What's up everybody and welcome back here to the channel. I'm ill rabbit RDS on the channel. So a lot of you guys been telling me I should get on RDS Well steam sails on so dig it RDS. So we're gonna test it out. Dig it one of the cars pinch packs That's what we're staring at a 370 z so we're gonna go drift have see what we can do with it on the wheels See how much fun we can have see how different it is And well, let's see if we can get used to it because I've heard a mixed reviews about it's drifting very well It's very weird. It feels good on a wheel doesn't feel good on the wheel So we're gonna give it a shot with the fan. It's like great We should guys follow me and scram Twitter all the fun inscription box below. Let's Just go practice offline and see what track we want to go to Unsure where I want to go But I think we'll just go to drift park Japan 10-minute session by ourselves See how we can get acclimated in this 370 so RDS Russian drift series Definitely looks like it's been gonna be a lot of fun, but I'm sure it's gonna be a learning curve on the wheel for sure And let's go. We're just gonna go send it We did lower the power of the Z a little bit. Oh my It's the first impressions. It's definitely definitely different The wheel gets a little soft on me. I Feel like at certain parts of drifting, but I think we're Somewhat figuring out handbrake and everything working. Oh don't hit that So it's definitely different and definitely gonna take a little bit of getting used to but It looks awesome, and it looks like this could be a lot of fun if I could get used to it I've noticed in the quick testing that I did to make sure the wheel worked Throwing so super amounts of angle is a pretty hard to Actually save it just like that So RDS is definitely totally different than any other drift games. I'm used to Like a set of course and fours and horizon and all that stuff So it'll take a minute to get used to But I feel like once we get used to it. Maybe It could be a fun game It's nice to have some cars With the steam sail allowing me to get some of these upgraded cars Think we're getting the hang of it a little bit It's got to stay a lower angle.  I Wanted to go around this this little center section. That was totally planned. Oh Was it there's a lot of feathering of the gas and a lot of gentle Gentle transitions for sure for student owners right now And I'm not sure if maybe my wheel settings are incorrect or if Maybe just how it feels. It's all It gets a little light when it starts sliding and gets stiffer real, you know quick Like I said, I could just be my wheel settings But is it worth it right now on steam sail? Well, when you guys see this the seamstail will be over Definitely looks cool. Definitely fun and amazing looking game Get some of those clips it slides a lot So I am actually having a little bit of fun with this It's definitely harder and definitely more intense than what I'm used to but it's definitely a fun game We should have gotten those clips definitely would like to get online with some people and maybe do some tandem battles and stuff Like that because watching, you know, some of the other stuff about this but tandem battles It looks like it could be a lot of fun with the points and judging and like that But we don't have another car to go so we can't really do that tandem I'm gonna go this way hold it Other the gas there we go Now we're getting the hang of it. Oh, yeah So I do like, you know the graphics and stuff in the game the driving and the wheel feels a little bit different Not what I'm used to but I did not expect it to feel like a set-up Off the bat, I feel like if I could adjust Maybe the wheel settings a little bit better. Maybe I could fine-tune it make it a little bit nicer Trying to get those clips so it is I am liking the points totals with the clips Except when you go off course like that And I feel like I'm getting The flow of it as I said that we crash getting the flow of it and it's definitely different, but it's actually kind of fun We're definitely gonna maybe try to do a solo session with some ghosts and see about maybe trying to tandem with some ghost cars But already yes you guys want to keep seeing RDS on the channel Make sure you let me know down in the comment section down below and if you're not a subscriber Do tap that subscriber and I would appreciate all the support. Oh Almost lost it There we go One thing I'm not sure on is when I hit the brakes goes right in the clutch So I'm trying to maybe wonder if that's Just something in the game that I can't really left for a break Which would make me have to use the handbrake a lot more so let's see if we can't get some other cars on the track maybe add some Drone mode all that's sweet There's a lot of actually cool things in here. So if we can't get some other cars, maybe there'll be an online session We can maybe hop into Let's see competition online Nope, none found shadow match Where do we want to go? For a shadow match we'd go back to there go West Japan circuit airport Canada Sportsman Japan airport airport I'm really sure there's a lot of places and a lot of cool tracks Orlando. So I go sw Let's go drift for in Japan All players start session So if you guys like to say if you guys want to keep seeing this make sure you let me know down the comment section down below RDS if you play it, let me know if you got a good wheel setting if you do play it and you enjoy it Let me also know down in the comments down below Definitely a different game bringing to the channel RDS a lot of you guys have been saying I should get it See how we got all the cars Let them go ahead of us Oh overthrown mad at second gear though Oh don't lose it Kind of stay in first, but I can barely see We go there's some clips Definitely starting to get the hang of it But we did get knocked down, but I got a lot of points Bangs right now. I don't want to fail. I want to lose these We're banked those points. So now we got a decent amount of points Matt that second gear would like to get close to that wall, but you know what happens when I say let's get closer to walls We always tend to smack into it Go through it the other way There we go Slowly starting to get the hang of it Oh, don't lose that So we do have a bit of an advantage in points right now Kind of just banging second third gear second gear Don't lose those points This is actually kind of fun. It's kind of definitely out of my normality for Games and the way the feeling would be but this is a lot of fun.  There's some good amount. There's some good clips.  I have it on maximum density Bring a way out to those Or in seconds, we save it You gotta be on your game when it comes to this game right now Especially on a wheel We definitely have a bit of a Points lead right now On the shadow players with a minute three left There we go. See if we can't make this turn with these clips Handbrake is definitely my friend There we go That's that's what I wanted to see. That's what I wanted to do Oh, don't lose it Gonna paint those points Got 42 seconds left. Definitely Getting the feel of the game now Just a little wall grace No big deal. Don't lose it. Ah, don't lose it Kinda didn't lose it, but we didn't lose our points. So So with 16 seconds left. I think we have a comfortable First place here in this round RDS make it its way to the channel that you 36 spinning out Make it a way to the channel if you guys want to keep seeing it Make sure you follow me and also should mean let me know down in the comment section down below That's our first little uh look at rds here on the channel So make sure you follow me on social media all of which are found in the description box below 130 km an hour max drift speed first place. What kind of payout we get 7700 bucks? I'll take it So as always, I thank you guys for watching. I'm your rabbit. I'll see you guys on the track


This is from draft analyst Tony Pauline in his latest mock draft. Now a mock draft is not a report but when he writes up why he thinks the Patriots are taking J.J. McCarthy number three he says I personally am not big on McCarthy being a top ten selection but McCarthy to New England was the buzz on the pro-day circuit. DeFacto general manager Elliott Wolfe is pushing hard for McCarthy and he believes he has as much upside as any quarterback in this draft so that does feel like a report if Elliott Wolfe is in fact pushing for J.J. McCarthy Mike what are your feelings on that okay all right so so two thoughts the obvious thought is the same one everybody's having WTF what's going on Elliott Wolfe what are you doing J.J. McCarthy did you watch his games in college he was a good college good solid college quarterback but nothing special about him and let's give him a 10 percent 15 percent upgrade let's say Jim Harbaugh was holding him back in college and Harbaugh has never been accused of holding anybody back he makes you better so let's this state let's say just for some strange reason Harbaugh was holding him back and he's going to be better as a pro I still don't see J.J. McCarthy as a top five quarterback and I really struggle to see him as a top 10 guy but then my other thought Felger is that Elliott Wolfe is dumb like a fox that he has really mastered this chess checkers game he's got everybody thinking he's got them off the scent he really makes people believe he wants J.J. McCarthy and he doesn't he really wants either Drake May or Jayden Daniels and he didn't want anybody to know it so he's signaling J.J. McCarthy that's right Elliott you're brilliant you're just wishing that you're willing brilliant you're willing that to be the case again I don't feel like the Patriots are in chess checkers mode I've been sniffing this or feeling this for a little bit yeah you said it a while ago but just but nothing from the outside you know when Zolack a couple weeks ago it's just all of a sudden you know is over head over heels for J.J. McCarthy kind of out of nowhere he even apologizes to Michigan people I apologize for not giving this guy more