‘No one ever told me that grief felt so like fear’ (A Grief Observed, CS Lewis).
 
‘Your former life still seems to exist, but you can’t get back to it……The process creates panic and guilt’ (Hilary Mantel).
 
To grieve means to feel intense sorrow for a loss.  Grief is usually associated with a death, but we may need as much support for the intense sorrow caused by another type of loss.  Sometimes a divorce, the loss of a career, or the estrangement of friends or family can be experienced as devastating and as shocking as a death.  However, society does not often expect the term ‘grief’ to be associated with any loss other than the death of a loved one.  If someone is divorced, if they lose their career, or if they become estranged from a friend or family member, there is rarely the same level of support as when there is a death.  Instead there is (at best) a bewildered silence, or (at worst) an unspoken assumption that the person experiencing the loss is in some way to blame.  So what can help someone who is grieving for a loss other than the death of a loved one?
 
Elisabeth Kubler-Ross identified the following five stages of grief –

• Denial – Without denial of the loss, there is a danger that our feelings might become overwhelming.  Denial helps us to survive the initial experiences of loss.  Once denial subsides, this is when feelings flood in, and sometimes this is when we need support the most.
• Anger – People often try to look on the bright side of loss, but allowing yourself to truly feel your anger can help you move on through the stages of grief.  Kubler-Ross referred to anger as a means of giving you some sort of connection after feeling lost in a sea of grief.
• Bargaining – This is when we are consumed with the ‘if only’ questions.  This is often a painful stage because it can involve self-blame – for example, if only I had worked harder, if only I had reacted differently, I might not have lost this.
• Depression - This is a natural and expected stage of grief but there is a tendency to look on this as a symptom to ‘cure’.  Instead, it is useful to think of it as part of the healing process.
• Acceptance – This is not necessarily a point when the loss is viewed as a positive thing, as that may never happen.  Instead, this is about accepting the reality of the loss, and this is the new world we live in.  It is one thing to accept a loss intellectually, but to accept it emotionally is quite something else.

Some have criticised this as an over-simplification of what is essentially a complicated process, but Kubler-Ross responded by clarifying that the five stages ‘were never meant to help tuck messy emotions into neat packages’.  She explained that ‘our grief is as individual as our lives’, and the five stages ‘are tools to help us frame and identify what we may be feeling’.  Whatever the truth, the important question is whether or not you find these five stages to be helpful in making sense of what you may be experiencing.  Some of my clients have said ‘yes, this helps me to make at least a little sense of what I am feeling right now’, and other clients have found other concepts more helpful.
 
Here are some of the other concepts that have helped grieving clients –

• Allow yourself to grieve at your own pace – Some clients have tried to push through their grief in the mistaken belief that there is a ‘normal’ amount of time to process their loss.  Often clients have felt under pressure to ‘move on’ because a friend or partner has been pushing them to do so.  Perhaps the friend or partner has become anxious in the face of this grief because they fear the prospect of experiencing a loss of their own.  This is akin to someone who may avoid someone who is terminally ill because they fear their own mortality.  According to the fifth edition of the DSM, if intense grief continues for more than twelve months, this may be considered a disorder.  However, some say that there is not enough evidence to support the distinction between normal grief and a mental disorder.  When clients realise that they have been given permission to grieve at their own pace, a tremendous pressure is often lifted, and sometimes just alleviating the pressure of expectation can help the client move a little further through their grieving process.   
• Consider the importance of personal rituals – George Bonanno has studied grief for a number of years, and he has found that between 50 and 60 per cent of those studied showed no signs of grief after a month, and some even within a few days (‘The Other Side of Sadness’).  Michael I. Norton and Francesca Gino (Harvard Business School) identified one common factor amongst this significant proportion of people, and this was the use of a personal ritual during the grieving process.  The personal ritual is to be distinguished from the public displays seen in religious ceremonies, because the personal ritual can be done in private.  You could recite each day a poem you once shared with this family member, or you could have a walk in a park that you used to enjoy with a friend.  At times you may feel lost in the darkness of grief, and so to hold onto something familiar can be extremely comforting.  Jules Evans discussed the importance of rituals in response to a death, because ‘it’s hard to invent your own response to death’, and the same can be said for your response to any other loss.  If we suddenly find ourselves divorced or unemployed, we can find it hard to make sense of our new identity, and so, as Evans points out, a ‘ritual is comforting, enabling us to express something we struggle to put into words’ (Philosophy for Life). 
• There is strength in breaking down - When people ask us how we are, they rarely want to know the truth, and they want even less to see an open display of emotion.  Some people believe that grief should be kept “under complete control by strength of will and character, so that it need be given no public expression” (Geoffrey Gorer).  If you sense that someone is expecting you to maintain this ‘complete control’ (perhaps translated into the ‘stiff upper lip’) and you end up breaking down in tears, perhaps their discomfort is less about your strength and more about their insecurities.
• The degree of loss is directly related to the quality of relationship you once had – Learning how to grieve for a loss may depend on the quality of the relationship you had with the person or career you lost.  For example, if you had a violent relationship in your marriage, or an intense relationship with your career (viewing it as integral to your identity, for example), then the loss of that marriage or career may take longer to work through. 

