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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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Showing posts with label avoidance. Show all posts
Showing posts with label avoidance. Show all posts

Friday, April 4, 2014

Introduction to Body-Mind-Behavior Therapy (BMBT)

Many of us have suffer from anxiety or depression, yet are still looking for a solution. Whatever you have been doing must not be working or you would not still be looking for answers.

Maybe you have been looking in the wrong places! Maybe you have been focusing on changing the "content" of your life (words, thoughts, emotions) instead of the "context", the part you actually have control over when it comes to internal problems (e.g. cognition...your thoughts).

In my upcoming book, "Get Off Your Buts And Live A Value-Driven Life ... That's A Freakin' Order!", I explain my proprietary approach to psychotherapy, integrating traditional cognitive behavioral therapy (CBT) with mindfulness-based CBT, called Body-Mind-Behavior Therapy (BMBT).

In BMBT, we focus first on what your BODY is telling us in terms of proper exercise, diet, and sleep as well as those internal sensations that "set-off" your anxiety or depression. Next, we focus on the MIND, teaching you how to be mindful in the present moment, accepting thoughts and emotions, and changing the "context" of how you relate to your thoughts rather than changing the thoughts themselves. Finally, BEHAVIOR becomes the target by clarifying your values, setting achievable goals, and making a commitment to taking action toward achieving those goals.

The result of BMBT is not another "quick fix", but a new way of life where you are mindful of the moment and ACT based on your values, rather than avoiding the things that you fear or make you sad.

Visit and SUBSCRIBE to my POPULAR YouTube channel, The CombatCounselor Channel, and  send me a message, telling me about your problem, what you have tried to do to fix it, and what result you would like to achieve:


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acceptance, ACT, anxiety, are, avoidance, cognitive behavioral therapy, CBT, acceptance and commitment therapy, combatcounselor, DBT, depression, journey, ACT, mental health, ptsd, mindfulness

Friday, March 1, 2013

Anger Management ... Can You control Your Anger?

It is difficult, if not impossible, to manage or control anger. Control is the problem, not the solution. You can control many things in the world, but when you try to control what is between your ears, you will fail miserably. 

Dealing with anger issues can be very simple, yet extremely difficult, because you have learned to react the way you do. You cannot "unlearn" it because the mind is a one-way street of sorts, once "it" is in there, "it" is there for good. However, you can learn new ways of responding to angry thoughts, changing the context rather than the content. Let me briefly explain. 

You could practice accepting angry thoughts, which cause angry emotions, just as they are, non-judementally, in the present moment. Those thoughts, which may be true or valid, or may not be true or valid, are most likely not productive. So, by accepting the thoughts for what they are, merely thoughts, you can let yourself experience any valid anger rather than pushing it away or you can simply observe the thoughts and not attach any judgment or importance to them. In either case, you now have control over the process (context) and how you react to the thoughts.

I said it is simple because it is. It is as simple as accepting thoughts, sensations, behaviors, memories, and emotions for what they are and without judgement. Becoming competent at doing that is the difficult part. It takes practice, mindfulness practice, every day of the week for the rest of your life. Would you trade a life complicated by anger, anxiety, depression, shame, guilt (etc, etc) for one of calmness and tranquility if I told you it would take only 5 to 30 minutes a day?

The mindfulness-based cognitive behavioral therapies (DBT, ACT, MBMT) are not just for "crazy" people, but for anybody who is tired of letting their thoughts and emotions run their lives. It is a positive psychology in the sense that we train ourselves to look at negativity as a transient state and is based on the traditions of Zen Buddhism while incorporating modern, effective cognitive behavioral techniques based on the latest scientific research.

There are 15 episodes of BODY-MIND-BEHAVIOR (BMB) BASIC TRAINING on my YouTube channel: CombatCounselor Channel can read more on our website, www.KCCBT.com and my blog, The CombatCounselor Chronicle. You can also follow me on Twitter @CombatCounselor or LIKE my Facebook page: Like CombatCounselor on Facebook . You can also search using the terms mindfulness-based cognitive behavioral therapy and Acceptance and Commitment Therapy (ACT).

Don't forget to follow @CombatCongressman on Twitter, subscribe to his blog CombatCongressman Connection, visit his website CombatCongressman.com AND VOTE FOR THOMAS C. SORRENTINO IN THE 2014 MIDTERM ELECTION - MISSOURI'S 6TH CONGRESSIONAL DISTRICT!

Monday, February 18, 2013

Client Beware: Protecting Yourself from Un(der)qualified “Therapists”




By Chris Sorrentino, MS, LPC, NCC

Chris Sorrentino is 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.  Chris was an Assistant Professor of Behavioral Sciences and Leadership and Counselor at the United States Air Force Academy from 1988 to 1993.  He is the author of the future New York Times Best Seller Get Off Your Buts And Live A Value-Driven Life ... That's A Freakin' Order".

Many people seek the expertise and advice of “professionals”, paying top-dollar for, what they believe, is psychotherapy.  I have been a licensed psychotherapist (licensed professional counselor, or LPC, actually) for 20 years, having seen literally hundreds of clients, but very few ever asked me about my qualifications.  Of course, I am obligated, morally, legally, and ethically, to inform my clients about my education, experience, licenses, and approach to treatment (legally known as “informed consent”), and do so consistently.  However, there are multitudes of individuals and groups out there advertizing themselves as “therapists”, “life coaches”, “healers”, and other creative titles, hoping the public (you) will believe that they are qualified to help you with your psychological baggage.  Client beware!

