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What Is CBT?

Author: Stephanie Camins - MA, LPC

Cognitive behavior therapy (CBT) emphasizes the interaction between thoughts, behaviors and feelings.  Given any event, you can choose to think in positive or negative ways.    A negative, destructive thought about the event will lead to a response which is reactionary, impulsive, and maladaptive.  As a result, negative emotional states such as anger, anxiety, and frustration arise.  When you respond to the same event with positive or neutral thoughts or beliefs, you tend to react in a more proactive, solution focused manner and experience empowering, uplifting feelings.

What is the Goal of CBT?

The goal of CBT is to help develop constructive ways of thinking that will produce healthier behaviors and beliefs. CBT has strong empirical support and is the most widely used evidence-based practice for improving mental health. Studies have documented changes in brain activity, suggesting that this therapy actually improves your brain functioning as well.

CBT is a goal-oriented treatment method. It is "present focused" in its aim to change patterns of thinking (or core beliefs) and the emotions clients feel when being faced with distress or anxiety. CBT suggests that emotions, thoughts, and behaviors all influence one another in powerful ways. It is used to treat patients who have distorted thoughts that are unhelpful and irrational.  These thoughts don’t make sense and there is no evidence that they are true yet they are automatic and feel uncontrollable. Some examples include, “I’m not good enough, I’m unlovable, I have to be perfect, It’s all my fault, I’m a failure, etc.” CBT will help to identify inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.

CBT Can be Used to Treat Many Problems Such As: 

  • OCD
  • Bipolar
  • Perfectionism
  • PTSD
  • Anxiety disorders
  • Depression
  • Grief
  • Sleep disorders
  • Phobias
  • Low self-esteem
  • Better manage stressful life situations.

CBT is most often a 16-week treatment plan which can quickly help you identify and cope with specific challenges.  Skills focus on changing 1. thoughts and 2. behaviors.  Once these two things have improved your emotions will shift.

Cognitive techniques:

  • Identify the 10 thought distortions
  • Learn strategies to restructure these distorted thought patterns
  • Replace negative thoughts with more realistic thoughts
  • Quiet your inner critic

Behavioral techniques:

  • Relaxation
  • Mindfulness
  • Journaling
  • Exercise
  • Organization
  • Goal setting
 CBT will help you to manage many distressful life events from managing symptoms of mental illness to coping with stressful life situations.
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How to Build A Support System?

Author: Stephanie Camins - MA, LPC

Isolation is a major cause of depression in adults. As we move into adult responsibilities: work, parenting, marriages, we tend to let our relationships fade into the background. You may not be exposed to groups of people in your daily life like when you were younger. Many of us have jobs that are isolating.

The trend to work remotely has increased our isolation. In the ever increasing tasks of “adulting,” self-care often takes a back seat. Self-care includes Physical, Psychological, Emotional, Spiritual, Personal and Professional tasks. A healthy support system plays a role in all of these categories of self-care.

A support system is made up of individual people who provide support, respect, and care.

These are people who are in your corner. They do not judge you or ridicule you. They provide feedback that is genuine and in your best interest. Their support is not self-serving. They have a positive impact on your personal goals. These people may be close friends, relatives, or simply acquaintances. You may talk to them frequently or just occasionally.

Sometimes your support system includes people in your community.  Any interaction that is friendly and positive leaves you feeling happier. Frequent enough contact with that clerk, barista, or gym mate, is the foundation of building a network.  Any social connection can have a positive influence on your life. Being connected with others is vitally important to your happiness, self-esteem and ability to cope in difficult times. It also has a positive impact on self-acceptance and emotional health.

Most of us recognize the importance of this but it can be hard to build a network of supportive people, and stay connected to the support system we already have. Life is busy. It’s easy to find reasons why NOT to get together or call or email or even text. The excuse list is long:

  • I don’t have time.
  • I don’t know what to say.
  • ​It’s been so long since I’ve talked to them.
  • ​It will be awkward.
  • ​They’re probably too busy.
  • I don’t want to intrude on their life.

