This episode was pre-recorded as part of a live continuing education webinar. On-demand CEUs are still available for this presentation through all CEUs. Register at allceus.com slash counselor toolbox. I'd like to welcome everybody to today's presentation, Motivation, What It Is and How to Keep It. Over the next hour, we're going to define motivation, identify the five principles of motivational enhancement, review the concepts of motivation and identify the types of motivation and ways to enhance them. Now, generally when we think about motivation, we just think about this general concept of do I want to do it or not. But what you'll learn in this presentation is their actual facets to motivation that we can work on enhancing in order to ensure that people are as motivated as we can possibly get them. So thinking about it, why do people change?  What would make you want to change? And the answer to that, and we'll talk about a little bit more, is generally because you either want something you're not getting. So you're feeling a deprivation if you will. Or you're getting something that you don't want and you want to get rid of it. So there is some sort of discomfort associated with it. I had a mentor when I was in graduate school who said change causes crisis and crisis causes change.  Change causes crisis.  So what you can generally term that crisis, is it going to be debilitating? No. If it's debilitating, people aren't going to keep doing it, but it is going to be uncomfortable. So we have to figure out a way to keep people motivated, even when things are uncomfortable, even when the going gets tough. And crisis causes change. The other half of that, we know that when people feel some sort of a crisis, feel some sort of discomfort, they want to make it stop. So they're motivated at that point to change, which leads you into what is motivation. It's the desire to change. And there are a lot of different types of motivators that we'll look at. Can individuals motivation to change their behavior be modified? Yes. But they have to want to do it. It has to be more uncomfortable for them to stay the same. When I work with people who are in recovery or people who are addicted to something and maybe not ready to stop using, maybe they're not ready to stop smoking. Can I change their behavior? No. I can put a lot of things in their way, little obstacles. I can make it more unpleasant for them to stay the same. For example, increased in cigarette taxes, not being able to smoke in the office, not being able to smoke in restaurants. There are a lot of things that the government did to make things more unpleasant in order to keep smoking. So that did motivate some people to change. But basically the person themselves has to decide this is just not worth it anymore. Do clinicians have a role in enhancing clients motivation recovery? Oh yeah. Mainly because a lot of our clients are not aware of the motivational process. Once they understand it, a lot of times they can do it themselves. But there's also that other motivation out there. If they don't want to be coming to counseling, they're involuntary clients, then they're probably going to be motivated to not see you anymore. So they're going to change their behavior at least temporarily in order to get released from treatment. Another thing that we're looking at is even people who want to change their behavior, when they come to see you, they have to shell out money. And a lot of people don't like to part with their money. It's uncomfortable. So they're motivated to get better or make the change quicker. And that doesn't even begin to touch on the reasons that they're uncomfortable and the reasons they're wanting to make the change. So there's a lot of stuff here. Innovation is a combination of desire, willingness and ability to do something. You got to want to. But even if you want to, like I can sit in the living room and I can look outside at my garden and I can go, I would really like to get started on my garden. But I may not be willing to get off the couch. Or I may not have the ability to do so because at least in Tennessee the ground is still not ready to be worked for the spring. So desire, willingness and ability. We've got to make sure we're taking into account all three. Effectively enhancing motivation requires empathy and understanding. And if you're trying to motivate yourself or someone else, you have to have empathy and understanding. Why is it that I want to do this. And why is it that I don't want to what are the reasons that I might be him and and Holland and not just like jumping to it. Understanding that and working with what you've got identifying discrepancies between your desired situation and your current situation. So, you know, if you want to, you know, I want to have a beautiful garden in the summer. Well, that's great. The ground hasn't even been worked yet. So I can't even begin to start planting and there's a whole process in getting a garden to grow and produce food and all that kind of stuff. So there's a discrepancy between what I've got and where I want to be.  And pointing out how, you know, they may not be able to be as available to their kids if they keep smoking and they develop emphysema or, you know, pointing out some of the facts that may be there.  But we've got to look at probabilities because as soon as you start making mountains out of molehills and they go when they find out, well, the chances of this happening are like 3%, you know, no worries. Then you lose some credibility. So we want to make sure that we present information that's factual, that's credible, but it also highlights the difference between what they're doing and what where they want to be. Overcoming resistance to change means more rewarding behaviors or fears about change. So resistance, and I don't like this work and thankfully we've really stopped using it over the past few years, means that somebody's choosing more rewarding behaviors. You know, if they are choosing to use instead of stay clean, then using is more rewarding and we need to figure out why. What is it that makes using more rewarding and generally it comes down to it's helping them escape the pain from the depression and the anxiety and yada yada yada. Why is it they choose this because it looks awful? I mean they're stressed out, they're homeless, they're this, they're that or you know, whatever the case may be, but generally when people are in active addiction it looks to an outsider very painful. But we've got to understand that being clean and change in and of itself is even more terrifying and more painful.  So you don't know if you can do it. And if you've tried before and you failed then you already have a couple strikes against you and you're going well you know it hasn't worked before, what's the likelihood of success. All of these fears can add up to go, you know you've tried three times, you've relapsed three times just never mind. We need to help people understand why did they relapse those three times? Why did returning to use become more rewarding than staying clean? What did we miss?  I want to get in there with my clients and I want to say, what did we miss? It's not what did you do wrong? And it's not necessarily what I, what did I do wrong? But what did we overlook? What triggers? What happened? And let's figure out a way to tighten up your relapse prevention plan. And then supporting self-efficacy, helping people take that step, making sure they get frequent rewards, doing something and then getting a reward in six months. Not real rewarding. So we want to make sure that they have small successes and they can build on those successes. For example, if somebody's trying to stop smoking, what's something that a lot of people try to do?  And so you're still having that same kind of hand-to-mouth oral behavior, if you will. And it's not solving the problem. It's not addressing whatever was stressing the person out that made them want to smoke. But it is a healthy ER behavior. Okay. So let's start there. Let's start with a healthy ER behavior. And then while we're addressing these underlying issues that you're trying to deal with, with whatever your dysfunctional coping mechanisms are, stay with that one. And then once you start feeling less stressed, then maybe we can start looking for alternate, less similar behaviors to replace it. Change involves recognizing that something needs to be done. You know, my garden needs to be planted, the house needs to be cleaned, something needs to be done. And then we've got to increase motivation to do it. We've got to realize there's a problem and get the desire and the willingness to get up off the couch and do it. So in defining the problem, we want to create crisis. We want to say, where do you want to be? All right, now how is this situation, how are your behaviors, how is your current situation different than where you want to be? Or how is this current behavior negatively affecting it? Create that crisis when they do commercials on television. And I talk about them a lot because they just stab me in the heart. The ASPCA commercials can't even watch them. Their whole goal in that minute and a half commercial or something they're eternally long is to tug at your heartstrings and create crisis. So when they get down to asking you for money, you're like, sure, you know, I just I want to make the puppy stop hurting. Create crisis and then identify the solution. You don't want to create crisis and go, okay, this is the problem. So over the next 12 weeks or so, we'll work on it. We want them to know what their end goal is and be motivated to start taking the first step and have a success and say, okay, you know, that first step wasn't so hard. Identify the benefits to doing what you need to to reach your goal. If you want to, we'll stick with the smoking analogy or example right now. If you want to stop smoking, you know, eventually you need to be out here and there are a lot of different ways to stop smoking. You can do it cold turkey, you can wean off. We're going to say this person decided to go cold turkey. What are the benefits to stopping smoking cold turkey. And what are the drawbacks to stopping smoking cold turkey. And then we've got to figure out how to enhance the benefits and minimize the drawbacks which is a while a lot of people end up talking to their physician about getting some sort of a nicotine replacement. Some people are looking at e-cigarettes you know there's a lot of different theories and a lot of different debate about what the right way is. The right way is what's going to keep you motivated and going to help you keep moving forward. If you get stuck, then we need to look at why are we stalling out where did the motivation go. So they know what the problem is. They know where they want to be. They know why the problems are problem and they're motivated you know they're feeling uncomfortable. They want to change. So we create a plan. But that plan has got to be individualized and it's got to provide small reasonable goals. Again we want to have them receive some sort of reinforcement or reward or have the success