This is the first in a series of articles I will write that will take some of the mystique away from psychotherapy.  Many people understand therapy based on what they have seen in movies, on HBO, in books, and on TV (e.g. Dr. Phil) and have no idea of what goes on behind closed doors.  My goal is to help you understand what psychotherapy is and is not, so you can make an informed decision about whom you can trust with your deepest, darkest secrets and pay hundreds, if not thousands, of dollars to in the process. The purpose of this first article is to inform you about who is qualified to provide psychotherapy and who (in my opinion) is not.
At the most basic level, there are specific requirements in each state for practicing psychotherapy and therapists are regulated by the state in which they practice.  There is a governing body for each specialty (e.g. LPCs, social workers, psychologists, psychiatrists) which specifies the requirements to practice in that state and we (therapists) are required to meet those requirements prior to seeing a single client.  For example, an LPC (like myself) in the State of Missouri is required to hold a master’s degree from an accredited institution with an emphasis in ten core areas (counseling theory, human development, diversity, testing, etc.) completing a supervised practicum and internship as well as 3,000 hours (over a two year period) of supervision under a qualified, licensed clinician (therapist).  Additionally, an LPC must take and pass the National Counselor Examination, an extremely difficult, comprehensive, nationwide exam in addition to passing a background check (to make sure we are not murderers, child molesters, or rapists).  Only then, if the board sees fit, do you receive a license to provide psychotherapy in the state.  Most states have similar requirements for each profession, but some variation exists from state to state.  You can check the requirements for each profession in your state by going to your state’s website.  In the case of Missouri, the Missouri Division of Professional Registration oversees licensure for all of the psychotherapy professions and you can find the requirements for yourself by visiting  http://pr.mo.gov/default.asp.  This brings me to my next topic, the professions.

Titles vary slightly from state to state, so I will focus on Missouri guidelines to simplify the discussion.  Again, you can check with your state’s regulatory body for the specifics of the state in which you reside.  In  Missouri, individuals qualified and licensed to provide psychotherapy are called licensed professional counselors (LPC), licensed clinical social workers (LCSW), psychologists, or psychiatrists.  Let me explain briefly the differences between them.  LPCs and LCSWs are master’s-level (normally, a two-year post-baccalaureate degree) clinicians having completed their graduate degree in the field of study in which they are getting licensed from an accredited institution (not a diploma mill), completed supervised practicum, internship, and clinical supervision (3,000 hours – 24 months), successfully passed the required national or state exam(s), not be a felon (remember the background check? – this will be important later), and be approved by the state board governing their specialty.  Finally, we are all professionally and ethically required, above all else, to “do no harm” and to protect your confidentiality.

So what is the difference between an LPC or LCSW and a psychologist?  I am glad you asked!  A psychologist goes through an almost identical, if not more rigorous, qualification process, with the difference being that they have completed a doctoral program instead of a master’s, normally consisting of three to four years of post-baccalaureate education in a School of Psychology (PhD), School of Education (EdD), or Professional School (PsyD).  Doctoral-level clinicians, beside the additional 1-2 years of school, have more course work and experience in research design and psychological testing than master’s level clinicians do.

Many people get psychologists and psychiatrists confused and I often get the question, what is the difference?  In a nutshell, psychiatrists are physicians (medical doctors – MD) who have completed a three to four year specialization in psychiatry whereas a psychologist calls him/herself “doctor” (because they have a “doctorate” degree), but cannot prescribe medicine.  Psychiatrists are an excellent choice if you believe you need medicine (anti-depressants, mood stabilizers, anti-psychotics, etc.), but, in many cases (and in my experience) have limited “clinical” expertise (think “talk therapy” like CBT) because they were trained using the “medical model” and believe drugs are the answer to most problems (more about that in a minute).

It really does not matter whom you choose (LPC, LCSW, psychologist, psychiatrist) as long as you can verify that they are licensed to practice in your state and you believe they can help you based on their individual training and expertise.  Fees obviously vary with LPCs, LCSWs being the least expensive in general, and psychiatrists being the most expensive.  All things being equal, the most important things to consider are: does the clinician’s approach make sense; is their approach compatible with your beliefs and values; and do you think you can get along with the person (can they be trusted)?

You might ask yourself, what is the difference between being licensed (e.g. licensed professional counselor) and being certified (e.g. NCC – National Certified Counselor)?  Licensure is a legal requirement mandated by the state.  Certification is a process in which a governing body (sometimes a state, county, or city and sometimes a private organization) develops requirements to give additional oversight and credibility to an individual or profession.  For example, I am required by the State of Missouri to be licensed (LPC) in order to provide psychotherapy to clients, but I have chosen to seek additional certification (NCC) through the National Board of Certified Counselors (aka NBCC - which, by the way, requires an additional 100 hours of continuing education every five years).  Each certifying body has their own requirements and processes, some very stringent (like NBCC) and others not so stringent, as I will highlight for you now.

As I mentioned in the opening paragraph, there are many people, some well-meaning, some not, who call themselves therapists or something similar, making you believe they are qualified to help you with your psychological problems.  Client beware!  These individuals go by titles such as “life coach”, “intuitive life coach”, “energy healer”, “psychic healer”, “hypnotist”, “spiritual counselor”...the list goes on and on.  There are individuals hosting radio shows and writing magazine columns, giving relationship and other advice to strangers with their only qualification being having been married for five years.  Another example are “certified” life coaches or spiritual counselors, who take as few as two or three courses (and pay a few thousand dollars) or complete as few as 16 hours of training, sometimes even less!  Some of these titles may sound impressive (what exactly is an “intuitive” life coach anyway?) and lead you to believe the individual has received the training to help you, but there is no state licensing body overseeing their “practice”, no stringent internship or supervision requirement (think 16 hours versus 3,000 hours), no continuing education requirement, and (remember what I said earlier?) NO BACKGROUND CHECK!  Many of these individuals may have good intentions, please do not get me wrong, but do you really want to pay someone with 16 hours of training hundreds or even thousands of dollars, confiding in them and sharing your deepest feelings and concerns?  I know that I do not.

