Podcasts about CBT

Concentrar-se no que é controlável e aceitar o que é incontrolável. Essa á uma das máximas do pensamento estóico, criado pelo imperador romano Marco Aurélio e que voltou ao hype. Afinal, o que é - e, principalmente, o que não é - estoicismo?Confira o papo entre o leigo curioso, Ken Fujioka, e o cientista PhD, Altay de Souza.>> OUÇA (58min 48s)* Naruhodo! é o podcast pra quem tem fome de aprender. Ciência, senso comum, curiosidades, desafios e muito mais. Com o leigo curioso, Ken Fujioka, e o cientista PhD, Altay de Souza.Edição: Reginaldo Cursino.http://naruhodo.b9.com.br*APOIO: INSIDERChegou fevereiro, ilustríssima ouvinte e ilustríssimo ouvinte do Naruhodo.É quando a rotina aperta de verdade: o calor pesa, os compromissos se acumulam, o corpo sente, o Carnaval se aproxima — e a vida real acontece sem pausa.E qual é a roupa que acompanha o seu ritmo?Ela mesma: INSIDER.Afinal, INSIDER é a escolha inteligente que aguenta o dia inteiro, aguenta o calor, aguenta o movimento, aguenta a rotina.Ou seja: sustenta seu ritmo com muito estilo.Então use o endereço a seguir pra já ter o cupom NARUHODO aplicado ao seu carrinho de compras: são 10% de desconto para clientes cadastrados e 20% de desconto caso seja sua primeira compra.>>> creators.insiderstore.com.br/NARUHODOOu clique no link que está na descrição deste episódio.INSIDER: inteligência em cada escolha.#InsiderStore*REFERÊNCIASThe Western origins of mindfulness therapy in ancient Romehttps://link.springer.com/article/10.1007/s10072-023-06651-wA Comparative Analysis of Stoicism and Cognitive Behavioural Therapy (CBT)http://albertinejournal.org/10%20A%20Comparative%20Analysis%20of%20Stoicism%20and%20Cognitive%20Behavioural%20Therapy%20(CBT).pdfWilliam James and the Impetus of Stoic Rhetorichttps://scholarlypublishingcollective.org/psup/p-n-r/article-abstract/45/3/246/290269/William-James-and-the-Impetus-of-Stoic-RhetoricThe Ancient Origins of Cognitive Therapy: The Reemergence of Stoicismhttps://www.proquest.com/openview/742f90a1c1e13c9085ce2a9c8d0410fe/1?pq-origsite=gscholar&cbl=28723Core Beliefs in Cognitive Behavioral Therapy and Stoicismhttps://muse.jhu.edu/pub/1/article/964183/summaryPatricia A. Rosenmeyer (2001). Ancient Epistolary Fictions: The Letter in Greek Literature. Cambridge University Press. p. 214. ISBN 978-0-521-80004-4.https://catdir.loc.gov/catdir/samples/cam031/00041454.pdfA HISTORY OF CYNICISM https://www.holybooks.com/wp-content/uploads/A-History-of-Cynicism.pdfStoicism as a Panacea for Contemporary Problemshttps://www.proquest.com/openview/f128731c9d006eca833b90aa36167659/1?pq-origsite=gscholar&cbl=18750&diss=yThe Stoic Capitalist: Advice for the Exceptionally Ambitioushttps://books.google.com.br/books?hl=en&lr=&id=VR1VEQAAQBAJ&oi=fnd&pg=PP2&dq=stoicism+and+capitalism&ots=VuA23wsQ3C&sig=BUUMCHZI782I82BzPTwzSi6ui74&redir_esc=y#v=onepage&q=stoicism%20and%20capitalism&f=falsePopular Stoicism in the Face of Social Uncertaintyhttps://www.ceeol.com/search/article-detail?id=1075832Diógenes Laércio, Vidas e Doutrinas dos Filósofos Ilustreshttps://revistas.ufrj.br/index.php/FilosofiaClassica/article/download/40618/22230/110987Nietzsche contra stoicism: naturalism and value, suffering and amor fati https://www.tandfonline.com/doi/abs/10.1080/0020174X.2019.1527547Stoicism and sensation seeking: Male vulnerabilities for the acquired capability for suicidehttps://www.sciencedirect.com/science/article/abs/pii/S0092656612000530Can stoic training develop medical student empathy and resilience? A mixed-methods studyhttps://link.springer.com/article/10.1186/s12909-022-03391-xTroubling stoicism: Sociocultural influences and applications to health and illness behaviourhttps://journals.sagepub.com/doi/10.1177/1363459312451179Meditações - Marco Auréliohttps://masculinistaopressoroficial.wordpress.com/wp-content/uploads/2017/06/meditac3a7c3b5es-marco-aurc3a9lio.pdfBig boys don't cry: An investigation of stoicism and its mental health outcomeshttps://www.sciencedirect.com/science/article/abs/pii/S0191886907004473Naruhodo #26 - Meditação faz bem pra saúde, segundo a ciência?https://www.youtube.com/watch?v=cqzZlXHtxjkNaruhodo #404 - Por que algumas pessoas gostam de terminar as coisas e outras não?https://www.youtube.com/watch?v=pTSZ--4TKMkNaruhodo #135 - Como eu sei que você é você e não eu? - Parte 1 de 2https://www.youtube.com/watch?v=Fq-VjuiTOY0Naruhodo #136 - Como eu sei que você é você e não eu? - Parte 2 de 2https://www.youtube.com/watch?v=yRZkLKL6QH0Naruhodo #319 - O tempo passa mais rápido quando ficamos mais velhos?https://www.youtube.com/watch?v=8xgBvsN0b_INaruhodo #433 - Existe amizade entre homens e mulheres? - Parte 1 de 2https://www.youtube.com/watch?v=EFVaBfGaowgNaruhodo #434 - Existe amizade entre homens e mulheres? - Parte 2 de 2https://www.youtube.com/watch?v=H6D1yCni0rcNaruhodo #446 - O que é transfuga de classe?https://www.youtube.com/watch?v=HQQyT1sawZoNaruhodo #430 - Por que é tão difícil deixar o rancor de lado?https://www.youtube.com/watch?v=u0IesoD4A9ANaruhodo #346 - Programação Neurolinguística (PNL) tem base científica? - Parte 1 de 2https://www.youtube.com/watch?v=p9-iauANzY0Naruhodo #347 - Programação Neurolinguística (PNL) tem base científica? - Parte 2 de 2https://www.youtube.com/watch?v=yggQXOE9lRYNaruhodo #186 - O que são as 4 causas de Aristóteles?https://www.youtube.com/watch?v=GQnAQGbMpXcNaruhodo #393 - A psicologia positiva tem validade científica? - Parte 1 de 2https://www.youtube.com/watch?v=LnSZCHHfoWINaruhodo #394 - A psicologia positiva tem validade científica? - Parte 2 de 2https://www.youtube.com/watch?v=n8h3zC7YLNs*TEXTO MARCO AURÉLIOAo despontar a aurora, faça estas considerações prévias: encontrarei com um indiscreto, com um ingrato, com um insolente, com um mentiroso, com um invejoso, com um não-sociável. Tudo isso lhes ocorre por ignorância do bem e do mal. Mas eu, que observei que a natureza do bem é o belo, e que a do mal é o vergonhoso, e que a natureza do próprio pecador, que é meu parente, porque participa, não do mesmo sangue ou da mesma semente, mas das inteligência e de uma porção da divindade, não posso receber dano de nenhum deles, pois nenhum me cobrirá de vergonha; nem posso me aborrecer com meu parente nem odiá-lo. Pois, nascemos para colaborar, como os pés, as mãos, as pálpebras, os dentes, superiores e inferiores. Agir, pois, como adversários uns para com os outros é contrário à natureza. E é agir como adversário o fato de manifestar indignação e repulsa. Isso é tudo o que sou: um pouco de carne, um breve fôlego vital e o guia interior. Deixe os livros! Não te distraias mais; não está permitido a ti. Mas que, na idéia de que já és um moribundo, despreza a carne: sangue e pó, ossos, fino tecido de nervos, de pequenas veias e artérias. Olha também em que consiste o fôlego vital: vento, e nem sempre o mesmo, pois em todo momento se expira e de novo se aspira. Em terceiro lugar, pois, te resta o guia interior. Reflete assim: és velho; não o consintas por mais tempo que seja escravo, nem que siga ainda arrastando-se como marionete por instintos egoístas, nem que maldigas o destino presente ou tenhas receio do futuro. Para qualquer parte da natureza, é bom aquilo que colabora com a natureza do conjunto e o que é capaz de preservá-la. E conservam o mundo tanto as transformações dos elementos simples como as dos compostos. Sejam suficientes para ti essas reflexões, se são princípios básicos. Afasta tua sede de livros, para não morrer amargurado, mas verdadeiramente resignado e grato de coração aos deuses. Não consumas a parte da vida que te resta fazendo conjecturas sobre outras pessoas, a não ser que teu objetivo aponte para o bem comum; porque certamente te privas de outra tarefa. Ao querer saber, ao imaginar o que faz fulano e por que, e o que pensa e o que trama e tantas coisas semelhantes que provocam teu raciocínio, tu te afastas da observação do teu guia interior. Convém, consequentemente, que, no encadear das tuas ideias, evites admitir o que é fruto do azar e supérfluo, mas muito mais o inútil e pernicioso. Deves também acostumar-te a ter unicamente aquelas ideias sobre as quais, se te perguntassem de súbito “em que pensas agora?”, com franqueza pudesses responder no mesmo instante “nisso e naquilo”, de maneira que no mesmo instante se manifestasse que tudo em ti é simples, benévolo e próprio de um ser isento de toda cobiça, inveja, receio ou qualquer outra paixão, da qual pudesses envergonhar-te ao reconhecer que a possui em teu pensamento. Porque o homem com essas características, que já não demora em situar-se entre os melhores, converte-se em sacerdote e servo dos deuses, posto ao serviço também da divindade que habita seu interior; tudo que o imuniza contra os prazeres, o faz invulnerável a toda dor, intocável a todo excesso, insensível a toda maldade, atleta da mais excelsa luta, luta que se entrava para não ser abatido por nenhuma paixão, impregnado a fundo de justiça, apegado, com toda a sua alma, aos acontecimentos e a tudo o que lhe tenha acontecido. E, raramente, a não ser por uma grande necessidade e tendo em vista o bem comum, cogita o que a outra pessoa diz, faz ou pensa. Colocará unicamente em prática aquelas coisas que lhe correspondem, e pensa sem cessar no que lhe pertence, o que foi alinhado ao conjunto. Enquanto, por um lado, cumpre o seu dever, por outro, está convencido de que é bom. Porque o destino designado a cada um está envolvido no conjunto e ao mesmo tempo o envolve. Tem também presente que todos os seres racionais têm parentesco e que preocupar-se com todos os homens está de acordo com a natureza humana Mas não deves considerar a opinião de todos, mas somente a opinião daqueles que vivem conforme a natureza. E, em relação aos que não vivem assim, prossegue recordando até o fim como são em casa e fora dela, pela noite e durante o dia, e com que classe de gente convivem. Consequentemente, não considera o elogio de tais homens que nem consigo mesmos estão satisfeitos.Na convicção de que pode sair da vida a qualquer momento, faça, fale e pense todas e cada uma das coisas em consonância com essa ideia. Pois distanciar-se dos homens, se existem deuses, em absoluto é temível, porque estes não poderiam atirar-te ao mar. Mas, se em verdade não existem, ou não lhes importam os assuntos humanos, para que viver em um mundo vazio de deuses ou vazio de providência? Mas sim, existem, e lhes importam as coisas humanas, e criaram todos os meios a seu alcance para que o homem não sucumba aos verdadeiros males. E se restar algum mal, também haveriam previsto, a fim de que contasse o homem com todos os meios para evitar cair nele. Mas o que não torna pior um homem, como isso poderia fazer pior a sua vida? Nem por ignorância nem conscientemente, mas por ser incapaz de prevenir ou corrigir esses defeitos, a natureza do conjunto o teria consentido. E, tampouco, por incapacidade ou inabilidade teria cometido um erro de tais dimensões como acontece aos bons e aos maus indistintamente, bens e males em partes iguais. Entretanto, morte e vida, glória e infâmia, dor e prazer, riqueza e penúria, tudo isso acontecem indistintamente ao homem bom e ao mal, pois não é nem belo nem feio, porque, efetivamente, não são bons nem maus.*APOIE O NARUHODO!O Altay e eu temos duas mensagens pra você.A primeira é: muito, muito obrigado pela sua audiência. Sem ela, o Naruhodo sequer teria sentido de existir. Você nos ajuda demais não só quando ouve, mas também quando espalha episódios para familiares, amigos - e, por que não?, inimigos.A segunda mensagem é: existe uma outra forma de apoiar o Naruhodo, a ciência e o pensamento científico - apoiando financeiramente o nosso projeto de podcast semanal independente, que só descansa no recesso do fim de ano.Manter o Naruhodo tem custos e despesas: servidores, domínio, pesquisa, produção, edição, atendimento, tempo... Enfim, muitas coisas para cobrir - e, algumas delas, em dólar.A gente sabe que nem todo mundo pode apoiar financeiramente. E tá tudo bem. Tente mandar um episódio para alguém que você conhece e acha que vai gostar.A gente sabe que alguns podem, mas não mensalmente. E tá tudo bem também. Você pode apoiar quando puder e cancelar quando quiser. O apoio mínimo é de 15 reais e pode ser feito pela plataforma ORELO ou pela plataforma APOIA-SE. Para quem está fora do Brasil, temos até a plataforma PATREON.É isso, gente. Estamos enfrentando um momento importante e você pode ajudar a combater o negacionismo e manter a chama da ciência acesa. Então, fica aqui o nosso convite: apóie o Naruhodo como puder.bit.ly/naruhodo-no-orelo

New 2026 Power & Purpose Podcast Schedule!!!Guest Episodes released every Monday. Vanessa Soul Astrology episodes released every Thursday. Find the Podcast on Apple Podcast: https://podcasts.apple.com/us/podcast/power-and-purpose-podcast/id1713095352Episode 142: CBT, Energy Healing, and the Science of Subconscious BeliefsIn this episode of The Power and Purpose Podcast, Vanessa Soul sits down with Virtue Chan, a psychotherapist and quantum healer who blends cognitive behavioral therapy, mindfulness, meditation, crystal energy, astrology, and vibrational medicine to help people reprogram their subconscious and reclaim their power.Virtue shares her powerful awakening after a health crisis that forced her to confront deep patterns of self-sacrifice, people-pleasing, and subconscious conditioning. Together, Vanessa and Virtue explore how our thoughts and emotions shape our reality, why we truly “become our environment,” and how subconscious beliefs inherited from family and ancestors quietly run our lives.This conversation bridges neuroscience, CBT, energy healing, crystal work, and higher-dimensional consciousness, offering grounded tools you can actually use to shift your inner world and your external reality. Whether you're navigating burnout, fear of being seen, identity shifts, or questioning your path in a rapidly changing world, this episode offers clarity, perspective, and powerful reframes.In this episode, you'll learn:1. Why your subconscious mind projects most of your reality2. How people-pleasing and self-sacrifice impact your health and nervous system3. A practical CBT method to reprogram fear of being seen and judged4. How thoughts and emotions act as magnetic frequencies5.The role of ancestral and inherited subconscious beliefs6.What 3D, 4D, and 5D consciousness actually mean in real life7.How AI reflects human consciousness and collective evolution8.How crystal energy supports emotional and subconscious healing9.Why amethyst is one of the most powerful tools for limiting belief workCONNECT WITH VIRTUE CHAN: Website: www.highlyordered.bizInstagram: @highly.orderedCONNECT WITH VANESSA SOUL Website: https://vanessasoul.com/Sacredsoulenergetics

Teens need specific support from their parents, but for various reasons many parents struggle to understand and provide this support.What specific support do teenagers need?How can parents and others best support teenagers to support good mental health?Join me, Dr Julie, as we talk candidly about what teenagers are facing today, the specific support they need from their parents, and how CBT tools can help.Click to listen now! Visit us on Instagram at MyCBTPodcast Or on Facebook at Dr Julie Osborn Subscribe to the podcast at Apple Podcasts Email us at mycbtpodcast@gmail.com Find some fun CBT tools at https://www.mycbt.store/ Thanks for listening to My CBT Podcast!

Support the podcast through Buy Me a Coffee! https://buymeacoffee.com/drlizbonet Jeremy Lipkowitz joins us on the podcast to talk about porn addiction and recovery from a Buddhist perspective rather than 12-step recovery. We talk about: When a habit crosses over from a problem to addiction How to approach a partner about a problem behavior or addiction Key buddhist concept for recovery from addiction The men's porn recovery group Jeremy runs based on Buddhist principles Mindfulness and meditation for the meditation averse and ADHD mind See more about Jeremy and his online group for porn addiction recovery at https://https://www.unhookedacademy.com Take an online quiz to see if you have a sex or porn addiction at https://www.saa-recovery.org   -------------- Support the Podcast & Help yourself with Hypnosis Downloads by Dr. Liz! http://bit.ly/HypnosisMP3Downloads Do you have Chronic Insomnia? Find out more about Dr. Liz's Better Sleep Program at https://bit.ly/sleepbetterfeelbetter Search episodes at the Podcast Page http://bit.ly/HM-podcast --------- About Dr. Liz Interested in hypnosis with Dr. Liz? Schedule your free consultation at https://www.drlizhypnosis.com Winner of numerous awards including Top 100 Moms in Business, Dr. Liz provides psychotherapy, hypnotherapy, and hypnosis to people wanting a fast, easy way to transform all around the world. She has a PhD in Clinical Psychology, is a Licensed Mental Health Counselor (LMHC) and has special certification in Hypnosis and Hypnotherapy. Specialty areas include Anxiety, Insomnia, and Deeper Emotional Healing. A problem shared is a problem halved. In person and online hypnosis and CBT for healing and transformation.  Listened to in over 140 countries, Hypnotize Me is the podcast about hypnosis, transformation, and healing. Certified hypnotherapist and Licensed Mental Health Counselor, Dr. Liz Bonet, discusses hypnosis and interviews professionals doing transformational work. Thank you for tuning in!

Dr. Ben reviews the top tinnitus apps of 2026 and how they support sleep, focus, and emotional calm. He covers sound therapy, CBT-based tools, and self-guided programs for tinnitus relief. Find which apps may fit your needs and support a balanced treatment approach.Get started with Treble Health:Schedule a complimentary telehealth consultation: treble.health/free-telehealth-consultation Take the tinnitus quiz: https://treble.health/tinnitus-quiz-1Download the Ultimate Tinnitus Guide: 2024 Edition: https://treble.health/tinnitus-guide-2025

You're listening to Burnt Toast. I'm Virginia Sole-Smith. Today my conversation is with Dr. Lauren Muhlheim. Lauren is a psychologist, a fellow of the Academy for Eating Disorders, a certified eating disorder specialist and approved consultant for the International Association of Eating Disorder Professionals. She's also a Certified Body Trust Provider and directs Eating Disorder Therapy LA, a group practice in Los Angeles. Lauren is the author of When Your Teen Has an Eating Disorder and a co-author of the brand new The Weight-Inclusive CBT Workbook for Eating Disorders. Lauren joined me to chat about how she and her colleagues have been working to make eating disorder treatment less fatphobic, because, yes, that really needed to happen. We also get into why it's feeling harder than ever to treat eating disorders, or live with one, in this era of RFK, Jr., MAHA and GLP-1s. Plus what to do if your child is hiding food, lying or otherwise showing signs of developing an eating disorder. When do you intervene? And how do you do so in the most supportive way possible?If you enjoy this conversation, a paid subscriiption is the best way to support our work!Join Burnt Toast

In this episode, we covered: 1) Pete's 4-part framework for modern leadershipPete lays out what he sees as “endemic” to great leadership today:Master cash flow (because nothing survives without it)Know whether you're a visionary or an integrator (and don't pretend you're both)Be the master motivator (the era of fear-based leadership is over)Own the culture (and use story as one of your most powerful tools to shape it) 2) Storytelling as culture-engineeringWe dig into why stories are more than “nice to have.” Stories become the myths that create the mythology of a company—how values become behavior at scale. And if you want to influence culture, yesterday was easier than today. 3) The next AI infrastructure shift: from training to inferencingPete breaks down the difference between:Training LLMs (building the model)Inferencing (asking the model questions in real time—what most people experience as “prompting”)Then he takes it further: the next wave isn't human inferencing—it's machine inferencing. Robots, cars, devices, sensors… constantly asking “what do I do next?” at massive scale. 4) Why “edge” data centers are coming backPete predicts we'll move away from only massive, centralized “mega” campuses toward distributed, high-performance data centers near the edge—“in every town,” similar to telecom “points of presence” in the 1990s. That's the strategic thesis behind Gray Wolf Data Centers.   5) The modern mystic: mind, body, and the inner gamePete shares a candid chapter of his own life—anxiety, therapy, CBT, and a pivotal lesson: don't make the events you can't control your “problems.” He connects this to resilience through sleep, health practices, and the belief that we can reshape the mind through neuroplasticity—and even how he sees us as “quantum beings,” responsible for how we observe and choose our reality. 6) A hopeful thesis: “good AI” vs “bad AI” + post-scarcityWe touch the fear many people carry (yes, I mention growing up in the Terminator era), but Pete offers a provocative counter: the way we beat bad AI is with good AI—models designed around human flourishing and shared broadly as a public service. He believes we're headed through disruption toward post-scarcity, and that our descendants will wonder why we didn't support each other sooner. 7) The closing leadership message: “we are all one”Pete's final note is the one that matters most to me: we're all connected—and we're here for each other. In my book, that's not just a spiritual idea; it's a leadership standard. ----- Resources Mentioned:Pete's company: Gray Wolf Data CentersPete's book: Living in Bliss: Achieve a Balanced Existence of Body, Mind and SpiritPete's site: PeteSacco.com (signed copies + meditation materials)Dr. David Burns: The Feel Good HandbookDan Sullivan: Who Not How (and other referenced works)Peter Diamandis: longevity reference ----- If you want to apply this immediately:Ask yourself: Am I the visionary or the integrator here? (And who do I need as my counterbalance?)  Choose one cultural value you care about—and tell a story that proves it.  If AI is making you anxious, zoom out: are you preparing for the training era, or the inferencing era?  ----- https://petesacco.comPete Sacco is a visionary entrepreneur, technologist, and modern-day mystic who blends conscious leadership with breakthrough innovation. As the founder of multiple ventures—including PTS Data Center Solutions, INTUVA, GRID7, InstaGuardIP, and Gray Wolf Data Centers—Pete has led transformative initiatives across AI, energy, blockchain, and digital infrastructure. His journey from electrical engineer to spiritual author and advisor reflects a rare fusion of high performance and inner awakening. Pete is the author of Living in Bliss: Achieve a Balanced Existence of Body, Mind, and Spirit, a guide for high achievers seeking fulfillment beyond success. A finalist for Ernst & Young's Entrepreneur of the Year, Pete holds a B.S. in Electrical Engineering from Fairleigh Dickinson University, and serves on the advisory board of its School of Computer Sciences and Engineering. Based in New Jersey, he helps purpose-driven professionals unlock clarity, vitality, and purpose—one system, one person, and one moment at a time.  --------John Bates provides 1:1 Executive Communications Coaching, both in-person and online. He also gets 92+ Net Promoter Scores for his large and small group leadership development trainings at organizations like Johnson & Johnson, NASA, Google, Intuit, Boston Scientific, and many more. Find more at https://executivespeakingsuccess.com.Sign up for his weekly micro-trainings for free at https://johnbates.com/mini-trainings and create a great leadership communications habit that makes you the kind of leader who inspires trust, loyalty, and connection.

