We all know that we have an ageing population:  According to one source, "by 2032, there will be more people 65 and older than the total number of children under the age of 15".  But did you know that you are more likely to find an initiative to meet the mental health needs of children and adolescents than the elderly community?

Age often brings a number of transitions (the end of a career, moving home, personal loss, reduced income), which can be stressful in itself.  But age can also bring a decline in physical health, isolation, and a sense of vulnerability.  If you add all of that up, you are faced with a significant impact on one’s mental health. 

Psychotherapy helps people to manage life’s transitions, isolation, vulnerability, and the emotional impact of physical health.  It is a place for “support, guidance and normalization of the emotional responses to each stage” of life (Suzanne Degges-White, president of the Association for Adult Development and Aging, a division of the American Counseling Association).

The ageing population is a diverse population.  I have mentioned in other articles the unique needs, for example, of the LGBTQIA+ and nonbinary elder populations.  It is important that we consider the mental health impact of discrimination experienced by this, and any other, minority group.  
 
Psychotherapy can help individual members of the elderly community, but it can also transform the surrounding family.  One person’s mental health issues inevitably has an impact on the family structure that surrounds them.  In an article published by the American Counseling Association, Rebeca Cowan discusses the concept of “caregiver burnout”, explaining how she works with the caregiver to “brainstorm ways to increase support” and experience “brief relaxation exercises”.  Psychotherapy can include these family members, so that everyone gets a chance to experience the support, guidance and normalization that is on offer.

As we anticipate a time when the elder population outnumbers the adolescent population, we need to consider how prepared we are to meet their needs.

If you have any questions about this, please do get in contact.
​
Chris Warren-Dickins, Licensed Professional Counselor
NJCA Public Policy & Legislation Committee Member
WPATH Member
www.exploretransform.com
chris@exploretransform.com
(201) 779-6917

Wedding buzz killed off by living under a tyranny of ‘shoulds’?  Relationships often transform once the initial excitement has subsided.  You can be left with a bitter aftertaste if you expect life, and everyone living in it, to be a certain way.  This is known as the 'tyranny of shoulds':  He should think about my feelings before he stays out late.  She should know that I need time to myself.  
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We all have needs, and so the 'shoulds' are an attempt to communicate these needs.  But your needs are more likely to be met if you consider these three things -

1.  Communication comes across better in a less mandatory way.  If you replace 'you should' with 'I would like it if you could...' it sounds as if there is more wriggle room for the other person.  As a result, it is less likely that their defences will be up, and they are more likely to listen.
2.  If your partner is listening, rather than defending a perceived attack, they are more likely to hear how important this is to you, and why it is important.
3.  With more wriggle room for the both of you, there is the chance that your partner might also communicate their needs in response.  Once you have heard your partner's perspective, you might end up altering your position.

I hope that you find this helpful. 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
#mentalhealt

Do you ever feel as if you are the scapegoat in a group, the one who ends up carrying the blame for everything when things go wrong? Or perhaps you feel compelled to take the lead in a group, frustrated that no one else has stepped up to take some of the responsibility. If this is happening, perhaps the forces of group dynamics are taking hold. On one end of the scale, a lack of awareness about group dynamics might lead to your feelings or needs remaining unheard. At the more extreme end of the scale, this group dysfunctional group dynamics could lead to persecution of the more vulnerable members of the group. How can you protect yourself when you interact within a group, and how can you ensure that your feelings and needs are met? 

Every time a group is formed, it is arguable that group dynamics are being played out. Group dynamics comprise of –

1.    Group roles adopted by each member of the group
2.    The development of a group as it progresses through its process (group process)

You may have heard of group dynamics in the context of your working life. But you probably find yourself in a group in other parts of your life, whether that is in your immediate or distant family, your friendships, or the group of parents you meet up with as your child participates in sporting practice.