There are some properly trained professionals (LPCs, LCSWs, psychologists, etc.) who may use titles such as those described above (e.g. hypnotist), the key difference being that these individuals have attained licensure in their state, completing the rigorous requirements defined by law (think LPCs, LCSWs, etc.).  So, when you decide you want help sorting out your problems, do not let titles and fancy names fool you and make sure you ask many questions, do a little research, and ensure you hire someone qualified to give you the help you so richly deserve.  Even among professionally licensed clinicians, there are good ones and bad ones, so make sure you understand the process, ask the right questions, and ensure you are getting what you are paying for, sound, professional assistance in helping you manage your life.  Notice I did not say anything about “advice”, because if they are giving you advice, even a licensed professional, turn and run as fast as you can.  More about that in a future article.

C.T. Sorrentino is currently writing a series of articles entitled You Think, You AreThese articles take readers through ten steps toward better mental health, incorporating Kansas City Cognitive-Behavioral Therapy's proprietary, holistic, cognitive-behavioral approach to the treatment of anxiety and depression: Body-Mind-Behavior Therapy (BMBT).  These articles will also serve as the building blocks for his new book, also entitled Get Off Your Buts And Live A Value-Driven Life ... That's A Freakin' Order", a book that Chris hopes to publish in 2014.   He plans on writing a series of books focusing on the role of cognition, physiology (e.g. diet, exercise, and sleep), behavior (positive and negative), emotion, and values in maintaining a healthy mind and positive lifestyle.

COPYRIGHT 2013 – CombatCounselor and Kansas City Cognitive-Behavioral Therapy, LLC  ©

Friday, December 2, 2011

The Therapeutic Alliance


This article focuses on therapeutic (working) alliance in counseling, a critical component related to successful outcome in counseling.  I examine a small number of studies, providing background related to the general effects of counseling and the Working Alliance Inventory (WAI) and discussing the impact of the alliance in counseling.  I conclude with a discussion of the implications of the information presented, specifically focusing on the contextual model and the importance of general effects in counseling, the importance of developing a collaborative relationship with clients early on, understanding how clients early formative and current relationships affect their ability to form a working alliance, achieving a balance between process related techniques and alliance strengthening skills, and, finally, evaluating client attachment style and how it may affect the working alliance.  
                        Keywords: Alliance, therapeutic, counseling, client, attachment, contextual.


           The therapeutic alliance, or “working” alliance as Bordin (1979) defined it, is widely accepted as a crucial component of successful outcome in counseling and has been studied extensively.  I examine a relatively small number of studies here and with a somewhat limited focus due to time and other constraints related to this assignment.  I will start by providing some background related to the general effects of counseling as well as a widely used instrument in measuring the alliance, the Working Alliance Inventory (WAI).  I will then discuss the impact of the alliance in counseling, focusing on a few key studies, finishing with a discussion of the implications of the information presented.
General Effects and the Therapeutic Alliance
            In Wampold’s book, The Great Psychotherapy Debate, he identified therapist effects as a “critical factor in the success of therapy” (2001, p. 202).  More specifically, in their article on therapist and patient variability in the therapeutic alliance, Baldwin, Imel, and Wampold (2007) pointed out that it is the therapist’s contribution to the alliance that is foremost in determining a successful outcome for the client.  Wampold (2001) supported the contextual model (versus the medical model), contending that is the general effects (common factors – therapeutic alliance, therapist competence, a belief, by the therapist and client, in the effectiveness of the therapy, etc.) of psychotherapy that are key to a successful outcome, not the specific effects (techniques) of any particular therapeutic approach.   That being said, it is widely contended that it is the therapeutic alliance that will account for a great deal of the variability, both positive and negative, in the client’s outcome.
The Working Alliance Inventory (WAI)
            The Working Alliance Inventory (WAI), developed by Horvath and Greenberg in 1968, is a widely used instrument for measuring the therapeutic alliance and was the instrument of choice in the majority of the studies discussed here. The WAI is a 36-item self report survey consisting of three subscales that mirror Bordin’s three components of the working alliance, goals, tasks, and bonds, and uses a 7-point Likert-type scale.  Parallel forms are available for both clients and counselors (Satterfield and Lyddon, 1995).
The Therapeutic (Working) Alliance
            One of the most important tasks that we as counselors have is to form a positive, healthy, nurturing working alliance with our clients.  As we discussed briefly above, Bordin (1979) defined the working alliance as a collaborative process in which client and counselor  (a) mutually endorse goals or counseling outcomes; (b) join in tasks related to the attainment of successful outcomes; and (c) establish positive personal attachments, or bonds, which are characterized by trust, acceptance, and confidence.  A good working alliance is based on two important factors.  The first factor is the relationship that the counselor develops and fosters from the very beginning of counseling.  Kokotovic and Tracey (1990) found that clients who were viewed by their counselors as having poor social relationships in general had greater difficulty in forming working relationships (alliances) with their counselors.  A second factor is the relationship the client has or had with his or her parents, because that relationship will give us insight into how the client relates to their social network and, ultimately, most likely predict how they will relate to their counselor.  In support of that assertion, Mallinckrodt (1991) also reported evidence of a correlation between clients’ recollections of the quality of their childhood bonds with their parents and the strength of the working alliance.
            In Kivlighan’s (1990) study, the relationship between counselor technical activity (use of intentions – set limits, educate, assess, explore, change, restructure, and support) and working alliance (as rated by the client) was analyzed during the course of four counseling sessions.  Two groups of undergraduate students were asked to participate in a study in which sessions were analyzed to see if the use of intentions by the counselor affected the quality of the therapeutic alliance.  The study found that during the four sessions, three of the intentions mentioned above, assess, explore, and support, were negatively correlated with the working alliance as measured by the WAI.  The authors were somewhat surprised by the negative correlation of the support intention (offering support or encouragement) with the alliance, but concluded that this may have occurred because it put the client in a more passive role.  They also proposed the following questions: 1) “Can counselors be trained to decrease their use of the assessment, explore, and support intentions?” and 2) “Would this training affect client-rated alliance?” We are not sure that such training would be either indicated or useful based on a study with such obvious limitations, considering the importance of assessment, exploration, and support in counseling.  At best, the study points to the need to balance such strategies, with the counselor paying particular attention to the use of intentions that may put the client in a more passive role versus those that will enhance the working alliance.
            According to Satterfield (1995), a client whose attachment style is characterized by a lack of trust in the availability and dependability of others (low level of “depend”) may be more likely to evaluate the counseling relationship in negative terms, particularly during the early phase of counseling. The authors recruited ninety-six first-time clients seeking counseling through the university to participate in a study in which they completed the Adult Attachment Scale (AAS) prior to counseling and the WAI (client version) after the third session.  Sixty participants completed the study and the authors concluded that client attachment, particularly the “depend” measure, is in-fact negatively correlated with the working alliance and may lead to unfavorable counseling outcomes. They also recommended further research on the impact of counselor knowledge of client attachment dimensions and the affect they may have on the working alliance.
Conclusions
            What should counselors focus on if we are to accept the hypothesis of the contextual model and the importance of general effects in counseling as proposed by Wampold?  Based on the research, one of the most important things we can do is learn how to better foster a therapeutic, empathic, nurturing alliance with our clients.  As Bordin (1979) recommended, we should focus on developing a collaborative relationship with our clients early on, setting mutually agreeable goals, working together toward successful outcomes, and establishing positive bonds.  Kokotovic and Tracey (1990) and Mallinckrodt (1991), taught us that we should understand how our clients early formative relationships and their ability to form and maintain current relationships affect their ability to form a strong working alliance.  Kivlighan  (1990) emphasized the importance of focusing on a balance between process related techniques (intentions) and alliance strengthening skills, such as those endorsed by Carl Rogers (genuineness, empathy, and warmth).  Finally, Satterfield (1995) points us to the need to assess our client’s attachment style, looking particularly for those clients who may be characterized by a lack of trust in the availability and dependability of others, and how their attachment style may contribute to the alliance.   In conclusion, because alliance effects are so intertwined with outcome, whether positive or negative, we owe it to our clients to “do no harm” and do everything in our power to foster a positive working alliance.
References
Baldwin, S.A., Imel, Z.E., & Wampold, B.E. (2007).  Untangling the alliance-outcome correlation: Exploring the importance of therapist and patient variability in the alliance. Journal of Consulting and Clinical Psychology, 75 (6), 842-852.

