What is Cognitive Behavior Therapy (CBT) and How Can it Help Me?

Cognitive behavioral therapy (CBT) is a form of effective psychological treatment for depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. 

Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications, referenced at ada.org.

According to the American Psychological Association, the core concepts of CBT include:

  • psychological issues are partly based on unhelpful ways of thinking
  • psychological issues are partly based on learned patterns of behavior
  • those living with these issues can improve with better coping mechanisms and management to help relieve their symptoms

Healthline provides some of the most popular techniques used in CBT:

  • SMART goals. SMART goals are specific, measurable, achievable, realistic, and time-limited.
  • Guided discovery and questioning. By questioning the assumptions you have about yourself or your current situation, your therapist can help you learn to challenge these thoughts and consider different viewpoints.
  • Journaling. You might be asked to jot down negative beliefs that come up during the week and the positive ones you can replace them with.
  • Self-talk. Your therapist may ask what you tell yourself about a certain situation or experience and challenge you to replace negative or critical self-talk with compassionate, constructive self-talk.
  • Cognitive restructuring. This involves looking at any cognitive distortions affecting your thoughts — such as black-and-white thinking, jumping to conclusions, or catastrophizing — and beginning to unravel them.
  • Thought recording. In this technique, you’ll record thoughts and feelings experienced during a specific situation, then come up with unbiased evidence supporting your negative belief and evidence against it. You’ll use this evidence to develop a more realistic thought.
  • Positive activities. Scheduling a rewarding activity each day can help increase overall positivity and improve your mood. Some examples might be buying yourself fresh flowers or fruit, watching your favorite movie, or taking a picnic lunch to the park.
  • Situation exposure. This involves listing situations or things that cause distress, in order of the level of distress they cause, and slowly exposing yourself to these things until they lead to fewer negative feelings. Systematic desensitization is a similar technique where you’ll learn relaxation techniques to help you cope with your feelings in a difficult situation.

How CBT Can Help

Healthline states that typical CBT treatment often involves the following:

  • recognizing how inaccurate thinking can worsen problems
  • learning new problem-solving skills
  • gaining confidence and a better understanding and appreciation of your self-worth
  • learning how to face fears and challenges
  • using role play and calming techniques when faced with potentially challenging situations

The goal of these techniques is to replace unhelpful or self-defeating thoughts with more encouraging and realistic ones.

CBT can help with a range of things, including:

  • depression
  • substance misuse
  • post-traumatic stress disorder (PTSD)
  • anxiety disorders, including panic disorder and phobia
  • obsessive-compulsive disorder (OCD)
  • schizophrenia
  • bipolar disorder
  • eating disorders

CBT can also help with:

  • grief and loss
  • chronic pain
  • insomnia
  • relationship difficulties like a breakup or divorce
  • a serious health diagnosis, such as cancer

If you are interested in Cognitive Behavioral Therapy, SouthEnd Psychiatry is here for you. Our amazing team of licensed therapists are ready to walk along side you in this journey. 

Contact Southend Psych today to inquire about appointment availability and get you on your way to a better place.

Southend Psychiatry 

Schedule your appointment today with one of our SouthEnd Psychiatry clinicians. Book your appointment online or call 1-800-632-7969 to get started today.

5 Ways to Create Healthy Boundaries with Family

The holidays are here which for many means A LOT of potential family time. So, let’s look at five ways to set healthy boundaries ahead of the holiday season. 

Boundary issues are the most difficult to deal with when it comes to family. 

According to Terri Cole, author of The Boundary Boss, our boundaries are made up of our preferences, desires, limits, and deal-breakers. Think of your boundaries as your own personal rules of engagement.

Boundaries can be uncomfortable and even painful for some…until you practice the skill. Remember, you don’t need to sacrifice your identity in order to receive love or be accepted. Know what you will or will not tolerate from others. Draw the line and enforce it.

Here are five ways to establish those healthy boundaries:

  1. Define what your boundaries are. What will you tolerate or not tolerate in your life? What behaviors will you accept or not accept from family members? 
  2. Clearly communicate your boundaries.  This is particularly important for the people closest to you. Give them the chance to honor your preferences.
  3. Follow through. If someone crosses your boundaries, do what you said you would. Be compassionate, but be firm. This might be a new side of you that no one has seen before. 
  4. Show the respect you want to receive. Begin to really listen to what others prefer. Lead by example. Honor others boundaries.
  5. Keep loving yourself. It is not mean or selfish to have boundaries. Some will respect them. Others will not. How people treat you is a direct reflection of how you allow them to treat you. 

