 Thanks to Jonathan Hoxmark on Unsplash for this beauty! Perfectionism and OCD
What is perfectionism? Oxford dictionary defines it as “refusal to accept any standard short of perfection.”[1] That’s automatically problematic.[2] Perfectionism leads to a circumscribed focus, stress, and suffering for not only individuals, but for loved ones nearby who feel the weight of being perfect. Is this the same as OCD? Nope. OCD and perfectionism often get confused. They both can affect and drive distress in one another, but they are separate. OCD involves unwanted (intrusive) thoughts, urges, and impulses that cause distress; furthermore, compulsions are repetitive behaviors or thoughts that attempt to reduce distress or prevent something bad from happening. Perfectionistic manifestations of OCD, often referred to as “just right / not just right” fit this categorization. Separately, in Perfectionism, someone pursues “perfect” thought, behavior, or action initially out of interest or enjoyment (rather than to suppress an intrusive thought/urge/impulse, like in OCD).[3] There are typically problems that go with this, however. So a difference between the two is that OCD is ego-dystonic and Perfectionism is typically ego-syntonic (you can check out my video here explaining the difference). Examples of perfectionistic thoughts and behaviors[4,5]:
My Perfectionism I am a "recovering" perfectionist. And it’s a problem when I’m not, well, “recovering” from it. One of the mechanisms that keeps perfectionism going is the belief that it is helpful (this is a “Positive Belief” about perfectionism, and it is a cognitive distortion). When I succeed at a task- and especially if I get a lot of praise, it is a natural reinforcer that I must be doing well. However, if I spent 8 hours researching, writing, and proofing this blog today, that is problematic for me at this point in life (and I easily can spend that much time). What is a problem or not sometimes depends on the person and their situation- maybe a journalist would spend that much time or even more, but I am a full-time clinician with a family, church, volunteer involvements, and hobbies. If I make this post “perfect,” in my perfectionism, I will seriously miss out on other things. This pursuit of perfection doesn't stop with one blog post. It will always generalize if allowed. So if I let it, the pressure of perfection will continue (and does, at times) to move on to other things like caring for my home, caring for people in my life, my relationship with others, my diet, exercise, my spiritual walk, my car, money, and so on. And being honest with you, these things are tied up in anxiety and simultaneously selfishness- attempting to control these things rather than to engage with them/others in a meaningful way by learning to lean into the fear and live based on what is valuable. Parenting is probably the single biggest event that pressed me with the realization I need really challenge my perfectionism. There are two stark realities to me in life: I can either do my work/relationships/home life/etc. “perfectly” and end up in an ever narrowing scope of anxious overwhelm trying to keep all the balls in the air, OR learn to tolerate the distress that comes doing things "not just right" and focus on the big picture, growing towards what I love and value. And the reality usually is that in time, this fear habituates when not engaging in avoidance, rituals, or control strategies. Making Change Whether in therapy or personal life, to change how I behave and think and respond in life, I need to be aware/monitor what it is that needs to change (good therapy, support, and resources such as on my website can help). Even if I know what needs to be done, if I can’t effectively observe and catch it when it occurs, I will not be able to change it. Next, I will need tools and strategies to effectively grow and mature. In therapy, some of these are Exposure Therapy, Cognitive Restructuring, and more. In essence, at the point of the problem I must be able to insert the solution- and consistently. Lastly, I want to continue to monitor and gain feedback to incorporate learning and solidify growth. I don’t want to oversimplify this- if you are having a problem with any of the areas I have discussed, please reach out to a competent trusted person and/or therapist. Today I gave myself the time limit of 3 hours- start to finish- to research, write, upload and post. And it’s simultaneously stressful and joyous at the same time. I’m going to do a behavioral experiment and keep doing it- “testing” whether or not my choice(s) in leaning into my fear of failure a) doesn’t end up as bad as it feels like it will, and/or b) I was able to handle or face it anyway. We’ll have to see- I'm leaning in!!! Openly, Justin K. Hughes References: [1] https://www.lexico.com/en/definition/perfectionism [2] First of all, it’s a whole mess to even get into a truly perfect standard- if I make and continue to make mistakes, I am not perfect. I cannot even begin to conceive what perfect is, then, since I would make a mistake in defining “perfect.” [3] The Diagnosis of Obsessive Compulsive Personality Disorder (OCPD) may apply when a person pursues perfectionistic behavior to pathologically disordered levels. [4] Grayson, J. (2014). Freedom from obsessive-compulsive disorder: a personalized recovery program for living with uncertainty. New York: Berkley Books. [5] Minirth, F. B., & Meier, P. D. (2015). Happiness is a choice: enhance joy and meaning in your life. Grand Rapids, MI: Spire.
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"Ah sugar, ah honey honey. You are my candy girl, and you've got me wanting you." The Archies may have been describing a relationship with their lyrics, but that’s been me with my relationship to actual sugar. I love added sugar.[1] 5 years ago, I easily would:
 I didn’t think much about it. Once I began to shift from a trim guy in my young 20’s to borderline overweight/obese by my late 20’s, I was introduced to research on the deleterious effects of consuming so much added sugar in my diet. But I also gained maybe the most crucial part of any health advice: the support to live it out.
