Cognitive Behavioral Therapy for Anxiety & Depression

Do you have anxiety around health issues? According to a recent article in The Lancet, researchers have found that "10-20% of hospital patients suffer from health anxiety, and this poses a substantial burden on health services since a patient's fear of having a serious disorder leads to medical consultation. The study authors note that previous studies have demonstrated that CBT (Cognitive Behavioral Therapy) - a therapy that aims to change a person's behavior and thought patterns - is successful as a treatment for other anxiety disorders. Therefore, the researchers set out to determine whether this therapy would be effective in treating health anxiety." Medical News Today Article. Health anxiety can actually CAUSE some people to experience physical symptoms such as chest pains, headaches and other somatic symptoms leading them to believe they are suffering from a more serious disorder, despite reassurance from a medical professional. How many times do you have a physical discomfort, pains in your chest and believe you are having a heart attack. You go to the emergency room to find out your heart is fine, but have anxiety with panic. Of course, you need to Take ensure that you get cleared medically, but then pursue CBT to help with your anxiety. Take a look at this chart to see what happens to your body when panic attacks. Remember, there is help. Anxiety is manageable. There are tools, techniques to quiet the mind and relax the body.


Qualities of a Good Boss

In an recent article in Scientific American, Sunny Sea Gold writes about the qualities that make a good boss. So what are the keys to being a good boss? According to her, there are three standout features that combined, make a good boss. "1) humility, 2) confidence and 3) using the right carrots." The most damaging qualities for a boss include arrogance, disrespect, blowing off feedback and blaming others. Since we know workers don't leave companies, they leave bad bosses and managers, it may be time to reflect on how to manage yourself in a difficult situation. Stress, morale, medical costs, turnover, lost productivity, anxiety, depression and absenteeism are just a few of the causalities workers experience due to bad managers. Ultimately, productivity suffers and the workers lose all sense of value. The remedy is multifaceted. Using a positive, supportive, engaging and validating style motivates employees. Employees need to feel a sense of control, challenge and growth to get engaged. Recently I found an interesting article on the concept of a "stay interview." As opposed to an "exit interview" when it is too late to save or retain a valued employee. There are several questions a manager can ask an employee to get to know them better,  understand their professional or career goals, aspirations, develop a sense of meaning and purpose to promote job satisfaction. This process just may help you keep valued employees. Like a doctor taking your pulse or blood pressure, being a good manager, leader and communicator will help you keep pulse on what is going on in employee minds, increase engagement and be motivating. Some questions you might consider asking include:
  • If you could change one thing about your job, company or team, what would it be?
  • What have you felt good about accomplishing in your job/career here?
  • What talents, interests and skills do you have that we haven't made the most of?
  • What kind of flexibility would be helpful in balancing your work and home life?
  • What opportunities for self-improvement would you like to have that go beyond your current role?
  • What kind of feedback would you like about your performance that you are currently not getting?
Job coaching can help. Check out my coaching website. Just click on the link. Coaching Website
Scientific American Article

Pain & Addiction: Why doesn't my pain medicine work anymore?

Last week, I attended a most excellent presentation by Dr. Boone from La Hacienda Treatment center on "Addiction and Medications." Dr. Boone was an engaging, informative and provocative speaker on topics including Pain, Anxiety, Insomnia, Anxiety, Colds, ADHD & Weight Loss. I will try and summarize some of his main points in this blog post related to addiction and pain management.
If you know someone with chronic pain who is not able to manage their pain and possibly addicted to painkillers, this information may be helpful. There are alternatives and help to manage pain, but not without learning new skills and acquiring proven techniques, which take time to develop and master.
Pain is a subjective experience and everyone has a different pain tolerance. As Dr. Boone pointed out, and I paraphrase, we need to move away from an "I feel..........I take........." mentality as patients to just use our doctors or medications to manage physical AND emotional pain. Instead of the medical model of "I feel......I take......." we move to adopt the "I feel.......I relax, meditate, stretch, do yoga, get acupuncture, manage my stress, do psychotherapy (Cognitive Behavioral Therapy or CBT), physical therapy, massage, hypnosis, imagery and biofeedback" to manage chronic pain without addictive medications.  Pain encompasses various states of discomfort including anxiety, depression, insomnia, stress with complications of increasing dependence on addictive pain medications. Therefore, pain tolerance and sensitivity actually increases with the use of pain medication. Subsequently, a condition known as "hyperalgesia", or hypersensitivity to pain develops.  Keeping pain medicated "coats the pain" and actually creates a lowered pain threshold due to the fact that the body no longer produces beta endorphins to manage pain naturally. The body and mind lose the ability to get relief. Pain signals persist and suffering increases. One objective is to break the pain cycle and close the pain gate sending the signal to the brain.
Addiction is also associated with a lack of stress resistance. When pain persists, most people seek immediate relief. Medication accomplishes this.....but only in the beginning. After a short time, tolerance to the medication develops, so you need more pain medication to get relief. Ultimately, no amount of pain medication really helps and by this time, addiction, tolerance sets in. 
A multidisciplinary team with alternative pain management is considered most effective. The best chronic pain treatment programs all strive to reduce and then eliminate the use of all narcotic medications and muscle relaxers, which are addictive and shut down the body's natural ability to manage pain. Examples of medications that should eliminated are opiates like Hydrocodone, Codeine, Oxycodone, Morphine, Tramadol, Lyrica and muscle relaxants like Soma and Flexeril.
There are pain programs and specialists that can help. Call or email if you want additional information. 713-621-2490 or click on my name to email for questions of comments.  Dr. Klaybor