Fireworks and PTSD

Every year millions of Americans look forward to seeing fireworks displays on the 4th of July, but for many combat veterans fireworks are anything but enjoyable. For combat veterans with Post Traumatic Stress Disorder (PTSD) fireworks can be triggers that cause them to relive their worst days in combat. PTSD is developed from having experienced a traumatic event such as mass violence. In fact, 67% of people who have experienced mass violence develop PTSD.

Last year Military with PTSD launched a campaign, Explosion of Kindness for which signs were distributed to combat veterans allowing them to let their neighbors know to be courteous with use of fireworks.

via militarywithptsd.org

By spreading awareness, less veterans were subject to unexpected triggers coming from fireworks being launched near their homes. If you do not know if a combat veteran with PTSD is living near you, consider going to a public fireworks display instead of launching fireworks from your own backyard.

There are 7.7 million American adults suffering from PTSD and one of them might just be your neighbor. When celebrating this weekend please be mindful of those around you.

NECBT intern

Kelly Masotta

5 Ways to Rediscover Joy

Dreams are strange. I have not studied dream interpretation but do find dreams to be fascinating. I generally do not remember my own; but when I do, I pay close attention. This week I had two memorable dreams. The first was actually a nightmare that included terrorism. The second was about a patient that came into my office (never saw this person before) and she said to me, “I’m too serious all the time”. She wanted to find out how to get her joy for life back. My response is inspired by both of these dreams. How do you get less serious and find joy?

1.      Turn off the news – Yes, I realize that it is important to know what is going on in the world but when we are bombarded over and over again with negativity and bad news it can have a disturbing impact on us. There seems to be no good news, which inspires hope, to balance the bad. Negativity breeds negativity and when terrible events in our country and world are replayed over and over, it can bring on a sense of angst, anger and fear. What also happens is one of our Mental Mishaps (general irrationalizations), Generalization. This means when something negative has happened, sometimes we believe it will keep happening even if it hasn’t happened to us. I have patients who are not living fully by deciding not to do things even if the possibility of something negative happening is so remote. Imagine the good things they may be missing because of their fear. Fear may eliminate the possibility of joy.

2.      Go outside – Yes, spend time in nature. Go to a state park, national park, botanical garden, beach or wherever you can find some beautiful nature to see, smell and feel. Beauty in nature can take you outside of yourself, remind you of how beautiful life on this world can be and distract you from negativity. Nature can build joy.

3.      Endeavor to take yourself less seriously – Oh boy, there are so many ways we do this. The most common way is with negative self-talk. Why do we beat up on ourselves so viciously? Try to be more empathetic to yourself. Be kind to your mind by changing your negative thoughts through I-CBT and you will feel more joy.

4.      Resolve conflict - Another way that we take ourselves seriously is through our righteous indignation. You know, when we feel we are right or have been wronged and no one can tell us any different….wow, does that sap some joy. That is the time to assertively and diplomatically start a conversation toward resolution. Then try to let some of that indignation go and move forward. Forgiveness can give you more peace which can lead to the possibility of joy.

5.      Do something for others – It is wonderful when you decide to do something for someone else and receive the unexpected benefit of feeling really good inside! Reach out to others in some way. It doesn’t take much; random acts of kindness are easy. Volunteer or even just talk in a friendly manner to the person waiting in line. It just may brighten the day for both of you.

Some of these actions are easy while others are hard. The point is that the more we allow situations, things or people to have the power to steal our joy, the less joy we will feel. Remember the first Cognitive Emotive Rule: It is not people, situations or things that make us feel bad, it is what we think about people, situations and things. Change your thinking and choose joy!

Bonnie Lillis, LPC

Moving Toward the Middle Ground

I have someone in my life that tends to live in the zone of inflexibility. What is this? It is called “rigid thinking” or thinking in black and white terms. I like these definitions: “unable to bend or be forced out of shape; not flexible, not able to be changed or adapted.” Now, before I go on I should say that there are occasions that we all have rigid thinking, especially when it comes to something that pushes against a strong belief system. Rigid thinking only becomes problematic when our passion to be right overrides our rationality.

