A Guide to Assertive Communication

–By Melissa Kurkoske

Have you ever experienced a time where you were just dreading a conversation with a specific person? A former employer of mine used to be known as a “bully.” Every time I had something important to discuss with him, I would become such a nervous wreck that I wouldn’t express myself in the way that I wanted. I was not able to get my point across, and I found that it really affected my work experience and self-esteem.

Terry Freedman/flickr

I shared this with family members, and they would say that I needed to more “assertive”. Yeah, I thought, but what does that even mean?

Being an assertive communicator means that you express your opinions effectively, while respecting yourself and others as you do so. Communication styles can be observed on a continuum, with passive communication operating on one end of the spectrum, and aggressive communication dominating the other end.

But where is that sweet spot between passive and aggressive? That elusive and mysterious spot is assertive communication.

Mr. Seafall/Wikimedia Commons

Before we can really get into what assertive communication is, perhaps a better understanding of what assertive communication is not would be helpful.

In general, passive communicators may tend to be seen as:

• Shy, less directive
• Someone who does not stand up for themselves or express their opinions
• Someone who does not take a verbal and firm stance on a topic
• Someone who prioritizes his or her own personal needs and desires below others’
• Someone who tries to maintain peace by not speaking
• Someone who thinks his or her needs do not matter

The problem with passive communication is that you are not able to express your own desires and opinions, which can cause feelings of stress, resentment, anger, and even victimization.

Lars Plougmann/flickr

Now let’s talk about the other end of the spectrum, aggressive communication. In general, aggressive communicators tend to be seen as:

• Angry, forceful
• Superior
• A bully
• Someone who disrespects or belittles others

Aggressive communicators may damage relationships or burn bridges because they are not respectful of others’ opinions and beliefs. This type of communication is more likely to lead to shouting matches and angry arguments.

Automotive Space/flickr

Assertive communicators, however, tend to be seen as:

• Fair
• Willing to compromise
• Respectful of themselves and others
• Clear and confident

Being assertive can improve the quality of your conversations, boost your self-confidence, and enhance your relationships with others. Here are some tips on improving your communication style:

1. Think about where you fall on the spectrum of communication styles
2. Be aware of what your body is saying to others when you speak (e.g. when your arms are crossed, you can appear “closed off”)
3. Practice what you’d like to say in front of people you trust and ask their honest opinion of how they perceive you
4. Remember that your opinions matter just as much as those around you

Here are some additional resources for how to be more assertive:

• https://www.mindtools.com/pages/article/Assertiveness.htm
• http://www.cci.health.wa.gov.au/resources/docs/Info-assertive%20communication.pdf

 

 

 

 

 

Stress Management Techniques

–By Melissa Kurkoske

They say, “when it rains, it pours,” and I could not agree more. I am a graduate student, and I find myself wishing that there were more hours in a day. I am constantly juggling schoolwork, dissertation writing, and a social life. Stress and me? We’re old pals.

Stress is an inescapable part of life for many of us, and sometimes we forget that we need to take care of ourselves. Stress can have some serious impacts on the way that we perceive and interact with our world. Watch this short but informative video on the physiology of stress and stress management to gain a deeper insight into what goes on in our bodies when we stress, and what we can do to combat this inevitable part of life.

Leave us a comment below to let us know your own personal stress management techniques. If you feel like you could use some additional support in handling life’s curve balls, you can always make an appointment at Pacific Psychology and Comprehensive Health linic to speak with a clinician who can help you manage stress more effectively.

Cover photo by Bernard Goldbach/flickr

The History of OCD Treatment

—By Jason Swift

Do you know someone with Obsessive-Compulsive Disorder (OCD)? It can be a very time-consuming, debilitating disorder consisting of obsessions (repeated, intrusive thoughts) and compulsions (repetitive behaviors).

Some examples of compulsions include washing hands or checking to make sure doors are locked. These behaviors can occur dozens or even hundreds of times a day, severely disrupting life. People with OCD may experience a great deal of distress or anxiety when they are unable to complete their compulsions.

For decades, OCD was considered untreatable and associated with a poor prognosis. For most patients, conventional therapy was not helpful. Interestingly, animal research (by behaviorists) led to some important discoveries in learned behaviors, which helped guide treatments for OCD.

Researchers who were studying classical conditioning placed dogs in a contraption called a shuttle box, which was a box that had two compartments separated by a hurdle.