Let’s look at each part of group dynamics in a little more detail –

Group roles
When you are interacting in a group, you may feel that you are compelled to do something that other group members are not. You may not understand why you feel compelled to do this, but it may be because you feel a task of the group needs to be achieved. For example, everyone in your group might be complaining about the rise in crime in the area, and you are all wondering how you can stay safe. You might feel frustrated about these constant complaints without any action, and, as a result, you might decide to seek out the exact numbers of crimes in your area, to see if there has been a rise, or whether this is just perception. It is arguable that you are adopting a group role here, and that might be the role of ‘information-gatherer’. 

There is theory to explain why you may feel compelled to become the ‘information-gatherer’. In a paper called ‘Functional Roles of Group Members’ Kenneth Benne and Paul Sheats wrote about group roles and, in doing so, they identified several roles, including the role of ‘information-seeker’. Here are some of the group roles, and you can see that Benne and Sheats organised them into three different categories: 1. Group task roles; 2. Group building and maintenance roles; and 3. Individual (or dysfunctional) roles –
“Group Task Roles
Initiator-Contributor – suggests new ideas and ways of looking at problems or goals.
Information Seeker – asks for clarification and for supporting facts and authority.
Opinion Seeker – asks for clarification of pertinent values.
Information Giver – offers ‘authoritative’ facts or generalisations or relates relevant aspects of his or her own experience.
Opinion Giver – states belief or opinion, emphasising values rather than facts or information.
Elaborator – spells out suggestions (eg with examples), offers a rationale for proposals, and explores likely implications of proposals if adopted.
Coordinator – shows or clarifies relationships among ideas and suggestions, tries to pull them together, tries to coordinate activities.  
Orientor – defines the group’s position with respect to its goals by summarising what has occurred, identifies departures from agreed directions and goals, or raises questions about the direction discussion is taking.
Evaluator-Critic – assesses suggestions, etc, and questions their practicality, their logic, the facts, the procedure.
Energizer – prods the group to decision, action, ‘higher quality’, etc.
Procedural technician – expedites ‘group movement’ by performing routine, tasks, etc.
Recorder – writes down suggestions, records group decisions, acts, etc. As the ‘group memory’.
Group Building and Maintenance Roles
Encourager – praises, commends, agrees with and accepts the contributions of others. Conveys warmth and solidarity.
Harmonizer – attempts to reconcile disagreements, relieve tension by joking, etc.
[There is also the Compromiser, Gatekeeper/Expediter, Standard setter, Group Observer/Commentator and the Follower *** ]
Individual [or ‘Dysfunctional’] Roles
Aggressor – may seek to deflate the status of others, express disapproval of the values, acts and feelings of others, joke aggressively, try to take credit for another’s contribution.
Blocker – tends to be negative or stubbornly resistant, to disagree and oppose without and beyond reason, to reopen issues after the group has dealt with them.
[There is also the Recognition Seeker, Self-Confessor and Playboy [or Playgirl] *** ]
(*** For a full set of the group roles, please see ‘Functional Roles of Group Members’ - Journal of Social Sciences, Vol. 4, Issue 2)

So you may ask: So what? This is all very interesting on a theoretical level, but what does it mean for me? With awareness of the group role we may be adopting, we can see that

1.    There is a purpose for our behaviour. If we each adopt different roles, this might help achieve the tasks that the group has (consciously or unconsciously) formed to achieve. Knowing this can often counteract the frustration we initially felt when we thought that we were always the one who was doing all the work. Instead, we might see that each group member is still working in a way that fulfils a particular group role. 
2.    Conversely, we might see that we are the only one who is adopting a task role, and others are adopting dysfunctional or individualistic roles. With this awareness, we are in a better position to assertively challenge this dysfunctional behaviour.
3.    We can be flexible as the needs of the group develop. For example, once we have achieved the task of information-seeking, we might need to then adopt the role of information-giver. To know what roles are required of us, we need to understand what stage our group has reached in terms of group development. As a result, we will turn to the second aspect of group dynamics, and that is ‘group process’. 

