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Best Practices for Anxiety Treatment | Dr. Dawn Elise Snipes

Best Practices for Anxiety Treatment | Dr. Dawn Elise Snipes
hierdie episode is pre-aangeteken as deel van 'n lewendige voortgesette onderwys webinar op aanvraag CEUs is nog beskikbaar vir hierdie aanbieding deur al CEUs registreer by allceus.com streep berader toolbox Ek wil graag welkom almal om vandag se aanbieding oor die

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e praktyke vir die behandeling van angs, ek is u gasheer, dr.

Dawn

Elise

Snipes

, nou het ons nie te lank gelede 'n voorlegging gedoen oor op sterkte gebaseerde biopsigososiale benaderings om angs aan te spreek nie, en hoewel dit wonderlik is, weet u dat ek gedink het dat ons miskien na u moet kyk, waarvan ons weet die huidige navorsing, sodat ek na PubMed gegaan het. Ek weet nie dat dit 'n speelplek vir my is nie; dit is waar u baie tydskrifartikels vind, en u kan sorteer en ek het gesorteer volgens artikels wat gedoen is en meta-analises wat binne die afgelope vyf jaar so dit gee ons 'n idee oor die huidige navorsing ek bedoel daar is 'n baie dinge wat nog dieselfde soos sommige van die medisyne wat tien jaar gelede aan die werk bekend is nog steeds bekend te wees jy KNO w goeie eerstehandse behandelings, maar daar is ook 'n paar nuwelinge waaroor ons sal praat, en daar is ook 'n paar veranderinge waaroor ons gaan praat, sodat ons 'n paar algemene oorsake van angsimptome sal ondersoek om dit te behandel ons moet dit regtig doen, en natuurlik speel dit 'n rol in die biopsigososiale aspek, ons moet regtig verstaan ​​wat dit veroorsaak, want angs wat veroorsaak word deur...
best practices for anxiety treatment dr dawn elise snipes
byvoorbeeld iemand wat 'n wedrennehart het, kan anders wees as angs wat veroorsaak word deur iemand wat verlatingskwessies het. Ons gaan die twee dinge anders behandel, sodat ons na 'n paar van die algemene oorsake wil kyk. Ons kyk na 'n paar algemene oorsake van angs. U weet wat hierdie algemene temas in die praktyk is en ek sal u vra om 'n paar van die temas wat u sien, te deel wat baie van u kliënte se angs onderlê of onderlê, en die huidige

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e praktyke vir angs

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uur identifiseer , insluitend beradingsintervensies, medisyne, fisiese intervensies en rtive behandelings so ons omgee, want angs kan verlammende en 'n groot deel van ons kliënte het angs 'n groot deel van ons kliënte het angs comorbide met depressie en hulle is op soek na ons gaan hoe kan ek voel angstig en gestres en soos ek kan nie sit stil en terselfdertyd terselfdertyd weet jy dat as jy depressief is, jy baie keer wil slaap, mense wat albei probleme het, wil regtig slaap, maar hulle kan nie, so ek wil kliënte help om te verstaan dat soms ook angs as mense lank genoeg angstig is, die liggaam begin om vas te hou aan die kortisol, wat die liggaam op 'n sekere punt herken, dit is 'n verlore stryd, ek gaan nie meer energie daaraan steek nie, so dit begin met teken sommige van sy opwindende neurotransmitter, so te sê, en mense begin depressief voel, die brein het reeds gesê dat dit hopeloos is; dit is dat u hulpeloos is om die situasie te verander, en dan begin mense...
best practices for anxiety treatment dr dawn elise snipes
hopeloos en hulpeloos voel. is 'n soort van die definisie as u wil van depressie lae graad chroniese stres en angs het energie ontstaan ​​en mense se konsentrasievermoë, so as ons hulle gaan help om hulself te word, moet ons hulle help om uit te vind hoe om angs aan te spreek, nie net nie veralgemeende oorweldigende verswakkende angs, maar ook paniek in sosiale angs en die geringe angstrigters wat voorkom, wat moontlik nie die drempel vir 'n diagnose -angs bereik nie, is 'n belangrike oorsaak van verslawing terugval as u 'n kliënt het wat voorheen selfmedikasie gehad het of 'n verslawing gehad het vir sommige rede angs is 'n belangrike oorsaak verhoogde fisiese pyn wanneer angs toeneem mense is geneig om hul spiere te span as hulle hul spiere span, hulle is geneig om meer pyn te voel . u rug en dinge wat reeds seergemaak het, kan meer seermaak, want serotonien, een van ons belangrikste neurotransmitters teen angs, is ook een van ons belangrikste pynmoduleerders. serotonienvlakke is te laag omdat angs hoog is, dan sal ons pynpersepsie meer skerp wees en mense kan slaapprobleme hê as u stresvol voel, en u liggaam dink dat daar 'n bedreiging is dat u nie so diep kan ingaan nie As u 'n rustige slaap het, slaap u moontlik baie, maar dit is waarskynlik nie kwaliteit slaap nie, wat beteken dat u neuro -oordragstowwe uit u liggaam kan kom, en u liggaam sal uself in 'n aanhoudende toestand begin sien stres as ons uitgeput is, weet die liggaam...
best practices for anxiety treatment dr dawn elise snipes
dat ons moontlik die swakste skakel in die kudde is, sodat dit voortgaan om kortisol af te skei om u 'n bietjie waaksaam te hou, sodat u weer kan rus soos wanneer u 'n nuwe baba by die huis die eerste paar maande wat my kinders tuis was uit die hospitaal, ek het geslaap, maar ek het nie lekker geslaap nie, ek bedoel die geringste geraas en ek was wakker en ek kyk rond en u weet ek het dit gevoel, ek was uitgeput en baie nuwe par En dit doen die oorsake van angsverlating en verwerping, en ons gaan praat oor maniere waarop ons hierdie dinge wil hanteer, maar sommige van die onderliggende temas wat ek by baie kliënte gesien het en wanneer ek navorsing doen, baie van wat temas wat uit te kom sluit 'n lae selfbeeld as iemand 'n lae selfbeeld hulle soek na ekstern dikwels word bekragtig hulle is op soek na iemand anders om hulle te sê jy lief jy is oukei so wat kan lei tot angs omdat mense nie vir hulle moet sê dat dit goed gaan nie, wat hul verhoudings swak maak en disfunksionele irrasionele gedagtes en kognitiewe verwringings kan veroorsaak dat mense glo dat as ek nie perfek is nie, ek byvoorbeeld nie lief is nie. na 'n paar irrasionele gedagtes en kognitiewe verwringings kyk, ongesonde sosiale ondersteuning en verhoudings as u in 'n verhouding is, neem dit twee om te tango, en selfs as u kliënt relatief geestelik en fisies gesond is as hy nie funksioneel is nie verhouding kan hulle verlating en verwerping vrees as die ander persoon altyd sê as jy dit...
nie doen nie X ek gaan jou verlaat of as die ander persoon hulle altyd bedrieg, of wat ook al, verhoudings kan verlatingsangs en ondoeltreffende interpersoonlike vaardighede veroorsaak kan tot onrus in die verhouding en sosiale ballingskap lei as ons kliënte in verhoudings is, selfs al is hulle nie heeltemal wanfunksioneel nie, as ons kliënte nie kan vra wat hulle nodig het nie en gepaste grense stel en konflik effektief

