Don E. Gibbons, Ph.D., NJ Licensed Psychologist #03513
This Blog is published for information and educational purposes only. No warranty, expressed or implied, is furnished with respect to the material contained in this Blog. The reader is urged to consult with his/her physician or a duly licensed mental health professional with respect to the treatment of any medical or psychological condition.

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The New Center for Counseling and Psychotherapy, LLC

The New Center for Counseling and Psychotherapy, LLC, is located at 675 Route 72 E Manahawkin, NJ 08050. Telephone us at(609)709-2043 and (609) 709-0009.Take Mill Creek Road South, just off Route 72, on the road to Beach Haven West.After about 400 feet, turn right into the office complex of Greater Coastal Realty. Then turn right and go past the Lyceum Gyn. Continue on to the Prudential Zack Building. We. are the last office at the end. We accept Medicare and most other major insurance.Weekend and evening office hours are avalable.

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Sunday, June 17, 2018

How to Train Yourself NOT to Be Anxious

With 99% of the same genes as our closest monkey cousins, the chimpanzees, it's no wonder that under the pressures of modern life, the tendency to become anxious can sometimes spiral out of control! This brief posting is not intended to serve as a substitute for counseling or therapy. If anxiety has begun to affect your personal or work relationships, you should definitely seek the services of a duly licensed mental health professional. However,for many everyday situations, the following information may be helpful in correcting the habits that can sometimes get us into trouble.

It is generally agreed that cognitive-behavioral psychology is the fastest-growing oreintation within the profession. There is also a rapidly-accumulating body of evidence that it actually works! Cognitive-behavioral therapy, or CBT, may be summarized as the study of the relationship between thinking, feeling, and behavior.  Just as physical therapists can provide you with exercises to improve physical functioning, cognitive-behavioral therapists provide exercises to develop more effective psychological adjustments.


The information below was garnered from several different sources, and provides you with a variety of useful forms and worksheets so that you can use whatever combination of these CBT tools you find most helpful for training yourself not to be anxious The information referred to in any of the links below can be downloaded from your computer by clicking on the link and using the print command on your computer. 


Cognitive-behavioral therapists frequently use a document called a thought record in order to examine just what goes on when we keep making those angry responses that keep getting us into trouble. Here is what one looks like, courtesy of www.getselfhelp.co.uk. They also provide a summary of the STOPP technique, which they describe as "CBT in a nutshell," and which can be summed up in one sentence: "Try not to act merely in the moment. Pull back from the situation. Take a wider view; compose yourself." Following is a hypothetical example of how the anxiety thought record form might be used to see a situation from a different perspective, using the example of being suddenly cut off in traffic by another car, with the column headings in italics and one set of possible responses in standard type. You can practice using these forms for a number of other hypothetical situations, or situations that have actually made you angry in the past, in order to be prepared for a variety of possible situations in the future. 

Situation: A car suddenly swerves in front of you and slows down, causing you to slam on your brakes in order to avoid hitting it.


Feelings, Emotions,:  An increase in heartbeat and blood pressure, clenched jaw, faster brething.


Emotions/Moods (rate 0-100%):  Anxiety


Physical Sensations & Reactions: Swearing, gripping the steering wheel


Unhelpful Thoughts/Images:  Urge to speed up and pass the car in front of you, honk at the driver, make an angry gesture, and cut back in front of him.


What I Did/What I Could Do/What's the Best Response? (Re-Rate Emotion 0-100%)  Realize that the emotion will pass in a few moments, but if you act on it the situation could escalate and possibly lead to serious complications.



The ABC Worksheet from www.smartrecovery.org, which is downloadable as an Adobe pdf file, can become your daily companion for taking control of your life in matters large and small! You can use it to make motivational and behavioral adjustments not only for controlling anxiety, but also for everything from paying your bills on time, to stopping smoking, or deciding on which career path to follow. 

