Research on mental health and pet ownership has consistently shown that owning pets, particularly dogs and cats, can have a positive impact on mental well-being. While pets cannot replace professional mental health care, they can offer significant psychological benefits that contribute to reducing stress, improving mood, and enhancing overall emotional health. Below are some key findings from the research: 1. Reduction in Stress and Anxiety • Lower Cortisol Levels: Several studies have found that pet ownership, particularly of dogs, is associated with lower levels of cortisol (a stress hormone) and lower blood pressure. Interacting with pets can trigger a calming response, reducing the physical symptoms of stress and anxiety. • Increased Relaxation: Petting a dog or cat has been shown to activate the parasympathetic nervous system, which promotes relaxation and helps counterbalance the fight-or-flight response. Studies show that spending time with pets can lower heart rates and reduce anxiety, even in people with anxiety disorders. • Support for Anxiety Disorders: Research suggests that pet ownership can offer emotional support to individuals suffering from generalized anxiety, social anxiety, and other anxiety-related disorders. Pets provide a sense of safety and companionship that can alleviate anxious thoughts. 2. Improvement in Mood and Depression • Mood Elevation: Pet ownership is associated with improved mood and reduced feelings of loneliness. People with pets often report higher levels of happiness, contentment, and life satisfaction. The bond between a pet and its owner provides emotional comfort and an avenue for unconditional love and affection. • Combatting Depression: Pets, particularly dogs, have been shown to provide emotional stability and companionship, which can help reduce symptoms of depression. Pet owners often experience feelings of purpose and connectedness, which are essential for improving mental health. In fact, people with pets tend to report fewer depressive symptoms compared to those without pets. • Engagement in Social Interaction: For individuals with depression, pets often serve as a catalyst for social interactions. Walking a dog or attending pet-related events can help people connect with others, improving feelings of isolation and loneliness, both of which are common in depression. 3. Increased Physical Activity and Mental Well-being • Physical Exercise: Dogs, in particular, require regular walks, play, and exercise, which can encourage pet owners to be more active. Increased physical activity has been shown to have a direct impact on mental health, helping to reduce symptoms of depression and anxiety and boost overall mood. • Routine and Structure: Pet care requires a level of responsibility and routine, which can help individuals, particularly those struggling with depression or other mental health issues, create structure in their daily lives. The act of caring for a pet can promote feelings of competence, control, and self-worth. 4. Reduction of Loneliness and Social Isolation • Emotional Support and Companionship: Pets provide unconditional companionship, which can be especially beneficial for individuals who are socially isolated or live alone. Pet owners often report feeling less lonely, as pets are seen as non-judgmental, loyal, and always present. • Social Interaction: Pet ownership, particularly of dogs, often encourages social interactions with others, such as neighbors, other dog owners, or community members. This can help reduce feelings of social isolation and increase opportunities for forming connections and friendships. • Boost in Social Confidence: Having a pet can also improve social confidence, especially in people with social anxiety. Pets can act as a social bridge, helping their owners feel more comfortable in social situations by giving them something to talk about or by providing a sense of security. 5. Emotional Benefits of Pet Attachment • Bonding and Attachment: Pets provide a secure attachment figure for many individuals. Attachment theory suggests that having a loving and caring relationship with a pet can fulfill emotional needs for affection, comfort, and security, especially for those who may have experienced trauma or emotional distress. • Psychological Safety and Comfort: For people with PTSD, emotional support animals (ESAs) can offer comfort during distressing moments. Research shows that having a pet can reduce the frequency of PTSD symptoms, such as hypervigilance, anxiety, and nightmares, by offering a calming and grounding presence. 6. Cognitive and Therapeutic Benefits • Cognitive Stimulation: Interaction with pets can help stimulate cognitive function, particularly in older adults. Pets can provide mental stimulation through play, training, or simply the need for care, which helps keep the brain engaged and sharp. • Therapeutic Use of Animals: Animal-assisted therapy (AAT) is increasingly recognized as an effective treatment for mental health conditions. AAT involves the use of trained animals, often dogs, to help individuals with various psychological issues, including anxiety, depression, and trauma. Pets are used to help clients feel safe, calm, and more open to engaging in therapy. • Improvement in Children’s Mental Health: Research has shown that children with autism or anxiety disorders can benefit from animal-assisted interventions. Animals can provide a calming influence, teach empathy, and improve social skills. 7. Long-Term Effects on Mental Health • Companionship Over Time: The long-term presence of a pet in an individual’s life can help provide ongoing emotional support, promoting sustained improvements in mental well-being. This is especially true for elderly individuals, who may experience loneliness or isolation as they age. • Pet Loss and Grief: While pets provide many psychological benefits, the loss of a pet can also trigger grief and emotional distress. However, this grief can also foster healing and self-compassion, as pet owners reflect on the loving bond they shared with their animal and the positive impact it had on their mental health. 8. Pet Ownership and Specific Populations • Veterans: Many studies have shown that veterans with PTSD benefit from pet ownership, particularly service dogs or emotional support animals. Dogs can help veterans feel more secure, manage anxiety, and reduce PTSD symptoms by providing a sense of safety and companionship. • Older Adults: For older adults, having a pet can combat loneliness, improve emotional regulation, and provide both physical and cognitive stimulation. Some studies suggest that elderly individuals with pets are more active, healthier, and experience fewer mental health problems than those without pets. • Children: Pet ownership is associated with better social and emotional development in children. Pets can provide a source of unconditional love and teach children important life lessons about responsibility, empathy, and compassion. 9. Barriers to Pet Ownership and Mental Health Benefits • Financial and Logistical Constraints: Despite the potential mental health benefits, not everyone has access to pets due to financial barriers, living arrangements, or time constraints. Pets can be expensive to care for, requiring food, medical care, and other supplies, which can be a significant burden for some individuals, especially those with mental health challenges. • Allergies and Health Conditions: Some individuals may not be able to own pets due to allergies or health conditions that make pet ownership difficult or contraindicated. In these cases, other forms of animal-assisted therapy or interaction with pets in controlled environments (e.g., petting zoos or animal shelters) may be beneficial. Research supports the idea that pet ownership can be a powerful tool in enhancing mental health. Pets provide emotional support, reduce stress and anxiety, improve mood, and help combat loneliness and social isolation. They also promote physical activity, routine, and structure, all of which are beneficial for mental well-being. While pet ownership is not a substitute for professional therapy or medication, it can be a valuable complementary strategy in managing mental health challenges. However, it’s important to recognize that the benefits of pet ownership are not universal and depend on factors such as the individual’s lifestyle, resources, and health conditions. We knew we loved our pets and now we know more about why. Did you learn anything about your furry, feathered, scaley or prickly companion?