respect and then you know again all they've talked about this all off season is toughness and leadership a toughness and leadership a toughness and leadership and then dried mail last week really sort of unprompted you'll hear the sound coming up talks about Drake May's floor I'm like I just start to add it up and add it up and add it up and then Gasper last week kind of out of nowhere is scolding the Patriots for being risk adverse and being too concerned about someone's floor versus their ceiling and I just add it all up and people who do talk to people you know I sort of read their commentary and say what's up here now I does it offend me no because I don't buy the hype like I don't think it's an absolute certainty that Drake May right or Jayden Daniels is better than J.J. McCarthy I so I just I don't personally see it with McCarthy but what the hell do I know what I do know is that the pre-draft experts are going to be wrong so it's somewhere so why not here I'm just trying to think now defensively it happens all the time defensively a guy is not highly regarded in college and turns into a star in the pros I mean like Aaron Donald just just retired he went you know he was he went like 13th in a draft you know good draft position for the for the Rams but nobody knew he'd become one of the greatest defensive players in the history of football but offensively I'm just trying to think and I know you know Brady's sixth round I'm just saying a guy who is not like Tom Brady was a good player in college by the way Tom Brady was better in college than J.J. McCarthy was in college as a passer yeah I mean Tom Brady was the reason Michigan won game he was 25 as a start he was 25 Patrick and a captain Patrick Mahomes won 11th you know I mean yeah 10th yeah yeah okay 10th sorry so but but that's still yeah I guess Aaron Rodgers went 20 seconds but okay but but think about this Aaron Rodgers he was sitting around the green room because they thought he could have gone first as was Alex Smith and Aaron Rodgers right he had a great college career Patrick Mahomes it did like do for 5000 yards 5000 plus yards a senior year I'm just saying I've never seen a guy who was just not much in college just kind of jump up to super stardom and the pros I guess it could happen offensively I just can't think of any examples okay even Joe Montana Joe Montana third round pick was still really good and Notre Dame won a bunch of games he was won games dramatically in college just like he did in the pros hey hey maybe this is the first time for everything I Mike I just be stunned if this guy turns out to be worthy of a top five pick largely because you and others watch him at Michigan and you see him in his quote unquote big games and there's just not much there at Penn State he throws for 60 yards against your Iowa State Buckeyes which they won going away right 150 yards not going away well winning all right anyway calm down versus Iowa again under 150 the national semi-final game he did throw three touchdowns that was a good game for him absolutely but he didn't have to do much in the national title game so we bring on Andrew Callahan of the Boston Herald I know you're big on Drake May would you be offended by JJ McCarthy I would be so offended no I would be disappointed you know this is not a player that anyone is describing as a top five player in this draft not a top 10 player and rarely even a top three quarterbacks so the fact that we're just skipping here Drake May and Jane Daniels let alone on April Fool's Day tells me we've gotten bored and I understood this started with Tony Pauline who does a lot of research in the draft his history is a bit spotty with this stuff it just does not pass the smell test and JJ McCarthy does not pass the eye test all right let me ask you this though let's say Elliott Wolfe is pushing for anybody what JJ McCarthy Drake May Jane Daniels it doesn't that say something that Wolfe who is about to conduct his first draft as the guy he's got experience but the first guy in charge the first draft he's in charge when he says I'm going to push for it does that tell you about his lack of self-awareness or does that tell you about his position now with the Patriots where he has he feels the confidence to do that I don't know what it tells me because Michael who is he pushing like if this is his first draft where he's in charge is he looking in the mirror and trying to convince himself like he gets to make the call and we know he wants to be collaborative right maybe he's trying to convince drive Mayo or TC McCartney their new quarterbacks coach or Robert Kraft yeah Robert said like he'll have his input and he'll back off the thing is for me I think if you take JJ McCarthy he is the quote unquote safer prospect right we're talking about floor and this would be indicative to me of a guy who just wants to keep his job right I took the guy who won the most he's accurate you know he's athletic enough he doesn't wow you but he doesn't occur the risk of Drake may bottoming out having this lower tier kind of outcome for him where JJ McCarthy you plug and play you know what he is and that to me would be a bad decision you don't want to be scared going into the draft you're pursuing excellence you have a third pick find a difference maker at number three okay I don't like your depiction of them saying well well we must be bored like just because someone like someone you don't they're they're making it up or it's a narrative or we must be bored well think about it why is JJ McCarthy suddenly in play at number three I don't know but listen listen hold on just let me introduce Greg Bidad talked to six NFL executives he wrote this on Sunday he talked to six NFL executives about the third pick about the top three quarterbacks all six guys said Williams Jaden Daniels one two that's pretty clear then when it got to three you're getting talked to six guys two of them said Drake may two of them said JJ McCarthy two of them said they'd trade down so you don't think opinions are mixed across the league you think the opinion across the league is consensus Drake may over Drake is consensus Drake may over JJ McCarthy and anyone else who says otherwise is just making it up that's not what I said I never said there was a consensus there's certainly a majority whether do you want to go within the league whether you want to go on the drafts the media side of things like at no point even going back to a year ago right we heard Caleb Williams and Drake may that JJ McCarthy ended the conversation as a franchise quarterback don't you know and we all know that the media conversation is different than the internal league conversation the internal league conversations and internal boards are way different than your mock draft and Mel Kipers mock draft and we all know this right so I don't think so though because the gap has been closing right like Todd McShea was offered a job to work for the Jets in their front office Daniel Jeremiah's worked for three different teams it's beginning closer and closer because we have all the same information it's from pro football focus where all the teams subscribe it's from the GPS data that I could find access to we've never been smarter on this end it doesn't mean we're going to have identical opinions this is the draft and I'm not saying he's making you say GPS like GPS data like the thing that's in my car anything you look this you're wrong I love about this advanced stuff I'm talking about the speed and all of the different tracking information that's all shared now between media and the teams because we're all subscribing to the same services my point is it was around this time we were also convinced that Mack Jones is going to go number three to the 49ers three years ago again a middling guy who had won a lot in college and played for a big time program won a national championship well when we finally got to the draft that dude fell to 15 if I had a bet right now JJ McCarthy is going to go much closer to 15 than he will number three all right well we've talked about JJ McCarthy and we've talked about Drake May and Jayne Daniels are you convinced Andrew Callahan that the Patriots are going to take a quarterback not in a specific quarterback this guy but just that position do you think that is going to happen at number three yeah I think so and it speaks to something I hit on earlier right like the idea of job security LA Wolf's contract is up in May same with a lot of front office if you miss on one of these guys say it's Drake May or JJ McCarthy and he takes off somewhere else in Minnesota or wherever and you traded back and the crafts have to not only watch Tom Brady leave four or five years ago they had Anna and in that but his potential successor after Mack Jones go thrive somewhere else and you could have had him that's a fireable offense in two years I think they take the guy it's the right draft it's the right need this is so simple oh yeah they're taking a quarterback it's just which one and where


