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Features

12 HOW TO EAT AN ELEPHANT By ROBERT MEAD, LMFT, BCPC, DAPA

DEPARTMENTS 11 NEW MEMBERS

COLUMNS

08 SUCCESS FILES:

FACE-TO-FACE NETWORKING by Wendy Briggs

10 chair’s corner:

WHAT HAPPENS IN VEGAS…

By Daniel J. Reidenberg, PsyD, FAPA, DAPA, BCPC, CMT, CRS

22 GUIDED MEDITATION:

Integrative Health 17 18 VERONICA ANDERSON:

A VOICE IN KEEPING AMERICA HEALTHY by CHERYL BARNETT

24 Natural Remedies: FEVERFEW

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56 PRACTICE MANAGEMENT:

26 OUR BODY:

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Become a member of the American Psychotherapy Association®. We provide mental health professionals with the tools necessary to be successful and build stronger practices. For more information, or to become a member, call us toll-free at (800) 592-1125 or visit www. americanpsychotherapy.com. 2012 EDITORIAL ADVISORY BOARD Debra L. Ainbinder, PhD, NCC, LPC, BCPC Janeil E. Anderson, LCPC, BCPC, DBT Kelley A. Armbruster, MSW, FAPA Diana L. Barnes, PsyD, LMFT Cherie J. Bauer, MPS Phyllis J. Bonds, MS, NCC, LMHC Sabrina Caballero, LCSW, DAPA Stacy L. Carter, PhD, BCPC Susanne Caviness, PhD, LMFT, LPC Linda J. Cook, LCSW, CRS, DAPA, BCETS John Cooke, PhD, LCDC, FAPA Caryn Coons, MA, LPC Clifton D. Croan, MA, LPC, DAPA Catherine J. Crumpler, MA, LPC, BCPC Charette Dersch, PhD, LMFT David R. Diaz, MD Carolyn L. Durr, MA, LPC Adnan M. Farah, PhD, BCC, LPC Patricia Frank, PsyD, FAPA Natalie H. Frazier, PhD, LPC Sabrina Friedman, EdD, CNS-BC, FNP-C Robert R. Gerl, PhD Rebecca Godfrey-Burt Sam Goldstein, PhD, DAPA Jacqueline R. Grendel, MA, LPC, BCPC Richard A. Griffin, EdD, PhD, ThD, DAPA Yuh-Jen Guo, PhD, LPC, NCC Lanelle Hanagriff, MA, LPC, FAPA Ray L. Hawkins, PhD, LPC, AAMFT Gregory B. Henderson, MS Douglas Henning, PhD Mark E. Hillman, PhD, DAPA Elizabeth E. Hinkle, LPC, LMFT, NBCC Ronald Hixson, MBA, BCPC, MT, DAPA Judith Hochman, PhD Antoinette C. Hollis, PhD Irene F. Rosenberg Javors, MEd, DAPA Gregory J. Johanson, PhD Laura W. Kelley, PhD

Gary Kesling, PhD, FAAMA, FAAETS C.G. Kledaras, PhD, ACSW, LCSW Michael W. Krumper, LCSW, DAPA Ryan LaMothe, PhD P. K. Frederick Low, MAppPsy, MSc, BSocSc, DAPA Edward Mackey, PhD, CRNA, MS, CBT Frank Malone, PsyD, LMHC, LPC, FAPA Beth McEvoy-Rumbo, PhD Thomas C. Merriman, EdD, SBEC (Virginia) Ginger Arvan Metcalf, MS, RN William Mosier, EdD, PA-C Natalie H. Newton, PhD, DAPA Kim Nimon, PhD Donald P. Owens, Jr., PhD Thomas J. Pallardy, PsyD, BCPC, LCPC, CADC Larry H. Pastor, MD, FAPA Richard Ponton, PhD Joel G. Prather, PhD, MS, BCPC, Helen D. Pratt, PhD Ahmed Rady, MD, BCPC, FAPA, DABMPP Daniel J. Reidenberg, PsyD, FAPA, CRS Arnold Robbins, MD, FAPA Arlin Roy, MSW, LCSW Maria Saxionis, LICSW, LADC-I, CCBT, CRFT Alan D. Schmetzer, MD, FAPA, MTAPA Paul Schweinler, MDiv, MA, LMHC, DAPA Bridget H. Staten, PhD, CRC, MS, MA Suzann Steadman, PsyD Ralph Steele, BCPC Moonhawk R. Stone, MS, LMHC Mary E.Taggart, LPC Patrick O.Thornton, PhD Mary A.Travis, PhD, EdS, MA, BS Charles Ukaoma, PsyD, PhD, BCPC, DAPA Lawrence M.Ventline, DMin Melinda L. Wood, LCSW, DAPA Cecilia Zuniga, PhD, BCPC