Over a number of years the concept of a ‘death cafe’ has gained in popularity.  This is a place where people can meet and increase ‘awareness of death with a view of helping people make the most of their (finite) lives’ (deathcafe.com).  Perhaps it is time to start a Grief Café, where people can meet others who need to share their experiences and understanding of grief as a result of any type of loss.  I would be interested to hear your thoughts on this.

Get in contact today. You can send an email, telephone, or use the online booking system.
 
Email - chris@exploretransform.com
Telephone - (201) 779-6917
https://www.exploretransform.com/
Online booking https://www.therapyportal.com/p/cwarrendickins/

Chris Warren-Dickins LPC , Licensed Professional Counselor in Ridgewood, New Jersey. Sessions are also available online
#chriswarrendickins
#ridgewood #depression #anxiety #angermanagement #trauma #relationships #stress #counseling #bergencounty #newjersey #therapy #Support #psychotherapy
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Anxiety hates exposure.  If you are anxious about speaking on the telephone, anxiety will only grow if you always avoid the situation.  The best way to tackle this is to expose yourself to the thing that makes you anxious.   

Start slowly, though.  Don't try and hold fifteen exceptionally important business calls all in one morning.  Try calling someone who you feel safe with, a close friend or family member, for example.  I have had some clients in the UK who called the speaking clock as a first step.

When you try exposure, monitor the thoughts that are popping up in your head.  Are you making assumptions about yourself, and the other person?  Are you assuming that you will make a mistake?  Are you assuming that, even if you make a mistake, that it will matter that much?  And are you assuming that the other person will really care, even if you do make a mistake?  

And monitor the voice you adopt.  Are you speaking to yourself in a kind voice, accepting mistakes, and supporting yourself in these first steps to managing the situation?  Or are you judgmental, critical, and even punitive?  If so, would you adopt this voice when you talk about another person who is trying this exposure exercise?

​Get in contact today. You can send an email, telephone, or use the online booking system.
 
Email - chris@exploretransform.com
Telephone - (201) 779-6917
https://www.exploretransform.com/
Online booking https://www.therapyportal.com/p/cwarrendickins/

Chris Warren-Dickins LPC , Licensed Professional Counselor in Ridgewood, New Jersey. Sessions are also available online
#chriswarrendickins
#ridgewood #depression #anxiety #angermanagement #trauma #relationships #stress #counseling #bergencounty #newjersey #therapy #Support #psychotherapy
#counselor
#mentalhealth

It is hard to take that first step, and booking a therapy session.  Why not ask Chris Warren-Dickins LPC any questions.

Get in contact today. You can send an email, telephone, or use the online booking system.

Email - chris@exploretransform.com
Telephone - (201) 779-6917
https://www.exploretransform.com/
Online booking https://www.therapyportal.com/p/cwarrendickins/

Chris Warren-Dickins LPC , Licensed Professional Counselor with an office at 162 E Ridgewood Ave, Ste 4B, Ridgewood, New Jersey. Sessions are also available online
#chriswarrendickins
#ridgewood #depression #anxiety #angermanagement #trauma #relationships #stress #counseling #bergencounty #newjersey #therapy #Support #psychotherapy
#counselor
#mentalhealth
#onlinetherapy

As a member of the LGBTQ community, we have experienced anger because we are likely to have experienced discrimination.  It comes with the territory.