 

Erica Zabowski/flickr

In one experiment, a light was turned on just before the floor became electrified. In other words, the light signaled to the dog that it was about to be shocked. The dog quickly learned to jump the hurdle to the side of the contraption where it was safe from the chock.

Interestingly, researchers found that the dogs continued to jump when the light came on, even if the electricity was unplugged. Some dogs continued to jump hundreds of times despite no actual threat of shock! This experiment raised some important questions: What, if anything, can stop the dog from jumping over in an OCD-like fashion?

Researchers discovered that if they turned on the light, but then gave no option for the dog to move to the other side, it would provoke an intense fear response in the dog. The dog would begin to yelp, jump, urinate, and/or defecate. That is, the dog anticipated the shock and became so afraid, it had an emotional and physiological reaction.

 

smerikal/flickr

Importantly, however, this reaction subsided after several trials in which the light was paired with no shock. Finally, the dogs displayed calmness without the slightest hint of distress when the light was turned on. Thus, after several trials, the fear response was “extinguished.”

So what does this research have to do with treatment of OCD? In 1966, Victor Meyer is credited as first utilizing Exposure and Response Prevention (ERP) as a treatment for OCD. He persuaded patients with severe OCD to intentionally confront situations and stimuli they usually avoided such as bathroom floors (Exposure). He told the patients to refrain from engaging in ritualistic behaviors such as hand washing (Response Prevention).

Like the fearful dogs, individuals with OCD may have very strong reactions to exposure to the things that distress them. However, most individuals who receive ERP treatment make and maintain clinically significant improvements. Researchers have demonstrated, using randomized controlled trials, that ERP is more efficacious than placebo, relaxation training, and anxiety management training.

Giusi Barbiani/flickr

Thus, when it comes to OCD, one of the best treatments is to literally face your fears, (with the guidance of a professional of course). To read more about the history of treatment of OCD, please see:

• http://www.jabramowitz.com/uploads/1/0/4/8/10489300/canjpsychiatryreview.pdf
• http://www1.appstate.edu/~kms/classes/psy5300/Documents/SolomonKaminWynne1953.pdf

Speaking Up: Why I Support Black Lives Matter

–By Roxanne Duran

My heart is heavy and I am filled with anger—once again I have opened Facebook and my news feed is filled with posts and comments about a police officer shooting a Black man. I’m reading about other people’s anger about this injustice and as I scroll through comments, I start to read comments supporting ALL lives and supporting police. Comments saying, “If these Black people knew how to show respect to officers they would not get shot.” I am so disgusted, I log off.

How can people miss the point? Yes, all lives matter and it is the lives of Black people that are being ended so carelessly. Police have the privilege of being supported by the system, while Blacks in America have a negative stereotype they are fighting against. We all have an automatic, unconscious response to certain ethnic groups. Family members say I have nothing against Black people, but they tell you to not bring a Black man home, and you watch them clutch their bags tighter when they walk by a Black man on the street. It doesn’t help that the media portrays Black men as thugs or gangsters.

I am an Asian American woman, which means I am a member of America’s “model minority”—an ethnic group that is widely perceived to be more successful and educated than population average. Asian Americans may be viewed positively by others, but we too face negative stereotypes and microaggressions. Research in the Journal of Personality and Social Psychology suggests that that, to most Americans, America equals White.  It’s not just White people who think that to be American is to be White—it’s Asians and Blacks, too.

Morning Calm/flickr

While I still face my own type of discrimination in dominant culture, I still have a choice what I can do about what is going on in the US today. When it comes to police violence against Black and Brown communities, I have the privilege to sit back and do nothing. I can think to myself, it’s not my problem.

But I refuse to do this, and I choose to become an ally and support the Black community. People of color are stronger when we are united. Our struggles may look different, but compared to White people, we have to fight harder to get where we are and fight against systems that are working against us.

I am tired of being that model minority who does not stand up for what I believe in in order to not make waves. I am Filipino American and I support Black Lives Matter.

Romano Cancelli/flickr

What is a Clinical Neuropsychologist?

–By Jason Swift

Jerry’s father was not himself. He became confused easily and was no longer leading conversations or coming up with witty retorts. He had great difficulty remembering things he normally retained easily, like current events and sports results. He became lost in places that should have been familiar to him.

“I’m concerned about Dad,” Jerry confided in his mother. “You and me both,” she replied. “But what am I supposed to do?”