Annals of Psychotherapy & Integrative Health® (ISSN 2167-2113 / print • 2167-213X / online) is published quarterly by the American Psychotherapy Association. Annual membership for a year in the American Psychotherapy Association is $165. The views expressed in Annals of Psychotherapy & Integrative Health® are those of the authors and may not reflect the official policies of the American Psychotherapy Association. Abstracts of articles published in Annals of Psychotherapy & Integrative Health® appear in e-psyche, Cambridge Scientific Database, PsycINFO, InfoTrac, Primary Source Microfilm, Gale Group Publishing’s InfoTrac Database, Galenet, and other research products published by the Gale Group. Contact us: Publication, editorial, and advertising offices at 2750 E. Sunshine St., Springfield, MO 65804. Phone: (417) 823-0173, Fax: (417) 823-9959, E-mail: editor@americanpsychotherapy.com. Postmaster: Send address changes to American Psychotherapy Association, 2750 E. Sunshine St., Springfield, MO 65804. © Copyright 2012 by the American Psychotherapy Association. All rights reserved. No part of this work may be distributed or otherwise used without the expressed written consent of the American Psychotherapy Association.

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CONTACT MEMBER SERVICES: Karen Hope (karen@americanpsychotherapy.com) PHONE: (800) 592-1125 WEB: www.americanpsychotherapy.com FOUNDER & PUBLISHER: Robert L. O’Block, MDiv, PhD, PsyD, DMin rloblock (rloblock@americanpsychotherapy.com) ANNALS EDITOR: Cheryl Barnett (cheryl.barnett@americanpsychotherapy.com) EDITOR: Julie Brooks (julie.brooks@americanpsychotherapy.com) SENIOR GRAPHIC DESIGNER: Brandon Alms (brandon@americanpsychotherapy.com) GRAPHIC DESIGNER: Stephanie Lindberg (stephanie@americanpsychotherapy.com) ADVERTISING: Cheryl Barnett (cheryl.barnett@americanpsychotherapy.com) (800) 205-9165 ext. 116

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CONTINUING EDUCATION The American Psychotherapy Association’s sister organization, American College of Forensic Examiners International (ACFEI), provides continuing education credits for accountants, nurses, physicians, dentists, psychologists, psychiatrists, counselors, social workers, and marriage and family therapists. ACFEI is an approved provider of continuing education by the following: Accreditation Council for Continuing Medical Education National Association of State Boards of Accountancy National Board for Certified Counselors California Board of Registered Nursing American Psychological Association California Board of Behavioral Sciences Association of Social Work Boards American Dental Association (ADA CERP) Diplomate status with the American Psychotherapy Association® is recognized by the National Certification Commission. For more information on recognitions and approvals, please visit www.americanpsychotherapy.com

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Don Londorf, MD, CM, LAc, FRCPC Cheyenne Luzader, MS, ADS Robert McCarthy, PhD, LPC, BCPC Bill McClure, DC, JD Pamela McKimie, CHom, LAc Celestine McMahan-Woneis, PhD Mark Morningstar, DC Barbara Phibbs, OMD Donna Scattergood, PhD Cheryl Schuh, CBT, CBS Erin Sharaf Marilia Silva-Brand, FAAIM, DCNT, DCCN Martha Stark, MD Gayle Stockwell, DC Rodger Uchizono, DDS Paul Yanick, PhD, ND

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2012 EDITORIAL ADVISORY BOARD Martin Alpert, MS, DC Eleanor Barrager, DCCN, FAAIM Maggie Bloom, PhD Brenda Brown, PhD, ND Phillip Carlyle, DC, CCWP Zhaoming Chen, MD, PhD, MS, FAAIM Debra Dallas, PhD, MIFHI, DCNT Lynn Demartini, DSH-P, RN, LMT Kenneth Dennis, PhD David Getoff, CCN, CTN, FAAIM Cindy Griffin, DSH-P, DIHom, FBIH, BCIH, DCNT, FAAIM Christine Gustafson, MD W. Jeffrey Hurst, PhD Steva Komeh-Nkrumah, DrPH, RD, CNS, BCIM Cuneyt Konuralp, MD, LAc Robert Kornfeld, DPM Tim Leasenby, DC

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MEMBERS: Shashi K. Agarwal, MD, FAAIM Joseph Di Turo, MD, DAAIM, DEM, BCIM Brian L. Karasic, DMD, MBA, CMI-V, FAAIM, BCIM Mary H. McFerren Morosko Casseday, MA, LMFT, DAAIM, BCIM Gregory W. Nevens, EdD, FAAIM, FACFEI, DAAPM, DABDA Richard C. Niemtzow, MD, PhD, MPH, CHS-V, FAAIM Gail C. Provencher, APRN-BC, MSN, CNS, BCIM, DAAIM Col. Richard Petri, Jr., MC, BCIM, DAAIM Robert E. McCarthy, PhD, LPC, FAAIM, BCIM, MTAPA, FACFEI Mark H. Scheutzow, MD, PhD, DHom, FAAIM, DABHM, DAAPM William M. Sloane, JD, LLM, PhD, FACFEI, FAAIM, DABFC George D. Zgourides, MD, PsyD, DCM

