NICABM

Success Board



Did you try something with a client?

Did something you heard spark an idea that helped someone?

We’d like to hear your successes because we can all learn from your experience.

Please leave a comment.

 

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75 Responses

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  2. I used Dr. Germer’s three steps this evening with an intern grieving the loss of new found friendships as she prepares to move on for more and different experiences in her life. As we walked through the steps, she was able to validate that it was hard and name the emotions. She easily accepted that relationships are messy. When we got to step three and I asked her what she would tell her friend who might be saying the same things, she looked as if a light bulb turned on. She said, “I would tell her that was a ridiculous to think someone who loves you will forget you.” In that moment she put away all the fear, all the blame, all the shame. Ten minutes after walking into my office in a sad space, she walked out with the confidence that saying goodbye and moving on would not end the relationships built during her time with us.

    Thank you Dr. Germer for such a straight forward presentation. I know I didn’t use your strategy for a couple, but it worked beautifully with a blooming care-giver.

  3. Hi there.
    I have been thinking about posting for a while but wasn’t sure where I would post my thoughts as they aren’t about moments of success, but rather about a gradual decline in confidence in my ability to do the work !
    I have really enjoyed these videos and they have really added to my understanding of different therapeutic issues. I have also found that I have more words to use when I am doing a bit of psychoeducation with clients!
    I really wanted to reach out to see whether anyone other practitioners lose their confidence for time to time, and if so, how do they remedy this? I am in therapy and I must admit, I have always battled to have a sense of being good enough. I am curious however about others! Is this just me??

    1. Often times the last two videos are the most helpful in the seminars. The critical insights and the last video speaks to application. I find they have a nice way to summarize the speakers.

      I especially appreciate Kelly McGonagel’s insights. She has so many hands on ideas for work with clients. I always check in to see her ideas.

      Peter Levine is so helpful regarding connecting to the body while Stephen Porges really helps with understanding the nervous system. Thier ideas have enhanced years of being a clinician and reminders of how things went wrong early on in the mental health field. Collaboration used to be the norm.

      These webinars used to help be to see the hope that was a constant in my training along the way but managed care started to tumble and collaboration became the exception after awhile. These webinars have a hope that we can get that collaboration back.

      Daniel Siegel is a genius with imparting how to present the brain and on and on. You will find many of them well versed with how to augment your work with clients.

      Lately the webinars have not been as helpful with hints, but I am sure there will be many more to come. I used to find watching the new topic in a recent webinar helped pump me up for the week when feeling discouraged when our profession is oftentimes being smeared in the news.

      Know in your heart are, oftentimes, the sole support in a client’s life. Helping them open up those freeze states and move with energy out of the fear states can be life changing. It is hard not to be discouraged at times, but those times when wonderful improvements come it is worth increasing your hope. I am sure you are skilled but need to have a strong support system in this day and age. Counseling can be helpful, but a strong positive supervisory team can be most effective.

      Take good care!

    2. Hi Jacqui I’ve always struggled from time to time with not being good enough and it drives me to always want to learn more and more. However, when it gets triggered to a certain level I’ve found therapy can become ‘stuck’. I think it’s getting the balance – I think if we have a sense of not being good enough then we’ll never have an ego where we think we’ve nothing to learn and there will always be something to learn. I’ve found that during the times when the “I’m not good enough” core belief comes up, its affected by other things in my life too and it can be time to step into some personal therapy so that it doesn’t become a hindrance to client work. I always have to strike the balance and bring evidence of the good outcomes from client work. So no it’s not just you.

  4. I am a new subscriber to Next Level. As Sr. Minister of a large UCC church, the pastoral care demands are heavy and the training light. Thank you for creating this amazing and practical resource!

  5. I love these weekly videos. I find myself reaching for my journal, where I record messages from the videos, on a daily basis working with clients. There are so many gems to share along the way. Just yesterday, while working with a client who has a long history of sexual abuse and is currently pursuing an MSW degree but struggling with feeling “not good enough” and believing they won’t be able to complete the program, I shared Bill O’Hanlon’s quote “You are in the middle of the story now, don’t make the conclusion yet.” This simple statement allowed the client to step back and realize how they do not yet know for certain that will be the outcome. We then examined all the evidence that does not fit with that pre-determined outcome. This person is getting A’s on every assignment, the feedback from professors has been very positive. By the end of session this client was willing to acknowledge that just maybe there is an opportunity to see a different outcome from the one they had previously imagined. It was such an exciting shift to witness.

    1. Your client might like to watch Amy Cuddy’s Ted Talk: “Your Body Language May Shape Who You Are.” Amy Cuddy shares her own story of “Not good enough” -“I don’t belong here.”

      1. Thanks, Jane, I shall check out the video. I have a client who is always obsessed with her body image and refuses to identify her issues. Her view of her body is so imbedded in her identity. I am not as skilled regarding body dysmorphia and need guidance at times on this subject.

        They always seem so locked into the image they portray of themselves even when I either avoid any kind of pressure or solutions, no matter what approach I use I am never as affective as I would like.

        They heal despite any interventions but it baffles me how they succeeded except I just allowed them to talk and talk…

    2. Tahni, thank you for the great idea about recording the info as we are watching the videos. I will incorporate that idea immediately! It will be something I will take into sessions with clients as a reminder of new “alternative tools” I can utilize.

  6. Elisha Goldstein spoke about the imortance to have people aroynd, in reality or at least, virtually. I live in a big city in Argentina, but it is not easy for me to share all I am learining with all of you for many reasons, first few of them could be able to understand english quickly while listening, and seond, they are not so familiar with the ideas shared through nicamb. So Ruth, I feel really sorrounded by all of you, and supported by each one of the speakers and this program had chanaged my life very significantly. I will never be able to be grateful enough to some of you, as Dr. Van der Kolk, as while listening to him I could finally understand and forgive myself for things I have been carrying around along all my life, and immediately, this understanding could help my pateints and friends, releasing this way their shame and pain . Thank you, many many times.