Top 12 Myths About Trauma: How Trauma Is Often Misunderstood by Survivors and Their Loved Ones  Trauma is an extremely complex and deeply personal experience, and there are several misconceptions that can lead to misunderstanding, stigmas and barriers to healing. In my work as a counselor, I have found that discussing, working through and processing trauma is often made more difficult when certain erroneous assumptions or ideas about trauma are held.  Here are the 12 most common misunderstandings about trauma I come across during therapy.   1. “Trauma is only about life-threatening events.” • Misunderstanding: Many people assume that trauma only refers to extreme or catastrophic events, such as war, natural disasters, or physical/sexuall abuse. • Reality: Trauma can result from any event that overwhelms an individual’s ability to cope, regardless of whether it is physically life-threatening. This can include emotional or psychological abuse, neglect, bullying, a divorce, loss of a loved one, or even witnessing an event that causes distress. Psychological trauma can stem from seemingly smaller or more personal experiences that affect a person deeply. 2. “People should be ‘over’ trauma after a certain amount of time.” • Misunderstanding: There’s a common belief that people should heal from trauma after a specific period, or that if someone hasn’t moved on, they’re not trying hard enough. • Reality: The healing process from trauma is non-linear and varies greatly from person to person. Trauma can affect people in different ways, and long-term effects can linger, especially if the trauma was prolonged, repetitive, or not properly addressed. Some people may experience post-traumatic stress disorder (PTSD) or other lasting impacts, and healing can take years or a lifetime. 3. “Trauma only affects those who are weak or vulnerable.” • Misunderstanding: There’s a stigma that trauma only impacts people who are “weak” or overly sensitive. • Reality: Trauma can affect anyone, regardless of their strength or resilience. It doesn’t discriminate. In fact, people who are typically seen as strong or high-functioning may be more likely to suppress their emotions or avoid seeking help, which can worsen the long-term effects of trauma. Resilience is not about being impervious to pain; it’s about how one copes with it, and trauma can affect even the most resilient individuals. 4. “You must have clear memories of a traumatic event to have been traumatized.” • Misunderstanding: People often believe that trauma survivors must have vivid, detailed memories of the traumatic event for it to be valid. • Reality: Some individuals may not remember the event clearly or may experience dissociation—a defense mechanism in which the mind blocks out or distorts memories of the trauma. In fact, fragmented or repressed memories of trauma are common, and the lack of clear memories does not mean the trauma didn’t occur or doesn’t have an impact. 5. “Trauma leads to permanent damage or dysfunction.” • Misunderstanding: There’s a misconception that trauma permanently damages a person’s ability to function or live a fulfilling life. • Reality: While trauma can have long-lasting effects, people can heal and recover over time. Many survivors of trauma lead fulfilling, healthy lives, often with the help of therapy, support systems, and coping strategies. The brain also has neuroplasticity, meaning it can heal and adapt after trauma, especially when the individual receives appropriate care and treatment. 6. “Trauma survivors are always visibly distressed.” • Misunderstanding: People often think that trauma survivors must always appear visibly upset, anxious, or distressed. • Reality: Trauma is not always visible. Many people with trauma go on to appear perfectly fine on the outside while struggling on the inside. Survivors may hide their emotions, avoid triggers, or cope in unhealthy ways to mask their distress. Complex trauma, such as ongoing abuse or childhood neglect, can be especially difficult to detect because the symptoms are often more subtle or internalized. 7. “Trauma is only about the event itself, not its aftermath.” • Misunderstanding: There’s a tendency to focus on the trauma event (what happened) rather than the aftermath—how the individual processes and reacts to it over time. • Reality: The impact of trauma often lies not just in the event but in the ongoing effects it has on a person’s mental health, behavior, relationships, and worldview. The way a person internalizes the trauma and the coping mechanisms they develop play a huge role in the long-term consequences. 8. “Everyone reacts to trauma the same way.” • Misunderstanding: People often assume that everyone who experiences the same traumatic event will react in the same way. • Reality: Trauma responses are highly individual. Some people may experience PTSD, while others may show resilience, and still others may cope with the trauma in ways that are not immediately visible. Factors like personality, social support, pre-existing mental health conditions, and coping skills all influence how someone responds to trauma. 9. “Trauma always leads to PTSD.” • Misunderstanding: There is a belief that everyone who experiences trauma will develop post-traumatic stress disorder (PTSD). • Reality: While trauma can lead to PTSD, not everyone who experiences a traumatic event will develop it. Many factors influence whether someone develops PTSD, including the nature of the trauma, the person’s support system, and their coping resources. Resilience and adaptive coping can reduce the likelihood of PTSD, and many people recover without developing it. 10. “Talking about trauma will make it worse.” • Misunderstanding: Some people believe that discussing trauma will only re-traumatize or make the individual feel worse. • Reality: While it can be painful to talk about trauma, processing and expressing it with the right support can be a crucial part of healing. Therapists, especially those trained in trauma-informed care, help individuals process trauma in a safe and structured way. Avoiding the trauma or bottling up emotions can actually make things worse over time. 11. “People who experience trauma will always be traumatized.” • Misunderstanding: There’s a belief that once someone has experienced trauma, they will always be “damaged” or permanently affected. • Reality: While trauma can have long-lasting effects, healing is possible. Many survivors go on to build meaningful lives after trauma, especially with appropriate treatment, support, and coping strategies. Trauma doesn’t define a person’s entire life, and people can grow and find post-traumatic growth after their experiences. 