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Anxiety

Counseling by Penny

anxiety

Everyone experiences anxiety at some point in life.  Certain levels of anxiety and worry can be helpful and productive- for example, we worry about being hungry and having a place to live, so we work to obtain the resources needed to buy food and pay bills for a house, apartment, or other domestic living environment.  However, there is a threshold point at which worry and anxiety can cause dysfunction and mental distress.  So, one may ask, how much anxiety is too much?

Generalized Anxiety Disorder (GAD) is a condition characterized by chronic worry and anxiety.  Not to be confused with depressive symptoms, which are typically feelings of sadness and thinking about the past, anxiety is more fear-oriented about potential events taking place in the future.  Those suffering from GAD are consistently anxious, to the point where it interferes with everyday functioning and activities.  Anxiety is reported in nearly every life scenario, even when there is no apparent cause for worry, and the worst is expected in virtually every situation. Individuals that experienced pervasive, stressful life events throughout childhood are more vulnerable to developing GAD, but thankfully there are therapeutic treatments and tools that can be used and worked on to alleviate the symptoms of anxiety.

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Some of the treatments in therapy vary from practitioner to practitioner. At times medication management may also be beneficial in handling various degrees of anxiety. Within our own practice we use several techniques to help overcome anxiety such as biofeedback, mindfulness, sand tray, and help with cognitive distortions.

What is Biofeedback and how is it helpful in treating GAD?

Biofeedback is an evidence based treatment which gives the opportunity for someone with anxiety to learn to properly respond to anxiety without the use of medications. The tools available when using biofeedback allow the client the opportunity to actually visualize the physiological symptoms of anxiety without using invasive procedures.

The client is able to learn how to effectively breathe to help decrease uneven breathing (rapid or shallow) patterns and to decrease the rapid heartbeat. The biofeedback machine will also help the client to depict muscle tension within their body which becomes more evident with episodes of anxiety. Another added benefit of biofeedback is the ability to learn how to maintain proper brainwave levels.

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Mindfulness

Mindfulness is a technique used by many counselors. Mindfulness allows one to accept what they feel and to process the feeling while coming back to the present. The goal is to calm the mind and to stop the repetitive thoughts that often accompany anxiety. With mindfulness a lot of focus is put on sensations, kinesthetic activities, and meditation.

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Sandtray

Sandtray is an expressive form of therapy which can be done outside of talk therapy, and is used with adults and children alike. Sandtray allows the client complete control in constructing their own world based on symbolic figures. Sandtray does not require a client to be artistic and allows the client the opportunity to look for potential triggers, barriers, and obstacles which may be unforeseen to the client. The sand in itself is also a sensory based tool used to help soothe the client.

Cognitive Distortion

Cognitive distortion is a type of thinking which is often seen in clients with anxiety. This occurs when the client takes any problem or issue and begins to magnify it. Helping with cognitive distortions means the therapist helps to discredit these false beliefs with the client and gives them tools to help them with any future cognitive distortions.

 

Resources

Beck, A. T. (1976). Cognitive therapies and emotional disorders. New York: New American Library.

Burns, D. D. (1980). Feeling good: The new mood therapy. New York: New American Library.

Halpenny, E. A. & Linzmayer, C. D. (2013). “It was fun”: An evaluation of sand tray pictures, an innovative visually expressive method for researching children’s experiences with nature. International Journal of Qualitative Methods, 12, 310-337. Retrieved from http://ejournals.library.ualberta.ca/index.php/IJQM/article/view/17085/15435

The Columbia World of Quotations (1996), Columbia University Press. Retrieved April 11, 2013, from http://quotes.dictionary.com/search/sand_?page=3

Suicide: The Thoughts, The Trends, and The Ways to Help

Written by: Teresa Johnson, MS, NCC, LPC-Intern

Supervised by Penny Haight, M.Ed., LPC-S

 

Hope is a necessity for normal life and the major weapon against the suicide impulse.

—Karl A. Menninger

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How Real of a Threat is Suicide?

Suicide is a very real problem in America. Nearly 30,000 Americans commit suicide every year. Suicide is the second leading cause of death amongst 24-35-year-olds, and is the third leading cause of death amongst 15-24-year-olds. This means that there are two times as many deaths to suicide as there is to HIV/AIDS. Males make up 79 percent of all completed suicides. Women are more prone to attempts and/ or suicidal ideation.

Why Someone May Commit Suicide?

There are various reasons regarding why someone may attempt or complete suicide. The most common reason for suicide is Major Depression. When someone suffers from major depression and begin to contemplate suicide they likely feel hopeless, helpless, and worthless. They may feel as though life is not worth living. Suicide may often feel like the only way out.