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uur omdat konflik in elke verhouding plaasvind kan meer begin argumenteer, wat tot vrees kan lei, wat kan lei tot verhoudings wat in die verlede eindig, en hulle gaan goed, elke verhouding wat ek kry, eindig, wat beteken dat ek nie lief moet wees nie, sodat hulle begin verlate en verwerping vrees, so dit is vier gebiede wat ons kan doen kyk na nog een wat kliënte beoordeel, ' n ander probleem is die onbekende en verlies van beheer baie keer negatiewe selfspraak en kognitiewe verwringing c 'n bydrae daartoe dat as ek nie beheer oor alles het nie, dit alles 'n ramp -negatiewe sal wees, ander as kliënte uithang of as mense met negatiewe mense kuier, dit 'n bietjie op u dra, as u agterkom dat mense wat geneig om meer negatief te wees, is pessimistiese sameswering geneig om te kuier saam met mense wat ook negatief pessimisties is en sameswering ingestel het, so as u met iemand wat geneig is om angstig te wees, kan die angs voelbaar wees en dit kan fisiese klagtes deurdring kan mense angstig maak omdat hulle nie weet wat dit veroorsaak nie,...
soos ek vroeër gesê het, as u hart begin jaag as u nie weet wat dit veroorsaak nie, kan u begin dink dat ek 'n hartaanval kry of ek Sal sterf as mense paniekaanvalle kry, byvoorbeeld, hulle dink regtig dat hulle 'n hartaanval kry , en ek het dit gehad, maar dit is baie onaangename ervarings, maar as mense fisiese klagtes begin kry, kan dit wees dat u weet dat hulle hulle het 'n vreemde uitslag dat hulle nie kan weggaan nie, of wat ook al, maar as hulle nie weet wat dit is nie en hulle dit nie kan beheer nie, kan hulle dit nie laat verdwyn nie, begin hulle dink aan die ergste geval scenario's en om aanlyn te gaan en op WebMD te gaan, wat u gewoonlik die ergste scenario's gee, so fisiese klagtes is belangrik, ons moet die feit normaliseer dat niemand die hele tyd pynloos is nie en u weet dat u pyn kan hê of 'n pyn of 'n knop of 'n stamp of as u 'n hoes ken, waarskynlik weet u dat as ons na waarskynlikheid kyk, die waarskynlikheid dat dit iets beduidend is, redelik klein is, wil u dit waarskynlik laat ondersoek, maar u weet die waarskynlikheid dat dit enigiets is om oor bekommerd te wees, is relatief klein en 'n gevoel van magteloosheid kan die vrees vir die onbekende en verlies van beheer veroorsaak vir iemand wat nie voel dat hulle 'n agentskap in hul lewe het nie, as hulle 'n eksterne beheerplek het of as hulle voel slagoffers hul hele lewe lank dan hulle mag vrees nie in beheer hulle kan vashou en sê okay dit is die een...
gebied van my lewe wat ek kan beheer wanneer ek grootgeword het jy geweet ek het grootgeword in 'n baie chaotiese omgewing Ek het geen beheer Ek is gestuur om in die pleegsorg stelsel yadda yadda yadda noudat ek 'n volwassene is, weet u dat ek hierdie dinge kan beheer, en ek hou vas met wit kneukels, en as ek nie alles kan beheer nie , is dit 'n skrikwekkende dood en verlies, en dit veroorsaak ander angs. Dit kan mense of troeteldiere wees en troeteldiere is belangrik. Ek wil nie troeteldiere verminder nie, want u weet dat dit klein dele van baie van ons gesinne is. nou dink ek en jy weet dat sy gesond is, ons het haar na die veearts geneem en die veearts het gesê ja, sy het 'n klein hartgeruis, maar dit word verwag vir ' n 14 -jarige hond, maar as sy uitgaan as sy nie terugkom as Ek noem haar, ek het 'n oomblik hierdie angsgejaag, oh my g O, ek hoop dit was nie die dag nie, so angstig om mense te verloor, en jy weet as sy die brug oorsteek, en jy weet ek is reg daarmee, ek het dit moeiliker om die emosionele onrus van my dogter te hanteer as dit gebeur en omdat sy met hierdie hond grootgeword het, sodat u weet dat dit die tipe dinge is waaroor ons met ons kliënte wil praat, watter dinge op u weeg, waaraan u miskien nie eers dink nie, want ek weet agterin my gedagtes is dat daar altyd kommer oor een van ons esels en haar honde -werk en promosies kan angs veroorsaak as mense bang is dat hulle hul werk gaan verloor as hulle altyd bang is dat u weet dat...
hulle binnegaan en 'n pienk kry gly of word ontslaan, u weet dat ons hulle wil help om te kyk hoe realisties dit is: doen u wat u moet doen om u werk te behaal en te behou, en soms is dit nie maklik om te antwoord nie, ek bedoel die eerste gedagte dat baie van ons het is goed, jy weet as jy die regte ding doen, so jus Ek doen dit nie, maar daar is die base daar buite, en ek het baie ongelooflike base gehad, en ek het twee vreeslike base gehad, en ek kon nooit die gevoel kry dat ek iets reg kon doen nie en daar was altyd 'n angs oor wat ek is, waarvoor ek vandag in die moeilikheid sal kom, sodat u met mense wil praat, veroorsaak u werk angs, wat kan u doen om die angs dieselfde te matig? Met promosies kan mense angstig raak of hulle veiligheid en sekuriteit bevorder, wat u weet as u veiligheid en sekuriteit verloor, u kan baie angstig voel, so as daar by die huis langsaan ingebreek word of 'n skietery op die pad is of as u na die nuus kyk, kan u baie vinnig onveilig en onseker voel, so ons wil mense help om uit te vind hoe veilig en veilig u is, en baie daarvan gaan terug na feite as mense hul drome en hoop of vrees verloor dat hulle th gaan verloor eir drome en hoop dat hulle angstig kan begin raak, u weet dat hulle hierdie droom het dat hulle ' n dokter gaan word, of ek het pas die aanbieding voltooi om hoërskoolleerlinge te help om na die kollege te gaan, en baie hoërskoolstudente, byvoorbeeld, begin kollege met hierdie groot oë en hoop om die wêreld te...
red, en hulle wil dokters en ingenieurs wees, en dit en dat, en hulle kom daarin en besef dat dit baie moeiliker is as wat hulle gedink het, of hulle besef dat u weet wat ek regtig nie doen nie soos hierdie, maar ek het dit alreeds daartoe verbind, wat moet ek doen, of ek wil mense help , maar ek kan dit nie doen nie? na die mediese skool gaan omdat ek nie die berekening sou slaag nie en dit het baie angs veroorsaak, dit was goed, wat gaan ek nou doen, weet u watter loopbaan ek moet kies, sodat mense help om uit te vind of u drome het wat miskien vriendelik is van neergestort en gebrand, en u moet nuwes vind wat u goed ken een wat ons moet aanvaar, moet uitvind dat dit nie gaan gebeur nie, en wat kan u nou doen, mense kan ook drome hê oor verhoudings wat hulle in verhoudings aangaan en hulle sien hulself vir ewig met hierdie persoon, en dan eindig hierdie verhouding of begin dit raak rotsagtig en hulle is soos, maar dit is my droom wat gebeur as ek moet gebeur, want dit is my droom, ek weet nie hoe om te funksioneer nie, as dit weggaan, wil ons mense help om hul verhaal te herskryf en dan siekte spinnekoppe en ander fobies gaan dikwels met die dood saam, baie keer as mense siek word, begin hulle angstig raak, o wee, as dit eindelik is, wat sou dit wees, weet jy dit is ongeneeslik as ek deur 'n spinnekop gebyt word, dit sal doodmaak ek, en wat skaars is, jy weet daar is baie min spinnekoppe wat eintlik dieselfde giftige ding is met slange wat oor brûe gaan, wat ek met...
jou gedeel het, dit is nie een van my irrasionele vrese nie, jy weet ek is net bang dat jy weet dat iets gaan aan h Appen en ek gaan om ontslae te stoot af aan die kant van die brug wat is heeltemal irrasioneel, maar ons moet help mense kyk na die deur en identifiseer die gedagtes wat hulle hulleself nou vertel oor dié fobies en deal met wat angs mislukking is 'n ander sneller vir angs, veral in hierdie kultuur, plaas ons kultuur in die Amerikaanse kultuur grootliks 'n groot premie op sukses en perfeksionisme, en as mense besef dat hulle nie perfek is nie, kan hulle angstig raak omdat hulle voel dat ek nie perfek is nie, dan kan ek Ek is ' n mislukking, u ken die kognitiewe verwringings van alles-of-niks-denke en hulle begin met die negatiewe selfgesprek, u weet dat u niks reg kan doen nie, so dit is 'n paar van die probleme wat u weet wat ons gereeld in beradingsessies sien so wat doen ons, weet u dat iemand inkom en dit lyk asof ek nie so kan leef nie, maar angsdepressie en substansversteurings, sowel as 'n verskeidenheid fisiese afwykings, kom dikwels saam, so dit is die eerste ding wat ons moet besef As ons besef dat ons baie selde te doen het met 'n baie eenvoudige diagnose, weet u dat as iemand inkom, ons moet uitvind dat u weet of hulle inkom en depressief is, laat ons daaroor praat , en dan begin ons besef dat hul depressie begin optree het na 'n lang tydperk waarin hulle regtig angstig was, so ons moet dit hanteer, maar ons moet hulle ook...
help met hul gevoel van hopeloosheid en hulpeloosheid, ons moet die gevoel van bemagtiging ontwikkel en dan substansversteurings Weet dat stofgebruik dikwels 'n manier is om selfmedikasie te gebruik, maar ons weet ook dat dit ape is met die neuro-chemikalieë in die brein, en kan bydra tot angs en depressie, dieselfde as met fisiese probleme, as gevolg van fisiese afwykings, angs oor die feit dat u fisiese afwykings het. As u fisiese afwykings neem, kan dit almal tot angs bydra , daarom moet ons na die persoon as geheel kyk en alles doen wat bydra tot die angs en wat is al die dinge waartoe die angs bydra, sodat ons begin met 'n groot lys met dinge wat aangespreek moet word, en dan kan ons begin uitvind waar ons begin, sodat ons kan weet dat hierdie dinge comorbied is, en dit help navorsers om paaie te ondersoek aan geestesversteurings, sodat hulle kan begin uitvind, u weet watter tou ons kan trek om hierdie kombers van angs te ontrafel, sodat dit nie iemand versmoor nie en vir ons as klinici bied dit ons belangrike geleenthede om in te gryp, u weet soms dat kliënte binnekom hulle begin praat, hulle begin praat oor hul angs en hul fisiese probleme. U weet miskien dat hul angs oor u hartkloppings ken en omdat dit gereeld voorkom, wil ons hulle dalk aanmoedig om die dokter te raadpleeg om uit te sluit dat u weet sluit alles uit wat met hormoonwanbalanse te doen het, of u weet van harttoestande of enigiets anders wat daartoe kan bydra wat hulle kan help om dit aan te...
spreek en as dit wel die geval is As u fisiese afwykings het, laat ons gaan met hormonale wanbalanse wat bydra tot die hartkloppings, dan kan hulle begin behandel dat as hulle dit nie begin behandel nie, die hoeveelheid praatterapie wat ons doen, hulle nie tot die lewensgehalte sal bring nie hulle is op soek na omdat hulle dit nog steeds sal voel, so ons wil seker maak dat ons hulle holisties aanspreek: angsversteurings moet behandel word met sielkundige terapie, farmakoterapie of 'n kombinasie van beide en wat hulle gevind het, en dit is geen verrassing nie dit is 'n ou nuus dat berading plus farmakoterapie geneig is om die

