Blog

By: Eric Kruse 

A Thanksgiving Exercise to do with Family and Friends

We all take things for granted. It’s easy for us to forget about the things in our life that we are lucky to have. For example, if you are able-bodied, you probably forget to be grateful for you ability to walk. Often, we take our relationships for granted. We forget to tell our family, friends, and loved ones how much we appreciate them. Thanksgiving is the perfect opportunity to tell your loved ones how much you appreciate them, and you can do it with the following exercise that I call The Gratitude Hot Seat.
Setup
Add an empty chair to the thanksgiving dinner table. This will be the Gratitude Hot Seat.
Exercise
Each person at thanksgiving table will take turns sitting in the gratitude hotseat. The person sitting in the gratitude hot seat will listen to the others express what they appreciate about them. Going around the table, every person takes a turn saying what they appreciate about the person in the hot seat. 
Conclusion
I came up with this exercise for a thanksgiving dinner with my family a few years ago. I learned things about my family that I had not considered before. It’s amazing what happens at a family dinner when only one person speaks at a time and the focus of the dinner is about expressing what you appreciate about one another. 

by Rachel Thomasian

What makes you unique and special?
One of the ways I help clients gain confidence and self esteem while decreasing symptoms of anxiety and depression is by identifying, tapping into and expressing gratitude for the best parts of themselves. We all have traits that make us uniquely special. By identifying and nurturing these qualities, we can feel a bigger sense of belonging, purpose and exceptionalism all at the same time.
If you're having trouble identifying your strengths, I recommend the VIA Character Strengths and Virtues Classification, which measures 24 strengths across 6 virtues. Learning yours helps you gain a better understanding of your assets. ​Find your signature strength by taking the free survey at ​VIA. 

Talking about money seems to be a topic so often avoided in our intimate relationships. Culturally we have often been taught more often than not that it is taboo to ask about money. We have learned to never ask someone how much rent they pay, or what they make at their job, or what they are saving for. Money is seen as private, so we don’t ask about it and we don’t talk about it. However, money cannot be avoided. We make money at our jobs, we need money to pay rent and bills, and we need money to do the things we want to do. In many ways, our lives revolve around money, making it even more imperative that we learn how to talk about it openly- especially with our partners. 
 
In couples therapy, part of my job is to help couples learn how to be more comfortable when speaking on the topic of finances. Below are some important steps that can help in making the topic of money one that can be talked about more openly and freely. 

1. Identifying your “Money Operating System”

Financial Wealth Manager and ‘Profit Boss’ radio host Hilary Hendershott has spoken a lot about our ‘money operating system’ or “MOS”. These MOS are the beliefs that we have come to have surrounding money. Some common “MOS” include the belief that ‘there is never enough money’, ‘there is always enough money’, ‘money is bad’, ‘money gives me value’, ‘spend now, worry later’ etc. We have all grown up differently and been taught different things about money. This greatly impacts how we view and spend money as we get older, as well as how comfortable (or not comfortable) we may be when talking about money. It is important to begin to learn and have a deeper understanding of you own money operating system. Not uncommonly, we often pair up with someone who has different beliefs about money, spending, and saving than we do. Being able to first learn to identify and talk openly about our own MOS and then learn to listen to our partner’s experience with money is an important step for being able to then get on the same page about finances. 

    2. Getting on the same page- asking the hard questions
This next step is important! Often couples get engaged and married and have never talked about what their financial future will look like together. Will we combine finances? Who will pay for what? If I make more, do I pay for more? Will we have a joint credit card? Joint savings? Is my debt now our debt? Do you get access to my trust? What if I want a prenup? These are extremely important questions to address when approaching marriage or combining finances. Often these questions around money can be charged, and often carry with them a lot of emotions. This is normal! Money is a complicated topic and can have many feelings attached, including shame, stress, anxiety and worry. Being able to acknowledge these and navigate them when talking about money is where therapy can be super helpful. Ask the important questions that need to be asked in order to get on the same page with your partner. 
​
    3. Budgeting- setting goals and expectations
 As individuals, we often have our own thoughts about spending, saving and budgeting. These are important topics to talk about with your partner, especially if you are going to be combining finances in any way. Is saving a priority? Do we want to buy a house or rent? Do we want to have kids? Do we want to take vacations? Sitting down and talking about what goals you have financially and what those goals will cost is important. This also involves being able to budget together and look at how much money is coming in and going out each month. Having mutual goals surrounding what you want life to look like together can be helpful when carving out where money will be going. 
 
As mentioned- talking about money is hard and something we often have not learned to do well. Couples therapy is a wonderful place to start to explore and talk about this crucial and inevitable topic between partners. When you learn to more openly talk about and navigate the topic of money together, you will be setting yourself up for less stress and better communication in the future. 