Bordin, E. S. (1979).  The generalization of psychoanalytic concept of the working alliance. Psychotherapy, 16, 252-260.

Kivlighan, D. M. (1990). Relation between counselors' use of intentions and clients' perception of working alliance. Journal of Counseling Psychology, 37(1), 27-32.

Kokotovic, A. M. and T. J. Tracey (1990). Working alliance in the early phase of counselor. Journal of Counseling Psychology, 37, 16-21.

Mallinckrodt, B. (1991). Clients' representations of childhood emotional bonds with parents, social support, and formation of the work alliance. Journal of Counseling Psychology, 38, 401-409.

Satterfield, W. A. and W. J. Lyddon (1995). "Client attachment and perceptions of the working alliance with counselor trainees. Journal of Counseling Psychology, 42 (2), 187-189.

Wampold, B. (2001).  The Great Psychotherapy Debate. Mahwah, NJ: Lawrence Erbaum Associates.

© CombatCounselor 2011 – All Rights Reserved

Thursday, December 1, 2011

Freud and Psychoanalysis versus Hayes and ACT: Time for a Change?

Sigmund Freud
It goes without saying, Sigmund Freud is an icon, having had a tremendous influence on psychology in general and psychotherapy in particular.  However, exposure to Freud and psychoanalysis in undergraduate, graduate, and post-graduate programs, I believe, has outlasted his contributions and become rather tedious.  Studying Freud and psychoanalysis in an undergraduate introductory psychology course or even an undergraduate or graduate theories course is understandable and warranted.  I have been exposed to Freud countless times in numerous courses and, to be totally honest, I think it is a waste of time to continue to study a theory that has never been proven and been the laughing stock of serious behavioral scientists for decades.  It is hard to believe that clinicians still practice psychoanalysis in the 21st Century and that a current text applying developmental theories to counseling (Kraus, 2008) or one on theories of human development (Newman and Newman, 2007) would spend as many as 67 pages discussing it.  Surely, there are more deserving, practical, and recent theories that could have been printed on those pages, Relational Frame Theory for instance.
“The third wave of behavior therapy” (Hayes, 2004, p.16), as Steven Hayes and others have called it, has emerged to provide an experiential option for those who practice and are treated with cognitive behavioral therapy (CBT).  This third wave of therapies includes Acceptance and Commitment Therapy (ACT – pronounced as a word, not an acronym) and Dialectical Behavior Therapy (DBT – Linehan, 1993), both of which focus on mindfulness and acceptance, and influenced by the tradition of Zen Buddhism.  ACT is based on the philosophy of Functional Contextualism and a developmental learning theory known as Relational Frame Theory (RFT), a fairly recent theory developed by Hayes over the past 15 to 20 years. 
Relational Frame Theory is a rather difficult theory to grasp, but both Blackledge (2007) and Blackledge and Hayes (2001) helped clarify the theory and the connection between language, experiential avoidance, cognitive defusion, and exposure.  Blackledge and Hayes (2001) also clarified the difference between ACT and CBT, where thoughts emotions, and memories are simply accepted as such (in ACT) rather than trying to modify them as is done in CBT.  According to RFT (Blackledge and Hayes, 2001), language and rule-governed behavior are additive in the sense that what we have experienced (behavior, thoughts, emotions, memories, etc.) can never be eliminated and, therefore, we must create positive, novel, experience-based memories founded on acting in accordance with personal values rather than “replacing” negative experiences.  This concept is quite contrary to CBT, where thoughts are analyzed and manipulated, even though ACT is considered a cognitive behavioral therapy.
            Relational Frame Theory has been studied extensively and Hayes et al (2006) has done an excellent job of describing the framework of ACT, explaining the basic philosophy, theory, principles, and processes in a succinct and easily understandable manner.  There is a large and ever-accumulating body of research and literature, both on RFT and on ACT, empirically supported and validated research as opposed to the unproven psychoanalytic or psychosexual theories of Freud and his cohorts.  In my opinion, the 67 pages spent on Freud in our two texts would have been much better spent focusing on a more recent and exciting theory such as RFT. I have personally seen RFT and ACT in action in my own practice, and the results are quite amazing, results taking days or weeks rather than years, as is the case in psychoanalysis. In conclusion, my reaction to Freud and psychoanalysis are, obviously, quite strong.  Again, my goal is not to diminish Freud’s impact or contributions, only to recommend that our time might be better spent on something more current and relevant to clinical practice in the 21st Century.