Group process
Groups usually develop according to a predictable process. My favourite way of putting this is Bruce Tuckman’s approach: 
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1.    Groups form, when there may be a lack of group cohesion, a lack of certainty as to which group roles each member should adopt, and a dependence on some sort of group leader.
2.    Groups storm, which means that group roles are slowly being allocated, but this may be the subject of dispute as the group establishes itself. 
3.    Groups norm, which means they (consciously or unconsciously) agree on how the group should be, and there is greater clarity in terms of group roles.
4.    Groups perform whatever task(s) they have (consciously or unconsciously) formed to achieve.
5.    Finally, groups adjourn, when the group task(s) have been achieved.

An awareness of group process can help us to understand what is happening, and it can offer the opportunity to become more sensitive to individual group members. For example, if we know that in the early stages of a group we are storming, we will expect more conflict and disruption, and we might be able to develop a healthy distance from this, seeing it as a natural, and important part of the group’s development. The same can be said for child development: If we have a general understanding of certain tasks that are expected of certain stages of child development, we can adopt a more understanding attitude towards that child or teenager.

Talking to a psychotherapist
Without awareness of what is going on, we can fall into a trap, and, as a result, we can end up doing things that we would not have chosen to do. Talking to a psychotherapist can help you to become aware of group dynamics. Once you have this awareness, you can work with the psychotherapist to make an informed choice about how to respond. You may decide to carry on in the same way, but if you decide to make a change, for example, by challenging a group member who is adopting a dysfunctional role, this can be difficult to manage alone. Other group members may have come to expect you to be a certain way, and so, working with the support of a psychotherapist, you can explore what life might be like if you did decide to change, and what strength and resources you have to face this challenge. 

Hope you found this informative.
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

The bully at work:  He might sit right next to you, breathing down your neck as you read this, or she might be the person who conducts your performance review.  It is easy to spot the snarling, curled lip spite of a bully because we daily dodge them during our commute as they shoulder us out the way. We have been ducking and diving out of their way since the school playground.
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However, unlike the school playground bully from our past, or the shoulder-shover on the train this morning, there is no escape from the work bully.  We can hold our breath for a train journey, but to face a work bully for the entire day, every working day, can sometimes be more than we can endure. Changing jobs is drastic, and sometimes not even an option, especially in this fragile economy.  We have all heard the statistics about lost work days due to stress, anxiety and depression.  So what can we do to withstand this?  If we cannot change what is happening to us, perhaps we can look at ways to strengthen our resolve.  To befriend the bully from within.

As I am an integrative psychotherapist, I work with clients to find the approach that suits them.  You might find one or more of the following approaches might be useful to befriend the bully from within –

Karpman’s drama triangle (Transactional Analysis)
Bullying can be an act of overt or passive aggression.  In addition, as situations are often fluid, we adopt different roles in response to different circumstances.  As a result, the ‘bully’ label is often not fixed.  Only the honest amongst us can admit that we all have the potential to become a bully at certain points in our lives.  Just as any one of us can adopt the role of ‘victim’ or ‘rescuer’.

A concept from Transactional Analysis is Karpman’s drama triangle:  In social situations we can sometimes adopt one of the following roles:  Persecutor, Victim or Rescuer.  If one person is leaning in one direction (for example, they are becoming a Victim), that can often make others appear as if they are adopting one of the other roles (they are becoming the Persecutor or the Rescuer).  As a result, people perceive each other in terms of these contrasting roles, without recognising that we have elements of each in all of us.