at least once a week that way they keep going okay I can do this. They need to implement the plan and then adjust the plan is needed to ensure that working toward this goal is more rewarding than staying the same. So like I said if they hit a plateau if they stall out we need to look at it and say okay what needs to be adjusted. You seem to be losing interest or losing momentum here. Maybe something else just totally changed in their life and they're dealing with that and their stress has gone through the roof. Okay. Totally understandable. We need to address that though. So you can keep with your momentum and we can address the plan as it is. Maybe we need to slow down the progress. So you can get a hold of all the other stuff that's going on in your world right now. And then pick it up again. A lot of times treatment needs to be somewhat episodic because people need to solidify their gains, if you will. Motivation is often doing something to get a reward. We do it because we want to achieve a goal we want to feel better we want to we want something. So what do we know about motivation and this can be found in tip 35 on the salsa website so you can go and you can read in depth about it but we're going to hit the highlights here. It's a key to change. If you're not motivated you're not going to change. It's multi dimensional. This is the part we're really going to spend a lot of time on. It's dynamic and fluctuating when the going gets tough when it gets uncomfortable to keep making this change. A lot of times people go you know what, never mind. It's just not worth it. Think about New Year's resolutions you've made maybe you decided that you were going to get healthy maybe you decided you were going to start working out. So you go to the gym and the first day you're really motivated you're stoked you learn about all the machines.    Well anyway, you keep doing this for a little while. Eventually, you may get to the point where either you wake up in the morning you're stiff and you're sore and you just don't want to get out of bed that morning and your bed is more rewarding than the gym. I know surprise surprise. So we've got to say what is going to keep this person going on those days that they've got a lot to do at work, or that their bed is way more rewarding than going to the gym. What's going to help them keep going. Motivation can be modified. So when people's motivation starts to wane, all we've got to do is go okay. How can we increase your motivation. How can we we remind you or how can you remind yourself of what you're doing and why you're doing it. And then again really look and adjust the plan is necessary if the person is going to the gym and getting sore. Maybe they need to back off and not increase so quickly. That way it's not punishing to go to the gym. If they are stopping smoking. There are going to be times when maybe they're around a lot of people who do smoke they smoke outside but they come in and they smell like smoke and it's a trigger for them. Okay, so that's something we need right there.  We identify those address those. So the person doesn't have that stress, we can make motivation increase again. That's the key to change. We've talked about that. When we're not motivated, we're not going to do it. And that means doing your homework that means coming to this class that means doing your progress notes.  You don't get your motivated that's your motivator is rewarding is reinforcing it's fun. Resistance is often a lack of a motivation for the new behavior, or more motivation for the old behavior. So we've got to say, what is more rewarding, you know, about the person who wants to stop smoking, you know, what is smoking do for you. What are the benefits to it, and how can we achieve those benefits without smoking. How can we help you figure out how to deal with stress. How can we help you figure out how to break those habits, because sometimes you smoke just out of habit. You wake up my mother was a chain smoker the entire time I was growing up she would wake up in the morning. And before she even had her first cup of coffee she was smoking her first cigarette. Whether she was that stressed that early in the morning, I don't know. But I think a lot of times it was just more habit, wake up, turn off the alarm, light up. We need to help people figure out how to address those. One of the first steps in developing motivation for changes to create a crisis so help them identify. What are the problems with the current situation. You want to stop smoking. Okay. You don't want to have to go out and smoke outside when it's cold and rainy and okay, that's one. You want to save money, because it's getting expensive to smoke. You want to be healthier. Great. You want to be around for your kids. Great. You are finding it more difficult to breathe, since you've been smoking so much. Okay, those are all reasonable problems. So in what ways will the change be worth the effort. What are you going to get out of this because stopping smoking is hard. So I want to know aside from being there for your kids, which is a motivator don't get me wrong, but what else makes the change worth the effort in the short term to get you through today or this week. So you're not going you know what, I can have a little slip here. And a motivation is multi dimensional. And this is one of my favorite parts, emotional motivation, whatever you're doing makes the person happy, or it makes, they make themselves happy by doing it. So, if you're stopping smoking, how can the person feel happy about doing that. They may need to find rewards to put in if they get through an entire day without smoking. What could they do at the end of the day to make themselves happy, because stopping smoking itself is not necessarily happy. What could they do instead when they're stressed that they might enjoy besides smoking. And you know my fallback is always cat videos on YouTube, but whatever it works for a certain person. Help them really fair it out.  Is this the logical choice and how is it the logical choice how does it make sense that this is what they need to do. So emotional is it's what they want to do either for the for the reward itself, or because they're going to get a reward for making it through the day. What are the physical motivations, it improves your physical health, it may reduce pain. It may increase energy. What are the physical motivations for doing this. In what ways is it going to help you feel better in your body. Socially, social motivations, look at how that will this improve relationships with yourself, or others. And I emphasize with yourself because a lot of times we overlook that we say how is it going to help you with in your relationships. And we sort of hint or indicate that relationships with others. But we're also talking about our relationship with ourselves, doing things for ourselves in order to make ourselves healthier, happier, yada yada yada. And in order to help you embody what you envision as your self esteem. Social motivation could also come in the form of a listening positive feedback, again from self and others you've got to pack yourself on the back and go you know what, today was a really crappy day, but I didn't light up. I thought about it, but I didn't do it. Have other people around you that are willing to provide positive feedback when you have a good day or a good week or achieve a goal. Get a buddy. One of the best ways to maintain motivation is if you're both doing it together so maybe the two of you are stopping smoking together, so you can give each other positive feedback support and reinforcement. And then environmental motivation, anything that makes the environment more comfortable. If you stop smoking, what will be better about your environment. Back to my mother, when, and you know it was the time when everybody smoked, but there was always nicotine on the walls and nicotine and the drapes, and there was always kind of a, you know, nicotine smell. And when she quit smoking, that all went away. So you didn't have to wash the walls as much and wash the drapes as much. So that helps in the environment. What else might stopping smoking change about the environment. Well, hey, you don't have to get up from the meal, or leave work four times during the day to go out and, and smoke you can go out to lunch with your friends, instead of having to grab lunch so you can eat in your car and smoke. There are a lot of different motivators. This is a good activity to do in group if you're, if you've got 612 people that all have a similar goal, put each type of motivation on a flip chart page, keep it around the room, break them into groups and have them identify what they see as the emotional motivations, mental, physical, social, environmental, you see, see what I mean. And then you'll have a whole list and people can go through each one and go, yeah, I hadn't even thought about that benefit. It helps gets people stoked and reminds them of all the various even sort of tangential reasons they're doing this. Interventions, creating the crisis. If you have someone who is in pre contemplation or contemplation they're not quite ready yet to make the change. We need to kind of create a crisis so we want to examine the ways that the mood issue or addictive behaviors are impacting each area of wellness and so we want to look at how is this problem that you're presenting with impacting you emotionally. How is it making you sad, angry stress depressed, guilty, any of those dysphoric emotions. How is it impacting you cognitively. Is it stressing you out. Are you thinking about it a lot. Are you worrying about it.  We want to recognize that each negative impact is likely the result of energy shortages.  I want to say, why do you want to stop smoking what is motivating you to stop smoking.  So worry is down here so they're spending a lot of energy on worry. And we want them to understand that one of the ways they're coping with this worry.  Identify individualized interventions, identify ways to reduce stress and improve each area of wellness.  However you want to put it. And then on top of that, instead of just focusing on this one issue, like stopping smoking. Let's look at all these other areas that will help you be healthy in your mind and body. So, emotionally, what can you do to be happy each day because you know what, you can't be stressed out and happy at the same time. It's for 10 minutes, it may not be forever, but even as if it's for 10 minutes, what can you do. What can you do to help yourself stay focused, think better, improve your memory. That's usually not a big motivator for people but you know, you can look at it. Physically, what can you do to improve your health and you're, you know, I'm going to go back to looking at those vulnerabilities, sleep, nutrition and pain. What can you do to give your body the tools it needs to recover, rebalance and support you in this change. And socially, how can you improve your relationships right now, how can you improve your relationship with yourself.  