Adolescents, Teens, Depression & The Warning Signs

By Concentric Counselor Katie Ho, LPC, NCC

At a time in life when the only thing certain is constant change, recognizing and being aware of depression during adolescence can be a challenging feat without the knowledge of warning signs and risk factors. Mental health and the seriousness of depression continue to be topics of conversation following the headlines of national news and tragedies - but an equally, if not more urgent conversation is the one that needs to be started at home. The pressures of adolescence and impact of today’s culture of social media appearances and limited interpersonal connection only reinforce the need for education and awareness on depression. Parents and caregivers can provide their support and intervention through having the skills and knowledge to address their young person’s greatest mental health needs.

The answer to why we should talk about depression with teenagers is becoming more clear as the topic continues to be normalized, de-stigmatized and commonplace in the discussion of healthy emotional development; but the answer of how is where the light could shine a little brighter. How do you initiate a conversation around feelings, emotions and concerns of your child or loved one’s changes in mood and psychological health? How do you create a safe environment that fosters and promotes honest, sometimes uncomfortable dialogue about profound sadness or even thoughts of self-harm or suicide? Many of those answers involve one important action: listening.

In order to fully understand and be prepared for a conversation around your young person’s mental health, it’s vital to know the warning signs and symptoms involved with depression during adolescence. These characteristics can be different than how they typically manifest in adults, and can oftentimes be mislabeled as expected changes during a new phase of life. It’s important to distinguish between depression and normal sadness. Depression can consume their day-to-day life; interfering with the ability to work, eat, sleep, study and have joy. It can involve feelings of helplessness, hopelessness and worthlessness with little to no relief.

Here are some signs and symptoms of adolescent depression:

● While some individuals may appear sad - many and most appear irritable (unrelenting)
● Negative view of self and/or the world and future
● Withdrawal from family and friends (isolation)
● Anger/Rage
● Overreaction to criticism
● Excessive sleeping
● Significant change in appetite
● Increased reckless or impulsive behaviors
● Substance use or acting out in an attempt to avoid feelings
● Violence
● Running away

If you suspect your teenager is struggling with depression or begins showing signs of concerning behavior, finding the time, the patience and the space is the first step in creating an environment for an honest discussion.

❖ Remember the value in listening over lecturing: initiating a conversation about emotional pain or hardships means being willing to hear their truth without judgment or criticism.
❖ With unconditional love will need to come unconditional support; let them know you’re committed to helping them fully and in a way that respects their experience, choice and voice.
❖ Be gentle, but persistent - if your teenager claims nothing is wrong, but is otherwise unable to explain the concerning observations and behaviors, trust your intuition and consider options for getting them to open up. The most important goal is to get them talking - whether it’s to you or to a reputable third party, give them the resources and options to share with someone they can trust.
❖ Validate their feelings - always. Try to avoid talking them out of their feelings or giving them an alternative perspective in which to view their experience. Acknowledging and communicating that you believe and hear them will foster trust and empathy. In combating adolescent depression, it can be effective to take a holistic approach - making their physical health as much of a priority as their social and emotional health. Encourage movement!

Physical activity can be incorporated in a number of ways, whether it’s a sports team, individual activity, dance class, walking the dog or riding their bike - all movement is good movement! Healthy, balanced eating and limited screen time are essential requirements for anyone’s lifestyle, but particularly those in adolescence. These items can also be partnered with the important aspect of positive interactions with family or loved ones. Sharing a meal or spending quality time can help that young person feel connected and valued.

Should the need for professional help and intervention be determined, be sure to involve your teen in those decisions. Respect their thoughts and opinions, and talk openly about their options for treatment. It may be a struggle for them to feel connected or comfortable talking with a professional, and collaborating with them on identifying someone who could meet their needs may help to bridge that gap. Depression and recovery can feel scary to both parent and child, but having open conversations with clear understandings of love, validation and support can make helping them more manageable so that they can live their most meaningful life.

Men, Loneliness, and the Substance Substitute

By Concentric Counselor Myron Nelson, LCPC

We know it is true when we take stock of our lives, although it is easier to simply ignore. We do not have the same number of friends that we used to. We definitely do not have the same number of close friends, friends we could call in an emergency. Whether it is technology taking up more of our time, a culture that promotes handling problems on your own, or some other reason, it is clear we do not connect in the same way.