We all need people. I’m often asked how to overcome this list and build a support network?

Let's start by make a list of who is already in your corner.

Who do you already have in your life? Make a list of ALL the people you currently interact with. This should include family, friends, neighbors, and acquaintances. Think of your home, your work, your community, your church, your gym, your children’s school, your local Starbucks, any activity you do in your life that you are around people. You can also include professionals such as counselors, teachers, mentors, and clergy.

Go through this list and put a star next to each person who is supportive. Write next to their name what makes them supportive. Answer the following questions.

  • Do I feel respected by this person?
  • ​Do I trust this person?
  • ​Does this person bring out my best qualities?
  • ​Does this person allow me to feel good about myself?
  • ​Do I leave interactions feeling positive?

Make a point to contact these people and ask how they are doing.

How do I Build my Network?

You may find that your list is much smaller than you’d like. If this is the case, what is standing in the way of you building a support network? You may decide that seeing a counselor or talking with another professional advisor such as clergy or personal coach can help you develop your capacity to connect with others in a safe and supportive environment.

You might need help to identify the roadblocks you have created that keep you from connecting in meaningful ways with other people. A few examples of roadblocks include, low self-esteem, lack of confidence, depression, misguided life priorities, disorganization in your life, or difficulty asking for and accepting help from others.

Support systems are only effective if you use them.

Let’s work through the following roadblock example, "I dont like to rely on others." It’s hard for many of us to ask for help. Consider the following questions if this is an obstacle for you in using your support system.

  • When do I ask for help?
  • In what situations have I asked for help in the past?
  • ​When I ask for help, what am I feeling?
  • ​What do I think will happen?
  • Do I have negative or positive expectations?

Identify one situation you are dealing with in your life right now that you are overwhelmed with. Look through the list of supporters you made in this exercise, pick one person you can ask for assistance…and ASK.

Your support system should be just that, supportive. If you find that certain people tend to take much more than they give, if you feel drained after each interaction, this isn’t considered supportive. In relationships there is an ebb and flow to support. Each person takes turns being the supporter as life happens.

However, if this support isn’t balanced it may be time to set healthy boundaries for yourself -See my article: Setting Emotional Boundaries in Relationships

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I've created a helpful e-book:

Boundaries in Relationships

  • Why do People Abuse Relationship Boundaries?
  • Setting Emotional Boundaries in Relationships
  • What Makes a Healthy Relationship?
Stephanie Camins

What Is Resiliency?

A 12 Step Plan to Increase your Own Resilience When Life becomes Overwhelming

Author: Stephanie Camins - MA, LPC

Resilience is referred to often in emotional wellness circles but typically without adequately describing the importance of having or attaining this quality. Any challenging life circumstance that creates a flood of emotion and a perceived loss of control can challenge our ability to cope. Resilience is the human ability to rebuild or come back from difficult situations.

reslience 1

We all cope in some way to extraordinary life events. The positive psychology movement has long focused on the skills people use to navigate major life events. Sometimes negative events such as loss and sometimes positive events such as marriage or a promotion can challenge our ability to cope.

What’s the point of this movement? Why is this important?

The answer lies in the extraordinary number of people who cope in self-destructive ways, ruining relationships and sabotaging anything good in their lives.

Resilience theory states that we all have the ability to cultivate these positive characteristics and traits. Building resilience is a skill set involving thoughts, behaviors and actions which can be learned. It is an important component of PTSD Recovery, as well as, recovering from depression and anxiety. With these skills in place you not only manage the distress caused by PTSD or other major life events, but also inoculate yourself from the adverse effects of negative life events in the future.

