What is Cognitive Therapy?

Often clients are referred to my office to for Cognitive Therapy or Cognitive Behavioral (CBT).  Once they arrive at my office it is not uncommon for these clients to ask what CBT is. Having said that I thought it would be appropriate to write this blog to help educate clients.

Cognitive Therapy was pioneered by Dr Aaron T. Beck in the 1950’s and is the most widely used form of psychotherapy to date.  Cognitive Therapy can be used for a number of problems such as; depression, anxiety, panic disorder, phobias, eating disorders, stress, just to name a few.

What is Cognitive Therapy?  Well “cognitive” means the way we think or our thought process.  This includes our perception of how we view events in our lives and our historical experiences. It also includes our worldly knowledge, how we understand the world around us.

How is this model applied?  Typically the therapist and client would explore the client’s thoughts and beliefs attached to the mood, physical experiences, behaviors (hence the B in CBT), and historical experiences or events in our lives.  So what are the nuts and bolts of this concept? Cognitive therapy would suggest that our perception of a particular experience or event has a profound affect on our emotional, physiological and behavioral response to that event.  An example of this might be, you are waiting in the Doctor’s office.  Your appointment was at 10 a.m. but it is now 11 a.m.  Now you have a choice. If you believe that the Doctor is really busy this day and working hard to see patients you might grab a magazine read a few articles and wait until your name is called. However if you think the Doctor’s office overbooked and that this has put you out, you may complain, get agitated, angered, and fidgety and feel you mood changing.  Cognitive therapy helps clients challenge their way of thinking and subsequently changing their reaction to the thought or event thus improving mood.

Parenting Young Children

We learn our jobs as parents as we go along, unfortunately children are not born with manuals, each child is unique.  What works with one doesn’t always work with the next.  We as parents quickly realize that love isn’t all that is needed.  We need patience, endurance and creativity and sometimes these qualities are in short supply.Caring for small children is tiring!  Caring for older children is less physically draining but more worrisome because they spend more time outside the home.  Being a parent can put a strain on being a couple, with less time to connect and enjoy each other’s company.

Have a realistic attitude and remember that there are no perfect children and no perfect parents, everyone makes mistakes.  Expecting to have the perfect family can get in the way of enjoying the one you have been blessed with.  Accept your children for who they are and remember that children that are loved, encouraged and allowed to grow up at their own pace will develop good self-esteem and confidence.

Sometimes in parenting we can do all the “right” things and still get poor results, we need to step back and realize that we tried our best and it is alright.  To lower stress that can build in parenthood you should make time for yourself regularly to enjoy your own activities.  Don’t feel bad asking for help, talking about your worries is the best stress reducer.  Set aside time to spend with the children, time for you and your spouse and time for yourself alone.

Laugh together, be appreciative of each other and give compliments often.  Parents and children need to spend one on one time together, you could read a bedtime story, play a game or take a walk together.  Talk over family problems in a warm, relaxed atmosphere.  Focus on solutions instead of blame.  Say what you mean and mean what you say.  Enjoy your children, they don’t stay little for long.

Separation “Are we doing the right thing?”

When the decision to separate is finally made, each of you will be profoundly affected.  Studies show that both groups (the leaver and the left) undergo roughly the same amount of emotional turmoil.  The leaver experiences guilt and self-blame where as the left experiences hurt and anger.  The length of the relationship doesn’t seem to affect the depth of mourning.

The four major emotional stages of separation and divorce are: 1. Separation Shock  2. The Roller Coaster  3. Identity Work  4. The Re-centred self.  These stages are similar to the stages of grief experienced by widows and widowers.  Mourning the loss of a marriage is a lot like mourning a death.  Following a divorce there will be times when you fees very much alone. Remember that many people have felt the same way and survived.

The effects of divorce take four points of view 1. some only focus their attention on their ex’s         faults  2. some blame themselves entirely, even if they aren’t the leaver  3.  some try to put the whole thing out of their mind  4.  the more healthy reaction is to try to figure out what went wrong so you can part with as little conflict as possible.

Just like any grief the healing process takes time but it is possible to come out at the end whole and happy.

Adult Child of an Alcoholic (ACOA)

Adult children of alcoholics often rely on the same coping skills that helped them survive through tough situations when they were younger.  As adults those skills can cause problems in their relationships.  ACOA’s may have addictions to substances or behaviours such as alcohol, drugs, eating, work or gambling themselves or they tend to find people that they can “save” such as alcoholics and substance abusers. They often criticize themselves and continuously seek approval of others and may lose some of their identity in the process.  ACOA’s often have an overdeveloped sense of responsibility and have guilt feelings for standing up for themselves instead of giving in.  The Adult Child of an Alcoholic usually has a dependent personality that is afraid of abandonment and will do “anything” to keep a relationship, they are frightened by angry people and confrontation.  It is hard for them to trust others.  It is helpful for the ACOA to work on their addictive behaviours first and then they can begin to see their other problems more clearly.  They can learn to feel hope, trust and healthy love again.