It first asks you about the causes of something you would like to change in your life, and then asks about the emotional consequences which were the result, your beliefs about what happened, what beliefs could be substituted for the ones which brought about the unpleasant results, and how those changed beliefs make you feel. You can write on the form itself, clearing and changing it as often as you like. Then, when you are finished, you can either print it out or save it as a text file, using a different form for each problem you would like to work on. To re-examine it or re-do each form that you have completed, just call up that particular file and continue to modify it as you progress. It could prove to be extremely helpful if you are willing put enough thought into it to give it a try!


Finally, the folks at www.smartrecovery.org have a tool chest of resources which is a treasure-trove for people who want to alter hard-to-change behaviors of every type.They have prepared a selection of tips and tricks for managing anxiety in such a manner that in many instances you can not merely control it, you can get rid of it!  Here is a partial list of some of the other materials which they have to offer. The information may be downloaded free of charge by using the print command on your computer, although donations are encouraged. Here is a partial list of some of the materials which they have to offer:

Of course, training yourself not to be anxious is going to take time and patience. However, once you get the hang of it, if you continue to do these mental workouts as regularly as you would exercise physically in a gymnasium, you will  be able to think, feel, and act in a calm and confident manner in almost any situation. On the other hand, if you do not use the CBT Thought Record to identify your triggers and the other choices that you have, you might very well continue to feel anxiety when you know you it could continue to get you into trouble, but never do much about it. 

Just as reading a book on surgery will not make you into a surgeon, and reading an exercise manual will not build muscles, merely reading a Blog posting on how to train yourself to avoid anxuety will not be enough to enable you to get rid of it. People who practice meditation, for example, do not hope to attain enlightenment merely by reading about it!  Regular practice using the thought record for a variety of situations is the key to success. 


Confucius said, "The journey of a thousand miles begins with a single step." But once you have taken that step, you have to keep going. The two rules for success in any self-improvement program are: 1) Begin, and 2) Don't stop!  If you frequently experience problems with anger, you should have plenty of motivation to follow both of these rules. No matter how long the journey, cognitive-behavioral psychology, especially when undertaken with professional guidance, can be of great assistance in successfully reaching your destination!

See also: 
How to Keep Your Boss from Driving You Crazy
Toxic People who can Wreck Your Life


 

Toxic People Who can Wreck Your Life


The following descripions of personality disorders have been compiled by some of the best minds in the field of mental health, drawing upon years of clinical observation and literally hundreds of research studies to find patterns which “clump together” in present-day culture. Personality-disorderd people can indeed wreck your life when they are bosses, friends, or family members, they cause you to doubt yourself and to believe their toxic opinions about you. Of course,actual diagnosis and treatment should only be undertaken by a mental health professional but There is an old saying, "If it walks like a duck, and quacks like a duck, and looks like a duck -- it's a duck!"

Narcissistic Personality Disorder.

The ancient Greeks used to tell the story of Narcissus -- a lad who was so good-looking that he fell in love with his own reflection in a pool of water, and spent so much time gazing at it that he eventually fell into the pool and drowned. People who are given a diagnosis of narcissistic personality disorder are often perceived as being selfish or conceited. They may often spend a great deal of time telling you how great they are, or boasting of their achievements or accomplishments.

Some people think of a person with a narcissistic personality disorder as having a superiority complex to cover up for an inferiority complex. When you get to know such people well, it soon becomes apparent that the reason they spend so much time “tooting their own horn” is that deep down inside, they really feel afraid, inadequate, and unlovable.

Narcissists do not always act selfishly in the short term. They are often highly motivated to pursue long-term goals in order to prove their worth both to themselves and others. For this reason, narcissists often tend to gravitate to positions of leadership in business, government, education -- and yes, even churches.

Narcissists often cause a great deal of suffering, particularly when they happen to be employers, family members,  or romantic partners. Yet there are ways of dealing with them. (Since no two personalities are exactly identical, however, you cannot stereotype them and treat them all exactly the same way.)

