​If you only feel good about yourself when you achieve something, you are fighting a losing battle. Albert Ellis called this an ‘irrational belief’ which is bound to cause emotional distress.
 
We all fail, and we learn from our mistakes, so try and align your sense of self-worth with the actual fallible you.  not some idealised future-never-going-to-happen you.

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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Joshua G. Parmenter offers us clinicians some useful advice for helping transgender and gender non-conforming clients (TGNC):

1. “Validate and believe the client’s experience and reactions”, particularly when assessing for trauma
2. “Develop self-advocacy skills as a way to build resiliency when combating discrimination and oppression”
3. Target “rigid cognitive schemas about masculine ideals held within institutions, organizations, or even perpetrators of violence that favor cisgender masculinity”
4. Become “social agents of change” because there are no non-discrimination laws “that provide universal protection for TGNC individuals in the United States”
5. Create “positive and affirming environments, not only within organizations, but also within our legislation and government”

 
Thank you, Joshua, for these excellent action points

Read more at the LGBTQ+ therapy page.
An initial telephone consultation is free.  Book this by clicking on the link below, or calling or emailing Chris Warren-Dickins
Online booking – https://app.acuityscheduling.com/schedule.php?owner=16644928
Telephone – +1 (201) 862-7776
Email – chris@exploretransform.com

We all know that a sustainable relationship requires empathy.  But here Dr Dan Siegel discusses five types of empathy.

How many of these have you recently experienced in your relationship? And could a knowledge of these help to deepen your connection? -  
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1. Empathic resonance - When you experience the feelings of someone else (you feel excited when someone else feels excited)
2. Perspective taken – You put yourself in someone else’s position, and see things how they would
3. Cognitive empathy – An appreciation of the influence of memory and emotion on perspective
4. Empathic concern – Compassion (I feel your feelings, and I want to help)
5. Empathic joy – I get excited about your happiness

Read more at https://www.exploretransform.com/couples-therapy-ridgewood.html

An initial telephone consultation is free.  Book this by clicking on the link below, or calling or emailing Chris Warren-Dickins
Online booking – https://app.acuityscheduling.com/schedule.php?owner=16644928
Telephone – +1 (201) 862-7776
Email – chris@exploretransform.com

There is no doubt that we are now deeply immersed in a digital world.  But to what extent can we say that there is such a thing as ‘digital addiction’?

A generally accepted definition of addiction is: ‘Not having control over doing, taking or using something to the point where it could be harmful to you’.  Arguably, this definition could apply equally to a person’s use of digital devices (such as smartphones) as it does to a person’s use of drugs or alcohol.  But others disagree.  In an article in the New Yorker, Maria Konnikova points out that there is a distinction to be made between ‘substance addictions’ and other types of addiction, and the key difference is that ‘a substance affects a person physically’ because ‘something new’ has been introduced to your ‘bloodstream’ in a way that other behaviour does not. 

Unlike addiction to substances, digital addiction is often categorised as a ‘behavioural addiction’, along with other types of behaviour such as gambling addiction.  However, unlike gambling addiction, digital addiction was not included in the fifth edition of the Diagnostic and Statistical Manual (DSM).  Some say that this is simply because we are in the early days of digital devices, and it is only a matter of time before we gather sufficient evidence to support its inclusion.  But as Konnikova pointed out in her article, ‘there’s something different, and more complicated’ about digital addiction:  ‘Unlike gambling’, the internet ‘is a medium, not an activity in and of itself. If you spend your time gambling online, maybe you have a gambling addiction, not an Internet addiction. If you spend your time shopping online, maybe it’s a shopping addiction’.

No matter what the conclusion of this debate, the job of the psychotherapist would be to work with a client to explore the following questions:

• What does this behaviour mean to the client?
• Has the client lost control of their use of digital devices?
• Is this behaviour harmful?