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e uitkomste te hê, maar in twee gevalle het hulle soortgelyke uitkomste, maar dit is net om na te kyk en ek haat dit om eenvoudige angs te noem, maar ons kyk net na angsimptome hier kyk ons nie na die volle lewensgehalte nie en wil ons seker maak dat ons ook mediese probleme insluit, wat gedragsterapie beskou word as die psigoterapie met die hoogste bewys ce daar is 'n verskeidenheid kognitiewe gedragsbenaderings, wat wissel van aanvaarding en toewydingsterapie tot dialektiese gedragsterapie tot CBT, om te weet dat enige van diegene wat met die gedagtes te doen het, en die kognisies in daardie gebied val, en dit is effektief gevind in die huidige Die konseptualisering van die etiologie van angsversteurings sluit 'n interaksie tussen psigososiale faktore soos teenspoed in die kinderjare of stresvolle gebeurtenisse in, en 'n...
genetiese kwesbaarheid, sodat die psigososiale faktore, en dit is ander dinge wanneer ons ons assessering doen, waaraan ons aandag wil gee, omdat ons benadering tot behandeling is gaan anders vir mense byvoorbeeld wat trauma verwante brein verander miskien dan vir iemand wat nie so ons wil om te kyk na die kinderjare teenspoed en stresvolle gebeure wat dit veroorsaak het basies wat ek wat ek kliënte vertel te wees is soos rewiring van die brein is daar trauma -verwante breinveranderinge by soldate en veral by kinders of by mense wat blootgestel is tot uiterste trauma wat daarop gemik is om hulle te beskerm, maar dit kan ook later komplikasies veroorsaak in die hantering van angsverwerkingsvaardighede wat geleer is en wat ondoeltreffend is, weet u soms dat mense in 'n huishouding of 'n omgewing grootword of in 'n situasie waar hulle nie om effektiewe hanteringsvaardighede aan te leer, so ons moet hulle help om dit te leer en nuwes te leer om voort te bou op hul sterk punte en traumakwessies wat moontlik nog hanteer moet word, soos gesinsgeweld, wat u weet as hulle baie groot geword het huishoudelike geweld, hulle dink miskien dat u weet dat ek uit die situasie is, dit is verby, ek wil nie daaraan dink nie, dit pla my nie meer nie, of ek is afwesig deur die ouer, en ek plaas afwesigheid, want dit kan die dood wees, dit kan 'n ouer wees wat net dit kan 'n kind wees wat aangeneem kan word, ongeag wat die kind in 'n posisie het om te voel asof hy deur...
'n ouer verwerp is, kan baie traumaties en afknouery wees, maar daar is baie trauma mense dat as hulle uit die situasie is, dikwels sê dat u weet dat ek daaruit is, dit is nie 'n groot probleem nie, laat ons voortgaan, en hulle besef nie die volle gevolge nie en hoe dit bydra tot hul huidige angs en hul huidige selfgesprek en kognisies huidige stressors as iemand baie huidige stressors het, wat ook 'n impak sal hê of hulle veralgemeende angs ontwikkel, u weet dat ons die dek hier stapel en die huidige beskikbaarheid van sosiale ondersteuning as hulle dit nie doen nie As u effektiewe huidige sosiale ondersteuning het, sal hulle probleme ondervind om alles op hul eie skouers te dra, so ons wil na al hierdie psigososiale faktore kyk as ons ons assessering doen en nou teruggaan na trauma -kwessies as u die traumakursusse gevolg het By al die CEU's weet u dat sommige mense nie gereed is om te erken dat die trauma hulle steeds pla of aan die trauma werk nie, en dit is goed dat ons hulle kan opvoed dat dit 'n probleem kan wees en hulle dan kan laat kies ose hoe om dit aan te spreek, maar ons wil in gedagte hou dat jy weet dit kan soort van 'n onderliggende krag motiveer sommige van die huidige kognisies en genetiese kwesbaarheid, sodat jy enige drie mense neem en jy sit hulle of 300 mense en jy sit deur ongeveer dieselfde psigososiale situasies, sal hulle waarskynlik ' n bietjie anders reageer op grond van hul vorige ervarings, maar ook as gevolg van...
hul genetiese samestelling is daar sekere permutasies en hulle het vier gevind waaroor ons later sal praat, wat die brein meer of minder reageer op stres en meer of minder reageer op serotonien, wat u kalmerende chemikalie is, so breine wat minder reageer op serotonien weet nie, stuur soveel of stuur serotonien so maklik uit dat mense gespanne kan bly en bedraad dit is regtig oorvereenvoudig verduideliking maar dit is al wat jy regtig nodig het vir nou vatbaarheid se so genetiese kwesbaarheid impak mense om die gevolge en ontwikkeling van afhanklikheid o n sekere stowwe wat angs kan verhoog as mense van alkohol ontgift wanneer hulle van bensos ontgift as hulle van opiate ontgift, hulle kan hoë vlakke van angs voel as hulle opiate neem, sommige vind dat opiate wonderlike anti-angs eienskappe het, nie dat ek my beywer vir die gebruik van opiate. Ek het net kliëntervarings getoon dat dit waar kan wees, sodat sommige mense meer vatbaar sal wees vir die anti-angs-effekte van sekere stowwe, en dat sommige mense Cerrone sal word afhanklik van stowwe waar ander kan nie en dat 'n deel van dit is genetiese kwesbaarheid en hulle skat sowat 30% van die voorspelbaarheid van die ontwikkeling van angsversteurings is genetiese en genetika ook impak wat medikasie doeltreffend as jy genetiese samestelling 'n dan SSRIs kan wees nuttig as u 'n genetiese samestelling het, dan kan atipiese antipsigotika meer effektief wees en kan SSRI's niks doen nie, daarom het baie van ons...
kliënte ge Ek is so gefrustreerd omdat u weet dat daar geen manier is om presies uit te vind nie. Ek dink daar is nou genetiese toetse , maar tot dan was dit moeiliker om uit te vind met watter medisyne u moet begin, en die meeste dokters weet eintlik nie van 'n enkele dokter wat eintlik begin deur goed te sê, laat ons 'n genetiese profiel doen om te sien watter medisyne u die meeste kan begin , ons begin met gebeure, soos met 'n SSRI of 'n ander anti-angsmedikasie, 'n soort benzo wat my ervaring, so ons wil kliënte moontlik aanmoedig om genetiese toetse te oorweeg as hulle probleme ondervind om 'n medikasie -regime te vind wat vir hulle werk en hulle voel dat hulle genetiese kwesbaarheid moet hê, beïnvloed ook wat iemand meer kwesbaar gaan maak Van almal van julle in die klas weet julle vandag dat julle aan slaap dink, maar dat slaap nie 'n groot probleem vir sommige van julle is nie; ek ken mense wat dae of weke kan gaan met vier of vyf uur slaap dit is nie 'n groot probleem nie ek nie, ek het agt of nege ure slaap nodig, so geneties, om watter rede ook al, ek is geprogrammeer om baie slaap nodig te hê, so as ek nie so baie slaap nie, is ek geneig om dit moeiliker te wees. om die lewe op lewensvoorwaardes te hanteer, en ek weet dat dit my meer kwesbaar maak vir prikkelbaarheid, sodat genetiese kwesbaarheid beïnvloed wie verslaaf kan raak, watter medisyne die

