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We are Hiring! Come Join Anchor Counseling Center or Anchor Memory Clinic

Dec 10, 2015   //   by Richard Figueira   //   Anchor Counseling Center, Behavioral Health in RI, Blog, Counseling, Psychiatry, Psychiatry in RI, Uncategorized  //  2 Comments

http://www.anchorcounselingcenter.com/about/employment-opportunites/

Anchor Counseling Center: 4 Tips to a Happy and Healthy Relationship

Tips for a Happy and Healthy Relationship


Each week couples come into our office seeking help for problems in their relationship. Some couples have been married for several years and feel that they have lost a connection with their spouse. Others have only been together a couple of years but feel that they are no longer happy together. Whichever category you fall into, it is important to seek some kind of counseling as soon as you start to feel unhappy. According to John Gottman, a relationship expert, the average couple waits six years before seeking therapy for problems in their relationship.

Here are some tips for a healthy and happy relationship:

Trust: According to Gottman, trust is the most vital ingredient to a successful relationship. Many factors go into building trust and it is something that couples need to nurture every day.

Good communication: It is important to listen to what your spouse has to say and consider their feelings when making decisions. One way to make sure everyone feels that their opinion is heard it to take turns talking and not allow interruptions until the other person is done speaking.

Make time for each other: Often couples report that they are not spending time together like they used to. This can be due to busy schedules or having children. Some couples feel that finances hold them back from doing things together. All couples, no matter what their situation, can take half an hour each day to go for a walk or cook together.

Parenting: Being on the same page in terms of parenting is crucial. Not agreeing on rules and consequences at home can lead to children acting out which can make for an unhappy household.

If you feel that this applies to your relationship, please call us at Anchor Counseling Center today to schedule an appointment with one of our therapist.  You can visit our website by clicking here.  If you would like to call us our number is 401.475.9979

Tania Weld, LMFT

Anchor Counseling Center

Do we need Stress in our lives? 6 Steps to decrease.

Sep 17, 2012   //   by Richard Figueira   //   Blog, East Bay, East Providence, Lincoln, Rhode Island, Mental Health, Stress, Uncategorized, cranston  //  No Comments

Do you really need stress in our lives?

I know many of you may be thinking “Well of course not, who needs stress?” but believe it or not we do need some level of stress in our lives in order to function.  There is such a concept as good stress (eustress) as well as bad stress (distress).  I think most of us are more familiar with distress but eustress actually helps us thrive in our daily lives.

Eustress (good stress) can be events such as starting a new job, getting married, having a baby, etc.  To most of us, we may think these are great moments in our lives and of course while they are great moments, it also involves some level of stress.

So now let’s switch over to distress.  It’s something everyone has encountered and coped with differently.  If we are able to see challenges in our lives as manageable, it will lead us to handling stressful situations effectively.

I would like to offer some self-care techniques that can help us cope with stress more effectively.  These are strategies that when implemented on a consistent basis will help improve our mood, overall well-being, and perspective in general.  Please check out the bulleted list below to learn more about these strategies and see if you are already applying them in your daily lives.

v Take time to relax. Seriously this is important.  Try to take mini breaks throughout your day.  Examples include going outside for a brief walk, stretching, taking deep breaths.

v Get enough sleep. We underestimate how much sleep we really need in order to function.  A healthy range for adults is anywhere between 6-8 hours every night.  If you can get more then you’re in good shape.

v Practice positive self-talk. This will help us to view stressors as manageable rather than impossible.  Examples include:  “I will get through this”, “Things will get better”, etc.

v Exercise. Believe it or not adding physical activity to your day will help release energy in a positive way and provide you with a more balanced outlook on life especially stress.

v Make a to-do-list. Getting organized by making a checklist at the beginning of your day of reasonable items you can accomplish will alleviate stress.

v  Enlist social/family support. Talk to friends and/or family members on a regular basis.  It is vitally important that we connect with others and share our feelings.  It is okay to ask for help.

Can you think of a time in which you were faced with what you thought was an impossible thing to overcome?  Think about how you handled and could you have handled it differently.  If so, would it have made a difference on how you felt following the outcome of that event in your life?

The Military presents challenges for all!

Sep 17, 2012   //   by Richard Figueira   //   Blog, East Bay, East Providence, Lincoln, Rhode Island, Marriage, Mental Health, News, Self Help, Stress, Uncategorized, cranston  //  No Comments

At Anchor Counseling we provide therapy to families from deployed individuals.  As a military wife/SO for over 10 yrs I have been a part of many different experiences. Military life is a unique cultural that at times can present challenges to individuals and families as well as lots of successes.  As the war comes to an end, there will be many soldiers returning home that may be dealing with many different changes and expectations.  As a clinician, I think it is extremely important to become educated with this population and be aware of different issues/needs and concerns that they may face on a daily basis.  Reintegration is a joyous and stressful time!  Reintegration is about more than coming home. It is about resuming and establishing relationships that provide pleasure, comfort and support.

Many service members returning from deployment may experience what are referred to as “invisible injuries”. Invisible injuries include posttraumatic stress disorder (PTSD),  traumatic brain injury (TBI), depression and anxiety that can result from combat exposure. Sometimes alcohol, tobacco and drug use, as well as impulsive or aggressive behavior can magnify these conditions.   All of these problems can compromise relationships reducing one’s ability to enjoy pleasurable and health activities.  Here are a few helpful tips for what soldiers/spouses and children may feel/experience.

With deployment comes change. Knowing what to expect and how to deal with changes can make homecoming more enjoyable and less stressful. Below are some hints you might find helpful.

With deployment comes change. Knowing what to expect and how to deal with changes can make homecoming more enjoyable and less stressful. Below are some hints you might find helpful.

Expectations for Soldiers:

  • You may miss the excitement of the deployment for a while.
  • Some things may have changed while you were gone.
  • Face to face communication may be hard at first.
  • Sexual closeness may also be awkward at first.
  • Children have grown and may be different in many ways.
  • Roles may have changed to manage basic household chores.
  • Spouses may have become more independent and learned new coping skills.
  • Spouses may have new friends and support systems.
  • You may have changed in your outlook and priorities in life.
  • You may want to talk about what you saw and did. Others may seem not to want to listen. Or you may not want to talk about it when others keep asking.

