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Ashley Solomon, Psy.D is a psychologist who specializes in the treatment of eating disorders, body image, trauma, and serious mental illness.

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Tag: Cognitive Behavioral Therapy

25 Oct

Going to Therapy: What You Can (and Should) Expect

Education, Ideas to Consider 38 Comments by Ashley @ Nourishing the Soul

couch {image via pinterest; originally found at The Quilted Castle}

 

Despite having been one half of hundreds of therapeutic relationships over the years, I work hard to remember that for many individuals who sit down in my office, this could be the first time that they’ve entered into this experience.

I recognize that making the decision to go to therapy isn’t an easy one. It usually comes on the heels of deciding that something significant in one’s life isn’t working as she thought it should. Sometimes what isn’t working is incredibly profound, and touches nearly all aspects of her life. Or it may seem on the surface to be minor, trivial even – but hits on such valued parts of an individual’s life so as to push them into my office. Whatever the reason that someone decides to enter treatment, it’s a big decision and one that is never taken lightly.

So if you’re that person – you’ve decided to allow a trusted professional to help you make important changes in your life – you might want to know what to expect. While sitting down in a stranger’s chair is never easy, per se, being armed with an understanding of the process is key to developing the trust that is vital to the process.

Here’s what you can – and should – expect when starting therapy:

1. You’ll be asked why you’re there. It may sound obvious, but the therapist will want to get a thorough understanding of what brings you to treatment. Even if you’ve alluded to “relationship issues” on the phone, he will want to hear in your own words (and in more detail) how you think about the problem, and why you’ve chosen to get help now. Even if you think that certain parts are irrelevant, share them. It helps the therapist to help you if he has a richer context in which to understand the issue that concerns you.

2. You’ll be told about your rights as a patient. The therapist will spend some time letting you know about what you can expect from her and the process of therapy. She’ll likely explain that you can expect your information to remain confidential and secure, unless you are at risk of seriously hurting yourself or someone else. She should generally also let you know things like her fees, cancellation policy, how you can access your records, and more. The specifics will be based on the laws of your area and the specifics of her profession.

3. You’ll learn about the nature of the therapy relationship. The therapeutic relationship is quite different than other relationships that we are used to. When you think about it, it can actually seem a little strange. You’re pouring your heart out to a person who just met you recently and you know nothing about. But certain therapeutic boundaries are in place for a reason. You should be able to trust that you will not have to take care of your therapist’s needs and feelings. You’ll learn, likely quickly, what your therapist’s style is when it comes to this. Some may disclose some personal information about themselves, and you’ll need to decide what you feel comfortable with.

4. You’ll learn about the therapist’s approach. There are more styles and approaches of therapy than we could possibly discuss here, but they often fall along a continuum of directiveness. Some therapists will take a more active approach, asking you to do things like monitor and challenge thoughts and feelings and experiment with changing your behavior. Others will spend time helping you to develop insight into your patterns of functioning and work to provide a new relationship experience via the therapy itself. Others will do a bit of both. While it’s not always important to know precisely how things are working (in fact, it can sometimes steer you off course to get caught up in the details), you should check in with yourself to determine how comfortable you are with the therapist’s style.

5. You’ll be invited to ask your own questions. I encourage you to use this space to really be a savvy consumer. Questions that can be helpful to ask include: What kind of license do you have to practice? Do you have a supervisor or will you be consulting about my case? Have you worked with others who have my issue? What can I expect from therapy? Can I call you between sessions if I need to? How will I know if things are improving? If the therapist avoids these questions or doesn’t give you the answers you are looking for, I suggest proceeding cautiously.

It’s important to remember that the effectiveness of therapy is based heavily (very heavily, in fact) on the therapeutic relationship, so it’s vital to feel a good fit is in place. If you don’t initially, however, that might not mean the therapist isn’t for you; it could mean that you need to give the process time. Unless there is a significant issue, I always encourage patients to give a therapy relationship at least a few weeks for trust and rapport to develop. If these things don’t happen, I urge you to seek a therapist who will meet your needs. Remember, this is your treatment and your mental health.

If you’ve been to therapy, what has your experience been like? What would you ask a new therapist?

NTS-Medium

14 Mar

Healthy apps that could change your life

Current Events, Education 14 Comments by Ashley @ Nourishing the Soul

Recently I was minding my own business, browsing facebook – to read up on the latest news from eating disorder centers and body image blogs, of course – and what do I get but an invitation to learn… wait for it… “How sexy is your name?”

I immediately dismissed the invitation as junk, until I found myself thinking back to the the application and the question it posed a few moments later. How sexy is my name? I wondered. Does it sound sexier if I put “Doctor” in front of it? And more importantly, Why does anyone care enough to create a program to provide an answer?