Alcoholism

Alcoholism is a mental obsession that causes a physical compulsion to drink.  A mental compulsion is a thought processwhich you have no control over.The vast majority of problem drinkers are people with families and jobs.  They may be dependent drinkers, binge drinkers or people who just drink too much on a regular basis.

It is estimated that for every problem drinker there are 3 or 4 other people affected directly and many more indirectly.  Those problems affect the family, relationships, routines and damage the quality of individual life experiences and opportunities.

The cost of alcoholism is outrageous.  A recent study estimates that the annual economic costs of alcohol and other drug abuse in Canada may be as high as $24.6 billion.

Alcoholism is a progressive disease, it starts with the mental compulsion that is stopped by having a drink and soon one is not enough, then maybe four is not enough to stop the compulsion and it continues until the individual can only stop the compulsion by passing out.

The progression of the disease is so subtle and has  usually taken place over an extended period of time that even the alcoholic themselves have failed to notice when alcohol took over their lives.

For those that have realized that alcohol is a problem there is help but for those that haven’t realized sometimes intervention is the only way.

Gambling “Will I ever get out of the hole?”

As with other addictions, the first step is admitting there is a problem.When is it a problem?
Can you answer yes to any of these questions?

Have you gambled more often or higher stakes to win back your lost money?
Does gambling cause you to have sleep difficulties?
Have you ever lost time from work or school to gamble?
Lying, borrowing or criminal activity to finance gambling?
Spending long or increasing amounts of time in gambling venues?
Gambling to escape the daily pressures of life?
Has gambling ever caused your home life to be unhappy?
Have you ever gambled until you lost your last dollar?
Have you ever sold anything to finance gambling?
Constantly thinking about or preparing for gambling?
Neglecting family, nutrition, or general well-being?

For most people, gambling is simply a form of recreation, something fun to do occasionally but for others it can be a devastating and life-threatening addiction.

A very serious effect of problem gambling is what is called “the loss of hope”.  Compared to other addictive disorders, the rate of attempted suicide is highest among compulsive gamblers.

Grief – sorrow or mental suffering resulting from loss, affliction, regret, death…

David James Cockman - BSW, MSW, RSW

David James and Associates Professional Counselling Services
Six Locations in Southern Ontario & The Niagara Region
Mobile 905.685.2787
Free  1.866.775.4991
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Web    www.davidjamesandassociates.com

Grief is a normal human reaction to loss and change.  Sharing our grief allows us to heal quicker.  To go through the many layers of grief takes time, the bigger the loss the longer the time.  For minor losses the grieving process could take a few hours, days or even weeks.  For moderate loss the time could be months to a year and for severe loss the grieving time could take 2 to 4 years for healthy completion.

There are as many ways to grieve as there are personalities, everyone grieves differently and at different paces.

One model based on Kubler-Ross’s stages of accepting death is as follows:

Numbness:
This reaction often follows the death of a loved one and may last for seven to ten days.  Some have referred to numbing as the body’s way for protecting itself from the shock of the loss.

Denial and Isolation:
Here the bereaved person has difficulty accepting their loss.  Although acceptance is part of the complete grief process more acute difficulties with acceptance are included in this stage.

Anger:
In this phase the bereaved feels anger with everyone.  A strong feeling of “Why me?” ensues here and bargaining with God for the return of the deceased may be a part of this phase.

Depression:
As the bereaved accepts their loss and the reality of that loss sets in they may experience extreme sadness or depression.

Acceptance:
The bereaved person comes to terms with their loss and is able to return to life on a daily basis with an absence of the extremes of emotion previously experienced.

Trauma – “Understanding Why You Feel this Way”

DAVID JAMES & ASSOCIATES
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Feburary, 2011

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At some point in your life you have probably cut your finger with a knife.  Depending on the sharpness of that knife and the force behind it you either bled a little or a lot.  Even if you had extremely tough skin, you would bleed.  There are events in life that can make you bleed all over on a psychological level.  It is these events that make people susceptible to developing Post-Traumatic Stress Disorder (PTSD).

