somatic experiencing therapy
Managing emotions

The blame game: How to stop the cycle of anger and self criticism

Written by Kristi Wollbrink

I had this self critical moment the other day.  I had made a plan for all the things I needed to get done.  I was going to stop and get a few errands done before I headed into the office.  I was sure I could get things completed and into the office with plenty of time to spare.  But I found myself with a very unexpected change in my plan.  In an instant, I noticed myself in this space where it felt like everything else in me was in wild turmoil, as if the world had stopped for a moment and I was stuck in this frenzy of emotion and frustration.

Maybe you’ve faced one of these moments.  One moment you are sailing along perfectly, feeling calm, centered and ready to conquer the day.  The next moment, you find yourself feeling overwhelmed, your mind and emotions spinning.  It’s in these moments that you can feel like you’ve been completely derailed from the place of focus and connection with yourself.  Like your very sense of safety and happiness is gone.

Blaming Others vs. Blaming Myself

Often in these moments we can find ourselves moving toward two common responses.  The first is this feeling of anger at the people or situation around us.  We press our fear and frustrations outward onto those around us.  You may find yourself feeling your internal pressure rising and getting defensive and reactive.  This can lead to moments of responding with yelling or blaming others.  

On the other side of this is frustration toward yourself.  Your mind starts to race and you find yourself stuck in these self-defeating thoughts.  The feeling of fear and anger are aimed within us, with blame and self-criticism toward ourselves.   You may find yourself feeling foolish or embarrassed, and begin to blame yourself for all the things you should (or shouldn’t) have done.   

These responses are both natural coping mechanisms that we use to help us to try to move through difficult moments.  Whether is an unexpected change of plans or a critical comment from a co-worker or partner – these moments can cause us to begin to move toward these responses of blame and self-criticism.  This is linked with our survival instinct as a way that our nervous system is using to try to protect us from moments where we feel some kind of threat, which results in this fear response turning on.  

woman freed from self criticism

Begin to understand the pain behind the blame.

Whether the blame is internalized in blaming ourselves, or more external in our frustration and anger toward others, both of these are an emotional response to a deeper sense of pain that we are responding to.  

But the only way to help in moving past these, is to begin to understand what is going on that is behind these behaviors.

Using these three steps, you can begin to allow yourself to slow down the frustration and begin to calm these patterns of blame.

3 steps to slow down and stop self criticism.

1. Tune in to slow down.

Slowing to take a few breathes can be a huge help when you notice these feelings of anger or blame that you may be experiencing.  Often, when we are overwhelmed with fear or anger we are unable to access the place of being able to regain control and calm.  It can be helpful to just allow yourself to be present in the feeling and try to regain control of yourself in the moment.  In these moments our fear response often has us going into a place of heightening of physical tension – our heart rate rises, our breath gets short and shallow, our muscles can get tense.  It is important to disrupt this place of physical tension to be able to then allow yourself to feel safe enough to slow down and decrease the blame.  Breathing in as you count up to 5 and then counting back down from 5 as your breath out can be a great way to help slow yourself down.  Tuning into notice this intentional act of slowing your breath can remind you that you are able to regain control.

2. Begin to understand what you are feeling.

It can be helpful to ask yourself, what is it that is feeling attacked or threatened right now?  It can be hard in the moment to be able to understand what it is that is going on underneath the anger and blaming behaviors, but taking a moment to consider what it is that is the deeper feeling can help us to begin to allow a greater space for understanding that can help us to feel more calm and in control.  You may first start with stating that you are feeling angry or frustrated.  Then begin to ask yourself what am I feeling that is fueling the feeling of anger or self-criticism.  Anger is usually a response to a deeper internal feeling and it is important to be able to name that underlying feeling to help in reducing the blame and criticism that you are experiencing.  It could be that you feel helpless or unseen; maybe you feel alone or unsupported.  Whatever it is, taking a moment to understand and name this feeling is a powerful way to begin to regain control over the anger and blame.

3. Imagine yourself as you would a close friend.

As you begin to notice this underlying feeling, it can be helpful to imagine yourself as you would a close friend.  If for a moment, you can imagine your friend telling you about how they are feeling misunderstood and helpless, you might do something like slow down and take a moment to say that you are sorry they are feeling this way.  You might lean a little closer and ask how you can help them.  You might remind your friend of all the ways you see her as helpful and valuable.  These are likely the same things that you are needing to know to help you to slow down the blame and anger and begin to regain a feeling of internal control and support that you need to be able to move forward.  It could be helpful to use a word or phrase that you can say to yourself that can help to calm this feeling of anger and frustration.  Something like, “I am able to make decisions for myself” or “I am not alone and can ask for help” can be really helpful to slow down regain a sense of confidence and control. 

These overwhelming moments of blame and frustration don’t have to keep you from being able to stay in control and in tune with your truest self.  Learning these three simple steps can help to take you from a place of regret, anger and fear and into a place of connectedness with what you need most. 

Gaining the confidence you need to help you overcome these patterns of blaming yourself and others is possible.  It can be helpful to have someone to come alongside you in this process of change. 

I help people like you to begin to understand their own needs and to move toward a greater place of connection with themselves and those they are closest with. 

 Click below to schedule a free consultation.

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Anxiety, Managing emotions

What is somatic psychotherapy? How body awareness restores your mind

Written by Here Counseling

Somatic psychotherapy is the umbrella term for methods of therapy that are rooted in the body where trauma, stress, and memory are housed. Somatic psychotherapies are based on the theory that the body holds emotion and experience. When hard-to-handle feelings and traumas are not processed, they can manifest as anxiety, panic, depression, chronic pain or illness, relational issues, self-esteem problems, grief, or post-traumatic stress disorder. Somatic methods aid in draining the power of these feelings through attunement with the body – its positions, gestures, energies, and sensations. 

Somatic Psychotherapy Modalities

There are many somatic psychotherapeutic modalities. You may have heard of some of them such as, Somatic Experiencing, Sensorimotor Psychotherapy, Eye movement desensitization and reprocessing (EMDR), Hakomi Method, Brainspotting, and plain old Mindfulness. Ultimately, the kind of somatic work that happens in the therapy room depends on the client and the therapist and can involve a wide variety of techniques, including breath work, visualizations, sensory awareness, posture tracking, guided imagery, gesture, and movement. 

