Cognitive Behavioral Therapy: 5 Things You Should Know About It

If you’re thinking of starting therapy, you’ve likely run into the term modality before. A modality is the approach a therapist takes when providing care for their patients. One of the modalities we utilize here is called Cognitive Behavioral Therapy (CBT). 

CBT is an approach that focuses on how our thinking patterns influence our behavioral patterns. The main idea behind CBT is that thoughts influence how we feel and act. Basically: how we act can in turn also affect how we think and feel in a given situation, and our unhelpful thoughts can then lead to unhealthy behaviors and feelings. CBT helps you to understand and break this cycle.

Here are five things you should know about Cognitive Behavioral Therapy: 

1). CBT has been shown to be effective for a wide range of presenting concerns: 

CBT is an active, goal-oriented psychotherapy treatment. As a treatment, it’s been studied and shown to be highly effective in treating a wide range of people (children, adolescents, and adults) with a wide range of presenting emotional and behavioral concerns such as: 

• Depression

• Anxiety

• bipolar disorder

• Perinatal mood and anxiety disorders (e.g., postpartum depression)

• Sleep

• Relationship problems

CBT has also been found to contribute to significant improvements in functioning and quality of life.

2). CBT has been studied extensively in both research and clinical practice. 

CBT is an evidence based treatment. What that means is that its efficacy has been proven to be safe and effective through extensive scientific and clinical research. This research involves thousands of patients and meticulous comparison of effects to alternative treatments. Evidence based treatments help increase the effectiveness of the treatment and helps reduce the risk of recurrence of damaging behavioral patterns. There’s heaps of scientific evidence out there showing that CBT is effective in producing meaningful change and improvements for clients.

3). One of the core principles of CBT is that problems with mood are related to unhelpful behaviors and thought patterns. 

These negative thinking patterns can influence our mood and exacerbate feelings of anxiety, depression, or other feelings of insecurity and self doubt. This can then contribute to a pattern of unhealthy behaviors–which in turn starts the cycle all over again. With CBT, these thought and behavior patterns are explored and new, healthy ways of coping are explored to effectively relieve symptoms and improve quality of life. 

4). Psychologists and clients work together collaboratively to develop goals and to actively target symptoms. 

Time is spent examining present-day issues, thoughts, and behaviors. For example: 

A teen who is depressed might think, "Everything is hopeless," or "There's no point to anything I do." 

Emotionally, these thoughts may occur with feelings of sadness, depression, apathy, and lack of motivation. Behaviorally, the depression may appear as increased isolation, withdrawal from usual activities, refusal to attend school, etc. However, these behaviors only reinforce the negative thinking patterns, and exacerbates the cycle of withdrawing from life due to a feeling that there’s no point in participating.  

For this, treatment would involve teaching the teen to identify and challenge negative thoughts, skills to cope with depressed mood (e.g., activity scheduling), and working with parents to develop a reinforcement system to encourage positive behaviors and use of coping strategies. CBT is highly collaborative, practical, and goal oriented. 

5). Because CBT is very goal oriented, there are many skills clients develop as part of the process. 

They are learning how to face fears, problem solving difficult situations, recognizing patterns of unhelpful thoughts and behaviors, and ways to calm the mind and body. Other skills taught as part of CBT include:

• Problem solving

• Communication training

• Cognitive restructuring aka learning to identify and dispute cognitive distortions. You can read more about cognitive distortions from these posts on our blog: 

• 8 Common Cognitive Distortions to Watch Out For

• 10 More Cognitive Distortions to Be Aware Of

• Managing Cognitive Distortions

• What is All or Nothing Thinking?

• Why “Should” Statements Make You Feel Worse

• Social skills training

• Relaxation training

• Behavioral activation aka intentionally practicing specific behaviors that promote a positive mental state, or avoid negative thinking traps. 

Are you interested in CBT? Our clinicians at Hope+Wellness offer CBT therapy in our office and online. We serve the McLean, Great Falls, Falls Church, Arlington, Alexandria, and the greater Washington DC regions, as well as offering online services in DC, MD, VA, and all PSYPACT states. If you would like to talk to one of our therapists, please contact info@hope-wellness.com.

What You Should Know About EMDR

Have you ever heard of EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing. It’s a kind of psychotherapy that was developed in the 1980s by Francine Shapiro. Dr. Shapiro was walking outdoors in 1987

when she noticed that the distress she was feeling, related to upsetting memories, was lowered when she moved her eyes back and forth. She did further studies on this phenomenon, and eventually developed EMDR as the treatment it is today, as well as the Adaptive Information Processing model to explain how the treatment works. 