Due to factors that will be explored in this blog post, half of the population is more vulnerable to the Great Friend Migration. Men, myself included, are bombarded with societal forces that encourage segregation. We are instructed to cope with problems silently, internally. Isolate yourself or be shamed. We are taught to detest emotions, push them down or aside but do not let them grow. Best to not spend time with other people if we are in an emotional state.

Consequently, our problems grow bigger, the stress becomes heavier, and the emotions continue to build up until we are neck deep. Keeping quiet and keeping it to ourselves, we fall deeper into our own thoughts. Expecting that other people do not want to be burdened with our issues. We drift apart from friends because we do not know how our problems could possibly fit into their lives.

What’s next? We turn to something that can help. Something that makes us feel better, it’s reliable, it’s dependable, it does not judge us, and it does not share our secrets. Alcohol and other drugs can become a refuge for emotional pain. They can buffer feelings of anxiety or depression and temporarily give us the mask we want to keep the facade going.

Alcohol and drugs can slowly become something we depend on but that dependency is dangerous. What starts as a solution to the problem becomes its own problem. Substances attempt to fill the void that other people used to, but they will never be enough. Substances can never talk back to us and make us feel cared for and understood. They cannot debate options with us and challenge us to be better. Substances offer complacency but relationships give us acceptance and growth. It takes courage and a leap of faith to connect with another man and share your problems but it is truest the solution.

The irony is, that we all want to lean on each other but are scared to lean first. It is society’s expectation about men and men’s expectations about society that propel this problem into an epidemic. When we let our predictions go and venture into reality, it’s clear that other men feel the same way we do and we can meet each other with compassion and caring.

Men are not inherently isolating and society is not inherently cold. Expect that other people feel the way you feel. Expect that as a man you will experience things that other men experience. Expect that others want to know about your struggles because they want to be able to lean on you too.

If you find yourself experiencing The Great Friend Migration, convincing yourself that filling your loneliness with substances is better than the alternative - opening up, reaching out, and relying on a male friend, I encourage you to stand up to your shame, choose connection, and lean it to a friend.

Is Your Saw Dull? A Self-Care Mandate Is Your Sharpening Tool→

By Concentric Counselor Stacey Kiran, LSW

This blog post goes out to anyone who has said to themselves recently, “I really need a break.” or “I have no time to relax!” I am here to tell you – Your time has come! Huzzah! I am going to provide all readers with a Relax and Self-Care Mandate.  My purpose for this mandate stems from learning the importance of self-care in graduate school. During grad school, students are told to 'take care of yourself' so often, it felt like a mandate.  And I often found myself thinking, “I wish someone would have forced me to take care of myself before grad school, I could’ve used it then, too!”

Are you feeling burnt out from the grind of work and life?  Noticing negative effects of this routine in your personal or even work relationships? Do you feel you are missing out on some understanding of your your family or friends' experiences? If you answered yes, you may be experiencing empathy-deficit for others.  Also known as compassion fatigue in the field of counseling and therapy.  

Maybe you will need to first ask yourself “Is empathy important to my relationships?” If that is a question that is hard for you to answer, I am going to point you to the Queen of Empathy, Dr. Brene Brown. She has a short, fun cartoon for you to watch on the importance of empathy, check it out here. 

The article Self Care as an Ethical Imperative offers the story of a person sawing down a tree with a dull saw. Try to tell that person to take a moment to sharpen their knife and they say “I don’t have time to sharpen it! I am too busy sawing!” Well, you can easily imagine using a dull saw will wear on that person, making that person feel depleted and disconnected. This same story applies to many people.  I am sure you may feel like you are a personal or professional lumberjack in your life.  For example, caregivers (including therapists) are in the role of taking care of others, but may feel too busy to take of oneself.  Or people who are not necessarily in the helping role, but who go through the daily grind may feel there is not enough time to nourish oneself. 

So, I ask you, "How's your saw?" Finding yourself too busy or depleted to pause and sharpen your saw?  In graduate school, I was taught the role of a therapist needs to take time for self-nourishment. If you don't take care of yourself, you can't responsibly help others.  Relax and Self-Care Mandate. 