JESSICA BAUM, is a licensed mental health counselor, relationship expert, and the founder of the Relationship Institute of Palm Beach. Jessica is the author of the new book SAFE: Coming Home to Yourself and Others–An Attachment-Informed Guide to Building Secure Relationships. This book is a timely and grounded new book built on decades of research and therapeutic practice about how to heal the invisible wounds that shape our relational lives. Jessica is a certified addiction specialist and Imago couples therapist with advanced training in EMDR, experiential therapy, CBT, and DBT. Her bestselling book, Anxiously Attached: Becoming More Secure in Life and Love, established her as a trusted authority on healing attachment wounds and building secure, fulfilling relationships. Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us a textThe ringing is real...and so is the plan to fix how we manage it. Blaise sits down with Jeffery Reagan, a heart transplant survivor, tinnitus patient, and founder of Tinnitus Learning Health Network, to share a practical blueprint for transforming tinnitus care through a learning health network that centers outcomes, empathy, and shared data. Instead of waiting years for guidelines to catch up, Jeff shows how patients, clinicians, and researchers can collaborate in near real time to reveal which therapies—CBT, TRT, sound therapy, hearing aids—work best for specific subtypes and life contexts.We explore the watershed moment that pushed Jeff to act, the structure of a learning health network, and why placing the patient's voice at the center changes everything. You'll hear how standardized measurement with tools like the Tinnitus Functional Index and Tinnitus Handicap Inventory lets clinics compare results, reduce disparities, and end the dead-end phrase, “there's nothing we can do.” Along the way, Jeff introduces the team guiding this movement, including leaders like Dr. James Henry and Dr. Donna Murray, and outlines concrete milestones: pilot sites across VA and academic centers, a rebrand to the Tinnitus Learning Health Network (TLHN), and a path to insurer buy-in through real-world evidence.If you or someone you love lives with tinnitus, this conversation offers both hope and a plan. We talk funding models, data culture, and how machine learning can guide (not replace) clinical judgment to speed up the path to relief. Join us as we turn fragmented efforts into a connected community that learns, shares, and improves together. Subscribe, share this episode with someone who needs it, and leave a review to help more people find expert-backed tinnitus care built on real outcomes.Omega AI hearing aids don't just keep up. They redefine what it means to be modern and discreet yet durable and comfortable for all-day wear.They're waterproof, everyday-proof, and designed to go the distance of your day and then some. All while tailored to your unique hearing needs. Connect with the Hearing Matters Podcast TeamEmail: hearingmatterspodcast@gmail.com Instagram: @hearing_matters_podcast Facebook: Hearing Matters Podcast

How can healthcare professionals transform burnout and trauma into a revitalized life and practice?In this special episode of Heartline: Changemaking in Healthcare, Dr. Andrea Austin reads from her book Revitalized, focusing on the chapter "The Revitalization." She reflects on her own soul-level burnout at the end of the pandemic, sharing a formula for change: inflection point + inner work + clarity = revitalization. Drawing from personal experiences and expert insights, she emphasizes embracing the past's pain as part of growth, avoiding trauma loops, and intentionally "doing the work" for self-improvement.You'll hear how to:Recognize burnout as a chronic issue requiring inner reflection, not just quick fixes, and frame it as an opportunity for revitalization beyond "bouncing back."Differentiate top-down therapies (like CBT and talk therapy) from bottom-up approaches (like EMDR, somatic experiencing, and art therapy) for trauma healing, especially in high-stress fields like medicine.Understand coaching as a future-focused partnership for unlocking potential, while knowing when to seek therapy first, given high rates of PTSD (40%) and depression (30%) among healthcare workers.Navigate "VUCA" (volatility, uncertainty, complexity, ambiguity) in healthcare, including life quakes like job loss or health crises, and avoid maladaptive coping like overconsumption or addictions.Build vulnerability in hard conversations, reflect on perfectionism, and beware predatory coaching programs while prioritizing ethical, supportive resources.If you're a healthcare professional grappling with burnout, trauma, or the desire for more fulfillment, this episode offers empathetic guidance, reflective questions, and actionable steps to craft your own revitalization.

In this episode, Trisha and I answer three listener questions. We talk about the overlap between anxiety, ADHD traits, trauma, hormones, parenting, and overwhelm — and how to know when something is manageable and when it's time to seek further support. We also answer a question on nutrition and endurance training, and why nutrition can unravel when training volume increases. Finally, we talk about confidence and identity, and how working from home can slowly change how you feel about yourself and your social confidence. This episode is a practical, honest conversation around issues many people are dealing with but rarely talk about. If you've ever felt stuck in patterns that feel exhausting, confusing, or out of your control, click play and let's dive in. To apply for membership to Jessica's Thrive Academy go to www.jessicacooke.ie/apply To contact Trisha for more information on Therapy and Counselling services: galway@mindandbodyworks.com 091 725 750 About Trisha MacHale: Trisha is a Psychotherapist and Director of Mind & Body Works Counselling and Psychotherapy Centre, based in Galway, with centres in Galway and Dublin. Their team of over 50 Psychotherapists and Psychologists work with adults, couples, adolescents, and children, offering therapies including CBT, EMDR, and Art Therapy. They also run a low-cost counselling service. Click play and let's dive in.

Stories from a Giant and Gadfly Discover the Protest Music of RainFall!-- like "The Antidepressant Blues!" Today, we are delighted to spend some time with a dear friend and highly esteemed colleague, Dr. David Antonuccio. David is a retired Clinical Psychologist and Professor Emeritus in the Dept. of Psychiatry and Behavioral Sciences at the University of Nevada, Reno, School of Medicine. In addition to his academic work, David had his own clinical practice for 40 years. He has published over 100 academic articles and multiple books, primarily on the treatment of depression, anxiety, or smoking cessation. Since his retirement from practice in 2020, he has been making music as part of a duo called RainFall, with his musical partner Michael Pierce. Their music can be found on Spotify, Apple music, and Soundcloud, among other streaming services. I first became familiar with David when a colleague recommended his article entitled: "Psychotherapy versus medication for depression: challenging the conventional wisdom with data," which was published in Professional Psychology: Research and Practice way back in 1995. The article blew my socks off. In the first place, he had come to the many of the same conclusions I had come to, that antidepressants had few "real" effects above and beyond their placebo effects. However, he also had incredible insights into some of the problems and loopholes with drug company research studies on antidepressants, so I tried to get as many colleagues and students as possible to read that article. Here is the article link Although I had never met David, he became my hero. One day, while I was giving one of my two-day CBT workshops in Nevada, I was singing his praises and urging participants to read that classic article, but, unexpectedly, some people started chuckling. At a break, I asked someone why people had been laughing. They said, "Didn't you know that David Antonuccio is here attending this workshop? He was out visiting the bathroom when you were singing his praises, so he didn't hear you!" And that's how we met! I couldn't believe my good fortune in meeting this brilliant and humble man in person. And to my good fortune, we became good friends right off the bat and eventually did a lot of fun professional work together, like our exciting conference challenging the chemical imbalance theory of depression which we called the Rumble in Reno. I was also proud to be included as a co-author in a popular article with David and William Danton reviewing the brilliant work of Irving Kirsch. Kirsch had re-analyzed all the data on antidepressants in the FDA archives and concluded that the chemicals called "antidepressants" had few, if any, clinically significant effects above and beyond their placebo effects. In that paper, we also emphasized the ongoing power struggle between the needs of science and the needs of marketing. Science is devoted to discovering and reporting the truth, based on research, regardless of where it leads, while marketing, sadly, is ultimately loyal to the bottom line, even if deception is required. Here is the link to our article: And here is the full reference: Antonuccio, D. O., Burns, D., & Danton, W. G. (2002). Antidepressants: A Triumph of Marketing over Science? Prevention and Treatment, 5, Article 25. Web link: http://journals.apa.org/prevention/volume5/toc-jul15-02.htm I was sad when David retired from his clinical, teaching, and research career a number of years ago in order to spend more time on creating and recording music because, a passion he'd put on the shelf during the most active years of his career. I felt we'd lost an important and courageous leader in the behavioral sciences, and felt an emptiness, like an important pioneer was suddenly missing. The following link provides a highly readable brief overview of David's career focus and interests. I was thrilled to learn just recently that David has partly resumed his role as gadfly of the behavioral sciences, rejoining the fight for science, ethics and for truth, regardless of where that leads or whose feathers are ruffled. And now, we sit down together to reminisce about his personal life and experiences with many of the greats in our field, like Dr. David Healey, Irving Kirsch, and others who have also stood up for the truth, based on their research, in spite of intense opposition from the establishment. And, today David also brings us his music, with his colleague, Michael Pierce, RainFall. Some of his music has psychiatric / psychological themes, like his "Antidepressant Blues," Some of David's music has humanistic and political themes. He said: Here's a song we just released yesterday that i will assume would not be relevant to the podcast. It is called Final Embrace and was inspired by a heart-breaking international wire photo of a Salvadoran immigrant father hugging his daughter, both deceased, in the rio grande in 2019. Here's the link to the original news story. David's two-man group, RainFall, wrote and recorded the original acoustic version of this song in 2020. He explains: We decided to record a more dynamic updated version of the song with some electric guitar chords, electric bass, and drums. We are calling it "Final Embrace Electric". The story is still heart-breaking, and it still makes me cry to sing it. Here is a link to the new version of the song, And here are the heart-breaking lyrics: Final Embrace Electric (For Oscar and Valeria) By RainFall (David Antonuccio and Michael Pierce) I'm sorry I couldn't help you I'm sorry you lost your life You took a deadly risk I'm sorry for your wife What were you supposed to do? Stay home and watch your family die? Or take a chance at freedom Reach for the sky Some say you should have known better They say that you are a criminal But they don't know your fear, your pain, your hunger For them it's the principle Some say we were here first It's not our problem Despite your dire thirst We're full, no more asylum Let's ask them what they would do If their family were faced with danger If they're honest, they'd take the chance Hope for kindness from a stranger You tried to get in the front door But it was slammed closed So you swam the deadly current Despite the perilous flow You never lost your grip Though the river was not crossable Only another parent can know How that is even possible Everyone can tell you loved your daughter Even in that place You never let her go It was your final embrace I'm sorry I couldn't help you I'm sorry you lost your life You took a deadly risk I'm so sorry for your wife Everyone can tell you loved your daughter Even in that place You never let her go It was your final embrace Your final embrace It was your final embrace It was your final embrace   Thank you for joining us today. Stayed tuned for Part 2 of the David Antonuccio interview next week! David, Rhonda, and David

Episode Overview  If you've been struggling with betrayal for a long time despite trying multiple healing approaches, this episode reveals why well-meaning practitioners and proven methodologies often miss the mark when it comes to betrayal-specific recovery.  Key Topics Covered  Why Life Coaching Isn't Enough  Life coaching excels at goal setting, accountability, and mindset shifts  Works beautifully for career advancement, relationship improvement, and business growth  Falls short for betrayal survivors because you're not starting from the same place  When betrayed, your reality is shattered and your nervous system is in crisis  The Therapy Gap  Traditional therapy covers diagnostic criteria, CBT, trauma treatment, and mental health conditions  Post Betrayal Syndrome® isn't in the DSM yet, so therapists don't know to look for it  Over 100,000 people have taken the Post Betrayal Syndrome assessment with staggering symptom statistics  Physical, mental, and emotional symptoms like brain fog, anxiety, hypervigilance, sleep and gut issues all share one underlying cause  The Trust Rebuilding Misconception  Relationship coaches often focus solely on rebuilding trust with the betrayer  Multiple aspects of trust are shattered: trust in yourself, others, your intuition, and your judgment  Rebuilding trust with your partner is actually the last piece, not the first  Why Other Modalities Fall Short  Trauma-informed training: Doesn't differentiate betrayal from other traumas  Somatic training: Critical for nervous system regulation but doesn't address the complete framework  Attachment training: Valuable for relationship patterns but doesn't address identity shattering  Grief counseling: Helpful but betrayal involves grief PLUS reality disruption, identity crisis, and complete trust shattering  The Five Stages from Betrayal to Breakthrough™  General trauma treatment doesn't account for betrayal-specific stages  Someone in Stage 2 presents very differently than someone in Stage 3, 4, or 5  Understanding the stages reveals why certain responses occur and what's needed to progress  The Timing Problem  Right tools at the wrong time backfire  Stage 2 (shock/trauma) clients aren't ready for accountability structures  Stage 4 clients don't need basic nervous system regulation anymore  Proper healing requires the right modalities at the right stage  The Stage 3 Trap  What a Stage 3 Life Looks Like:  Surviving but not thriving  Managing and suppressing Post Betrayal Syndrome symptoms  Keeping people at bay out of fear  Building a safe but flat life  67% of betrayed individuals prevent forming deep relationships to avoid being hurt again  84% have an inability to trust again (out of 100,000+ studied)  The Ripple Effects:  Limited depth in relationships  Challenges with workplace collaborations and partnerships  Inability to trust yourself, your judgment, or your perception of reality  Attracting more of the same situations  Making decisions from Stage 3 thinking versus Stage 4 or 5 thinking  The Solution  Why Specialized Betrayal Training Matters:  All aspects need rebuilding: physical, mental, emotional, psychological, and spiritual  Requires a proven roadmap through all five stages  Not just talk therapy, not just somatic work, not just goal setting—all of it together at the right time  Updated PBT Certification:  Newly revised certification modules  New exam, experiential exercises, forms, and worksheets  Designed to help clients identify their current stage and move to the next one  Makes it easier to work with clients using stage-specific tools  Key Statistics  Over 100,000 people have taken the Post Betrayal Syndrome assessment  67% prevent forming deep relationships due to fear of being hurt again  84% report an inability to trust again  The Bottom Line  There's no reason to stay stuck in Stage 3. People need to get back to their lives, their work, their kids, families, and friends in the way they can only do when they heal. The roadmap exists—it's the Five Stages from Betrayal to Breakthrough™.    Resources Mentioned:  Post Betrayal Syndrome® Assessment  PBT (Post Betrayal Transformation) Certification: https://thepbtinstitute.com/get-certified/   The Five Stages from Betrayal to Breakthrough™: https://thepbtinstitute.com   For Practitioners: The more coaches, practitioners, and healers who become certified in this methodology, the more people can access the specialized help they need for betrayal recovery.    Discover why traditional therapy, life coaching, and healing methods fall short for betrayal recovery. Learn about Post Betrayal Syndrome®, the Five Stages from Betrayal to Breakthrough™, and why specialized betrayal training is essential for true healing and transformation. 

Well I wanted to talk more about productivity but I clearly had some inner need to express my opinion about how crappy CBT is for my depression and getting things done. What to do when you don't love your brain, and you don't care about it's opinion of you, and you have stuff to do?! Let's discuss. Join ADHDBB and improve your time management, get shit done, and learn YOUR way to become consistent? Get started here: https://adhdbigbrother.circle.so/adhdbbInterested in the Consistency Crew? Contact me and let me know: https://www.adhdbigbrother.com/contactrussStuck? Start here. Get the exact framework I use to get moving when my brain is frozen. Download the "Ready S.E.T. Go" guide here - https://www.adhdbigbrother.com/readysetgo

This episode gives a clear, calm explanation of what the Social Confidence Club is and what it isn't. If you've lived with social anxiety for years and have tried things like therapy, exposure, CBT, or tapping, you may have had some relief that didn't last. This video explains why that happens and how a different, nervous-system-based approach can support more stable change over time. In this orientation, I explain:  • what makes the Social Confidence Club different from courses or quick fixes  • why social anxiety isn't a logic problem, but a nervous system issue  • how gradual change happens without forcing, rushing, or exposure pressure  • what participation actually looks like, including anonymity and replays  • who this approach is and isn't a fit for This episode will help you understand the approach and decide calmly whether it makes sense for you. Do you feel awkward in social situations? Do you struggle to be yourself around others? And do you fear being judged, being seen anxious, and embarrassing yourself? You're not alone. I've been there. It sucks. Big time. But there's hope. I've been fortunate enough to overcome my Social Anxiety... ... and I've helped hundreds of socially anxious clients overcome their struggles too. Thankfully, there's a gentle, powerful, and effective solution to beat it. It won't happen overnight, but with certain techniques and strategies, you can reduce your Social Anxiety quickly. And with persistence, you can become completely anxiety-free. Without needing to force yourself to awkwardly face your fears. Ready to get started on your journey to Social Confidence? Here are your first steps: 1.) Follow this Podcast and always get the latest episodes! 2.) Go to https://bit.ly/socialconfidencepodcast and receive access to a short transformational video to reduce your anxiety immediately. AND you'll also get my FREE "7 Secrets to Social Confidence" Mini Course. 3.) Let's connect! ●     SUBSCRIBE to my YouTube channel ●     Facebook ●     Instagram ●     X ●     TikTok ●     LinkedIn All the best on your journey to effortless social ease. 

Send us a textIn this episode, Dr. Amy Gelfand, a child neurologist specializing in pediatric headaches, discusses the complexities and treatment of migraines in children. Gelfand explains the genetic nature of migraines and their commonality among kids, noting triggers like menstrual cycles and changes in sleep patterns. She elaborates on distinguishing features of migraines and provides insight into preventive and acute treatments, including NSAIDs, triptans, neuromodulation devices, and supplements. The discussion also covers the importance of a regular schedule, the benefits of cognitive behavioral therapy (CBT), and recent advancements in migraine-specific medications. Dr. Gelfand emphasizes the significant progress in migraine treatment and encourages families to consult specialists for personalized care.About Dr Gelfand:Dr. Amy Gelfand is a pediatric neurologist who specializes in diagnosing and treating children with a variety of headache disorders, as well as those with childhood periodic syndromes (such as abdominal migraine), which may be precursors to migraine headache later in life. Her research focuses on the epidemiology of pediatric migraine and childhood periodic syndromes.Gelfand received her medical degree from Harvard Medical School. She completed residencies in pediatrics and child neurology at UCSF.Gelfand has received a teaching award from the UCSF pediatric residency program and writing awards from the medical journal Neurology. She is a member of the American Academy of Neurology, Child Neurology Society and American Headache Society.Your Child is Normal is the trusted podcast for parents, pediatricians, and child health experts who want smart, nuanced conversations about raising healthy, resilient kids. Hosted by Dr. Jessica Hochman — a board-certified practicing pediatrician — the show combines evidence-based medicine, expert interviews, and real-world parenting advice to help listeners navigate everything from sleep struggles to mental health, nutrition, screen time, and more. Follow Dr Jessica Hochman:Instagram: @AskDrJessica and Tiktok @askdrjessicaYouTube channel: Ask Dr Jessica If you are interested in placing an ad on Your Child Is Normal click here or fill out our interest form.-For a plant-based, USDA Organic certified vitamin supplement, check out : Llama Naturals Vitamin and use discount code: DRJESSICA20-To test your child's microbiome and get recommendations, check out: Tiny Health using code: DRJESSICA The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditi...

