9 Dangerous Myths & Misconceptions About Mental Illness

Are mentally ill people violent? Can mental illness be overcome through willpower? Is addiction a choice? This post addresses some of the myths and misconceptions about mental illness.

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There is stigma attached to mental illness and substance use. The media, unfortunately, perpetuate stigma by spreading misinformation.

For example, every time a school shooting occurs, the media attributes it to (or at least references) mental illness. Journalists first, and then social media trolls sensationalize news stories about the shooter’s eccentricities and all the signs that were missed. Upon learning that the shooter was having problems at home and didn’t get along with his peers, one might suspect mental illness. And suspicion becomes certainty when mental illness is viewed as the only plausible rationale behind the senseless violence. (It’s also rationalized that ‘normal’ people don’t shoot each other for no reason. So when there is no apparent motive, mental illness is blamed.)

Next, mainstream media circulates the story about the depressed kid turned killer. The message received is “mental illness is dangerous” or “people with mental disorders are criminals.” This misinformation is absorbed and regurgitated in society, online and off, and misconceptions about mental illness persevere.

Unfortunately, misconceptions about mental illness are common, and not just with the media. Even healthcare workers, including mental health professionals, believe common myths.

In this post, I will address some common myths and misconceptions about mental illness.

Ignorance is the root of stigma. The more you know, the less you fear, and the less you’ll stigmatize. Read on to learn about myth versus fact.

9 Myths & Misconceptions About Mental Illness

1. Bad parenting causes mental illness.

MOSTLY MYTH

Even today, there is no single identified cause that explains mental illness.

However, there are multiple known risk factors (biological, environmental, and social) that contribute to the development of mental disorders. Having a genetic predisposition to mental illness is the biggest risk factor. Genetics largely determine if a person will develop schizophrenia, depression, substance use disorder, etc. About 40-60% of mental illness is determined by biology.

Physiological factors (such as structural differences or chemical abnormalities in the brain) are another risk factor. Additional biological risk factors include prenatal damage, brain injury or defects, illness or exposure to toxins, and damage from drug and alcohol use.

Environmental and social factors include fetal exposure to a toxin and childhood trauma, among others.

Childhood abuse and neglect undoubtedly fall into the ‘bad parenting’ category. What’s more, adverse childhood experiences (ACEs) are associated with chronic disease, obesity, decreased immune function, substance use, and mental illness in adulthood.

While childhood abuse, neglect, and even spanking are linked to poorer mental health outcomes, bad parenting does not cause mental illness. Bad parenting can be a risk factor, depending on severity and impact, as well as the presence or absence of protective factors. (Protective factors include resiliency, health, feeling safe at home, etc.) Also, ‘bad’ parenting is somewhat subjective.

Generally, the more risk factors (and fewer protective factors) a person has, the more likely they are to develop a mental illness.

2. Mental illness is not a medical disease.

MYTH

Heart disease affects the heart. Colon cancer affects the colon. Autoimmune disorders affect the immune system. Brain disorders (i.e. mental illness, addiction, brain cancer, dementia, Parkinson’s, Alzheimer’s, etc.) affect the brain.

Like other organs, the brain is susceptible to disease. Brain disease manifests as changes in behaviors, thoughts, memory/processing, speech, emotional regulation, judgment, and more. Because your brain is the body’s control system, brain disease may also impact balance, muscle coordination, the ability to use your sense of taste, smell, touch, etc.

You cannot ‘see’ mental health symptoms the way you can see some physical health symptoms (such a rash or a broken bone), but you also don’t see most physical health symptoms.

When you have a headache, no one else can see it. You don’t even know what’s happening to the neurotransmitters and synapses across the lobes in your brain. You’re solely responsible for describing the pain to your doctor so they can prescribe the right treatment.

In reality, there’s not such a huge distinction between so-called physical and mental illnesses. They can both be painful and debilitating, and may require medical treatment.

3. All sociopaths are dangerous.

MISCONCEPTION

The term ‘sociopath’ (or psychopath) is frequently associated with serial killers. The reality is that you probably know a sociopath and they aren’t a murderer.

In fact, ‘sociopathy’ and ‘psychopathy’ are no longer recognized as diagnoses in the mental health world due to negative connotations. The diagnosis became associated with a sterotypical portrayal of a psychopath as a ruthless and insane serial killer. The stereotype is perpetuated by filmakers and TV producers and continues to show up in movies and series even today, despite the glaring inaccuracies with the diagnosis.

The correct term is antisocial personality disorder (ASPD), a mental illness characterized by an ongoing disregard for and violation of the rights of others. An individual with ASPD may also be exceptionally charismatic. (Some of the most charming and engaging clients I’ve ever worked with had ASPD.)

However, research indicates that an individual with ASPD is more likely to become involved in criminal activity,to have a substance use disorder, and to be aggressive; about 50% of individuals with ASPD have some sort of criminal record.

While it’s a misconception to say all individuals with ASPD are dangerous, the link between ASPD and crime is not unfounded.

4. Mental illness can be overcome with willpower.

MYTH

This is 100% myth. The notion that mental illness can be overcome with willpower goes hand-in-hand with the belief that mental illness is not a ‘real’ medical condition.

A mental disorder typically requires treatment, such as medication and therapy, and ongoing illness management.

All the willpower in the world will not help someone overcome heart disease. And it does not work that way with mental illness either.

5. Addiction is a choice.

MYTH

Substance use disorder is no more of a choice than diabetes or cancer. Like most diseases, addiction develops when a combination of genetic, physiological, psychological, and environmental factors are present. Lifestyle choices also play a role. Unfortunately, the myth that addiction is a moral failing persists.

An individual who has an addiction receives more blame than someone with a heart condition, even though lifestyle choices heavily impact both disorders. I have even heard the argument that addicts who overdose should not be revived because it was their ‘choice’ to use. If that is the logic, then should we stop providing life saving care to someone who is obese when they have a heart attack or to a smoker with lung cancer? Of course not.

At times, we all make poor decisions. For someone with a predisposition for addiction, the choice to drink may lead to alcohol use disorder. For the person with a predisposition for diabetes, eating an unhealthy diet or living a sedentary lifestyle will result in consequences.

Furthermore, once a person develops a substance use disorder, physiological and structural changes in the brain dissolve the element of choice. The brain misinterprets a craving for drugs or alcohol. (Remember the last time you experienced extreme thirst? That is what it is like to be addicted to something.)

Having a substance use disorder is miserable, lonely, and shameful. No one chooses that.

6. People with mental illness are violent.

MISCONCEPTION

Having a mental illness does not make someone more likely to commit a crime or act of violence, especially if that person is following treatment recommendations for psychotherapy, medication, etc. Rather, biolocial, psychological, and environmental factors are associated with violent behavior. In the general population, younger males in lower socioeconomic classes with lower levels of education and employment are the most likely to engage in violent acts, not persons with mental illness.

While the media would have us believe that mental illness is at the root of every mass shooting, this isn’t the case. Most people with mental health problems do not commit violent acts or crimes, and most violent acts are not committed by people with mental illness. It’s also true that persons with severe mental illness are more likely to be victims of crime.

Moreover, individuals with mental illness are more likely to die by suicide. Persons with schizophrenia have higher rates of suicide than the general population. Depression, bipolar disorder, and borderline personality disorder are also linked to suicide.

A mental disorder is a medical condition; having weak morals is a personality trait, and while it seems mentally sick, it’s not fair to compare a lack of morals to a condition like depression or anxiety.

7. Mental illness is the same thing as mental retardation.

MISCONCEPTION

I am friends with a nurse who did not know the difference (until I pointed it out). A person with a mental illness may seem less intelligent due to various factors, but mental illness is not comparable to mental retardation. Today, we refer to mental retardation as intellectual disability (due to the negative connotations attached to the word ‘retarded’).

A person with an intellectual disability (ID) struggles to understand, comprehend, and/or form memories. A person with mental illness, on the other hand, may have superior intelligence, but could seem slow due to distractions brought on by their illness. (For example, it is difficult to focus on a conversation when you’re having racing thoughts or hearing voices.)

8. A person with schizophrenia has multiple personalities.

MYTH

A person with schizophrenia may hear voices and even respond to what they hear, but they do not have multiple personalities. Multiple personality disorder (MPD), on the other hand, is associated with distinct personalities.

Today, MPD is referred to as dissociative identity disorder (DID). A person with DID has at least two distinct personality states, and suffers from gaps in memory. The prevalence of DID is largely unknown, but it’s estimated that 1-2% of Americans have DID. DID occurs so rarely that its existence was once disputed in the scientific community. There is a strong correlation between DID and childhood trauma and abuse.

With schizophrenia, the voices may be distinct, have their own names, and can be experienced as different personalities (male, female, child adult, friendly, cruel, etc.) or entities, but someone with schizophrenia has only one personality. Dissociation is not a typical symptom of schizophrenia.

In addition to auditory hallucinations, someone with schizophrenia may experience visual hallucinations, delusions, disorganized thoughts, cognitive deficits, and/or what’s referred to as negative symptoms. A negative symptom is a lack of something that is typically present in someone without schizophrenia. For example, a person with schizophrenia may be socially withdrawn or he/she may seem very flat, or without emotion.

9. Alcohol makes you depressed because it is a depressant.

MISCONCEPTION

Yes, alcohol is a depressant. As a depressant, it depresses your central nervous system, leading to slurred speech, trouble with coordination, etc. The intoxicating effects of alcohol are not symptoms of depression.

However, heavy alcohol use is associated with depression and other mental disorders. Someone who has depression or anxiety may drink to self-medicate. Alternatively, someone with an alcohol use disorder may develop depression, as alcohol upsets the chemical balance in the brain. What’s more, a person may regret the things they do while intoxicated, leading to intense guilt, shame, and/or hopelessness.

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5 Powerful Things Counseling Taught Me (Part Two)

Learn to be more effective in your personal and professional life! This is the second installment of how counseling has led to a better understanding of people. Working with addiction and mental illness has gifted me with the capacity to better recognize why people do what they do, which in turn enhances how I relate to others.

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This is the second installment of life lessons counseling taught me. Being a therapist has led me to a better understanding of humanity and myself. (In Part One, I discussed life lessons on calmness, silence, active listening, partial truths, and hidden agendas.)

Working with addiction and mental illness has gifted me with the capacity to better recognize why people do what they do, which in turn enhances how I relate to others. As a result, I’m more effective in my personal and professional life. I have a sense of peace and “okayness” in the world.

One thing I hadn’t previously considered was brought up by Quora user and mental health professional, G. Bernard (MA Counseling); he shared that counseling revealed the truth about change. “It has really reinforced that idea that people who want change will work harder to achieve it; those who are forced (legally, by parents, spouse etc.) probably won’t.”

I agree with this 100%. People can’t be forced into change; and when they are, their efforts lack fortitude and it doesn’t last. Those who are internally motivated will fight for change, making it worthwhile and enduring.

Here are additional truths and life lessons I gained through my counseling career.

What counseling taught me (the second installment of life lessons):

1. A new perspective

The DSM – Diagnostic and Statistical Manual (the “Bible” for mental health professionals) – uncovered a whole new world for me. Sure, I was familiar with mental illnesses like depression, PTSD, and anxiety before grad school. I took Abnormal Psych in college and even before that, I’d read books on schizophrenia, eating disorders, and other mental disorders. (Guess who did their middle school science project on schizophrenia? Me!)

But my fleeting knowledge was laughable compared to what I found in the DSM; it provided me with information on every single diagnosable mental disorder. When I started working with clients, I was able to see how mental illness manifests in real life.

The more I learned (and saw), the more I was able to make sense of behaviors. Consequently, this led to me looking back on people I’ve encountered throughout the years. I realized how many of them had been struggling with a mental illness. (At the time, I probably just thought they were just a jerk, or acting inconsiderately.)