Then from Mandate to Practice.  Let me get to the point here - I am talking about moving away from a Mandate to a Practice. It’s not like I never heard the term Self-Care before grad school. But, in grad school, the phrase Self-Care began to mean something much more to me than “Go to an exercise class.” It meant ask yourself, "Am I feeling okay?"  "What is my body telling me I need?" And, be honest. Because if you are not feeling okay and you ignore it, you could burn out at work or at home or burn the candle at both ends. What is the cost of you continuing your life while still burnt out? The cost is the energy you could be curating and nurturing that can go in to a better tomorrow, a better you, and better relationships.

Many people reach out to therapy to improve themselves and their relationships.  If you want to better your relationships– start by relaxing. Sounds counterintuitive? Well, like non-nourished therapists who cannot responsibly help their clients, can you take care of your loved ones if you are depleted?  Be fully present?  Can you be empathetic towards the people you care about? 

In grad school, I kept finding myself think I want empathy in my personal life, not just my professional. I want to be present in my personal relationships.  I want my loved ones to present to me!  Why should this only be taught to grad students in the field of social work or counseling?  Or to therapists? It shouldn't be reserved for a select few.

So, I want to pass along this important information by first giving you a Relax and Self-Care Mandate.  Followed by a simple, but yet effective step-by-step guide to help you move into Relax and Self-Care Practice.                                                                                                            

1. Ask yourself, “How do I feel?” – You can ask yourself this question at anytime: every morning, or when you notice yourself doing something you don’t particularly like (i.e. eating an entire large pizza), or when you are doing something or know you will soon be doing something that is stressful (visiting family, perhaps). And this is a good one, if you find yourself fighting against something that usually helps you (i.e. listening to music when sad or going to yoga after work – be aware of those feelings! Listen to them!)

2. Listen to yourself. Closely. Carefully. With compassion and non-judgment. Judging yourself will only prolong your path to feeling good or better. (Hint – You can tell that your Critic is speaking in this part of the Practice if you feel small. Your truest, most helpful answers here will always make you feel more open, not smaller.)

3. Ask yourself, “What do I need?” – non-judging is the name of the game. And dare to dream! You can also pose the question “What is standing in my way of feeling however you want to feel. (This is a concept from the book I recommend, Focusing by Eugene Gendlin, Ph.D.).

4. If you can’t hear the answer, then close your eyes. Often when I cannot hear an answer, I just need a break to think about it and to listen, carefully. Think about it. If you can’t hear an answer about what you need for yourself, then chances are that you can’t hear others’ needs. And, you can't be as present in life. So take a break until you can get an answer.

5. Follow through. Your answer appears to you, and now you need to connect, commit and follow through. For instance you find yourself wanting or needing a break or vacation. Let's say you have no PTO. Find a way to give yourself the break, even if it's taking an afternoon off.

And, in closing, I want to remind you – when things get shaken up (could be due to a stressful life event, positive transition, recurrent memories, trouble in relationships), our Relax and Self-Care Practice may need to begin to include the use of a professional therapist.  I invite you to utilize the tools and guide I have learned for my own Relax and Self-Care Practice. Following your internal instincts of what you need is not just good Self-Care, it is, ultimately, being true to yourself, which may feel foreign in a life of meeting others’ expectations.

It is possible to follow your own voice, meet your own needs, and be true to yourself in a life of others’ needs. And, if you have children, loved ones, or employees looking to you for example or direction, you may model to those little ones, loved ones, or employees that it is OK and appropriate for them, too, to take care of themselves. So, get out there and sharpen your knife.  Engage in your Relax and Self-Care Practice.  And, start enjoying your life!  

A Therapist's New Year's Resolution

By Concentric Owner & Counselor Jennifer Larson, LCPC, NCC

In only a few more days, 2017 will come to a close.  It will be a time to think ahead – many will ignite their New Year’s resolutions.  While I may not routinely come up with New Year’s resolutions, I do think about and write down my personal desires and goals throughout the year.  And, I have decided that I will come up with a New Year’s resolution for 2018.  Before I share my resolution, I would like to share part of my roadmap that has led me to this juncture.

