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Welcome to CombatCounselor Chronicle, an E-zine dedicated to giving you the most current, pertinent information on cognitive behavioral therapy (CBT) and mindfulness-based CBT available.

Chris Sorrentino, a.k.a CombatCounselor, is a leader and expert in cognitive behavioral therapy. He combines 30 years of experience in psychology with the discipline from having served as a U.S. Air Force officer for 20 years, 4 of those in combat zones, retiring as a lieutenant colonel in 2005.

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Saturday, December 24, 2016

BMB Basic Training (Episode 8): "Cut Defense Spending?...NOW?...REALLY?

In Episode 8, CombatCounselor discusses his views on defense spending, or rather, the reduction of defense spending occurring today under President Obama, Congress, the Joint Chiefs of Staff (JCS), and Department of Defense (DoD).



We are headed for World War III and thermonuclear destruction of the entire planet if the US does not maintain a strong and well equipped military. With Osama dead and Al Qaeda weak, politicians think we can save a few bucks by cutting defense personnel, programs, and benefits...WRONG! Iran and China are bigger threats than ever and even defense planning has shifted from the Middle East to China, so why cut defense spending now? It is ludicrous and I am not talking about the artist!

Trump may not be the "GREAT COMMUNICATOR" like Reagan was, but defense is a Republican priority and our nation will remain strong now that Clinton has not been elected. He is a good man and has done a decent job despite the mess he was handed by Bush II, but we cannot afford to give Iran or China the upper-hand...THE RAMIFICATIONS WILL BE DISASTROUS IF WE DO!


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Title: BMB BASIC TRAINING - Episode 7: "Values"

Key Words: BASIC, TRAINING, CombatCounselor, mindfulness, anxiety, depression, Body, Mind, BMBT, treatment, cognitive, behavioral, CBT, dialectical, behavior, DBT, Acceptance, Commitment, Therapy, ACT, 

Friday, December 16, 2016

Clay Hunt Suicide Prevention for Veterans Act ... Great Idea, Poor Execution

By C.T. Sorrentino, LtCol, USAF (Ret)
      LPC, NCC

In regard to the Clay Hunt Suicide Prevention for American Veterans ACT, the legislation states:

Clay Hunt Suicide Prevention for American Veterans Act or the Clay Hunt SAV Act - (Sec. 2) Requires the Secretary of Veterans Affairs (VA) to: (1) arrange for an independent third party evaluation, at least annually, of the VA's mental health care and suicide prevention programs; and (2) submit a report to Congress, by December 1 of each year, containing the most recent evaluations not yet submitted to Congress and any recommendations the Secretary considers appropriate. 
(Sec. 3) Directs the Secretary to survey the VA's existing Internet websites and information resources to publish an Internet website that serves as a centralized source to provide veterans with information, updated at least once every 90 days, regarding all of the VA's mental health care services.(Sec. 4) Requires the Secretary to carry out a three-year pilot program to repay the education loans relating to psychiatric medicine that are incurred by individuals who:
are eligible to practice psychiatric medicine in the Veterans Health Administration (VHA) or are enrolled in the final year of a residency program leading to a specialty qualification in psychiatric medicine;  
demonstrate a commitment to a long-term career as a psychiatrist in the VHA; and 
agree to a period of two or more years of obligated service with the VHA in the field of psychiatric medicine, as determined by the Secretary.
Limits the loan repayment to no more than $30,000 for each year an individual performs such obligated service.
The Clay Hunt SAV Act is a great start and long overdue, but shortsighted considering that over 8,000 Veterans commit suicide each year. Psychiatrists, like all medical doctors (M.D.), are mostly concerned with prescribing pills, which is not the answer for post-traumatic stress disorder (PTSD) or many other psychological problems (anxiety and depression, the most common psychiatric conditions) for that matter. Pills only mask the symptoms of an underlying problem (disorder) and, in most cases, do little or nothing to help resolve the problem. After over 30 years in the mental health field, I am not aware of a single medication that “cures” a psychological disorder. Psychotherapy by a trained, licensed professional is currently the most effective treatment for anxiety and depression and, by the American Psychiatric Association's (APA) own admission, the cognitive behavioral therapies (CBT) are the most effective treatments for most disorders.

The APA, a large and powerful special interest group, and proponent of the "medical model" (physicians/psychiatrists and pills/"Big Pharma" ... another massive and very powerful special interest group), has blocked Licensed Professional Counselor (LPC) access to many government programs because we (LPCs) are a threat to the status quo. If people (Veterans in this case) actually receive treatment (therapy) and resolve or reduce their psychological problems, what need would there be for psychiatrists and/or pills? There would be little or none ... big problem for psychiatrists and the big pharmaceutical companies that bring in tens of billions of dollars each year from psychotropic medication (antidepressants, antipsychotics, etc.) prescriptions.  So the APA does whatever they can to make sure LPCs are blocked from government jobs and contracts just as they are doing by controlling puppets like Paul Rieckhoff, IAVA, and Congress, ensuring that only psychiatry students receive financial support (and, eventually, jobs) under the Clay Hunt SAV Act.