The most significant early clinical and research voice for me was Dr. Mark Hyman, Director, Center for Functional Medicine at the Cleveland Clinic. I was watching a documentary on Netflix in 2015[2] that featured him significantly. It added to my already growing knowledge and personal experience, which especially helped me a) stop compartmentalizing nutrition (150 calories from Coke ≠ 150 calories from vegetables) and b) look more closely at what I put in my body. Bolstered by personal recovery in multiple areas of my life, and leaning on my wife who was super supportive of me, these convergences facilitated what I hadn’t been able to do prior:
One of my discoveries is that existing advice often conflicts, and (as with all things) can be driven by profit, greed, and ambition. Instead of getting embroiled in all these details, I began to think critically for myself and make a plan with support. Here’s the simplest advice that’s now supported relatively across the board: Recommendations for Added Sugar: CDC (U.S.)
Part of a healthy body, mind, and spirit involves an honest look at what we put in our bodies. Nutrition is, of course, one of the most important realities of daily life. Much success and suffering comes from our consumption and discipline around food- and in that regard, it’s not much different from other areas of life such as our thoughts and beliefs, exercise, generosity, and work and rest. I’m nowhere near an expert in the food realm, and this post is more personal in nature. I hesitated writing it for a while so as not to make another one of those ‘Look at me now!’ posts. The last thing I want is for anyone reading this to feel shamed by a braggadocious post on self-improvement. I personally didn’t have a bunch of shame about my weight prior, nor would that have helped. I want to thank my sister-in-law, Camille, for encouraging me that people might benefit from my personal story. I hope it helps. As a therapist, I walk with people every day through CBT and counseling to take action. Traditional medicine, articles, and diets all serve their purpose. My job is to help people make change, personalized to them, in the context of reality- that we must all live in, or not- only to our detriment. If you take nothing else away from this, here are the keys I want to share:
Sincerely, Justin [1] Added sugar is different than sugar as it naturally occurs, like in fruits and vegetables. See Harvard Health's post here. [2] “Fed Up”- not that I endorse everything in it, but there were a couple key lessons that I have incorporated from this documentary. [3] This whole resource is quite fabulous with lots of good research and narrative. I nerded out with it! This post is intended for Christians looking to deepen their faith and mental health.  The Bible has a lot to say about fear and anxiety. In fact, some variation of “do not be afraid” is the most common directive in Scripture, occurring in some fashion more than ‘do not steal,’ ‘do not kill,’ and even ‘love your neighbor.’ How do anxiety and fear work? When we study these constructs in research, we are understanding mechanisms through which the body/brain is informed to face a threat or danger. We can argue these responses are inherently good, with their purpose being survival, protection, and preparedness. Its activation results in the sympathetic nervous system being primed: adrenalin and noradrenalin are produced, cortisol increases, heart rate increases, blood flow moves to muscles and away from extremities, speed and depth of breathing increases, and many other physiological changes occur.[1] I’m grateful to have these responses- when they are in context. Out of context, they suck, to put it bluntly. Problems like panic attacks, worry, phobias, obsessiveness, skin/hair picking/pulling, preoccupation, social fears, avoidance, and more can be quite terrible. One of the things I love most in my walk with Christ is context. Direction. “The Lord is at hand; do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God” (Philippians 4:5b-6, ESV). What is being said here? Partly, “Do not be anxious about anything.” Since anxiety is a feeling of imminent threat- or in other words, it’s at hand- it’s very interesting that immediately before this phrase in Scripture we have another observation revealing a different type of imminence: “The Lord is at hand.” In the context of the Lord being near we are told, “Do not be anxious.” This Greek word for ‘be anxious,’ μεριμνᾶτε (transliterated as “merimnate”), means to be divided and distracted, fearful, and caring for things that are out of context.[2] Sounds a lot like anxiety disorders, right? Yep. Or even just day to day worry/anxiety? Yep. When a person feels anxiety and fear and misinterprets this as significant, a person’s entire life and values can shift to focus on whatever is the subject of their fear, whether classified medically as a disorder or not. This can lead to a preoccupation with avoiding something or someone (spiders, relationships, sex, social situations) to obsessively checking to make sure everything is okay (car, stove, locks, bodily sensations, health, perfectionistic behavior), or pursuing something (money, security, approval of others)- and MUCH more.[3] To help work through these things and avoid pathological responses, I believe we need supports like therapy, help from friends, breathing techniques, mindfulness, exposure techniques, etc. This only underscores our complexity (we are “fearfully and wonderfully made”[4] yet simultaneously all messed up[5]) and highlights what we are told in Scripture about our limits.[6] We can rightly use these tools to help us, just as we do nutrition, medicine, community, and so forth. But there is one thing these tools can’t do on their own: attach us to the very God of the universe and give us a lasting hope and focus- with meaning and purpose at the highest level. So God gives us a jewel of a passage in Philippians 4 where we are kindly reminded what our attention is to be on (context), and a little bit of how we can live it out (practice).[7] It is well known within the anxiety treatment world that even the most effective therapies (here’s looking at you, classic CBT, which I love and specialize in) often need supports to connect to larger beliefs, values, and commitments (ACT, DBT, and MI are some of the most common modalities). If we don’t connect a person to larger motivations and goals than “I just want to feel better,” it is often near impossible for a person to grow with sustainable change for the long term because they don’t have a sufficient reason and value to keep them invested. God gives us this.
Want more? Well, there’s two tips in the next two verses, Philippians 4:8-9
“Anxious for nothing” will take a lifetime to put into practice. I’m grateful to have the opportunity. ~Justin [1] Continued misinterpretation and repetitive experience of these symptoms worsens disorder, like in Panic Disorder, GAD, Phobias, OCD, PTSD, and more.