References
Blackledge, J.T. (2007). Disrupting verbal processes: Cognitive defusion in Acceptance and          Commitment Therapy and other mindfulness-based psychotherapies. The Psychological Record, 57, 555-576.

Hayes, S.C. and Blackledge, J.T. (2001). Emotion regulation in Acceptance and Commitment Therapy. Psychotherapy in Practice, 57 (2), 243-255.

Hayes, S.C., Luoma, J.B., Bond, F.W., Masuda, A., and Lillis, J. (2006). Acceptance and             Commitment Therapy: Model, process and outcomes. Behaviour Research and Therapy,             44, 1-25.

Hayes, S.C., Strosahl, K.D., and Wilson, K.G. (1999). Acceptance and Commitment Therapy:      An Experiential Approach to Behavior Change. New York, NY: The Guilford Press.

Hayes, S.C. and Strosahl, K.D. (Eds.). (2004). A Practical Guide to: Acceptance and Commitment Therapy.  New York, NY: Springer Science+Business Media, LLC.

Linehan, M.M., (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder
New York, N.Y: Guilford Press.

Newman, B.M. and Newman, P.R. (2007). Theories of human development. Mahwah, NJ:            
Lawrence Erlbaum Associates, Publishers.

Walser, R.D. and Westrup, D. (2007). Acceptance and Commitment Therapy for the Treatment     of Post-Traumatic Stress Disorder and Trauma Related Problems: A Practitioners Guide         to Using Mindfulness and Acceptance Strategies. Oakland, CA:  New Harbinger     Publications, Inc.

Wednesday, November 16, 2011

Institutional Terrorism: The “Good Ol’ Boys Network” at Work

Institutional Terrorism:
The “Good Ol’ Boys Network” at Work

By Chris T. Sorrentino, MS, LPC, NCC

Chris Sorrentino is a combat and disabled veteran, retired military officer, and licensed professional counselor.  He was an Assistant Professor of Behavioral Sciences and Leadership and Counselor at the United States Air Force Academy from 1988 to 1993  and has over 30 years of experience and education in clinical psychology and mindfulness-based cognitive-behavioral therapy.  He is the author of You Think, You Are…Anxious: A Journey from Avoidance to Acceptance, the first installment in the You Think, You Are series and is the creator of Body-Mind-Behavior Therapy (BMBT).

Jerry Sandusky, Penn State’s long-time defensive coordinator, has been exposed long after an alleged 2002 child molestation incident, and several others apparently, and Penn State’s legendary coach, Joe Paterno, has been fired. Moreover, this is just the tip of the iceberg.
Apparently, “Stand-Up” Joe (Paterno), as he is affectionately known by the student-body, did not stand-up and do the right thing when one of his former players, a graduate assistant at the time, approached him with news of a ten year old boy having been molested in a shower at Penn State University by Sandusky in 2002. Sandusky’s alleged attacks apparently go back to the mid-90s and continued long after he was reported to Paterno and the Penn State Athletic Director.  I will not go into the details of the allegations because that is not the subject of this story. This is merely one example among thousands that occur in this country each year where innocent people are harmed and the institutions sworn to protect them stand by and do nothing…what I call “Institutional Terrorism”.

The Penn State cover-up reminds me of a similar case in the Diocese of Kansas City and St. Joseph, Missouri, very recently in the news for similar allegations. Catholic Bishop Robert W. Finn and the Kansas City-St. Joseph Diocese have been indicted by a grand jury on a charge of failure to report suspected child abuse by one of the diocese’s priests. This Class A misdemeanor carries a potential sentence of up to one year in jail and a fine up to $1,000 for the bishop. Finn reportedly failed to notify the police regarding the sex abuse of a minor by one of the priests in his diocese after having been made aware of the situation in December of 2009. According to the Huffington Post, Finn is the highest-ranking Catholic clergyman ever to be indicted on criminal charges in a court of law in the United States.  As I will discuss later, this is only one example of Bishop Finn’s propensity to cover-up for one of his own, also known as (a.k.a.) the “good ol’ boys network”, even when he knew his subordinates had done wrong.

As a retired military officer and licensed professional counselor for over 20 years, I have seen and heard of numerous incidents over the years where individuals have been abused, harassed, bullied, discriminated against, then ignored, ostracized or retaliated against for having the audacity to come forward to protect themselves or to file a complaint against their aggressors.

The United States of America has been in a “War with Terror” since September 11th, 2011, a war with an invisible enemy and a relatively small number of casualties worldwide, comparatively speaking. The U.S. has spent billions and sacrificed the lives of thousands of men and women in the armed forces to wage this war, yet we are no closer to a conclusion than we were ten years ago. 

Institutional terrorism is a term I use to define what our nation’s corporations, institutions, and bureaucracies (large organizations) are doing to their workers when they abuse, harass, bully, or discriminate against them or tolerate the illegal or unethical treatment to occur without any repercussions to the offenders. Thousands, possibly hundreds of thousands or more, of our citizens are being tormented every day by an abuser, bully, “control freak”, sadist, or micro-manager, so much so that the stresses caused by these perpetrators result in illness, mental anguish (anxiety and depression), and even suicide or murder (as in going “postal”). What are the other costs? Not just the emotional costs the victims must face night after night, morning after morning, but the real costs related to sick days, medical treatment, administrative time, legal fees, and court costs brought about by their perpetrators? We are talking about billions of dollars annually, and those are just the monetary costs.