Paul Rieckhoff, founder and CEO of Iraq and Afghanistan Veterans of America (IAVA), of which I am currently a member, possibly for not much longer, sits atop his throne at HQ/IAVA just off of Times Square (another topic altogether - why does a non-profit need offices in downtown New York City and Washington D.C. when that money could be going to help Veterans?) and makes decisions affecting millions of Veterans, apparently without proper counsel. 

When a longtime proponent of and advocate for effective mental health treatment for our Veterans, me, a retired military officer and Veteran of four combat operations as well as a clinician with decades of experience treating military and Veterans with PTSD, anxiety, and depression offered constructive criticism to Mr. Rieckhoff on Twitter:
Mr. Rieckhoff responded with this defensive and poorly conceived notion:
Beside being defensive when an expert in the field offered very accurate, factual, and compassionate advice with only the best interests of Vets in mind (I am not selling anything, do not have an office on Madison Avenue, nor do I have a massive ego to feed by getting face-time with Congress and the President of the United States), Mr. Rieckhoff is either completely ignorant and/or controlled by the powerful special interests (e.g. APA, big pharma) if he truly believes that, pardon my English, "bullshit". 

Of course the APA disagrees with me because they have a very big dog in that hunt ... it is called money, a lot of it! In regard to "every veteran group in America", they would of course be remiss not to support such legislation to reduce Veteran suicides.  The problem being that, like Mr. Rieckhoff and IAVA, those groups also do not completely understand the issue.  Mr. Rieckhoff obviously also does not understand that Licensed Psychologists and LPCs are key to effective therapy and the long-term resolution of psychological problems, not just the symptoms, helping America's Veterans to heal, not just cope with their symptoms (e.g. taking antidepressant medications).

According to Roethel (2012), the National Center for Health Statistics reports that:

1. Americans are taking more antidepressant medications than ever before. When researchers compared the data from 1988 to 1994 with data from 2005 to 2008, they found that the rate of antidepressant use increased by almost 400 percent. 

2. Antidepressants rank among the top prescription drugs among U.S. adults up to age 44, they are the most common prescription medication for Americans between the ages of 18 and 44, and the third most commonly prescribed drug across all age groups.

3. 60 percent of Americans taking antidepressant medications have used them for two years or more and 14 percent have taken them for more than 10 years.

4. 11 percent of Americans over age 12 take antidepressants.

According to Cohen (2007), the "U.S. Centers for Disease Control and Prevention looked at 2.4 billion drugs prescribed in visits to doctors and hospitals in 2005. Of those, 118 million were for antidepressants" alone.

Big Pharma has long been tied (financially) to the APA in general and psychiatrists in particular:
In March 2009, the American Psychiatric Association announced that it would phase out pharmaceutical funding of continuing medical education seminars and meals at its conventions.  However, the decision came only after years of controversial exposure of its conflict of interest with the pharmaceutical industry and the U.S. Senate Finance Committee requesting in July 2008 that the APA provide accounts for all of its pharmaceutical funding.  Despite its announcement, within two months, the APA accepted more than $1.7 million in pharmaceutical company funds for its annual conference, held in San Francisco. 
With the U.S. prescribing antipsychotics to children and adolescents at a rate six times greater than the U.K., and with 30 million Americans having taken antidepressants for a “chemical imbalance” that psychiatrists admit is a pharmaceutical marketing campaign, not scientific fact, it is no wonder that the conflict of interest between psychiatry and Big Pharma is under congressional investigation. (CCHR International, No Date)
New Yorker Magazine reported (Greenberg, 2013) that “It’s been just over twenty-five years since Prozac came to market, and more than twenty per cent of Americans now regularly take mind-altering drugs prescribed by their doctors. Almost as familiar as brands like Zoloft and Lexapro is the worry about what it means that the daily routine in many households, for parents and children alike, includes a dose of medications that are poorly understood and whose long-term effects on the body are unknown. Despite our ambivalence, sales of psychiatric drugs amounted to more than seventy billion dollars in 2010. They have become yet another commodity that consumers have learned to live with or even enjoy, like S.U.V.s or Cheetos.”

Unfortunately, there are also many uninformed and/or ignorant people in the world like Paul Reickhoff and many others who do not understand the difference between psychiatrists, psychologists, counselors, and social workers, much less all of the unlicensed frauds out there taking advantage of people and the system, lumping all psychotherapists under the label "psychiatrist". FYI folks ... a psychiatrist is a medical doctor (M.D.) and normally prescribes pills, being much different than psychologists, counselors, and social workers who are trained primarily in psychotherapy and do not prescribe medications. You can read more about the differences here.

I once asked you to please show your support for the Clay Hunt SAV Act by writing to your representatives and let them know that something must be done to help reduce the number of Veteran suicides (22) each day and that the answer is not more psychiatrists in the Veterans Affairs (VA) system or subsidizing their education. As I stated, the best answer is effective, empirically supported treatment by well-trained, licensed, professional psychotherapists (psychologists, LPCs, and social workers), insisting that the Clay Hunt Suicide Prevention for Veterans Act be amended to also include the subsidizing of LPCs, social workers, and psychologists in-training, not just psychiatrists. 