While EMDR is a newer treatment, it’s been shown to be incredibly effective in both research and in clinical settings. Many people experience a dramatic decrease in their distress level after EMDR therapy, and studies show it’s effective for many many mental health issues, including trauma, depression, anxiety, and OCD. 

How does it work?

The basic premise of EMDR is that our minds can heal wounds in the same way that our bodies can, but sometimes those wounds don’t heal correctly and cause pain long after the event in question. It’s almost like the painful memories and emotions get stuck. When this happens, we experience negative outcomes like trauma, anxiety, and other kinds of emotional and mental distress. Resolving these issues requires us to access and process these stuck memories and emotions, which happens through EMDR. 

EMDR offers a way to locate, access, and reprocess these stuck memories and emotions. The goal is to change the way the brain is storing these stuck memories so that they stop causing pain. EMDR treatment requires a clinician who is trained in EMDR, because the process of accessing and reprocessing traumatic memories is very sensitive. EMDR therapists have extensive training in the background of why EMDR works, and how to adapt it for different situations based on what the client needs.

What happens during an EMDR session? 

EMDR helps you to locate and reprocess traumatic memories, so it’s not something you can just jump into without preparation. EMDR has 8 phases, and each phase is essential, especially the phases where you work with your therapist to develop resources to help you during upsetting moments. 

• The 8 phases of EMDR are: 

• History & Treatment Planning

• Preparation

• Assessment

The first 3 phases are completed before reprocessing can begin. These phases are focused on understanding how EMDR can help the client based on their history, developing a treatment plan, building a rapport between the client and therapist, providing resources for the client to use in moments of distress, and deciding what event or memory to reprocess. 

• Desensitization

• Installation

• Body Scan

The next 3 phases are the reprocessing phases, where the client works with the therapist to access and reprocess the memory until they no longer feel distress around it. These phases include the bilateral stimulation that EMDR is famous for. Some clinicians will have you use eye movements, tapping, headphones, lights, buzzers, or tappers to direct the bilateral stimulation that allows you to access the memory networks that need reprocessing. 

• Closure

• Reevaluation

The final 2 phases help to build safety for the client as each session ends and begins. Each session will end with helping the client return to a calm state of mind, and each session will begin by checking back in to make sure that their distress level stays low around the reprocessed memory. 

Some of the phases go faster than others, and once you are ready to begin reprocessing, most of your EMDR sessions will be some combination of phases 3-8. 

What can EMDR help with?

EMDR was initially developed to help process trauma, and lessen the effects of PTSD, and it is an incredibly powerful way to treat trauma, including trauma from childhood or abuse. However, research has shown that EMDR can be helpful with a number of other mental health concerns, including: 

• Anxiety

• Depression

• Chronic Pain

• Dissociative Disorders

• Personality Disorders

• Addiction

• Eating Disorders

• Grief

• Self Esteem 

• OCD

EMDR is a treatment that can be used for children, teens, and adults. There are some situations where EMDR is not an appropriate treatment, so it’s important to check with an EMDR therapist to determine if it’s a good treatment choice for you. 

What are the benefits and drawbacks of EMDR?

One of the biggest benefits of EMDR is how effective it is as a treatment. Although it’s a newer treatment modality, there have been many studies conducted on EMDR that show it works. The data showed that EMDR was working for people before we even understood why it worked! Many organizations, including the World Health Organization, the American Psychological Association, and the US Department of Veterans Affairs recognize EMDR as an effective treatment for PTSD and other disorders.

Another major benefit of EMDR is that it doesn’t require a person to talk in detail about the distressing memories they have to reprocess them. EMDR does require you to focus on the memories, but you don’t have to put them into words. While focusing on the memories is definitely upsetting, it’s less intense than having to narrate or fully relive a traumatic memory. EMDR is also fully confined to the therapy session - you won’t have homework to do or be expected to process things on your own, everything will take place with your therapist, which can be appealing. 

Are you interested in EMDR? Our clinicians at Hope+Wellness offer EMDR therapy in our office and online. We serve the McLean, Great Falls, Falls Church, Arlington, Alexandria, and the greater Washington DC regions, as well as offering online services in DC, MD, VA, and all PSYPACT states. If you would like to talk to one of our therapists, please contact info@hope-wellness.com.

Don't Know What You're Feeling? Try This.

You’re sitting in therapy and your therapist asks the dreaded question: how are you feeling right now?

But there’s a storm of emotions in your head that you can’t decipher so you just say: I don’t know. 