Boundaries are healthy. Establishing and keeping them is hard work. However, it is worth it!  SouthEnd Psychiatry is here for you. Our amazing team of licensed therapists are ready to walk along side you in this journey. 

Contact Southend Psych today to inquire about appointment availability and get you on your way to a better place.

Southend Psychiatry 

Schedule your appointment today with one of our SouthEnd Psychiatry clinicians. Book your appointment online or call 1-800-632-7969 to get started today.

Family, Stress & the Holidays

When you think of the upcoming holiday season, does it immediately raise anxiety and stress levels? If so, you are not alone. This season can sometimes bring unexpected gatherings with toxic family members, an overcommitment of gift-giving, streets full of impatient drivers, and the stress of managing it all.  

There is hope. Believe it or not, we can all still have a joyous holiday despite the stressors that come with this season. Here are some practical tips to help make this holiday one you can genuinely enjoy.

Boundaries. Boundaries. Boundaries.

Boundary issues can be the most difficult to handle at the family level. It can feel uncomfortable if we haven’t practiced this skill. Start with these 4 rules:

  • Set your boundaries. What will you tolerate and not tolerate? What behaviors will you accept and not accept? Include everything from protecting your schedule to how someone can treat you. Write them down and trust your decisions. 
  • Decide the consequences. Most of us have at least one “boundary breaker” in our family therefore decide ahead of time what the consequences will be if your boundary is broken…regardless of who breaks it.
  • Communicate clearly. Make your boundaries and consequences known…especially with family members who are known to cross the line. Be direct and clear. Their response or reaction is not your responsibility.  
  • Follow through. If a boundary is broken, you know what to do. Be firm yet compassionate. Honor yourself by not allowing people to treat you poorly.

Set Realistic Expectations.

For some reason, we can feel like the holidays have to be perfect or even better than last year. We try to top last year’s gift list or attend more parties. FOMO (fear of missing out) is a real struggle for many however it comes at a cost. Consider these ideas:

  • Stick to a budget. Decide ahead of time how much you can afford and stick to it. If you are someone who loves showering people with gifts, think of ways to do this without overspending.
  • Plan ahead. Choose specific days for shopping, baking and family gatherings. Avoid last minute trips to the store by planning your menus and shopping lists in advance. 
  • Take time for yourself. This season is meant to be enjoyed by all…including you. Even setting aside 15 minutes a day alone to take a walk, read, or meditate can drastically reduce stress.

Know When to Seek Professional Help.

Talk therapy is always a good idea…especially when it is with a licensed therapist. If you are feeling persistently anxious, unable to sleep at night or focus during the day, let’s talk. 

Southend Psychiatry is here as you navigate the pressures, demands and triggers of the holidays. We can come alongside you to offer support and help. Contact Southend Psych today to inquire about appointment availability and get on your way to a better you.

Southend Psychiatry 

Schedule your appointment today with one of our SouthEnd Psychiatry clinicians. Book your appointment online or call 1-800-632-7969 to get started today.

Understanding Codependency: What, Why, & How COVID-19 Has Made it Worse

Unless you have gone to therapy or been close to someone seeking help for codependent tendencies, your perception of codependency is likely inaccurate in some ways. Aside from popular belief, the term does not refer to the behavior of people who “can’t do anything on their own” or “had parents who did everything for them growing up.” In fact, it often means quite the opposite.

And, believe it or not, codependency doesn’t just affect a small portion of the population! Some estimates suggest that close to 90% of people demonstrate codependent behavior in relationships, with many having realized they struggle with codependency only during and after COVID-19.

So, what is codependency, why do so many of us experience it, and how has COVID-19 made it worse? Keep reading for the answer to these questions and more.

What is Codependency?

