I am pleased to announce the formation of a mens' psychotherapy group intended for new and expecting fathers (all ages).  This group is designed to help fathers articulate and share their new parenting experiences with one another in a safe and supportive environment.  The term "new fathers" refers to all fathers of infants or toddlers, even if they are not first-time fathers.   

The group will be both supportive and process-oriented in nature. Common issues associated with becoming a father will be explored.  In addition, pertinent relationship and parenting issues will be examined as they arise in the "here-and-now" parallel process of the group experience. 

The group will meet weekly on Mondays from 6:30 PM - 7:45 PM (75 minutes).  Sessions will be held at my office, located at 132 S. 17th Street, Philadelphia, PA 19103 (17th & Sansom streets).  The office is a convenient 5 minute walk from SEPTA and PATCO regional rail lines, offering easy access to fathers commuting from the Main Line or Southern New Jersey.

For more information, please call (215-222-4825) or e-mail (espiegelphd@gmail.com).

In addition to the above group, I also run a group dealing with general relationship issues for men and women in their 20's and 30's.  More information is available on my website.

According to a recent English study published on Nov. 18 in the journal Health Economics, Policy and Law, psychotherapy may be 32 times more cost-effective at improving well-being than receiving more money.  The study examined data from thousands of participants who responded to questions about their well-being.  Based on the data analysis, the increase in happiness garnered from a $1329 course of therapy is so large that it would require a $41,542 pay raise to achieve similar results (e.g. increases in happiness).

As quoted in the article, lead researcher Chris Boyce, from the University of Warwick, said: “We have shown that psychological therapy could be much more cost effective than financial compensation at alleviating psychological distress. This is not only important in courts of law, where huge financial awards are the default way in which pain and suffering are compensated, but has wider implications for public health and well-being.”

“Often the importance of money for improving our well-being and bringing greater happiness is vastly over-valued in our societies. The benefits of having good mental health, on the other hand, are often not fully appreciated and people do not realize the powerful effect that psychological therapy, such as non-directive counselling, can have on improving our well-being.”

I should note that I am summarizing the results as published in news outlets.  I do not have access to the actual journal article [irony: the journal requires a subscription, which costs too much for a single blog article], and therefore cannot evaluate the study's methodology or ascertain what types of therapy were utilized.  Being able to review this information is an important part of critically examining the results.

Nonetheless, I find the basic implications striking.  The results support my belief ascertained from clinical work that money does not lead to happiness.  Rather, it seems to suggest that the insight, reflection, self-awareness, and growth garnered from the psychotherapy process helps to increase individuals' happiness and well-being.  This is something I see repeatedly in the psychotherapy work that I do, and it is refreshing to see a study that supports this.

Journal Reference:

1.Boyce et al. Money or mental health: the cost of alleviatingpsychological distress with monetary compensation versus psychologicaltherapy. Health Economics Policy and Law, 2009

As most of you are aware, on November 5th, 2009, army psychiatrist Maj. Nidal Malik Hasan, for reasons unknown at the time of this blog entry, went on a shooting spree at his station base Fort Hood.  As a result of his actions, 13 people were killed and 30 wounded.  My deepest condolences and sympathies go out to the victims (and their families) of this senseless act.

Although more details are likely to emerge in the days and weeks to come, I thought this might be an appropriate time to address the issue of post-traumatic stress disorder (PTSD) and trauma treatment.  Although this term has yet to get much coverage in the wake of this story, I am particularly focused on the concept of vicarious traumatization in this incident.  Vicarious traumatization is also known as "secondary trauma", and involves involves therapists (and other close caregivers) of trauma victims becoming traumatized themselves through the process of empathizing (stepping into the patient's shoes as if he/she was the person) with the patient as he/she re-lives the trauma during the treatment.

In this case - and I should be clear that I do not have all the pertinent information - it appears that Dr. Hasan was treating multiple cases of severe combat-related PTSD while struggling with his own personal and religious beliefs about the wars in Iraq and Afghanistan.   As I follow the coverage of this story, I find myself wondering what kind of peer supervision or consultation system he had in place to process his experience of treating these complicated trauma cases.  Mental health providers are always encouraged to seek consultation or supervision for difficult cases.  Trainees are obligated to be supervised as part of the degree and licensure process.  However, once licensed, consultation/supervision is no longer mandatory.  However, almost all mental health associations - including the American Psychological Association, of which I am a member - strongly encourage their members to continue to seek out peer consultation / supervision, and self-care.  Why is this important?  Because countertransference, or the therapist's personal reaction to the clinical material, is unavoidable.  In the case of trauma, the material is extremely graphic and disturbing, which increases the likelihood of a strong countertransference reaction in the therapist.  Even therapists with extensive experience providing trauma treatment cannot avoid having reactions to some of the stories they hear from their patients.  For this reason, it is important for mental health professionals to have outlets to process their reactions, and ultimately provide better care to the patient.

