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Anthony Quintiliani, Ph.D, LADC

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December 31, 2019 By Admin

Behaviors People Display When in Groups

Behaviors People Display When in Groups

After more than 35 years of facilitating hundreds of classes, workshops, family therapy sessions, group therapy sessions, and work project groups it has become clear that we do some strange things when we participate in groups. It appears to me that many of these in-group functions serve both ego and limbic needs. Yes, our prefrontal brain and our lower brain regions (limbic and rewards) play important (if outdated) roles in how humans function in group settings. Here I will simply list a sampling of such behaviors.  Many of these behaviors need to be observed, assessed, utilized, and sometimes addressed  if a group leader/facilitator/therapist will be successful. Here is the short list of what to observe and use.

  1. Underlying messages and beliefs signaled by behavior and/or facial/emotional expression;
  2. Patterns of communication within the group, both verbal and nonverbal;
  3. Emotional acting out as process or diversion;
  4. Sub-group alliances, both short-term and long-term;
  5. Behavioral changes when the make up of group members change;
  6. The way social and emotional influence are used;
  7. How personal power is used;
  8. Patterns of activity – acting out/ acting in, etc.;
  9. When silence dominates;
  10. Patterns of hostility, cooperation, compassion, caring, etc.;
  11. Possible hidden agendas;
  12. Possible secrets between members;
  13. The openness and closeness of the group and its process;
  14. The power of truth in what is shared and shown;
  15. How people look at each other, and how they address each other;
  16. Self and other oriented talking;
  17. How blame is used;
  18. Willingness to allow others to speak for you – or not; and,
  19. Consistent roles people tend to play.

Although this is a partial list, the best solution is the same: speak truth; share power; protect group process; protect others; do no harm; deeply listen with all your senses; be as kind as possible; be as compassionate as possible; and do your best to help the group achieve its goals. For an interesting view of this process (one based on human doubt), see Abblett, M. (2018). The Five Hurdles to Happiness and the Mindful Path to Overcoming Them. Boulder, CO: Shambhala Publications, pp. 170-218.

Anthony R. Quintiliani, PhD., LADC  

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon

Filed Under: ANTHONY QUINTILIANI, Behavior, Featured Tagged With: BEHAVIORS IN GROUPS, MINDFUL HAPPINESS

July 29, 2019 By Admin

Quintiliani’s Brief Life Experience Screening

Quintiliani’s Brief Life Experience Screening

Years ago, when I received a rather large number of managed care referrals for  adolescent “treatment failures” and their families, I soon realized that typical screening, assessment and therapy was NOT working well. I tried so, so hard to reach these young people – all experiencing extreme psychological suffering with little hope for relief. Suicide risk was high, uncomfortably high! Nothing seemed to work very well; cognitive, behavioral, and mindfulness interventions fell short of the goals. My alliance building skills did work, but other than a meaningful and emotional relationship there was very little positive change in their cognition, emotion, or behavior. For the most part my young clients did show up, so I guess the therapeutic relationship was a motivating factor. For some, legal consequences may have been a factor. After ample frustration, I decided to start fresh; I decided to break things down into logical, sequenced patterns in their lives. Behavioral task analysis was helpful, but insufficient for success. Then in a meditation, it came to me as clear as a Vermont summer sky. There were some fluffy clouds. Below I will share what worked much better, and how to use it as a transitional screening and treatment strategy. Ok, get ready for a lot of letters!

Hx – Mp – CEB – VAKGO – I-S – Rels:  This represents what I came up with to  reach these young clients, and how we collaboratively discovered deficits/problems and more than a few solutions. The administration format is quite simple: Simply move through the letters (and their meanings), and as you do ask for the major negative/unhelpful memory/characteristic/experience the person remembers.  After each entry, asks for the major positive/helpful memory/characteristic/experience the person remembers. When you complete the screening you will have highly significant self-report about core live processes and major life experiences – both unhelpful and helpful. Allow me to clarify each step. The process is voluntary, and the client may stop at any time. Be sure to obtain informed consent. Stick with the dyadic formula – both negative and positive experiences. The negatives are problems to be resolved via relationship and skills; the positives are sources of personal strengths to help resolve problems. Obtain information up to the present; this wide window of time will allow the person to include all significant experiences they are willing to share with you.