You feel like motivations for change in as many areas as possible and define and identify motivations to change in each dimension. That's kind of what we talked about on the last slide with emotional, mental, physical, social and environmental motivations. Sorry, I'm losing my voice. Motivation is dynamic and fluctuating. Tough motivation gets going. I have had many, many, many, many clients over the years come into treatment. They get out of detox, they come into residential, they are motivated. I mean, the detox process was not pleasant. So they've been pretty uncomfortable. They're ready to change. They are in an environment where it's really pretty comfortable. You know, they've got a roof over their head, they've got food. There are some, you know, they may be packed in like sardines depending on what facility that you're at. But they start going to group and they start feeling not so bad. You know, they're getting further and further away from that detox period. So they're not physically feeling as bad. They're making friends. There's not a whole lot of stress going on. So they forget about all the stuff that's out there, not in the treatment center. And then you hit a hot button. It starts getting uncomfortable. You start hitting some of their issues and they're like, you know what? I feel pretty good. I think I've got this licked. I'm out of here. And they discharge AMA. And that's when it's really important for a clinician to be able to step up and say, let's talk. Give me, you know, sometimes I would say, can you give me an hour? Can you stay for at least another hour and let's talk about what's going on? And then if you decide you're ready after that, you know, I can help you with your discharge paperwork. If you think you can get until the next day, think it over because you're not going to be able to get back in right away. Before you went into detox and when you were in detox, what were your motivations for recovery? Yeah, you're feeling a little bit better now. And that's good because that means you're making progress.  So it's up to us to really create that crisis again, which kind of seems mean when they were feeling pretty good. But if you know or you suspect that the reason they want to leave is because it started getting more uncomfortable. And they say, you know, dealing with my past trauma is worse than anything I had to deal with on the street. Then it's time to talk and maybe time to put the brakes on some of the interventions that you're doing in treatment because maybe you're going a little bit too fast for them at that point. Motivation is also a combination of commitment, your willingness to do something. And these are the three aspects of hardiness. If you want to look back into the 1970s, I believe is when the concept of hardiness came about. Commitment, control and challenge. You have to be committed to making the change and ready to stay the course, even when it gets uncomfortable. Control. You have to believe that you actually can affect change in your own life. You have to have some self-efficacy because if you don't believe that you'll be able to do it, then why try? If you've gone through treatment before and you've relapsed two, three, four times or even just once, then the next time you go through, you may be questioning your self-efficacy. So as clinicians, it's up to us to highlight what they did do. And when they were working their recovery program, whether it's for addiction or depression or mood disorders. When they were working their recovery program, how were things going? What triggered the relapse? Was there a major change? Was there a major crisis? Or did they just quit working their program and fall back into old behaviors? So what we want them to understand is when they're doing the next right thing, when they're using these new behaviors, things are pretty good. It's when they start getting slack that a lot of times they'll fall back into old behaviors. Emphasize how well they did during that period they were doing the right things. You were clean for three months, the longest you've been clean in five years. So that's really awesome. Let's build on that. And we need to make sure there's a little bit of a challenge. If they think that there's nothing to recovery, then there's not going to be a whole lot of investment in it. We want to challenge them to figure out how they can make it last for themselves. Reasons, motivation, wanes, no effective plan. You want to stop smoking, okay? Today is the last day I'm going to smoke. Henceforth and forevermore, I'm just not going to buy any more cigarettes and I'll white-knucklet through the cravings. In my personal opinion, for most people that's not going to be an effective plan because the smoking was more than just a habit for most people. It was helping them deal with stress. So if they're not also learning new coping skills for stress and or reducing the stress in their life, they're going to have a real hard time not returning to the one thing they were using to cope with stress. Distractions. You're wanting to, and this isn't quite as appropriate with smoking. We'll talk about addiction recovery in general. In addiction recovery, you need to go to meetings or you need to go to support groups or you need to go to church. There are a lot of different places you can receive support and work your program. There's a lot of different ways to work a program. But if you start getting too busy at work and getting distracted by things on TV and getting distracted because the car broke down, if there's always an excuse and you're not engaging in your recovery plan, then motivation is going to wane and you're likely not going to keep doing those new behaviors that may not have kind of solidified yet as just part of what you do. Drawbacks. If we don't take into consideration the benefits of the old behavior, what did it do for the person? And how can we help them meet that need? And, and the drawbacks of the new behavior. What are the potential reasons you might not want to do this? When I talked with people who are trying to live a healthier lifestyle and part of that being nutrition and they're like, you know, I can do a lot of it, but I just can't eat rabbit food all the time. I'm like, you can eat a healthy diet without confining yourself exclusively to rabbit food. So we want to make sure that whatever you're putting out there for this new behavior is something that they're willing and able to continue for the duration, not just for three weeks or three months. Negative motivation. In behavior modification, one of the principles we have is you always want to add three behaviors for any behavior you will eliminate. And why is that?  The dog eventually learns not to bark. And he starts making noise running around the house because he wants to play and everything he does that makes noise to indicate that there's either a problem, or he needs to go out, you scold because it's disruptive.  Why didn't you tell me you needed to go outside? And the dog's just in there looking at you going, I couldn't bark. I couldn't run around. I couldn't bring you my leash. Everything I tried to do, I got punished for and I had no other behaviors to do. So if you take away a behavior that is serving a function, you've got to replace it with something in order to increase the chances of effective change. So negative motivation means when you're setting goals, yes, we're probably trying to eliminate something, get rid of depression, stop smoking. That's your initial problem. What is your goal? Your goal is to add something to get healthier, to feel happier. That's what you want to add. That's the reward that you're going towards. Extrinsic motivation means depending on the outside world, waiting for somebody else to go, good job. You've got to be able to pat yourself on the back. You've got to make these changes for you. A lot of times people make changes in order to try to save a relationship or in order to try to save a relationship, get a promotion, do something that involves someone else validating it. And it's important to make sure that the person is doing this for themselves. That way if whoever it is doesn't pat them on the back, they don't go, well, that was a waste of effort. And yes, a lot of motivation, you can work in the decisional balance exercise where you look at the benefits and drawbacks to both staying the same and change.  Enhance the benefits to change and the drawbacks to staying the same. So I hated the color clash, but I had to do it. Green means go. We want to enhance these things. Red means we want to stop or remove them. We want to remove the benefits to staying the same. So if you got social rewards for doing this, how can we make sure that you're getting social rewards and your new behavior. And we want to eliminate the drawbacks to change. This is probably my favorite example when we talk about readiness for change, because you've got to motivate people. And my first supervisor when I was doing my practical. day because I was getting really frustrated that our clients were coming back, they were relaxing. And his point to me was, and it's another one that stuck with me, if somebody's been doing something for five, 10, 20 years, and they come into treatment for 28 days. If you can move them from one stage of readiness for change to the next. You have done more than your job. You have done a great job. You're not going to get them from pre contemplation all the way to maintenance in 28 days. So start with where they are and look for small episodes of care. You have to be motivated to move forward. And when someone is in pre contemplation they're not motivated because they don't see a problem, or they do and they're not ready. There are three types of pre contemplators. These are the people that go, you know what, I'm okay. Staying the same is better than whatever this changes you're offering me. Reluctant pre contemplators often don't have the information they need to understand that this is a problem. So we want to increase their knowledge or awareness about the problem and the personal impact it's having on the problem. Religious pre contemplators. They fear that somebody's trying to force them into treatment or make them do something, and they fear loss of control. So we want to take that and go, you know what, it's okay. With my clients who are on felony parole, we would do this group and none of them wanted to be there. They were all pre contemplative. That was okay. So instead of lecturing on drug addiction and pharmacology every night. I would turn it around and I'd go, what is it that you want to get out of this 10 weeks that you're stuck with me. The state's paying for it so you might as well benefit. What is it that you want to get from it. So shift the energy from fear of losing to control to what can I get out of it. Because most of the time, the goals are going to be overlapping. They're not mutually exclusive. So if they want to get off probation and not have to do deal with their PO anymore and not have to deal with you anymore. That's great. But that means they've got to stay clean. My goal is for them to stay clean. But by helping them work on their goal. I also achieve Michael resigned pre pre contemplators have tried before and they failed so they feel like it's hopeless. And we want to rekindle that hope and optimism by highlighting their successes strengths and supports. Okay, you relapsed, but you were clean for a month. You weren't you were not depressed for six months before this episode came along again. So that's good. And each time that you recover from a depressive episode, you stay happy or not depressed depending on how the person presents it for a little bit longer. Let's look at how you're doing that and let's build on that for the person again going back to smoking. Maybe you've tried and failed before and you've tried and failed before let's look at what caused those failures and tighten that up. We're just learning about you as an individual and what you need in order to recover. Now I use the analogy of a pool pre contemplators. It is 95 degrees in the shade. You are hot, but you're looking at the pool going it is really cold in there. Pre contemplators either have tried to get in the pool before and it's been uncomfortable and they're like no I don't do pools, or maybe they just, they don't even realize how hot they are yet. They're sitting there and they're like no I'm fine. It's not really a problem in contemplators. It's getting a little hot, but but I'm still okay.  