Like most people who have a loved one suffering from dementia, they are not sure where to go for help. A primary care doctor? A neurologist? While those are certainly good starting options, Jerry’s father will, more than likely, end up at the office of a clinical neuropsychologist. But what on earth is a neuropsychologist?

floeschle/flickr

“Neuro” is a term that means ‘related to the brain’ whereas “psychology” is the study of cognition, emotion, and behavior. Thus, neuropsychology is the study of the relationship between cognition, emotion, and behavior as they relate to brain functioning. Neuropsychologists differ from traditional psychologists in that their focus is more on assessment and less on treatment*.

A neuropsychological assessment typically includes: a clinical interview, a variety of neurocognitive tests, and assessment of psychological functioning. The number of tests used varies depending on clinician preference and as well as the referral question.

Types of Tests

• Intelligence testing is often included in a “battery” of neuropsychological tests; however, intellectual functioning is only one aspect of neuropsychological functioning.
• Other domains of functioning that may be evaluated include language, learning & memory, attention/concentration, visual spatial functioning, and motor functioning.
• Psychological assessment is another important component of a neuropsychological battery because symptoms of depression, anxiety, and trauma can influence scores on neurocognitive tests (not to mention impact daily functioning).

Tony Walmsley/flickr

Diagnosis and Treatment

Neuropsychologists are trained to evaluate all of the information gathered to diagnose and make treatment recommendations for numerous neurodevelopmental disorders (e.g., autism spectrum disorder, intellectual disability, ADHD) and neurodegenerative diseases (e.g., dementia, cognitive disorder).

Neuropsychologists are also commonly employed to assess and follow individuals who have undergone treatment of diseases like cancer because radiation and chemotherapy can negatively impact neurocognitive functioning. Neuropsychologists work in hospitals and private practices and collaborate with a variety of providers.

Bruce Guenter/flickr

To find a board certified neuropsychologist in your area, please see the following links:

• Board certified adult neuropsychologist: https://theaacn.org/directory/
• Board certified pediatric clinical neuropsychologist: http://www.theaapn.org/aapn-provider-directory.php

If you are in Portland, Oregon, the Pacific Psychology and Comprehensive Health clinics offer neuropsychological assessment services at competitive rates.

^*Neuropsychologists receive training in therapy as part of their doctoral program. Therapy conducted by neuropsychologists may include treatment of post-concussion symptoms such as depression, fatigue, and low motivation.

 

Moving From Mindless to Mindful

–By Melissa Kurkoske

There I am, driving down the road, tired and groggy, with way too much on my mind. I am on my way to work thinking about my hunger, my plans for that evening, my stress about school—anything but the road in front of me. As I race toward my destination, I realize with a start that I have completely passed my freeway exit.

Has this happened to you? This form of mindlessness is referred to as “auto-pilot.” Many of us probably spend a great deal of time on auto-pilot, which leads to us missing a great deal of what is going on internally and externally. Luckily for us, there is a skill called mindfulness that can be practiced and acquired to improve our moment to moment experience.

Mindfulness is a term that has gained some popularity over the last few years. According to Jon Kabat-Zin, author of Wherever You Go, There You Are, mindfulness is “paying attention to something, in a particular way, on purpose, in the present moment, non-judgmentally”.

Research shows that mindfulness can lead to improvements in well-being, stress, health, relationship satisfaction. Whether you have a limited or firm understanding of mindfulness, this short video posted below can serve as an informative video on the concept of mindfulness, or a gentle reminder to practice and hone your skills. The video emphasizes that mindfulness is, in fact, an achievable state of consciousness, and that your mindfulness practice will be unique to you, and only you.

Let us know your thoughts on mindfulness, including how you intend to incorporate some mindfulness into your everyday life by commenting below!

Cover photo by Moyann Brenn/flickr

Perils of Second Impact Syndrome: One Thing Everyone Should Know About Sport Concussions

–By Jason Swift

It is common in contact sports for athletes to suffer a concussion. Although coaches, athletes, and sports fans are becoming far more educated about the subject, there are still some myths and conflicting ideas out there. One thing that everyone should be aware of is a condition called Second Impact Syndrome.

