excerpt from 10 Simple Solutions to Chronic Pain

Depression afflicts 50 percent of chronic pain patients (Fishbain et al. 986), and some have estimated the figure to be much higher (Romano and Turner 1985). Most experts agree that symptoms of depression occur following the onset of pain and are more likely to be present in people who are psychologically susceptible (Sullivan et al. 2001).

In addition, people with chronic pain seem to experience more problems with anxiety than the general population (Craig 1994). Fears of reinjury and pain, worries about future losses (especially of functional abilities and finances), and a sense of threat of psychological harm from the stress and strain of chronic pain are common (Rosensteil and Keefe 1983). Anxiety, when present, contributes to higher levels of distress and disability associated with chronic pain (Waddell et al. 1993).

Anger is also a frequent problem for many people with chronic pain (Fernandez and Turk 1995). Patients in our clinic often report feeling more irritable and angry after the onset of their pain. Anger, in turn, interferes with activities and increases pain intensity and symptoms of depression (Tearnan and Lewandowski 1992; Kerns, Rosenberg, and Jacob 1994), fueling a vicious cycle. Anger may also significantly interfere with motivation and acceptance of treatment goals in people with chronic pain (Gatchel 2005).

Depression, anxiety, and anger have another debilitating effect: They often make people believe they’ve changed into someone they don’t like—a person who is always angry and discontented, someone indecisive and lacking confidence, a shell of their former self. And in fact, it is difficult to feel or think like your former self when you’re depressed, anxious, or angry. However, you haven’t lost the things you cherish about yourself— your values and core beliefs. They still reside within you.

Before working on specific techniques to improve your mood, you need to understand the nature of depression, anxiety, and anger. This will help you recognize when you’re having problems. Also, bear in mind that negative emotions rarely exist in isolation. When people are angry, they’re often depressed and anxious. The suggestions and interventions in this chapter are effective in modifying all three negative emotions.

excerpt from The Chronic Pain Care Workbook

People react differently to pain. How you cope with your pain is largely based on how functional you are physically and psychologically. The more you are able to do the things you want, the easier it is to cope with pain. The more you are able to view your self as healthy, the more sound your ideas and thoughts about living with pain. Conversely, the more you see yourself as sick, injured, or damaged, mentally or physically, the harder it is to cope with life. In short, the higher your psychological and physical function, the better you do. Your thoughts and ideas about having pain can play a major role in determining how well or how poorly you cope with pain.

Ellis and Harper introduced an important way of looking at how thoughts and beliefs influence behavior in their work helping people with problems other than chronic pain. However, many pain management centers around the world have adapted this model to evaluate how people’s thoughts and beliefs shape the chronic pain experience.

New Harbinger's second piece on Huffington Post.

By Stephanie Sarkis, Ph.D., author of 10 Simple Solutions to Adult ADD

Approximately 4 percent of the general population has attention deficit hyperactivity disorder (ADHD). You may be wondering if you have ADD - you have difficulties staying on task, and tend to interrupt others, among other difficulties. Here are some ways that may help you find out if ADHD is an issue for you:

read the rest of the piece here.

excerpt from Trigger Point Therapy for Low Back Pain

We’ve often tried to account for the almost total lack of attention myofascial trigger points receive in the medical field—despite the fact that every day we perform therapy that relieves chronic pain in the great majority of people coming to us.

We’ve had many patients who were scheduled for surgery but after being treated with trigger point elimination techniques, chose not to go through with surgery because their pain was gone. We’ve also treated people who had already undergone surgery. Some of them qualified for the diagnosis of failed back surgery syndrome. Although pain relief is more difficult in such cases, we are usually able to help. Additionally, general anesthetic and surgical procedures sometimes activate latent trigger points, so we often treat painful conditions caused or exacerbated by surgery.

by guest blogger Judith Siegel Ph.D., LCSW, author of Stop Overreacting

Too often, people believe that the best way to manage anger is to suppress it. I have worked with so many clients whose problems are directly linked to their need to distance from their ‘bad’ feelings. But is anger always bad? Research based on neuro-imaging suggests that anger is an emotional response that generates from the amygdala. Like other hard-wired emotions, anger is a response to stimuli that sets off a reaction in our minds and bodies. The most important question is not how to suppress it, but to understand how we process it. Working with beliefs about anger is helpful, but is only part of the solution. If childhood experiences with adult anger have programmed us to shut down, then it is almost impossible to access thoughts and beliefs in the presence of the emotional intensity and anxiety that anger produces.