My guest on this podcast asserts that a huge chunk of our psychological stress isn't caused by what's happening but by the demands one quietly places on reality. In this episode, Dr. Walter Matweychuk teaches me about Rational Emotive Behavior Therapy (REBT), which focuses on identifying and disputing irrational, self-defeating beliefs to reduce emotional distress and change negative behaviors. Walter makes the case that REBT is not just a therapeutic modality but a philosophy for living based on emotional responsibility, resilience, and a way to stop rating yourself as "good" or "bad." Walter is a psychologist with the University of Pennsylvania Health System and an adjunct professor at NYU who specializes in REBT. Formally trained by pioneers Dr. Albert Ellis and Dr. Aaron Beck, he integrates their foundational insights into a private practice serving clients worldwide. He is the author/co-author of multiple books and writes the Intermittent Reinforcement newsletter. Beyond his clinical work, Dr. Matweychuk is widely recognized for hosting the weekly REBT Conversation Hour, a long-running public demonstration of practical cognitive-behavioral strategies available at REBTDoctor.com. In this conversation: What Walter learned training with CBT legends Albert Ellis and Aaron Beck Shame vs. healthy concern, and Walter's "shame-attack" experiments The two big engines of disturbance: "ego disturbance" vs. "discomfort disturbance" The way dogmatic "musts" turn a bad moment into an emotional spiral "Philosophical acceptance": how to stop personal scorekeeping How to catch the belief that's driving a feeling in real time The little "8 ideas" card Walter sends people Long-term hedonism: how REBT thinks about pleasure, meaning, and tradeoffs Secondary disturbance: the second layer of suffering that keeps people stuck Emotional responsibility and why it's closer to freedom than "positive thinking" If stress is often a "demand in disguise," this episode might help you spot the demand and loosen its grip. Enjoy! Show notes and more at larryweeks.com   

Kink 101: What is a munch? Plus Alan Colorado needs our pervy help!Newbie kinksters can learn all about the kinky social event known as the munch. And storyteller Alan Colorado needs the wisdom of the audience to expand his sexual repertoire. From our Seventh Anniversary show October 12, 2025. The October live show's main show sponsor was Rowan Tree Counseling. On the episode:FetLife Galleria Domain 2 (GD2) LRA Host Karen Yates  karen-yates.comOur Valentine's Kick Off Show is in Chicago, February 8, 6pm at Lincoln Lodge. Get tickets! Want more Wild & Sublime? Join The Afterglow for bonus content and Wild & Sublime goodies! Check out our new line of tees and accessories! Be wild & sublime every day! Shipping discounts for orders over $50.Do you feel stuck? Work with host Karen Yates in Zoom groups and one-on-one as she uses the energy of sound to reduce stress and help repattern behavior. Learn more about Biofield Tuning.Show your love for sex-positive podcasting: Leave a lil' tip!Get tickets to our Valentine's Kick Off in Chicago! Burlesque, standup and lively conversation about sex. Sunday Feb 8 at 6pm at the Lincoln Lodge! Tickets here!Support the showFollow Wild & Sublime on Instagram and Facebook!

Embedding Diversity and Equity in Practice - When Training Ends but Hours Remain In Episode 364 of the Counselling Tutor Podcast, your hosts Rory Lees-Oakes and Ken Kelly take us through this week's three topics: Firstly, in ‘Ethical, Sustainable Practice', we explore the question ‘Will AI Replace Counsellors and Psychotherapists?', examining how AI is currently used in mental health care and what this might mean for the future of the profession. Then in ‘Practice Matters', Rory speaks with Mamood Ahmad about his newly published book A New Introduction to Counselling and Psychotherapy, which calls for embedding diversity, equity, and context at the heart of practice. And finally, in ‘Student Services', Rory and Ken explore what happens when your counselling course ends but your placement hours are incomplete – offering guidance on how to stay motivated and complete the journey. Will AI Replace Counsellors and Psychotherapists? [starts at 03:33 mins] In this section, Rory and Ken explore the question ‘Will AI Replace Counsellors and Psychotherapists?', addressing a growing concern about whether artificial intelligence could one day replace human therapists. Key points discussed include: AI is already being used to support mental health in areas such as assessment, triage, and CBT-based coaching, but not as a replacement for human connection. The therapeutic relationship - empathy, intuition, and shared presence - remains central and cannot be replicated by machines. AI can be used ethically by counsellors to streamline tasks, improve assessments, and support practice without replacing core therapeutic roles. The rise of AI highlights the importance of counsellors developing digital literacy and understanding the ethical use of technology. Future therapists will benefit from embracing AI as a tool rather than fearing it as a threat. As job displacement due to AI increases in other sectors, therapists may become key support figures for those affected by these societal shifts. Embedding Diversity and Equity in Practice [starts at 33:12 mins] In this week's ‘Practice Matters', Rory speaks with Mamood Ahmad about his latest book, A New Introduction to Counselling and Psychotherapy and the need for systemic change in training and practice to include equity, context, and diversity as core elements. Key points from this conversation include: Traditional counselling models often overlook the contextual, cultural, and systemic influences on mental health. Mamood proposes a new baseline model where diversity, embodiment, and lived experience are embedded - not treated as optional extras. This approach enriches practice for all, recognising that every client (and therapist) brings their own cultural, social, and personal history into the room. Therapists must reflect on their own normativity and differences to meet clients with authenticity and depth. The book acts as a manifesto for change, advocating for a curriculum that prepares therapists for real-world complexity and inclusivity. It is relevant to both trainees and qualified practitioners committed to ethical and effective practice. When Training Ends but Hours Remain [starts at 59:05 mins] In this section, Rory and Ken discuss the common situation where a counselling course finishes, but a student still has placement hours outstanding. Key points include: It is common - and perfectly acceptable - for trainees to need extra time post-course to complete their client hours. Knowing the deadline and formal policy of your training provider is essential; always get this information in writing. Motivation can drop sharply after training ends, so it's important to build support networks through placements, peer groups, supervisors, or online forums. Visual motivators (like hour tokens in a jar) can help sustain momentum during this post-course phase. Stay engaged with CPD and peer connection to keep your confidence and learning alive. Remember: this is just one part of your journey, and with steady effort, the finish line is within reach. Links and Resources Counselling Skills Academy Advanced Certificate in Counselling Supervision Basic Counselling Skills: A Student Guide Counsellor CPD Counselling Study Resource Counselling Theory in Practice: A Student Guide Counselling Tutor Training and CPD Facebook group Website Online and Telephone Counselling: A Practitioner's Guide Online and Telephone Counselling Course