Hx (History):   involves early attachment, object relations, educational experiences, medical and psychological issues. Simply ask for a significant problem and a significant benefit for each area noted.

Mp (Mind Perception):   involves personal reflections about significant life events and emotional responses/reactions to them. Emphasize how the person utilized perceptual processes in these experiences. Are they anxious and/or depressed? Are they open to change? Are they at all optimistic? Are they pessimistic?

CEB (Cognition, Emotion and Behavior):   involves highly significant unhelpful and helpful experiences in thinking, feeling, and acting. What are the dominant negative and positive repeating thoughts, emotions, and behaviors? Keep behavioral reinforcement and conditioning in mind for the behavioral area. Special attention may be required for addictions (substances, processes, eating, cellphone, self-harming, etc.).

VAKGO (Sensory – Visual, Auditory, Kinesthetic, Gustatory, Olfactory):  involves the past experiences of sensory processing. What are the most unhelpful and helpful recalled sensory experiences the person has had? Be sure to ask about negatives and positives for each sensory category. Interoception may be important: they ability to perceive and interpret internal body sensations is a special sensory attribute. Caution: Since serious traumatic experiences are processed and recalled most often via the CEB and VAKGO categories, be sensitive to client readiness to share. Be prepared to stop and become more psychodynamically supportive.

I-S (Intuition and Spirituality):  involves the person’s history of negative and positive experiences regarding their intuition and their spirituality. Since some people are not at all spiritual, go easy on this category. Some people, however, are highly spiritual with and without formal religious practice. This may be an area of primary strength for some people.

Rels (Relationships):   involves the negative and positive nature of significant relationships in the person’s life.This is also the core area where all of the above categories may become quite integrated. Most people experience pain and suffering as well as joy and happiness via their interpersonal relationships – the more significant, the more powerful.

Summary: Now you have a sheet of paper that notes significant aspects of a client’s history (up to the present), as well as significant areas of suffering and happiness. Work on working through and witnessing the suffering, and be sure to help your client improve their ability to use mindful skills to improve their future. Feel free to integrate other evidence-based therapies into the process. The process is trans-theoretical, but one that fits common human experiences across various domains. Good luck on this. Hope it is helpful to you and your clients.

Anthony R. Quintiliani, PhD., LADC  

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: ANTHONY QUINTILIANI, Behavior, Featured, Screening Tagged With: ANTHONY QUINTLIANI, PERCEPTION, SCREENING

June 12, 2018 By Admin

Calming Your Self-Critical Self with Mindfulness

Calming Your Self-Critical Self with Mindfulness

A core problem for many people is their incessant self (or other) criticism. This is a major part of our psychological mind suffering today. In the past life for most people was more difficult, so human basic needs were the energized priorities; today so many of us have been “spoiled” by having basic needs met and lingering with more time to worry about usually less important things.  Observe the number of TV ads aimed at improving how you look, or improving what others may thing about you. Note how the aim of some ads is to improve your perceived status, but not your inner reality of who you really are.Yes, looking ok, being healthy, and more importantly being happy are all important to our successful functioning. However, we tend to be dominated by limbic-brain survival mechanisms that boil down to interpersonal attraction and feeling liked by others. We ask: Am I good enough?  D. W. Winnicott may have some answers for us, and he would be more apt to focus on psychological well-being above superficial qualities – how we look, status,  etc.