12. “Trauma is only a mental health issue, not a physical one.” • Misunderstanding: People sometimes think trauma only affects the mind and emotions, not the body. • Reality: Trauma has significant physical effects. It can disrupt the autonomic nervous system, leading to chronic stress, muscle tension, digestive problems, and other physical ailments. Somatic therapy and other body-focused approaches often help people process trauma through the body as well as the mind. Overall Takeaway: Trauma is deeply personal and can affect individuals in vastly different ways. The most significant misunderstandings often arise from oversimplifications of what trauma is, how it affects people, and how recovery works. Addressing these misconceptions can lead to greater understanding, more compassionate responses, and better support for those experiencing trauma.  It is especially important for us to not compound and intensify the lasting effects of trauma, by judging our own or others’ response to trauma.   Blame and shame, especially when self-directed are among the most powerful detractors to the path of healing.

#mentalhealth #bodymind #PTSG #lowerbp #TBI #cancer #therapy #counseling #texas #grateful The Miracle Cure That Lowers Blood Pressure, Increases “Anti-Aging” Hormone & Improves Mental Health and Relationships Want to lower your blood pressure, improve your immune system, increase production of the “anti-aging” hormone, DHEA and create more feel-good hormones in your body and brain?   Are you looking to feel more joy and happiness in your life while decreasing anxiety and depression?  Would you like to enhance  both your interpersonal relationships and intrapersonal insight?  If you want to achieve all of this with a simple (FREE) task, keep reading! The Biochemistry of Gratitude Through neuroimaging scans research has shown that when we feel and express sincere gratitude it activates areas in the brain that can synchronize the brain and heart rhythms. The synchrony creates a shift throughout the entire body which produces a scientifically measurable state of mind referred to as coherence.  Self-evoked feelings of gratitude flood our system with the feel-good hormone, endorphins.  It also increases the production of dehydroepiandrosterone (DHEA) which is considered the anti-aging hormone and immunoglobulin A (IgA) our bodies’ first line of defense against pathogens thereby boosting our immune system functioning.  Research has also illuminated that the practice of gratitude is one of the single most reliable means of increasing life satisfaction.   Gratitude Research The 2000s brought more research on the experience and practice of gratitude.  These studies revealed that an attitude of gratitude improves sleep quality.  Individuals also showed to recover more quickly from trauma and emerge more resilient after having experienced trauma.  This decreases the occurrence of PTSD and increases the likelihood of post-traumatic growth following a traumatic experience. Gratitude is also a powerful protector against the negative effects of anger.   The Social and Relational Benefits of Gratitude Gratitude has been correlated with pro-social behavior and increases altruism.  Practicing authentic gratitude is one of the most powerful ways to cultivate compassion and connection in your life.  Moving from a private personal gratitude practice to one in which you directly express your gratitude to the person to whom you are grateful has shown to inspire the recipient of one person’s gratitude  to pay it forward by expressing gratitude towards another person or persons.   Conclusion: A The Prescription for Gratitude Whether it is an intentional practice that you choose to document daily in your calendar or journal, or the last thing you do in your head at night before you go to sleep, practicing gratitude is good for your mind, body and spirit.  Its mental and physical health benefits are proven and powerful.  Gratitude is completely free to practice and is available to everyone, anywhere at any time.  There are no negative side effects and the benefits of gratitude affect not only you, but those around you.  Start now, what are you grateful for today?  (Comment below and spread the word.) References Jarrett, C. (2016, January 7). How expressing gratitude might change your brain. NY Mag . Retrieved from http://nymag.com/scienceofus/2016/01/how-expressing-gratitude-change-your-brain.html   Shaughnessy, M. & Shepherd, J., Gratitude. Salem Press Encyclopedia of Health, 2021. p.3. What is gratitude? (2016). Greater Good: The Science of a Meaningful Life . Retrieved from http://greatergood.berkeley.edu/topic/gratitude/definition

I had the pleasure of working with a transformative non-profit with locations in Fort Worth and Plano called Brain Injury Network, BIN for short. If my three semesters of practicum and internship at BIN taught me anything, it is that to be a survivor of a traumatic brain injury (TBI) one must be a warrior. One would think as an acquired TBI survivor myself that this kind of observation would have been gleaned from personal experience, but I have found that it is in the presence of others we are able to recognize truths that tend to go unnoticed in the echo chambers of our own minds.  Members come to BIN for a plethora of reasons. For some it is with the goal of returning to work, as BIN follows a clubhouse model in which the members run all aspects of the day-to-day operations of the non-profit.  For others it is with the desire to continue physical, occupational and speech therapy when insurance has denied any additional coverage.  Not only do members come to BIN for a variety of reasons, their TBI origins vary, as well.  For some it is due to a brain tumor, some malignant  and some benign.  For others, their life changed in a matter of milliseconds and their stories include everything from near fatal car crashes, motorcycle accidents, gunshot wounds, skydiving accidents, and other life-altering falls and accidents.  Strokes are another common source of TBIs.  In fact, strokes can occur at any age and even in vitro causing a TBI.  The members at BIN are a variety of ages from 18 to 70 and come from all different backgrounds, ethnicities and cultures and travel to the Plano and Fort Worth clubhouses from all over the metroplex and beyond. No matter why or how an individual joins BIN, it became patently clear that they stayed for the camaraderie, sense of purpose and perhaps most importantly, the normalization of their past and current lived experiences.  