If you wanted to become calmer and more relaxed, your goal would be to slow down your heart rate. You would set the watch so that if it exceeded a certain number of beats per minute, the “beeps” would go off.

As a psychologist, using biofeedback, I would first teach you a form of relaxation training, such as deep breathing, muscle relaxation or guided visualization and then monitor your ability to control your heart rate and/ or muscle tension. As you became more proficient, I would adjust the sensitivity of the biofeedback machine so that it would require you to relax increasingly deeper to keep the beeps off. This is essentially how biofeedback training works.

With the use of computers and various software programs, you can now have pictures and games to motivate you. For example, in a game, you are floating in a hot air balloon and the deeper you relax the higher the balloon on the screen goes.

Many individuals who like objective measures to monitor their progress like to use biofeedback training as a part of their treatment program whether it be to regulate emotions or improve concentration and attention.

In Yoga as Medicine, there are chapters on yoga’s application to anxiety and depression, case studies and references to controlled research seeming to document significant improvements in patients who incorporate yoga therapy in their overall mental health program.

Over the years, I have incorporated the principles and practices I have learned in my yoga therapy with the cognitive therapy and other treatment methods I offer to my clients. Breathing, brief mediation, being in the present, awareness without judgment and the classic yoga poses ( asanas) are a part of what I try to incorporate in my own practice and the work I do with many of my own psychotherapy clients.

Overall, yoga therapy, appears to be very beneficial as well as compatible with the cognitive therapy approach that I practice. As I continue to evolve as a yoga student and cognitive behavior therapist (38 years and counting), I look forward to adding new and effective tools to my professional tool kit.

Another limitation of using health insurance for mental health services is that you need to have a “medical or psychiatric” diagnosis to be eligible. In most cases, “marriage counseling” is NOT a covered service, nor would seeing a psychologist to “improve your tennis or golf game”.

A big consideration in using health insurance for mental health is that there are no guarantees on the confidentiality of your diagnosis and related matters in that once your information is public record it case be lost, stolen or found out if someone knows what they are doing.

Finally, when you use your health insurance for mental health, it can affect you down the road. You may have to answer questions about your current or previous mental health condition which could affect you receiving health insurance or the premiums you pay for health insurance. You may be disqualified or past over when you apply for certain job positions.

In spite of the fact that millions of individuals go to therapists or are on drugs for anxiety, depression and related conditions, there is still a “stigma” associated with having had a mental health condition. When you use your health insurance for mental health services, you are leaving a paper trail and opening up the box.

I realize for many people, the cost of mental health services may just be too expensive to use without the help of insurance. But for those who may need just short term help or can afford it, the freedom to see who you want and the peace of mind knowing others won’t know your business seems to be big pluses in NOT using your health insurance for mental health.

In a recent New York Times interview Dr. Shapiro summarized the considerable research around EMDR which mostly concluded that EMDR was an effective treatment for PTSD and more effective than either control groups or groups receiving other forms of therapy.

In comparing EMDR with Cognitive Behavioral Therapy, Cognitive Behavioral Therapy was superior to EMDR on several measures however the Cognitive Behavioral Therapy consisted of many more hours of treatment and daily homework on the part of the client.

When compared to a Behavioral Therapy, exposure therapy, EMDR did about as well and required less exposure and no homework. This may make EMDR more attractive and reduce the drop out rate which can be a problem for exposure type therapies.

In my own experience using EMDR for many years with PTSD and related problems, I have found it to be a useful approach well tolerated by most clients. I sometimes combine EMDR with Cognitive Behavioral Therapy, and even hypnosis.

While the controversy over what EMDR is, how it works and what are the essential components continue, the evidence continues to accumulate as to its clinical usefulness and for being helpful in treatment other psychological problems.

Like most forms of treatment, effectiveness is likely linked to the experience and skill of the therapist and the type of rapport developed between the client and the therapist. Having a therapist you like and respect and an approach that makes sense to you can go a long way towards a client’s improvement.

In a recent New York Times interview Dr. Shapiro summarized the considerable research around EMDR which mostly concluded that EMDR was an effective treatment for PTSD and more effective than either control groups or groups receiving other forms of therapy.

In comparing EMDR with Cognitive Behavioral Therapy, Cognitive Behavioral Therapy was superior to EMDR on several measures however the Cognitive Behavioral Therapy consisted of many more hours of treatment and daily homework on the part of the client.

When compared to a Behavioral Therapy, exposure therapy, EMDR did about as well and required less exposure and no homework. This may make EMDR more attractive and reduce the drop out rate which can be a problem for exposure type therapies.

In my own experience using EMDR for many years with PTSD and related problems, I have found it to be a useful approach well tolerated by most clients. I sometimes combine EMDR with Cognitive Behavioral Therapy, and even hypnosis.

While the controversy over what EMDR is, how it works and what are the essential components continue, the evidence continues to accumulate as to its clinical usefulness and for being helpful in treatment other psychological problems.

Like most forms of treatment, effectiveness is likely linked to the experience and skill of the therapist and the type of rapport developed between the client and the therapist. Having a therapist you like and respect and an approach that makes sense to you can go a long way towards a client’s improvement.

The recent CBS 60 minutes episode on “The Placebo Effect” sent shockwaves through the mental health community from cognitive therapy through psychiatry as Harvard researcher, Dr. Irving Kirsch, discussed his research on the placebo effect.

In reviewing lots of research, he concluded that, for example, while depressed people sometimes get better when put on anti-depressant medication, they also improve just about as much when they are given a “sugar pill”. That is NO active ingredients. In fact, in some studies, people got better on the sugar pill even when they were told it was a sugar pill!

