Mental Health Counseling in Maryland

Counseling for Adults w/ ADHD, Anxiety, Addiction, & Men's Issues in Maryland

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Resources

Here is a list of psychological concepts, exercises, and worksheets that often come up in client sessions.

The 3 C’s: Courage, Competence, Confidence

Courage is the willingness to take bold action despite feelings of fear or uncertainty. It involves stepping outside of one’s comfort zone, taking risks, and confronting obstacles head-on. You may feel afraid, but you do it anyway.

Competence is having the necessary skills, knowledge, and abilities to perform a task or achieve a goal. You build competence by being courageous, repeatedly.

  • Competence forms the foundation of confidence because when individuals are proficient in what they do, they are more likely to feel confident in their abilities.
  • This is done through behavioral practice.

Confidence is the belief in yourself, your abilities, and your judgment. It’s about trusting that you have the skills and resources needed to succeed, even in different or challenging situations.

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Control: What is and is not within your control

Dichotomy of Control Worksheet

Your intended behaviors are within your control. You can learn and practice to think, act, and respond differently. You can condition yourself to create a space between reaction and response through practice. The consequences of your behaviors, however, are outside of your control.

  • What you intend to think about (and you may get distracted).
  • What you intend to feel (and you may feel something else).
  • What you intend to do (and something else may happen).
  • How you intend to respond to thoughts, feelings, and other people.
  • Your intended behaviors only occur within the present moment (not the past or present).

Everything other than your intended behaviors is outside of your control. People encounter resistance when they try to control something beyond their control. If you want the weather to be different than it is and become upset or frustrated because it isn’t what you expected or wanted, you are creating that upset or frustration by trying to control something (the weather) that you cannot control.

  • What others feel, think, say, and do is outside your control.
  • How other people interpret what you say or do is outside your control.
  • How others react or respond to you and the world is outside your control.
  • External events, circumstances, and situations are outside your control.
  • The past and future are outside of your control.

Reference Note: The Dichotomy of Control originally came from Stoicism. Cognitive Behavioral Therapy (CBT) adopted this and called it the Circles of Control, but created a Venn diagram with the center representing what one can influence, along with what one can and cannot control. Then, Acceptance and Commitment Therapy (ACT), which is a form of CBT, came up with the Control vs. Acceptance Framework, which focuses on promoting psychological flexibility and encouraging individuals to distinguish between what they can control and to take value-based action, and what they cannot control, which requires acceptance.

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Demandingness Words

Words of demandingness are “should” statements. When we tell ourselves, and others, or are told by others that we “have to… need to… should… must” do something. There is an expectation or demand from ourselves, society, religion, community, and family that we do things a specific/certain way. We are being told what to do in an absolutistic or rigid kind of way. In turn, we may avoid or resist doing that thing; get frustrated; and have a sense of failure if we do not do it… or if we do not do it “perfectly”. A couple of things…

  • What we resist, persists.
  • There is no such thing as perfection.
  • Absolutistic thinking is a rigid thinking process that views there is only one correct or universal way of thinking, behaving, or being; that one must, should, completely, never, or always follow exactly. It is rigid, meaning, there is no flexibility or options.
  • The category term, words of demandingness, comes from Rational Psychotherapy, aka REBT, and are viewed as irrational beliefs that lead one to experience emotional distress.

Linguistically, words of demandingness are called a modal operator of necessity. Modal operators are a mode of operating or being in the world. It is a deductive pattern – it brings things down to a point – and it forms the rules we live by.

Solution: add options, and flexibility, into the thinking by adding words of possibility and probability that allow you the individual to take on responsibility or ownership of the action. By using words such as could, would, might, maybe, may, can, am, try, will, want, etc. one introduces flexibility to their thinking. One can use the negation of the above words, as well. E.g., might not, won’t, do not want, can not, etc.

Demandingness Examples

  • I should learn Spanish –> I want to learn Spanish
  • I have to go to the store after work –> I am going to the store after work
  • You have to call your mother –> You get to call your mother
  • I need to finish this assignment –> I am choosing to finish this assignment

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Emotional Contagion (Psychological Social Contagions)

This phenomenon refers to the idea that emotions, behaviors, or beliefs can spread within a group due to social influence, often without individuals consciously realizing it.  Studies have demonstrated that individuals are influenced by not only their direct contacts but also friends-of-friends up to three degrees of separation (“Social Contagion Theory”). For emotional contagions, this is like ‘catching someone’s mood’.

Emotional contagion is the phenomenon when the unconscious spread of emotions from one person to another through facial expressions, tone of voice, body language, or behavior occurs. I.e., one person’s emotions and related behaviors directly trigger similar emotions and behaviors in others. This can lead to a domino effect. In relationships, for instance, anger can spread this way, escalating conflicts. It is a shared emotional experience.

  • Mirroring Frustration: One partner comes home angry from work, and the other, sensing the tension, also becomes irritable.
  • Escalating Arguments: One partner raises their voice, and the other instinctively matches or exceeds it, intensifying the conflict.
  • Defensive Reactivity: A partner criticizes the other, who then becomes defensive and retaliates, fueling mutual resentment.