A common mantra at the clubhouse is, “only another brain injury survivor can understand a brain injury survivor.”  I, too, found great comfort in being with others like me.  It was a sense of belonging I had not felt since I began my TBI journey back in 2017.  While I would not be here if it was not for the unwavering support and love from my family, they also cannot truly understand what living with a TBI on a daily (sometimes hourly) basis is really like.  But, when I walk into BIN, a bit of that weight is lifted.  Being there has the miraculous ability to transform the longing for what was before the TBI, into authentic belonging with others in the present moment.  The profound power one reclaims when we turn our pain (physical, emotional and psychological) into purpose cannot be overstated. All the members at BIN had to fight for their lives.  Surviving a TBI in the face of often slim odds, medical missteps and mistakes, additional critical injuries, health and medical complications, infection and disease, takes a warrior.  In the words of British poet William Ernest Henley’s famous poem Invictus , as neophyte members of BIN, our “head is bloody, but unbowed”.   Following are the top 5 lessons I learned from my experiences at Brain Injury Network that I carry with me and now inform the foundational purpose of Empowered Counseling of Texas, LLC which is to show individuals their warrior within and ability to not just overcome life’s most difficult trials, but to thrive because or in spite of them. Growth and healing comes when you transform your (physical, emotional, psychological) pain into purpose, passion and personal power. To thwart longing, seek belonging. We are all tougher than we think and there is a miracle in each of us. Perception is reality. If your reality is unbearable or undesirable, change your perspective.  If you simply can’t, fake it ‘til you feel it! Obstacles are often cleverly disguised opportunities to take a new or different path. Trade skepticism for curiosity. Invictus  by William Ernest Henley (1849-1903) Out of the night that covers me,     Black as the Pit from pole to pole,   I thank whatever gods may be     For my unconquerable soul.    In the fell clutch of circumstance   I have not winced nor cried aloud.   Under the bludgeonings of chance     My head is bloody, but unbowed.    Beyond this place of wrath and tears     Looms but the Horror of the shade, And yet the menace of the years     Finds, and shall find, me unafraid.    It matters not how strait the gate,     How charged with punishments the scroll,   I am the master of my fate:  I am the captain of my soul.

Counseling Lloyd Dobler from the film Say Anything   I thought it might be helpful for me to look at a character in a movie and develop a treatment plan, protocol and interventions, so that I can share a inside glimpse at counseling.   It also gives me the opportunity to be transparent with you about what the counseling relationship looks like from a therapist’s perspective and specifically how I show up in the counseling relationship without breaking confidentiality nor does ignore the fact that when it comes to humans, mental health professionals, should never diagnose someone with whom they have not personally seen in their practice.I look forward to your thoughts and comments! On April 14 in 1989,  Say Anything , introduced the world to somewhat directionless, but lovable Lloyd Dobler and his crush and eventual girlfriend valedictorian, Diane.  I chose to add the qualifier ’somewhat’ because in the classic scene with Diane’s father Lloyd responded to his question about his future plans with the following: I don't want to sell anything, buy anything, or process anything as a career. I don't want to sell anything bought or processed, or buy anything sold or processed, or process anything sold, bought, or processed, or repair anything sold, bought, or processed.   Following is an overview of what counseling with Lloyd might look like as he and Diane’s life together unfolds.   Psychoeducation: Adolescent and Young Adult Development Adolescence and young adulthood are periods of development that come with continued growth and development in the brain.  Additionally, during both of these periods individuals are individuating and independence, identity development and social relations are one of the central concerns.   While young adulthood is marked with a slowing of physical growth adolescence is marked by continued physical growth and puberty (Boyd & Bee, 2019).   Based on our legal system’s definition of an adult, a common misconception is that at 18 years-old we are done growing and our brains are fully developed.  But in fact, there are two growth spurts that occur in the brain between ages 17 and 22 and again in the mid to late 20s (Boyd & Bee, 2019).  During young adulthood cognition continues to develop in order to address and manage the problems of adulthood which are often complex and multi-layered. Formal reasoning ability no longer suffices as a means to manage the complex issues and decisions adults face.  Developmental and cognitive theorists have labeled this a fifth stage in cognitive development where one develops the ability to accept and manage uncertainty, duality, ambiguity and contradiction in decision-making and life in general (King & Kitchener, 2004). Therapeutic Application  Background Story Llyod Dobler, the male lead in Say Anything,   is an optimistic and lovable underachiever.  To pick up where the movie left off with Diane and Lloyd on a plane flying to England together where Diane’s has been accepted into a prestigious university program.  After living blissfully in England together for over a year, Diane gets news that her father is terminally ill.  The pair return to the United States and Diane enrolls at a local university and emerges herself in her studies and caring for her father.   Llyod’s transition back to the States, however, was not as smooth.  Feeling depressed, Lloyd reaches out to his physician.  He is diagnosed for the first time with ADHD, but does not want to take mediation, thus he is then referred to me for individual counseling (Sawamura et al., 2021). Personal Reflection – Why Lloyd? I chose Llyod Dobler for a handful of reasons.  Like myself, especially at that age Llyod is an underachiever with a huge heart.  Many, many years ago in 1994, when I first attended college, I really began to struggle.  I stopped completing assignment and eventually stopped going to class all together.  