Histrionic Personality Disorder.

People who have been diagnosed with histrionic personality disorder may often be compared to an adult version of the “spoiled child” who will do anything to remain the center of attention. If histrionics are able to “show off” and remain the center of attention by doing a good job, they often accomplish a great deal. But if they feel that they are being ignored, or that the attention which they crave so deeply is denied them, they may become angry and disruptive in order to get it back again -- even if it’s unfavorable attention this time! ("I don't care what you say about me," one publicity-hungry histrionic is reported to have said to a reporter for a scandal magazine. "Just be sure you spell my name right.!")

Antisocial Personality Disorder.

People with a diagnosis of antisocial personality disorder did not incorporate our society’s standards of right and wrong into their personalities as well as the rest of us have. They begin getting into trouble with the authorities by the time they are adolescents, and don’t grow out of it. As you might suppose, this pattern is much more common in men than in women.

Since personality disorders are so difficult to change, many such people keep going back and forth to jail from their teen years until middle age, when they seem to mellow out of their own accord. They make up the bulk of most prison populations, and often have a history of substance abuse or substance dependency. However, people with antisocial personality traits (I like to call them stealth anti socials) may be encountered almost anywhere, even at the highest levels of many organizations; and they may not be found out until their behavior gets them into trouble. (The discovery and apprehension of stealth anti socials in high-profile positions is the basis of many of the news stories we read about every day.)

Borderline Personality Disorder.

To understand the person who qualifies for a diagnosis of borderline personality disorder, think back to some of the stormiest days of your own adolescence, or the adolescence of someone you know well. With an incompletely developed sense of self, the borderlines have no firm idea of who they are and where they are going. Their lives are often erratic, with frequent job changes and alterations in long term goals, and intense and unstable friendships and romantic involvements.

Because of their poorly developed sense of self, borderlines often have difficulty with so-called “boundary issues,” or the ability to distinguish between what is appropriate and what is inappropriate in a given situation. Some borderlines, in fact, may find it difficult to even talk to a person of the opposite sex for very long without acting as if they are falling in love with them. As would be expected, the romantic lives of borderlines tend to be especially intense and tumultuous. The manipulative abilities of people with borderline personality disorder often enable them to deceive those who do not understand the inner storms which produce such behavior, which frequently causes their sudden bouts of passion to be mistaken for genuine love.

Borderlines often engage in “splitting,” with either extremely positive or extremely negative feelings towards others, sometimes suddenly reversing from extreme friendliness to extreme rejection and vice-versa. This changeability frequently leads them to engage in behavior that is highly manipulative. This splitting may also be the reason why the interpersonal relationships of borderlines are often centered around real of imagined fears of abandonment. (One book on borderline personality disorder is entitled, I Hate You - Don’t Leave Me!) These tendencies to engage in splitting may also explain why borderlines also seem to have a strong ability to divide those around them into separate camps of friends and enemies.  

Borderlines usually have very low self-esteem, and suicidal gestures, genuine attempts,
and successful suicides are not uncommon. Since many borderlines have a history of cutting themselves, or other forms of self-injurious behavior, it has been speculated that this represents an extreme attempt to combat the overwhelming numbness of an otherwise empty life.

Obsessive-Compulsive Personality Disorder.


People who have been diagnosed with an obsessive-compulsive personality disorder may be popularly known as a “nit-picker” or “neat freak.” They may become so involved with orderliness, perfectionism, and control that efficiency suffers as a result. This culture tends to place a high value on preoccupation with detail in certain jobs. With proper training, people who have milder forms of obsessive-compulsive personality disorder may become excellent law clerks, college registrars, bank auditors, or personal physicians -- in which case, it may not be a personality disorder any more, unless it interferes with their functioning off the job!