[2] Bible Hub. (n.d.). 3309. merimnaó. Retrieved July 13, 2019, from https://biblehub.com/greek/3309.htm [3] I think it’s very important to note that we have to be very careful with saying anxiety/fear is sin- and what we mean by this. A lot of Christians get tripped up on this, and many, ironically, become more anxious. The extent of this point would likely require an entire book, so I will not take the space here to elaborate. [4] Psalm 139:14; Genesis 1:26-27 [5] Jeremiah 17:9; Romans 3:23 [6] Psalm 73:26; 2 Corinthians 12:9-10 [7] Oh yes, there’s a whole lot more in Scripture on this topic. Let's not reduce a couple sentences into a "how-to-manual." Addiction is confusing. It is confusing to seasoned professionals. Let’s just admit it.
It is not a specified diagnosis under the DSM or ICD; it’s only broadly referential to a sometimes amorphous categorization.
Take a look at a broad array of definitions (some even from reputable research organizations), which emphasize sometimes different things:
Clarity through the confusion While still in the middle of a ‘call to arms’ in clarifying Addiction is, we ultimately have a very stable understanding of the symptoms/criteria of problematic behaviors, and most of the time, how to treat them.
Substance Use and Addictive behaviors do exhibit many consistencies despite the actual substance or reward behavior pursued, and they respond to similar treatments. Regardless of the organization, the following are usually consistent details across definitions:
"Types" of Addicts There is an extensive history of attempts to categorize addiction, through “typologies.” Prior to scientific research, which began with E.M. “Bunky” Jellinek, there were many attempts to understand the mystery of addiction, but mostly from an observational or anecdotal standpoint.
We don’t have any consensus yet, but why is it important to know what type or level or continuum a person is on? At a minimum, we need to understand where a person falls on a continuum if we are to treat effectively. Here is one continuum of use problems (Adapted from Earleywine, M. (2016). Substance use problems (pg. 2). Göttingen: Hogrefe.):
Effective Treatment As I like to say, "Don’t drive your lawnmower on the freeway." Just like you wouldn’t do this (I hope), don’t assume that therapy alone, or a doctor alone, or worse, doing nothing- alone- will be enough “horsepower” to get you where you need to go. Effective treatment requires applying the factors necessary to get the job done. The person who abuses a substance occasionally on weekends will need to be treated different than the person who is “hooked” on something. Two categories of professional treatment exist, with incorporation of several additional supportive factors:
Besides treatment, supportive factors often include, but are not limited to:
My plea: Take addiction seriously. Don't know whether your are addicted or not? Find out. Addiction is a complex- bio-psycho-social-spiritual- issue. Problems with drugs, alcohol, or behaviors on a spectrum of addiction cause substantial disability, even death. And here's the kicker- people who have problems with these often experience lapses in judgement and poor insight into having a problem. Start with a strong assessment by a competent professional who is trained and experienced. Look for evidence based treatments (think CBT or Motivational Interviewing). Advocate for truth and be assertive. Ask hard questions of your provider. When providers get shifty or start to recommend some unusual treatment when you need a first line treatment, exercise caution. I'm Justin K. Hughes, MA, LPC, and I specialize in the treatment of Addiction through CBT and Motivational Interviewing (MI). As always, please like or follow me, using whatever platform you prefer. Also, subscribe for meaningful content regularly! The Myth of Disappearing Distress. If I do the right things, I won't have to face suffering, right?
It's easy for me as a therapist to exhort my clients to stay focused on the prize DESPITE the distress they feel. How easy it is to get off track! And while it's also easy for me to tell someone else this, it can be very cumbersome to do in practice. I, too, struggle to keep focused when challenges hit. But I'm always best prepared when I lean on my team: #support #faith #accountability #truth. Music: Remember Musician: @iksonofficial In Vivo Exposure
Directly facing feared objects or situations, examples include: Getting on a flight, touching a doorknob that feels “contaminated,” not going back to check a lock, or going to a social gathering. Good exposure attempts to match the content and detail of a person's fear as close as possible. So, for example, if a person fears “going crazy” in a social setting, the best exercise will be working up to facing that, not just exposing to the thought or word. On the other hand, if the fear is that a person will have inappropriate impulses (to harm, sexually, etc.), sitting with the intrusive thought and being present will serve best. Imaginal Exposure Imaginal exposure involves accessing the content of fears and anxieties through cognitive means. For example, a fear that someone will fail, make the wrong decision, harm someone, die, or choose the wrong relationship are not accessed by activating these life occurrences. They are addressed imaginally. There are many ways to practice Exposure imaginally, but the most common are writing scripts, stories, listening to recordings, watching videos, or using visualization. To be clear, Imaginal exposure often is the most confusing and hardest to grasp of exposure practices, as it seems to be creating negative thoughts or “bringing” unrealistic and negative thoughts on- the seeming antithesis of most of psychology and cognitive therapy. But what is really done here is only facing what a person is already experiencing, thinking and feeling. Interoceptive Exposure Intentionally bringing up physical sensations that are feared, such as: Heart racing, shortness of breath, sweaty palms. Ways to do this when a person's health allows are breathing through a cocktail straw, breathing rapidly, or sitting up quickly. Virtual Reality (VR) Exposure With the advent of new technology, we have a recently emerging type of exposure. Some may class Virtual Reality into imaginal exposure, but it can be seen as a cross between in vivo (situational) and imaginal. This is especially helpful with treating disorders such as Flying Phobia, where the access to an actual plane and flight to practice can be cost-prohibitive and difficult. What is Exposure Therapy?