Expectations for Spouses:

  • Soldiers may have changed.
  • Soldiers, used to the open spaces of the field, may feel closed in.
  • Soldiers also may be overwhelmed by noise and confusion of home life.
  • Soldiers may be on a different schedule of sleeping and eating (jet lag).
  • Soldiers may wonder if they still fit into the family.
  • Soldiers may want to take back all the responsibilities they had before they left.
  • Soldiers may feel hurt when young children are slow to hug them.

What Children May Feel:

  • Babies less than 1 year old may not know you and may cry when held.
  • Toddlers (1-3 years) may hide from you and be slow to come to you.
  • Preschoolers (3-5 years) may feel guilty over the separation and be scared.
  • School age (6-12 years) may want a lot of your time and attention.
  • Teenagers (13-18 years) may be moody and may appear not to care.
  • Any age may feel guilty about not living up to your standards.
  • Some may fear your return (“Wait until mommy/daddy gets home!”).
  • Some may feel torn by loyalties to the spouse who remained.

Amy J. Chirichetti, LICSW

https://www.militarymentalhealth.org/

You can also visit our website at www.AnchorCounselingCenter.com

Mental Health News: 10 Steps to Prevent Suicide

Jul 19, 2012   //   by Richard Figueira   //   Blog, East Bay, East Providence, Lincoln, Rhode Island, Marriage, Mental Health, News, Self Help, Stress, Uncategorized, cranston  //  No Comments

Anchor Counseling Center is sharing the latest on Suicide Prevention.  As a private practice with locations in East Providence, Cranston, Lincoln, and North Attleboro, we are very involved in the community and reach out to our members with a caring and supportive manner.  Our mission is to provide our patients with the help they want as quickly as possible with reliable, courteous, and professional counseling and psychiatric interventions.

Just as CPR has been promoted to save lives, it is vital that the general public knows how to recognize suicide risk and prevent suicide. Here are the steps:

1. Notice if the person appears quiet and withdrawn, oversleeps, has crying episodes, has loss of appetite and energy, appears dishevelled, the gaze is downward, the voice tone is flat, consistently negative comments, irritability, or says things like, “Life’s not worth living,” or “I hate my life,” etc.

2. Ask: “How would you rate your mood right now on a scale of zero to ten with zero meaning life’s not worth living and ten meaning life is great?”

3. If the person rates the mood as 5 or under, ask: “Have you had any thoughts of suicide or of harming yourself?” *

4. If the person indicates yes, go to the next step. If the person says, “I don’t know,” hear this as a “yes” to the question in #3.

5. Ask: “Have you thought about how you might end your life?” If the person says yes, the risk is increased.

6. Ask: “What have you thought about as how you might do it?” If the plan or method is ineffective or non-lethal, such as cutting wrists, the risk is low. If the method is lethal such as using a gun or jumping from a bridge, etc., the risk is high.

7. Regardless of the method, ask: “Can we agree together that if you have thoughts of killing yourself, you will speak to me personally (not my voice mail) before carrying out a plan to harm yourself?”

8. If the person says “no” or “I don’t know,” to the question in #7, say: “What I am hearing is that you are in a lot of pain right now and thinking of ending your life, so I am wanting you to go to the emergency room right now and get some help to feel better right away. Will you go? I will make sure you get there safely. Is there a family member or someone I can call to go with you?” Or tell the person you will go with them yourself.

9. Arrange for the suicidal person to be accompanied to the emergency room, and call ahead to tell emergency staff the person is coming.

10. If the person refuses, then ask the person to wait there with someone while you call police in another room to report that the person has threatened suicide with a lethal method. Ask the police to come and accompany the person to the emergency room.

If you know someone that needs help please call us immediately at 401.475.9979.

*Note: If the person rates his mood as 6 or over, after feeling consistently depressed, and he now reports life is great and he is smiling, the risk may be increased because he has decided to end his life and has made arrangements.

Article shared from http://www.prlog.org/11928309-mental-health-news-ten-steps-to-prevent-suicide.html

Inspirational Quote

Mar 27, 2012   //   by Richard Figueira   //   Uncategorized  //  No Comments

You are responsible for your life, and doing the best at this moment puts you in the best place for the next moment.”―Oprah Winfrey

Project Goal! Invites Corporations and Small Business

Mar 1, 2012   //   by Richard Figueira   //   Blog, East Providence, Lincoln, Rhode Island, Uncategorized, cranston  //  No Comments

Project GOAL invites Corporations and Small Businesses to have your employees and friends show off their soccer skills in support of inner-city youth at our First Annual Corporate 7 vs 7 Charity Soccer Tournament

This event will benefit Project GOAL
a local after-school non-profit academic program that uses soccer to leverage keeping kids off the street and focused on their academic careers.

There will be Open and Co-ed Divisions and Games and Prizes for the whole family

This event is made possible thanks to the generous dedication of students from SportsCorps at Brown University

For more information and tournament packages please contact:

Darius Shirzadi 401-258-2300, darius@projectgoal.org www.projectgoal.org

Being alone while still connected! Technology Today!

Feb 14, 2012   //   by Richard Figueira   //   East Providence, Lincoln, Rhode Island, Uncategorized, cranston  //  No Comments

We loved this article so much we decided to put it on our own blog.  This article is filled with very insightful information regarding today’s world on how difficult it can appear to be alone.

The End of Alone

At our desk, on the road, or on a remote beach, the world is a tap away. It’s so cool. And yet it’s not. What we lose with our constant connectedness.

By Neil Swidey
February 8, 2009 http://www.boston.com/bostonglobe/magazine/articles/2009/02/08/the_end_of_alone/

Don’t get me wrong. I love technology. It’s magical how it makes the world closer, and more immediate. Take, for instance, the real-time way we learned about the plane that skidded off a Denver runway and burst into flames in December. One of the passengers on Continental Flight 1404 used Twitter to share everything from his initial profanity- and typo-laced reaction to making it out of the fiery jet (“Holy [bleeping bleep] I wasbjust in a plane crash!”) to his lament that the airline wasn’t providing drinks to the survivors who’d been penned into the airport lounge (“You have your wits scared out of you, drag your butt out of a flaming ball of wreckage and you can’t even get a vodka- tonic.”)