As I have engaged in reflection, I found myself returning back to a perpetual theme that would emerge and re-emerge over this past year.  One particular theme is what I will name as the ‘non-self-disclosing' therapist vs. the 'self-disclosing' therapist wrestling match.  I have no idea when the sport of wrestling season begins and ends, but I can tell you this particular wrestling match has persisted season after season. And, my hope for 2018 is the self-disclosing therapist will take the lead and possibly bring the wrestling match to a close someday soon.     

Let’s start back when these 2 wrestlers first met.  Perhaps they were both first introduced way back when, before the days of graduate school as 'non-self-disclosing' me vs. 'self-disclosing' me.  In my formative years, I grappled with how much to disclose and how much not to disclose my vulnerabilities. And if I did, I chose wisely with a very select few.  Some would say this is normal as we need privacy and boundaries while others may offer a difference of opinion.  Now, let’s fast forward to when I enter into graduate school where I am confronted again with choosing and deciding on how much to disclose.  This time it is focused more on me as an emerging therapist, not me personally.  In the earlier stages of education, students learn about various theoretical orientations and the relevance and implications of non-disclosing and disclosing to one’s clients. 

Just after the start of the millennium, I recall being enthralled with the tug-of-war game that was played during a semester course on ethics.  Our instructor was instrumental in leading the charge on getting all of us graduate students to really explore how to handle ethical dilemmas that can and will mostly likely confront a professional counselor, social worker, or psychologist.  Depending on the topic, some students would sinuously form into 2 teams, tugging and vying for one end (yes, it’s okay to self-disclose to a client; yes, it’s okay to hug certain clients upon closing a session), while the other group pulled and vied in the other direction (no, it’s not okay to self-disclose and hug a client). It was one of my favorite graduate courses as our professor and the course curriculum gave us the space and freedom to think critically and to share our perspectives and beliefs.  Some topics called upon us to unequivocally unite together whereas other topics had students participating in the game of tug-of-war, and well some (ahem) left all of us pooling together in the middle, gray area -- scratching our heads saying, “It just depends, it’s not so black-and-white.”    

Does a therapist merely act as a ‘blank slate’ allowing for one to free associate more easily? Or does a therapist offer some disclosure about their experience and feelings in relation to one’s client (countertransference)?  As therapists, do we divulge some our personal, relatable experiences, such as, “I share the same fear of heights as you do – here are tools that have been helpful to me.”  To disclose or not became even further embedded post graduate school during professional training courses and consultation. And for good reason, this particular topic warrants so much attention in the world of psychotherapy.  I understand the clinical relevance and implications – I get it. 

Over the past 15 years with greater professional and personal life experiences, I have found myself continuing to think about the inquiry of the self-disclosing therapist. At times, I have put forth a tidbit of self-disclosure when I believed it to be ‘clinically appropriate’ or when it simply felt right.  The self-disclosing therapist is not uncommon for some psychotherapists, and it's probably still one of the more debated issues in the field.  Over the past year or so, the inquiry in my mind has expanded beyond the closed doors where therapist-client, supervisor-supervisee, and consultant-consultee relationships are formed, maintained and evolve.  

Questions continue to knock on my door, such as, do I as a therapist share my story (or stories) with others publicly?  Is there value in therapists who choose to open up in a more public forum?  How about us therapists taking our practice even further by exercising vulnerability and using our voice through other outlets?  Are age and credibility in the field some of the salient determinants when choosing to publicly divulge as a professional?  What is too much to self-disclose in written form? Could casting a wider net be detrimental to a therapist’s profession?

While these particular questions have lobbed around in my head for just over a year now; admittedly, they have not been all ‘heady’ taking up rent in my mind.  Sometimes (and many times), I would simply experience this feeling inside of me – near my heart or gut – nudging me to share more and to share with more people.  Stop thinking so much and just take action.  Take the leap and have faith.  Even a call to duty would emerge from within as well.  But why and for what purpose?  The answers didn’t seem readily available to me.  And then over the past few months, it all became clearer.