Another issue that this incident raises in my mind is the differences in training across disciplines.  Psychiatrists, while often viewed at the top of the hierarchical chain perpetuated by the medical model, often have the least experience amongst mental health professionals in providing therapy treatment.  As MDs, psychiatrists are trained first and foremost to understand the biological and pharmacological dimensions of mental illness.  This is an extremely important piece of a comprehensive mental health treatment approach, and I do not want to minimize it.  But the provision of specific training in providing therapy is often minimal for psychiatry students.  Thus, I often come across psychiatrists who only provide "medication management" - that is treating mental illness from a diagnostic and pharmacological perspective.  They have little experience or desire to provide therapy to their patients for the illnesses they are treating pharmacologically.  Let me be clear - I have many colleagues who are psychiatrists andprovide outstanding therapy treatment.  But if you ask many of them, Isuspect they will tell you that they sought out additionalpost-doctoral training in therapy to augment their work.  I believe this raises a troubling ethical question.  What happens, when because of strained provider resources, psychiatrists who do not have the proper experience are thrust into a therapeutic treatment role? 

In the case of Dr. Hasan, he appears to have had expertise in working with PTSD.  But was this expertise in the pharmacological management of the disorder - or in treating it therapeutically?  In addition, what kind of consultation/supervision was he seeking or receiving in support of his work?  What resources (or lack thereof) did the military provide in support to the mental health professionals treating service members with PTSD?  These seem like important questions that need to be addressed as the investigation of this incident unfolds.

If you, the blog reader, are someone who has experienced a trauma or are suffering from symptoms of PTSD, I would like to offer some advice for you as you consider seeking treatment of your trauma (or if you currently are in treatment).  Do not be afraid to ask your treatment provider about what whether he/she receives consultation/supervision in support of his/her work.  Depending on your provider's theoretical orientation, he or she may not feel comfortable sharing this information with you (some providers belief that self-disclosure is a distraction from the patient's clinical material).  Regardless, this could lead to an interesting, productive, and ultimately empowering conversation about what it is like for the therapist to bear witness to your trauma and share in this experience with you. 

A great book I recommend on the subject of trauma (and vicarious traumatization) is "Trauma and Recovery" by Dr. Judith Herman (who is, ironically, a psychiatrist).  This book is geared towards mental health professionals, but I believe can also be helpful for trauma victims.

I am pleased to announce the roll-out of three new corporate wellness programs for businesses in the Philadelphia region.  These programs feature a combination of interactive group presentations and individualized wellness sessions for business employees.  Drawing upon my clinical expertise in health and wellness and extensive teaching experience, these programs are a great way to enhance overall health awareness and behaviors in your workforce, leading to greater productivity and job satisfaction.


Please visit my website for more information. 

For a general description of the corporate wellness programs,please click here.

For more specific information on the three corporate wellness programs offered, please visit the following links:

Hypnosis Smoking Cessation

Stress Management

Mindful Eating

I am pleased to announce the formation of a relationship psychotherapy group for clients in their twenties and thirties.  This group will focus on general relationship issues (peer/romantic/work) within this period of development, including the themes of communication, commitment, trust and intimacy.  Membership in the group is open, which means that adults of all relationship statuses and sexual orientations are welcome.

 

In addition to examining relationship issues, this group will focus on interpersonal interactions between the group members, with an emphasis on greater awareness of “process,” or how we relate to one another both verbally and non-verbally.  One of the goals for this group is to help members develop greater awareness of their interactions in relationships.

 

This group will begin on Tuesday, May 12^th, 2009.  After May 12^th, membership will remain open until the group has been filled.

 

The group will be held weekly on Tuesdays from 6 - 7:15 PM at my Center City office, located at 132 South 17^th Street (corner of 17^th & Sansom streets).  Please note that the location provides convenient access for both city and suburban residents.  The office is a brief 5 minute walk from the SEPTA Suburban Station at 16^th & JFK streets and PATCO Broad Street Station.

 

If you would like more information about this group, please contact me at [phone: 215-222-4825; e-mail: espiegelphd@gmail.com].