Amber had always been someone people counted on. A nurse. A mom. For most of her life, sleep wasn't something she worried about. It just happened. Then life changed. After her second baby — who arrived early and had some health problems — nights became more difficult. She'd lie down only to wait for the next cry. It felt easier to stay awake than to sleep. Years working as a NICU nurse added another layer. More responsibility. More pressure to perform. Sleep felt increasingly fragile and one night she couldn't sleep at all. Panic showed up. Heart racing. Mind spinning. Insomnia became something to fix. She researched. Tightened her routine. Optimized sleep hygiene. Tried teas. Tried prescriptions. Got in and out of bed. Tried relaxing harder. Tried doing everything “right.” Nothing worked. In fact, the harder she tried, the more she struggled. Nights became lonely and exhausting. Life started to revolve around sleep. Then, in the middle of the night, searching for help, she stumbled across stories of people who weren't fixing sleep — they were changing how they responded to being awake. Less fighting. More flexibility. More focus on living. It wasn't quick. It wasn't perfect. But little by little, Amber’s struggle loosened. And sleep stopped being the boss. Click here for a full transcript of this episode. Transcript Martin: Welcome to the Insomnia Coach Podcast. My name is Martin Reed. I believe that by changing how we respond to insomnia and all the difficult thoughts and feelings that come with it, we can move away from struggling with insomnia and toward living the life we want to live. Martin: The content of this podcast is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. The statements and opinions expressed by guests are their own and are not necessarily endorsed by Insomnia Coach LLC. All content is provided “as is” and without warranties, either express or implied. Martin: Okay. So Amber, thank you so much for taking the time out for your day to come onto the podcast. Amber: Thank you. Martin: Let’s start right at the very beginning, as always. Can you tell us when your issues with sleep first began and what you think might have caused those initial issues with sleep? Amber: Yeah. For the most part I’ve been a pretty good sleeper. Amber: However, I’ve had some points in my life where it’s become a little bit hard and I would say the first time that I noticed a significant change was that was after I had my second baby, he was early, he had some health problems. And I noticed, that I started losing my sleep then. Obviously every new mother does anyways, but I was worried about feeding him. Amber: I was worried about him getting enough to eat. I would get him settled and then I would lay down and just be waiting for that next cry. And so it was like almost easier to stay awake in a way, but not in the long run. So that was the first time I noticed it. And then the bulk of my career I have been a NICU nurse, which also made me a little anxious about my newborns. Amber: Sometimes I would be a little bit anxious before certain shifts. Not always, ’cause I worked for 25 years and it was great. But occasionally I would be anxious about getting to bed and in time and getting enough sleep. And so I noticed it there. And then I went back to school a few years ago to become a nurse practitioner and I probably had a little bit of a harder time sleeping during school. Amber: I got a lot more sensitive to my husband’s snoring during that time and, very light sleeper. And then after that, when I got my first job as a nurse practitioner, I was very on edge and very anxious. And while I was orienting for that job, I did not get a lot of sleep. I still at that time wasn’t paying a lot of attention to the sleep itself. Amber: Just aware that I wasn’t sleeping enough. Then I would say a couple years ago is where it really came to a head. I had various just normal life stresses going on with various kids and things. And one night I just could not sleep. And I started to recognize that I was having a bit of panic attack and I had some experience with panic and anxiety in the past, like mainly around that baby that I told you about. Amber: I had learned to work through that and I really hadn’t experienced a lot of it for probably a good decade and a half, but I noticed it that night and that generated a real fear response to me. And I thought, I remember distinctly having thought, oh my gosh, is this gonna keep me from sleeping now? And that’s, that was the hallmark. Amber: That’s what started it. And it became its own beast from that point on. Martin: You can recall a lot of times in your life when there were some stressors going on, for want of a better word, and that impacted your sleep. But it tended to be the case that once those initial triggers were no longer present or as relevant, things tended to get back on track. Amber: I had experienced times in the past where my anxiety was higher and I have always known that my personality goes a little in that direction, but it was manageable. I had been able to manage it and I had learned to manage it pretty well previous to that. Amber: But this time it I think the fear that it was going to affect my sleep, I did not know how to deal with that, and that scared me on a whole new level. And so now I feel like I was dealing with two things, just, being an anxious sort and now not being able to sleep on top of that. Amber: I value my health and I work in healthcare and so I do pay attention to details for sure. Amber: And getting enough sleep was very important to me. I know all the health benefits of that I’ve, and so the thought of not being able to have that and trying to function without it was quite terrifying to me, especially thinking of taking care of other people’s health. Martin: So you’ve got that added pressure to perform sleep because it’s not just about you, it’s also about all the other people you’re interacting with and caring for each day. What were you doing to try and get things back on track? Amber: I just go right to trying to problem solve. And of course that’s an important part of my job. That’s how I’ve dealt with being a mother and any other role I’ve had is to figure out, okay, what do I need to do differently? Amber: I need to understand this better. I’m gonna research it. I’m going to read about it. I’m gonna see what other people do and I’m gonna try all those things just, and I’m gonna, I’m gonna fix this. That’s what I thought. I’m gonna fix it. And so I did several different things. A lot of things that I’ve heard described on your other episodes. Amber: Sleep hygiene was a big thing, and that is actually something I talked to patients about. And so I thought I need to make my sleep hygiene better and I need to make sure I get in bed at a certain time and have everyone be quiet. I can’t have my noise in my room. I need to be really relaxed, so I’ve got to force myself to be relaxed. Amber: Try some of the sleep herbal teas. I don’t love medication, so I was trying not to go there in the beginning. Eventually I did go and try some medication. I have plenty of nurse practitioner friends that could write me a prescription for something. And so I tried various things, but only briefly I will say I, because I quickly realized that there was no medication that was helping. Amber: It might help initially. And then very quickly I discovered that my alarm system was stronger than the medication. And I think I tried maybe two or three different things and I just thought, I’m not gonna do this anymore. ’cause I don’t really wanna be on it anyways and it’s not helping. So yeah, I tried all those things. Amber: It was a difficult time. Amber: There was one night where I tried Ambien. I had tried hydroxyzine, I had tried Trazodone. Those two didn’t help at all. Amber: And one night I tried Ambien and I knew as a professional that’s not a medication that you want to take for very long ’cause it can really be disrupted to sleep. But by that point I was so desperate that I thought maybe if I took it a couple nights, it would help reset me. And that was even the term that the provider I talked to and I had was that maybe I needed a couple nights of reset. Amber: And I, so the first night I tried it and I was really relieved knowing that I had it that night. So I think my anxiety went down quite a bit right there. ’cause I knew I had something that was going to help and I just slept like a log that night. And so I thought, great this is it. I’m gonna do this a couple nights, I’m gonna get rid of it and I’m gonna move on and be normal again. Amber: And the very next night I took it and I slept really hard for maybe two hours and then I was up the rest of the night and I was pretty blown away that I had overpowered that medication that I knew to be pretty strong. And so from, I just threw it out at that point because I thought this isn’t working and it’s not gonna, it’s gonna, give me side effects anyway, so I don’t want it. Amber: So yeah I was really to the end of my rope at that point. I didn’t know what else to do. Martin: I think a lot of people will identify with at least some kind of aspect of your experience with the medication there. You’ve got that thing and it can feel like a sense of relief. Martin: It’s almost like you’re delegating all of the effort that you might felt you had to put into sleep to try and make it happen, now it’s not your issue anymore, it’s down to whatever this thing is. So you take it and it’s that’s it. Now there’s no more effort. There’s no more trying, there’s no more pressure, there’s no more performance anxiety, and that in itself can just immediately create better conditions for sleep. Martin: Maybe the real issue is all the understandable trying and the pressure and the effort. Amber: Yeah that’s very true. And as you were talking, I actually was thinking of something else I tried. I had an another provider tell me to at night it was a CBT thing. It was to get out of bed when I started feeling those anxious feelings so that I wouldn’t associate my bed with that anxiety. Amber: And I thought that makes sense ’cause I’m really struggling when I’m laying in my bed. And she told me also to pull out the Old Testament and read Leviticus ’cause it’s really boring. And maybe that would help. And I did it and it was boring. But I found after a while it, it helped a bit initially, but I found after a while that the exercise of getting in and out of bed when I was feeling anxiety was adding to my anxiety. Amber: ’cause I was just like, oh, here I go again. I’ve, been in bed for 15 minutes. I gotta get out again. It was just something else I had to keep track of. Martin: Did it almost feel like an additional punishment on top of being awake, this kind of obligation that I should be getting out of bed as well? Amber: Yes, it did. Very much yeah, it was not relaxing to me. Martin: I’ve had guests on the podcast that have found it really helpful to get out of bed during the night, and I have other guests just like yourself that did not find it helpful to get out of bed during the night. Martin: And I think really it just comes down to what our intent is. If we are getting out of bed because we are trying to get rid of anxiety or thoughts or feelings or to get rid of insomnia, to make ourselves feel sleepy again, to make sleep happen, then we might be setting ourselves up for some struggle if our experience tells us that’s out of our control if we’re getting out of bed, just because to us, that feels like a more productive way of spending our time awake during the night. Martin: Maybe that is gonna be helpful for you. And if your goal is to just use that time awake in a way that’s more useful, that involves less struggling, we can then see that it doesn’t matter, does it? You can do that in bed. You can do that out of bed. Because our goal is just to experience this with less struggle. Martin: It’s the struggle that kind of adds all that extra difficulty on top. Amber: That is very true. And that is what I had to come to. It took me a while. And I know I actually emailed you a few times about, I wanted you to tell me exactly what to do and of course you won’t do that. Amber: Your answers are to help people search themselves to find out what they need to do because it is very individual. And I finally came to. I just need to see how I feel in the moment. If it feels better, if I want to stay in bed, then I’m gonna do that. But if the feelings of, I don’t know, anxiety or restlessness, get too much for me and I would rather do something out of my bed, then I’ll do that. Amber: So I really ended up not having a certain way of doing things, which I think was a key. Martin: You were giving yourself more flexibility. Whereas when we were in problem solving mode, it’s I have to do this, I have to do this, I have to do this. And they’ve got this long list, haven’t we? Amber: Yeah, the algorithm. Martin: Exactly. Yeah. But then when we start to ease up a little bit, don’t cling onto it quite so tightly, we can become a little bit more flexible. And that in itself can be quite freeing, right? Because Amber: it is Martin: now we realize we’ve got options again, and that just opens things up a little bit. Martin: That doesn’t mean that things are just immediately gonna change, but it can just relieve some of that weight from our shoulders and help us realize that we can choose what we want to do. Amber: It’s quite liberating actually, when you get to that point. Martin: Just to rewind a little bit, what was an average night like for you back then, if there was such a thing? Amber: In the beginning, just sheer difficulty. It was miserable. It was absolutely miserable. I felt very isolated and very alone because of course everyone else in my house is completely out sleeping beautifully. And I am not. Amber: And it seemed to me like everybody in the neighborhood was sleeping great too. And I am up pacing and walking the hallways or trying to, focus on something that I can’t focus on. Having a lot of an anxious feelings. It just was awful. And then dreading the next day when I was going to be exhausted and very certain I wasn’t going to be able to perform in any of my roles the way I wanted to. Amber: That was the beginning. As time went on, that very slowly improved, but I did still have a lot of difficult nights as I moved forward. Martin: How was this influencing your days when you were still tangled up in the struggle? Amber: Yeah, that was really hard. I called in sick the next day at work and I hardly ever call in sick. I think I’ve missed, gosh, two days and two and a half years. I really, but I didn’t think I could be capable of my job the next day, and I was terrified of myself and terrified of how I would let down other people. Amber: And so I stayed home and just continued to suffer at home. And then, I mentioned my job a lot. That’s a really important role to me. But of my most important role is that of mother. And as family member to my family. And I also felt like I was not able to do a good job there. I felt like I was not quite present. Amber: They could tell that I just wasn’t as happy or didn’t have the energy. I wasn’t doing things that I enjoyed as much. It was just really became enclosed in myself and an obsessed about how I could fix this problem, not a good way to live. Martin: It makes sense why you called in sick to work not only for yourself, for your own wellbeing. It felt what if I might make a mistake at work because I can’t really focus. I’m so distracted. So it’s completely understandable why you would do that. And then at the same time, when you call in sick, you’re not doing that career or that job that might feel important to you. Martin: That’s reflection of who you are. It’s all this stuff influences your actions in a way that you get pulled away from that life you want to live. And that could be your work, your home life, your family life, your identity. It just feels like your actions start to serve insomnia, sleep, all these thoughts and feelings rather than your actions serving you, who you are and the life you want to live. Martin: And that just makes it all so much more difficult. Amber: Yeah, that’s so true. It’s like insomnia became the boss. Amber: I wasn’t new to the sensation of anxiety or panic. I had episodes of that in the past and I was feeling pretty confident that I knew how to handle that. ’cause it had been so long and I had moved through some really difficult things in my life. Amber: And I did okay. So then this thing came along and it was mysterious because I’d had this confidence so I could handle anxiety and difficult things. But this was a whole new thing and it caused me to go right down to the bottom again and go, what is wrong with me? What is wrong with my brain? Amber: Why I felt like I wasn’t doing it to myself, but I couldn’t understand how or why I was doing it to myself. So yes, very mysterious and very difficult for me to understand in the beginning. Martin: When you came across my work, what made you think that there was something different or something new or opened up this possibility that there’s a new way forward here? Amber: As probably most people that encounter your work it was in the middle of the night while I was on, looking for help in the middle of the night because I was just desperate. And I stumbled upon some of your, maybe one of your YouTubes, I think, and you were interviewing somebody like this. Amber: I listened to the person’s story and I thought, oh my gosh, that sounds exactly like how I feel right now. They were really expressing how desperate they were in the beginning and how confusing all the feelings I was feeling at the time. And so that really grabbed my attention because I heard the same level of desperation in this person’s description of themself, and yet they were now being interviewed by you and having worked through that. Amber: And so it gave me hope. And as I listened to it more, I realized that it actually was very similar to how I had learned to manage anxious thoughts or anxiety in the past. And that was to let them happen. So it was a different level of learning how to let something happen. So that cognitive understanding started coming. Amber: The more I would listen to your things on YouTube and your podcasts, I had, I felt like it made sense. It resonated with me. Martin: This is why I’m just so grateful that people like yourself are willing to come on because it, it can be so powerful to hear these journeys and these stories. Martin: There’s that validation. There’s the acknowledgement that you’re not alone, and then there’s that hope, and you had the bonus of being familiar with an approach of opening up to insomnia, opening up to panic, fear, anxiety. Amber: It’s a paradoxical thing that, that is how you get through it is by actually allowing it to happen. Amber: So that, that was a pivotal moment for me and started my process of recovery, which certainly didn’t happen overnight. But the cognitive understanding was there. Martin: So in terms of allowing it to happen, in a practical sense, how do you allow insomnia, for example, to happen when you really don’t want it to happen. Martin: How do you allow anxiety to happen when you really don’t want it to happen? What does that look like in, in terms of practical action? Amber: Yeah. That that, that was the next big hurdle was trying to figure that out. I asked that question of myself and of you, I think several times again, and it’s not something that you can figure out overnight. Amber: It takes a lot of practice. I think ongoing practice, I don’t think that practice ever ends because there’s always a new layer of things. Amber: One of them was to not beat myself up for things, because I realized that when I would get really frustrated and go, why can’t I do this? Why can’t I? What’s, why do I think this? Amber: Why is my brain so busy? Why do I think I have to problem solve everything? Why? I realized that I was just throwing fuel on the fire. I was just putting more pressure on myself. Friend said to me one morning, something that stuck with me, and you actually repeated in an email something very similar. Amber: She said I would never change your problem solving mind. It makes you who you are and look at all the things you’ve been able to do and accomplish. Because of the way your mind works and who would you be without your mind the way you were? And you had said something pretty similar to me about that too. Amber: So from that point on, I started looking at that differently and not flogging myself for just being who I am and seeing the benefit of the way my brain works. That was a big realization for me. And then another one was to realize when I was starting to try to prob over problem solve, maybe, oh, it worked this night but this didn’t work that night. Amber: Maybe I did it a little bit wrong. Maybe you know, I’m not following the algorithm. It was frustrating ’cause professionally, I really do have to follow algorithms a lot. And so I was having to pull away from that natural way of thinking. And not get stuck in this loop of problem solving and just letting it be, not worrying about it so much. Martin: Step one perhaps was, not beating yourself up over something that your own experience is telling you is out of your control. If you could have made a certain amount or type of sleep happen, you would’ve, you’d be doing it, right? If you could magically and permanently delete anxiety from your mind, you would’ve done it. Martin: But your experience tells you that’s not possible. You tried and tried. The conclusion from your experience was that’s not possible. So it sounds like part of your journey towards opening up a little bit more to this difficult stuff that you’d rather not experience is to acknowledge that it is out of your control and that your mind isn’t working against you, it’s not your adversary, even though it can sometimes feel that way. Martin: Because anxiety generally speaking doesn’t feel good. We can see it as a negative thing or a bad thing. If only this anxiety will go away, I would be able to sleep. If only this anxiety would go away, I would be able to be the person I want to be. Martin: But the brain generates anxiety because it’s trying to give us information about something. It’s trying to remind us of something that’s important. It’s trying to protect us. It’s trying to look out for us. It’s trying to keep us safe, and it’s gonna do this whether there’s a real threat or not, because it’s hyper cautious. Martin: It’s focused on doom and gloom. ’cause all the good, happy, fluffy, safe stuff isn’t a threat or a concern. So the brain spends no time on that. It’s only ever gonna focus on what might happen or the worst possible outcome or the worst possible experience. Martin: If we feel anxious that maybe we left the gas stove on. And so we turn around in our driveway and we go back in, we find out we did leave the gas stove on. Is anxiety still a bad thing when it stopped our house from exploding? It’s like what we add on top of it that is the source of so much of our struggle. Amber: Yes, very true. I think, I started using an analogy in my head as I was figuring this out more as a NICU nurse, which. Amber: All those years, if you’ve ever been in, in a neonatal intensive care, there’s a lot of alarms that go off all the time. And so sometimes the nurses get a sense of whether it’s an alarm that needs to be paid attention to or not. And people who haven’t been in there are really on edge because they can just, why are we not getting on top of all these alarms, but the nurses like this one, this is okay. Amber: We’re okay. We don’t need to do anything about it. And I started to realize that’s what was probably going on in me is I, I had an alarm that had some value to it and at times I needed to, of course I need to attend to it. I don’t wanna not be fearful of anything. But it also can go off for things that are not really urgent or really emergent. Amber: It might be a mistake, it might be like in the nicu, maybe the baby’s wiggling and setting off their alarm, and it’s not a problem. So realizing that a little more was helpful to me. Martin: I think that’s a fantastic analogy and I love how you connected it to a real ongoing experience that’s relevant to your life. Martin: ‘Cause that always makes this stuff so much more powerful. And yeah, there’s, these alarms are going off. Sometimes they’re helpful, sometimes they’re useful, sometimes they’re less helpful, sometimes they’re not helpful, they’re not useful. Sometimes maybe they’re more of a distraction than anything else, but what are they? Martin: At the end of the day, they’re snippets of information and we get to decide how to respond. The alternative approach if you’re in that ward is to just be so focused on, I must not hear any alarms today. I can’t hear any alarms. That’s first of all, that’s just gonna take so much of your energy, focus and attention. Martin: How are you gonna be able to care for your patients and do the stuff that matters when your brain is, all of its capacity is on trying to avoid hearing an alarm. Amber: And as time went on, I think my alarm system got a little smarter. I wasn’t going off as much because it wasn’t bothering me as much. Amber: One other thing that’s come to me while we’ve been talking that I also realized I had a few different epiphanies while going through this, and I realized, I kept realizing different levels at which I was trying to force something to happen. Initially it was trying to force sleep. Amber: Then it was trying to force myself to relax and not have anxiety. And then when I started doing your program and going about it that way, then I was trying to force myself to be okay or maybe even being awake or be okay with the anxiety. And I wasn’t. And it took me a while to realize, oh, I don’t have to like this actually, I can acknowledge this is hard. Amber: It is not. This is not ideal. This is not what I wanna do. This is not how I wanna feel. And that’s okay. But I can make a choice here. I do have a choice in what I’m gonna do next. I can have a choice in my discernment. And that was probably one of the bigger epiphanies that I had. ’cause that one really carried out over into other parts of my life too. Martin: I’m glad you made that point because when we hear about this idea of reducing our resistance to something that we don’t really want to experience or to accept it, this whole philosophy of acceptance, a common reservation I guess that people have is but I’m not okay with this. How do I make myself be okay with something that I’m not okay with? Martin: I want to be asleep. I don’t want to be awake. And that’s where we can get tripped up. Because it’s not about pretending that you are okay with it. It’s not about pretending that you enjoy being awake pretending that fatigue doesn’t exist, pretending that anxiety doesn’t make things more difficult, that you enjoy it, that it’s great to experience. Martin: It’s about accepting that this stuff is gonna show up and it’s trying to fight it or avoid it just makes things more difficult. And it’s about, just as you touched upon, bringing your focus back to how you choose to respond to it when it shows up. Choosing to respond in a workable way, a way that isn’t going to layer on all these extra pieces of difficulty and struggle on top of it when it shows up. So I’m really glad you mentioned that because I think that is important. Amber: Yeah. Yeah. I think that is important. I think that’s a really common misconception when someone starts back on this journey, whether it’s insomnia or trying to deal with anxiety, is then trying to figure out how am I supposed to be okay and enjoying this? And you really can’t, that’s not, that’s really not what we’re trying to do here. Amber: It’s okay to acknowledge that it’s hard. Martin: It might even be essential to acknowledge that it’s hard and that in itself might be part of opening up to it. Amber: Yeah. Agreed. Amber: I have memory of when I was young, when as a child and I’d get the stomach flu and I had to throw up. It was just a horrible thing. I did not wanna throw up. I would fight it, and my mom would come with me to the toilet, she would hold my head up and she would just rub my back. Amber: And she would keep saying, just let it come. Just let it come. And I trusted her, and I would let it come, and I would let you know, have the release, and then I would feel better. And it’s more like that to me now. It’s I can let this happen. It doesn’t feel good right now. Might even feel worse before it’s done, but it’s not gonna stay this way. Amber: I know that now. So that’s a different thing. And then instead of getting really frustrated with my busy brains that likes to think about everything and figure out everything. Now it’s more oh, let’s just see what’s on, what’s on TV tonight? What’s on the brain tonight? Amber: I’m more like, wow, look at my busy brain. Isn’t that amazing? It can bounce back and forth. To this, that and the other. And it goes fast. Sometimes it’s a little fast for me, but I’m actually more grateful for it now ’cause it helps me keep track of a lot of things and stay on top of a lot of things. Amber: So I look at that differently as well. Amber: Another big learning point is what what I can control and what I cannot, and to, there are a lot of things we cannot control and to try to control them, escape from them, or numb yourself to them, distract yourself, it just adds to something that might already be difficult. Amber: So letting those things be, and then finding where I can control, which is my actions, my response I went into, when I started this out, I did try some meditation, but my understanding of meditation has changed so much in the beginning. I was trying to force myself to relax. I was trying to make my really naturally busy brain not think of anything, and it just doesn’t happen. Amber: And so that would become more and more frustrating to me. It was just a frustrating experience. I thought I’m never gonna get this down. Now. I choose to relax. I can relax my muscles and my body and I can let myself breathe. But it, you mentioned the word intent or motive in the beginning. My intent of my motive is different. Amber: It’s not to force total relaxation and calm and quiet my brain and not have thoughts. Now it’s, I am relaxing myself to allow them, if that makes sense. And it has been that has been a real game changer for me as well, because I realize the more I do that, oh, actually, I. I don’t really feel that anxious anymore. Amber: It’s just gotten better and better. It doesn’t mean I don’t have anxiety, but I’ve, I have a very different approach now and it feels so doable to me compared to the way it used to feel. Martin: Would you say it’s almost like you are practicing and building skill in experiencing, I’m just gonna say anxiety ’cause that’s the last one that you mentioned. Martin: Experiencing anxiety with less struggle. So it’s showing up, but it’s losing the more you practice experiencing it with less resistance, it’s almost like it starts to lose its power and influence. So it still shows up, but it’s not as strong, it’s not as distracting. It’s not got that power it once maybe held over you. Amber: That’s exactly what’s happening now. The thing if I, if for example, if I go to bed and I’m worried about one of my kids or a patient I saw, and it’s leaving me with this unrest inside. I, now we’ll just realize, okay, I’m going into one of these loops where I’m thinking about this a lot, worrying about it all. Amber: The worry in the world is not gonna change it. I’m gonna just name I’m feeling this way because this is going on, or this is happening and I’m just gonna allow it to happen. I’m gonna relax and allow it to happen. I can maybe think of some more solutions tomorrow, or I can check in on the thing. I just start coming up with things I can do. Amber: To help it. And it really has it has more of a profound effect on me in helping me get through this. Martin: Whilst you were talking, I was thinking back to that alarm analogy you were sharing, and I was thinking that maybe a brand new member of staff, maybe they’ve just finished their training and they’re in that ward for the first time, hearing all those alarms go off, it must be terrifying. Martin: It feels like you’ve really thrown in the deep end, but then as you build up that experience of listening to those alarms going off nonstop choosing through experience on how you’re responding to each of one, each of them, the alarms are still going off, but they’re not having that huge effect on you, that huge physiological effect on you anymore. Amber: Yeah, that’s exactly right. It’s very it’s very comparable to that experience. Martin: How does this transfer to sleep then? So we’ve talked about opening up to the thoughts and the feelings. How does that get you to a place where you are not struggling with sleep anymore? Amber: With sleep it’s really was the same thing. Amber: The, I bring up anxiety a lot because I feel like the anxiety and the lack of sleep was just so intertwined with this experience. I did have to become more okay with being awake and that took time. And your direction on choosing values, value-based activities was very helpful to me because I’m very aware of what my values are and you know what things lead me more towards those and that type of life I wanna live and. Amber: So I did go I went through a very sleepless period of time. I think there was one time where I felt like I didn’t get sleep for three nights in a row. Sometimes I don’t know that we’re totally aware of how much sleep we actually get, but that’s what it felt like to me. And I actually carried on. Amber: I didn’t feel my best. Of course it wasn’t great, but I carried on very normally for those days and I was able to see, wow, I was able to accomplish, these things at work, at home. I had connection with people. I laughed with people. I had some good conversations. And so that was a big confidence builder to see that I actually really can do a lot without sleep. Amber: It doesn’t feel, the way I like to feel, but I can do it. And so it took some of the fear out of that for me, and that was very helpful. Martin: Maybe it comes down to exploring what we can do that might make this whole experience a little bit less difficult or a little bit less traumatic. It sounds like one way that you moved toward that goal was by committing to actions that reflected your values, living the kind of life you wanted to live, even when sleep wasn’t showing up. Martin: And by doing that, I think a natural byproduct maybe, is that we do start to get a little bit more comfortable with being awake because it’s not having such a huge impact over our lives anymore. Even if it’s just a 10th of a percentage point better, we’ve got that 10th of a percentage point more control over our lives now. Martin: It can snowball. So we become a little bit more comfortable with being awake. That’s not to say we want to be awake, but we just start to get a little bit more comfortable with it. We are less resistant to it. It’s not gonna pull us into quite so much of a struggle and in effect. That kind lowers it down on our list of priorities, perhaps for our problem solving brain. Martin: Our brain’s oh, maybe we don’t have to fight this quite so hard. We don’t have to engage in this battle. And when we are not engaged in that battle conditions for sleep just become better because we’re not in the middle of a battleground at two o’clock in the morning. We’re awake. We’re experiencing all these thoughts and these feelings, but we’re not in a battleground anymore. Amber: That’s absolutely correct. And since then, my attitude now I’ve had a couple of circumstances with maybe a teenage child that’s, been late for curfew coming home or maybe a medical issue with somebody that I need to help with. It’s late in tonight. And instead of thinking, oh my gosh, I’m not gonna get sleep now, I’m like, bring it. I can stay up and I can handle tomorrow. I’ve done it for three nights in a row. Amber: I, it doesn’t scare me like it used to. So it’s a big shift in my perspective on that now. Martin: That is a really big shift. I’m curious to know, as you were practicing this whole new approach that we’ve been talking about, did you find that progress was just it was kinda like this up upward curve where things just progressively got better and easier and less struggle. Martin: Or was it more kind of ups and downs, or was it more just like someone had thrown a plate of spaghetti against the wall and it was just all over the place? What was it like for you? Amber: I like the spaghetti analogy that it probably felt like that for a while. All over the place. I keep using the term cognitive understanding because in my head I could understand what you were saying or what I was hearing from other people. Amber: It made sense to me. It resonated and I knew this was the way to do it, but anything else I’ve had to learn, whether it is becoming a nurse or a nurse practitioner or I used to run a lot of marathons, learning the best way to do that. Learning it in the book can make absolute sense. Amber: And you think you’ve got it, but then actually putting it into reality and doing it experientially is an entirely different thing. And that does not come as quickly and it takes a lot of practice. And that’s exactly what happened with this. It took a lot of practice and I had a lot of ups and downs. I have a plate of spaghetti. Martin: Yeah. And like when you’re learning any new skill there’s gonna be times when it maybe things feel easy, that you’re making great progress, you’re ahead of schedule, and then there’s gonna be times where it feels like nothing is working. You’re doomed to failure, you’re beyond help that you need to go back down that rabbit hole of looking for some something else to do instead. Martin: I love the fact that you drew in your experience, in marathon running in your own career, the skills, achievements, they take a lot of practice, they take a lot of action, they take a commitment to action, and they also come with ups and downs, and they also come with all those thoughts and feelings that I just gave a few examples of, this isn’t working. We should give in. Martin: If we think of where we’re most skilled in life, that wasn’t just immediately given to us, we had to earn it, and we earned it through committed action. Even if it’s just doing a little bit every day, it all adds up. It’s just continuing to do things that move us in the direction that we want to be heading. Amber: Absolutely. And I do think when you start making that initial improvement, so when I first started to improve and I had a few good nights of sleep and I thought, oh, this is it. I’ve arrived. I figured it out. And then you have your first whatever you wanna call it, set bump, or, barrier in the road and you have another bad night. Amber: It can be really deflating. ’cause you thought, oh, I figured this out and now this isn’t working, and what did I do wrong? You start, you catch yourself going through all of the same rabbit hole again. And so it is, there is a lot of patients required with those setbacks, they are going to continue to happen. Amber: And I heard. I don’t remember where I heard it, but I heard someone say that they those types of setbacks come up for a reason. It’s an opportunity to practice. It just means that you need to practice again. It’s not really a bad thing, it’s just an opportunity to refine a skill. And again, changing the way I looked at those, ’cause those were pretty, they’re pretty hard, those setbacks once you start on the road to recovery. Martin: 100%. And especially like you said early on especially if you’re really early in your journey and maybe you string some good nights together, or you have a few days where you notice you’re not completely overwhelmed with all these thoughts and feelings and you can feel really confident and motivated, yes, this is working, I’m doing really well. Martin: And it can be so deflating and difficult when the difficult stuff shows up again. And even when you are further along in your journey, there can be lots of ups and downs and it can feel like you’re, it’s almost like your brain is, whoa, you’re back to square one. Martin: Everything you’ve been doing up to this point was a complete waste of time, waste of effort. The truth is that it’s just your brain looking out for you. Again, the truth is you’ve just had this experience of some difficult nights or some nights where less sleep happened or some nights of no sleep, or you’ve noticed those thoughts and feelings showing up and gaining a little bit more power. Martin: That’s what’s happened. Anything else that you are getting from that is stuff that we are understandably adding on top because we still don’t want to experience it. But what matters is identifying this is a normal part of any journey and that it is about how we choose to respond. And that’s something that we always have power over. Martin: We have the power over our choice of actions, and it’s easy to respond in the way we wanna respond. When things feel good, when things feel easy, it’s when things feel difficult, that it’s most important we respond in the way that reflects how we wanna respond, and that’s really what counts. Martin: How long would you say it took for you to get to a point where insomnia and all the thoughts and the feelings that can show up with it and after it weren’t creating a struggle for you that you could do things that matter, live your life, do what’s important to you, independently off sleep, and even in the presence of uncomfortable, difficult thoughts and feelings. Amber: I think it’s hard to put a specific number on that because in the journey, I feel like I, I would go to that for quite a while and then maybe have a little, regression or whatever, and then I would go back to that. Amber: But I will say, I think over time those regressions would get further and further apart. And so maybe six to eight months is where I started feeling like I was settling in back into my more normal self, my more baseline self. Martin: Yeah, that’s helpful because I think it’s a reminder that really what we’ve been talking about this whole time are skills. They’re action-based skills and skills. Take time to learn, to develop, to practice. There’s gonna be ups and downs, there’s gonna be setbacks. And that takes time. We all obviously want immediate results. We wanna be able to just deal with this right now. Martin: If I could offer that to people, I would offer it. I’d be a trillionaire. But it doesn’t work that way. It’s not easy, it’s difficult, and it requires ongoing practice. Amber: I can honestly say that even though there were times where I just feel like this really brought me to my knees I wouldn’t change it now because of the benefit I’ve gotten from it. I don’t think there, there’s things that I don’t think I could have learned in another way. I think it’s benefited how I’m able to help others and of course my values, my roles, my role as mother. Amber: Professionally as nurse practitioner or family member or friend, the people in my life, those are really important to me. And so this outlook and this focus of what I can and cannot control and how to allow these things to move through, to just be able to move through them and not go down the rabbit hole has been really helpful. Amber: I’m very empathetic towards people that are going through something similar and it doesn’t have to be insomnia because so many struggles go down this road, right? They don’t necessarily have to be insomnia. And of course professionally I hear a lot about these types of things. I’m in that type of a position, and so I do, I have a lot of empathy. Amber: I understand how things feel how difficult thoughts and feelings can fill, and I can give better guidance and direction. I can do that for my children and other people in my life. Martin: It can be really hard to think of any positive aspects to this struggle when you are in the midst of it. It can almost sound disrespectful to think that there could be a growth opportunity, or it could have somehow have any positive impact on our lives. But a common theme that runs through so many of these podcast episodes is this sense of growth that can only come from that journey that has been experienced. Amber: I mentioned how when I have had setbacks with insomnia or anxiety, I can see it more as an opportunity to practice. And so now when other things occur in my life that are difficult I think I can go to that maybe a little more quicker now because of that experience that here’s another opportunity. Amber: This is happening. How can I go about handling it? What can I control, what can I not? And let myself move through it. And then I would say even just day to day, I think I take more I have more gratitude for things too, because. I’m not struggling with the battle and the calv calvary, as you mentioned. Amber: Now I have more awareness of things around me that are important to me, or even small things like, good weather or flower. It does, it opens your eyes to other things. Martin: These are transferable skills. Martin: They don’t exist only for insomnia, only for anxiety. They can enrich or enhance your life in so many other ways, and that’s where you can end up coming out ahead. So like you shared, maybe now you’re finding yourself better at practicing gratitude. You find yourself better able to focus on values-based action. Martin: Maybe you’re getting more from life because your values have just become more front and center. And so you’re ensuring that your actions reflect who you are, who you want to be and your, you focus, the focus of your attention is expanded. So maybe you are able to savor a few more of those moments that we might once have been on autopilot and missed out on. Martin: If someone with chronic insomnia is listening. And they feel as though they’ve tried everything. They’re beyond help. They’ll never be able to stop struggling with insomnia. Martin: What would you say to them? Amber: Yes, I’ve anticipated that question and that’s really the reason I did this. I was a little reluctant in saying yes, but because this helped me so much, I couldn’t say no to you. Because this is doable. Even though you may be at the point where you feel like you’re completely broken, you’re completely alone. Amber: No one understands. I’ve tried, A through Z, it’s not working. It is doable. It’s not gonna happen overnight. But it will happen. And it’s the key things that we’ve been talking about. It’s practicing, it’s being patient with yourself in the process. It’s being kind with yourself in the process. Amber: It’s identifying what you have control over and what you do not. And, practicing those things over and over is really what will help this settle down. It’s very doable. Martin: Great. Thank you again, Amber, for coming on. It’s just been a pleasure listening to you describe your journey and your transformation. So thank you. Amber: Thank you. Martin: Thanks for listening to the Insomnia Coach Podcast. If you're ready to get your life back from insomnia, I would love to help. You can learn more about the sleep coaching programs I offer at Insomnia Coach — and, if you have any questions, you can email me. Martin: I hope you enjoyed this episode of the Insomnia Coach Podcast. I'm Martin Reed, and as always, I'd like to leave you with this important reminder — you are not alone and you can sleep. I want you to be the next insomnia success story I share! If you're ready to stop struggling with sleep and get your life back from insomnia, you can start my insomnia coaching course at insomniacoach.com. Please share this episode!