  7. This video on Uncertainty as a possible sanctuary was very helpful as all clients face that & not only clients but therapist too as to the outcome of therapy, but if we focus on the possibilities then uncertainty is what we work on leading to a better future- learn from past, stay in the present to be able to focus on future is helpful…..

  8. This topic of uncertainty for me was a breath of fresh air.
    A relief
    A message of hope
    In the desert of my childhood
    Even hope for me as a practitioner of mindfulness and a certified therapist in so many modalities.

    I remember when I was living in chronic shame, fear, loneliness, isolation and abandonment while maintaining a full private practice as a somatic psychotherapist.

    Why? Why so much loneliness and depression?

    Because for me there was no place in any of my clinical training programs to bring into the training environment or even during time of social engagement that I had been living in chronic fear, dread, uncertainty and grief my entire childhood and many many years into my adulthood.

    Programmed like many men to zip the lip and pursue success and esteem in the Professional world.

    So many moments of uncertainty:
    My birth
    My mothers psychotic breakdowns
    My brother’s ongoing dance with crack cocaine
    What my teachers were going to do or say with my reality.
    Now. A father Living daily with Dimentia. Don’t know if he is aware of me or not each and every day that I visit
    A husband who wants to play music, retire and travel around the world.
    My health
    My weight
    The future of my potential inheritance.
    No money coming in.
    Loosing income in taking care of family members.

    Uncertainty..
    The gift that I now have
    It is 12 steps that bring me to acceptance
    12 steps and meetings that teach me every day that I can survive and thrive with internal and external uncertainty.

    Never know when the next headache is going to emerge.

    And the weight on my body.

    Uncertainty is now a gift of consciousness

    Having lost my brother to a drug overdose last year.
    I had to now give up control.
    The one human blessing who was so precious to me is now gone.

    Dead
    Uncertain about the future.

    And I am still alive.

  9. Dr. Segal’s comment about developing relationship with the unknown so it does not control the person was very inspiring. My adolescent client does not like her body and wants to change gender. The time is spent in focusing on school, anger, shame, tension headaches, not talking to siblings and not going out. Fighting with mother who is conerned is another activity. Activities have not reduced her tension. I would now increase her choices and help her become more prepared and informed. Helping her look into emotions and building up internal resources as suggested by DR Porges. Very useful discussion on 2/20 and 2/21. Thank you

  10. Ron Seigel mentioned a little bit ago that he had a client with chronic pain, being very nice and not acknowledging his pain. He started validating that this client might be a bit “pissed off”, and the client liked that. I also have a client with chronic pain, and his doctors can’t find a reason. He is in his early 30’s. After thinking about Ron’s session, I shared with him the story of Ron’s client. This client suddenly remembered a time at sleep away camp when he was about 8 years old. He never liked camp and felt he didn’t fit in, which he mentioned before to me. But in this session, he described a night when the counselors let the bunk sort of go wild. In a mass group of boys acting out, there was some sexual exploration. The client needed to work through feelings of guilt about that night, that he did enjoy parts of it, and that he wasn’t responsible for their actions at that age, but the counselors weren’t doing their job. We talked about how he would feel if he ever had a child who he trusted a camp to take good care of him and what he would expect out of responsible counselors? This client became nauseated in the session thinking about that night, but he did come to see that the counselors were not being responsible to him and his bunk mates in allowing this open run amok behavior. He had never spoken to anyone about this night before, and he said it did feel good to openly talk about it.

    This past week, I asked my client how the session about camp had affected him. He said he felt more resolved about that night now, and doesn’t think about it any more. He was also experiencing a better sex life. He still feels pain, but I need to do as Ron did and validate that one might have feelings about their experiences, and see if I can get him to explore his feelings more. He’s a challenging client, because he intellectualizes a lot. That is something I would I like to explore more with NEXT Level Practitioner, how to get someone who intellectualizes a lot to be more comfortable exploring feelings, or widening a window of tolerance for affect.

    Anyway, I was grateful for Ron’s story of what happened with his client, and how it helped me with my client in recovering this lost experience and helping him heal it. Thank you Ron!

  11. This series has truly been a transformative one to me. I consider myself to be a “journeyman” therapist, as I am a little over 12 years in as a independent practitioner. Before this series started, I would rely on my gut and go where I felt prompted. While that worked to a degree, I now find myself exploring, probing, and building with my clients in a more enriching and safe way. I have also been able to come to the point in my life where I realize that I can live my own life and not be constrained by my past. I have also decided invest in myself and pursue certification in the Emotionally Focused therapy model as I really feel that it suits me and my style. Thank you to the Next level team for this amazing gift!

  12. I am really appreciating everything that is being offered here. Such a deep well of resources! And very confirming of what I’m already doing…

    I have been using Belleruth’s “Hidden Splendor” technique and I can see why she uses it with all of her clients. It works like a charm. I was so gratified yesterday to see my client’s face light up when she heard the words and she actually teared up. This was huge considering she had dragged herself to the session and came in saying she was really depressed and would not have come in were in not for my 48-hour cancellation policy. I am learning a lot just in these first couple of weeks.

    It is a discipline to watch the videos and it’s totally worth it.

    Thank you!