Unfortunately, Mr. Reickhoff apparently does not like to listen to Veterans and experts in the field before proposing legislation that affects millions of Veterans and reduces the number of suicides as the Clay Hunt SAV Act has now passed both Houses of Congress with no changes.  What a shame! Maybe if Paul Rieckhoff cared about Veterans as much as his massive ego, he would have consulted with real experts instead of only the large special interest groups before drafting such a critical piece of legislation affecting our brothers and sisters-in-arms.

Do not get me wrong, the Clay Hunt SAV Act is a start and I am extremely pleased that our government has finally recognized that there is a problem as well as a need for a solution. I am only saddened by the fact that such a poorly conceived notion, that more psychiatrists are the answer to the Veteran suicide problem, was put before Congress and ultimately the President for signature in this landmark legislation.


Mr. Reickhoff recently appeared on CNN, complaining about "veteran leaders" (meaning him) not being invited to meet with President-Elect Donald Trump while people such as Kanye West get access to our next president. While Mr. Reickhoff may have a valid point, I can guarantee you that his motivations are strictly personal and narcissistic:
Reickhoff was a reservist, serving on active duty for a couple years before starting the Iraq and Afghanistan Veterans of America (IAVA) organization in 2004. According to the blogs ThisAintHell and A Soldier's Perspective, this is also a guy who falsely wore a Bronze Star Medal and Special Forces patch in photos. In fact, his highest award was an Army Commendation Medal which are handed out like candy to anybody that happens to be breathing during military service. Mr. Reickhoff also continually boasts on Twitter and other social media platforms about his meetings with top leaders while staying in lavish hotels and with offices in the most expensive areas of New York City and Washington D.C. all at IAVA and veteran's expense. According to Stars and Stripes, his 2012 salary was reportedly $145,000, over 2% of IAVA's operating budget for the year, so God only knows how much of IAVA's budget goes to him and his lavish lifestyle instead of those who really need it.

You can read more about my views on mental health treatment, and the associated stigmas, among military and Veterans as well as the implications in regard to PTSD and suicide in my article: The Stigma Killing American Heroes on my blog and as published in De Oppresso Liber magazine.

Here are a few more articles from my blog that are related to the information detailed above if you want to do some more reading:







References

CCHR International (No Date): Shrinks for Sale: Psychiatry’s Conflicted Alliance - The Corrupt Alliance of the Psychiatric-Pharmaceutical Industry
http://www.cchrint.org/issues/the-corrupt-alliance-of-the-psychiatric-pharmaceutical-industry/

Cohen, Elizabeth: CDC: Antidepressants Most Prescribed Drugs in U.S., July 9, 2007, CNN: 

Greenberg, Gary: The Psychiatric Drug Crisis. New Yorker Magazine, September 3, 2013 Issue – Elements: http://www.newyorker.com/tech/elements/the-psychiatric-drug-crisis

Grishim, C.J.: Paul Reickhoff’s Grand Misrepresentation, Published August 27, 2016, A Soldier's Perspective: http://asp.tacticalgear.com/paul-reickhoffs-grand-misrepresentation/

Lilyea, Jonn: Paul Rieckhoff and Needless Embellishment, Published July 13, 2012, ThisAintHell: thisainthell.us/blog

Roethel, Kathryn: Antidepressants - Nation's Top Prescription, Published 4:49 pm, Tuesday, November 13, 2012, SFGate: 


Title: Clay Hunt Suicide Prevention for Veterans Act ... Great Idea, Poor Execution

Key Words: Clay Hunt Suicide Prevention Act, SAV, ACT, Afghanistan, America, anxiety, Clay, Clay Hunt, depression, Hunt, IAVA, Iraq, legislation, Paul Rieckhoff, prevention, suicide, veterans, PTSD, Reickhoff

Saturday, December 10, 2016

BMB BASIC TRAINING - Episode 7: "Values"


In this episode of BMB BASIC TRAINING, Chris discusses "values" or the lack thereof in society, American and around the world, today. Individuals, institutions, and nation states are in disarray today, and Chris believes it is because of a lack of or alienation from CORE VALUES. They either never had any values to begin with or have lost their way somehow.

Chris goes on to describe how to define values as well as how you can define your own values and goals. Without values and goals, people and institutions tend to act based on emotion, and that is not a smart way to act in a world where we depend on one another.

Body-Mind-Behavior Therapy helps people and groups learn to focus on the present moment, StayPresent; develop resilience skills in order to be able to act more effectively when challenged by crisis, BeResilient; and how to define and commit to acting in accordance with those values...it does not get much simpler than that!




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Title: BMB BASIC TRAINING - Episode 7: "Values"

Key Words: BASIC, TRAINING, CombatCounselor, mindfulness, anxiety, depression, Body, Mind, BMBT, treatment, cognitive, behavioral, CBT, dialectical, behavior, DBT, Acceptance, Commitment, Therapy, ACT, 

Saturday, December 3, 2016

BMB BASIC TRAINING - Episode 6 - "StayPresent, BeResilient, StayTheCourse" ™


In BMB BASIC TRAINING - Episode 6, entitled "StayPresent, BeResilient, StayTheCourse" ™, CombatCounselor describes the three pillars of Body-Mind-Behavior Therapy (BMBT), putting each in the proper context. Learn how to focus on the present moment (here and now), develop resilience skills, and live in accordance with your values.