Somatic Psychotherapy Exercises

Sometimes, somatic exercises are very straight forward, such as simply sending compassionate breath toward a particular part of the body that is experiencing activation. Other times, exercises are created on the spot to aid a client’s specific needs in the moment. For example, a client who struggles with low self-esteem feels they are unable to accept compliments. They might say, “Positivity just flows right through me – in one ear and out the other.” In this case, we might mindfully “build” a space in the body to hold compliments, positive feedback, and love. Then, when they hear a compliment, they can visualize the affirmation dropping into and being held compassionately in the space they created for it in their body.

Somatic psychotherapy is a way to help people feel safe in their bodies while exploring thoughts, feelings, and memories. Painful experiences live in us on a cellular level, but we can heal by restoring the body to live with vitality, ease, and joy.

Questions about Somatic Psychotherapy

  • One question I often get is, “Does somatic psychotherapy include talk therapy?” The answer is YES! Although somatic practices are body-based, talking through feelings and sensations is an essential component of the therapeutic work.
  • Another question I get is, “Do I have to dance?” And the answer is NO, not unless you want to. Like most productive therapy, somatic work is client-centered and client-lead. Together with your therapist, you decide when and how to integrate the body into the healing process.

If you choose to work with me, you can expect:

  • I will naturally return to the body in the here and now as a way to ground and understand authentic self.
  • I utilize body scanning techniques to gain awareness of where pain or emotion is located in the body.
  • I track and bring awareness to repetitive gestures or postures that align with certain memories or feelings to aid in self-knowledge.
  • I share tools for calming, centering, and releasing emotions in productive ways.
  • I gently guide clients through painful experiences while noting the accompanying physical sensations and addressing them in the moment.
  • I emphasize the body as a base to locate natural resources, strengths, and self-empowerment.

If you have interest in somatic psychotherapy and healing your body, I would love to talk with you.

Learn about Somatic Psychotherapy with Arianne

Further reading on somatic psychotherapy:

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (Hardcover) by Bessel van der Kolk 

Hakomi Mindfulness-Centered Somatic Psychotherapy: A Comprehensive Guide to Theory and Practice (Paperback) by Halko Weiss 

Somatic Psychology: Body, Mind and Meaning (Paperback) by Linda Hartley 

Awakened Heart, Embodied Mind: A Modern Yoga Philosophy Infused with Somatic Psychology & Neuroscience (Kindle Edition) by Julian Walker

Here Counseling

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Managing emotions

Constantly worrying? How to soothe rumination using somatic psychotherapy

Written by Here Counseling

Have you ever been driving somewhere, and a memory from the past suddenly overwhelms you and you forget where you are going? Have you ever woken up in the middle of the night and began to worry about all the things you need to do, until the thoughts take over and you cannot fall back to sleep? Or have you ever had a perfectly normal day, when all of a sudden, a negative thought creeps into your head and snowballs into a sadness that you can’t shake off? This is rumination, persistent negative thoughts that hijack our minds, interfering with normal activity.

Many clients turn to therapy because they cannot get out of their heads or worry too much. Rumination is common, normal, and most of the time, temporary. In some severe cases, it can become continuous and negatively impact daily functions. More common temporary rumination is the mind’s way of letting us know we are anxious, and we can do something to help soothe ourselves out of this state.

Do thoughts have you, or do you have thoughts?

The way I like to describe rumination is that it feels like thoughts have you, rather than you having thoughts. It’s as though your thoughts are dragging you away from your centered self. Thoughts are in control, not you. Here are a few techniques that can get you back to feeling that you are in control of where you mind goes.

1. Move your body to reduce worry

A great way to unlock ourselves from rumination is to move our awareness into our body. If you find yourself ruminating in bed while trying to fall asleep, hug your knees tightly to your chest and then alternate that position with a long, big, full-bodied stretch. You will find that you naturally inhale deeply on the stretch and exhale slowly when you crunch you knees to your chest. Do this a few times. You might even want to exhale with aahhh, shhhhhh, or hhmmm sound, which stimulates the vagus nerve system, helping to promote inner balance and relaxation. 

If you’re driving, shoulder rolls can help bring your focus to your body and you can keep both hands on the wheel! Try inhaling as you roll the shoulder forward and up, and exhaling as you roll them back and down. Try to trace the widest circle your shoulders can make. Again, you can add a sound on the exhale – and the best thing about doing this when you’re driving alone is that no one can hear you. So, make the sounds as loud and weird as you want. A sense of playfulness can also help ease our way out of obsessive thinking.

2. Touch your body to reduce worry.

If you find yourself ruminating, you can give yourself a gentle face massage, or lightly tap the tips of your fingers on your face, head, neck, chest, and shoulders. This body stimulation will aid in notifying your brain that you are safe and not in harms way. It will signal to your brain that it’s OK to relax. You can also alternating tapping your right and then left thigh, which activates your right and left brain, aiding in re-orienting and unhooking from repetitive thinking.

3. Focus on your breath to reduce worry

A tried-and-true method that has helped many of my clients fall back to sleep or bring them swiftly out of a rumination episode is a ten-count visualization. This works best with eyes closed or soft inward focus, so do not do this on the road! Tune into your natural breathing rhythm. When you’re ready, visualize the number one in your mind’s eye as you exhale. Conjure the number so that you see it in front of you, almost like the number appears in your mind floating. Do this for each number all the way to ten, and then begin again with number one. This is the key – always return to one after you reach ten. Some nights, it might take three rounds before you fall sleep and others, ten or twenty. Keep at it! If you find your mind returning to intrusive thoughts let them glide by and return to your ten count visualization.

If you can’t close your eyes, but you need a breathing technique to re-center yourself after you have moved or touched your body out of rumination, a simple box breathe can help. Visualize your inhale moving up the left side of a square, extend or hold the inhale as you visualize tracing the top line of the square, exhale as you visualize tracing down the right line of the square, and extend or hold the exhale as you visualize tracing the bottom line, completing the square.