I also became more aware of the prevalence of severe mental illness and the way it presents in society. This led to increased tolerance and patience regarding behaviors I’d previous found annoying; counseling taught me to recognize them for what they were.

Mental illness can easily be interpreted as something it’s not. By having an awareness, I’m more compassionate. Instead of judging, I observe. Someone who seems snobby may have social anxiety. That coworker who calls out sick every Monday may be struggling with addiction. A friend who never wants to go out anymore could be depressed.

Mental illness is everywhere if you know what to look for. Counseling taught me to strive to give everyone the benefit of the doubt, which is better for my mental health.

2. Don’t give money to the homeless

I worked with a client at a residential program who had an amazing talent for creating clever signs. He’d use markers to write his message (“Will dance for food!”) on a piece of cardboard before grabbing his pail to hit the streets. He didn’t need the money; he received government benefits (funded by taxpayers). The money he earned panhandling funded his K2 habit or the occasional beer.

Many of the “homeless” people you meet are not homeless; they’re con men (or women) who make a profit on your sympathy. Some are either addicted to drugs/alcohol and/or severely mentally ill; they need treatment, not the crinkled dollar bill in your pocket. Giving your spare change isn’t helping that person. Instead, offer to buy a meal, give them a pair of socks, or hand them a bottle of water.

3. Telling someone what to do is not helpful

Giving advice rarely leads to lasting change.

There are a few different reasons why advice, no matter how well-meaning, isn’t helpful. Firstly, it doesn’t account for the person’s full experience or struggle; it could seem ignorant or insensitive. (For example, “Why don’t you just get a divorce?” is not helpful to a woman struggling with her husband’s infidelity; the problem is more complex than just getting a divorce. Children could be involved. Maybe she’s financially dependent on her husband. Maybe she’s still in love with him. Or maybe it’s against her religious beliefs.)

Advice also robs a person of the ability to solve their own problem. We need to learn to find solutions in life in order to grow and to be effective. If someone is always told what to do, they’re not going to learn to function independently.

Lastly, if advice is taken, and it works, the credit goes to the advice giver, not the taker. The results are less meaningful. Alternatively, if advice is taken and it doesn’t work, it becomes the advice giver’s fault. Advice deprives a person of being able to take full ownership of their actions.

Counseling taught me that if you own your decision and fail, the blame falls on you (helping you to grow as a person) or if you succeed, the triumph is yours alone. Either way, you’re better off finding your own solutions; this allows you to feel capable and you’ll become better at solving problems in the future.

4. The value of transparency and honesty

Counseling taught me that people like to know what’s happening and what to expect. I get better reactions from clients when I explain why I’m doing or saying what I am. I’m honest, and when I can’t be (or believe it would be inappropriate to do so), I tell clients exactly that. For example, if a client asks about my religion, I’d let them know I don’t feel comfortable sharing personal aspects of my life.

Personally, I prefer the company of others who are straightforward. I don’t like having to guess if someone is upset with me. I don’t like it when someone is nice to my face, but gossips when I’m not around. Those types of games are played by people who are insecure or who are attempting to manipulate you. Life is complicated enough. With me, you’ll know if your fly is down, and if you ask for my opinion, you’ll get it. (There’s much to be said for tact though!) Gentle truths are worth more than flattery.

5. You can’t demand respect

It’s something that’s earned through words and actions, not freely given. Forced respect is not true respect; it’s fear or deception. And while I believe in treating everyone with respect, I don’t truly respect someone until I know what kind of person they are.

Furthermore, I’ve learned that if someone chooses to disrespect me, it’s not a threat. Respect is powerful, but disrespect? Feeble and pathetic. If someone is disrespectful, it won’t harm you or make you less of a person (unless you give it that control).

Throughout my career, I’ve been disrespected on many, many occasions by clients who don’t want to be in treatment (and even by colleagues with differing opinions). Counseling taught me that my sense of self-worth is not dependent on how others treat me. As a result, disrespect from angry clients (or rude salespersons or drivers who cut me off, etc.) doesn’t faze me.

In sum, being a counselor is life-changing. I imagine many professions are to a degree, but I can’t picture any other job leading to such a deep understanding of humanity. Entering the mental health field is like having horrible vision and then finally getting glasses (except it happens over the course of years). I have an enhanced awareness of who I am along with an unforeseen sense of serenity.

Every single client who’s shared a piece of their story has contributed to my awareness (and to my own personal growth), and I owe them gratitude for the life lessons I received. I’m more cautious in life, yes, but I’m also more compassionate. Instead of having high expectations, I have high hopes. I don’t attempt to control things I have no control over; and I don’t get angry over the decisions, views, or actions of others. Instead, I channel my energy into something more productive; I’m passionate and I’m an advocate. My beauty pageant answer to the stereotypical question is not “world peace”; it’s for everyone to have a deeper understanding of each other.

What life lessons have you learned in your career? Please share in a comment!

5 Powerful Things Counseling Taught Me (Part One)

Counseling is generous in that it’s supplied me with the tools needed for not only professional growth, but personal success, emotional well-being, personal development, and effective communication. It’s also taught me about various aspects of human nature, from the brightest to the murkiest.

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In grad school, I learned theories and techniques of counseling. I learned basic and advanced counseling skills; I practiced various interventions and methods. My professors taught developmental theories and multicultural competence. I took classes in career counseling, family counseling, and couples counseling; I studied research and ethics.

And when I accepted a substance abuse counselor position at a drug and alcohol treatment center… I had no clue what I was doing… or how to be a counselor. I went into my first year as a clinician with self-doubt and uncertainty.

Negative thoughts consumed me. I questioned myself and wondered if I was in the right field.

“Do I have what it takes to be an effective counselor?”

“Should I have pursued a career in research instead?”

“Should I have pursued anything instead?”

“Am I capable of helping others?”

Furthermore, social anxiety crippled my ability to relate to clients; being genuine was difficult. I couldn’t stop comparing myself to other “seasoned” clinicians, which only made things worse.

Gradually, my doubts and fears subsided; I felt more comfortable in my role. I accepted and settled into my new identity as a professional counselor; it was a good fit. I stopped trying to “fix” or control clients.

Anxiety no longer dictated my actions; I found a way to take ownership of my mistakes and accomplishments. Moreover, I learned to be okay with making mistakes. I accepted that I would never have all the answers. I let go of irrational beliefs that had previously plagued me. I thrived.

Today, I can reflect on my journey and on the positive changes I’ve made throughout the years. My chosen career is generous in that it’s supplied me with the tools needed for not only professional growth, but personal growth — success, emotional well-being, personal development, and effective communication.

I’ve learned a lot the past ten years. This post explores the discoveries I’ve made and how I apply that knowledge to my life. But before delving into what I’ve learned, here’s what a few other clinicians have said on the topic:

Nancy Lee, MA, LPCC, Psychotherapist in Aurora, CO

“Being a counselor has shown me that it’s possible to live on the edge of what I know and don’t know. In a single moment, I can feel strong and confident, yet small and humble. Counseling isn’t about fixing problems. It’s about believing in my client’s capacity to connect with their own solutions, insight, and growth.”

Robert Martin, M.Ed Early Childhood Education & Counseling, Francis Marion University

“There is no learning … if there is not a relationship… The foundation of counseling and teaching is [the] relationship. There must be a connection. The student must know that you care about them personally and it is ok to make a mistake … Consequences and corrections can be given, but always directed at the behavior [and] never the person … That you are only talking about their behavior when you correct them … and not them. They must feel that you respect them … and if you make a mistake say, “I’m so sorry. I made a mistake.” … [Always respect] their differences, their hopes and weakness, their failures, their dreams, their divinity. There is nothing more important than this…”

Bridget Cameron, Artist, Depth Psychologist, Stress Counselor (1992-present)

“To accept people as they are, to be non-judgmental, to be directed by compassion, and to know how to be impartial so that I am fair-minded with all people and do not project any of myself into my client’s history and am non-attached to the outcome.”

In comparison, while I’ve learned much about compassion, connecting, and being okay with being wrong, I’ve also learned how to use counseling to be effective, both personally and professionally… and I’ve learned to be more guarded due to the darker aspects of human nature.

Here’s my list of small wisdoms, or, what counseling has taught me (the first installment):

1. How to remain calm

Emotion regulation was difficult for me as an adolescent and young adult. My emotions ruled me – lorded over me, even! Then, as a counselor, I observed emotion disregulation in clients. I realized how truly counterproductive (and ridiculous-looking) it can be.

I made a choice to stop engaging in negativity, with both self and with others. Feeding into an argument solves nothing, but the effort leaves you emotionally and physically drained. Luckily, my personal transition from chaos to calm was painless. By the time I learned how to remain calm, I was in my mid-20s; the intensity of my emotions had already naturally subsided. Today, calmness is my natural state.

2. Comfortable silence

In grad school, I learned to use silence as a counseling technique. Instead of filling up every minute of a session with reflections, open-ended questions, and paraphrases, we were encouraged to use “comfortable silence.”

Silence allows the client time to process and/or collect their thoughts. To me, it always felt horribly awkward (remember, social anxiety!) and wrong. I wanted to rush on to the next topic or to ask a question or… anything.

I’m not sure when it finally stopped feeling awkward. I just knew that one day I was sitting in silence with a client and it felt natural. Today, I use silence in my professional and personal life all the time. It feels nice to sit quietly and not feel pressured to talk.

3. Active listening

Counseling taught me to really listen. I learned to quiet my internal dialogue to hear and comprehend what’s being said. Instead of thinking about how I’m going to respond, I give my full attention to the speaker. I’m aware of body language and other nonverbals. Counseling has strengthened my communication skills.

4. Partial truths

Counseling taught me that people don’t always say what they mean. They often tell partial truths. There are many reasons for this: Fear of being judged, not fully trusting the therapist, feeling embarrassed, etc.

For example, a client who isn’t ready to change their drinking probably wouldn’t tell me they drink three bottles of wine every night. Instead, they’d offer a partial truth. “I usually drink a glass of wine with dinner, but that’s it.”

Partial truths are not lies; they allow for a certain measure of comfort. (A lot of people feel uncomfortable with lying because they were taught it was wrong, or possibly because they view themselves as honest – and honest people don’t lie.) Partial truths, on the other hand, don’t feel wrong (or less wrong, at least). Plus, they’re safe. A person can be partially truthful and still protect their secrets.

When I realized how common partial truths are, I changed the way I listened to clients… and to everyone. Instead of taking things at face value, I listen to what is being said while recognizing that much more is not being said.

5. Hidden agendas

I also discovered that there are plenty of people out there who seek counseling with hidden agendas. For example, a man sees a therapist, stating he wants to learn anger management techniques. What he doesn’t reveal is that he’s abusive to his wife. He recently lost control in an argument and pushed her down the stairs. She gave him an ultimatum: Therapy or divorce. He doesn’t believe he needs counseling, but he’ll do it to save his marriage. And he doesn’t tell his therapist this (of course). Why would he? It’s none of her business.

Both partial truths and hidden agendas happen outside of therapy (and for similar reasons). Words paint a very limited piece of the entire picture. People often show only what they want others to see while keeping their true motives hidden.

Because of counseling, I have a better awareness and understanding of why hidden agendas (and partial truths) exist. It’s not cynicism, but a form of acceptance. I recognize that half truths and hidden agendas serve a purpose. While I may never understand their purpose, I’m okay with it.

This awareness fosters caution; I’ll never be caught off guard.

There’s more to tell, but for the sake of keeping this post to a reasonable length, I’ll save my remaining insights of things counseling taught me for the second installment of this post (in which I’ll discuss giving money to the homeless and demanding respect, among other “lessons” from counseling).

75 Free Online Academic Journals for Counselors

This is a list of 70+ free and open-access online academic journals for counselors and other mental health professionals.