Contentment and a value-driven life are yours with the knowledge and skills provided in BMBT and CombatCounselor helps you locate the path to your own enlightenment on CombatCounselor Channel and on his blog: CombatCounselor.com



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Title: BMB BASIC TRAINING - Episode 6 - "StayPresent, BeResilient, StayTheCourse" ™

Key Words: BASIC, TRAINING, CombatCounselor, mindfulness, anxiety, depression, Body, Mind, BMBT, treatment, cognitive, behavioral, CBT, dialectical, behavior, DBT, Acceptance, Commitment, Therapy, ACT, 

Saturday, November 26, 2016

BMB BASIC TRAINING - Episode 5: "What is Mindfulness? How Do I StayPresent?"


Are you tired of being anxious or depressed? Have you tried everything, yet are still looking for the magic answer? Well, you've been wasting your time. That's right! The therapies and self-help books you have been so diligently following are all wrong! 


I'm Chris Sorrentino, better known as Combat Counselor. The answer to your problems is not in the content of your life or thoughts, but in the context. You've been looking at your problems from the wrong perspective! No wonder you never seem to get any better! 

My weekly series, BMB BASIC TRAINING, takes you through the details of my exciting new therapy, Body-Mind-Behavior Therapy. Episode 1, 2, 3, and 4 are already complete and in upcoming episodes I will answer questions from viewers about how BMBT works and how it can help you.

This week's question: "What is Mindfulness and how Do I StayPresent?" - Elisa F. - Lawrence, Kansas



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Title: BMB BASIC TRAINING - Episode 5: "What is Mindfulness? How Do I StayPresent?"

Key Words: BASIC, TRAINING, CombatCounselor, mindfulness, anxiety, depression, Body, Mind, BMBT, treatment, cognitive, behavioral, CBT, dialectical, behavior, DBT, Acceptance, Commitment, Therapy, ACT, 

Saturday, November 19, 2016

BMB BASIC TRAINING - Episode 4: "StayPresent, BeResilient, StayTheCourse"™

Are you tired of being anxious or depressed? Have you tried everything, yet are still looking for the magic answer? Well, you've been wasting your time. That's right! The therapies and self-help books you have been so diligently following are all wrong! 

I'm Chris Sorrentino, better known as Combat Counselor. The answer to your problems is not in the content of your life or thoughts, but in the context. You've been looking at your problems from the wrong perspective! No wonder you never seem to get any better! 

My weekly series, BMB BASIC TRAINING, takes you through the details of my exciting new therapy, Body-Mind-Behavior Therapy. Episode 1, 2, and 3 are already complete and in upcoming episodes I will answer questions from viewers about how BMBT works and how it can help you.



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Title: BMB BASIC TRAINING - Episode 4: "StayPresent, BeResilient, StayTheCourse"™

Key Words: BASIC, TRAINING, CombatCounselor, mindfulness, anxiety, depression, Body, Mind, BMBT, treatment, cognitive, behavioral, CBT, dialectical, behavior, DBT, Acceptance, Commitment, Therapy, ACT, 

Saturday, November 12, 2016

BMB BASIC TRAINING Episode 3 - "The First Sessions"

In Episode 3, CombatCounselor answers the question: 

What happens in the first sessions of therapy? What can I expect? - Matt S. Colorado Springs, CO

CombatCounselor focuses on the therapeutic relationship, assessment, and the first phase of Body-Mind-Behavior Therapy (BMBT), the Body. He explains how diet,exercise, and sleep are critical to mental and physical health, giving some tips based on his experience and studies. Finally, he discusses mindful meditation of the breath, an integral part of BMBT and something he starts from the very beginning.


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Title: BMB BASIC TRAINING Episode 3 - "The First Sessions"

Key Words: BASIC, TRAINING, CombatCounselor, mindfulness, anxiety, depression, Body, Mind, BMBT, treatment, cognitive, behavioral, CBT, dialectical, behavior, DBT, Acceptance, Commitment, Therapy, ACT, 

Monday, November 7, 2016

Watch All 12 Episodes Of BMB Basic Training ... FREE ... With A New Episode Posted Every Saturday Morning

Now you can watch a new episode of BMB BASIC TRAINING with CombatCounselor starting every Saturday morning for 12 consecutive weeks!
BMB BASIC TRAINING focuses on mindfulness-based cognitive behavioral therapy and the "100% natural" things you can do to eliminate anxiety and depression from your life. 
Chris Sorrentino (aka CombatCounselor) earned his B.A. in Psychology (1980) and an M.S. in Clinical Psychology (1982) at Cal State Los Angeles, becoming a Licensed Professional Counselor (LPC) and National Certified Counselor (NCC) in 1991 while an Associate Professor of Psychology at the United States Air Force Academy in Colorado Springs, Colorado.

