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	<title>Richard Zwolinski - Therapy Revolution &#187; Anxiety</title>
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		<title>Stress at the DMV: Why Less Power Means More Stress</title>
		<link>http://www.richardzwolinski.com/zwolinskisite/2010/06/25/stress-at-the-dmv-why-less-power-means-more-stress/</link>
		<comments>http://www.richardzwolinski.com/zwolinskisite/2010/06/25/stress-at-the-dmv-why-less-power-means-more-stress/#comments</comments>
		<pubDate>Fri, 25 Jun 2010 18:02:09 +0000</pubDate>
		<dc:creator>richard</dc:creator>
				<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Power Differential Factor]]></category>
		<category><![CDATA[Stress]]></category>

		<guid isPermaLink="false">http://www.richardzwolinski.com/zwolinskisite/?p=593</guid>
		<description><![CDATA[If you are in a position of power (or even if you aren’t), and have trouble imagining how those with less power feel, think of your last trip to the DMV or the Post Office (or any dealings you may have had with the IRS).

]]></description>
			<content:encoded><![CDATA[<p><img class="alignnone size-thumbnail wp-image-594" title="IMG_0757 - Copy" src="http://www.richardzwolinski.com/zwolinskisite/wp-content/uploads/2010/06/IMG_0757-Copy-150x150.jpg" alt="" width="150" height="150" />Our friend Rachel called the other day to vent. She had been stuck in a line in the DMV for nearly two hours only to find out when she got to the head of the line that she had to go home and bring in some documents. We sympathized. We’d been there.</p>
<p>One of the greatest sources of stress is what we call the PDF, or <em>Power Differential Factor</em>. It works like this:</p>
<p><span id="more-593"></span>In general, a person who has less relative power is under greater stress – especially in personal and <em>societal relationships</em>—than someone who has greater <em>relative power</em>. Someone with greater relative power (depending on personality, cultural upbringing, the present situation), will generally have less reason to fear fallout from negative interactions than someone one with less power.</p>
<p>If you are in a position of power (or even if you aren’t), and have trouble imagining how those with less power feel, think of your last trip to the DMV or the Post Office (or any dealings you may have had with the IRS).</p>
<p>Now do you remember what it feels like to have less relative power? Think about the long lines and the unintelligible forms you have to fill in that seemed designed to trip you up! Think about the sheer amount of time you have to spend attending to these bureaucratic requirements. In these and other taxpayer-funded agencies the citizen has almost no power relative to the public employees whose salaries they pay.</p>
<p>In these situations, people you have had no previous relationship with, i.e. government bureaucrats, have been granted an incredible amount of control over your ability to travel or communicate with others or simply control over your time and the money you’ve earned! They are in power, you are not.</p>
<p>Power can be about control over others, but <em>true power</em>, the <em>kind of power</em> that gives us the deepest and longest lasting rewards, is the kind of power we have over ourselves. When we learn that we are able to control our desires, our thoughts, and even our reactions to the world, we have a gift that transforms and mitigates the stress caused by PDF and some cases, even nullifies it.</p>
<p>There are several ingredients necessary to upping our PDF quotient. In the West, and especially the United States, where authority and hierarchies are relatively fluid, two of the most important of these ingredients are:</p>
<p><strong>Information and Education</strong><br />
(there are more ingredients, but we will only explore these, here due to space limitations).</p>
<p>Information, as we use it here, refers to current, relevant data (news, scientific discoveries, formulas, statistics, and so on), that gives us the facts we need to know to make intelligent, and powerful, decisions.</p>
<p>Education refers to the techniques and methods with which we make the information we have access to, useful.</p>
<p>Information and the education that helps us utilize it, are arguably the most important playing-field levelers in any democracy. If we look at totalitarian regimes, such as the former U.S.S.R., or the current regime in Iran, the <em>powerful control</em> not only access to information but also the content itself, thereby creating misinformation. Information and education becomes tools for the creation of and maintenance of <em>power and control</em> over others.</p>
<p>Though some argue that<em> information overload</em> produces stress, our opinion is that even massive amounts of information helps us maintain our power as citizens of the state as well as autonomous individuals. When access to information is combined with the necessary education that helps us discern what data is important and how to use the information once acquired, we gain power.</p>
<p>This helps us reduce stress due to the PDF.</p>
<p>This blog post first appeared at <a href="http://www.stopstressingnow.com/2010/06/stress-at-the-dmv-why-less-power-means-more-stress/" target="_blank">StopStressingNow.com</a>, Steven Diamond&#8217;s terrific site about stress.</p>
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		<title>More with Dr. Eric Chamberlin on Biofeedback as A Therapy Tool</title>
		<link>http://www.richardzwolinski.com/zwolinskisite/2010/06/24/more-with-dr-eric-chamberlin-on-biofeedback-as-a-therapy-tool/</link>
		<comments>http://www.richardzwolinski.com/zwolinskisite/2010/06/24/more-with-dr-eric-chamberlin-on-biofeedback-as-a-therapy-tool/#comments</comments>
		<pubDate>Thu, 24 Jun 2010 18:35:13 +0000</pubDate>
		<dc:creator>richard</dc:creator>
				<category><![CDATA[Addiction Treatment]]></category>
		<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Depression]]></category>
		<category><![CDATA[Mental Health Treatment]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Therapy Patients]]></category>
		<category><![CDATA[Biofeedback]]></category>
		<category><![CDATA[Dr. Eric Chamberlin]]></category>
		<category><![CDATA[Heart Rate Variability]]></category>
		<category><![CDATA[Therapy Soup]]></category>

		<guid isPermaLink="false">http://www.richardzwolinski.com/zwolinskisite/?p=589</guid>
		<description><![CDATA[HRV allows an individual to stimulate the cardiovascular system at its resonant frequency for a sustained period of time. Deep breathing, visualization, and meditation are all useful complimentary clinical tools, however they lack this critical property. Stimulation at the resonant frequency strengthens the baro-reflex, resulting in enhanced physical and psychological resilience by influencing heart rate, blood pressure, vascular resistance, pain threshold, central nervous system processing, mood, and attention.  Analogous to physical conditioning, the baro-reflex can be thought of as the “muscle” of core Mind-Body strength.]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.richardzwolinski.com/zwolinskisite/wp-content/uploads/2010/06/Chamberlin4236b4161.jpg"><img class="alignnone size-medium wp-image-591" title="Chamberlin4236b4161" src="http://www.richardzwolinski.com/zwolinskisite/wp-content/uploads/2010/06/Chamberlin4236b4161-258x300.jpg" alt="" width="258" height="300" /></a></p>