Many people fear their anger, and these are four myths why -   

1. We believe that feeling anger is wrong.  This is a myth.  It is actually okay to feel anger, anytime, anywhere.  It doesn’t mean you have to act on it
2. We believe we don't get angry.  I call BS.  We all get angry, we are just aware of it to differing degrees.  It is important to be aware of our anger, and the cause of it. Otherwise it might leak out in passive-aggressive behaviour
3. If we express our anger, we will lose a friend or loved one.  Another myth.  If you have to communicate your anger, and you do so assertively (rather than aggressively or passively), it might be an opportunity for the other person to understand what is going on for you.  It is a fair thing to do.  It is a little unfair if they never know how they are impacting you
4. If we let the anger out, we will be unleashing a danger on the world.  It is not worth the risk.  As you can guess, this is another myth.  Don’t assume there will be disagreement, confrontation, and heartache.  Sometimes, once you have assertively communicated your experiences and needs, this offers an opportunity for connection with the other person. Your relationship might evolve for the better

Get in contact today. You can send an email, telephone, or use the online booking system.
 
Email - chris@exploretransform.com
Telephone - (201) 779-6917
https://www.exploretransform.com/
Online booking https://www.therapyportal.com/p/cwarrendickins/

Chris Warren-Dickins LPC , Licensed Professional Counselor in Ridgewood, New Jersey. Sessions are available in-person, or online
#chriswarrendickins
#ridgewood #depression #anxiety #angermanagement #trauma #relationships #stress #counseling #bergencounty #newjersey #therapy #Support #psychotherapy
#counselor
#mentalhealth

How can you detect anxiety in your loved ones?

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, concentration at work, ability to engage in usual activities such as sport, etc).

How can we detect anxiety in our loved ones?
Each person is different, but here are some common characteristics to look out for –
1. Behaviour For example, excessive use of electronic devices such as social media, avoiding work, withdrawal from social events, and sleeplessness
2. Mind and feelings For example, irritability, expressing negative thoughts, or crying more often
3. Body For example, headaches, heart racing, and stomach aches

What do you do if you suspect your loved one is struggling with anxiety
1. 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
2. Show them you are available for them if they feel able to explain what is going on.
3. Empathise – Try to understand things from their perspective, and show them you are trying to do this
4. 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
5. 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)
6. Look for any root causes – For example, a new boss at work, or conflict between friends, or a recent transition (such as moving house, or starting a new sporting activity)
7. 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

Get in contact today. You can send an email, telephone, or use the online booking system.
 
Email - chris@exploretransform.com
Telephone - (201) 779-6917
https://www.exploretransform.com/
Online booking https://www.therapyportal.com/p/cwarrendickins/

Chris Warren-Dickins LPC , Licensed Professional Counselor in Ridgewood, New Jersey. Sessions are available in-person, or online
#chriswarrendickins
#ridgewood #depression #anxiety #angermanagement #trauma #relationships #stress #counseling #bergencounty #newjersey #therapy #Support #psychotherapy
#counselor
#mentalhealth

‘I don't want to see anyone. I lie in the bedroom with the curtains drawn and nothingness washing over me like a sluggish wave.’  In her novel ‘Cat’s Eye’, this is how Margaret Atwood describes depression.  As a psychotherapist, I have worked with a number of clients who have worked through their depression, and Atwood’s description is spot on.  Someone who is depressed will often find himself caught in the following double-bind –

• He assumes that there will be a negative outcome to most situations, and
• He assumes that he is inadequate or deficient.

As a result, if something negative does happen, this simply proves his assumption that he is inadequate or deficient.  Trapped in this double-bind, he does not have the ‘escape clause’that other conditions offer:  For example, if someone with OCD follows a routine, they will find relief from the anxiety.  With depression, it often feels like there is no end to the ‘sluggish wave’.