Obsessive-compulsive personality disorder is closely related to another disorder with a similar name, obsessive-compulsive disorder, or OCD for short, which is similar in nature but more limited in scope. Obsessive-compulsive disorder refers to a pattern of continually recurring thoughts (obsessions), or behaviors which one is compelled to continually repeat, such as checking a door several times in a row to be sure that it is lockedO

Avoidant Personality Disorder.

People who carry a diagnosis of avoidant personality disorder have had such unpleasant social interactions in the past that with the possible exception of one or two close relatives or special friends, they have come to fear all human contact. Avoidants are frequently not merely shy about most social situations, they are genuinely phobic about them. Their avoidance is often centered around a core belief that if people really got to know them, it would immediately become obvious how incompetent and worthless they really are, and the immediate result would be scorn, rejection, and loss of employment. People with an avoidant personality disorder often tend to gravitate to solitary occupations -- researchers, librarians, or forest rangers, for example; and they may be attracted by certain monastic orders. (Of course, not everyone in these types of occupations could be diagnosed with an avoidant personality disorder!)

Dependent Personality Disorder.

A central theme in the life of people who have been diagnosed with a dependent personality disorder is a need to be looked after and taken care of, often accompanied by excessive fears of real or imagined abandonment. Ironically, some people who qualify for a diagnosis of DPD may behave in exactly opposite fashion. Those with milder forms of this disorder may attempt to satisfy their underlying dependency needs by becoming so efficient and thorough that they make themselves indispensable. Others, whose disorder is more severe, become highly dependent on instructions from above, and are reluctant to show any initiative in carrying out their responsibilities for fear that they will have made the wrong decision.

Paranoid Personality Disorder.

People who have been diagnoses with paranoid personality disorder tend to see the activities of other people as ill-intentioned -- even when the opposite is true. Compliments may be seen as attempts to gain undue influence through flattery, and offers of help may be seen as evidence that the person to whom the help is offered is viewed as incompetent. The resulting suspiciousness and hostility may tend to bring about the negative attitudes and behaviors which the person with a paranoid personality disorder believes were always there. (The saying goes, “Just because you’re paranoid, it doesn’t mean they aren’t out to get you!”)

Schizoid Personality Disorder.

The person who has been diagnosed with schizoid personality disorder is an extreme loner or a “cold fish” who just isn’t interested in being around people. Such people are often found in the most solitary jobs which others might tend to shy away from. Because of their extreme lack of social skills, they should not be expected to change simply by inviting them to parties or by introducing them to a wide circle of people.

Schizotypal Personality Disorder.

People who have been diagnosed with schizotypal personality disorder typically have bizarre notions of cause and effect, and may practice unusual rituals of their own devising, either to make things happen or to prevent them from happening, similar to those who have been diagnosed with schizophrenia. Their everyday speech patterns and favorite topics of conversation are usually regarded by those around them as being somewhat bizarre, although not totally “crazy” in the popular sense of the term. They may also take a keen interest in cults and in the paranormal. Although certainly not everyone who is interested in such topics has a schizotypal personality disorder, the true schizotypal still tends to stand out because of bizarre thought patterns.

Passive-Aggressive Personality Disorder.

Although the American Psychiatric Association no longer officially lists this as a separate personality disorder, people with passive aggressive tendencies try to disrupt things by sabotaging the success of their employers, their family, or their friends without appearing do so deliberately, because they feel that their own needs for recognition, status, or achievement are not being met, or that other people are more successful than they are. Passive aggressive people may risk an occasional confrontation if it helps them to get their frustrations out, but they can usually gauge their actions carefully enough to avoid losing their jobs or their families.

If they are not frankly and firmly confronted about their behavior, their passive-aggressive patterns may become worse over time as they continue to follow their own “hidden agendas” and they feel that their actions are being accepted or condoned. They may single out for special treatment vulnerable individuals or groups who will not or cannot “fight back,” and their behavior may degenerate into outright bullying. Then, when the inevitable day of reckoning does arrive, the consequences may be much more serious -- both for the victims and for the organization -- than if the problem had been immediately and forcefully dealt with.