By adopting one of these roles, there is often a payoff.  If we become the Victim, for example, we might be protected by a Rescuer in our life.  We do not have to go to the effort of rescuing ourselves.  If we adopt the role of Persecutor, we do not have to accept the pain of recognising that we all have vulnerabilities.  Our tendency to adopt one of these roles can often be subconscious, so it is hard to challenge this alone, but the more we recognise that these roles exist, the more likely we are to challenge this, and avoid viewing a situation in such a simplistic way as consisting of a Persecutor (or ‘bully’), a Victim and a Rescuer.
To view the ‘bully’ as a whole person, rather than simply the Persecutor – 

• See the workplace bully as someone who is probably acting in fear. Aggression, whether it is overt or passive, is born of fear, so if we just see the aggressive behaviour, we have missed a trick.
• A bully often feels inferior, and so their behaviour is a way of managing that perceived inferiority.
• When you interact with the workplace bully, make eye contact and remain civil, even if the bully has descended into childishness

 
‘Pain’ Management (Mindfulness; Cognitive Behavioural Therapy)
To befriend the bully, we need to learn how to tolerate the discomfort.  I have worked with clients who have been living with a physical condition which causes them chronic pain, and together we have tried out the following suggestions that you might like to try to manage the ‘pain’ this bully causes you –

• Enter into the ‘pain’. Really tune into the thoughts, feelings and bodily sensations this bully evokes in you.  Become aware of, and accept, what is, rather than trying to ignore it, or fear the future uncertain.  Try to be specific when you describe these experiences, but at the same time recognise these thoughts, feelings and bodily sensations as simply thoughts, feelings and bodily sensations.  If you allow yourself to experience a distance from these, you may be able to see that they are often temporary.  They are not the whole of you.
• If entering the ‘pain’ seems overwhelming, anchor yourself in the moment by focusing on your breath. Allow thoughts, feelings and bodily sensations to come and go, but keep returning your attention to each breath.  Ask yourself ‘How uncomfortable is it right now?’ rather than fearing the future uncertain.
• Manage your expectations. It is probably unrealistic to expect to never suffer any ‘pain’ from this bully, and so you will set yourself up for disappointment.
• Caricaturise the bully. In the privacy of your own home, draw him with distorted features and give him a comedic name.  This can offer you distance from his aggression. 
• You can try all sorts of affirming statements including: I am choosing to go to work today.  I have strength to withstand this situation.  There is more to me than my working life. 
• Give yourself space when you need it. This can even be in a toilet cubicle, or a refreshing walk during a lunch break
• Give yourself a few minutes each day to stop and become aware of your breathing, letting thoughts, feelings and bodily sensations come and go without resistance or challenge
• When you leave work, try as much as you can to leave it behind. Change your clothes when you return home, and resist working at home.

 
Assertiveness (Cognitive Behavioural Therapy)
Whether it is the person who is perceived to be the ‘bully’, or the person perceived to be the ‘victim’, either party may feel that the situation has arisen because either party has an issue with assertiveness.  No one is assertive all the time, so to assess how assertive you are in a situation, ask yourself:  ‘How much do I act on other people’s wishes at the cost of my own?’  If you are frequently doing this, and it is causing you difficulties in your life, you may need to consider working on your assertiveness.

Assertiveness includes the ability to ask for something but also the ability to say no.  Consider the following points when you think about times you have asked the work bully for something, or when you have had to say no to him –

• Watch for inappropriate smiles or apologies
• Keep it brief, speak clearly and confidently
• If you are unsure, if you feel unable to answer immediately, ask for more information. If you are still unsure, state clearly that you will need to think about this and you will come back to him with an answer at a later date
• If you have given your view and the work bully keeps asking the same question, trying to force you to change your mind, consider yourself like a strong old tree swaying in the wind: Simply repeat your point without changing it.  You can empathise with the work bully’s position without having to alter your own position in any way:  For example, ‘I understand you are under pressure to have an answer today but, based on the information I have at the moment, I will not be able to offer you an answer today.  I will, however, come back to you first thing tomorrow with an answer’. 
• Don’t use the phrase ‘I cannot’ when you mean ‘I will not’
• Avoid blaming others

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

Bullies are not just in the classroom.  They are lurking at the back of a meeting room, and on your daily commute, and, worst of all, in the places you have to frequent with your family (the shops, the swim club)

Here is an infographic of some quick tips to handle a bully.  If you take nothing else from this, remember to turn them into a caricature (in your mind, not out loud!)

