Most parents feel a sense of dread or anxiety when someone even mentions night terrors. Nothing quite compares to the experience of one’s child screaming and thrashing, all while wide-eyed and seemingly awake. My own mother tells the story of wrangling me into the car in the middle of a night terror and driving me around with the windows down. Her hope was that the movement of the air against my face would calm me from yelling “Get me out of here!” Something clearly seemed horribly wrong.
The next morning, my frazzled mother asked me about the incident just hours prior. I had no memory of it whatsoever. My eyes had been wide open. I was out of my bed. I had even been put in the car and driven around until I calmed down in the back seat. How could I possibly have no memory of all that activity?
Unlike nightmares, children have no recollection of night terrors. These experiences happen usually earlier in the night and during the deepest stage of sleep when the mind is least active. Essentially it has been described as the body acting out without any input from the higher functioning mind.
Night terrors typically happen during times of stress in a child’s life. For example, they may occur when the family moves to a new house, divorce or remarriage of parents, addition of a new sibling, or change of schools.
The bad news is that they are very difficult to stop in the moment. Attempting to awaken a child during a night terror is ineffective at best. At worst, successfully arousing a child having a night terror leaves the child confused, disoriented, and frightened.
There are several bits of good news. First, night terrors tend to be temporary. They often only last a few minutes at a time and children almost always outgrow them. Night terrors are quite rare in adults.
Second, because there is no dream content associated with night terrors, the experience is much more traumatic for the parent than the child. With this in mind, treating night terrors is fairly straightforward. The parent first needs to remember to not panic. Though the child acts like they are in great distress, they are actually in no distress at all. In the midst of a night terror, the parent’s role is to keep the child safe from injuring themselves. This may mean trying to block escape from a room or the house. It could also involve removing potentially dangerous objects from the child’s reach, or padding the area with extra pillows if the child is thrashing.
For the majority of families experiencing this, the best plan is to ride it out as best you can. The behavior should stop. In rare cases, if it becomes too disruptive, causes physical injury, or results in excessive daytime sleepiness, parents should consult with the pediatrician. Occasionally medication or evaluation for other sleep disorders may be necessary, but these are the exception, not the rule.
For me and my mother, the solution was to help me work through the disruption of going to summer day camp for the first time. The stress of the new environment, the new people, and the new expectations was enough to trigger the night terrors. My mother talked to friends about it and learned that she is not alone in this frightening experience. Ultimately, what seemed like a horribly traumatic experience at the time has become a distant memory for the both of us, as it will for most families.Lear More
Addiction knows no bounds. In fact, well over 20 million people are struggling with it today. Those who struggle with addiction can be of any age, socio-economic class, race, and gender. The one thing that all those battling addiction should know is that they are not alone. Celebrities can suffer from addiction just like you. The only thing that is unique about their experience is that they have to live through their addiction in front of cameras and in the spotlight. They are tempted by the same things, have the same triggers and fight against relapse each and every day. Demi Moore, Lady Gaga, Zac Efron, Brad Pitt, and Drew Barrymore are some of the celebrities who have opened up about their drug addiction in the last decade.
What Does Addiction Look Like?
The most common addictions are to tobacco, alcohol, marijuana, painkillers, cocaine, and heroin. While addiction may manifest differently in each of us, some commons signs that you might be addicted to drugs include:
- Difficulty or inability to stop using the drug
- Spending excessive amounts of time trying to get the drug, with those who sell the drugs, etc.
- Willingness to engage in high risk or illegal activities to obtain drugs
- Sleeping excessively and spending more time alone than usual
- Losing interest in activities that you love and neglecting your everyday responsibilities
- Physical symptoms of addiction, sudden weight loss, enlarged or small pupils, bloodshot eyes, slurred speech, body odor and looking like you are not taking care of yourself.
Using Cognitive Behavioral Therapy to Treat Addiction
These signs and symptoms of addiction look the same whether you are a celebrity or someone who has no interest in the spotlight. No matter who you are, getting treatment for your addiction is critical to your long-term health and wellness. The Cognitive Behavioral Therapy Center of Western North Carolina offers cognitive behavioral therapy to our clients to treat a wide variety of conditions and issues, including addiction.
