Anxiety is complex, and the best approach is to talk to a trained professional. But we all need a starting point.  So have a look at these top 10 tips for anxiety to start the process -

1. Anxiety is an umbrella term covering a number of different disorders (including Generalised Anxiety Disorder, Post-Traumatic Stress Disorder, phobic anxiety disorders, panic disorders, social anxiety disorder, etc)
2. Anxiety can sometimes tell you that something in your life needs to change.  Perhaps it is an unhealthy relationship, or it might even be something in your work life
3. Anxiety and depression often arise together, with slightly differing perspectives (anxiety tends to concern the future, and depression tends to focus on the past)
4. Anxiety can often arise when we have the mistaken believe that worrying about something is working on that issue, that worrying is somehow going to achieve change
5. Cognitive Behavioural Therapy (CBT) is often offered to help manage anxiety.  This helps you to challenge unhelpful thinking patterns that might increase anxiety
6. Mindfulness can be useful, not least because it helps you to stop thinking about the future, and instead to just focus on the present.  As a starting point, you can attempt to do this by focusing on your breath
7. Set aside time to relax.  Put away electronic devices such as smart phones, and give yourself the space you need to stop worrying about the future
8. Some say that the more choices we have in life (with developments in technology, etc), the more anxious we get
9. Adopt a kinder voice when things don’t necessarily go to plan.  Sometimes there is an important learning opportunity in what you believe to be a ‘failure’
10. Anxiety can often leave us with the belief that we have no control over anything in our lives.  Remind yourself of all the aspects of your life where you are in control

Chris Warren-Dickins is a Licensed Professional Counselor in Ridgewood, New Jersey.  He specializes in psychotherapy for couples, adolescents, men, and the LGBTQ+ community. 
Sessions are available in-person at 162 E Ridgewood Ave, Ridgewood NJ 07451, or via the internet or telephone. Book a consultation today www.exploretransform.com
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So the first nor-easter of 2018 approaches. We need to hunker down, we need to protect what and whom we hold dear.  We also need to look after ourselves.

What is the number one method of self-care you practice?  I am a big fan of 'kind self-talk'.  If I catch myself becoming overly critical, I challenge myself, and ask whether I would be so unkind to someone else. I wouldn't, so I need to adopt a kinder self-talk.  

How do you look after yourself?  I would love to hear from you.

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Want to rate your teenager's self-esteem?  Ask them. 

Beyond that, if you need some guidance on how to frame the conversation, ask them how much they agree with the statements set out below.  They can rate, on a scale of 0-10, how much they believe the statement (0 = not at all, 10 = I complete, whole-heartedly agree) –

1. I am happy being me
2. I look at pictures of myself, and I am okay with what I see
3. I am capable of being loved
4. I am not a failure
5. I have stuff to offer the world
6. I don’t need to be anyone except me
7. I am on the right path in terms of learning about life, and emotionally growing
8. I accept compliments when I am given them
9. I accept myself, even if others do not
10. I am worthy of love

Once you assess their self-esteem, and you are concerned about it, you can read my blog with 5 tips to build your teenager’s self-esteem by clicking here

Chris Warren-Dickins LPC specializes in psychotherapy for adolescents, and the LGBTQ+ community.  Read more about his work on this page.
His office is located in downtown Ridgewood at 162 E Ridgewood Avenue, Suite 4B, Ridgewood, NJ 07450.  
Easy online booking is available by clicking here. Or feel free to call or email him 201-779-6917 / chris@exploretransform.com
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If you are concerned about your teenager's self-esteem, have a look at these 5 tips -

1. Focus on the positive – What strengths does your teenager demonstrate?  When did they last demonstrate them?  When have they shown you that they could put in the effort to achieve things?
2. If you are to look at goals, make them SMART – Specific, Measureable, Achievable, Realistic, and with a Timeframe
3. Try not to overshadow them – Don’t talk for them, and try to encourage them to take the initiative
4. Celebrate the differences – Don’t compare their peers and siblings.  Recognise their unique character and strengths
5. Do not underestimate kindness – We are so focused on doing, and achieving, that we underestimate the importance of kindness.  It is healing, and it reinforces a positive self-image.  Likewise, if you notice kindness demonstrated by your teenager, acknowledge this.  Your teenager might not even recognise the importance of it