  13. Hi All,–I thought that last weeks talks on resilience were “a keeper”.Resilience for me, and my coaching practice is a state that many clients desire to work on, as do I. I particularly found the talks by Joan when she discussed the work of Seligman-the 3 “P’s” that contribute to a state of helplessness and the work of Suzanne Kobasa the 3 “C”s” that contribute to stress hardiness- an event is not a threat but a CHALLENGE-(what is the essence or meaning of the situation to you),The second, CONTROL-to me is best stated in the “Serenity Prayer” authored by Reinhold Riebuhr (an American theologian):
    God, grant me the serenity to accept the things I cannot change,
    Courage to change the things I can,
    and The wisdom to know the difference
    In my work over the years this “prayer” has had a prominent place as a core principle in the 12- step programs the best know being Alcoholic Anonymous (AA). The third “C” -CONTROL -means to stay with the issue at hand. One way of doing that is to explore its truth (as was beautifully discussed by Dr Goldstein in week 23 in”4 Questions to help Clients Evaluate their Beliefs”.

    A comment about the talk on Monday by Dr Linehan. She offered as a way of getting us out of a state of “overwhelm” the use of a physiological process called the “diving reflex”. I first used this technique in 1975 in the Emergency Room of a teaching hospital of the Brown University Medical School. I found the technique in a “Letter to the Editor” in the New England Journal of Medicine. A patient came into the ER with a very rapid heart rate . We tried the tried and true methods of slowing the heart by engaging the vagus nerve-the valsalva maneuver(holding your breath and bearing down on your belly), and carotid massage.I didn’t know Joan B.”s technique of blowing out through pursed lips-as if blowing out through a straw. Any way nothing worked–so– I -We- tried for the first time (to my knowledge at Brown-the Diving Reflex. We got a stainless steel basin, filled it with ice and water, and told the now very anxious patient to put his entire face into the water. Really, I haven’t seen a face like that again-really. Well he did it-once,twice and a third time.After he came up for air his heart was still beating very fast–maybe faster–but he no longer looked OVERWHELMED(maybe a little catatonic) . Now we WERE. overwhelmed. What followed was some more traditional medical stuff with an IV and then we called his cardiologist.

    Here’s the issue-for me at any rate. The “diving reflex” is an evolutionary reflex that all mammals have to slow their heart rate when their face hits water. Babies have it. It is one reason that humans can survive drowning for a longer time when in cold water. Sensory nerves on the face and in the nose stimulate the vagus nerve (parasympathetic) and slow the heart ( the freeze part of fight-flight –freeze). It is really quite powerful in my experience-for overwhelming situations as Dr Linehan discussed. Yet–BE Careful- and this is solely my opinion – not a medical claim.You have to be sure that the person who uses this doesn’t have a heart/ medical issue. Most of us can do this easily. I personally would be cautious – to ask an overwhelmed 80+ year old to put her face into a bucket of ice cold water-well that might be clear- know your own health status or the status of the person to whom you suggest it. We know that it works-when you want to wake up you splash cold water on your face.

    Yup-one issue we have in the US is being overwhelmed. And I concur that overwhelm puts a blanket over the fire of resilience.

  14. Soon after listening to Ervin Polster, I had a 15 y.o patient come in and discuss her negative thinking. She complained that after any negative incident, these thoughts drug her to spiral down and feel very depressed and hopeless. As we discussed what is coming up next in her life, she stated that she had an AP History class she was looking forward to. She began to discuss the current american elections. As we talked I asked her if her thoughts could be given a name, she promptly stated that they were just like one of the candidates and gave them that name. I then produced an action figure that looked somewhat like the devil and she began to laugh and laugh. Then I produced an action figure that looked like an angel. She said.”That’s it!” -” that’s the conflict I go through constantly.” We discussed which of those figures she wanted to believe and stated that she saw that one had no basis in evidence. She named the thoughts by the political candidate names, and stated she would use them this week to help with the helplessness. Waiting to see how it worked.

  15. I was able to successfully integrate several different ideas from this series this week, and I’m finding the combination of things helpful with several clients with more entrenched negative beliefs. Not in order of importance, but here’s what I’m using that has helped:
    1.) Educating clients on Peter Levine’s & Bessel van der Kolk’s concepts of the body retaining trauma. I have used the example of the women crossing the street with the gun fire and how their shoulders stayed permanently up after the 3rd day. Clients are starting to notice their own body and feeling that this is a normal response to the trauma they have previously experienced. They seem to feel less like a victim, less like they are different than others, and less isolated from others in this knowledge.
    2.) Joan’s Devils Circle: even though I had been feeling like I was in a devils circle with hearing certain of my clients repeating their themes, in pointing it out to them with this terminology, I think it made the implicit explicit to them. I could see clients suddenly realizing that they are in a circle, and there is a way out.
    3.) Limiting Negative Beliefs/ thoughts and feelings connection: I have started saying to certain clients, “I feel as if you are in a movie, feeling this situation very strongly, and it feels like your identity at that moment.” And the client response with more than one client has been,”Yes!” I then have responded with it’s possible to change the movie. One client did say at this point, “But it’s real! It’s really happening!” By being able to have a conversation about how their limiting negative belief is coloring what they see, there is starting to be “aha” moments. And by noticing it, the “movie” becomes less of their identity. They are not their thoughts. They do have power in that they can focus on different thoughts, or they start to notice what their belief is in that moment. That alone has been creating a positive movement.

    Thank you again for all the wonderful presenters and to you Ruth in being the master interviewer and organizer of this series!

    1. One last addition: Yesterday I met with my client who is an adult child of Holocaust survivors. We’ve been going around and around in the devil’s circle for a long time. She has been very reluctant to try any tools like breathing, focusing on coping thoughts. She switched to a new psychiatrist, one who moved into our building, and I referred her to him as she wanted to change psychiatrists. She had a session with him this week that she was happy with, as he spent a lot of time with her. He was able to point out to her when she said a limiting belief. She told me about this, and she seemed to understand this concept better than before. In discussing her and my work together, she said that she’s too set in her ways to change and to use the tools I’ve been trying to offer. I said, “And that is a limiting belief.” It was an “aha” moment for her. She and I created a list of coping thoughts for her to try and focus on, which centered more around, “It’s possible to make changes. It’s possible for me to focus on a coping thought and find relief.” She seemed willing to give it a try at the end of the session. I’m curious how she will be in our session next week. But it felt to me like a good shift for her.

