Tips, Ideas & Recommendations in CBT Treatment

Life can be hard at times. For many of us, hardship comes in the form of a traumatic event that takes place unexpectedly. This could be the abrupt loss of a loved one, a violent assault, chronic abuse, a serious injury, or a car accident, for example. When faced with a dangerous situation, our bodies react automatically by activating the fight-or-flight response. That's usually helpful: it quickly gets us ready to deal with a threatening stimuli and mobilizes our resources to succeed in that endeavor. When things go according to plan, once the threat is neutralized, we go back to baseline and life moves on, hopefully in more positive directions. Unfortunately, in about 1 in every 3 cases, we don't really get back to baseline. We get stuck in the stress of that moment, unable to cope with it.

When this high level of post-traumatic stress lasts for a while (for more than a month), there is a possibility that the set of symptoms experienced qualifies for a diagnosis of Post-Traumatic Stress Disorder (PTSD). According to the DSM-5, the manual used to label and categorize mental health illnesses, the following are conditions necessary for a diagnosis of PTSD:

1. Exposure to trauma, e.g., threat of death or injury.
2. Intrusive memories, flashbacks, repetitive dreams, psychological distress, or physical distress at reminders of the event.
3. Avoidance behaviors such as trying not to think about the trauma or avoiding places that remind you of it.
4. Negative alterations in thought and mood, e.g., amnesia, negative beliefs, distorted views of the world, lack of interest, detachment, estrangement from others, inability to experience positive emotions.
5. Excessive arousal, e.g. irritability, angry outbursts, reckless behavior, hypervigilance, exaggerated startle response, difficulty concentrating, insomnia.

If you have yourself suffered a traumatic event and are struggling with any of the symptoms above, psychotherapy can help. Indeed, talk therapy is considered the most effective first line of treatment for PTSD and several psychological interventions have been tested and proven very effective for diverse patient populations.

To learn more about the different modalities of PTSD treatment, visit the National Center for PTSD from the VA Administration. And call a therapist.

Those of us who are lucky enough to be able-bodied and perfectly capable of putting one foot in front of the other should be walking at least 30 minutes a day, 5 days a week. Why? Because walking brings enormous benefits for our health, both physically and mentally.

​This article from Fresh Daily Health details several ways in which walking can help us lead healthier lives. Benefits of regular walks include:

• Prevents muscle atrophy
• Improves blood circulation
• Builds muscle
• Builds stronger bones
• Lowers risk of several diseases such as heart conditions, cancer and diabetes
• Leads to weight loss
• Prevents dementia
• Boosts Vitamin D levels
• Increases energy levels
• Extends life span
• Boosts mental health

On this last point, it is worth highlighting that walking can help reduce stress, ease anxiety, and combat that nagging desire to do nothing that comes with a clinically significant depression. So, if you can find a few breaks on your calendar daily, even if it is just 10 to 15 minutes two or three times a day, get out there and start putting one foot in front of the other! Your body will thank you.

When presented with important choices in their lives, clients often ask me "Is this the right choice?...Is this OK?..." The clear answer for that is "It depends!!!". What is right for your life obviously hinges on your personal values, dreams, and aspirations. While no one can give you answers on what to aim for, we can suggest parameters to consider when weighing your choices and making important (or even everyday...) decisions.

A "great life," however it looks like for you, should maximize your ratings and satisfaction across the dimensions below:

• Purpose: Finding meaning and enjoyment on what you do every day
• Social: Having important relationships and love in your life
• Financial: Managing your economic life to reduce stress and increase security
• Community: Being engaged and involved with the areas where you live and work
• Physical: Having good health and energy to get things done daily

​In short, choices that increase your purpose in life; social, financial, and physical well-being; or community belonging are likely "right" and definitely "OK." Sometimes we move along these axes in unison, other times we need to make trade-offs among them. But those are the key ingredients in a great life for everyone of us. How you mix them up to create your own unique recipe, it's up to you. 

In TEAM-CBT, when patients are looking to improve their interpersonal relationships, we first spend some time analyzing the nature of the conflict that they're facing before jumping in to solve it. Even though there are as many different flavors of interpersonal conflict as there are people in the planet, if we look closer, we can find a few broad patterns of common relationship concerns.

If you are having problems with someone close to you (romantic partner, family member, boss, co-worker, etc), odds are that the issue will fall into one of these three categories:

1- Character Issues: they don't see themselves!
These are problems where you firmly believe that the person with whom you are in conflict is just flawed. They may be self-centered, dumb, histrionic, unfair, needy, controlling, unreasonable...and a lot more! For example:

"He is mean and stubborn!"

2- Appreciation Issues: they don't see me!
These are problems where you feel under-appreciated in the relationship. You firmly believe that the person with whom you are in conflict doesn't see you for everything that you do. They may frequently criticize, blame,  disrespect, ignore, or belittle you. All said, they either don't value you, don't value your needs, or don't value the relationship. For example:

"They never recognize how much I do for them!"

3- Give-and-take issues: they don't see us!
These are problems where you find a fundamental imbalance in the relationship in terms of the give-and-take. It can be that the other party just doesn't listen, no matter how hard you try to communicate with them. Or they just don't share, regardless of your valiant efforts to engage them. Or it can be that they don't reciprocate when you do something nice for the relationship. For example:

"They ignore my advice!"  

There are naturally many other ways of thinking about interpersonal issues. This is just one of them. But the goal here is to recognize that the first step in solving a problem is defining it! If you are suffering because the relationships in your life are not intimate, respectful, and fulfilling, cognitive-behavioral therapy can help.