Exposure therapy is a psychological treatment that is practiced in Behavioral and Cognitive Behavioral Therapy (CBT). It is indicated as a first line treatment for a number of disorders such as
Exposure therapy helps clients to systematically confront fearful stimuli along with changing fearful responses. This relearning increases confidence and decreases disruption in life. Over time, discomfort and fear typically decreases through active engagement rather than avoidance, suppression, neutralization, or ritualization. The evidence base is very strong for its use and effectiveness, though it is currently only applied a minority of the time in clinical settings. How Do You Do Exposure Therapy? The principles of exposure may be simple, but the specifics- personalized to any one individual- involve many working parts. Assessment
According to Dictionary.com, their word of the year is "Misinformation." Defined as "false information that is spread," misinformation occurs "regardless of whether there is intent to mislead." Misinformation, and its brother, disinformation, can be harmful. Clearly. Though much of the current state of discussion around this concerns external affairs. Much of what we are responsible for at least begins internally (how we respond and engage). Aligning our thoughts, beliefs, and behavior with reality- what's true and realistic- is a crucial "mechanism of action" that helps facilitate positive outcomes. This is particularly true in the method of therapy I use- CBT (Cognitive Behavioral Therapy), We know that cognitive distortions [click for pdf list] only prevent us from succeeding and growing. These errors are harmful especially when they are consistent approaches to thought, such as All-Or-Nothing Thinking (I missed my workout today; I might as well skip this week), Mental Filtering (I know they said they enjoyed meeting me, but they must not like me because they talked more to other people), and jumping to conclusions (I just know that she got off the phone quickly because she thinks I'm an idiot!). The deeper these go, the more impactful they are and harder to break. So in a world of misinformation, make sure you first tell yourself the truth, whether it's difficult or comforting. In this time of the year that is special, wonderful, challenging, or downright awful for some, what can you do? Be realistic. Tell yourself the truth, and to others. Align your thoughts, beliefs, and actions with commitment, purpose, and meaning (and if you're not sure what yours is, find it with help!), and try to get as close to what's honest and accurate. Be a good researcher (humble). Don't get snowed by misinformation. Give the gift of realistic, truthful thinking. Your brain will thank you (and probably everyone else will, too). Merry Christmas, and Happy Holidays! Yours truly, ~Justin  Photo by Toa Heftiba on Unsplash Want a surefire way to experience more gratitude? Be grateful. I'm not trying to sound trite; those who practice gratitude are more grateful. I struggle to apply this discipline myself. But when I do, I see the world differently. Enjoy the following video (thanks to my brother for passing along). Happy Thanksgiving.  $1.6 Billion. That's 1,600 x 1 MILLION Dollars. For the person who won roughly that amount in South Carolina (and the rest of us):
Would it surprise you that your emotional well-being really doesn't improve by becoming wealthy? There’s been a host of research in recent years that look into happiness and money. Possibly the most commonly known one is the National Academy of Sciences study on well-being and money. This study’s now famous $75,000 mark suggests that a person’s emotional well being (how they feel day-to-day) AND their evaluation of life (their overall perspective of how they are doing) improves up to the point of earning $75k per HOUSEHOLD in the United States. Beyond this mark, emotional well-being doesn't significantly improve, though a person will evaluate their life as better if they earn beyond this mark. To quote their findings, “We conclude that high income buys life satisfaction but not happiness, and that low income is associated both with low life evaluation and low emotional well-being” (Kahneman, et al. 2010). So what do "happy money" spenders do? Research by Elizabeth Dunn and Michael Norton in Happy Money: The Science of Happier Spending (2014) reveals how money is spent makes the crucial difference in happiness.
Are you making the most of what you have? Are you caught up in materialism and consumerism? Today is always a great day to do something different. Yours Truly, Justin K. Hughes, MA, LPC Do I want this, or do I not? Is this my actual desire, or what I don't want? Does this thought or desire define me? What if it's terrible or horrible? Sometimes the things I think about are because I value them or desire them. Sometimes the things I think about are because I don't value them or desire them. What the heck? Egosyntonic and Egodystonic are two psychological terms to describe phenomena of thoughts/urges that are synonymous and antonymous to what a person desires or wants. Sometimes our thoughts reflect very much what we desire or want, but around 90% of people endorse having "intrusive thoughts," or unwanted thoughts. It is crucial to do a good functional analysis on a thought/behavior to determine whether someone is doing something in order to pursue- or to avoid- the very same thing.  Photo by Joel Fulgencio on Unsplash  Photo by Dhiva Krishna on Unsplash Yesterday and today both I witnessed bad car wrecks. I haven’t seen a car wreck in over two years. Not only have I been more cautious driving since, today I caught myself telling my wife possible reasons for seeing two crashes in a row.
“Hey babe, maybe people are absent-minded with summer and vacations. Be careful.” Possible. However, I inferred meaning that may have nothing to do with what actually happened. Do you ever do that? Read into what your significant other is saying? What your clients are thinking? Make an assumption? We all do that. Decisions. Determinations. Judgments. I work with thoughts and thinking day-in and day-out. A big part of my job is to help folks live in reality. Correcting distortions and errors in their thinking is a large part of this. Of course, as a human being, I experience this just as much as the next person. It is a discipline to not only look to logic and reason, but also to connect with emotions and experience- and attempt to be grounded. I hope I always continue to work on this. So the reasons why a nice Mercedes got its hood completely crumpled may not really be in my purview. Nothing wrong for me to guess. However, it is significant for me to stay aware that my thoughts stick close to reality, because the further they diverge from it in day-to-day life, the more likely I am to make determinations that are wrong. The more I do this, the more firmly rooted my beliefs become. My emotions will follow my beliefs. And my beliefs determine my course. My course affects others. Others affect history. See where this is headed?  Photo by Jonatán Becerra on Unsplash Incredibly sad is the news that in a matter of days, two revered, loved, and famous celebrities committed suicide. This morning I was hit by discovering that after Kate Spade ended her life, Anthony Bourdain also ended his. After I prayed for their families, I knew I needed to send out this blog.
