March 19, 2024

Archives for December 2013

New Year’s Resolutions versus The Stages of Change

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The Christmas holiday is over.  Surrounded by the carnage of torn wrapping paper and mangled boxes, we look to the future.  Soon, it will be New Year’s eve.  Maybe because it’s a “natural” transition…or maybe because it’s tradition, we tend to start thinking about the past and looking to the future.  From this has arisen the idea of the New Year’s resolution…the promise of change that we make to ourselves to hopefully make the next year a little better than the one that just passed us by.

Truth be told, I’m not a big fan of the resolution.  Well, that’s not true…I’m all about making resolutions and change for the better.  I just don’t see why we should only do it once a year.  I figure if you need to change…then change.  Don’t wait for an arbitrary date to do so.  However, that’s not the point of this article.  No…I want to speak to you about HOW to change…not when or why.

I.                   Ever struggled with making changes?

If you answered “no” to that question, you are either the luckiest, most enlightened person in the universe…or a total liar.  Everyone struggles with change.  Change is difficult.  It’s stressful.

I can’t tell you how many times I’ve decided to make a change in my life.  Committed to the process…only to fall on my butt.  Sometimes it’s because life got in the way.  Other times I wasn’t really ready.  Still other times I changed, but it just didn’t “stick”

I tell you this now because I often reflect on how ironic it is that I as a mental health professional whose job it is to facilitate change in others struggle personally with making changes myself.  In fact, all my colleagues seem to have the same dilemma.  However, in my studies I have learned a thing or two about change…things that have helped me personally and certainly helped my clients to change.  So, in the spirit of making changes for the new year, I offer you this look into the theory of “stages of change.”

II.                 Prochaska and DiClemente — Stages of change

I came across this change model while I was finishing up my degree.  I’ve found it to be incredibly helpful in my own efforts at change as well as those of many of my clients.  Here it is in a nutshell:

  1. “I don’t have a problem…YOU have a problem”– (Precontemplation) – Not considering change.  Doesn’t recognize there’s a problem.  “Ignorance is bliss.”  You probably won’t recognize if you are in this stage…but you will know if a loved one is here.  If your child, spouse, friend, etc is here, then your goal is to raise awareness.  Make connections between the person’s behaviors and the problem at hand.  I often find myself saying “How’s that working for you?” to clients stuck at this stage.
  2. “I know I have a problem, but what can I do about it?”—(Contemplation) – Recognizes there may be a problem or a need to change, but doesn’t know what to do about it.  Most of us become aware at this stage.  We often try to force a change here but this is a mistake.  Because we don’t know everything about the problem any solution we come up with is liable to be inadequate. It’s like trying to bake cookies without reading or understanding the recipe.  The goal here is to be patient and really understand the problem thoroughly.  Once you understand it, then you can change it.
  3. 3.       “I know what’s wrong, just need to figure out what to do about it.” – (Preparation) – Recognizes a need for change and is starting to explore the problem and come up with a plan to address it.  Here we start putting together a plan for change.  We draw on all our resources to get ready to change. 
  4. 4.       “I’m working my plan!” – (Action) –  Recognizes a need for change.  Understands what needs to be done, has a plan and is “working” that plan.  Pretty straight forward.  This is where most of want to be but try to get here too soon.
  5. 5.       Maintenance – Has achieved the desired change and is now actively maintaining that change for the long haul.
  6. 6.       Relapse – Due to unforeseen circumstances, has reverted to old patterns of behaviors and regressed.

It is important to note, while most people go through the stages in order, one does not have to go through ALL the stages.  One might go from precontemplation to action in a short period of time if a plan comes together.  One might also move backwards through the stages if bad things happen.  Also, one can be in different stages of change with different problems all at the same time.  The bottom line is, change can be complicated and messy (no surprise there, right?).

III.              Match the intervention to the stage

What does this have to do with you and your New Year’s resolution?  Everything!  If what you are trying to change does not match up with your readiness to change (the stage you are in) then you are most likely doomed to fail from the get go.  So, take a good long look at what you are planning to do.  Examine where you are at…be honest with yourself.  What stage are you at?  Once you figure out that, then the next steps become easier to figure out.  Match what you are going to do with the stage you are in and work towards the next stage your chances for success are increased.