Another term for this is all or nothing thinking – what we call a mental mishap taught through Interpersonal Cognitive Behavioral Therapy. What is the matter with this type of thinking?  THERE IS NO MIDDLE GROUND! Unfortunately, this type of thinking is so problematic because it does not allow for the sharing of ideas, being able to communicate effectively, and can be extremely destructive in relationships.

One of the things I notice about people who live in the zone of inflexibility is that they seem to feel that they are right. There is this righteousness (arrogance?) that comes across in their language. Almost as if they are thinking, “how can you not agree with me???” When I hear a patient express this type of thinking, I frequently hear myself say something like, “how is this thinking helping your relationship? Will your rigidity hurt or help your relationship?” You see frequently people who have all or nothing thinking often struggle in their relationships. It is hard to live with someone who is inflexible.

It is my job to point out the irrationality of this form of thinking. With I-CBT I ask people whether their thinking is actually factual or is it just their interpretation. I ask them if they are getting their needs met, whether they ultimately end up feeling good and meet their goals. The answer is generally no, no and no…..yet somehow it is hard for them to challenge their irrationality even if they can see that it doesn’t help them. This is one of the most difficult challenges for an I-CBT clinician – to watch such self-destructive behavior all in the name of feeling “I’m right and you’re wrong!!”

Guess what – there is always a middle ground. It occurs when we are able to step back, push the emotion aside, listen to the other person, challenge our irrational thinking and then compromise. Even if it means to agree to disagree, it still has a much better outcome than pushing others away with inflexibility.

What are your areas of rigid thinking? Do you recognize when you are using this? If not, ask a family member. I bet they would be happy to educate you! Next see if you can become more aware when it happens and then use I-CBT – life can be much more rational when you can learn where the middle ground lies.

Bonnie Lillis, LPC

5/27/16  

Bring Back Playtime!

I love having my grandson around. Jack has only one job – to play! Through his play he learns how things work, learns disappointment when it doesn’t work and gets downright silly when his Grammy makes funny noises. It made me remember what my playtime was like.

How many of you remember these games?

Red Rover

Mother May I

Hide and Seek

Kick the Can

Spud

Chinese Jump rope

Roller skating or Skate boarding in the street

Building forts and pretending we were King of the Mountain

Pick-up basketball, baseball or football

I come from a ridiculously large family and grew up in a variety of houses and neighborhoods as we moved frequently. My favorite memories took place in a large stone house in Buffalo, New York. The rule was to go outside and don’t come in until the street lights came on. This neighborhood was full of kids to play with. However, even if there was no one to play with, we made up games to play with each other. Some of the games we made up were Medusa, Bombs over Tokyo (yep, post -World War II offspring) and Sock War. There was another one but for the life of me I can’t remember what it was. Most games involved chasing after one another or using objects to throw at each other. Kick the Can was my favorite – we almost always had a lot of kids around to play that game. I had this memory that our yard was huge with so many places to hide. Years later I visited this house and found the yard to be quite small. The point was that it seemed like a vast adventure land full of fun memories.

My kids had it a bit different. We didn’t live in a neighborhood that was swarming with kids but we had a large back yard and bikes for them to ride around town. I remember them having friends over all the time (not arranged) and they would be wrestling, playing karate, shooting hoops, making music or riding their bikes in the woods. They didn’t have a video game console. There were no cell phones and computer time was limited. They did go to other kid’s homes and played video games and computer games. I’m sure they could tell me some of the other things they did but that’s okay – sometimes a mother doesn’t really want to know!

I wonder what the kids of this generation would tell me. When I walk through the waiting room at work I see just about every child and teen playing video games on I Pads, or scrolling through social media on their cell phones. Their lives are more scheduled with structured activities like gymnastics, dance, structured baseball, basketball, soccer leagues, and scheduled play dates. One teen I counseled didn’t have friends, but boy oh boy, did he have a lot of friends through on-line computer games! I found this to be very scary.