Suicide is an incredibly complex issue. Let me be simple at the risk of sounding reductionistic. Working in various settings in mental health for around 13 years, I have seen incredible hope bloom out of the desolate landscape of deep, dark depression. I have seen hope abound where there seems to be no hope. Personally, I have lost a friend, a neighbor, and a fellow college colleague to suicide over 15 years- and those are just the closest to me. There’s more. It’s so sad. But there is hope. How can I say this? I see it every day. None of us can ever fully control even our own best intentions for ourselves, let alone outcomes for others. Even as a counselor, I don’t have any more ultimate power to stop someone from committing suicide. Treatments that work for most are readily available. Treatment is often very effective. Sometimes several tries and different types of programming are needed. But you must take a step. Maybe it is to help, maybe it is to seek help. Things that don’t work:
Things that do work:
If you or someone you love struggles, please seek help! My industry’s entire focus is helping people. Please call 911 or go to the hospital if your life- or someone else’s- might be in danger. There is no shame in this. Reach out to a therapist who is experienced in treating your concerns. May you find hope for yourself or others- hope that runs deeper than the saddest and darkest moment. National Suicide Prevention Lifeline Call 1-800-273-8255 www.justinkhughes.com/resources Look under “Crisis” or find other helpful resources. Sincerely, Justin  Photo by Owen CL on Unsplash Did your anxiety increase over flying after news of the engine failure on Southwest Flight 1380? Even a little? I have booked plane tickets twice since the incident in mid-April 2018, and when choosing seats, I hovered precariously as I decided whether to select my favored window seat, or if I go for the "safer" aisle. My wife mentioned slight concern over the window seat because of the tragedy that occurred. Working closely with the CBT treatment of Anxiety Disorders and OCD, I knew the moment I read the news- first about engine failure and the sad death of a wife and mom, Jennifer Riordan, and more recently the loss of cabin pressure and a window crack on a separate flight- there would be increased fear and anxiety about flying. Why? Flying commercially is statistically more safe in the U.S. than it’s ever been. Even with these incidents. Even with 100 of these incidents. The fear is natural, and even normative, to some extent. It makes sense that we’d instinctually be a bit curious about our well-being in a metal tube soaring at 500 mph with tons of jet fuel propelling it. Even the possibility of flight has been denied in most of human history. But what about when fear starts to cause problems ? Affect choices? Leads to avoidance of life pursuits and goals? Or becomes one more in a cumulative list of anxieties and worries? One way to be 100% certain that you will increase your fear load is by giving the aforementioned flight(s) unrealistic credit. By associating personalized, catastrophic meaning to a situation that is one of the safest things you can do (safer than riding a bike), a distortion has taken place. Some disorders, such as Specific Phobias, PTSD or OCD, make it pathologically difficult (i.e., neurobiologically) to change how one feels and thinks, regurgitating fear quicker than your vertigo-experiencing seatmate with their airline-branded “barf” bag. With Flight 1380 being the first fatality on a U.S. passenger airline since February 2009 (over 9 years), flying on a plane is a remarkably secure form of travel. Unconvinced? Check out Forbes’ mining of some reputable stats. Here’s the thing; education and stats are helpful, but only go so far. Fear is more than a reasoning thing- or in neuro terms, more than a prefrontal cortex (PFC) thing. Fear is an emotional thing. An amygdala thing. A learned response and genetic thing, along with a pervasive attitude and decision thing. It’s something that can destroy, harm, and erode, or it’s something that can be used in its rightful context, and set aside when not useful (e.g., PTSD treatment where a person can balance both safe and smart decisions, while facing disordered fear, so they can live life more fully). So if you’re like most people who need a bit more than statistical education to counter anxiety and become stress resilient, remember this: What you think and believe (cognitively) is vitally important. What you do (behaviorally) is vitally important. Your health and well-being are intricately tied to these. Small decisions today can lead to a long-term impact. For many of us, the greatest threat we face today is fear. So I chose the window seat. ~Justin “I am an old man and have known a great many troubles, but most of them never happened.”  Photo by Leio McLaren on Unsplash “Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing.” – Helen Keller
I don’t want to live my life being overly cautious, but rather appropriately cautious. We are discovering in the research of anxiety disorders, OCD, and now depressive disorders, that possessing an Intolerance of Uncertainty (IU) is a common construct linked with higher anxiety and life disruption. What is IU? My favorite definition: “Belief that uncertainty, newness, and change are intolerable because they are potentially dangerous” (Steketee et. al 2005, p. 125). IU links threat with uncertainty. But is uncertainty a threat? Take a moment and ponder one of your favorite memories. What did it involve? Was there any risk? Any vulnerability? Any chance of failure? Most of the best life stories I hear are of those that involve, well, all of these things. A person who cannot tolerate not knowing actually misses out. How? Isn’t knowledge power? What happens is this: the more control a person must have, the less control a person has. The more certainty that is sought, the more narrowly circumscribed life becomes. Quick examples:
Want to know how you handle uncertainty? Take the free IUS-12 assessment here. [Go to "Read More" below to find out how to score the assessment.] Let’s be clear: everyone is uncomfortable with some uncertainty. And reasonable protection from risks is part of being wise- which can also be subjective. But the more you necessitate that certainty must exist, the following is more likely to happen:
In the research on IU, there are also two subset strategies identified: Prospective anxiety (desire for predictability) and Inhibitory anxiety (uncertainty paralysis) (Fourtounas et. al 2016).