Often when these questions are explored, a key lightbulb moment is the realisation that the client is no longer in control of their behaviour.  The harm is often obvious, and it is sometimes the reason they have come for psychotherapy, but it is only when they realise that they no longer have control over their behaviour that they accept that they are addicted.

So how can a psychotherapist help someone who is addicted? 

• A lack of connection and Cognitive Behavioural Therapy (CBT)–

In an article in Huffington Post, Johann Hari suggested that addiction was a person’s reaction to a lack of connection.  In his article Hari quoted Professor Peter Cohen when he said:  ‘Human beings have a deep need to bond and form connections’ and ‘if we can't connect with each other, we will connect with anything we can find -- the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about 'addiction' altogether, and instead call it 'bonding.' A heroin addict has bonded with heroin because she couldn't bond as fully with anything else.  So the opposite of addiction is not sobriety. It is human connection’. 

A psychotherapist might explore with the client whether this is something that rings true, and if it is, the client can look at alternative ways to create that connection.  This is likely to be an approach followed by a Cognitive Behavioural Therapist as they focus on a client’s thoughts or assumptions.  Cognitive Behavioural Therapists offer their clients the opportunity to identity their thoughts or assumptions (for example, through Socratic questioning), and once these have been identified, they are able to challenge (and sometimes change) the unhelpful thoughts and assumptions.

• The addiction cycle and the multimodal approach –

Some clients find it helpful to look on addiction as a cycle, and by viewing it this way, they can see how to break that cycle.  Arnold Lazarus, who used what is known as a multimodal approach to therapy, referred to addiction in this way.  He said that ‘the individual in stress situations makes a number of different responses, one of which might be’ engaging in certain behaviour ‘which affords him temporary relief.  Repetition...eventually leads to a conditioned response between stress and’ further engagement in that behaviour.  ‘This may soon occasion feelings of guilt ... which in turn adds to the already mounting stress.  This 'self-perpetuated stress' precipitates further behaviour, which in turn creates the addiction.

Lazarus argued that this vicious cycle must be broken at several strategic points, and so he suggested the multimodal approach, which examines a client’s addiction from each of the following perspectives (BASIC ID):  Behaviour, affect (feelings), sensations, imagery, cognition, interpersonal relationships and drugs.

• Mindfulness –

Some clients find mindfulness to be a useful approach to an addiction.  Mindfulness starts from a place of awareness, so the client is simply noticing how they are with their digital devices, they are not trying to change anything.  In order to really become aware of what is going on for the client when they use their digital devices, it might be useful for them to reflect on the following questions –

• How did they feel when they were using the device?
• Did they notice any particular thoughts arising?
• What was going on for them at the time? (For example, was anything happening in their physical environment?)

They should ask the above questions at each of the three following stages –

• Before they used their digital device
• Whilst they used their digital device
• After they had used their digital device

​Whether we like it or not, we are now immersed in a digital world, but that does not mean we have to drown.  No matter what the official term for digital addiction, if this behaviour has become harmful, and we do not have control, we can take control by talking to a trained expert.  We cannot change anything we are not aware of, so the first part of this will involve becoming fully aware of our behaviour, the underlying thoughts and assumptions that drive that behaviour, and the resulting feelings.  Once we are fully aware of all of this, we can look at changing our thoughts and assumptions, our behaviour, and ultimately the feelings that flow from these. ​

Chris Warren-Dickins LPC is a Licensed Professional Counselor in Ridgewood NJ 07450 and Teaneck NJ 07666. To book an appointment, please telephone +1 (201) 862-7776 or email chris@exploretransform.com
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Sometimes just the thought of food can leave us feeling overwhelmed.  It can be the enemy, our only friend, or the annoying pest who just appears everywhere we look. 