After that, I decided to browse the app store to see what other philosophical questions creators were posing and what I found was, well, disheartening. From apps based on the concept of “Hot or Not” to ones in which you could remove blemishes from your profile picture (I guess I need to add facebook airbrushing to my media literacy curriculum. Sigh…), there were tons of applications that just felt icky. And yes, icky is a technical term in my field.

My mind started mulling over the post that I would write on this topic, when I thought, Hey, there have got to be some really positive, healthy apps out there too. Check me out – always looking for the positive! Or something.

What I found was that there truly are some awesome apps out there for your smartphone that can make living a life balanced in body, mind, and spirit a bit easier. Who says technology has to be the end of healthy civilization as we know it?

Here are some of the best that I found. Please be advised that some of these do have a cost attached, but no more than $1.99. I got your back, right?

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Daily Affirmation:

If you have trouble coming up with your own affirmations, let your iPhone do it for you. This app offers inspirational phrases and positive self-statements, a strategy that many therapists encourage clients to use to boost self-esteem and body image. This app even lets you select a category, such as “Career” or “Anxiety.”

affirmation

Zen Timer

It can be difficult to be deep in a meditative state and watch the clock. This app takes care of that by signaling when your time has elapsed with the high-quality ringing of a Tibetan singing bowl. Set your phone to Airplane mode to prevent interruptions and you’re set!

zentimer

A.D.A.M. Symptom Navigator

Curious about that mole on your neck or have an unexplained headache? This app allows you to search your symptoms based on your gender, age, body type and more to find out if your ailments might require medical attention. It’s based on the A.D.A.M. Health Illustrated Encyclopedia, so this is legit, people.

adam-symptom-navigator

eCBT Mood

So I don’t want to put myself or my colleagues out of business here, but this app is pretty darn cool. Based on the principles of cognitive-behavioral therapy, it allows you to assess your stress, log and explore your thoughts, feelings, and behaviors, and challenge your automatic thoughts and core beliefs. It’s like a therapist in your purse. That’s a weird visual.

ecbtmood

Authentic Yoga with Deepak Chopra

Whether you’re a certified yogi or a total yoga beginner, this app will help you learn various poses and customize routines, as well as connect you to others to ask questions. It’s a beautifully done application and now you have no excuse to not keep up with your practice while traveling!

yogaapp

TED App

To expand your mind and potentially even your heart, download the free TED app. This simple tool brings you ideas worth spreading via your own phone or iPad. You can watch incredible speeches by the best of the best and learn a little something instead of playing that silly Angry Birds game. (A personal TED favorite is Dr. Brene Brown’s talk on vulnerability. Go watch it now!)

TED1

Have you ever used an app to enhance your mind, body, or soul? What are you favorites?

NTS-Medium

19 Jan

Insert Creative Title {Self-Discovery, Word by Word}

Word by Word 14 Comments by Ashley @ Nourishing the Soul

WordbyWordImage Here’s a confession: I procrastinated on this particular Self-Discovery, Word by Word post. For those who don’t know me well, I do not procrastinate. I’m the one who has turned in the paper before the professor has had a chance to explain the requirements. I shop for food for a party so far in advance that I have to re-shop because it’s all gone bad. I was ready by day one with gratitude, vulnerability, and authenticity. Dawdling is not my thing.

But when Margarita, who blogs fabulously over on the body image hub, Weightless, introduced this month’s words as creativity, my stomach sort of did one of those somersault deals. Kind of like the ones it does when I see a rollercoaster or a fish swimming toward me (I haven’t told you about my fish phobia? Another time…). I can clearly identify this emotion as fear.

Exploring this fear a little deeper, I recognized that it comes from a lifetime of telling myself that I. am. not. creative. It was part of my story. My husband studied at one of the premier art and design programs in the country. My brother creates beautiful abstract paintings using large printing machines. I have friends who take beautiful photographs, write music, perform on stage. Me? I read. I learn. I run. I myself am just not creative.

Or so I’ve always said.

What I recognized in reflecting on this word is that because I have always considered myself uncreative, I have avoided creative endeavors at all costs. Sure, I’ll be the first in line at the Van Gogh museum and download beautiful music all day long. But when it comes to expressing myself creatively, I’ve held back. This has then, in what we psychology-types call the self-fulfilling prophecy, confirmed my belief that I am not creative.

Well, you know what? That’s just wrong.

Watch out, I’m about to go all CBT (cognitive behavioral therapy, for those of you playing along at home) on you here. Some self-therapy, if you will. Seriously, play along. Use one of your own limiting beliefs.

What is the evidence against this thought or belief?

Creative is not something you “are” necessarily. It’s a practice. And I practice things like writing quite often. In fact, I think I’m a fairly creative writer. While I am a lover of all things grammar and don’t go to e.e. cummings levels of defying convention, I can think outside the box now and then. In fact, I come up with some creative ways of looking at situations for my clients all the time.