​Chris Warren-Dickins LPC specializes in psychotherapy for adolescents, and the LGBTQ+ community.  Read more about his work on this page.
His office is located in downtown Ridgewood at 162 E Ridgewood Avenue, Suite 4B, Ridgewood, NJ 07450.  
Easy online booking is available by clicking here. Or feel free to call or email him 201-779-6917 / chris@exploretransform.com

An important part of adolescence is forming an identity independent of their parents.  To do this, they need to experiment with life outside of the norms and expectations of their parents.  Within the bounds of safety and legality, this is to be welcomed.  But it can be extremely frustrating for the parent.  So here are 5 tips to ride the rebellion rollercoaster –

1. Independence does not mean abandonment.  You need to let them feel the freedom to fail (a little), but not freefall into oblivion.  Remind them that you are available if they need to check anything out with you.
2. Establish a new relationship.  It really will be a new world between the two of you.  It has to be, for them to really develop into a mature person.  So you will need to remain alert to the opportunity to spend time together. This may involve new activities, but at least you are continuing a connection.  It is just a new type of relationship. 
3. Really point out the positives.  Rebellion, or acting out, might be a sign that they are not happy.  It isn’t just about establishing an independent identity.  It is hard to work out what the true motivation is at every given moment, but you cannot go far wrong with compliments, and highlighting when they have achieved something, or taken the initiative
4. If your teenager needs space, give it to them as much as possible.  Try and return much later, then they have calmed down, and when they are ready to listen
5. Let go of the minor stuff.  With all the turmoil that comes with adolescence, they really need a bit of wriggle room.  This means letting go of the small stuff.  And you will need to constantly reassess what you can let go, and what is a bare minimum for them to comply with.  A good way to tackle this is to jointly negotiate this with them.  Hold a family meeting, sharing observations without accusations

Chris Warren-Dickins LPC specializes in psychotherapy for adolescents, and the LGBTQ+ community.  Read more about his work on this page.
His office is located in downtown Ridgewood at 162 E Ridgewood Avenue, Suite 4B, Ridgewood, NJ 07450. 
Easy online booking is available by clicking here. Or feel free to call or email him 201-779-6917 / chris@exploretransform.com

A few years ago I was interviewed by Wandsworth Radio to discuss Men's Health Week (here is a link to the interview:  http://www.wandsworthradio.com/show/wandsworth-tonight/ ).  During this discussion I mentioned this: “Women seek help — men die” (Jules Angst and Celile Ernst).  This is a blunt way of summarising the statistic that suicide is the single biggest cause of death in men aged 20 to 45 (in the US there are 3.53x more male suicides than female suicides).  To seek help, to share the burden, implies that we are admitting defeat, and that we do not have the strength.  “We are less of a man.”
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Instead of seeking help, the statistics suggest that men deal with distress in other ways -

1. Men are nearly three times more likely than women to become alcohol dependent
2. Men are three times as likely to report frequent drug use than women
3. 73% of adults who ‘go missing’ are men
4. 87% of rough sleepers are men
5. Men make up 95% of the prison population
6. Men commit 86% of violent crime
7. Boys are around three times more likely to receive a permanent or fixed period exclusion than girls

We need to challenge our perception of men seeking help.  Strength has many facets, and it includes emotional awareness, intellectual savvy and tactical planning.  It is a sign of strength to learn what our vulnerabilities are, and to work out what our most constructive coping mechanisms are.  When we are in distress, this can be difficult to do alone, and so it makes sense, it is a sign of strength, to seek help.
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In an article in the Guardian Matt Haig quoted from the book ‘White Noise’ (Don DeLillo):  ‘What could be more useless than a man who couldn’t fix a dripping faucet - fundamentally useless… to the messages in his genes?”  And Haig added:  “What if, instead of a broken faucet it is a broken mind?”

