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Anthony Quintiliani, Ph.D, LADC

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October 8, 2020 By Admin

Clinical Practice in Times of Uncertainty

In Times of Uncertainty; Clinical Practice

H. Colodro and J. Oliver provide sound advice in their new book, A Guide to Self-Care for Practitioners in Times of Uncertainty. This 2020 New Harbinger publication is loaded with helpful suggestions on surviving, even thriving, in our time of struggle. Their core questions include: What do my clients need most now? Am I able to provide what is needed and do so effectively? What might I do regarding my own uncertainty and struggles? Here are some of their suggestions.

  1. Spend some time daily practicing self-compassion.
  2. Know what you are facing, and if you are in a position (emotionally) to provide what is needed.
  3. Recognize the effects of chronic stress on yourself and your clients. Make adjustments as needed.
  4. Work smart! Work with only what you have some control over and not what is beyond your control.
  5. Be sure to take good care of yourself: sleeping, eating, attending, worrying, being aware, obtaining social-emotional support, meditating/doing yoga, and holding onto a strong sense of consciousness.
  6. Check in with yourself. Ask: How am I doing right now? Why did I react emotionally to that? etc.
  7. Release yourself from a “fix-it” mentality. Rather focus on emotion regulation, stability, and safety.
  8. Be there with your own, personal losses, sadness and fear. Deal with these and seek help when needed.
  9. If appropriate, include happiness-enhancing activities and skills in your therapy.
  10. Recognize the reality of impermanence in all things, including current problems and yourself.
  11. Settle into a more self-caring flexible outlook. If possible, work less. Take breaks! Do not over-extend.
  12. If you experience psychological exhaustion or failure in behavioral activation, seek support and consider doing more telehealth rather than live, person-to-person therapy. Cut back if necessary.
  13. Follow all guidelines regarding masks, gloves, social distancing, disinfecting, etc.
  14. Consider using “good enough” standards in your work in these times. See D.W. Winnicott for details.
  15. Remain safe, calm, competent, and helpful in your work.
  16. Consider using the same breathing training techniques you teach to your clients on yourself.
  17. When you feel stuck or sucked-into the craziness of the times, use CBT-M (CBT with mindfulness) on yourself.
  18. If you feel overwhelmed, hopeless, etc. seek your own clinical help.

Refer to Colodro, H. and Oliver, J. (2020). A Guide to Self-Care for Practitioners in Times of Uncertainty. 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  

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New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Covid-19, Featured, Helena Colodro, Joe Oliver, Self Care Tagged With: CLINICAL PRACTIVE, CORONA VIRUS, COVID-19, MINDFUL HAPPINESS, PANDEMIC, SELF CARE

January 12, 2020 By Admin

Two Forms of Self-Help Journaling

Self-Help Journaling – Two Methods

Generally there are two forms of self-help journaling: writing about worries and concerns OR writing about joy and happiness. In my more than 35 years of clinical experience I have not found the former to be very helpful. Most people stuck in negative mood states are not easily able to disengage themselves from negative, worrisome thoughts. For these folks journaling and placing more cognitive and emotional attention on negatives is often unhelpful. So I  stopped recommending this form of journaling to clients years ago. If you suffer from anxiety, depression, trauma, addictions and/or eating problems, I would not recommend negative problem solving journaling as a practice. Our limbic brain sets us up for overdrive when dealing with negative emotions and experiences, so no need to add more cognition and attention to it all. Better to work on positives!

I have found positive journaling to be amazingly helpful for some people. The practice is quite easy. Simply find a journal you like to look at and hold. Yes, visual and kinesthetic pleasures are important as motivators. Place it near your bed, and every night a few minutes before you go to bed do some journaling – even a few minutes can be helpful.  Just write freely, without censoring in any way. It is a good idea to use all your sensory experiences here. What did you see, hear, feel, smell, taste, experience that you may wish to write about? Once you get into the process, try to go a bit deeper: exactly what was it about the positive experience that impacted you, and how deeply? Do your best not to seek ideal happiness experiences (there may not be nirvana); these realities are far and few for most people. So best to begin with simply paying more attention to positives during the day. You may begin to notice that some of the experiences and things you have been conditioned to take for granted are actually positive in nature. Pick only one experience to write about. Later go back often and re-read what you wrote.

For more information refer to J. Smiechowski’s ideas in Easy Health Options Home; MedicalXpress; Journal of Psychophysiology; and University of Rochester, Journaling for Mental Health.