Other’s may have more impulsive tendencies such as acting out to get attention. An example of this would be getting into a fight with a significant other or the threat of a loss of relationship. They may choose to do something that is risky and dangerous to get their attention, and may even take it too far.

Finally, another cause may be accidental or due to a new trend. There are several ways a person can attempt or complete suicide accidentally. One example are new games that some are playing that restrict their airflow. When playing this game, the person may not be playing with the intent of dying. Some may also accidentally overdose on medication or drugs.

What to do if Someone is Contemplating Suicide?

Often when the topic of suicide is mentioned, people tend to become frightened and are unsure of how to respond. It is important to know if the person’s thoughts are only thoughts or if they have a plan and intent. It is ok to ask the person if they are having thoughts about hurting themselves. Keep in mind that although a person is contemplating suicide, they’re end goal is not really to die, it is to end the pain and suffering they feel.

When talking to someone who is suicidal, be your genuine self. It is important to let them know that you care about what happens and you are there to help. Remember to listen. The conversation may be negative and hard to hear, but if they are willing to talk, listen. Remain sympathetic, calm, accepting, and most importantly remain non-judgmental.

Reassuring the person that there is help available and the thoughts of suicide are also temporary can be beneficial. Always take the person serious. Make sure you ask if they have thought about how they would hurt themselves and remove anything that may be harmful to them such as: guns, razors, knives, or anything else that may be potentially hazardous.  If someone is threatening to harm themselves, it is important not to leave them alone. Most importantly, make sure you can find help.

 

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Resources

Counseling by Penny– Follow-up treatment and suicide risk assessments. Face to face appointments. Visit www.counselingbypenny.com  or call (817) 657-1115 to schedule an appointment.

National Suicide Prevention Lifeline – Suicide prevention telephone hotline funded by the U.S. government. Provides free, 24-hour assistance. 1-800-273-TALK (8255).

National Hopeline Network – Toll-free telephone number offering 24-hour suicide crisis support. 1-800-SUICIDE (784-2433). (National Hopeline Network)

The Trevor Project – Crisis intervention and suicide prevention services for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. Includes a 24/7 hotline: 1-866-488-7386.

SAMHSA’s National Helpline – Free, confidential 24/7 helpline information service for substance abuse and mental health treatment referral. 1-800-662-HELP (4357). (SAHMSA)

 

The World of Play Therapy

Image result for play therapy

Written by: Teresa Johnson, MS, NCC, LPC-Intern

Supervised by: Penny Haight, M.Ed., LPC-S

“Toys are like a child’s words and play is the child’s language.”   ― Dr. Gary Landreth

Often times, people ask, “What is play therapy and can it really help?” The following will answer a majority of questions about play therapy, but is it important to know ….. Yes! Play therapy really helps!

A Brief Synopsis

There are many types of play therapy, whether directive or non-directive, and it is important to know and understand which form of play therapy is being used with your child. Directive play therapy is a type of play therapy in which the therapist interacts more with the child and may use prompts in order to create dialogue or play. Non-directive play therapy is a type of play therapy in which all cues are given by the child. The therapist emphasizes their actions and makes no assumptions. The therapist also avoids labeling any toy or movement.

Non-directive play therapy allows the child the independence to “make the rules” so to speak. Everything which is done in therapy is done at the child’s request. The therapist only plays when the child asks them to join. The therapist refrains from interjecting and allows the child to ask for help when they feel they need it.

How is this helpful to my child?

Children are not like adults who can talk about the way that they feel about particular situations in their lives. Most of the child’s talking and processing is done through play. The child may have a hard time identifying their triggers to anger or anxiety so they are unable to say what exactly made them angry. Play therapy affords them the opportunity to play through the “anger” or “anxiety” so that they do not carry it with them throughout the day.

Non-directive play therapy does have boundaries associated with it, when it is needed. For instance, if a therapist is working with a child who is aggressive at home, and wants to help curb that behavior the therapist would work with the child to learn new alternatives to relieving anger rather than aggression towards family members. The therapist would also work with the family to help them assert boundaries. An example of that dialogue may look similar to this:

“You are screaming and shouting and hitting, but Mommy is not for hitting. You may hit the pillows or stomp your feet, but Mommy is not for hitting.”

It is important for the child to know that they are allowed to feel angry, but to help them express it in a healthy way. This is important for any emotion. The goal is to help the child develop their emotional intelligence.

Benefits of play therapy

Play therapy helps to reduce the child’s stress and promotes a trusting relationship, not only between the counselor and the child but also promotes healthy and safe relationships in general. Play therapy also encourages communication. In addition to these great benefits play therapy will also help to promote problem solving, self-control, self-direction, self-respect, self-acceptance, and self-reliance

Children who benefit from play therapy

There are many different children who benefit from play therapy. Play therapy is a good technique for those with depression, anxiety, dealing with issues of divorce or separation, trauma, grief, challenges at school, impulse control issues, social withdrawal, ADHD, and anger management.