best

e werk en watter situasies die neiging het om iemand meer kwesbaar te maak...
vir angs, sodat ons medikasie en ek weet die tipe hier is klein, maar ons gaan dit deurgaan. Die eerste-lyn medisyne is die SSRI-selektiewe serotonienheropnameremmers en die SNR is selektiewe norepinefrienheropnameremmers, nou is die name 'n bietjie misleidend omdat selektiewe norepinefrienopname inhibeerders verhoog ook die beskikbare serotonien, maar die werkingsmeganisme is anders, die werkingsmeganisme vir elke SSRI is ook 'n bietjie anders, daarom kan u iemand op Pr ozac en hulle het 'n vreeslike ervaring, en u kan dit op zoloft plaas, en hulle het 'n baie beter ervaring, soos ek vroeër gesê het, baie navorsing is vyf jaar gelede gedoen oor medisyne en zoloft paxil luvox lexapro celexa en hul generiese produkte het alles Daar is bevind dat dit effektief is by die behandeling van angs by sekere mense, dat geen medikasie die afgelope vyf jaar vir almal werk nie, maar effexor het op die radar gekom, en dit is effektief volgens die Hamilton -graderingskaal vir angs. kliënte is nie suksesvol nie, of kry nie die behandelingseffek wat hulle op sommige van die ander medisyne benodig nie, maar niemand van ons is waarskynlik voorskrywers nie, maar ons moet kliënte opvoed waarom die eerste geneesmiddel of selfs die derde geneesmiddel wat die dokter probeer, nie werk sodat hulle nie hulpeloos en hopeloos begin voel nie, soos ek vroeër gesê het, daar is ten minste vier verskillende genetiese variasies wat verband hou met die ontwikkeling van algemene en...
angsversteuring en verskillende medisyne is min of meer effektief, afhangende van die genetiese samestelling van die persoon, is daar 'n hoë sterftesyfer na twee bensos, die aanbeveling het eintlik oorgedra na die gebruik van bensos, want sommige dokters sal 'n SSRI voorskryf en vir die eerste vier weke terwyl die SSRI opbou in die stelsel wat hulle sal ook 'n benzo voorskryf wat geneem moet word as wat nodig is om matige die angs en jy weet jy kan weerskante van daardie argumenteer as iemand het 'n geskiedenis van stof gebruik of substansafhanklikheid bensos is regtig 'n slegte idee, want hulle het 'n hoë afhanklikheid, maar die ander redes waarom hulle nou waarsku teen die gebruik van bensodiasepiene, is dat daar 'n hoër sterftesyfer onder benzo-gebruikers is in vergelyking met nie-gebruikers. risiko vir afhanklikheid as u dit langer as ses maande gebruik, en dit is 'n lang tyd om benzo te gebruik en as ons praat van afhanklikheid en ses maande praat ons oor iemand wat dit elke vier uur of elke agt uur gebruik, afhangend van u benzo elke dag, nie ' n PRN -gebruiker nie, as iemand dit snags gebruik om hulle te help slaap, of u weet drie of vier keer per week wanneer die angs regtig raak die risiko van afhanklikheid is relatief laag, maar baie mense met angs, want as hulle die regte benzo vind, laat hulle soveel beter voel dat hulle nie daarvan af wil wees nie en vir baie mense as die benzo die helfte bereik -lewe en begin nog meer uit...
die stelsel kom, hul angspieke, u weet dat hulle angs het wat hulle met meer benzos wil genees, wat 'n probleem vir hulle sal wees om met hul dokter te bespreek . Daar is ook 'n verhoogde risiko vir demensie -Benzodiasepiengebruikers weer, dit is vir die mense wat u gebruik, elke dag vir ses maande of relatief elke dag vir ses maande of meer, en dit maak nie saak of u weet dat ons van iemand praat nie wie is 65 of iemand wat 35 is wat bensos vir u gebruik, weet ses maande per jaar twee jaar, is die risiko van demensie in die latere lewe aansienlik verhoog, volgens die navorsing, behandel bensodiasepiene ook nie depressie nie, so as u iemand het wat gelyktydige angs en depressie, is daar 'n baie groter selfmoordrisiko as hulle bensodiasepiene gebruik, dus as u daarvan bewus is dat die selfmoordrisiko die gevolg is van 'n oordosis van die bensodiasepiene, maar nie altyd ander behandelingsopsies wat u ken as die bensos nie iets is wat mense wil aanraak nie jy weet hulle skrik die lewendige dagligte uit my uit, en SSRI's en SNRI's lyk nie of dit werk nie, dan kan trisikliese antidepressante probeer word, die ou generasie antidepressante seroquel word baie gebruik, en daar is navorsing wat toon dat dit regtig kan wees effektief met angs soos sommige van die antidepressante, en afhangende van die persoon kan die benzos seroquel mense baie slaperig maak, sodat u weet dat dit nie die newe-effekte van die seroquel die gewigstoename en die moegheid en u weet dat...
slaperigheid vir sommige kliënte onaanvaarbare newe-effekte kan wees en perón verhoog, die derde opsie, boost barone werk meer soos 'n anti-depressiewe serotonienheropname-remmer en dat u vier weke moet weet of so, tot 'n mate van opbou in die stelselstudies, het getoon dat daar geen langtermynvoordeel daaraan verbonde is nie, maar dat dit ses maande tot agtien maande se gebruik effektief is om met kliënte te praat, en baie kliënte meen dat dit 'n hupstoot gee As hulle dit neem, help dit hulle nie noodwendig om angstig te wees soos 'n bensodiasepien nie, maar dit help hulle om nie in 2,3 sekondes van nul na 200 te gaan nie, maar u weet dat hulle nie elke keer 'n storm van 'n freak out -reaksie kan hê nie iets loop verkeerd, wat baie kliënte meen, help omdat hulle gedurende die dag stabieler voel nadat remissie -medikasie vir ses tot twaalf maande voortgesit moet word en gedurende die laaste ses maande die eerste ses maande hou dit soos die afgelope ses maande, u weet dat hulle sê dat afname die