  16. All presenters have given useful info that I will put into my tool box.

    To rephrase some of the information presented by Dr. Hanson I refer to the work of Byron Kate in her book “Loving What Is: Four Questions that Can Change Your Life”-For the right client , with an appropriate level of trust I can present these questions (outlined on Wikipedia) when I recognize a limiting belief:

    1-Is it True?
    2-Can you absolutely know that it true?
    3-How do you react,what happens,when you believe that thought? and
    4-Who would you be without that thought?

  17. For Joan’s “Devil Circle” – That presentation was so insightful, a fascinating useful approach, and very very touching.
    I intend to use it. I sense that it will work with many. How well did it work with the young woman who thought herself ” ugly”?
    PS- I had the great pleasure of conversing with Joan when she was in Rhode Island. May God bless her. Her presence and wisdom is contributing greatly to a saner more loving world.

  18. A client who was really hurting about her spouses distancing from her came to session today and told me how helpful it was when I share Michael Yapkos story about a million dollars. It made a huge difference in her experience of her husband. Another success I had was in sharing Esther Perels 6 verbs. We explored which were easy and which were hard and why that was so. What were the blocking beliefs that restricted them. Then the homework was to focus and increase the ones that were difficult. Learning so much and using new knowledge every day. This is helping me feel more vital and alive in my work. So grateful.

  19. I am writing this as my personal experience of four types of depression with “successful recovery from each state.

    The first state occurred with the death of my mother. I was at first “frozen” when I learned of her unexpected death.After this state I was anxious, experienced grief and was greatly helped by being surrounded by caring men and women while “sitting shiva”. The grief came and went for many months (but was mostly gone within one year. There was not the sense that I experienced in later forms of depression,

    With the death of my father,who had a long bout of leukemia,I experienced an extension of grief despite social support. Clearly there was a different relationship that I experienced with him. This and my social stress at the time may have resulted in a depressed state.

    Here, I was able to work,but the sadness was not only profound but was associated with a state of brain fog,mild despair, a lack lo enjoyment for life, but not a severe state of helplessness nor hopelessness

    This state appears to be the state at worst, that many of the patients discussed experienced.This is at worst. Many more of the patients were at the end of state one discussed above. The interventions employed in section #15 certainly helped the first state and helped bring me temporally mildly out of state two. With time and help it resolved.

    The third depression occurred when I was under severe prolonged stress that I could not resolve. It was here that I became suspicious early in its course that I was possibly predisposed to depression. This was severe. The only way to describe it was a”sickness unto death” a state of despair that had unbearable pain. I had every symptom described in the Beck Inventory of depression multiplied many times. I became non-functional. Thoughts of suicide ran through my head because of the severity of dreadful pain.There were no medications available,I say the traditional therapists who used primarily analytic methods. This resolved-I don’t remember how long it took.My memory of the experience is a best cloudy and mostly gone as it is in marked anger episodes.

    I began to experience depressed “feelings” of the type of dreadful pain again, and at that time SSRI’s were available. I cleared within two weeks.

    Therapies of the types discussed in #15 have been a life long adventure for many -off and on- periods in my life.

    At times I experience the “dread”-the sickness” for only a few seconds then it was gone.

    Despite all that I have experienced, I have come to believe that I can understand , with much better states of empathy and understanding than clinicians that have not had my life experiences. It is like experiences a state of infatuation or forms of love toward a grandchild. You can’t “understand it until you have experienced it-in your own way- yet probably in a similar way like we all experience the color blue.

    When to employ the techniques described in #15 and Cognitive Behavioral Therapy has become easier because of experience not only logic. I thank God that we we have progressed in our techniques and medications.

  20. My takeaway regarding Dr. Sue Johnson’s talk.

    She stated “this is part of trauma-the brain is vigilant for danger and his brain would find the crack”.
    She then used this “crack”, the negative attributes he projected upon his wife,the only place that she(Sue) found and talked about the issue regarding his feeling unsafe as her her understanding and approach of where she could work toward repair of his attachment and an enhancement of his feeling of safety. A shot term analysis?

    What would happen if she continued to work on that approach while modifying his medication would be of tremendous interest. In today’s world, how practicable is this regarding financial/insurance concerns and time needed in repair. I believe that we are doing a tremendous dis- service to patients.
    The health care system has a real chance of collapsing because people will become increasingly ill with our present care model. We can’t pay for an increase in ill health both mentally and physically.

    It’s obvious that I enjoyed her approach a lot- it takes an ability to “experience” what the patient is experiencing- which, in my experience, most health care professions may truly not possess. She does,however.

    I will keep in mind the sentence containing the words trauma,vigilant, and looking for the “crack” in the “armor”. It explains a lot.

  21. I posted this to the comment board yesterday, and as I thought about it, I decided I’d like to post it to the Success Board as well. Here is that post: Yesterday I was thrilled to suddenly recognize and become aware of how many of these ideas, techniques, and approaches from the experts we have spent time with so far are becoming embodied for me. I find this idea or that approach right there at the forefront of my thoughts as I go deeper with clients, getting to better know their challenges and their goals. I’m so very appreciative of the tools I have already acquired, and for the difference I can see it making in my clients as they step a bit farther away from their challenge, and a bit closer to what they’re hoping for. My process has been to watch the video, and then to read the transcript…which I highlight, star, and use post-it page tabs to designate what I want to remember. And, as I mentioned before, I also make a small post it note for client files. I will also, at times, actually visualize being with a client and applying that idea, technique, or approach with them. Doing it this way really seems to have helped me to absorb the information. I’ve put those transcripts in to a binder…My manual of practitioner possibilities!