By: Eric Kruse

​The fight or flight response is a physiological response that occurs when danger is present. It was essential to our survival in the Paleolithic period.  If the Paleolithic man saw a tiger, the fight or flight response would increase adrenaline and anxiety and cause us to run away from or fight against the source of danger (i.e., the tiger). 
Modern society is much different. Generally, there are no tigers running around that are threatening our survival.  However, our fight or flight response is still intact, and it gets triggered when we get into arguments with our loved ones. For example, have you ever felt severely emotionally dysregulated when a loved one makes a comment that you perceive as emotionally hurtful? Does this increase your anxiety? Do you get angry? Perhaps you feel like running away or lashing out with hurtful comments. That is your fight or flight response. You feel emotionally dysregulated because your body is perceiving the hurtful comment as a tiger that is threatening your life. However, your life is not threatened. Your loved one is not trying to kill you.
When our adrenaline and anxiety increase, we become impulsive and are at risk of saying things or doing things that we may regret. It is important that we slow down our thoughts and calm down before we react to the present situation. It can be helpful to name what is happening by saying to yourself, “this is my fight or flight response perceiving a threat, but there is no physical threat.” Take a break and step away from the situation if you need to. Just let your loved one know you will come back after you calm down.
Often, having the awareness of what is happening in our body can be the first step to regulating our emotions. It can be comforting to understand why we feel anxious and wound up. Once we feel calmer, we can utilize our “observing mind” to analyze the situation free of judgements, heightened emotions, and adrenaline. 
For example, perhaps you get a new job and your partner says, “I never thought you would be able to get that job.” You feel nervous that you will not be able to handle the new job and your partner’s comment triggers your insecurities. Your negative thoughts start to spiral and you feel emotionally dysregulated. You feel the impulse to lash out and make a hurtful comment in return. This is the time to remind yourself that your fight or flight response is perceiving a threat and that you need to calm your thoughts before your react. Consider the possibility that perhaps your partner is proud that you got the job because they thought it was a hard position to get hired for. 
The more you pay attention to your body and raise your awareness of when you are feeling emotionally dysregulated and why, the easier it will be for you to center yourself and observe the situation free of judgments and heightened emotional sensitivity. You can look at your interactions from a objective perspective rather than an emotionally reactive perspective. This will increase the quality of your relationships and help reduce the anxiety that you experience in life.

Book Review by Eric Kruse

​Recently I was fortunate enough to receive a complimentary copy of Addicted to the Monkey Mindby J.F. Benoist. It was sent to our office, so I decided to start reading it since someone was kind enough to take the time to send me a copy. I must admit that although I use cognitive behavioral therapy techniques in my practice, and I am very familiar with the inner critic that we all have, I have never heard it referred to as the monkey mind.  I did some research and discovered that “monkey mind” is a Buddhist term that refers to being unsettled, restless, or confused. Perhaps the content of this book could help me, or my clients battle their inner critic.
The book highlights two different states of mind: the “monkey mind” and the “observing mind.”  The monkey mind is the inner critic that spirals your emotions out of control, invokes erratic thoughts, and creates anxiety. The “observing mind” offers an objective perspective free of judgments. 
The book uses characters and stories to illustrate how the “monkey mind” and the “observing mind” play out in our lives. Early on, the book tells the story of Elizabeth, a woman with a drinking problem who is dissatisfied in her marriage because her husband is consumed by his work.  She consults with two of her friends for support. One friend, Paula, embodies the essence of the “monkey mind” and the other, Sarah, embodies the essence of the “observing mind.”
Paula (monkey mind) tells Elizabeth that her husband is probably cheating on her with his secretary at the office, which is a judgmental conclusion based on anxious doubts. On the other hand, Sarah (observing mind) asks Elizabeth for more details, such as who, what, why, where, and when. Sarah points out that it is a huge leap to go from “he works too much” to “he is having an affair.” As can be expected, Elizabeth feels more anxious and emotional after speaking with Paula (monkey mind) and calmer and more relaxed after speaking with Sarah (observing mind). 
This is just one example of the many stories that are captured in this book.  J.F. Benoist does a great job of showing how we develop our monkey mind from not just our families, but from growing up in a “shame-based society.”  Benoist claims that the more we use our “observing mind” the less anxious we will feel in our day-to-day lives.  I don’t know about you, but the thought of having less anxiety in my life sounds like a welcomed outcome. I found the characters and stories in this book to be relatable and I was able to see how I can make more use of the “observing mind” in my own life. 

