Tag: Habit

Great Books Volume 5: Contemporary and Wildly Useful Books Written by People I Know

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Great Books Vol 5: Contemporary and Wildly Useful Books Written by People I Know (at least on Twitter!)

Transcend by Scott Barry Kaufman – This book is for everyone! It’s deeply humanistic and optimistic and transformational. If you thought you knew anything about Maslow’s “hierarchy of needs,” you should FOR SURE read this! It’ll both blow your mind and give you a great new metaphor for understanding human needs and actualization. Also, SBK is just this very cool, super authentic, and genuinely KIND human person. Oh, and he has the best podcast ever, too – The Psychology Podcast.

Show Your Anxiety Who’s Boss by Joel Minden – This is my favorite CBT book for clients. It’s easy to read, and the take-home message is simple and easy to remember (even though Joel knows I always roll my eyes at acronyms that are made to be cute, it turns out they are memorable!). One of my favorite things is how comprehensive it feels without turning into a long list of cognitive distortions. And I just really like the term “anxious fictions!” 

The Habit of a Happy Life: 30 Days to a Positive Addiction by Jeff Zeig. Jeff has written a lot of books, and I like all of them that I’ve read (because the way he thinks, especially about therapy, is just brilliant), but they’re not all for a very broad audience. This one, however, would be very useful for many clinicians and clients alike. If you ever read Positive Addiction by William Glasser, I’d say this is like an update version – same great concept, newer research, and I like Jeff’s writing better than Glasser’s, too! 

The Suicidal Thoughts Workbook by Kathryn Gordon – Is it weird to get really excited about a book on so heavy a topic? NO! Not for therapists, it’s not! Haven’t you lamented how few good resources there are for clients around suicide? This workbook is incredibly compassionate and thorough, gentle and practical. There’s no shying away from any difficult topics, and everything is handled with confidence in and grace for the reader. This is an indispensable resource for therapists, and I have no doubt it will be life-saving for clients. 

Brains Explained by Micah & Alie Caldwell (and sort of by their cats). Look, I know I’m an intense nerd and so you won’t like all the books I like. But if you’re one of the HUGE number of therapists who is both really interested in neuro/brain stuff but sometimes also intimidated by neuro/brain stuff, you’re going to SWOON for this book! There’s definitely enough in there that’s genuinely relevant to clinical practice to make it worth the buy on its own – but be prepared to accidentally get swept up in all the rest of it, too. It’s just so…. accessible and hilarious! And the chapters are almost bite-sized. They’re like…dessert-sized. What more could you want? (Oh, they have a fun YouTube channel, too!)

ZigZag by Michael Apter – Michael is one of my most treasured mentors. If you’ve read any of the Reversal Theory blog posts, you have also benefitted from his brilliance! He’s also written several books, but this one is the newest introduction to RT and it’s really accessible. So many more people (including your clients and yourself!) will find this book somewhere between interestingly useful and life-changing, so give it a try! 

Updated! Come As You Are by Emily Nagoski CAYA is my all time favorite book about sex!! Although it’s geared toward women, I almost always have men in relationships read it, too, especially if they’re in relationships with women. Emily is an incredible writer – she has a wild gift of taking really good, dense research and turning it into something both understandable and meaningful for the lay reader. Make sure you get the newest (revised & updated) version that was published in 2021, mostly because she says she likes it better. 

Also, CAYA has a workbook! (In fact, two cool things about the workbook. One is that I am one of the people who helped review it for initial edits, which was super fun! The second is that I’m pretty sure my husband is the reason the book exists – when we first read CAYA in 2013, before Emily was crazy famous and busy, he just emailed her to ask if she had any of the exercises in PDF, so we didn’t have to mark up the actual book and we could have 2 of each of them. So, she made them into PDFs and emailed them. Then, she put them on her website. Then, this book became a thing!)

And, yes, I’m a Nagoski superfan, so Burnout: Unlocking the Secret to the Stress Cycle (by Emily & Amelia Nagoski) makes this list, too. Incredibly useful, especially for that subset of adult female clients who grew up learning that they had to always play support roles, even unto exhaustion (and maybe developed resentment, anxiety, or low self esteem as a result). Goes along nicely with the podcast The Feminist Survival Project 2020. Just a note – both the book and the podcast lean pretty heavily liberal, but as long as I have warned my conservative clients about that, it’s been ok. 

Oh, and SURPRISE! I wrote a book, too! 😉 But you can’t have it until August! 

 

 

Comment below: What are your favorite therapy-oriented books these days? 

If you can quit biting your nails

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If you can quit biting your nails, you can do anything…

How does someone go about quitting a nail-biting habit? Admittedly, some people seem to just miraculously stop, some people never really got started, some people need a Habit Reversal Training procedure. But nail-biting is still an accessible idea to most people and it’s a common enough and acceptable enough habit that it makes it comfortable to talk about in session. 

Here’s how people think you’re supposed to stop biting your nails. 

(1) You decide you’d like to stop biting your nails. 

(2) You exercise your willpower and stop biting your nails. 

(3) The end. 

And that’s definitely NOT how it goes. 

So, what are the real steps? Something like this…

(1) You decide you’d like to stop biting your nails.

(2) You bite your nails.