This episode was prerecorded 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 on relapse prevention techniques. We're going to define relapse and really talk about it in terms of a return to prior functioning, not necessarily focusing on addiction because too often we forget, I guess, to really address relapse prevention planning in our mental health clients. We'll examine some relapse prevention techniques, learn how to help clients identify relapse warning signs, and examine what needs to be included in a relapse prevention plan. And yes, even for mental health clients, it's ideal if we can let them walk out the door with a relapse prevention plan kind of in hand. That way they can identify those relapse warning signs and hopefully they won't have another episode as bad as the episode that brought them into counseling. So relapse is a return to addictive behaviors or the recurrence of mood symptoms.  Relapse often starts long before the person uses or experiences symptoms again. They get caught up in the day in, day out. Now think about some of our clients and we'll focus on anxiety today because we usually talk about depression. Clients who develop really good mindfulness skills to address their anxiety and really good coping tools and all that kind of stuff. And you find that some of their anxiety was brought on by poor time management being pulled in too many different directions, not enough self-care, yada yada. Well, they're doing fine. They feel great. They start taking on a little bit more and they're still feeling good and they start taking on a little bit more. And before they know it, they're not practicing their mindfulness. They're not getting the rest they need. They're not taking care of themselves anymore. So they start feeling run down and they start feeling anxious and symptomatic again. And this can also be referred to or whatever you want to call it as starting to act mindlessly. They're on autopilot. They're used to saying yes. They're used to doing, you know, what they always did and they want to be able to go back to doing what they always did. And one of the things sometimes we need to help people address in counseling is the fact that maybe what you always did wasn't a good fit for you. And yeah, you may want to go back to doing what you always did, but it may not be in your best interest when you're looking at those things that are important and meaningful in your life. You know, do you really want to risk having another symptom exacerbation? They may start, stop going to meetings, counseling, church or whatever their lifeline is, you know, whatever their social support is, whatever their activities are, whatever helps them stay grounded and feel connected and develop that social support. If they start neglecting those and you know, I always think of the movie, oh golly, The Shining, when he starts typing, all work in no play makes Jack a dull boy and has his psychotic break, but I digress. Hopefully our clients aren't going to get that to that state of problem and problems, but the same sort of thing can be true for all of us, not just our clients. If we start, start working and you know, even if you love your work and that's awesome, but you still need downtime. You still need recovery time. You still need to do some things in your life that bring joy because work by virtue of what it is has a certain element of stress associated with it. Now, if all your social supports are there, you know, you may be able to finagle a few more hours at work than some other people who may not have a great working environment, but it's important to feel balance in your life and you know, when we stop having balance, we start having problems. If you think, again, back to some of those things that we talked about when we were doing multicultural responsive services, look at the connection even if you tend to be an individually focused person. Look at the connection between what you do and your moods. So people start, you know, burning the candle at both ends. They stop doing things that bring them joy. They begin running out of energy to do new behaviors because they're getting worn down. They're getting tired and frustration, irritability and exhaustion can set in. So it's generally this kind of slow gradual taper as they regress or revert to their to their old behaviors, which oftentimes are what brought them to counseling. So we want to help them see that what parts of those can you incorporate, you know, maybe you loved working out. And you want to work out again. Great. Well, instead of doing three hours a day, let's talk about an hour a day. Maybe you love your work and, you know, because there are some of us who really love what we do. But maybe instead of working 12 hours a day, you need to set limits and work, you know, six or eight hours a day.  Woohoo! But, you know, it depends on the person, whether they do it like a straight six and, you know, work that hard. I know I cannot see, you know, when I'm working with clients and in clinic, I cannot see more than four clients in a day because then I've got paperwork and other things to do. But after four clients, I start feeling like I'm not making the connection and being with them 100%. And yeah, I could probably work up to it when I was in community mental health. We had to have 30 billable hours a week. So that's a minimum of six client contact hours a day. But, you know, that was a struggle to get through. And, you know, by the time I got to my fourth intake of the day, I was having difficulty remembering, you know, have I already asked you this and that's not good for clients and that's not good for us. You know, we start feeling kind of like cogs in a machine instead of the helpers that we are. So we want to look at the behaviors that triggered the depression or the anxiety or the addictive behaviors and the things that they do in recovery that support their recovery. So we're aware of, you know, when we see these old behaviors or thoughts or feelings start creeping in that that might be a, you know, big red old flag saying you got to stop and step back and take a look. There is one caveat for relapse and that's that an extreme stressor can prompt an immediate relapse. If there's a death in the family, if there's a divorce, if you lose your job, there are things that can cause, you know, that sock in the gut that may cause depression or anxiety symptoms to just like go through the roof again. And, okay, you know, so having the person develop a relapse prevention plan, they'll have some tools that they can look at right away, even if they can't get in to see you.  So relapse is the return to something that's been previously stopped and it's multi-dimensional. We have emotional relapse. People get sad. People get anxious. You know, their feelings return to what they were prior to recovery. Mental relapse, they may start becoming more negative, may start holding on to grudges. They may start having more difficulty making decisions. You know, think about the mental symptoms in depression and anxiety diagnoses. They may have difficulty concentrating. Their memory may kind of get dicey. Physical relapse symptoms, you know, if they're they've got an addiction, there may be some cravings. There may be some craving food, different food cravings, but they generally tend to start to feel run down and fatigued and exhausted. And if they've got some anxiety going with it, they may start feeling panic attacks, sort of symptoms. And, you know, all the other associated stuff, the upset stomach, the migraines, the stress in the muscles. Social relapse is when they start hanging out with people that either co-sign on their BS and say, yeah, you're right, you know, everybody's against you. And, you know, compound that feeling and or, you know, sometimes this is the same group. They hang out with people who have similar diagnoses. So they're kind of feeding on each other. And yeah, the world is against you or yes, the sky is going to fall and everybody gets anxious and is like stressed out all the time. Because in a social relapse, so to speak, you're going to withdraw from those people or you've often withdrawn from those people who kind of moderate you and say, you know, let's stop and think about that for a second. Is it how likely is it that the sky is going to fall tomorrow? Yes, it could, you know. No doubt it is possible and but how likely is it? And those are the people that, you know, you may have backed away from unintentionally and you don't have their good presence kind of balancing you out. So relapse is multi-dimensional. It's not just one thing. Those things that overwhelm your ability to cope are what I refer to as extreme stressors. They thrust you into the fight or flight mode. New coping skills and support resources may not even be considered or they may only be considered half-heartedly.  They're kind of, you know, dizzy and wobbly. Think about a boxer that just got his bell wrong. So we want to have clients identify things that may be extreme stressors for them that they could anticipate coming up and even just do some, you know, role plays if nobody has anything they can anticipate. One thing in Florida, you know, where I came from, we regularly have hurricanes and hurricanes can be really stressful because people start worrying about their house and their loved ones and their this and their that. Okay, so let's have a hurricane, you know, rehearsal. If a hurricane comes, what are you going to do? How are you going to plan for it? Up here in Tennessee, we don't have hurricanes. We have tornadoes.  How do you cope with it? Yada, yada, but and that's especially true if people have been in a tornado or a hurricane and had significant losses. So it may trigger some post traumatic stress type of stuff. Other things that could be an extreme stressor include a job loss or the diagnosis of a terminal or chronic illness such as cancer, ALS, HIV, any of those that they're going to have to be dealing with. And you know, when that happens, we don't expect their coping skills to be able to keep up because that is a very unusual situation. So we need to have a plan for when your coping skills are overwhelmed. What can you do? Beginner tools for extreme stress. I tell people get support. They're outnumbered. They have the positive voice in their head that's going, you got this. It's going to be okay. Let's be rational. Let's use the tools we learned in counseling. And then they have the other voice that has been in their head for much longer going. This guy is going to fall. The world is going to end. There's no way you can handle this.  Whatever it says, that critical voice, that one that's always, you know, calling doom. So get support.  