The World Health Organization predicts that by 2030 depression will be the ‘leading cause of disease burden’ worldwide (‘The increasing burden of depression’, Jean-Pierre Lepine and Mike Briley). In the UK it is reported that one in five people become depressed at some point in their lives (Royal College of Psychiatrists), and so it is very common.  Sadly, not enough people talk about having experienced it, and so there is often an element of shame attached to it.

If someone is experiencing depression, they may find that they are helped by –

• Talking to a trained expert , and/or
• Seeking a prescription of anti-depressants from their GP.

If a person with depression decides to talk to a trained expert, one of the approaches is Cognitive Behavioural Therapy (CBT).  This is the approach recommended by NICE, but there is some debate about whether this is the only approach that is useful.  As I am an integrative psychotherapist, I would work with the client to make choices about how to work through their depression.  These choices would be informed by the client, the presenting issue, and any current research. 

Whichever approach we choose, I always work from a person-centred core.  This means that I listen actively to the client, paraphrasing their experiences back so that they know they are understood.  I do not make assumptions and instead I work hard to understand the client’s meanings (for example, what he means by ‘depressed’ and how this impacts on his life).  Sometimes just having the magnitude of one’s feelings acknowledged can be healing in itself.  But sometimes this is not enough, and so I work with the client to see what else we can do with the client’s experiences.

There is currently research being carried out to investigate what is known as the analytical rumination hypothesis. In brief, this hypothesis suggests that depression serves a function, just as a fever indicates that the body is fighting an infection.  Some have suggested that the ruminative thoughts involved with depression might offer opportunities for that person to improve.  What a trained expert can do is to help that person along the rumination process, finding solutions for the problems that are causing the depression. For example, someone might be depressed because of a recent relationship breakup, and the ruminative thoughts might be about the depressed person trying to work out how they will live as a single person, or how they might live in a relationship differently in the future.  This implies that there is a resolution to the process, once the depressed person makes sense of this new information.  If this is true, trying to medicate someone who is depressed might not be useful, as it might prevent the person from working through these ruminative thoughts and finding some sort of resolution.  The research on the analytical rumination hypothesis is far from conclusive, and so professionals urge people to not stop taking prescribed medication, but it is interesting to at least consider this as a possible explanation for depression.

Some clients have found mindfulness to be a useful approach with depression.  This approach was best described by Jon Kabat Zinn in his book ‘Full Catastrophe Living’:  ‘The essence of the practice is non-doing', it is a letting go’.  The purpose is not to achieve anything but to acknowledge and be aware of what is’.  So one approach might be to stop trying to fight the depression and see how it might be to accept it, in the hope that this might give it less power, and it might eventually fade into the background.

If CBT is the chosen approach, this would involve examining a client’s thoughts and assumptions.  For example, by talking to a trained expert the following clients might start to understand that –

• Jane often labels herself a ‘failure’ simply because she has made one or two mistakes at work.
• Paul often personalises situations, assuming that when something goes wrong, it is automatically his fault.
• Bill often lives by ‘rules’ that were once useful but now trap him in a depressed state: For example, he believes in the ‘pleasure-pain principle’, assuming that if it is pleasurable to have lots of money he will be in perpetual pain if he is not rich. 

Using CBT, a trained expert would help these clients to challenge these assumptions. For example –

• With help, Jane could start to question whether one or two mistakes at work necessarily means that she will always make mistakes. Reality testing is important here, so it would be important to find examples where she has done well, or when she has not made mistakes. 
• With help, Paul might begin to realise that a situation might have gone wrong for a whole number of reasons that do not involve him (a process known as ‘decentering’).
• Finally, with help, Bill might begin to challenge these constraining ‘rules’, and he might look for evidence to the contrary (for example, he might realise that there is pleasure derived from non-monetary sources).

In addition to challenging a client’s thoughts or assumptions, behavioural techniques might also be explored.  For example –

• A depressed client could explore the possibility of participating in activities that lead to a small success. As confidence grows and apathy diminishes, these activities can increase in number and duration.  This can help counterbalance the hopelessness that is an inevitable part of depression.
• One technique might be to consider things that stimulate the client, such as pleasant smells, sensations, sights, tastes or sounds. Having a list of these can be useful when the ‘sluggish wave’ draws in.
• The client could also start to engage in more physical activities. It is well established that exercise can increase the endorphins, and so even a regular short walk every now and again might help.  