As clinicians, we can address the ambivalence by tipping the decisional balance scales have them do one of those decisional balance exercises. We want to address their anxiety about change. What are you afraid of with change are you afraid of failing. Are you afraid of losing friends what what are your anxieties and apprehensions and also their grief. Letting go of something not being able to smoke anymore. It could there could be some grief in it. So let's talk about what does it mean to you to not be a smoker anymore, or to not be able to turn to cigarettes when you get stressed. Help them visualize change help them see what it's going to be like. When they start reaching their goal when they start changing. So you can do this through either just talking about it through what's the word I'm looking for collages. There are a lot of different ways to help them visualize change. If they've had clean times in the past, or happy times or not asymptomatic times. What what did life look like. How was it awesome help them remember that that's where they want to be. So, they're getting that like okay yeah I'd really like to be back there again. So they move into preparation. They realize they've got to do something. It's getting too hot, and they've got to do something. So, they stick their toe in. They start trying to think about change what they might do what they might need to do differently. They're not into making action yet they're still in the thinking stage. In terms of the pool they're sticking their toe in to see how it feels and then they're going to make a decision if it's too uncomfortable on their toe, then they may not be ready yet. Increase self efficacy by increasing that commitment control and challenge. What is one thing that you can control that you want to change. Let's start working on that. You know it may not have anything to do with this other problem over here. Let's start working on that. We find that positive changes in any one area have reciprocal positive changes on whatever other issue is over here. Encourage the person to begin learning about the issues of its depression, learn about what causes it and what interventions are out there. Addiction smoking, whatever their issue is point them in the right directions so they're not just drowning in a sea of Google. Identify motivations in each area and create small successes for components of the goal. If somebody's dealing with depression, you know, maybe they are not sleeping well, they're not eating well, and they're having difficulty concentrating. And they have no energy. Okay, that's four different components of that goal to be happier to not be depressed. We want to address all four of those. So where do you want to start? You want to start with sleep, nutrition, energy, foggy headedness, and then create the goal from there. Clarify goals and strategies by identifying and addressing barriers to change. What has tripped you up in the past? What might trip you up in the future? Or is there something coming up that you know is going to cause you a problem? I'm based just out of Nashville. And some of the clients that I work with are musicians and they tour. And so I'll have clients come in and they're like, well, I've got seven weeks and then I'm going to be overseas for the next three months. Okay, you're ready to change. I want to keep your momentum going. So let's see what we can do in the time that you're here. Now, what are we going to do when you're overseas? How are we going to handle that barrier to change? And there are ways. There's Skype, there's email, there's a variety of different things they can get. If they're working on addiction, there are online meetings that they can go to. There are a variety of things, but you need to plan them out. Highlight strengths and past successful strategies. Garner social support. Get a cheering section going. Get a battle buddy. Get ready and make sure that you've got some support for it. Maybe not necessarily, you know, even if you don't have somebody making that same change, maybe people who are willing to help you. So you have more energy to focus on making this change instead of doing laundry and dishes and carpool and whatever else. And envision change. If you've never been there or you don't know what it's going to look like or somebody's sort of ambivalent here, find motivating stories about others who have changed, who has struggled with depression and succeeded to come out the other end and be happy. You know, it doesn't mean you're not going to have another depressive episode, but it means you can cope with it. Who's quit smoking? Who has gotten into recovery from addiction? Find stories, whether it's celebrities, people in their church, people that they know. Encourage them to build off those. So they're dipping their toe in now. Okay, they're tired of being hot. They're going to take the plunge. They're going to jump in. We want to make sure that motivation is maintained. So when they get in and it's really cold, there's some discomfort there. We want to make sure that they remember, remember how uncomfortable it was being hot. In order to make sure they're maintaining motivation, mindfulness activities are wonderful. I encourage my clients to do mindfulness activities every morning and every evening for the first three months after they get out of residential. How are you feeling? And just go through the list emotionally, mentally, physically. In my program, we talk about spiritually. What is going on? Are there any particular stressors? Just check in with yourself. And then proceed from there knowing what your vulnerabilities or your strengths are for that day.  You can identify it, deal with it, and then rest comfortably. Identify triggers, how they could cause relapse and how to deal with them. So, you know, one of the triggers for the pool is cold. It could cause you to want to get out of the pool. So how do you deal with that cold? You can tread water, you can swim, you can dive.  With our clients, help them identify what's triggered you in the past. What is it that you think, what are the things that could happen that would make you go, screw it. We need to address those right now. Let's make a plan. Maintenance, this is the time to enjoy your successes. Step back and look how far you've come and go, you know, six months ago I was feeling pretty bad and look where I am. Or six months ago I was smoking three packs a day and now I'm a non-smoker. Awesome, good for me. Stay mindful of continuing to work your program and remain vigilant for relapse triggers. We have that behavior in the back of our head as sort of a drop back and punt coping skill. So if our new coping skills and our new strategies fail to work, we always have that one that we could potentially go back to. We need to be aware of that and be vigilant for it. If we're talking about depression, you know, there are relapse triggers like holidays or three weeks of no sunshine all rain. If that's a relapse trigger, how do you prevent that from triggering a relapse and make minor adjustments as needed? Relapse, so the person got in, it was too cold and they jumped out. Relapse means following back into old ways of thinking and acting. Relapse is not a requirement for recovery. Some people have one depressive episode and that's it. Some people, when they're trying to stop smoking, do it the first time, stop drinking, do it the first time, it is possible. But it requires a whole bunch of diligence and mindfulness to be aware of all those triggers and things that come up and sort of trip you. I'm a trail runner and when I'm out running, I'm always having to look for routes and things that I'm not the most graceful thing in the world. It never fails. At the end of the run, I'm always trying to beat my partner because I'm a little competitive and I will start running and I'm tired and I'm not paying attention and I'm trying to, you know, go fast and really just push through to the end.  So this is sort of something that people need to be aware of with recovery. They need to pay attention when they're getting tired, be aware of vulnerabilities, not try to rush through and be cognizant of what's going on so they can adjust. They can dodge those tree roots and not trip and relapse. The earlier you catch a relapse, the better. So if they do use, okay, you used what caused you to use. Let's look at what happened and how can we prevent it from happening again. We found that shaming people does no good. They've already shamed themselves. They already feel guilty. They already feel disempowered. So it's up to us to empower them and go, All right, you were already clean for three weeks or three years, whatever it was, you'd stop smoking and you hadn't smoked for eight months. What was it that what changed? Let's look at that and address it. What things need to be addressed to keep recovery the most rewarding choice. The pie's approach proximity. When you put in motivational enhancement, the best way to do it the best way to encourage behavior change is to provide the intervention in the natural environment. So not wait till somebody's in your office. It's going to be much more effective if they try to practice it out out there. The immediacy, intervene as soon as the problem or loss of motivation is noted is not wait until their next appointment a week from today. What can they do? What can they do to build up their motivation, encourage clients to make sure with when they're creating their relapse prevention plan, and they're creating their plan for treatment. So how to increase their motivation if they start waning and what are the emergency steps if they're just like, I'm really going to relapse here. Expectancy, expect the intervention to be successful and emphasize self-efficacy. Make sure they know that you believe