Freedom to be.

Repetitive thoughts do not have to drag us away from ourselves. They are signals that we need some reassurance, re-calibrating, and re-centering. Activating the body is a powerful way to exit the hamster wheel of obsessive thinking and anchor ourselves in the life force of breath, and just be.

-Arianne MacBean

Somatic therapy in Pasadena with Arianne MacBean, AMFT
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Person utilizing EMDR to address trauma
EMDR, Managing emotions

Is EMDR the best way to treat trauma? Proven therapy options to help you recover

Written by Here Counseling

Emotional trauma can be a daily struggle. It can be upsetting to have feelings like fear, panic, anger, or sadness pop-up uninvited. Maybe you have wondered about how to get help, but have felt overwhelmed at the options. Which therapist is going to help me? Is there a “right” kind of therapy that will make my daily life better? And what is EMDR?

I understand how hard it can be to settle on the right kind of therapy for you. In this blog, I’m going to help you make sense of a few of the most common approaches to treating emotional trauma, including EMDR, Somatic Experiencing, CBT, and DBT.

Is there a “go-to” way to treat trauma?

In short, no. Trauma affects people in very different ways. It can be caused by a single highly traumatic event or by repeated experiences to what therapists refer to as “little ‘t’ traumas.” Regardless of the form it takes, trauma can cause long-lasting psychological distress that affects every aspect of one’s life.

Let’s talk options, EMDR and otherwise

The most common form of therapy for trauma is talk therapy. Talk therapy can utilize numerous modalities, from psychodynamic to CBT (cognitive behavioral therapy). Both integrate evidence-based practices. They have been tried and tested and demonstrated effectiveness across various populations and symptoms. EMDR is a new method that many people find highly effective to alleviate their symptoms of trauma. However, it is just one of many therapeutic techniques that can help you more effectively cope with and overcome your trauma. Depending on your needs and preferences, you may select for a therapist who specializes in one/multiple of the following forms of treatment.

1. Eye Movement Desensitization and Reprocessing (EMDR)

In recent years, EMDR was developed. It quickly became a popular form of treatment for trauma. EMDR was developed in the late-1980s by psychologist Francine Shapiro to treat PTSD (Post Traumatic Stress Disorder). EMDR targets trauma’s underlying emotional and cognitive processes. Therapists who practice EMDR believe that traumatic experiences can become “stuck” in the brain. Memories of trauma can thus cause negative beliefs and emotions that affect one’s ability to cope. EMDR can help reprocess these experiences and help develop more adaptive beliefs and coping mechanisms.

In summary, EMDR involves bilateral stimulation. This may be achieved through eye movements, tapping, or auditory cues. While focusing on these cues, the client focuses on a traumatic memory. This bilateral stimulation is believed to aid the client as they reprocess their traumatic memory, thereby facilitating the client to process the memory in a new manner. In my next blog, I’ll interview a therapist who integrates EMDR into treatment for trauma to further explore the goals, practice, and effectiveness of EMDR therapy.

2. Somatic Experiencing (SE)

Of the other treatment methods included in this blog, Somatic Experiencing (SE) has the most in common with EMDR. If you have ever heard of “tapping,” you are already familiar with SE! SE focuses on the physical sensations associated with trauma. It is based on the belief that traumatic experiences can become “trapped” in the body. SE theorizes that by releasing these physical sensations, you can release the trauma and heal. In SE, the therapist will help you become more aware of the physical sensations associated with trauma. This may include tightness in the chest, tension in the muscles, or a racing heart. You will then learn to tune into these sensations and to develop strategies for releasing them. SE often involves gentle physical touch, such as tapping or holding, to help the person release the physical tension that is associated with the trauma. The therapist might also guide you through movements or exercises to help release the trauma from your body.

3. Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) focuses on the triad relationship between thoughts, emotions, and behaviors. It is often used to treat anxiety and depression, but can also be effective in treating trauma. CBT will teach you how to identify negative thought patterns associated with your trauma. Then you will learn to challenge them, and then replace them with more realistic, positive, and adaptive ones. This can help you develop coping strategies and improve your overall well-being.

4. Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) was originally developed to treat borderline personality disorder. However, it has been found to be effective in treating other mental health disorders as well, including trauma. DBT focuses on helping you learn to regulate your emotions and develop more effective coping strategies. In DBT, your therapist will teach you how to identify the triggers that lead to emotional dysregulation. You will then learn and practice skills to help you manage your emotions. These skills may include mindfulness, distress tolerance, and interpersonal effectiveness.

So how do I determine which method is right for me?

Actually, you don’t need to choose just one! EMDR is not a standalone treatment for trauma. That means that it is often used in combination with other therapies. EMDR’s goal is to reduce traumatic memories’ intensity and associated negative beliefs. Thus, EMDR can make it easier for you to engage in other forms of therapy. Overall, there are many different therapeutic approaches to treating trauma, and no one approach is right for everyone. The best approach will depend on your individual needs, preferences, and experiences.

What are my next steps?

Whether you choose EMDR, CBT, DBT, SE, or another approach to treating trauma, the most important thing is to take that first step and seek help. If you are struggling with trauma or a trauma-related disorder, it’s important to seek help from a qualified mental health professional who can help you find the right treatment approach for you. As a psychologist, I appreciate when potential clients ask me about my qualifications to help them achieve their treatment goals! I hope this empowers you to ask the therapist you are considering working with about their level of experience and expertise in treating trauma in general and/or in a specific form of treatment.

Trauma can have a profound impact on a person’s life, but it doesn’t have to control it. With the help of a qualified mental health professional, you can develop the skills and strategies you need to heal from the effects of trauma and live a happier, more fulfilling life.

Don’t let trauma hold you back any longer – book an appointment with a psychologist today and start your journey towards healing and recovery. Your mental health and well-being are worth investing in, and there is no better time than now to take that first step towards a brighter future.