Let's think about how likely that is. You know, you've got these two different messages going on. You're not sure what's going on. What's the worst that's going to happen? So support is good. Practice self soothing and de-escalation techniques. What can you do to help yourself calm down in the midst of extreme stress? Part of that is getting your heart rate to calm down. Some people will practice combat breathing. When you breathe in for three, hold for three, breathe out for three. Just slow their heart rate down. Some people find it helpful to move around using the big muscles of your legs. Tends to bring the energy so it doesn't feel like it's going to come up and make your head explode. Brings the energy down to your feet. When your heart is racing, when you're stressed out, another way to look at it, your body is going, oh, we need to move, fight or flight, we need to go. So in a way, walking, even if you're walking around in circles, can help your body go, okay, we're doing something, we're moving. That's a step in the right direction. So encourage clients to walk. Whenever we would have a incident, if you will, on one of the residential units, that was one of the first things that we would do. We would have staff members go in, talk to the people that were involved, and we would separate them and we would go out and walk around the property. We used to call it the compound, but that doesn't sound very nice. We'd walk around the property and just talk. You know, tell me what happened and generally we weren't making direct eye contact and we were just, we were looking forward. So there wasn't a stress on the person. We could listen to them. They were moving, so they weren't feeling like they were a caged cat and that's helpful. Systematic desensitization can help. If there are things that periodically come up that are extremely stressful, encourage the person to practice systematic desensitization. You know, get to the point where they can think about doing this public speech without getting totally freaked out. Get to the point where they can walk into the place where they do the speech and think about giving the speech without getting totally freaked out. You know how all that goes. But that can help people start practicing and this is especially useful for people who have experienced some sort of traumatic stress and obviously it needs to be used with care. But there was a police officer I worked with who had a traumatic incident on the interstate. So the smell of fumes whenever he would smell those even being in traffic not on the interstate getting on the interstate. Those would all trigger sort of extreme stress reactions. So we worked with systematic desensitization there. Cognitive behavioral therapy can also be helpful. I'm big into note cards and now that we have mobile devices, you know, you can use that instead because it's more eco friendly. But have a note card that people can look at that says I feel whatever the feeling is I feel anxious because and whatever it is. So to get them to identify what's going on. Then the next question is I feel this I'm upset about this because and what are the facts for and against this belief that, you know, the world is going to end or I'm going to die or whatever they're feeling right now. Am I using all or nothing thinking or jumping to conclusions? And then the last one is I need to call and they put a person's name in there to get an objective perspective or if they can't reach that person what would this other seemingly objective person do in this situation? So I have them keep that on a note card. So when they get stressed, they can look at it and they can go through these questions. Even if it doesn't provide great answers to them, it gives them time for that adrenaline rush to go away and them to get more in their wise mind and be able to make better decisions. The four D's of relapse prevention delay most urges feelings and cravings rise and fall like waves in about 20 minutes. If you don't feed them. So if you start thinking about it and thinking about how awful it's going to be and worrying about it and then thinking about all the permutations, you're feeding it. If you can change direction of your thoughts for a few minutes, then urges and feelings will go away. Oftentimes and I liken it to having a B landing on your arm. If a bumblebee lands on your arm, you're going to look down at it and your first reaction, your first urge is probably to swipe it off. You don't want it on there. But if you do that, what's going to happen? You're going to get stung most likely. So probably not the best idea. If you can delay that urge, eventually the bee is going to fly off. Same thing with our other urges.  So we want to try to delay our reaction until that urge goes away and we can think about it more clearly and this can be stress eating. This can be you know, calling an ex after a breakup. There are a lot of different urges we have that can be destructive. So encouraging people to when they have an urge to do something that may not be in their best interest to think about it first and just give it 20 minutes. Let the bumblebee set distract. You know, during this time, you're not just going to sit there and look at the walls. There's no way to clear your mind when you're doing that for most people. So distract the craving time passes more quickly when engaged in a distracting activity for a few minutes. Now I'm not saying just stuff that stuff down and never come back to it. That's not what I want people to do. But when they are in that really wound up state when they've got that adrenaline going, they're in the fight or flight. They're in their emotional mind. They're not making necessarily the best decisions. So let's let all that energy and drama bleed off for a little bit. Until we can get into our wise mind. So use distress tolerance skills, the improve and accept acronyms. You can Google those. We won't go into those right now or you can watch the dbt video on our YouTube channel. Give different ideas for people to distract themselves and there are a lot of mindfulness things in there. You can even do different activities or practice the opposite emotion. So if you're stressed out, well, stressed out order pressed, it doesn't matter. Do something that's going to make you happy. Distress by reducing your stress and distress. You're allowing your body to maintain higher levels of calming and happy chemicals. So in the moment, it may not be possible to do this. You're distracting and delaying right now, but leading up to it, if you can make it a practice in your life to regularly distress, you're going to have more serotonin. You're going to have more dopamine in your system. So you're going to be, you're not going to be like teetering right on the edge of freaking out. You're going to be calm. You're going to be able to handle what comes your way. Cause think about it. When you're having a regular month, you know, we'll go with a month because things can add up and nothing majors happened and then all of a sudden something big happens.  If all month, you know, every time you turn around something happens, then whatever that incident is that happens at the end of the month may just kind of push you to the point where you have a relapse of the anxiety or the depression because you're, you're out of energy. Your skills are done. You are worn down. So distressing. You can also work on preventing vulnerabilities and helping clients remember how important it is to eat well, sleep well. And recharge their batteries by, you know, doing things that make them happy. Yes, it's important. Remember when we talked about culturally responsive counseling counseling with Asian persons? There's that yin and yang.  They don't have enough happiness and the yin just kind of naturally curves over because it's always in a balance. So if the yang shrinks, the yin is going to grow. So you want, we want to add happiness to balance out the stress that everybody has. I mean, we've got bills. We've got things. Adulting can be stressful and help people learn to decatastrophize, encourage them to challenge their thoughts and when necessary, reframe them into more accurate notions like, yeah, this is really uncomfortable, but I can manage and uncomfortable is not usually the word I use, but it sounded better for the presentation. There's a video on thinking errors also on our website that you can look at. Please feel free to use it. You know, I've had people tell me they use some of the videos or parts of the videos in counseling groups and that's totally cool. You know, if you find something that's helpful, more power to you. Relapse prevention card is another thing that you can have, fold a paper into four squares on the first square, right? Delay, distract, de-stress and decatastrophize. On the second square, write out five personally relevant distraction ideas. So going back to that DBT, the improve and accept acronyms, identify five things in there that you think you might be able to do that sound workable for you. On the third square, write out three of your most significant reasons for wanting to recover or to be happy.  And on the fourth square, write out some negative expectations or accurate predictions for what will happen. If you slip, if you go back into a major depressive episode, what's going to happen? You know, you might be wanting to sleep all day and you're going to start missing your kids ball games and, you know, there can be some, you know, obviously there are some negative consequences when we're not able to function the way we hope or prefer to. So encourage people to, you know, create a relapse prevention card. So they've got a snapshot of what they need to do, why they want to do it and, you know, why they don't want to go back to being the old way. Relapse prevention plans, triggers and vulnerabilities just like relapses are multidimensional. So I want people to go through and they can do this as homework. You know, you don't have to do it in the office because this is kind of psycho ed stuff. You can, this is great to do in group. If you've got, you know, eight people or whatever who are working on this because they will talk about triggers and each person may throw out triggers and other people may go, oh, yeah, you're right. I didn't even think about that one. So emotional triggers, what makes you sad? Y'all know that the ASPCA commercials, oh my gosh, during the holidays, they were on, I swear they were on every channel I was watching. I'd be at the gym and I just have to like look down at the monitor because I couldn't watch the TVs that were up there because I can't see those poor little suffering puppies kills me. But I know that's one of my triggers.  