in them. If they think that you're going, yeah, let's see how long he stays clean this time, then that just kills self-efficacy. Keep it really simple. Don't make these complicated treatment plans. Keep it really simple. When we talk about nutrition, you can total macros and microbes and vitamins and all kinds of stuff. Or you can say have three colors on your plate at each meal. A lot simpler. Most people can do the second one, whereas the first one is just overwhelming. The more types of motivation involved, the stronger the motivational force. So if it's emotional, emotional, social and environmental motivation, that's a whole lot better than just somebody going, yeah, I think I might like to change. Signs of decreasing motivation include failure to attempt change, what we call resistance back in the day, but, you know, basically a lot of yes-butts, excuses and yes-butts, and lack of enthusiasm. People not coming to appointments or when they come, they're just kind of half there. They're like, all right, I'm here. What are we going to talk about, Doc? Let's talk about why you're here then. Have clients rate their motivation on each target behavior, not each goal, but each target behavior each day. So if somebody's trying to lose 15 pounds, maybe they need to go to the gym. Maybe they need to start drinking eight glasses of water each day and start eating healthier. So you want to rate their motivation on each one of those target behaviors, because there may be more motivated to eat healthier, but that water is hard to get down. Okay, let's talk about how we can increase your motivation and make that more pleasant. Motivation is behavior-specific, so you want to make sure that you're addressing all of the behaviors that need to change, but you're also looking at the motivation for each one of those behaviors. Emotional motivation are things that make things happy, so we want to increase things that make the person happy, and we want to help them see how the old behavior adds distress. We want to decrease the ways the old behavior makes a person happy, like smoking helps them calm down. Okay, well, what else can you do instead? And we want to decrease the ways the new behavior adds distress. This particular emotional motivation is more powerful with people who have more of a feeling temperament. Mental motivation, things that people see as logical. So if you've got somebody who tends to be more logic-oriented, this will help increase their motivation. So again, looking at that decisional balance activity, you want to increase the green and decrease the red. Social motivation increases the person's self-esteem and self-acceptance, as well as social approval and acceptance from those people that are important to them. So we want to identify all of the reasons that this new behavior will increase their self-acceptance and self-approval. Environmental motivation identifies the new way the behavior will allow the person to improve their environment. Maybe they'll be around people who are kindred spirits. Maybe they will get to go on vacation. It'll allow them to, you know, do that, or move to a different house, change their environment. Or maybe it'll allow them to get things that they want. It's, you know, a perfectly individual choice. So we want to help them identify environmental motivators. Motivation is essential to behavior change. It involves choosing the behavior that provides the greatest rewards for the effort. Increasing motivation means enhancing rewards and reducing punishment. So we got to enhance the rewards, not just reduce the pain. Motivation is behavior, not goals specific. There are five phases of readiness or steps to change, which clients will bounce between pre-contemplation, contemplation, preparation, action, and maintenance. So making sure they're aware of where they are in the stages of change. Waning motivation is one of the most overlooked components to relapse. Too often, as clinicians, we don't pay attention to waning motivation, and then all of a sudden a client relapses from out of the blue. And you and I both know that stuff generally doesn't happen from out of the blue. So let's look at when did their motivation start to wane to do the things they needed to do to stay happy and healthy. But remember that relapse is not necessarily a component of recovery. And I got in a minute and a half under the wires. So there are a couple of questions that came up. If you're working with a family for family therapy with a parent and child, the child is in the action stage and the parent is in reluctant pre-contemplation stage. How do you proceed? Well, the first thing I would say is, you know, looking at who's the identified patient in that particular case, and what is it that the family, what goal does the family hope to achieve? If the child's in action, you know, I want to support that motivation for change. So anything that I can give the child to do to start feeling happier and, you know, whatever solving this problem is going to be good. So maybe, you know, thinking of addicted families that I've worked with. The child really wants this addiction problem to go away that's in the household. And the parent is the one who is the identified patient and addicted. They're not quite ready to change yet. So how do we help the child? Well, the child can't change the parent. And that's the first thing that I would stay with with that in this particular scenario. But help them look at what is it that they expect to get out of the addiction going away from the family? And how can I help you achieve that now? And then work with the parent, the addicted parent, the identified patient, whatever we want to call them, on increasing motivation. If they're reluctant, helping them identify ways that they might help junior, because they're probably there to help junior. And so if stopping using is one of those, then that may come up eventually. But this will help give them some control back. What are some of your goals? What are some of the things that you want to see happen? Most likely it will overlap with the family goals and hopefully the child's goals. Okay, everybody. Thank you very much for being here today. If you have any questions, comments, concerns, whatever, you can always email me at support at allceuse.com, and I will get back to you, usually within 24 hours. If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube. You can attend and participate in our live webinars with Dr. Snipes by subscribing at allceuse.com slash counselor toolbox. This episode has been brought to you in part by allceuse.com, providing 24-7 multimedia continuing education and pre-certification training to counselors, therapists, and nurses since 2006.


Welcome to Paranormality Magazine. Each week, Paranormality Magazine explores all 40 subjects from phantoms to UFOs, and every cryptid creature in between. Each week, you are treated to a collection of well-researched and investigated stories, interviews and reports on cutting-edge paranormal projects and topics they know you crave. And here in the podcast, I share stories from the magazine to give you just a taste of what you receive in every issue. I'm Darren Marlar and this is Paranormality Magazine. A lot of people interested in ghost hunting read Paranormality Magazine. Many contribute to it, including Elaine Kelly, who had an investigation at the Shakespeare Tavern, Durham's oldest inn. Here's what she wrote. My name is Elaine Kelly and I'm the lead investigator for Spectre Detectors, one of the northeast of England's most hard-working team of paranormal investigators. We work extremely hard to bring you evidence of the spirit world, watching and listening to hours of footage from each investigation. As a team, we have been investigating for 12 years and have visited some amazing buildings in England and Scotland. This article is about our investigation at the Shakespeare Tavern at Durham, which is said to be one of the oldest and most haunted inns within the city. The name, Durham, comes from the Old English word for hill, dun, and the Norse word for island, Holm. The legend of the Dun Cow and the Milkmaid also contributes to the naming of this country town and Dun Cow Lane is said to be one of the first streets in the original city. The legend follows the journey of a group of Lindisfarne monks carrying the body of the Anglo-Saxon saint Cuthbert in 995 AD. During a ghost walk at Durham, we investigated the passage that goes along the side of the Shakespeare Tavern. We were aware of children being made to work as prostitutes and we did a portal session. We heard a girl's voice. The portal said, Emily, and talked about many murders. We were close to where the first-ever jail was in the city, so it could have been referring to that. We were aware of a very large man who made these ladies work. We picked up the name William. As we were stood there, my hand started to get sore and it looked like there was a W scratched into my skin. I asked if I could take a photo and caught an EVP saying no. As Shayno was recording on the handy can, we caught a figure watching us in the distance. I had sent them photographic evidence of what we had caught in the alley at the side of the tavern and asked if we could investigate to feature it in our next book about Durham. They said that they'd allow it and the date was arranged. So after ten years of trying, we were allowed access to the oldest, most haunted pub in Durham City. We met Michelle and Chloe outside and they led us up the alley to the side of the tavern and in through the side door. You could feel the energy as soon as you entered the building and you could feel the layers of energy. None of us had been in before so after a little chat about what would happen during the evening, we made our way upstairs to the second floor. I set up a handy can pointing towards the door because this is where George had said a lot of activity happened. Michelle also opened the door at the bottom of the stairs that led to the top floor. We couldn't investigate up there because it's where the office is but she did allow us to investigate the landing and staircase. I realized instantly that I had made an error in not bringing the whole kit as it was bigger than I thought but we only had a few hours to investigate it and I didn't want to waste time setting it up. We all settled down in what is now the gin bar and started the investigation. Firstly, we sat in the quiet to see what we were picking up. We used our mediumship to see if we could link with spirits before using any equipment. Shayna was aware of the name Howard and felt that he would sit with people to get free drinks but people didn't seem to mind. As she was telling this to us, we caught a man groaning on the voice recorder. We also caught thuds coming from the floor above. I asked if he was there and if he would tap on something. Then there were a couple of thuds caught on the voice recorder. I reassured him that we didn't mean him any harm and came with total respect. I started to get a sore throat and asked Howard if he had a problem with this throat as did Shayna. I felt