Some clients go through years of psychotherapy without attaining meaningful change in their lives. When we look deeper into those situations, it is easy to understand why. Their reality is such that feeling joyful, free, satisfied just doesn't make sense. For example, if I am failing a class, having conflict in my marriage, or fearing riding any and all elevators, there are very valid and straightforward reasons for feeling distraught. In many instances,  the very feeling of sadness, nervousness, or distrust is a reflection of something beautiful and positive about that person's value system. I would not be feeling sad for failing my classes if achievement and responsibility weren't important to me! When therapists try to change a client's emotional reactions without honoring the positive facets and functions of those reactions in the context of the individual's overall experience, the efforts are doomed to fail. That is why, in TEAM-CBT, we spend a healthy amount of time in Agenda Setting, before moving forward with any attempt for change. Dr. David Burns explains why some clients may not want to change - and why helping is not always helpful - in this insightful article in the latest issue of Psychotherapy Networker: https://www.psychotherapynetworker.org/magazine/article/1076/when-helping-doesnt-help

With marijuana being recently legalized in California, questions about its positive and negative effects on health overall and mental health in particular have intensified. There is an appropriate amount of debate around it and a growing body of investigative research attempting to arrive at conclusive findings. But in short, we really don't know yet.  My overall take on the state of the literature is that, like with any other foreign substance that you are introducing into your body, avoid or limit it if you can. However, compared to other drugs that are commonly abused - and particularly alcohol - marijuana has a lower profile of long-term damage and side effects. The article below does a good job of listing areas of interest in the research of clinical uses of marijuana and where we are in our understanding of them. For example, while we all know that marijuana's THC can have a 'feel good' effect on the brain, it also elevates heart rate and impacts coordination and balance. Cannabidiol (CBD) has been demonstrated to help in pain management, but marijuana can also affect memory, mood, and potentially activate  schizophrenic symptoms in those prone to the condition. https://www.healthiguide.com/health/what-marijuana-really-does-to-your-body-brain/ If you are considering or actively using marijuana for mental health concerns, I suggest discussing it with your doctor to investigate any potential physical health risks and with a therapist to learn additional or alternative ways to manage your pain or mood. All said, natural, healthy, and drug-free solutions are always best!

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: Exposure to trauma, e.g., threat of death or injury. Intrusive memories, flashbacks, repetitive dreams, psychological distress, or physical distress at reminders of the event. Avoidance behaviors such as trying not to think about the trauma or avoiding places that remind you of it. 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. 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.