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ADHD, Managing emotions

How to pay for your Child’s ADHD Assessment: 3 Ways

Written by Connor McClenahan

An ADHD assessment provides answers. It can help you understand your child’s behaviors and illustrate their strengths and weaknesses. It clarifies a diagnosis and provides a clear path forward. But how do you get an ADHD assessment for your child and how can you pay for it?

Thankfully, you have some options. There are 3 ways to receive or pay for an ADHD evaluation: through your child’s school, through insurance, and through private pay. Each option has pros and cons to consider.

ADHD Assessment through your Local School District 

First, consider having your child evaluated through your local school district. Whether your child attends private or public school, the school district is required to provide educational evaluations for students who are struggling academically.

Pros:

  • Cost: There is no cost for an evaluation through the school district.
  • Access: You do not have to find an outside provider or take your child out of school for extended periods of time. This is because all testing can be done at school by school staff.

Cons:

  • Qualifying: It may be difficult to get the school to complete an evaluation if your child is doing well enough academically. Schools are only required to provide evaluations for students who qualify based on low academic performance.
  • Long wait times: Schools usually have a long process to determine if students qualify for an evaluation. Even once the school approves an evaluation, it may take months to complete.
  • Less comprehensive: A school evaluation considers academics and school behavior, but is less likely to take other parts of your child’s life into consideration. A school evaluation might not be able to provide a diagnosis of ADHD.

ADHD Assessment through Insurance

ADHD is a medical diagnosis and so an ADHD assessment may be covered by your insurance provider.

Pros:

  • Cost: There is low cost to you or may be paid completely by your insurance.
  • Provider list: Check with your insurance for a list of providers who take your insurance in your area.

Cons:

  • Access: It is sometimes difficult to find a provider through insurance. Providers may have long wait lists.
  • Comprehensiveness: Insurance plans limit what they pay for. Your insurance will likely not cover academic testing or testing for other mental health diagnoses. The evaluation may only be able to determine whether or not a child has ADHD, and not include what else could be going on for your child (ex. learning or emotional problems.)

ADHD Assessment Through Private Pay

Lastly, you have the option of paying out of pocket for an ADHD evaluation. You pay for the evaluation up front but insurance may still cover some or all of the cost of an evaluation. Many providers offer a superbill, which is a receipt that you submit to your insurance. Based on your plan, your insurance may reimburse the full or partial cost for the evaluation.

Pros:

  • Choice of provider: Paying out of pocket allows you to choose a provider who will be the best fit for your child’s needs based on location, specialty, availability and your comfort with the provider.
  • Comprehensiveness: Your provider can tailor the assessment to answer your specific questions instead of only focusing on what insurance covers. Get all of your questions answered, without the limits of school resources and insurance coverage.

Cons:

  • Cost: This may be a more expensive option since you pay up front and there is more uncertainty regarding insurance reimbursement, depending on your plan and deductible.
  • Access: You may have to take your child out of school longer to travel to see your provider.

Weighing Your Options 

All of these options can be really helpful for getting support for your child. You may decide to check in with school and insurance before deciding whether or not private pay is the right option for your family. Whichever you choose, having more answers and clarity will empower you to advocate better for your child’s needs.

If you would like to discuss which of these options would be the best fit for you or if you are ready to schedule an appointment, please contact us for a free consultation.

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Therapist giving ADHD assessment to client with ADHD to diagnose ADHD and comorbid ADHD diagnoses
ADHD, Managing emotions

ADHD Often Comes with a Partner: How Comorbid ADHD Diagnoses May be Affecting Your Focus

Written by Here Counseling

Comorbid ADHD Diagnoses: What does it mean?

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder with a high frequency of comorbid ADHD diagnoses. A decade ago, many psychologists worried that ADHD was being “over-diagnosed.” However, in recent years, psychological research has proven that almost 10% of the population has ADHD (6 million children: 9.8%, according to the CDC). In 2003, this number was estimated to be only 4.3% of children in the United States.

Interestingly, researchers now understand this 9.8% statistic to be global. Thus, this implies that it is not culture or ethnicity-dependent but, rather, universally prevalent. People diagnosed with ADHD may have ADHD, Predominantly Inattentive Presentation, Predominantly Hyperactive Presentation, or Combined Presentation. This is dependent on their diagnosable symptoms: are they predominantly focus and attention based? Hyperactivity and impulsivity based? Alternatively, do they meet clinical criteria for a number of both types of symptoms?

A statistic that is not often discussed, however, is how common it is for people with ADHD to also have comorbid ADHD diagnoses. A comorbid diagnosis is a co-occurring diagnosis. In other words, it is common for an individual to not only have ADHD, but also have one or more diagnoses simultaneously. This is an important fact, as many people misdiagnose their anxiety, depression, bipolar, or other such disorders as ADHD. Then, they do not seek or receive the help they need to best cope with these additional disorders. Treating ADHD is so important. However, so is treating comorbid diagnoses for truly effective symptom management.

What are some Common Comorbid ADHD Diagnoses? How common are they?

In short, the answer is: very common! Approximately 65% of all individuals diagnosed with ADHD meet diagnostic criteria for a comorbid mental, emotional, or behavioral disorder. This is a higher comorbidity rate than with many other well-known psychological diagnoses. Here are some specifics. Of all individuals in the U.S. diagnosed with ADHD, the following percentages meet criteria for these diagnoses:

  • 52% have a behavior or conduct disorder
  • 50% have a sleep disorder (such as insomnia)
  • 50% have ODD (Oppositional Defiant Disorder) as children, developing into a behavioral disorder in adulthood
  • 45% have a learning disorder.
    • This is believed to contribute to the finding that 33% of students with ADHD drop out of high school.
    • Notably, research has found that males diagnosed with ADHD have an approximate 65% risk of developing dyslexia or another form of writing disorder, while females have a 57% risk
  • 33% have anxiety (e.g.: Generalized Anxiety Disorder or Social Anxiety)
  • 20% have bipolar disorder
  • 17% have depression
  • 14-25% have ASD: Autism Spectrum Disorder
  • 10% of children with ADHD will develop Tourette syndrome (tics, etc.); 1-2% of whom maintain this syndrome into adulthood
  • 10% have a speech disorder
  • 10% will develop substance use disorder (alcohol or drugs)

To put this into context, this means that more than 2 out of every 3 individuals with ADHD also have a comorbid disorder. It is important to note that these statistics are based on diagnosed disorders. That implies that far more individuals with ADHD actually have these comorbid ADHD diagnoses than we psychologists have discovered through research thus far. You can learn more about ADHD statistics here:

  1. CDC’s ADHD Facts and Figures 
  2. ADDitude’s ADHD Statistics

How do I know if I or my Loved One has a Comorbid ADHD Diagnosis?