<p>We continue talking with <a href="http://chamberlinneuroscience.com/about.htm" target="_blank">Dr. Eric Chamberlin </a>about Heart Rate Variability Biofeedback and it&#8217;s usefullness in psychotherapy. What have you noticed from working with your patients? </p>
<p>A suburban mom comes in distraught after not sleeping the night before.  Very anxious, she has been ruminating unproductively about not being able to get her boys to camp this summer for trivial reasons.  The therapist’s attempts to encourage her to think about the situation differently are no match for her urgency and desperation.</p>
<p><span id="more-589"></span>She begins HRV to try to get her into a more balanced state where she can process more effectively.  After 12 minutes she states “I feel better…they can go next year…it’s no big deal right?”  With her balance and problem solving capacity restored, the solution was spontaneous and straightforward.</p>
<p><img title="More..." src="http://blogs.psychcentral.com/therapy-soup/wp-includes/js/tinymce/plugins/wordpress/img/trans.gif" alt="" />What followed was an emotional and very productive discussion about opportunities she had missed as a child because of her family’s dysfunction.  She realized that the feeling of desperation was from <span style="text-decoration: underline;">her</span> experience, and didn’t apply to her children who were very well cared for. </p>
<p><strong>Have studies been done that support your observations?</strong></p>
<p>Its an exciting time to be involved with HRV because it is in a “Translational Phase” meaning the basic neurophysiology has been well established and that knowledge is now being translated into clinical use.</p>
<p>Recent studies by Reiner at NYU, Karavidas and Lehrer at Robert Wood Johnson, and Zucker demonstrate the efficacy of HRV in clinical anxiety, depression, and PTSD respectively. A PhD Dissertation by Chaudri pending publication shows the efficacy of HRV combined with Psychotherapy in depressed patients with coronary artery disease. Specifically this study documented gains in focus, awareness, and emotional regulation.</p>
<p><strong> </strong><strong>What does the biofeedback technology offer that stress reduction methods such as breathing techniques, guided visualization, and meditation don’t?</strong></p>
<p>HRV allows an individual to stimulate the cardiovascular system at its <span style="text-decoration: underline;">resonant frequency</span> for a <span style="text-decoration: underline;">sustained</span> period of time. Deep breathing, visualization, and meditation are all useful complimentary clinical tools, however they lack this critical property. Stimulation at the resonant frequency strengthens the baro-reflex, resulting in enhanced physical and psychological resilience by influencing heart rate, blood pressure, vascular resistance, pain threshold, central nervous system processing, mood, and attention.  Analogous to physical conditioning, the baro-reflex can be thought of as the “muscle” of core Mind-Body strength.</p>
<p><strong>We are very interested in creating a trauma program that makes use of these techniques as well as other emerging technologies. In many cases, trauma patients struggle with substance abuse and addiction and comprehensive treatment for this would need to be available. After trying various techniques myself,  I am teaching some of my addiction patients Dr. John M. Kennedy’s B.R.E.A.T.H.E. technique which, though designed for heart-related stress, has a palpable and relaxing mind-body effect. </strong></p>
<p><strong>Have you done any specific work with HRV biofeedback and psychotherapy for addiction/addiction treatment? </strong></p>
<p>Trauma and addiction are ubiquitous in clinical practice.  With trauma comes difficulty in modulating arousal effectively, and people frequently resort to substance use to obtain relief. I have found HRV to be a very helpful tool for developing the capacity for self-regulation in clients who are seriously compromised.</p>
<p><strong>Where is HRV biofeedback available?</strong></p>
<p>The HRV devices currently available on the consumer level are the emWave “Desktop” (PC/Mac), emWave PSR (Handheld) and StressEraser (Handheld). This can be purchased from the manufactures directly, or authorized resellers.</p>
<p>An independent review of the StressEraser vs. emWave(s) is available at <a href="http://www.mindbodytechnology.com/">www.MindBodyTechnology.com</a>.</p>
<p><strong>Thank you for your time, Dr. Chamberlin. We look forward to learning more about HRV Biofeedback.</strong></p>
<p>Eric Chamberlin, MD of <a href="http://chamberlinneuroscience.com/blog3.htm" target="_blank">Chamberlin Applied Neuroscientist </a>is currently authoring a book about his work with clients employing an unusual tapestry of clinical tools.  Inspired by changes catalyzed by Heart Rate Variability Biofeedback, it describes the power of self-transformation that comes with balancing the nervous system at a deep level.  He has served on the faculty of Harvard and Dartmouth Medical Schools, lectures on Mind-Body Medicine, and has a full-time clinical practice in Glastonbury, CT.</p>
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		<title>Can Heart Rate Biofeedback Improve Therapy’s Effectiveness?</title>
		<link>http://www.richardzwolinski.com/zwolinskisite/2010/06/23/can-heart-rate-biofeedback-improve-therapy%e2%80%99s-effectiveness/</link>
		<comments>http://www.richardzwolinski.com/zwolinskisite/2010/06/23/can-heart-rate-biofeedback-improve-therapy%e2%80%99s-effectiveness/#comments</comments>
		<pubDate>Wed, 23 Jun 2010 18:35:02 +0000</pubDate>
		<dc:creator>richard</dc:creator>
				<category><![CDATA[Addiction Treatment]]></category>
		<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Mental Health Treatment]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Therapy Patients]]></category>
		<category><![CDATA[Biofeedback]]></category>
		<category><![CDATA[Dr. Eric Chamberlin]]></category>
		<category><![CDATA[Heart Rate Variability]]></category>
		<category><![CDATA[HRV Biofeedback]]></category>
		<category><![CDATA[Stress]]></category>
		<category><![CDATA[Therapy Soup]]></category>

		<guid isPermaLink="false">http://www.richardzwolinski.com/zwolinskisite/?p=587</guid>
		<description><![CDATA[HRV devices all work by measuring the pulse from a fingertip or earlobe. The heart rate is calculated and the data undergoes processing which is used to provide visual and auditory feedback. The client uses breathing (to control her heart rhythm), and then uses the feedback to enter a balanced state.