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(Updated 5/23/21) This list is comprised of 70+ academic journals that you can access online. Most of the journals are open-access; others offer limited access (with some free articles).

All of the publications are related to mental health, addiction, or wellness. I use many of them for research for this blog.

The research is relevant to all health professionals and to anyone who is interested in learning more about mental illness.

75 Free Online Academic Journals for Mental Health Professionals

A

B

Behavior and Brain Functions
Bipolar Disorder
BMC Neuroscience
BMC Psychiatry
BMC Psychology
Borderline Personality Disorder and Emotion Regulation
Brain: A Journal of Neurology
Brain and Cognition
Brain Disorders and Therapy
The British Journal of Psychiatry

C

D

Drug and Alcohol Dependence
Dual Diagnosis

E

F

Frontiers in Psychology

H

I

J

L

Learning & Memory

M

Mental Health and Physical Activity

N

P

Personality and Individual Differences
PsyArt Journal
Punishment and Society

S

T

Please contact me if you have a suggestion or if a link is not working!

Why “Playing Hardball” Doesn’t Work

How can you consistently get great results with customer service representatives? Hint: “Playing hardball” doesn’t work. Instead, use seven basic counseling skills to get the best deal.

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Years ago, I was visiting new friends at their home to watch a college football game on TV. (It should be noted that I’m not a big sports fan, but my at-the-time boyfriend was.) The game was pay-per-view (pre-ordered through the cable company).

We were relaxing in the living room, eating snacks and chatting, waiting to watch some football. When the game didn’t play as scheduled, they called the cable company… and much to my dismay, the male friend starting yelling and cursing at the customer service representative.

I felt embarrassed, and couldn’t help thinking how awful it would feel to be on the receiving end of that call. (It’s not like it was the representative’s fault, afterall.)

At one point, my angry friend got too worked up and ended up handing the phone over to his female counterpart. I thought, Thank god! She’ll smooth this over... And then she proceeded to shout and curse! Yikes.

What is it that makes people treat another human being like scum? Why does the belief persist that belittling, cursing, intimidating, i.e. “playing hardball,” is the way to go?

More recently, my husband and I went to a store to pick up an item he’d ordered online. He had previously called the store to ensure he’d be able to use a gift card for part of the balance, and was assured he could.

Upon arrival, we were informed that since his credit card had already been charged, there was no way to apply the gift card to his purchase. My husband was soooo mad! His typically easy-going, relaxed demeanor changed. He started arguing with the clerk; he was rude and sarcastic. Naturally, the clerk became defensive (and somewhat defiant). I wanted to disappear. My husband ended up paying full price for the item. The clerk’s day was probably ruined. I wondered if things would have turned out differently had my husband been his usual friendly self.

Why it is widely believed that playing hardball is the best approach for getting what you want?

Why Playing Hardball Doesn’t Work

Think about what motivates you to go out of your way to help; maybe you’re inspired to assist someone in need because they’re friendly (and likeable). Or maybe you feel sorry for them. Maybe you want to help them because they’ve helped you in some way or shown you a kindness; you’re happy to return the favor.

It’s much less likely you’re motivated to help the angry guy who insults you. So why would it be different with customer service? Customer service reps are human, and therefore deserve to be treated with dignity and respect.

In my experience, consideration and good manners (thanks, Mom!) go a long way with customer service. Not once have I yelled or threatened. And I (almost) always get optimal results.

By utilizing one or more of the following therapeutic techniques, you can be more effective when returning an item without a receipt, requesting a lower interest rate, or asking your cable company for a better deal.

Use these 7 counseling skills to receive optimal customer service

1. Unconditional positive regard

Instead of bracing yourself for the worst, anticipate that they’ll be able to help.

As a professional counselor, I value my clients while appreciating their unique perspectives and views.

This same principle can be applied to conversations with a customer service representative. Approach them with respect. Appreciate the services they provide. Treat them with courtesy. Rather than, “I need this issue resolved,” try, “Hi [their name], how is your day going?”

Don’t brace for the worst, but anticipate that you’ll receive the help you need. Instead of an aggressive hardball approach, open with, “I’m hoping you’re the person who can help me with…” It’s likely the person you’re speaking with will strive to live up to your expectations; they will be the person who can help you.

2. Empathy

Empathy, the ability to understand another’s perspective and sense their emotions, is crucial to all helping relationships. Empathy is not sympathy or feeling sorry for someone. Sympathy pities; empathy empowers.

Empathy has the potential to open the door for exploration and healing.

To illustrate, I’ll discuss empathy’s role in counseling. Imagine a client who’s afraid she’ll be deemed selfish or weak for contemplating suicide. She recently lost her job and is going through a horrific divorce. She feels worthless; she thinks the world would be better off without her.

Empathy drops you into in her shoes and allows you to experience her anguish. To convey empathy, I’d say, “I can see you’re in a tremendous amount of pain. It’s gotten so bad, suicide seems like the only solution.” Empathy validates her suffering and recognizes that her pain is unbearable. Empathy has the potential to open the door for exploration and healing. (In contrast, the opposite approach would be to scold her, to tell her “it’s not that bad,” or to say she’s only looking for attention. All of those things are harmful and would invalidate her struggle.)

When applied to customer service, empathy acknowledges the experience of being a service representative. If you’re empathetic, you understand what they feel. You recognize the challenges of dealing with angry customers who yell or threaten (like my football-loving friends).

Furthermore, unlike playing hardball, which creates resistance, fear, and defiance, empathy promotes helping behaviors. Convey empathy by saying, “I can’t imagine what you must deal with.” Or “I imagine this job requires a lot of patience.” Empathy has also been linked to persuasiveness.

On the flip side, if the customer service rep empathizes with you, you may have a better chance of convincing them to grant your request, at least according to one study.

3. Genuineness

With clients, I say what I mean. I share what I’m thinking or feeling. I’m myself, flaws and all. Genuineness promotes trust and strengthens the therapeutic relationship.

When talking to a customer service rep, don’t put on an act by playing hardball. Don’t play tough and/or make threats. That’s not how you’d treat a co-worker or an acquaintance (at least, I would hope not?)

And don’t play dumb. Instead of, “I had no idea my payment was late,” try, “My payment was two days late, but since this is the first time, would you consider waiving the fee?” You could also explain your situation: “Honestly, I’ve always been happy with your services, but since the rates went up, I’ve been thinking about canceling. I’ve researched [competing company] and they have better rates. I’m not sure if I can afford your services anymore.” The rep would probably be able to relate (and even empathize), which translates to a better outcome for you.

4. Call them by name

Dale Carnegie said, “A person’s name is to him or her the sweetest and most important sound in any language.” While using a name isn’t a “textbook” counseling skill, what it conveys is.

Using a name conveys respect. It makes that person feel important and valued. Speaking a person’s name also commands their attention. In a counseling session, to make the greatest impact with my words, I’ll say the client’s name before sharing a thought. A name is powerful.

The hardball approach is often dismissive; instead, repeat the rep’s name after they introduce themselves to help you remember. (Write it down if you’re on the phone.) Use their name throughout the conversation. Someone who feels respected, important, and valued is more likely to help than someone who feels disrespected, unimportant, and unappreciated.

5. Patience

Patience is invaluable in counseling. I’m patient with clients who are guarded and resistant to help. I’m patient in sessions; I sometimes sit in silence, allowing for the time to process, contemplate, or sort through thoughts. I’m patient when a client isn’t progressing. (Change takes time.) Lastly, I’m patient with myself when I say the wrong thing or when it seems my efforts aren’t helping.

For the person seeking assistance from customer service, patience is an asset. Hold times can be ridiculously long. It also takes time to connect with an actual human. And when you do connect, they could say you’ve reached the wrong department. They may transfer the call to someone in a different department (who may then transfer you again). You may be placed on hold more than once (and have to explain yourself multiple times). The call could be dropped and you’d have to start the entire process over.

Alternatively, if you’re dealing with in-person customer service, the line could be long. There could be a crying baby nearby or a man with a stinky odor standing in front of you. Or maybe the person behind you keeps bumping into you. It could be too hot or too cold in the store. When you finally get to the front of the line, the clerk may not know how to help. You’d be asked to step aside and wait for the manager, which would take even more time.

Patience is an art; it can be cultivated through mindfulness and gratitude. To foster patience, anticipate that your customer service issue is going to take a considerable amount of time. Expect to run into some unforeseen snags. If you’re already rushed or in a bad mood, skip it. Instead, make that call or trip to the store when you’re relaxed and have plenty of time to spare.

6. Humor

Okay, this is another one that’s not an official counseling skill, but it’s one of my counseling skills. What’s more, research suggests that when used appropriately (and never at a client’s expense), humor is a powerful tool for healing.

In my experience, humor allows clients to open up and relax. It improves mood and helps clients to view their problems from an alternative perspective. Humor is an important coping skill and may reduce mental health symptoms. Humor connects us; laughing together fosters positivity.

Also, never underestimate the power of laughing at yourself. If you can find humor in your flaws and life fails, you can forgive yourself and move on. (It’s refreshing to not have to take yourself so seriously.) Humor makes me a better counselor… and a better person.

Humor connects us; laughing together fosters positivity.

When talking to a customer service rep, use humor instead of playing hardball. Poke fun at yourself or your inadequacies. If your issue is even slightly humorous, go ahead and make a joke about it or have a laugh.

Example: a year or so ago, I had a problem with my FitBit. According to FitBit, I was climbing hundreds of flights of stairs every day. I contacted customer service to report the issue. In my email I wrote, “Although I wish it were true, I can assure you that I have not been climbing hundreds of flights of stairs on a daily basis. Please assist.” They sent a new FitBit.

Humor generates positive feelings; research suggests that a positive mood increases helpfulness. For in-person customer service, instead of playing hardball, try smiling. A smile may increase your chances of getting the help you need. A happy customer service rep is more likely to grant your request.

7. Remain calm

Composure is the opposite of reactivity. An effective clinician is calm and serene; this promotes healing while reducing client anxiety. Moreover, it’s essential to remain calm in a crisis or with trauma work. Reactivity, on the other hand, is chaotic and ineffective.

When you react, you lose a small piece of your control. The more you react, the more out of control you feel. When fully escalated, you give up all your power; you’ve essentially handed it over to the person you’re reacting to. Furthermore, when emotions are heightened, the logical part of your brain becomes less active. You’re driven by your emotions.

In contrast, remaining calm enables you to respond instead of react. Maintaining composure will almost always benefit you in an argument.

Similarly, it’s to your benefit to remain calm when talking to a customer service rep. When playing hardball, it’s difficult to keep your cool. If you get angry or upset, you lose effectiveness. Research indicates that when negotiating, people dealing with angry counterparts are more likely to walk away from the deal. Expressing anger has limited effectiveness when employed as a negotiation strategy. If you happen to anger the customer service rep, you won’t end up getting what you want, at least according to one study.

To increase your ability to regulate your emotions, practice mindfulness meditation or deep breathing exercises. Neurofeedback is another tool for training your brain to remain calm.

Conclusion

In conclusion, playing hardball is rarely effective. The best strategies for getting your needs met include respect, genuineness, and empathy. Use a customer service rep’s name throughout the conversation. Be patient. Increase your likability with humor; remain calm (no matter what). The above methods will boost your odds for great customer service.

Do you have any tips for getting exceptional customer service? Share about it in a comment!

Interview: Tips for Health & Sustainable Weight Loss

“We only get one body in life, so it makes sense to treat it well by fueling it with nutritious foods.” An interview with Dr. Lisal Folsom, who discusses optimal health, nutrition, and sustainable weight loss.

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Interview: We Only Get One Body in Life

Tips for Health and Sustainable Weight Loss from an Endocrinologist

On a typical day, what are your patients’ complaints and how do you resolve them?

