Jeffrey Fisher, M.A.

Anger out of Control? Maybe your thinking patterns are a bit out of whack.

Jeff — Thu, 29 Dec 2011 05:54:07 +0000

If you find yourself getting angry a lot when others around you are relatively calm it may be for a number of reasons. Lack of sleep, depressed mood, a low tolerance to stressful situations, and thoughts and/or expectations that may not really be all that realistic.

Of course anger management is a fairly dense topic and we all deal with our anger in different ways, nevertheless if you do have some anger issues (a little too much, a little too often, a little too intense) you may want to think a little bit about how your thinking style may cause your anger to escalate.

Do you have any of the following kinds of thoughts/beliefs/assumptions?

I can’t be wrong. It’s a sign of weakness.
When someone drives poorly/ doesn’t keep things neat/ doesn’t do well in school, etc. - it’s clearly intentional (not lack of skill).
Most of the time I’m right and others are wrong.
Most people can’t be trusted.
The louder I get the more people respect me.

There are many more thoughts and feelings common to those who have issues with anger management. What most of them have in common is some level of distortion. That means that they are based on a faulty believe system that tends to filter thinking in ways that are not always true and not always healthy.

While it’s likely that some of these beliefs might have honest roots in early experiences, they don’t typically allow others to have the benefit of the doubt. In fact they often don’t represent what’s true at all. For example, taking the last statement, “The louder I get the more people respect me”. That’s really not the case at all. The result of loudly making a point is that others often feel that responding truthfully will probably get them into more trouble. Others may also react by being “loud” or by “shutting down”. These types of responses are not great for building closeness or intimacy. In fact significant anger issues in relationships make relationships often make it challenging to stay connected. They certainly don’t enhance connection.

While the above information needs to be considered when addressing anger management concerns it’s definitely only one piece of the puzzle. An angry person definitely benefits from increased body awareness, improved assertiveness skills, conflict resolution techniques. In short, anger management techniques holds the promise of developing a range of skills to connect more calmly and effectively with others.

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What can help me sleep when I’ve tried everything else?

Jeff — Tue, 05 Jul 2011 23:53:51 +0000

Well by now you’ve probably figured out that this is a trick question. Since there really is a wide range of things that you can do to assist with sleep it’s important that you have a sense of what they are, and follow through with the most reasonable ones for you until you are successful. You can be sure that anybody you talk to will be full of ideas about what you can do to sleep better. Sometimes it’s just better to go with what’s recommended by the experts. You be the judge.

I’ve worked with several hundred clients with sleep problems over the years and have seen that some simple strategies, implemented regularly, results in long lasting improvements in sleep. So going back to the original question “What can help me sleep when I’ve tried everything else?” I would say trying all the right things consistently.

So what are the right things? The following is a good start.

What has been shown to help improve sleep

Get up at the same time every day. You might think to yourself that this could not possibly make sense particularly if you find yourself waking up exhausted. The tendency is to want to sleep in. In reality our internal clock mechanism is most easily set to our morning wake time. This is why people who find themselves in a new routine, that involves consistently waking up at the same time, often find that their sleep patterns fall into place quite readily. So do yourself a favor and get up at the same time of day, even if initially it results in greater feelings of fatigue.
Do not lie in bed for more than 20 minutes if you are still awake. This one is a hard sell. Why would you want to leave your bed when the point is to actually sleep. Well the reality is that if you are trying to fall asleep, and you still find that your wake after 20 min, you’re likely not all that relaxed. It’s really important that the bed be associated with sleep and not stress. So the best thing you can do at this point in time is to actually leave the room, and perform some boring activity, until you can no longer keep your eyes open. When you’re just at that point when you can hardly keep your eyes open return to your bed and hopefully I’ll have better luck this time. One really important part of this step is to make sure that you only “estimate” the 20 minutes. You don’t want to be looking at the clock since that’s potentially another anxiety producing behaviour.
Clear your head. How many times have you found yourself wanting to fall asleep and realizing that they are a number of things that you forgot to do that day or some issues that keep replaying in your mind. This really is not going to be helpful if your intention is to have a good night sleep. So sometime, within a couple of hours of bedtime, right down outstanding issues on a piece of paper and a list of actions that you can take to address them the following day or sometime after that. Many will find that this simple act helps their mind become clear and therefore more likely to be conducive to sleep.
Save your bedroom for sleep and sex. Arguing, watching TV, exercising, ironing, and other activities are best done elsewhere. If you save your bedroom for sleep and sex then you are establishing a set of cues for the room that will help remind your body that the room has only a couple of purposes.
Set the stage This can involved taking a warm relaxing bath before bed, although many suggest that a cold shower prior to bed can be beneficial. You might also want to practice relaxation techniques right before bed. Practiced regularly this can not only help to initiate sleep but improve the quality of sleep. Setting the stage certainly does not watching something stressful on TV, particularly the news. Shut the TV down early.