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Annals of Psychotherapy & Integrative Health速

FALL 2012

Success Files

Success with Face-to-Face

Networking

By Wendy Briggs

FALL 2012

While networking through social media may be more popular than ever, according to Noshir Contractor, Professor OF BehaviorAL Sciences at Northwestern University, it has not replaced the face-toface meeting. During the NASBIC’s Midwest Private Equity Conference in Chicago, Contractor pointed out that conferences such as the one he was speaking at are drawing larger crowds. Apparently, people still like to meet in person and exchange ideas the old-fashioned way. Daniel Kehrer, founder of Bizbest, an independent information service for small business and startups, goes so far as to say that “successful business owners know that real networking only happens face-to-face, and most often with people who are not their peers.”

Annals of Psychotherapy & Integrative Health®

With the 2012 Executive Summit in Las Vegas quickly approaching, you may be looking forward to the potential networking opportunities that come with attending such an event. If this year is like previous Executive Summits, you will no doubt have the opportunity to make some very beneficial connections with some very interesting people. Networking is a crucial part of managing any kind of business. In any given industry, it’s not just what you know, it’s who you know and how you get to know them that leads to business success. But networking isn’t just about meeting new people, it’s much more than that. In her book The Networking Survival Guide, Diane Darling defines networking as “the art of building and sustaining mutually beneficial relationships.” These relationships can lead to collaborations, referrals, exchanges of information and tips, as well as sales opportunities. Here are a few tips to making the most of your next networking opportunity. • Focus on making quality contacts and building relationships rather than trying to meet as many people as possible. Vickie Milazzo, owner of an education company on Inc. magazine’s list of the 5000 fastest growing small businesses in America and author of Wicked Success Is Inside Every Woman, says “successful people are selective about where and with whom they network….They create a network of colleagues, clients, consultants, vendors, and acquaintances they can depend on to deliver anything from information to referrals.” • Entrepreneur.com suggests creating a networking plan and committing to it. How many leads and prospects do you want to make at the event? What kind of connections would you like to make? Which businesses, organizations, and individuals would benefit from your business? Which ones would be most beneficial for your business or practice? Be proactive and step outside your comfort zone to meet the people who will both help you and be helped by you. • Assemble a “kit” of items that can help you network successfully. This kit should include a supply of business cards, a place

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In any given industry, it’s not just what you know, it’s whom you know and how you get to know them that leads to business success. to put business cards you get from other people, paper and pen (or some other way to take notes), breath mints, and a printout of the event schedule. Also, make sure to bring a positive attitude and plenty of energy. • First impressions matter. You can win or lose a new business contact within the first few seconds. A good first impression starts with having a professional appearance. Looking professional is about having an appropriate appearance for the situation, not necessarily the most expensive clothes. Most conferences are a dress down affair, so business casual is acceptable and probably expected. Hygiene is also an important part of making a good first impression. Clean hair, fresh breath, and a pleasant odor keeps you from standing out from the crowd in a negative way. • Take notice of your body language, words, and listening skills. First impressions aren’t just about how you look. On the Hive Digital Marketing website, www.hivedigitalmarketing.com, Carin Pike suggests making yourself approachable by making eye contact with others and not clinging to the people you know. Smile genuinely and be friendly. Shake hands with confidence but not too aggressively. Don’t stand too close to the other person. Stand up straight. When meeting a new person, learn his or her name right away. It’s okay to ask someone to repeat his or her name if you don’t hear or understand it the first time. Repeat the name to make sure you heard it correctly. • Communicate who you are and what you do in a concise manner. Develop a ten to fifteen second introduction that explains what you do. Also, have a thirty second presentation that gives more detail. The short intro should encourage the other person to ask for more information, then you can share your thirty second presentation. Include an example of what you’ve done in the past and the kind of results you usually achieve. Rehearse these two introductions so you can share them more effectively. (800) 592-1125 | (877) 718-3053

