June 29, 2018

The Science of Pain Explored

     Most people think of pain as a purely physical experience. A hot stove burns my hand, my skin is hurt, my brain sends a pain signal, Ouch!  This sensory feeling is but one source, one explanation of pain. The second explanation is the role of emotions in the experience of pain. Fear and example, for example, amplifies the pain signal.  If we are worried about our pain, it hurts more.  The more we worry the stronger the pain signal.  The brain is a complex interaction between our physical selves and our emotional experience of what our body is feeling, especially where chronic pain is concerned.

     To help us understand more about this, Nicola Twilley has written about the neuroscience of pain in New Yorker magazine, here

April 10, 2018

Meltdown: What it could Mean, How to Respond

I don't see children in my practice but I do see adults who are parenting children.  We talk about "meltdowns," or what used to be called "tantrums."

Thought I would share HandInHand's insightful look at what is happening when a child has a meltdown, understand what is possibly at the heart of it, and how to respond.  Click here.

April 2, 2018

Even on the Sidewalks of NYC

In broad daylight, a person can relax and meditate:

For more on-the-street photography, you can visit Brandon's website,  Humans of New York.

January 7, 2018

Decide Not to Decide

It is quite common for people to enter therapy in the midst of a crisis. They want answers.

Is my marriage over?

Cognitive therapy is all about replacement thinking. A cognitive therapist will listen for faulty or dysfunctional thinking patterns that are contributing toward a client's lowered mood, anxiety, anger, or indecision.

And sometimes those problematic thoughts are questions. Especially questions whose answers involve major life decisions. Upheaval.

My job is horrible! Should I quit now or find a new job first?

One calming thought replacement is decide not to decide. At this moment, anyway. Perhaps for an undetermined period of time, if the situation allows. Give yourself the time to make a more informed decision.

I'm not happy here. Should I move back to the West Coast?

First we must explore whether there is an urgency to decide now. Many, if not most, of life's crises do not require immediate action. They may, at some point, require a decision. But right now? Not usually. And hasty decisions are often the source of regret or self-doubt down the road.

My neighbors are so toxic. Is it time to move?

What crises typically do require is calm and thorough deliberation. Careful consideration of the options available. Analyzing the situation so that we know what we're dealing with. Generating a range of steps to take before making a drastic change.

By the time someone has entered the therapy room, however, they are often worked up into a frenzy or feeling overwhelmed to the point of depression. They are not thinking clearly. They cannot focus. They are unable to come up with creative solutions. They're engaged in black or white, all or none, thinking.

So rather than focus on making the decision, we want the client to slow down, calm down, reduce the stress, increase the self care, and decide not to decide.

Concentrate on self-soothing. Take care of yourself until you are in a position where you can carefully assess the available information, until it can be gathered in a calm, deliberate and accurate manner. And then reflected on without haste. Seek opinions from respected experts or someone who has been in your shoes.

Slow down.
Get some good sleep.
Think of my options.
List pros and cons.
Get some support:
Consult with friends, colleagues, loved ones, a professional.
Take a walk. Appreciate the sky, the clouds, the trees. 
Sit on a park bench. 
Take deep breaths.
And full, emptying exhales.
And again.
Give myself the time to decide.
In good time.

Decide not to decide.
Until I am ready.

Sandy Andrews, PhD is a Licensed Clinical Psychologist and Psychotherapist in Austin, Texas
She practices Cognitive Behavioral Therapy or CBT

October 6, 2017

Beyond Fear

Sandy Andrews, PhD is a Licensed Clinical Psychologist and Psychotherapist in Austin, Texas
She practices Cognitive Behavioral Therapy or CBT

August 14, 2017

Taking Steps to Overcome Chronic Loneliness

There are many studies that look at loneliness and are finding it is increasingly common and associated with serious health problems.  Although social media is designed to connect people (facebook, instagram, twitter, and the like) psychologists and researchers are finding more people are feeling disconnected and lonely than ever.

Cultivating friendships becomes so important as a way to combat loneliness.  Dr. Randy Kamen makes numerous suggestions for making friends, here. I have written about strategies in previous posts, here.

I offer a few of the most often cited suggestions:

1.  Choose a volunteer activity.  One that helps a needy population or is helping solve a societal problem that concerns you will likely be most beneficial to you.  Engaging in meaningful work, whether a paid job or volunteer work, can help ease feelings of loneliness and increase feelings of positive well being.