Limitations of a Personality Disorder Diagnosis.

In order to qualify for any of the foregoing diagnoses of personality disorder, the disorder must be seen to cause people significant distress in their social, intellectual, or occupational functioning, regardless of whether or not they are aware of this fact. Temperamental but highly successful movie stars, for example, whose demanding and self-centered behavior would interfere with their adjustment in another setting, would probably not qualify for a diagnosis of narcissistic personality disorder as long as they can "get away with it." Similarly, people who live alone in a remote location miles from the nearest neighbor would not qualify for a diagnosis of avoidant personality disorder as long as they are able to function well their current situation, regardless of how intensely they may dislike having social contact with their fellow human beings.

It's easy to see how more than one personality disorder, or the traits of several, can work together in the same individual. Most of us are familiar with, or have heard stories about, the narcissistic borderline who sleeps her way into an executive position and then proceeds to systematically eliminate all those who are familiar with how she got to where she is, while tyrannizing over the ones who have been hired as their replacements. We are also not surprised to learn about a narcissistic antisocial convict (sometimes referred to as a psychopath), who immediately commits another crime upon his release from prison, which entitles him to several more years of "three hots and a cot," plus free medical and dental care. Many of us have also witnessed instances of a passive-aggressive histrionic, who regularly disrupts public meetings with their oft-repeated tales of woe, to the extent that it becomes next to impossible to get any business done. 

People with personality disorders are not likely to seek professional assistance, because they are frequently inclined to blame their troubles on everyone but themselves. When they do seek help, it is usually because they are forced to do so (often in conjunction with an assault or a suicide attempt, or because a family member insists on it). They tend to remain as long as they are "hurting," or as long as they are forced to stay. When they are no longer hurting and are in a position to stop, they discontinue treatment.

Instead of seeing the personality-disordered individual directly,a therapist is much more likely to see a family member, romantic partner, or employee who presents with anxiety or depression as a result of their interaction with someone who has a personality disorder (whom they may refer to as a "toxic person" or an "energy vampire").

A final word of caution: as stated previously, an actual diagnosis of a personality disorder should only be made by an appropriately trained mental health professional. One of the easiest and most powerful ways to insult people is to let them know that you suspect them of having a personality disorder! While avoiding making such a diagnosis yourself unless you are properly trained to do so, and not communicating your suspicions to the individuals concerned, knowing how to recognize the major symptoms of a personality disorder will place you in a much better position to deal with such people on a daily basis, and to seek professional assistance in order to better cope with them if you need to do so. 

Print Sources

Cavaiola, A. C., & Lavender, N. J. (2000). Toxic co-workers: How to deal with dysfunctional people on the job. Oakland, CA: New Harbinger Publications.

American Psychiatric Association (2013). Diagnostic and statistical manual, DSM-V. Washington, DC: American Psychiatric Association. 

Wednesday, June 13, 2018

How to Mend a Broken Heart

Many of the clients we see daily in our psychology practice have a broken heart somewhere in their past. Sometimes, however, you may be able to fix it yourself -- or at least, you can ease the pain enough to make a rational decision about the best way to proceed,



Saturday, June 9, 2018

Hypnosis IS NOT Mind Control!

The possibility of using hypnosis to commit a crime has long been the object of speculation, some of which is humorous and some which is deadly serious. Here's an example of how society seems to take for granted that hypnosis is a power which you can use on someone to commit a murder. In the following cartoon, Wylie E. Coyote decides to do just that. Notice how he helplessly glances at the audience once he realize his own impending death as the result of his actions.