Cognitive behavioral therapy is a form of psychotherapy that works to change your behavior or your thinking patterns in order to treat the issues that you are battling. This treatment is highly effective for helping individuals who struggle with addition. Our team strives to give you the personalized help you need – when you need it. For more information about using cognitive behavioral therapy as a tool against addiction, call the Cognitive Behavioral Therapy Center of Western North Carolina today at (828) 350-1177 or (828) 232-8934.Lear More
Insomnia is a common disorder that affects as many as ⅓ of Americans on a short term basis. Insomnia is characterized by having trouble falling or staying asleep or waking up too early and not being able to fall back asleep. It can cause extreme daytime fatigue, a difficulty with focus, poor memory, mood changes, low motivation and even an increase in mistakes and accidents. Many individuals who struggle with insomnia try to treat it with sleep medications, which can be helpful for short term use, but can have side effects and may be habit forming. Cognitive behavioral therapy may be an ideal treatment option if you have struggled with insomnia or difficulty sleeping for an extended period of time.
How Does Cognitive Behavioral Therapy for Insomnia Work?
Cognitive Behavioral Therapy (CBT) focuses on helping you change your thinking about your sleep while you develop tools for improving your overall sleep habits. The Cognitive Behavioral Therapy Center of Western North Carolina, PA, specializes in helping clients who battle insomnia. We can help you develop tools to sleep well without taking medication by improving your sleep environment, addressing your anxiety about sleep and developing a sleep schedule that works for your body. Your treatment plan will be specifically designed for your unique needs. After we complete a 90 minute individual sleep assessment, we offer a two part program that includes eight weeks of weekly individual sessions to develop a sleep plan that is tailored to each participant’s specific needs.
What are the Benefits of Cognitive Behavioral Therapy for Insomnia?
Treating your insomnia will leave you feeling better and more rested and ready to tackle your day. Some specific benefits of using cognitive behavioral therapy to address your insomnia include:
- Addresses the underlying causes of insomnia, rather than treating just the symptoms
- Allows you to optimize your sleep habits for longer, deeper, better sleep
- Medication-free approach
- No side effects or concerns about becoming dependent on sleep medications
- Develop relaxation techniques that can be used in other aspects of your life
- Can help anyone with a sleep problem without concern about interactions with current medications for other health conditions
If you are looking for a solution for your insomnia, contact the team at the Cognitive Behavioral Therapy Center of Western North Carolina for more information about using Cognitive Behavioral Therapy as a treatment option for insomnia. You can reach us by calling our program director, Erin Shadle, LCSW at (828) 350-1177 for more information.Lear More
Racing heart. Knots in the stomach. Trouble focusing. Sweaty palms. Regardless of the cause, these symptoms of anxiety are a nearly universal part of life. Almost everyone can relate to feeling this way at some point, but why? What is the purpose of anxiety, aside from making us uncomfortable?
Like all parts of human anatomy and behavior, the experience of anxiety is a product of evolution. Imagine our ancient ancestors, hunter-gatherers living in small tribes and family groups. They lived their lives almost exclusively outdoors without the protection of walls, doors, or modern weapons. If a larger, stronger predator attacked, the risk was high that a human caught off guard would not win the fight.
In this vulnerable setting, a keen sense of awareness of surroundings was crucial for survival. If someone heard rustling in the leaves, it could be a wolf or a mountain lion hunting for prey, or it could be a harmless squirrel. Those who survived were the ones who assumed it was a fierce predator and responded accordingly. Humans have been bred to be anxious.
Our bodies still hold the genetic predisposition toward anxiety despite the threats having changed drastically over the years. Unless you are an outdoorsman, you are unlikely to have anxiety about being hunted by a mountain lion, but you may become anxious when you get a phone call from a certain person, or if you have to drive during rush hour. When we look closely at the reasons why certain things make us anxious, we can usually trace it back to some type of fear for our safety. It may be perfectly reasonable to be anxious if we get a phone call from someone who has hurt us in the past. The alertness that we experience with anxiety might help keep us safe from other drivers.
If we can see anxiety as friend and protector, we can work toward making peace with the discomfort that anxiety causes. Granted, there are times when anxiety is unreasonable and can cause more harm than good. In a future post, we will explore how to tell the difference and what to do when anxiety gets the best of us.Lear More
On June 9th, 2018, friends, family and mental health professionals gathered with those experiencing obsessive compulsive disorder (OCD) to walk in solidarity and raise awareness of OCD. The One Million Steps 4 OCD walk, coordinated by the International OCD Foundation (IOCDF), is now in its sixth year as a national event. This is the second year the Asheville chapter has participated. Under the shade trees of the French Broad River Park, the group enjoyed snacks and conversation before starting the approximately three mile walk. Dr. Haley Elder opened the event welcoming participants and telling the story of the origins of the walk.
