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Working with the Stressed-Out Client

Therapists,

Stress is increasingly common among our client population these days. I have been working with Army soldiers and see a common set of symptoms among this very stressed out population.

Two of the symptoms we see often are …

Headaches … Stress is at the bottom of headaches a good deal of the time (although there are other generators of headaches as well, such as diet, medication side effects, and so forth). Migraines can happen when clients are under substantial stress, and they often hold their tension in the back of the neck. The pain can end up at a 7 to 9. There is light sensitivity and sometimes nausea. The sufferer wants to curl up in bed in a dark room until they can ride out the migraine, which can go on for several hours. Learning stress reduction techniques such as mindfulness meditation can often alleviate these headaches, but a consult to a neurologist is sometimes indicated.

Sleep … It is not uncommon to see a person getting two, three, four hours of sleep per night. Their mind may race and they wake up frequently throughout the night. Drug-based sleep medication often interferes with REM sleep and the sufferer ends up groggy in the morning and unable to concentrate through the day. A better alternative is melatonin (a natural hormone produced by the pineal gland in the brain). Nine or ten milligrams half an hour before bedtime often does the trick. And of course, there are the standard sleep hygiene techniques. Turning off the thinking and just focusing on the breathing while the body is relaxed, in conjunction with melatonin, can often put a person to sleep within a few minutes.

The topic for the September/October 2015 issue of Emotional Wellness Matters will be The Passive-Aggressive Partner.

Till next time … Bob

Working with the Stressed-Out Client

Therapists,

Stress is increasingly common among our client population these days. I have been working with Army soldiers and see a common set of symptoms among this very stressed out population.

Two of the symptoms we see often are …

Headaches … Stress is at the bottom of headaches a good deal of the time (although there are other generators of headaches as well, such as diet, medication side effects, and so forth). Migraines can happen when clients are under substantial stress, and they often hold their tension in the back of the neck. The pain can end up at a 7 to 9. There is light sensitivity and sometimes nausea. The sufferer wants to curl up in bed in a dark room until they can ride out the migraine, which can go on for several hours. Learning stress reduction techniques such as mindfulness meditation can often alleviate these headaches, but a consult to a neurologist is sometimes indicated.

Sleep … It is not uncommon to see a person getting two, three, four hours of sleep per night. Their mind may race and they wake up frequently throughout the night. Drug-based sleep medication often interferes with REM sleep and the sufferer ends up groggy in the morning and unable to concentrate through the day. A better alternative is melatonin (a natural hormone produced by the pineal gland in the brain). Nine or ten milligrams half an hour before bedtime often does the trick. And of course, there are the standard sleep hygiene techniques. Turning off the thinking and just focusing on the breathing while the body is relaxed, in conjunction with melatonin, can often put a person to sleep within a few minutes.

The topic for the September/October 2015 issue of Emotional Wellness Matters will be The Passive-Aggressive Partner.

Till next time … Bob

The Importance of the Initial Intake

Therapists,

Something I come across frequently in working with my clients is that point when the therapy runs out of steam. I hate to think of myself as a therapist who keeps asking the question at the start of a session, “How was your week?” or “What are we going to talk about today?” While it may get things started, it may not keep the therapy focused. And, ethically, most clients (and surely the insurers) want to make progress toward a goal. (There is room, of course, for the client who wants to explore his or her life, to develop a life narrative – and that tends to be less focused.)

So, in my opinion, this points to the first intake session and how it has to be complete. (This is the first 90-minute initial intake session.) I type up my intake session so that I can easily go back to it on the computer and I use a template so that things can stay organized. When my therapy with a client begins to lag, I always go back to the intake where I can pick up clues that lead us to stay focused in the therapy. So, now I can go back to the age of the client when her parents got divorced, and I can begin to ask what that must have been like for her mother and what impact those years must have had on the client. It’s just a clue I pick up on when I review the initial intake again, and it really adds to the richness of the therapy.

The topic for the July/August 2015 issue of Emotional Wellness Matters will be Actively Listening.

Till next time … Bob