This can happen in both positive and negative emotional contexts and is a key element in group dynamics and social interactions. For example, if someone is anxious or joyful, others nearby might start to feel anxious or joyful as well.

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Emotional Processing

Emotional Processing Method Worksheet

  1. Awareness: Become aware that you are feeling something.
  2. Acknowledgment: Acknowledge the feeling sensation without judgment and name what you’re feeling.
  3. Acceptance: Accept that, at this moment, what you are feeling is real, and accept it without judgment.
  4. Understanding: Once you identify the emotion, work to understand its meaning and significance, exploring why you feel this way and what the emotion is trying to communicate.
  5. Mindful Deliberation: Reflect on what led you to what you are feeling and the interpretations, assumptions, or appraisals you made.

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Emotional Regulation: Frustration & Anger

Emotional Regulation: Frustration and Anger Worksheet

Frustration and anger come about because one does not accept reality.

Frustration is a precursor to or a milder form of anger; a feeling of resistance in response to the refusal to accept something as it is, or the failed attempt to change or get the desired outcome of something. When what you want is different from what is actual reality, then you get frustrated because you do not accept things as they are.

Anger is a reaction to a perceived wrong; i.e., someone thinks they were wronged, challenged, or attacked in some way, such as a boundary violation, an injustice, or that life is not fair. It prompts someone to act w/ assertion, confrontation, attack/aggression, or suppress the emotion.

Frustration Exercise

Being aware, acknowledging, and accepting a situation prevents resistance.

  • Awareness is the perception of something in existence.
  • Acknowledgment is admitting the existence of something.
  • Acceptance is allowing something to exist.

See the worksheet for the full process.

Anger Management Exercise

This exercise is meant to provide insight into what the rules are that you get angry about if broken. It is based on The Rule Model of Anger that I teach. See the worksheet for full process.

Also check out information on emotional contagion, emotional processing, emotional venting, and evocation of anger and expectancy confirmation on this page.

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Emotional Venting

Venting may seem cathartic; however, it is unhealthy. It is a pseudo-solution that may appear to work but did it solve the actual problem or handle the situation? Or is it temporary relief until the same thing happens again?

People tend to vent about their thoughts/feelings to avoid how they think and feel. Also, if anger is physically expressed as a way to cope with it (e.g., rage rooms or punching bags), then it increases arousal levels and ends up being counterproductive.

Increasing your arousal level – aka upregulation of emotions – increases the intensity of the emotion and heightens physiological arousal (e.g., increased HR, faster breathing, heightened alertness, muscle tension, restlessness, and release of stress hormones). Instead, reduce your arousal level. Reducing arousal – aka downregulating – reduces the emotional intensity and reactivity along with decreasing physiological arousal (e.g., a lower HR, deeper breathing, lower stress hormones, and overall calming and relaxing effect). This can be initiated through mindfulness, deep breathing, and relaxation techniques.

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Evocation of Anger and Expectancy Confirmation

In personality psychology, this concept of evocation says that certain personality traits may evoke consistent responses from the environment, particularly the social environment. So, personality plays a key role in the process of evoking emotions from others.

Evocation of Anger and Upset in Partners

This says that the behaviors of one person can evoke the emotion of anger or upset in another person. The strongest predictor of evocated anger or upset in partners were the personality traits of disagreeableness and emotional instability, with disagreeableness being the strongest predictor.

Evocation Through Expectancy Confirmation

This says that people’s beliefs about the personality characteristics of others cause them to evoke those characteristics from others. I.e., our beliefs can evoke other people’s behaviors because we embody it first in ourselves and then the other person perceives it and then matches it. Also known as behavioral confirmation or simply as a self-fulfilled prophecy.

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Linguistics, Negations, & Conflated Words

The field of linguistics, including cognitive linguistics, neuro-linguistics, etc., studies the structure, meaning, and use of language and how we learn and are influenced by language. This includes how language shapes human thought processes and beliefs. Things like storytelling, metaphors, sociocultural factors, and vocabulary can influence and change how we perceive and interact with the world. The words we use are reflective of our beliefs and how we construct our subjective reality.

One important concept is that our brain does not process a negation. Don’t think of an elephant. Do not think of a pink baby elephant in a tutu. Don’t do it. Don’t touch the stove. To understand what not to do, we have to understand what is being said. Some people will visualize the elephant or touching the stove to understand the concept being mentioned and then have to cancel it out in their minds. Whatever we are talking about is what we are eliciting in someone’s mind – including our own – even if we are saying “no”, “not”, or “don’t” in front of it. So, discuss what you want to discuss, think about, talk about, or do. Use “positive language” instead of negations or “negative language”.

Some common words that are conflated:

  • Expect vs. want: I expect Maryland weather to be unpredictable because of my experience with Maryland weather. I want it to be a nice, warm, sunny day. I may not get what I want.
    • An expectation is predictive behavior based on experience and available information. It is a projection or forecast of how a person or thing will act, react, respond, or what a situation will be like.
    • A want is what one would like to possess or have happen. It is self-contained within the individual – it is their wish or desire. The individual has to act to bring it to fruition (if it is within their control).
    • When we confuse what we expect to happen and what we want to happen, then we take things personally and get upset.
    • We get frustrated or upset when we want things to be a certain way that is outside of our control. E.g., if I want it to be 70 degrees and sunny and I open the door and it’s cold and rainy then I may get upset because reality is not as I want it to be. But I cannot control the weather, so it is silly for me to get upset, and being angry punishes me.