In today's episode, we connect with Dr. Scott Eilers to discuss his upcoming book, The Light Between the Leaves: 6 Truths Your Therapist Won't Tell You About Healing Depression and Trauma, set for release in April 2026. Known as "The Depression Doctor," Dr. Scott is a clinical psychologist who has spent decades working with people whose depression, trauma, and emotional disconnection don't fully respond to conventional approaches. Drawing from both his professional work and his own lived experience with severe depression and self-isolation, Dr. Scott shares how his healing journey led him beyond traditional therapy models — toward nontraditional paths like reconnecting with nature, rebuilding emotional safety, and addressing the internal systems that quietly block recovery… This discussion delves into: Why joy, comfort, and connection can feel inaccessible even when life seems "fine" on the outside. Why positive moments fade quickly while emotional lows feel permanent. The hidden patterns that sustain certain forms of depression and trauma. What actually helps restore emotional connection and long-term healing. Ready to take a deeper look at the reality of depression? Hit play to hear how Dr. Scott challenges surface-level solutions and offers a more integrated, human approach to healing. Click here to connect with Dr. Scott and his work!

If you've ever felt stuck in your thoughts-overanalyzing, spiraling, or assuming every anxious thought must mean something...this episode is for you. The Chicks are breaking down one of the most important CBT skills for anxiety: learning to detach from your thoughts instead of believing them. You'll learn how to observe your thoughts as mental events—not facts—and how this shift alone can reduce anxiety, rumination, and emotional overwhelm. This isn't about stopping thoughts or “thinking positively.” It's about learning how to change your relationship with your thoughts so they have less power over your nervous system. SINGLE LADIES 40+ Join The Single Sisters Circle for FREE! Don't forget to rate and review The Chicks!

Psychogenic nonepileptic seizures (PNES) are common, often misunderstood, and increasingly encountered in pediatric emergency care. These events closely resemble epileptic seizures but arise from abnormal brain network functioning rather than epileptiform activity. In this episode of PEM Currents, we review the epidemiology, pathophysiology, and clinical features of PNES in children and adolescents, with a practical focus on Emergency Department recognition, diagnostic strategy, and management. Particular emphasis is placed on seizure semiology, avoiding iatrogenic harm, communicating the diagnosis compassionately, and understanding how early identification and referral to cognitive behavioral therapy can dramatically improve long-term outcomes. Learning Objectives Identify key epidemiologic trends, risk factors, and semiological features that help differentiate psychogenic nonepileptic seizures from epileptic seizures in pediatric patients presenting to the Emergency Department. Apply an evidence-based Emergency Department approach to the evaluation and initial management of suspected PNES, including strategies to avoid unnecessary escalation of care and medication exposure. Demonstrate effective, patient- and family-centered communication techniques for explaining the diagnosis of PNES and facilitating timely referral to appropriate outpatient therapy. References Sawchuk T, Buchhalter J, Senft B. Psychogenic Nonepileptic Seizures in Children-Prospective Validation of a Clinical Care Pathway & Risk Factors for Treatment Outcome. Epilepsy & Behavior. 2020;105:106971. (PMID: 32126506) Fredwall M, Terry D, Enciso L, et al. Outcomes of Children and Adolescents 1 Year After Being Seen in a Multidisciplinary Psychogenic Nonepileptic Seizures Clinic. Epilepsia. 2021;62(10):2528-2538. (PMID: 34339046) Sawchuk T, Buchhalter J. Psychogenic Nonepileptic Seizures in Children - Psychological Presentation, Treatment, and Short-Term Outcomes. Epilepsy & Behavior. 2015;52(Pt A):49-56. (PMID: 26409129) Labudda K, Frauenheim M, Miller I, et al. Outcome of CBT-based Multimodal Psychotherapy in Patients With Psychogenic Nonepileptic Seizures: A Prospective Naturalistic Study. Epilepsy & Behavior. 2020;106:107029. (PMID: 32213454) Transcript This transcript was generated using Descript automated transcription software and has been reviewed and edited for accuracy by the episode's author. Edits were limited to correcting names, titles, medical terminology, and transcription errors. The content reflects the original spoken audio and was not substantively altered. Welcome to PEM Currents: The Pediatric Emergency Medicine Podcast. As always, I'm your host, Brad Sobolewski, and today we are talking about psychogenic non-epileptic seizures, or PNES. Now, this is a diagnosis that often creates a lot of uncertainty in the Emergency Department. These episodes can be very scary for families and caregivers and schools. And if we mishandle the diagnosis, it can lead to unnecessary testing, medication exposure, ICU admissions, and long-term harm. This episode's gonna focus on how to recognize PNES in pediatric patients, how we make the diagnosis, what the evidence says about management and outcomes, and how what we do and what we say in the Emergency Department directly affects patients, families, and prognosis. Psychogenic non-epileptic seizures are paroxysmal events that resemble epileptic seizures but occur without epileptiform EEG activity. They're now best understood as a subtype of functional neurological symptom disorder, specifically functional or dissociative seizures. Historically, these events were commonly referred to as pseudo-seizures, and that term still comes up frequently in the ED, in documentation, and sometimes from families themselves. The problem is that pseudo implies false, fake, or voluntary, and that implication is incorrect and harmful. These episodes are real, involuntary, and distressing, even though they're not epileptic. Preferred terminology includes psychogenic non-epileptic seizures, or PNES, functional seizures, or dissociative seizures. And PNES is not a diagnosis of exclusion, and it does not require identification of psychological trauma or psychiatric disease. The diagnosis is based on positive clinical features, ideally supported by video-EEG, and management begins with clear, compassionate communication. The overall incidence of PNES shows a clear increase over time, particularly from the late 1990s through the mid-2010s. This probably reflects improved recognition and access to diagnostic services, though a true increase in occurrence can't be excluded. Comorbidity with epilepsy is really common and clinically important. Fourteen to forty-six percent of pediatric patients with PNES also have epilepsy, which frequently complicates diagnosis and contributes to diagnostic delay. Teenagers account for the highest proportion of patients with PNES, especially 15- to 19-year-olds. Surprisingly, kids under six are about one fourth of all cases, so it's not just teenagers. We often make the diagnosis of PNES in epilepsy monitoring units. So among children undergoing video-EEG, about 15 to 19 percent may ultimately be diagnosed with PNES. And paroxysmal non-epileptic events in tertiary epilepsy monitoring units account for about 15 percent of all monitored patients. Okay, but what is PNES? Well, it's best understood as a disorder of abnormal brain network functioning. It's not structural disease. The core mechanisms at play include altered attention and expectation, impaired integration of motor control and awareness, and dissociation during events. So the patients are not necessarily aware that this is happening. Psychological and psychosocial features are common but not required for diagnosis and may be less prevalent in pediatric populations as compared with adults. So PNES is a brain-based disorder. It's not conscious behavior, it's not malingering, and it's not under voluntary control. Children and adolescents with PNES have much higher rates of psychiatric comorbidities and psychosocial stressors compared to both healthy controls and children with epilepsy alone. Psychiatric disorders are present in about 40 percent of pediatric PNES patients, both before and after the diagnosis. Anxiety is seen in 58 percent, depression in 31 percent, and ADHD in 35 percent. Compared to kids with epilepsy, the risk of psychiatric disorders in PNES is nearly double. Compared to healthy controls, it is up to eight times higher. And there's a distinct somatopsychiatric profile that strongly predicts diagnosis of PNES. This includes multiple medical complaints, psychiatric symptoms, high anxiety sensitivity, and solitary emotional coping. This profile, if you've got all four of them, carries an odds ratio of 15 for PNES. Comorbid epilepsy occurs in 14 to 23 percent of pediatric PNES cases, and it's associated with intellectual disability and prolonged diagnostic delay. And finally, across all demographic strata, anxiety is the most consistent predictor of PNES. Making the diagnosis is really hard. It really depends on a careful history and detailed analysis of the events. There's no single feature that helps us make the diagnosis. So some of the features of the spells or events that have high specificity for PNES include long duration, so typically greater than three minutes, fluctuating or asynchronous limb movements, pelvic thrusting or side-to-side head movements, ictal eye closure, often with resisted eyelid opening, ictal crying or vocalization, recall of ictal events, and rare association with injury. Younger children often present with unresponsiveness. Adolescents more commonly demonstrate prominent motor symptoms. In pediatric cohorts, we most frequently see rhythmic motor activity in about 27 percent, and complex motor movements and dialeptic events in approximately 18 percent each. Features that argue against PNES include sustained cyanosis with hypoxia, true lateral tongue biting, stereotyped events that are identical each time, clear postictal confusion or lethargy, and obviously epileptic EEG changes during the events themselves. Now there are some additional historical and contextual clues that can help us make the diagnosis as well. If the events occur in the presence of others, if they occur during stressful situations, if there are psychosocial stressors or trauma history, a lack of response to antiepileptic drugs, or the absence of postictal confusion, this may suggest PNES. Lower socioeconomic status, Medicaid insurance, homelessness, and substance use are also associated with PNES risk. While some of these features increase suspicion, again, video-EEG remains the diagnostic gold standard. We do not have video-EEG in the ED. But during monitoring, typical events are ideally captured and epileptiform activity is not seen on the EEG recording. Video-EEG is not feasible for every single diagnosis. You can make a probable PNES diagnosis with a very accurate clinical history, a vivid description of the signs and appearance of the events, and reassuring interictal EEG findings. Normal labs and normal imaging do not make the diagnosis. Psychiatric comorbidities are not required. The diagnosis, again, rests on positive clinical features. If the patient can't be placed on video-EEG in a monitoring unit, and if they have an EEG in between events and it's normal, that can be supportive as well. So what if you have a patient with PNES in the Emergency Department? Step one, stabilize airway, breathing, circulation. Take care of the patient in front of you and keep them safe. Use seizure pads and precautions and keep them from falling off the bed or accidentally injuring themselves. A family member or another team member can help with this. Avoid reflexively escalating. If you are witnessing a PNES event in front of you, and if they're protecting their airway, oxygenating, and hemodynamically stable, avoid repeated benzodiazepines. Avoid intubating them unless clearly indicated, and avoid reflexively loading them with antiseizure medications such as levetiracetam or valproic acid. Take a focused history. You've gotta find out if they have a prior epilepsy diagnosis. Have they had EEGs before? What triggered today's event? Do they have a psychiatric history? Does the patient have school stressors or family conflict? And then is there any recent illness or injury? Only order labs and imaging when clinically indicated. EEG is not widely available in the Emergency Department. We definitely shouldn't say things like, “this isn't a real seizure,” or use outdated terms like pseudo-seizure. Don't say it's all psychological, and please do not imply that the patient is faking. If you see a patient and you think it's PNES, you're smart, you're probably right, but don't promise diagnostic certainty at first presentation. Remember, a sizable proportion of these patients actually do have epilepsy, and referring them to neurology and getting definitive testing can really help clarify the diagnosis. Communication errors, especially early on, worsen outcomes. One of the most difficult things is actually explaining what's going on to families and caregivers. So here's a suggestion. You could say something like: “What your child is experiencing looks like a seizure, but it's not caused by abnormal electrical activity in the brain. Instead, it's what we call a functional seizure, where the brain temporarily loses control of movement and awareness. These episodes are real and involuntary. The good news is that this condition is treatable, especially when we address it early.” The core treatment of PNES is CBT-based psychotherapy, or cognitive behavioral therapy. That's the standard of care. Typical treatment involves 12 to 14 sessions focused on identifying triggers, modifying maladaptive cognitions, and building coping strategies. Almost two thirds of patients achieve full remission with treatment. About a quarter achieve partial remission. Combined improvement rates reach up to 90 percent at 12 months. Additional issues that neurologists, psychologists, and psychiatrists often face include safe tapering of antiseizure medications when epilepsy has been excluded, treatment of comorbid anxiety or depression, coordinating care between neurology and mental health professionals, and providing education for schools on event management. Schools often witness these events and call prehospital professionals who want to keep patients safe. Benzodiazepines are sometimes given, exposing patients to additional risk. This requires health system-level and outpatient collaboration. Overall, early diagnosis and treatment of PNES is critical. Connection to counseling within one month of diagnosis is the strongest predictor of remission. PNES duration longer than 12 months before treatment significantly reduces the likelihood of remission. Video-EEG confirmation alone does not predict positive outcomes. Not every patient needs admission to a video-EEG unit. Quality of communication and speed of treatment, especially CBT-based therapy, matter the most. Overall, the prognosis for most patients with PNES is actually quite favorable. There are sustained reductions in events along with improvements in mental health comorbidities. Quality of life and psychosocial functioning improve, and patients use healthcare services less frequently. So here are some take-home points about psychogenic non-epileptic seizures, or PNES. Pseudo-seizure and similar terms are outdated and misleading. Do not use them. PNES are real, involuntary, brain-based events. Diagnosis relies on positive clinical features, what the events look like and when they happen, not normal lab tests or CT scans. Early recognition and diagnosis, and rapid referral to cognitive behavioral therapy, change patients' lives. If you suspect PNES, get neurology and mental health professionals involved as soon as possible. Alright, that's all I've got for this episode. I hope you found it educational. Having seen these events many times over the years, I recognize how scary they can be for families, schools, and our prehospital colleagues. It's up to us to think in advance about how we're going to talk to patients and families and develop strategies to help children who are suffering from PNES events. If you've got feedback about this episode, send it my way. Likewise, like, rate, and review, as my teenagers would say, and share this episode with a colleague if you think it would be beneficial. For PEM Currents: The Pediatric Emergency Medicine Podcast, this has been Brad Sobolewski. See you next time.

In this episode, Dr. Julian Barling and Dr. Simon Rego speak with host Jen Knox Shanahan about how leaders can use cognitive behavioral therapy (CBT) skills to navigate change, uncertainty, and transition with greater confidence. They explore what resilience really looks like in practice, how to lead hybrid teams intentionally, and preparing for the future […]

When parents start looking for help for a child with OCD, the process can feel confusing, overwhelming, and high-stakes. Between therapy options, medication questions, and different levels of care, it's hard to know what actually matters — and what doesn't.In this episode, I break down what parents really need to know when seeking treatment for OCD.We talk about why the therapist's training matters more than their degree, and what specific approaches are most effective for OCD. I explain the importance of evidence-based modalities like CBT with ERP, ACT, and why family involvement is essential, especially for kids and teens.I also walk through the different levels of care, from outpatient therapy to intensive and residential programs, and how to know when a higher level of support may be appropriate.For parents considering more intensive treatment, I share key questions to ask programs so you can better understand whether the environment is truly appropriate for a child with anxiety or OCD, including how much individual therapy is provided, the mix of diagnoses in the program, and the overall level of safety and stability.Finally, I touch on several well-known OCD treatment programs parents often hear about, and how to think through these options thoughtfully.This episode is designed to help parents feel more informed, more grounded, and more confident as they navigate treatment decisions, because finding the right support can make a meaningful difference in your child's recovery.If you are new to this OCD journey, take my free OCD webinar, 5 Things Every Parent Needs to Know When Helping Their Child with OCD.***This podcast episode is sponsored by NOCD. NOCD provides online OCD therapy in the US, UK, Australia and Canada. To schedule your free 15 minute consultation to see if NOCD is a right fit for you and your child, go tohttps://go.treatmyocd.com/at_parentingThis podcast is for informational purposes only and should not be used to replace the guidance of a qualified professional.Parents, do you need more support?

Everyone deserves a safe and dignified birth, but when Louise Thompson gave birth to son Leo, she was left with post-traumatic stress disorder.In this chat with Fearne, Louise talks through how her PTSD manifests, the way she disassociates, and the therapies she's tried to work through it, including CBT and EMDR.She explains why her own experience has led her to petition the government. She wants to appoint a Maternity Commissioner to improve maternity care for mums and babies in the UK.Four years post-birth, Louise is reflecting on the ways she's grown from her trauma, and is exploring how she can allow herself to slow down while maintaining her ambitious nature.Louise and Fearne also both share how they use busyness as a distraction from their uncomfortable thoughts, and wonder what being ‘likeable' even means...Sign Louise's Maternity Commissioner petition here If you liked this episode of Happy Place, you might also like: Davina McCall Liberty Mills Ellie Simmonds Hosted on Acast. See acast.com/privacy for more information.

Dr. Michelle explains how cognitive behavioral therapy helps retrain the brain to reduce tinnitus distress and calm the nervous system. She breaks down why tinnitus feels louder when the brain sees it as a threat and how CBT changes that response.Get started with Treble Health:Schedule a complimentary telehealth consultation: treble.health/free-telehealth-consultation Take the tinnitus quiz: https://treble.health/tinnitus-quiz-1Download the Ultimate Tinnitus Guide: 2024 Edition: https://treble.health/tinnitus-guide-2025

Modern Wisdom: Read the notes at at podcastnotes.org. Don't forget to subscribe for free to our newsletter, the top 10 ideas of the week, every Monday --------- Donald Robertson is a cognitive-behavioral psychotherapist, an author and an expert on ancient philosophy. Why are we so anxious in the safest time in human history? Our brains evolved for real danger, predators, hunger, survival, not notifications and deadlines. So what are the modern tools for calming our primitive nervous system in a modern world? And is the answer something our ancestors already knew? Expect to learn what Donald wishes more people knew about anxiety, how it works and what causes it, how CBT might be the best therapy to combat chronic anxiety, what the main problem with the major psychoanalytic theorists is, why CBT is just a modern extension of Stoicism, why modern American culture has become extraordinarily passive aggressive, how people can keep their life in alignment with their values and much more… Sponsors: See discounts for all the products I use and recommend: ⁠https://chriswillx.com/deals⁠ Get 10% discount on all Gymshark products at https://gym.sh/modernwisdom (use code MODERNWISDOM10) Get up to $50 off the RP Hypertrophy App at https://rpstrength.com/modernwisdom Get the brand new Whoop 5.0 and your first month for free at https://join.whoop.com/modernwisdom Get 35% off your first subscription on the best supplements from Momentous at https://livemomentous.com/modernwisdom Extra Stuff: Get my free reading list of 100 books to read before you die: ⁠https://chriswillx.com/books⁠ Try my productivity energy drink Neutonic: ⁠https://neutonic.com/modernwisdom⁠ Episodes You Might Enjoy: #577 - David Goggins - This Is How To Master Your Life: ⁠https://tinyurl.com/43hv6y59⁠ #712 - Dr Jordan Peterson - How To Destroy Your Negative Beliefs: ⁠https://tinyurl.com/2rtz7avf⁠ #700 - Dr Andrew Huberman - The Secret Tools To Hack Your Brain: ⁠https://tinyurl.com/3ccn5vkp⁠ - Get In Touch: Instagram: ⁠https://www.instagram.com/chriswillx⁠ Twitter: ⁠https://www.twitter.com/chriswillx⁠ YouTube: ⁠https://www.youtube.com/modernwisdompodcast⁠ Email: ⁠https://chriswillx.com/contact⁠ - Learn more about your ad choices. Visit megaphone.fm/adchoices

Margaret talks with clinical psychologist Dr. Meredith Elkins, author of the new book PARENTING ANXIETY, about how anxiety really works—and how parents can stop unintentionally reinforcing it in themselves and their kids. Dr. Elkins, a faculty member at Harvard Medical School and director of the McLean Anxiety Mastery Program, shares insights from her new book Parenting Anxiety: Breaking the Cycle of Worry and Raising Resilient Kids. Together, they unpack why anxiety isn't something to eliminate, how avoidance makes fear stronger, and why modern “intensive parenting” may be increasing anxiety for both parents and children. You'll learn the three key markers that distinguish normal anxiety from an anxiety disorder (interference, distress, and duration), why psychological flexibility is one of the most important skills we can teach kids, and how cognitive behavioral therapy—especially exposure—helps people face fear instead of shrinking from it. This conversation offers practical, compassionate tools for parents who want to support anxious kids without over-accommodating, and for anyone who wants to change their relationship with anxiety itself. Here's where you can find Dr. Elkins: https://www.meredithelkinsphd.com/ @drmeredithelkins on IG and FB LinkedIn Buy PARENTING ANXIETY: https://bookshop.org/a/12099/9780593798812 What Fresh Hell is co-hosted by Amy Wilson and Margaret Ables. We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on our website: ⁠⁠⁠https://www.whatfreshhellpodcast.com/p/promo-codes/ What Fresh Hell podcast, mom friends, funny moms, parenting advice, parenting experts, parenting tips, mothers, families, parenting skills, parenting strategies, parenting styles, busy moms, self-help for moms, manage kid's behavior, teenager, tween, child development, family activities, family fun, parent child relationship, decluttering, kid-friendly, invisible workload, default parent, parenting anxiety, child anxiety, anxiety in children, anxiety disorders, psychological flexibility, cognitive behavioral therapy, CBT for anxiety, exposure therapy, intensive parenting, mental health for parents, anxiety coping skills, raising resilient kids, parenting mental health, postpartum anxiety, intrusive thoughts, anxiety management, Harvard psychologist, Meredith Elkins, anxiety treatment, family mental health Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this episode, Drew and Josh discuss the world of anxiety cures and the "miracle" solutions often marketed to those struggling with panic, OCD, and health anxiety. They share personal stories of the various methods they tried during their own recoveries and explain why many popular trends fail to provide long-term relief.The Magnetism of the Miracle Cure: Why we are drawn to supplements like magnesium or specialized "breathing devices" when we are desperate to feel better.Control vs. Acceptance: How many anxiety cures are actually just hidden control strategies that prevent true psychological flexibility.The Reality of "Natural" Supplements: A look at the laxative effects of magnesium and the empty promises of "science-based" miracle powders.The "Secret" Rituals: Why techniques like EFT tapping or specialized humming might feel helpful in the moment but often reinforce the idea that anxiety is a danger to be managed.The Risks of "Gurus" and Online Cults: How to identify predatory marketing and why a "lived experience" qualification does not replace professional, evidence-based training.The guys break down why the search for an external fix often leads to more discouragement. They discuss how true recovery is found in learning to tolerate and be with difficult internal experiences rather than trying to engineer them away with bracelets, essential oils, or "secret" techniques.If a solution is marketed as a "miracle" or "what nobody tells you," be cautious.Recovery is an internal process of building distress tolerance, not an external process of finding the right product.Support people are there to cheer you on through the fear, not to keep you "safe" from a feeling.About Disordered: Drew Linsalata and Joshua Fletcher are therapists and authors who have both recovered from severe anxiety disorders. They use evidence-based principles from ACT, CBT, and mindfulness to help you navigate your recovery journey without the empty promises of "magic" cures.---The Disordered Guide to Health Anxiety is now available. If you're struggling with health anxiety, this book is for you.---Want a way to ask questions about this episode or interact with other Disordered listeners?  The Disordered app is nearing release! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Visit our home page and get on our mailing list for more information..---Struggling with worry and rumination that you feel you can't stop or control? Check out ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Worry and Rumination Explained⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, a two hour pre-recorded workshop produced by Josh and Drew. The workshop takes a deep dive into the mechanics of worrying and ruminating, offering some helpful ways to approach the seemingly unsolvable problem of trying to solve seemingly unsolvable problems.

