevents you from growing.

Pressure from friends and family to stay

Maybe your Dad told you that this was a great job and that you shouldn’t leave or take it for granted. Maybe your friends have told you to stay because hey, it’s a job, and nobody likes their job. These words are often spoken by people who also don’t like their job and who may be trying to convince themselves of something rather than you. Friends and family are important, but recognize when they are truly helping you to grow, and when they may be contributing to the thing that’s holding you back.

I’ve failed before or I lack confidence

Maybe you’d tried it before. You had a dream to start you own business, move out west and become a photographer, or maybe you weren’t able to get yourself through college or grad school. Previous failures often hold us back from taking the steps in life that will lead to personal growth. The funny thing about failing is that it is most often the source of success. As Michael Jordan once said, “I’ve failed over and over again in my life… And that is why I succeed.“

I can’t tell you how many therapy clients there are that I’ve worked with who attribute their current happiness to that time when they bottomed out. Sometimes you have to know where the bottom is in order to ascend into the person you know you can be.

I’m not sure exactly what job I want next

Whenever I have counseling clients who have no idea what to do next in life, I ask them to respond to the following 4 questions:

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  1. What are you GOOD at?
  2. What do you absolutely LOVE to do?
  3. What are the VALUES that you want to live your life according to?
  4. How can you use what you love to HELP others or society at large?

I work with people to help breakdown the expectations that may have been placed in them from other sources (parents, teachers, religious leaders, friends), and focus in on what they truly value. What are the values that you truly want to live by? We will work together to identify how a career might fit into your values system and growth process.

Are you interested in Career Counseling?

Do you want to make a significant change in your life?

Talking with a licensed counselor, psychologist, or therapist at our counseling practice in Ann Arbor can be a great way to kick start the kind of change that you’re looking for. We’d love to work with you on a plan that will allow you to grow.

Contact us to schedule an intake!