Write those down. Mental triggers, what triggers your negativity? What makes it harder for you to concentrate?   You can also look at other physical triggers that may prevent you from sleeping well and may make you want to crave unhealthy foods or foods that are higher in sugar and fat, which tend to, when you eat them, make your brain excrete dopamine or secret. I never got the grammar on that one. Oh well. So those are things, if you start craving those foods, you may realize that you're headed down a slippery slope. Social triggers, what things, and it could be social things that you've got to do like going to holiday parties or family reunions or mixers or whatever it is, or it could be the people you're hanging around or you're exposed to, but what social triggers are in the environment? And what are your environmental triggers? And people forget about this. I mean, it's not just the billboards, but it's what you watch on TV. It is, you know, around the holidays, whether it's Christmas or Valentine's Day. There are always these Hallmark movies on. And if you have a crappy family situation at the moment, you know, watching those may feel like somebody is stabbing in the gut and it may trigger more depression. So look at what you're watching on TV.  Does it say I am happy and energized or does it say pull the curtains? I don't want to see anybody. I just want to bury my head and watch Netflix. Whatever it is, but encourage people to look at that. Vulnerabilities are the same way and triggers and vulnerabilities can kind of be the same. But understanding vulnerabilities, emotional vulnerabilities, if you're starting to feel stressed or sad, I know when I used to work in the clinic, I had an office right up front and most of the time I'd leave the door open so my staff could come in, the clients could come in. I tend to be an extrovert. So I like having people drop in, but if I was having a particularly stressed out day for some reason, I'd close my door because I knew that I was emotionally vulnerable to being a little bit more snippy or less hospitable. So, you know, I was aware of that through mindfulness. I was aware when I was having a day where I needed to give myself a wider birth. Mentally, your vulnerabilities understand when you start thinking more negatively. Physically, nutrition, sleep and, you know, ideally exercise also sunshine, you know, remembering that there are oodles of vitamin D receptors in the areas of the brain responsible for mood. They don't know how it works, but they know vitamin D is implicated in depression. So make sure that, you know, there's been enough sunlight, even if it's not the winter and you can't call it technically seasonal effective disorder. Some people start to be very affected after two or three days of just reary rainy weather. So if that's the case, what can you do? Social vulnerabilities, if you're feeling, if you have social anxiety or if you don't like going to these mixers or whatever, I don't like going to mixers. So I use that example. Whenever I have to go to one of those for the chamber, I take somebody with me because I just, I don't walk up to people and go, Hey, how you doing? Very well. Just not my thing. So I know that that's a vulnerability. I'm going to be stressed out going in unless I bring, you know, somebody to kind of be my wingman. And what are your environmental vulnerabilities for people with addictions? That would be having the stuff in the house.  Somebody who's a smoker probably doesn't want to be around cigarettes or nicotine. You know, so you want to look at these things. What things do you need to prepare for? When somebody has cravings, and this goes in the relapse prevention plan, once they've identified their triggers and their vulnerabilities and ways to deal with those, then you move on to cravings. Compile a list of who you can call and what you can do to distract yourself from craving and how you could stop a craving altogether. And this refers to gambling, smoking, sex, overeating, or even self injury.  So, you know, think about it in terms of that. And then healthy tools need to be in there too, not just all the doom and gloom, and this is how we intervene, but we want to be proactive, not just reactive. Think about what new and old behaviors you can use to keep you on the right track. So what do you need to do every day? Set an alarm in your, on your smartphone that reminds you to do your mindfulness activities if you need to. Some examples include writing a list of consequences, should you relapse, attending support meetings, exercising, journaling, writing a gratitude list. For some of my clients, like if they have anxiety disorder, for example, and they're, they're worried about everything. At the end of the day, I have them write down, you know, what they were worried about and whether it came true. And so they can see, you know, yeah, I probably was worrying about that for too much, maybe not for no reason, but, but too much. And then what they can do to control that worry. Emotional relapse. In emotional relapse, your emotions and behaviors become negative and unpleasant. You find it difficult to experience pleasure. So encourage people to think, and we're going to go through each of these. And yes, it can get granular. It can get kind of tedious, especially if you do it all at once, but it's important to think about what triggers their negative emotions. And this is another one of those. We talked about station learning, you know, you can put flip chart paper or whiteboards up around the room and have each emotion listed and then have the group go around, break them into groups of like three or four, have them go around and list on the papers what triggers their anxiety, what triggers their anger, resentment, jealousy, yada, yada. So you can get a whole list of what may trigger it for people and what they can do about it. Encourage them to think about things, the media, people, places and events that may trigger those feelings. Negative emotions make us uncomfortable. So encourage people when they start to feel uncomfortable, not to just stuff it or avoid it, but to identify the emotion and explore why they're feeling that way and take steps to fix the problem, not to fight it. I feel angry, I feel depressed, I feel however I feel right now. Okay, I don't want to continue feeling this way. Instead of fighting it, what can I do to improve the next moment? People can sometimes become stuck in their emotions, nurturing it and blowing it out of proportion. If you think about something long enough, you can, you know, get that snowball. It's kind of like telling fish stories and each time you tell it, that fish gets a little bit longer. You can compound it with other emotions like anger and guilt.  They may feel angry at themselves for not being able to do what they used to or what they think they should be doing, you know, and guilt for the same reasons. So, you know, you're getting this anger onion or this emotional onion, so to speak, and there's layer upon layer. Think about the bloomin' onions at outback steakhouse. So you have the center core emotion and then all these surrounding things. You can also get stuck in the emotion and start personalizing it. You know, this is happening because I am yada yada. Okay. And you might get stuck trying to escape from it. So instead of dealing with it head on, you start fighting with it. And we know that telling yourself you shouldn't feel depressed or you shouldn't feel anxious doesn't work. You feel that way for a reason, so you need to figure out how to fix it, how to address it instead of trying to run away from it, stuff it or compartmentalize it. Remember that emotions are just cues like a stoplight or, you know, I make the analogy of the smoke detectors in my house. Every once in a while, you know, I will be cooking and then I will get sidetracked to something else.  Does that mean the house is on fire? No. Does that mean there's a big problem? Well, not yet, but it's telling me that there could be a problem. So I need to pay attention. Our smoke detectors were faulty for a little while. I don't know what was causing them to do it and we would have the windows open and when the wind would blow really strong through the house, it would set them off.  But that was just the smoke alarm saying there might be something to be concerned about and we go around and look and there was no problem. Emotions are the same way. Sometimes we feel anger or we feel anxiety and we need to stop and look around and go, is this something that's actually a threat to me right now? If so, cool. You know, let's figure out what to do about it. How to fight flea deal. If it's not, then I need to figure out how to let it go because a lot of times we get all riled up over things that really aren't that big of a deal.  So we don't want to just tell people you're getting riled up over nothing. We want to look at it. We want to examine it and then figure out how to deal with it. Negative emotions. You got to remember you feel how you feel in the moment. So if somebody feels angry, they are angry. Don't tell them, you know, there's no point in being angry. Well, that's how they are. So we need to figure out how to deal with it and help them figure out how to change or improve the next moment. Encourage people to practice mindfulness, increase positive experiences. Keep a gratitude journal. Add one thing to it every day. I am grateful today that and sometimes it can be something like I'm grateful. I didn't get in a car wreck. Or I'm grateful that I've got a job or whatever it is. It doesn't have to be something earth shattering, but encourage people to write in this gratitude list each day. So they remember that things aren't all bad. Encourage them to increase positive experiences. Avoid personalizing something that may not be about them. I always tell them to identify three other reasons that this might have happened that have nothing to do with them and then evaluate, you know, where they're at.  