Technology also makes life infinitely more manageable. It’s what allows me to begin writing this essay from a packed coffee shop on a snowy winter afternoon while still being connected with my editors and finish writing it from my kitchen in the middle of the night, when all the interruptions of the day have faded away (unless I want to check Facebook to see how many of my friends are also nuts enough to be staring at a computer screen at 3 a.m.). And technology simply makes things more fun, like the way my wife will hold her iPhone up to a restaurant ceiling speaker and instantly be told that the vaguely familiar tune of funky ’70s cheese she hears is “Sky High,” by the one-hit-wonder band Jigsaw, rather than letting that little mystery make her cerebrum ache for the rest of the day.

So please don’t confuse what I have to say for that tired Luddite screed about how technology is ruining us. It isn’t.

Except it just might.
Because of technology, we never have to be alone anymore. And that’s the problem.

I’M SITTING IN A PEW near the back of St. Anne’s Church in Fall River, a soaring structure of Vermont blue marble that could rival a lesser European cathedral. It was built in the late 1800s, when the southeastern Massachusetts mill city’s French Canadian community was big enough to warrant a church able to seat 2,000. On this blustery afternoon, the crowd is more like a tenth of that. The priest is talking, but the lousy PA system makes it hard to hear what he’s saying. So I’m doing what I’ve done before in this situation: trying to keep my young daughters occupied by whispering for them to study their surroundings — the exquisitely carved red-oak woodwork near the high ceiling, the enormous pipe organ in the rear balcony, the colorful stained-glass windows on every wall. With its combination of architectural grandeur and crumbling-plaster fatigue, the place is like Venice in the unforgiving light of morning, rather than the soft-lit romanticism of night. It’s honest and beautiful.

Then I hear an odd chirping. My eyes follow my ears to a pew to my left and behind me, where a guy with slicked black hair and dark glasses is sitting. He’s chewing gum and wearing one of those Bluetooth cellphone attachments in his ear.

Hey, man, I’m bored, too. But, c’mon, take that infernal thing out of your ear. Say a prayer. Collect your thoughts. Or just do what my 4-year-old is doing and stare at the ceiling.

Did I mention it was Christmas Day Mass?

Not long ago, I was sitting in the “quiet study” section of my local public library when a middle-aged woman wearing an annoyed expression plopped down in the green upholstered chair next to my table, her teenage daughter in tow. She flipped open her cellphone and dialed her daughter’s therapist. After giving the therapist’s secretary her full name and slowly spelling her daughter’s — loud enough for every soul in that wing of the library to hear — she said, “We have an appointment for next week, but I want to know if he has any availability before that. She is really not doing well.”

I looked up from my laptop, incredulous that a mother could be so blase about violating her daughter’s privacy, not to mention library decorum — and convinced that the therapist and the daughter must have no time to discuss anything besides mother issues.

Now, I know what you’re going to say. There have always been boors blabbing in places where they should be quiet, blithely ignoring the shushes from librarians or the stares from fellow elevator passengers while behaving as though they’re the only ones whose problems matter. Bad manners are bad manners, irrespective of technology, right?

Yes, only technology has vastly expanded this bad behavior, eroding much of society’s stigma against it, and making it everybody’s problem. But here’s the real point: It is dulling our very capacity to ever be alone, or alone in our thoughts. The late British pediatrician and psychoanalyst Donald Winnicott popularized the phrase “the capacity to be alone” in the 1950s, to describe a pivotal stage of emotional development. Winnicott argued that an adult’s capacity to be alone had its roots in his experience as a baby, learning to function independently while still in the presence of his mother. Yet today we’re seeing this capacity weakened, whether we’re in public places known for contemplation, like churches and libraries, or whether we’re just sitting by ourselves at home, losing the fight to resist answering our BlackBerries (just ask our new president) or checking our laptops for Facebook updates.

“We’ve gone from an American ethic that championed the lone guy on a horseback to an ethic of managing multiple data streams,” says Dalton Conley, a sociology professor at New York University and author of the new book Elsewhere, U.S.A.: How We Got From the Company Man, Family Dinners, and the Affluent Society to the Home Office, BlackBerry Moms, and Economic Anxiety. “It’s very hard for people to unplug and be alone — and be with the one data stream of their mind.”

What’s fueling this? Conley says it’s anxiety borne out of a deep-seated fear that we’re being left out of something, somewhere, and that we may lose out on advancement in our work, social, or family lives if we truly check out. “The anxiety of being alone drives this behavior to constantly respond and Twitter and text, but the very act of doing it creates the anxiety.” This is particularly true among young people, mainly because they don’t know life when it wasn’t like this.

I HAD A GREAT TIME in college and was fortunate to make lots of close, lasting friendships. But if I want to be honest with myself, I can remember plenty of times when I felt uncomfortable. And many of the earlier ones involved eating alone in the dining hall. I didn’t eat by myself often, and when I did, it was usually a simple matter of conflicting schedules with my friends. But my unease sprang from my inability to convey that to the strangers around me. Honest, I’m not a loner. I had to learn to deal with the discomfort. Sometimes, it would force me to strike up conversations with strangers or be receptive when they engaged me. Other times, I would just sit alone and read or think. The discomfort never went away entirely, but it sure receded with practice.

If I were in college nowadays, I doubt that would happen. I would be filling my alone time texting any friend I could think of.

Whenever I’m on a college campus these days, almost all the students I see sitting by themselves are furiously thumbing their iPhones or BlackBerries. For all I know, they could simply be playing Sudoku. Yet the message they’re sending is unmistakable. I am not alone.

Sure, texting a friend can make you feel less awkward. But, in the long run, so can learning to step outside of your shell, or becoming at peace within it.

This change in campus life isn’t restricted to dining halls. The quads are teeming with ear-budded students texting and talking on cellphones rather than sitting with an open book or talking to the person next to them. In important ways, they’re not fully there.

To see how these technological patterns are changing the college experience, University of Toronto researcher Rhonda McEwen tracked the communication behavior of students across their freshmen year. She found them delaying the full plunge of forming new friend networks and breaking away from their old ones. In their first semester, the freshmen generally hold on tightly to their high school friends, talking with and texting them frequently and keeping up with them on Facebook. As the year moves on, they generally shift their high school friends to Facebook and instant messaging while focusing more of their texting and phone calls on their new college pals. In the summer, they shift back, with high school friends returning to the top of the communication hierarchy.

There are things to be happy about in these patterns. The lifeline of old friends can help staunch the feelings of loneliness that are as common to the freshman experience as rapid weight gain.