best

e is; dit is beter om nie 'n koue kalkoen te stop nie, maar dit is beslis belangrik vir mense as hulle eers in remissie is, om nie net skielik goed te gaan nie, ek voel beter U hoef dit nie meer nodig nie; hulle moet daarin werk en seker maak dat hulle die vaardighede en gereedskap ontwikkel het wat hulle nodig het om die angs wat in die lewe gaan gebeur, te hanteer, sodat fisiese tekens en simptome van angs kan die volgende insluit moegheid...
geïrriteerdheid spierspanning of spierpyn probeer gehou gevoel zenuwachtig word maklik geskrik moeilikheid slaap naarheid diarree prikkelbare derm-sindroom hoofpyn so die eerste ding wat ons wil doen met kliënte wanneer ons praat om hulle goed tweede ding eerste ding is sê get a physical lets rule out physiological causes of this but we can also help clients look at you know what might be causing these things that you can do to mitigate it what might be contributing to your fatigue what mi ght be contributing to your irritability and your muscle tension or your muscle aches I mean let's look at economics did you recently get a new bed or do you need to get a new bed what about your desk chair I know you know I get more muscle tension and muscle achy when I do a lot of mousing because I have deplorable posture being becoming aware of that helps and then I'm like okay well I know it caused it it's unfortunate it's unpleasant but it's not a big deal trembling or feeling twitchy you know that can be caused by low blood sugar that can be caused by

anxiety

that can also be caused by early onset Parkinson's symptoms you know there's you know it can be worst case scenario or it can be something really benign so we want to have people figure out you know when you start trembling or feeling twitchy is there something that it's related to you know I know when my son gets really excited he's he just sits there and you can see him almost shake...
because he's so excited about something so we want to have people prevent misidentification we don't want them to jump to that worst-case scenario we don't want them to go onto WebMD and go oh my gosh I've got cancer I've got this debilitating disease and I'm going to die in six months probabilistic Lee speaking it's not gonna happen yes get a doctor's opinion I'm certainly not going to tell them it's all in your head I definitely want them to get an evaluation but I do want to in the meantime help them really think about how likely is this and other things for headaches and this is one another one of those that can be frustrating as we get older our eyesight starts to go and you know there was a period there I did fine and then after I hit 45 my eyesight just started to like steadily and kind of rapidly in my mind decline so I have to get my eye glass prescription changed every couple of years and that can cause headaches so instead of starting starting to worry about oh my gosh I've got a headache all the time maybe I've g ot a brain tumor you know I know that it's it's probably my glasses or I'm grinding my teeth so other biological interventions that have been evaluated there's something called the floatation rest system reduced environmental stimulation therapy it reduces sensory input into the nervous system through the act of floating supine which is on your back in a pool of water saturated with Epsom...
salt you know I'm looking at this going that sounds really good and you can't quite get the same experience in a bathtub because you're not floating you've got pressure points and you're still hearing stuff clients can sort of simulate it with you know earplugs or whatever but it's if they can access this it's been shown to be really effective the float experience is calibrated so that sensory signals from visual auditory olfactory gustatory thermal tactile or tactile vestibular gravitational and preceptive channels are minimized that means you don't see here taste touch smell feel nothing as is most movement and speech so you want people to lay just like completely motionless and not talk which can be hard for some people with

anxiety

in the study the study that I looked at fifty participants reported significant reductions in stress muscle tension pain depression and negative effect and it was accompanied by significant improvement in mood characterized by increases in relaxation happiness and well-being I read the study I'm like where can I sign up you know it sounds in looking at some of the research this was actually more effective for addressing

anxiety

than something like a massage Tai Chi also produced significant reductions in

anxiety

there was approximately a 20%

treatment

effect 25%

treatment

effect in patients with

anxiety

and fibromyalgia who practiced twice a week for a year now you know we want to look at the con founding...
things here is it the Tai Chi itself or is it learning to control the muscles and becoming more in tune with your body and learning to control your breathing that helps people reduce their

anxiety

either way you know Tai Chi helps people do that and it was shown that after a year after the first six months there was a significant

treatment

effect but after a year you know it kept growing and after a year it was about 25% so Tai Chi can be really effective an acupuncture at the HT 7 median Meridian can attenuate

anxiety

-like behavior induced by withdrawal from chronic morphine

treatment

through the meditation of the GABA a receptor system what does that mean that means if you if the acupuncture is done in very certain places places the

anxiety

behavior the the GABA a receptor system GABA is your main calming relaxation neurochemical that is triggered and it causes your body to sort of flood that receptor system and this research was done on people who were detoxing from morphine

treatment

but we can look at generalizing the results and I would be interested to see further studies on it pain other things we need to do to help peopl e with

anxiety

when people are in chronic pain they often have

anxiety

that oh my gosh this is getting worse or it's never gonna get better or I just can't take this pain anymore or they may get anxious that they're going to be rejected because they can't do some of the things they used to do because they're in so much pain so...
there's a lot of guilt and