After the first semester of my sophomore year, at 19 years-old, I returned home deflated, defeated and depressed.  I began counseling and was subsequently diagnosed with ADHD.  As I began reading about ADHD, I could immediately identify with the symptoms and I found much alleviation of my shame and guilt regarding my lackluster or rather non-existent academic performance.   The juxtaposition of Lloyd’s lack of direction and discipline with Diane’s drive and ambition is exacerbated upon their return.  Diane is easily able to learn from Lloyd and take risks to expand and explore her own identity and well-being.  This is evident from the start of their relationship as she decides to attend the graduation party despite her reserved social nature.  Conversely, Llyod is not so easily able to learn from Diane and the diagnosis of ADHD helps to explain his struggles and the resulting depression he is experiencing.  Diane remains a constant source of support and Lloyd, too, is Diane’s rock and teddy bear.  From all accounts, their relationship remains a bright spot in his world and hers. Following our initial session and assessment, Lloyd completed the VIA Character Strength Survey, which identified his character strengths in order from greatest to least (Peterson & Seligman, 2004).  I chose the strength-based assessment for two reasons.  First, with a new diagnosis of ADHD alongside depression, strategies that lean on the individual’s strengths helps to reframe the previous and current struggles and the new diagnosis (and any shame that may be present around being diagnosed with ADHD) as neurological difference.  Of additional note during the assessment process, Lloyd was identified at an early age as gifted, scoring in the 99th percentile on IQ testing at age 11.  However, his academic performance throughout most of his middle and high school years was abysmal and was certainly not a reflection of his intelligence.  This nugget is especially important considering his late diagnosis and the many years of underachievement in school. Addressing this issue will mean that Lloyd reflects upon this time in his past and how it has affected his self-efficacy and self-concept and we will examine his thoughts and feelings about being diagnosed with ADHD now.  I am curious to learn how receiving this new diagnosis during the dawn of his adulthood has affected his self-concept and identity. Lloyd is passionate about kickboxing, but since returning to the U.S., he has been unable to re-engage with the sport as competitor.  Upon returning, he reports that he began teaching children’s  kickboxing classes at the same gym at which he trains, but still has not engaged in any competitive matches.  He is concerned that at his current age, now 20 years-old the window to become a professional in mixed martial arts (MMA) is quickly closing.  While training and competing was always a place Lloyd excelled despite that it required great discipline, focus and tenacity.  However, it, too, eludes him, now.  Currently, he is struggling to motivate himself and to maintain consistent effort and drive in his pursuits.   Following our initial session and assessment, Lloyd completed the VIA Character Strength Survey, which identified the his character strengths in order from greatest to least (Peterson & Seligman, 2004).  I chose the strength-based assessment for two reason.  First, with a new diagnoses of ADHD alongside depression, strategies that lean on the individual’s strengths helps to reframe the previous and current struggles.   I will provide a safe space for Lloyd to better understand his new diagnosis and express any and all emotions, frustration or shame that may be present around being diagnosed with ADHD, especially later in life.  I believe reframing ADHD as neurological difference that has its benefits as well as challenges will be important, as well (Sawamura et al., 2021) Of additional note during the assessment process, Lloyd was identified at an early age as gifted, scoring in the 99th percentile on IQ testing at age 11.  However, his academic performance throughout most of his middle and high school years was abysmal and was certainly not a reflection of his intelligence.  This nugget is especially important considering his late diagnosis and the many years of underachievement in school. Addressing this issue will mean that Lloyd reflects upon this time in his past and how it has affected his self-efficacy and self-concept and we will examine his thoughts and feelings about being  diagnosed with ADHD now (Galvez-Contreras et al., 2022).   Treatment Plan Including  Orientation of Techniques Following are the therapeutic techniques initially employed while working with Lloyd along with the theoretical orientation from which they were derived and excerpts from our conversation during session (Neukrug, 2019): VIA Character Strengths — Positive Psychology & Strengths-Based Counseling  Hope Humor Hope Perspective  Appreciation of Beauty & Excellence Honesty Spirituality Love of Learning Gratitude Fairness Sparkling Outcomes/ Exceptions — Narrative Therapy & The Miracle Question — Solution-Focused Brief Therapy (SFBT) Utilizing  the techniques from narrative therapy and SFBT, I inquire about a time in Lloyd’s life where he felt the most focused and driven.  Was there a time in his life where he did not struggle with discipline and drive?  An excerpt of the conversation follows: Me : Lloyd, can you think of a time during your life, when you felt the most focused and driven? Lloyd : Hmmm,…well, my sophomore year in high school I transferred to a new school.  I had joined the wrestling team for the first time and it felt like everything was coming together, like maybe the fresh start helped…but, I was not just focused on training, but was also in the zone at school. Me :  Can you tell me a little bit more about what was going on in your life at the time?  What was the reason for the transfer? Lloyd :  I was at my home school and I got in a fight with this asshole who was constantly picking on and making fun of this other kid, who was a family friend with severe learning problems.  I was able to stay in the district and transferred to another high school. Me :  At 15 years-old trying to protect and stand up for your friend against someone who was preying on him, because of his learning differences, only to be expelled must have been confusing and disheartening.  How did you manage to recover from this to go on and have the most focused and driven period in your life?  