But those old contacts can also turn into a crutch that prevents students from truly engaging with the new world around them or learning to be alone in their own mind. One of the freshmen McEwen interviewed confessed that every day she spent her lunchtime sitting on the steps outside a campus building, calling or texting her sister. That was less painful for her than sitting alone. Yet like the helicopter parents who hover over their children at the playground in the hopes of shielding them from bumps and bruises, we can delay the hurt only so long. As the Talmud tells us, sometimes a little bit of pain can be a blessing.

“Loneliness is ubiquitous,” says Amherst College political science professor Thomas Dumm, whose new book, Loneliness As a Way of Life, grew out of his experience of losing, in short order, his wife and mother to death and his daughter to college. “But people are less equipped to deal with it. Rather than going deeper, they try to push it aside.”

How will this all play out in years to come? Leysia Palen, a University of Colorado computer scientist, worries that “how to be alone in a public space is a skill that is going to disappear.” And that hole could become glaring when people’s life circumstances change. “As friends die, do you find yourselves in a different reality than before? I don’t have any problem being alone, but it’s something I learned — through living it.”

More than anything, McEwen found in her University of Toronto study that college students are constantly connected to the point of having no concept of a truly unplugged life. There’s a time- honored tradition in Canada of “going to the cottage,” usually in the summertime, and being blissfully disconnected from the rest of the world. “The participants in my study had real discomfort going to the cottage,” McEwen says. “If there’s no cellphone reception, no Internet access, they think, ‘What the hell am I doing out there?’ ”

It’s hard to imagine a Henry David Thoreau emerging from this millennial generation, someone motivated to log two years and two months alone in the woods around Walden and wax about how he “never found the companion that was so companionable as solitude.” He’d have no time to observe the bullfrogs or water his bean plants. He’d be too busy searching for a Wi-Fi signal.

DESCARTES, NEWTON, LOCKE, Spinoza, Kant, Nietzsche, Kierkegaard — they share the distinction of having been some of the greatest thinkers the world has known. They also share this: None of them ever married or had their own families, and most of them spent the bulk of their lives living alone. In his provocative 1989 book Solitude: A Return to the Self, British writer and psychiatrist

Anthony Storr made a persuasive case for the value of deep, uninterrupted alone time. He found it in ample supply in the lives of not just philosophers and physicists, but also some of the greatest poets, novelists, painters, and composers.

Maybe this concept of the lone genius is somewhat exaggerated. While Newton was celibate, many of these other thinkers had transient affairs and interacted to varying degrees with the world around them. Even Thoreau would leave his cabin every once in a while and stroll into downtown Concord to visit with friends. But the point is, they were all able to remove themselves from the bustle of daily life for long stretches, in order to contemplate and create. We’re all the richer for their having done that. Now, ask yourself, when was the last time you were truly alone and unplugged for a long spell? How many of you can even say you’ve gotten this far in this essay without having once stopped to answer a call, reply to a text, or check your in-box? I must confess that I haven’t. (Another confession: To ensure that I finish writing this, I’ve now moved myself to an undisclosed remote location where I’m sitting in a small windowless room with some sort of orange carpeting material on the walls — no lie — and where no Wi-Fi is available. Something tells me Descartes never had to go to these lengths for quiet time.)

It’s important to distinguish between being alone and being lonely. In the new book Loneliness, University of Chicago psychologist John Cacioppo and his Massachusetts coauthor William Patrick argue the pangs of loneliness that we sometimes experience are the evolutionary equivalent of the shooting pain we feel after touching a hot stove. These pangs are ingrained reminders of how bad social disconnection is for our well-being. Cacioppo uses everything from brain imaging to blood-pressure analysis to demonstrate the serious drag on our health that loneliness can have.

At first pass, this line of thought would seem to contradict the argument Storr made in Solitude and pretty much everything I’ve written to this point. Yet that’s not the case at all. It turns out that research shows people who feel lonely are no more likely to be physically alone. Cacioppo acknowledges that solitude can be very healthy, and he compares loneliness to a sort of thermostat, a state of mind that kicks in at different points for different people.

While we humans need social interaction, he’s in agreement that we won’t find it through Twittering and texting. Cacioppo points to research showing that electronic communication can increase social isolation and depression “when it replaces more tangible forms of human contact.” Another team of psychologists termed this form of communication “social snacking.” But, as he writes, a snack is not a meal.

So why do we feel so compelled to swap messages with people who aren’t next to us and rack up hundreds of friends to keep electronic tabs on?

Dalton Conley, the NYU professor, says it’s worth looking back several decades, to two groundbreaking social-science studies. (Both, as it turns out, are tied to the Boston area — who knew we cold New Englanders could be so social?) The first is the 1967 experiment that indirectly made us all aware of the disturbing pervasiveness of Kevin Bacon in our lives. Psychologist Stanley Milgram gave a letter to a bunch of people in Omaha, Nebraska, and instructed them to hand-deliver it to someone they knew. The unstated goal was to get a copy to a stockbroker in Sharon, Massachusetts. The experiment laid the groundwork for the popular notion of “six degrees of separation.” (Conley says newer research suggests the number is actually closer to eight.) The second study, based on interviews with Boston professionals that psychologist Mark Granovetter conducted in 1972, suggests that your closest friends are less valuable to you in finding new jobs or new mates than the friends of friends whom you don’t know that well. The idea is that you’re probably already aware of the same job openings or single people that your close friends know about. But those tangential acquaintances hold the key to new and potentially valuable information. Granovetter’s paper, called “The Strength of Weak Ties,” could have been used as the business plan for LinkedIn, the fast-growing site for professionals

that is like Facebook except stripped of all mildly interesting content and about as much fun as a Chamber of Commerce networking night.

Here’s the irony: The explosion of all this electronic networking and friending may ultimately rob weak ties of most of their strength. If we’re all linked up with hundreds if not thousands of people, there is no longer much value to the information they possess. It’s no longer exclusive. A stock tip whispered in your ear by someone in the know can make you a mint (if it doesn’t land you in jail). But what good is a stock tip broadcast on CNBC?

SCHEHERAZADE QUIROGA has a heavy name but a buoyant personality. In August, the 28-year- old left her parents’ home in Caracas, Venezuela, where she has lived her whole life, and moved here to begin a master’s program in television management at Boston University. The first time she left her family was 10 years ago, when she and her sister took a guided tour of Europe. As soon as they arrived in Madrid, the first stop on the tour, she found a pay phone and called her mother in tears. “Mama, Mama!” she cried, “I miss you so much!” This past November, when she returned to Venezuela to vote and saw her family for the first time since moving to Boston, her mother came running over, saying, “I need to hug you!” Quiroga thought to herself, “It’s no big deal.”

