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Justin K. Hughes, Licensed Professional Counselor: Dallas CBT and Exposure Therapy for OCD, Anxiety, Addictions & More
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Justin's Blog

Thriving Mental Health Alongside COVID-19

4/14/2020

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One of my first questions to a professor in my earliest IOCDF BTTI (Exposure Therapy training) at Massachusetts General Hospital was, “What happens if someone actually gets sick after a contamination exposure?”  I haven’t forgotten the simplicity of the answer that went something like this: “People get sick all the time. Yes, that might create some additional hesitancy to face exposures at first, but you have an incredible opportunity for learning.”  Life involves not only facing bad things that don't happen, but also bad things that do.

Exposure Therapy involves the systematic confrontation of fearful triggers while reducing and eliminating fearful, pathological responses.  In the end, it can relieve a lot of suffering.

During this global pandemic of COVID-19, people actually are getting sick.  One might not think the principles of exposure therapy would apply (i.e., "Don't you do exposure therapy for risks that don't happen?").  Quite the contrary.  I believe exposure therapy provides one of the best evidence-based ways forward, helping us stand up to fear we need to squarely face.  So today, whether you have a disorder or not, there is an opportunity for learning and growth in the face of COVID-19.  

This guide, "Thriving Mental Health Alongside COVID-19," is dedicated to my clients and the IOCDF and provides a thorough summary of the main steps of Exposure Therapy with me, with key tips for general mental health.  May you be enriched by this!

~Justin

Intro

Whether you have a mental disorder or not, there is an opportunity for learning and growth in the face of COVID-19 (SARS-CoV-2).  Now, more than ever, we need stable footing to stand on.  People go to every extreme. You don't have to. Mental health is about being grounded in reality, insomuch as we can grasp it.

Getting sick will happen.  Yes, people die. Relationships break up and fail.  Businesses go under. We might get it wrong. However...many people can experience health.  Some people live with purpose and to the full (which is not the same as perfect). Relationships can be incredible.  Businesses can thrive. We can get things right.  

When I utilize the method of Exposure Therapy in counseling (a subset of Behavioral and Cognitive Behavioral Therapy), it involves the systematic confrontation of fearful triggers while reducing and eliminating fearful, pathological responses.  It is Gold Standard treatment for OCD & Phobias, and is a first line treatment for all Anxiety Disorders and PTSD.  What we think happens is that relearning occurs, which for most increases confidence and decreases disruption in life when they follow the treatment.   Exposure, then, gives us two opportunities:
  1. To learn that we don’t have to fear something.
           and/or
     2.  
To learn we can face it anyway.
Its principles connect us to some of the best of life: face the thing you have reason to face; gain the opportunity to live more fully.  

This guide is a very brief summary of the main points of the exposure therapy process with me, particularly with clients who have OCD and Anxiety.  Many of my clients actually are faring better in this crisis than people I have talked to and seen in the general public- and why wouldn't they?! They've been training and learning- and now it's game-time.

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Sugar!

9/25/2019

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2013
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2019
"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:
  • Down 3-4 large glasses of Dr. Pepper with a great Tex-Mex meal (150-200 g. of added sugar)
  • Gobble full pints of ice cream in a sitting (100 g of sugar)
  • Chomp 8 servings of cereal- “it was only 2 bowls,” despite the box’s nutrition content being based on ½ - 1 cup of cereal- (60-80 g. Of added sugar)
  • Finish a pound cake within a few days- just for the record, it’s called a “pound cake” because it historically has been made with a pound of added sugar (75 g. Of sugar per MY serving)
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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:
  • I almost entirely cut out added sugar from my daily diet at first, and now use sparingly with a limited number of desserts.  
    • I lost 45 pounds in about a year and a half, the first 5-10 pounds was just cutting out sugary sodas.  
    • I slowly cut consumption (small things to begin, like not eating past 10:30 pm at night), and then really worked on eating vegetables.  If I wanted a snack, I’d learn to find vegetables, nuts, and fruits). I found foods I enjoyed that I could eat basically as much as I wanted.
    • I began to look BIG-picture at food with an observant eye- and discovered (shocker!) that even my favorite salads possessed added sugar, and not just in the dressing.  Places like McDonald’s and Chik-fil-A add sugar into different items in their salad toppings and breadings (can anyone say candied pecans?).  Stores like Costco sell a lot of “organic” items, but when I look at the packages and see the ingredients lists on most items, I still find a lot of added sugar, sodium, etc.  
    • I still enjoy dessert!  I just had two slices of cake at my sister-in-law’s wedding!  And I loved it.

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.)
  • In a 2,000 calorie diet, 50 g of added sugar is the max recommended (10% of total energy intake).
WHO (World Health Organization) Recommendations[3]
  • Strongly recommends less than 10% of total energy intake as free sugars, 
  • And conditionally less than 5%.

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:
  • You (and others) are inherently valuable.
  • Nutrition is a significant part of life that, when it goes well or poorly, affects all other aspects of life.
  • Consider introspection over your relationship to things like added sugar that, when over-consumed, creates major problems.  
  • Goals are great, but change has to be doable.  Unrealistic expectations are a killer of motivation and long-term success!
  • I’m here as a resource if you need me!
  • Everyone is different, but all of us have to live by the principles of reality.  The more realistic we are about looking and facing it squarely, the more congruent our lives will be.


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!
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    The Jog:

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    All Content on this Site, justinkhughes.com, was created for informational purposes only. Content is not intended as a substitute for professional advice, treatment, or diagnosis.  Always seek the advice of your own personal health provider who is qualified to treat you, along with asking them any questions you may have regarding medical or other conditions. Never disregard professional medical advice or delay in seeking it because of something you have viewed on justinkhughes.com. Also, due to the sensitive nature of topics and material covered through this Site, which contains very descriptive and/or advanced content, you may not want to use justinkhughes.com. The Site and its Content are provided on an "as is" basis.  Some posts are written for specific populations (OCD, Christians, Professionals)- with the intent to remain respectful to all- some content may not fit or go counter to your beliefs, perspectives, and what is explored for you in a professional counseling session with Justin K. Hughes, MA, LPC.  The posts are intended solely for the population they are written to and can be designated by their titles and tags.
    Links to external educational content are taken at your own risk. Justin K. Hughes, MA, LPC is not responsible for external content.  

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    Justin K. Hughes, MA, LPC of Dallas Counseling, PLLC participates in the Amazon Services LLC Associates Program.  This means that some links on this site will produce a small commission from Amazon.com and affiliated sites.  I NEVER link products I don't use or clinically find benefit in.  Many of them have been recommended for years inside and outside therapy sessions.  You are under no obligation to purchase any book, product or service recommended on this site.  However, they are provided on this site only educationally and are not meant to be interpreted as treatment or therapy in any way.  I am not responsible for the quality or experience of any items purchased through affiliate links, as they are entities completely separate of myself.  

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​Justin K. Hughes, MA, LPC
Owner, Dallas Counseling, PLLC 

justin@dallascounseling.com
P: 469-490-2002

17330 Preston Road, Suite 102D
Dallas, TX 75252
 
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