We need to normalise the concept of a man seeking help.  To seek help for emotional distress is just about as normal as a man fixing a tap!

Chris Warren-Dickins is a Licensed Professional Counselor in Ridgewood, New Jersey.  He specializes in psychotherapy for couples, adolescents, men, and the LGBTQ+ community. 
Sessions are available in-person at 162 E Ridgewood Ave, Ridgewood NJ 07451, or via the internet or telephone. Book a consultation today www.exploretransform.com
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It feels like pain is all around us:  Opioid abuse is in the news, healthcare reform is being debated in the US, and in the UK the (lack of) availability of cancer drugs is under close scrutiny. 

If we are unable to escape pain through other means, how can we manage it?  For many years I have been fascinated by Jon Kabat-Zinn’s ‘Full Catastrophe Living’, and in that book he offers a number of techniques that might help with pain management.  Have a look and let me know what you think -

• “Enter into the pain – tune into the sensations.  Be aware of the descriptions you give to the 'pain' – what does it actually feel like.  'Pain' is just the name, a thought, it is not the actual experience.  Feelings are just feelings, they are not you, they are not the whole of you.  If we can witness these thoughts and feelings, at a distance, then they cannot become us
• Remind yourself on a regular basis that you are a whole person who happens to have to face and handle pain
• If sitting is uncomfortable, try lying down or walking mindfully.  Close your eyes, tune in to your breathing, and watch your belly expand gently on the inbreaths and recede on the outbreaths.
• As detailed in the body scan, use your breathing to direct your attention down to the toes of your left foot.  Start working from there, maintaining moment to moment awareness.  When your mind is on one region of your body, the idea is to keep it focused on that region, feeling any and all sensations in that region (or lack of sensations if you don't feel anything), and breathing in to and out from that region. 
• Every time you breathe out, see if you can let your whole body sink a little more deeply into the surface you are lying on as the muscles all over your body release their tension and relax.
• Move your attention slowly through your entire body.  Tune in as you breathe into each region of the body in a few moments of stillness.  If your mind wanders, gently notice where it has gone and bring it back, using your breath as an anchor.
• As you move through a problem area of the body, see if you can treat it like any other part of your body that you come to focus on, in other words gently breathing in to and out from that region, carefully observing the sensations, allowing yourself to feel them and open up to them and letting your whole body relax and soften each time you breathe out.
• When it comes time to let go of that region and move up (if it helps, try saying 'goodbye' in your mind silently on an outbreath), and see if you can flow in that moment into calmness and stillness.
• If the pain does not change, just move on to the next region and direct your full attention to it.  If the pain does change, see if you can note precisely what the qualities of that change are.  Let them register fully in your awareness and keep going with the body scan.
• It is not helpful to expect pain to disappear.  Just keep up the watching and letting go, breath by breath, moment to moment
• Anything you notice about your pain, or about your thoughts or feelings, is to be noted non-judgmentally as you maintain your focus on the body scan.  You don't have to like it, you just need to keep repeating it.
• After a few weeks you can alternate between a body scan and sitting meditation or yoga postures.
• Remember, you are trying to find out about your pain, to learn from it, to know it better, not to stop it or get rid of it or escape from it.
• Ask yourself 'How bad it is in this very moment?', rather than dreading the next moment”

Chris Warren-Dickins is a Licensed Professional Counselor in Ridgewood, New Jersey.  He specializes in psychotherapy for couples, adolescents, men, and the LGBTQ+ community. 
Sessions are available in-person at 162 E Ridgewood Ave, Ridgewood NJ 07451, or via the internet or telephone. Book a consultation today www.exploretransform.com
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“The shame tattoo.” I heard that phrase a couple of years ago, and it has stayed with me ever since. It is such a striking way to encapsulate the concept of shame: It is the insertion of something that leaves an indelible mark deep beneath the skin. 

