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Dialectical Behavioral Therapy (DBT): Skills Training Group

This group therapy is for clients that may be struggling with any of the following:

  • Poor self-esteem
  • Excessive Worry
  • Impulsivity
  • Unbearable Emotional Pain
  • Overwhelming Feelings
  • Self-destructive Behaviors
  • Self-injurious Behaviors
  • Chaotic/ Stormy Relationships
  • Poor Boundaries
  • Drug or Alcohol Abuse
  • All or Nothing Thinking
  • Confusion About Self

 

Dialectical Behavioral Therapy (DBT) is a structured therapeutic treatment based from Zen Mindfulness practice placing emphasis on the balance between acceptance and change. Outcomes of this class will provide DBT clients with tools to recognize and increase awareness of thoughts, feelings, and body sensations while strengthening attention to the present moment in order to respond with healthy strategies to maintain control, cultivate living life from a place of “wise mind,” gain interpersonal skills to improve relationships, and begin building a life worth living.

Our Dialectical Behavioral Therapy (DBT): Skills Training Group will provide a validating and safe environment for clients to learn coping skills to manage stress they encounter in life. Dialectical Behavioral Therapy teaches skills that help reduce the intensity and frequency of overwhelming emotions, while also offering guidance for navigating these distressing emotional moments. DBT skills include:

Mindfulness—Mindfulness is a core concept within DBT that promotes full awareness of your present moment (i.e. thoughts, feelings and physical sensations) without judgment and without trying to change it. Mindfulness strives to focus the mind, direct attention and achieve a better understanding of feelings.

Emotional Regulation—Emotional Regulation concentrates on taking control of emotions. Difficulty controlling extreme emotions can lead to impulsive or ineffective behaviors. The goals of Emotion Regulation are to better understand the emotions you experience, reduce emotional vulnerability and decrease emotional suffering.

Distress Tolerance—Pain is a part of life and being unable to deal with pain may lead to impulsive or destructive behavior. The goal of Distress Tolerance is to help people better cope with painful or distressing moments in more effective ways that won’t make the situation worse.

Interpersonal Effectiveness—The focus of Interpersonal Effectiveness is building and maintaining positive relationships. This module introduces tools to express beliefs and needs, set limits and negotiate solutions to problems without threatening relationships with others. Interpersonal Effectiveness skills can help in taking care of relationships, balancing your needs with the demands and needs of others, balancing things you want to do with things you ought to do and building/developing mastery of self and self-respect.

The group will be led by Elyssa Reid Ed.S., LPC, CRC, NCC and Scott Leenan M.S., LPC, CRC. Once enrolled in the program, clients who do not have a DBT therapist may be assigned a clinician to meet with once per week. The fee for the group is $125 per week. Space is limited to 10 participants so please register as soon as possible to ensure your space. For more information, you may contact us at Intown Counseling and Wellness at 404-478-9890 or e-mail us at admin@intowncounseling.com

 

nightmarebeforechristmas

Nightmare Before Christmas

Do the weeks leading up to Christmas seem like a nightmare? During the Christmas season your days may be filled with comments like: “I need an iPad for Christmas,” “I want a Smartphone, everyone else has one,” or “If I don’t get me an Xbox One, I’m never talking to you again.” Children are psychologically wired to want what they want, when they want it. Children have a hard time understanding the concept of money, especially when society tells them a mysterious man named Santa is bringing them the gifts. Since kids are mostly unaware that your working hard to earn money to buy them presents, they think they can ask for and have as much as they want. Children can easily develop a sense of entitlement and become materialistic in today’s world. Many times, as parents, you also want the newest gadgets and best clothes, and enjoy providing your children with the things they want. However, we all get busy and forget to teach gratitude in the midst of the giving. Children should learn that they need to earn the things they want and to also be thankful for the gifts they are given. Here are some tips on teaching gratitude during the holiday season:

1. Give fewer gifts: Set a limit for yourself and your family. When children are given lots of presents on Christmas morning, it is hard for them to appreciate each gift and trains them to never be satisfied.

2. Write thank-you notes: Writing thank-you notes is a lost art. A handwritten note is very thoughtful, and teaches children to take the time to think about the gift they received and put real effort into thanking the gift-giver. Make this into an art project and help your child make the thank-you note and write a personal message inside.