All public and private institutions in our country are required by law to treat the people within their organizations fairly and without animus based on their race, religion, gender, national origin, age, sexual orientation, veteran status, and other protected categories. The laws which protect these people include Title VII of the Civil Rights Act of 1964, which prohibits employment discrimination based on race, color, religion, sex, or national origin; the Equal Pay Act of 1963, which protects men and women who perform substantially equal work in the same establishment from sex-based wage discrimination; and the Age Discrimination in Employment Act of 1967 among others. However, the penalties for not complying with these laws are considered “civil” infractions, not “criminal” acts and those found guilty are given a “slap on the wrist” in the form of monetary compensation to the victim by a jury, if it ever gets that far. Even then, these large organizations have high-priced lawyers defending them, scaring away complainants whom rarely have the resources to fight back, and insurance policies to “pay off” the claims if they are, in-fact, ever held accountable in a court of law.

Having defined institutional terrorism and discussed how our laws (fail to) protect workers and others covered under these statutes, I will now elaborate on a few such cases and provide a synopsis of what I believe needs to be done to put an end to these practices. 

Victim #1 is in a helping profession, a generally tolerant, easygoing, empathic person and it is normally quite difficult to ruffle his feathers. Having spent many years in the military, several of them in combat zones, he has also learned to be very patient, respectful of others, and loyal to his superiors and to the organization in which he works.

In December of 2007, Victim #1 and his wife were traveling from their home in Colorado Springs, Colorado to visit Florida with the intention of possibly relocating.  He had told an old and dear friend who lives in a large Midwestern metropolitan area that they would be passing through, so his friend was gracious enough to invite them to stay at their home for the night, which happened to be Christmas Eve. This man had been Victim #1’s commander while assigned to the NATO headquarters in Naples, Italy and, beside being his former boss, they had become very good friends. Who else would invite you to spend Christmas Eve and morning with him and his family, right?

To make a long story short, on Christmas eve, as they sat around the fire having a glass of wine, His friend asked Victim #1 if he would be interested in moving to the area because he had an opening for a purchasing manager in his company. His friend had become the president of a subsidiary of one of the nation’s largest construction companies after retiring from the Army a few years before and was in a position to offer Victim #1 a quite tempting and lucrative offer.

After quite a bit of deliberation, Victim #1 and his wife decided the offer was too good to turn down even though they had no desire to move to the Midwest. He had a cursory interview for the job shortly thereafter, was hired, and moved 600 miles to the area in March 2008. Sounds wonderful, does it not? In such a friendly Midwestern city, what could possibly go wrong?

Well, Victim #1 was bullied, harassed, and threatened by his new thirty-something MBA of a boss from the very beginning, putting up with it for over a year before approaching his friend (his boss’s superior) to discuss the problem. To Victim #1’s utter amazement and dismay, his “friend” threw Victim #1 out of his office, not wanting to even listen to his side of the story. Victim #1 went immediately to human resources (HR) to fill them in on what was going on. He filed a formal complaint against his immediate supervisor a few days later.

Victim #1 had thought that his good friend would never believe the word of such a rude and unprofessional person over that of an old friend and fellow military officer. Friendship is an important bond, one that cannot be broken except in the most extreme circumstances, but officership, the bond between fellow military officers, is one that Victim #1 thought was insurmountable and unbreakable. His “friend” had broken both of those bonds and Victim #1 was devastated.

Once he filed the complaint, the retaliation commenced. The very day he visited HR for the first time, his ex-friend approached him and asked, “So, are you going to resign”? Victim #1 told him that he had no intention to resign and that he (his ex-friend) was picking the wrong side. In addition, the very day he filed the complaint with HR, Victim#1 was brought into an office with his bosses and a representative from HR and, after having been a model employee for over a year, receiving a promotion and a substantial bonus in recent months, Victim #1 was given a written performance plan. Suddenly it was his behavior that was in question, not his boss’s.

It was obvious what was happening in the weeks that followed with Victim #1’s supervisors, including his ex-friend, scrutinizing everything Victim #1 did on a micro-level, bringing him into meetings and lambasting him for one thing or another, even in front of subordinates. He complained to HR about the retaliation, but it was obvious that they would not interfere with the “good ol’ boys network” within the company. His ex-friend was too powerful and had chosen whom he would support. Not knowing what his rights were and psychologically beaten, Victim #1 resigned from his lucrative position after just 15 months, during the worst recession since the great depression, rather than be subjected to the daily torment he had been subjected to for so many months.

Victim #2 had a secure position in one of the “best” school districts in the city. Having been lured from Colorado Springs, she had given up a well-paid tenured position for an excellent salary in this highly respected school district. Victim #2’s principal, who was also new to the school and uninvolved in her hiring, made it obvious from the beginning of year one that she did not like Victim #2, treating her coldly and differently than she did all of the other teachers (who happened to be fair-haired, blue-eyed, and fair- skinned for the most part). I will also point out that there was not a single minority out of 35 full-time employees in the entire school. Year one seemed to go well even though Victim #2 was routinely treated rudely by her principal.

However, at the beginning of year two, it was obvious that something had changed. A little over a month into the school year, Victim #2’s principal decided to put her on a performance plan, even though she had been a model educator for 17 years without a single blemish on her record. I cannot go into details because Victim #2’s discrimination and retaliation case has not yet gone to trial, but she was terminated illegally for filing a lawful complaint based on national origin discrimination (she is an Italian citizen).

The school district supported the perpetrators of the discrimination, performing a cursory investigation at best before finding that “no discrimination” had occurred (one of the perpetrators actually performed the initial  investigation). Of course, they would say that, not admitting publicly that one of their own had been negligent. The superintendent and school board even refused to hear Victim #2’s appeals in order to protect their employees from further unwanted public scrutiny. Fortunately, the teacher’s union was involved from the very beginning, sitting in on every meeting between Victim #2 and the district and supporting her 100 percent. She has a solid case and one of the best discrimination lawyers in the city on her side, but the worst that can happen to the district and the perpetrators is a financial judgment against them. Their insurance company will probably end up paying a majority of the costs once Victim #2, hopefully, prevails.