]]></description>
			<content:encoded><![CDATA[<p>Dr. Eric Chamberlin discusses his work in Mind-Body medicine, and how a relatively new technology brings something new to psychotherapy.</p>
<p><strong>Welcome, Dr. Chamberlin. Can you tell us about the genesis of your work with Heart Rate Variability Biofeedback and psychotherapy?</strong></p>
<p>I really enjoy seeing people get better, and am always looking for tools that will increase efficiency and enhance outcome.  In 2006, HRV Biofeedback devices became available on the consumer level. Having practiced Mind-Body Medicine since the early 90’s, I was intrigued by the possibility of individuals being able to fine-tune their nervous systems at a very deep level.  When the so-called “Autonomic Nervous System” was discovered it was erroneously believed to be out of the realm of voluntary control.</p>
<p>HRV represents an exciting leap forward by helping people learn to balance the two branches of the ANS—the <em>Sympathetic “Fight or Flight”</em> and <em>Parasympathetic “Rest and Digest”</em> systems.  And with balance of the ANS comes greater balance in life.</p>
<p>Psychotherapy can be extremely powerful, however the progress is often uneven.  A common factor is clients not being in the “right mood” or “frame of mind” to be able to engage and benefit from treatment.  For example, a person may be so anxious and preoccupied that she can’t focus effectively.  Or, in talking about emotionally charged issues she may become overwhelmed, frozen and shut down. My hope was that by using HRV to balance the nervous system that it would be possible “to keep the train on the tracks,” moving toward resolution of the problems that brought them to treatment.  It works.</p>
<p><strong>Meditative techniques, breath-work and medication can all be used to address this, however, there are drawbacks/limitations to each of those methods. HRV Biofeedback doesn’t appear to have the same kinds of limitations. Can you describe the HRV technology and how you employ it? </strong></p>
<p>HRV devices all work by measuring the pulse from a fingertip or earlobe. The heart rate is calculated and the data undergoes processing which is used to provide visual and auditory feedback. The client uses breathing (to control her heart rhythm), and then uses the feedback to enter a balanced state.</p>
<p>Clients use HRV before sessions; in the waiting room, car, etc., to balance and optimize readiness to engage in the challenging work to follow. If needed, clients will use HRV for 5 to 10 minutes to “get back on track” during a session.  (It’s disturbing to realize how much time was wasted in the past when clients “derailed,” and the rest of the session was spent just trying to get them back on track.)</p>
<p>In the hours and days after a session, clients use HRV to help “digest” the experience and make change.  It is a very effective “force multiplier.”</p>
<p><strong>Thanks, Dr. Chamberlin. We are looking to hearing more about HRV Biofeedback in Part Two.</strong></p>
<blockquote><p>Eric Chamberlin, MD is currently authoring a book about his work with clients employing an unusual tapestry of clinical tools.  Inspired by changes catalyzed by Heart Rate Variability Biofeedback, it describes the power of self-transformation that comes with balancing the nervous system at a deep level.  He has served on the faculty of Harvard and Dartmouth Medical Schools, lectures on Mind-Body Medicine, and has a full-time clinical practice in Glastonbury, CT. His website is <a href="http://chamberlinneuroscience.com/index.html" target="_blank">Chamberlin Applied Neuroscience</a>.</p></blockquote>
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		<title>Is There An Epidemic of Hopelessness?</title>
		<link>http://www.richardzwolinski.com/zwolinskisite/2010/06/16/is-there-an-epidemic-of-hopelessness/</link>
		<comments>http://www.richardzwolinski.com/zwolinskisite/2010/06/16/is-there-an-epidemic-of-hopelessness/#comments</comments>
		<pubDate>Wed, 16 Jun 2010 16:18:33 +0000</pubDate>
		<dc:creator>richard</dc:creator>
				<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Depression]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Therapy Patients]]></category>
		<category><![CDATA[Economic Downturn]]></category>
		<category><![CDATA[Karol Ward]]></category>
		<category><![CDATA[Oil Spill]]></category>
		<category><![CDATA[Therapy Soup]]></category>
		<category><![CDATA[Worries]]></category>

		<guid isPermaLink="false">http://www.richardzwolinski.com/zwolinskisite/?p=579</guid>
		<description><![CDATA[Everything is interrelated.  I wanted to have readers remember that when they got worried all they had to focus on what the three C’s.  Calmness, Clarity and Community. ]]></description>
			<content:encoded><![CDATA[<p>In the first part of our talk with NYC therapist Karol Ward she agreed that she has noticed an increase in the number of patients contacting her. Many of them seem to be doing so to discuss anxiety they are having that is related to the economy, unemployment fears, the environment (especially prompted by the terrible oil spill), and other national, rather than personal issues. We continue, below.</p>
<p><strong><span id="more-579"></span>Welcome back, Karol. In your opinion, what is therapy able to offer patients who believe they are truly powerless to overcome the effects of living in what seems to be an increasingly polarized country? How do you suggest they cope with their fears about the negative political and economic situation?</strong></p>
<p>Therapy provides the space for patients to slow down and gain perspective.  When patients feel powerless, it is often because their fear (valid or irrational), has them stuck in particular mindset or emotional state.  They see the worst and imagine the worst.  They lose sight of their own innate abilities to take charge of the areas of their life that they truly can control. </p>
<p>No matter what type the therapy is, it is my belief that a therapist provides mirroring, support, reality checking, and the place to “think and feel out loud”.  I have found that helping patients complete the “incomplete picture”, meaning where they get stuck and what keeps them from moving forward, gets them back in charge.  Completing the incomplete picture has them really imagine and talk through their worst-case scenario fears, which moves it from the unknown to the known.  Usually they come to the realization that they are much more resilient than they ever imagined.</p>