2.  Explore support groups.  Support groups are usually led by volunteers, typically someone who has benefited from several years of experience in the support group arena. One support group I often refer to is Recovery International (formerly Recovery, Inc.).  This group helps it's members with skills to overcome anxiety, depression, and loneliness. You can email the contact person for the Austin, TX area, here.  I talk in more detail about this support group in an earlier post, here.

3.  Participate in group therapy.  Here in Austin, TX we have The Austin Group Psychotherapy Society which provides a convenient website that lists many group therapy opportunities available in the Austin area.  Click here to see the list and description of group therapy experiences available. For readers in other parts of the country, try contacting a licensed psychologist in your nearest city and ask for referrals to group therapy providers. Group therapy is lead by paid professionals.  I strongly recommend a professional who is licensed with a mental health certification in your state (licensed psychologist, clinical social worker, marriage and family therapist, etc.)

People who feel lonely sometimes are people who have struggled with shyness for most of their lives.  Many report feeling awkward in social interactions, feeling unable to converse in a way that helps them connect with others or in a way gains them reciprocal interest.  Group therapy, support group participation, and other types of settings which promote conversation between people (MeetUps for example) is one avenue to observe and practice the art of talking to people in a way that garners friendships.  Practice may not make perfect but it certainly can help shy and lonely people reach out more effectively.

Sandy Andrews, PhD Psychologist Specializing in CBT
South Austin, TX 

May 22, 2017

Advice for Grandparents Who Want More Time with their Grandchildren

Yes, even psychologists like to read advice columns.  Or at least this one does.  My thinking is we need to keep an eye on our competition. Gain a few common sense pointers for those tricky problems that outcome research hasn't studied yet.

My personal favorite is The Washington Post's Carolyn Hax.  I like the way she frames her answers. She takes many variables into consideration rather than jumping to the most obvious, and sometimes the most judgemental, conclusion.

Recently she tackled one of the most common dilemmas posed by grandparents who want to see more of their grandchildren.  When they feel left out, uninvited, unwanted, and unappreciated.  In a word, unloved, but that's certainly not how they put it.

So for any grandparents out there who wish their children would include them more often, I suggest reading, and considering the advice of Ms. Hax, here.  You might also consider scheduling an initial session with a licensed psychologist or licensed marriage and family therapist.  Sometimes the insights of a professional can help open doors with your children and grands.

January 16, 2017

Mindfulness is the New Black

Like orange is the new black, mindfulness may be the new psychotherapy.

Talking to a licensed therapist can be a critical step to wellness.  It can include sharing problems, worries, and yes, those reliable and messy mainstays, family of origin issues. Getting evaluated by a professional can be one of the most important tools for treating anxiety, depression, and other emotional disorders.

Learning cognitive behavioral tools ( CBT ) is another branch on the tree called getting back to wellness. One of the most up-and-coming, state-of-the-art CBT tools is mindfulness.  Thirty years ago, when I was walking my dinosaur on my college campus, mindfulness was never echoed in the hallowed halls of learning.  I'm not sure it was even a thing back then.  But it certainly is now.

Mindfulness is a form of meditation.  It is the art and skill of redirecting one's mind away from the everyday thoughts, worries, judgments, and distractions that occupy our brain when it's on auto-pilot. Where are my keys? Did I take the load of laundry out of the dryer? Don't forget to return those pants, pick up that prescription, talk to my professor, get the car inspected.   "Monkey mind" is what Dr. Alejandro Junger, M.D., cardiologist, calls collectively, all those pesky thoughts. As a stress reduction, happy heart tool, Dr. Junger recommends a five-minute mindfulness meditation that you can try, here.

For more ideas on how to learn about and practice mindfulness, have a look at Harvard University Medical School's suggestions, here.    Because maybe, just maybe, fifteen minutes a day is the new 60 minutes on the couch.

Sandy Andrews, Ph.D. Psychologist
Teaching CBT in South Austin, Texas

Psychologist Austin TX CBT Cognitive Behavioral Therapy Anxiety Depression Panic Disorder Anxiety Attacks Psychologist Psychothrapist Therapy e

December 15, 2016

Holiday Self Care

Whether your holiday plans involve spending time alone or spending time with a large gathering of family, it's often a good idea to come up with your own Holiday Plan.

What do I mean by this?

A Holiday Plan is one way of making sure the holiday is special and pleasurable for you.