Codependency is a pattern of behavior characterized by a mental, emotional, physical, and/or spiritual reliance on another person in a close relationship (e.g. spouse-spouse, friend-friend, coworker-boss, sibling-sibling, etc.). It can also be thought of as an imbalanced relationship in which one person (“the giver”) assumes the responsibility of meeting the needs of the other person (“the taker”) and, in doing so, cannot acknowledge their own feelings and needs to the point of personal detriment. 

Codependent people are typically empathetic, highly capable, and independent in that they take care of everyone, including themselves, without asking for help. The problem with this ultra-independence is that it is impractical; we all have needs, and they can only go unmet for so long. And while codependents can maintain complacency for extended periods of time (months, years, sometimes decades), they do eventually become resentful of the lack of reciprocation from others and explode—either internally or externally.

At their core, codependents want to feel secure and wanted for their true selves, but in pursuit of this safe connection, they self-sacrifice so much that they end up losing all sense of themselves. In other words, by making others “need”/depend on them, they make the very thing they crave, authentic connection, impossible. 

What Causes Codependency?

Codependency is not a personality disorder or clinical diagnosis but rather a learned behavior that can be passed down from one generation to another. Those who struggle with codependency usually developed the condition by watching and imitating other family members who managed situations of abuse, neglect, illness, addiction and other traumatic situations (usually within the family) the same way—by “fawning” (repressing one’s own needs in order to be loved and accepted, i.e. people-pleasing).
But it goes deeper than that. At its root, the compulsion to self-deny is the result of a complex form of attachment disorder and PTSD developed in childhood. As children, codependents received inconsistent attention, affection, and emotional support from their parents—a sort of hot and cold dynamic interpreted by children as a reflection of their own inadequacy. To cope and thus reduce these feelings of abandonment, they learned to attain more consistent love through people-pleasing, a softer form of manipulation and control.

Unfortunately, as these children become adults, the fear never goes away (PTSD), driving them to continue fawning in hopes of never being abandoned again. What they don’t realize, though, is they are still being abandoned—only now by themselves. For these reasons, codependency can be considered a symptom or defense against PTSD.

…AKA relationship addiction

When we think of addiction, alcohol, drugs, sex, and gambling are the first words that come to mind, but a less commonly known form of addiction is the addiction to people, which is codependency in of itself. As codependents begin to only think of the thoughts, needs, and desires of the one they are pleasing (“the taker”), they are no longer able to identify their own. This enmeshment means that their only sense of worth derives from the praise, recognition, or affection they receive from the other person. Over time, this creates an addiction to the highs of validation and affirmation, much like the highs you would see in any other addiction. The codependent looks for ways to help, and they are rewarded with praise in return. On the flip side, when their help goes unnoticed and the other person withdraws, the codependent fears the relationship will end and falls in a state of severe emotional distress until they feel valued again. With time, the caretaking becomes compulsive, and the codependent experiences feelings of helplessness in the relationship, unable to break free.

Signs of Codependency

  • A tendency to do more than your share all the time.
  • Never asking for help; overwhelming yourself with tasks that others could do.
  • Fear of losing relationships/abandonment.
  • Fear of rejection.
  • Doing way more than the other person to hold onto your relationship.
  • An overwhelming need to be reassured and recognized.
  • A compelling desire to control others.
  • Lack of trust in yourself and/or others.
  • An exaggerated sense of responsibility for the actions of others.
  • A tendency to love people you can rescue.
  • Excessive concern with loved ones’ behaviors.
  • Constant feelings of hurt when people overlook your efforts.
  • Guilt after asserting yourself.
  • A tendency to apologize to keep the peace.
  • Difficulty naming your feelings or fully feeling them.
  • Minimizing your feelings when you do feel them.
  • Worrying about what others think of you.
  • Problem with creating and keeping boundaries.
  • Difficulty making decisions.
  • Dishonesty.
  • Doing things you don’t want to do to make others happy.
  • Poor communication in relationships.
  • Idealizing loved ones to the point of maintaining relationships that don’t fulfill you.

The Link Between Codependent Tendencies & COVID-19

COVID-19 has taken its toll on couples with underlying, previously unnoticable or manageable codependent tendencies. Without breaks from one another and access to other sources of fulfillment and support (such as exercise classes, lunch with friends, in-office work, etc.), many report feeding off of each other’s emotions more than ever and relying heavily on the relationship for every emotional need. Couples who don’t live together have also experienced strains on their relationship but for the opposite reason: not being able to spend enough time together due to shutdowns, quarantine, and limited date nights.