Here are 10 top tips to help you manage food addiction.  It is a starting point, and talking to a trained professional can help build on these initial steps
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1. If you have lost control of the amount of food you eat, and it has become harmful, you are addicted to food
2. Maintaining a food diary can help you to see, in black and white, your habits around food.  Sometimes we distort reality by merely thinking about it, but writing it down makes it more concrete 
3. Really challenge yourself to reflect on what food means to you.  Is it merely fuel to survive, or is it a means of coping with difficult times? 
4. Try to identify the ‘hot spots’ when it comes to food.  Do you tend to reach for chocolate during times of stress?  Do you tend to overdo it on coffee first thing in the morning? 
5. Once you are aware of the hot spots, you can put things in place to make a change. For example, if you anticipate a stressful period, try to schedule a relaxing run at the gym, rather than relying on the chocolate bar
6. Try to identify the ‘maintaining factors’ that keep you caught in this food addiction. For example, are you in a relationship where food is also an issue for that partner?  Working together to manage this can often work much better than trying to go it alone
7. Cognitive Behavioural Therapy (CBT) can help you to examine the thoughts and assumptions that are attached to food.  For example, you might catastrophise each time you give into the temptation of having more food.  You might overlook the moments when you have managed to resist the problematic food.
8. Adopt a kinder voice.  Try to congratulate yourself for the times you were able to resist, rather than constantly punishing yourself for the slipups.  The trouble with punishment is that is fuels the guilt, which may ultimately lead you to eat more in an attempt to feel better
9. You can learn from the positives.  Instead of focusing on all the times you ate chocolate, when did you not?  Do you notice any patterns about those positive moments when you did not eat the problematic food?  You might learn from these moments how to set up more of the same, and increase your chance of breaking the cycle of addiction
10. Mindfulness can help you to become aware of the present moment, and this can reveal what might otherwise have become automatic behaviour (for example, reaching for the nibbles during a television programme or as you read an article about food addiction)

Chris Warren-Dickins LPC is a Licensed Professional Counselor in Ridgewood NJ 07450 and Teaneck NJ 07666. To book an appointment, please telephone +1 (201) 862-7776 or email chris@exploretransform.com

I have written before about the importance of social connection.  Previously I pointed to a link between the lack of connection and addiction. 

​In this fantastic talk by Dr Ryan McKelley he highlights the need for connection when considering how we help men. Dr McKelley suggests that it is a mistaken belief (stereotype, in fact) that men are less capable of emotional connection:  “Studies show when men's physiological responses to emotional stimuli are measured, their internal experience is similar to that of women.”

Have a look - it is worth it!

Someone once spoke of the beauty of a tiger lily.  It was beautiful not because it crouched down, for fear of being discovered.  Instead, it stood proudly reaching for the sun.  The pride was its beauty, and its strength. Stand tall, strand strong, and stand proud.  And the beauty will shine

An initial telephone consultation is free.  Book this by clicking on the link below, or calling or emailing Chris Warren-Dickins
Online booking – https://app.acuityscheduling.com/schedule.php?owner=16644928
Telephone – +1 (201) 862-7776
Email – chris@exploretransform.com
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If I read one more tweet about standing still and enjoying life, I may throw a yoga mat at the cat.  Just as much as I have rushed around and felt frazzled by the demands of life, I have been guilty of these tweets.  Sometimes the fizz can be taken out of stress by standing still, taking stock, and being in the moment.   Sometimes a little bit of mindfulness, or reading The Power of Now, can help.  But sometimes this is not enough.
 
It is okay to live under a little bit of pressure, because we all need this to keep going.  But too much pressure can lead to stress, which means to burn out, or to break.  Stress can show itself in a number of different ways, but the common symptoms include racing thoughts (or even a blank mind), palpitations, nausea, tightness in the chest, and breathlessness.  We all know that stress is unhealthy, we do not need to go into that.  But if we work, and if we have children to care for, it is not always realistic to expect to have time to put our own needs first.  This is especially so if we are working in a busy city where overcrowding is an issues.  What makes things worse for us city-dwelling working parents, studies have found that people who lives in cities are at greater risk of developing mental health issues (for example, The current status of urban-rural differences in psychiatric disorders, Peen J, Schoevers RA, Beekman AT, Dekker J).
 