A Holiday Plan can be therapeutic for people who are alone over the holidays. People in transition (recently divorced, widowed, relocated) are especially vulnerable to feeling lonely, alienated, sad, and in some cases, ashamed of their solitary status. Ashamed when others ask them, for example, "Who did you spend your holiday with?" The fear that others will judge them in some negative way or feel pity for them can weigh heavy. Many feel worse about their solo status when confronted with an onlooker's pity, no matter how caring and well-intentioned the concern may be. A Holiday Plan can help fill the gap when asked, "What did you do over the holiday break?"

Sometimes people who are alone prefer the solitude to merry making or the energy required to put on the facade of feeling merry. Take, for example, someone who works two jobs and is looking forward to the precious down time. Or someone who is grieving and prefers the quiet recovery time. Or the recovering alcoholics who refrain from a holiday gathering because they are newly sober and don't trust themselves to be around a spiked punch bowl. There are many reasons for choosing to be alone but the choice isn't always understood, or approved of, by others.

So back to a Holiday Plan. Think about ways you can make your holiday a special time of relaxation or pleasure or holiday ritual.

Make a list. This is a great time to consult with your personalized Pleasant Events List, discussed in an earlier post.

What are some activities that would give you pleasure? Which would help you feel the most refreshed? A hot bubble bath? Reading the latest edition of your favorite mystery series? Video gaming? A phone call to a friend or loved one? Taking a long walk along a scenic trail? Slipping out to see a movie? Starting a new knitting, art or woodworking project? Putting a puzzle together? Baking cookies? Sometimes getting caught up on household chores can be fulfilling. Just so long as it brings you pleasure.

If you expect to be around a large group over the holidays and you anticipate feeling drained rather than rejuvenated, as many of us do, give yourself permission to modify your plans. Excuse yourself for a walk after the large meal. Pass on the egg nog for a healthy drink you have brought as an alternative. Leave early so you can fit in some relaxing alone time at home or in your hotel room. Bring along a fun board game or favorite magazine as an alternative to the usual football game watching. Unless, of course, watching the bowl game is on your Holiday Plan.

Whatever your plan includes, be sure to give yourself plenty of time to prepare. Research a pleasant outing or day trip. Shop for needed supplies. If your list includes cuddling under a blanket, with a cup of hot cocoa (mini-marshmallows on top) while watching several rented movies with a pleasantly scented candle nearby, you will want to make your trip to the video and grocery store in advance. Most stores close or keep earlier hours during the holidays. You don't want your Holiday Plan foiled because you are caught empty handed.

Happy holiday planning, everyone!

Sandy Andrews, PhD is a Clinical Psychologist and Psychotherapist 
teaching CBT in South Austin

October 12, 2016

When Someone You Care About Is Grieving

Many years ago a very good friend of mine lost her husband. He died suddenly.  They were married a few short years. She was grief stricken. Inconsolable. I visited her whenever I could.  Tried to cheer her up but I failed miserably.  There was no cheering, I found.  I would leave her home, sit in my car, and feel helpless.  I couldn't make her feel better, I got that.  But worse, I didn't know what to say.  What does one say when someone has lost the love of their life?  Or their mother. Their child.

The Christi Center of Austin is a support network available for those recovering after a loved one has died. They "offer hope after the death of a loved one by providing support networks, community education and therapeutic activities that are free, peer-based, and ongoing."  On their website they provide numerous suggestions for those of us who want to offer comfort but don't know What to Say, including:

-Acknowledge the loss – “I heard that your _________ died.” It is ok to use the word “died”.
-Be genuine and honest – “I don’t know what to say, but I just want you to know that I care and I’m here for you.”
-The loved one’s name – “________” was a good person and a dear friend of mine. I will miss him/her.” Talk openly about the person who died.
-Ask how they feel – “Please tell me what you’re feeling right now – I have never been through something like this and I am here to listen whenever you are ready.” And then listen without judgment.
-Accept silence – “We don’t need to talk about this right now if you don’t want to – just know that I’m here when you need me.”
-Let them know they’re not alone – “We all need help at times like this – I’m just a phone call away, anytime.”
-Offer support – “Tell me what I can do for you.”
-Nothing – sit in silence, and just be with the person. Give them a hug or hold their hand.

AVOID saying things like “At least she is in a better place”, “There is a reason for everything”, “God needs him/her with him”, “I know how you feel”, “Be strong”, and “It has been awhile – you must get over this”. Minimizing, attempting to justify/explain, and putting a timeframe on the loss are not helpful at all.

Sandy Andrews, PhD  is a Clinical Psychologist / Therapist who provides CBT in Austin, Texas