Dear Creatively Patients,
Effective today, June 20, 2017, I will be beginning my maternity leave. Please allow one week for me to contact you about scheduling if we have made telehealth arrangements. Otherwise, please allow for 2 weeks before contacting me for an appointment. Appointments will resume in 4 weeks from today. For emergencies, don't hesitate to call 911 or go to the nearest emergency room. For non-emergencies that are urgent, please refer to your list of urgent resources in your new patient paperwork, also found on the "Services" page under "new patient paperwork."
Wishing you the best in your mental health,
​Cindy

 When I talk about journaling as a therapeutic tool, I am not talking about "Dear Diary, today I..." entries.  I am talking about what I commonly describe to patients as a daily emotional download- a freestyle writing session of what is on your mind, what you are feeling, or what you need to "dump" somewhere to free up some space in your brain.  Sometimes I may recommend specific topics based on our session for you to explore and try to make connections about- this homework-style journaling is also important.  I will not recommend journaling to my patients without some simple guidelines and words of caution.  Journaling is a powerful creative tool that is healing when utilized in the right way. 

 If you are interested in using journaling a word of caution: since it can be such a powerful tool, please do not embark on this unless we have first talked about its usefulness to you in your process, as well as safe and responsible ways for you to utilize it.  Specifics, as always, will be particular to you and your journey.  The following guidelines, however, are important for your journaling in general. Come back and review these tools as often as you need to as you write. 

First, it is important to briefly explore: why is journaling so powerful? I will give you the analogy I frequently use with kids and teens.  Imagine a balloon, filled up with air.  You are holding it by the end, pinching it off so no air will escape.  You can at this point either add more air (balloon may explode) or release some air (to prevent this).  Imagine you let go of the balloon- what does it do?  Flies all over the room as it expels the air that was trapped inside (also not a good plan).  In a simple analogy, journaling is powerful for one reason because it is releasing air from your balloon so it won't explode.  However, there are techniques to use while journaling to prevent your balloon from flying out of control (imagine releasing some air through your fingers, then pinching the balloon closed again, for example).  A guideline that is important here is emotional containment. 

Emotional containment, simply put, is containing your emotions.  We do this by creating parameters for how long we will expose ourselves to something emotionally triggering.  For journaling in the beginning, for example, I will recommend writing one page, freestyle, then stopping.  Put the journal away (have a place for it like a drawer or a shelf) and follow this with another activity that is completely different.  Read a book that is not related to what you wrote about (SciFi or Fantasy anyone?) Take a warm shower, take a walk, go into a different room- do something different to "close" the journaling activity.  Do not continue to write, do not sit and ruminate, do not call someone and rehash what you wrote, etc.  Separate the time and space from the journaling activity with something else.  Limit the amount of time spent.  This is a simple, but important journaling guideline. 

A second reason why journaling can be so powerful: you will make connections in your brain.  Have you ever heard the studying recommendation: see it, say it, write it down?  Our brain processes information in different ways, and by writing about things you have also talked about in therapy, looking back over what you have written, writing more, etc, you are helping your brain make powerful connections about your experiences, both past and present, and how they impact you.  These can be significant and emotional realizations, that also need support and rules to help protect you and assist you in receiving them in a positive way.  This guideline for journaling is to simply be sure you are discussing in session what you are writing and following your therapist's recommendations when you return to write again.  You may not always have to do this as thoroughly as I would recommend that you do when starting out,  but, until you learn more about your journaling process and how it impacts you this is a very important guideline.

When you are journaling in therapy, talk to your therapist about what you write, what you learn about yourself, how you feel before, during and after, and how the work impacts your symptoms.  Like most therapeutic processes, you will work with your therapist to adjust and mold this tool to best help you on your journey to mental wellness!

(c) 2017 CREATIVELY, LLC

Therapists like to tell you that your thoughts are powerful and affect how you feel. We will tell you to use positive affirmations and to think positively and it will in turn make you feel better.  We watch you take this skeptically.  After all, can it really be so simple?  Yes and no.  Will it cure what ails you?  Probably not.  Will it be an impactful and important tool for your recovery? Absolutely.

Here is a simple illustration of positive thought:  Think about a freshly baked, warm, chocolate chip cookie.  Smell it?  Taste it?  Want one?  How about this negative one:  Don't think about an elephant.  Did you?  I never can help myself.

