Resolutions: A New Year is Upon Us

What do we make of New Year's resolutions?  Do we even bother making them anymore? Many of us still do and several of us set ourselves up with grand plans of losing mega weight, making mega bucks, or some other far reaching goal with little planning or thought of how to go about getting there.  So today let's talk about thinking our goals through and planning for success. Don't make a huge list, start with one or two goals at a time.  

First: Let's start with identifying your expectations for the year and the resolution you are making:
How will your goal benefit you? Identify your goals and address these expectations and define your objectives. Setting a timeline for yourself at the outset is important; now keep this realistic.  However, remain open to setbacks and work them into the process.  If you need help ask for it.

Second: After you know what your goals are and are sure of your timeline you should be feeling confident about yourself, your plan, and feel ready to begin your process.   Resolutions need not start on January 1st, although planning for them can begin soon after. But this is where the majority of your  action and enthusiasm drive your momentum, and desire to get started, so take advantage of the extra enthusiasm.  Again, don't be afraid or frustrated with setbacks, we all experience them from time to time.  Just get back on course as quickly as you can and again if you need help don't be afraid to ask for help.

Third: As you continue to build on your momentum you may find that you need additional support.  Friends will be supportive, but you may feel alone in your accomplishment.  You may want to re-examine your objectives and being flexible and not feeling frustrated or let down by the speed of the process.  Like all skills, your new skills were learned over the course of months, so be flexible and forgiving of yourself as you may slip from time to time, so seek out support where it is available to you.

Once you have followed this more systematic way of meeting your goals you should feel a sense of accomplishment, but if you don't feel fulfilled, re-evaluate your initial goals and expectations, and if you want more support feel free to call me to set up a consultation.

As always, I hope you found this helpful and informative.  Feel free to call for a consultation.

All the Best to you and yours this Holiday Season.

Dr Kevin
www.DrKevinOBrien.com

Being Prepared for the Holidays: Don't Sweat the Small Stuff

Holidays are a time of high emotion, powered not only by nostalgia but unrealized expectations that can leave us feeling unfulfilled. If you are feeling frazzled, consider making time for yourself. Doing so can be an effective way to avoid getting caught up in the folly of the overstressed gift exchanges, and social media displays of status and achievement. It may be completely out of character for you to take time out for yourself but you will feel less exhausted and more present at the events you do attend.  So, give it a try: grab a hot chocolate and rest your feet, catch up on a phone call, or something else that helps you feel that you are re-energizing yourself.   

Going into the family gathering with the expectation that relatives will be on their best behavior can be a set up for disappointment. Remember that friends and family will not be any different, and you will be in a much better mind set.  Arrive prepared for this and you won't get "plugged in" to their incipient behavior. You'll get along with Uncle Fred and his excessive drinking and bombastic stories, and accept them for what they are and from whom they are coming.   You will have survived a holiday gathering unscathed and with little emotional cost to yourself or your ego. 

Not sweating the small stuff goes a long way when it comes to family and work especially during the holidays. Generally during the holidays, family and folks are so caught up in their own folly that rarely do they take the needs of others into consideration. People will let us down at times, but when we apply these life lessons about not sweating the small stuff, we realize it is rarely with any real malfeasance or malice.

This major attitude adjustment does take practice, so be patient and start with yourself.  For instance Uncle Fred is drunk again, is he your responsibility personally? NO. Is he the family's responsibility? Maybe. Or is he responsible for himself? Yes. Uncle Fred, his partner and the rest of the family may need to discuss the emotional costs of his drinking, and the benefits of seeking help. If they are unwilling to, you may wish to discuss this with your therapist so you can learn to let Fred live his own life as he chooses until he decides he wants to change it. You may decide that it's most constructive to limit your contact with your your uncle for the time being.  

As always I hope you found this helpful and informative, Feel free to call on me for a consultation.

All the Best,

Dr Kevin.

www.DrKevinOBrien.com

  

Managed care and "Out of Network" Therapy

There appears to be a lot of confusion about managed care, and with confusion comes inertia. We see it playing out on a National level so of course it is effecting us on a local level. The reality is that not much has really changed in the scope of things.  Insurance companies still reimburse for "out of network" service although the deductibles have begun to vary greatly over the years from one provider to the next.  

Finding a therapist on a list is similar to looking in a phone book these days and can be quite daunting.  The other difference is that "in network" reimbursement rates have declined dramatically in the last few years as well; which partially explains the exodus of medical and psychiatric providers from many high profile insurance panels. Not to mention that finding a therapist on a list is similar to looking in a phone book these days and can be quite daunting.

These are two primary reasons, along with practice freedom that many doctors choose not to deal with the bureaucracy and unnecessary oversight of having to justify every medical or psychiatric decision by disclosing patient confidential information repeatedly to insurance companies.  

Another unfortunate problem is the language regarding out of pocket expenses; co-pays -vs- co-insurance payments, as well as deductibles.  Until there is a universal deductible for mental health the confusion and rate  wars will continue.  Speaking for myself, as an "out of network provider" I charge a fair market rate that clients either find agreeable or not.  It is lower than many of the in network practitioners charge the insurance companies, but they balance it out once their rate drops following the client meets the insurance deductible.  

However, on a personal note, I do not reveal (without your permission) your reasons for treatment and your notes to your insurance company for any reason.  I release the minimum amount of information necessary for you to be reimbursed for your costs, if you want to be reimbursed.  Many clients prefer remaining confidential in their treatment and choose not to be reimbursed.    