Robert* also liked to call his shame ‘the shame tattoo’. When we came to the end of our counseling sessions, he added it to the list of things he would take from our work together. He also liked the fact that a tattoo was something from the past, and it was only a mark on his skin: It was not the whole of him, and so the darkness did not define nor consume him.

When Robert first came to see me his world was a place of enemies. Every encounter involved a defensive posture, with an occasional tight-lipped smile and short, non-committal statements weighed down by negativity. The strapline to social dialogue was persistently: ‘There is a trap here, so keep your guard up.’ Given his lack of faith in mankind, I was surprised he made the initial appointment with me, let alone turn up for it. But he did, and he persisted with the entire course of therapy.

Often shame is at the heart of something else presented by a client: Addiction, anger, depression, anxiety. And so, with Robert, we examined his anger in the early sessions, and his disappointment, and his mistrust, and his anxiety, but there was no mention of the word ‘shame’. At times I struggle with the tipping point between taking the lead from a client (using their words and meaning), and offering my own insight. I continuously challenge myself on this, questioning whether I am bringing in stuff from the client or stuff from my own world. But part of our job can include imparting information, and so the information I imparted was that the word ‘shame’ has sometimes been used when other people have presented stuff that Robert was presenting. I offered it tentatively, and he snatched at it, stared at it, and then nodded.

By saying the word ‘shame’, Robert could finally identify what had been itching beneath his skin for all these years. Finally he could make sense of that nausea he felt when he looked in the mirror. He believed that people could see the shame etched across his face because he believed that what had been done to him had defined him. And he believed that this shame made him unlovable. 

And that is what shame is: It is about your very being. It is about something internal, a self-belief, whereas guilt is about something external: Guilt is about something you have done (or not done). Shame often emerges in someone’s core beliefs, usually in the form of statements such as ‘I am unlovable’, or ‘I am unworthy’, or ‘There is something about me that is just not right’. Shame might make someone withdraw, whereas guilt might make someone seek forgiveness.

Once we identified shame, we looked at what Robert might need.  He needed to tell his story, and he needed to be believed. That was hard enough when shame was undermining his very foundation. But as he told his story, and he saw that I continued to accept him unconditionally, he began to question the belief he had held onto for so long. Perhaps, after all, there was not something rotten about his core. 

It is difficult to step away from a belief that you have held onto for so long, especially if others have reinforced that belief. When I work with survivors of sexual violence, often the perpetrator has reinforced a belief that the survivor is somehow unlovable, or to blame. A child’s sense of survival is inextricably tied to a caregiver (whether that is a parent, older sibling or grandparent). If that caregiver is abusive, they may shame the child into secrecy. The survivor is essentially given a choice: Accept this shame and survive, or face extinction. Inevitably they are going to choose shame.

In her book ‘Narrative Approaches to Working with Adult Male Survivors’ Kim Etherington warned against ‘moving too quickly towards forgiveness’, pointing out that this can be an avoidance of anger and fear. This is especially so if the perpetrator was a caregiver. It is hard, after so many years, to accept that someone you might have loved actually abused you. When I work with survivors of abuse, we often end up turning shame on its back and seeing it for what it really is: Someone else’s shame. A client who has been abused will often believe that they were somehow to blame, or they are tarnished because of someone else’s action. In reality, they are taking on the perpetrator’s shame, and often the perpetrator has been complicit in fostering this belief. It helps protect the perpetrator: ‘If you tell anyone, they will think you are the unclean one.’ Or: ‘Keep quiet because they will never believe someone like you.’
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To work through shame, that person needs to feel accepted for the whole of who they are. This is where the relationship between therapist and client is so important: If someone can feel unconditional acceptance, they can start to distance themselves from the shame. But this is not a linear process. My work with Robert came to an end, but we were both aware that the process was not necessarily linear. The pressures of everyday life can have a triggering effect, so Robert knew that he would need to continuously monitor himself and watch out for times when he may need additional support.
*Names and details have been changed

Chris Warren-Dickins is a Licensed Professional Counselor in Ridgewood, New Jersey.  He specializes in psychotherapy for couples, adolescents, men, and the LGBTQ+ community. 
Sessions are available in-person at 162 E Ridgewood Ave, Ridgewood NJ 07451, or via the internet or telephone. Book a consultation today www.exploretransform.com
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What is anxiety?
The most simplified definition of anxiety is a ‘fear of a perceived danger’.  It can become problematic when the fear is out of proportion to the perceived danger, and/or the anxiety interferes with everyday functioning (for example, academic achievement, peer interaction, sporting activities, etc).