Lloyd :  I know, that when I transferred from Lakewood High School, I went in trying to see it as a fresh start…I remember reading a lot and always having a book with me…Just prior to the fight and expulsion, I had done something that I have done multiple times usually only to turn around and purchase another, I sold my X-Box.  So, yeah, when I started at the new school I did not have an X-Box but I had wrestling training and competitions to fill my time.  Oh,…I just remembered that during the fight my phone was crushed and completely inoperable to the point I threw it away, so I didn’t have a phone at the time either.  Don’t get me wrong, I do like to read, but I think the book initially was more about having something to do while everyone else was on their phone. Me : Wow, there is a lot there for us to unpack there!  Knowingly or unknowingly you employed some strategies then that were extremely effective.   You reframed the situation in your mind, so that you could in turn, behave and feel differently in this new environment.  Very insightful, Lloyd. Lloyd : Yeah, I guess so.  I never looked at it like that before.   Me :Additionally, what stands out to me is your decision to completely remove of certain distractions all together, like your cell phone and X-Box.  Can you tell me more about coming to that decision? Lloyd : Yeah, um,…I never thought about that.  I was just committed body and mind, you know? Me :  Yes, exactly!  I wonder what your training regiment and competitive efforts might look like in the future, if you were to eliminate certain distractions that may be competing with and/or deterring your focus and drive? Lloyd :  Maybe more like it did my sophomore year… Me : Over the next week, could you spend sometime, just noticing where your time is spent.  I can provide you a blank hourly worksheet to document your activities until our next session. Understanding first, where your time is spent and then examining the benefits or detriments of those activities will help you to become more intentional with how you spend it and to what ends.   Mindfulness Meditation & Urge Surfing — Dialectical Behavioral Therapy (DBT), Existential Therapy, Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT)  Mindfulness meditation and urge-surfing are techniques that run counter to CBT’s efforts at changing one’s thoughts to change one’s behavior.  Rather, mindfulness meditation and urge-surfing are about accepting one’s thoughts as merely that, just thoughts.  The concept of urge-surfing applies the concept mindfulness to the sensation of an urge.  Allowing oneself to sit with urges without responding to them and noticing the feelings emotions and thoughts that come up diminishes the power the urges have on one’s behavior (Neukrug,. 2019).  Following is an excerpt regarding mindfulness meditation and the practice of urge-surfing: Me : I know you are very familiar with Eastern traditions through you study of mixed martial arts. Lloyd :  Yeah, its fascinating. Me :  Have you ever meditated or engaged in a meditative practice. Lloyd :  Actually, yes, some of my teachers throughout my training had us meditate at the beginning or end of class and I had a coach once that always made me do what he called breath work every time before  I stepped into the ring. Me :  Say a little more about your experience with breath work and meditation, how was it for you in the moment? Lloyd :  Hard,…impossible almost when I was younger.  It used to drive my instructor up the wall, because I couldn’t sit still much less meditate, but when I worked with Master Takashi, the breath work really centered me.    Me :  I wonder what your thought are on re-engaging in that practice.    Lloyd :  I am totally open to that and I think that would be really helpful. Me : Does five minutes a day seem like a good starting place or would you prefer to start with two minutes a day?  I am more interested in you doing it everyday than how long you do it, so make it something you feel is relatively easy to begin.        Lloyd :  Okay, that makes sense.  How about three? Me :  You tell me. Lloyd :  Three it is then! 10-Minute Rule    (Ramsey & Rostain, 2015; Otto et al., 2011) — Cognitive Behavioral Therapy (CBT) During the assessment and also in the sessions that followed, issues with procrastination and initiating or  beginning activities..  After exploring any possible underlying causes and identifying the task or activity that Lloyd currently found most abhorrent thus experienced the most difficulty when attempting to engage in or begin the task, I employed a technique common to CBT by asking Lloyd the following (Ramsey & Rostain, 2015; Otto et al., 2011): Me :  Even though it may be difficult and uncomfortable feeling may arise, how much is the minimum amount of time you commit to being at the sparring and competition gym? Lloyd : Since we’ve been back, I have yet to set foot in that gym…I know it’s crazy,…or kinda sad, but I am fine in the main gym.  I workout and teach in the main gym, but the SAC (sparring and competitive) gym…? Me :  Tell me what could or will happen if you were to spend any amount of time in the SAC gym? Lloyd :  (Sighs) Someone will ask me to spar or get in the ring with them. and it’s been over a year since I have been gone from here, the gym, my team and the sport in general….(silent pause) Me : I hear you voicing concern about the level in which you can or will perform, having been on somewhat of a hiatus for a year.  Tell me more, have you been approached by anyone who has asked you to get in the ring with them and how did you respond?   Lloyd : Nope, why do you think I avoid the SAC like the plague?  I mean, before, I would go in the ring anytime someone asked me.  But, now,…I just don’t know. Me :  I noticed you looking down and your posture has changed.  Can you talk about what is going on emotion-wise right now? ( Attending to the Here and Now — Existential Therapy) Lloyd :  I dunno, I feel like a failure,…a fraud. Me :  Okay, that’s a good start…how does feeling like a fraud and a failure effect you emotionally?                             Lloyd :  I am ashamed.  It is just not who I am or who I thought I was.  Me :  That is huge, Lloyd.  And those thoughts and the resulting feelings sound painful and difficult to carry. Lloyd :  Yeah, for sure.  And I am sick of feeling this way!                                                        Me :  You have made a huge leap in addressing this issue and together I think we can tackle it.  Our time is almost up, so how about this week you journal about what comes up for you when you think about competing and how the thought of training and sparring sits with you.  