Understanding the link between ADHD and its common comorbid diagnoses: how they overlap, are separate, and interact, is key for effective treatment. The high degree of overlap can make it challenging for non-psychologists to differentiate them without a trained professional. For instance, individuals with ADHD may struggle to relax and focus. In combination with other symptoms, this may indicate a comorbid diagnosis of Generalized Anxiety Disorder. People with ASD (Autism Spectrum Disorder) can struggle with Inattention and Impulsivity: two hallmark characteristics of ADHD, Combined Presentation. Therapy and assessment with a psychologist who specializes in ADHD and comorbid diagnoses are your two tools to clarify this overlap.

When an individual calls me wondering if they qualify for multiple diagnoses, including ADHD, the first step is assessment (psychological testing). There are two types of ADHD testing. The more expedient and moderately less expensive option is an ADHD testing. However, this only tests for ADHD. Choosing to be assessed through a psychologist qualifies individuals who are diagnosed with ADHD for stimulant medication through a psychiatrist, should they choose this treatment route, and accommodations at work or school. The second type is a comprehensive testing. This is referred to as a “psychodiagnostic” assessment. It assesses for all relevant diagnoses listed above. It can help individuals understand the links and differentiate the overlap between these various diagnoses’ symptoms.

How do I Learn more about Assessment?

If you feel you may benefit from an ADHD or Comprehensive ADHD Psychodiagnostic Assessment, then contact me today for a free consultation call. I’ll talk you through the benefits of the various options as well as discuss the next steps, fee, insurance reimbursement, and scheduling with you to make the process clear, calming, and effective. By reaching out today, you can learn more about your ADHD testing options and schedule an intake interview to begin your ADHD testing process. You’ll be that much closer to getting the answers you need to manage your symptoms and live a more balanced, fulfilling life.

Differentiating your diagnoses and how they interact is key for effective therapeutic treatment in the future. It provides clarity as to what you need to work on in therapy. Then, you will know what you need your psychologist to specialize in to ensure you receive the most effective treatment.

Many of my clients who came to me for testing transitioned to working with me for therapy for their ADHD and comorbid diagnoses. This is my speciality: an area of expertise I am passionate about and eager to help my clients in as we collaboratively work towards therapeutic treatment goals that are directly improving each of their comorbid ADHD diagnoses.

Remember, a psychological assessment is an investment in yourself. In your future. In your potential to discover clarity about your diagnoses and certainty about the path forward. I provide extensive and personalized recommendations to your unique case to help you develop the effective behavioral strategies needed to thrive with symptom management and alleviation. Reach out to me today to schedule a complimentary consultation call and take the first step towards gaining clarity and understanding.

 

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Anxiety, EMDR, Managing emotions, Neurology

Maximize EMDR Therapy: How to Find a Good Therapist

Written by Connor McClenahan

Maybe you’re wondering about how EMDR therapy can treat trauma. Trauma can negatively impact an individual’s life and well-being for years, even decades, after the traumatic event has passed. Trauma is a natural survival response to any life-threatening situation. If you’ve experienced trauma, you may notice how it seems to intrude into everyday situations.

Trauma can impact:

  • Sleep: the quality and restfulness of your sleep
  • Relationships: increase feelings of insecurity and fear
  • Anxiety: increase blood pressure, heart rate, jumpiness
  • Addiction: increased dependence on external substances to reduce symptoms
  • Focus: increased scattered, intrusive thoughts

Our brains heal from trauma.

In fact, like a wound that simply needs rest and clean bandages, there’s a natural reparative process that takes place – all on its own – when our minds feel safe enough. We find ourselves sharing more, feeling more, telling the story of what happened with a trusted other. EMDR therapy taps into this natural healing process.

EMDR (Eye Movement Desensitization and Reprocessing) therapy is a powerful tool in helping individuals overcome trauma and regain control of their lives. In this article, you’ll learn how EMDR works for you, and why the relationship between the therapist and client is key in producing long-term change.

How EMDR works

EMDR therapy is based on the idea that traumatic memories are stored in a person’s brain in an unintegrated form. Normally, in non-traumatic experiences, memories of the experience can be retrieved and shelved easily with language (think of checking out a video at a library), giving us control and mastery. When someone experiences a traumatic event, however, their brain shields itself from the painful memory, leading to the memory becoming “stuck” in the right prefrontal cortex and limbic system. This can result in persistent symptoms such as anxiety, depression, and post-traumatic stress disorder (PTSD). EMDR therapy works by accessing these stored memories and integrating them through a shared experience with the therapist.  

EMDR Therapy and Tapping

The key component of EMDR therapy is the rapid back-and-forth movement of the eyes, also known as “tapping.” This tapping is believed to stimulate the brain’s information processing system, allowing it to process and integrate the traumatic memories. As a result, the negative emotions and physical sensations associated with the trauma are reduced. The individual is then able to move beyond the event and regain control of their life.

EMDR Therapy and the hidden ingredient: Your therapist

While the tapping component of EMDR therapy is crucial, it is not the only factor that leads to successful outcomes. In fact, research has shown that the therapeutic relationship between the client and the therapist is even more important in producing long-term change in trauma. A strong therapeutic relationship provides a safe and supportive environment for the individual to explore their traumatic experiences and work through them in a controlled and guided manner.

Your brain wants – and even needs – to process trauma. Biologically, your brain is looking for safety. While safety can come from trusting a specific intervention or technique, such as EMDR, it will primarily come from your relationship with your therapist. Your ability to feel comfortable and safe with your therapist is exactly the environment your brain is looking for to integrate a painful emotional experience.