For general information about my psychotherapy groups, please visit:

http://www.ericspiegelphd.com/Psychotherapy/Group-Therapy/Group-Psychotherapy.html

For general information about my practice, please visit:

http://www.ericspiegelphd.com

During this current recession, it seems like everyone is being affected in some way by the economic downturn.  On the one hand, it might feel good to know that you are not alone in worrying about your money.  On the other hand, sometimes financial anxiety is contagious.  Being surrounded by nervous co-workers discussing shrinking 401K plans can influence your own anxiety levels.  Effective stress management involves learning how to identify your own strengths and growth edges.  Although research has supported the efficacy of certain coping strategies, these strategies tend to be depend on the individual.  For example, certain people tend to be active types and like to confront their problems directly; whereas others take a more accepting view of what comes their way.  In reality, knowing when to take action and when to accept stressors out of your control is an important part of effective stress management.

Here are a few general tips for stress management in times of financial anxiety:

1) Social Support:  In general, having a good support system is a helpful way of dealing with stress.  Research tends to show that people who are more isolated have worse stress outcomes (although this can vary based on the stressor and the type/level of social support).  Family members, friends, and fellow community members are part of a good support system.  At the same time, be aware of the individual dynamics of the members of your support system.  There are certain people who are good listeners, and others who may tend to make you more anxious.  Think proactively and choose carefully whom to speak to about your financial worries and general stress.

2) Distinguish between useful thoughts and repetitive worries:  The difference between a thought and a worry is that a worry tends to stay with you like an unwelcome house guest.  Proactive problem-solving is useful; part of this involves thinking about potential obstacles and formulating a plan for dealing with them.  However, when your thinking starts to become ruminative, e.g. you are worrying about the same issue again and again, this is a signal that you are becoming "stressed out."  One basic technique for dealing with repetitive worries is a "thought-stopping" technique.  Identify which worries are repetitive.  Then, practice visualizing a bright, red stop sign.  Have fun with this visualization - imagine all the details around the stop sign.  Then, when the worries arise, imagine the stop sign and tell yourself "Stop!  I am not going to worry about this problem anymore.  I have reached my daily limit."  While a basic technique, this strategy can help you recognize when you the worry is no longer productive.  Agreeing to allow yourself to postpone it can be helpful.  Coming up with distractions is another way of delaying the worry.  For more entrenched worries, contact a mental health practitioner to deal with the issue more comprehensively.

3) Identify physical symptoms of anxiety, and learn basic strategies for reducing them:  Many people do not understand the connection between their minds and bodies.  Thoughts and feelings tend to effect the body, oftentimes in ways people do not realize.  An important first step is to allow yourself to slow down enough to notice when your body is reacting in new, different ways.  Some examples of physical symptoms of anxiety include elevated heartbeat, indigestion, sweaty/clammy hands, and shallow breathing.  Try to allow yourself to step into more of an observational rule.  Observe yourself without judgment and notice if/when these or other symptoms occur.  What tends to be happening in your life to bring them on?  Once you have become more effective at identifying these symptoms, learn some basic relaxation strategies such as diaphragmatic breathing, stretching, and meditation.  I teach relaxation strategies as part of my wellness services.  They are also incorporated into the hypnosis work that I do.  You can also learn some of these strategies through yoga, physical training, acupuncture and other holistic approaches.

4) Develop a self-care routine:  Think of the healthy things you enjoy to do, and make them a more constant part of your life.  Examples could include reading, walks, going to the gym, time with the family, meditation, yoga, therapy, self-hypnosis, etc.  Creating a positive, healthy foundation is an important part of proactive stress management.

5) Have patience!   Your 401(k) wasn't built in a day, and similarly, you are not going to dig out of a financial hole immediately.  Take the long-term approach.  Be realistic about what you can accomplish in a given day, week, etc.  Having a structured, consistent routine will enable you to reach your goals over time.

Financial anxiety is a sign that you have become distracted by the demands of the outside world.  Good stress management involves turning inwards and re-centering yourself in order to re-gain your perspective.

For more information on my services, please visit my website.  Also, be on the lookout for an upcoming "Health & Wellness" blog entry.  In it, I will be detailing strategies for staying well, as well as descriptions and links to related areas and practitioners who work holistically (acupuncturists, chiropractors, nutritionists, yoga, etc.).      

When I am contacted by prospective clients inquiring about hypnosis, there is often a "magical" quality to their questions.  What I mean by the word  "magical" is that they expect that in using hypnosis, I am going to work some kind of magic on them.  This is part of an inaccurate myth that people in hypnotic trances are passive subjects being manipulated by the hypnotherapist.  This couldn't be any further from the truth.