In July 2010, Victim #3 was attacked in what he thought was a safe haven, the university he attends as a post-graduate student. By the way, Victim #3 is a Phi Kappa Phi Honor Society scholar with a 4.0 GPA in four semesters in the School of Education and a 96 percent average in his courses. Victim #3 is also a non-traditional student being over 50 and a military (disabled) veteran.

He filed a complaint against an instructor in July 2010 for possible discrimination on a course project on which he was graded drastically different (lower) than his classmates for no apparent reason. His advisor, a woman of color, accepted the complaint on behalf of the university, the investigation was mediated within the School of Education, and both sides were satisfied with the result. His advisor did make a strange comment at the end of their first meeting on the issue, stating, “I hope you learned something from this”, as if he, the victim, should learn something from being treated differently and discriminated against? He sent an email to his advisor noting the inappropriate nature of her comment, but thought little more about it.

In May 2011, Victim#3’s advisor called him into a meeting and accused him, without warrant, of acting “aggressive and threatening” in email communications with faculty. He noted that he was surprised by such an accusation and when he asked for specific examples of such behavior, his advisor could provide not a single example, saying “it’s just a perception” (that’s what people apparently say when they want to demean or accuse a person and have no evidence to substantiate their claims). His advisor then threatened his status in the program, telling him that she did not think he had the ability to complete the program successfully, even though Victim #3 is a high-ranking retired military officer, highly decorated war veteran, and Phi Kappa Phi scholar. After doing a little research, it turned out that his advisor was friends with the instructor Victim #3 had filed the complaint against in July 2010, having done research, written papers for journals, and presented at conferences together on several occasions.

When Victim #3 filed a complaint of retaliation and discrimination with the university’s Office of Affirmative Action against his advisor, he was met with resistance from the beginning. Having officially accepted the complaint, they gave him the email runaround for over a week, even insulting him, comparing him to those who had discriminated and retaliated against him (in an email inadvertently sent to him and meant for the Chancellor’s Chief of Staff). The Deputy Chancellor for Diversity, Access and Equity finally decided that Victim #3 had no basis for a complaint because he “had not followed proper procedures” and refused to investigate his legitimate complaint when, in fact, he had followed university policies to the letter.

Having nowhere to appeal within his university, Victim #3 appealed to the president of the state university system, his chancellor’s boss. Even the president of the university refused to acknowledge his complaint until it was sent certified mail, return receipt (signature required) with copies going to the victim’s U.S. senator and representative, state senator, Missouri Department of Higher Education, and the governor as well as several local media agencies (television and print). Since the acknowledgment of receipt of his complaint by the president’s assistant over three months ago, Victim #3 has not heard a single word from anybody, including his elected officials. In the interim, he was forced to withdraw from courses two semesters in a row, being only two semesters shy of graduation, because his complaint has not been successfully resolved. Victim #3’s principles prohibit him from attending an institution that treats people the way this institution has done and will not pay another cent in tuition, even if that means not graduating, which seems highly likely at this point. It is amazing that a public institution of this size and stature, a state university, is not held accountable for their actions when they fail to enforce the very diversity policy and U.S. laws they are sworn to uphold.

Victim #4’s church has joined the list of organizations that could not care less about human beings, protecting their own at all costs.  Having gone through a very difficult two years financially (and emotionally), Victim #4 and his wife started businesses to try to make ends meet. Their only option, to try to salvage their lives from financial ruin, was to start businesses in their respective areas of interest and expertise.

Because they were struggling financially, the only way they could give back to their (Catholic) church was through the donation of time and services, and they had been attempting to do so for several months. They attempted to contact the business manager of their parish on several occasions, offering  thousands of dollars worth of their services to the needy. Having been ignored for months, they wrote an email to the manager explaining their situation, but they received a reply from the parish priest, not the business manager. Instead of getting answers to their questions and concerns, the response from the priest was superficial, defensive, and insulting. He defended his business manager’s behavior, indicating that Victim #4 was incorrect in his assessment of the situation. 

Victim #4 decided to write back, telling the priest he was confused and disappointed by his response. Two weeks passed without a word, so Victim #4 decided to take it to the next level, sending an email to the bishop of the diocese (with all previous messages attached), again explaining what he wanted to accomplish and expressing his disappointment with the response from his priest. He told the bishop (this is the same bishop, Bishop Finn, who is now being investigated for covering up knowledge of a pedophile priest and indicted) what had happened and, again, the bishop missed the mark, defending the parish priest instead of offering a simple apology and solution to the situation.

Once again, the diocese protected one of their own instead of doing the right thing, admitting to a mistake, and trying to resolve the problem professionally and amicably. Bishop Finn obviously has a history of covering-up for and protecting his own as is obvious in the charges against him for covering-up for the pedophile priest.

Finally, Victim #5’s business advertisements (postcards) were approved by his local YMCA’s general manager to be placed in their “vendor” area, providing several customers and hundreds of dollars in business revenue each month.  The ads were left “mostly” undisturbed for over a year, having been located in the same exact spot during that entire time.  Various business owners, who felt they could displace the ads with their own any time they pleased, had vandalized the postcards from time to time during that period. In May 2011, Victim #5’s advertisements were once again displaced by another business’s, so Victim #5 complained to YMCA staff. The staff, including the general manager, all of whom appeared defensive, saying they “didn’t have time” to manage business advertisements, seeming  perturbed by the complaint. Oddly, the postcards suddenly started to disappear in bulk (50 or more at a time) and when Victim #5 asked a staff member what had happened to the cards, he was  informed that the general manager had removed them.