One thing that is worth appreciating is that most people have issues with sleep some of the time. Whether it be as a result of our diets, changes in routine, a particularly stressful series of circumstances in one’s life–most of us are challenged by sleep at times.

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Too much stress . . . solved

Jeff — Sun, 16 Jan 2011 08:44:54 +0000

Canada’s national newspaper, The Globe and Mail, published an article a while back entitled “Stress: How your Busy Life is Killing You”**.

It was a fascinating article, full of research on the ways that too much stress affects us physiologically. The author mentioned that high levels of cortisol and adrenalin affect fat stores and result in high rates of obesity. It also can result in an increase in the production of cholesterol, as well as generally setting the stage for more rapid aging and age-related illness.

It now appears that work-life balance is one of the major culprits. Too much email, long commutes, arguments at home, stress at work from cranky bosses, lack of recognition and too much work can start to eat away at ones health. What’s fascinating, and somewhat frightening, is that people that do not learn to keep their stress to a manageable level can become hyper-secretors of cortisol — and continue to remain so. And ongoing stress can cause changes at the cellular level that result in chromosomal changes and more rapid aging.

4 Things you can do right now to manage your stress more effectively

1. Really put things in perspective.

When you are feeling that what you are currently experiencing is intolerably stressful, is it really? When you look at what’s going on for you do you think you might look at it differently tomorrow? How many times have you felt that you can barely cope and then discover that you feel absolutely fine when you wake up the next morning?

And even if it is the most stressful event or situation you’re experienced in a while can you talk to someone about it who is good at putting things in perspective for you? If you can’t speak to that person can you imagine what that person would say if he/she heard about the situation?

The point of the matter is that much of what makes things feel stressful for us is the twist we put on them. Some people catastrophize unnecessarily. Do you?

2. Learn to track simple triggers

We are creatures of habit. Some of us have routines and structure that ultimately reduce stress. Others of us continuously engage in habits that increase our stress levels.

Lately I’ve been reminded of the simple memory aid called HALT.

For those of you who don’t know what this stands for, each letter reminds us to look at what our immediate need might be. Addressing those needs can often be hugely helpful.

The H stands for hungry.

The A stands for angry.

The L stands for lonely.

And the T stands for tired.

But so often we don’t look at the fact that failing to attend to immediate, simple needs can often be the source of our stress. While we may find ourselves becoming increasingly irritable we sometimes fail to see simple solutions.

Some of my clients fail to notice that addressing factors from the above list can significantly reduce their levels of stress. Many don’t realize, for example, that blood sugar levels from poor diet or irregular eating can strongly influence the way we act to stressors. One of my friends knows that he cannot talk to me about important issues if he hasn’t eaten in a while. He might say something like “Jeff, let me get something to eat before we talk about this. Otherwise I’ll just be grumpy.” I feel that this level of self-awareness is quite beneficial for him. He knows that certain things that he can easily do will prevent him from being reactive.

This is a type of awareness that is worth developing. So the above mnemonic – HALT - can be really helpful in reminding people that there are simple things that they can do to keep their level of physiological reactivity to stressors at a minimum.

3. Get organized

Some people are habitually disorganized and fail to see the possibility of change. Even though they want to change they figure that their habits are so ingrained that change will never happen. In reality it is very difficult to develop organization skills but those who try different approaches really have a better chance of maintaining a reasonably organized life. And feeling organized can certainly drop levels of experienced stress significantly.

Another approach that is often useful for individuals that struggle with disorganization is to consider whether what challenges you can be delegated. For example if it is overwhelmingly frustrating to do your own taxes, you may want to consider lowering your stress level by simply giving the information to a professional.

4. Taking time each day for some form of mediation or relaxation approach

There is simply a massive amount of evidence that practicing some form of relaxation or meditation technique on a regular basis can have significant reduction in stress levels and improve health and longevity. You can readily find this information in research journals or by doing a search on the internet.

