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To cope or not to cope…

When you think of “coping” with a problem, how do you define that term?  Here are three definitions of “cope.” (1) To deal with and attempt to overcome problems and difficulties, (2) To deal effectively with something difficult, (3) To deal successfully with a difficult situation.  Notice that in each of these definitions of coping, it is not simply enough to “deal with” a problem; the key is to do so in such a way as to “overcome” it “effectively” or “successfully.”

When you become aware of a problem in your life, what do you do?  The problem might be a troubling present situation, or may be one that is coming, perhaps just around the corner.  Viktor Frankl, a famous doctor, writer and concentration camp survivor, teaches us that there are some situations in which there is absolutely nothing we can do to alter a painful external situation (e.g., being in a concentration camp, being held hostage, etc.), and that in such a situation, one can still exert the “last of the human freedoms,” to alter one’s attitude toward one’s situation and one’s suffering.  However, in most situations, we can most certainly make decisions and act in ways to make our problems dissipate or resolve.

Yet how many times do we find ourselves doing counterproductive things?  We want for the situation to get better and to feel better, but we hesitate to do what is required of us in that situation.  We make the mistakes of being in denial, avoiding, procrastinating, etc. While these avoidance techniques may help you to (temporarily) feel better, what they are also doing is allowing the problem to fester and perhaps get worse.

So, we need to get clear on what exactly the problem is, its’ scope and dimensions, and to do that we need to face it.  After all, how can we solve a problem if we won’t allow ourselves to understand it.  The goal is to figure out a solution, a way forward, to devise a plan, and then to execute the required steps to get there.  So, ask yourself when you come across a situation that is a challenge or problem, “Do I want to solve this, or, not?”  It seems to me that it is far preferable to do all that one can do to alter the actual situation so that the problem is successfully managed.   We can all learn to cope better by sharpening our problem-solving skills, but remember, the most important idea here is that one must first be willing to face and directly confront our problems.  If you will allow yourself do this, you are already on the road to coping better.

Cheers,

Steve Bailley, PhD

All Therapy Is Not Created Equal

Ask anyone on the street what they imagine when they hear the words “therapy” or “psychologist” and you’ll likely hear something along the lines of lying on a long couch, talking about the past, and some form of analysis, whether it be your dreams, childhood, unconscious, or relationship with your mother.

When new patients come in for therapy, they often do not know what to expect. And they often come in with these preconceptions. However, when it comes to mental health treatment, there is a significant amount of variety, from level of training (masters, doctorate) to type of provider (counselor, social worker, physician, psychologist) to treatment approach (psychoanalysis, cognitive behavioral therapy).

We know from research that the single most important factor associated with treatment success is the strength of relationship between patient and therapist, something called therapeutic alliance. However, therapeutic alliance by itself is only one piece of the puzzle, as there are a number of other factors also associated with treatment success. One of these factors is treatment approach, also called theoretical orientation. This refers to how a therapist generally understands and explains a patient’s symptoms or difficulties, and importantly, guides how the therapist will provide treatment.

Cognitive behavioral therapy (CBT) is a treatment approach that assumes emotions, thoughts, and behaviors are connected and influence one other. Patients typically come in for therapy because of unpleasant or painful emotions, such as anger, depression, anxiety, or worry. But the problem is this: Telling someone, including ourselves, not to feel a certain way has little or no effect. Just think of the last time you were angry and someone asked you to calm down, or feeling depressed and told you to cheer up.

Put simply, we can’t change the way we feel just by choosing to feel differently. However, we can change the way we think and we can change the way we behave. And because these are related to our emotions, we can target how we feel.

For example, say your friend is feeling depressed. Simply telling them “don’t be sad” wouldn’t have much success. But suppose your friend is also having thoughts such as “I can’t seem to do anything right,” “things will never get better,” or “I’m a failure.” And suppose they’re isolating themselves, not exercising, or socializing with friends or family. It’s no surprise these patterns would make your friend’s depression worse.

A cognitive behavioral therapist would challenge these thoughts: Is it really true you can’t do anything right? What evidence do you have that nothing will get better? Have things ever been difficult in the past and actually did get better? And what does being a failure even mean? Living under I-10 addicted to heroin? The therapist would also target the behaviors maintaining depression. In-between sessions, they would assign homework to increase more adaptive behaviors, perhaps call one friend each day, walk/run around the block three times this week, or engage in activities they used to find pleasurable.

The take home message is this: Our thoughts and behaviors are not written in stone. They are malleable. Changeable. And behaviors can be learned. Unlearned. Relearned. And it is this very process of change that lies at the core of cognitive-behavioral therapy, and why it is so often successful.

Tyson Reuter, Ph.D.

New Beginnings

Change is hard, but beautiful. After 17 years of being in the same office practicing psychology, we are moving. Not only will we have a new location, but we also have a new practice. Psychology Houston, PC was a concept to bring evidence-based treatment to Houston in a cohesive and direct way. All of us in the practice specialize in treating people with diverse backgrounds and issues utilizing state of the art treatment that has been proven to work in research studies. Treatment is effective, but conducted in a way that really focuses on the therapeutic relationship. In the end, it doesn’t matter what treatment you are doing, if your client does not feel safe, trust in the therapist, and comfortable in the relationship, the treatment will likely not work. So as I packed up my office yesterday I felt sad, but excited for this new beginning. Change is hard and creates many questions and fears about the unknown. As I teach my clients, I am focusing on embracing the unknown, going boldly into the future, curious about how things will unfold over the years to come. Thanks to everyone who has contributed to this move and to all of my clients who have supported my practice over the years, to you all I am truly grateful.

Suzanne Mouton-Odum, Ph.D.