• Try to stand out from the crowd. How many times have you been to an event and came home with a stack of business cards, but couldn’t remember who gave them to you? Think of ways you can stand out in the networking crowd. In an article for Inc.com, Lou Dubois suggests including more than just the traditional contact information on your business card. You might include your LinkedIn URL, personal website, Twitter moniker, and your photo. You can stand out by sharing a funny and unique story about what you do. You might wear something unusual or brightly colored for visual impact. Just make sure whatever you do to stand out enhances your presentation rather than detracts from it. • Be interested in the other person. This is one of the best ways to stand out in a networking event. People will remember those with whom they’ve made a valuable connection. In networking situations so many people are trying to get their name out, they neglect to find out about the other person. Ask questions about what the other person does. Ask them about their business or practice. Ask about their previous network experiences. Ask follow-up questions that show you’ve been listening and care about what they have been saying. Showing a genuine interest in the other person ensures that they will remember you. • Follow up. Networking is useless if you don’t follow up on the contacts you make. This should be done as soon as possible after the networking event. This can be done via LinkedIn, Facebook, email, or over the phone. Ask the person if they have a preferred way to be contacted. If possible try to set up a lunch or a short coffee break at the person’s work. Author, Diana Darling, suggests that you let the person know up front why you want to meet with them and give them the opportunity to say no. A person who feels forced into a meeting will not be the most receptive contact. If a face-to-face meeting isn’t possible, talk to the person

over the phone about what they do and any challenges they face. You may offer suggestions and ways you can help them. Don’t treat this as a sales call. Use this time to build a genuine relationship. Don’t let this list overwhelm you. Successful face-toface networking is all about showing common courtesy to others. Being thoughtful and showing respect goes a long way in making a good impression and creating lasting business connections. So, make your reservations for the 2012 Executive Summit, think about what you want to accomplish and create a networking plan, brush up on your networking skills, and get ready to make some valuable business connections this October.

References: Darling, Diane. 2010. The networking survival guide: Practical advice to help you gain confidence, approach people, and get the success you want. 2nd Ed. New York, NY: McGraw-Hill Dubois, Lou. 2010, August 11. How to network effectively. Inc. magazine website. http://www.inc. com/guides/2010/08/how-to-network-effectively.html (Accessed July 9, 2012). Entrepreneur.com. Networking. http://www.entrepreneur.com/encyclopedia/term/82568.html (Accessed July 10, 2012). Kehrer, Daniel. 2012, June 4. 10 timeless traits of successful entrepreneurs. SCORE website. http:// www.score.org/resources/10-timeless-traits-successful-entrepreneurs (Accessed July 10, 2012). Milazzo, Vickie. 2011. Wicked success is inside every woman. Hoboken, NJ: Wiley. pp. 250-251. Pike, Carin. 2012, April 17. Networking the old fashioned way: do’s & dont’s. Hive Digital Marketing website. http://www.hivedigitalmarketing.com/ index.php/blog/15-execution/18-networking-theold-fashioned-way (Accessed July 10, 2012). RTT Staff Writer. 2011, February 17. Midwest private equity conference: Social networking not a replacement for in-person meetings. RTT Newswires website. http://www.rttnews.com/Story. aspx?type=ts&Node=B1&Id=1555974 (Accessed July 10, 2012).

Annals of Psychotherapy & Integrative Health®

FALL 2012

Chair’s corner

What happens

VEGAS..

By Daniel J. Reidenberg, PsyD, FAPA, DAPA, BCPC, CMT, CRS

Of course I would be remiss to not mention some of the other benefits of attending the annual Executive Summit:

What really happens in Vegas, and why is it that what happens there stays there? If you are talking about celebrities, gambling, shows, buffets, and water fountains, you are right— they all stay in the city with all of the amazing neon lights; but if you are talking about all of that PLUS learning, healing, practicing skills, and advancing your mind-power, you would also be right.

This year’s Executive Summit is shaping up to be another in a long history of excellent professional conferences. Sure there will be the sights, sounds, and tastes to tempt everyone who attends, but the lineup of speakers and sessions is just as impressive this year as it has always been. What does this mean for you? It means you will hear from some of the nation’s leading experts on the topics of most importance to you. It means that you will learn some of the newest treatments and interventions that you can use in your work. It also means continuing education units (CEUs) for licensure renewals. Over the years I have been asked many times, “Why do you come to the Executive Summit each year?” The answer is really pretty simple for me: it is the best way for me to stay current with the field and better than that, it keeps me ahead of the field. Coming to the conference each year also allows me to network with others on a national level, and that gives me a depth of perspective outside of my closer colleagues that I connect with on a daily basis. Attending the conference is also exciting because the keynote presentations are inspiring. This year having Dr. Cummings present will be a oncein-a-lifetime experience. Don’t miss this opportunity to hear from one of the preeminent leaders in the field. 10

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♦ Who doesn’t want to take a few days off in October? ♦ You can meet with our founder, Dr. Robert L. O’Block. ♦ The reception always has amazing food (and if you’ll recall last year it was served by a live food-hostess with food around her waist). ♦ You get a chance to buy organizational products that promote your work and area of specialty. ♦ The leading experts in your field will tell you what it takes to survive and thrive. So sharpen your card skills, read up on how to beat the slots, fast for a week or two before the conference because you will be eating well, and block out a few days in October to attend the annual Executive Summit. It will be time and money well spent. And who knows, if you’re lucky you just might make some money while you are there to pay for your trip and then some!

about the author Daniel J. Reidenberg, PsyD, FAPA, DAPA, BCPC, CMT, CRS, is the chair of the American Psychotherapy Association’s Executive Advisory Board and has been a member since 1997. He is a Fellow and Master Therapist of the American Psychotherapy Association and executive director of Suicide Awareness Voices of Education (SAVE) in Minneapolis, Minnesota. Contact him with your thoughts at dreidenberg@save.org.