EMDR Therapy Girl wanting to process trauma with an EMDR therapist

A good EMDR therapist will help you

  • Gingerly approach the trauma, listening to your comfort level
  • Will appropriately challenge you to trust yourself to share
  • Give you space to stop when you’re feeling overwhelmed
  • Review and help you understand what you’re feeling
  • Check in about your symptoms

In conclusion, EMDR therapy is a powerful tool in helping individuals overcome trauma and regain control of their lives. The rapid back-and-forth movement of the eyes (tapping) stimulates the brain’s information processing system, allowing it to process and integrate traumatic memories. However, it is the therapeutic relationship between the client and therapist that is the most important factor in producing long-term change. A strong therapeutic relationship provides a safe and supportive environment for the individual to work through their traumatic experiences, leading to a more successful outcome.

EMDR Therapy can help you

Consider reaching out to a qualified EMDR therapist. With the right support and guidance, it is possible to overcome trauma and reclaim your life.

You want a therapist who fits you, who you feel safe talking with. I promise, it’s worth it to work through trauma. We can help you find the right fit so you can regain health and peace.

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Client working with best fit mental health professional: a therapist who fits her needs to develop coping skills for anxiety and depression and ADHD symptoms
Managing emotions

What kind of therapist do I need? How to choose the right mental health professional

Written by Here Counseling

It’s a huge relief to finally find the mental health professional who is your “right fit.” Not only will you be able to receive the help and support you need, but you may also find that your overall sense of well-being improves as you work through your unique issues with the guidance of a compassionate and understanding professional. Certainly, when beginning the process of finding the right mental health professional, it can be difficult to know where to start. However, it is well worth the effort.

Sometimes, the decision is simple. If your goal is solely to seek information or a psychiatric medication prescription, then a psychiatrist is likely the best fit. Additionally, if you seek assessment to determine your diagnoses or if you qualify for accommodations, then you likely need a psychologist. However, if you are looking for therapy, then you have numerous options.

Why does it matter which type of mental health professional I choose?

Mental health is an important aspect of overall well-being. Thus, seeking out the right type of mental health professional for your needs can make a significant difference in your journey towards healing and self-improvement. Finding the right fit is crucial. It can impact the effectiveness of treatment and how comfortable you feel opening up and discussing sensitive topics. Presently, in this blog we’ll explore factors to consider when choosing a mental health professional so that you can choose the right type of therapist to best match your needs.

Mental health professionals are trained professionals who provide support, treatment, and care to people experiencing mental health challenges. There are many different types of mental health professionals, each with their own specific training and areas of expertise. Understanding the role of each type of mental health professional can help you find the right support for your needs.

How to Find the Right Mental Health Professional

I hope this chart helps you decide which type of mental health professional best meets your needs. To make an informed decision, I broke this chart down into detailed information about each type of therapist who can help you accomplish your treatment goals for therapy, assessment, or medication.

Mental Health Professional Graph

Types of Mental Health Professionals:

  1. Psychiatrists

    A lot of patients call me and are unsure of whether they need a psychiatrist vs psychologist. Psychiatrists are medical doctors who specialize in the treatment of mental health conditions. They can prescribe medication, provide therapy, and order laboratory tests or other diagnostic procedures to help diagnose and treat mental health conditions.
    • Training: They went to medical school, as opposed to graduate school for psychology/therapy. In California they are the only professionals on this list who can prescribe medication. Their training includes 4 years of medical school and another 4 years of residency in psychiatry.

  1. Psychologists

    Psychologists (like myself) are trained in the science of the mind and behavior. They can provide therapy to help individuals understand and cope with their thoughts, feelings, and behavior. They may do this by helping clients process their experience, identify patterns, and develop coping and problem-solving skills to better cope with or eradicate their symptoms.
    • Therapeutic Approach: They may use a variety of therapeutic approaches to help people change negative patterns of thought and behavior. This can include a wide variety of psychodynamic, humanistic, or cognitive-behavioral therapy (CBT). This could include ACT, solution-focused therapy, relational, DBT, and so many other potential modalities. If you are looking for depth-oriented short or long-term psychotherapy with a specialist trained to work with your specific symptoms, a psychologist may be your best fit.
    • Training: Psychologists’ training includes 4-6 years of post-undergraduate additional schooling and specialization that incorporate clinical work throughout. This is followed by 2-3 years of pre- and post-doctoral clinical training. 
    • Assessments: Psychologists are also trained to administer psychological assessments. This involves administering and interpreting tests to help understand an individual’s cognitive, emotional, and behavioral functioning. If you aim to learn whether you qualify for diagnoses (and associated work or school accommodations), psychologists can conduct a wide variety of assessments.
      • For instance, do you think you might have ADHD? Do you feel you may qualify for many different diagnoses and aim to learn which actually apply to you? If so, then assessment can help you gain these answers as well as receive personalized recommendations about how to more effectively manage or eradicate your symptoms
      Degree Types: It is important to note that there are two different types of psychologist degrees: PhD and PsyD. PhD’s are doctors of Philosophy, whereas PsyD’s are doctors of Psychology. PsyD graduate programs prepare graduates to apply scientific knowledge to working with clients therapeutically. PhD programs emphasize research by preparing graduates to study the theories behind psychological principles and practices. Many PhD programs also require applied clinical training. However, the major difference frequently lies in PhD programs requiring double the research as PsyD’s, and PsyD programs requiring double the clinical work (conducting patient therapy and assessment) as PhD programs.

  1. Marriage and Family Therapists

    Another common question I receive is about the differences between a psychologist vs MFT. Marriage and family therapists are trained to work with individuals, couples, and families to address relationship issues, communication, and problem-solving. They may work with people who are dealing with a wide range of issues. This may include mental health conditions, relationship problems, and parenting challenges.
    • Training: MFT’s are typically the second most trained type of therapist (excluding psychiatrists) after psychologists on this list. Their training includes a two-year graduate program followed by approximately two years of working with clients pre-licensure.
    • MFT vs Psychologist: Ultimately, the decision between a psychologist and an MFT will depend on your specific needs and preferences. If you are seeking support for a specific mental health condition, such as anxiety or depression, a psychologist may be a good choice. If you seek support for relationship issues or to improve communication and problem-solving skills within your family, an MFT may be a better fit.