anxiety

that can kind of revolve around pain what can we do to help clients guided imagery is generally very helpful if we can help them imagine you know if that pain in their shoulder imagine the pain is like the color red and flowing out of their arm or other focus mindfulness so you know when you think about something you know when I get a shot if I don't think about it it doesn't hurt near as much is if the nurse says okay now one two three and you know she's counting down and I'm getting prepared and I'm really focused on it I had another nurse one time who she was just talking to me and you know put the alcohol on my arm and just kept on talking didn't tell me she was getting ready to give me a shot and before I knew it she had given me a shot and she was like okay we're done I'm like you didn't give me a shot yet she said yes I did it's like oh so not focusing on it and next time you have an itch for example if you've ever been driving on the interstate and you can each on your on your foot I get those on the bottom of my foot sometimes and I'm like okay I'm not going to pull over to each my foot if you focus on something besides the itch eventually it goes away I'm not saying pain is gonna completely go away but the more people focus on it the more it hurts physical therapy can help so encourage them to get a referral and encourage them to do a self-evaluation if nothing else of...
ergonomics in their car at work where they watch TV and spend most of their time at home and they're sleeping so those are the four places that they spend most of their time what do their ergonomics look like and that can help for a l ot of people mitigate a lot of pain hormones are another thing that we need to look at imbalances of estrogen and testosterone can contribute to

anxiety

symptoms heart palpitations fatigue irritability having people get a physical we can't as clinicians do anything about it but doctors can rapid heart weight rate sweating palpitations are not uncommon in women in perimenopause or menopause so a lot of women start feeling like they're developing generalized

anxiety

and/or something's going wrong when they start reaching that mid 40s to mid 50s area and they start having some of these symptoms again we're not going to diagnose it but we do want them to recognize that it may not be anything you know catastrophic this is something that a lot of women experience and help them figure out how to deal with that supportive care biologically now you know this isn't gonna treat anything but we can help them minimize their vulnerabilities help them create a sleep routine so their brain and body ca n rebalance this can help repair any adrenal issues that may be going on and improve energy level people with

anxiety

don't sleep well so helping them figure out how to get some quality sleep is important nutrition minimizing caffeine...
and other stimulants is going to be a big help because those make people feel anxious encourage them to work with a nutritionist to try to prevent spikes and drops in blood sugar which can trigger the stress response when your blood sugar goes way up or way down you can start getting kind of shaky and feel weird and that can cause people

anxiety

because they might think oh my gosh I'm having a stroke or a heart attack or you know I don't know what these tremors are so it's important that they don't miss identify symptoms and encourage them to drink enough water dehydration can lead to toxic Ardea which is increased heart rate sunlight vitamin D deficiency is implicated in both depression and

anxiety

mood issues vitamin D has been found in those main areas where serotonin receptors are found vitamin D receptors are found so we know the serotonin and vitamin D have something going on sunlight prompts the skin to tell the brain to produce neurotransmitters and set circadian rhythms which impact the release of serotonin your calming neuro chemical melatonin which is made from breaking down serotonin and it helps you sleep and gaba so sunlight actually helps increase the release of gaba when it's time to start calming down and going to sleep exercise studies have shown that exercise can have a relaxing effect encourage clients to start slowly there's not a whole lot of new research on exercise and

anxiety

aromatherapy has been used a lot in especially in...
other countries in the

treatment

of people with

anxiety

people with hospital

anxiety

people women who are giving birth and they have some birth

anxiety

there they've been found to be really effective in a lot of those studies essential oils for

anxiety

include lavender rose Bedevere ylang y lang bergamot chamomile frankincense and Clary sage encourage clients to just go to a health food store and you know sniff some of these see if it makes them feel happy and calm and content the aromatherapy molecules enter the nasal membranes and they will start triggering neuro chemical reactions and so you don't need to apply it you don't need to ingest it all you need to do is so encourage clients if they're open to it to think about this because aromatherapy can be integrated into their bedroom for example with an atomizer or a mr. it can be incorporated in a lot of different places again where they're not applying it or ingesting it in any way all they're doing is smelling it they've used it in defusing aromatherapy in hospital emergency rooms and they found that it reduces stress and irritability of the people in emergency rooms and I've been to enough emergency rooms over the course of the years to know that people who are in ers typically are not in the

best

mood so if it can help those people then it's probably going to have some sort of an effect so psychologically helping clients realize that their body thinks there's a threat for some...
reason that's why it triggered the threat response system which is what they call

anxiety

so they need to figure out why is there really a threat you know sometimes it's like the fire alarm going off in my house it just means that the windows are open and there's a strong breeze there is no fire there is no problem there's just a malfunction it's a false alarm a lot of times for clients they get this threat reaction they get this stress reaction and it's not a big deal right now so they can start modifying what their brain responds to and again those basic fears that a lot of people worry about failure rejection loss of control the unknown and death and loss distress tolerance is one of those cognitive interventions that has taken center stage in the

anxiety

research and it isn't about controlling your

anxiety

you know helping people recognize their

anxiety

acknowledge it and say okay I'm anxious it is what it is how can I improve the next moment instead of saying I'm anxious I shouldn't be anxious I hate being anxious and slang with that

anxiety

let it go just accept it is what it is have the client learn to start saying I am feeling anxious okay so distract don't react because and I explain to them the whole notion feelings come in crest and go out in about 20 minutes it's like a wave so once they acknowledge their feeling if they can distract themselve s for twenty or thirty minutes you know obviously they figured out...
there's no real threat they if they can distract themselves for twenty or thirty minutes those emotions can go down and then they can deal with it in their wise mind encourage them to use distancing techniques instead of saying I am anxious or I am terrified or whatever have them say I am having the thought that this is the worst thing in the world I am having the thought that I cannot handle this because thoughts come and go and that comes from acceptance and commitment therapy functional analysis makes it possible to specify where when with what frequency with what intensity and under what circumstances the anxious response is triggered so it's important that we help clients develop the ability to do functional analyses on their own so when they start feeling anxious they can stop and say okay where am I what's going on how intense is it what are the circumstances and they start really trying to figure out what causes this for them so they can identify any common themes from their psychoeducation about cognitive distortions and techniques to prevent those circumstances or mitigate them can be provided so if the client knows that they get anxious before they go into a meeting with their boss and it's usually a high intensity of

anxiety

okay so we can educate them help them identify what fears that may be related to techniques to slow their breathing and calm their stress reaction and help them figure out times in the past when they've handled going in and...
talking to their boss and it really wasn't the end of the world you know there's lots of different things we can do there for them there but the first key and it gives them a lot of a huge sense of empowerment to start becoming detectives in their own life and going okay now under what situations does this happen positive writing this was another really cool study each day for 30 days the experimental group and this was high school-aged youth in Ch ina but you know the experimental group engaged in 20 minutes of writing about positive emotions they felt that day so they're writing about anything positive that make them happy that made them enthusiastic that gave them hope whatever long-term expressive writing a positive emotions so after 30 days it appeared to help reduce test

anxiety

by helping them develop insight and use positive emotion words so it got them out of the habit of using the destruction and doom words and encouraged them to get in the habit of looking at the positive things and being more optimistic it's a really cool activity that clients can try it's not gonna hurt anything if you have them journal each day for 30 days mindfulness was also came up in the research and was shown to be really effective in a meta-analysis six articles about mindfulness based stress reduction four about mindfulness based cognitive therapy and three about fear of negative appraisal and emotion regulation were reviewed all of these sho wed that mindfulness was...
an effective strategy for the

treatment

of mood and

anxiety

disorders and is an effective in therapy protocols with different structures including virtual modalities so you know if you're doing it via teleconference mindfulness can still be helpful mindfulness helps people start learning how to observe what's going on and become aware of what's going on more aware of those circumstances which will help them complete their functional analysis but it also helps them become aware of vulnerabilities and head off things at the past and if they're taking better care of themselves that they're living more mindfully then they may not experience as many situations that trigger their