Sure, she’s a decade older than that girl crying from the pay phone in Madrid. But the real difference is that, although she’s living abroad now, she hasn’t really had to leave her family. Every night at 9 o’clock, she logs on to the Internet video chat service Skype and catches up with her mother, usually for two or three hours at a stretch. “I don’t feel the distance as much,” she says.

What’s wrong with this? On one level, nothing at all. Quiroga is sociable, happy, and well adjusted. She’s managed to form close friendships with other students in her program while still keeping strong ties with her family.

But if international travel and study were once surefire ways for people to learn deep truths about themselves as they experienced new cultures, that’s probably not the case anymore. Contrast Quiroga’s Boston experience with the backpacking tour Dalton Conley took alone across Bolivia and Peru in the early ’90s. Once, after making vague plans to meet up with a friend in La Paz, he took a hellish bus ride clear across the country, suffering altitude sickness along the way, only to arrive at the station in the Bolivian capital and find out that his friend had just left. He spent much of his time in South America feeling lost, miserably alone, and utterly disconnected from his normal life. “But I look back at it as one of the greatest experiences of my life,” he says. “It helped in forming a sense of who I am.”

I ask Quiroga when she feels truly unplugged and off the grid. (I’ve learned to be specific with this question. Another college student I posed it to said her definition of being unplugged was keeping her cellphone on vibrate.)

She pauses. Her green eyes widen. Then she smiles. “Hmm. I think only when I’m on the T and we go into the tunnel. As soon as the Green Line train hits Kenmore and goes underground, I think, ‘Well, that’s it. No one can reach me now.’ ” She smiles again. “Isn’t that sad?”

Neil Swidey is a staff writer for the Globe Magazine. E-mail him at swidey@globe.com © Copyright 2009 Globe Newspaper Company.

An Anxious World! Anxiety Treatment in RI

Jan 26, 2012   //   by Richard Figueira   //   Blog, East Providence, Lincoln, Rhode Island, Marriage, Mental Health, News, Self Help, Stress, Uncategorized, cranston  //  No Comments

An Anxious World

At Anchor Counseling Center we believe that s human beings, we all experience a form of anxiety at some point during our lives.  Anxiety is often thought of as worry and fear about uncertainties. It is usually depicted as a negative attribute, but it can also serve the useful purpose of alerting one of lurking danger. We may find ourselves worrying about school, work, our kids, or paying bills, and that’s all perfectly normal. When anxiety and worrying is a persistent, or common, feature causing disruption to your daily life, then it becomes a maladaptive. Excessive worrying may interfere with your relationships, your leisure activities, and can eventually lead to physical health issues.  According to the National Institute of Mental Health, approximately 40 million adults in the U.S., in the span of one year, suffer from an anxiety disorder2. The average age of onset for anxiety is 11 years old; so many children are affected by anxiety disorders as well2.  Also, women are more likely do experience anxiety disorders than men2. So anxiety is not a new or unheard of phenomenon, and it is fairly common, however, some may not recognize symptoms of maladaptive anxiety because it may not look like the common perception of an anxiety-ridden individual.

In fact, anxiety disorders can take on many forms, and one person’s experience with excessive worrying can be completely different than another person’s experience. Some people have very general based anxiety of which they worry excessively about every little thing throughout the day, from work, school, paying bills, to having enough time to complete a task, or to what will happen if my car stops working. A popular perception of an anxiety disorder is of people with specific phobias. For instance, an individual’s fear-based worrying may only be provoked by exposure to specific stimuli, such as a bridge above water, or snakes. Even though the phobia is highly specific, it may be clinically significant if the individual experiences anxiety about it on a daily basis and it interrupts his/her daily tasks.

Obsessive-Compulsive Disorder, commonly termed OCD, is also a form of an anxiety disorder1. A person with OCD will have obsessive thoughts, which tend to cause marked anxiety or distress, and/or compulsions, which are often performed in order to reduce anxiety.  Take for example, a man who has a fear of germs contaminating his body. This man worries constantly throughout the day about contracting some disease from all the germs he believes surrounds him. In order to reduce the likelihood of him contracting this horrid disease, he washes his hands 52 times, every time he goes to the bathroom or touches an object he does not own. As a matter of fact, he also showers at least twice a day for more than 45 minutes, and if he forgets to clean any body part, he goes back and re-showers entirely.

Posttraumatic Stress Disorder, or PTSD, and Acute Stress Disorder, are characterized by “anxiety from re-experiencing a traumatizing event, often accompanied by symptoms of increased arousal, and avoidance of stimuli associated with the trauma”1. While PTSD can occur any time after the traumatic event, Acute Stress Disorder occurs immediately after the traumatic event, lasting for at most, four weeks. In this form of anxiety disorder, there is a distinct trigger event where the individual felt threatened.

Other forms of an anxiety disorder to mention is Panic Disorder With and Without Agoraphobia, Agoraphobia without a history of Panic Disorder, and Social Phobia.  Panic Disorder without Agoraphobia is characterized by recurrent, unexpected panic attacks about which there is persistent concern, while a person suffering from Panic Disorder with Agoraphobia may experience both recurrent, unexpected panic attacks, and anxiety about places or situations that may not be easily escapable.  That being said, Agoraphobia, “is anxiety about or avoidance of places or situations from which escape may be difficult (or embarrassing)”1. Social Phobia is basically when a person’s “anxiety is triggered by exposure to social situations in which he/she is exposed to unfamiliar people or to possibly scrutiny by others”1.

As you can see, there are a variety of anxiety disorders; however, one thing to note is that anxiety has an altering effect on one’s perception of the world around them and an effect on one’s interpretation of the stimuli he/she is exposed to. A Common behavior associated with people who have anxiety disorders is avoidance behavior. For example, the man with a phobia of bridges above water may stop going to visit his parents because he refuses to drive or walk over any bridge above water. In fact, he may miss a work conference next week that is detrimental to his job security because it’s across a bridge over water.  Another example is people with social phobias who avoid public speaking at all costs. Even with OCD, the compulsions acts as an avoidance mechanism set to reduce ones anxiety about an obsessive thought.