  1. Clinical Social Workers

    Clinical social workers train to provide therapy, support, and advocacy to individuals, families, and groups. They may work with people who are dealing with a wide range of issues, including mental health conditions, relationship problems, and substance abuse. Social workers often work for organizations that provide community services, such as in government agencies or non-profit organizations.
    • Training: Similar to MFT’s, social workers’ training includes a two year graduate program. MFT’s typically follow this with approximately two years of training in the field.

  1. Counselors

    Many people wonder about the difference between a counselor vs clinical social worker. Counselors can provide therapy and support to people facing a variety of challenges. This includes mental health conditions, relationship issues, and career problems. They may use a variety of therapeutic approaches, such as CBT or mindfulness-based therapy, to help people overcome their challenges.
    • Training: MFT training tends to be more variable. Depending on their qualifications, it often includes a 1-3 year training course followed by clinical work pre-qualification.

So which Mental Health Professional is right for you?

In summary, each type of mental health professional has different training and qualifications. Therefore, it’s important to find the right fit for your needs. It’s important to choose a mental health professional with whom you feel comfortable and safe. Trust and rapport are key to the therapeutic relationship. Therefore, it’s important to find someone whom you feel comfortable talking to about personal issues. Most mental health professionals offer a free consultation call to discern goodness of fit. Remember, if a therapist feels you are looking for something beyond their scope of practice, they should discuss your options. They may refer you to the type of mental health professional that is most likely to best meet your needs. Keep in mind, may take some trial and error to find the right fit. However, the effort is worth it for the benefits of effective treatment.

Understanding the Letters Behind the Name (PhD, LMFT, etc)

Understanding the letters behind a therapist’s name can help you decipher which type of professional you are reading about when you see someone’s title:

Psychiatrists:

  • Doctor of Medicine (MD)
  • Doctor of Osteopathic Medicine (DO)

Psychologists:

  • Doctor of Philosophy (PhD) in the field of psychology
  • Doctor of Psychology (PsyD)

Counselors and Therapists:

  • LMFT, Licensed Marriage and Family Therapist
  • LPC, Licensed Professional Counselor
  • LCADAC, Licensed Clinical Alcohol & Drug Abuse Counselor

Social Workers:

  • LICSW, Licensed Independent Social Workers
  • LCSW, Licensed Clinical Social Worker
  • ACSW, Academy of Certified Social Worker

Finally, remember that it’s okay to take your time and be selective in your search for a mental health professional. Your mental health is just as important as your physical health. Finding the right person to work with can make all the difference in your journey towards healing and growth. So, when you’re ready to take the next step and begin therapy or seek assessment, fill this out to schedule a free consultation call. Begin your journey today: contact a therapist

 

Shannon N. Thomas, Psy.D.
Shannon N. Thomas, Psy.D.

I work with individuals and couples struggling with ADHD, anxiety, vocational, or relational issues who seek to thrive emotionally, individually, and relationally.

LEARN ABOUT SHANNON
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Managing emotions

How to have Holiday Conversations with Family

Written by herecounseling

Times around the Holidays can be a mixed bag of emotions. With the joy and excitement around this time of year, there may also be anxiety and the anticipation of hard conversations with family members and loved ones. We have all felt that pressure, regardless of dynamics, connecting with loved ones can be difficult. 

However, maybe it’s about reframing your mindset around these talks. Instead of assuming it will be hard or uncomfortable, why not go into these environments with a few topic ideas? Let’s give a few tips and tricks for navigating your holiday conversations. 

Choose your Holiday audience wisely. 

It may not be beneficial to talk to your conservative uncle about the political climate as it always results in tension or resentment. Go into conversation knowing that the other is a safe person for you, even if that circle is small. 

How do you choose who is safe? Ask yourself these questions before the gathering: 

  • Who here makes me feel heard? 
  • Where do I feel cared for? 
  • Am I accepted by this person? 

Pick topics that add connection than isolation around the table. 

There’s not an issue talking about what you do for a living or if you’re in a relationship, but these kinds of questions can feel singular and dry and somewhat uncomfortable to answer. Adding in some vulnerability offers an open space for warmth and connection, without feeling too pointed. 

Asking questions with intention can sound like this: 

  • Who in your life are you enjoying time with? 
  • What are you finding fulfillment in these days? 
  • What activities have you been excited about lately? 

Small talk topics don’t have to be so forced. 

Personally, small talk bores me and I can’t bring myself to tune into what the other person is saying. Questions about the weather or latest news only get you so far. But small talk can be intriguing and fun if you take a different take on questions. 

Taking an interest in the lives of others with small talk questions like these: 

Ask about their routines! 

  • Their morning or evening routines create a layer of connection and you may find some inspiration to try something new in your own routines. 

Low stake debates. 

  • Do you think the Nightmare Before Christmas is a Christmas movie or a Halloween? What fashion trends should never come back in style? Asking fun, engaging questions lightens tension and feels inclusive with others.

Heres the bottom line. 

Holidays can feel hard when we let our anxiety, past interactions, or history outweigh what’s in front of us. Remember, it is not your responsibility to keep the energy in a room flowing but it is your responsibility to manage your own. 

If all of this feels overwhelming, if the holidays are painful for you, please reach out to our offices to set up a consultation. After all, the Holidays are meant to be spent in community and we hope to be here for you. 

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ADHD, Managing emotions

5 ADHD Myths Debunked

Written by Here Counseling

When you’re diagnosed with ADHD, it can be difficult to discern facts from reality. The same is true if you are in the contemplation phase; wondering if you qualify for an ADHD diagnosis can be difficult while sifting through all the misinformation on social media that is perpetuated across the internet and pop-culture. Here I explain the reality behind the five main ADHD myths I encounter the most when working with new clients who struggle with symptoms of ADHD.