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: Activities, Featured, Journal Writing, Self-Help Tagged With: JOURNALING, SELF CARE

July 16, 2019 By Admin

Helper Self-Care is Important

Helper Self-Care is Important

In the most current issue of The National Psychologist (July-August, 2019) an article linked helper effectiveness, risk management, and clinical outcomes to helper self-care. To make a long story shorter, I will simply paraphrase and re-word the suggestions.  These recommendations support YOUR emotional survival and successful risk management as a helper as well as your clients’ progress.

Here are the specific self-care ideas. Since it is my post, I will add some of my own ideas.

Strategies for Helper/Therapist Self-Care

Focus on your own self-value and growth (personal and professional):

  1. Involve yourself in your own personal counseling/therapy if needed.
  2. Practice awareness and monitoring skills (mindfulness) regarding your needs.
  3. The regular practice of mindfulness and self-compassion skills is recommended.
  4. Spend some time learning and doing what improves resilience – block out time in your schedule.
  5. Do your best to maintain healthy personal boundaries at work and in life.
  6. Recognize and act upon limitations and manage your time well.
  7. Cultivate and practice activities that enhance belonging and spirituality.
  8. Monitor the quality of your inner speech and thoughts – improve them as needed.
  9. Do the same for your inner emotional experiences.
  10. Practice interoception by intentionally noting your inner body feelings – improve them.

Focus more closely on what you find rewarding, reinforcing AND take care of yourself:

  1. Experience the rewards of your work, and have gratitude for them
  2. Understand the stressors, risks, and burnout issues in your job role without exaggeration.
  3. Get help – obtain supervision, consultation, confer with peers.
  4. Do your best not to complain often, since this will make stress reactivity worse.
  5. Figure out ways to get what you need – rest, nutrition, fun, hydration, exercise, connection.
  6. Smile more! Yes, have the intention and behavioral response to improve facial emotions.
  7. Practice a regular exercise regimen.

Nurture your relational world and its objects:

  1. Be active in peer support groups, supervision and training activities.
  2. Network with others via continuing education workshops and meaningful conversations.
  3. Schedule regular meetings with mentors, peers, supervisors.
  4. Make the best of positive emotions in all significant relationships.
  5. If you have pets, spend some quality time with your pets. Play!
  6. Make sure you have a positive social life outside of work.
  7. Discover and re-visit what you find helpfully humorous in life.

Pursue creativity and personal growth in your inner and outer environments:

  1. Do what you can to make your office or work areas rewarding and reinforcing to you.
  2. Consider all of your senses in the above endeavor.
  3. If you can limit the number of high risk-high demand clients you work with.
  4. Obtain administrative supports that may reduce your stress level and intensity.
  5. Take regular self-care breaks at work, alone and in small groups.
  6. Do not isolate! When we feel wounded and worn out, we tend to isolate ourselves.
  7. If possible limit your exposure to traumatic experiences and material.
  8. Practice periods of silence and solitude in nature (“forest bathing” practices).
  9. Schedule and take time off and go on vacations – even if just staying at home.
  10. Continue to pursue your values-driven behaviors.
  11. Continue to learn new things that may improve your work role and outcomes.
  12. If spiritual do more practice.
  13. When engaged in pleasurable activities, use all your senses to experience them.

For more information refer to Bryant, L. M. (July/August, 2019). Self-care is essential to risk management. The National Psychologist.

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, Featured, MIndfulness, Self -Kindness, Self Care Tagged With: ANTHONY QUINTILIANI, MINDFULNESS, SELF CARE

June 21, 2019 By Admin

Loving Kindness – An Alternative Version

Loving Kindness – An Alternative Version

The writings of Thich Nhat Hanh offer a different version of Loving Kindness Meditation or Metta (Pali). This version may be influenced by Buddhaghosa in Visuddhimagga (or The Path to Purification,  fifth century system of The Buddha’s teachings). The reality of no-self, or a static, permanent and inherent self is a core teaching of Buddhism; however, humans do experience life in Samsara via their perceived self – the experiencer of events and circumstances. Sensory awareness and mental formation make our realities. It is important to know yourself well, thus it is important to go deeper and deeper into the sources of your self-experiences. Negative emotions and feelings cause great suffering; fears and internal turmoil prevent happiness. To move beyond suffering, we need to understand and experience self-compassion and self-love. Our best hope may be the regular practice of Loving Kindness Meditation, especially if we are able to feel (interoception) the words as they transform inner body feelings and mind-thoughts. Here is a version of loving kindness. Try it. I have made several of my own adjustments in wording.

May I be free from suffering, aversion, and emotional conflict.