Resilient People Display the Ability to:

resilience 2
  • set and move toward realistic goals
  • ​have an ability to look long term
  • accept change as part of life
  • ​engage in active decision making
  • ​engage in self-discovery
  • ​communicate and problem solve
  • actively learn new things
  • ​have an optimistic outlook
  • ​have a realistic perspective of themselves and the world around them
  • ​accept and manage the presence of strong feelings
  • be flexible
  • ​have a positive view of self
  • ​actively engage in self-care
  • build connections with others

As you begin your journey down this road to resilience, focus on your own strengths. Remember what has worked well for you in the past. Who did you reach out to? What activities did you incorporate to reduce stress and anxiety? How have you overcome obstacles in the past? What gave you hope and purpose? Use the list below to develop and execute your own personal plan. The Road Map to Resilience is a task list to increase resiliency. Take your time focusing on each step. It will be helpful as you move through this process to create a journal to keep track of your emotions, thoughts and the actions you take.

Road Map to Resilience – A 12 Step Plan

reslilience 3
  1. Develop Caring and supportive relationships that are filled with love, trust, encouragement and reassurance.
  2. Manage your feelings You will feel strong emotions. Give yourself space to feel them. You can regulate emotions by focusing on positive emotions, such as, hope, courage, and happiness and decreasing the focus on negative emotions, such as anxiety, depression, frustration, anger, and resentment. To decrease these uncomfortable emotions, it’s important to remember to give yourself permission to feel these feelings, get support when needed and then shift your focus. Denying feelings only intensifies your reaction. Feel and release is a good rule of thumb here.
  3. Build on your strengths Remember to celebrate small achievements.
  4. Have positive expectations and expect things to turn out for the best. Visualize what you want rather than focusing on a negative outlook. Reframe negatives to positives, look for the silver lining in situations, others and yourself. Difficult life events happen. What lessons can you learn from adversity? How can you help others in a similar circumstance?
  5. Practice positive self-talk rather than engaging in self-sabotaging thoughts.
  6. Engage in activities which increase self-confidence including hobbies, personal development and work projects. Do what you love, what you’re good at and take action daily.
  7. ​Increase positive physical behaviors such as exercise, healthy eating, and good sleep habits. Develop regular routines.
  8. Create meaning and purpose
  9. Set SMART goals to increase and enhance your sense of self-control, mastery and competence, break tasks down to achievable parts, prepare and plan for setbacks, commit to hard work. Identify one thing you can accomplish today in the direction of your goal.
  10. Be flexible Create a list of alternative thoughts, feelings and actions by looking at things from different or opposing perspectives. You may need to shift your goals or direction in your life as a result of events that arise in life. Focus on the road in front of you, and adapt.
  11. Create a social support system Seek and accept help, access community resources, volunteer in your community, work toward positive communication and problem solving with those around you, actively engage in a social network, share your feelings with someone you trust.
  12. Forgive others and yourself

Following this road map, you will be able to identify not only your own personal map but also what your roadblocks are. This process involves deep emotional work and may require the assistance of a professional counselor. Life is a journey! Embrace your strengths!

Can Depression Be Cured ?

Author: Stephanie Camins - MA, LPC

What is Depression?

Depression is a persistently low mood which includes feelings of hopelessness, helplessness, lack of joy in activities, decreased motivation in addition to changes in sleeping patterns and appetite. See the article Why Am I Depressed for more on the depression checklist.  Can depression be cured? This is a common question that I am faced with so I put together a few steps that can help you find the answer.

Can depression be cured?

What to Do About Depression

Treating depression is a three pronged strategy focusing on thoughts, feelings and actions.

Strategy 1:  Change Your Thinking

Change your thinking.  You’re brain forms entrenched pathways based on those thoughts you engage in repeatedly.  As a result, if you are constantly thinking depressed thoughts, your brain becomes better and faster at this pathway. It’s harder to access a wellness plan when your brain is in the habit of thinking negatively. The goal is to form a new thinking habit that is positive, solution focused and driven to a productive purpose. To reverse the negative thinking process, focus on recalling happy memories and proud moments. This is easier said than done. The following techniques can help you to get started.