Yeah, you need to get to the gas station or hunger pangs that tell us blood sugar is fixing to get low. Probably need to eat something.  You might need to do something dwelling on nurturing avoiding or hiding from negative emotions. Generally doesn't make them any better. You need to figure out what to do with them and you can choose to feel and fix or relapse and repeat and and feel and fix. Obviously you feel that emotion. You're like, okay, you know, I don't like feeling this way. How can I improve the moment or relapse is doing what you used to do with emotions and shoving them down, avoiding them. Well, they're going to come back up on you like bad spaghetti. So relapse and repeat. One activity you can have clients do is to list 10 things that they chose to get anxious or angry about over the last week. Identify why they got upset. What their mind was telling them needed to be fixed. So that's that cognitive behavioral stuff. The B and the ABCs did holding on to the upsetness. Do them any good. And when I do the ABCs, that's the E the evaluate. Was this an effective reaction? And what was your initial reaction and was it helpful? And what could you do differently next time to either change or fix the situation or improve the next moment? Change how you feel about the situation, which may mean walking the middle path, accepting that this sucks, but I can get through it or let it go. And that that radical acceptance it is what it is. And with clients, obviously we need to walk through these activities in group to help them figure out what the difference is between all of these things versus what they always used to do, but help them get used to evaluating their reactions in mental relapse. There's a war going on in your mind. Part of you wants to stay positive, but part of you struggling with tolerating the stress. The signs of mental relapse are focusing on the negative and tending to have a pessimistic helpless, hopeless attitude. If people have an addiction, they also may be may start thinking about people places and things that they used with glamorizing past use. Now, you know, think about overeating or binge eating. They may start thinking about that chocolate cake lying to yourself and others, justifying behaviors, minimizing the impact of one drink hit bet.  I don't care. Nothing I do works. So screw it, which kind of goes with the helpless, hopeless attitude. So encourage people to think of what types of things trigger the negative thoughts, things, people, places and events, and what thoughts do you have that make you feel angry, irritated, resentful, guilty, envious, scared, anxious, worried or stressed. So what thoughts? And that's, you know, one that takes some thinking about. So it could be thoughts like I'm not good enough, or it could be thoughts like everybody's against me. So encourage them. And this is obviously, you know, if they do some ABC worksheets throughout the week and they bring them in, we can look at some common themes in the thoughts in the bees and see what types of thoughts that may be triggering those dysphoric emotions. So then we can address them because they often relate to fears of rejection, isolation, loss of control or failure. So connecting feelings and unpleasant thoughts. You can have them do this chart where they look and they say thoughts that make me feel angry, irritated or resentful. What, which of these thoughts relate to loss of control or the unknown? Which of these thoughts relate to failure? You know, so you're grouping them by themes. Which of these thoughts relate to isolation or rejection? And which of these thoughts relate to death or significant loss and death and loss of control or kind of end up getting mushed sometimes, you know, because you can have death of dreams or loss of dreams. But help people kind of figure out how to categorize these. And then they can see visually which types of themes are keeping them stuck, which can help them figure out what areas they need to work on with us. Preventing mental relax. Kiss. Keep it simple, silly. Trying to change too many things at once can lead to failure. So encourage them to do one thing at a time. Let's develop self-efficacy and confidence. And like we talked about with the brief, let's focus on one thing that's going to affect every area of life. Prevent and address vulnerabilities that can make you focus on negative or have strong negative emotional reactions.  Include people, encourage people to look at life like a roadmap. The destination is recovery or happiness or whatever they want to call it. And encourage them before they act, think about whether what they're getting ready to do keeps them on the right path or is an unplanned detour. And that'll help them kind of figure out is this helping me or is this kind of, you know, maybe even making me spiral around and get lost in the process. And encourage them to maintain head, heart and gut honesty because the head will tell us this is the logical thing to do. The heart will tell us tell us what we want to do. What's going to make us feel happy tend to be a more emotional. And the gut is the one that is kind of like the spidey senses, the wise mind that says, yeah, let's think about it.  So encourage people to make sure that they've got head, heart and gut honesty. Social relapse. You can return to the old people and places who cosine on your BS. So if you're hanging out with those people that you were hanging out with before may not be helpful. You've withdrawn from your social support become self centered or just withdrawn completely from everything. So again, encourage people to look at what triggers you to withdraw from people for some people holidays can be a huge trigger. So I encourage them to really look at holidays and see if that may trigger some withdrawal because once you start withdrawing from your social supports, then you're bearing the stress on yourself and you're also eliminating some of the positive some of some of the Yang and and you know, you could be putting yourself in a position where you might be more vulnerable to relapse. Preventing social relapse. I encourage people to contact their healthy social supports on a daily basis for the first three months. It doesn't have to be huge. I mean, we all have Facebook or text messages or something. Just say hi, how you do and how was your day going? Get get involved. Know what's going on. So you can ask them. Well, you know, did you get that promotion instead of calling them up? You hadn't talked to him for three months and go, Hey, what's been going on with you? By the way, I need a shoulder. Keep a business card in your wallet with the names and numbers of three social supports or keep it on your mobile device. Change your phone number if you need to and destroy contact information for people who might trigger a relapse. Obviously, this is definitely critically important for people who are who are recovering from addiction. We would have clients in the residential facility. They would have been there for three weeks and their dealers would still be blowing up their cell phones. So a lot of times we recommended that they they changed their phone number. But even for anxiety and depression, you know, sometimes people have contacts that are draining and they can't set effective boundaries with because those people are just there constantly. This isn't so much for mental health. Definitely more for addiction. But sometimes, you know, getting a fresh start. Sometimes I change my phone up my personal phone number periodically because telemarketers will get it. And I hate getting 81015. Yes, no joke. Telemarketing calls per day. It just infuriates me. Well, I don't need that kind of stress. So, you know, that's the good thing about Google numbers. You can change your number periodically. And find at least one pro-social activity to do each week. Volunteer, go to church, go to the gym, whatever it is where you can be around other people and feel like you're improving your health, your wellness and or the world that you live in. Physical relapse is characterized by fatigue, increased anxiety, difficulty sleeping, neglecting physical health, and if there was an addiction, cravings, and maybe even dreams about the drug. To prevent physical relapse, we talk about the acronym HULT. Hungry, nourish your body with proper nutrition so it can make the neurotransmitters you need to be happy, healthy, and not anxious. Nourish your mind with activities and things that increase those happy chemicals. When you do things that make you happy, you're getting the dopamine to flow. You know, when you exercise, you're getting the serotonin increases. Your dopamine can increase. So those things are good. Hungry doesn't necessarily just mean food. Hungry can mean your hungry for companionship.  