Sometimes a huge step towards stress reduction is realism.  If we are realistic with what we can achieve, then the weight of expectation is instantly lifted.  We might hope to achieve some sort of ‘downtime’, but if we limp towards the weekend without a moment to stop, then that should not be viewed as another failure.  There may be things we can change, but we have to accept that sometimes we have set things up in a way for a particular reason. 
 
Instead of jumping straight into relaxation exercises or mindfulness, we first need to understand what makes us tick, or to use another phrase, we need to understand our process.  Our ‘process’ includes
 

• The assumptions we make about us, our loved ones, and the world around us.  Albert Ellis, the founder of Rational Emotive Behavioural Therapy, stated that there are three basic assumptions that cause stress:
  • Assumptions about the world (for example, the world must be a fair place),
  • Assumptions about others (for example, others must be kind and fair to me), and
  • Assumptions about ourselves (for example, I must be hard working and successful)

Once we change these assumptions, or ‘must’ statements into preferences (for example, ‘I would like to be successful’ rather than ‘I must be successful’), then, if things do not work out as planned, this can de-awfulise the situation, and alleviate the stress.

• Our ‘process’ also includes
  • Our values, which essentially means what we view as important in life,
  • Our triggers (for example, we might tend to get stressed about work more than home life),
  • Our relationships (how we view the quality of our relationships, and how we tend to relate to people), and
  • How we regulate our emotions, and whether we have certain tendencies (for example, we might tend to be more anxious or depressed than others).

Once we understand our process, we have more information to see why we might be how we are.  We can then adopt a kinder voice when things don’t necessarily go to plan.  For example, if you fail to find time for yourself, perhaps this is as a result of choices you have made, and those choices have been informed by your values.  Once you change a perceived failure into a choice, life feels more in control than before.
Then there are the blind spots.  We may feel like we have no time whatsoever, but perhaps we are not looking hard enough.  Time to unwind, to practice mindfulness or just be in the moment, can be a few minutes each day.  It could be that we use part of the journey into work, or a moment on the toilet, just to stop our minds racing, and check in with what is happening in that moment.  What are we aware of?  Are we short of breath?  Are our minds racing round corners of future uncertainty?  We do not have to achieve anything in that moment other than just to stop.  And sometimes that can be enough.  If not, perhaps it can give us a little more space to realise what we do need.
There are plenty more ways to combat stress, and perhaps you have encountered some of these.  I have set out below a handful of tips, and I have also included a very simple relaxation exercise.  The key point to take away from this is forgiveness.  If you manage to remember a few of these tips every now and again, brilliant.  The worst thing you can do is use these to beat yourself up, adding further stress with the idea that you are somehow failing –
 

• Ask for help when you need it.
• Be flexible whenever you can.
• Be clear what being assertive involves, and practice it when you can.  I have set out below a link to my assertiveness article.
• Don’t try to tackle a project but approach each task in turn.
• Make use of your calendar.  You can never get through your ‘to do’ list in one go, so perhaps schedule certain days for certain tasks.
• Try not to blame others.
• Be open to feedback (giving and receiving).

 
Quick and easy relaxation exercise  –
 

• Make some space in your day, whether that is a few minutes, five or fifteen.  Just knowing that you have that space can help with the relaxation process, because you can look forward to it when you are busy.
• During that time period –
  • Breathe in gently and hold your breath for a few seconds.
  • Breathe out so that you can hear the exhalation of your breath.  Notice the breath as it goes out. Is it cool or hot, is it strong or weak?  Make no assumptions about it but just notice it.
  • Breathe in again and hold for a few seconds.
  • Again, breathe out and notice the exhalation. 
  • Repeat for your allocated time.