The event, sponsored by the CBT Center of WNC, included signs along the route with facts about OCD. The beautiful warm weather drew a large crowd of outdoors enthusiasts to the public park who were able to learn about the disorder as they enjoyed their picnics, jogging, and walking their dogs.
Each year as more grassroots chapters organize awareness walks, the generous contributions from participants goes to support research and availability of effective care for OCD across the country. To learn more about OCD or to make a contribution, click here.
Photos by Katie Kelleher.
Working with a therapist means starting a relationship based on vulnerability. It means getting to know someone who, starting out as a stranger, may quickly know some of the most intimate details of your life. This is not a decision that many people are willing to take lightly. I am frequently in the position to help people find a new therapist which inevitably becomes a daunting task for everyone involved. Here I’ve compiled a list of the three most common questions and concerns that arise from this process:
Q: I’ve done a search online and there are so many listings. How do I start to narrow it down?
A: First, consider how you plan to cover the cost of therapy. This has, in my experience, been the single most effective way to narrow down the search. If you are using insurance, ask your insurance company to give you a list of providers who accept your insurance. Many insurance company websites can help you narrow it down further by gender (if that’s important to you), location, and specialty. Regardless of your method of payment, you may want to check with a website such as www.psychologytoday.com which offers a therapist directory.
Q: What should I look for in a therapist?
A: If you’re looking for someone with a practice speciality (such as someone who treats trauma, grief, works with children, etc.) you’re already well on your way to answering this question. You may still want to proceed with caution. All licensed therapists are required to attend continuing education courses regularly. The topics can vary dramatically. Just because a person says they treat OCD, for example, that may not mean they have specialized training in the treatment of OCD. It could also mean they took a one or two day workshop several years ago. You have a right to know the training and experience of any healthcare provider who provides care for you. It’s appropriate to ask a prospective new therapist to describe their level of training and experience. It’s also appropriate to ask them what methods they use to treat any specific problem you are seeking therapy to address. There are many different ways to treat each problem and if someone uses a term you’re unfamiliar with, ask for an explanation. As a therapist, I welcome it when a prospective client asks me, “I’ve heard the term CBT but I don’t know what it means. Can you explain it to me?”
Q: How do I get started with a new therapist?
A: Most therapists have either a phone call or an email address listed. You can leave as much or as little detail on the voicemail or email as you’d like when you take the first step to reach out. That person should contact you within a few days. If not, you may want to try again. If the therapist does not take the initiative to offer it, you can request a phone conversation to speak with the therapist. Take that opportunity to ask questions and get a sense of the therapist’s personality. Once you decide to make an appointment with a new therapist, the first session is usually considered an “evaluation.” This session helps the therapist better understand your needs so he or she can know what techniques will be most likely to work for you. Perhaps more importantly, this is also your chance to interview the therapist in person. Each day I keep in mind that every therapy session is also my job interview. It is your choice as the client if you want to hire this person to work with you or not. If you feel uncomfortable or it becomes apparent that the therapist does not have the skills you need, you are not obligated to return to that person and can continue your search for the right therapist.
Finding the right therapist can seem like a challenge. It is important to find someone with the right skills, but also the right personality. Ultimately the choice is yours. These are only three of numerous possible questions, so if you have any other questions about this process, please leave a comment and I would be happy to try to address them.Lear More
I have a ridiculously sensitive startle reflex that has made me the butt of jokes for many years. Every coworker, family member, and friend has at some point accidentally startled me. I even joke with new coworkers that they haven’t finished their orientation until they’ve made me jump. It’s just one of my quirks.
One thing I’ve noticed over the years is every time I’m startled, I reflexively take a short, sharp, shallow breath. It is often accompanied with a little gasping sound, and inevitably I find myself holding that breath until I get my wits about me and figure out why I’ve been startled (while the other person giggles and apologizes). That’s when I exhale.