Also many anxiety stricken individuals have cognitive errors set in place that alter their ability to make judgments and function in the every-day world. Most people with anxiety tend overestimate the probability of the occurrence of the worry at hand. On the other hand some people assume that an outcome will be much less manageable than it actually is, also known as catastrohpizing. A big commonality amongst those suffering anxiety is the human tendency to be intolerant of uncertainty, the fear of ambiguity, and the acceptance of change.

Most people don’t like to be surprised by negative events, and more often than not, we want to try and control (or limit) the amount and impact of those negative events. But humans cannot know, or evade every problem—sometimes we just have to go through the pain. And attempting to control or change something you have no power to control or change is physically exacerbating to the human body and psyche. Taking risks, accepting change, and understanding that uncertainty is not an abyss of pain and negativity is a part of alleviating some anxiety.  Dr. Biali (2012), as do many psychologists, argues that anxiety is not always bad—it’s a part of experiencing life and trying something new3,4. Now, excessive anxiety about things you truly can’t control becomes tiresome and is often how clients present—overly stressed. Biali (2012), suggests several healthy ways to help people reduce anxiety, including, writing one’s worries down, practice breathing exercises, do yoga or stretching and exercise to alleviate muscle tension, and to avoid stimulants (like caffeinated beverages)3. Will this rid you of your anxiety? Probably not, but it can help you manage it.

Biali (2012) and Markway (2012), both suggest that in order to address and solve issues regarding your anxiety and excessive worry, one should invoke the assistance of a professional that is trained to guide you in restructuring your current cognitive methodology, and avoidance behaviors. According to the National Institute of Mental Health and the Psychological Diagnostic Manual, people with anxiety disorders usually benefit from methods of Cognitive Behavioral Therapy and/or Exposure Therapy. Here at Anchor Counseling Center, we have therapists trained in both CBT and exposure therapy to help you reduce your anxiety and manage healthier lifestyle.

By: Aryssa Washington

Sources

1The American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, Washington, DC, American Psychiatric Association, 2000.

2www.nimh.nih.gov/health/publications/anxiety-disorders/complete-index.shtml

3Biali, S. (2012). How to manage the anxiety that comes with change. Prescription for Life: Psychology Today com

4Markway, B. (2012). Can Willpower help you overcome social anxiety: willpower is not always about giving something up. Shyness Is Nice: Psychology Today.com

Creative Group Therapy! Using creative measures with teens!

Jan 25, 2012   //   by Richard Figueira   //   Blog, East Providence, Lincoln, Rhode Island, Marriage, Mental Health, News, Self Help, Stress, Uncategorized, cranston  //  No Comments

The Adolescent Struggle for Autonomy and Self-Identity:

Using Creativity in Group Therapy

By: Aryssa Washington, Roger Williams University (2011)

Therapeutic work with adolescents is often seen as a challenging task, especially in the initial stages of the therapy processes (Allen, 2005). It is important to remember that while some adolescents may be in therapy voluntarily, others are required to participate in therapy by parents and/or court mandate. Since adolescents are not often in the position to initiate the process of therapy, they may express apprehensive attitudes that work against the formation of a healthy therapeutic relationship. As with adults, some teens may not have the insight to perceive the need for therapy. Also, adolescents involuntarily participating in therapy may feel that clinicians are allied with their adult guardians, as opposed to with them. Regardless, if the therapeutic experience is new, most youth will be processing feelings of discomfort in the therapy environment; thus, creative and culturally-aware approaches that address adolescents’ uneasiness and resistance become a necessary feature in therapy (Allen, 2005).

According to Erikson, social and cultural experiences are integral to human development (Zayas, 2001). His theory expressed the need to cogitate both the individual and the common needs all humans share (Zayas, 2001). During latency and preadolescent development, youth are challenged with assuming socially-specified roles and balancing a sense of autonomy with the sense of inferiority (Erikson as cited in Zayas, 2001). For adolescents, developing a sense of individuation and independence is an important achievement, and the society surrounding the youth “provides the guidance, opportunities, challenges, motivation, experience, counsel, and instruction for accession into adulthood” (Zayas, 2001, p.363). In accordance with Erikson’s theory, youth will rehearse the roles that perceived to be essential to later success in life, as observed within his/her social culture (Zayas, 2001). The confidence that is associated with a sense of autonomy helps form the adolescent’s identity, and occurs when he/she feels supported (Zayas, 2001). Because of the universal adolescent struggle with self-identity and independence, group therapy is often thought to be an effective option. Aadolescents, with and without a clinical disorder, have ongoing issues with low self-esteem, and developing problem solving skills (Hartz & Thick, 2005; Richmond, 2000). Group work with adolescents often aims to address this over-arching issue, in the process of targeting more specific issues such as, behavioral/conduct problems, trauma, medical illness, and substance abuse (Veach & Gladding, 2007). One way of targeting the issue of self-esteem, self-identity, and autonomy, as it is associated with more specific clinical issues, in adolescent group therapy is through creative therapy modalities.

Creativity, in the therapeutic setting may be described as the “ability to produce work that is both novel, and appropriate” (Sternberg & Lubert, as cited in Veach & Gladding, 2007, p.72 ). Creativity is the creation of original work by clients that is useful to the therapeutic goal. Contrary to popular belief, creativity is not to be misconstrued as unstructured work. Many therapists recommend the use of creative therapies within the construct of some theory basis—most often found as an adjunct to cognitive behavioral or client-centered group therapy (Veach & Gladding, 2007; Pardeck, 1994).  In fact, working creatively in groups with youth requires structure, albeit a subtle use of directives when facilitating groups (Vick, 1999; Backos & Pagon, 1999; Pifalo, 2002).  For the purpose of this paper, creative therapies and expressive art therapies are used interchangeably.

Expressive arts therapy, as posited by person-center theory, includes “movement, art, music, writing, sound , and improvisation  in a supportive setting  in order to facilitate growth and healing” (Rogers, 1993, pg. 3). Person-centered theory supports the notion that all individuals are innately creative, thus expressive art therapy can be used as a process of self-discovery through emotional depth and self-expression. Humanistic principles support that the focus of expressive art therapy has nothing to do with the end product or the mechanical principles of any art form, but its focus is on the clients ability to “let go, express, and release emotions and to gain insight from studying the presented symbolic and metaphoric messages” (Rogers, 1993, pg.4). For adolescents, the production of artwork operates as a medium of ownership and a means to explore personal identity. The group setting provides the social support necessary in increasing confidence, as well as provides another modus to gain insight and learn new ways of thinking from social peers. Based on the adolescent struggle for self-identity, and desire to be self-productive, this paper examines the use of several creative therapy methods with different adolescent populations.