As an endocrinologist, I care for patients with all types of gland and hormone disorders. The most common reasons patients come to see me include diabetes (both type 1 and type 2), concerns about growth and puberty, thyroid dysfunction, hirsutism (unwanted hair growth), polycystic ovarian syndrome, and adrenal disorders. I also provide gender-affirming hormone therapy for transgender individuals. Depending on the patient’s symptoms and diagnosis, I may order lab tests and/or radiology studies such as thyroid ultrasounds or bone age xrays as part of my evaluation. Once we have a diagnosis, I work with the patient to create a personalized plan for treatment and follow up.

What about common questions or concerns?

Regardless of the reason they’ve come to see me, many patients are concerned about fatigue and weight gain. Everyone loves to blame these symptoms on the thyroid gland, but there are many other possible contributors to both fatigue and weight gain, including lack of quality sleep, sleep apnea, suboptimal eating habits, and infrequent exercise.

How does diet impact health?

A balanced diet and good nutrition are essential for optimal health. The only way to nourish and fuel our bodies is through food, and multiple studies have shown the benefits of good nutrition on health.

People who eat a diet composed of fruits and vegetables, whole grains, and lean proteins have lower blood pressure, better cholesterol, and decreased risk of obesity than those who follow a typical Western diet. There is a lot of research going on right now investigating the health effects of switching to a whole foods plant-based diet. A study comparing gut bacteria found that individuals following vegan and vegetarian diets had a more diverse selection of microbes in the intestines, which can lead to better health.

“People who eat a diet composed of fruits and vegetables, whole grains, and lean proteins have lower blood pressure, better cholesterol, and decreased risk of obesity than those who follow a typical Western diet.

Another study published in Clinical Nutrition this year found that people with high cholesterol had improvement in their cholesterol numbers when they followed a whole foods plant-based diet. Their cholesterol worsened when they switched back to a diet containing animal products and refined carbohydrates.

We only get one body in life, so it makes sense to treat it well by fueling it with the healthiest, most nutritious foods.

What are the main risk factors for diabetes?

Type 2 diabetes is an acquired metabolic disease associated with insulin resistance and high blood sugars. Until relatively recently this was a disease of adults, but in the past few years more and more children have been diagnosed with type 2 diabetes as well, partly because of the increase in obesity.

Risk factors for developing type 2 diabetes include being overweight or obese, carrying extra weight in the abdominal area, lack of regular physical activity, a family history of type 2 diabetes, and being diagnosed with prediabetes. Gestational diabetes during pregnancy is also a risk factor for developing type 2 diabetes later on.

A person will not necessarily develop type 2 diabetes just by eating a lot of sugar, but a long-standing pattern of unhealthy eating, lack of exercise, and weight gain will certainly increase the risk of developing type 2 diabetes down the road.

Can diabetes be treated with lifestyle changes?

Lifestyle changes are vital in diabetes treatment! Medicines can help to lower blood sugar, but the underlying cause of type 2 diabetes is insulin resistance, which is exacerbated by weight and lack of regular activity.

We know that people who exercise on a regular basis tend to have lower blood pressure, better cholesterol, and are more likely to be at a weight considered to be healthy, than people who don’t exercise often. Part of the reason for this is that exercise improves the body’s sensitivity to insulin. When we exercise, our bodies don’t have to work as hard to turn the food we eat into energy and fuel for our cells.

Studies have shown that people with type 2 diabetes who exercise after a meal have lower blood sugar levels than those who don’t. Exercise and a healthy diet are important for everyone, but these elements are especially crucial for people who are looking to improve their health.

Which is worse: Fat or sugar?

Ooh – tough question. I would say both and neither. Both fats and sugars come in healthy and unhealthy forms. Omega-3, polyunsaturated, and monounsaturated fatty acids help lower cholesterol and decrease the risk of heart disease. These healthy fats are found in nuts, peanut butter, avocados, flaxseed, and olive, canola, and soybean oils. Some eggs contain omega-3 fatty acids as well, depending on whether the chickens that laid them were given supplementation.

Unhealthy fats include saturated and trans fats. These types of fats are found in fatty cuts of meat, poultry skin, fried foods, high fat dairy products, processed and prepackaged foods, and solid oils such as shortening and lard.

Healthy sugars include those occurring naturally in fruits and vegetables. A good rule of thumb is to try to choose foods that are as close to their natural state as possible. For example, when you eat an apple, rather than drinking apple juice, you get the added benefits of the fiber from the apple, and vitamins from the skin. These added health benefits of eating whole fruits and vegetables allow the sugars to be absorbed more gradually by your body, and are lost when foods are processed.

What is one food you’d never eat and why?

Cracklins. This southern delicacy consists of fried pieces of pork fat and skin, flavored with Cajun spices. Although I’m sure they’re very tasty, they’re also oozing with saturated and trans fats, contain almost 500 calories per serving, and are high in sodium.

You could eat an entire avocado and two slices of whole wheat toast for fewer calories. This alternative snack is not only delicious, it also comes with the added benefits of healthy fats, whole grains, and fiber.

If given the opportunity, is there anything you’d change about the current dietary recommendations?

The current dietary guidelines are a good place to start. They recommend eating a variety of fruits and vegetables, making at least half of our grains whole, and limiting saturated and trans fats, added sugars, and sodium.

I wish they went a little further though, by emphasizing the health benefits of whole rather than processed foods, and offering alternative options for people looking to follow a plant-based diet. There are some really great dairy alternatives out there, including nut milks (almond, cashew, macadamia), soymilk, plant protein products, and tofu. Many of these are made without added sugar, and are fortified with calcium and vitamin D, so the nutritional content is quite similar to the animal-based versions.

What are your thoughts on the obesity epidemic in America?

Obesity is a growing problem in our country, and it’s going to keep getting worse unless we as a society make some major changes. Obesity is a multifactorial disease, with many different levels of influence.

Personal dietary choices have a role of course, but so does the environment in which people live. If a family lives in a food desert, and the only place to buy groceries is the convenience store where one banana and a 6-pack of ramen noodles each cost $1, parents are veritably forced to choose the less healthy, but inexpensive and filling options to feed their children. Many children in the U.S. eat both breakfast and lunch at school through the federally subsidized National School Lunch Program. This program is underfunded, and as such is unable to provide the highest quality, most nutritious food for the children who need it most.

There are so many barriers to optimal health that exist at societal and cultural levels; it’s going to take a lot of work to tackle obesity. It’s possible, but change will need to happen from the top down.

What advice do you give to patients who are trying to lose weight?

At the end of the day it’s all about math: Energy in = energy out. If we put more calories into our bodies than we burn, our weight will go up. Alternatively, if we burn more calories than we eat, our weight will go down.

“At the end of the day it’s all about math: Energy in = energy out. If we put more calories into our bodies than we burn, our weight will go up.

Metabolism plays a role, certainly, and we all know people who can eat a dozen donuts without gaining a pound, which is just not fair, but overall consistent, purposeful, portion control is the key to sustainable weight loss.

Exercise helps, but it’s really hard to burn enough calories by exercising to offset what we eat. A typical adult woman walking on a treadmill for 30 minutes burns around 150 calories. As a comparison, a pint of Ben & Jerry’s Chunky Money contains 1,160 calories. You would need to spend nearly 4 hours on the treadmill to burn off that pint of deliciousness, and nobody has time for that. It makes more sense to limit your total calorie intake through portion control and careful meal planning.

Everyone should have a treat now and then, just plan for them ahead of time and pay attention to the nutrition label including serving size.

What’s one thing you wish everyone knew about hormones?

It’s probably not your thyroid. Seriously though, endocrinology is an amazing branch of medicine. Since our glands make hormones that then flow into the bloodstream, they have effects on so many different parts of the body. Endocrinologists have to consider the entire person when making a diagnosis, and this makes the field both challenging and exciting.

As an endocrinologist, what are the most useful things you’ve learned?

Weight loss is hard, but possible. Diabetes sucks, but you are strong, so don’t let it take over your life. Everybody loves to talk about food. Patients and physicians work best as a team. Good health is priceless.

Interviewer: Cassie Jewell, M.Ed., LPC

Dr. Lisal Folsom is a board-certified physician who specializes in endocrinology, diabetes, and metabolism. She also provides gender-affirming hormone therapy for transgender individuals. Dr. Folsom’s medical research has been published in the academic journals Endocrine Practice, The Journal of the South Carolina Medical Association, Current Osteoporosis Reports, Journal of Adolescent Health, and Endocrinology & Metabolism Clinics. She has been practicing for nine years.

Sleep Deprivation: What Dreams May… Cure?

What happens to your mind and body when you’re sleep-deprived? Poor-quality sleep is linked to a variety of health conditions, including obesity and heart disease. Poor sleep leads to cognitive impairment and poor judgment. A lack of sleep can even lead to schizophrenia-like symptoms! Learn why sleep is essential for health and well-being.

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According to the American Academy of Sleep Medicine, about 10% of Americans struggle with chronic insomnia and up to 35% of Americans experience insomnia at least occasionally. I’m part of the 10%. I’ve spent countless nights tossing and turning, dreading the obnoxious sound of “quantum bells” (my cell phone alarm) as daylight slowly creeps in. Due to this, I’ve done quite a bit of research on the subject. (And as a clinician, it’s important for me to know the relationship between restful sleep and mental health so I can educate my clients.)

Sleep recharges us; it makes it possible for us to remember what we learned throughout the day.

We all know that basic sleep hygiene is essential (i.e. having a regular sleep schedule, refraining from watching TV or reading in bed, avoiding alcohol before bedtime, etc.) And if you struggle with insomnia, you’ve probably heard of sleep medications and supplements like Ambien, trazodone, or melatonin. We also know how vital sleep is to health and wellness. Sleep significantly impacts mood, energy levels, and overall well-being. Sleep recharges us; it makes it possible for us to remember what we learned throughout the day.

Knowing how crucial sleep is for both physical and mental fitness, I set out to explore what happens when we don’t get enough. What exactly does a lack of sleep do to a person? I sifted through the research to learn more about the impact of sleep deprivation. This post explores how sleep deprivation affects physical health, perceptions, memory, and critical thinking.

SLEEP AND YOUR PHYSICAL HEALTH

Sleep deprivation is associated with signs of aging

Sleep deprivation has been linked to aging skin. One study found that poor-quality sleepers had more fine lines, uneven pigmentation, and reduced elasticity.

It makes sense that chronic sleep deprivation is associated with signs of aging; sleep is needed for overall rejuvenation (mind and body), which includes skin cell renewal. For smooth and supple skin, high-quality sleep is essential.

Snoring and sleep deprivation are linked to obesity

A 2016 study looked at the relationship between sleep characteristics and body size/weight. Snoring was associated with having a higher BMI, a larger waist, and more body fat. (It should be noted that snoring doesn’t cause obesity; the two are simply related.)

Poor sleep quality and shorter durations of sleep were linked to larger body size and more body fat. The relationship between sleep and obesity is further explored in the next few paragraphs.

If you’re dieting, you’re more likely to lose body fat when you’re getting adequate sleep. Researchers studied participants who slept for either an average of seven and a half hours or five and a quarter hours per night over a 14-day period. Calorie consumption was the same; participants lost similar amounts of weight. However, when participants slept more, they lost more body fat; in fact, about half of the weight they lost was fat. Sleep-deprived participants lost only a pound of fat; the other five pounds were fat-free body mass. Furthermore, it was found that sleep helps with appetite control; this is due to ghrelin, a hormone that stimulates appetite and promotes fat storage. Sleep-deprived participants had higher levels of ghrelin.

If you’re watching what you eat, incorporate healthy sleep habits to maximize your efforts; adequate sleep is needed for optimal weight loss.

Sleep affects our food choices

Other studies have examined specific the ways sleep deprivation affects food choices and calorie intake. Sleep deprivation is associated with especially poor food choices the day following poor-quality or no sleep. One study found that sleep deprivation led to strong cravings for junk food. The researchers measured increased activity in the part of the brain that responds to rewards, but decreased activity in the “decision-making” part of the brain. Study participants choose unhealthy items (i.e. pizza, donuts) over fruits and vegetables.