Our breath has more to do with regulating our emotions than most of us give it credit for. After all, we breathe all the time, right? We even breathe in our sleep. Why would we ever need to think about breathing?
Take a big, deep breath, then hold it as long as you can. Notice your pulse, the color of your cheeks, your heartbeat as you count the seconds before you exhale. If your body works the same way mine does, you probably noticed your pulse quicken, your cheeks become flushed and pink, and your heartbeat increase. What changes in the moments following the exhale? Eventually your body returns to its normal, calm state.
The changes you noticed in your body as you held your breath are very similar to some of the changes the body experiences when we feel anxious. In a state of heightened anxiety, our blood pressure rises, we become aware of our pulse, and we might feel warm and flushed. Now try taking a few very slow, deep breaths. Notice how your mind and body feel after consciously breathing this way. What we’ve learned is that the inhale tends to be stimulating whereas the exhale relaxes us.
The breath is a companion that stays with us every moment of our lives. We tend to ignore it until it becomes a problem, but with a little mindfulness we can also see it as a friend that guides us through times of distress. Many people enjoy a step-by-step guided breath practice, but I find that often it’s not necessary or we can’t access it when we need it the most. Instead, it can be as simple as a single thought: “How does my breath feel right now?”
Consider asking yourself one of these questions:
Am I holding my breath?
Does my chest or belly feel tight?
Do I feel like I’m having a hard time catching my breath?
If the answer to any of them is yes, take a moment to let out a deep sighing exhale. Take in another breath, and slowly sigh again on the next exhale. Repeat this as long as necessary. This practice can take the edge off of anxiety, calm crying, and help clear the mind. “Breathe through it” is one of my favorite ways to guide clients through intense emotion.
Check back for an in-depth guided breathing exercise to be published here in the coming weeks.Lear More
This year has brought big changes to the Cognitive Behavioral Therapy Center: On August 1st, 2018, we opened the doors to our second location on New Leicester Highway. For several years, the CBT Center has been growing steadily in the services we offer and the number of clinicians on our team. Now with the second location, we have the space and resources to continue our goal of providing comprehensive mental health services to western North Carolina.
The New Leicester Highway location will accommodate up to seven clinicians, effectively doubling our size. In addition to many of the services offered at the original Tunnel Road location, the New Leicester Highway location will include comprehensive psychological testing services for all ages.
When you arrive, you will be greeted by office manager Earlene Reese. If you have been to the CBT Center before, you probably already know her. She is missed at the Tunnel Road location, but we are happy to have her experience and expertise at the new site.
The new location is bright and welcoming with comfortable offices. We hope you will feel as at home here as we do.Lear More
“I know what you’re thinking!”
Are you sure?
We’ve probably all been on both the giving and receiving end of this common flaw in logic. Sometimes it’s easier to notice it when others direct it toward us. Starting a sentence with, “You must think…” is an almost guaranteed way to get someone to disagree with us. The reality is that we have no idea what anyone else is thinking, yet we so frequently try to impose those guesses on others.
In this article, we look at specific ways we find ourselves in this all too familiar trap:
- Reading too much into text. So much of our communication is text-based now. Depending on our mood, we could view a message of “Thanks, you’re so helpful” as a genuine compliment, or a sarcastic insult. Communication is far more complicated than simply the words we convey. Tone, volume, and body language speak just as much, if not more meaning than the words. When these cues are absent, our minds are prone to fill in those gaps and assume additional meaning. Frustratingly, we often get it wrong, which can result in tension and hurt feelings.
- Assuming it’s all about us. “Why did my friend ignore my text? Is he mad at me? I must have said something to upset him.” Sometimes a missed text is just a missed text. The mind dislikes gaps in information. Our desire to understand why people behave the way they do can lead us down dark paths if we are not cautious. We assign meaning – and often blame – in the interest of filling in gaps in meaning, but be careful with this. Until the other person has confirmed your assumptions, you may not be in as much trouble as you thought. Maybe their actions have nothing to do with you.
- Acting like we’re right. If I assume a person dislikes me, I’m going to behave differently around them than if I assume they like me. This leads to the trap of the self-fulfilling prophecy. If I ignore a person because I assume they don’t like me, they’re not going to like me because I’m ignoring them. By acting this way, I’m making myself very unlikable.
So now what? Once we catch ourselves mind reading, what do we do about it?