<p><strong>We are in the middle of a series of posts on God in Therapy with an emphasis on Western (rather than Eastern) spirituality and so we can’t resist asking the following: How do you and your patients work together to make sense of these issues? Do you or your patients ever discuss Judeo-Christian prayer, God or religion as part of the response?</strong></p>
<p>I do have patients who use prayer and talk about their relationship with God as a way to handle anxiety and depression.  They attend church and talk to God as a way to find answers.  Sometimes they question their faith and relationship God when things are emotionally rough.  I have found that when they allow themselves to “feel their feelings” they are able to hear God’s voice and support more clearly.   They find great comfort in reclaiming their connection with God once more.  </p>
<p><strong>We haven’t done a survey, but it seems that we have been hearing more about big-picture issues such related to the meaning of life and God and religion far more than even a few years ago.</strong></p>
<p><strong>Karol, please tell us about your new book. I think many of our readers will be interested to hear how you came to write it.</strong></p>
<p><strong> </strong>My new book, <a href="http://www.amazon.com/Worried-Sick-Chronic-Achieve-Physical/dp/0425234118/ref=sr_1_3?ie=UTF8&amp;s=books&amp;qid=1276475699&amp;sr=1-3" target="_blank">Worried Sick: Break Free From Chronic Worry to Achieve Mental &amp; Physical Health </a>(Berkley, 2010), was the result of seeing how worry and anxiety was increasing in my practice.  In addition, I had my own significant worry to deal with due to the deteriorating health of my mother. </p>
<p>With a diagnosis of Alzheimer’s and vascular dementia, my bright, articulate mother began to decline in what seemed to be a short period of time.  I had to use every tool I had ever used as a therapist to keep myself stable while I cared for her.  This made me contemplate what I had used in my practice to help my patients combat and manage their worries.  I found it interesting that writing my book would be parallel to the journey I was having with my mom. </p>
<p>As a therapist who really believes in the importance of the body-mind connection, I know that addressing how worry effects us on the physical, psychological and behavioral level is a key to making changes.  I wanted to offer the techniques that I had seen reduce worry and anxiety with my patients.</p>
<p>Using a body, mind, spirit approach was important because in my experience they are related.  When the body is relaxed, the mind is affected and when the mind is clear, we are open to the possibilities of life, which helps our spirit.  In turn, having a spiritual life helps us feel better in our mental outlook and that in turn helps us feel less physically tense.  Everything is interrelated.  I wanted to have readers remember that when they got worried all they had to focus on what the three C’s.  Calmness, Clarity and Community.  </p>
<p>Calmness-Using techniques that help release physical and mental tension.</p>
<p>Clarity-Utilizing the logic of the mind to address irrational fears.</p>
<p>Community-Tapping into the people and recourses that offer ongoing support when you are worried and anxious. </p>
<p><strong>These three Cs are quite important, Karol. Upon reflection it seems that everybody finds one of these comes more naturally to them than the others but all of them must be explored and cultivated. In big cities such as NY, the third one, Community, is often a real challenge for people. </strong></p>
<p>The purpose of my book was to not condemn worry because it will always be part of our lives.   Rather my goal was to offer guidance and solutions so that readers can get unstuck, find support and keep going when worrisome situations enter their lives.   </p>
<p> <strong>Thank you.</strong></p>
<p>About Karol Ward <a href="http://karolward.com/" target="_blank"><strong>Karol Ward, L.C.S.W.</strong> </a>is a licensed psychotherapist, nationally recognized speaker and the author of <a href="http://www.amazon.com/Worried-Sick-Chronic-Achieve-Physical/dp/0425234118/ref=sr_1_3?ie=UTF8&amp;s=books&amp;qid=1276475699&amp;sr=1-3" target="_blank"><strong>Worried Sick</strong> </a>(Berkley, 2010) and <strong>Find Your Inner Voice</strong> (Career Press, 2009).  Karol combines her training as a psychotherapist with her passion for communication and has appeared as a psychological media expert on CNN, NBC, ABC, and in magazines such as Cosmopolitan, Experience Life, Black Enterprise, Readers Digest , Idea Fitness Journal and The New York Daily News.  She has also been featured on MSNBC.com, Sheknows.com, DivineCaroline.com and the Examiner.com as well as numerous radio shows.  The core of her work is the importance of the body.</p>
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		<title>Worried Sick About the Oil Spill, the Economy, and Unemployment? Could Therapy Offer Hope?</title>
		<link>http://www.richardzwolinski.com/zwolinskisite/2010/06/14/worried-sick-about-the-oil-spill-the-economy-and-unemployment-could-therapy-offer-hope/</link>
		<comments>http://www.richardzwolinski.com/zwolinskisite/2010/06/14/worried-sick-about-the-oil-spill-the-economy-and-unemployment-could-therapy-offer-hope/#comments</comments>
		<pubDate>Mon, 14 Jun 2010 16:27:31 +0000</pubDate>
		<dc:creator>richard</dc:creator>
				<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Depression]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Self Help Books]]></category>
		<category><![CDATA[Therapy Patients]]></category>
		<category><![CDATA[Karol Ward]]></category>
		<category><![CDATA[Oil Spill]]></category>
		<category><![CDATA[Therapy Soup]]></category>
		<category><![CDATA[Worried Sick]]></category>

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		<description><![CDATA[I think what’s uncomfortable for lots of us is that there doesn’t seem to be a future point where we can look forward and say: Okay, by such and such a date, this will all be cleaned up. ]]></description>
			<content:encoded><![CDATA[<div id="attachment_575" class="wp-caption alignnone" style="width: 160px"><a href="http://www.richardzwolinski.com/zwolinskisite/wp-content/uploads/2010/06/Karol-Small-Red-Photo.jpg"><img class="size-thumbnail wp-image-575" title="Karol Small Red Photo" src="http://www.richardzwolinski.com/zwolinskisite/wp-content/uploads/2010/06/Karol-Small-Red-Photo-150x150.jpg" alt="" width="150" height="150" /></a><p class="wp-caption-text">Karol Ward. LCSW</p></div>