that a lady had been badly treated and was battered. I asked if they would talk to me if I put the portal on. Shayna felt that someone had sold their wife as a prostitute. I agreed that whoever this lady was was also sold for prostitution. I felt like a punching bag and Shayna wondered if that was why I had a problem with my ear outside. Michelle said that this floor was supposed to have been a brothel so that figured. I then asked Howard if he badly beat her and Bev saw a shadow move out of the landing and block out the light on the floor. Michelle heard a bang on the landing and we caught an EVP of a laugh on our recordings. I then started getting a watery mouth and I know that usually means that I'm picking up on a poisoning. I went out to the landing and Chloe said that she saw a tall, thin shadow move across the upstairs door and block the light from the kitchen. We did hear a girl humming and luckily it was caught on the voice recordings. Bev saw a shadow figure at the doorway. It looked like someone had gone to enter the room but changed their mind as she only saw the feet. It was like they were coming from the bottom floor and then stepped back. Both Shayna and I felt a pain in the neck at the same time and thought we were picking up on a hanging. We made our way to the landing of the top floor. Chloe said that there was a cold spot exactly where she was standing. Shayna was picking up on illegal abortions and she felt that someone was touching her back very gently. We started to hear noises downstairs. I decided to take some photos before we went back downstairs. Michelle said that when we heard the jangling of the keys she left the keys in the lock at the bottom of the stairs but she said that they would have had to give them a good shove for us to hear them. I said that if I had brought the CCTV and covered every area we might have caught them. We made our way back downstairs. Michelle moved the keys to see if they sounded the same as what we had heard. To make the sound you had to lift the bottom key but it did sound the same. We moved into the kitchen area and Shayna felt off-balance and I had my bottom touched. I also felt that I had been whacked above my eye on the forehead. Michelle said one of the members of the staff had also been touched in there. We made our way into the back bar. Michelle told us that the sewing machine stand moves on its own at times and the dog won't go in there. The room at the back seemed to be a secret room. They knocked through it when the renovations were done. As I was walking in I felt I was grabbed by the ankle. As I was telling the group what had happened there was a breath caught on handicap and an EVP saying get off me. I started to have a look at the photos I had taken. I had caught a very strange light anomaly that was sat on the table. It looked like a child. We talked about it looking like a baby. Shayna talked about illegal abortions and if it was after 12 weeks it would look like a baby. We wondered where they would have put the babies once terminated and Michelle said that she thought they went into the alley. Michelle thought it was called Blood Alley or Butchers Alley as the blood from the Butchers used to be thrown in the alleyway. I did some calling out asking for spirits to use everyone's energy and draw close.  Michelle went really hot and felt sick. I asked her if she wanted to move. Shayna felt that the ladies were starving. I thought that if Shayna thought that that they were starved that might explain my watery mouth. Shayna felt that when the ladies weren't in use anymore that they'd be put in here and left. I took some photos and caught an extra face on one of the photos. We decided to have a quick break as we had been going for nearly two hours. Michelle felt funny still and I said that she should step out of the room. As we were preparing to leave, I felt like I'd received a smack around the head again. I was panning around quickly with the handicam and caught a man's face on film. We made our way down to the cellar. As we entered the cellar, I saw a shadow figure block out the light on the back wall. Michelle asked if it was a rat but it wasn't. It was a person. I popped up to get some fresh batteries for the equipment and as I went to come back down the cellar steps, the door at the top slammed on me. Michelle said that it shouldn't have done that as it was held back by a chair. I could smell antiseptic but no one else could. Michelle heard a thud coming from upstairs and it was caught on voice recorder. I asked Bev if she was touching me but she wasn't. Something was touching my bra strap at the back and I said that they could pack it in. It touched me again and I moved. Chloe said that she stood there before and got touched. I was taking some photos in the cellar. Shayna had a sharp pain in her stomach and Chloe said it was maybe an abortion pain. There was a loud thud coming from upstairs and Michelle went to check that she had locked the door. I joked about them leaving me alone in the cellar and I was touched again and maybe jump and I practically ran out of the cellar. There were two really loud thuds upstairs. We made our way back upstairs and thought we would end the investigation there. Michelle wondered if there'd be anything caught on CCTV. It had gone very quiet and the energy had dropped. It had been a very long investigation but it was well worth the wait and we were amazed by how active it was. This article came with several photos from the investigation. If you'd like to see them you can find them in the July 2023 edition of Paranormality Magazine. The phrase glitch in the matrix was first coined in the 1999 film The Matrix which posited the idea that humanity is living in a giant computer simulation. Over the years glitch in the matrix has become shorthand for an example of an unusual occurrence that cannot logically be explained and it happens so often that Paranormality Magazine has dedicated a section of their publication to it. Here's one of their recent stories from the August 2023 edition. From Redditor Wii U. This happened this afternoon and I'm still super weirded out. I have yet to find a single plausible explanation to what went on. My husband and I live in a small work-in-progress cabin in the woods on an acreage in Atlantic Canada with two parrots, a rabbit, a senior citizen cat, and two absolutely rambunctious dogs. My husband just can't say no to something fluffy that is in need of a home. Cleaning up after this zoo is quite the daily effort.  Once the dogs were outside and merrily jumping around in the mud puddles I got to work on the floors.  After I wrapped up the chores I went to go retrieve the dogs. The dog run is accessible by a doggy door that is off of a room that's completely separate from the room I was cleaning. As I already mentioned the cabin is a work-in-progress and entirely unfinished and the room at the doggy door is the newest room to be added onto the build and is even more unfinished than the rest. I entered into this room and shut and latched the door behind me as I knew that the soggy dog's stampede was going to be fierce. I planned on letting the pooches dry off in that separate room while I went to town to run a couple errands. I opened the doggy door and the two canines bounded into the room and began to shake and pounce and play with all their doggly enthusiasm. They were soaked and muddy and seemingly more than content to hang out in this room so I undid the latch on the door that led to the main room and carefully opened it a crack just enough to squeeze my body through so that the dogs could not follow after me. I closed the door behind me and latched it shut, picked up the water bowl and reached for some toys so that I could toss them into the side room to keep the dogs entertained while I was gone. As soon as I entered the main room and looked down, however, I absolutely froze. There were fresh, muddy paw prints on the floor that I had just cleaned. I could still hear the dogs bouncing around on the other side of the door in the room I had locked them into. They did not follow me and yet here I was looking at fresh, muddy paw prints that were not here a moment ago. Perhaps there was mud on the bottom of my flip flops and I had made the prints myself. I lifted my feet one at a time and the bottoms of my flip flops were totally clean. The prints were not from me. Then I lifted my gaze and was horrified to see that the paw prints continued all down the length of the room from the kitchen to the front door of the cabin where they suddenly stopped as though a muddy dog had taken a single run through the length of the room and then completely vanished. The prints only went in the one direction. There were no smudges of mud or backwards prints to indicate a muddy dog changing direction in any way. Just a straight line of fresh, wet, muddy prints and then nothing. They weren't there moments before. My dogs had not entered the room and were still locked up in another room. There were no other creatures in this room and no possible entrances for rogue invaders. I have no explanation. I don't understand. I feel like I'm either losing my mind entirely or else in an alternate timeline one of the dogs slips past me into the cleaned room and runs down the floor and somehow the timelines bled together for a moment. Just long enough for alternate dimension dog to leave the muddy paw prints and then vanish back into his own timeline. Want more paranormality? Subscribe to Paranormality magazine and each month get it delivered digitally or via mail in our print version. Paranormality magazine is a collaborative endeavor featuring works from people like you who have a passion for all things mysterious and unexplained. Our goal is the pursuit of knowledge gathering captivating stories from our own team of writers researchers and investigators as well as from writers such as yourself. Each monthly issue also includes a list of paranormal, horror, UFO and cryptozoology events around the country, incredible paranormal themed artwork, articles and writing sent in from our readers, suggested books and podcasts to consume and more. Visit ParanormalityMag.com and subscribe today for as little as $3.99 a month. That's ParanormalityMag.com ParanormalityMag.com It may be surprising, but the first several thousand years of human history are more connected than you would think. Stories of giants, monsters, massive wars and beings from the sky, almost every culture has these stories and they are even eerily familiar. Why? How? When? Brandon Wills from Paranormality magazine brings us the story of the web of the ancient world. There isn't a culture that has existed on earth that didn't have a creation story. The Greeks believed that before time there was nothing and they called it chaos. Then out of the darkness our planet was born. Gaia and from her came other gods. Gaia was also said to have given birth to monsters, like the Cyclops-esque monsters called Hecatencarys, the 100-handed ones which were later banished to Tartarus by Uranus, one of the original gods. Now does that sound familiar to any of you? From