If you struggle with any of these, the next questions is this: How do I live with uncertainty and anxiety, while also taking suitable precautions? The solution is fairly straightforward, but not easy. Once a problem area has been identified (along with what is reasonable, normative, or within your values), gradually and consistently gain ground by pressing into your fear without using a false reassurance strategy that reinforces the false threat of uncertainty. In therapy, one of the most powerful tools that exists to deal with uncertainty is what we call Exposure and Response Prevention (ERP). This is the single most effective tool in treating OCD, and it is very valuable in other disorders. The reasons it usually has to be done in therapy are several:
I personally love Exposure because it helps me face life with a “bring-it-on” attitude rather than a “stumble-through-best-I-can.” ERP in therapy is very specific, very structured, and very powerful. However, even the person who is not in therapy can benefit from its principles:
“Some men storm imaginary Alps all their lives, and die in the foothills cursing difficulties which do not exist.” ~Edgar Watson Howe So what uncertainty are you not letting yourself live with? When is ‘not knowing’ unacceptable to you? Uncertainty is not the problem. It is unrealistic to be 100% certain about most everything in life. Life has few certificates of guarantee, and those are only as good as what is backing them. Ready to face your uncertainty? ~Justin Most people think I’m an extravert. They see me being sociable, laughing, communicating- and the consensus is, “There’s NO way you’re an introvert.” My friends have confused being outgoing with being extraverted. In fact, even in counseling, the average person I work with believes that extraverts are outgoing and communicative, introverts shy and introspective. And though this can apply, it is not actually the technical definition- nor the most helpful definition of what it means.
Simply put, think “Recharge” when thinking Introversion / Extraversion (I / E). I will spare you the extensive history of folks like Jung and the modern day Myers-Briggs test, and there are many wonderful resources available on our topic we are considering- so feel free to consult my friend, “Google,” for more on the topic. I have come to believe that, at least in terms of personality psychology, understanding and application of this domain is one of the most significant for personal success. I am an introvert. Most of my life I have tried to be an extravert. Most days now I accept how I function, but I still find myself expecting I will magically change this. I find myself around groups of people almost all day for several days in a row, and I wonder, “Why am I getting so edgy, tired, and experience a pressure to just want to go home and get away? I want to just be able to power through!” Ohhhh yes. That’s right. I’m a mid-level introvert. Many claim that our world rewards extraverts. Maybe that’s true. But I know that if you are an extravert, your success is not handed to you on a platter. In fact, some of the hallmark characteristics of the introvert include abilities that many with extraverted tendencies desperately want. The best way to think about I / E is, “How do I recharge? Where am I most focused (the external world or the internal world)? How do I get energy? In what capacity do I restore and recharge my batteries?” If your answer is a clear, “With people!” or “Alone!” you may have a more obvious answer. If it’s a mix of the two, you may be more in the middle, or an “ambivert.” (There’s testing you can do to figure this out better, such as the MBTI or five factor model testing (FFM)/”Big Five”) But the answer to this question is pivotal to how you approach life- and frankly, how you NEED to approach life. No one questions the merit in stopping to eat a meal or getting a good night’s rest. But, how easy it is to question the way our own body and mind gets its energy back! For me, I question myself usually because I want to be more “productive,” able to knock out more things to be “successful.” But getting more stuff done is not necessarily a good thing in many circumstances. When dealing with buried emotions with clients, I often say a phrase my supervisor taught me: “Emotions buried alive never die.” We therefore have to deal with these emotional “undead.” So it is with how we recharge. Our needs will eventually come up, and if we haven’t been nurturing them in a reasonable way, they will come up with a vengeance, ready to threaten burnout and exhaustion. One of the keys to the application of one’s recharge style is how to work within a system of an infinite number of variables, styles, and circumstances. Put another way, we must learn to function both independently and dependently in the system with which we find ourselves. Extraverts, you will need to find ways to connect with others, but have to be disciplined (and usually work harder) at resting and reflection. Introverts, you will need to find ways to be alone and collect your thoughts, but have to be disciplined (and usually work harder) to make sure you stay social. “Ambiverts,” well, you’ve got it all together. :) All joking aside, ambiverts will need to find ways to connect and be alone, but have to be disciplined to have a foundation that allows them not only to “go with the flow,” but to make choices for both ends of the spectrum rooted in their own convictions. My personal journey with I / E will always be evolving as life changes and I transition through different stages. It is nice, now, to not have to waste energy in being the “vert” I want to be and focus on living faithfully with the reality that is. ~Justin {And just for the record, my writing of this blog was 90% introversion, 10% feedback from others.}  You may have just gotten an activity tracker over the holidays, or maybe you’ve already jumped on the bandwagon of wearable tech. Not only do activity monitors like Fitbit, Apple Watch, and Spire track steps, heart rate, sleeping, and more, you can turn your tracker into an ally for mental health.
Here’s how. Being able to track and monitor your thoughts, mood, emotions, symptoms, and sensory experiences is arguably one of the central tenets of most schools of therapy. It is nowhere more prominent than in Cognitive Behavioral Therapy (CBT), where awareness of internal processes is a first step to changing outcomes. For years, techniques such as journaling and monitoring have been used, but this new technological age adds a few extra tools that can be a boon for awareness. But you also have to build the emotional intelligence and discipline to catch what’s going on and translate that into meaningful action. Following are some tips. (Remember that some people will have more stress by using a monitor- if so, practice these same tips without help from Mr. Fitbit).
Justin  In this season of rush....I hate to admit it. Mom and Dad, please don't laugh too hard when I say....this.... I sometimes miss being told what to do. There. I said it.