With all behavioural techniques, it is important to explore all the possible risks and benefits of these techniques, paying careful attention to any assumptions that the client might offer to avoid pursuing or sustaining these activities.  One common assumption amongst depressed clients is that the activity will inevitably fail to achieve any change, or they believe that they lack the ability to succeed in the task.  But it would be important to ask the client: 

• What would the client lose by trying?
• Has their previous approach really been helpful?
• How do they really know they will fail, if they don’t try

It might be useful to end this article with a checklist of assumptions that often trap people in depression.  How many of these ‘rules’ do you live by, and how helpful is it for you?  There is a big difference between rules to improve your life, and rules to trap you.  If you are at least aware of the rules that you live by, you can then decide which ones are useful, and which ones are destroying your life -

1. If I make a mistake, that means I am a failure
2. If I do not succeed at a task, there is no point in trying
3. I must be liked by everyone at all times
4. Because it is pleasurable to be wealthy, it is painful to have little or no wealth
5. My value depends on how other people view me
6. Disagreement means conflict, which is to be avoided
7. To be loved, I must fulfil certain conditions

​Get in contact today. You can send an email, telephone, or use the online booking system.
 
Email - chris@exploretransform.com
Telephone - (201) 779-6917
https://www.exploretransform.com/
Online booking https://www.therapyportal.com/p/cwarrendickins/

Chris Warren-Dickins LPC , Licensed Professional Counselor in Ridgewood, New Jersey. Sessions are also available online
#chriswarrendickins
#ridgewood #depression #anxiety #angermanagement #trauma #relationships #stress #counseling #bergencounty #newjersey #therapy #Support #psychotherapy
#counselor
#mentalhealth

When we feel anxious, our thoughts can become overwhelming.  But thoughts are just like bubbles - they appear, temporarily, but then they float away or burst before your eyes.

Get in contact today. You can send an email, telephone, or use the online booking system.

Email - chris@exploretransform.com
Telephone - (201) 779-6917
https://www.exploretransform.com/
Online booking https://www.therapyportal.com/p/cwarrendickins/

Chris Warren-Dickins LPC , Licensed Professional Counselor with an office at 162 E Ridgewood Ave, Ste 4B, Ridgewood, New Jersey. Sessions are also available online
#chriswarrendickins
#ridgewood #depression #anxiety #angermanagement #trauma #relationships #stress #counseling #bergencounty #newjersey #therapy #Support #psychotherapy
#counselor
#mentalhealth
#onlinetherapy

If food and eating has become an issue for you, you might like to try mindfulness.  Mindfulness helps you to focus on the present.  You become aware of every aspect of what you are doing, even if that is uncomfortable.

Try and notice become aware of your thoughts, feelings and bodily sensations at every stage of your encounter with food and eating:
1.  When you anticipate eating
2.  When you purchase food
3.  When you prepare food
4.  When you eat food
5.  After consumption, including the clearing up process. 

Try not to change anything but simply become aware of every aspect of the experience.  Try also to eat a meal silently and slowly, so that you are aware of every part of the process.  What do you notice about the colours, the textures, and your thoughts and feelings as you eat?  Ask yourself how much food you want.  Are you aware of any impulses?  What sensations tell you that you have had enough?
 
If you focus your attention, you might start to see how much control you have over your eating. 
 
Let me know how you get on with this.
Get in contact today. You can send an email, telephone, or use the online booking system.

Email - chris@exploretransform.com
Telephone - (201) 779-6917
https://www.exploretransform.com/
Online booking https://www.therapyportal.com/p/cwarrendickins/

Chris Warren-Dickins LPC , Licensed Professional Counselor with an office at 162 E Ridgewood Ave, Ste 4B, Ridgewood, New Jersey. Sessions are also available online
#chriswarrendickins
#ridgewood #depression #anxiety #angermanagement #trauma #relationships #stress #counseling #bergencounty #newjersey #therapy #Support #psychotherapy
#counselor
#mentalhealth
#onlinetherapy