See you in Las Vegas where the stories will stay, but the lessons will carry on beyond the strip! www.americanpsychotherapy.com | www.AAIMedicine.com

Welcome New Members, newly credentialed, life members, Diplomates, and Fellows!

provisional new members Dorothy Bales Kathryn Benninghove Lela Bloodsworth Therese Bolton Peter Botteas Magda Brouzos Denise Burton Curtis Callender Norma Carrillo Jose Castro Jr. Ruth Cox Ellen Craine Leanne Cura Mimi Da Silva Paul Falconer Ronald Field Ronald Fox Paul Gasser Glenda Graham Cora Hayes Lori Horstmeyer-Grubb Earkie Hughes Kevin Hull Pamela Karandos Kathleen Karnoff Susan Kelly Michael Kessler C.F. “Kim” Kimberling Jonathon Larson Tanya Laughinghouse Anissa Lauriston

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Dana Little Fidel Loverton Rodney Mailloux Sherry Malm Jan Mann Mary McGhee-Pasternak Sandra Moore Dorothy Penry Allison Puckett Beverley Riddle Heidi Rohani Mariano Sanchez Meghan Spillane Carolyn Sundstrom Stacey Torigian Samantha Tubbs-Crews Wesley Turnage Kari VanLopik Rosanne Visco Scott Wade Barbara Werre Paul Wess Judith Williams newly Credentialed Lee Dorpfeld Paul Falconer Tamika Gulley Kevin Hull Eduardo Lelli Lynn Moosman Paul Pound Cora Thompson Lynda Tyson NEW DIplomates Gordon Bruin Cindy Bunin Raymond Butts Tammie Crews Mimi Da Silva

Kyle Day Warren Elliott Rhonda Furlong Patricia Lewis Linda Sanders Cheryl Smith Stephen Williams NEW fellows Tetsuya Hirano Robert Mance

Margaret Hanagan Stuart Hoover Caitlyn Johnson Michael Kessler Robert Kuhn Atousa Mahdavi Steven Sutton Sam Wang NEW DIplomates James D’Adamo Anthony Ganem Caitlyn Johnson Jason Kelberman Atousa Mahdavi Sam Wang

provisional new members Bharat Bhushan Christine Dumont John Duong Anthony Ganem Margaret Hanagan Lauren Hollingsworth Chavez Stuart Hoover Barbara Houk Robert Kuhn Atousa Mahdavi newly Credentialed Salvatore Di Liello Christine Dumont John Duong Anthony Ganem

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FALL 2012

F e at u r e Article

How to Eat an

Eleph ant

ROB

ERT M C, D E A D, L M F T, B C P

A AP

hile working in the Mental Health field for approximately 25 years now, it has never ceased to amaze me how sometimes just a simple question can give you so much information! We, as a profession, try our best to educate ourselves out of asking a simple question that can have such a profound impact on people. The question that I ask when doing any kind of therapy is this: “How do you eat an elephant?” The responses that come with that question are quite telling in terms of where that patient is at that moment, and can be used from that moment on to assist in dealing with any and all issues that come up in therapy. It is also a good tool to use in treatment planning and future guidance in the therapeutic process.