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

This summer marks the 50th anniversary of the Stonewall riots.  We are an aging population, and yet how well does our society handle the needs of an aging LGBTQIA+ community?
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There is a severe case of under-reporting of discrimination against the LGBTQIA+ community, so we need to bear this in mind when we read reports claiming that 8.3 percent of “LGBT elders” have been “neglected or abused by a caretaker due to their sexual orientation or gender identity”.  I am pretty sure the number is much higher than that. 

As pointed out in an article by Sage USA (an advocacy service for LGBT elders):
“LGBT older people have lived through decades of stigma and discrimination by their peers, families, and society’s systems of care. For much of their lives — and still for some people, especially trans folks — LGBT people could be fired, involuntarily hospitalized, arrested and prosecuted, and worse by the very societal systems designed to protect people. Because of that, LGBT people carry a tremendous amount of fear and concern about mistreatment.”

The article was released last year, and it reported a lawsuit by Marsha Wetzel against a senior housing facility.  Wetzel claimed the facility failed to keep her safe from discrimination:

"After losing her partner of 30 years to colon cancer — which followed being shunned by her adult son, being evicted from her home, and getting shut out of the family by her late partner’s relatives. “No one would drive me to her funeral.”

Experiencing discrimination is a form of trauma, and so is concealment of a person’s sexual or gender identity.  There are studies that claim that concealment can produce symptoms similar to PTSD (Post-Traumatic Stress Disorder): hypervigilance, a distorted sense of blame, a diminished interest in activities, difficulty sleeping or concentrating, and self-destructive behavior. If you couple this with the other demands of ageing (physical health, isolation, financial issues), you are bound to see a significant impact on a person’s mental health.

As we look back over the last 50 years of achievements by the LGBTQIA+ community, we need to also look forward, and anticipate how we are going to meet the unique needs of an ageing LGBTQIA+ population.

If you are struggling with depression or anxiety, one of the first steps is to identify your methods of self-care.  There are endless ways to look after yourself, and everyone has their preferences, but when depression weighs heavily, or anxiety burns through our every vein, we can forget even the most basic things.
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You could ask someone to help you to make a list of all the potential ways people can exercise self-care.  I have my own list of self-care items, and reading fiction and drinking hot chocolate are just two. 

Once you have brainstormed as many different methods of self-care as possible, choose the ones you want to appear on your own list.  Which one are you going to choose for today?  And when are you going to do it?  When I finish this blog post I am going to give myself a small amount of time to lose myself in a Margaret Atwood novel.
Depression or anxiety is difficult to manage alone.  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

There are plenty of headlines about blunt and crass remarks made by world leaders. And in the working environment, I am sure we have witnessed similar comments.  Nothing new there. But recently there has been a tendency to explain away these comments, even an attempt to justify them as signs of an ‘assertive leader’ because they are ‘telling it like it is’. Let’s be clear: blunt and crass remarks are signs of a weak leader who is too afraid to let anyone disagree. It is a fear-driven attempt to manipulate people into agreeing with them, and this is an example of aggression, not assertiveness. 

It is not just world leaders who exert themselves with aggression. I have worked with clients who have suffered stress and anxiety which is the direct result of aggressive behaviour from a manager or colleague. I have also worked with managers who have felt trapped in a toxic work environment, and it has taken a long time for them to realise that the conflict at work was due, at least in part, to their own aggressive managerial style. 

I am going to place a bet on the basic goodness of mankind and assume that most leaders do not intend to lead using aggressive behaviour. Perhaps they just know no other way of relating to people, or they do not realise that squeezing out the views of others is simply not okay. They may not even see or hear the views of others, because if they have never been taught to watch and listen, how could they? 