How can we detect anxiety in adolescents? 
Each person is different, but here are some common characteristics to look out for –

• Behaviour For example, excessive use of electronic devices such as social media, avoiding school, withdrawal from sporting activities, reduced social interaction, and sleeplessness
• Mind and feelings For example, irritability, expressing negative thoughts, or crying more often
• Body For example, headaches, heart racing, and stomach aches

 
What do you do if you suspect your loved one is struggling with anxiety

• Start with what, not why – When you talk to them, describe what you have noticed in your loved one, rather than trying to rush into an explanation or assumption as to why they might be acting this way
• Show them you are available for them if they feel able to explain what is going on.
• Empathise – Try to understand things from their perspective, and show them you are trying to do this
• Normalise – Explain that anxiety is a normal reaction to perceived danger, but it can sometimes get out of hand if you don’t get a little help
• Structure some sort of stability – Because for anxious people change or uncertainty is difficult.  For example, try and incorporate a regular routine such as the same time for bed each night, or the same place to visit each week (such as a relaxing outdoors walk, or a trip to the cinema)
• Look for any root causes – For example, bullying via social media, academic struggles, or a recent transition (such as moving house, or starting a new sporting activity)
• Develop their resourcefulness and resilience – Demonstrate where they have used their resources before, and build on that.  Give them opportunities to practice, for example, letting them request things, rather than speaking or doing things for them.  Sometimes a behavioural diary can help, to keep a track of their increasing resourcefulness and resilience

​You can find more advice on my adolescent therapy page https://www.exploretransform.com/adolescent-ridgewood.html
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What is the secret ingredient to a long-lasting relationship?  Each relationship is unique, just as each person is unique, but there appears to be at least one common factor throughout:  Connection.

Too often we end up functioning with, rather than truly experiencing, truly connecting with, the other person.  Without this connection, we can quickly forget why we were ever together in the first place.  And then we open our relationship up to danger.

Connection can mean a whole range of things but some can include:

1.  Looking at the person when they are talking to you
2.  Responding to confirm you have understood what they have said 
3.  Asking them questions to show you have an interest about them
4. Offering physical contact, such as holding someone's hand
5.  You try to carve out (even the smallest amount of) time together, without anyone else
6.  You put down/turn off electronic devices such as social media
7.  You follow up on a previous conversation with that person, to check in with how they are with that topic
8.  You share vulnerabilities, admissions of mistakes, and you are not afraid of how you might be viewed by the other

Re-establishing a connection is such a common theme in my work.  I have previously written about the myths about men and connection, and the link between addiction and a lack of connection.  So too can a lack of connection rest at the heart of a relationship's problems.  

To try and re-establish that connection, ask yourself these four questions - 

1.  What was it that first made me fall in love with my partner? What was the 'secret ingredient'?
2.  How much of that is still present in our relationship? 
3.  How much more of that ingredient do I need to get back into our relationship (this is the long-term goal)?
4.  What is the first step I need to take to start my journey towards that long-term goal (this is the short-term goal)?

It takes time and attention to re-establish that connection.  And it is never a one-time exercise. But if we incorporate a small amount of connection (the secret ingredient) into our regular patterns, as much as we incorporate household chores, we will start to see results.

​To read more about couples psychotherapy, click here.

Chris Warren-Dickins is a Licensed Professional Counselor in Ridgewood, New Jersey.  He specializes in psychotherapy for couples, adolescents, men, and the LGBTQ+ community. 
Sessions are available in-person at 162 E Ridgewood Ave, Ridgewood NJ 07451, or via the internet or telephone. Book a consultation today www.exploretransform.com