  22. I practiced Medicine for 44 years as an Internist, Rheumatologist, Rehab Physician, and forms of Complimentary/Alternative Medicine. I was fortunate in working with Dr George Engel who coined and developed the “biopsychosocial model”. At a minimum the known precursors of biological illness and the concomitants of stress as a part of continuing of chronic illness need addressing.Many Chronic diseases are caused by and perpetuated because of Stress in its various forms.

    This program is at the heart of correcting this oversight. It is unfortunate that it is not presented to medical students and physicians and incorporated into their practice. Obviously modification would be necessary but the essence is appropriate presently.

    During my career I became a Life Coach. The approaches to care here are the ones used in coaching. Coaching does not at its heart approach issues of psychological dysfunction that occurred in childhood (the more analytic issues) but issues that presently encourage ones potential and issues of “Stuckness, Change, with a sought after outcome”.

    I strongly believe that some thought be given to introducing this type of program to all health care professionals .

    Their time constraints make this addition very difficult for them to employ in depth. If they are AWARE that there are issues and therapy for these issues appropriate referral would be enhanced. Clinicians with knowledge in these areas SHOULD be part of every medical practice. Since practices are increasingly becoming group practices this is possible. Problems that perpetuate chronic disease WOULD be markedly reduced in my experience. Issues that now plague society such as drug addiction I’m sure would be greatly reduced as well.

    As a start, presenting this program to teachers in a medical school would be appropriate to begin in earnest.

  23. I wanted to write and share how much I have gotten from this program. Most of my career I have wondered if I was doing what other professionals were doing, and now that I can literally train with them on an ongoing basis, I can be both validated that I am on a good footing, and inspired and challenged to work in more effective wording and techniques. I love the fact that there is a lot of resiliency talk, because my life motto and the name of my Private practice is AOP, which stands for Adapt, Overcome, Prosper. With this program I feel like I have been able to do all three! Thank you!

  24. At a conference workshop Monday while discussing supervisors response secondary trauma and vicarious trauma I used the idea talked about by Joan Borysenko’s of re-writing, or re-intrepreting our grievance story. It was amazing to watch to participants eyes light up and their bodies perk up when we discussed the idea of acknowledging the hurt and pain, yet looking for growth and increased resilience in challenging situations. In the case of the workshop, it was reframing the idea of being a bad clinician. We are not weak when we feel and act on the pain we experience through those we serve. Rather, we are connected with them. The connection and relationship are what make great clinicians. Thank you, thank you, thank you for helping not only me improve my clinical skills, but also helping the 50+ clinicians in the workshop.

      1. And . . . here’s Joan’s reply:

        Thanks for sending this along, Ruth. I’m so happy that Dr. Spencer implemented the narrative repair with such compassion! When secondary trauma disrupts our ability to care and to be compassionate, it seems especially important to understand how narrative medicine can heal the clinician and preserve the connection that heals.

        Yay!!!

        Sending you much love and thanks for all your trust and support, Joanie

  25. We explore the life long challenge of learning to live with dysfunctional grooves or neural networks and to impose ones that seek to promote “inner freedom” and the ability to “howl at the moon”.This appears to be a major goal for a “good” life as well as for a proficient therapist.

    I have found Dr. Hanson’s work to be the clearest in creating states of positive being and doing.I use his techniques and attempt to balance the catabolic ( energy draining) states with the anabolic (energy promoting) states in a ratio of 3 or 5 to one (+ TO -) as proposed by Gottman and Fredrickson.

    The issues as always are what are the first small steps that the patient or client can employ, remember to use, stay with, help be aware of, that will enhance working with both grooves; and secondly, I don’t have enough time to do this if I take insurance!

    So, I attempt to work on myself as well as the people that I work with to be so motivated as to “help myself stay with it”–be mindful/focused/aware of my intention and have this experience as part not only of my mind but of my body.–and do it 10,000 times, 10 seconds at a time.

    Actually, coming close to this goal is possible- but it almost always requires the help of another person or of a group. MD and Life Coach

  26. Before moving on:
    I just saw the shift in topic to “Aliveness and Vitality” and am very much looking forward to this week’s videos. Before moving on, I first want to say that I over recent weeks I have been noticing a very positive and uplifting cumulative effect of watching these videos steadily. I now feel like our teachers and the learning community are in the room with me as I work, and I am also noticing a healing effect on me personally. I want to go back through my notes very soon to make a list of the wonderful questions and reframes which I have been noting and working with. More specifically, the very first week that this program started, i got a new referral from a retiring colleague. The client arrived describing to me how deeply depressed and stuck she had been and how her psychiatrist had tried all the possible med combos and maybe she was just going to have to accept that it couldn’t get any better. She felt she could never pursue her artistic endeavors and show her work because of her anxiety and that she was a complete failure. She also has a painful situation with a very ill adult son living at home which causes her great anxiety and heartache. I noted my energy going down with hers as she spiraled lower and lower as she spoke. I had just listened to the first week videos and from there on I continued listening VERY CAREFULLY –applying questions and techniques suggested. Even more importantly, the focus coming from the teaching and the community gave me energy and greater access to my own natural compassion and curiosity. The client arrived at our third session having shown her art work and given a talk about it at a recent art show–she was smiling and speaking of it as if it were completely natural. We have lots more work to do, but will continue in this spirit, building the new pathways. Thank you very much to all the presenters for your depth, skill, humor and love of the work and to everyone willing to share so much insight and wisdom.
    PS: I am better known as Nina Miller, my practice is in Burlington VT