Use the Broken Record Technique to form a new, happier thought pathway. Write down your positive thoughts, your purpose driven goal statements and recall and repeat them whenever you find yourself thinking low thoughts or find yourself in a low mood. List and honor your strengths. The goal is to increase the frequency in which you are thinking positively. Remember the times you aren’t or weren’t depressed. Write down what is different in these moments. Recall and repeat them often.

Identify and correct distorted thinking patterns which reinforce the negative thought pathway. This includes your self-defeating beliefs. Use the Detective Technique to refute these beliefs. What is the evidence these thoughts are true and what is an alternative explanation for these thoughts. How often are you misinterpreting situations due to a negative lens? If you look at the same situation with positive lenses what alternative thoughts can you identify? Is there another way of looking at the situation? If your best friend was struggling with this same situation, what would you advise them to do?

See “How to Control Anxiety - 10 Tools for Managing Stress” for additional strategies.

depression in women

Strategy 2: Accept Your Feelings

Accepting all feelings as they happen, even the negative ones will help prevent overreacting to low moods or dissatisfaction. You are less likely to get stuck in a negative feeling state if you accept that “right now, I feel sad, but it will pass.” Feelings are fluid states, consequently feelings ebb and flow. They are inherently not a permanent state. Coming from a place of acceptance prevents you from falling into a negative thought loop while repeating your self-defeating tapes. The more you think about a depressive circumstance or event, the more you will sink into depression.

Strategy 3:  Increase Positive Actions

Set measurable goals. The goal to "be happier" seems smart,  but it can backfire and add to the depression and feelings of helplessness simply because it is not a well-defined goal. What specific measurable steps can you plan to increase feelings of happiness? Goal creation can be self-defeating if you become overly focused on unattainable goals. Developing smart goals is a skill that once learned will provide a steady direction while propelling you toward a life purpose you define and work toward every day.

Develop an Action Plan. Identify healthy lifestyle choices you can make and track them in a wellness journal. This should include physical activity, social activity, a sleep routine along with a work schedule. Your work schedule includes time for professional activity and work on your personal goal development.

Treating depression without medication can be effective when you consistently engage in a wellness plan which includes assessing environmental factors. This includes lifestyle choices, stressors, sleep routines along with physical activity routines which contribute to low or anxious moods. Practice the strategies for combating negative thinking patterns. Develop realistic, achievable goals which focus on purpose. Build your resources and practice your wellness plan daily.  

In conclusion, the road out of depression involves changing how we think, our goals, our relationships, our environments and our physical wellness through sleep, diet, and exercise. Getting over depression requires the daily practice of wellness not just a plan to reduce symptoms. Counseling services provided by a qualified psychotherapist are often necessary to implement these strategies. Most noteworthy, depression can involve serious thoughts of harming oneself and suicide. If you have any of these serious symptoms of depression, contact a mental health professional immediately.

Why am I Depressed?

Author: Stephanie Camins - MA, LPC

I think I have depression is a sentiment expressed by nearly 35 million American adults. Why am I depressWhy am I Depresseded? is often the followup thought that may never really get expressed or vocalized. Approximately one in five of us will struggle with depression at some point in our lives. Symptoms of depression in women are identified at the rate of 33 percent as compared to 27 percent of men. The increasing demands on our time and energy have a direct impact on our susceptibility to low moods. Our busy lifestyles have decreased the amount of sleep we get, decreased the amount of physical activity we get, decreased the amount of sunlight we get, and decreased our availability to connect in meaningful relationships. Chronic dissatisfaction and lack of defined purpose have developed in part from the pressures of a cultural focus on performance and achievement. Environmental factors such poverty, hunger, abuse, violence and instability increase the symptoms of chronic depression.