3. Encourage random acts of kindness: If we help children learn to focus on others rather than themselves, it will reduce their level of entitlement. Help an elderly neighbor with their lawn, bake cookies for a friend or clean a relative’s house without a material incentive. You could also organize a toy donation in your household. Make it a Christmas tradition for your children to donate toys they no longer play with to those less fortunate. The reward will be the satisfaction of helping others in need.

4. Write a letter of gratitude: Christmas morning can be a blur. Children furiously open all their presents, barely stopping to appreciate them and forgetting how lucky they are to have presents under the tree. Have your children write a letter about what they are thankful for this holiday season and read it together as a family before opening presents. This can shift the mood of Christmas morning to thankfulness!

by Afton Murphy

Surviving-the-Holidays-PIC

Surviving the Holidays

Holidays are usually a time for amazing food, travel, and for most people a lot of family interactions. While spending time with family can be fun, it is not uncommon for people to feel overwhelmed or experience an increase in anxiety at some point during the holiday season. These feelings are normal and to be anticipated since there is more to do than during our typical day-to-day lives. For most people, increases in stress put us at greater risk for unhealthy interactions with those who are closest to us. The unhealthy interactions typically include withdrawing from situations or engaging others with anger, frustration, or fear. Here are a few tips to encourage health and wellness during the upcoming holiday season.

1) Don’t stop engaging in self-care. It is very easy to substitute your daily routine or “me time” for holiday to-dos or to spend time with family you may not see very frequently. If you’re not taking care of yourself, you are more susceptible to inappropriately reacting, instead of effectively responding, in times of high anxiety. Therefore, taking care of yourself actually means you are trying to facilitate family health, so don’t feel guilty for saying no or scheduling things around your established self-care routine!

2) Know your triggers and prepare to manage them. Most people have “hot buttons”, or issues, that they know family members will push. When the triggers are present, people are more likely to engage in unhealthy behaviors. However, by being aware of these triggers, acknowledging that they will most likely be present, and having a planned, healthier response, the triggers don’t have to be as powerful. For example, if you know that you get annoyed when people mention that you haven’t ______ (Fill in the blank. For many it could be that you aren’t married; you haven’t had children; or you aren’t in the job you want to be), you can prepare a statement that is polite, but doesn’t encourage further discussion, such as, “I appreciate your interest. I’m sure when the time is right, it will happen.” If you have a particularly persistent family member, a statement like, “I know you ask because you care about me, but I would prefer not to discuss ______, and would appreciate it if you could respect that.” Whatever statements you choose to use, it is important to develop them beforehand so you aren’t reacting from a place of anger.

3) Practice mindfulness. It may seem that there is always something to do, somewhere to be, or someone to see. This may certainly be true, but you rob yourself of holiday pleasures when you don’t allow yourself to truly experience them. By practicing mindfulness you allow your senses to fully experience all that is in your environment. For example, you can mindfully prepare meals by focusing your attention on the aromas of the food, the textures of different ingredients, and the sound of appliances around you. Focusing on these details encourages you to live in the moment, and can push stress-inducing thoughts away.

4) Slow down. Through mindfulness you are slowing your mind and forcing it to pay attention to one thing. Slowing yourself down is also especially useful in the event that you find stress has gotten the better of you. If you find yourself recognizing signs that you are becoming annoyed, angry, or frustrated, take deep breaths or give yourself “time outs” so that you can regain control. Bathrooms are great places to escape and center yourself. Drawing your attention to your breathing helps to calm your nervous system and decreases feelings of stress.

While these tips won’t guarantee a stress-free holiday season, they may help decrease your anxiety and increase overall health and wellness. ENJOY the holiday season and most importantly, the time with those you love!

By Cassandra Lettenberger-Klein, Ph.D.

How-do-you-really-know-if-you-have-a-problem-with-addiction

How do you really know if you have a problem with addiction?

You would think that this would be an easy question to answer, but for most of us it’s quite confusing. In America, we tend to believe that 1 drink per day for women and 2 drinks per day for men is acceptable, but what if you’re a woman who has 2 glasses of wine every day – does that make you an addict? And not only do we have to worry about the amount of alcohol or drugs that we consume, people can also develop addictions to behaviors, like gambling, exercise, sex, work and spending. So when does too much of a good thing tip the scale and become an addiction?