We tend to label events and situations as ‘Good' or ‘Bad.' But what does that really mean?When we get caught up in labels, it can affect our feelings, which can result in catastrophic thinking.How can you use CBT tools to reframe life events and situations in a more balanced way?Join me, Dr Julie, as we talk about existential dread, catastrophic thinking, and finding perspective.Click to listen now! Visit us on Instagram at MyCBTPodcast Or on Facebook at Dr Julie Osborn Subscribe to the podcast at Apple Podcasts Email us at mycbtpodcast@gmail.com Find some fun CBT tools at https://www.mycbt.store/ Thanks for listening to My CBT Podcast!

Support the podcast through Buy Me a Coffee! https://buymeacoffee.com/drlizbonet There are so many unknowns and confusing information about Fibromyalgia. Just getting the diagnosis is difficult. But once you have it, then what do you do? Tami Stackelhouse joins us to discuss how to navigate it and build a better life with a specialized health coach. Tami was diagnosed with Fibromyalgia in 2007. She's spent the last 16 years helping people reduce their fibromyalgia symptoms and, in many cases, reach remission. She is the author of "Take Back your Life" and "The Fibromyalgia Coach." She is a certified Fibromyalgia Health Coach and hosts the Fibromyalgia Podcast. In addition, she is the executive producer of INVISIBLE, a documentary about Fibromyalgia. See more about her at https://tamistackelhouse.com/ -------------- Support the Podcast & Help yourself with Hypnosis Downloads by Dr. Liz! http://bit.ly/HypnosisMP3Downloads Do you have Chronic Insomnia? Find out more about Dr. Liz's Better Sleep Program at https://bit.ly/sleepbetterfeelbetter Search episodes at the Podcast Page http://bit.ly/HM-podcast --------- About Dr. Liz Interested in hypnosis with Dr. Liz? Schedule your free consultation at https://www.drlizhypnosis.com Winner of numerous awards including Top 100 Moms in Business, Dr. Liz provides psychotherapy, hypnotherapy, and hypnosis to people wanting a fast, easy way to transform all around the world. She has a PhD in Clinical Psychology, is a Licensed Mental Health Counselor (LMHC) and has special certification in Hypnosis and Hypnotherapy. Specialty areas include Anxiety, Insomnia, and Deeper Emotional Healing. A problem shared is a problem halved. In person and online hypnosis and CBT for healing and transformation.  Listened to in over 140 countries, Hypnotize Me is the podcast about hypnosis, transformation, and healing. Certified hypnotherapist and Licensed Mental Health Counselor, Dr. Liz Bonet, discusses hypnosis and interviews professionals doing transformational work. Thank you for tuning in!

Fall asleep with this guided sleep meditation for safety and soothed nerves, designed to help you find a deep sense of belonging within. If you struggle with anxiety or feeling like an outsider, tonight's journey on Michelle's Sanctuary will help you regulate your nervous system and find your "inner home." It's time to dream away. Original Script, Narration, Sleep Music, Sound Design, and Production by Michelle Hotaling Dreamaway Visions LLC 2026 All Rights Reserved✨ Find inner peace & healing with guided meditations. ✨Subscribe for NEW meditations regularly: ► https://www.youtube.com/channel/UCKp9S0rMUS1hrKTCV68Lk2wMichelle's Meditation Sanctuary offers FREE, calming guided meditations led by a soothing female voice.What to expect:

This week, Vee and Elle chat with Mistress Chi, a tantric dominatrix and erotic facilitator who blends sacred sexuality with BDSM and ritual. They explore discovering your inner switch, blending tantra and kink, and how power exchange can become a portal for emotional and erotic transformation. From impact play to pussy-led creativity, this episode is full of insights for anyone curious about kink, tantra, and embodiment.Discover your inner switch: how Mistress Chi tapped in to both sides of herself. (00:00)What is tantra? (06:30)Why is the word sacred so overused? Just say COCK and PUSSY! (07:23)Blending tantra and kink: how do they intersect? (12:32)Transformational Scene: "being a dominatrix is an empathic career." (15:46)Madame O's Showroom: Erika Lust porn is realistic and hot. (20:49)Timid Boys: why Mistress Chi likes them, and why involuntary responses are hot. (25:23)Mistress Chi's First Dominatrix Scene: pushing our own edges, and exploring CBT (cock and ball torture) for the first time. (29:02)Pussy Impact Play: escalating from soft sensation play to using a riding crop on the clit. (34:13)Nipple Impact Play: how nipple sensitivity changes throughout pregnancy and menstrual cycles. (38:42)Write From the Pussy: using your pussy for creative energy. (42:56)Impact Play for Getting Out of Your Head Into Your Body: flogging and spanking. (47:08)Fisting: what the inside of an asshole actually feels like. (49:35)____________________________

Dr. Riz Ahmad could have been diagnosed with social anxiety, autism spectrum, and depression as a teenager. Instead, he became one of the most talented psychologists I've ever worked with.In this episode, Riz shares his journey from fear-driven perfectionist—completely fused with his mind and disconnected from his body—to an eight-week stay at a Zen Buddhist monastery that changed everything. What happened when his mind finally went quiet? And what does his story reveal about the dangers of how we label and treat human suffering today?A radically genuine conversation about ego, consciousness, and what mainstream psychology is missing. Visit Center for Integrated Behavioral HealthDr. Roger McFillin / Radically Genuine WebsiteYouTube @RadicallyGenuineDr. Roger McFillin (@DrMcFillin) / XSubstack | Radically Genuine | Dr. Roger McFillinInstagram @radicallygenuineContact Radically GenuineConscious Clinician CollectivePLEASE SUPPORT OUR PARTNERS15% Off Pure Spectrum CBD (Code: RadicallyGenuine)10% off Lovetuner click here

In this episode, Dr. Julian Barling and Dr. Simon Rego speak with host Jen Knox Shanahan about how cognitive behavioral therapy (CBT) can support effective leadership by helping leaders manage stress, reframe unhelpful thinking patterns, and improve decision-making. The conversation highlights the role of leadership mindset, mental health, and values-based leadership in sustaining performance and […]

In this episode of "From Borderline to Beautiful," host Rose Skeeters shares a compelling story illustrating the importance of practice and preparation in managing stress and emotions. Rose encourages listeners to reflect on their own approaches to therapy and recovery. She stresses the importance of daily practice, routine, and self-care in building resilience against emotional challenges. By committing to small, consistent actions, individuals can better prepare themselves for moments of stress and emotional upheaval. The episode concludes with a call to action for listeners to engage in their recovery work daily, fostering a deeper understanding of their emotions and enhancing their ability to cope with life's challenges.Keywordsemotional regulation, therapy, DBT, CBT, self-care, recovery, practice skills, mental health, resilience, personal growthNeed individual support? Schedule a session with Rose here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.thriveonlinecounseling.com/product/individual-sessions/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠To schedule with Jay, click here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.thriveonlinecounseling.com/product/22608/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Gift cards now available for purchase here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.thriveonlinecounseling.com/product/gift-card/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠**This episode is colloquial not clinical, using personal anecdotes to support conveying information in an informal, relatable way**

[Rerun] Dr. Kirk and Paulette talk about hair pulling disorder. December 21, 2015This episode is sponsored by BetterHelp. Give online therapy a try at betterhelp.com/KIRK to get 10% off your first month.00:00 Intro01:45 Trichotillomania & BFRB16:08 What causes BFRB18:01 Forms of treatment21:18 Medications & side effects23:53 Taking in those we love26:01 CBT in a nutshell Become a member: https://www.youtube.com/channel/UCOUZWV1DRtHtpP2H48S7iiw/joinBecome a patron: https://www.patreon.com/PsychologyInSeattleEmail: https://www.psychologyinseattle.com/contactWebsite: https://www.psychologyinseattle.comMerch: https://psychologyinseattle-shop.fourthwall.com/Instagram: https://www.instagram.com/psychologyinseattle/Facebook Official Page: https://www.facebook.com/PsychologyInSeattle/TikTok: https://www.tiktok.com/@kirk.hondaThe Psychology In Seattle Podcast ®Trigger Warning: This episode may include topics such as assault, trauma, and discrimination. If necessary, listeners are encouraged to refrain from listening and care for their safety and well-being.Disclaimer: The content provided is for educational, informational, and entertainment purposes only. Nothing here constitutes personal or professional consultation, therapy, diagnosis, or creates a counselor-client relationship. Topics discussed may generate differing points of view. If you participate (by being a guest, submitting a question, or commenting) you must do so with the knowledge that we cannot control reactions or responses from others, which may not agree with you or feel unfair. Your participation on this site is at your own risk, accepting full responsibility for any liability or harm that may result. Anything you write here may be used for discussion or endorsement of the podcast. Opinions and views expressed by the host and guest hosts are personal views. Although, we take precautions and fact check, they should not be considered facts and the opinions may change. Opinions posted by participants (such as comments) are not those of the hosts. Readers should not rely on any information found here and should perform due diligence before taking any action. For a more extensive description of factors for you to consider, please see www.psychologyinseattle.com(By The Daily Telegraph. Copyright holders of the image of Madeleine at three are Kate and Gerry McCann. The age-progressed image was commissioned by Scotland Yard from forensic artist Teri Blythe for release to the public. Both images have been widely disseminated by the copyright holders, and have been the subject of significant commentary., Fair use, https://en.wikipedia.org/w/index.php?curid=39861556)

In today's episode, Trisha and I answer three powerful listener questions that so many women quietly struggle with. We talk about family estrangement — what's really happening when an adult child cuts off communication, the deep hurt and confusion it causes on all sides, and whether these breakdowns can be prevented or gently repaired. We also dive into long-term social anxiety. One listener shares her experience of living with anxiety since her teens, how bullying shaped her fear of speaking up, and the toll it's taking on a job she genuinely loves. We explore why “just pushing yourself” often makes things worse, what's happening in the nervous system, and what can actually help when anxiety feels overwhelming and ingrained. Finally, we look at people-pleasing and over-performing in conversations — the urge to say the right thing, be liked, keep the peace, and carry the emotional load — and why these patterns are so hard to break, even when you're aware of them. As always, Trisha McHale brings a compassionate, practical psychotherapist lens to each question, helping you understand what's really going on beneath the surface — and where real change starts. If you've ever felt stuck in patterns that feel exhausting, confusing, or out of your control, click play and let's dive in.   To apply for membership to Jessica's Thrive Academy go to www.jessicacooke.ie/apply To contact Trisha for more information on Therapy and Counselling services: galway@mindandbodyworks.com 091 725 750 About Trisha MacHale: Trisha is a Psychotherapist and Director of Mind & Body Works Counselling and Psychotherapy Centre, based in Galway, with centres in Galway and Dublin. Their team of over 50 Psychotherapists and Psychologists work with adults, couples, adolescents, and children, offering therapies including CBT, EMDR, and Art Therapy. They also run a low-cost counselling service. Click play and let's dive in.

Helping a Loved One with Schizophrenia Treating OCD! My Hands Might Be Contaminated! How To Mend an Angry, Broken Heart The answers to today's questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question. Here are the questions for today's podcast. Joel asks: How can we use TEAM CBT to help a patient or loved one struggling with schizophrenia? Jean asks: Since CBT won't work with OCD, should we use exposure or the Hidden Emotion Technique instead? Jim asks: When someone has objectively hurt you, like your partner has had an affair, how do you get over that pain?  And here are the answers. Question #1  Dear Dr Burns, I learned from you that the foundational principle of CBT is that our emotions, and ultimately our behaviors, are rooted in thoughts or beliefs. Are there emotional and/or behavioral disorders (perhaps like schizophrenia) that are rooted in abnormal neurobiological brain pathologies, rather than in distorted cognitions or self-defeating beliefs? And if so, is TEAM CBT relevant to helping those suffering from these "psychoses"?  With much gratitude, respect, and affection, Joel Question #2 Dear Dr. Burns: I'm curious if you have thoughts about the problem of talking back to the obsessive thoughts in OCD.  Thank you, Jean Question #3 Dear Dr. Burns: When someone has objectively hurt you, like your partner has had an affair, how do you get over that pain?  I am not having thoughts that I did anything wrong, or there is something the matter with me, I feel sad, hurt and confused and angry. Jim Thanks for listening today! Matt, Rhonda, and David

Ever open your Bible and think, "Where do I even start?" You're not alone — and you don't have to stay stuck. In this week's podcast episode, Barb talks with Ellen Krause, Ashley Armijo, and Taylor Krause, co-authors of The Easy Bible Study Method, about how to approach Scripture with a simple 4-step framework that helps you actually understand what you're reading — and delight in it. If you've been craving a deeper walk with God but feel overwhelmed by Bible study, this conversation is for you.   RESOURCES FROM THIS EPISODE Connect with the ladies of Coffee and Bible Time on Instagram Connect with the ladies of Coffee and Bible Time on Facebook The Easy Bible Study Method: A Guide to Understanding, Applying, and Delighting in God's Word Visit the Coffee and Bible Time Website   ABOUT OUR SPECIAL GUEST ELLEN KRAUSE, aka Mentor Mama, is cofounder of Coffee and Bible Time with daughters Ashley and Taylor. She hosts the CBT Podcast, which equips people to delight in God's Word and thrive in Christian Living! Ellen has been involved in women's ministry for over 20 years and mentors women worldwide through CBT. Her MA in marketing and her years in corporate America help CBT flourish. In her free time, she enjoys working out, doing mixed media art, sewing, gardening, and cooking. ASHLEY ARMIJO is cofounder of Coffee and Bible Time, a ministry that helps women learn how to delight in God's Word and thrive in Christian living. She is an alumna of the Moody Bible Institute with a Bachelor of Science in Integrated Ministry Studies. It is Ashley's passion to teach women how to study and delight in God's Word whether that is online through Coffee and Bible Time or opening up her home to young women in the community. When Ashley doesn't have her nose in the Bible, she is spending time with her family, painting, and homemaking. TAYLOR KRAUSE holds a bachelor's degree in pre-counseling and has devoted herself to extensive academic and personal study of the Bible. She is passionate about helping women apply biblical principles to their everyday lives, guiding them to grow closer to God through His Word. With a deep commitment to integrating spiritual and mental health, Taylor encourages women to embrace their true selves and feel fully loved. In her free time, she enjoys writing music, playing games with family, and taking time to relax.

Check out Part 2 as we offer some tips and solutions to changing thought patterns. Step into these new behaviors and step out of the cycle! Below is the STOPP method we have shared in a past pod. It's worth resharing and we discuss this again in this session. To support our work:https://www.patreon.com/u33636... To purchase our book: Fueling on Purposehttps://a.co/d/idGo0pp STOPP !    Just pause for a moment TAKE A BREATH    Notice your breathing as you breath in and out - use 7/11 breathing technique OBSERVE - What thoughts are going through your mind right now? - Where is your focus of attention? - What are you reacting to? - What sensations do you notice in your body? PULL BACK - PUT IN SOME PERSPECTIVE - What's the bigger picture? - Take the helicopter view. - What is another way of looking at this situation? - What advice would I give a friend? - What would a trusted friend say to me right now? - Is this thought a fact or opinion? - What is a more reasonable explanation? - How important is this? How important will it be in 6 months time? - It will pass. PRACTICE WHAT WORKS - PROCEED - What is the best thing to do right now? - Best for me, for others, for the situation? - What can I do that fits with my values? - Do what will be effective and appropriate. HOW TO USE STOPP - Practice the first two steps often for a few days - many times every day at any time. - Read through the steps often. - Carry written reminders with you (use the printable resources below). - Practice STOPP by running through all the steps several times a day, every day...when you don't need it. - Start to use it for little upsets. - Gradually, you will find that you can use it for more distressing situations. Like any new habit or skill, it will become automatic over time. THE STEPS EXPLAINED STOP! Say it to yourself, in your head, as soon as you notice your mind and/or your body is reacting to a trigger. Stop! helps to put in the space between the stimulus (the trigger, whatever we are reacting to) and our response. The earlier you use STOPP, the easier and more effective it will be. TAKE A BREATH Breathing a little deeper and slower will calm down and reduce the physical reaction of emotion/adrenaline. Focusing on our breathing means we are not so focused on the thoughts and feelings of the distress, so that our minds can start to clear and we can think more logically and rationally. OBSERVE We can notice the thoughts going through our mind, we can notice what we feel in our body, and we can notice the urge to react in an impulsive way. We can notice the vicious cycle of anxiety, sadness or anger. Noticing helps us to defuse from those thoughts and feelings and therefore reduce their power and control. PULL BACK / PUT IN SOME PERSPECTIVE The thought challenging of CBT. Thinking differently. When we step back emotionally from a situation, and start to see the bigger picture, it reduces those distressing beliefs. We can do this by asking ourselves questions. PRACTICE WHAT WORKS / PROCEED This is the behavioral change of CBT. Doing things differently. Rather than reacting impulsively with unhelpful consequences, we can CHOOSE our more helpful and positive response. REFERENCE: Full credit to this technique is owed to Carol Vivyan of http://www.getselfhelp.co.uk/