Chris Warren-Dickins LPC is a Licensed Professional Counselor in Ridgewood NJ 07450 and Teaneck NJ 07666. To book an appointment, please telephone +1 (201) 862-7776 or email chris@exploretransform.com

​It is thought that 2.6 in every 100 people suffer from depression (Mind).  As common as it may be, and sometimes it is even patently clear that it is right there in front of us, it is rarely talked about.  Winston Churchill described depression as the ‘black dog’ but it seems that it seems more to be the elephant in the room.

When I start working with a client who is depressed, we look at all the potential causes, whether that is in the present, the past, an unhelpful way of thinking, or even an unhealthy relationship.  It is important to have as open a mind to the potential causes, and it is rare that the depression is attributable to one factor. 

Once we have a clear idea of what might be the potential causes, the difficult part is to challenge the status quo.  This is difficult because we often develop ways of living for a very good reason.  For example, as a child it might have been easier to believe that we were intrinsically a bad person, if this meant that it made sense of the cruelty inflicted on us by a parent. 

To let go of the belief that we are intrinsically a bad person, and so deserving of the cruelty, we have to identify, and gently start to challenge, our distorted thinking.  We need to reality-test our assumptions and replace these with more rational ways of thinking.  But how can we do this?  Here are some examples of distorted thinking, and how we can challenge these–

Perfectionism
Depression often makes us believe that we cannot do anything unless we do it perfectly.  If we do not challenge perfectionism, we will end up caught in the depression cycle.  This is where your negative thoughts cause a low mood and you end up less willing to engage in the activities you previously enjoyed.  As a result, the reduced activity will lead to further negative thoughts, and a lower mood, and even less activity.  To challenge perfectionism - 

• Consider the fact that there is an important learning process involved with making mistakes
• Open yourself to the moment.  There may be a certain level of enjoyment by simply experiencing the task, rather than placing expectation on any certain result.
• Realise that many people feel more comfortable with someone who is less than perfect
• Do not avoid activities, and try to set deadlines for tasks.  Perfectionism often makes someone avoid a task altogether or spend a disproportionately long time on a task.

Tyranny of the 'shoulds'
I often work with clients who are depressed because they believe that certain things should happen (I should, they should), and if these things do not happen, they are left feeling frustrated.  It can be helpful to try and challenge these 'shoulds' in the following ways - 

• Why should it be that way?  Does it matter so much that you end up feeling frustrated and stressed out when things do not go accordingly?
• Once you have identified all of the 'should' statements, prioritise them.  Some will be more important than others, so this might help you realise that your reaction is not always proportionate. Perhaps some are even so low down on the priority list that you could learn to live without them.
• Make sure these 'should' statements are about your own values and not those you have blindly swallowed from someone else.  We all grow up hearing the values of our caregivers, but sometimes these are not values we would consciously choose as an adult.  Choose to let go of those that are not really ours.
• It can ease pressure on the situation if you replace 'I should/they should' with 'I would like....but I accept that this may not happen'.

In parallel with the focus on your thinking patterns and underlying beliefs, you should take care not to fall into the depression cycle.  This is where your negative thoughts cause a low mood and you end up less willing to engage in the activities you previously enjoyed.  As a result, the reduced activity will lead to further negative thoughts, and a lower mood, and even less activity.  Break out of this cycle and set yourself simple tasks to achieve each day.  Include a mixture of different types of activities (social, educational, creative and recreational), and use an activity diary to rate your feeling of achievement for each task.  Do not expect to immediately find these tasks enjoyable, and each day, increase the frequency and number of activities.

I hope you find this useful.  Do get in touch if you would like to discuss any of this.
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Chris Warren-Dickins LPC is a Licensed Professional Counselor in Ridgewood NJ 07450 and Teaneck NJ 07666. To book an appointment, please telephone +1 (201) 862-7776 or email chris@exploretransform.com