Another study looked at total calorie intake; sleep-deprived participants consumed an extra 385 calories per day. They also ate higher-fat foods. Additionally, researchers found that a sleep-deprived person purchased items that were higher in calories when grocery shopping.

A 2016 study looked at the relationship between sleep deprivation and the consumption of high-calorie, sugar-sweetened caffeinated beverages in a sample of 18,000 adults. It was found that adults who averaged less than five hours of sleep per night were more likely to consume sugary drinks like soda or energy drinks than their well-rested counterparts. The researchers weren’t able to determine whether drinking caffeinated beverages caused people to sleep less or whether being sleep-deprived caused people to crave more sugar and caffeine; it’s likely that both are true.

Without high-quality sleep, it’s difficult to lose body fat.

Regarding obesity, sleep deprivation plays a significant role. A lack of sleep causes us to feel hungry. We crave junk foods and consume more calories. At the same time, sleep deprivation promotes fat storage while decreasing our energy levels. Without high-quality sleep, it’s difficult to lose body fat.

If you struggle with chronic insomnia, make an active decision to make healthy eating a habit; you’ll be less likely to submit to your cravings. Visit the grocery store only when you’re well-rested. Know that you may not feel like exercising; practice determination. Be mindful to counter some of the health risks associated with sleep deprivation.

In addition to obesity, sleep deprivation is associated with heart disease, high blood pressure, diabetes, and stroke. A lack of sleep takes a toll on the heart. In a recent study, researchers looked at 24-hour shift workers. It was found that sleep deprivation led to a significant increase in cardiac contractility, blood pressure, and heart rate. Furthermore, study participants experienced thyroid changes and an increase in cortisol (the stress hormone).

Research also indicates that chronic sleep deprivation and disrupted sleep are linked to an increased risk of developing or dying from coronary heart disease or stroke. Diabetes and hypertension are associated with sleep deprivation as well.

A lack of sleep may impact women more than men. Researchers found that women who got less than eight hours of sleep per night were at a higher risk of heart disease and other heart-related problems when compared to men who got the same amount of sleep.

Have you ever noticed that you heal slowly or get sick more often when you’re sleep deprived? According to research, chronic sleep deprivation is associated with reduced immune function. If you’re not regularly getting at least six to seven hours of sleep, you’re more susceptible to illness. Your immune system won’t be as effective at eliminating viruses and bacterial infections.

Chronic sleep deprivation is associated with bone loss

Sleep even affects your bones. One study found that chronic sleep deprivation was associated with a loss of bone mass (in rats, at least). The rats underwent sleep restriction measures for three months. A lack of sleep led to significant decreases in bone density, volume, and thickness.

SLEEP AND YOUR BRAIN

Sleep deprivation is associated with increased pain sensitivity

The first part of this post examined sleep’s impact on physical health; the next half will explore how sleep affects the mind, including the way we sense and perceive the world around us. Research indicates that sleep deprivation and/or disruption increase sensitivity to pain. Interestingly, in one study, stimulants like caffeine had the ability to “normalize” the pain sensation (meaning it would feel the way it would with adequate sleep).

Sleep and chronic pain seem to be intricately connected, but the relationship is not fully understood; up to 88% of individuals with chronic pain report sleep issues and nearly 50% of individuals with insomnia have chronic pain..

A lack of sleep affects the way you hear and process sounds

In addition to the sensation of touch, sleep deprivation affects the perception of sound. A lack of sleep impairs central auditory processing (CAP). CAP is crucial for aspects of hearing such as language comprehension, identifying sounds, and recognizing patterns.

In one study, participants took a longer time identifying sounds after being deprived of sleep for 24 hours. It appeared there was a “transfer delay” (from hearing to identifying and then interpreting). To be effective, CAP requires alertness and concentration.

Sleep deprivation affects the formation of memories

We know that sleep deprivation causes cognitive impairment; the brain can only store so much information before it must recalibrate. During sleep, memories are encoded; the brain “consolidates” memories by strengthening them and transforming them from short-term into long-term memories. Without sleep, long-term memories can’t form. Short-term memories are lost and/or altered. Even procedural memories are impacted by sleep deprivation. A lack of sleep leads to forgetfulness and an inability to retain new information.

Sleep affects the way we interpret emotions

Sleep deprivation impairs your ability to interpret facial expressions. A recent study found that a lack of sleep made it difficult for participants to recognize the facial expressions of happiness or sadness. Interestingly, the ability to detect anger, fear, surprise and disgust was not affected. This suggests we’re biologically wired to recognize the emotions related to survival. The researchers hypothesized that the brain preserves functions that perceive life-threatening stimuli while sacrificing functions associated with empathy, bonding, and friendship.

“Real life” implications: If you’re majorly sleep-deprived, you could misinterpret the intentions of others, negatively impacting relationships with co-workers, family, friends, and others. Furthermore, you could read people wrong or miss important social cues; you might not respond appropriately or you could seem lacking in empathy.

When someone is sleep deprived, they’re slower to adopt another’s perspective

In addition to perception and memory formation, sleep deprivation impacts decision-making skills and thoughts, including the ability to accurately assess a situation.

If you have chronic insomnia, you might experience interpersonal problems.

In 2015, researchers hypothesized that sleep deprivation would impair the capacity to recognize sarcasm. Study results didn’t support the hypothesis, but the research generated an unexpected outcome. It was found that someone who was sleep-deprived was slower to adopt another person’s perspective. Implications? If you have chronic insomnia, you might experience interpersonal problems.

Sleep deprivation affects our moral judgment

Sleep deprivation affects moral judgment. In one study, participants were sleep deprived (awake for 53 continuous hours) and then faced with moral dilemmas. They had difficulty solving the dilemmas and making appropriate judgments. Other studies support this as well; a lack of sleep is related to decreased moral awareness. When you’re faced with a tough decision, especially one that involves ethics or morals, be sure to get adequate sleep. You can’t always trust your moral compass.

Sleep deprivation is linked to impaired decision making

Moral decisions are taxing if you’re sleep deprived… the opposite is true with risky ones. Sleep deprivation alters areas in the brain that assess positive and negative outcomes; sensitivity to rewards is enhanced while attention to negative consequences is diminished.

If you haven’t slept, tough decisions can wait.

Researchers found that when gambling, sleep-deprived individuals were more optimistic about their odds of winning. Another study found that sleep deprivation made it difficult for study participants to come to a quick decision when pressured. Sleep-deprived participants also made more mistakes. If you haven’t slept, tough decisions can wait.

A lack of sleep affects optimism

If you’re not getting enough sleep, you could lose your ability to remain positive-minded. Research indicates that individuals with insomnia have lower rates of self-esteem and optimism. In 2017, researchers found that sleep-deprived study participants were less likely to focus on positive stimuli. An inability to think positively is also a symptom of depression.

A lack of sleep can lead to schizophrenia-like symptoms

Sleep deprivation can lead to perceptual distortions, cognitive disorganization, and anhedonia (an inability to feel pleasure).In a 2014 study, participants experienced psychosis after staying awake for 24 hours. The sleep-deprived individuals reported attention deficits and being more sensitive to light, color, and brightness. They exhibited disorganized speech, which is a common symptom of schizophrenia. Participants also reported an altered sense of time and smell. Some of them actually believed they were able to read thoughts; others noticed an altered body perception. Implications? If you miss a night (or two) of sleep, don’t be surprised when you hear voices or when your reality is somewhat altered.

Conclusion

In conclusion, sleep deprivation, especially when it’s chronic, is detrimental to your health. Based on my review of the research, poor-quality sleep can adversely impact your skin, your weight, your cardiovascular system, your immune system, and your bones. (It should be noted that I barely skimmed the surface of an immense body of scientific data on sleep.)

Sleep is also related to brain health. Sleep deprivation impairs sensory perceptions, memory formation, the ability to assess your environment, moral awareness, critical thinking skills, and mood. Sleep deprivation can even induce psychosis.

If you’re like me (the one out of 10 Americans with chronic insomnia), in addition to practicing good sleep hygiene, go ahead and Google “CBT for sleep.” Research suggests that for some, CBT is more effective and longer-lasting than sleep medication. Do a little bit of research. CBT is not a quick fix for insomnia, but it’s worth a try; and your health and wellness are definitely worth it!

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Johns Hopkins Medicine. (2017, February 2). Sleep deprivation handicaps the brain’s ability to form new memories, mouse study shows: Chemical recalibration of brain cells during sleep is crucial for learning, and sleeping pills may sabotage it. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2017/02/170202141916.htm
Khatib, H., Harding, S., Darzi, J., &, Pot, G. (2016). The effects of partial sleep deprivation on energy balance: a systematic review and meta-analysis. European Journal of Clinical Nutrition, DOI: 10.1038/ejcn.2016.201
Killgore, W., Balkin, T., Yarnell, A., &, Capaldi, V. (2017). Sleep deprivation impairs recognition of specific emotions. Neurobiology of Sleep and Circadian Rhythms, 3(10) DOI: 10.1016/j.nbscr.2017.01.001
King’s College London. (2016, November 2). Sleep deprivation may cause people to eat more calories. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2016/11/161102130724.htm
Knutson, K. (2012). Does inadequate sleep play a role in vulnerability to obesity? American Journal of Human Biology, 24(3), 361. DOI: 10.1002/ajhb.22219
Liberalesso, P., D’Andrea, K., Cordeiro, M., Zeigelboim, B., Marques, J., &, Jurkiewicz, A. (2012). Effects of sleep deprivation on central auditory processing. BMC Neuroscience, 13(83). http://doi.org/10.1186/1471-2202-13-83
Mitchell, M. D., Gehrman, P., Perlis, M., &, Umscheid, C. A. (2012). Comparative effectiveness of cognitive behavioral therapy for insomnia: A systematic review. BMC Family Practice, 13(40). http://doi.org/10.1186/1471-2296-13-40
Perelman School of Medicine at the University of Pennsylvania. (2017, July 17). You’re not yourself when you’re sleepy. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2017/07/170717120048.htm
Petrovsky, N., Ettinger, U., Hill, A., Frenzel, L, Meyhofer, I., Wagner, M., Backhaus, J., &, Kumari, V. (2014). Sleep deprivation disrupts prepulse inhibition and induces psychosis-like symptoms in healthy humans. Journal of Neuroscience, 34(27): 9134 DOI: 10.1523/JNEUROSCI.0904-14.2014
Prather, A., Leung, C., Adler, N., Ritchie, L., Laraia, B., &, Epel, E. (2016). Short and sweet: Associations between self-reported sleep duration and sugar-sweetened beverage consumption among adults in the United States. Sleep Health, DOI: 10.1016/j.sleh.2016.09.007
Radiological Society of North America. (2016, December 2). Short-term sleep deprivation affects heart function. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2016/12/161202100943.htm
Universität Bonn. (2014, July 7). Sleep deprivation leads to symptoms of schizophrenia, research shows. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2014/07/140707121415.htm
University Hospitals Case Medical Center. (2013, July 23). Sleep deprivation linked to aging skin, study suggests. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2013/07/130723155002.htm
University of Arizona. (2017, March 23). Sleep deprivation impairs ability to interpret facial expressions. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2017/03/170323132524.htm
University of California – Berkeley. (2013, August 6). Sleep deprivation linked to junk food cravings. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2013/08/130806145542.htm
University of California – San Francisco. (2016, November 9). Shorter sleep linked to sugar-sweetened drink consumption: Treating sleep deprivation could potentially help reduce sugar intake. ScienceDaily. Retrieved March 8, 2018 from www.sciencedaily.com/releases/2016/11/161109112553.htm
University of Chicago Medical Center. (2010, October 5). Sleep loss limits fat loss. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2010/10/101004211637.htm
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Xiao, Q., Gu, F., Caporaso, N., &, Matthews, C. (2016). Relationship between sleep characteristics and measures of body size and composition in a nationally-representative sample. BMC Obesity, 3(1).
Xu, X., Wang, L., Chen, L., Su, T., Zhang, Y., Wang, T., &, Zhang, Y. (2016). Effects of chronic sleep deprivation on bone mass and bone metabolism in rats. Journal of Orthopedic Surgery and Research, 11(87). http://doi.org/10.1186/s13018-016-0418-6

75 Free Online Resources for Continuing Education for Mental Health Professionals

A list of over 75 sites that provide free online education for counselors, including training courses and webinars, some offering CEs.