What may be lost in this electronic age is emotional intelligence. Emotional intelligence is important because it will determine your ability to navigate the world and have your needs met. Some of the most successful people in the world have a higher level of emotional intelligence. What is emotional intelligence? It is being able to be intelligent about emotions. It is being able to connect with your own emotions, manage them appropriately, recognize emotions in others and relate to others in a healthy manner, feel with people (empathy), have motivation to work toward goals, have good social skills and adaptability to different environments.  How can kids today develop emotional intelligence if the majority of their time is spent on electronic devices? Will they understand the difference between what is actually going on and what others are choosing to show them on social media? Will all of their text messaging help them to learn the importance of recognizing non-verbal cues such as facial expressions and body language? How will they learn to have imagination if their time is always scheduled? How will they learn to manage disappointment if everyone on the team gets a trophy? How will they learn to make friends if play dates are arranged for them? How will they learn to manage conflict or develop empathy if their world is social media and video games?

Although there is research that the use of electronics may have a positive impact on the brain due to strengthening the neurons that help with focus and concentration, the negative impact is the lessening of social skills. What gets lost? The ability to recognize their own emotions and the impact their emotions have on others, their ability to manage their impulses (just look at Facebook and Youtube!), learn the importance of goal setting, empathy (again, look at Facebook and Youtube), manage conflict, develop leadership qualities and adapt to different social situations. Dropping the electronics and having unstructured play can help build emotional intelligence.

I hope that unstructured play will be a big part of Jack’s life. When I am with him, I plan on modeling good emotional intelligence. If he didn’t get this, he would be missing out on the most important learning process in his life as he wouldn’t be able to relate to others in a positive way as well as get his needs met.

How about you? Is it time to limit your kid’s time on electronics? Is it time to tell them to go outside and use their imagination? Let’s see Jack, where can we play Kick the Can?

Bonnie Lillis, LPC

Clinical Director, NECBT

To Accept or not Accept? Radical Acceptance used with Interpersonal-Cognitive Behavioral Therapy

Have you have had a situation in your life when someone you love either does something or says something that is seemingly totally irresponsible and incredibly hurtful? I am guessing most of us have. Since this has occurred in my life very recently, I have been trying to figure out the most rational manner of dealing with it. Of course, I have used Interpersonal Cognitive Behavioral Therapy (I-CBT) to recognize my angry and sad thoughts and have been challenging those thoughts on nearly a minute by minute basis. Yes, I am really angry and really sad. Unfortunately, it is a situation that has no comfortable solution and one I have absolutely no control over.  Aren’t those the most difficult?

One of the components of I-CBT that we teach here is the five cognitive-emotive rules. The first rule is “It’s not the people, things or situations that make you feel bad, it’s what you think about the people, things or situations”. This is so very true in my situation, because I was actually thinking that it was so and so’s fault that I feel this way (sound familiar?) Actually, it was what I was thinking about the person’s motivation to do what she did and interpreted it negatively (mind reading!). As a result I became very angry and sad because it caused pain for several members of my family (including me). I am very protective of my family and unfortunately take anything that is said against one of them as a personal attack. This is my baggage – I am quite aware that it is irrational. However, this is clearly a situation that I need to come to a place of radical acceptance. I can do that through challenging my irrational thoughts and coming up with alternative situations. Radical acceptance is quite a concept – easy to understand, difficult to accomplish. However, the more I focus on this, the more I can use it in my current situation.

So, what is Radical Acceptance? It is to acknowledge the present situation without judgment of the events or criticizing yourself or others. It is when you recognize that the present situation is due to a chain of events that began far in the past. Radical acceptance is looking at yourself and the situation and seeing it for what it really is. It means that you stop trying to change the situation through anger and blame; just that you can refocus on what you can do now. This is very much in tune with I-CBT – seeing your thoughts for what they are and challenging them to calmer thoughts which leads to changing how your feel about the situation.