Dr. Kirsch further revealed that none of the many studies that found these “lack of improved results” get published and they are “buried” by the drug companies that fund the studies.

Furthermore, the Food and Drug Administration has a policy that if even 2 of 10 studies report positive findings, the drug is often approved in spite of the 8 negative studies.

These findings support approaches like cognitive behavioral therapy, rational-emotive behavioral therapy and hypnosis which emphasize, to a large degree, the power of our mind in both causing and reducing negative emotional reactions and mood states.

The Psychiatry profession is up in arms, in part since the vast majority of their livelihood is based on prescribing medications for patients and managing them, rather than on verbal therapy. This is also true on the drug companies who spend billions of dollars touting the benefits of various drugs to treat depression and other mood states.

According to the report, in England, NO drugs are administered for mild-moderate depression until at least a 10 week trial of talk and/ or physical therapy is tried.

For more information about how approaches like Cognitive Therapy and Hypnosis works you can check on my video clips on You Tube and read additional blogs and articles on my website, www.cognitivetherapy.cc

Please address your comments to Dr.Robert Heller at info@robertheller.net.

In today’s world there is a strong tendency to avoid responsibility, make excuses and blame everyone and everything for situations we don’t like or results we are not happy with: “It’s not my job.”  “It’s his fault.”  “If I only had more time.” “It’s because of the rain… wind … sun …”,  etc.  One part of cognitive therapy teaches individuals to think and say positive things about themselves. Through repetition of  positive thoughts read out loud, you can make effective changes in your behaviors and life.

I believe taking personal responsibility is related to mental health. In cognitive behavioral therapy, I teach clients to condemn the behavior but not the person. I also teach and practice the use of affirmations; sayings, thoughts or phrases that are repeated at regular intervals.

Here are some ideas adapted from an article written by Chick Moorman and Thomas Haller:

- I am responsible for the thoughts I think.

- I am responsible for the feelings I feel.

- I am responsible for the choices I make.

- I am responsible for my actions.

- I am responsible for how I use my time.

- I am responsible for my relations with others.

- I am responsible for what I learn.

- I am responsible to accomplishing my goals.

- I am responsible for my values, morals and ethics.

- I am responsible for what I read and listen to.

- I am responsible for what I believe.

- I am responsible for what I say to others.

- I am responsible for my happiness.

Use these affirmations regularly and see what difference they make in your life.

At the root of the caregiver’s problem is the often perfectionist notion that they should take care of the parent around the clock and are fully responsible for the parents well being. As a result, they don’t take enough time to manage their own lives and stress and feel guilty when they do.

Recently, a therapist colleague reached out at a group meeting to share her personal struggles in this area. When someone suggested she take more time for herself and assured her that she was doing a fine job as a loving daughter and caretaker, she said , “Yes, I know that intellectually, but I don’t FEEL it”.

I chimed in and posed the following; I would guess by that you mean that you occasionally during the day tell yourself that you need and have a right to take some time for yourself, but with far greater frequency you tell yourself that you really should be at her side and should not be taking the time away, that if something happened, it would be your fault, etc.” She readily agreed that is exactly what says to herself often during the day.

She agreed to work on this and thanked me for my insight and suggestion.

Adult children of elderly parents need to have a degree of “healthy selfishness” and take care of themselves so they may have the physical and emotional energy available for their parents.

As a psychologist practicing in Boca Raton, Florida I have a number of elderly clients I work with as well as have opportunities to interact with a number “super seniors” who live, work and play in the community.

Suzanne Sommers believes that taking a regimen of hormones along with her continued involvement in fitness will allow her to age successfully into her 100’s.

Some research indicates that calorie restriction, that is eating around 1500 calories a day, is one of the important behaviors associated with longevity. A vegetarian diet, and movement, whether through direct exercise, hobbies or work had strong associations with longevity.

Jack La Lanne claimed he was exercising 2 hours a day and drinking fresh squeezed juices and vegetables into his 90’s.

A yoga based “laughter program” was advocated as a key to longevity bases on the idea that laughter creates more oxygen for the body and brain.

The mind needs to be exercised as well and there are centers opening with computer based game programs designed to strength mental faculties the same way lifting weights strengthens muscles.

From a psychological perspective generally, reducing stress by not worrying, nor sticking rigidly to time demands, having something you look forward to doing each day and not holding grudges were some of the behaviors and attitudes conveyed by those who had achieved longevity.

By committing to making and maintaining sensible life style changes and getting professional help and support when needed, many more of us will be able to live long forever.

Because I am a psychologist and treat people with this problem, you may view me as self-serving. However, I just viewed the latest television advertisement for the smoking cessation drug, Chantix and it scared the death out of me. Of the 60 seconds of the commercial, the announcer spent 40 or two thirds of the time warning about the side effects of the medication- which could include DEATH!  Given the significant and serious side effects this “prescription” drug has, drug therapy should be considered the treatment of last resort ( and it might be for some people!)

In my experience, some people will need and benefit by counseling because “smoking” is just the tip of the iceberg and until they recognize and effectively deal with the multiple sources of the stress in their lives, they will continue to rely on smoking as a coping method.

For others, hypnosis can be a useful and effective strategy that I customize with each client. The treatment program is usually between 3-5 sessions.

For those who want to try self-help first or to learn more about treatment options and methods, they can check out my pocket-sized guidebook, “Freedom from Tobacco”, available at the products section of www.cognitivetherapy.com