By Katrin Steinert

 ​Death is apart of life. It is also one of the most painful, agonizing and difficult experiences that a person can go through. Most of us are familiar with the five stages of grief, which are: 

1. Denial and Isolation
2. Anger
3. Bargaining 
4. Depression
5. Acceptance 

 
The stages are meant to be gone through one after the other with little flexibility in revisiting stages. J William Worden disagreed with the fives stages and created his own idea of how grief is experienced. He proposed the Four Tasks of Grief model. The model is meant to flexible and allows mourners to tailor each stage to their own experience versus having to fit their grief into pre-determined stages. The tasks are as followed: 
 
Task 1: To Accept the Reality of a Loss
            During task one the mourner is faced with the death to the point where it almost might not feel real. It may not hit the mourner how deep the death can affect their lives. What will holidays look like? Who will I call when I need support? During this task some ways to help accept the death are by completing rituals including funeral planning or creating a way to honor the life of the loved one. 
 
Task 2: Process Grief and Pain
            The second task is all about feeling whatever comes up for the mourner. That can include anger, sadness, relief, and exhaustion to name a few. The spectrum of feelings will be large and vast. The most important part of task two is to remember that the mourner must express these feelings and not avoid them. To acknowledge how grief is felt and be open about the feelings will help to work through the complex feelings. 
 
Task 3: Adjust to the World Without Your Loved One
            With the death of a loved one many holes will be left. Some of the holes are internal and others are external. If a parent has died, it will require adjustments to parental support and roles in families. The adjustment to the new reality is emotional and can require a lot of time. To help work through this task, it will require awareness of the impact of that the death had and how to create a new life without that person in it. 
 
Task 4: To Find a Connection with the Deceased While embarking on a New Journey
            Task 4 is about creating a way to remain emotionally connected to the person who has died. There are many ways to achieve the connection by remembering the person who died, finding a physical memorial connection or rituals such as visiting their gravesite. 
 
Death is permanent and painful. It is important to practice self-care in the time of grief and maintain relationships that bring you joy. 

By: Eric Kruse

​Dialectical Behavioral Therapy uses a concept called “The Wise Mind.” The Wise Mind is where your emotions and your intellect come together to create a balanced perspective.
The Emotional Mind
Emotions are beneficial because they help us feel things. We cry when we are sad. We smile when se are happy. It provides opportunities for us to cultivate relationships with others because others can relate to our emotional responses. Emotions are the catalyst for empathy and empathy is greatest tool in developing deep emotional bonds with others. 
The Reasonable Mind
Intellect helps us solve problems and think about the world around using knowledge and information. We use it to cook or meals, fix our cars, drive technological advancements, study medicine, and to write blog articles such as this one.
Knowing when to use each state of mind
Being overly emotional or overly intellectual at the wrong time can cause problems. For example, sometimes people in your life want you to empathize with their situation when they are struggling rather than trying to “fix it” with intellectual problem solving. Sometimes, it’s better to keep your emotions under control, such as when you make a mistake at work and you start to feel defensive. You don’t want to act impulsively. 
The Wise Mind – Finding balance
The Wise Mind strikes a healthy balance between intellect and emotions. It allows you to understand others by reading their emotional cues and allows you to process what you want to say and how you want to proceed without impulsively acting on your emotions.
 
The following website link shows a Venn Diagram of The Wise Mind, The Emotional Mind, and The Reasonable (intellectual) Mind:
https://www.therapistaid.com/worksheets/wise-mind.pdf
The bottom of the sheet asks you to list an example of an experience that you have had with each of the three states of mind. I encourage you to apply the knowledge from this by describing your own experience with each state of mind so that you can be more aware of when you are using each state of mind.

By: Eric Kruse

​It has been estimated that humans have anywhere from 30,000 to 70,000 thoughts per day and that up to 80% of these thoughts can be negative. It should be no wonder why so many members of the population struggle with anxiety and depression. It’s impossible to stop ourselves from having negative thoughts, which is why we call them “automatic thoughts,” but we do have control over the thoughts that follow our “automatic thoughts.” 
An effective tool for doing this is to treat our automatic thoughts as guesses. For example, you see people in your office whispering and looking at you and your automatic thought is, “they must be making fun of me.” Instead, try framing that thought as question by altering it to, “Are they making fun of me?” Then follow it with another question, “Are they saying nice things about me? Are they talking about someone or something else and just looking in my general direction?” There are so many conclusions that are positive or neutral that we often miss the chance to consider.
The next step is to write down all the guesses and arrange them into a pie chart. Consider the evidence that supports each guess (i.e., hypothesis) and then assign probability percentage to each guess. For example, the fact that you cannot hear what your colleagues are saying about you and the fact that you don’t know if they are actually looking at you is evidence to support the guess that “they are talking about something or someone else and looking in your general direction” so you can assign I high percentage of the pie chart to that guess. Furthermore, the fact that up to 80% of our daily thoughts can be negative is evidence against the possibility that your colleagues are making fun of you because you now know that statistically there is a high chance that your first automatic thought will be negative. 
Your pie chart can be drawn out by hand our done as a mental image if writing things down is not your thing. The purpose of this exercise is to slow down and consider that your thoughts may not always been accurate, especially when they are tainted by a smoke-colored lens. Treat your thoughts as guesses and make an active effort to follow your negative guesses with neutral and positive guesses. 