Episode Notes This week on Live Like the World is Dying, we have another re-run episode. Margaret and Smokey talk about ways to go about mental first aid, how to alter responses to trauma for you self and as a community, different paths to resiliency, and why friendship and community are truly the best medicine. Host Info Margaret can be found on twitter @magpiekilljoy or instagram at @margaretkilljoy. Publisher Info This show is published by Strangers in A Tangled Wilderness. We can be found at www.tangledwilderness.org, or on Twitter @TangledWild and Instagram @Tangled_Wilderness. You can support the show on Patreon at www.patreon.com/strangersinatangledwilderness. Transcript LLWD:Smokey on Mental First Aid Margaret 00:15 Hello and welcome to Live Like the World is Dying, your podcast are what feels like the end times. I'm your host, Margaret killjoy. And, this week or month...or let's just go with 'episode'. This episode is going to be all about mental health and mental health first aid and ways to take care of your mental health and ways to help your community and your friends take care of their mental health, and I think you'll like it. But first, this podcast is a proud member of the Channel Zero network of anarchists podcasts. And here's a jingle from another show on the network. Margaret 01:52 Okay, with me today is Smokey. Smokey, could you introduce yourself with your your name, your pronouns, and I guess a little bit about your background about mental health stuff? Smokey 02:04 Sure, I'm Smokey. I live and work in New York City. My pronouns are 'he' and 'him.' For 23 years, I've been working with people managing serious mental illness in an intentional community, I have a degree in psychology, I have taught psychology at the University level, I have been doing social work for a long time, but I've been an anarchist longer. Margaret 02:43 So so the reason I want to have you on is I want to talk about mental health first aid, or I don't know if that's the way it normally gets expressed, but that's the way I see it in my head. Like how are...I guess it's a big question, but I'm interested in exploring ways that we can, as bad things happen that we experience, like some of the best practices we can do in order to not have that cause lasting mental harm to us. Which is a big question. But maybe that's my first question anyway. Smokey 03:12 I mean, the, the truth is bad things will happen to us. It's part of living in the world, and if you are a person that is heavily engaged in the world, meaning, you know, you're involved in politics, or activism, or even just curious about the world, you will probably be exposed on a more regular basis to things that are bad, that can traumatize us. But even if you're not involved in any of those things, you're going to go through life and have really difficult things happen to you. Now, the good news is, that's always been the case for people. We've always done this. And the good news is, we actually know a lot about what goes into resilience. So, how do you bounce back quickly and hopefully thrive after these experiences? I think that is an area that's only now being really examined in depth. But, we have lots of stories and some research to show that actually when bad things happen to us, there is an approach that actually can help catalyst really impressive strength and move...change our life in a really positive direction. We also know that for most people, they have enough reserve of resiliency that....and they can draw upon other resiliency that they're not chronically affected by it, however, and I would argue how our society is kind of structured, we're seeing more and more people that are suffering from very serious chronic effects of, what you said, bad things happening, or what is often traumatic things but it's not just traumatic things that cause chronic problems for us. But, that is the most kind of common understanding so, so while most people with most events will not have a chronic problem, and you can actually really use those problems, those I'm sorry, those events, let's call them traumatic events, those traumatic events they'll really actually improve your thriving, improve your life and your relationship to others in the world. The fact is, currently, it's an ever growing number of people that are having chronic problems. And that's because of the system. Margaret 06:19 Yeah, there's this like, there was an essay a while ago about it, I don't remember it very well, but it's called "We Are Also Very Anxious," and it it was claiming that anxiety is one of the general affects of society today, because of kind of what you're talking about, about systems that set us up to be anxious all the time and handle things in... Smokey 06:42 I think what most people don't understand is, it is consciously, in the sense that it's not that necessarily it's the desire to have the end goal of people being anxious, and people being traumatized, but it is conscious in that we know this will be the collateral outcome of how we set up the systems. That I think is fairly unique and and really kind of pernicious. Margaret 07:17 What are some of the systems that are setting us up to be anxious or traumatized? Smokey 07:23 Well, I'm gonna reverse it a little bit, Margaret. I'm going to talk about what are the things we need to bounce back or have what has been called 'resilience,' and then you and I can explore how our different systems actually make us being able to access that much more difficult. Margaret 07:47 Okay. Oh, that makes sense. Smokey 07:49 The hallmark of resiliency, ironically, is that it's not individual. Margaret 07:57 Okay. Smokey 07:57 In fact, if you look at the research, there are very few, there's going to be a couple, there's gonna be three of them, but very few qualities of an individual psychology or makeup that is a high predictor of resiliency. Margaret 08:20 Okay. Smokey 08:21 And these three are kind of, kind of vague in the sense they're not, they're not terribly dramatic, in a sense. One is, people that tend to score higher on appreciation of humor, tends to be a moderate predictor of resiliency. Margaret 08:46 I like that one. Smokey 08:47 You don't have to be funny yourself. But you can appreciate humor. Seems to be a....and this is tends to be a cross cultural thing. It's pretty low. There are plenty of people that that score very low on that, that also have resiliency. That's the other thing, I'll say that these three personality traits are actually low predictors of resiliency. Margaret 09:13 Compared to the immunity ones that you're gonna talk about? Smokey 09:16 So one is appreciation of humor seems to be one. So, these are intrinsic things that, you know, maybe we got from our family, but but we hold them in ourselves, right? The second one is usually kind of put down as 'education.' And there tends to be a reverse bell curve. If you've had very, very low education, you tend to be more resilient. If you've had extreme professionalization, you know, being a doctor, being a lawyer, well, not even being a lawyer, because that's the only...but many, many years of schooling, PhD things like that, it's not what you study. There's something about... Smokey 10:10 Yeah, or that you didn't. They're almost equal predictors of who gets traumatized. And then the the last one is kind of a 'sense of self' in that it's not an ego strength as we kind of understand it, but it is an understanding of yourself. The people that take the surveys, that they score fairly high....So I give you a survey and say, "What do you think about Smokey on these different attributes?" You give me a survey and say, "Smokey, how would you rate yourself on these different attributes?" Margaret 10:11 It's that you studied. Margaret 10:32 Okay. Smokey 10:59 So, it's suggesting that I have some self-reflexivity about what my strengths and weaknesses are. I can only know that because they're married by these also. Margaret 11:11 Okay. So it's, it's not about you rating yourself high that makes you resilient, it's you rating yourself accurately tohow other people see you. Smokey 11:18 And again, I want to stress that these are fairly low predictors. Now, you'll read a million books, kind of pop like, or the, these other ones. But when you actually look at the research, it's not, you know, it's not that great. So those..however, the ones that are big are things like 'robustness of the social network.' So how many relations and then even more, if you go into depth, 'what are those relationships' and quantity does actually create a certain level of quality, interestingly, especially around things called 'micro-social interactions,' which are these interactions that we don't even think of as relationships, maybe with storepersons, how many of these we have, and then certain in depth, having that combined with a ring of kind of meaningful relationships. And meaningful meaning not necessarily who is most important to me, but how I share and, and share my emotions and my thoughts and things like that. So, there's a lot on that. That is probably the strongest predictor of resilience. Another big predictor of resilience is access to diversity in our social networks. So, having diverse individuals tend to give us more resiliency, and having 'time,' processing time, also gives us more...are high predictors of resiliency, the largest is a 'sense of belonging.' Margaret 13:14 Okay. Smokey 13:15 So that trauma...events that affect our sense of belonging, and this is why children who have very limited opportunities to feel a sense of belonging, which are almost always completely limited, especially for very young children to the family, if that is cut off due to the trauma, or it's already dysfunctional and has nothing to do with the trauma, that sense of belonging, that lack of sense of belonging makes it very difficult to maintain resilience. So. So those are the things that, in a nutshell, we're going to be talking about later about 'How do we improve these?' and 'How do we maximize?' And 'How do we leverage these for Mental Health First Aid?' We can see how things like the internet, social media, capitalism, you know, kind of nation state building, especially as we understand it today, all these kinds of things errode a lot of those things that we would want to see in building resilient people. Margaret 14:28 Right. Smokey 14:28 And, you know, making it more difficult to access those things that we would need. Margaret 14:34 No, that's...this...Okay, yeah, that makes it obvious that the answer to my question of "What are the systems that deny us resiliency?" are just all of this. Yeah, because we're like....most people don't have...there's that really depressing statistic or the series of statistics about the number of friends that adults have in our society, and how it keeps going down every couple of decades. Like, adults just have fewer and fewer friends. And that... Smokey 15:00 The number, the number is the same for children, though too. Margaret 15:05 Is also going down, is what you're saying? Smokey 15:07 Yes. They have more than adults. But compared to earlier times, they have less. So, the trend is not as steep as a trendline. But, but it is still going down. And more importantly, there was a big change with children at one point, and I'm not sure when it historically happened. But, the number of people they interacted with, was much more diverse around age. Margaret 15:39 Oh, interesting. Smokey 15:40 So they had access to more diversity. Margaret 15:43 Yeah, yeah. When you talk about access to diversity, I assume that's diversity in like a lot of different axis, right? I assume that's diversity around like people's like cultural backgrounds, ethnic backgrounds, age. Like, but even like... Smokey 15:56 Modes of thought. Margaret 15:58 Yeah, well, that's is my guess, is that if you're around more people, you have more of an understanding that like, reality is complicated, and like different people see things in different ways. And so therefore, you have a maybe a less rigid idea of what should happen. So, then if something happens outside of that, you're more able to cope, or is this...does... like, because I look at each of these things and I can say why I assume they affect resiliency, but obviously, that's not what you're presenting, you're not presenting how they affect resiliency, merely that they seem to? Smokey 16:34 Yeah, and I don't know, if we know exactly how they affect, and we don't know how they...the effect of them together, you know, social sciences, still pretty primitive. So they, they need to look at single variables, often. But you know, we know with chemistry and biology and ecology, which I think are a little more sophisticated...and physics, which is more sophisticated. The real interesting stuff is in the combinations. Margaret 17:09 Yeah. Okay. Smokey 17:10 So what happens when you have, you know, diversity, but also this diverse and robust social network? Is that really an addition? Or is that a multiplication moment? For resiliency. Margaret 17:23 Right. And then how does that affect like, if that comes at the expense of...well, it probably wouldn't, but if it came at the expense of processing time or something. Smokey 17:33 Exactly. Margaret 17:35 Or, like, you know, okay, I could see how it would balance with education in that, like, I think for a lot of people the access to diversity that they encounter first is like going off to college, right, like meeting people from like, different parts of the world, or whatever. Smokey 17:49 I forgot to mention one other one, but it is, 'meaning.' Meaning is very important. People that score high, or report, meaning deep, kind of core meaning also tend to have higher resiliency. That being said, they...and don't, don't ever confuse resiliency with like, happiness or contentment. It just means that the dysfunction or how far you're knocked off track due to trauma, and we're, we're using trauma in the larger sense of the word, you know, how long it takes you to get back on track, or whether you can even get back on track to where you were prior to the event is what we're talking about. So it's not, this is not a guide to happiness or living a fulfilled life. It's just a guide to avoid the damage. Margaret 19:01 But if we made one that was a specifically a 'How to have a happy life,' I feel like we could sell it and then have a lot of money.Have you considered that? [lauging] Smokey 19:11 Well one could argue whether that's even desirable to have a happy life. That's a whole philosophical thing. That's well beyond my paygrade Margaret 19:22 Yeah, every now and then I have this moment, where I realized I'm in this very melancholy mood, and I'm getting kind of kind of happy about it. And I'm like, "Oh, I'm pretty comfortable with this. This is a nice spot for me." I mean, I also like happiness, too, but you know. Okay, so, this certainly implies that the, the way forward for anyone who's attempting to build resiliency, the sort of holistic solution is building community. Like in terms of as bad stuff happens. Is that... Smokey 19:58 Community that's...and community not being just groups. Okay, so you can, I think, you know, the Internet has become an expert at creating groups. There lots of groups. But community, or communitas or the sense of belonging is more than just a shared interest and a shared knowledge that there's other like-minded people. You'll hear the internet was great for like minded people to get together. But, the early internet was really about people that were sharing and creating meaning together. And I think that was very powerful. That, you know, that seems harder to access on today's Internet, and certainly the large social media platforms are consciously designed to achieve certain modes of experience, which do not lend themselves to that. Margaret 21:06 Right, because it's like the...I don't know the word for this. Smokey 21:10 It's Capitalism. Like, yeah, we're hiding the ball. The ball is Capitalism. Margaret 21:14 Yeah. Smokey 21:14 And how they decided to go with an advertising model as opposed to any other model, and that requires attention. Margaret 21:21 Yeah. Because it seems like when you talk about a robust social network, I mean, you know, theoretically, social network, like social networks, you know, Twitter calls itself a social network, right? And is there anything in the micro social interactions that one has online? Is there value in that? Or do you think that the overall...I mean, okay, because even like looking at... Smokey 21:46 I think there has to be value, I think, yeah, they did. I was reading just today, actually, about research, it was in England, with...this one hospital decided to send postcards to people who had been hospitalized for suicidal attempts. Margaret 22:09 Okay. Smokey 22:10 Most of them ended up in the mental health thing, some of them didn't, because they they left beyond, you know, against medical advice, or whatever. But, anyone that came in presenting with that a month, and then three months later, they sent another postcard just saying, "You know, we're all thinking about you, we're hoping you're all you're doing, alright. We have faith in you," that kind of thing like that, right. Nice postcard, purposely chosen to have a nice scene, sent it out. And they followed up, and they found a significant reduction in further attempts, rehospitalizations of these people, so that's a very, you know, there's no, it's a one way communication, it's not person-to-person, and it had some impact on I would guess one could argue the resiliency of those people from giving into suicidal ideation. Right. Margaret 23:13 Yeah. Smokey 23:14 So I think this is to say that, you know, we'd be...unplugging the internet, you know, that kind of Luddite approach doesn't make sense. There is a value to answer your question to the the internet's micro social interactions. It's just we...it's complicated, because you can't just have micro-social interactions unfortunately, but you need them. Margaret 23:44 Yeah. No, that that's really interesting to me, because yeah, so there's, there is a lot of value that is coming from these things, but then the overall effect is this like, like, for example, even like access to diversity, right? In a lot of ways, theoretically, the Internet gives you access to like everything. But then, instead, it's really designed to create echo chambers in the way that the algorithms and stuff feed people information. And echo chambers of thought is the opposite of diversity, even if the echo chamber of thought is like about diversity. Smokey 24:16 Yeah, I mean, it's set up again, almost as if it were to kind of naturally organically grow, we would probably have just as chaotic and and people would still just be as angry at the Internet, but it probably would develop more resilience in people. Because it wouldn't be stunted by this need to attract attention. The easiest way to do that is through outrage. Easiest way to do that is quickly and fast, so it takes care of your processing time. And relative anonymity is the coin of these kinds of things, you know, that's why bots and things like that, you know, they're not even humans, right? You know, they're just...so all these kinds of things stunt and deform, what could potentially be useful, not a silver bullet, and certainly not necessary to develop resiliency, strong resiliency. You don't need the internet to do that. And there are certain...using the internet, you know, there's going to be certain serious limitations because of the design, how it's designed. Margaret 25:42 Okay, well, so hear me out. If the internet really started coming in latter half of the 20th century, that kind of lines up to when cloaks went out of style.... Smokey 25:54 Absolutely, that's our big problem. And they haven't done any research on cloak and resiliency. Margaret 26:00 I feel that everyone who wears a cloak either has a sense of belonging, or a distinct lack of a sense of belonging. Probably start off with a lack of sense of belonging, but you end up with a sense of belonging So, okay, okay. Smokey 26:15 So I want to say that there's two things that people confuse and a very important. One, is how to prevent chronic effects from traumatic experiences. And then one is how to take care of, if you already have or you you develop a chronic effect of traumatic experiences. Nothing in the psychology literature, sociology literature, anthropology literature, obviously, keeps you from having traumatic experiences. Margaret 26:52 Right. Smokey 26:54 So one is how to prevent it from becoming chronic, and one is how to deal with chronic and they're not the same, they're quite, quite different. So you know, if you already have a chronic traumatic response of some sort, post traumatic stress syndrome, or any of the other related phenomena, you will approach that quite differently than building resilience, which doesn't protect you from having trauma, a traumatic experience. It just allows you to frame it, understand it, maybe if you're lucky, thrive and grow from it. But at worst, get you back on track in not having any chronic problems. Margaret 27:48 Okay, so it seems like there's three things, there's the holistic, building a stronger base of having a community, being more resilient in general. And then there's the like direct first aid to crisis and trauma, and then there's the long term care for the impacts of trauma. Okay, so if so, we've talked a bit about the holistic part of it, you want to talk about the the crisis, the thing to do in the immediate sense as it's happening or whatever? Smokey 28:15 For yourself or for somebody else? Margaret 28:18 Let's start with self. Smokey 28:20 So, self is go out and connect to your social network as much as you can, which is the opposite of what your mind and body is telling you. And that's why I think so much of the quote unquote, "self-care" movement is so wrong. You kind of retreat from your social network, things are too intense, I'm going to retreat from your social network. The research suggests that's the opposite of what you should be doing, you should connect. Now, if you find yourself in an unenviable situation where you don't have a social network, then you need to connect to professionals, because they, they can kind of fill in for that social Network. Therapists, social workers, peer groups, support groups, things like that they can kind of fill in for that. The problem is you don't have that sense of belonging. Well, with support groups, you might. You see this often in AA groups or other support groups. You don't really get that in therapy or or group therapy so much. But that is the first thing and so connect to your group. Obviously on the other side, if you're trying to help your community, your group, you need to actively engage that person who has been traumatized. Margaret 29:33 Yeah, okay. Smokey 29:35 And it's going to be hard. And you need to keep engaging them and engaging them in what? Not distractions: Let's go to a movie, get some ice cream, let's have a good time. And not going into the details of the traumatic experience so much as reconnecting them to the belonging, our friendship, if that. Our political movement, if that. Our religious movement, if that. Whatever that...whatever brought you two together. And that could be you being the community in this person, or could be you as Margaret in this person connecting on that, doubling down on that, and often I see people do things like, "Okay, let's do some self care, or let's, let's do the opposite of whatever the traumatic experience was," if it came from, say oppression, either vicarious or direct through political involvement let's, let's really connect on a non-political kind of way. Margaret 31:19 Ah I see! Smokey 31:21 And I'm saying, "No, you should double down on the politics," reminding them of right what you're doing. Not the trauma necessarily not like, "Oh, remember when you got beaten up, or your, your significant other got arrested or got killed by the police," but it's connecting to meaning, and bringing the community together. Showing the resiliency of the community will vicariously and contagiously affect the individual. And again, doesn't have to be political could be anything. Margaret 32:01 Yeah. Is that? How does that that feels a little bit like the sort of 'get right back on the horse kind of thing.' But then like, in terms of like, socially, rather than, because we 'get back on the horse,' might mean might imply, "Oh, you got beat up at a riot. So go out to the next riot." And that's what you're saying instead is so "Involve you in the fundraising drive for the people who are dealing with this including you," or like... Smokey 32:28 And allowing an expectation that the individual who's been traumatized, might be having a crisis of meaning. And allowing that conversation, to flow and helping that person reconnect to what they found meaningful to start with. So getting right back on the horse again, it's reminding them why they love horses. Margaret 33:02 Yeah. Okay, that makes sense. Okay, I have another question about the the crisis first aid thing, because there's something that, you know, something that you talked to me about a long time ago, when I was working on a lot of like reframing. I was working on coping with trauma. And so maybe this actually relates instead to long term care for trauma. And I, I thought of this as a crisis first aid kind of thing, is I'll use a like, low key example. When I was building my cabin, I'm slightly afraid of heights, not terribly, but slightly. And so I'm on a ladder in the middle of nowhere with no one around and I'm like climbing up the ladder, and I'm nailing in boards. And I found myself saying, "Oh, well, I only have three more boards. And then I'm done. I can get off the ladder. "And then I was like, "No, what I need to do is say, it's actually fine, I am fine. And I can do this," rather than like counting down until I can get off the ladder. And so this is like a way that I've been working on trying to build resiliency, you can apply this to lots of things like if I'm on an airplane, and I'm afraid of flying or something I can, instead of being like, "Five more hours and then we're there. Four more hours and then we're there," instead of being like, "It's actually totally chill that I'm on an airplane. This is fine." And basically like telling myself that to reframe that. Is this....Am I off base with this? Is this tie into this, there's just a different framework? Smokey 34:27 That is what the individual should be trying to do is connect the three different things, keeping it simple. One, is to the community which gives them nourishment. On a plane or on your roof, that's not going to happen. Margaret 34:44 Yeah. Smokey 34:45 Though, actually, to be honest. If you're nervous and you have...go back to your roof example, which I think is a pretty good one. Let's say that you had more than three boards. Let's say it was gonna take you a couple hours to do that. But it's something you're nervous about, connecting to somebody in your social network, whether you, you have your earphones on, and you're just talking to them before or during...after doesn't help. That does one way. Or the other is connecting to what you were doing, which is connecting to kind of reframing or your own internal resilience. I've done something similar like this before. This is not something that is going to need to throw me, it is what's called pocketing the anxiety. Margaret 35:45 Okay. Smokey 35:45 Where you're other-izing it, being like, it's coming from you too, right? being like, "Hey, you could fall. This plane could go down," right? That that's still you, you're generating that. You're not hearing that over to, and you're saying, "Okay, but I'm going to try, you know, give primacy to this other voice in my head. That is saying, "You've got this, it's all right, you've done things like this before."" So that's the second thing. And that's what you were doing. So you could connect to your community, you could connect to kind of a reserve of resiliency. And to do that is allow that one to be pocketed. But be like, "Hey, I want to hear from what this core thing has to say. I want to hear from what the positive person on the front row has to say." You're not arguing with that one. You're just listening. You're changing your, your, what you're attuned to. And then the third one is, if you can, you connect to the meaning. What is the meaning of building the house for you? Where are you going on your flight? And why is it important? Margaret 37:03 Yeah. Okay, Smokey 37:05 And that anxiety and the fact that you're doing it, you want to give again, the primacy to the importance, that "Yeah, I'm really nervous, I'm really freaked out about this, but this thing is so important, or so good for me, or so healthy for me to do this. This must mean it's going to be really important. And I'm connecting to why it's important and focusing on that. So those are the three things that the individual can do. The helping person or community is engagement. The second one is the same, reconnecting to the meaning. Why did you love horses in the first place? Okay, don't have to get back on the horse. But let's not forget horses are awesome. Margaret 37:58 Yeah. Smokey 37:58 And Horseback riding is awesome. Margaret 38:01 Yeah. Smokey 38:01 And you were really good at it before you got thrown. But you know, you don't have to do it now, but let's, let's just let's just share our love of horses for a moment and see how that makes you feel. And then the third one is that kind of drawing upon, instead of drawing upon the individual resilience, which you were doing, like, "Hey, I got this," or the plane, you know, you were, you're hearing from other people, you're drawing upon their individual resilience. "Smokey, tell me about the time you did this thing that was hard." And I tell ya, you're like, "Well, Smokey can fucking do that I can do it. You don't even think...it doesn't even work necessarily consciously. Margaret 38:50 Right. Smokey 38:51 So you could see that what you're doing individually, the helper or the community is doing complementary. Margaret 38:59 Yeah. Smokey 39:00 And now you can see why a lot of self care narrative, a lot of taking a break a lot of burnout narrative, all these things, at best aren't going to help you and at worst, in my opinion, are kind of counterproductive. Margaret 39:17 Well, and that's the, to go to the, you know, working on my roof thing I think about...because I've had some success with this. I've had some success where I....there's certain fears that I have, like, suppressed or something like I've stopped being as afraid of...the fear is no longer a deciding factor in my decision making, because of this kind of reframing this kind of like, yeah, pocketing like...And it's probably always useful to have the like, I don't want to reframe so completely that I just walk around on a roof all the time, without paying attention to what I'm doing, right?Because people do that and then they fall and the reason that there's a reason that roofing is one of the most dangerous jobs in America. So a, I don't know I yeah, I, I appreciate that, that you can do that. And then if it's a thing you're going to keep doing anyway, it becomes easier if you start handling it like, carefully, you know? Smokey 40:17 Well, you don't want to give it too much. So why do we? Why is it natural for us to take anxiety or fear and focus on it? It's somewhat evolutionary, right? It's a threat, right? It's supposed to draw your attention, right? It's supposed to draw your attention. And if you're not careful, it will draw your attention away from other things that are quieter that like that resiliency in the front row you need to call on, because they're not as flashy, right? So I don't think you have to worry about threat....You're right. You don't want to get to the point where you and that's why I say 'pocket it,' as opposed to 'deny it, suppress it, argue with it. demolish it.' I think it's good to have that little, "Beep, beep, beep there's a threat," and then being like, "Okay, but I want to continue to do this. Let's hear from resiliency in the front row. What? What do you have to tell me too?" You have to not...what happens is we go into the weeds of the threat. Oh, so what? "Oh, I fall off and I compound fracture, and I'm way out here in the woods, and no one's going to get me. My phone isn't charged." That's not what the original beep was. Original beep like, "You're high up on a ladder, seems unstable. This seems sketchy," right? Okay. Got that. And then resilience is, "Yeah, you've done lots of sketchy stuff. You've written in the back of a pickup truck. That's sketchy, so seatbelt there, nothing, you know, let me remind you that that you can overcome." And, but by going into the anxiety, going into the fear, you're forcing yourself to justify the thing. And then it becomes more and more elaborate, and it gets crazier and crazier very quickly. You know, all of sudden, you're bleeding out and you're cutting your leg off with a pen knife. It's like, "Wow, how did all this happen?" Margaret 42:38 Yeah, well, and that's actually something that comes up a lot in terms of people interacting with the show and about like preparedness in general. Because in my mind, the point of paying attention to how to deal with forest fire while I live in the woods, is not to then spend all of my time fantasizing and worrying about forest fire. But instead, to compare it to this ladder, if I get this "Beep, beep, the ladder is unstable." I climb down, I stabilize the ladder as best as I can. And then I climb back up and I do the thing. And then when I think about like, with fire, I'm like, "Okay, I have done the work to minimize the risk of fire. And so now I can stop thinking about it." Like, I can listen to the little beep, beep noise and do the thing. And now I can ignore the beep beep because just like literally, when you're backing up a truck and it goes beep, beep, you're like, yeah, no, I know, I'm backing up. Thanks. You know, like, Smokey 43:35 Yeah, it's good to know, it's good to know, you're not going forward. Margaret 43:39 Yeah, no. No, okay. That's interesting. And then the other thing that's really interesting about this, the thing that you're presenting, is it means that in some ways, work that we present as very individual in our society, even in radical society, is actually community based on this idea, like so conquering phobias is something that we help one another do, it seems like, Smokey 44:02 Absolutely. I mean, the best stuff on all this stuff is that people reverse engineering it to make people do dangerous, bad things. The military. Margaret 44:18 Yeah, they're probably pretty good at getting people to conquer phobias. Yep. Smokey 44:21 They have a great sense of belonging. They have a great sense of pulling in internal resilient, group resilient, connecting to meaning even when it's absolutely meaningless what you're doing. It's all the dark side of what we're talking about, but it's quite effective and it literally wins wars. Margaret 44:47 Yeah, that makes sense. Because you have this whole... Smokey 44:50 Literally it changes history. And so, the good news is, we can kind of reclaim that for what I think it was originally purposed to do, which is to protect us from the traumas that we had to go through in our evolutionary existence. So we couldn't afford to have a whole bunch of us chronically disabled. Meaning unable to function, you know, they've just taken it and, and bent it a little bit, and learned very deeply about it, how to how to use it for the things that really cause, you know, physical death and injury. And, and, you know, obviously, they're not perfect, you have a lot of trauma, but not, not as much as you would expect for what they do. And every year they get better and better. Margaret 45:51 Hooray. Smokey 45:53 We have to get on top of our game. Margaret 45:56 Yeah. Smokey 45:57 And get people not to do what they do. I'm not suggesting reading...well maybe reading military, but not...you can't use those tools to make people truly free and resilient. Margaret 46:17 Yeah. Smokey 46:18 In the healthy kind of way. Yeah. Margaret 46:22 Okay, so in our three things, there's the holistic, prepared resiliency thing, then there's the immediate, the bad thing is happening first aid. Should we talk about what to do when the thing has, when you have the like, the injury, the mental injury of the trauma? Smokey 46:42 Like with most injuries, it's rehab, right? Margaret 46:45 Yeah. No, no, you just keep doing the thing, and then hope it fixes itself. [laughs] Smokey 46:53 My approach to most medical oddities that happen as I get older, it's like, "It'll fix itself, this tooth will grow back, right? The pain will go away, right?" Yeah, just like physical rehab, it does require two important aspects for all physical, what we think of when someone says I have to go to rehab, physical rehab, not not alcohol rehab, or psych rehab, is that there's two things that are happening. One, is a understanding, a deep understanding of the injury, often not by the person, but by the physical therapist. Right? That if they know, okay, this is torn meniscus, or this is this and I, okay, so I understand the anatomy, I understand the surgery that happened. Okay. And then the second is, short term, not lifelong therapy, not lifelong this or that. Short term techniques to usually strengthen muscles and other joints and things around the injury. Okay. And that's what, what I would call good recovery after you already have the injury. It's not after you've had the traumatic experience, because traumatic experience doesn't necessarily cause a chronic injury, and we're trying to reduce the number of chronic injuries, but chronic injuries are going to happen. chronic injuries already exist today. A lot of the people we know are walking around with chronic injuries that are impacting their ability to do what they want to do and what in my opinion, we need them to do, because there's so much change that needs to happen. We need everybody as much as possible to be working at their ability. So wherever we can fix injury, we should. So so one is where do I get an understanding of how this injury impacts my life? And I think different cognitive psychology, I think CBT, DBT, these things are very, very good in general. Margaret 49:22 I know what those are, but can you explain. Smokey 49:22 Cognitive Behavioral Therapy, Dialectical Behavioral Therapy. These all come out of cognitive psychology from the 50s. Our techniques, but most therapists use versions of this anyway. So just going to therapy, what it is doing initially, is trying to, like the physical therapist, tell you, "This is the injury you have. This is why it's causing you to limp, or why you have weakness in your arm and wrist. And what we're going to do is we're going to give you some techniques to build up, usually the muscles, or whatever else needs to be built up around it so that you will be able to get more use out of your hand." And that is what we need to do with people that have this chronic injury. So, one, is you need to find out how the injury is impacting. So, I'm drinking more, I'm getting angry more, or I'm having trouble making relationships, or I'm having, and there's a series of, you know, 50 year old techniques to really kind of get down and see, okay, this injury is causing these things, that's how it's impacting me, and I don't want to drink more, or I want to be able to sleep better, or I want to be able to focus, or I want to be able to have meaningful relationship with my partner or my children or whatever, whatever that is, right? And then there are techniques, and they're developing new techniques, all the time, there's like EMDR, which is an eye thing that I don't fully understand. There DBT, dialectical behavioral therapy, has a lot of techniques that you kind of practice in groups. As you know, we have mutual aid cell therapy, MAST, which is also a group where you're sharing techniques to build up these different things and resilience. So, community, and meaning, and all those...reframing all those kinds of things. So, but they shouldn't, despite the length of the injury, how long you've been injured, how long you've been limping, and how much it's affected other parts of your psychic body in a way. These are things that still should be able to be remediated relatively quickly. Smokey 49:31 That's exciting. Yeah. Smokey 50:10 But this is not a lifelong thing. Now, that doesn't mean, if you're traumatized as a child for example, it's sort of like if you've completely shattered your wrist bone, and they've put in pins and things like that, that wrist, may never have the flexibility, it did, the actual wrist bone, you know, the bones in the wrist. But by building muscles, and other things around it, you could then theoretically have full flexibility that you had before, right? But it's not the actual wrist bone, but that that injury is still there. You've built up...Sometimes it's called strength-based approach or model where you're building up other strengths, you have to relieve the impact that that injury, so like, a common thing with with trauma is trust. My trust is very damaged. My ability to trust others, or trust certain environments, or maybe trust myself, right, is completely damaged. So if, if my...and that may never fully heal, that's like my shattered wrist bone. So then, by building up, let's say, I don't trust myself, I did something, really fucked up myself, you know, psychologically, traumatically, but by building up trust in others, and then in the environment, or other things, that can mediate that damage or vice versa. Margaret 53:53 You mean vice versa, like if you? Smokey 53:59 Like, if my problem is a trust of others, or trust with strangers, or trust with friends, you know, I've been betrayed in a really traumatic way by my mother, or my father or uncle or something like that then, you know, building up my friendships to a really strong degree will reduce and eventually eliminate, hopefully erase the impact of that injury on the rest of my life. I'm not doomed to have dysfunctional relationships, lack of sleep, alcoholism or whatever are the symptoms of that traumatic event, that chronic traumatic event. Margaret 54:54 Okay, so my next question is, and it's sort of a leading question, you mentioned MAST earlier and I kind of want to ask, like, do we need specialists for all of this? Do we have people who both generalize and specialize in this kind of thing? Are there ways that, you know, we as a community can, like, get better at most of this stuff while then some of it like, you know, obviously people specialize in and this remains useful? Like... Smokey 55:22 You need. I wouldn't say...You need, you do need specialists, not for their knowledge, per se so much as they're there for people that the injury has gone on so long that the resiliency, all those other things, they don't have a social network, they haven't had time, because the damage happened so early to build up those reserves, that that person in the front row, the front row, the seats are empty. That is, it's really great we live...Now, in other cultures, the specialists were probably shamans, religious people, mentors, things like that, that said, "Okay, my role is to," all therapy is self therapy. That was Carl Rogers, he was quite correct about that. The specialist you're talking about are the kind of stand in for people who don't have people to do that. I would argue all real therapy is probably community therapy. It's relational. So if you have friends, if you have community, if you have a place, or places you find belonging, then theoretically, no, I don't think you need....I think those groups, and I think most specialists would agree to actually, those groups, if they're doing this can actually do a much better job for that individual. They know that individual and there's a natural affinity. And there there are other non specifically therapeutic benefits for engaging in re engaging in these things that have nothing to do with the injury that are just healthy, and good to you. So sort of like taking Ensure, Ensure will keep you alive when you're you've had some surgery, you've had some really bad injury, or if you need saline solution, right? But we're not suggesting people walk around with saline bags. There are better ways to get that, more natural ways to get that. I'm not talking alternative, psychiatric or, you know, take herbs instead of psychiatric medication. But there are better ways to do that. And I think, but I'm glad we have saline. Margaret 58:08 Yeah, Smokey 58:08 I think it saves a lot of people's lives. But, we would never give up the other ways to get nutrients because of other benefits to it. You know, sharing a meal with people is also a really good thing. Margaret 58:21 And then even like from a, you know, the advantages of community, etc. I'm guessing it's not something that's like magically imbued in community. It's like can be something that communities need to actually learn these skills and develop like, I mean, there's a reason that well, you know, I guess I'm reasonably open about this. I used to have like fairly paralyzing panic attacks, and then it started generalizing. And then, you know, a very good cognitive behavioral therapist gave me the tools with which to start addressing that. And that wasn't something I was getting from....I didn't get it from my community in the end, but I got it from a specific person in the community, rather than like, everyone already knows this or something. Smokey 59:03 Well, I think what we're doing right here is, is....I mean, people don't know. So they read....People were trying to help you from your community. Undoubtedly, with the right. intentions, and the right motives, but without the information on what actually works. Margaret 59:27 Yep. Smokey 59:28 And that's all that was happening there. Margaret 59:30 Yeah, totally. Smokey 59:31 So, it's really, you know, as cliche as it sound. It's really about just giving people some basic tools that we already had at one time. Margaret 59:44 Yeah. Smokey 59:45 Forgot, became specialized. So you know, I'm throwing around CBT, DBT, EMDR. None of that people can keep in their head. They will....The audience listening today are not going to remember all those things. And nor do they have to. But they have to know that, you know, reconnecting to the horse, but not telling people to get back on the horse, that kind of tough love kind of thing isn't going to work, but neither is the self care, take a bubble bath... Margaret 1:00:19 Never see a horse again, run from a horse. Smokey 1:00:21 Never see a horse, again, we're not even going to talk about horses, let's go do something else, isn't going to work either. And I think once we...you know, it's not brain science...Though it is. [laughs] It is pretty, you know, these are, and you look at how religions do this, you know, you look at how the military does this, you look at how like, fascists do this, you know, all sorts of groups, communities can do this fairly effectively. And it doesn't cost money. It's not expensive. You don't have to be highly educated or read all the science to be able to do that. And people naturally try, but I think a lot of the self help kind of gets in the way. And some people think they know. "Okay, well, this is what needs to happen, because I saw on Oprah." That kind of thing. " Margaret 1:01:26 Yeah, Well, I mean, actually, that's one of the main takeaways that's coming from me is I've been, I've been thinking a lot about my own mental health first aid on a fairly individual basis, right? You know, even though it was community, that helped me find the means by which to pull myself out of a very bad mental space in that I was in for a lot of years. But I still, in the end was kind of viewing it as, like, "Ah, someone else gave me the tools. And now it's on me." It's like this individual responsibility to take care of myself. And, and so that's like, one of the things that I'm taking as a takeaway from this is learning to be inter-reliant. Smokey 1:02:06 There isn't enough research on it, again, because of our individualistic nature, and probably because of variables. But there's certainly tons of anecdotal evidence, and having done this for a long time talking to people and how the place I work is particularly set up, helping others is a really great way to help yourself. Margaret 1:02:30 Yeah. Smokey 1:02:31 it really works. It's very, I mean, obviously, in the Greeks, you know, you have the 'wounded healer,' kind of concept. Many indigenous traditions have said this much better than the Western. And I believe they have...and they needed to, but they had a much better kind of understanding of these things that we're we're talking about. You know, it. So, where people can...and I've heard this podcast, your podcast too, talking about this ability to be, you know, have self efficacy. But it's more than self efficacy. It's really helping others. Margaret 1:03:22 Yeah. Smokey 1:03:23 And that, that is really powerful. And there's not enough research on that. And I think that's why support groups, I think that's why, you know, AA, despite all its problems, has spread all over the world and has been around for, you know, 75 years, and is not going to go away anytime soon. Despite some obvious problems, is there's that there's that... they hit upon that they they re discovered something that we always kind of knew. Margaret 1:03:59 Yeah. Okay, well, we're coming out of time. We're running out of time. Are there any last thoughts, things that I should have asked you? I mean, there's a ton we can talk about this, and I'll probably try and have you on to talk about more specifics in the near future. But, is there anything anything I'm missing? Smokey 1:04:15 No, I think I think just re emphasizing the end piece that you know, for people that have resources, communities, meaning, social network, you know, that is worth investing your time and your energy into because that's going to build your...if you want to get psychologically strong, that is the easiest and the best investment, Put down the self help book. Call your friend. You know, don't search Google for the symptoms of this, that, or the other thing. Connect to what's important to you. And then lastly, try to help others or help the world in some way. And those are going to be profound and effective ways to build long lasting resilience as an individual. As a community, we should design our communities around that. Margaret 1:05:35 Yeah. All right. Well, that seems like a good thing to end on. Do you have anything that you want to plug like, I don't know books about mutual aid self therapy or anything like that? Smokey 1:05:46 I want to plug community. That's all I want to plug. Margaret 1:05:50 Cool. All right. Well, it's nice talking to you, and I'll talk to you soon. Smokey 1:05:54 Yep. Margaret 1:06:00 Thank you so much for listening. If you enjoyed this podcast, please tell people about it. Actually, I mean, honestly, if you enjoyed this episode, in particular, like think about it, and think about reaching out to people, and who needs to be reached out to and who you need to reach out to, and how to build stronger communities. But if you want to support this podcast, you can tell people about it. And you can tell the internet about it. And you can tell the algorithms about it. But, you can also tell people about it in person. And you can also support it by supporting the, by supporting Strangers In A Tangled Wilderness, which is the people who produce this podcast. It's an anarchist publishing collective that I'm part of, and you can support it on Patreon at patreon.com/strangersinatangledwilderness. And if you support at pretty much any level, you get access to some stuff, and if you support a $10 you'll get a zine in the mail. And if you support at $20, you'll get your name read at the end of episodes. Like for example, Hoss the dog, and Micahiah, and Chris, and Sam, and Kirk, Eleanor, Jennifer, Staro, Cat J, Chelsea, Dana, David, Nicole, Mikki, Paige, SJ, Shawn, Hunter, Theo, Boise Mutual Aid, Milica, and paparouna. And that's all, and we will talk to you soon, and I don't know, I hope you all are doing as well as you can. This podcast is powered by Pinecast. Try Pinecast for free, forever, no credit card required. If you decide to upgrade, use coupon code r-69f62d for 40% off for 4 months, and support Live Like the World is Dying.