Here are some of the statements of radical acceptance or challenged thought statements that have helped. Note that many of them come from a place of emotional intelligence through the use of empathy:

• I can’t control other people’s behavior; I can only control how I think and feel about it.
• I can’t change what has already happened.
• Everyone has some brokenness; perhaps that person is coming from a broken place.
• Everyone is doing the best they can in this situation.
• My righteous anger can only create more hurt if I allow it.
• I know that I need to be forgiven for some of my past decisions; can I not offer forgiveness in this situation?
• It is what it is. 

I want you to know that radical acceptance (just like forgiveness) does not mean that thoughtless behavior is condoned. It means reframing the thinking that may lead you to irrational vindictiveness or hurtful behavior. It means being able to be in the moment, without judgment, and seeing the situation for what it is. Then you can use new rational coping thoughts and actually feel some peace and empathy instead of rage, indignation, and hurt. If you do this, imagine how you will be able to communicate your thoughts to the offending party – you will be able to talk about this in a diplomatic, assertive, and calm manner. This tends to be much more effective than flying off in a blind rage or using vindictiveness.

Practice radical acceptance along with the I-CBT concept of challenging your thinking and creating new, calm thoughts. You will feel better for it!

Bonnie Lillis, LPC

Clinical Director, NECBT

Emotional Intelligence Versus Entitlement

I was thinking about the word “deserve” today. I was working with a patient who had very definite ideas of different things that he deserved. This person had the mistaken belief that he was entitled. I began to challenge this notion of entitlement specifically because I believe this person did not have a clue that this is not how life works. If he continues thinking this way he will have a very difficult time finding satisfying work, quality relationships and a meaningful life.

So in reality, what do we “deserve”? We deserve (or need) water, food, and air. We do not deserve to have the newest electronic device, the highest paying salary, or have people clean up our messes.

Unfortunately, I have seen an increase in this entitlement thinking lately in my work with kids and teens. Entitlement means “the belief that one is inherently deserving of privileges or special treatment”. Inherently means “essentially”. If I thought I was essentially deserving of special treatment that would mean that I could do what I wanted when I wanted, have people wait on me and always be treated like a queen. Nice thought….totally irrational and unrealistic. If I felt this way then how many employers would want me as an employee? How many people would want to be around me? Who would want to be my spouse? Nada, None, Zero. The point is that none of us are deserving of special treatment just because we exist. We all have to earn respect, be flexible, compromise and understand that we are not better than anyone else or less than anyone else.

If our kids believe that they don’t deserve to be made to go to school, that their parents are supposed to take care of everything for them, and are entitled to getting everything they want, then we are dreadfully failing in our true responsibility as parents. It’s time to start teaching our children Emotional Intelligence instead of Entitlement. Did I hear the question “What is Emotional Intelligence?” It is:

• How to recognize our own emotions and how those emotions impact others
• How to be aware of others feelings
• How to be motivated towards goals
• How to have empathy
• How to have good social skills
• How to socially adapt to different situations

Emotional Intelligence will help our kids be kind, flexible, responsible and feel good about themselves. Entitlement will only lead to disappointment and irresponsibility. I encourage parents to strive to teach your children Emotional Intelligence – it’s not too late to start eliminating the entitlement idea and learning the emotionally intelligent way!

Bonnie Lillis

Clinical Director, NECBT

Catch 22: School Exercises Better Prepare Kids for Danger?