Chris is a highly decorated veteran of four combat operations, having retired from the United States Air Force as a lieutenant colonel after 20 years of dedicated service to his country. 
In BMB BASIC TRAINING, Chris discusses Body-Mind-Behavior Therapy (BMBT), his proprietary approach to treatment as well as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and Acceptance and Commitment Therapy (ACT).
All 12 videos in the series, 3 hours and 15 minutes in total, will be published on this blog AT NO CHARGE every Saturday morning after 3:00 AM (PST). Unlike most "free" programs, there are no gimmicks because I have absolutely nothing sell. I am offering my 34 years of education and experience totally free in order to help you live an anxiety and depression-free life.
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Title: Watch All 12 Episodes Of BMB Basic Training ... FREE ... With A New Episode Posted Every Saturday Morning

Key Words: BASIC, TRAINING, CombatCounselor, mindfulness, anxiety, depression, Body, Mind, BMBT, treatment, cognitive, behavioral, CBT, dialectical, behavior, DBT, Acceptance, Commitment, Therapy, ACT, 

Saturday, November 5, 2016

BMB BASIC TRAINING - Epsode 2: "Client Beware"

In Episode 2 of BMB Basic Training, CombatCounselor explains the difference between different types of therapists (counselors, psychologists, life coaches, etc) and what to look for when hiring a therapist. Particularly important are licensure and certification, so ask to see their credentials before saying a word or paying a penny.



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Title: BMB BASIC TRAINING - Episode 2: "Client Beware"

Key Words: BASIC, TRAINING, CombatCounselor, mindfulness, anxiety, depression, Body, Mind, BMBT, treatment, cognitive, behavioral, CBT, dialectical, behavior, DBT, Acceptance, Commitment, Therapy, ACT

Tuesday, November 1, 2016

BMB BASIC TRAINING - Episode 1: Introduction to Body-Mind-Behavior Therapy (BMBT)

Series "premier" of BMB BASIC TRAINING with CombatCounselor - Episode 1: An Introduction to Body-Mind-Behavior Therapy (BMBT)


BMB BASIC TRAINING is a YouTube series on the "CombatCounselor" Channel which focuses on mindfulness-based cognitive behavioral therapy and the things you can do to eliminate anxiety and depression from your life. 

Chris Sorrentino (LPC, NCC) discusses Body-Mind-Behavior Therapy (BMBT), his proprietary approach to treatment as well as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and Acceptance and Commitment Therapy (ACT).

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Title: BMB BASIC TRAINING - Episode 1: Introduction to Body-Mind-Behavior Therapy (BMBT)

Key Words: BASIC, TRAINING, CombatCounselor, mindfulness, anxiety, depression, Body, Mind, BMBT, treatment, cognitive, behavioral, CBT, dialectical, behavior, DBT, Acceptance, Commitment, Therapy, ACT, 

Free Video Series Now Available On CombatCounselor.com - Learn How To Eliminate Anxiety And Depression From Your Life Naturally

BMB BASIC TRAINING with CombatCounselor focuses on mindfulness-based cognitive behavioral therapy and the "100% natural" things you can do to eliminate anxiety and depression from your life. 
Chris Sorrentino earned his B.A. in Psychology (1980) and an M.S. in Clinical Psychology (1982) at Cal State Los Angeles, becoming a Licensed Professional Counselor (LPC) and National Certified Counselor (NCC) in 1991 while an Associate Professor of Psychology at the United States Air Force Academy in Colorado Springs, Colorado.

Chris is a highly decorated veteran of four combat operations, having retired from the United States Air Force as a lieutenant colonel after 20 years of dedicated service to his country. Leading over 2,000 airmen during his career, Chris was highly respected by the men and women that worked for and with him as well as others he had the honor of serving with.
In BMB BASIC TRAINING, Chris discusses Body-Mind-Behavior Therapy (BMBT), his proprietary approach to treatment as well as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and Acceptance and Commitment Therapy (ACT).
All 12 videos in the series, 3 hours and 15 minutes in total, will be published on this blog AT NO CHARGE. There are no gimmicks because I have nothing sell. I am offering my 34 years of education and experience totally free in order to help you live an anxiety and depression-free life.
Follow Me To Mental Health!

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Subscribe To My Popular Blog ... Nearing 100,000 Visitors!

Title: Free Video Series Now Available On CombatCounselor.com - Learn How To Eliminate Anxiety And Depression From Your Life Naturally

Key Words: BASIC, TRAINING, CombatCounselor, mindfulness, anxiety, depression, Body, Mind, BMBT, treatment, cognitive, behavioral, CBT, dialectical, behavior, DBT, Acceptance, Commitment, Therapy, ACT, 

Wednesday, September 21, 2016

Get Of Your "But" And Live A Value Driven Life ... That's A Freakin' Order!


What if I told you that I have the key to controlling anxiety, or depression, or anger, or whatever might be ailing you, psychologically speaking?  What if I told you that after 30 years of searching, I finally figured it out, this “psychotherapy” business?  There are probably hundreds, if not thousands, of self-help psychology books out there, and they all claim to have “the answer”. What if I told you that controlling anxiety is not the answer to your troubles, but the problem?  What if I told you that the answer to controlling your anxiety is to give up the struggle and simply accept the anxiety?  Would you think I am crazy? Yes, probably. Would you be right? Well, maybe. But, what do you have to lose by reading a little further and finding out if what I am saying makes sense, then deciding if you want to keep reading and, possibly, changing your life forever? If you are looking for a quick fix, you have come to the wrong place. If you are looking for an exciting new way of living and are willing to do some work to get wherever you want to be, psychologically, this is the book for you. But first, a little background about me. 