Music Therapy

Music therapy may include the creation and/or deconstruction of musical pieces. This could comprise the analysis of musical lyrics, the composition of musical pieces, or even playing beats on a drum (Towse, 2007). In their overview of the literature on creative techniques with adolescent groups, Veach and Gladding (2007), found that music therapy was often used to help improve social communication and as a preventative measure by increasing the development of coping skills. DeCarlo and Hockman (2003), found that the use of RAP therapy in conjunction with psychoeducational therapy promoted prosocial behaviors. These researchers posited the use of rap music in order to connect with African American juvenile offenders, status offenders, and high school students (with no record) from the same urban setting. The rap music served as a connection between therapy and the contemporary customs of the youth.  The rap therapy condition analyzed the lyrics of chosen songs that related to the specified psychodeducational topic of the day. While very much a goal-oriented treatment, DeCarlo found it was important to use cultural customs, to relate to the adolescents on their level, in order to influence desired behaviors.

Movement

A common use of movement, or dance, therapy is with adolescent female groups (Veach & Gladding, 2007). Movement therapy often has a preventative focus for young females experiencing radical body changes, or with teenage females struggling with self-image or self-identity conflicts (Block, 2001). In her clinical work with female adolescents and in dance, Block (2001) has created a framework for dance therapy in efforts to address young women’s issues with self-confidence, identity, and image. Again, the group setting functions as social support and a forum for discussion and insight development. In her framework, Block (2001), proposes that the members chose an undesired body part to lead with in a sequence of movements. Then the girls go into a group and discuss how social media and cultural assumptions contribute to their own perceptions of their self-image and self-concept. Following this, the group works as a team to build a dance with their new perceptions of the previously unwanted bodily feature.  The final stage is for the members to create a dance that illustrates how they view their bodies now (Block, 2001). In this type of dance therapy, transformation occurs when the teens become aware of his/her Self, and how society may contribute to the formation of one’s Self. The members must also become aware of others and how they relate (physically and mentally) to others (Block, 2001).  The resultant creation is an external demonstration of how he/she views him/herself. The performance of the Self for the group helps to facilitate confidence in how the youth identify themselves.

Literature

The use of literature in therapy is often termed “Bibliotherapy.” In essence, participants read specifically themed books, poems, or news articles, to explore particular issues that the members of the group may be dealing with (Pardeck, 1994; McArdle & Byrt, 2001). Bibliotherapy is often used as an adjunct to cognitive behavioral therapy with teen groups because it is a creative method that allows for therapists to address cognitive distortions or faulty impressions adolescents may have. Group members work through the stages of identification, catharsis, insight, and universality in relation to the main character and the other group members. Group bibliotherapy usually includes interactive projects, writing exercises and discussions (Pardeck, 1994). This creative methodology has been effective with various teen and even adult populations, but there has been a large amount of research done with the use of bibliotherapy and juvenile delinquent populations, or with teens that have emotional and aggressive regulation difficulties (Bogestad et al., 2010; Schetman, 2000; McArdle & Byrt, 2001).  McArdle and Byrt (2001), and Pardeck (1994), found that bibliotherapy was efficient in providing a place for emotional purging, problem solving opportunities, increased personal insight, and a medium for positive expression.

Expressive Writing

Prominent psychologist, Stanley G. Hall’s “intellectual emancipation” concept coincides with Aristotle’s notion of empowerment through understanding language and how it is used (Leary, 2006). The idea of teaching writing principles and then allowing the individual to narrate his/her own story applies to the use of expressive writing in group therapy with adolescents. As with bibliotherapy, expressive writing provides the means for emotional purging, self-expression, and personal insight. Expressive writing is often used with juvenile offenders, youth suffering from chronic or acute illness, or with youth who have suffered some form of trauma (Baerg, 2003; McArdle & Byrt, 2001; Veach & Gladding, 2007). The issue, as it relates to these aforementioned populations, is the youth’s feelings of powerlessness and/or low self-esteem.  According to Dr. Kane (as cited in McArdle & Byrt, 2001), the aim of expressive writing is to generate creativity and empowerment which is likely to assist in the establishment of self-identity.  In most cases, the group members are taught basic writing principles and are given a writing prompt, the resultant product provides each member with a narration of his or views and experiences (McArdle & Byrt, 2001). Basically, it provides teens with a tangible visualization of his/her thought processes and cognitive patterns.  This provision of self-understanding promotes feelings of power and self-esteem in situations where adolescents may not actually have/ or did not have a lot of control over. McArdle and Byrt, (2001), also found that in adolescent forensic populations, expressive writing promoted social interest, helped develop decision-making skills, as well as aided in increasing youth accountability.

Drama Therapy

Drama in group therapy with adolescents can be used as both a preventative or intervention method. For instance, group members may be asked to role play and act out parts of life in order for them to practice different behaviors (Veach & Gladding, 2007).  One study used Shakespeare’s play Hamlet, to explore the idea of consequences in relation to personal choices and accountability (Veach & Gladding, 2007). Participants were asked to act out the play and discuss the various choices the characters made in relation to how they would respond and the associated consequences.

With the intention of promoting positive youth development, Dutton (2001) used drama as a preventative measure for preadolescent youth. Positive youth development included building competencies, increasing the teens self-worth, and promoting the recognition of individual and group strengths (Dutton, 2001). In this type of drama therapy, the initial step is to form a group, then to get the group to form an identity, and then to get the group to use the forum as a place to enhance decision-making skills. In Dutton’s study (2001), a group of ten members was formed and then asked to put on a performance using any art medium they chose. The group facilitator acted as a monitor, mediator, and was there to reflect the ideas of group members. The main decisions had to be made by the group as a whole. The ten members agreed to do a Hip Hop drama, and created their own group name. The group was provided with a snack, over which they discussed ideas, concerns, and problems. They also created their own session times to accommodate students with busy schedules, and agreed to go see a different play outside of therapy to get ideas. Eventually, the group chose and performed Romeo and Juliet, which included setting up a dress rehearsal, charging admissions, advertising, and selling concessions during intermission. Allowing the teens to create together and agree on all major decisions, promoted a sense of autonomy, and helped in the development and verbalization of problems, concerns, and decisions. Granted this creative modality generates a sense of autonomy and prosocial behaviors, certain populations of youth may not benefit from such a therapy as it relies heavily on participant responsiveness and group work.