So, let’s say you are in the contemplative stage.  You know that you need to change but are not sure what to do.  Your task then is to understand the whats, whys and wherefores of your desired change.  How did the problem come about?  What are the resources you bring to bear?  Once you gain enough understanding, then you can move towards preparation and make a plan.

Let’s say you are at the action stage.  Great!  Work your plan…but how are you going to maintain the change?  What are you going to do if things go off the rails?  Figuring that stuff out ahead f time can increase your chances of success.

What if you are in maintenance?  You’ve made that change and are successful?  What happens if you relapse?  How are you going to view yourself?  Do you have a plan to get back on track? If you do, then your chances of overcoming a setback are much greater.

I hope you’ve found this information helpful.  If you want help in navigating a life change, then please contact me for a free consultation. erikyounglpc@verizon.net  or 484-693-0582

 

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ADHD: Disorder or Super Power? Part Four

       I.            Succeed from your strengths!

Partially because I didn’t receive formal therapy, but also because I needed to grow up, I did not get a handle on my ADHD until I was in my 20’s.  What happened is that I became a father.  All of a sudden I was motivated.  I looked at my son and thought “he deserves better than a slacker parent.”  I enrolled in college and started to apply all the study and organizational strategies I’d been taught but stubbornly refused to use in high school.  A funny thing happened, I started getting straight A’s.  In fact, I maintained a 4. GPA for 6 straight semesters in my undergraduate program.  It was hard work at first and I had to be very disciplined, but I didn’t want to let my baby son down.  Over time though, it got easier as I got habituated to doing these things.  Pretty soon I could tap into my super focus whenever I wanted.

Today, I’m still hyperactive (I cannot sit still).  I can be impulsive.  I talk too fast.  I procrastinate.  BUT I can control that when the circumstances call for it.  I run a successful private practice.  I pay the bills.  I have a good life.  As long as I have goals that motivate then my ADHD brain works FOR me rather than against me.

Here’s the bottom line.  If you have ADHD or think you might have ADHD, then here is what you need to do to be successful:

  1. Stop internalizing the bad messages from the world around you.  Stop internalizing the daily little failures as a measure of your self-worth.  It’s not necessary and it just drags you down. You may be forgetful at timesbut so what?  Focus on the positives.  Celebrate your strengths.
  2. Find your passion! Figure what things engage your focus and then work them into as much of your day-to-day life as possible.  This will help make boring activities more engaging.
  3. Always have a goal with firm deadlines.  This will help stave off procrastination.  Don’t just say “I’ll do _____ someday.” Or “I will get to it later.”  Set a day and time and then get it done.  You might do it last-minutethat’s ok as long as you meet your goal.  When you meet your goalset a new goal.  Never be without a goal.
  4. Look for new passions so you can change things up.  Remember, boredom is the enemy!  Keep it fresh.  It’s ok to rotate through interests.  Going through two or three things then returning to the first thing as you feel like it.
  5. Learn how to organize and engage your focus even in low-stim situations.  It’s difficult.  It takes time.  But, sometimes we just have to gut through the boredom.

If you want to schedule a free consultation please call 484-693-0582 or press the “schedule appointment” button to the right.

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ADHD: Disorder or Super Power? Part Three

       I.            Hidden gifts

Having ADHD confers some distinct advantages.  First, lets do away with the myth of the attention-deficit.  The name of this condition is a misnomer.  It’s not that we can’t pay attention, quite the contrary.  We have super, laser-like focus and attention.  The problem is that the cost of entry is very high to engage that focus.

I explain it to my private practice clients like this.  Everyone has a “goldilocks” zone of stimulation.  When the environment stimulation is in this zone then we feel comfortable.  For neurotypical people, the world generally puts us in this comfort zone.  However, for those of us wired for ADHD, our need for stimulation is very highmuch higher than the norm.  Most of the time the world is not giving us what we need.  We are under-stimulated.  So, our brains seek out stimulation to make us feel normal. So, we seem distracted because we are constantly going “whats that!  What’s that!  What’s that!”  seeking normalcy.  Our existence is one long battle with extreme boredom.  However, when our need for stimulation is met, then our focus kicks inand it is much stronger than that of mere mortals.  When I’m doing something that stimulates me and I get in the zone….I lose track of time.  I can get more done in a couple of hours than most people do all day!  The problem is that it can be difficult to access that focus when others expect that of us.