May I be mindful of peace and affection.

May I experience the inner light of my soul and feel safe.

May I learn from the loving spirit of myself.

May I be free from all afflictions, including greed, craving, fear, anger, and negative moods.

May I practice freeing myself from the skandhas of form (body), feelings, perception, mental formations, and consciousness.

May I learn to be at peace in impermanence when such things arise.

May I liberate myself from the suffering of my own “second arrows.”

May I allow myself the inner joy of silence.

May I accept and love myself.

May I be happy.

For more information refer to Thich Nhat Hanh (2014). No Mud, No Lotus: The Art of Transforming Suffering. Parallax Press.

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: Featured, Love and Kindness, Loving Kindness, Meditation, Thich Nhat Hanh Tagged With: ANTHONY QUINTILIANI, LOVING KINDNESS, MEDITATION, MONKTON SANGA, PRACTICE, SELF CARE

October 30, 2018 By Admin

Setting Emotional Boundaries from Work to Life

Setting Emotional Boundaries from Work to Life

Anthony R. Quintiliani, Ph.D., LADC

Sometimes setting emotional boundaries from the psychotherapy room to your life outside of work can be a difficult thing to do. Shifting from “experience near empathy” (Kohut), “unconditional positive regard” (Rogers), “hovering attention” (Freud), “the holding environment” in “intersubjective space” (Winnicott),  and compassionate awareness to emotional distancing, separation, and dispassion is no easy task. In more in-depth clinical interactions, the process of projective identification between therapist and client may drain your emotional resources; sometimes being “as if” you were the experiencer of your client’s pain and suffering can take a serious toll on your own emotional resources. At time the therapist’s own emotional life lacks the quality of connection experienced in the therapy session. Success in setting emotional boundaries is a very important self-care skill. It may determine your success, failure, joy, or misery in the clinical work you do. It will definitely prevent most case of “burn out.”

Therapists may wish to complete a brief self-care assessment at the end of each emotionally demanding day. Some things to check are as follows:

  1. Are you taking care of your own physical, psychological, spiritual, and emotional needs?
  2. Are you using mindfulness, self-compassion, clinical supervision, or journaling to get to know how you are doing?
  3. Are you valuing yourself enough regarding self-rewards, positive self-talk, cognitive and behavioral restructuring?
  4. Are you giving yourself time to experience some form of creativity?
  5. What about your spiritual self?
  6. Do you spend quality time in nature, among the awe of it all?
  7. Are you involved in the type of quality relationship you desire?
  8. Be sure to act on your own behalf if you find problems in the above areas.

Another very powerful process is to develop improving self-compassion for yourself, often blurring the inner boundaries of your own emotional life experience and the clinical work you do. Therapists are, in the end, only people with a set of specific helping skills. We suffer just like other people do. Hopefully, our training and experience have given us a bit of a positive edge here. Here are some things you may wish to consider to improve your own level of self-compassion.

  1. Using mindful awareness, observe the level and intensity of your self-criticism.
  2. Let go of personal resistance to being real, being your true self.
  3. Get out of your head! Get out of the past!
  4. Do loving kindness meditation often.
  5. Recognize your own difficult emotions (shame, anger, revenge, trying to control others, etc.), and simply be with them as a sacred part of who you are and be real about it. Use emotion regulation to improve things.
  6. Practice much more self-appreciation.
  7. Do not dwell on the pain and suffering of your past. All that stuff probably made you a stronger person.
  8. Welcome and LOVE all of you, with special attention to the sacred quality of your own life suffering.
  9. When you experience or re-experience anxiety, depression, addictive behaviors, or trauma – hold an open, soft heart for it.  Then make changes to improve your life experience.
  10. Always get help when you need it, and do your best not to dwell on what you have little control over.
  11. Be certain too make changes to improve self-compassion regarding any problem areas above.

Fo more information refer to Norcross, J. C. and VandenBos, G. R. (2018). Leaving it at the Office: A Guide to Psychotherapist Self-Care. New York: Guilford.  Neff, K. and Germer, C. (2018). The Mindful Self-Compassion Workbook: A Proven Way to Accept Yourself, Build Inner Strength, and Thrive. New York: Guilford.

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: Boundries, Featured, Leadership, MBSR, Mindful Awareness, MIndfulness, Self -Kindness, Self Care, Self Compassion, Self Esteem, Spiriuality, Stress Reduction, Therapist, Therapy, Well Being Tagged With: EMOTIONAL BOUNDRIES, MBSR, SELF CARE, THERAPY.

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