J E Therlot/flickr

When someone experiences a concussion, the medical term to describe the event is a traumatic brain injury, or TBI. TBIs can vary in severity, but most often they are mild, with recovery occurring within 7-10 days. However, a break from sports and strenuous activity is pivotal for recovery. If an athlete is not given time to recover from a TBI, a particularly dangerous syndrome, Second Impact Syndrome, can occur. Second Impact Syndrome occurs when an individual experiences two TBIs within a short period of time, which can cause catastrophic damage to the brain or even death. Here’s the story of a football athlete who survived Second Impact Syndrome:

Preston Pleveretes’ story is tragic, and his life will never be the same. Thankfully, knowledge about the dangers of successive concussions is spreading and incidents like his are becoming less frequent. Resist the temptation to return to play too soon after an injury. If someone you know is considering returning to play after recently experiencing a concussion, you can make a difference by helping explain the risks involved. For more information about Second Impact Syndrome–and how to know when it’s safe to return to play–visit: http://www.brainandspinalcord.org/second-impact-syndrome/

3 Things You May Not Know About Stress

–By Jacob Manuel

Stress in daily life is something that we all may be aware of to a certain degree, but often we aren’t aware of how it affects our lives, minds and bodies. Unless you’re a researcher or psychologist, you probably don’t put stress in to different categories every day and rate its severity. For most people, stress exists as a simple thought like, “This is (or was) really stressful!” Understanding stress as a dynamic facet of daily life can help you to address it like the living creature it is.

1. There are two kinds of stress: Actual and Perceived.

 

skeeze/pixabay

Actual stress involves physical or influential stressors in your life that cause a physical change in a chemical called cortisol. These stressors can look like almost anything; from running late to class or work, to something as scary as crashing your car, you will likely run in to actual stressors every day. These will cause your body to react regardless of your awareness of the stress.

On the other hand, Perceived stress happens entirely in your mind. Take running late to work for example. You see the time and realize you’re late, this builds your cortisol (stress hormone) naturally. But then maybe you start to think about all the things you need to do before you go and what your boss might think or say to you when you get there. This part is the perceived stress and it actually contributes the most to negative impacts in the body.

2. Your body and mind are more stressed out than you think.

A recent study by the American Psychological Association found that American teens are just as stressed as their adult counterparts and further, that over half of people are not maintaining healthful practices to reduce the stress. To add on to that, stress takes a toll on our sleep patterns, our eating habits and our organ health (including our brains). So, if we’re more stressed than we think we are and it’s affecting our bodies, what do we do? Keep reading.

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3. There are many ways you can reduce daily stress that take little to no effort at all.

We’ve all heard the old adage, “Eat right and exercise.” When it comes to stress management, these are some of the most important preventative factors, but they do take effort. What you don’t often hear is that other healthful practices like getting enough sleep or finding some time to do something you enjoy will massively reduce stress.

Finally, something you may have read about in a previous post here that can be incredibly helpful in modulating stress levels is having a practice of mindfulness. Mindfulness, simply put, is a practice of noticing internal experiences (like thoughts and emotions) in addition to bodily sensations and doing so with intent, kindness and nonjudgment. Most of us don’t take the time to sit down, take a few breaths and notice how we’re feeling, but have shown that by doing this, we actually can reduce up to 50% of our daily stress.

Social Anxiety Expressed through Slam Poetry

—By Kara Friend

Fear of judgement

Fear of attention  

Fear of someone watching

Fear of meeting new people

Fear of being in big groups

The list goes on, but the theme remains the same: what are other people thinking about me? (Answer: nothing good.) Social anxiety is the fear these thoughts evoke.

Everyone experiences these thoughts and feelings in some way, but for those of us with social anxiety, these fears often feel like they are running our lives. Sometimes our inability to speak doesn’t feel like a choice.

Social anxiety disorder is the third most common mental health problem in the United States, and chances are we are someone or know someone who experiences these feelings and thoughts.

How has social anxiety impacted your life or someone you love? If you have noticed someone you or someone you love has been impacted, therapy individual or group is just one way to help! Here are some more practical skills to help out!

Can Your Phone Hurt You?

–By Alisa Hurtado

Walk into any public place and one can’t help but notice that most people are staring at their phone. Even when gathered with several close friends or family members people are still likely to be engaging with their phone as much as each other.

So, how is your phone changing you? From our posture to our sleep, AsapSCIENCE addresses this and many other surprising details about how phone use has impacted human life in the brief yet entertaining video linked below.

There are some benefits to the increase of access to cell phones, such as increased access to information and instant long distance communication. Given the many harmful side effects of frequent use, however, should we reconsider the way we utilize these handy yet distracting tools? Do you think that you could take a smart phone vacation? How would you imagine this vacation affecting your daily life, both positively and negatively?