Other good things that come with ADHD:

  • Creativity
  • Energy
  • Sociability
  • Independence
  • Fun
  • Quick thinker
  • Decisiveness
  • Passionate

So, ADHD shouldn’t be considered a disorder.  It’s a rough descriptor of neurology.  We don’t pathologize shorter than average people.  We don’t say they’re broken.  We give them access to stools to reach the top shelf.  Whether or not you need meds.  No matter what behavioral/organizational strategies you need to get through the daythese are simply “stools”tools to help us adapt.

Go to Part Four.

If you would like to schedule a free consultation, please call 484-693-0582 or press the “schedule appointment” button to the right.

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ADHD: DISORDER OR SUPER POWER? Part two

       II.            The problems with the diagnosis

The DSM-V is the official manual of mental disorders.  If you have a formal diagnosis of ADHD (or any other mental health disorder), then it should flow from the criteria laid out in that book.  Here is what the DSM-V says about ADHD.

DSM-5 Criteria for ADHD

People with ADHD show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development:

  1. Inattention: Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
  • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
  • Often has trouble holding attention on tasks or play activities.
  • Often does not seem to listen when spoken to directly.
  • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
  • Often has trouble organizing tasks and activities.
  • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
  • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
  • Is often easily distracted
  • Is often forgetful in daily activities.
  1. Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
  • Often fidgets with or taps hands or feet, or squirms in seat.
  • Often leaves seat in situations when remaining seated is expected.
  • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
  • Often unable to play or take part in leisure activities quietly.
  • Is often “on the go” acting as if “driven by a motor”.
  • Often talks excessively.
  • Often blurts out an answer before a question has been completed.
  • Often has trouble waiting his/her turn.
  • Often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition, the following conditions must be met:

  • Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
  • Several symptoms are present in two or more setting, (e.g., at home, school or work; with friends or relatives; in other activities).
  • There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
  • The symptoms do not happen only during the course of schizophrenia or another psychotic disorder. The symptoms are not better explained by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

Just take a look at that.  Pretty dismal huh?  Can’t sit still.  Can’t pay attention.  Can’t control oneself.  Totally out of control.  What a mess!  This is the only picture the mental health community uses to diagnosebut it is a very incomplete picture.  The diagnostic criteria focus on the “negative” aspects of ADHDwhich really revolve around the struggles with school and “typical” work environments (where sitting still and doing seat work are prized).  The definition neglects to look at the positives of being wired for ADHD.  It totally misses the amazing strengths we have.  Thus, we are pathologized and often made to feel inferior when we are simply different.  Allow us to capitalize on our strengths and we can do amazing things and be very successful.

Go to Part Three.

If you would like to schedule a free consultation, please call 484-693-0582 or press the “schedule appointment” button to the right.

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ADHD: DISORDER OR SUPER POWER? Part one

       I.            A confession

My name is Erik and I have Attention Deficit Hyperactivity Disorder.  Like many people my age (the “wrong” side of forty) I wasn’t ever diagnosed as a child and never received treatment.  As a child I was always on the go.  I learned to run before I could walk… I even have a small calcium deposit bump on my forehead from falling on my face so much during that time.  I had a terrible anger from being hypersensitive.  The most mild name calling would send me into full-out temper tantrums.  By the time I was in middle school, my straight A grades started to suffer due to poor organization, an overwhelming sense of boredom and my insistence that I read my favorite books rather than what my teachers wanted me to read.  I was the poster boy for “he can do the work…”

It wasn’t until I was well into my adulthood and was struggling to make sense of life, the universe, and everything that I finally figured out what was “wrong” with me.  Soon after, I realized that NOTHING was wrong with meI was simply wired a certain way and as long as I was aware of that and made the appropriate adjustmentslife could be amazing.  As a result, I am well-educated, successful and reasonably happy.  In fact, I attribute much of my success to my ADHD.  For me, today, life IS amazing.  I am so blessed.  Let me tell you why…

Go to Part Two

To schedule a free session, call 484-693-0582 or press the “schedule appointment” button to the right.

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