Actually, depending on one's level of hypnotizability (most people tend to fall in the moderate range), chances are you have already been in a light hypnotic trance on your own without intending to do so.  A key component of hypnosis is the concept of focused attention (known as absorption).  We focus our attention all of the time.  We might be incredibly productive in a given moment at a task that we are working on.  I am a basketball fan, so I will use the recent example of Kobe Bryant's 61 point outburst at Madison Square Garden a month ago.  Kobe was "in the zone."  He was really focused on what he was doing - he was less susceptible to external distractions (other players, crowd).  This is an example of absorption.  Daydreaming is another example of absorption... in our own thoughts.

I mention this because when people come see me for hypnotherapy, chances are they already have hypnotic talents.  My role is to channel their natural hypnotic ability in efficiently inducing a hypnotic state, then to utilize specific imagery and language to create hypnotic suggestions that target their presenting concerns (examples might include anxiety, phobias, insomnia, weight concerns, IBS, smoking cessation, etc.).

Thus, in the hypnotherapy sessions, the emphasis is on consistent induction of hypnotic trance, symptom reduction during and after trance, and increased feelings of overall well-being.  This varies based on the individual person and concern, but most clients experience some positive effects within session in the first few sessions. 

At that point, the focus becomes on moving from hetero-hypnosis (another name for "hypnotherapy", e.g. hypnosis between a hypnotherapist and client in session) to self-hypnosis.  There are certainly some clients for whom this is not necessary.  I recently worked with a smoking cessation client who quit smoking after one hypnotherapy session.  Factors that influence timeliness and effect of the hypnosis include the level of hypnotizability, motivation, and the hypnotic and post-hypnotic suggestions given.  This subject will be covered in another blog entry.

For many other clients, however, an important part of transferring the positive hypnotic effects is repeated practice at home.  This practice allows the body and mind to more readily remember the physical, cognitive, and emotional sensations associated with trance.  Practice yawning, for example, and you will remember exactly how your body feels when you yawn, and you will be more readily able to produce those effects on cue.

In order to help my clients practice self-hypnosis, I prepare hypnosis recordings based on our hypnotic work in session.  These MP3 CDs can also include music background tracks (with and without the hypnotic language) at the client's request.  As clients continue to practice self-hypnosis, they begin to become more comfortable with inducing hypnosis and giving themselves suggestions related to their concerns.   Essentially, we have come full circle!   Clients are going into hypnosis on their own, except now they are doing it with intention, purpose, and skill, rather than by accident and/or without awareness.

I recommend self-hypnosis for everyone.  It is an important component of wellness and proactively managing stress.  Self-hypnosis is easy and fun.  You can set aside 15-20 minutes a day (e.g. before bedtime) for self-hypnosis; you can also practice hypnotic techniques to better cope with stress during the day (e.g. during traffic or a stressful work meeting).

For more information about hypnosis and self-hypnosis, I encourage you to read the page titled "What is Hypnosis?"on my website

Whoever said “location is everything” wasn’t kidding.  Wellness is about feeling your best.  The last thing you want is to get stressed going to therapy!  For this reason, my office is centrally located to make your trip as easy as possible.  I am located at 132 South 17th Street, just south of Sansom Street.  My office is housed in the quaint, red brick Frank Furness historic building, on the 3rd Floor.  

If you work or live in the city of Philadelphia, most likely you are a brief walk, subway, or cab-ride away.  And, commuting from the suburbs is a breeze.  The office is a 5 minute walk from both SEPTA (Suburban Station, 16th & JFK Streets) and PATCO (16th & Locust Street) regional rail line stops.  So, if you live in the suburbs, leave your car at the train station, take some reading material or relaxing music with you, and enjoy the train ride.  You’ll be at my office in no time.

This central location truly makes it possible for me to work with people from all over the Greater Philadelphia area.  I work with clients in neighborhoods all across Philadelphia, including Rittenhouse Square, Fitler Square, Old City, Fairmount, Northern Liberties, Society Hill, Queen Village, Bella Vista, University City, Chestnut Hill, and Mt. Airy.  In addition, my solo practice also serves the surrounding Pennsylvania and Southern New Jersey suburbs, including the Main Line, Montgomery County, Chester County, Bucks County, Camden County, Lower Merion Township, Bala Cynwyd, Elkins Park, Jenkintown, Wynnewood, Gladwyne, Ardmore, Bryn Mawr, Narberth, Haverford, Rosemont, Havertown, Villanova, Wayne, Malvern, Media, Swarthmore, Collingswood, Haddonfield, Cherry Hill, and Haddon Township.