A new approach to anger management is to focus on helping connect the dots. One line of dots runs from the left to the right hemisphere of the brain, creating a neural pathway between thoughts and feelings. Without that path, the triggers that have generated anger can not be comprehended, and the result is senseless rage or shutdown. Another set of dots that need to be connected runs between awareness of our physical selves and awareness of feelings. I have worked with so many people who, even in the middle of an explosive outburst, have no awareness that they are angry. Learning to measure the degree of anger that you feel at any given moment in time is a helpful exercise, for it is important to comprehend and accept that there is a full range of emotional experience that involve both mind and body.

excerpt from When Anger Hurts

1. First, and most importantly, STOP.

2. Watch what you say to yourself.

3. Act the opposite.

Laura J. Knoff, NC, discussed her book, Whole-Food Guide to Overcoming Irritable Bowel Syndrome, tips on eating healthy, and loving it on Bay Sunday.

excerpt from Letting Go of Anger

“When I’m really mad at others, I sometimes take it out on myself.” “I get just as mad at myself as I do at other people.” “I just hate my guts.” Anger turned inward means taking the feeling of anger, and behaving in a way that turns that anger on ourselves. The results are that we hurt ourselves, sometimes knowingly but often without thinking much about it. Although anger is a feeling, it can lead us to angry behaviors such as blaming, ignoring, shaming, criticizing, attacking, condemning, abandoning, and physically harming its target. What happens when we target ourselves for these kinds of punishments? We often hear people say they are frustrated, angry, even furious with themselves. Some people get as angry with themselves as they do with others in their lives. But many say they are angry only with themselves. There are also those who refuse to admit any anger whatever, but treat themselves like yesterday’s trash. They are angry and disgusted that they are here in this world, feeling inadequate and paralyzed, they try to justify the fact that they exist, and often feel like failures.

It is when we turn our anger inward often, with too much energy, calling ourselves names and feeling angry with ourselves for whatever we do, that our anger becomes a problem—for us and usually for those who love us, as well.

Present Perfect by Pavel Somov, Ph.D. is Psych Central's Book of the Month. Read Psych Central founder John Grohol's review here

excerpt from The Relaxation and Stress Reduction Workbook for Kids

Think back to your own childhood for a moment. What are the five most stressful moments that come to mind? If you are like many adults, family fights are at the top of your list.

All couples argue at some time. All kids lose their tempers, too. It is rare to find siblings who don’t occasionally quarrel or call each other names. But arguing and fighting should be an exception, not a rule. If your family life is tainted by constant bickering, sarcasm, yelling, or other forms of arguing, you should put peacemaking at the top of your stress-reduction to-do list.

Everyone, even children as young as five, can learn peacemaking or conflict-resolution skills. Conflict-resolution programs have been used in schools for more than a decade, and there is one thing we know about them: they work. There are many ways to teach these same skills at home. Here is one activity that can help family members find peaceful ways to resolve their differences.

excerpt from Parenting Your Out-of-Control Child

Research suggests that one important factor in differentiating parents who become physically abusive from those who don’t is the parents’ belief that their child is misbehaving on purpose; that is, the child knows the right way to behave but is misbehaving to spite the parents or make them angry. It has been my experience that many parents of out-of control children share this belief. At times, they see their child behave appropriately. Consequently, during those times when he misbehaves, they assume that he has purposefully decided to do so. This belief is further strengthened when parents experience their child’s verbal challenges of authority, such as when the child says, “You can’t make me” or “I hate you.” However, this belief is incorrect as well as counterproductive; it only serves to exacerbate the parents’ anger.

Instead, recognize that out-of-control children are usually impulsive and tend to follow the path of least resistance to get what they want. They are likely to repeat what has worked for them in the past to obtain the consequence that they want, even if the manner of doing so was inappropriate. As many noted behaviorists have pointed out over the years, it is the consequence after the behavior that determines whether that behavior will be performed again. If a behavior results in a consequence that your child considers desirable, he is more likely to perform this behavior in the future. If not, the likelihood of performing the same behavior is diminished.

New Harbinger Publications is now on Huffington Post! Our first piece is Top 10 Tips for Getting Your Dream Job. Bill Knaus, Ed.D., co-author of Fearless Job Hunting wrote this piece.

To see our latest pieces, please visit our Huffington Post page. Look forward to more pieces from a host of authors in the future!

by guest blogger Kiera Van Gelder, MFA, author of The Buddha and the Borderline

When Merinda Epstein, a Policy and Law Reform Officer of the Mental Health Legal Centre in Melborne Australia, made the decision to “come out” with borderline personality disorder as a consumer advocate, her therapist was horrified. She asked Epstein, “why would you want to talk about that diagnosis in public for? You’ve got a perfectly good psychotic diagnosis to use in public!”