Earlier in 2017, I learned about On The Table and the #BreakTheSilence initiative by The Kennedy Forum.  I was immediately pulled in as I loved the mission and purpose of this initiative.  Bring people together to give people an opportunity and space to talk about mental health in effort to reduce the stigma that still hovers around and shrouds the already cocoon existence of mental health. The idea is that when more people talk about a topic – in this case mental health and addiction – a positive rippling effect can ensue. 

The more people talk about mental health…

• The easier it will be for all of us to talk about it.

• Better yet, the easier it will be for all of us to talk about it without feeling shame, crazy, or embarrassment.

• The more we will feel safe and free of judgment.

The more people talk about mental health, the more…

• People will seek out help.

• We will honor and view mental health as another facet of humanity and life, just as we do with other areas, such as our physical health.

• We will advocate for change across cultures, families, and even within the helping professional field.

• Opportunity for positive changes within the health care insurance industry.

The continual, cascading effect.  The more people talk about mental health and addiction…

• The more we will become intimate and experience love.

• The more we will be empathic and compassionate.

• The more we will be more understood and connected.

• The healthier we will all become and the more lives will be saved.

Who doesn’t want to experience these things for themselves and others? 

Concentric Counseling & Consulting hosted its first On The Table Discussion on May 16, 2017.  The turn out and experience was inspiring and moving. We even shared people’s stories, experiences and solutions for people to read in our blog.  However, the Concentric’s therapists served as hosts and guides – we were not active participants in this discussion.  No self-disclosing.  This is not a terrible thing, but the knocking on my door didn’t go away.  Should we have re-considered actively participating in this dialogue?  Sharing would mean ‘more people’ talked about mental health and addiction, right? 

There have been other initiatives and movements this year, including one of the more recent ones that started in October 2017. The #MeToo movement gained momentum and traction which has given people collective permission to break free of the shackles that have promoted and reinforced silence, inequality, sexual harassment, discrimination, and assault, shame, and for some, the cocoon existence of mental health. The #MeToo movement encouraged women to share their stories in effort to give people permission to break their silence to unite and to bring greater awareness about the prevalence of sexual misconduct.  The more people talk about their experiences and hardships, the same effects will occur as with the more people talk about mental health and addiction.  Movements like these promote the cascade effect which in turn promote movements – a positive feedback loop. 

All of these experiences along my personal roadtrip have touched and impacted me.  And, while I recognize that I am helping people, I have also recognized that choosing (more times than not) the non-self-disclosing therapist may just not be as helpful.  I believe in the importance of using one’s voice, honoring one’s experiences with integrity and respect, and I want to help become a part of the bigger picture.  I want to talk more about mental health and addiction publicly in effort to help achieve with many others a positive cascade effect.  It won’t be easy for me, that I know. Truthfully, I am not quite sure where to start, what I will disclose about and which platforms to traverse.  What I do know is I now have a clearer understanding of the persistent themes that knocked on my door.  My deeper desires and hopes for all by talking about mental health.

So, my New Year’s resolution for 2018 is for me as a therapist is to start leaning in, to become more of a self-disclosing therapist by sharing more publicly some of my own mental health challenges and triumphs.  Happy New Year Everyone! 

Listening to Our Inner Critic

By Guest Blogger Santiago Delboy, MBA, LCSW, S-PSB

Santiago is a bilingual psychotherapist in Chicago, where he works with adults who feel stuck, broken, empty, lonely, or out of control. He uses a relational approach to help people develop self-awareness, understanding, acceptance, and growth. Find more at www.santiagodelboy.com.

Michael is a bright and sensitive man in his 30s. He is the youngest of four siblings and grew up in what, from the outside, seemed like a happy and stable home. In many ways it was indeed happy, but Michael always felt like an after-thought to his parents. He struggled to feel seen and loved, and tried very hard, in many unspoken ways, to find his place in the family. The weight of this longing and the intensity of his efforts became overwhelming as a teenager, when he abruptly fell into a deep depression.

After college he had a number of jobs and romantic relationships, all of which left him feeling drained. For a long time he struggled to recognize his value and skills, doubted his capacity to love and work, and felt flawed and inadequate. Unsurprisingly, Michael felt constantly reminded of all this by a very loud and active inner critic.

We all have a voice in our head that is critical, judgmental, and disapproving of ourselves. That voice can be mild and not always present. We may hear it in specific situations or with specific people. Sometimes, however, that inner voice is constantly giving us unsolicited commentary and incessant chatter, becoming part of what Buddhists would call our Monkey Mind.