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This post is archived and will no longer be updated. For the newest version of this post, see 200+ Free CE Trainings for Counselors.

(Updated 8/29/22) Are you looking to expand your clinical knowledge or need CEs to renew your license? In-person workshops and seminars are ideal for learning up-to-date practices and the latest research, but they are often expensive and/or require travel. And while there are plenty of online education programs that offer CEs, most charge a fee.

75 Free Online Resources for Continuing Education for Mental Health Professionals

This is a list comprised of over 75 sites that provide free online education, including training courses and webinars, some offering CEs.

Please share this resource for free online education with anyone you think might benefit!

For additional resources for professional development, click here.

Free Online Training Courses and Webinars

6-Module DBT Course | An educational course designed for professionals to learn the basic principles for the diagnosis and treatment of borderline personality disorder. There are six 20-minute modules.

Addiction Treatment Forum: Online Continuing Education Free Training Modules | Trainings on Hepatitis/HIV/AIDS and medication-assisted treatment for opioid addiction
Alison – Mental Health Courses | Free courses on stress management, burnout, and more
American Institute of Stress | Videos and online courses
American Society of Addiction Medicine | Webinars
Anxiety and Depression Association of America | Free monthly webinars. You can access archived webinars. You can also watch a six-part series for professionals on treating anxiety disorders.

Battered Women’s Justice Project | On-demand webinars on sexual violence prevention and policy
Brain & Behavior Research Foundation | A variety of webinars. (Sign up for the newsletter to be notified when new webinars are available.)

CAMH – Mental Health 101 | Basic mental health tutorials
CDC Train | Over 1,000 public health training opportunities, many offering free CEs. Create an account to access a variety of online courses.
CE4less: Ethics and Boundary Issues | Free 5-hour course, account registration required, there may be a fee for CEs
Center for Adolescent Studies – Resilience and Self-Care Basics for Helping Professionals – CAS Online Courses | 1.5-hour online course, registration required, free CEs
Center for Deployment Psychology: Webinars & Online Courses | Free trainings, CEs for a fee
Center for Healing Shame – Intro Healing Shame In Couples | 1-hour training video on-demand, no CEs
Center for Youth Wellness: CYW Learning OnDemand Courses | Training courses on ACEs
Clinical Provider Training | Online trainings (national provider webinars) offering free CEs (approved by the NBCC)
Co-Occurring Disorders: A Training Series | Free training modules from the University of South Florida

DSM-5 Online Training Course | Free course through Relias Learning

Eating Disorders HOPE | View recorded webinars on topics related to eating disorders

Free Mental Health Webinars | SocialWork.Career posts a list of free webinars every month
Free Online Psychology Courses from Top Universities | LearningPath.org provides links to a variety of psychology courses
Free Racialized Trauma Course | From Cultural Somatics Training & Institute
FUTURES Without Violence | View recorded webinars on topics relating to violence against women and children.

Hazelden Betty Ford Foundation: Webinars for Professionals | Online learning on topics related to substance use and behavioral health
Health eKnowledge | Free online courses on a variety of topics including clinical supervision, substance use, and behavioral health. You must create a free account and login to access the courses.
Healthy Minds | A public television series on mental health (and ending stigma)
Honor Our Voices | A learning module that allows you to see domestic violence through the eyes and voices of children, includes a printable guide

Implicit Bias Module Series | From the Kirwan Institute for the Study of Race and Ethnicity
Improving Cultural Competency for Behavioral Health Professionals | The goal of this 4-course e-learning program is to help behavioral health professionals increase their cultural and linguistic competency. Earn up to 5.5 contact hours. 🆕
Indiana Prevention Resource Center | Webinars and online modules on drug education and treatment. You must register to access the courses. Free CEUs.
Institute for Creative Mindfulness (thinkific.com) | Several free on-demand courses
Institute for Research, Education, and Training in Addictions | Register for a free account to access web-based training (webinars and online courses) on addiction and recovery topics. Free CEUs for NAADAC and Social Work.
International Society for Bipolar Disorders | Free webinars. The site also offers videos and tools for clinicians.
Interpersonal and Social Rhythm Therapy | IPSRT is an evidence-based treatment for bipolar disorder. With registration, this course offers a free 8-hour online training.

Just Detention International Webinars | Current and archived webinars on sexual abuse in detention centers, no CEs

Mad in America Continuing Education | Free and low-cost courses
Magellan Health E-Learning Center | Professional learning opportunities. Many of the continuing education courses offer free CEs approved by the following organizations: APA, ASWB, NBCC, and NAADAC.
Maryland Behavioral Health (University of Maryland School of Medicine) – Online Training | Several free courses, some offering CEs. Must register for a (free) account.
Massachusetts General Hospital Psychiatry Academy | Search for free online education (CE credits) for mental health, primary care, and nursing professionals
Mental Health America | Recorded webinars on various mental health topics
Mental Health Professionals’ Network | Australia-based site. Webinars on topics ranging from complicated grief, complex trauma, anxiety, LGBT issues, and more.
Mental Health Recovery: Wellness Action and Recovery Plan Webinars | On-demand webinars related to WRAP – Wellness and Recovery Action Plans
Mindful Ecotherapy Center: Archived Courses | Several free courses, including a suicide risk and prevention course. Other courses for a fee.
Mindfulness-Based Stress Reduction | Learn mindfulness with this free 8-week course
Minnesota Tobacco Prevention Quitlogix Training | Free online courses offering CE credits, must register for access

NAADAC | Webinars on addiction, CEs for a low fee for nonmembers
National Association for Continuing Education | For medical professionals
National Center for Healthy Safe Children – Learning Portal | Modules and webinars, along with supporting materials and related resources
National Center for PTSD | Training materials, online courses, information, and tools for professionals
National Center on Domestic Violence, Trauma, & Mental Health | Free webinars and seminars. (You must register for the webinars.) The site also provides free toolkits and other resources.
National Center on Substance Abuse and Child Welfare | Sign up for free online tutorials. (An access key will be sent via email you register.) CEUs offered for NAADAC professionals.
The National Center on Violence Against Women in the Black Community: Webinars and Trainings | Recorded webinars, no CEs offered
The National Child Traumatic Stress Center Network: The Learning Center | Online courses and webinars on childhood trauma. CEs for social workers, counselors, and psychologists
National Clearinghouse for the Defense of Battered Women: Webinars | Several webinar series with slides and handouts, no CEs
National Council for Behavioral Health | Webinars on various topics related to behavioral health
National Indigenous Women’s Resource Center: Resource Library | Webinars to support Tribes, Tribal programs, and advocates working on issues of violence against Native women
National Institute of Mental Health | Multimedia section has a variety of webinars and recorded series
National Institute on Drug Abuse: Health Professions Education | Videos and CE opportunities
National LGBT Health Education Center – Learning Resources | Free webinars and learning modules
National Sexual Violence Resource Center: Online Learning Campus | Both free and certificate courses offered

Office for Victims of Crime Training and Technical Assistance Center | Online trainings, webinars, and other training tools, some trainings offer CEUs
OMNI Behavioral Health Webinars | Both free and for-a-fee webinars on a variety of topics, some offering CEs

Partnership to End Addiction: Online Learning | A skill-building (self-paced) course designed to address adolescent substance use
Pathways to Positive Futures: Research and Training Center | Register for upcoming live webinars or access previous webinars on-demand
PESI Free Trainings | Free CEs offered for select online courses, email registration is required
- Free CE Seminar: CBT for Anxiety and OCD (pesi.com)
Preventing Firearm Injury: What Clinicians Can Do | This course was developed by the BulletPoints Project, a program of the California Firearm Violence Research Center at the University of California, Davis. BulletPoints aims to teach medical and mental health care providers how to reduce the risk of firearm-related injury and death in their patients. The course is taught by Dr. Amy Barnhorst, the Director of the BulletPoints Project and a Professor of Psychiatry and Emergency Medicine at UC Davis. This course provides an opportunity for participants to earn one Continuing Education (CE) credit. In order to earn the CE credit, participants must complete all activities, pass the final quiz by answering at least 70% of the questions correctly, and complete an unscored course evaluation. 🆕
PsychAlive Webinars | Free and low-cost scheduled and on-demand webinars
Psycharmor | Free courses on military cultural competence, PTSD, combat stress, and related issues

Quantum Units Education | Several free CE courses available, account registration required

SAMHSA – Practitioner Training | Tools, training, and technical assistance to practitioners in the fields of mental health and substance use disorders
SBIRT for Health and Behavioral Health Professionals: How to Talk to Patients About Substance Use | A 3.5-hour self-paced course on screening, brief intervention, and referral to treatment for substance use. Offers free CEs for NAADAC and NBCC (among others).
SMI Adviser | Free on-demand and lives courses, search catalogue by credit type
SOAR Works: SSI/SSDI Outreach, Access, and Recovery Online Course | A free 20-hour course with seven comprehensive classes that teaches how to navigate the SSI/SSDI application process with clients with mental illness, who are at risk of homelessness, have a medical impairment, or a co-occurring disorder. CEUs offered for NASW.
Stanford Center for Continuing Medical Education | Free health and medical courses
Suicide Prevention Resource Center | Online courses on suicide prevention, assessment, and recovery

Teaching Tolerance: Professional Development | On-demand webinars
TF-CBT Web 2.0 | Self-paced, online training course on trauma-focused CBT, $35 fee, 11 contact hours offered

Uniformed Services University: Center for Deployment Psychology | Self-paced learning courses and webinars, CEs available for a fee

VHA Train | Register for a free account to access on-demand trainings, some free CEs available for counselors and social workers

YMSM & LGBT | Archived webinars on topics related to treatment services for the lesbian, gay, and transgender population. You can also access a monthly webinar series held on the 4th Friday of each month. CEs offered

Zero Suicide | Articles, tools, videos, and webinars

Free Online College Courses

Course Buffet
Coursera
edX

19 Unique Ways to Be More Charitable

(Updated 6/22/18) Ideas for charity contributions that are easy, cheap (or free!), and fun. An awesome list for people who may not have a lot of money or time, but still want to give back.

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To build self-esteem, one must do “esteemable” acts.

Charitable acts help to build self-esteem; it feels good to help others. As a substance abuse counselor, I worked with adults who were worn down or broken from their battle with addiction; an individual with a substance use disorder often feels tremendous guilt and shame.

One of the best things a person can do to build self-esteem or live a more meaningful life is to help others…

I taught my clients to cherish themselves, to forgive, and to find a purpose in life. One of the best things a person can do to build self-esteem or live a more meaningful life is to help others; random acts of kindness, volunteering at a homeless shelter, reading to children at a library, donating toiletries or blankets to someone who has lost their home in a fire… There are countless ways to help. Research indicates that practicing compassion and volunteering build self-esteem.

Unfortunately, not everyone has the time to volunteer (or the resources to donate). The purpose of this list is to provide ideas for charity contributions that are easy, cheap, and fun. I created this list for people who may not have a lot of money or time. I found some awesome ways to give back that aren’t time-consuming; many of the ideas require minimum effort and/or are 100% free. Build them into your life and feel happy about helping those in need!