Such unfortunately is the reaction many of us who self-identify as “borderline” encounter. You can be a drug addict, have depression, OCD, schizophrenia, or any other number of diagnoses and people will shake your hand and congratulate you on your courage and honesty. But if you say you have BPD, everyone—from counselors to well meaning friends to even DBT therapists, will prophesize that you’ve just ruined your chances of ever getting a good job, relationship or credit rating. The last thing you ever want to be in the line-up of mental illnesses is borderline. Even if you have it. Perhaps, especially if you have it.

I didn’t know this at first. I came to the diagnosis from the twelve step community, where they say “you can’t save your ass and your face at the same time.” I didn’t care what I had, so long as I knew there’d be a solution to it. And the doctor assured me there was, in the form of a new treatment called dialectical behavior therapy (DBT). I called one of my few remaining friends as soon as I got out of the doctor’s office. “Good news!” I gushed “I have borderline personality disorder! And it makes perfect sense!”

There was a pause on the other end of the phone and then Laura shrieked, “there is no f-ing way you are borderline!!” I pulled the phone away from my ear. “Why not?” “Think fatal attraction.. Knives and stalking. Psychobitch from hell. That’s not you!”

by guest blogger Fugen Neziroglu, Ph.D., co-author of Overcoming Compulsive Hoarding

Hoarding is defined as the acquisition and failure to discard a vast amount of items that appear to have little or no value. It is a serious disorder that can have a severe impact on one’s everyday life. The clutter associated with hoarding provides a lack of functional living space, and even can lead to unsafe, unsanitary living conditions. Hoarding is often associated with obsessive compulsive disorder (OCD) with 20-30% of individuals with OCD showing hoarding symptoms. However, hoarding can also be seen in obsessive compulsive personality disorder (OCPD), depression, dementia, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), and eating disorders.

While many individuals may acquire multiple items or collect things, individuals with hoarding have difficulty in regulating the amount of items that are acquired, discarding items, and /or organizing the items. Many individuals with hoarding provide rationales for hanging on to their objects. This reasoning includes emotional comfort, a reminder of an important memory, a perceived value of the item, or a sense of responsibility that one must not be wasteful, and control over their possessions among others. Individuals that hoard items can have an intense perceived connection to the items acquired, thus discarding the item can provoke severe anxiety.

The repercussions of hoarding are severe and dangerous. Individuals that hoard have poor quality of life. Their living space is often unhealthy and unsafe. The incredible amount of clutter and disorganization can lead to health issues including headaches, insomnia, and allergies. Often there can be structural damage to homes such as water leaks due to the weight of the possessions, as well as fire hazards with the multitude of items blocking the exits. Additionally, hoarding may to lead to social isolation. The clutter environment does not provide opportunities for others to visit. Hoarding greatly affects family members as well as the patients. Hoarding can lead to strain in familial relationships. There may be financial problems or resentment from a spouse, child, or sibling, ending in divorce, separation, or children moving out of the home. Family members have to make accommodations and adjustments to their everyday life, for example, children and spouses cannot have friends over due to the living conditions.

excerpt from The Cognitive Behavioral Therapy Workbook for Personality Disorders

Develop Alternative Responses to Unhelpful Thoughts

If you already recognize the unhelpful thinking style that you use, find it below and learn how you can challenge it. However, if you haven’t already identified the style you frequently use, be patient. For the moment, just review the list and become familiar with the unhelpful thinking styles and their alternative responses.

excerpt from Visualize Confidence

Self-confidence affords you the belief that, within reason, you do have the ability and skills to accomplish what you envision for yourself. Since confidence isn’t with each of us all the time and in all situations, our beliefs and behavior can change according to the tasks and situations at hand. You can be confident in one area of your life but not in another. For example, you may be confident in math but not in biology. You may be confident in your academic abilities but not in sports. You may relish the excitement of giving a talk before a large crowd but feel awkward going on a first date.

Since self-confidence exists within the context of your own beliefs, self-image, self-esteem, self-efficacy, memories, and perceptions, it can be summed up in three terms: attitudes (how you feel), behavior (what you do), and cognitions (what you think).

excerpt from Visualize Confidence

As children we start out full of confidence in our abilities and strengths, with unlimited creative imaginations. Free from self-doubt, we are eager to try out new things and explore new worlds. It’s only as we grow older that we start to evaluate our behavior, second-guess ourselves, and judge ourselves against others. And, as a result of hard knocks and disappointments, our self-confidence takes a beating. Self-doubt comes first and foremost from our inner critic. Let’s consider how the inner critic sabotages our confidence.