Here are 10 important questions that you need to ask yourself:

  1. Do you feel unable to control the behavior you are engaging in?
  2. Are you unable to consistently abstain?
  3. Is the behavior counter-productive to you, meaning, instead of it helping you adapt to situations or overcome problems, it tends to undermine your abilities?
  4. Is the behavior persistent despite it causing you significant problems medically, at home, at school or at work and/or difficulty in interpersonal relationships?
  5. Do you have an increasing “hunger” for alcohol, drugs or rewarding experiences?
  6. Do you hide your behavior from your friends or loved ones?
  7. Since engaging in the behavior, have you experienced an increase in anxiety, depression, agitation, and mood fluctuations, or have you noticed an increased sensitivity to stressors or difficulty in identifying your feelings?
  8. Do you need larger and more regular amounts of whatever you are engaging in to receive the same effect?
  9. Do you spend an excessive amount of time engaging in the behavior or recovering from its effects?
  10. Do you feel preoccupied with the behavior or substance use?

If you answered ‘yes’ to ANY of these questions or if you feel that your behavior is leaning in that direction, you may want to consider talking to a professional to determine the best course of action for you.  The sooner you can get the appropriate help you need the better.

By: Melissa G. Macdonald, LCSW

 

 

A Back-to-School Checklist for Parents

Summer is nearly over and it will be time for the kids to go back to school soon! You may be overjoyed at the thought of your children returning to school, but you may also dread the inevitable meltdowns that occur when the kids have to adjust to going to bed and waking earlier and completing their homework each night. The kids have gotten used to staying up later, sleeping in, and having more freedom to choose their activities over the summer so getting them back into a routine can be difficult, so here are some tips:

1 .) During the initial transition, give your kids a break and extend some compassion and understanding. Think of how hard it is for you to return to work after a short vacation. Summer is essentially a 2-month vacation for your kids!

2 .) Even though summer break is over, continue to plan fun activities with your kids. Schedule fun outings on the weekends and/or plan a fun activity to do on a weeknight.

3 .) Incorporate some academic games, science projects, or story writing activities each week to prepare your child’s mind for the long school days. These activities can be fun and entertaining while also developing their interest for learning.

4 .) Children need more sleep than adults and are more adversely affected by insufficient sleep. If you haven’t been keeping your kids on a bedtime routine that is similar to their school year bedtime, start now! Gradually move their bedtime up 10-15 minutes every night and start waking them up 10-15 minutes earlier until you’ve reached appropriate times.

5 .) Start eating breakfast every morning. Hungry children have a hard time focusing and retaining information at school. Healthy breakfast foods that are rich in whole grains, fiber, and protein while low in added sugar are your best bet.

6 .) If you have a difficult time getting your children dressed and ready to hit the door, making a list with their morning tasks may help! If they complete each task, give them a check mark or sticker next to that task. If they complete 75% of the tasks for the day, they get a small reward (i.e. quarter/dollar, TV/electronic time). If they complete their tasks 3 out of 5 school days, reward them with a larger incentive on the weekend (i.e. trip to the movies, dollar store, small toy). It’s very important that parents stay consistent while using this type of behavior chart. If the child does not complete the tasks, they should not be rewarded and more importantly, if the child does complete the tasks, they should get rewarded to encourage appropriate behavior in the future.

7 .) A new school year is often filled with a lot of anxiety inducing as kids navigate new classes, teachers and classmates and possibly new schools. It’s very important to help your children cope with their anxieties. Usually a simple conversation is helpful and dinnertime is great time to check in with the kids. Many parents also find that therapy is a great tool to help during times of adjustment. It provides kids a place to explore their feelings, while getting additional support outside their families.

By: Afton Murphy, MA, APC

 

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Family Therapy

While individual therapy is by far the majority of what we do at Intown Counseling and Wellness, we also get a lot of requests for relationship counseling, couples counseling, family therapy, marriage counseling and pre-marital counseling. When people initially call our office seeking therapy, they’re often unsure which of our services will serve them best. After getting some details about their concerns we consider treatment options while considering the individual and their family system.