A quick Google search for “inner critic” results in advice on how to silence, get rid of, overcome, or ignore this voice. This advice usually entails a number of steps that promise quick relief. They include becoming aware of the self-criticism, conducting reality-testing to check it against the evidence, separating ourselves from the critical voice, replacing negative thoughts with positive ones, and having a realistic appraisal of the criticism’s implications and consequences.

These are basic cognitive-behavioral tools sprinkled with some mindfulness, which can definitely be helpful for some people in certain situations. I understand that if people feel their inner critic is a nuisance, they may want to shut it down. However, there is something about the notion of disproving, silencing, or reasoning away our inner voice that doesn’t feel right to me.

Not all criticism is created equal

When I hear the inner critic from people like Michael, or myself for that matter, I wonder what that voice is really saying. The messages we are aware of might be “I could never start a conversation with a stranger” or “I don’t know how to ask for what I need,” but what they really say is “I am broken and don’t deserve to be loved” or “my needs don’t really matter.” I believe that it makes a big difference whether the judgment is about our actions, or about who we are as human beings.

When the latter happens, the voice in our head is carrying a message of shame. It tells us we are not smart enough, attractive enough, funny enough, or good [fill in the blank] enough. That voice is abundant in “shoulds”, telling us that we should behave, should think, or should feel differently, and that there is something fundamentally wrong about us if we don’t or can’t.

To make things more complicated, our inner critic is not only active when we hear it and it doesn’t only manifest verbally. Michael’s depression during his adolescence, for example, could be understood as a massive expression of his inner critic. Those years were embedded with feelings of helplessness, hopeless, and worthlessness. The connection between depression and self-deprecation is not new; Sigmund Freud discussed it eloquently a hundred years ago, in his paper “Mourning and Melancholia.”

From trauma to self-criticism

I am not sure the messages from Michael’s inner critic, as a teenager and as an adult, were distortions that could be corrected with reality testing and cognitive reframing. Michael tried those things before I became his therapist, and in a way they set him up to feel more shame. There had to be something wrong with him, he told himself, if he couldn’t get better by thinking better. He started developing acceptance and feeling more compassion toward himself once he started understanding that his inner critic was an expression of the trauma he had experienced, and the feelings he had learned to ignore as a result.

The trauma Michael experienced did not require a specific event. His parents had a relatively stable marriage without significant economic difficulties, and he didn’t recall anybody being verbally, physically, or sexually abusive at home or elsewhere. However, he grew up experiencing emotional neglect, not feeling seen or loved unconditionally. He learned that no matter how hard he tried, he would remain invisible and his needs for connection would not be met. As a result, there were parts of himself that remained invisible and disconnected from his own awareness.

This is part of what is called fragmentation, which is one of the key features of trauma. Our sense of self is split and we may lose contact with some parts of who we are. These parts may hold overwhelming feelings that are too hard to tolerate, let alone accept, such as pain, hatred, terror, or desolation. Some of these feelings might turn into anger, which we may then direct at ourselves. That is often times what is behind our inner critic, anger that is really masking sadness, fear, pain, or emptiness.

Move toward, not away

If our inner critic is a part of ourselves that we disowned, seeing it as the enemy means seeing ourselves as the enemy. Trying to silence or ignore that voice means trying to silence or ignore a part of ourselves that is suffering, a part that may have already been struggling to find its own voice for a very long time. Feeling ignored, silenced, or invalidated was precisely part of the problem, as it contributed to give birth to our harsh inner critic in the first place.

Because of this, the question I try to answer with my patients is not so much how to silence that critical voice, although that might be important to address, but why is it there? What happened to them, first to feel so angry, and then to direct that anger to themselves? And, more importantly, is it possible for the two of us to keep a curious stance and an open mind toward his inner critic, to be able to listen to it with compassion and kindness, and to become willing to accept it, embrace it, and love it?

Listening doesn’t mean agreeing with what it says. Accepting it doesn’t mean taking on its criticism. Embracing it doesn’t mean believing that its judgements are fair or accurate. But unless we do those things, that part of us will remain unseen and unheard.