Lastly, start thinking about what the minimum amount of time you think that you could commit to being at the SAC gym and we will look it again together. Future Sessions and Moving Forward For Lloyd, social media could act as a support or a distraction.  As he shared in the sessions, which is also consistent with his recent ADHD diagnosis, his most sustained focus time was when he did not have a cell phone or gaming device.  Limiting distractions will be very important to Lloyd productivity and discipline.  Tools and applications like setting focus times, Pomodoro timers and digital planners that build-in structure, organization and boundaries to support times of sustained focus.  Strategies like being extremely intentional and selective about which apps he downloads on his phone and committing to only productive ones can help support his efforts.        Lloyd comes to therapy with many strengths and an openness to the therapeutic process.  There is much to build upon and his commitment to he and Diane’s future is solid and backed by his actions and care on a daily basis.  While living with his sister in his last year of high school, his schoolwork may have been lackluster, his devotion to caring for his young nephew was evident in how big of a role he played as caregiver to him.  His kind and loving spirit and his innate optimism will serve him well in counseling and life in general.   I look forward to our continued work together. References Boyd, D. R., & Bee, H. L. (2019).  Lifespan development  (8th ed.). Pearson.  Boyer, B., Geurts, H., Prins, P., & Oord, S. (2016). One-year follow-up of two novel CBTs for adolescents with ADHD. European Child & Adolescent Psychiatry, 25(3), 333–337. Galvez-Contreras, A., Vargas-de la Cruz, I., Beltran-Navarro, B., Gonzalez-Castaneda, R. E., & Gonzalez-Perez, O. (2022). Therapeutic Approaches for ADHD by Developmental Stage and Clinical Presentation. International Journal of Environmental Research and Public Health, 19(12880), 12880. Neukrug , E. (2018). Counseling Theory and Practice  (2nd ed.). Cognella, Inc.  Otto, M. W., Simon, N. M., Olatunji, B. O., Sung, S. C., & Pollack, M. H. (2011). 10-Minute CBT: Integrating cognitive-behavioral strategies into your practice. Oxford University Press. Peterson, C., & P., Seligman M. E. (2004). Character strengths and virtues: A handbook and classification. American Psychological Association.  Proți, L. E. (2016). Aspects of Existential Psychotherapy in Cognitive Behavioral Approach. Romanian Journal of Cognitive-Behavioral Therapy & Hypnosis, 3(3),11–18. Ramsay, J. R., Rostain, A. L., & Ramsay, J. R. (2015).  The adult ADHD tool kit: Using CBT to facilitate coping inside and out . Routledge.  Sawamura, Y., Hirokawa-Ueda, H., Kawakami, T., Sakane, H., Teramoto, K., Yamamoto, A., Taketani, R., &; Ono, H. (2021). Increased prefrontal cortex activity on near-infrared spectroscopy after interpersonal counseling in individuals with attention deficit hyperactivity disorder. Journal of Physical Therapy Science, 33(9), 668–671.

Losing a loved one or dealing with a traumatic event can leave a lasting impact on our mental health. Grief, especially when associated with a traumatic brain injury (TBI) or acquired brain injury, can be an intense and challenging experience. During such times, it's essential to prioritize our mental well-being and adopt strategies that help us cope and heal. Understanding Grief and Its Impact on Mental Health Grief is a natural response to loss, but when combined with the complexities of a brain injury, it can become even more overwhelming. Traumatic brain injuries can alter our cognitive functions, emotions, and behaviors, adding another layer of complexity to the grieving process. It's crucial to recognize that grief manifests differently for everyone, and there is no right or wrong way to grieve. Mental Health Strategies for Coping with Grief Seek Counseling Support Professional counseling can play a crucial role in navigating the complexities of grief, particularly in the context of a brain injury. Counseling provides a safe space to express emotions, gain perspective, and develop coping mechanisms tailored to your unique needs. Whether it's individual therapy, group sessions, or online counseling, finding the right support system is paramount. Practice Self-Care and Mindfulness In times of grief, self-care may seem like a daunting task. However, simple practices like taking a walk in nature, practicing deep breathing exercises, or engaging in mindfulness activities can significantly impact your mental well-being. Remember to be gentle with yourself and prioritize activities that bring you comfort and peace. Connect with Supportive Communities Engaging with others who understand your experience can provide immense comfort and solace. Online support groups or local community gatherings focused on grief and brain injury can offer a sense of belonging and understanding. Sharing your story and listening to others can create a supportive network that aids in the healing process. Reflect and Express Your Emotions Journaling, creative outlets, or engaging in physical activities can serve as powerful tools for processing emotions and expressing pent-up feelings. Allow yourself the space to reflect on your thoughts and emotions without judgment. Expressing your grief through various mediums can be cathartic and help in integrating your loss into your life journey. Seek Professional Guidance for Brain Injury If the grief is intertwined with a traumatic brain injury, it's essential to consult with healthcare professionals specializing in brain injuries. Proper medical guidance and rehabilitation programs can address the physical and cognitive aspects of brain injury, offering a comprehensive approach to recovery and healing. Conclusion Coping with grief, especially in the context of traumatic brain injuries, requires patience, self-compassion, and a willingness to seek support. By integrating mental health strategies such as counseling, self-care practices, community connections, and creative expression, you can navigate the complexities of grief with resilience and grace. Remember, healing is a journey, and it's okay to seek help along the way. Embrace your emotions, honor your journey, and know that you are not alone in your healing process. Together, we can navigate the challenges of grief and brain injury with strength and compassion. Remember, it's okay not to be okay, but it's essential to take small steps towards healing every day. Let's navigate this journey of healing together.