Depression Hurts

Depression hurts you and your loved ones. A person’s perspective which is unrealistic, overly focused on negatives, highly self-critical or highly anxious contribute to the effects of depression and affect your relationship with yourself and those around you. Depressed people tend to exhibit self-defeating patterns of thinking and behavior. When we become fixated on unattainable goals, we set ourselves up for failure and disappointment. You may be impacted by lifestyle choices, environmental stressors, negative family or social situations, physical illness, hormone changes such as menopause depression and post-partum depression, or a negative personality type. The more you understand about the causes of your depression the better you can learn to combat depression and move toward a happier state of being.

What is Depression?

Symptoms of depression vary somewhat by individual and typically include persistent low mood, feelings of emptiness, hopelessness, helplessness, lacking joy in activities, changes in sleep patterns, changes in appetite, difficulty focusing, isolation, irritability, self-destructive thoughts, agitation, low libido, low energy, excessive guilt and negative attitude. Physical signs of depression can include an increase in headaches, stomach problems, weight loss or gain, and chronic aches and pains. If you recognize yourself in some of these symptoms you may be wondering how to diagnose depression. This depression checklist is used by counselors to diagnose levels of clinically significant depression along with assessing the degree to which these symptoms disrupt your daily functioning.

What to do About Depression?

How you react and cope with negative mood states is directly correlated to depression. Learning to incorporate healthy lifestyle choices into your routine, change negative thought patterns, connect in meaningful relationships and work toward a positive purpose in your life will reduce your depression significantly. Increasing your support network will help you to learn and maintain healthy ways of coping with the ever increasing demands of life. This support network can include friends, family, clergy, doctors and counselors. Your physician may help you with an appropriate medication protocol if your symptoms are severe and unremitting. A psychotherapist or counselor can help you identify your level of depression as well as aid in a plan to climb out of the depression. Depression can be very serious, sometimes involving suicidal thoughts. In this case seek professional help immediately. For more information on treating depression stay tuned for my next article, “Can Depression Be Cured?” If you’d like to be notified by e-mail when this article is posted, sign up for the e-mail newsletter on the homepage of this website.

A Therapists Journey Through Grief

Author: Stephanie Camins - MA, LPC

I have many roles in my life. I am a therapist, as a profession, but I am also a daughter and a mother. As a therapist, I spent many years training in counseling others in a multitude of different issues, one of which was the treatment of grief and loss. I learned about the stages of dying, the stages of grief, and grief recovery. My focus here is to share some of my personal experience with anyone going through the loss of a loved one.

Given my schooling and my experience counseling others through grief, I thought I was well prepared for the loss of my mother. Imagine my surprise when I absolutely was not. A little about my Mom, she had been sick for several years with a combination of health problems. Each time she was hospitalized, she got progressively worse. Due to the length of her illness, my grief journey started long before she passed away. Grief happens not only when a loved one dies but from the initial diagnosis through the long journey to passing on. Like many others who witness a parents declining health, I had periods of denial, anxiety, depression, anger, fear and confusion.  Sometimes the loss of a loved one is sudden and unexpected. Sometimes it is a long, grueling journey. I’ve been asked many times which I thought is harder to process. My answer is that they are both equally difficult in their own ways. Mine was the lingering process, constantly hanging like a black cloud over my head. I tried very hard to appreciate the time I had with my Mom and was able to do that at times, but largely, I was so overwhelmed with my grief that it was hard to focus on the present. As a therapist, I will tell you that focusing on the present and appreciating every moment is important, but I know from my own experience it’s very hard to do without letting the negative emotions of grief take over.

The stages of grief; denial, anger, bargaining, depression and acceptance apply to the entire process, from the initial diagnoses to death. They are presented in order, however like waves in the ocean, they ebb and flow, often overlapping, and moving between and amongst each other. They are not distinct stages that progress from one to the next. Knowing this did not prevent me from feeling the “grief crazies”. My emotions were all over the place all the time. The following list of coping skills will help you keep your feet on the ground, while wading through the journey of grief.