I am a combat and disabled veteran, retired military officer, and licensed professional counselor with over 30 years of experience and education in clinical psychology and cognitive-behavioral therapy.  I was an Assistant Professor of Behavioral Sciences and Leadership and counselor at the United States Air Force Academy from 1988 to 1993 and  am author of the future New York Times Best Seller: You Think, You Are…Anxious: A Journey from Avoidance to Acceptance, the first installment in the You Think, You Are series.  I will bestow my knowledge and wisdom, a proprietary approach to cognitive-behavioral therapy known as Body-Mind-Behavior Therapy (BMBT), in the first of the series, which follows forthwith.

The earliest cognitive-behavioral therapists lived thousands of years ago and the origins of cognitive-behavioral psychology go back as far as Buddha (563-483 BC) who said, “We are what we think; we are shaped by our thoughts; we become what we think.” Actually, he said it in Chinese, because his English was not great.  Confucius (551-479 BC) also pointed out (in Chinese, of course) the importance of thoughts and mindfulness in behavior, when he said, “The more man meditates upon good thoughts, the better will be his world and the world at large.”  How about that!  Those two guys were pretty smart because, here we are two thousand five hundred years later and, we have only recently rediscovered the validity and usefulness of these profound statements.  

Wait a minute; did he say he was a future New York Times bestselling author?  Bestow his knowledge and wisdom?  What? Is he nuts?  Some might think so, but I prefer to think of myself as mildly eccentric.  But, think about what Buddha said for a minute: “We are what we think” (hence, the title of this book and series).  It is so true, but we take it for granted that sometimes, many times, in fact, that what our minds tell us is far from reality, yet the majority of the time we believe exactly what our thoughts tell us, even though our thoughts may not be, and probably are not, true.  Scientists say that we have as many as 50,000 thoughts a day. If we knew how accurate our memories actually are at remembering things correctly, we would be hesitant to believe anything that goes through our minds.  The mind is a very funny thing as we shall see as we progress in our “Journey from Avoidance to Acceptance”.

How many times have you been absolutely sure something was true, but it turned out not to be the case (or vice versa)? “I’m going to get really nervous during that upcoming presentation and forget what I’m supposed to say.”  “What an idiot I am.”  “Those people are laughing at me because I’m fat.”  Is what you think is reality or are they just thoughts?  What goes through your mind could possibly be true, you could get nervous, freeze, and forget what to say in front of a bunch of people, but it most likely would not happen, had you not given those doubts credibility in the first place.  Nevertheless, you believe the thoughts anyway, making yourself more nervous than you probably need to be, a self-fulfilling prophecy of sorts.  Because you think you will get nervous, you, in fact, become nervous which, in turn, negatively affects your performance, making you even more nervous. That is what we call “meta-cognition”, which can be defined as “thinking about thinking” (cognition originates from the Latin verb cognoscere, literally meaning "to know") or, in this case, getting nervous about getting nervous, and it is ruining your life! It is also an excellent example of a vicious cycle, a cycle which, if not interrupted or broken, can escalate out of control into severe anxiety or full-blown panic.

So what are you going to do about it?  Well, you can do nothing about it and be miserable for the rest of your life, or, you could try to sort things out on your own, maybe read a self-help book (like this one), or you can get some help from a professional counselor.  Cognitive behavioral therapy (CBT) is the most widely researched mode of psychotherapy and efficacious (that is scientist talk for “effective”), particularly when it comes to anxiety and depression.  But, what exactly is CBT?  Well, I am going to tell you, the way I understand it, and introduce you to my approach to cognitive behavioral therapy, what I call Body-Mind-Behavior Therapy or BMBT, for short.

BMBT is a cognitive behavioral approach, in that we focus on thoughts and behaviors, but is different to traditional CBT, in that with BMBT, we focus on changing the context of thought rather than the content. That might not make much sense right now, but I am going to explain it to you in simple English (not Chinese) and in “un-”scientific terms, but first we need to know how we got here . . . a little history perhaps.

Behavior therapy got its start in the 1920s and 1930s, but really took off in the 50s when Joseph Wolpe designed a method called systematic desensitization.  In the late 1950s and early 1960s, Albert Ellis and Aaron Beck began what we call cognitive therapy today, a therapy where negative automatic thoughts (aka NATS – like those annoying little buggers that swarm around your head on a hot summer day and drive you nuts, but spelled slightly differently) are analyzed, challenged, and tested. Because their methods contained behavioral elements as well (exposure, activity scheduling, and so on), the therapy has commonly become known as cognitive behavioral therapy or CBT for short.  In the 1980s, along came the "third wave" (as Steven Hayes and others have called it) of cognitive behavioral therapy.  Dr. Marsha Linehan developed a therapy called Dialectical Behavior Therapy (DBT) for the treatment of borderline personality disorder at the University of Washington and Steven Hayes developed what is now known as Acceptance and Commitment Therapy (ACT - pronounced like the word, not as an acronym) at the University of Nevada in Reno.  Both DBT and ACT incorporate "mindfulness" and "acceptance" into CBT, hence the tag "third wave" which has become associated with these evolutionary and revolutionary new treatments.  MBMT (BMBT??)incorporates the best of CBT, DBT, and ACT into a powerful, yet extremely simple package, a package that is deceptively basic and drastically different than anything you have ever tried before.  Are you getting excited yet?