FALL 2012

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I will give a history of how this question came into being, and the ways in which I use it to open doors for people to speak; build rapport with others; be able to direct the counseling sessions in productive ways for the individual to better their lives; and give them a base from which to start the process of individual change. This question is a wonderful tool to use in treatment planning, as well as a great homework assignment to give when “stuck” at a point in therapy that we all seem to hit at some time. This tool can fit into all types of psychotherapeutic orientations without difficulty. It is useful for insight therapy, and can be used as a teaching tool to point out patterns of behaviors, as well as utilizing narrative therapy to assist in their process for example. In learning how to assess people for mental health issues, and to do the “right” thing for that individual in terms of what it is they, the patient, want to change, we are taught to ask question after question after question. Depending on the theoretical orientation that a counselor follows will dictate how the questions are asked, or not asked. So, as a struggling young apprentice in the arts, I kept trying to come up with “THE” question that would give me as much information as possible while opening up doors of communication in which to build rapport and facilitate change. I kept trying to formulate the question to keep it as brief as possible, yet be profound in its simplicity and still have an impact on the patient. One day while listening to a conference about substance abuse, one of the points that the speaker kept talking about was the “elephant in the room,” with the elephant being a metaphor for the problem and everyone ignoring it. Yet, here this elephant is stomping around, creating chaos, driving people nuts, yet no one wanted to talk about it! The proverbial AH HA! Moment occurred. I now had the metaphor that I wanted, but how to utilize it in a question about therapy? This now meant I needed to define my question or problem to a greater depth. What I now needed was to figure out what I wanted out of the question I was asking. In asking our questions as therapists, we ask questions about the here and now, about the past, choices made, and the why. Again, unknowingly I had stumbled upon my question that I wanted answered! And the question was about choices. We try to get to the core of the problem by means that will do no harm to the patient and will assist the patient in facilitating change. Remember, the patient is paying us to help them with what they perceive their problem to be, from their perspective. This is why when we ask our questions, it is with this thought in mind that we listen to their perspective without interjecting our own. What I have discovered is that, we are turning into a society of giving away our individual power. In essence, we are training ourselves to not accept responsibility for our behaviors and being constantly victimized by others. As therapists, we are trying to teach others about the concept of choices being made, how they are made, and why they are being made. With this in mind, my question that I wanted answered was a way to grab the attention of the individual that I was seeing, give them a point of reference to start from, and to remember it for the bizarre question that it is. And so, during the assessment process, when the time felt right for the (800) 592-1125 | (877) 718-3053

question, I will ask the following“How do you eat an elephant?” The time can be right when there really seems to be a disconnect between feelings and intellectualization of what the patient is attempting to describe. That question is then one that will completely throw them off of what they were attempting to think of as it is something that is not asked every day. The responses are incredibly telling as to their current state of emotional, mental, and physical state at that moment. In the 25+ years I have used to develop that question, I have yet to have one person give me a response that tells me that they know what is going on with them and why. I have had 2 people give me a superficial response to the question, showing some insight, but upon further probing, were not able to flesh out the answer. Back to the question, “How do you eat an elephant?” When you break down the answer they give you on the spot, it is a snapshot of where they are at that moment. And it is in that moment you, as their therapist, begin to adjust what you present, such as homework to provide, and open up a new line of communication that will be of benefit to the patient. It also gives you that snapshot in which to start assisting the patient looking at a wide variety of points, decision making skills, and begin to teach the reframing necessary to start the change. The responses will range from “you can’t,” and “you don’t,” to “with a knife and fork.” Interpreting this response will tell you that at that moment, for the individual, they are thinking very concretely, with no idea as to how to break down the question to its simplest part in order to answer the question. Part of this can be due to the fact that our society is running around at such breakneck speed; we have forgotten how to break down problems because we want everything solved now!

“This question is a wonderful tool to use in treatment planning, as well as a great homework assignment to give when “stuck” at a point in therapy that we all seem to hit at some time.” Annals of Psychotherapy & Integrative Health®

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F e at u r e Article With the information age, Twitter, Internet, and other means of instant gratification literally at our fingertips, we are unable to slow down the process long enough to get the correct answer. We take the process of information at such a speed that we lose sight of what it is we are trying to answer. For some individuals this can become catastrophic to their lives, as it will affect them both individually, as well as socially, creating more barriers than they can cope with. This can lead them to depression, anxiety, self medicating with illegal drugs, and unsafe sex until they end up losing most, if not all, of everything they are as a person. I will use this tool to dictate where I need to start the process of therapy and education for the patient in how to slow down the process to a more manageable level for them to cope with. I will use their response as a jumping off point, or anchor, in which to show them how they make choices, hundreds per day, and then break it down for them to the smallest detail. I show them that even the most mundane, simplest things they do, are the results of choices they made to get them to that point. It is a way to show them that even though they feel powerless in the face of the world, it is the choices being made that have them feeling like they are. When they are making the choices to give away their individual power, then they need to reevaluate who, or what, they have control over. Most individuals will make that cognitive leap to the one thing they do have control over—themselves, and only themselves. I will then use this tool to show them how to use communication skills of “I” statements, and “I feel” statements, providing a more congruent method of accepting the responsibility of their feelings and thoughts. By utilizing this tool, and really breaking down the thought process for the patient, they will report having a sense of empowerment that they have not felt in a long time. For those who have a difficult time in making that cognitive leap, I will use examples that I know they will understand, as I have been listening to them and have a general idea as to where they are cognitively. There are times when I will break down the

“Once the patient makes this connection, they then start to fly with the concept and watch the growth taking place!” 14

