By Tom Horvath, PhD How well can I calm myself or energize myself using my own abilities? How much do I need to use a substance for help? Although at times a mild sedative (one drink) or mild stimulant (a cup of coffee) can be a helpful tool, the more we rely on such tools the more our internal abilities diminish (atrophy). Daily low doses of sedatives or stimulants can be helpful. As the doses get higher, problems can emerge. In cases of substantial addictive problems, it is common to see someone bouncing between “downers” and “uppers,” sometimes even multiple times per day. At that level of substance use we can lose all sense that self-regulation can be accomplished by ourselves. None of us may reach the ideal of regulating ourselves entirely from our own resources. However, ...

By Tom Horvath, PhD Boredom is the perception of being under-stimulated. We all have optimal levels of stimulation (some generally want more, some generally less). Whatever your level, when you are not getting enough, you are bored (and when over-stimulated, you may be stressed). Boredom is often considered an undesirable state. However, let’s start with its advantages. If not much is going on in your immediate world, you have time to consider the larger context of your life. It is easy to lose track of what is more important than day-to-day and moment-to-moment issues. If bored you have a moment to consider what is important, rather than just immediate or urgent. When feeling bored you might say, “I’m glad nothing is pressing on me at the moment; I can think about the bigger p...

By Tom Horvath, PhD Regret is the feeling or sense that we did not behave or choose as well as we could have or should have. How many times might we ask ourselves, “why did I ….?” Or, “why didn’t I…?” Not only is it impossible to live life without regrets (who does not make mistakes?), regret appears to be quite common. One study suggested that we might regret nearly 1/3 of our decisions. It makes sense, then, instead of trying to avoid regret, to turn our attention toward coping with regret. Two Types of Regret There seem to be two main types of regret. You might regret falling short on responsibilities to others. When you realize the problem, it may be easy enough to correct your behavior or make amends. On the other hand, do you make a similar effort when you fall short on actin...

By Tom Horvath, PhD, ABPP One of the simplest but most powerful ways to reduce stress is to focus on breathing. Although books have been written on this subject, the following ideas may be a sufficient guide for you. Because we breathe continuously, you will have lots of opportunity to practice! Less is More Perhaps the most important single step to reduce stress is to breathe less, while breathing regularly, through your nose. A deep breath or two can get you started on “breath work,” but after those initial breaths, focus on breathing regularly but more slowly, and with lower volume of air. You are not going to reduce your rate of breathing instantly. However, over the course of many breaths your rate will (probably not entirely smoothly) reduce. With practice you might breathe a...

by Tom Horvath, PhD It seems that almost everyone worries at times. We can think about a problem over and over and not make any progress. Ineffective strategies for worry include telling ourselves to “just stop,” and looking for guarantees or certainty when they are not available. Very little is guaranteed in life, and yet somehow we keep moving forward. Worry can be considered a problem-solving effort that is not working well because we are focused on the wrong parts of the problem. Most problems have aspects that 1) can be dealt with now or cannot be dealt with until later; 2) are under our control or not under our control; and 3) are more important or less important. If you focus your thinking on aspects of a problem that can only be dealt with later, are out of your control, o...

by Tom Horvath, PhD, ABPP Dialectical Behavior Therapy (DBT) places a primary focus on improving distress tolerance. One of several tools DBT offers for tolerating distress is radical acceptance. The context of using any of the distress tolerance tools is the recognition that life will have distress, and that we need to learn how to bear up under it. Life is worth living even if it can be painful. DBT distress tolerance skills are designed to help us get through a crisis, but these tools benefit from practice in advance. These skills can help us accept the discomfort or pain that occur in a crisis, while preventing that discomfort or pain from rising to the level of suffering. Radical = “going to the root,” like a radish. Radical acceptance does not mean we approve of reality. ...

by Tom Horvath, PhD, ABPP Dialectical Behavior Therapy (DBT) is an approach to psychotherapy designed for individuals who are highly emotionally sensitive, who struggle with depression and anxiety, and who may at times become suicidal. DBT tools, which focus on distress tolerance, interpersonal effectiveness, emotion regulation, and mindfulness, can be helpful to anyone. You can remember these 4 categories as DIEM, as in carpe diem (seize the day). DBT is part of the larger family of CBT (cognitive behavior therapy). Marsha Linehan, a psychology professor emeritus at the University of Washington, Seattle, developed DBT as a result of coping with her own emotional problems. Linehan, born in 1943, revealed in her late 60’s the personal connection to her professional work. Distres...

by Tom Horvath, PhD, ABPP Dialectical is a word with a long history (back to the Greeks), but for now let’s define it as “focusing or acting on the interaction of opposing forces or ideas.” Dialectical Behavior Therapy (DBT) identifies and addresses three common dialectical dilemmas, in order to improve emotional self-regulation, one of the primary goals of DBT. DBT can be helpful for individuals in whom large and rapid emotional swings (e.g., from love to hate) are common, painful, and harmful. The first of the dialectical dilemmas involves being emotionally vulnerable (either at present, or over a lifetime as a result of being emotionally more sensitive than average), but then downplaying the intensity of emotions. Typical self-statements are “this won’t be that hard” or “I shou...

by Thaddeus Camlin, PsyD Villains certainly make prime scapegoats.  Because villains make great targets they are also susceptible to false allegations and wrongful convictions.  Despite its dominance in the retail sector, global mega-merchant Wal-Mart manages to retain a special sort of derision from many.  Recently, Wal-Mart’s been under fire for ignoring red flags as opioid sales boomed in the past decade.  Given Wal-Mart’s ubiquity, it would follow that one of the largest dispensers of prescription medicine ignoring red flags while opioid sales soared deserves a lion’s share of blame for the opioid epidemic, right?  Wrong.   What Role Does Walmart have in The Opioid Epidemic? Ignoring red flags while quarterly profit numbers tickle the fancies of board members and shareh...

By Thaddeus Camlin, PsyD Holidays are ripe with tales of family gatherings gone sour.  Many families anticipate disruptive antics from at least one family member, maybe more.  As the beloved Lion King character, Zazu, memorably proclaimed about rabble-rousing kin, there’s one in every family, two in mine actually!  Whether there are one, two, or 10 family rascals to navigate this holiday season, SMART Recovery offers effective tips for family communication to help maximize enjoyable interactions with loved ones. The SMART acronym PIUS outlines four core communication skills.  The ‘P’ stands for positive communication.  Before anyone jumps to ‘captain obvious’ critiques about how much of a no-brainer it is to try to communicate positively, let’s take more than a passing, dismis...