ADHD Myth #1: “You’re just lazy”

One of the biggest misconceptions about undiagnosed people with ADHD is that they just aren’t trying hard enough. Over half of the patients with ADHD I work with have been blamed for their untreated symptoms. Do any of these statements sound familiar?

  • “You’re just not trying hard enough!” 
  • “Everyone else can get it done in time!” 
  • “You just need to be more determined.”

These are fallacies! Not to mention incredibly damaging and demoralizing. The reality is that there is NO psychological correlation between ADHD and laziness.  Lack of effort is NOT a symptom of ADHD. In fact, most people with ADHD work harder than their neuro-typical counterparts because of the symptoms they’re knowingly or, too often, unknowingly combating.

ADHD Myth #2: Symptoms include…”

If you have TikTok or Instagram then you probably haven’t managed to avoid the endless cycle of videos explaining what ADHD looks like.

Social media would have us believe that everyone qualifies for an ADHD diagnosis. Now, social media has done a great job of raising awareness about disorders that people may otherwise not have thought to explore, get tested for, and treat. 

However, they also contain a lot of myths about ADHD. I’ve lost track of how many completely incorrect symptoms I’ve heard on social media, from symptoms that actually indicate other disorders altogether to “frequent tripping.” 

The truth is, whenever you want to learn the specifics of psychological disorders, social media is such a mixed bag of fact and fiction that you’re likely to encounter too many of they myths we’ve discussed so far. 

Instead, consult with a psychologist or the DSM. The DSM is our Diagnostic Statistical Manual, which we use for differential diagnosis. It describes the symptoms of every psychological disorder and how many of them you need to experience in a certain time frame to qualify for various disorders and specifiers. 

In short, there are three subtypes for ADHD:

  • Predominantly Inattention Presentation
  • Predominantly Hyperactivity Presentation
  • And ADHD, Combined Presentation

Depending on how many of each type of symptom you meet, you can be diagnosed with one of these specifiers. In a future blog, I’ll break down each of these specifiers in greater detail. In the meantime, you can check the DSM (our current version is the DSM-5-TR) to learn more.

ADHD Myth #3: “Adderall is always dangerous and addictive”

A lot of people have concerns about taking medication for ADHD. This isn’t incorrect, but there are also a lot of myths about the statistics of how medication can impact you. In short, there are numerous types of medications that can be used to treat ADHD. Some of these are stimulants, such as Adderall and Ritalin, and some are non-stimulants, such as Wellbutrin and Stratera which can also be used to treat depression. 

  1. Just as psychologists are the experts on therapy, psychiatrists are the experts on medication. Your psychiatrist can provide education about the different types of medications and which may be the best suited to your specific needs and concerns. 

Adderall is a class-A stimulant, which is why it needs to be carefully monitored by your psychiatrist. It certainly has the potential to be addictive, and can be dangerous due to its side effects such as appetite suppression which can lead to dangerous weight levels. 

However, if used correctly and monitored responsibly, many people find Adderall to be highly effective to help mitigate their symptoms. But, then there’s the other side of the coin…

ADHD Myth #4: “Adderall is a magic pill; it fixes ADHD”

Adderall is not a one-stop-shop magic pill that will get rid of your symptoms. It won’t suddenly make you stop procrastinating or maintain focus on what you feel that you should be focusing on. However, many people find that it can give you a choice. In other words, it can help you feel capable of, for instance, maintaining attention, but that doesn’t mean that you aren’t still capable of procrastinating just like a person without ADHD can.

    Some people do find that Adderall feels like this “night and day” experience that drastically helps them manage their symptoms. If you try it and find that is not your experience, remember that there are plenty of medication options and that plenty of people try various medications or dosages before finding the right fit.

    I like to recall the mantra that a psychiatrist I used to work with utilized when advising patients beginning ADHD medication: start low, go slow. 

    ADHD Myth #5: You grow out of ADHD, it’s “a childhood thing”

    This popular myth may have stemmed from the fact that, in order for a psychologist to diagnose you with ADHD, your symptoms must have manifested prior to age 12. So yes, ADHD must be present in childhood, but it isn’t confined to childhood. 

    Some people do find that their symptoms lessen with age. Some people needed medication while in school, for instance, but find it less necessary to take medication in later life. 

    Remember, however, that many people do not find that their symptoms decrease as they age. Many people report that they discovered coping mechanisms to aid their ADHD symptoms, which may contribute to them feeling that their symptoms lessened as they got older. These strategies may include the following, which I’ll expand upon in a future blog:

    • Breaking larger projects down into its minor components
    • Setting reminders for daily or important tasks 
    • Taking regular breaks when studying or working, such as employing the Pomodoro technique
    • Making their work/study environment as distraction free as possible
    • Using rewards to motivate themselves
    • Identifying and utilizing an “acountabili-buddy.”

    Next Steps

    Separating the myth from reality is key when learning about your new or suspected ADHD diagnosis. ADHD is a diagnosis with a high percentage of comorbidity, which means that people with ADHD sometimes also have another diagnosis, such as Anxiety, Depression, or ASD (Autism Spectrum Disorder).

    When the line between myth and reality becomes murky, it can be difficult to discern which diagnosis (if any) is currently impacting you. That can make it hard to figure out the best “next steps.” These next steps likely include working with a psychologist to be assessed for ADHD and learn if you qualify for a diagnosis. A psychologist will help you develop behavioral strategies to alleviate your symptoms or differentiate the impact of multiple diagnoses. Your psychologist may also help you meet with a psychiatrist to learn if medication could help you manage your symptoms more effectively. My hope is that this blog will help dispel some myths, arm you with truths, and help you begin to discern the next step that will be most beneficial for you. 

    Don’t know if you have ADHD?

    I can help you answer that question.

    A clear assessment can make all the difference in your life. Find out how we can help you

    ADHD Testing Options

     

    Shannon Thomas, PsyD
    Shannon Thomas, PsyD

    I work with individuals and couples struggling with ADHD, anxiety, vocational, or relational issues who seek to thrive emotionally, individually, and relationally.

    LEARN ABOUT SHANNON
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