You Can Always Ask, They Can Always Say 'No'

There's a list of recommended exercises I pull from when working on assertiveness with clients. It comes from Dr. Linehan's DBT Manual - the Interpersonal Effectiveness chapter. It's a whole list of ways to make requests of people in settings that are generally safe. For some (including myself), a portion of the exercises can feel like a real challenge. 



There's two suggestions that didn't make the list, but other clients and group members have recommended. (I have since found them in other material.) One of those suggestions is asking a sales associate to open a display case for you without buying an item. I regularly picture the scene from Wayne's World in which the sales person in the guitar shop reluctantly obliges. BUT the salesperson draws the line at the first few notes of "Stairway." And, he ultimately asks Wayne to put the guitar back in the case. (Yes, I realize Wayne then purchases said guitar.) When building assertiveness, it helps to recognize that other people we make requests of have some responsibility in setting their own limits and refusing or rebuffing. If they don't want to hold resentment, it's their responsibility to keep to a line or say "No." Most people let us know gently and politely that we're putting them out or crossing a line.

Another suggestion brought up has been sending food back when dining at a restaurant (even if it is exactly what you asked for.) This tends to get a debate going in DBT skills groups I've led. In session, it often gets a strong pushback, as well. I'm all for the "social experiment" for a good cause -- restoring a person's voice and recognition of one's own worth. It excited me to read this article. "Why sending something back at a restaurant is perfectly fine — and how to do it right" Seattle Times Yes, it still does not bring up the issues of the legitimacy of the "social experiment"/exposure therapy in a restaurant setting. It does, however, show that a dish may still be sent back while by all measure it's a fine plate -- it comes down to personal taste.

Fall's Here -- Couple's Return Home

As we slide on into October, Seattleites also begin their preparations to transition much of their time back to indoor activities. Much of that time ends up being time at home. We see a lot more of our loved ones and partners as the clouds start hanging in The Sound. When relationships are working well, the time at home can be just as enriching. If there are tensions, pains, and frustrations that can be avoided while outside and active -- the discord is much harder to avoid when fall and winter bring you face to face with your partner.
Disagreements are a given. If the disagreements are confronted and discussed, a couple has an opportunity for deeper understanding and a chance to work together as a team. Your intuition can gauge how productive your arguments unfold and resolve. Believe it or not, having the same arguments and differences of opinions do not mean the relationship is doomed. People in lasting relationships disagree about more things than they do agree. The ways in which arguments are approached are more telling of a relationship's resiliency.  Arguments where respect is lost, a person feels insecure, shut down, or like they're walking on eggshells -- these are feelings that signal deeper issues are influencing interactions with a partner.
Some helpful advice in soundbite form:

Build opportunities for teamwork: Find some chores and projects to take on together. Cook some meals together. Recognize those moments that you do agree about solutions.
Make time for quality time: Set a date night. Eat meals together.
Stoke warmth and intimacy: Massages, Cuddling, Day at the spa, adventures, and, yes, of course, sex.
Stay curious: Have an authentic interest in your partner, their growth, their feelings. You need not interrogate, but show that you simply are curious to know about their day, what was enjoyed, what was difficult, and what was noteworthy.

Kids Have the Scoop on Coping Skills

I love the neurophysiology lesson about the neocortex. I'm taking an extra easy breath right now.

SHORT FILM ‘JUST BREATHE’ HELPS KIDS DEAL WITH EMOTIONS

New Trauma Credential -- CCTP

Officially a Certified Clinical Trauma Professional... with even greater knowledge in promoting growth after trauma.

Personality Inventory for DSM-5

The American Psychiatric Association developed some great measurements to use with folks to screen, and more importantly in my work, meter progress. Recently, a colleague introduced me to the Personality Inventory for DSM-5.  I think it can be a great tool, but it discouraged me that I could find no reliable key to crunch the numbers. Clinicians interested are welcome to use This File to help score the measure.

(For others, please note that the test is a clinical tool and does not constitute a diagnosis, recommendation, or treatment.)

Congrats, Grads!

A First Job Is Like A First Date, And Other Advice For Graduation Day

A recent article from NPR that lists economists' advice about getting your first job.
New grads often feel like that first job will define the rest of their careers. First jobs are simply the first position you hold. If anything a job that's disliked is always a learning experience. It can be helpful to know what you do not want to do, what your limits are, and learn when you actually have a choice.
Good luck and great job new grads!

Stressed Americans without Services

Let's hear all the tips out there for stress management. I'll start -- get at least 7 hours of sleep each night. (9 is the optimal median.)
Stressed Out Americans Want Help, But Many Don't Get It from NPR

Healthy Eating = Healthy Feelings

The mind and body share a strong link - our mind comes out of our body's many movements, impulses, and chemical reactions. Literal movement from our muscles, to the hormones that surge through our body all play a part. Of course, how we eat impacts our thought and emotion! I always love simpler tips to healthy eating.
The Environmental Working Group has put forward its recent Good Food on a Tight Budget guide. EWG's webpage gives a number of helpful guides for healthy living all worth consideration.