As we navigate through life, we are inevitably faced with challenges and obstacles that can take a toll on our mental and emotional well-being. In times of hardship and trauma, seeking the guidance of a professional counselor can make a world of difference. Empowered Counseling of Texas is a beacon of light for those struggling with PTSD, anxiety, and depression. Their team of dedicated counselors specialize in providing support for individuals who have experienced major life changes such as traumatic brain injury, chronic diagnosis, divorce, acquired disability, loss, and death. With a focus on promoting and supporting mental health, Empowered Counseling goes above and beyond to create a safe and nurturing space for clients to heal and grow. One of the standout features of Empowered Counseling is their commitment to meeting the needs of their clients by offering virtual online appointments. This flexibility allows individuals to receive the support they need from the comfort of their own homes, eliminating the barriers of time and location. By making mental health services more accessible, Empowered Counseling is breaking down the stigma surrounding therapy and empowering individuals to prioritize their well-being. The website of Empowered Counseling serves as a valuable resource for those seeking information and guidance on mental health support for trauma. By providing informative content and tools tailored to specific challenges, individuals can find a sense of validation and understanding in their experiences. From coping strategies to self-care tips, the website offers a wealth of information to support individuals on their healing journey. If you or someone you know is struggling with the aftermath of trauma, know that you are not alone. Empowered Counseling is here to offer a helping hand and a listening ear, guiding you towards a path of healing and resilience. Take the first step towards empowerment and reach out for support – your mental health is worth prioritizing.

In today's fast-paced world, the need for mental health support is more crucial than ever. Dealing with PTSD, anxiety, and depression can be incredibly challenging, and having a safe space to address these issues is essential. This is where virtual counseling provided by Empowered Counseling of Texas comes in. Empowered Counseling of Texas offers virtual online appointments, making it convenient for individuals to seek the support they need from the comfort of their own homes. Through these virtual sessions, clients have access to professional counselors who specialize in addressing PTSD, anxiety, and depression. The services provided by Empowered Counseling of Texas are particularly beneficial for individuals going through major life changes such as traumatic brain injury, chronic diagnosis, divorce, acquired disability, loss, and death. These significant life events can have a profound impact on one's mental well-being, and having a support system in place is crucial for navigating through these challenges. By focusing on promoting and supporting mental health, Empowered Counseling of Texas aims to provide a safe and nurturing environment for individuals to address their mental health concerns. Through therapy sessions tailored to their specific needs, clients can work towards healing and overcoming their struggles. If you or a loved one is in need of support for PTSD, anxiety, or depression, consider reaching out to Empowered Counseling of Texas. The virtual counseling services offered can provide invaluable support and guidance on the journey towards healing and improved mental well-being. Remember, it's okay to seek help, and taking that first step towards counseling can be a powerful act of self-care.

Major life changes can be a significant source of stress and can greatly impact our mental health. At some point in our lives, we may encounter situations such as traumatic brain injury, chronic illness, divorce, acquired disability, loss, or death that can turn our world upside down. Navigating through these changes can be overwhelming, but it is essential to prioritize our mental well-being during these challenging times. It is crucial to acknowledge and process your emotions when facing a major life change. Whether you are experiencing feelings of sadness, anger, fear, or confusion, it is important to give yourself permission to grieve and seek support from trusted individuals. You are not alone, and reaching out for help is a sign of strength, not weakness. One valuable resource during major life changes is counseling. Professional counselors can provide you with the necessary support, guidance, and coping strategies to navigate through this difficult period. Therapy can offer a safe space for you to explore your feelings, gain insight into your situation, and develop healthy ways to cope with the challenges you are facing. Additionally, practicing self-care is essential for maintaining good mental health during major life changes. Make sure to prioritize activities that bring you joy and relaxation, such as exercise, mindfulness, hobbies, or spending time with loved ones. Taking care of your physical health by eating well, getting enough sleep, and avoiding unhealthy coping mechanisms like excessive drinking or substance abuse is also crucial. At Empowered Counseling of Texas, a counseling service dedicated to supporting individuals experiencing PTSD, anxiety, and depression, they understand the impact of major life changes on mental health. Through virtual online appointments, they offer a convenient and accessible way to receive professional support during difficult times. Remember, it is normal to feel a range of emotions when navigating major life changes. Be patient with yourself, practice self-compassion, and seek help when needed. Your mental well-being is important, and taking steps to prioritize it during challenging times can make a meaningful difference in your overall health and resilience.