You should talk to a counsellor if you have re-experienced the trauma in the form of dreams, flashbacks or intrusive memories, if you experience a numbing of emotions and reduced interest in others and your surrounding.  Also if you are experiencing insomnia, agitation, irritability or outbursts of rage that persist for at least one month.

Secondary Traumatization

Professions such as doctors, nursing staff, fire workers, police and search and rescue are at risk for secondary traumatization, which is known also as compassion fatigue, secondary or vicarious traumatization, and “burn-out”.  The symptoms are usually less severe than PTSD but can still affect the livelihoods of these professionals.  There are 3 risk factors for secondary traumatization, the first is exposure to the stories (or images) of multiple disaster victims.  Secondly your empathic sensitivity to their suffering and lastly your unresolved emotional issues that relate to the suffering seen.

Critical incident stress

Critical Incident Stress is the natural reactions of a person to an extreme situation.  They may occur immediately or in days, weeks or even months.  People that have experienced an extreme  situation often benefit from a critical incident debriefing,  which is a meeting held for those individuals that were directly affected by the event.

Seasonal Affective Disorder (SAD) – “What is it? And Does It Affect You?”

DAVID JAMES & ASSOCIATES

http://www.davidjamesandassociates.com

January, 2011

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Seasonal Affective Disorder (SAD)
“What is it? And Does It Affect You?”

Seasonal Affective Disorder (SAD) is when a person suffers clinical depressions only during the autumn and winter seasons, in the spring and summer they feel well and “normal”.

Symptoms of SAD:

-Extreme fatigue and lack of energy
-Increased need for sleep; sleeping more than usual
-Carbohydrate craving and increased appetite
-Weight gain

If you think that you may have SAD you should visit your family doctor to be assessed because some physical problems can show up as depression.

How common is SAD?

Researchers believe that SAD results from the shorter day length in winter. SAD seems to be more common in northern countries because the winter day is shorter as you go north. Up to 2 million people in Canada may have difficulties in the winter months due to significant clinical depression.

What treatments are available for SAD?

Many patient with SAD benefit from exposure to bright, artificial light, called light therapy or photo therapy. As little as 30 minutes per day of sitting under a light box results in significant improvement in 60% to 80% of SAD patients. People with certain medical conditions or taking certain medications should avoid light therapy. Other treatments for depression, such as antidepressants and counselling may also help. If you suffer with milder symptoms of the “winter blahs” it might be beneficial to spend more time outdoors and exercise more in the winter.

Why does light therapy work?

Nobody know for sure why light therapy works, there are a few theories. One theory is that people with SAD have a disturbance in the “biological clock” in the brain that regulates hormones, sleep patterns and mood. This clock runs slow due to the diminished light in the winter and the light therapy helps to trick the clock. Another theory is that SAD patients have reduced retinal light sensitivity in the winter that is corrected with light therapy. A final theory is that the shorter periods of light in the winter cause less brain chemical function, particularly the production of serotonin and dopamine. Light therapy or anti-depression medication corrects this imbalance.

Learning Disabilities

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DAVID JAMES & ASSOCIATES
http://www.davidjamesandassociates.com
December 6, 2010

 

REMEMBER:  “People with learning disabilities are smart, they just learn differently.”

 

Why is it some students struggle while most have no difficulty?

Some believe the problems with children who do not succeed at school are:

 

Temporary:  The problem will go away with time; they will pull out of it

Home Environment:  The parents must be doing something wrong.

Intellect:  They are simply not smart enough or not fit for school.

Motivational:  They are simply not motivated and do not apply themselves.

School Environment:  The teacher must be doing something wrong.

 

While each of these is a possibility, it is likely that the particular student is suffering from Learning Disabilities.

 

The Facts

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A learning disability is a disorder that interferes with an individual’s ability to interpret what they see and hear or to link information from different parts of the brain.

Left unaddressed, people may suffer unnecessary hardships such as low self-esteem .

Learning disabilities cannot be cured, however they can be lessened through  interventions and helpful learning strategies.

Bright and gifted children who are under-achieving  may have learning disabilities and those who do often fall between the cracks in our educational system.

It is important to identify whether or not a person has a learning disability in order to determine

the strategies to compensate for it.

 

If difficulties in several of the following items pertain to you or your child, learning disabilities may apply.

-Planning or organizing work

-Completing homework

-Basic reading and reading comprehension

-Listening comprehension

-Math calculations and reasoning

-Language skills

-Spelling

-Note taking

-Class participation

-Following verbal direction

-Easily frustrated with school work   

-Time management

-Remembering facts and school-related content

 

Learning disabilities are assessed in 5 areas:  Visual, Auditory, Motor, Organizational and Conceptual.