Victim #5 brought the matter to the attention of the general manager, but she appeared to care less, giving him the impression that she was in-fact behind the vandalism and petty theft of the cards.  The victim’s business is a service-disabled veteran-owned small business by the way.  Having mentioned the problems to management on numerous occasions, they seemed to care less, appeared to not want to be bothered, and in-fact appeared resentful and even hostile at times.

Getting no assistance or resolution from YMCA staff, Victim #5 decided to file a report with the local police department and sent a letter of complaint (certified mail with return receipt/signature) to the YMCA Board of Directors, asking them to have their staff refrain from stealing postcards and treating him (a service-disabled veteran business owner) differentially from other business owners.  Nearly six months have passed and the YMCA Board of Directors has yet to either acknowledge or respond to his official complaint against YMCA staff. He has since removed his business’s advertisements and the businesses are, unfortunately, closing due to lack of clientele and some additional assistance from the local YMCA.

Does anybody deserve the kind of treatment these victims have been subjected to? Absolutely not! Does it happen? You bet it does and these victims are not alone. Discrimination laws in this country are a joke. As I mentioned earlier, there is no criminal penalty for discrimination or retaliation. I had thought it was a crime to discriminate until just recently. However, discrimination and retaliation cases, when they proceed to trial, are heard in “civil” court, not “criminal” court.

It is not a crime to discriminate and nobody goes to jail for mistreating people based on color, national origin, religion, veteran status, or other protected categories. The worst that happens is a slap on the wrist. If an organization is found negligent, their insurance company usually ends up paying the bill. Most cases are swept under the rug and never heard about because the insurance companies settle with the victims before it can go to trial, avoiding negative media exposure and possible internal sanctions.

If you have not figured it out yet, you may be surprised to know that I am Victim #1, 3, 4, and 5 and my wife is Victim #2.  This has been the story of our lives over the past three years. Having spent nearly 25 percent of my 20 year military career in combat zones, being shot at by Bosnian-Serb snipers in Sarajevo, the target of Serbian artillery while fighting for the liberation of Kosovo, and on an aircraft targeted by Al Qaeda surface-to-air missiles while in Saudi Arabia shortly after 9/11 while supporting Operation ENDURING FREEDOM, I have never in my life been the target of such unwarranted, ruthless, and needless attacks as we have since moving to Kansas City, Missouri in 2008.

As I said earlier, we are not alone and this is a huge problem in our nation. Many thousands of citizens and non-citizens are being abused, bullied, harassed and discriminated and retaliated against while the bureaucracies their aggressors work for turn their heads the other way, covering up for the corporate elite and refusing to do the right thing.

Joe Paterno and Bishop Finn could have stopped needless sexual abuse had they come forward immediately and reported the offenders as is required by law, but the institutions they represent let the offenders continue their abuses in the name of protecting their own and their institution’s “good” name. Whether it is child abuse, sexual abuse, bullying, harassment, discrimination, or retaliation, if an institution covers-up an offense, whether criminal or civil, they are not acting in the public interest, they are acting in their own interest.

As I see it, being not just an expert in human behavior, but a management and leadership expert as well, the many difficulties we are experiencing as a society stem from a lack of accountability as well as a lack of clarity regarding our values. Let me explain briefly.

First, individuals are not held accountable within organizations because to admit wrongdoing when a complaint of abuse, harassment, bullying, or discrimination is lodged against an employee, is to admit that the institution is culpable. I have seen it repeatedly that the powers that be refuse to protect the victim, siding with the aggressor in order to save face and avoid possible litigation and responsibility.

Because bullying, harassment, discrimination and retaliation are civil crimes at the very worst, they are swept under the table until the victim navigates a complex web of requirements and deadlines in order to file a case, often without the assistance of a lawyer.  Why no lawyer? Because the legal profession will not lift a finger until they see “dollar signs” and, by then, it is often too late because the victim had missed one step or strict deadline along the way, negating the validity of the case in the eyes of the law.

Did you know that if you are discriminated against, you have just 180 days (in most states), only 6 months, after the alleged offense to file a formal complaint or you lose your right to justice? Even then, you must follow the institutions complex policies to the letter, then filing with the appropriate state agency (e.g. Human Rights Commission) or the Equal Employment Opportunity Commission (federal).  Until these laws are changed, making them criminal rather than civil offenses, and the aggressors, as well as those who cover-up those offenses, are held accountable, going to jail when appropriate, these institutions will continue to hide their atrocities as was recently the case at Penn State and in Kansas City’s Catholic diocese.

Second, individuals and institutions have lost touch with their values, if they ever had any in the first place. I have seen it repeatedly in my practice; people do not have a clue what their core values are. That is why my therapy, Body-Mind-Behavior Therapy (BMBT) focuses on values clarification and living a value-driven life. Without clearly defined values, it is impossible to set clear, just, and attainable goals. These institutions have lost touch with what it means to do the right thing, even if it means making themselves look bad or turning-in one of their own when they have done wrong.

Until many more Americans and American institutions start holding their people accountable and stop giving “lip service” to their core values, starting to make decisions based on them instead, our country is going to continue to deteriorate. We see it more and more very day. Bernie Madhoff, Elliot Spitzer, Enron, AIG, Bank of America, Joe Paterno, Bishop Finn, the list goes on and on, people and institutions will do practically anything and crush anybody that gets in their way in the name of self-preservation, preserving the status quo…“the good ol’ boys network”.

Chris Sorrentino is host of the weekly series, CombatCounselor Q&A, on YouTube’s CombatCounselor Channel, airing Saturdays at 11:00 AM CSTThis series answers viewer’s questions, taking them through ten steps toward better mental health while incorporating his proprietary, holistic, cognitive-behavioral approach to the treatment of anxiety and depression known as Body-Mind-Behavior Therapy (BMBT).  Chris also plans to write a series of books, the You Think, You Are series, focusing on the role of cognition, physiology (e.g. diet, exercise, and sleep), behavior (positive and negative), and emotion in maintaining a healthy mind and positive lifestyle. You can follow Chris on Twitter @CombatCounselor or read his blog, CombatCounselor, on Blogspot.

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