You're hungry for whatever, but hungry, angry and anxious. So encourage people to reduce chronic stress. What things can you eliminate? What things don't have to be draining on you right now? Lonely. Encourage people to nurture their social supports to buffer stress and be willing to ask for help and help them differentiate between being lonely and being alone. Because people can be lonely in a group of 600 other people and they can also be alone and not be lonely. So having them look at the difference, the semantics, that's sort of esoteric, but there is a concept here to help people realize that they can be alone without being lonely and tired. It's important to encourage people to get sufficient quality sleep and address issues such as sickness and pain that prevent quality sleep because lack of quality sleep just does so much to keep our HPA access or our threat response system kind of on, which keeps us from resting and relaxing and it also prevents us from accessing as much serotonin and it impacts all of our hormones. So let's make sure people are getting good sleep. For relapse prevention planning at the end of counseling or maybe even from the beginning you start talking about this. Review people's strengths. Ask them what life is like when they're happy. What's different and what's the same? Because what's the same? We obviously want to keep going and what's different? We want to bring that back. Have them list three ways that they already cope with stress. What activities they like to do? Their positive qualities and strengths because when relapse starts to come in when people start to feel depressed their self-esteem may start going down too. So having them have a written list of their qualities and strengths and encourage them or talk with them about how to use this information to prevent relapse. How can we use all this information to create a recovery lifestyle for you? Encourage them to review prior relapses and recoveries. What was happening before this happened? So before the relapse what led up to it? But when you were in recovery you started and you were feeling pretty bad and then what led up to you feeling good again? What did you start doing? What changed? What triggered the relapse or the recovery? You know, what things did you start doing that either made you relapse or helped you recover? And encourage people that to remember that change occurs when old behaviors are more rewarding or stronger than new ones. So things we've been doing for 20 years are pretty darn strong. These things we've been doing for 20 days we're still getting the hang of them. So it's going to be harder to use these new tools at first. So it's important for them to you know, have confidence and remember to use them in practice and cut themselves a little slack. If they relapse ask them what became more rewarding than your recovery program. You know, what happened? What changed? What made you want to slide back into those old behaviors? And when they recover ask them what made doing the hard work of recovery so rewarding. You've done great. You know, what kept you going even through the tough things? Encourage people to look at their emotions, thoughts, behaviors and interactions with others before relapses and in recovery. So they can see the difference. They can see how they are different and how their environment is different. Encourage them to identify relapse warning signs such as feeling unable to cope and developing a strategy for that. For example, if somebody has that feeling they may need to learn how to say no to taking on extra projects limit work to 45 hours a week and learn how to use relaxation exercises and meditation to unwind. You know, if they're feeling like they're out of energy they need to figure out what they can do to help them get the energy to cope again. Irrational thoughts. Somebody may have the thought that I need to try harder in order to get things under control or else I'm going to be a failure and so encourage them to counter that with a more rational thought such as looking at I'm burned out because I'm trying really hard. I need time to rest or I'm going to start making more mistakes. So taking out the extreme notions looking at the cognitive distortions unmanageable feelings such as humiliation embarrassment or this feeling of failure. Sometimes we get these feelings and it's hard to shake them and they feel oppressive. So what can you do? Talk about your feelings with others. Remind yourself possibly and this may or may not be true that there's no reason to be embarrassed. You may do something that is embarrassing but who's going to remember it two weeks, six months from now and remind yourself that all human beings are fallible. You know, not not just you. So, you know, consider having counter statements that you tell yourself when you start having catastrophic unmanageable feeling going through your head. Self-defeating behaviors such as driving yourself to keep working even though you need to rest the constructive behavior would be to take a break and relax. Ask someone to review the project and see if they can help you to solve the problem. Remembering from the seven habits sharpen the saw. We need to take time to do what's right and you can do it wrong. I mean, you can just pull through and do it. But let's do it right the first time because you really have energy and time to do it the second time. Self-defeating behaviors kind of that way.  A lot of times that leads to errors and more problems. So what can you do that's more helpful? That's probably going to take the same amount of time or less time than having to redo or deal with all the problems. When creating the plan encourage people to identify why they want to change the most common pitfalls for relapse for them. What they can do to prevent that from those pitfalls from happening again for me, I'm big on, you know, alarms and text messages to remind me to do stuff because otherwise I get a little mindless and focus on what's worked in the past. Encourage them to include in their schedule recovery activities, things that make them happy, healthy, connected work, obviously.  Reflection time. So they can look back and go, you know what, things are good. This is their mindfulness time. Positive health behaviors and nurturing positive relationships. People's self-esteem is, you know, a sense of pride in who they are and acceptance of strengths and weaknesses. So we need to help clients work on their self-esteem as part of their relapse prevention plan because if they feel good about themselves and they feel confident, they're more likely to take on this challenge when they start feeling anxious or depressed or craving again. Lack of self-esteem can lead to a need for external validation. Self-esteem workbooks abound out there to help people develop positive self-esteem. You can use them as an adjunct to group therapy. You can use them as an adjunct to individual or people can get them on their own. But, you know, it's not necessarily something that you have to spend a lot of time on if you don't have a whole lot of sessions with somebody. Eradicating harsh, self-critical self-talk is the second part of working on self-esteem. One book that I like is Taming the Critical Intervoice I do have a video review on that that you can look at online. But, you know, I like that book may not be for you. And being aware of the imposter phenomenon and that's when somebody does something or makes accomplishments and they're like they should be just overjoyed that they did it and but they feel like they're an imposter. They feel like they shouldn't have made that accomplishment or something and they're just waiting for somebody to find out. So they're always anxious. They don't feel like they deserve the accomplishments that they've achieved. Relapse often begins when mindfulness ends. Mindfulness is being aware of who you are, how you feel and what you want. Encourage clients to keep morning and evening journals to document these sorts of things for themselves if they have to write it down or even spend time thinking about it. It can it can help them get grounded and encourage them to develop behavior interruption activities. So if they start feeling like they're getting into this anxiety spiral, what can they do to interrupt that behavior? Another thing that we can have clients do is the acceptance and commitment therapy and just real briefly. Again, there's a video on our on our website. On our YouTube channel about it. But the mindfulness, the act matrix and basically you have four quadrants and over here is moving toward those things that are important to you to give you a rich and meaningful life. Who and what is important and what behaviors could you do to move you toward who's who or what's important. Where you are right now.  You are anxious. You are depressed.  It is what it is. So what is the next thing you could do that would help move you toward those things that are important. So when you get angry, sometimes you're getting angry about something that you just can't control. Is holding on to it and stewing about it. Going to move you towards those things that are important. Probably not. It's probably going to move you away and drain your energy. And then on the away section. What behaviors do you do like running away from stuff stuffing it down, drinking, smoking, sleeping, eating, whatever. That move you away from your goals. Stewing and what unwanted internal stuff shows up when something happens that moves you away from those things that are important to you like negativity and suspicion and all that stuff. So you can walk clients through completing these quadrants. So they have an idea about the different types of behaviors and thoughts that they can use you know, even cognitive restructuring to move them towards what's important to them. So relapse prevention begins Oh, and Kevin Polk has several videos on YouTube walking you through that as well. His book is complicated. If for clinicians, you know, it might be a great resource for clients. I don't think it's super helpful. But the videos are really helpful. Relapse prevention begins when remaining aware of your wants and needs. It begins when the old behaviors start to surface such as avoidance, minimization, rationalization, denial, numbing, anger, resentment, and regret. People need to learn how to self govern as part of their recovery. Okay. Sorry, y'all. At least I made it through the presentation this time without coughing. Um, those are some tips and tools for relapse prevention. Does anybody have any questions? All right. Then everybody have an awesome weekend and a wonderful new year and I will see you in 2018. 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 seven multimedia continuing education and pre-certification training to counselors, therapists, and nurses since 2006.