anxiety

mindfulness also encourages clients to learn acceptance that radical acceptance of it is what it is I'm not gonna fight it I'm angry right now I am anxious right now however I'm feeling right now is how I feel and that's okay and it's hard for clients to get to that but once they get a hold of that and they truly believe it and they can say all right it's fine I'm not gonna feel this way forever I'm gonna do something else until the feeling passes it helps and that's where the labeling and letting go comes in mindfulness can also help them identify trigger thoughts what thought were you having right before you started feeling anxious if people are mindful or let's start back when people are not mindful they often notice or don't notice...
that they're getting anxious until they're like super super anxious when people are mindful they become more aware of subtle cues address unhelpful thoughts when they say or believe it's a dire necessity for adults to be loved by significant others for almost everything they do always running gonna happen why is it a necessity what we can encourage them to do is concentrate on their own self-respect on winning approval for practical purposes you know for promotions or whatever but it's not about me being lovable it's about me gettin g a promotion and making more money and focusing on loving rather than being loved because when we give love we generally get love back unhelpful thought number two people feel they aren't able to stand it if things are not the way they want them to be or are not in their control so encourage clients to focus on the parts that are in their control and other things in life which are going well and to which they're committed number three misery is invariably externally caused and is forced on us by outside people and events just reading that makes me feel disempowered so encouraging clients to focus on the fact that reactions such as misery or happiness are largely caused by the view that people take of the conditions so if you see it as a tragedy and devastating then it's probably going to produce misery if you see it as an opportunity and a challenge it's probably going to produce a different emotional reaction...
if something is or may be dangerous or fearsome people should be terribly u pset and endlessly upset about obsess about it a lot of people with

anxiety

gets stuck on this you know if I feel like its fearsome I need to worry about it getting on a plane for example if I fear that that's dangerous that I need to think about it and worry about it that's not going to do any good so encourage clients to figure out how to face it and render it harmless if possible and when that's not possible accept the inevitable so looking at airplanes you know facing it means doing the research to figure out how dangerous is it really and realizing that it's really not that dangerous so that helps render it a little bit harmless in their own mind it proves to them that it's not as dangerous as it could be and when it's not possible accepting the inevitable you know you got a fly so getting on there figuring out how you're gonna get through it hurricanes are the same way people especially in places like Texas Louisiana Florida may obsess as soon as it starts coming to hurricane sea son or if a hurricane is spotted out in the Atlantic somewhere they start checking the weather every hour or more wondering what the path is going to be and you know what there's you can't change the path of the hurricane so all you can do is board up your house evacuate if necessary and deal with the fallout child driving is just another example I'll give you know my children are...
learning how to drive and that's kind of scary and fearsome you know what's gonna happen when they're out there you know you see crashes all the time well render it harmless by making sure they've got good training on how to drive make sure they're good drivers and then accepting that some things are just not within my control it's easier to avoid than face life difficulties and responsibilities well running from fear is usually much harder in the long run so encourage clients to look back at times that they've avoided difficulties and responsibilities and the eventual outcome you know what happened there peo ple believe they should be thoroughly competent in achieving in all possible respects or they will be isolated rejected and failures we need to encourage clients to accept themselves as imperfect with human limitations and flaws and focus on what makes them a loveable human being what qualities like courage and intelligence and creativity and those things that can't be taken away what inherent qualities do they have that make them awesome people because something once strongly affected people's lives they should indefinitely fear it if you got lost you know when little kids get lost it's terrifying when you're grown up if you get lost you turn on the GPS and you figure out your way but some people still you know freaked out about getting lost if they got lost once so we want to help people look back at past episodes that may be...
contributing to the current

anxiety

and compare the situation's you know are you the same person or is this not a big deal now that you're older wiser stronger encourage them to learn from past experiences but not be overly attached to or prejudiced by them yeah you could have maybe got lost in the past and it was a horrible experience well you were six I can see where that would be terrifying and a horrible experience but it doesn't have to continue to impact you that way now when you're you know 26 getting lost you know could be an opportunity to try a new restaurant or something people must have complete control over things well this doesn't happen so encourage clients to remember that the past and the future are uncontrollable we can't change the past it is what it is we can learn from it so it doesn't repeat but we can't change it and the future is largely uncontrollable I mean there's a lot of things I can do to stay moving toward a rich and meaningful life but life is going to throw me curveballs sometimes and there's nothing I can do to plan for or control that we can control our actions in the present to stay on our preferred path an d general develop general skills to deal with adversity should it arise so we want to help clients develop those general problem-solving skills and the general support system so when they are thrown a curveball you know it doesn't knock them upside the head people have virtually no control over...
their emotions and cannot help feeling disturbed by things well encourage them to think about the fact that they have real control over destructive emotions if they choose to work at improving the next moment and changing inaccurate thoughts then they're not going to experience the destructive emotions as intensely or as frequently when you feel an emotion you feel how you feel but again you don't have to wrestle with it fight it and nurture it you can say this is how I feel how do i improve the next moment when it comes to cognitive distortions encourage them to find alternatives when they start to personalize things if somebody laughs when you walk out of the room then the and the person start s getting anxious thinking oh they were making fun of me I wonder what they thought I wonder if I had something stuck to the back of my dress and they start getting all panicked about it that doesn't do any good encouraging them to think you know what our three alternate explanations that hadn't but had nothing to do with you for why they laughed magnification of the worst thing you know taking something and saying if this happens then it's going to be a catastrophe and minimisation going along with that a lot of times when people magnify and see a catastrophe they minimize not only their own strengths and resources but all the other stuff that they've got going for them all they're seeing is this catastrophe so encouraging them to focus on the facts what...
is actually happening and what is the high probability event and and encourage them to get information and look at the broader picture you know yes you got into a car crash and your car is totaled and that is unfortunate you know it r eally sucks but you know that is not going to cause you to lose your job and then become homeless and penniless and yadda-yadda it might cause your insurance to go up but okay so you don't have a car but what are the resources that you have who can who do you work with that might be able to give you a ride to work you know let's look at the resources you have and work around so problem-solving helps with magnification and also focusing on you know let's be grateful for what didn't happen you know you could have been killed but you weren't the car was totaled it's replaceable all or nothing thinking again have them think about what else could have been happening like Brittney suggested finding the exceptions instead of saying she always does this look for exceptions when has she not done that what else has she done instead of this selective abstraction and filtering is when people look for the good the bad and the ugly a selective abstraction means you kind of see what you expect to see so if you expect something to be devastating you see only the devastating aspects of it which kind of goes with the magnification and minimization you filter out the stuff a lot of times when people are in a bad mood or are anxious they see...
the negative because that's the state of mind they're in so encourage people to complete the picture alright there's all this bad stuff now what's the good stuff you know encourage them to look at the good the bad and the ugly so they get a wide view of exactly what's going on and encourage them to remember that hindsight is twenty-twenty when people have something embarrassing happen or they get anxious about something that that happened they look back and they go I should have or I could have or oh I wish I wouldn't have when you were in that situation you did what you did and you know maybe you may have had a reason for it or you know you may have not had other options or it may have just been a bonehead thing to do but okay so you made one mist ake hindsight is 2020 that's gonna that mistake is gonna stand out just like the great big letter on the eye chart because you're thinking back and you're looking at it and that's all you see but encouraging clients to remember that other people are too busy worrying about themselves to really remember what you did jumping to conclusions encourage clients to remember to get all the data if your significant other male significant other comes home and is smelling like perfume don't just jump to the conclusion that he was cheating on you maybe he went to the to the mall to get a new tie and walked through the perfume area and got spritzed or bought you some perfume or who knows maybe the...
person sitting next to him at work sprayed her perfume at the desk and some of it filtered on there's all different reasons that that might happen so encourage people to get all the data mind reading we can't do it you know you can't read somebody's mind you don't know what they're thinking so ask them if you what do you think about this don't assume anything and emotional reasoning encourage people to step back from a situation and ask themselves am i feeling anxious about this because I'm feeling anxious and I'm looking for reasons that it should be scary or am i feeling anxious about this because it's really scary for some reason there's actual facts support my

