What is Stress Mentality? In S.M. the belief is:
“I can’t take care of myself until I get everything done.”
We have all experienced the short-term stimulation of an upcoming deadline, exam, or speaking engagement, and when necessary temporarily set aside our basic needs to accomplish a higher goal. Stress mentality here refers to a more ongoing, chronic, “self-sacrificial” way of thinking.
Many people self-medicate with sleeping pills, alcohol or other substances, or are prescribed antidepressants or addicting benzodiazepines for stress or anxiety. While medications can play an important role, all too often they are utilized instead of more powerful alternatives, such as changing the way you think, or how you take care of yourself.
What are the pros and cons, the plusses and minuses of stress mentality? Is there a better alternative?
First, what are the plusses, the benefits, of stress mentality?
I. Many people believe they need stress and fear of failure, or bad consequences to be motivated. However, there are much healthier ways to self-motivate (Hint: it is connected to your values and passions).
Now, what are the minuses, the cons, of S.M?
I. There are always things that need to get done.
II. S.M. generates chronic stress and all of its negative effects on the body. (link to Body states Video)
III. Like a car, our mind and body needs basic maintenance to run. I have to put gas in and change the oil even if I’m busy or else bad things happen.
IV. Similar to the car, stress mentality ends up with some sort of breakdown of mind or body.
What, then, is the alternative? The reverse. In Reverse-Stress Mentality the belief is:
“If I take care of myself first I will be more efficient in getting my work done.
“I have to differentiate between what needs to be done and what can wait so there’s balance.”
What are the plusses of reverse-stress mentality?
You start to take care of yourself, therefore you will have:
What are the negatives of reverse-stress mentality?
I. Not everything will get done right away.
II. You have to learn new (healthier) ways to motivate
III. You have to set limits, including saying “no” and sometimes disappointing people.
Most of us have a never-ending conveyor belt of things that need to get done. Many people really believe that they can’t take care of themselves until the belt stops.
When I refer to self-care that means biological, psychological, social and spiritual needs. What gets in the way of carving out time for self-care, or “pushing the pause button” on the conveyor belt? Those factors include:
– Self-worth, how you judge yourself
– Fears about how others will judge you
– Fear of failure and inadequacy
– Fear of getting people upset, angry, or disappointed in you
– Fear of asking for help.
There are many ways to get help overcoming these obstacles; psychotherapy is only one of them. Learning and practicing mindfulness helps to get rid of your judging and fears about how others will judge you. It also helps take your mind out of the past, out of the future, and into the present moment, where it is needed in order to make the best decisions.
Successful implementation of the reverse stress mentality requires skills for managing time and setting boundaries, and these skills are teachable. Coaching or therapy can be helpful. If you have trouble setting boundaries and saying “no,” maybe a 12-Step program such as CODA would be helpful. If you can’t stop obsessing, newer antidepressants help that a lot, with minimal side effects.
Mindfulness (and other types of meditation), physical exercise, and other routine practices can literally change the brain, as evidenced in recent brain imaging studies. It takes hard work but it’s worth it.
Change doesn’t happen overnight. Set an intention, and mindfulness will help keep you focused on that intention. You’ll frequently slip back to your old thinking and behaviors; but when you notice that happening don’t judge – just ground yourself and re-establish your goals.
How To Choose a Psychotherapist
By Jerry Gelbart, M.D., F.A.P.A.
Most people I talk to have no idea where to start looking when they want a good therapist. Many therapists can be amiable, supportive, encouraging, but in 2013 we need to expect more than that. We now have therapies such as Dialectical Behavioral Therapy (DBT), Cognitive Behavioral Therapy, (CBT), Acceptance and Commitment Therapy (ACT), and others that have been shown to be effective in scientific studies, and many therapists are not up to date with these. For example, many therapists still use older models such as Jungian, Analysis, or Supportive therapies that have not proven to be cost-effective in getting the job done.
Here are 7 things to look for if you’re choosing a therapist:
1. Therapist sets tangible goals with you. Goal setting:
a. Gets you, therapist, and other members of treatment team (i.e. Psychiatrist, Primary Care MD) all focused in same direction
b. Helps you see if you’re making progress.
c. Goals help you move forward instead of looking back.
2. Therapist is open minded to various treatments, including nutritional, medications, Eastern approaches, group therapy, hospital outpatient or inpatient. “Whatever works.”