Aside from the physical benefits (and clearly related to them) are the emotional benefits which include:

Gaining a new perspective on stressful situations
Increased self-awareness
Increased capacity to be in the present
Reducing negative emotions
Improved rest and sleep

**http://www.theglobeandmail.com/news/national/time-to-lead/work-life-balance/stress-public-health-enemy-no-1/article1778188/

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Being Assertive, Being Balanced – It has a pay off.

Jeff — Wed, 15 Dec 2010 06:35:46 +0000

Real assertiveness is personal power. It means that you have learned that your feelings and your thoughts are worth expressing if they are important enough to you. It means you have learned to understand that you have a place in this world, and that you value yourself enough to claim it. On the other hand, being truly assertive means that you also appreciate the fact that others have the same rights as you. You are not offended by the assertiveness of another but are able to dialogue with another assertive person, both clear about who you are and what you both need.

Being assertive by no means means that you always get what you want but it can help intensify your sense of self, your value, your right to express who you are and what you need. And that’s a great feeling.

The challenge with assertiveness is that people who don’t do it, often have a hard time fully integrating a belief that they can. This is often because they have received the message that what they say is not important, which of course can translate into the sense that they themselves are unimportant.

Sometimes early efforts at assertiveness overshoot their mark and may feel like aggression to the receiving party. I always think it’s helpful to let others know if you’re working on being assertive. That way they might “cut you some slack” and let you know if your delivery is perhaps a little too harsh, while (hopefully) still supporting your efforts.

I have always liked the following Assertiveness Script which is suitable to use with people that are important to you. It may feel a bit contrived but it becomes more natural with practice.

Assertiveness Script

1. “I think I understand that you. . .” (statement of empathy). eg. are preoccupied with a number of things in your life

2. “But when you . . ” (description of behaviour). eg. miss appointments that we have made

3. “I feel . . ” (expression of feeling). eg. annoyed, sad, etc.

4. “Because. . .” (expression of impact). eg. I feel I could have filled my morning with other things

5. “I would prefer that you. . .” (specification of desired behaviour). eg. Call me well in advance to cancel instead of not showing up

6. “And if you do, I will. . . ” (positive consequences of desired behaviour change). eg. be glad to reschedule at a time that is convenient to us both.

7. “I am concerned because. . .” (affirmation of the relationship). eg. I value my connection with you.

8. “How can we work together to. . . ?” (request for mutual problem solving). eg. sort out this issue

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Accept your anxiety and commit to your life

Jeff — Mon, 06 Dec 2010 02:26:06 +0000

When I first read about Acceptance and Commitment therapy I have to say that it made more sense to me than pretty well any other approach I’ve studies that addresses anxiety. As a society, we’re pretty much conditioned to look for ways to reduce unpleasant symptoms. If you’re experiencing anxiety you will want to make that anxiety go away, and one of the best ways is to simply avoid situations that triggers anxiety or makes it worse. But is that really good for you? Intuitively we know that it isn’t. If you avoid school, my job, or an important issue in my life how could that actually be beneficial. It actually means that you are closing off important parts of your life because of the symptoms. In short, anxiety is controlling you.

The goal of Acceptance and Commitment therapy is quite different than many other anxiety reduction approaches. It is to increase psychological flexibility so that one can be fully present in the moment and act according to whether the action taken is in line with one’s values – regardless of uncomfortable sensations or distorted thinking. Dealing with emotions this way means that you are willing to acknowledge that life can be challenging, and your thinking can be unproductive, but that when you actually look at what you value and wish to achieve, moving forward means being aware of some of the challenges – including symptoms of anxiety – but recognizing that what you achieve is based on what is really important for you to achieve —- a fuller life that is not controlled by symptoms.

If you ask the most successful people in your life how they move forward despite their anxiety and self doubt they will often say that the just push through it all because they know where they want to end up.

The following are the core principles of Acceptance and Commitment Therapy:

Cognitive defusion: Learning to perceive thoughts, images, emotions, and memories as what they are, not what they appear to be.
Acceptance: Allowing the thoughts to come and go without changing them.
Contact with the present moment: Being open and aware in the present moment.
Observing the self: Observing everything that is the self which includes thoughts, feelings, and sensations
Values: Discovering what is most important to the true self. What one values and wants to create.
Committed action: Setting goals according to values and carrying them out responsibly.

It’s really about finding balance but still moving towards what you want in your life.

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8 Ways to lower your level of Self-Esteem

Jeff — Fri, 19 Nov 2010 06:23:46 +0000

While it’s quite clear that most people would not consciously want to lower their level of self-esteem, many many have mastered this ability through a combination of beliefs, thoughts and actions. Thinking patterns can become distorted, and often from an early age. Sometimes my clients were made to feel that they had to try extra hard just to be accepted. Others continually strived to achieve, and even then received the message that they weren’t competent. Some have been emotionally or physically abused, and as a result of that felt that they were somehow or other damaged.