anxiety

a lot of times when we go into new situations we may feel anxious because it's a new situation but when we step back we say you know what there's really nothing to be worried about here you know no big deal I got this and move on so instead of rolling with it and trying to figure out okay I feel anxious so there must be a reason not necessarily very likely a false alarm other psychological interventions relaxation skills encourage people to learn how to relax not only physically but mentally diaphragmatic breathing is helpful encouraging them to breathe through their stomach and put their hand on their belly and feel their belly expand and contract slows breathing down which triggers the rest and digest reaction in the brain which is calming meditation can...
be helpful for some people some people find trying to quiet their mind too frustrating because they've got too much monkey mind going on that can be later or maybe never for some people we don't want to increase their

anxiety

with interventions cute progressive muscular relaxation also has a lot of research support and remember with cute progressive muscular relaxation we're Sakura geing them to attach a cue AK you word like relax or breathe with the relaxation response so they tense their muscles and then they relax their muscles and as they relax their muscles they say their q''-word like relaxed and they work from head to toe or from toe to head tensing and relaxing different muscle groups so they become more aware of what a tense muscle feels like versus a reactive relaxed muscle there are great scripts that are online that people have alread y recorded that can walk people walk clients through CPM are I highly encourage it because once they get used to it then they can just think that cue they can think relax and as they exhale they will start to feel their entire body kind of relaxing because it's trained when it hears that just like when you hear the word pop quiz when you were in high school you had a stress reaction well we want to use it in reverse and train train the body so when it hears a cue word it relaxes help them develop self-esteem because fear of failure and rejection a lot of times come from needing other people's approval help...
them develop a rational idea of their real self develop compassion self-talk instead of saying I'm an idiot or I'm stupid or I'll never measure up to anything encourage them to talk to themself like they would talk to their child or hopefully their

best

friend and encourage them to spotlight strengths whenever they feel like they've got an imperfection identify these three strengths that they have so they're you know balancing out the imperfections and the strengths cognitive restructuring reframe challenges in terms of current strengths not past weaknesses so if you're going to give a presentation in front of 60 people and you hate public speaking instead of thinking about you know this is terrifying because the last time I went up in front of people I forgot everything I was going to say and drop my note cards well that's a past weakness what is your current strength you're prepared you know your material you yada-yada so encourage people to look at all the strengths and resources they currently have have them develop an attitude of gratitude and optimism because like I said with that the positive writing exercise when people are in a grateful optimistic frame of mind they tend to see more of the good stuff they see the bad stuff too but they can also see more of the good stuff and some of the bad stuff they see opportunistically instead of as a devastation acce ptance and commitment therapy says that we some of the reasons that we're...
miserable is fear we get fused with our thoughts we think I am terrified well if I am terrified then I can't I mean if I am I can't get rid of anything I am if I'm having the thought that I'm terrified well I can get rid of a thought I can forget things easily encourage people to evaluate their experience and empower them to look at things as challenges and opportunities instead of hardships encourage them not to avoid their experiences so things that are scary gradual exposure and finding exceptions like for me bridges you know I love public speaking so that's not a thing but when I go to a bridge you know when I Drive to the bridge you know when I'm on the bridge somebody else is driving I get used to doing that when I Drive over a bridge then when I Drive over one of those bridges that opens up I hate those bridges um I know y'all are just like oh my gosh yeah it's an irrational fear I realize that but instead of going straight for the bridge that opens up going for the little bridges first and then thinking back over times that I've gone over bridges and there's been no problem you know there's exceptions nothing happened it wasn't a big deal sometimes I didn't even notice it until somebody pointed out hey look down there at that pretty water and I'm like oh we're on a bridge so encourage people to not avoid their experiences get used to them embrace them and learn that they have the power to deal with them and...
stop reason giving for behavior you know use the challenging questions if something is fearsome let's look for the at the evidence for and against it instead of you know making excuses social interventions improve their relationship with their self which goes with self-esteem improvement people are going to feel less anxious about getting their needs and wants met if they know what their needs and wants are so part of that is becoming mindful cuz a lot of our clients don't know what they need and want they just they want to feel better but they don't know how they don't know what they need to feel better so helping them identify their needs and wants encourage them to be their own

best

friend you know when they get a promotion take themselves out to dinner pat themselves on the back whatever it is don't rely on other people to do it because other people it's not that they don't care but other people are often very involved in thinking about their own stuff and they may not notice encourage them to develop a method of internal validation so they can feel like they are all that 'no bag of chips and they realize why they are lovable human beings and they accept the fact that everybody is not going to like them and nobody is gonna like them all the time and that's okay you know my kids don't like me all the time my husband doesn't like me all the time I'm okay with that I know I can be challenging but you know most of the time you...
know they like me and and that's oka y and there are some people you know who don't like me at all and okay there's nothing I can do about that helping our clients develop and okayness with that helps relieve a lot of

anxiety

because a lot of people feel like they have to be liked by everybody and if somebody doesn't like them it's like what did I do wrong oh my gosh encourage them to develop healthy supportive relationships with good boundaries develop assertiveness skills so they can ask for help when they need it

anxiety

a lot of times you know that's the body saying there's a threat well if there's a threat maybe you need some help you know dealing with it so people need to be willing and able to ask for help and not feel like that's going to lead them to be rejected and allow them a certif this will allow them to say no to requests again without feeling like that's going to result in them being fully rejected describe the ideal healthy supportive relationship and encourage them to separate the ideals from the reals y ou know let's look at if you had a

best

relationship what would it look like okay you know warden June Cleaver we got that now how realistic is that you know let's look at you know rephrasing this a little bit so it's less extreme you know warden June Cleaver never fought their kids were perfect you know all those extreme words let's look at what's real what happens in real relationships encourage...
people to identify who would be a good partner in supportive relationships I'm not meaning necessarily romantic I'm meaning friends and where they can be found you know where would you find people that you could be friends with and encourage them to play though what does it mean when game cuz a lot of times again this goes with mine reading you know what does it mean when your friend doesn't return your text right away what does it mean when your friend cancels dinner on Friday night what does it mean when you see where I'm going with this and a lot of times clients with

anxiety

and rejection issues and low self-esteem will go to the worst-case scenario so encourage them going back to finding the exceptions what else could have been happening what else could it be that caused this and it's not about you so

anxiety

is a natural emotion that serves a survival function excessive

anxiety

can develop from lack of sleep nutritional problems neuro chemical imbalances failure to develop adequate coping skills cognitive distortions low self-esteem and a variety of other stuff recovery Ambala involves improving health behaviors make sure your body's functioning and make the neurotransmitters it needs and you know release them as needed identify and build on current coping strategies address cognitive distortions and develop a healthy supportive relationship with self and others if you enjoy this podcast please like and subscribe either in your podcast player or...
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