The judgement, criticism, and negative self-talk can be very harsh, cruel, or even hateful, but they are usually symptoms of old wounds that run very deeply. Martin Luther King, Jr. said that hate cannot drive out hate; only love can do that. Within ourselves, only love toward our inner critic can begin to heal the wounds that hide behind its harshness.

It is true that self-criticism can sometimes get in the way of our accomplishments, boycott our relationships, and put a hurdle to our growth. However, the main challenge is not really to eradicate, tame, ignore, or disprove our inner critic, but to be able to hold it with love and make space for the feelings it carries within. The more difficult and upsetting it becomes, the more patience and kindness it probably needs. Our inner critic is a part of who we are and it deserves, like every other part of us, our unconditional love and regard. The journey toward a fulfilling and wholesome life is long and worthwhile, but we cannot really take it if we cut off a part of ourselves.

Choosing a Theoretical Orientation in Graduate School

By Concentric Counselor Myron Nelson, LCPC

Excerpt from Online Counseling Programs blog:  How to Choose a Theoretical Orientation

It is easy to be awestruck by an influential author or enamored by a theory’s concepts but that does not automatically translate into successful treatment. I will pass on advice that was given to me and served me well.

Choose a theoretical orientation based on how comfortable and effective it is for you in practice. Explore the boundaries of what you understand and enjoy about using a theoretical framework beyond the textbook.  Your clinical orientation is extremely important to your work as it provides a foundation and language for therapy. At the same time, don’t let it overshadow the other critical factors of your work including how you present and relate to others.

For more thought-provoking concepts and tips on identifying a theoretical orientation (or even orientations and models -- plural) on counseling, psychotherapy, and psychology, you are encouraged to read the entire post here.  This blog post is particularly useful for graduate students or new grads who are in the exploration phase of selecting a good theoretical fit.

Simple Meditation Steps For All Ages

By Concentric Counselor Michelle Taufmann, LCSW

These are the instructions for the basic meditation on the breath that I teach clients. Meditation on the breath is a simple, classic form of meditation that has been used for thousands of years to strengthen one’s focus and ability to sustain full awareness.

First, sit on the floor on a meditation pillow, or in a chair. Sit in a comfortable position with your back straight, but not rigid. If you are sitting in a chair it is best to sit forward with your back away from the back of the chair (rather than leaning back into the chair). You want
to assume a posture that facilitates being alert, yet relaxed. Next, close your eyes, or if you prefer, lower your to a gaze about a foot in front of your feet on the floor. The purpose of closed eyes (or lowered gaze) is to remove visual distractions from the field of perception. Now, take a moment to relax your head, neck, shoulders and arms by rotating them, tensing and releasing them, and/or shaking them out; these parts of the body tend to hold a lot of
tension.

You are now ready to begin the meditation on the breath. Start by noticing your breath as it comes into and out of your body. The experience of the breath coming into or out of the body is most noticeable in the following areas of the body: at the nostrils (the sensation of the breath going into and out of the nostrils), at the chest (the sensation of the chest rising and falling, and at the abdomen (the sensation of the abdomen rising and falling). Choose one of these areas on which to observe the breath. It usually works best to choose the area of the body where the sensation of breathing is the strongest for you. Now, simply attend to the breath. Think of it as being present to the experience of breathing. Your attention on the
breath should be light; you do not want to concentrate or think about the breath.

Once you have stabilized your attention on your breath, sit in this way for the designated amount of time. Ten minutes is the recommended amount of time for beginners. If you are like most people, you will fairly soon notice that your mind has wandered. When you notice
this, gently let go of the distraction, whether it is a thought, sound, or  internal sensation, and bring your attention back to your breath. Continue in this way, returning your mind to your breath each time you become aware that it has wandered. Remember to do this with
patience and gentleness.

Try not to become frustrated or judge yourself if your attention wanders frequently. Frequent mind-wandering is normal and to be expected, especially for beginners. Becoming frustrated or judging yourself for not being able to sustain attention on the breath is simply further distraction from your meditation practice and should be dropped as quickly and gently as other distractions are dropped during your practice. 

With practice, mediation of the breath will strengthen your focus and ability to sustain full awareness.