I remember the drill of childhood. "When did you last eat? Here, have some food." "Looks like you could use a hug." "You're getting cranky; it's time for a nap." In my super-mature “I'm-smarter-than-a-child” mentality, I miss some of the plainest truths in life. One of these is the importance of rest. It’s the weekend before Christmas, and all through my house are temptations to “achieve” and find my worth in what I do and the approval of others. I’m trying to step back and rest. And I often will remind myself, “I’m more efficient when I rest.” What’s funny about that statement is that I still am finding an excuse for resting. What would it be like if I stop running the show for a moment? Slowing down the crazy pace of life is not only a discipline, it is an act of faith- one that acknowledges that I don’t control all and know all. And I don’t have to carry the universe on my shoulders. That’s freeing. I hope you “achieve” some great rest during this time of the year. Merry Christmas and Happy Holidays!! Yours truly, Justin  Ben Kolde on Unsplash This post was originally published on 09/14/2016 on my wordpress and is newly updated. Happy September (Recovery Month)! School’s back in session and vacations are over for many. If you’re like most, you’ve been seeing everyone’s summer pics on facebook and Instagram. While you might expect this post, written by a Professional Counselor, to talk about the influence of social media on self-esteem or depression, I want to invite you into a more personal journey- one of compulsive behavior, learning, and communication.
The Back Story Starting early in 2015, I had been recognizing for months how distracting my daily social media consumption was to me- and how much time and emotional energy was being spent. And then a stroke of insight came- why not just stop? I didn’t have to make any extreme commitment or do a PR campaign. Why not just see what happened? And see what happened I did. With no end in sight, I stopped personal social media use through May 2016. My days started to become more efficient at work; I found creative ways to engage or disengage with people; I was less stressed over the high dose of negative news I was seeing; I let go of the pressure of having to keep up with posting or needing to respond; I focused on the core things that mattered as opposed to the (look, a SQUIRREL!) distractions. I began to see how compulsive I had become, even a little dependent. I felt fear about missing out on something. I got a “hit” (or high) from that next new message or like or share in my notifications. I had worried if someone didn’t respond soon enough. The Addiction Framework In the addiction world, physiological dependence is two things: tolerance (more is needed to achieve the same result) and withdrawal (I feel powerfully adverse negative affects when the “drug of choice” is removed). The treatment world has been closely watching the impact of using the internet, apps, social media, and the like- to see how it activates and affects the brain and body and mind in similar ways to substances. And we’re starting to acknowledge how behavior can trigger some of the same brain processes as a substance being ingested. DARN, I guess I can’t say, “Well, it’s not like I’m abusing drugs or anything.” Actually, sometimes I am abusing the chemicals already in my brain that drugs simply play with. Varying levels of compulsivity exist, and my expertise in Professional Counseling focuses on providing help and hope when a person can’t break through their compulsive patterns. Even though a year break taught me about my personal misuse of social media, don’t expect a crusade AGAINST social media from me today. As much as I benefited from my “vacation,” there were a few things I missed out on, too. I overlooked a few announcements (sorry for missing that birthday heads-up). I lost a bit of connection to the world around me. In essence, some communication was actually stunted for me. And I missed out on a little healthy distraction I find encouraging. The Rest of the Story My personal story may not be yours. Here are some observations: The modality of communicating by tech IS effective and helpful for many. We can complain all day about children not learning to communicate well because they “can’t even” (and I do believe that is a concern to be aware of as a parent). However, social media can be helpful. Social media is a communication platform. Whether we like it or not, things like social media are the new telegram or front porch conversation of years ago. And they don’t appear to be going away any time soon, only adapting and changing. As with many things in this world, the actual vehicle of social media may be relatively neutral- what makes it egocentric, compulsive, and harmful OR helpful and relational, is likely the purpose and motivation and heart behind its use. I want to be “linked in” to the latter so I can live free, not compulsively. Sincerely, Justin Further Reading: Dr. Geraint Evans- “What I Learned in My Year Off Facebook” Dr. Kristen Fuller- "Social Media Breaks and Why They Are Necessary" Shala Nicely, LPC- "Are You Handcuffed To Your Devices, and Is OCD At Fault?  Thomas Plets on Pexels This post was originally published on 05/26/2016 on my wordpress and is newly updated. You’re surrounded by setpoints every day. They literally keep you alive. One of them is your set body temperature. If your body drops or rises a mere 15% beyond your core temperature, death occurs. Think of a setpoint like a reference point, a sort of boundary. Medically, it’s called homeostasis. The body regulates internal functioning (temperature, blood flow, oxygen) despite external circumstances. The body is always seeking homeostasis. So is the brain. And you can intentionally take charge for your mental, emotional, and relational health. Examples In our bodies, we break out in a fever when something is wrong- which is one way the body makes conditions unfavorable to viruses and bacteria- because they are temperature sensitive. In addicts, their brains have faced an onslaught of dopamine rushes- and the brain counters it by producing less dopamine to balance out- even sometimes ELIMINATING dopamine receptors. This is the brain naturally seeking to turn down a party that’s gotten too loud. The system Balanced functioning (homeostasis), whether biological, technological, or psychological, will involve three interdependent elements that help reach homeostasis- all centered on a setpoint:
Get negative In order to bring a system back to normal, negative feedback is used to regulate it. So when I say, “get negative,” or course I’m not telling you to have a negative outlook on life. What I AM saying is that a system that is out of control will only be put back in control/order by it being regulated by setpoints, carried out by either an internal or external force- and this is negative feedback. Okay, have I been sufficiently nerdy? Let’s get practical!! Sample exercises Check out how William uses all three processes of homeostasis as a married entrepreneur with children, who is also dealing with some alcohol abuse (#2 in each is the setpoint). Entrepreneur- 1) Financial accounts are reconciled daily by William (outside help oversees them weekly). 2) The business plan was developed with a setpoint of no greater than $100,000 debt. Crossing $50,000 debt signals a problem and requires meeting with the board. 3) If the setpoints are not honored, the board has full power and autonomy to enact established strategies. Temperature- 1) William’s two year old, Thomas, is running a fever- revealed by his behavior, and then it was gauged with a thermometer. 2) If 24 hours pass with a fever over 100 F- or at any point it goes beyond 103 F- the setpoint has been crossed. 3) Visit the doctor immediately. Remodeling- 1) Extra money was left over- discovered in the budget by William’s wife, Katie. 2) They determine no more than $10,000 will be spent on a kitchen remodel. The goal is $8,500; beyond the goal is a warning flag. 3) At the $8,500 mark, a conversation will be held with the contractor to hold to the budget. Alcohol Use- 1) After running into various troubles with alcohol, William considered his personal/family values and health recommendations. 2) A setpoint was made: only 2 drinks or less daily. 3) If this line is crossed, the commitment is to have an entire month sober. If this cannot be done, it is agreed on with his support team to increase treatment (e.g., go to a group, go to counseling). Got the hang of it? These steps can be applied to about anything, though I mostly use the Setpoints Exercise (click on the link below to access!) to help increase ownership and boundaries with addictions. It’s a straightforward way to get honest with anything you are facing, the amount of help you need, and what supports can get you there. This concept has helped assist many of my clients to face problems squarely, and in turn, to be more successful and realistic in addressing life challenges. Give it a try!  Will Malott on Unsplash  Vera Arsic on Pexels This post was originally published on 04/19/2015 on my wordpress and is newly updated. In Latin, Quid Pro Quo means, “something for something.” You scratch my back; I scratch yours. Tit for tat. It’s how the world runs. Or is it? In the business world, this often works. Social psychology calls it “reciprocity.” In relationships, well, this is where it gets fuzzy. Relationships require sacrifice regularly; they require that you stick around, presuming it’s reasonable to do so. In business, if someone doesn’t offer you a good deal, you can move on. If you keep doing this with relationships, you will bankrupt your heart and anyone close to you quicker than ever thought possible. Relationships involve the molding and holding of hearts. Business involves the flow of money. I want to call to the table that many principles that work for business DON’T in relationships, which is partly why someone can be extraordinarily successful in the business world but trade in relationships as often as changing underwear. The concept of reciprocity is fascinating, and I regularly utilize it in respectful ways when I consider how to engage in business, such as when I “add value” to interactions with businessmen and women by offering helpful counseling materials. This, in turn, increases my odds of getting a favorable response. Nothing wrong with it. I attempt to not do it ONLY for this reason. However, when I expect a certain response- demand it, even- I am not respecting a person’s freedom, uniqueness, or spontaneity. And this is precisely the problem when quid pro quo is present as a foundation in relationships. Everyone from Hendrix to Gottman to Eggerichs (see references below) point out the necessity of proactive initiative in love- an active, intentional doing what’s best for another, choosing love over “balancing the budget.” In fact, the eminent researcher Dr. John Gottman states the myth of quid pro quo in The Seven Principles for Making Marriage Work (2002): “But it’s really the unhappy marriage where this quid pro quo operates, where each feels the need to keep a running tally of who has done what for whom” (p. 15). Isn’t this the definition of selfishness? And it tears relationships apart. I don’t know of anyone who says, “Yes, being completely selfish is good; I want to live by the principles of selfishness and teach my kids to do the same.” No one really debates this. How quickly it takes over, though! My role as counselor isn’t to point a finger; it’s to help uncover what’s holding people back. Consider how you might be “losing while winning,” holding grudges, keeping a record of wrongs. These things are the opposite of contentment- and love. "Love keeps no record of wrongs," (1 Corinthians 13:5d) as is often quoted at weddings. Don’t wait for a person to do good to you. That’s the whole importance of the Golden Rule and the Greatest Commandment. If you wait around for the other person to “play by the rules” in loving you, prepare to be unsatisfied. There will come a time (in EVERY relationship) when loving another becomes hard: when the "high" of newness wears off, when the attractiveness of another becomes the norm, when that little quirk that you thought was wonderful turns out to annoy the heck out of you. If it’s left up to reciprocity, we’re screwed. In friendships, romantic relationships- ANY relationship. If a relationship fundamentally relies on quid pro quo, it will prove an unhappy ending. Find out how to love others despite what they bring to the table, and reap the overflowing results. If one person brings a feast to the table, just because the other doesn't bring one won't mean you can’t enjoy yours- and just maybe win them over in love. Sincerely yours, Justin For more information: Business Networking That Works...It's Called Quid Pro Quo (Forbes) Getting the Love You Want (Drs. Harville Hendrix and Helen LaKelly Hunt) Influence and Persuasion (Robert Cialdini) Love and Respect (Dr. Emerson Eggerichs) The Seven Principles for Making Marriage Work (Psych Central summary)  Photo by Everton Vila on Unsplash |
Justin K. Hughes, MA, LPC
Owner, Dallas Counseling, PLLC
justin@dallascounseling.com
P: 469-490-2002
17330 Preston Road, Suite 102D
Dallas, TX 75252
Owner, Dallas Counseling, PLLC
justin@dallascounseling.com
P: 469-490-2002
17330 Preston Road, Suite 102D
Dallas, TX 75252
©2019 Dallas Counseling, PLLC
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