A few weeks ago our family’s nightly dinner discussion became centered around my 10-year-old son explaining what it was like to experience a school lock down exercise earlier that day. As he “in a matter of fact way” told his story about a teacher instructing him and his classmates to hide; I couldn’t help but notice a tinge of fear in his voice. Was his fear more projection on my part? Possibly my own fears and anxieties coming into fruition, due to concern for the welfare of my boy and the overall reality of the world we now must live in? This shocking authenticity proclaiming that “I’m here to take your life! I’m here for your children and to deprive you of the very freedom that you hold dear!” The freedom that so many sacrificed and gave their all for; only to replace it with fear for our lives, distrust and vigilance. Was my boy overtaken with this same fearfulness? or “to him” was this simply a certainty that we all must live with? A realism that will soon become a “normal” part of an ordinary day in the life of a child "similar to the cold war air-raid exercises of the 1950s?" The only difference being the cold war attacks did not occur, but legitimate terrorism "more recently" has occurred and "in 2001"on a mass scale. The words I heard on the news days before regarding the San Bernardino attacks echoed through my mind “terrorist attacks are usually done and over before the police arrive.” “We have three options which are to run, hide, or fight.” It makes sense for our schools to break down our children’s options to only two of those choices which are to “run and hide.”

When pondering the overall effects that these modern world threats may have on our children we must understand a few relevant points. Our kids tend to break the world down to its simplest form. They look at things two dimensionally in terms of good or evil, friend or foe. After listening to my child describe ISIS, I realized it sounded more like the dark side in the Star Wars films. Regardless of all the complexities involving human nature, my son was absolutely correct! The difference “of course” being that Star Wars is a fantasy science fiction and fundamentalist terrorism as well as homegrown terrorism along with the deadly promises that both embody are about as real as it can possibly get.
I believe that the effect of the "terrorism threat" on our children can be compared to exposure to other types of violent threats that occur within the backdrop our society. The majority of human beings “children included” are resilient. In time children begin to habituate to specific situations and conditions. In other words, once they become used to lockdowns and the overall threat of attack, the fear or “anxiety” is incorporated into their everyday lives and they eventually learn to adapt “somewhat like the soldier who learns to adapt and survive in the wartime theatre; who learns to sleep at night with bombs detonating in in the backdrop.” In this day and age learning to be prepared for potential threats of violence is an absolute necessity. This does not necessarily mean that children who are warned about the dangers of terrorism and better prepared for it will constantly struggle with anxiety or trauma. Nor does it mean that they’ll have to contend with mental illness throughout their lives. When children become clinically anxious or traumatized, it’s usually associated with direct or continual exposure to violent acts and images or physical abuse and/or neglect, which is not necessarily correlated with learning self-defense or being taught where to run and hide when you’re being targeted by predators. However, it’s probably not a good idea to allow children to view graphic, violent images of the atrocities associated with terrorism or to let them watch overly violent television shows meant for mature audiences. Allowing our children to incessantly play violent video games on a continual basis is also not a good idea. These vehicles can become preoccupations and are known to produce genuine anxiety and fear in our children and sometimes aggression. 

Please do not misinterpret what is being said here. The world has changed and it is a very different world that we are raising our children in. We need to face this fact. These changes do indeed affect our children’s emotions and thinking as well as the forming of their beliefs and ideologies. But, let us not associate the teaching of preventive measures, preparation and vigilance and proper informative discussions with them about terrorism, violent threats and safety as direct causation for our children to become overly anxious, traumatized, insecure and significantly unstable. Being made ready is a good thing and it saves lives. The limiting of preventative measures such as lockdown exercises and failure to explain these very real threats to our children would leave them ill-equipped and more exposed to danger. I believe that It is better to be educated and informed than not prepared.

Dr. Thomas Cordier is an author and public speaker on mental health topics. He is also a researcher and psychotherapist specializing in cognitive-behavioral treatment aspects. His book entitled, "An Introduction to the Interpersonal-Cognitive-Behavioral Therapy Treatment System (I-CBT): A Recie for Mental Health Treatment Success" is curently available worldwide. He has extensively researched the efficacy of an interpersonal, integrative approach to cognitive-behavioral-therapy (CBT) and created a model and manual that is easily comprehensible regardless of the patient's age or learning abilities. Dr. Cordier created the interpersonal-cognitive-behavioral treatment program (I-CBT and the I-CBT Family Systems Program at the New England Center for Cognitive Behavioral Therapy (NECBT) and the NECBT Cordier Institute for I-CBT. http://www.NECBT.com