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Mindfulness: The Basics

Mindfulness Overview Worksheet

Mindfulness is shifting one’s awareness to the present moment experience. It involves recognizing and acknowledging the reality of a situation – what is.

Shawn outlines the mindfulness process in four steps.

  1. Awareness of the present moment
  2. Acknowledge that this is reality
  3. Accept what is
  4. Mindful deliberation

A few mindfulness techniques

  • Body scan technique
  • Five senses grounding exercise
  • Three-step mindfulness exercise
  • Moving awareness exercise

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Reaction vs Response

Reaction vs response: The difference between a reaction and a response is a space. There is a pause; a moment of conscious awareness.

  • A reaction is an automatic, unconscious, programmed action that is triggered by a stimulus. Reactions are involuntary thoughts, emotions, and movements that are impulsive and outside of one’s control.
    • E.g., someone broke a glass and you yell at them. Did you choose to yell at them or was it an automatic behavior?
    • E.g., someone broke a glass and you checked to see if they were okay. Reactions are not inherently good or bad, they just are.
  • A response is a deliberate action in a given situation. One filters their thoughts, considers their options, and chooses how to express themselves, if at all.
    • E.g., someone broke a glass and you noticed yourself getting upset so you took a breath, counted from 5-to-1, and then checked on them to see if they were okay. You learned how to control yourself through training, practice, and self-awareness.
  • How to create a space:
    • Behavioral training includes mindfulness to cultivate self-awareness and stillness along with practice to re-condition how you act.
    • Taking a deep breath and slowly exhaling creates a space.
    • Deliberation creates a space between reaction and response.

“Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

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Socratic Method

The Socratic Method Steps Worksheet

The Socratic Method is used to understand what someone believes and why they believe it by identifying the topic of discussion (and their beliefs) and then breaking it down into small parts through clarification and open questions to understand them and ensure you are both on the same page.

  • Clarification
  • Examining the Evidence
  • Considering Alternatives
  • Reflection
  • Summarization

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Values Clarification

Values Worksheet

“Your values are your unconscious mind’s blueprint for how to live your life when you’re on automatic pilot.” John Overdurf

Values are things that are important to you in different contexts. They are based on your beliefs and past experiences, and act as cognitive filters for making decisions. They are the basis of motivation and basis of evaluation. Values are beliefs themselves, and like other beliefs they have supporting (subjective) evidence that presupposes the existence of that particular value.

Value words are abstract nouns – you cannot easily perceive them with your five senses; you cannot easily draw it. E.g., safety, health, communication, faith, honesty, success, career, wellbeing, etc.

Values are synesthesias – a connection or link between between something we perceive and how we feel. When we think of or experience a value, it can elicit a specific internal sensory response. It’s a stimulus-response pattern. When you get your values met you feel good.

“Your values are basically generalizations about what kind of experiences are important to you. You value experiences that feel good, and negatively value the ones that feel bad.” Steve Andreas

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“WH” Question Words

Most of our language is directional. Meaning, that when we communicate, we direct someone’s attention. When a question is asked, our brains tend to go on a search to find an answer. If it is a general, non-exact, or non-literal question, then our brain does a “transderivational search”. This is when someone’s mind is looking through their memories and mental representations to find a possible meaning, answer, or match. There are patterns to certain questions we ask, such as the “WH” question words, aka interrogatives. Each “WH” question operates as a directional cue. So, be aware of what you are asking and why. What’s your outcome?

  • “What” questions elicit the representation, structure, definition, or identification of something; it’s about content and specifics. It encourages someone to provide details or to clarify the situation.
    • What kind of x do you want? What do they need? What would happen if x?
      • You are asking to identify, define, or gain clarity on something.
  • “How” questions elicit a process, method, steps, means, or the epistemology (knowledge) of something. It encourages exploration to identify descriptions of the way something occurs, is achieved, or is known.
    • How do you know?
      • This is called “the reality question”. It elicits the evidence of what someone says, believes, or thinks they know to be true, i.e. the epistemology of experience.
    • How can you make this situation better?
      • You are identifying a strategy.
    • How do you feel (about the situation)?
      • This calls for self-awareness and self-reflection on what someone is experiencing – what is happening – a process.
  • “Why” questions elicit the justification, reason, motivation, cause, or meaning of something. Use it to search for a reason, but use caution when asking “why” to someone angry or depressed because they will give you all the reasons to justify why they are feeling that way, which will in turn prolong that emotional state. Asking someone why keeps them in the state that they are in. “Why” questions can sometimes lead to defensiveness, as they often invite a justification or rationalization for someone’s behavior.
    • Why did you do x?
      • It asks for the justification for doing x.
  • “Who” questions focus on identity or relationships; they identify a specific person or group.
  • “When” and “Where” questions elicit temporal and spatial coordinates of something, respectively.

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