<p>Some people appear to be experiencing what can only be described as an <em>epidemic of hopelessness</em> in the past several months. On an anecdotal level, only, this general hopelessness seems to be manifesting in some individuals as increased anxiety and to a certain extent, depression. Rather than sharing just our own views on what appears to be a growing phenomenon Therapy Soup is speaking about the situation with <a href="http://karolward.com/" target="_blank">Karol Ward, L.C.S.W., </a>author of the new book, <a href="http://www.amazon.com/Worried-Sick-Chronic-Achieve-Physical/dp/0425234118/ref=sr_1_3?ie=UTF8&amp;s=books&amp;qid=1276475699&amp;sr=1-3" target="_blank">Worried Sick: Break Free From Chronic Worry to Achieve Mental &amp; Physical Health (Berkley, 2010).</a></p>
<p><strong><span id="more-574"></span>Welcome to Therapy Soup, Karol. </strong><strong>Have you experienced any changes in the number of people contacting you regarding depression or anxiety? </strong> </p>
<p>Yes, I have definitely experienced an increase in the number of people contacting me for therapy.  In general, I would say there was a 30 percent increase. <em></em></p>
<p>This started around the time the worsening economy began to have a real impact in people’s lives.  I practice in New York City and I think there were many people who were caught off guard when they were laid off by their companies. </p>
<p>I also had an increase in my couples therapy work as the impact of the economy started to affect how couples were relating to each other.  The roles in their relationship that had been so firmly in place were now shaken up.  The couples had to adjust to new ways of coexisting together.  Sometimes on half of the couple was depressed over a job loss while the other had to find an inner strength to keep the finances going. </p>
<p><strong>Have you had any patients who have openly disclosed that they believe their depression or anxiety to be at least partially related to or compounded by world events? What world events?</strong></p>
<p>Yes, there has been a correlation between, “situational anxiety and depression” from outside events. This type of mood disorder is prompted by external events that then affect the mood and perception of the patients I am working with. </p>
<p>Initially it was the economy, with those patients who have also struggled with money issues being triggered even more so.   Then there were people who had been let go and found that they were struggling to look for and find work. </p>
<p>There was also another group who felt anxiety because they had kept their jobs and felt upset that their colleagues had lost their positions.  This particular group had an underlying anxiety because “they could be next”.  They often feel powerless and pressured to work harder because times are tough.  Sometimes that is the message in the work place and sometimes it is an internal self-created pressure.</p>
<p><strong>That is an excellent point—but having an employer who is compassionate and supportive can be a big help in helping people cope with this anxiety. Also, having an employer who openly discusses the situation with employees also helps them feel less powerless. But, I am sorry to say, I have heard instances of employers taking full advantage of the situation and actually using it to “control” their employees by creating an atmosphere of fear.</strong>  </p>
<p><strong>There are, of course, other issues that seem to be affecting people’s anxiety levels and one that I hear about frequently is the tragic oil spill and the fact that it appears to still be gushing with no end in sight. Have any of your patients spoken of the oil spill and how it has affected them personally? </strong></p>
<p>There is now upset occurring with some patients now about the current oil spill and interestingly it is more about the animals being affected.  The patients I see relate to the vulnerability of the birds, mammals and fish that they perceive are innocent victims.  Feelings of depression have come up around this particular issue.  These patients connect this back to their own issues around be powerless or victimized.  No one has expressed a direct connection with the oil spill such as living in that particular area but feel a general hopeless about the state of the environment.</p>
<p><strong>I think what’s uncomfortable for lots of us is that there doesn’t seem to be a future point where we can look forward and say: Okay, by such and such a date, this will all be cleaned up. Also, though the oil spill is devastating and it is important for people to be aware and share the tragedies that other Americans are going through, the constant media images and stories might not be healthy focus for some people.   </strong></p>
<p><strong>Thanks, Karol. We’ll continue next time with a discussion on how you believe therapy can help, as well as learn some more about your book!  </strong></p>
<p>About Karol Ward</p>
<p><a href="http://karolward.com/" target="_blank"><strong>Karol Ward, L.C.S.W.</strong> </a>is a licensed psychotherapist, nationally recognized speaker and the author of <a href="http://www.amazon.com/Worried-Sick-Chronic-Achieve-Physical/dp/0425234118/ref=sr_1_3?ie=UTF8&amp;s=books&amp;qid=1276475699&amp;sr=1-3" target="_blank"><strong>Worried Sick</strong> </a>(Berkley, 2010) and <strong>Find Your Inner Voice</strong> (Career Press, 2009).  Karol combines her training as a psychotherapist with her passion for communication and has appeared as a psychological media expert on CNN, NBC, ABC, and in magazines such as Cosmopolitan, Experience Life, Black Enterprise, Readers Digest , Idea Fitness Journal and The New York Daily News.  She has also been featured on MSNBC.com, Sheknows.com, DivineCaroline.com and the Examiner.com as well as numerous radio shows.  The core of her work is the importance of the body-mind connection.</p>
<p>(Read the original interview <a href="http://blogs.psychcentral.com/therapy-soup/2010/06/worried-about-the-oil-spill-economy-and-unemployment-could-therapy-offer-hope/" target="_blank">here</a>, at Therapy Soup at PsychCentral.com)</p>
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		<title>God in Therapy: A Jewish Confession</title>
		<link>http://www.richardzwolinski.com/zwolinskisite/2010/06/09/god-in-therapy-a-jewish-confession/</link>
		<comments>http://www.richardzwolinski.com/zwolinskisite/2010/06/09/god-in-therapy-a-jewish-confession/#comments</comments>
		<pubDate>Wed, 09 Jun 2010 21:17:03 +0000</pubDate>
		<dc:creator>richard</dc:creator>
				<category><![CDATA[Addiction Treatment]]></category>
		<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Depression]]></category>
		<category><![CDATA[Psychotherapist Ethics]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[God]]></category>
		<category><![CDATA[God in Therapy]]></category>
		<category><![CDATA[Judaism]]></category>
		<category><![CDATA[Repentance]]></category>