Well, don’t get too excited just yet because here is the bad news. People in general, and Americans in particular, spend a lot of time (and money) being anxious and depressed.  According to the National Institute of Mental Health (NIMH), some 40 million American adults, 18 percent (nearly two (2) out of every ten (10) people), suffer from an anxiety disorder in any given year.  The anxiety disorders include specific phobias (like acrophobia – fear of heights – accounting for 8.7%), social anxiety disorder (fear of people and being evaluated – public speaking anxiety is an example - 6.8%), post-traumatic stress disorder (PTSD – a devastating disorder, resulting from a severe trauma – making up another 3.5%), generalized anxiety disorder (excessive worry - 3.1%), panic disorder (strong, urgent anxiety attacks that come out of the blue - 2.7%), obsessive-compulsive disorder (or OCD – hoarding, excessive checking, or fear of contamination are examples - 1%), and, finally, agoraphobia (fear of open spaces – more accurately, the fear of having a panic attack when away from home - often found with panic disorder -  coming in at .8%).  If that were not bad enough, another 9.5 percent of the U.S. population, age 18 and older, (nearly one out of every ten people), has a mood disorder, like depression or bi-polar disorder, in any given year according to the NIMH.  These disorders (illnesses, problems…pick a label) cost millions, if not billions, of dollars each year in therapy, visits to general practitioners, medications (can you say Zoloft?), and lost productivity, including missing work.

Now for the good news.  The anxiety and mood disorders we have been talking about can be treated quite effectively with CBT, DBT, ACT or, in this case, BMBT.  As a matter of fact, the vast majority (nine out of ten) of the "well-established" empirically supported treatments (according to the American Psychiatric Association) for the anxiety and mood disorders are cognitive-behavioral.  In simple terms, CBT works very well for many problems, anxiety and depression in particular.  Over the next several chapters, I will be describing BMBT in much more depth, taking a lot of the mystery out of psychotherapy and dispelling many of the myths that surround it.  If you have seen the show Obsessed on A&E, a show about OCD and CBT, you have a very rough, and I do mean very rough, idea of how cognitive-behavioral therapy works, at least for people with OCD.  I will now give you a brief glimpse of what is to come in upcoming chapters.

I will start by providing a historical overview of where cognitive behavioral therapy has been, and where it is going, looking at some of the philosophies and theories behind cognitive  behavioral therapy as it has evolved and how it exists today. I will briefly discuss B.F. Skinner, Albert Ellis, Aaron Beck, Marsha Linehan, Steven Hayes and the tremendous contributions these incredibly talented individuals have made over the past half-century as well as the theories behind their successes. It is important to know where you have been, at times, to have an idea of where you are going, and the people I mentioned, and their theories, are at the forefront of psychotherapy today. Notice I did not say “cognitive behavioral” psychotherapy, I said “psychotherapy” in general, because the cognitive behavioral therapies are the most studied, effective, and widely used of all therapies in existence.
I will then elaborate on mindfulness and acceptance, both of which are the key to successful treatment, particularly for anxiety.  Mindfulness has been integrated into cognitive behavioral therapy by asking clients to focus on the here-and-now, using techniques derived from Zen Buddhism.  Mindfulness is not a spiritual process in the sense that it is associated with any particular religion (as it is used in DBT, ACT, and BMBT anyway ???), it is a state of mind which allows the client to maintain contact with the present, allowing him or her to accept thoughts, memories, and emotions as they are, without judgment.  This is a powerful method of reducing anxiety and other painful psychological problems, and is something I strongly encourage my clients to try.  Personally, I find no conflict between mindfulness, acceptance, and my faith, but that is a judgment you will have to make for yourself.  Cognitive behavioral therapy can work quite well without the mindfulness component, but I believe you will be short-changing yourself if you ignore it. You can find a series of mindfulness exercises on the accompanying CD, along with several other resources we will be talking about later, making this an extremely user-friendly experience and complete package, one-stop shopping for your psyche, if you will.
Next is “dialectical” thinking, the cornerstone of Linehan’s DBT and a philosophy I embrace in BMBT.  The dialectical philosophy is too complex to explain here, but basically entails looking at things in terms of shades of “grey”, getting away from “black and white” or “dichotomous” (all or nothing) thinking many of us tend to gravitate toward.  The primary dialectic Linehan teaches is “acceptance versus change”, where the therapist accepts the client (and the client accepts her/himself) as he/she is in the here-and-now, validating any problems and struggles, while pushing him/herself to change for the better.  It is not the therapist that challenges thoughts or makes the decisions, it is you, the client (or reader), that makes the decisions, with expert assistance from a professional counselor, or in this case,  my book.