In a study published in 2014 Daniel Ames and Abbie Wazlawek found that there was a significant difference between how a worker viewed himself compared with how his colleagues viewed him (Pushing in the Dark, Columbia University): A “large share of those seen as showing too little or too much assertiveness appear to be unaware” and “many people seen as getting assertiveness right mistakenly think they are seen as getting it wrong”. Ames and Wazlawek strikingly conclude: “oblivious jerks may indeed be as common as knowing ones and unwitting pushovers may indeed be as widespread as self-conscious ones”.  But also, to their surprise, they also found that “many of those seen as having the right touch think that they have gone too far.

So what might explain this discrepancy? It might be a genuine case of lack of awareness, on behalf of the leaders, or perhaps the actual employees. Or it might be that people don’t really understand what assertiveness means. 

Assertiveness sits in the middle of a spectrum where aggression is at the one end and passivity is at the other –

Aggression = Leaders are aggressive when they attempt to dominate others without respecting the rights or boundaries of others.   
Passivity = The opposite of aggression is a failure to communicate one’s needs, and/or to allow others to encroach on your boundaries. Sometimes this is as a result of fear of, or failure to, assert one’s rights. This behaviour can also be an attempt to manipulate someone into doing something that they want.
Assertiveness = Assertive leaders communicate their own needs in a way which respects the rights of others.  They listen carefully to those around them, and they are flexible in their approach. It is a careful balancing act of maintaining one’s own boundaries without encroaching on the boundaries of others.

Nobody is assertive all of the time. We can all lean towards aggression or passivity, depending on internal factors (such as anxiety, depression, stress levels), and depending on external factors (for example, we may become passive around certain types of people). But to maintain more of a middle ground on this spectrum, here is a quick reminder of the seven sides of assertiveness –

1.    Assertiveness includes the ability to make requests, to say no, to give and receive compliments, and to give and receive criticism. To evaluate your own level of assertiveness, ask yourself: ‘How easy is it for me to do these things? For example, how much do I do what I want to do, and how much do I do what others want me to? How easy is it to say no?’ 
2.    It might be useful to carry out a cost-benefit analysis in order to assess whether you should assert yourself in any given situation. There may be good reasons for not asking for what you would like.
3.    When you attempt to communicate assertively, keep it brief and get to the point.
4.    Make sure you do not offer inappropriate apologies or smiles. Also, do not expect them to agree with you, or you expect them to say no.  You are assertively communicating how you view the situation, or what your needs or feelings are. You are not seeking their approval of these.
5.    Some have offered the image of a swaying tree when they try to describe assertiveness. It may sway a little in the winds of challenge, but it remains rooted in the ground. In the face of a challenge, a calm repetition of your position is all that is needed to demonstrate assertive communication. If it helps, try and imagine that you have your two feet placed within a box, and this is your own space for your own views, feelings and needs. You can describe this viewpoint to other people but they do not have to accept it, just as you are not under any obligation to accept the viewpoint of others.
6.    If you continue to be challenged, you can communicate empathy with the other person’s position, and perhaps even offer alternatives.
7.    A useful tactic is to ask for more time, or for more information. You do not necessarily have to offer a response there and then.

Assertiveness requires self-awareness, but it also requires a certain knowledge of how others perceive our behaviour. As Ames & Wazlawek point out, this can be quite difficult as this relies on feedback from others. This is not always going to be forthcoming or as candid as we would hope for, especially if it is feedback from a current work colleague or line manager. As Ames and Wazlawek put it, “we are often pushing in the dark and our counterparts may sometimes be complicit in turning out the lights—or even firing up a beacon that leads us astray”.

According to research, assertiveness ‘is a highly valuable characteristic’ and ‘leaders who are perceived as being more assertive are also perceived as being more honest and having higher integrity than those who are not’ (Joseph Folkman, Forbes). Some say that assertiveness can also lead to a less stressful lifestyle. If you feel able to communicate your needs, and you have stronger, healthier relationships as a result, it is arguable that this would make life a little less stressful. I have not yet seen hard empirical evidence to say one way or the other, but coming across a little less like some of our world leaders may be a strength to be proud of.
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

I was once told that physical conditions such as hepatitis and diabetes are not my concern.  ‘As a psychotherapist’, the person said, ‘you should focus on the emotional needs.  Leave the physical ailments up to the doctors’.