Our competitive world and the American economic rat-race cause many to suffer from on-going “red ants” – what I call automatic emotionally loaded negative thoughts. Cognitive Therapy, Recovery Oriented Cognitive Therapy, Cognitive-Behavioral Therapy, Mindfulness-Based Cognitive Therapy all can help reduce our thought-caused suffering. These approaches when implemented correctly work much faster than psychodynamic methods, which tend to prolong and deepen  dependency on therapists and serve mutually self-rewarding experiences (some unconscious for therapists). All evidence-based approaches work, but how well and how fast do they work? There may be a moral question involved when a therapist uses a much slower method with outcomes that are no  better than more efficient methods. They all involve a strong therapeutic alliance and clinical relationship. That also all involve a deeper change process not simply symptom reduction.

Why do we suffer so much from our own thoughts? Why do we sometimes project our own feared or actual character flaws onto and into others? There are so many causes. It all begins with the quality of our early attachment experiences. How good was the quality of your own early attachment experience with parental before thinkers like Freud came to the same conclusion. And, what about the level of your own self-medication? Do you self-medicate to reach some short-term joy or perhaps to just feel a bit better? In self-medication we eventually learn that it just works for a brief period and almost always leads to more serious problems – addictions of all kind including to our “I-Smart” phones.  figures and other caretakers? Were you reasonably satisfied and nurtured, or were you experiencing what The Buddha called dissatisfaction with what is. Did early life experience leave you craving for what you did not receive? We seek pleasure and hope to avoid pain; The Buddha noted this 2600 years ago – way, way

Below I have listed various self-critical patterns that we human have befriended. I also note some mindful ways to counteract their unhelpful emotional effects. Sometimes is means just taking better conscious control overs our CABS – cognition, affect, behavior and sensory sensations. Other times to means learning and using regularly new skills. At times it means we need professionally competent therapeutic help to improve our lives.

Do what is needed! Here the list.

  1. Self-Devaluing thoughts – STOP and be mindful of your strengths. Use the ‘doing” of your strengths as antidotes.
  2. Feeling inadequate – STOP and recall times when you had a lived experience with success no matter how small.
  3. Deep distortion of self-disdain (even self-hate) – STOP and do your best to practice
  4. mindful self-compassion.
  5. Not being “good enough” – STOP and recognize this is a social construct of unhealthy competition. Use strengths.
  6. No spiritual self – Consider what if any spiritual practice you might explore or do more of. Being in nature helps.
  7. Feeling you do not have enough – Recognize that if basic needs have been met, it is time to work harder on higher emotional needs. Stop thinking – only if I had… then I would be happy. This is almost always untrue.
  8. Hopeless perfectionism – STOP and recognize this is also a social construct based on the projections of others, who believed they were not perfect enough. These introjects became your beliefs. There is NO perfectionism; it is totally impossible to achieve it because it does not exist. Think: I am good enough as I am now!
  9. Stuck in conditioned life (samsara) – where when you are happy you become dissatisfied because it does not last, and when you are suffering you become dissatisfied because you are not happy. Craving and trying to prolong happiness and being without happiness both lead to just more suffering. Find small things to have gratitude for.
  10. A list of more mindfulnesss-based “things” you can do to counteract automatic negative thinking and feeling: live in the present moment; stay grounded with helpful cues – things are ok; allow negative thoughts to pass – do not get hooked by them; Un-trap yourself from a painful past by living presently with what is; practice radical acceptance of what you cannot change; meditate and do yoga a lot to cultivate more inner peace; practice self-efficacy in a very conscious manner; learn and live by the Four Noble Truths; let go of your shame so you can flourish; learn and use The UCLA four step process; use cognitive disputation and reframing more and more often; DO better self-care and learn to locate and “feed” your protective dragons; ask your inner self-helper for guidance on how to be healthier and happier; seek out and learn from an ethical mindfulness mentor; if possible, practice more self-love and less self-doubt. Do more of these practices more often; I believe you will find things will improve.
  11. I realize that some of you may not be aware of some of the terms noted above, so do some good “Googling” about them. When you have a set of practices you like – practice them every single day of your life.