Can hypnosis be used as an instrument of mind control? Is it really possible to commit a crime by means of hypnosis?  Laboratory investigations into whether or not hypnosis can be used for antisocial purposes inevitably fall short of the mark, because the situational background is not sufficiently taken into account. Imagine that you are a student in introductory psychology, taught by Prof. Snarf, who asks for volunteers in a psychological experiment. You accept the invitation, and are given a hypnotic induction, followed by the instructions to pick up a beaker of acid and hurl it in the experimenter's face, to pick up poisonous snakes, or to shoot the experimenter with a supposedly loaded gun. Would you  really believe that a reputable scientist would let you commit a murder as part of a psychological experiment? Or would you be inclined to believe that because you are ordered to do these ridiculous things there must be a reason for it other than the one that was given, so you might as well go ahead and do as you are told? Some people, at least, choose the second option (Sarbin & De Rivera, 1998), Dr. Martin Orne coined the term demand characteristics to refer to this tendency of a subject in an experiment to act in the way that the subject thinks one is supposed to behave, rather than simply reacting to the instructions in themselves.

Some years ago, I was asked to testify in the case of a man who had falsely advertised himself as a psychologist and had begun hypnotizing teen-age girls in the area, one of whom subsequently accused him of rape. In order to make its case that hypnosis could be used to compel behavior, the prosecution had pointed to an incident in Eastern Europe several decades earlier, in which a stage hypnotist had handed a man a pistol loaded with blanks and commanded the man to shoot him. The hypnotized subject, who was an off-duty police officer, drew a loaded revolver from his pocket and shot three members of the audience. 

I testified that while hypnosis cannot force people to people do something which is against their moral and ethical codes, it is impossible to conclusively demonstrate in the laboratory whether or not hypnosis could be used to compel anti-social behavior. You could never actually allow such behavior to occur in an experimental setting, or in any kind of staged demonstration, and the subjects know it! But, in what I like to call "the laboratory of life," the results are more clear-cut. Hypnosis in its modern form has been around for over two hundred years; and if you have to go half way around the world and back several decades in time in order to find even one instance of its alleged use in the commission of a crime, then it would be easier to conclude that this individual was psychotic or personality disordered than to conclude that his behavior was the result of the alleged coercive power of hypnosis. If hypnosis could be used in such a manner, by this time its anti-social applications would be well-documented -- in organized crime, in international espionage, by thwarted lovers, and in many other settings. And the evidence simply is not there. 

When a hypnotist is accused of rape or seduction, the problem is not with hypnosis itself, but with the power differential which is inherent in a therapeutic relationship, as it is when the abuser is a person in a position of high status, as was the case with Rasputin, a priest and an advisor to the Tsarina in the court of imperial Russia. This trust must never be abused. The responsibility always lies with the person in authority. It is necessary for the trusted person to maintain strong boundaries and to stop any inappropriate relationships from developing, even if a client displays seductive behavior due to transference, a personality disorder, mental illness, physical attraction or simple intimidation.. A teenager would be especially susceptible to such suggestions; and If he or she subsequently accused the hypnotist of rape, then the chances are, the hypnotist may have abused his or her position of trust and authority in order to have sexual relations with the client, which is tantamount to rape, as we are currently seeing on the news where hypnosis is not involved at all. Therefore, the prosecution's mistake was to attack hypnosis itself, rather than the power differential which the hypnotist (who had falsely advertised himself a psychologist) had abused, 

Instances such as these tend to be reported in great detail by the media, and are amplified still further by depictions of hypnosis in fiction. Because of the publicity which results from them, there are many people who will not have anything to do with hypnosis .And because these abuses continue to surface from time to time and dramatized by the mass media as illustrated in the foregoing cartoon, the public is probably never going to be won over completely, despite our repeated assurances that hypnosis is perfectly safe when used by ethical and appropriately trained professionals.  

(I am grateful to Dr. Annette K. Schreiber for her collaboration and assistance in the preparation of this posting.)

Reference
  
Sarbin, T. R., & De Rivera, J. (1998),  Believed-in imaginings:The Narrative Construction of Reality (Memory, Trauma, Dissociation, and Hypnosis) . Washington, DC: American Psychological Association.