(3) You notice after the fact that you bit your nails, and feel a little irritated with yourself. Your therapist explains habit formation (normalizing and depathologizing) and helps you to develop self-compassion. 

(4) You begin to notice you are biting your nails while you are biting your nails. 

(5) You make an attempt to stop, but they’re a little jagged now so you go ahead and finish biting them. 

(6) You begin to notice you are biting your nails when you start to bite your nails. You wish you had a nail file right near you. But you don’t. 

(6a) You repeat step 5. Your therapist repeats step 3. 

(6b) You get up and get a nail file. 

(7) You begin to notice that you are about to bite your nails. You wish you had a nail file right near you. But you still don’t. 

(7a) You repeat step 5. Your therapist repeats step 3. 

(7b) You get up and get a nail file.

(8) You get annoyed with always having to get up to get a nail file. 

(9) You accept that jagged nails are both bothersome and inevitable and now always carry a nail file or clippers in your purse/desk/car/etc.  

(10) You rarely bite your nails because those tools are accessible and you are aware of the need to fix nails early. You occasionally still bite your nails, and you react with self-compassion and simply manage the situation. 

 

Of course, this isn’t the only way change happens!

But this is one great way to talk about it because it emphasizes the importance of awareness, reduces emphasis on willpower (which is almost useless for meaningful, long term change), and makes central the importance of an incompatible behavior and addressing the reinforcer, which is really the foundation of change. It also addresses the impact of meta-emotion regarding the change process (e.g., how self anger, shame, etc. get in the way).

One of my favorite things about this model for explaining change is that when clients “fail” on their first homework attempt (or even later ones), I can tell them honestly that they’re making great progress. And they learn that it’s a process. 

 

Comment below: How do you talk about the change process with clients? 

 

 

 

 

 

Easier, cheaper, better

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Easier, Cheaper, Better

So, I was listening to news radio a few weeks ago (oh, the joys of adulthood!), to a story about electric cars. Without getting into politics or economics, let’s assume for the moment that people driving electric cars might be a good thing. Because the interesting part of this discussion was a question to the interviewee – How could the transition to most or all people driving electric cars happen? And the answer was so beautifully behavioral. In short, to get most people to drive electric cars (sooner, rather than later, when that might be all that’s available), electric cars need to be easier to buy than gas-powered cars, cheaper than gas-powered cars, and better than gas-powered cars, today. The INDUSTRY and the ENVIRONMENT need to change. Not the buyers. 

And so it is with all of our behavior changes. Shame and willpower get us nowhere. Well, that’s not quite true. Unfortunately, shame and willpower get us a tiny distance in the direction we’re headed, and then they collapse on us, leaving us typically worse off than we were before, with more shame, which leads to more undesirable behavior, and so we look more intensely for “more willpower” to get us to our behavior changes. And that system, while it fits nicely with the sort of hyper-American, Protestant-ethic model that likes to believe we can all be anything we want to be with enough will or inner strength or simple desire, is almost entirely useless. 

If we want to really change behavior in the long term, we need to think about how to make the new, desired behavior easier, cheaper, and better immediately. 

Here’s an example: Does a client want to exercise more? Preferably, we need to find a way to make that easier, cheaper, and better than not exercising, right now. 

  • What does easier mean for them? It’s going to be a challenge to make something like physical work seem like less effort than NOT doing physical effort! DO they want to try a gym? Help them find a close one, that’s on the way to or from work. (The farther away the gym is, the less often people go. ) But walking at the nearby park or exercising at home might be easier still. Is part of “easier” training their middle school age kid to do some of the laundry, so that the increase in workout clothes doesn’t feel like a burden? Does it mean getting a trainer so that they can learn to exercise in a way that’s “easier” on their knee joints? Let’s plan this in the “preparation phase” so that the benefit is immediate!
  • What does cheaper mean for them? This one usually means straight “less expensive,” but it might also mean less expensive in terms of other resources, like time spent. Would they be missing out on time with lover or kids? Could they join the exercise effort so that time isn’t missed? Walking is free, which might make it better than the gym, but it’s not cheaper than doing nothing… unless you can help them schedule their exercise at a time they might otherwise be spending money, like out to lunch or online shopping. If exercising in the morning helps them be more productive or in a better mood during the day, or sleep more restfully at night, maybe we could help them monitor that the very first week, to help “see” that additional value right away. 
  • What does better mean for them? Turns out rich folks will totally go to a far away gym as long as it’s SUPER nice! That after-workout-whirlpool is a Day 1 value and they should use it Day 1. Better health, fitness, weight loss, etc…. nice for long term goals but not helpful for that early part of the change process. Is the time-for-self they could get at the gym something that they need and want but would feel guilty about? Can we help reduce that barrier before they start, so that exercise gives them something nice right at the start? 

For long term, positive change – we don’t want to rely on willpower, and we certainly don’t want to get stuck in the shame cycle (that just leads to more Oreos, or self-criticism, or avoidance, or…). We want to change our environments to maximize the chances of following through – make the change as easy, cheap, and desirable as possible right away. If we can make it easier, cheaper, and better than the alternative, our chances are REALLY good. 

Comment below: How have you successfully used something like this model with yourself or clients in the past? Have you had the experience of thinking that a great change plan was in place, but one of these things got in the way? 

 

 

Online Resources and Apps (Vol 1)

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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!