- Don’t take it personally. If you feel tempted to blame yourself for your friend’s mysterious absence recently, or a family member’s failure to return a call, take a step back. What else might be going on in this person’s life that could explain their behavior? True, there are times when we might have actually done something wrong and they are in fact avoiding us. Why start with that assumption, though? There’s just as much of a chance that we were wrong as there is that we were right.
- Test your theory. There are many ways to do this. My favorite is perhaps the simplest: Ask. Approaching someone with kindness, honesty, and a genuine sense of curiosity has rarely steered me wrong. “Hey, I haven’t heard back from you after I texted you the other day. Just checking in. Is everything ok?”
- Remember that sometimes the mind lies to us. Simply second-guessing our thoughts is a powerful ability. Just because we have a thought doesn’t mean we have to believe it or agree with it. We have the power to choose which of our thoughts we hold onto, and which we let go. Letting go of the questions, the insecurities, and accepting the ambiguity of not really knowing can bring a calmness to our lives that we rarely find when we buy into the pressure to solve all of the mysteries.
Written by: Erin Shadle, LCSW
I’ve heard the argument that obsessive compulsive disorder (OCD) is one of the most difficult mental illnesses to live with. Imagine feeling intense anxiety over things that most people never think about, then believing you have to go to extreme lengths to make that feeling go away. Now imagine doing that while knowing that the fear is irrational to begin with, and even if you make the feeling go away, it will return soon.
I’ve also heard it said that OCD is probably one of the most misunderstood of the mental illnesses, often portrayed in the movies as a funny quirk that offers comic relief, or limited to excessive hand washing. We hear phrases like, “I’m so obsessed with this band!” or “My books have to be a certain way on my shelf. I’m pretty OCD about it.” The way OCD has woven its way into our vernacular almost always misrepresents the true experience.
To demystify the disorder, one organization is rallying groups across the country for the sixth year in a row to participate in the 1 Million Steps 4 OCD Walk. Chapters nationwide will walk together to raise awareness of OCD, and contribute financial support to the International Obsessive Compulsive Disorder Foundation (IOCDF).
The Cognitive Behavioral Therapy Center will be participating in Asheville, NC for the second year in a row. The following is an interview with organizer and OCD specialist Dr. Haley Elder:
What is the 1 Million Steps 4 OCD Walk all about?
In 2012, a father named Denis Asselin walked over 500 miles (which is roughly one million steps) from his home in Cheney, PA to Boston, MA in memory of his son Nathaniel. Nathaniel took his own life at the age of 24 after a long battle with OCD and Body Dysmorphic Disorder (BDD). His father Denis walked to both honor his son and raise awareness about OCD and BDD. At the end of his walk, Denis was greeted in Boston on June 5, 2012 by the staff of the IOCDF, friends, family, and members of the OCD community at a rally honoring Denis and supporting OCD and BDD awareness. The next year the first 1 Million Steps 4 OCD Walk took place in Boston with the goal of raising awareness, money, and hope for this illness.
Each year since, more and more cities have participated. As the walks have expanded, smaller grassroots virtual walks have started to pop up around the country and this year we are having the second organized one in Asheville, which we hope will continue to grow in size each year.
Why is it so important to raise awareness about OCD?
Our best estimate is that OCD affects roughly 2-3 million adults and approximately 500,000 children and adolescents in the United States alone. By building awareness of this disorder, it is the foundation’s hope that worldwide mental health professionals will become better educated about evidence-based treatments, the general public will gain access to information about treatments for OCD, and the stigma surrounding OCD and mental illness in general will be reduced.
How can I get involved?
OCD-NC, an official affiliate of the IOCDF, will be hosting a grassroots 1 Million Steps 4 OCD Walk in Asheville on Saturday, June 9, 2018. It will take place at French Broad River Park, 508 Riverview Drive, Asheville, NC 28806. Check-in for the walk will be at 9:15 am, with the walk commencing at 10 am. To register to attend or donate, please visit: https://www.crowdrise.com/AshevilleNCOCDWalk
I think I may have OCD, or I know someone who does. Where can I go to learn more or seek treatment?
The Cognitive Behavioral Therapy Center offers comprehensive treatment of OCD, including individual therapy, an intensive outpatient program, medication options, and a support group. Please contact us to learn more. You can also visit the IOCDF website at https://iocdf.org/ for more information about OCD and its treatment.