By: Ranjita Rao

​Did you know that over 90% of Americans own a smartphone? While there is no clinical diagnosis for cellphone addiction (yet), cellphone addiction is a very real thing, and it could be negatively impacting your life in more ways than you know. Cellphone overuse has been linked to eye strain, neck problems, car accidents, and even symptoms of anxiety and depression. Studies have shown that, like drugs, cellphones can trigger the release of oxytocin and dopamine, the “feel good hormones,” and because most of us have our phones with us all the time, it is very easy to use them to the point where it begins to negatively impact our lives. 
 
Here are some common signs that you may be addicted to your cellphone:

• You find yourself spending more time on your smartphone than you realize—Have you browsed through your phone recently, thinking you were only doing so for five minutes, only to look up and realize that an hour has gone by?
• You use your smartphone to mindlessly pass the time, when you could (or should) be doing other more productive things.
• You fall asleep with your smartphone either right next to you or under your pillow 
• You are distracted from your work and relationships because you are constantly checking emails, texts, or scrolling through social media apps 
• You are distracted by your smartphone while driving 
• You check your phone when you’re feeling bored or uneasy, as a way to distract you from what’s going on around you 

 
If many of these signs resonate with you, you may want to rethink how much time you are devoting to your smartphone. Fortunately, breaking your cellphone addiction doesn’t require you to break up with your smartphone completely. Here are some things you can start doing right now to set yourself up for success.
 
Figure out how much time you spend on each application 
By going into your settings, you can easily find out what percentage of your day and even week was spent on each of your apps. Finding this out can help you figure out which specific apps you spend most of your time on.   You may be surprised by what you find.  For most of us, the majority of our time are spent on apps that we use relatively mindlessly, whenever we are bored like Facebook and Instagram).
 
Pay attention to body cues 
Do you reach for your phone when you’re bored or maybe even anxious? Listen to what your body is trying to tell you, and ask yourself how your phone will make you feel better. More often than not, the “good” feelings you get from your phone is only a temporary fix. Figure out other coping skills to provide positive outcomes. Yoga, meditation, exercise and long walks are a few examples of more positive coping skills 
 
Create some barriers 
If you determine that you spend too much time mindlessly scrolling, you can set up some ways to make yourself more mindful of your usage. This could be something as simple as sticking a post-it note on top of your phone, or even changing your lock screen passcode every day.  These barriers force you to be cognizant, and help you break the habit of looking at your phone every time you have a free second. 
 
Practice separating yourself from your phone
Start small and work your way up to longer periods of time where you do not have your smartphone on you. For example, you could practice leaving your phone at home while you take a ten- minute walk outside, and eventually work your way up to going out to dinner without your smartphone. This also gives you a chance to notice what is happening around you and what your body is trying to tell you. Being more tuned into your surroundings and even to yourself will provide not only physical benefits but also improve your mental health. 

By: Eric Kruse

"Great stories happen to those who can tell them." --Ira Glass

“Storytelling is the most powerful way to put ideas into the world today” – Robert McKee
​
What is Narrative Therapy?
Narrative therapy is a medium for self-reflection and growth through stories or narratives (hence the name). The general idea is to change your perspective on your life by the way you tell your story. Every event that happens can be told from a positive, negative, or neutral lens. For example, let’s say you are suffering from depression. What is the story you are telling yourself about your depression? Are you telling yourself that there is something wrong with you and that you will feel depressed for the rest of your life? How does that story make you feel? Typing that out made me feel hopeless and sad. This is how the stories we tell ourselves about our life impact how we feel. 
Externalizing our Problem
What if I told myself a different story about my depression? What if my depression was not a part of me, but instead an evil entity that dwells inside me. I can even give it a name, such as The Dark Voyager. Sometimes The Dark Voyageris not inside me. Those are my good days. Whether The Dark Voyageris with me today or not, there is definitely nothing wrong with me. If anything, I am strong person for endearing The Dark Voyager’s poison. This is strength-based narrative that allows me to feel proud of my level of resilience to the depression I am facing. 
Life Stories
The story that you tell about your life does not have to be clever. You are not trying to win a creative writing contest. You don’t need characters, such as The Dark Voyager. You can start with a very simple template, such as “my past, my present, my future.” Here is a link to a free template online:
https://www.therapistaid.com/worksheets/life-story.pdf
Everyone has a story so don’t tell yourself that you don’t. If you tell yourself that your story is dull and boring, then you are formulating a negative narrative, which once again, will make you feel sad about your life. Regardless of how much you believe your life is mediocre and not worth telling a story about, the truth is, it’s not! We have all had formative experiences that have shaped us into the people we are today and those experiences are worth sharing and talking about from a strength-based perspective.