February 2021, EllisTangents

Online Resources and Apps (Vol 1)

Honestly, I’m not a huge fan of online resources. Let me make a caveat – we’ve known for a decade that things like internet-delivered CBT can be effective for depression and anxiety (e.g., Farrer et al., 2011), and that can be a life saver for someone who doesn’t have easy access to therapy. It’s just that when I have in-person clients, I much prefer for them to have resources that we have created together or that I have made personalized for them.

BUT… it’s 2021 and I’d have to be living under a rock to not engage with some of the really good stuff that available online and on apps. But… it’s 2021, which means the problem isn’t the availability of mental health resources/apps, but sifting through which ones are actually good!

My requirements for resources/apps that I’ll suggest to clients are that they are (1) FREE, (2) EVIDENCE BASED (as appropriate), and worthwhile based on my actually trying them. (Like recommending books, I have an ethical problem with recommending something I haven’t fully tried).

That said, here we go, in no particular order:

Online resources:

Ali Mattu’s videos – You’ll have to browse around a bit to find the topic you client needs, but these are very well done and super on point from a research-based standpoint. The dive reflex episode is one of my favorites.

Kristen Neff’s Self Compassion exercises – exactly what you think, better researched and less saccharine than Brene Brown, totally free.

This free online course in Acceptance and Commitment therapy from Public Health Wales is pretty cool and comprehensive!

Now Matters Now is a great resource related to suicidal ideation, for clients and clinicians.

I’m looking for some good DBT resources, btw. These videos are ok, but I’d like something more personable and more interactive. Please comment below if you know of any!

Apps:

Comfort Talk – this is an all-business, nothing-woowoo trainer in self hypnosis. Great research evidence!

All of the VA apps are empirically supported and they’re nicely done. I like the CPT and substance use apps as an adjunct to therapy sometimes, but the CBT-I (insomnia) is the one I recommend most. You don’t have to be a veteran to use them!

Insight Timer – I’ve liked this one for a long time, mostly because of the variety of meditations that are available and the ability to search based on how much time you have. Great free alternative to apps like Calm and HeadSpace.

Fluid – This is just a little app that lets you play with fluid dynamics (with lots of customization for time, color, etc.) It’s great for mindfulness work, and nice for clients who might otherwise fret while waiting in a line. It’s entrancing! You can see a screenshot above.

Done– I searched HIGH and LOW for SO LONG looking for a simple, free app that would allow clients to easily track how often they do XYZ – whatever we’re working on. The free version of done is more than adequate – it’s perfect!

Comment Below: What online resources or apps have you found to be helpful? Bonus if they’re free and evidence based!

Reversing

This is the third blog in the Reversal Theory series – if you haven’t, check out the first one here . And the second one here.

As a reminder, Reversal Theory posits that we each have 4 different sets of states that we are in some combination of all the time – one each from Serious/Playful (also called Telic/Paratelic), Conforming/Rebellious, Mastery/Sympathy, and Self/Other (also called Autic/Alloic). So, at work you might usually be in the Serious-Conforming-Self-Mastery states, and if you are, you’re probably killing it! But, if you’re in the Playful-Rebellious-Self-Mastery states, you’re probably daydreaming about skiing and not getting much done.

Despite the pervasiveness of the “continuum” in current psychological thinking, the ever-present bell curve, and the call for moderation in all things, the pairs of RT states do not operate this way. The bank of light switches above not chosen arbitrarily! At any given time, the light switch is positioned up or down. If pushed, it will flip to its opposite position. If not pushed hard enough, it will flip back to its original position. It does not rest in the center position. Likewise, a person is in one state of each pair or the other (this is called bistability). Bistability refers to a system which has two preferred ranges rather than one.

A Necker cube (above) is a good example of reversing. It can be viewed sensibly in two equal but opposite ways, but there is no intermediate position and one cannot focus on the transition between the two states because it happens too quickly. Similarly, each pair of RT states functions as a “bistable” system; one is either in the serious state or the playful state, there is no stable position in between.

So, how do we switch (or REVERSE!) our states? Three ways.

Contingent reversals are the most common. A contingent reversal occurs based on an event, setting, or other environmental influence. For example, an event that is seen as threatening is likely to produce a reversal into the serious state (e.g., when one is joy-riding and then sees a police officer behind them). An event that is perceived as unfair will likely produce a reversal into the rebellious state (e.g., when a teenager is planning to go out and then is told she has been grounded). Note that it is the perception of the event which is of consequence, as events will be interpreted by different people or at different times in different ways. Another environmental factor that often produces reversals is the setting. A sports stadium may induce the playful state; a nursery may induce the sympathy state; your boss’ office may induce the serious state. Any situational event (e.g., seeing your partner smile, feeling nauseous, music playing in the background) can prompt a state reversal.

Often, the combination of many situational factors in balance determines the state one is in. For example, I may be drinking cocktails and watching football with friends (all paratelic-inducing/playful for me) and see a spider (typically a telic-inducing/serious event for me), but I might not be moved from the playful state due to the influence of the aforementioned factors. In essence, the perceived situational factors may be viewed as if on a scale, or a see-saw. Situational factors may “add up” enough to tip the internal see-saw to the opposite state, or the opposing factors may not be weighty enough, in which case I remain in the state I was in.

Another way that reversals are induced is through frustration. If you remember from the second blog, each state has certain kinds of satisfaction embedded within it.

Telic -> Achievement

Paratelic -> Enjoyment

Conforming -> Fitting in

Rebellious -> Freedom

Mastery -> Power/control

Sympathy -> Care/nurturance

Self -> individualism

Other -> collectivism

When this satisfaction is not achieved over a period of time (which varies across times and individuals), the frustration will lead to a reversal. An example of this type of reversing is when, in the telic state, one does not feel they are making progress, cannot bring down their level of arousal, or comes to feel that what they are working toward is not worthwhile. A reversal to the paratelic state may take the form of abandoning the project in favor of something fun or distracting oneself with humor. Frustration-induced reversals may occur in the alloic sympathy state when one has heard quite enough of another’s complaining, in the negativistic state when one realizes that his/her efforts to change the system are not fruitful, or in the mastery state when one becomes exhausted with running on the treadmill.

The final factor in inducing reversals is known as satiation. This is hypothesized to be an internal mechanism in which a reversal is induced after a certain amount of time even when one is receiving the satisfactions of the state and in the absence of situational changes. Consider the student or retiree who, after a few hours, days, or weeks of leisure, longs for work. After a time, a loving caregiver who is content to nurture those in her household spontaneously craves some time for herself. In studies wherein participants can choose a telic-task or paratelic task for as much time as they like, will switch tasks without any seeming provocation. The process of reversing through satiation is often compared to the sleep-wake cycle, wherein the body simply recognizes that it has had enough of a certain natural and satisfying state, for reasons that are not entirely clear.

Those are the ways that reversals occur, and that’s plenty for this installment! Be on the lookout for #4, because it’s going to tie all of this into a very cool way of thinking about psychological wellness and therapy!