The final 10 megahertz B scan positions are axial scans. I leave them for the last because of two reasons. Number one, all the other exams we avoid the lens as much as possible. The crystalline lens and definitely an intraocular lens in an eye will act like a lens to the sound beam and cause a lot of aberrations in the image. So we normally avoid the lens, but there are times when it's nice to do an axial scan so that we can document the posterior lens capsule in relationship to the optic nerve and if there's another pathology in that view. So let's start with a horizontal axial, the most useful, because when I go horizontally, nasal, temporal, I will at least have the macula in this view. Although I would never make a decision or clinical decision about the macula or the retina from an axial view because when the lens is visible in our B scan, I don't trust the echoes from the retina completely. Look straight up to the ceiling for me, a little bit lower, there we go. So I put a big blob of gel and now when I get the optic nerve, there we go. And I'm going to freeze that for a moment just to show you that you have some aberrations here from scanning through the crystalline lens. Lots of artifact, that's not something in her vitreous. We actually can see anterior and posterior cornea and optic nerve. So if the marker was nasal, this is a nasal temporal scan, that means the macula is just inferior to the optic nerve on the screen. And you can see the reason why I can't make a clinical decision. Now the vertical axial scan some people like to do, but I find it less clinically useful and I wouldn't take the time to do that unless you had a pathology that were there. However, what I can do is just to show you how it'll look exactly the same and why labeling the picture, why labeling the image is very important because no matter what you see on the screen, you are the only one, the one who's holding the probe, the only one who knows where that image came from where that image came. Marker superiorly, lower the gain a little bit, that's a little bit cleaner now. There's the optic nerve and there's the double peak of the cornea. Anterior cornea, posterior cornea, posterior lens, capsule, optic nerve. So those are the components of a classic axial scan. You may need to do an oblique scan if the patient had an infrotemporal melanoma, for example, then I would do an oblique scan so that I would have both the tumor and the lens and the optic nerve all in my same view. And on the horizontal scan that we just did, that could also be used to take a measurement of the axial length when I have enough distance and I can clearly see the anterior cornea. I'm confident about double checking the measurement of a Staphyloma eye.


Hey survivors and frivers. In this video I'm going to be talking about how the Narciss sees you as an object. Please like, comment, share and subscribe. Click the bell icon to receive notifications for my future videos. If you are lighted tonight, my paypal link is in the video description. If you are interested in one-on-one coaching, you can email me at narcisfevercoaching.com. The Narciss sees you as an object. The Narciss sees you as an object or as an extension of them. They only care about what you can give to them or how you make them feel. They do not see you as a separate human being with your own needs or emotions. They don't really care about what you need or how you feel. The Narciss sees you as a material thing that can be seen and touched. You are also a thing to which a specified action or feeling can be directed. Other than Narciss is looking at you, touching you or directing a specified action or feeling towards you. This all revolves around regulating their self-esteem and their emotions. Whether it is positive or negative attention, it has nothing to do with you personally. Because the Narciss does not see you as a person. They see you as an object. Like any household item, you are there for when they need you. As an object, you are expected to serve them. The Narciss might give you what you need initially to take care of you and ensure that you are operating at peak performance. They don't think of it as developing an emotional connection or doing something beneficial or favourable to you. It's more like a man polishing his new car or putting fuel in the car. The Narciss sees you as a prized possession. You are meant to look good and you are meant to make them look good so that people will admire and compliment you. At the beginning of the relationship, the Narciss will see you as an object but also as a positive extension of them. In their minds, if people are admiring and complimenting you, they are admiring and complimenting them. They use you as a prized possession to extract supply from the people around them. You are providing them with what they need so they are taking care of you, ensuring that you are operating at peak performance. They also recognise from past experiences that unlike a car, you could leave at any moment if they do not give you a certain standard of treatment. But they still see you as an object. As time goes by, they might begin to neglect you or not provide you with the same treatment that they were giving you initially. Like with an object, they may get bored of you. This will affect your performance. You will no longer accomplish or fulfil a certain task or function as efficiently. The Narciss will not assume responsibility for the drop in your performance. They will not recognise that their change in how they treated you or neglected you could be the reason why you are no longer accomplishing or fulfilling a certain task or function. The Narciss will not assume responsibility because that would mean that they made a fault or mistake.  So they are not going to accept that they have made a fault or mistake. If they are not a blame, it must be you. You must be defective or not good enough. This is when they begin to devalue you and give you put downs or back end of compliments. The relationship is no longer performing as well as it did in the beginning. Although it may be due to the Narciss' change in how they treated you or because they neglected you, they are not going to acknowledge this. They are shame based individuals doing everything they can to avoid reflecting on their shame. So they are going to blame you. They are going to start devaluing and degrading you, telling you how you are not good enough for them or you can't do anything right. At this point, deep down they actually believe that they are not good enough for you, but they are doing everything they can to avoid reflecting on their true beliefs about the situation. They are actually envious of you and the qualities, talents and traits that you possess. But they cannot acknowledge this because that would trigger them to reflect on their shame. Instead they will treat you with contempt and act as though you are worthless or beneath their consideration.   They may also assume that you are going to leave them.  So they will discard you as though you never meant anything to them. It is a matter of how many years you were together or if you were married or had children. The narcissist saw you as an object, in their minds you exist to serve them. The object no longer accomplishes or fulfills a certain task or function, so it has no use to them. They will then look for a new object if they don't already have one, which can accomplish or fulfill the same tasks or functions that you once did when you are expressing your feelings to them. They might pretend as though they care about what you have to say but they really don't. Others are self-absorbed and lack empathy, they are imitating what they have seen someone else do or what they have seen on TV or in a movie, whether there was a similar situation they don't really care about what you are expressing to them. All they care about is what they can get out of you or how you can make them feel but if creating an illusion of love or significance will make you stick around and give them more time to extract what they need from you, they will create an illusion of love or significance. This does not mean that they really love or care about you, although they will say that they do, when they say these things it's because it helps to secure you as a source of supply. They also expect you to say the same thing to them in return, which makes them feel better about themselves, it's all about them and what they can get out of you or how you can make them feel, they don't even acknowledge that you exist at a human level when they try to fulfil your needs or give you compliments at the beginning of the relationship. This is all designed to either secure you as a source of supply or they are seeking validation or compliments in return from you, the narcissist recognises your value but they do not appreciate it, they see you as a valuable object rather than a valuable human being. The more time you spend with the narcissist the more this value will depreciate, the abusive manipulation will also have an effect on you. One day the narcissist will leave as though you never meant anything to them because there was no real attachment. The narcissist cannot emotionally connect to you, they can only plan or coordinate the elements of a situation to reduce the effects of an emotional connection, the narcissist does not see you as a human being, they see you as an object, this is how they can leave you as though you never existed or meant anything to them and then find someone else to replace you, no matter how many years you have been together or if you are married or had children they do not miss you as a person because they see you as an object, they might miss what you provided for them or how you made them feel but they will find someone else to provide for them and regulate their self esteem and their emotions, there are no real feelings evolved, only the illusion or simulation of feelings, sometimes it can seem real but narcissists will lie to themselves and act as though they are in love, that's why it may seem like they love you one day and then the next day they are gone, narcissists are shame based, they are not capable of experiencing emotional connections or love, they can't even have a genuine conversation, all they can do is feed off your energy and emotional reactions and take whatever it is you have to offer them, they are transactions where you are always given more value to them than they are given to you and that's why we end up feeling drained and lifeless at the end of these relationships because the narcissist is feeding off us, taking everything that we have to offer to sustain them but nothing is ever enough because they have a huge void within them that can never be filled, this is why they will constantly change jobs, locations, relationships, they are always seeking attention from people, always wanting to be admired, they are trying to regulate their self esteem and their feelings of shame, trying to fill the void within them, the irony is it is these desperate behaviours which are preventing them from healing from narcissism. Thank you for watching, please like, comment, share and subscribe, click the bell icon to receive notifications for my future videos, if you would like to donate my PayPal links in the video description, coaching enquiries you can email me at Narcisfivecoaching at gmail.com, we have a private Reddit community where survivors and frivers can share their experiences and knowledge, if you are interested in being a part of this community you can sign up for our Patreon page the links in the video description, check out the Narcisfive Mojdi store where you can purchase your own Narcisfive t-shirt or mug, we have a variety of designs and it is a great way to support the channel, the link to our Narcisfive Mojdi store is in the video description, thank you for watching and I will talk to you soon.