A helpful book to read is Brenner, G. (2018). Suffering is Optional: A Spiritual Guide to Freedom…Oakland, CA: New Harbinger Publications.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Behavior, Buddhism, Calming, Featured, Meditation Activities, Mindful Awareness, MIndfulness, Self -Kindness, Self Care, Self Medication, Spiritual Energy Tagged With: ACTIVITIES, CALMING, CRITICAL -SELF, MINDFULNESS, SELF CARE

December 30, 2017 By Admin

Very “SAD” Facts about the Addictions Field

Very “SAD” Facts about the Addictions Field

A recent issue of the Addictions Professional presented very disturbing news about how clinicians in the field are doing.  NOT WELL! Addictions clinicians treat people with addictions but mainly people with co-occurring disorders – addictions with trauma, depression, anxiety and/or eating disorders.  Often there is also a co-occurring medical condition. This is very difficult work. People suffering from these conditions often relapse into one condition when they improve in another. Trying to attain a healthier client life in this work is no easy matter, and places huge emotional strains on families and clinicians. It is a profession of the heart.

To begin with it is so sad how poorly the American public understand addictions. I think much of this wrong opinion is based on stigma, shame, and very poor public education about addictions.  A recent Harris Poll of 2,184 adults, of which 692 were parents of children between the ages of 6 and 25, noted that 66% of the people polled thought addictions could be cured; nearly all professional groups believe it is a chronic, progressive disease/syndrome that can be managed. Recovery, of course, is quite possible; recovery, however, does not meet clinical criteria of a “cure.”  18% believed that recovery was hopeless once a person relapses after intervention. In reality, relapse is simply part of the recovery process and may indicate by its repetition how severe the addiction is (a brain-based, mind-body-spirit disorder). 55% had an opinion that a person with an addiction could not perform well at work. In reality this situation if quite variable. 42% to 47% of respondents would feel uncomfortable if a significant person (potential in-law, teacher, medical doctors) had an addiction. Well we all know how poorly informed the American public has been and still is about the realities of addictions. What is the problem here?

A recent Quality of Life survey of 650 addictions clinicians found that in 2015 71% intended to work in the field until retirement. That number was reduced in 2016, with only 68% planning to retire from their current work. In 2017 the number went down again with only 59% of current addictions professionals intending to remain in the field until they retired. That is a 12% drop in just three years. Almost 10% noted that they would most likely seek another career. Workloads have increased and salaries have not move very much. 52% of a sample of workers noted that their caseload has increased over the past two years. What about compensation? Not so good! In 2017 71% noted that their current salary DID NOT reflect their training, experience, and job requirements. 35% have quit a job in addictions work.  13%noted that their clinical supervision needed improvement or was not good at all. These numbers are dismal.

At the same time documentation requirements of state and federal government funding, as well as health insurance company funding, have increased dramatically. In my own experience I supervised clinicians working with very difficult addiction clients. Most of them had to spend about 51% of their time documenting the work they did, while only 49% of their time or less was actually working with clients.  It was common for people to go back to work on weekends to complete overdue paper/computer documentation. I often joke that to be an addictions counselor you need to fill out more paper and/or computer screens than to transport nuclear waste across state line or to buy a house.  I think this may be true!  I call this “Organic Bureaucracy,” where record keeping and management functions increase to the detriment of time with clients. Is it not the goal to help client learn skills and stabilize emotions so that they may enter recovery process? This requires TIME!

How about self-care. Surely in such a “strained” field – often called the poor sister or poor brother of health care – where demand for services outpaces staff and funding availability – self-care must be seen as important. Perhaps not! Survey data suggests that only about 1/3 of addictions counselors perceive self-care as a high priority at their place of employment. 25% note that self-care receives little or no attention.  41% note that self-care is an occasional topic in the workplace. I fear that marginal supervisors may be fearful of emphasis on self-care, perhaps suggesting that the job really cannot be done in a healthy way. Lots and lots of “burn-out.”