  27. This week I saw a client (44 yr old female) who has a pattern of aggressive behaviour and poor emotion regulation which sabotages her relationships and belittles those closest to her. I helped her to stay with the emotion (of anger towards her father’s partner) and float back in her mind to a time where she felt she needed to be that dominant or forceful-and asked what purpose did it serve for her. She remembered a situation where her father was not physically present neither did he financially support her yet she was now supporting him emotionally and financially as he is ailing and what makes it worse is that he was physically present and financially supported another partner and his children from that union. She kept getting stuck on how easy they have it, driving fancy cars while she struggles. I helped her to see how much these early experiences allowed her to tap into her determination to survive, her sense of agency, utilizing her creativity in building her earning potential. The shift within her when we changed her narrative from an angry, resentful child to a resilient empowered adult-this recognition of her courage and perseverance caused a major affectual shift where she could acknowledge that this situation created opportunity for her to grow as a woman and this meaning melted away her anger. The techniques from Sue Johnson-going with the emotion and Joan’s help the person to find meaning in their experience allowed me to have this moment with her. How rewarding it was to be present with my client as she had this aha moment. Thank you to Ruth for conceptualizing this program and to the amazing experts who inspire us weekly with their insights.

  28. Joan Borysenko is amazing! And as a clinician, I see the benefit and know the effectiveness of finding the meaning in the story, and how forgiveness is key in healing. Helping the client to do this is the piece of the puzzle I find difficult at times, particularly adolescents, whose life experience is limited to their story.

  29. I am working with a couple that is seriously considering getting a divorce, and I have been able to use several of the techniques that I have learned in these videos, with great results! One of the most powerful for me was Ester Perel’s talk about time limits and decision making. I compared it a crock pot vs a microwave in terms of being able to wait for a decision, and it was a very powerful moment for them. Thank you for helping me to my practice to the next level without having to travel and spend a lot of money for a conference full of people, when I can really get down and focus on the techniques in the privacy of my office. Keep up the good work.

  30. In my session with a client today, I had the perfect opportunity to “expand the emotion”, as Sue Johnson shared with us in the two part video last week. My client, a 62 year old male, was making a connection with the fact that he gets anxious when his wife starts a conversation of a serious nature. I first asked him to rate the anxiety on a scale of 1 to 10, “1” being the least anxiety, and “10” being the worst. He immediately acknowledged the anxiety soaring to an “8” very quickly in those conversations. So, I then asked him what happens next, and he reported that he begins to shut down. I asked him what happens next and he said his wife gets frustrated and more upset and he wants less and less to interact, she gets more and more upset, and yells, and then won’t talk to him for days. He reported lying in bed at night continuing to feel the anxiety of what’s going to happen now, and thinking maybe he just doesn’t want to be in this relationship any more. I asked him when he’s feeling this anxiety what is he afraid is going to happen…and, up comes the story of when he was 8 years old, after another big fight between his mother and his father…which happened frequently, with a lot of yelling…his mother packed he and his siblings in the car, no conversation about what is going on, and left Washington for Nebraska…”I didn’t even get to say good-bye to my dad.” After a couple of months he told me they did return home to Washington, but that there never was any conversation about the whole situation, and nothing changed between his mom and dad. The fighting went on…not quite so intensely, but it didn’t change. My client was blown away by having made a connection to this experience, and just kept saying, “Wow!” and, “I can kind of see where this has been playing out now!” Such a wonderful breakthrough! Thank you, again Ruth, for this program, and Sue for sharing your incredible work with us!

  31. This week I had a session with a client who has been struggling with her children growing up and leaving for college and her husband being more distant due to his recent retirement. She frequently experiences feelings of loneliness and feeling unloved. Several sessions we had done had worked on looking at ways her family shows her love even if they aren’t the ways she would like them to show it (for example they like going out to eat with her but don’t want to go for walks with her). This week, I decided to try instead of having her change how she views their behaviors, I decided to just sit and talk about the struggle of feeling lonely and the emotion itself without changing it. This led to wonderful insights about how it’s actually sitting with her struggles throughout her life that has led to positive changes eventually in her life. As the topic continued she was able to see the value in the struggles and how the balance between struggling and hope were a necessary component to living a full life.

  32. Last week I had a session with a client who has been struggling with winning her mother-in-law’s affection and approval since the day she got married. She has been very hurt by her mother-in-law’s cold, judging and emotionally distant attitude and craved to be closer to her. My client lost her father at the age of four and her mother became withdrawn ever since then and she was raised by her maternal grandparents. Although she felt contented with all the love and support she received from her grandparents, she always felt deprived of her mother’s attention and fantasized that marriage might give her an opportunity to get close to her husband’s mother. That didn’t work out very well for her and she came to me to resolve her deep hurt feelings about her mother and her mother-in-law’s rejections. The NEXT LEVEL videos have been incredibly supportive to say the least in my sessions with this client and a few others. Michael Yapko’s and Pat Ogden’s videos made a real difference to my sessions with her and we have made significant progress with her finding ways of validating herself and investing time and energy in relationships that have potential for growth while also focussing on healing the hurt emotions through self-compassion. I am very thankful to the team at NEXT LEVEL for designing such a wonderful program.

    1. Ramya, I’m so glad to read that you’re feeling supported in your work. That’s was a driving force for us in putting this program together.

      So happy to read about your client’s progress.

  33. Last week I worked with this young woman on her fear of speaking in public, the intense shame she felt when others looked at her. Both her parents drank, and she remembered the horror of standing in front of her class in school, feeling so vulnerable.

    I use EFT tapping as my main modality, and inspired by the discussion on self compassion some weeks ago I suggested we add some self compassion to the usual balancing phrase of acceptance used in EFT tapping. I asked her to repeat “Even though I feel so vulnerable when the others look at med I accept myself with warmth and tenderness”. (Or words to that effect but in Swedish). She noticed a slight pain in her heart saying those words, a pang of sadness. We tapped a while and she said “I felt so bad when I was a kid, I had such a horrible childhood, I just want to forget all about it”.