the Book of Genesis, in the beginning God created the heaven and the earth, and the earth was without form and void and darkness was upon the face of the deep and the spirit of God moved upon the face of the waters and God said let there be light and there was light and God saw the light that it was good and God divided the light from the darkness and God called the light day and the darkness he called night and the evening and the morning were the first day. Let's take it a bit further back then ancient Greece and take a look at the Sumerians. Parts of their myth have yet to be found, but we know that their gods, An, and Leel, Enki, and Ninhursanga created a nice comfortable world for humans and then helped them found the earliest cities of Eridu, Batibira, Larik, Sipar, and Shurapak. Then for reasons not thoroughly specified, they decided to not save humans from a massive flood. A king named Zayud-Sura learns of this plot. In an Akkadian version of the story called the Atrahasis Epic Era, known in Sumerian as Enki, who was the god of the waters, warns the hero, Atrahasis, and gives him instructions on how to build an ark. You heard me right, an ark. In what's been found in the Sumerian version, Enki warns Zerosuda, the king of Shurapak, and provides him also with instructions for an ark. The flood raged for seven days and nights, then the storm subsides, and the sun, Utu in Sumerian, awakens and Zerosudra opens a window, then sacrifices an ox and a sheep. An, and then Leel then gives him with breath eternal for preserving the animals and the seed of mankind. Let's jump over to another epic from the Sumerians that also speaks of a flood. The first and earliest epic known to mankind, the Epic of Gilgamesh, tablet nine found in Nineveh, says that Gilgamesh was leaked a spoiler of the upcoming flood by Eya, or Enki, in the city of Shurapak. Eya also tells this story to Napishtim. Eya demanded that he deconstruct his house and build a boat from the pieces to keep living beings in. The Anunnaki gods lift up the earth with thunder as the storm raged.  The gods were frightened at the storm and fled back to heaven. The flood lasted six days and nights, flattening the land. On the seventh day, the storm began slowing down. After everything had died down, all humans had turned into clay. Utu Napishtim stuck his head from the boat and felt fresh air for the first time in those seven days. He searched across the waters and found a speck of dry land which was named Mount Nimush. He released a dove that flew away but returned to him. Then he released a swallow which also came back. He then released a raven who did not come back and that was when he decided it was safe to release the animals. We probably don't need to mention the correlations that these last stories had to Noah, but isn't it eerie? Now, according to the Bible, God was trying to rid the world of sin, later said to also include the Nephilim. Could the gods of the Sumerians be the storied Nephilim since we just read about them fleeing from it? There's evidence of massive floods that happen on a regular basis in the fertile Crescent area of the world, so much so that the Tigris and Euphrates have changed course many times over history. We also know that historical figures are known by different names in other cultures, so Utu Napishtim and Ziasudra be the same as Noah. We also can't ignore the mention of the Anunnaki and the ancient alien connection, or aliens involved. Almost all cultures have stories about beings from the sky bestowing knowledge to humans. The Bible even mentions a serpent convincing Eve to eat the forbidden fruit from the Tree of Life. Could this be a metaphor? Let's explore the Anunnaki a bit more. This was a pantheon in the Sumerian mythos which included An and Leel, Ea or Enki, Ninharag, Sin or Nanna, Shemash or Utu, and Ishtar or Inanna. And Leels regarded as the most powerful of all these, as he was the god of air who separated heaven and earth. According to a Babylonian story, Marduk was over 600 Anunnaki and commanded 300 to reside in heaven and the other 300 to reside on earth. The overall duty of the Anunnaki was to be over the fates of mortal people. However, if you believe the ancient alien theory, you may believe that the Anunnaki came from another planet that happened to pass close by the earth thousands of years ago and enslaved humanity to mine gold. Then they zipped away after they had enough, or that they were reptilians who brought knowledge to humankind and are still roaming the streets today. There are dozens of books on this subject and Ron probably owns most of them, so ask Kim if you want to borrow one. Another odd correlation these cultures had was their belief in monsters. Almost every culture on earth has stories about dragons and giants. Why? Were these just misidentified fossils? It would be entirely possible that these were just confused ancient people who were terrified of monstrous fossils that they found while digging for minerals. There have been hundreds of accounts of giant fossils found across the world. Then something happens and they are lost or destroyed without a picture being taken. It has been so common that the Smithsonian has even been involved, but later they deny ever possessing them. Why? Is this a conspiracy to alter history to their liking? Or is this to just hide information that would abruptly shift our understanding of evolution? Or were they just misidentified by earlier archaeologists? But there are some odd mentions of this. The Bible mentions giants, Greek mythology mentions it, Sumerian mythology also mentions it, and practically every other ancient culture across the globe has stories about them. But did you know that Josephus Flavius mentioned giants? Yes, he did. Here is a quote from Josephus, quote, For which reason they removed their camp to Hebron and when they had taken it they slew all the inhabitants. There were till then left the race of giants who had bodies so large and countenances so entirely different from other men that they were surprising to the site and terrible to the hearing. The bones of these men are still shown to this very day, unlike to any credible relations of other men. Now they gave this city to the Levites as an extraordinary reward, unquote. Josephus mentioned giants several times in his writings, but these were just second hand accounts. He himself does not say that he witnessed these himself, but he explains these as a history. You can come to your own conclusion there. But there is another quote from Josephus, quote, For many angels of God, this notion that the fallen angels were in some sense the fathers of the old giants was the constant opinion of antiquity. For many angels of God accompanied with women and begat sons that proved unjust and despisers of all that was good on account of the confidence they had in their own strength. For the tradition is that these men did what resembled the acts of those whom the Grecians called giants, unquote. This is where Josephus himself attempted to connect the dots. There are even connections of giants to the crucifixion of Jesus Christ. How? Well, let's jump back to Goliath. Josephus surmises that Goliath was actually six feet nine inches, which is still very tall for those times. But the KJV Bible claims he was nine feet nine inches. Some scholars take Josephus as being more accurate and that the Bible was just mistranslated and miscalculated. Now jumping to the hill where Jesus was crucified, it is known as Golgotha. Some scholars believe that Golgotha is a combination of Goliath and the name of his home city of Gath. Goliath of Gath. Golgotha. Some even say that his name was Gol in Philistine. Then they combined that with Gath. Gol of Gath. Goliath. It's the same idea, either way you take it. They claim that the hill is where the decapitated skull of Goliath was buried by David after the fact. This could be looked at as symbolic of Jesus doing his greatest miracle right on top of a descendant of the greatest ancient biblical atrocity of angels mixing with humanity. Now back to Sumerian connections to the Bible. Abram, later known as Abraham, is said in the Bible to be a descendant of Noah and from the city of Ur, the capital city of the Sumerians. He probably grew up knowing and experiencing the culture of the bustling city. Ur sits in the area where the Bible mentions the Garden of Eden as being located. We now know that Ur was one, if not the, first city in the world. Was this one of the first places that the descendants of Cain went? Or was that a metaphor for these sinful Sumerians? Is Ur one of the first places inhabited after the Great Flood mentioned by all these ancient cultures? One thing is for sure. The Sumerians laid the groundwork for many world cultures that came after them, including passing along their religion. The ancient Jews would clash with their predecessors, the Elamites, the Assyrians, the Babylonians, the Persians, etc. and thus would also assist with the rise of the Grecian city-states by trading of goods, knowledge, and religion. There are so many theories about what Gobekle Tepe was used for. No one really knows for certain because this site is much, much older than written language as we know. The site is approximately 11,000 years old or was built around 9,000 BC which would make it about 6,000 years old than Stonehenge and the earliest form of writing. That would mean that we are closer to the time of the first Sumerian writings than the Gobekle Tepe site is to the first Sumerian writings. I say currently because those figures could change and have changed occasionally. The tallest T-shaped stone found at the site is 16 feet tall and weighs approximately 20 tons. How did they manage this with literal stone age technology? Theories abound as to why the ancients built this place. Some believe it is the oldest temple in the world. Some believe that this is to commemorate the flood mentioned in the Bible and the Sumerian stories. And some believe it is there to mark a cataclysmic event such as the Younger Dryas. There are as many proposed and debated theories as Stonehenge. The Younger Dryas was a sudden cooling period that occurred approximately 13,000 to 11,000 years ago. This period caused global temperatures to drop on average of 14 degrees Fahrenheit and lasted for over 1400 years. There are many theories as to the cause but we know the effects caused the extinction of the giant animals of the Ice Age and possibly ended the Clovis period of Native Americans. Could the ancients who built Gobekli Tepe have experienced this and thought they survived in near earth-ending times and built this to appease their gods? The asteroid theory for the cause has been supposedly debunked but there is mounting evidence suggesting this could be true. In ice cores they have found evidence of burning which would be associated with massive wildfires that would happen after such a disaster. In fact, it is estimated that 10% of earth's grasslands and forests burned due to this. There are other theories like a volcano in modern-day Germany did erupt around this time and the effects most