Let’s HOPE that somewhere up the federal bean stock somebody wakes up. In not, we may see huge shortages of qualified addictions professional. Yes there are other resources, but often far less trained and experienced in helping people work their way out of their addictions and other clinical conditions. Then what?

For more information refer to Addiction Professional (Fall, 2016), pp. 16-18, 20, 40.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Addiction, Behavior, Featured, Therapist, Thoughts & Opinions Tagged With: ADDICTION PROFESSIONAL, ADDICTION SUPPORT STAFF, WORKING WITH ADDICTION

May 5, 2017 By Admin

Mind Training Over Our Impulses

Mind Training Over Our Impulses

Mindful awareness of our impulses is a very important pathway to improved emotion regulation and, perhaps, more happiness in life. It can be unusually helpful to people suffering from anxiety, depression, and substance misuse. Vedana refers to the feeling tone in our body.  It is one of the foundations of mindfulness in Buddhist Psychology and traditional practice. Through sense-door experiences, the mind evaluates personal experience in the body as pleasant, neutral, or unpleasant; virtually all human experiences fit into these categories. When we evaluate personal experiences as unpleasant, we tend to act more impulsively to escape from the painful feeling tone or to quickly improve it.  We tell ourselves stories about “how bad it is” as we immediately work to reduce the psychic suffering. This is where so many common human problems are born; this is where we may begin habitual behaviors around eating, consuming, angering, isolating, acting out, acting in, using mind-altering substances, and greediness, etc. There are ways to reduce this kind of mindbody stuckness and misery.

With strong application of mindfulness, we can train ourselves to simply label the experience as a short-term pain or suffering. We can practice radical acceptance and wait it out without emotional and behavioral impulsive actions. Simply practice labeling negative feeling tones with words like “temporary unpleasantness.” External and internal stimuli can be calmed by labeling without storylines and escapist behaviors. You do need to conserve a bit of tolerance for the unpleasantness; as you cope better and wait out the feeling tones, you will become more skilled in coping with them. From maintaining a quality of relaxed awareness – even in the chaos of chaos – simply ask: “What is this feeling?”  What is this that I am feeling? Without strong conscious evaluation, just note it as a temporary experience of living.  Pain and suffering cannot beat out the reality of impermanence. Stop your storyline; stop going into the past and future; stop judging as good or bad.  Simply BE fully with your feeling tone, pause, and know it will pass without you having to avoid or self-medicare it. As Rolo May and B. F. Skinner have suggested – we increase personal freedom with the skill of pausing between stimulus and reaction. Become more liberated by practicing your PAUSE, then label in a neutral manner – just wait it out. No need to avoid or to self-medicate the unpleasant feeling. This is our best HOPE to master choiceless awareness, especially when it leads to unpleasant feeling tones. Simply pause and label: “I am feeling unpleasantness in my body.”  This too will pass. Try NOT to be more specific, since doing so may lead to stories and avoidance behaviors (negative reinforcement). Negative reinforcement by way of quick relief from suffering WILL cause unhealthy habits to form. The more you avoid or self-medicate painful feelings, the stronger the habit will become. This is a path to powerlessness NOT liberation. Just pause and label “I am feeling unpleasantness.” WAIT! Get stronger is your tolerance. Become a more satisfied and happier person. Just keep labeling without actions.

If you become overwhelmed with your unpleasant feeling tone, you may also want to practice loving kindness meditation as part of your training. In this case you might say the following: “May I pause. May I be free from suffering. May I be well. May I become stronger. May I liberate my mind from fear and reaction. May I be happy.”  Good luck on your personal path toward liberation.

For more information refer to King, R. (March 17, 2017). Notes on – Ungripping Heart and Mind – Intimacy with Impulses. Retrieved from tricycle@tricycle.org on March 27, 2017.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Activities, Behavior, Featured, Meditation, Mindful Awareness, MIndfulness, MIndfulness Activities, Practices, Self Care Tagged With: ANTHONY QUINTILIANI, MIND TRAINING, MINDFUL HAPPINESS, VERMONT

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