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process of “eating the elephant” starting out with the idea of recognizing whether or not I am hungry? If I am hungry, what do I want to eat? I happened to pick an elephant, but where do I get an elephant? Do I go to the store? Do I have to hunt it? If I have to hunt it, what do I use to kill it? Then do I skin it? How do I cook it? Where do I start? Does it matter where I start? Who makes the choice as to where I start? Usually by the time I get to this point, the patient has begun to get the idea, and will start applying this to other areas of their life. What do I wear today? What am I listening to? What is my response? What am I feeling in response to what I am hearing? I feel…and then give the response. I will explain that all people have filters that they listen through, and part of learning about choices is to be aware of those filters and to make sure that they are appropriate for them. A person can always listen but does not have to agree with what they are listening to. This comes down to making the choice as to how they are going to respond to what they are hearing. From the moment that the question is asked, I will utilize anything and everything as a teaching moment for the patient to be able to learn and practice what it means to slow down the process. Since everything we hear and see can be analyzed for meaning, I am trying to bring beneficial behaviors to the collective attention of the patient. This includes both good and bad behaviors. By doing this, the patient becomes aware of self defeating behaviors and can start to make necessary changes that they are comfortable with doing. I encourage them to start out small, and then gradually build up to bigger and bigger things that they want to change; however, there are times when the changes are going to be coming from a couple of different angles at once. This happens because in order to achieve congruency between emotions, feelings, and mental attitudes, there needs to be practice occurring at different levels at the same time. Being able to appropriately verbalize what one is feeling in response to an emotion and integrate it mentally, can be a challenge. For example, exercise needs to be practiced until it becomes a habit. Once the patient makes this connection, they will then start to fly with the concept and be ready to watch the growth take place! When the patient has a firm grasp of the concept, their ability to focus on what they want to change about themselves becomes clearer in their mind. All of a sudden, the world is not a bad place after all, and they are now able to free up more time for taking care of themselves, having clear boundaries with themselves and others, becoming more efficient as a person and be able to enjoy life more fully. This concept is tied into George Kelly’s concept of personal constructs. This question of “how do you eat an elephant” can be quite diagnostic for any individual, regardless of age or cognitive ability. In testing this question on individuals who were on a unit prior to discharge, I was able to have a developmentally delayed (dd) male actually be able to take this question and relate it to his current circumstances. The elephant question can be used for individuals who are in a locked psychiatric facility on an involuntary hold as either a danger to self, others, or are gravely disabled. It allows for a teaching moment with individuals who are unable to perceive that the reason they are in a locked

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facility is due to the choices that they are making. It allows for the therapist to see into the thought process of that individual and to be able to begin the process of changing the thought process into something that is much more amenable to that individual and allow them to grow into a better person. It teaches better personal communication, as well as accepting responsibility for their own words and actions. An example of this would be to have an individual accept responsibility for decisions made and the subsequent consequences of those decisions based on their perceptions of how they view the world. This can be used to evaluate the risk benefit of each decision made. This is something that people do without even thinking of it. They won’t break it down into the most basic elements, but will instead jump from point A to point G, leaving out everything in between. It is here, at this juncture of individuals who are in a locked facility for a short time period, that this whole elephant question is now paramount. By asking this question, these individuals will blurt out a response, and more often than not, it is the true answer, which is how the diagnostics come into play. If the therapist listens to what is said, he will be able to tell what, when, where, and how that patient is currently thinking and then will be able to begin the process of changing the “stinking thinking” that is currently in practice. It is the concept of meeting the patient or client where they are at and then utilizing this question to open the door for that psychotherapeutic change to happen.

References Feist, Jess, and Feist, Gregory J., (2002). Theories of Personality, Fifth Edition. McGraw-Hill Companies, Inc., New York, New York.

about the author Dr. Robert Mead, LMFT, BCPC, DAPA, received his AA degree from College of the Desert, his BA degree from CSU Stanislaus, his MA in counseling psychology and school psychology from National University and is finishing his PhD from Capella University in clinical psychology with an emphasis in forensics. He has worked in the field of counseling for the past 25 years in a variety of settings including inpatient/outpatient clinics. Bob is currently working in a conditional release program in California. Bob is a Board Certified Professional Counselor as well as Diplomate in the American Psychotherapy Association. He has also published a previous article with the American Psychotherapy Association Journal on maintaining safety of the borderline patient in a crisis/inpatient setting as well as a book: The Unspoken Taboo: Male Victims of Domestic Violence. He is also a certified expert in matters of Child Welfare, Stanislaus County, Ca.

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shtz0312AN

Everyone Deserves to Hope! Last Summer with Oscar is a narrative case study about a 9-year-old Golden Retriever’s response to cancer. While my husband and I came to grips with the diagnosis, Oscar made an amazing discovery. Nestled among a patch of young trees were Slippery Elm seedlings, and eating them became his choice of treatment. Oscar’s determination to live enabled him to return to his patch to eat the leaves, thereby regaining his strength for continued walks with his littermate, Winston.