Dr. Ben answers real tinnitus questions from patients in episode two of the Ask Treble Health Show. He explains what triggers tinnitus spikes, how sound therapy and CBT can calm the mind, and why ear care matters. Learn practical strategies to manage tinnitus, reduce stress, and find lasting relief.Get started with Treble Health:Schedule a complimentary telehealth consultation: treble.health/free-telehealth-consultation Take the tinnitus quiz: https://treble.health/tinnitus-quiz-1Download the Ultimate Tinnitus Guide: 2024 Edition: https://treble.health/tinnitus-guide-2025

Welcome to the very first episode of the TELL ME IT WILL BE OK podcast, which used to be the Child Anxiety FAQ Podcast. In this episode, we explain the shift in focus from a Q&A format to a more flexible, topic-driven approach to address specific aspects of child anxiety. We delve into the cognitive distortion of catastrophizing and its impact on anxiety, discussing how to recognize these negative thought patterns and practical strategies to manage them. The episode also highlights the role of cognitive behavioral therapy (CBT) in addressing these issues and the importance of aligning actions with personal values. Tune in to learn how to navigate the complexities of anxiety and support your anxious child in an ever-demanding world.00:00 Welcome to the New Podcast Format00:15 Why the Change?00:45 Introducing the New Focus02:11 The Role of Cognitive Behavioral Therapy06:08 Understanding Catastrophizing07:22 Real-Life Examples and Coping Strategies14:13 Parental Catastrophizing and Child Anxiety18:37 Planning for Catastrophes25:03 Final Thoughts and Future Topics

Send us a textStrength without silence. That's the thread running through our conversation with Jeff Dill, a former battalion chief turned licensed counselor and the founder of the Firefighter Behavioral Health Alliance. Jeff has spent years validating firefighter and EMS suicide data, building workshops from real-world stories, and leading behavioral health efforts for Las Vegas Fire and Rescue. He brings hard-won clarity on what actually helps: simple language, daily habits, and policies that protect people when the job wears them thin.We break down the internal size up, a practical check-in that asks, “Why am I acting this way? Why am I feeling this way?” It helps catch irritability, isolation, and sleep loss before they morph into bigger risks. Jeff draws a vital line between PTSD and moral injury—showing how betrayal, guilt, and shame often sit beneath the surface while treatment chases fear and trauma. Forgiveness becomes a survival skill, not a pass for bad behavior, and we talk about how to practice it without forgetting or restoring unsafe trust.From there, we get tactical. Sleep debt, high call volumes, and 24-hour shifts push good people into impulsive decisions. Cultural brainwashing tells responders to be brave, strong, and self-reliant—until that story keeps them from getting help. We dig into the data, including surprising patterns among women in fire and EMS, and outline what a proactive program looks like: family education, annual mental health checkups, vetted clinicians outside insurance for privacy, real-time aftercare after tough calls, and telehealth to reach rural members. Leaders will hear budget-smart ways to protect training from the chopping block, and crews will gain language for checking on a partner without making it awkward.You can reach Jeff at the following websites:For the Firefighter Behavioral Alliance (FFBA), please go to: https://www.ffbha.org For the moral injury white paper, download it by clicking: https://www.ffbha.org/wp-content/uploads/2023/02/Moral-Injury-White-Paper-2-9-23.pdf For the Firefighter Behavioral Alliance (FFBA) Facebook page, please go to https://www.facebook.com/FirefighterBehavioralHealthAllianceIf you're a firefighter, EMT, dispatcher, or cop—or you love someone who is—you'll walk away with tools you can use today and a clearer picture of how to build a healthier culture tomorrow. Subscribe, share this with your crew, and leave a review so others can find it. You're not alone.Support the showYouTube Channel For The Podcast