likely could have spread to modern-day Turkey. The flood theory is most popular among biblical literalists. The supposed site of Mount Erarat is not that far away. According to Google Maps it is approximately a 16-hour walk between the two sites. Does the flood theory have any merit? That would be up to you and your religious leanings, really. Did the world really flood completely? This argument has come up for decades and I would recommend just deciding this with your own convictions. Perhaps there was a cataclysmic event that did happen in their time but we have not discovered the evidence for it yet. In the end, we may never know for sure because there are no writings that even mention this place or its purpose. Gobekli Tepe is much larger than most people are aware of. There are 16 other rings across the 22-acre site but Gobekli Tepe is just one that measures around one acre. When it was first excavated in the 1960s, it was dismissed by the University of Chicago and Istanbul University anthropologists and concluded it was just a medieval cemetery. It wasn't until the 1990s that scientists took a closer look and discovered how astonishingly old it really is. In Turkish, Gobekli Tepe translates to Belly Hill because of the gently rolling hill it is situated on, perhaps making it the world's first church on a hill. It is estimated that it would have taken hundreds of people to assemble the structures, essentially an entire community. But why? Scientists say there is little to no evidence of people living close to the area for thousands of years so it had to be a place of gathering. Here comes another why, which this place has many. The site is full of carvings of deadly animals but not that of game. The mayor of Sunlurfa was quoted recently saying that he believes the site was built by aliens. The ancient alien theorists have pointed to this site as the oldest indication of alien human contact. One image from the site suggests an alien gifting something to humankind and a possible alien vehicle hovering above it. Some also claim the humanoid depicted in the image could not be human due to the clothing, which is similarly described in alien abductions. We may never truly know the answers to all these questions but the one thing that most people do agree on is that the site depicts some sort of very early religion. Perhaps this site could be evidence of the origin for many of the area's cultures. In 2019, excavations began at a newly discovered site nearby and it was determined to be even older. Carahan Tepe, as it was dubbed, has been theorized to be 11,400 years old, which would make it older than we believe agriculture was. But could this discovery move that timeline further back? Evidence of farm vegetation and signs that people lived at that site year round for 1500 years could possibly do so. There are also dozens of other Tepe's nearby, many of which have not been thoroughly excavated. The ones that have been found show signs that there was a similar culture going on at the time. There are stone pillars placed in circular patterns and depictions of animals and people are carved into them. Some people even think that some of the bird depictions could be that of the famed bird man from South America. If that is true, then how did that information get passed all the way there? Back in 2012, archaeologists proposed that they found evidence that Neanderthals built boats to get around on the Mediterranean. This was determined after stone tools created by them were found on distant islands, which could only have been done so by sea travel. Carbon dating determined some to have been placed 100,000 years ago. Is it possible that early humans were also sailing and managed to find their way to South America, spreading their cultures and religious beliefs along the way? In closing, it is obvious that these early creation myths have commonalities. Is there an older culture and the truth lies within Gubecle Tepe and the surrounding sites? How far back in time would that culture have existed? Will we ever find a definite answer? While we are on the topic of history, when you dream about ancient civilizations, what does it mean? Well, it could be a reflection of various factors, such as your interest in history, a desire for adventure, or subconscious thoughts and memories. Here are a few possible interpretations, although it is important to note that dreams are highly personal and can have unique meanings for each individual. Exploring the past. Dreaming about ancient civilizations may indicate a curiosity or fascination with history and the desire to explore the past. It could reflect your interest in learning about different cultures, traditions, or ways of life. Connecting to ancestral roots. Dreams of ancient civilizations could signify a longing to connect with your cultural or ancestral heritage. It might be a subconscious expression of your desire to understand your roots or a call to explore your identity. Symbolic meaning. Ancient civilizations often carry symbolic associations, such as wisdom, mystery, or power. Dreaming about them could reflect your own personal journey of self-discovery, growth, or the need to tap into your inner potential. Archtypal imagery. The imagery of ancient civilizations may be archetypal, representing certain universal themes and ideas. These dreams could be tapping into collective human experiences and the shared symbols and meanings associated with ancient cultures. Past life connections. Some individuals interpret dreams of ancient civilizations as a connection to past lives or reincarnation. This perspective suggests that the dream is a glimpse into a previous existence where you may have lived during ancient times. It is essential to consider the context of the dream, your own emotions, and the specific details surrounding the ancient civilization depicted in your dream. By reflecting on these elements and considering your personal associations, you can gain a deeper understanding of the dream's meaning and its potential relevance to your waking life. In our last Paranormality Magazine podcast episode, we talked about the Forty in Society's Charles Fort, the society being named after that man. But we also mentioned quite often Theodore Dreiser, and we look a little more closely at him this time. Theodore Dreiser was a prolific American writer known for his gritty, realistic novels that explored the darker side of human nature and the complexities of social and economic systems. His work, which often confronted taboo subjects and challenged prevailing moral and social norms, made him a controversial figure in early 20th century literature. However, beyond his literary achievements, Dreiser's life took an intriguing turn when he became the first president of the Forty in Society, an organization dedicated to the study of anomalous phenomena in collaboration with the enigmatic researcher Charles Fort. Theodore was born August 27, 1871 in Terre Haute, Indiana, into a large German-American family. His upbringing was marked by financial struggles and personal hardships, experiences that would later inform his writing. After a brief stint at Indiana University, Dreiser moved to Chicago, where he worked as a journalist for various newspapers, gaining first-hand exposure to the harsh realities of urban life. These experiences would form the foundation of his literary career. Dreiser's breakthrough novel, Sister Kerry, published in 1900, caused a stir with its frank portrayal of a young woman's rise in society through her relationships with men. The novel defied prevailing moral standards and was met with controversy and censorship. However, it marked Dreiser as a writer unafraid to explore human desires, ambitions, and the consequences of social expectations. In 1902, Dreiser published his second major work, Jenny Gerhardt, another unflinching examination of a young woman's life choices in the face of societal constraints. Despite facing obstacles from publishers and moral watchdogs, Dreiser's reputation as a prominent writer continued to grow, earning him a place among the leading literary figures of the time. The Forty Inn Society, named after the American researcher Charles Fort, was established in 1931 as a platform for investigating and documenting unexplained phenomena, anomalies, and scientific heresies. Fort himself was a maverick figure who compiled an extensive collection of reports on strange occurrences from UFO sightings to poltergeists and strange rains of fish. Deeply intrigued by Fort's work, Dreiser became an ardent supporter of his research. The two men shared a fascination for the unconventional and a belief that the boundaries of human knowledge should be pushed further. In 1932, Dreiser was elected as the first president of the Forty Inn Society, a role he would hold until his death in 1945.  Through his presidency, Dreiser further propagated Fort's ideas and expanded the reach of the Society, attracting a diverse group of intellectuals, scientists, and artists who shared a common interest in the unknown. Theodore Dreiser was a literary trailblazer whose work broke new ground in the early 20th century American literature. His realistic and often controversial novels provided a stark portrayal of society and challenged prevailing norms. However, Dreiser's life took an unexpected turn when he became the first president of the Forty Inn Society, a testament to his enduring curiosity and his eagerness to explore the unexplained. Through his involvement with the Society and his collaboration with Charles Fort, Dreiser left a lasting legacy that extended beyond his acclaimed literary contributions, inspiring generations to embrace the mysteries that lie beyond the boundaries of conventional knowledge. Thanks for listening to Paranormality Magazine. Get more information about the magazine and subscribe to our monthly publication at ParanormalityMag.com or click the link in the show description.  We might feature you in our next issue. If you have a Paranormal Podcast, you can add it to our website so our readers can find your show. And artists, if you'd like your work to be featured in our magazine or on our back cover, contact us. Again, our website is ParanormalityMag.com. I'm Darren Marlar and I'll have more Paranormal for you next time from Paranormality Magazine.


The researchers have identified several biomarkers associated with diabetic kidney disease, DKD, as well as regulators and drugs that may help treat it. They found that certain immune-related genes are overexpressed in patients with DKD, while other genes are under-expressed. Additionally, they discovered that certain proteins and signalling pathways are altered in these patients, which can lead to further deterioration of kidney function. Furthermore, they identified several micro-ionase and transcription factors that may serve as potential therapeutic targets for treating DKD. Finally, they also found that certain drugs can modulate the expression of these genes and proteins, suggesting that these drugs may be useful in treating DKD. This article was authored by Shengnan Chen, Boli, Lei Chen, and others.