There's An App For That

The mobile technology innovation continues to permeate into our lives -- like most things -- it's a double edged sword. We have information at our fingertips at the cost of unsolicited information flooding our lives and minds and a loss of privacy.
Journaling provides a great opportunity to get thoughts out of the head, on paper, no longer bouncing around in your head. Someone pointed out to me recently that there are now great apps to keep journals. When the caveat to writing a journal has always been to make sure it can be kept safe from others' eyes, apps provide even greater security for our private thoughts. Here are a few mobile apps just for journaling:

 

Journal (Nook)

myMemoir (iPad)
iJournaler (iPad)

There are many other mobile apps that provide some bona fide benefits to our mental health:

Relax: Stress & Anxiety Relief (Android)

Stress Test & CBT Self-Help (Android)
Let Panic Go (iPad/iPhone)

Information Bias

Many of my posts have touched on the concept of perceiving Truth. It's an important topic to people - we rarely questions our own sense of truth and it scares a person when his sense of truth is rattled. The model that people have a set sense of Truth and all new information follows is not new to psychology. The idea of how prevalent and regular this occurs, however, has recently rattled the sense of the Psyche, however.

As psychologists developed the model of Cognitive Psychology, they regularly used the two terms Assimilation and Accommodation to describe the ways in which we retain knowledge and build our personal models of the world. Each day we're faced with a plethora of new facts, sensations, images. As we take in the information, we compare that info to our sense of the world. While our view and concept of the world may grow bigger, we are assimilating the new information into our picture of the world. If pieces of information don't seem to match our map, we find ways to adjust the picture. As one example, consider the different ways we draw flat maps of our spherical world.

 

Cartographers pinch maps one way or stretch it another in order to show a round world on a flat map -- they have to make different accommodations in their representation of the world. The more accurate a representation a person needs, however, it becomes more difficult to assimilate that info as the map is drawn. Ultimately, a person may need to accommodate their concept of the world by using a globe.

Similarly, we can take in information that matches our own perception of the world, or we can change our perception of the world. For adults, accommodating our perception is a more difficult task -- think of all the learned information we have to reevaluate! We become victims of our own preconceptions - it can be easier to accept the information that matches our perception of the world and omit/forget/ignore any information that may not match. We unconsciously choose to see, hear, feel, smell, and taste only what reasserts our image of the world. This information bias can be benign and help keep our lives efficient. The dangers, however, come in the potential to miss vital pieces of information or perpetuate troublesome patterns of suffering in our lives.
The specific information bias is called confirmation bias -- we are biased toward the facts, figures, and examples that confirm what we believe is true. Where psychologists once provided a model where people at worst ignored new information, confirmation bias, demonstrates that we're even more difficult to dissuade. We not only ignore information that might challenge our perceptions, but we assimilate information in a way that helps perpetuate any faulty beliefs and interpretations. It becomes more and more difficult to find evidence that proves us wrong because our brain often strengthens its ability to identify only what it believes to be true.
Consider this study by Victor and colleagues which demonstrates that people suffering with depression are more likely to identify sad faces even on an unconscious level. Research continues to demonstrate that the anxious brain and the depressed brain regularly practice information bias - easily identifying facts in our life that prove the rule and (often unconsciously) ignoring facts to prove the exceptions.
It takes active practice to question assumptions and identify exceptions to our preconceptions. I frequently give clients tools that help draw out the exceptions. By helping our mind find reasons for joy, hope, satisfaction and through training the brain to more readily see these examples in our life, it becomes harder to stay depressed or anxious.

Lists of 5

If there's work to be done between sessions, I often suggest to clients to write a list of 5. Lists of 5 give helpful signposts toward growth and insight. When creating a list of 5, it gives room for multiple possibilities, a choice of direction, and it is not such an overwhelming list that one gets lost. Lists of 5 can be sequential, or ranked, or simply what comes to mind first.
When faced with a complicated or long-term goal, I find it helpful to ask myself, "What are my next 5 steps?" It's not necessarily that #5 will mean mission accomplished, but it will leave me 5 steps closer to my gaol.
Lists of 5 can also be helpful in reflecting on mission and purpose. Some lists of 5 to think of:

What are my 5 passions?
Who are my 5 biggest supports?
What are 5 obstacles in life?
What are my 5 most disturbing memories?
What are my 5 strengths?

You can always lengthen the list. It's worth asking yourself, why those 5 before 6, 7, or 8.