What’s an alternative explanation or viewpoint?

Perhaps I am creative, just not in the Salvador Dali kind of way. Creativity is all about cognitive flexibility. It’s about being able to step away from a linear way of thinking and explore other options. I am able to do that, especially when I’m feeling more at ease and it’s something I enjoy or care about.

What is the worst that could happen (if you tried to be creative)?

You could all laugh at me. (But that could happen even if I didn’t try to be creative. Come to think of it, it often does.)

I could fail. (But then again, can you really “fail” at creativity, really?)

I could learn that I am not so sucky at being creative. (And then that might mean I have to try more often… scary!)

We could go on, but for the sake of making it in time to send this to Margarita, I’ll wrap this puppy up. I’m thrilled to have been able to use this word to challenge my own thoughts. That’s what self-discovery is all about. So while I won’t be winning any Grammy’s or Tony’s or Mike’s (I made that last one up. Obviously.), maybe I’ll give that photography class a whirl.

Do you consider yourself creative? How have you learned to challenge your limiting beliefs?

NTS-Medium

{Image Credit :: Justin Solomon}

14 Jul

Picky, Picky :: Do Selective Eaters Have a Disorder?

Current Events 12 Comments by Ashley @ Nourishing the Soul

Putting a pea in front of my mother’s face produces a similar reaction as one might expect from hiding a rattlesnake under someone’s pillow. Her face quickly contorts and she draws back in horror, afraid the small, green ball of poison might… shudder… touch her. The thought of putting it in her mouth and swallowing elicits panic. You’d sooner get her to sell one of her children (likely me, following this blog post).

My mother is what we commonly refer to as a “picky eater,” or what scientists, including psychologists, are now calling, a “selective eater.” Her preferred diet includes an extremely narrow repertoire of American foods, sprinkled with the occasional pizza or pasta. Interestingly, scientists have observed that picky eaters tend to have a not only small, but similar catalog of food choices. They tend to select items that are paler in color, such as white bread and pasta or pizza with cheese (hold the spinach!).  Also noteworthy, some scientists have found that almost all picky eaters like french fries (although, really, who doesn’t?).

A recent Wall Street Journal article suggested that the American Psychological Association is considering recognizing “selective eating” in the upcoming revision of the diagnostic manual. This new issue would, reportedly, be classified under the category of Eating Disorder, Not Otherwise Specified, a term used for individuals with symptoms that do not meet criteria for a major disorder. The WSJ article led to some hot debate on whether pathologizing people with picky palates is going too far. However, the DSM-V draft website makes no mention of selective eating as a potential inclusion.

While it’s easy to get frustrated with my mom for limiting our restaurant options to three places and for not being willing to try the beautiful appetizers I’ve made, researchers and clinicians point out that selective eating is often not voluntary. Many selective eaters feel desperate to expand their tastes, reporting extreme embarrassment and shame over their pickiness. These individuals are not the friend who has an aversion to green olives. These are people who limit their social engagements and feel anxiety around major events due to their distinct and restricted preferences. And for most individuals, these eating habits began even before they began feeding themselves.

Typically problems begin in childhood, a period during which some narrowness of food choices is expected. However, for adult selective eaters, their comfort level never expands. They continue eating stereotypically “childlike” foods, such as cheese pizza and chicken fingers. Researchers at Duke University and the University of Pittsburgh are currently trying to enhance our understanding of selective eating, recently launching the first national registry of picky eating. The public is asked to log on and describe their peculiar eating habits so that scientists can explore the phenomenon.

Currently, many researchers believe that selective eating is related heavily to aroma and texture. This makes sense to me as I consider my mom’s description of peas (her most loathed food) as slimy, slippery, and mushy (said in a disgusted tone). Makes anyone want to recoil, right? She, like many other selective eaters, cannot get beyond the texture of the food. Forget taste. She would have to actually be willing to touch them to determine whether the taste was acceptable. Evolutionary psychologists tell us that we are in fact wired to prefer foods less that evoke images of morbidity or bodily functions (in color, texture, etc.). I’ll leave this topic at that.

Fortunately, there may be hope for selective eaters. Duke University, like many other institutions, offers treatment for picky eating that is based on cognitive-behavioral principles, particularly exposure. Selective eaters are encouraged to develop improved assertiveness skills (to handle people like me, who harass you for not wanting to try the thing on the menu that you can’t pronounce), as well as methodically incorporate new foods. While there is limited evidence currently demonstrating the effectiveness of the treatment, results will be forthcoming. If the evidence suggests it works, which it is likely to, my mom will be on the next plane. But don’t offer her gourmet snacks onboard. She’ll just take the pretzels.

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