 The Guide above is provided entirely for free to newsletter subscribers. 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 IntroWhether 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:
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. Click "Read More" for a Summary
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 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.  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? |
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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