Anyways, here are 8 ways to lower your level of Self-Esteem:

Get involved in relationships with people that remind you of ones who frequently criticized you when you were young. Try to get them to recognize your strengths.
Avoid anything that is anxiety provoking and try not to challenge yourself to do something when you feel anxiety.
View any criticism that you receive as simply another indicator that you’re just not good enough.
Promise yourself you’ll engage in some activity. Fail to do it. View that as yet another confirmation that you are useless.
Practice daily positive affirmations thinking that that alone will change the way you feel about yourself.
Compare yourself with other people as often as you can, using standards that are irrelevant to who you are as a person.
Look back on all of your failures regularly without tuning in to any of your achievements
Project a never-ending series of failures into the future rather than visualizing success.

Of course this is the type of list that could go on and on. Many of us do have histories that influence how we view ourselves today. Part of the solution, of course, is to look at our own patterns and start to take a closer look at how they might have developed. Then we have the opportunity to look at which patterns are no longer serving us well and begin the process of change.

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Hungry, Angry, Lonely, Tired

Jeff — Fri, 29 Oct 2010 05:55:45 +0000

The short form of the title is, of course, H.A.L.T. which is a memory aid used with some success in drug and alcohol recovery. Connecting to the mneumonic, at the right time, is sometimes enough to prevent someone from going for a drink or using their drug of choice. It’s just one of those tools that can increase self-awareness and that might cause someone, who might not otherwise do so, to replace unhealthy solutions with healthy ones when anxious or angry.

I have a friend, whom I’ve always admired, who occasionally stops me in the middle of a conversation to tell me that he needs to eat something. It seems that his physiological makeup requires that he eats at very specific intervals otherwise he may get anxious, irritated, or angry in situations that don’t seem to warrant it. What impresses me about this is his ability to recognize that in order to remain civil and connected with his friends he sometimes has to assert himself and explain that having a bite to eat will make him far more enjoyable to be around.

Interestingly enough, I have told this story to many clients. Some have a particularly difficult time with self-awareness and taking care of their own needs. It’s wonderful when they begin to understand that both can actually be a healthy sign of healing.

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Why is my practice about finding balance?

Jeff — Thu, 28 Oct 2010 07:09:27 +0000

I know that in order to effectively work with my clients that I need to be present for them. I also know that in order to be present I need to be able to leave behind any minor (or major) irritations that may have accumulated over the recent past. I need to be present with myself – which means with my thoughts, my feelings, and the sensations that accompany them. When I can do that, my clients know it, and they feel safe to share and they are better able to be present.

When we learn to be “in the moment” we can see things with a fresh perspective. We can process emotions in a healing way. We can accept ourselves more readily.

When we are not “in the moment” it is more easy to get stuck in thinking patterns that get us nowhere. Our thinking can become more critical and more stuck. Our worries, our regrets, our anxiety can all solidify.

Being in the moment allows everything to be present in a balanced and more healing way.

Hopefully you found this information useful. If you feel that you need some additional assistance to address your stress levels, please feel free to contact me at 604 729-6059 or via the email form on the contact page

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The Power of Relaxation Techniques

Jeff — Thu, 21 Oct 2010 03:34:53 +0000

I have to say that in my work as a therapist over the past 20 years there are many things that help clients move through their concerns, their anxieties, their stuckness. With time clients often learn to marvel at how they have come through some of the most difficult challenges with new perspectives and renewed strength.

Many are able to see everything from a fresh and healing perspective when they find ways to to quieten their nervous system through meditation or relaxation techniques which, of course, take practice and perseverance.

One simple but highly effective practice is diaphragmatic breathing. To experience it do the following:

Diaphragmatic breathing technique

1. Lie on your back on a flat surface, with your knees slightly bent and your head supported. You can use a pillow or a bolster under your knees to support your legs. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.
2. Breathe in slowly (through your nose) so that your stomach moves against your hand. The hand on your chest should remain as still as possible.

3. Tighten your stomach muscles slightly, letting them fall inward as you exhale through pursed lips. The hand on your upper chest should remain as still as possible.

When you first learn the diaphragmatic breathing technique, it may be easier for you to follow the instructions lying down. As you gain more practice, you can try the diaphragmatic breathing technique while sitting in a chair.

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