Without ignoring the importance of looking at an individual’s internal dynamics, our practice takes a broader view that individual behavior can also be understood to occur within the framework of the family. A family member coming to us with symptoms is viewed merely as a representative of a family experiencing instability. The identified patient is thought to be expressing what other family member are thinking and feeling, but unable to acknowledge or that their behavior is diverting attention from other family problems.

The family structure today is very diverse and has evolved a great deal. Pulling from the popular television show Modern Family, our practice relies on traditional therapies when working with Atlanta’s modern families. Some of the families that we work with include married or soon-to-be married couples, cohabitating gay, lesbian and heterosexual couples, single-parent-led households (divorced or never married), families led by grandparents, and foster families to name a few.

Each family is unique in its rules, member roles, power hierarchy, communication styles and its way of problem-solving. Within our family system, individuals are tied to one another by powerful emotional attachments that usually endure over the lifetime of the family. The power of the family is deemed so strong that despite the possible separation of its members by vast distances and sometimes even death, the family’s influence remains.

Family therapy isn’t solely focused on one particular individual, even if only just one family member is engaged in treatment. We frequently get calls about couples counseling when one partner is not receptive to the idea. If you want to improve your relationship, work on yourself—even without your partner, therapy can be a powerful experience. As you begin to make changes, your partner’s behavior may also change. Even if your partner never goes to therapy, going alone can help you deal with the stress of relationship problems. Regardless of your situation, finding help requires speaking to a licensed professional counselor who will sit down with you to find out what will work best. No treatment fits everyone and understanding one’s unique situation is needed to determine how to move forward

By Scott J. Leenan, MS, LPC, CRC

familyrecovery

Addiction & Family Recovery

Addiction is often defined as an illness not just of the individual, but of the entire family.  Any change in the behavior of one family member affects not only each of the other family members, but the family system as a whole.  When a family member has a problem with addiction, the family responds in a variety of ways, many of which are deemed unhealthy.

Family therapy, even in only a few sessions can be an invaluable tool in reducing the family’s feelings of guilt or confusion related to addiction.  Family therapy can also be helpful in preparing a family for changes that are needed to enhance and maintain the addicted person’s recovery following treatment.  Understanding some aspects of addiction and the roles a family adopts are a key to recovery for the addict and the family because insight and understanding can help us move forward and inform action.

A family often adopts rules of behaviors and roles so that the family can adjust to having a family member with active addiction.  The rules and roles serve as survival techniques and are in response to and a way of dealing with the addiction in the family.  They are an attempt to bring order and stability to an often chaotic and stressful family structure.  Even though a family member might be in treatment and/ or early recovery, the rules will continue to operate within the family and be passed from one generation to the next, so a basic understanding is key.

There are four general rules that typically operate in a family struggling with addiction.

  • The Rule of Rigidity
  • The Rule of Silence
  • The Rule of Denial
  • The Rule of Isolation

 

The Rule of Rigidity—A family struggling with addiction is highly inflexible.  It doesn’t adapt to change very easily and is fights to keep its family members in line.  Its rigid behavior is an attempt to deal with the addiction within the family.  An individual struggling with addiction is unpredictable and the family learns to anticipate the increasing variability of its addicted member.  In order to maintain some stability, more and more rigid rules of behavior are imposed on the non-addicted family members.

The Rule of Silence—Families affected with addiction are bound by the rule of silence.  They cannot talk about what is happening within their family.  The rule of silence doesn’t just pertain to talking to people outside the family, but also restricts family members from talking to one another.  It not only prohibits talking about the behaviors and actions of the family, but also discourages discussion about feelings.  The family has a vested interest in keeping its members quiet about what is going on inside the family.  If there were open and free communication, individual members would be forced to change.  The rule of silence is often so strong that children who grow up in this type of family system have difficulty expressing themselves for the rest of their lives.  The rule of silence operates at the expense of one’s emotional well-being and one’s ability to function honestly and openly in the world.