Not defensive, willing to consult with others or send you to someone else if not a good match.
3. Therapist is engaged and engaging, versus passive, remote, disinterested.
4. Therapist is not just supportive, listening, reflecting (I call this HHT, “Hand Holding Therapy”).
5. Therapist can say what kind of therapy they are doing.
The models mentioned above are not the only effective therapies, but are a few examples based on learning new skills, and changing behaviors and thinking. They mostly stay out of the past and intellectualizing about “why” you are the way you are. Instead they are focused on being in the present, getting rid of judgments and taking more control over your life.
6. Therapist gives homework. Homework:
a. Keeps you thinking and working between sessions.
b. Helps with continuity.
c. Consider therapist sessions as mostly teaching while the lab/application is in the real world between sessions.
7. Therapist is willing to confront you with things you may not want to hear in ways you can hear it.
1. Coping skills training.
Especially teaching Emotion Regulation Skills (managing anxiety, anger, rejection, shame and guilt).
Mindfulness teaches you how to be in the present and disengage from judgments.
3. Biological, Psychological, Social, and Spiritual perspective.
Focuses on body, mind, relationships, and existential issues.
Remember that no one thing makes us healthy and well. Health and Wellness require a multi-pronged approach involving self-examination, reprioritizing values, and behavior change.
Jerry H. Gelbart, M.D.
A series of articles written by Dr. Gelbart for the Northern California Psychiatric Society Newsletter. These articles are a bit more “technical” than others on this blog, but they can help anyone interested in how mindfulness, positive psychology, Wellness approach, and skills training can help with self-esteem, anxiety, depression, motivation, and other difficulties. It may help you in choosing a therapist, and/or bring up questions for discussion with your therapist or friends.
We collaborate with the patient to set treatment goals and outline a roadmap to achieve them. In addition to medication management and psychotherapy that we may offer in our practice, there are many other resources available to augment and enhance our treatment plan. As Psychiatrists we’re in the best position to coordinate treatment and draw connections for the patient between their symptoms, goals, and available methods.
Originally published in NCPS, June 2009
A lot of anxiety, depression, and even psychotic symptoms relate to how patients see themselves, how they judge themselves. Usually a core problem is black or white thinking, that one is either good or bad, normal or not normal, worthy or unworthy. This belief system that comes from childhood has a deep hold.
The goal of psychotherapy is wellness. For some, that includes “fixing a disorder.” For others, perhaps taking a medication for life. Either way wellness is the goal.
Wellness practice (WP) is prioritization of behaviors that put the individual’s basic physical and emotional needs first. This includes exercise and healthy nutritional habits, setting up boundaries that allow relaxation, creativity and play, social interaction and spirituality. These behaviors help to reduce the effects of stress over time on our mind and body, including cardiovascular, G.I., and immune systems. WP also includes learning to be present and future oriented, and nonjudgmental toward our self and others.
Previous articles in this column have described the benefits of mobilizing the patient in the direction of lifestyle changes and prioritizing self care. Development of “healthy routines” in the areas of Biological, Psychological, Social, and Spiritual needs is THE crucial element of “Wellness” or “Fitness.”
Relapse prevention is an important part of our work. Teaching patients to take their medications regularly is part of routine maintenance of their biological needs. Encouraging healthy diet and exercise also fits that category (how often do patients actually change these behaviors?). We must also encourage and guide patients to understand and tend to their emotional needs, social and spiritual needs. We can explain that taking better care of their body, their social and spiritual needs will help them emotionally; and working on emotional “self-growth” will likewise help them in each of the other areas.
Is ‘Judgmentalness’ A Symptom?
A reality of our society is that most people don’t “complete” psychodynamic psychotherapy to resolutions of their childhood conflicts. Most often this is for cost reasons, and/or as people feel better they often fade from the psychological treatment, too often falling back on longer-term medications or relapses when perhaps psychological resolution would have been realistic.
SYNERGIES IN TREATMENT #1
What is Emotional Wellness? Just as the concept of physical wellness doesn’t necessarily mean that exercising and healthy nutrition will get rid of your diabetes or hypertension (although it sometimes will) an emotional wellness program won’t necessarily cure someone’s mood disorder. Such a program might however help prevent someone from getting depressed in the first place, or keep them from relapsing once their episode is treated.