    I thought I’d try out Jack Kornfields approach and said “Even tough you want to forget, for very good reasons, you’re really born with a heart that is big enough to hold all the pain and suffering that happens to you in your life with compassion.” Hearing that she cried softly for a few minutes while continuing to tap. And then, it was lovely to see, she took a deep breath, relaxed her shoulders and straightened up whith this look of clearness on her face. She opened her eyes and met my gaze steadily (she’d never done that before).

    Checking out her school memory again it really didn’t upset her any more, and the thought of talking in front of others was much less intimidating.

    Thanks a lot for bringing up self compassion as one really important component to change!

  34. Yesterday, as a client had just begun talking about their stress, she reported that she could feel the tightness in her chest and throat area. (We were already on the floor sitting on yoga mats, which I do with some clients who want to feel more grounded). As soon as she acknowledged the anxiety coming up, I asked her to place her hands on that area, breathe into it, and just be mindful. I asked what other feelings were present, and she was able to identify more fears, but also some happiness in her marriage, which I had never heard her say. My experience was very similar to Allison’s below (in comments). What is even better, I needed that deep breath as well!

    I also focused on the Parts . . .I had several clients who had definite agendas, another tool I have picked up again from this program (I ask clients straight out what they want to focus on today) to take a moment to draw or produce the ‘part’ of themselves they wanted to focus on. Each time, experientially, it led to new awareness, shifting emotions, and clarity in moving forward. One client with chronic anxiety in his gut said he felt it move and lessen for the first time. LOVING these helpful tips and reminders and new tools!

  35. I suggested to my client that she does homework around rigidity and flexiability. So she wrote about it in her journal and realised how rigidity was impacting on her life enormously. I had already discussed Kelly’s idea of the cost of being rigid and inflexible.
    So I have taken rigidity: applied Marshas homework principal and Kelly’s idea together.
    My client could not believe the insight she got.

  36. This week I used mindfulness with a client who has been very much intellectualizing, and having trouble staying with feelings. In this week’s session, as he mentioned an upset, I said, ” would you be willing to take a moment and breathe into that upset, and just accept that’s what happening now.” He said yes, and after a minute or so of breathing into it, he had the next thought about it, and I said let’s breathe into that. And we kept going. I feel that the breathing into the emotions and where he was feeling them in his body helped slow him down and notice, “hey this is what it feels like to sit in this feeling.” If I have a weakness as a clinician, it’s helping those who don’t want to feel their feelings to slow down and being willing to experience their feelings. Having a client sit and breathe into the upset under discussion has been a helpful tool for me to use with these clients. Thank you!

  37. This course is unbelievably supportive. I find that as I do the techniques mentioned – many that I have done in the past – my feeling of confidence in how I handle stuck problems has risen. One client yesterday left laughing when she had come to session in tears – Laughing at how we practiced getting her body involved in a morning chant to prevent her morning blues. Biggest takeaway is truly helping the client have a corrective experience…Thanks to all for their great supervision support.

  38. A change was sparked by Mark’s use of the word Rigidity. It actually became a personal change which I think is useful to share here. My parents have been undergoing health issues and I am geographically the closest. I have offered to help them in numerous ways and they have continued to be “embarrassed by needing” help and also resistant to suggestions which could make their lives easier. And yes, they have been consistently this way “forever.” I realized that I am the one who has been rigid. Rigid in how I perceive helpfulness, rigid in how I would like to be allowed to help etc. Once I recognized my own rigidity and lack of flexibility I could loosen my grip. I found I could let go of how I wanted to be and just offer myself in general. It was hugely helpful. I can breathe more easily, relax some and even accept that I am doing my best.

  39. I liked the concept that Michael Yapko presented in his video; that we can not change our parents and when they are so critical with us, we need to realize this is their issue and not capable of changing.
    I was able to successfully employ this with a client yesterday using “time line hypnosis & NLP.”
    I took my client who suffers from anxiety back to the event where she first experienced an event which led to her anxiety. We uncovered that her dad who was an alcoholic, did not have the capacity to provide her the love and support she needed. Once she realized this she was able to go back to this through hypnosis and hug her dad and tell him she loved him. We then “gifted resources” to the younger her (she was a 6 year old girl). Afterwards my client said she felt amazing! That she never felt so good before and had renewed energy!

  40. After watching Michael Yapko’s Bonus Video, I tried his technique this week. I have been working with a very angry, stuck client who lives in a senior housing building, due to her poor finances. She is the most functional person in the building, and the building management is gearing their functioning towards the group that is lower functioning. The building management has not been open to listening to her constant suggestions for improvement and she is constantly angry.

    So I used Michal Yapko’s technique of asking her for a million dollars. I didn’t ask her 12 times, but maybe 6. She was bewildered at what I was doing with her. We talked afterwards about how I was asking for something she didn’t have and couldn’t give, I wasn’t listening that she didn’t have the money, and I kept being insistent on getting what I needed.

    This helped her understand instantly that she has been doing the same thing with her building management. They don’t have the motivation to run the facility as she sees fit. It was a light bulb moment for her. I’m excited how well it worked and how fast it worked. This was a relief not only for this client, but for me too, her therapist, as we’ve been going around and around with this topic for quite a long time, with little change. This will definitely be a new tool in my tool belt that I will use into the future, as needed. Thank you for this great technique!