The Rule of Denial—The denial within a family struggling with addiction begins with the denial that there is any problem with addiction itself.  As the behavior of family members becomes more and more dysfunctional, the denial becomes stronger and stronger.  If the family system can effectively deny what is happening, it does not have to change.  The people in this system are told to deny what they see, hear, and feel as if it’s not true.  Not only are they told to ignore the behavior of the addicted member, but they are also supposed to pretend that nothing is wrong—to pretend that things are “normal.”  It becomes increasingly difficult for members to differentiate between what is real and what is pretend.  Over time members becomes less confident in their ability to trust themselves and others.  In addition to denial of behavior, this concept also applies to denial of feelings, which are hard enough for most people to understand, but denial of one’s feeling creates additional confusion.

The Rule of Isolation—A family with rampant addiction is a closed system.  It resists the movement of his members and resists adding outsiders as members.  The members cling to each other emotionally, but rarely if ever become intimate.  The family tries remaining self-sufficient, believing that no one outside the system could understand and that no one outside the system should be trusted.  The system cannot afford to have outsiders know what’s going on inside the system.  As the family’s behaviors become more extreme, the family becomes more and more isolated.

To become a health person and a member of a healthy family system it is helpful to understand these rules because by identifying them, one has the ability to break the cycle.  If the cycle is broken there is an opportunity to become healthy and lead a happy life.  This process is neither easy, nor quick, but it is possible and there are many people who are breaking through the chains of rigidity, silence, denial and isolation.  For more information about family therapy work at Intown Counseling & Wellness, please call our office at (404) 478-9890.

by Scott J. Leenan, MS, LPC, CRC

 

 

 

Group Therapy Treatment for Recovering Professionals (or the High-Functioning Addict)

During my time as an addiction therapist, many of my high-functioning, professional clients have remarked at the difficulty they feel in relating to other alcohol and drug addicts at 12-step meetings. Their reasons for this vary, but usually revolves around a common theme: Their addiction has not resulted in the same “rock bottom” as the other addicts who attend the meetings. While they admittedly have been drinking or using drugs excessively, they may not have lost their job, all of their money, been in rehab, been to jail multiple times, or been unable to maintain their family life and friendships. Because of this, there is a tendency to minimize or deny that they have an addiction problem until an eye-opening event makes it impossible for them to ignore their problem anymore. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) reported in a 2007 study that 19.5% of all alcoholics (nearly four million people) are of the “functional” subtype.

Being a high-functioning addict is equally as dangerous as being a lower functioning addict, and possibly more so. First, the warning signs tend to be overlooked due to the idyllic appearance of the high-functioning addict’s life. Second, treatment is frequently delayed. As there typically are underlying causes for dependence issues, some high-functioning addicts have the means to take extraordinary measures to keep their psychological discomfort away, such as going on a shopping spree or buying themselves a new car when they feel depressed. And finally, when these individuals fall, they fall hard because they have so much to lose. All of these reasons make it imperative for these high-functioning addicts to seek out timely and appropriate therapeutic help to support them in their recovery process.

While peer‐led self‐help groups, such as Alcoholics Anonymous (AA), can help keep the individual who abuses substances abstinent, group therapy really should be a staple of their recovery process. Group therapy provides opportunities for high-functioning addicts to understand and explore the emotional and interpersonal conflicts that contribute to their abuse amongst other relatable peers and a licensed therapist. The Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA/CSAT) reported in 2005 that “people who abuse substances often are more likely to remain abstinent and committed to recovery when treatment is provided in groups because of rewarding and therapeutic forces such as affiliation, confrontation, support, gratification, and identification. The capacity of group therapy to bond patients to treatment is an important asset because the greater the amount, quality, and duration of treatment, the better the client’s prognosis.” To find out more about our group therapy options, check out the Group Therapy Service page on our website, intowncounseling.com.

 

Written By Melissa Macdonald

MentalPress 9

What is Mindfulness and how it can be used to reduce Anxiety and Depression

Mindfulness has attracted a lot of attention from researchers and practitioners over the past 30 years and is the subject of a rapidly growing body of research.  Studies suggests that the practice of mindfulness is helpful in alleviating the symptoms of many problems, including generalized anxiety, depression, borderline personality disorder, eating disorders and drug addiction, as well as improving one’s overall well-being.

So what is Mindfulness?  The word “mindfulness” may conjure up images of yogis, incense, prayer flags and Buddhist monks, but simply put it’s the practice of “nonjudgmental, moment-to-moment awareness.”  More specifically, mindfulness is a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations without judgment.  You can think of it as a mental discipline that helps reduce a person’s tendency to react to one’s thought in ways that may lead to stress.