		<guid isPermaLink="false">http://www.richardzwolinski.com/zwolinskisite/?p=570</guid>
		<description><![CDATA[Teshuva means “return” (though it is often translated as repentance).  Judaism teaches that when one errs or does something harmful, one is able to “return” to the state he or she was in before the error. This return is ideally a return to one’s true self.]]></description>
			<content:encoded><![CDATA[<p>We hesitated. Should we share how Jewish beliefs are part of my clinical outlook? Then C.R. pointed to blog posts by Pavel G. Somov, PhD who eloquently shares a variety of Eastern spiritual and religious influences in his <a href="http://blogs.psychcentral.com/mindful-living/2010/06/perfection-aristotle-versus-buddha/" target="_blank">writings</a>. Thank you, Dr. Somov!</p>
<p>We could begin by making “Jewish guilt” jokes or jokes about neurosis a la Woody Allen, but the truth is that the fundamentals of psychoanalysis, psychology, psychotherapy have very strong connections with very ancient teachings of Judaism. In fact, they go back as far as Adam and Eve!</p>
<p><span id="more-570"></span>In part that’s because character analysis and character improvement are a way of life in traditional Judaism. There is a densely interwoven theme of self-knowledge and self-improvement in ancient—and modern—Jewish commentaries on the Bible (aka Torah). These topics are also overtly discussed in Kabbalah, numerous ancient ethics manuals, and numerous other sources. There are several schools of thought and different approaches and virtually every major scholarly work either focuses on or touches on the subjects of what it means to be human and what it means to work on one’s character.</p>
<p>Because all these teachings are regularly studied by observant Jews today as they have been for thousands of years, they are ingrained in our outlook.</p>
<p>Of course, psychology itself has Jewish roots. Others have commented on this, but we’ll leave that to Freud’s biographers and the many authors, both Jewish and not, who have written volumes on this subject.</p>
<p>I find it natural that the deepest of Jewish teachings as well as common-sense life lessons of Judaism inform my clinical work but then again, they inform every sphere of my life, just as being male, being born in America, and being very tall do, too. It’s hard to dissect and pull out what is the Judaism and what is the Richard, but there are several Jewish concepts that really do keep cropping up. We’ll start with one, “teshuva”.</p>
<p>Teshuva means “return” (though it is often translated as repentance).  Judaism teaches that when one errs or does something harmful, one is able to “return” to the state he or she was in before the error. This return is ideally a return to one’s true self.</p>
<p>This return will necessitate the use of various processes including but not limited to: confession (to God and self—not through intermediaries), honest reflection and assessment, self-education, sincere regret, apology—if another was harmed and if appropriate–prayer, implementing practical courses of reparative action, and resisting repeating harmful future actions.</p>
<p>In fact, sincere teshuva can bring a person to a higher spiritual state of being than before. According to Jewish teachings, teshuva can literally transform the actual harmful deed into a positive event. In other words, through corrective action one can actually change reality. There is even a saying that what a true penitent (one who achieves a rectification of his actions and himself), achieves spiritually, a saint (one who has done no wrong), isn’t able to achieve.</p>
<p>I find that sharing this general concept, especially when working with substance abusers or those who have harmed others or themselves, to be incredibly powerful. To believe that one has the power to change and repair not only himself but the world itself is a theme that to me is worth emphasizing in virtually every course of psychotherapy or addiction treatment.</p>
<p>Does this minimize the harmfulness of actions that have hurt others? No. It does not because there are consequences to one’s actions and teshuva does not generally negate consequences.  But it does transform self.</p>
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		<title>God in Therapy: Humility, Belief, and Control</title>
		<link>http://www.richardzwolinski.com/zwolinskisite/2010/06/08/god-in-therapy-humility-belief-and-control/</link>
		<comments>http://www.richardzwolinski.com/zwolinskisite/2010/06/08/god-in-therapy-humility-belief-and-control/#comments</comments>
		<pubDate>Tue, 08 Jun 2010 16:35:19 +0000</pubDate>
		<dc:creator>richard</dc:creator>
				<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Depression]]></category>
		<category><![CDATA[Mental Health Treatment]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Therapy Patients]]></category>
		<category><![CDATA[Belief]]></category>
		<category><![CDATA[Entitlement]]></category>
		<category><![CDATA[God]]></category>
		<category><![CDATA[God in Therapy]]></category>
		<category><![CDATA[Humility]]></category>
		<category><![CDATA[Self Esteem]]></category>
		<category><![CDATA[Therapy Soup]]></category>

		<guid isPermaLink="false">http://www.richardzwolinski.com/zwolinskisite/?p=565</guid>
		<description><![CDATA[A wise teacher (Rabbi Bunim of Peshischa; 1765-1827) said everyone should have two pockets, each one containing a slip of paper. On the first slip should be written, “I am but dust and ashes”, and on the other, “The world was created for me.”]]></description>
			<content:encoded><![CDATA[<p>(This post can be found at <a href="http://blogs.psychcentral.com/therapy-soup/2010/06/god-in-therapy-humility-belief-and-control/" target="_blank">Therapy Soup </a>on PsychCentral.com).</p>
<p>How we handle stress is due in large part to how healthy our sense of self is.  We contend that a healthy life requires the belief that life has meaning. Therapy can help uncover this meaning by allowing you to explore and discuss this in a safe environment.</p>
<p>Therapy means managing symptoms, finding root causes and/or addressing behavioral issues, developing insights into oneself and one’s life, and so on, but if someone truly believes life has no inherent meaning, that nothing matters, therapy will have failed. Without finding meaning in life it is difficult (though perhaps not impossible–the research simply has been done) to develop some of the key indicators of a healthy sense of self.</p>
<p><span id="more-565"></span>Someone with a healthy sense of self exhibits:</p>
<ol>
<li>A balanced blend of humility and confidence</li>
<li>Respect for others as well as  self-respect</li>