The truth:  our thoughts build our reality, including our sense of ourselves, our lives and the world around us.  We believe what we have been exposed to, things we regularly tell ourselves and/or hear from others.  We have inner monologues and committees shaping and discussing our viewpoints.  The louder and more repetitive the thoughts, the more impactful on our mood.  Negative thought exposure, especially when repeated over time, makes us feel negatively.  I think most of us can agree and come up with examples of negative people, places and things that have this effect on us. Doesn't it follow that positive thoughts work the same way?  It does!

A secret:  most of us are not as good at giving ourselves positive thoughts as we are the negative ones.  That means other people, places and things we are exposed to are likely to follow this same pattern.  What to do?  Start with yourself.  Fake it until you make it.  Also known as: positive affirmations.  This cheesy notion was right all along!  Come up with some phrases that are positive, and tell them to yourself regularly.  It will probably feel silly for awhile- but like the negative thinking, the positive talk will take time to build.  If you stick with it, it will be impactful.  You will find, in time, instead of thinking the automatic negative messages, you may say a positive one to yourself first.  Other areas in your life will begin to be impacted by the positivity until you find yourself looking for and appreciating more positive things, despite negative messages that still fill our lives. 

Are you ready to take control of this simple principal? Talk about it in your next therapy session. Problem solve some of your negative thought processes that you can start to replace with more positive messages.  Discuss ways to adhere to this new practice and watch your life change!

(c) 2017 CREATIVELY, LLC

What are biopsychosocial approaches?  Why are they important?  In treating mental health problems, I, like many other clinicians, take a biology-psychology-sociology approach.  This means I believe the etiology of mental health problems arise from a combination of biological, psychological and sociological factors.  As such, it is important to treat and address each of these in working towards symptom resolution.  Here is a brief summary of what each aspect is as related to your mental health, and some treatment approaches that may be discussed as part of your therapy session:

BIOLOGICAL:  The brain operates on electrochemical signals sent through the use of neurotransmitters.  When emotions are out-of-whack, this means that the neurotransmitters in the brain are out-of-whack, too.  Ever heard of serotonin, dopamine, norepinephrine, or epinephrine?  These are just some of the neurotransmitters responsible for our emotional responses in the brain.  Sometimes clinicians will call etiological symptoms from neurochemical imbalances "endogenous,"  meaning we are feeling too many effects of certain neurotransmitters and not enough of others.  There are both natural and psychopharmocological ways to treat endogenous symptoms.  In other words: there are natural and medicinal ways to improve the balance of neurotransmitters in your brain and reduce your symptom presentation.

PSYCHOLOGICAL: Therapists spend a lot of session time here.  This refers to cognition, or the way you think.  We may be predisposed to certain thought traps, patterns in our thought processes, assumptions, negative or anxious thoughts or other cognitive pathways that are precipitating our symptoms.  Identifying and addressing these in therapy has also been the focus of many theoretical approaches in psychology.  Have you heard of CBT? DBT? REBT? These are just a few of many theories in psychology that explain how the way we think impacts the way we feel, and by making changes in one, we can make changes in the other.  Recognizing and changing to healthier cognitive patterns is an important way to reduce your symptoms.

SOCIOLOGICAL: Human beings are greatly impacted by the interactions that they have with others throughout their lives.  Understanding these interactions and their impact is another powerful treatment tool.  Things like trauma, difficult life experiences and challenges, current stressors, grief and loss, relationships and more are all examples of sociological factors that impact us and our symptoms.  Looking for ways to build social support and address gaps in our support system is also an important therapeutic goal in therapy.

Consider when you are working towards mental wellness, your journey will include addressing and improving your biological, psychological and sociological health.  Expect to spend time in therapy on each of these and share your own insights and experiences on how they impact you.  The good news is, not only are symptoms presented and impacted in each of these ways, but each area also represents a group of tools to help you feel better!

(c) 2017 CREATIVELY, LLC

Friends in mental health:
I have decided to commit to a schedule of weekly mental health topics updated on this news feed! As I have worked in mental health over the years, I have noticed common psychoeducational topics, therapy themes and other information that I believe it will be beneficial to keep available to you for review and reference on my website.  I will refer you to these topics as reminders for homework assignments, as summaries of things we may have reviewed in session, things to read about between appointment times, information for friends and family members and more.  I will share links to the updates on my social media so you can easily find them.  And- don't forget you can always read up on past topics here in the archives!  If there are topics you are interested in having addressed in this format, send me an email, bring them to session, or share with me on social media. Coming up first:  biopsychosocial mental wellness.  Stay tuned!
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(c) 2017 CREATIVELY, LLC