Most of our minds tend to become preoccupied with thinking about the past, planning for the future, and labeling and making judgments about our everyday experiences.  While this is a normal human tendency, our racing minds can lead us to feel mad.  I don’t know about you, but my brain seems to have a mind of its own!  When we’re mindful we can observe our thoughts and feelings from a distance, without judging them as good or bad giving us the space to be present in the NOW.

I try to teach the concept of mindfulness to nearly every client who comes into my office these days.  Even in small doses, mindfulness can help with mood regulation with impressive changes in how we feel and think.  We can practice mindfulness at any time during the day and we can integrate mindfulness into our daily activities (washing dishes, doing the laundry, or even on your drive to work in the morning).

While mindfulness can be done anywhere, a formal meditation is also a helpful practice even if we only have a few minutes.  Nothing complicated here, just quietly observe whatever enters your field of awareness—whether thoughts, emotions, or sensations—without emotionally reacting to or judging them.  Think of your thoughts as clouds floating by in the sky of your mind and allow the clouds (thoughts) to gently pass without reacting to them.  It will take some practice, but with time you’ll get better.  If you prefer some guidance, there are plenty of guided meditations on the Internet.  I like those found on the UCLA Mindfulness Awareness Research Center website.
For many this is a new concept, so experiment with the idea in your life and lean into it.  Mindfulness is a fundamental concept in my counseling practice, so I will post more blogs on the subject.

Scott J. Leenan, MS, LPC, CRC
Executive Director & Therapist

Is therapy an appropriate place for me to work on setting SMART goals?


People often enter counseling when something in their life has caused them some sort of discomfort. Being uncomfortable is usually tolerable for a short period of time, but it isn’t a place we want to linger for too long.  Discomfort creates a doorway for change because it forces us to find way of alleviating our discomfort that’s not always available when life is status quo.  Our personal problems can provide an excellent starting point for creating personal goals.

The idea that our destiny will find us often holds people paralyzed from taking a more deterministic stance.  During counseling, I often help people understand the necessity of goal setting by using the analogy of going on a trip without deciding on a destination first.  It sounds silly to think that any of us would take time off of work without making travel plans, booking a hotel room and browsing the internet to find attractions that seem interesting to us; however, many people take that position when it comes to many life decisions.

Goal setting is a powerful process for thinking about one’s future and goals help keep us motivated and on course.  If goal setting sounds too stuffy or old school, then it might be helpful to think of goal setting as dreaming, which is nothing more than using your imagination. It may sound counter-intuitive, but I suggest considering the “big picture” and identify large-scale goals that you want to achieve.  Then, you break those larger goals into smaller targets that you must hit on the way to reaching your “big picture” goals.  Consider spending time brainstorming the various arenas in your life such as family, career, education, finances, health, spirituality and your social life. You will likely need to condense your ideas to focus on a manageable number of goals.  By knowing what you want to achieve, you know where you have to concentrate your efforts and the more quickly you can spot the distractions that may lead you off course.

If you have problems setting goals or you anticipate needing support, working with a knowledgeable therapist can be an invaluable tool.  Therapists can help draw out your personal goals by asking the “magic wand question.” The question goes roughly as follows: “If I could wave a magic wand in your life/business/career right now, what would you like to have happen?”  Asking yourself this question can serve to identify possible goals that you can work on.  Research also suggests that your chances for success increase when you make S.M.A.R.T. goals.  Your goals should be S=Specific; M=Measurable, A=Attainable; R=Realistic; and T=Timely.

Written & Published By: 
Scott J. Leenan, MS, LPC, CRC
Executive Director & Therapist

mindfulness101

Dialectical Behavioral Therapy (DBT): Skills Training Group

This group therapy is for clients that may be struggling with any of the following: Poor self-esteem Excessive Worry Impulsivity …

nightmarebeforechristmas

Nightmare Before Christmas

Do the weeks leading up to Christmas seem like a nightmare? During the Christmas season your days may be filled with comments …

Surviving-the-Holidays-PIC

Surviving the Holidays

Holidays are usually a time for amazing food, travel, and for most people a lot of family interactions. While spending time …