This happens to all of us, and not just in therapy. There are so many moments we find ourselves not knowing what we’re feeling–maybe because we haven’t taken enough time to sit with it, or maybe because we’re feeling something in a context we’ve never felt it before–or maybe because many of us aren’t taught to recognize and have compassion for what we’re feeling when we’re feeling it. This leaves us at a disadvantage later, when it feels like our emotions are controlling instead of informing us. 

What’s the purpose of our emotions? 

Emotions can seem scary because we just aren’t taught a lot about them. When we shy away from understanding them, they become these all powerful entities that can control our lives. But the truth is, emotions (and the experience of having any emotion) is neutral. While it may feel positive or negative, the emotion itself is never a “bad” one to have. 

Emotions serve different purposes, including providing information to us about certain situations, or communicating to others how we feel. They can motivate us to act or help us avoid dangerous situations or potential threats. Emotions give us information about how we process and respond to the world around us. 

But emotions aren’t just felt in our minds, they involve what’s called a mind-body connection as what we experience is processed in our minds and felt in our bodies and physiological responses. These physical responses can be another way of your body trying to get you to pay attention to what your feelings are telling you, and to take appropriate action. Learning these physical responses can help you identify what you’re feeling when you have regular ways your feelings manifest in your body. 

Why is it so hard to figure out what we’re feeling?

The trouble with emotions is that they’re tricky. For example, some people may feel generalized anxiety and tension all day even in the absence of any threat. Others may be prone to feelings of depression and tend to interpret different situations with negative thoughts, thus in turn creating greater feelings of depression.

And, sometimes we just don’t have the vocabulary to decipher what we’re feeling.

Developing a greater awareness of your emotions can help you find ways to cope with difficult emotions that arise, make values-aligned decisions, enhance relationships with others, and develop a greater sense of self esteem. Identifying emotions and how you feel in a given situation is often the first critical step towards figuring out how best to manage them.

So how do we identify what we’re feeling if we don’t have the vocabulary for it?

One option is to browse out list of feelings here. Another method we’ll explore today is the Feelings Wheel! The feelings wheel is a great place to start if you have trouble identifying your feelings. 

The wheel starts with 7 general emotions at the center:

1. Happy 

2. Surprised 

3. Bad 

4. Fearful 

5. Angry 

6. Disgusted 

To start, you pick which of the five emotions feels closest to what you’re feeling. As the rings move outward, the terms get more and more specific. So for example, maybe you can only identify that you feel sad. If you start at sad, and go one ring out, is there a more specific feeling that fits? Maybe your sadness is actually hurt, and that hurt is embarassment. From there, you can take time to think of what it was that made you feel that way and how that feeling manifested for you. 

It may help to keep a feelings journal where you record this process. Note where you started on the feelings wheel and where you ended up. Then you can use the journal to explore how that feeling showed up in your body and what the circumstances around the feeling were. 

What happens when we don’t name our emotions?

This process can seem like a lot of work, and maybe you’re thinking it’s just not worth it! But when we don’t take time to understand our emotions, they don’t just go away. Instead, they can get more intense the longer they’re ignored, and the way they show up as physical symptoms can get more intense too. Your body wil deman you pay attention to what you’re feeling at some point. 

Not naming our emotions impacts other areas of our life as well, not just our physical health. It can also impact our relationships! Our feelings impact our behavior–if you’re feeling anxious, you’ll behave differently than when you’re feeling joy, etc. Without communicating what you’re feeling, your behavior can be interpreted incorrectly by friends and loved ones, and relationships can suffer. Understanding your feelings helps you understand how they impact how you behave with everyone in your life, and also gives you an opportunity to be open with those around about how you’re feeling so they know how to best support you. 

Learning to tune into and understand how we’re feeling is hard work, so don’t be hard on yourself if it take you a while to get to a place where you do it naturally. If you’re looking for support in this, our clinicians can help you.  

7 Tips for Coping with Parenting Stress

Being a parent is really hard.

It’s a lot to navigate the responsibilities and challenges of raising children, especially in a world as complicated as this one. Parenting, especially during the last four years, can be a bumpy ride. Dealing with the fallout of the pandemic and the way it strained caregivers, relationships, and mental health is no small feat. The way the pandemic strained our caregiving systems has left a lot of parents feeling overwhelmed, stressed, anxious, and burned out with little relief. 

It makes sense that a lot of parents are dealing with stress and anxiety about parenting well. The world can be a scary place, and there are so many factors that parents today have to deal with that previous generations didn’t need to worry about, like social media and gun violence. It’s already nerve-wracking to be responsible for a whole person! Adding in the complications of life right now is a recipe for stress.