Survivor’s guilt and Surviving Suicide

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Written by: Teresa A. Johnson, MS, NCC, LPC-Intern

Supervised by: Penny Haight, M.Ed., LPC-S

“Don’t step off the road — There might be another one!”  ― James McGarrity

Survivor’s guilt is used as a term which explains the guilt one feels for surviving a traumatic event. Survivor’s guilt is also felt when losing a friend or a loved one to suicide. There are many questions as to “how could I prevented this?”, “I should have known,” “What if I told them …..”Although it seems simple to state there is obvious survivor’s guilt, many turn away from a general perspective and are unaware of why they feel this much guilt and wonder when the healing can begin.

Survivors of Grief

Typically, when dealing with grief there are 5 stages in which one can expect, not in any given order, which are: denial, anger, bargaining, depression, and acceptance. In general, there is a transition between each stage of grief. With survivors of suicide, it seems that the transition can be more difficult, and often times, one may feel they are stuck. More often, one may not even notice they are stuck in a particular stage.

Denial

The news of the suicide, or being there for the event- either way, it may be difficult to understand and to process. Although the news is there and the event occurred, there are still many unanswered questions. You may feel the unanswered questions hold you to this significant event.  You may feel like you need to know why or that you do not understand what led them to this ultimate decision. It is difficult to understand and to process that in order to move past this denial you will eventually have to learn that you will not be able to obtain all of the answers to your questions and some will remain unanswered.

In addition to this, in the beginning of the loss, you may notice an influx of bad memories. There are numerous triggers you may begin to develop and often playbacks and nightmares associated with this stage. You are often plagued by bad memories, images, and scenes of the loss. Unfortunately, this is part of a process one seems to go through before being able to get to the good memories. As the time and healing begins, the negative images become less and the positive memories become more.

Anger

Anger in the loss can often times coincide with grief. You may notice that you become angry with yourself feeling as though you should have known; should have seen something. You may also become angry at the deceased, and when you do, you may find yourself becoming angrier at yourself for even thinking that way. You may also find yourself becoming more hypersensitive to the world around you.

Bargaining

As stated previously, there are many unknown answers for the survivor. This makes this stage a bit different than the typical stage of bargaining. The survivor still goes through the “what if’s” or “If only” or “I should have” but the ultimate question of why will always remain at large. There is only the assumption as to why the loved one decided to take their own life, but generally never the definitive answer as to what exactly led them to that point.

Depression

During this stage, there is more than immense sadness as the label would lead one to believe. Suring the depression stage, there is a point where the sadness begins to fade slowly as the realization and certainty of the loss sinks in. During the depression stage one may realize they are not able to change what has happened, and they have lost the energy to continue to fight the inevitable.  This stage is more than sadness; this is the stage that the emptiness begins to take over, even at times vengeance.

During the depression stage, it is also common to shut others out. You may notice yourself becoming bitter and angry, sometimes hurtful to loved ones. You may also notice yourself becoming less emotionally attached to those who are closest to you. The depression is a natural stage needed to prepare for the acceptance stage. There is no set time as to how long this depression will last that is an accurate depiction, several factors affect the amount of time needed for someone to go through the depression stage to include the relationship with the loved one and our own personalities.

 

Acceptance

Acceptance is not a stage in which one bounces back and decides everything is ok. Acceptance is a stage that one reaches to acknowledge that the loved on is gone, and there is no turning back. Reaching this stage is difficult, but it is important to remember there is no right or wrong time frame to reach acceptance. One must also accept that acceptance does not mean you have to understand or be ok with the untimely death of a loved one, only to accept that it happened and that you are finally ready to adjust to a new life without the loved one in it.

 

Important Tips for Suicide Survivors

Here are some important tips for those dealing with the loss of a loved one through suicide:

  • Understanding that grief will take time, be patient with yourself
  • Learn to turn guilt into forgiveness
  • Acknowledge the anger that you feel
  • Reach out to others
  • Anger, guilt, confusion, forgetfulness are common responses

Important Tips for Family and Friends of those with Survivors Guilt

  • Accept the intensity of their grief
  • Acknowledge their need for grief
  • Listen openly without judgement
  • Never succumb to clichés (Look what you have to live for, time heals all wounds….)
  • Respect their faith and spirituality
  • Know where to find resources

 

Resources are available when they are needed. Some of the local resources for the Fort Worth area are located below.

http://www.counselingbypenny.com/

https://www.thewarmplace.org/

http://www.namitarrant.org/resources.html