  41. I used some of the words of wisdom from Michael Yapko. I worked with a single mother who, like many moms, is balancing a lot. Unfortunately in that balance, the kids get overlooked, or seen as mini-adults, instead of kids. She wanted to know how to get a therapist for her kids. Yesterday, in addition to explore therapists in her area, we also discussed finding one behavior or habit she can change that may have a positive impact on her boys. She went home and made not the one as suggested, but 2 changes. She got in touch with me to let me know how amazing these changes worked for her. What she did was: sat down and had dinner with her boys instead of doing the laundry, or cleaning; and and reflected back to her son his feelings when he refused to go to bed because he did not want her to go to work on the overnight shift. She found that through one change, or in this case two, she can have profound impact on the behaviors of her kids and the way she felt.
    Thank you for reminding us the importance of making one change.

  42. Recently I was working with a gay male client who had been sexually abused as an adolescent and who has a penchant for ambivalent relationships where his analysis of the relationship says that this should be right for him but his heart just isn’t in it. He has a very high level of communication skill, is relatively charismatic. He had moved to another city for a job and almost immediately met someone he really liked. They dated for year and the other guy definitely wanted to move the relationship forward towards permanence. My client kept holding back feeling that some how his heart just wasn’t there. He was frustrated because he couldn’t figure out why his heart was not coming along. He had had a relationship previously where the table were turned. He was instinctively attracted to this person and the other person was passive and ambivalent about moving forward. Finally I asked him to relax. (We actually did a bit of a hypnotic induction.) I asked him to remember the moment he met the previous boyfriend and felt the instant chemistry and then compare it with the moment he met the current boyfriend. He could instantly feel the difference between a relationship that had the chemistry to work at the heart level and a relationship that looks to his analytical mind as if it should work but doesn’t have the requisite chemistry. It was then easy for him to raise the issue, end the current relationship and move forward happily.

  43. Sometimes solutions are released by the questions we ask of our clients, questions that could have been asked by other practitioners who have worked with them (such as physicians and other therapists) but apparently were not. And by just being curious-and perhaps a little brave.
    I am thinking of a few EAP clients I saw during their respective initial sessions and about how by being curious and following a hunch with each, I was able to get to the bottom of what turned out to be easily-solved medical mysteries or just an inroad to a solution that did not take much effort.
    One came to me at the end of a 7 year marriage. She was full of sadness needless to say, but more importantly she felt she was to blame because of what was labeled as a case of vaginusmus so severe that her marriage was not consummated and that in order to have her annual pelvic exams with her gyn she had to go under general anesthesia. There was no hx of sexual abuse to her knowledge, and she was a bright competent young woman who was perplexed by all of this because it didn’t make sense to her. And that’s when I got curious because it didn’t make sense to me, either.
    She had told me that she had crohn’s disease earlier in the intake and I thought to myself, “now that is one painful condition-I wonder if there might be a connection between the flares and her vaginal pain during attempts at intercourse?” So, I asked her. She paused and said, “you know, no one ever asked me that, but yes, there might be.” That was it. We discussed a strategy-to go back to her ob-gyn and ask for help in dealing with this. She reported back that she was RXd kegels, relaxation, and over time she was able to actually experience her first gyn exam without anesthesia. He marriage was over and she moved across country to be with her family but found a new job and a life renewed with interest in dating again.
    Another person’s solution was found with the asking only one question-and after this person had gone to the ER after experiencing symptoms of what he and docs there thought was at first a heart attack but was determined to be a panic attack. Only this client did not present with one anxious bone in his body-calm, unflappable. So I asked him, “have you made any changes in your diet or environment recently?” The answer was, “well, yes, my wife and I have decided to go vegan.” I suggested he go back and get tested for vitamin deficiency and low and behold he wrote me a very long note explaining how surprised he was that this indeed was what it was-and that he was surprised that the docs he saw for it-his pcp and neurologist (he had a rare congenital condition) never thought to ask such an easy question and that the assumption by the er docs was that since nothing was wrong with him physically to their findings, that it “must be in my head” (they recommended that he see a counselor and that was why he came to the eap). He and his wife decided to go back to adding some animal protein and then building up to veganism while exploring supplements to help toward that end).
    A third was one that happened earlier in my career-a young man with a very rare congenital condition which rendered him virtually hairless, deformed and of extremely short stature came in to see me through his EAP. There were case notes on this man as he had sought help over the years, mostly for help with social situations. He lived at home with his aging parents and presented as lonely and wanting a girlfriend.
    I had not heard of his condition before and so as he spoke about wanting to date, I was struck by how isolated he was in general. So, on a hunch, I asked him, “so, would you be willing to tell me about your condition-I am not familiar with it.” “Oh, you mean my baldness and being so short?” He took off his baseball cap and revealed his head. He relaxed and we talked more about what his life was like. He complained that he was a grown man yet his parents treated him like a child. Again, acting on a hunch-that this was not just wanting to date, but to connect in a bigger way too-to connect with others, to be a part of the human experience, and to move beyond his narrow life of being closely guarded by parents who would no longer be in his life someday in the not so distant future, I asked him, “have you ever met anyone else with your condition?” And yes, he would love to meet someone just like him.

    He had not. We were located not even 5 miles from the National Institutes of Health the center that researches just such conditions. This being the pre-internet era, I picked up the yellow pages and began dialing one of the Institute’s #s and at the 2nd call, I was connected with a woman-get this-who not only dealt with the problem as a professional, but who had a brother who had a milder form of the condition!! The client connected with them, went to his first baseball game with them and then attended a conference for the condition’s clearinghouse later that year. Although he had not found a girlfriend, he was finding a life connected to a world that had more meaning for him-where he was not someone identified as ill and different but as someone who happened to have this rare condition but who could be out and about in the world.
    It was an early lesson I never forgot-to be brave enough to ask an uncomfortable yet albeit important question about what was in the room.
    There are others but you get the idea-to just be brave, to trust your gut and ask questions that others have not. You will be pleasantly surprised-and your clients will be too!