I happily ignored this person.  I know that to live with a physical condition can have a significant impact on one’s emotional wellbeing, and if someone’s emotional wellbeing is suffering, this can often have an adverse impact on the way that they take care of their physical health.

Today is World Hepatitis Day, and last month we had Diabetes Awareness Week.  I had noticed that both conditions seemed to receive little attention compared to other conditions, such as HIV and the various cancers, and yet hepatitis and diabetes can have a significant impact on a person’s physical and emotional wellbeing.

Hepatitis
The World Hepatitis Alliance states that ‘worldwide 400 million people are living with hepatitis B or C, and every year 1.4 million people die from viral hepatitis’.  A significant number of people with hepatitis also have depression.

At a recent Hepatitis C & Chemsex training event for health professionals, a speaker stated that treatment success for hepatitis C (often referred to as the ‘silent killer’) is relatively high but the following issues can often arise –

• In this country there is a lack of funding for the right sort of treatment
• Not enough people are getting tested – treatment can only be used on those who have been diagnosed
• Even if people get diagnosed, not everyone is adhering to the treatment
• Even if people get diagnosed, and adhere to the treatment, there is an issue regarding people becoming re-infected. Treatment is not a permanent cure

 
Diabetes
Diabetes UK states that 6% of the population in the UK is living with diabetes.  According to Dr Mark Pemberton, in an article in the Spectator, there is a greater risk of stroke for those who have type 2 diabetes.  In addition, ‘people with diabetes are four times more likely to have cardiovascular disease’ and ’20 to 30 per cent of people with diabetes’have damage to the kidney filtering system.  Statistics also show that a significant proportion of people with diabetes have depression. 

How a psychotherapist can help
If we accept that physical and emotional wellbeing is entwined, what are the different ways that a psychotherapist can help someone who has a physical condition such as hepatitis or diabetes?

• On initial diagnosis, clients are often anxious or depressed because they feel overwhelmed by the enormity of the diagnosis.  Talking to a trained expert can offer someone an opportunity to break down the concerns into manageable pieces. 
• By talking to an expert, someone with a physical condition will be able to see that the physical condition is not the full extent of their identity.  They will be able to see all the other aspects that make up their life, even if these other aspects have been somehow altered by the condition in some way
• A diagnosis is often about change:  someone’s body might change, or their significant relationships, or their lifestyle, or their work life.  Talking to a trained expert can help someone to make sense of these changes, allowing them to plan for what they may do about these changes
• A psychotherapist can help someone tolerate the uncertainty that the condition has created.  Suddenly the world will not seem like such a predictable, controllable place, and this can trigger significant anxiety.  It can be helpful to have a trained expert there to accompany someone through this anxiety, helping them to tolerate a measure of uncertainty, but also helping them to see where they may still have control over their life
• There are many myths surrounding physical conditions such as hepatitis and diabetes.  A client might need to work through experiences of discrimination and stigma, or the daily frustration of people being generally inconsiderate.
• It isn’t all about talking – Some clients find it helpful to draw out their feelings about the condition, and often the client will want to do something significant with that drawing, such as tearing it apart or stamping on it.  I have also worked with clients who have given the condition a name and spoken to it, sometimes even shouting at this unwelcome intruder

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 
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Here is an infographic to summarise how you can drain anxiety from your world. All of us believe that we have no time for relaxation, but we can schedule it in. Even if it is for a small part of the day. The same can be said for including mindfulness in our daily life

We should also consider whether our anxiety is telling us something important. Perhaps something needs to change, and we are avoiding making this change

Finally, monitor our thinking patterns for any unhelpful assumptions. For example, is our anxiety caused by irrational assumptions we might be making about ourselves or others

Have a look at this infographic, and let me know what you think

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
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