Dealing with parenting stress and anxiety is necessary for so many parents, but many don’t have the resources or the time to make changes to cope. It’s not right that parents are spread so thin, and there should be more protections for parents and families coming from our government–and there are a lot of people out there working toward just that. As change comes slowly, parents feel forced to do it all, often not knowing how to rely on their communities to fill in the gaps, which leaves them stuck with bandaid solutions to help lower stress levels–so they can get up again and do it the next day. 

Are you struggling with parenting stress and anxiety? You’re not alone. Below are some ways to cope with parenting stress and anxiety so you don’t feel so drained.

Be nice to yourself

It's easy for parents to be overly critical of themselves, feeling like they should be doing more or handling things better, especially during times of increased stress. However, it's important to remember that no one is perfect, and it's okay to cut yourself some slack. 

Practicing self-compassion involves treating yourself with kindness and understanding, especially during difficult times. Acknowledge your efforts, even if they feel small.

Remember, you’re doing the best you can with the tools that you have, in challenging circumstances. It’s not possible to be a perfect parent, so learning how to be nice to yourself when you don’t get things right or struggle can help lower your stress levels. 

Remember to have fun

Being a kid is fun, and finding ways to connect with your child that make you both happy can help you feel more resilient to stress and anxiety. There are a lot of un-fun things about being a parent, but there’s also so many fun things to cherish. It can also be healing to take some time to look at the world the way that a child would, and rediscover that childlike wonder that makes being little so magical. 

It’s also important to carve out some time that’s just for you to have fun for yourself. It might seem frivolous to make time for fun when you’re stressed out, but denying yourself moments of joy can make stress feel worse. Moments where you’re happy and having fun can be rejuvenating to your well-being. Making time for yourself to enjoy things also sends the message to your kids that taking care of yourself is worthwhile and necessary, which is hugely important as they grow up. 

Manage your expectations

Don’t be hard on yourself for not getting more done in times of stress and anxiety. When things aren’t going well, it’s easy to feel like you need to do more and to be more, especially for your kids. It's natural for parents to want the best for their children, but it's also essential to set realistic expectations for yourself and your family. You may not be able to accomplish everything you normally would when you’re overwhelmed with stress, and that's okay. 

It’s okay to prioritize the most important tasks and let go of the need for perfection. By setting goals that feel more doable, you can reduce feelings of overwhelm and increase your sense of accomplishment.

Lean on your community 

We need community to survive so many things, and parenting is no different. It’s increasingly hard to raise a family without help from your community, whether that be family, friends, neighbors, coworkers, or someone else. Leaning on others for support can be incredibly beneficial in times of stress. It’s validating to talk with other parents who can relate to what you’re going through. 

Having a support system in place can provide emotional validation and practical assistance when you need it. Don't hesitate to reach out for help when you need it, and offer your support to others in return when you’re able to. Remember, you're not alone in this journey. 

Use resources available

It’s not right that parents have to work so hard to find resources for support, but there are options out there to try to help parents manage things. Your city might have resources for parents on their website, or there might be a local childcare council you can work with. 

There are also organizations, like Chamber of Mothers that are working to advance paid leave for all parents, quality, affordable childcare, and improve maternal health to try to approach these problems at the source. Parenting groups on social media, whether they’re local or widespread, can help parents find creative solutions to problems and also help them feel less alone. 

Work on mindfulness

Incorporating mindfulness practices and stress-relief techniques into your daily routine can help you manage stress more effectively in the moment and overall. 

Whether it's meditation, deep breathing exercises, yoga, or simply taking a few moments to focus on the present moment, mindfulness techniques can help you cultivate a greater sense of calm and resilience, which are powerful against stress. Find what works best for you and make it a regular part of your self-care routine.

Limit media exposure

It's important to stay informed about what’s going on in the world, but consuming excessive amounts of media can contribute to feelings of anxiety and overwhelm. Try to set boundaries around your media consumption, to give yourself a break. When you do consume media, prioritize sources that provide accurate information without sensationalizing or causing unnecessary distress. Consider taking regular breaks from screens and engaging in activities that bring you joy and relaxation instead. 

When the world is scary, it can be hard to stop scrolling because you don’t want to be unaware of what’s going on, but sometimes that can just heighten your sense of panic and stress. Remember that no one person can fix everything. Seeking out local organizations that are doing work to make the world a better place can help you feel like you’re taking meaningful action without just causing distress for yourself. 

Are you looking for more support with parenting stress and anxiety? Working with a therapist on parenting concerns can help you find more ways to cope and build your confidence as a parent. Get in touch with our office today to get started.