Grief Recovery

  • Use your support system
  • Take care of yourself
  • Delegate tasks
  • Ask for help
  • Keep things simple
  • Prioritize your tasks – not everything is essential
  • Get plenty of rest – but not too much
  • Get some exercise
  • Don’t isolate yourself – talk with others
  • Back to basics – eat enough, hydrate enough
  • Stay away from unhealthy escapes such as alcohol or drugs
  • Keep your schedule written down – your memory will not be normal
  • Maintain a list of important tasks
  • Remind yourself that you will be OK
  • Attend a grief group
  • Plan for “anniversary” dates
  • Allow yourself specific times to grieve
  • Journal

10 Days To Reduce Stress and Increase Happiness

Author: Stephanie Camins - MA, LPC

People ask me all the time, what is the #1 problem I see in my counseling practice. I would extend this answer to, not only my clients, but my friends, my family and even myself. Hands down, the answer is STRESS!  As a culture, we are overwhelmed and over- stressed. The causes are many, but the foundation is the same; too much to do and not enough time to do it. Sounding familiar?  I’d like to introduce you to 10 easy steps to reduce your stress and live a happier life.

We live in a fast paced, achievement focused society. Our worth is determined by how much we achieve and how fast we accomplish these achievements.  When we get there, we are expected to go even further and in fact questioned as to why we aren’t already there. Then, when we are nearing the end of our proverbial rope, some well-meaning person, be it our friends, family, coworkers, boss or even stranger tells us to chill out, relax, enjoy life, find your happy place… (Insert ensuing explosion here!)

The expectations we put on ourselves or that others put on us snuff out any time or energy we have for this elusive “happy place”.  We stress out about money, health, kids, parents, spouses, work, bosses, coworkers, the endless to-do list. Some of these things are real and some are irrational.  This is when it’s essential to shift your focus from stress overload to a calmer state of mind.  I’m going to show you how to put the brakes on anxious, negative thinking and switch gears.

STOP Technique
Let’s start with the simple STOP technique.  STOP stands for Start To Observe Positives.  First,  you need to literally, STOP.  When a negative thought pops into your mind, say out loud, STOP.  Picture in your head the red octagon shape with the white letters you learned to read when you were a toddler.

STOPUse this as your visual cue to STOP thinking negatively. 

The next step is Start To Observe Positives. Look at each situation and find something positive. It can be a lesson you learned, a comical observation, a new way of understanding another person, or even the all-powerful, ”well, I’ll never have to do that again”. Learning to consciously shift your thinking from negative to positive is a huge step. You’ve been thinking a certain way for many years. Be consistent with this new way of thinking. Think of it like learning a new language. Just as it takes consistent repetition and practice over time to perfect a new language, this will also require practice!

Here are 10 simple, easy steps to reinforce positive thinking.  Break this down into one a day for ten days:
Day 1.   Take deep breaths – set an hourly alarm on your phone and take ten deep breaths each time it goes off
Day 2.   Say please and thank you (to as many people as you can)
Day 3.   Smile (A LOT and to as many people as you can)
Day 4.   Tell 2 people something you appreciate about them
Day 5.   Write 5 positive intentions for your day on a sticky note and carry it in your pocket
Day 6.   Visualize yourself accomplishing a goal
Day 7.   Get physical (walk, bike, jog, stretch, skip)
Day 8.   Set up a “coffee date” with someone (increase your social time)
Day 9.   Take 15 minutes for yourself (read, walk, meditate, take a bath, have a cup of tea, listen to music…)
Day 10. Write 5 positive things that happened today

Once you’ve reached your 10 day mark, congratulate yourself on a job well done!  Evaluate which of these tasks were easy and which were more difficult.  Each of these tasks plays an independent and integral role in your road to greater happiness. These 10 steps,  done in combination, and repeated over time, will change your life!