<li>Awareness of one’s own strengths—and acknowledgment of one’s weaknesses</li>
<li>Resolve to accept what can’t be changed—with ourselves, others, and the world— as well as a dedication to improving oneself.</li>
</ol>
<p>This is a tall order and no one is perfect. But it is essential that we all try to work on this balance if we are to have <em>healthy relationships</em> and <em>a sense of meaning in our lives</em>—two key factors in helping us cope with inevitable stress.</p>
<p>This is summed up nicely in our tradition. A wise teacher (Rabbi Bunim of Peshischa; 1765-1827) said everyone should have two pockets, each one containing a slip of paper. On the first slip should be written, “I am but dust and ashes”, and on the other, “The world was created for me.”</p>
<p>One of the failures of Western culture, especially some aspects of American culture, is that it encourages the belief in “the world was created for me” without <em>also</em> encouraging the belief that we aren’t immortal or perfect (that is, without belief in the corresponding, “I am but dust and ashes” concept).</p>
<p>There are a few weaknesses of the extreme adherence to what can be called the “self-esteem movement”. For example, success (of various kinds), is worshipped and failure is almost always re-labeled “success.” Also,  one is taught to love and rely on self above all others—“trust your gut instincts”, “follow your heart,” “honor your feelings,” and so on.</p>
<p>But what if your instincts are simply inaccurate or off-base? What if your heart leads you to indulge in unhealthy desires? What if your feelings demand that you hurt or negate others or focus on self to the exclusion of all else?</p>
<p>A total adherence to putting self first creates unrealistic expectations. If one’s expectations are constantly disappointed, it leads to dissonance between the self and the outside reality, or in simpler terms, between “I” and life. If I am so great, how come I…got sick? Failed to get into the college of my choice? Can’t sustain a relationship? Work hard but still can’t afford to take a vacation or buy a house?</p>
<p>There are very few options left. You can make peace with the fact that you aren’t perfect  and that not everything is within your power to change or you can  blame the outside world and make yourself out to be a victim, the opposite of what the “self-esteem movement” started out to do in the first place.</p>
<p>In order not breed a sense of entitlement, a healthy sense of self must necessarily be balanced with three key factors some or all of which can be found in many of the world’s religious traditions:</p>
<ol>
<li>Humility—the kind that combines a realistic sense of one’s own importance <em>and</em> a respect for others’ importance</li>
<li>Belief— in a higher power than ourselves which leads us to temper self-reliance with a balanced view of our own importance. </li>
<li>Control—A realization that we can’t control everything that happens to us but that we can control our responses and take control of ourselves. And yes, this is easier said than done!</li>
</ol>
<p>By achieving a realistic, healthy sense of who we are and our place in the world, by accepting that what we want isn’t always what we get, and by strengthening our relationships with others, we assist ourselves in our own recovery. Therapy can have a role to play in this. By seeking meaning and by honestly exploring what we believe, we enrich our lives.</p>
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		<title>A Day at the Bank</title>
		<link>http://www.richardzwolinski.com/zwolinskisite/2010/06/01/a-day-at-the-bank/</link>
		<comments>http://www.richardzwolinski.com/zwolinskisite/2010/06/01/a-day-at-the-bank/#comments</comments>
		<pubDate>Tue, 01 Jun 2010 20:29:16 +0000</pubDate>
		<dc:creator>richard</dc:creator>
				<category><![CDATA[Addiction Treatment]]></category>
		<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Depression]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[Mental Health Treatment]]></category>
		<category><![CDATA[Psychotherapist Ethics]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Therapy Patients]]></category>
		<category><![CDATA[addiction]]></category>
		<category><![CDATA[mental health]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[national mental health month]]></category>
		<category><![CDATA[Valley National Bank]]></category>

		<guid isPermaLink="false">http://www.richardzwolinski.com/zwolinskisite/?p=552</guid>
		<description><![CDATA[How do we know when mental illness has truly become less stigmatized? When a bastion of corporate respectability hosts an event that encourages open discussion of mental illness and related issues!]]></description>
			<content:encoded><![CDATA[<div>
<h1 id="post-670"><a title="Permanent Link: Mental Health Education &amp; Awareness at Valley National Bank" rel="bookmark" href="http://blogs.psychcentral.com/therapy-soup/2010/06/mental-illness-education-at-valley-national-bank/">Mental Health Education &amp; Awareness at Valley National Bank</a></h1>
<p>By Richard Zwolinski, LMHC, CASAC</p></div>
<p> </p>
<p>How do we know when mental illness has truly become less stigmatized? When a bastion of corporate respectability hosts an event that encourages open discussion of mental illness and related issues!</p>
<p><span id="more-552"></span>Although we speak and do workshops for a variety of organizations, usually sponsors are either in the mental health and addiction fields or corporations looking to learn about mental and emotional well being and addiction prevention in the workplace. Last week, that all changed. In honor of the end of National Mental Health Month, 2010, <a href="http://www.valleynationalbank.com/" target="_blank">Valley National Bank</a>, the largest bank headquartered in New Jersey (with many branches in the NY metro area), broke charitable ground and hosted a community mental health awareness and education event at one of its Brooklyn branches on 13<sup>th</sup> Avenue.</p>
<p>VP and assistant branch manager Anna Gelardo came up with the idea to host the free event which took place during regular banking hours. She and her team opened their doors to all who passed by, sent out dozens of news releases and personal invitations, handed out fliers, and set up a free, lavish dessert buffet. There was a table in the lobby where free educational materials were available including the <a href="http://blogs.psychcentral.com/therapy-soup/2010/05/therapy-patients-bill-of-rights/" target="_blank">Therapy Patient Bill of Rights </a>developed with the help of PsychCentral readers on this blog. The bank also raffled off several copies of our book, <a href="http://www.amazon.com/Therapy-Revolution-Better-without-Wasting/dp/075731418X/ref=pd_rhf_p_t_1" target="_blank">Therapy Revolution: Find Help, Get Better, and Move On Without Wasting Time or Money</a>.</p>