UNIQUE AND FUN WAYS TO BE MORE CHARITABLE

1. Purchase Who Gives A Crap toilet paper.

Products are environmentally friendly and 50% of profits go to help build toilets and improve sanitation in the developing world.

2. Donate your wedding dress to a charitable cause.

Here are a few of my favorites:

Wish Upon A Wedding: A nonprofit organization that grants weddings and vow renewals for couples facing serious illness or a life-altering circumstance.

Adorned in Grace: All proceeds are used to promote awareness and prevention of sex trafficking as well as crisis prevention for trafficked victims.

Cherie Amour: Proceeds from dress sales help low income individuals get jobs.

Fairytale Brides: Net proceeds from all sales are donated to charitable organizations supporting women’s empowerment programs.

3. Save a life by joining a marrow registry such as Be The Match or Gift of Life.

Your donation may save the life of a person with a blood cancer like leukemia and lymphoma. You must be in good health and you must be prepared to spend 20-30 (non-consecutive) hours of your time if you are chosen. Not everyone is chosen; according to Be The Match, about 1 in 430 members goes on to donate marrow or peripheral blood stem cells. If you join Gift of Life, you have a 1 in 250 chance of being a match, but then only a 20% chance of donating.

You can also donate blood at a blood drive. O-negative is the universal donor type because it is compatible with any blood type, but only about 5% of the U.S. population have this blood type. There’s a great need for O-negative donations (Source: https://www.redcrossblood.org/learn-about-blood/blood-types.html)

4. With Kiva, lend as little as $25 to help a borrower start or grow a business, go to school, access clean energy or realize their potential.

100% of every dollar goes to a loan. You can browse through different categories and attributes. According to Kiva, 97% of loans are repaid, but there’s no guarantee. You can read the borrower’s story before you submit your loan. (I loaned $25 to a woman in El Salvador to help her buy a sewing machine. Update: I received full repayment within three months.)

5. Help the homeless.

Keep a pack of bottled water in your car. Alternatively, you can provide someone in need with a small bag filled with toiletry items, socks, tissues, granola bars, etc. (Take the extra shampoo, lotions, and soap when you’re at a hotel and put them to use!) If the weather is cold, buy gloves or hats from the dollar store to hand out. Give $5 gift cards for Burger King or Taco Bell. Personally, I choose to not give cash. (Many of the “homeless” individuals you see are panhandlers.) However, if I’m in an area with a large homeless population, I buy a pack of cigarettes; when someone asks for change, I offer a cigarette instead. Lastly, because of the work I do, I have business-sized cards with a crisis line, a phone number for local resources (including shelters), and a number for a substance use program, which I pass out if needed.

6. Host a closet swap party!

Exy Castellanos, a social worker from Chattanooga, Tennessee, provided this idea. “My friends and I have a closet swap party. We swap clothes and stuff and whatever is left over we donate to a local thrift store (not Goodwill).”

7. Volunteer with Idealist.

It’s free to sign up, to search for opportunities, and to connect with others. Idealist is a global network of people and organizations that connects individuals with advantages to work, volunteer, or intern. To give you a better idea, here are examples of some volunteer opportunities: Reading partner at an under-resourced elementary school, judging a local competition, playing with homeless children one night a week, coaching a sports team, volunteer zoo guide, volunteering at a museum, cleaning up a national park, and interpreter.

8. Run (or walk/march/bike) for charity!

Pick a cause and raise funds.

9. An Internet search led me to Helping Hands: Monkey Helpers for the Disabled, which helps adults with spinal cord injuries and other mobility impairments in the U.S. to live more independent and engaged lives.

This is accomplished by providing the individuals with unique service animals (at no cost): Highly trained service monkeys to help with daily tasks.

10. Janelle Bennett from Michigan suggested Charity: Water, a great organization bringing people clean water.

100% of donations go to actually helping people. You can start a fun campaign to raise funds; one guy actually rented his face and let a stranger shave his beard on the street to raise money.

11. Every time you buy concert tickets, donate to charity.

At one point in my life, I decided that if I could afford concert tickets, I could afford a small donation ($25) for a good cause. (And it doesn’t have to be concert tickets; it can be anything you want! Buying a piece of jewelry, purchasing an electronic device, dinning out, etc.)

EFFORTLESS WAYS TO BE MORE CHARITABLE

12. Instead wedding favors, make a CHARITABLE donation TO YOUR FAVORITE CAUSE for each guest.

At my wedding, my husband and I picked a lung cancer nonprofit to honor his father, who passed away from lung cancer. You can buy cards on Etsy or, just make them yourself with pearl cardstock paper!

13. Tabs for a Cause is a free browser extension.

Every time you open a new tab, a donation is made to your favorite charity.

14. Lyft has a “round up and donate” setting; opt in, and your fare will round up automatically with each ride.

There are a variety of causes to choose from.

15. “Click to give” at GreaterGood.

It’s completely free. You can click once per day, and there are multiple causes to choose. I first discovered GreaterGood through The Animal Rescue Site; a single click helps to provide food and shelter to animals in need. (You can also do some shopping and a percentage of the item’s retail price is donated to a cause. I bought a beautiful handbag with a jungle print!)

16. Shop at AmazonSmile at no extra cost, and Amazon will donate a portion of the purchase price to your favorite charitable organization.

You can choose from nearly 1 million charities, including local charities.

17. If you use Swagbucks, you can donate your Swagbucks to various charitable causes instead of redeeming for a gift card or cash.

Similarly, some airlines will allow you to donate your miles to a cause.

18. If you’re a runner, download the Charity Miles app to earn money for charity for the miles you run.

You can also earn money for walking and biking.

19. Play free vocabulary games at Free Rice and for each correct answer, 10 grains of rice are donated to World Food Programme to help end hunger.

Free Rice has two goals: To provide free education and to end world hunger

Additional Charitable Ideas:

Wands for Wildlife: Donate old mascara wands! They’re used to gently remove fly eggs and larva from the fur of wild animals. (Wash in soap and warm water before mailing.)

Coin Up: Download the app to round up on credit or debit card transactions. Your “spare change” is then donated to the charity of your choice each month.

CoinStar Coins That Count: Take your change to a CoinStar kiosk to donate to a charity of your choice. A printed receipt will be provided.

Rake a neighbor’s yard or shovel their driveway.

Pay for a stranger’s coffee, dinner, grocery item, etc.

Before making a donation, you can check a charity’s credibility (including a financial breakdown of funds) at the BBB Wise Giving Alliance. Alternatively, you can use Charity Watch, which grades charities and includes “red flag” information. The site also provides a list of the top charities. Also, Charity Navigator, which includes guides and tips for donating items, volunteering, informed giving, and more.

What are some creative and unique ways to donate to charity? Leave an answer in the “Comments” section!

Updated June 22, 2018

Karche, M. (2009). Increases in academic connectedness and self-esteem among high school students who serve as cross-age peer mentors. Professional School Counseling, 12(4), 292-299.

Mongrain, M., Chin, J., &, Shapira, L. (2011). Practicing compassion increases happiness and self-esteem. Journal of Happiness Studies, 12(963).

von Bonsdorff, M.B. &, Rantanen, T. (2011). Benefits of formal voluntary work among older people: A review. Aging Clinical and Experimental Research, 23(162).

24 Characteristics of an Effective Therapist

Are you in therapy or have you sought counseling in the past? Are you currently practicing as a therapist or counselor? This article explores what makes a therapist effective (or not).

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What Are the Characteristics of an Effective Therapist?

The American Counseling Association (ACA) established a code of professional ethics and values as a guide in practicing as an effective therapist. The ACA’s mission is “to enhance the quality of life in society by promoting the development of professional counselors, advancing the counseling profession, and using the profession and practice of counseling to promote respect for human dignity and diversity.”

Professional values include the following:

enhancing human development throughout the life span
honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts
promoting social justice
safeguarding the integrity of the counselor–client relationship
practicing in a competent and ethical manner

Ethics include autonomy, nonmaleficence, beneficence, justice, fidelity, and veracity.

The ACA outlines professional values and ethics, but for the purpose of this article, I wanted to learn about current perceptions and views. Also, how do counselors exemplify the code in their practices? Using social media (Reddit and Quora) as a survey tool, I reached out to mental health professionals and therapy participants; I also browsed through older threads and posts on the topic.

I read about traits (like active listening and compassion) that are important to both therapy participants and clinicians. Additionally, I learned about negative experiences, which was disheartening. So what makes a good (or bad) clinician?

An effective therapist is someone who…

Actively listens
Is kind and compassionate
Practices honesty
Is transparent
Puts a lot of thought into what they say
Educates their clients (coping skills, symptoms, stress management, etc.)
Conveys warmth
Reflects and validates feelings
Understands human behavior and mental disorders
Is non-judgmental
Sets and adheres to healthy boundaries
Is genuine (and genuinely cares for their clients)
Has a wide range of techniques and a variety of tools
Is humble (and gives advice sparingly)
Creates a safe place for healing
Is knowledgeable (evidence-based practices, current research, etc.) and intelligent
Possesses emotional intelligence
Is respectful
Experiences and conveys empathy
Has a sense of humor
Is curious
Has patience
Is trustworthy
Recognizes and values other perspectives

Interestingly, a few responders took into account a therapist’s personal values and views (not just how they conduct themselves in a session). As a counselor, this resonated. For example, a therapist can’t be genuine if they’re empathetic with their clients, but rude or nasty otherwise. Being a counselor means fully embracing the code of conduct. Consider how it would feel to discover your therapist treats restaurant staff poorly or gets hammered and then drives. It would likely leave a bad taste in your mouth. A good clinician is a role-model. Furthermore, it’s important for a counselor to be emotionally stable and self-aware, which is something I’ll explore shortly.

Personal values/traits for effectiveness include…

Resilience
Optimism
Faith in humanity
Courage
Self-acceptance
Holding others and self accountable
Self-awareness
Seeking to improve self and grow, both personally and professionally
Self-esteem and acceptance
Practicing self-care

Regarding professional development, it was noted by Lazar_Milgram (Reddit user) that a counselor must commit to “relearning,” meaning re-reading text books, literature, and research to prevent it from fading. As humans, we forget things. We need to go back to the original source of knowledge now and again. It’s not enough to go to grad school; a counselor must commit to a lifelong education. Along those lines, Lazara_Milgram reported that an effective counselor re-visits his/her failures. If we were unable to help a client for one reason or another, it’s worth it to review their file and our records, consult, and then learn from our mistakes.

On self-awareness, Reddit user Valirony, a marriage and family therapist, shared it’s important for a therapist to be aware of “[his/her] own existing issues and [be] either well-processed on those fronts and/or very capable of compartmentalizing the baggage that is less well-processed.”

To expand on this, consider the experience of emotional anguish. An empathetic person who has experienced a personal tragedy may consequently feel a desire to ease suffering in others. Naturally, they’re drawn to the counseling profession; but if their wounds haven’t healed, they lack the capacity to help their clients.

Sadly, some counselors enter the profession seeking to “fix” others as an attempt to compensate for being unable to face their own issues. In contrast, an effective therapist recognizes his/her limitations as a counselor, especially in the face of personal tragedy. They recognize when it’s their own “stuff” (and not the client) triggering a reaction. They leave the past where it belongs and carry little to no emotional baggage. This allows them to be fully present and engaged.

Valirony (Reddit user) also discussed constructive criticism. It’s essential for the effective therapist to remain open to constructive feedback in order to grow. Valirony explained, “I see a lot of defensiveness in some of my colleagues during consultation; I’m no saint and I feel defensive here and there, but I always take a look at that defensiveness for whatever it is in me that I need to change.” Defensiveness is a clue that something’s not right. On constructive feedback, Reddit user Lazar_Milgram suggested, “Embrace criticism – every criticism is a 50/50 package of perceptual information about you. 50% tells something about you and 50% tells something about client.” Providing it’s thoughtful and well-presented, criticism can inspire insight or provide a new way of looking at something.