There are four primary factors involved in mental health (or mental disorders), factors that can become a “vicious cycle” when they get out of whack and left unattended. The four factors I am talking about are physiology (BODY -biochemical imbalances, diet, sleep, exercise), cognition (MIND – like those nasty, annoying NATS), behavior (BEHAVIOR - smoking, overeating, drinking), and affect (or emotions, a combination of BODY, MIND, and BEHAVIOR).  If any one of these domains becomes unstable, it can throw the whole system out of balance, resulting in anxiety, depression, or some other psychological problem. 

Figure 1
As a matter of fact, the logo on the front and back covers (Figure 1), which I created for my practice in Kansas City, includes the Greek letter "psi", representing psychology, and the circular blue arrows surrounding the symbol represent the physiological (BODY), cognitive (MIND), behavioral (BEHAVIOR), and emotional (BODY + MIND + BEHAVIOR) components of the human psyche.  As I alluded to earlier, those four components constantly interact to make you sad or anxious, a “vicious cycle”, or happy and serene, what I like to call a “precious cycle”.  I will address each of these factors separately, and in detail, so you understand how they can affect you and what you can do to help them work in harmony.

Life skills are skills that make it easier to navigate life, even when anxious or depressed, and are skills everyone can benefit from understanding and practicing.  We already mentioned one of them and that is mindfulness.  The others are distress tolerance (stuff you can do when things get rough), interpersonal effectiveness (how to get along with others and stand up for yourself at the same time), and emotional regulation (tools you can use to feel less stressed).  These really are very simple tools, but you will be surprised by how easy it is to forget how to use them when you are feeling stressed, anxious, or worried. I will explain how to recognize and use these tools, when appropriate, to help you be more effective in life and content in the present moment.

I will then address the biggest threat to mental health in general, and the crux of the anxiety disorders: avoidance.  Avoidance takes many forms, but some of the most common are smoking, overeating, excessive drinking, drug abuse, and sexual (and other) addictions (can you say video games???).  But are those not behaviors (you are probably asking yourself)?  Yes, they are behaviors, avoidant behaviors, because they help you avoid the things that are really bothering you, like those nasty NATs that are contributing to your anxiety and/or depression.  You can, and do, also avoid thoughts, physical sensations, emotions, and other “internal” behaviors.  In short, avoiding what you are afraid of, or find distressing is what causes and perpetuates anxiety (and depression). 

Now that we have a solid foundation, the real work begins! I will next take you through a series of steps (chapters) using experiential techniques and exercises while explaining the intent of those techniques and exercises in simple terms, something Steven Hayes would probably argue against doing, but that I believe is essential when dealing with intelligent, thoughtful human beings.

We will first review all of the things you have tried, to control anxiety over the years, but have obviously failed at, or you would not be reading this book. As I mentioned earlier, control is the problem, not the solution. It seems somewhat counterintuitive and it is, because, again, as I told you earlier, my approach is unlike anything else you have tried before. What you have been doing does not work, so how about taking a radically different approach? What some might call “thinking outside the box”.

We will then determine how you view yourself and offer some alternatives, giving you a solid foundation on which we can build a totally same you. Same? Not new? That is correct. There is nothing wrong with you, nothing broken. You have simply learned to think the way you do, the way that makes you anxious, and you can learn to think in a way that does not make you anxious.

Next, we will try some things that will give you a new perspective on anxiety and emotions. You will experience a new way of thinking about your thoughts, sensations, behaviors, and emotions, focusing on the context rather than the content, a deceptively complex, yet simple alternative to the way you have been doing it for so long.

The next step in the process will be to look very hard at your values.  Not the values you think you should have because your mother or partner wants you to be a certain way, but the values that are important to you.  To put it simply, those which would be important to you if you knew that nobody else would know what those values are.  Once you determine your true values, and I am not talking about hardware, setting specific goals based on those values and committed actions, is the obvious next step.  By having a clear guide, goals that are based on your values, and making a commitment to yourself (and others if you wish) to live your life every day in accordance with your values, you will find it much easier to face and conquer the fears which have become so debilitating and disabling.

In the final chapter, I will pull it all together, giving you step-by-step assistance in implementing this new way of living, along with some possible pitfalls, those things we therapists call “relapse prevention”.  I will also explain what a typical session and course of treatment might look like for those of you who decide to seek assistance from a trained professional. 

Body-Mind-Behavior Therapy and cognitive behavioral therapy are really very simple and straightforward, and all we as therapists do is teach you and coach you along until you know how to help yourself.  If you listen intently, are motivated to change and face your fears, and work collaboratively with your therapist, you too can live a long, happy, and fulfilling life. 

Finally, I will explain everything you ever wanted to know about psychotherapists, but were afraid to ask. Do you know the difference between a psychologist, a life coach, a licensed professional counselor, a spiritual healer, and a psychiatrist?  Well, if you do not know, and are planning on seeking treatment at some point, it could be the most important information you ever learned.  The differences are HUGE and the cost to you could be enormous, not only in terms of money thrown out the window, but in your emotional well-being as well. 



Are you ready to start your journey from avoidance to acceptance? Well hold onto your seat, because here we go....