Amidst traumatic circumstances, slipping back into old ways—natural instincts—is normal. Just like with PTSD from childhood, PTSD from the accumulation of stresses caused by COVID-19 can cause codependent habits to resurface, worsen, or appear for the first time. If that is you, rest assured that there is hope. As mentioned above, codependency is a learned behavior, meaning it is possible to unlearn the compulsions causing you distress and negatively affecting your relationships. The best course of action is to seek help. A therapist can show you how to form healthy attachments in your relationships, establish your own identity, and assist you in healing from the triggering experiences you have had, whether in childhood or more recently.

The good news is, post-pandemic, our environments and circumstances are changing. With that, and professional support, how you are feeling will change too. Book your appointment online or call 1-800-632-7969 to get started today.

Helping Someone Cope: Providing Hope

Grief is not our friend but is certainly not a stranger to most of us. It has knocked on our door and walked right in without an invitation, never facing a warm welcome. When those we love are grieving a loss and trying to cope, words can fail us. While there is no perfect response to one of the most challenging emotions we experience as humans, we can offer hope in the ways we help.

Communicate

Someone suffering a loss will feel alone and may even want to be alone, but a phone call, text, or card can provide a sense of comfort. Fear can sometimes creep in, making us think we will say the wrong thing or convey the wrong message. Don’t let this prevent you from reaching out. The reaching out is the comfort. A smile, hug, and just being present and available helps those grieving know you see their grief and remember their pain.

Serve

Cook a meal, pick the kids up from school, mow their lawn, or run errands. It helps the griever when we do, rather than ask. Acts of service speak for themselves when words are lost.

Listen

Hear their words. Hear their cries. Hear their laughs. Hear their silence. Be available and make it known that you are there to listen.

Provide

Ongoing support is critical. Whether it’s daily, weekly or monthly, any way you choose to do this will provide a sense of hope and a brace of connection. Mark important days such as birthdays on your calendar, and send a text or make a call to let those grieving know you remember their loss. 

Helping Someone Cope

Grief will almost always overstay its welcome. When we communicate, serve, listen, and provide comfort to those suffering an unwelcome visit from grief, we offer validation while acknowledging that what they are feeling is important and real. And although we know the process of grieving takes time, the time we take to help someone cope will offer them something they desperately need during this time: HOPE.

3 Ways to Revive Struggling Relationships

We want to talk today about significant others, and how to best nurture a healthy environment for vibrant, growing relationships. While this subject is relevant for any time, it’s particularly important to heed these suggestions now as we’re all living through social distancing. Every relationship has cracks and issues, but living through a pandemic and the stressors which come with it are adding an extraordinary amount of strain to even the most level, healthy relationships.

Schedule Separation

Particularly if you and your significant other are both working from home, it is so important to build areas + times of separation from one another. And having separation in the flow of the day can help too. For example, is there a clear definition between the work day and “family” time? Or does one bleed into the other? Or at dinner, do you just move the papers and laptop out of the way to make room for your plate? More than ever, having a routine which brings a sense of order and structure can be so reassuring to many people, in a world which can seem more chaotic every day. Be sure to separate the mundane, daily, unimportant activity from that which is more sacred, more meaningful, more elevated.

Recognize Efforts

It’s so normal to get lost in our own work and daily activity that we often don’t understand what our partner is doing with the majority of his/her day. We know they “work” or “go to the office” but we often don’t get to observe the pressures, accomplishments, challenges, etc. they encounter. So, make it a point verbalize your appreciation of your partner’s efforts when you see them. Simple acknowledgements can go a long way towards building feelings of empathy and appreciation, for each partner.

Benefit of the Doubt

Here’s the reality: you and your partner are BOTH dealing with increased stress and unpredictability right now. They’re likely emotionally overwhelmed and not trying to annoy you or hurt you. When you communicate, acknowledge his/her feelings, ask questions to help clarify what is being said, and listen to truly understand vs. trying to “defend” or “be right”.

Thank you for reading, please feel free to share with your friends if you found this post valuable. We are always here at SouthEnd Psychiatry to start a conversation and to hear from you!

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