Ann Veilleux, a private-practice psychotherapist and Quora user, identified emotional intelligence as a trait for effectiveness. “Intelligence comes to mind first, emotional intelligence certainly, a curiosity and interest in people [as] more [than] machines or plants.” Emotional intelligence is innate; it can’t be developed the way a skill can. Furthermore, a good clinician is curious, but their interest is attached to the well-being of their clients. Veilleux pointed out that an effective therapist must possess interest and ability – not one or the other – in order to sustain the level of investment therapy demands. It’s the “interest and ability to have intimate relationships with many people at the same time and not to tire of that.”

The Therapeutic Relationship

With regard to the client-counselor dynamic, an effective therapist recognizes that the relationship is central to the therapeutic process; it’s the key to healing and growth. A client must trust the counselor before they feel safe enough to share their pain or humiliation or guilt. Traits like warmth, humor, and transparency foster an honest and caring relationship. Counseling skills are important, but can only go so far without a trusting relationship.

To promote a supportive relationship, Reddit user RedYNWA suggested that counselors practice empathy without being overly emotional. RedYNWA described how they felt when their therapist cried in session. “I believe my topic brought up something personal for her. The minute she cried. I stopped talking, and changed the topic. I felt she was unable to hold my topic, and I felt a responsibility to ease her distress. It changed our relationship, I felt like the therapist, and it restricted my ability to divulge deep emotions. It was unintentional on her side. However, it destroyed the therapeutic relationship.”

In the above situation, a counselor’s emotional reactivity upset the balance of the therapeutic relationship. Unintentionally, the therapist sent a strong message. The message was that she was too fragile to hear her client’s pain. If the therapist can’t be strong, how can the client? A counselor who breaks that easily can’t be a source of unwavering support. It’s the client’s job to cry; the therapist’s job is to remain calm, to maintain a safe environment, and to instill hope.

I am acquainted with therapists (colleagues and former peers) who occasionally cry in sessions. Sometimes, it’s an instinctive reaction to hearing the horrors clients have gone through; the discrimination, the trauma, the abuse, and worse. There was a time I cried while facilitating a group, but it wasn’t related to anything being said. That morning, I had learned a former client died by suicide. He shot himself in the head. He was only 22. I felt vulnerable and self-conscious about crying in front of my clients. Later, my supervisor helped me to understand that crying can make a therapist seem more human and authentic, which has the potential to strengthen the counseling relationship while conveying empathy.

Some clients will feel closer to a therapist who cries; others will feel uncomfortable. There’s no right or wrong. Quora user Philippe Gross, Assistant Professor of Psychology at University of Hawaii, pointed out that even with all the right qualities, a therapist will not be a good fit with every client. When this happens, Gross stated that “an effective therapist should be able to recognize this soon and refer the client to a more appropriate therapist.”

One Reddit user and professional counselor, ForeverJung, touched on the importance of not getting caught up in their clients’ pain to the point it becomes their own (also known as vicarious trauma). It’s having “the ability to care deeply and then shut it off,” which can be difficult, especially for new counselors. ForeverJung also shared that an effective counselor must be able to listen, while at the same time “synthesizing data,” and then provide a constructive response that the client will be able to make sense of.

Redddit user blueybluel shared about a therapist they described as absolutely wonderful. “She was incredibly empathetic and patient with me, almost to a fault I felt like sometimes. But it really helped me a lot with my self-hatred, self sabotage and suicidal thoughts because for the first time ever, I was regularly associating with a person who was so soft with me. She genuinely thought I was a great person just the way I was, and that I didn’t have to accomplish and be perfect all the time just to have worth and to deserve to live.”

Similarly, Gatopajama (Reddit user) described positive interactions with their current therapist, who shares their odd sense of humor. “[My therapist] is serious when the topic calls for it, but usually a session with her feels very comfortable and laid back, like having coffee with a girlfriend. She also shares a little bit about herself sometimes (not in an inappropriate or TMI way) — it makes me feel like I’m talking to a real person and not a human psychology textbook. Plus, she’s got a gigantic bowl of moonsand in her office. Sometimes I plop that thing on my lap and play with it the whole hour to keep my hands busy if I’m trying to talk about something difficult.”

What are the Traits or Characteristics of an Ineffective Therapist?

While some traits (such as having a gigantic bowl of moonsand!) positively impact the counseling process, others contribute to nonproductive (or even harmful) therapy. When I elicited feedback on effectiveness, I learned about some horribly ineffective and disturbing practices.

An incompetent clinician lacks self-awareness and insight in addition to the required knowledge and skill. They may have entered the field for all the wrong reasons. They’re rigid and closed to new ways of thinking. Most importantly, they don’t listen to their clients. Ssdgmok, a Reddit user, described a bad clinician as “someone who talks about themselves each session, poor listening and ‘giving advice.’” Contrary to popular belief, a counselor’s role is not to advise the client. A therapist is more like a collaborative partner who leads the client to their own insights while providing the tools for change.

To give a personal example of a therapist who talked too much (although not about herself) and didn’t listen, I’ll use myself – but in the role of the client, not the clinician. I was in my late teens and it was one of my first experiences seeing a counselor (a middle-aged woman). The therapist had apparently just finished a session with a young woman who had attempted suicide. And the therapist proceeded to tell me all about it. Meanwhile, I was bursting with pain and self-doubt; and the therapist continued to talk about the client who had just left her office. She went on and on about how she couldn’t believe “that little girl” swallowed an entire bottle of Tylenol. It was like she didn’t hear a word I said, and I left feeling even worse. (Luckily, that experience didn’t poison my view of the profession or dissuade me from entering the field a decade later.)

A Reddit user shared about expressing thoughts of suicide to their therapist

Jwaggin
“Therapist: Are you suicidal
Me: Yea…
Therapist: You hate your mom?
Me: uhhh no
Therapist:Well if you kill yourself your mom would be very hurt
Me: uhhh ok (thanks for the guilt)”

If this happened, it’s clear that the therapist lacked not only empathy, but a basic understanding of mental illness. An effective therapist never shames or “guilts” a client. The client is already in pain (which is what brought them to therapy in the first place). Also, when a client says they’re suicidal, it’s the therapist’s responsibility to explore this with the client while ensuring the client’s safety. An effective therapist helps the client to identify what (if anything) would prevent them from killing themselves; the clinician won’t admonish the client for their hopelessness. To do so would be demeaning, with a disregard to human dignity.

Reddit user blueybluel shared, “When I told [the therapist] all my struggles, she seemed empathetic, but then got on this weird shtick of telling me to do homework of writing down things I like about myself, in an aggressive, demanding, pull yourself up by your bootstraps kind of way, and said, “Can you do that for me? By next week?” I canceled the next appointment and never saw her again.”

There’s no room for aggression in this profession. A good therapist is gentle; they don’t give orders. Instead, they explore, listen, and ask questions. It’s a respectful partnership between client and counselor.

After tragically losing their infant son, a Reddit user sought therapy

wonder-maker
“I explained my situation about having lost my infant son in a tragic household accident. She asked me to wait a moment, got up, walked to the front desk, came back with a sticky note from the receptionist and told me to come back and see a different therapist at a later date, then refused to make eye contact with me.
The next therapist said to my face ‘Boohoo, your kid died, get over it.'”

In the above example, the first therapist was a woman in her early 40s and the second was a male in his 60s. I’m disturbed by what happened to wonder-maker (Reddit user); and I’m horrified that these “helpers” are out there providing counseling services. The female therapist’s reaction could be explained by lack of experience or skill; alternatively, hearing about the accident could have triggered her (which is why self-awareness is so important). However, there is no excuse or explanation for what the male clinician said. You don’t have to be a therapist to feel empathy or compassion (but you do have to be a jerk to tell a grieving parent to “get over” the loss of a child).

Final Thoughts

In summary, there are many things that positively impact a counselor’s effectiveness, while opposite traits are related to incompetent practice. An effective counselor is an active listener, expresses empathy and compassion, and is genuine and transparent. They promote healing and self-exploration. The therapeutic relationship is also important. An effective clinician creates a safe environment for building trust while providing support. Additionally, to be effective, a therapist must commit to a lifelong pursuit of knowledge to learn new techniques and evidence-based practices, to understand how scientific developments will change the counseling profession, and to keep up-to-date on relevant research.

In contrast, a therapist who is uncaring, uninterested, and who doesn’t listen will never be effective. A counselor who constantly advises their clients or who shames their clients is incompetent and unethical. Furthermore, the absence of emotional intelligence greatly impacts a clinician’s counseling abilities.

Regarding personal values and lifestyle choices, there’s a gray area. Can a therapist who gossips or who abuses sleeping pills provide effective services? What about a marriage counselor who cheats on his wife? While a few therapy participants and mental health professionals emphasized the importance of a therapist’s personal integrity, most responders viewed effectiveness in the context of therapy alone.

Lastly, therapy participants who reported unproductive or even damaging experiences received services from therapists who did not adhere to the ACA code. Conversely, positive and effective experiences were related to ACA values.

9 Myths & Misconceptions About Mental Illness

1. Bad parenting causes mental illness.

2. Mental illness is not a medical disease.

3. All sociopaths are dangerous.

4. Mental illness can be overcome with willpower.

5. Addiction is a choice.

6. People with mental illness are violent.

7. Mental illness is the same thing as mental retardation.

8. A person with schizophrenia has multiple personalities.

9. Alcohol makes you depressed because it is a depressant.

1. A new perspective

2. Don’t give money to the homeless

3. Telling someone what to do is not helpful

4. The value of transparency and honesty

5. You can’t demand respect

Nancy Lee, MA, LPCC, Psychotherapist in Aurora, CO

Robert Martin, M.Ed Early Childhood Education & Counseling, Francis Marion University

Bridget Cameron, Artist, Depth Psychologist, Stress Counselor (1992-present)

Here’s my list of small wisdoms, or, what counseling has taught me (the first installment):

1. How to remain calm

2. Comfortable silence

3. Active listening

4. Partial truths

5. Hidden agendas

75 Free Online Academic Journals for Mental Health Professionals

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F

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Why Playing Hardball Doesn’t Work

Use these 7 counseling skills to receive optimal customer service

1. Unconditional positive regard

2. Empathy

3. Genuineness

4. Call them by name

5. Patience

6. Humor

7. Remain calm

Conclusion

Interview: We Only Get One Body in Life

Tips for Health and Sustainable Weight Loss from an Endocrinologist

On a typical day, what are your patients’ complaints and how do you resolve them?

What about common questions or concerns?

How does diet impact health?

What are the main risk factors for diabetes?

Can diabetes be treated with lifestyle changes?

Which is worse: Fat or sugar?

What is one food you’d never eat and why?

If given the opportunity, is there anything you’d change about the current dietary recommendations?

What are your thoughts on the obesity epidemic in America?

What advice do you give to patients who are trying to lose weight?

What’s one thing you wish everyone knew about hormones?

As an endocrinologist, what are the most useful things you’ve learned?

SLEEP AND YOUR PHYSICAL HEALTH

Sleep deprivation is associated with signs of aging

Sleep deprivation is related to weight loss and appetite

Sleep affects our food choices

Sleep deprivation is related to heart disease, hypertension, and stroke (especially if you’re a woman)

Chronic sleep deprivation is related to reduced immune function

SLEEP AND YOUR BRAIN

Sleep deprivation is associated with increased pain sensitivity

Sleep deprivation affects the formation of memories

Sleep affects the way we interpret emotions

When someone is sleep deprived, they’re slower to adopt another’s perspective

Sleep deprivation affects our moral judgment

Sleep deprivation is linked to impaired decision making

A lack of sleep affects optimism

A lack of sleep can lead to schizophrenia-like symptoms

Conclusion