Last Summer with Oscar: An Adventurous True Story of Love and Courage By Jan Schwartz, Ph.D. 9780983260127 | 198 pages 0983260125

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One World Books 16

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Integrative health

“Nutrition is the scientific study of the process by which an organism assimilates food and utilizes the nutrients to feed the cells for proper growth and good health.” Phylis Canion, ND, DCCN

18 VERONICA ANDERSON: A VOICE IN KEEPING AMERICA HEALTHY 24 natural remedies: FEVERFEW 25 healthy recipes: GRANOLA 26 OUR BODY: THE TOXIC WASTE DUMP (800) 592-1125 | (877) 718-3053

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Dr. Veronica Anderson A VOICE in Keeping America Healthy

By Cheryl Barnett

r. Veronica Anderson is the keynote speaker for the American Association of Integrative Medicine at our 21st Executive Summit in Las Vegas, Ne-

vada on October 17th – 19th. Veronica’s dynamic

personality and dedication to making a difference makes her an outspoken advocate of healthy living in America. As host of Medicine Woman, Modern World, she has a platform to convey her often-provocative thoughts. “I think eating well is a civil rights issue. Why should rich people stroll through aisles of organic produce at Whole Foods while those less fortunate are stuck buying too-big burgers at McDonald’s? C’mon!” Veronica is also the host of the weekly radio show, Wellness for the Real World, which is heard by over 40 million listeners on BlogTalkRadio and Old Grumpy Radio networks.

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ES - 2 1 , L AS V EGAS

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Dr. Anderson, a native of Newtown, Pennsylvania, knew from an early age what her life mission would be. At the age of four, she says she knew she wanted to be a doctor. After graduating high school, she completed her pre-medical degree at Princeton University. Dr. Anderson received her MD with honors after completing an internship and residency at Robert Wood Johnson University Hospital and New York’s Mt. Sinai Medical Center, where she received a fellowship in glaucoma. She is a fellow of the American Academy of Ophthalmology, a diplomate of the American Board of Ophthalmology, and a member of the American Association of Integrative Medicine. She has practiced at Robert Wood Johnson and Philadelphia’s Wills Eye Hospital.

As an ophthalmologist, Veronica became frustrated “with a health care system that embraces disease and sickness.” She was determined to have a voice that spoke out about healthy choices and the personal responsibility of individuals to take charge of their own health. Leaving her practice behind, she took her extensive knowledge and began an entirely different career. She is now the host of “Wellness Through the Real World,” a radio talk show heard on BlogTalkRadio and Old Grumpy Radio networks with over 40 million listeners each week. Veronica’s nononsense approach and straightforward manner appeal to listeners worldwide. Dr. Anderson is also the host of Medicine Woman, Modern World, a healthy living travel adventure series that can be viewed on the Internet. This show is loaded with practical tips, and it celebrates the mind-body-spirit connection as Veronica travels the world and opens the doors to other cultures. She has navigated rice paddies in Thailand, meditated in Morocco, and thumped melons in Pennsylvania. As her adventures unfold, she celebrates the journey of living life in the healthiest way imaginable. Medicine Woman, Modern World is beautifully shot and produced and is edited by four-time Emmy winner, Billy Ray of Dateline NBC and Cineray Films. Dr. Veronica insists that Americans are too dependent on a health care system that is based on sickness and disease. This outspoken doctor who is enraged by the national trend towards obesity and its deadly medical costs is an entertaining and lively guest that is sure to provoke discussion. To read Dr. Veronica’s article, Concierge Medicine, the Answer to Keeping America Healthy, go to our website at www.aaimedicine. com/articles/article1.php. This article provides a look at an optional practice that doctors may initiate to enhance their practice while providing their patients with the quality care that they deserve. 20

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Corporate Events

his thought-provoking doctor is available to speak at corporate events on a wide variety of subject matters:

• In Sickness and in Wealth – This topic gives you Veronica’s insight on health care’s overdependence on disease intervention and pharmaceutical companies. • Cross Training the Soul – Dr. Veronica unlocks ancient secrets for a modern-day audience as revealed through yoga and moving meditations. • No More Survivors – Lessons learned through positive living and an attitude of gratitude is discovered through this topic by Dr. Veronica. • Fits You to a “Tea” – This interactive herbal workshop on teas and natural remedies is culled from Veronica’s global travels.

Don’t miss dr. anderson’s keynote presentation at the executive summit in las vegas Thursday, October 18th at 9:30 a.m. www.americanpsychotherapy.com | www.AAIMedicine.com

This bracelet was a gift Amber Apodoca received from the center where she helped teens with drug and alcohol problems. She was wearing it when an underage drunk driver took her life.

Photo by Michael Mazzeo

10"

Friends Don’t Let Friends Drive Drunk.

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NOTE TO PUB: DO NOT PRINT INFO BELOW, FOR I.D. ONLY. NO ALTERING OF AD COUNCIL PSAS. Drunk Driving Prevention - Magazine (7x10) B&W DD201-M-06177-A “Bracelet” 110 screen