Activity Therapy

Activity therapy is basically the extension of play therapy with children, however, developmentally appropriate (Paone, Packman, Maddux, & Rothman, 2008). For the most part, the literature shows that activity therapy with adolescents is often used to promote a sense of achievement, teamwork, and prosocial behaviors (Veach & Gladding, 2007). Paone et al. (2008), used activity therapy with at-risk ninth grade students to examine the effects of group work on the development of moral reasoning. Paone et al. (2008), measured moral reasoning via pre and post test scores on the Maintaining Norms Schema Subscale of the Defining Issues Test 2 (DIT-2). This study addressed issues regarding the adolescent struggle of autonomy versus the constraints of social authority. Paone et al., (2008) posited that the moral values that help humans make decisions about what is right versus what is wrong, are formed by the observed patterns each individual learns(or perceives) in his/her social surroundings. This notion supported the use of the group as a social support unit and environment to observe and re-learn new behaviors or thoughts.

Participants were split into 12 small groups (N = 61) and received either group activity therapy (GAT) or group talk therapy (GTT). Each group was given 5 different dilemma situations over the course of 10 weeks.  While the GTT group simply talked through the issues and consequences presented with the dilemma, the GAT group had several stages.  First, the GAT group was presented with the dilemma by the group facilitator, then the group participated in a developmentally appropriate structured activity relating to the dilemma. Afterwards, the members could have free play by themselves or with other members, and the final stage consisted of a snack and discussion table.  Throughout all of these stages the facilitators reflected feelings, content, and behaviors to be incorporated in the activity (Paone et al., 2008).  The results revealed that the increase in moral reasoning was greater for those who had received the group activity therapy intervention. This creative therapy is heavily structured, but implements movement, interest (or fun), and interaction. The idea that youth can learn by simply being youth and having fun, was important in understanding how group activity therapy works. With this technique, teens can do developmentally appropriate activities that are set up within the context of situation the group facilitator desires the youth to derive knowledge from. Activity therapy allows for adolescents to actively make personally relevant choices/decisions as it relates to a problem, as well as see other ways to handle the same problem.

Art Therapy

Art therapy (visual art) has been used with a variety of juvenile populations. Hartz and Thick (2005), used visual art therapy with female juvenile offenders and found that it improved their self-esteem. They also found relevance for the discussion of social change elements when the group was discussing each other’s art work. Fliegel (2000) and Vick (1999), found that art therapy was useful in short-term psychiatric inpatient treatment programs for adolescents. An abundance of literature exists on the use of art therapy with sexually abused adolescents, and adolescents who suffer from chronic and acute illnesses. Unfortunately, most of the research with these two populations of teens in particular is focused on females. The emotional component of expressive art is used to its advantage with these two juvenile populations.

Pifalo (2002) found that art therapy provided female adolescents with a sense of power and control, which increased their overall self-esteem. Allowing the adolescents to explore their emotions in creating art and then attaching their own meaning to it put the power back into the hands of the victim. Pifalo (2002) also found that therapy through art reduced the anxiety, posttraumatic stress, and overt disassociation of adolescent victims. Backos and Pagon (1999) revealed similar results with their study of female adolescent sexual abuse survivors. They found that art therapy allowed survivors to first withdraw, then reflect, and finally explore their associated emotions and thoughts. The goal of their experiment was to assist adolescent survivors in forming a sense of a unified persona, with a feeling of mastery, or control over his/her life (Backos & Pagon, 2008).

According to Baerg (2003), many adolescents may not have the words to effectively express the depth of emotion they feel with regards to their sexual abuse or medical illness—art operates as a modus to express first, explore, and then attach meaning. Baerg (2003), who does art therapy with adolescents with chronic or acute illness, states that her role as the therapist is to make general and encouraging comments about the artwork group members present, and allow that individual to discuss their own work further, find their own meaning, and provide their own insight. The use of art in this fashion allows adolescents to feel in control, and provides them with the opportunity to explore those emotions and thought processes. Baerg (2003) also found that with adolescents suffering from a medical illness, showcasing his/her art work was an important part of group and individual therapy, because it enabled the members to tell their story as they perceive it in a very supportive setting (which an individual may or may not have outside of the group; Pifalo, 2002).

Conclusion

What seems to be an important focus of group therapy with adolescents is the fact that during this developmental stage, an individual may be struggling with more than a clinically diagnostic disorder (i.e. psychotic disorder, personality). Most teenagers are in that stage where they are trying to figure out who they are and who they want to be. Alongside the question of self-discovery, adolescents struggle to be independent, productive and successful, but they also fear the responsibilities associated with independence (Richmond, 2000). Both of these concerns result in conflicts with self-confidence and self-esteem, especially if the youth exist in an environment that lacks social support or proper role models of the desired success. What I found interesting was that the use of creative mediums in group therapy with adolescents often aimed to address these two over-arching issues.

Structure is a major element of therapy to be conscious of when using creative techniques, because adolescents do require more structure than adults in order to reach a therapeutic goal. In some art therapy settings, facilitators actually went as far as lighting a candle at the beginning of the session and blowing out the candle before the end of the session. The symbolic boundaries the lighting created allowed for the emotions or trauma an adolescent may have been expressing during the session to remain contained in that setting so the depth of the experienced emotions did not flow over into participants daily lives. In another study, the art materials were set up as a demarcation of creative space versus discussion and instruction space.  There also appeared to be more use of foods/snacks in group therapy with adolescents, which, from my experience, is a fantastic idea.  In a couple of the studies I presented, a snack was set up to separate the space of creation and activity, from the discussion and social interaction space.

Prior to doing the research on various creative group therapy methods, I thought that expressive arts was seen as ineffective or a waste of time in the therapeutic arena, but I found that most of the creative art therapies with adolescents are used in brief, or short-term therapy. For example, the predominate number of the studies presented in this paper had a therapy period of approximately 10 sessions or 10 weeks. Because I desire to do clinical work with both children and adolescents in individual and group settings, I was excited to discover that these creative methods really are not all that unconventional. I was impressed with how easily applicable creative methods are to theories such as cognitive behavioral, positive, existential, and humanistic.

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