<p>Most of the bank’s customers joined us when they were done with their banking business. Also, many people stopped in just to schmooze with us about mental health issues and enter the raffle. They stayed for the warm atmosphere and the buffet—not a typical day at the bank! A large number of guests had family members with mental illness or were mentally ill themselves, but many were simply curious. The entire bank staff, including the tellers, was genuinely welcoming.</p>
<p>We hope to do many more stigma-busting, awareness and education events—the more that people feel that the topic of mental illness (and addiction, too), can be discussed openly and brought into the public consciousness, the less they have to struggle with the additional burdens of shame and blame.</p>
<p>Many thanks to Valley National Bank and their wonderful team including Reetu Chokshi; Jr. Graphic Designer; Anna Gelardo, VP and Assistant Branch Manager; Inderia Ram, District Manager; Vincent Demeo, Regional Manager; Marc Piro ,Vice President, Marketing/Public Relations;  Maureen Zegler, Senior First VP; and Gerald Lipkin, Chairman, President, and CEO. (Please accept our apologies if we overlooked anyone).</p>
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		<title>Beverly Hills Shrink: Dr. Carole Lieberman</title>
		<link>http://www.richardzwolinski.com/zwolinskisite/2010/05/25/beverly-hills-shrink-dr-carole-lieberman/</link>
		<comments>http://www.richardzwolinski.com/zwolinskisite/2010/05/25/beverly-hills-shrink-dr-carole-lieberman/#comments</comments>
		<pubDate>Tue, 25 May 2010 15:21:42 +0000</pubDate>
		<dc:creator>richard</dc:creator>
				<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Depression]]></category>
		<category><![CDATA[Evaluation]]></category>
		<category><![CDATA[Mental Health Professionals]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Dr. Carole Liberman]]></category>
		<category><![CDATA[psychiatric medication]]></category>
		<category><![CDATA[psychiatry]]></category>
		<category><![CDATA[psychopharmacology]]></category>
		<category><![CDATA[Therapy Soup]]></category>

		<guid isPermaLink="false">http://www.richardzwolinski.com/zwolinskisite/?p=533</guid>
		<description><![CDATA[If a patient has a problem serious enough to require medication, then he certainly needs psychotherapy, as well.]]></description>
			<content:encoded><![CDATA[<div id="attachment_536" class="wp-caption alignleft" style="width: 240px"><a href="http://www.richardzwolinski.com/zwolinskisite/wp-content/uploads/2010/05/LIEBERMAN_120802_181.jpg"><img class="size-medium wp-image-536" title="LIEBERMAN_120802_18" src="http://www.richardzwolinski.com/zwolinskisite/wp-content/uploads/2010/05/LIEBERMAN_120802_181-230x300.jpg" alt="" width="230" height="300" /></a><p class="wp-caption-text">Dr. Carole Lieberman</p></div>
<p>In this no-holds-barred interview, Dr. Lieberman tells it as she sees it. Want PC? Don&#8217;t read this interview!</p>
<p>Therapy Soup is fortunate enough to be able to speak with three-time Emmy award winning psychiatrist and author, <a href="http://www.drcarole.com" target="_blank">Dr. Carole Lieberman</a>. We wanted to discuss why the vast majority of psychiatrists no longer do psychotherapy and why Dr. Carole (who is a psychiatrist who does psychotherapy), believes this to be detrimental to the patient.  </p>
<p><strong>Welcome, Dr. Carole. Can you tell us a little bit about the genesis of psychiatry and how it has changed over the years?</strong></p>
<p>Before the advent of psychiatric medication, the influence of Sigmund Freud, the Father of Psychoanalysis, and his ‘talking cure’ was profound. Then medications became the ‘shiny new toy’ that caught the eye of psychiatrists and gradually distracted them away from getting at the underlying root of the problem through therapy. There is no doubt that psychiatric medications can be, literally, lifesaving for many patients, but they should not be used without psychotherapy given along with them. Otherwise, the medications are simply masking the symptoms and allowing the patient to pretend that he doesn’t have any underlying problems. If a patient has a problem serious enough to require medication, then he certainly needs psychotherapy, as well. Read on, fearlessly&#8230;<a href="http://blogs.psychcentral.com/therapy-soup/2010/05/beverly-hills-shrink-no-holds-barred-interview-with-dr-carole-lieberman/" target="_blank">here</a>.</p>
<p><span id="more-533"></span></p>
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		<title>Podcast: Stress and Addiction with Steven Diamond and Richard</title>
		<link>http://www.richardzwolinski.com/zwolinskisite/2010/05/02/podcast-stress-and-addiction-with-steven-diamond-and-richard/</link>
		<comments>http://www.richardzwolinski.com/zwolinskisite/2010/05/02/podcast-stress-and-addiction-with-steven-diamond-and-richard/#comments</comments>
		<pubDate>Mon, 03 May 2010 00:06:44 +0000</pubDate>
		<dc:creator>richard</dc:creator>
				<category><![CDATA[Addiction Treatment]]></category>
		<category><![CDATA[Anxiety]]></category>
		<category><![CDATA[Mental Health Treatment]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Therapy Patients]]></category>
		<category><![CDATA[PodCast]]></category>
		<category><![CDATA[Radio Interview]]></category>
		<category><![CDATA[Steven Diamond]]></category>
		<category><![CDATA[StopStressingNow.com]]></category>

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		<description><![CDATA[Do you think you or someone you love might be drinking, taking prescriptions medications, or other drugs more than is safe or healthy? In-depth Podcast interview with Richard and Steven Diamond of StopStressingNow.com about substance abuse, stress, and the current understanding of why and how people abuse and get addicted drugs or alcohol. Learn how [...]]]></description>
			<content:encoded><![CDATA[<p>Do you think you or someone you love might be drinking, taking prescriptions medications, or other drugs more than is safe or healthy? In-depth <a href="http://www.stopstressingnow.com/2010/05/richard-zwolinski-addition-specialist-episode-24/" target="_blank">Podcast</a> interview with Richard and Steven Diamond of StopStressingNow.com about substance abuse, stress, and the current understanding of why and how people abuse and get addicted drugs or alcohol. Learn how people medicate uncomfortable emotions.</p>
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