Not everyone can afford not to be reimbursed however, so, confidentiality remains a major sticking point between "in network" vs "out of network."  Confidentiality is less secure when you work on a panel because the insurance company can audit your file when they feel fit to do so.  So one of the benefits you are paying for is the luxury of privacy with an "out of network" provider.  You are able to feel confident that your information is kept private and not shared with your insurance company, unless you want it to be.  

A bargain is not always the best or wisest course of action.  It does work for many, but many "out of network" providers have sliding scales to work with clients and make "out of network"treatment more accessible to more people.  Don't be afraid to try to negotiate a rate with a provider, It can't hurt and may help you get a better therapist in the long run.  

As always I hope you found this helpful and informative.  Feel free to contact me for consultations.

All the Best,

Dr Kevin

www.DrKevinOBrien.com

What Do We Do With What We Learn In Therapy?

What do we do with all the knowledge we learn in therapy?  Hopefully, you are applying it to your everyday life experiences, or at least trying to.  As much as people tend to want to believe that therapy is about the past, it is more about understanding the past so you don't repeat it.  We all have developed positive and negative patterns of thinking and behaving. So you are not alone.

It is understanding how these ingrained thoughts and behaviors "get in the way," or even benefit us that help to optimize our lives.  It is easy to say I live in the "here and now" and I don't need therapy. Understanding that your "here and now" is nothing less than an amalgamation of past experiences, both good and bad and even in between is what therapy helps to uncover.  In other words, it allows for you to finally be more in charge of your "Here and Now."

Of course this is not resolved in 12 easy steps, it is a process that requires an ongoing commitment of both therapist and client.  It often implies that there are setbacks and is not a linear process.  Developing trust with a therapist takes time, feeling safe enough to explore secrets requires trust and both of these take time to develop in any relationship, including a therapeutic one.  

Band-Aids have their purpose in the medicine cabinet, but if you need sutures see a doctor. So don't fall prey to the easy fix, it does work temporarily on the specific issue in question, but it is not modeled to help you understand causality (the reasons under the behavior in the first place) and the primary reason they are only "short term fixes" to long term problems.  Understanding the reasons why we repeat self sabotaging behaviors, helps offset new thinking and behaviors that help us make clearer choices and less damaging ones.

Self help is wonderful, and helpful to millions of folks, and that is often all they require or want out of their programs.  Some however, seek more answers to the questions and a deeper understanding that comes with growing mentally and emotionally stable in their particular self help program.  It is these individuals that seek outside guidance for deeper understanding of their questions and lead to a healthier lifestyle.  Therapy is an excellent option to helping explore those esoteric questions that are sometimes to complex for the self help route, or even the rooms.  

Again, what do we do with what we learn in therapy?  We apply it to live healthier and happier lives as more self actualized people that better understand what motivates their thoughts and actions.  Living in the present "here and now" as fully as possible, no longer prisoners of our past memories, behaviors, self destructive desires. This is what therapy can offer anyone seeking a happier life that is patient enough to work a little toward their goals to truly experience the moments in their life as they unfold in the "Here and Now." As always I hope you found this helpful and informative.  Feel free to contact me for consultations.  

All the Best,

Dr Kevin
www.DrKevinOBrien.com

Self-sabotage and how we stop ourselves from getting what we want

It has been my experience that, even those who protest that they have nothing to feel guilty about have underlying guilt feelings that stop them from achieving their goals. Goals as simple as applying for a promotion, or asking someone out on a date.  Learning what it is that you feel guilty about is often just the beginning breakthrough to better understanding of your motivations and what holds you back from achieving.  

Firstly guilt has many disguises: mainly fear, insecurity and procrastination.  All are sometimes present or just one of these outward symptoms of guilt.  Another example is hiding in ones work, workahoholism. Functioning and hiding are two very different animals.  Where the blackberry has become a new appendage and interrupts meals, meetings, and social discourse.  It is easy to say that we need these modern tools to function, and many of us do. 

These are often, but not always, symptoms or outward manifestations of guilt feelings.  However, they get in the way from meeting someone socially; say at dinner when you are constantly on your blackberry, then wonder why you don't get call backs.  Another is handing in projects at the last minute, or when they are months overdue, or on the day they are due prior to proof reading them. Then wondering why you do not get the promotion you are seeking. These are just some examples, I'm sure you have plenty of your own examples.  

A primary goal in therapy and in coaching is to help uncover the root causes of these symptoms, find alternate ways of behaving and stop self-sabotaging behaviors from getting in your way of your achievements.  To live and work more in line with your goals and dreams and help you live a more harmonious life.  Not all of these are resolvable and much depends on what you are willing to put into it.  In other words, much of the results depend on the the efforts you put in to your treatment.  It is always best to consult a friend in treatment for a referral, or find one with credentials in an area that you approve of. As always I hope this was informative and helpful.  

All the Best,

Dr  Kevin

www.DrKevinOBrien.com

  

Seasons Greetings: As the Holiday rush begins

Yes, it is already that time of year and the Holidays are here, Channukah  is next week along with Thanksgiving.  Christmas decorations and sales are already up for grabs.  The clanging bells of the salvation army have also begun to ring.  

So what do we do with the rush and hurry?  Learning to pace ourselves by making lists is a great help, and also trying to take the urgency out of the shopping experience by procrastinating less and having more than one option as a gift.  Pacing ourselves always allows for the space to truly take the time to enjoy the day, and the Holiday Spirit "mood" of family gatherings and can add so much more to the experience.  

For those of us fortunate enough to have families, pacing yourself can also make you more tolerant of the family dynamics that seem to set everyone off. Allow uncle Fred to be uncle Fred.  It is who he is, and he will not change just because its a Holiday gathering.  If you are rested, grounded in yourself, and have paced yourself, you will get through it unscathed and feel the better for it.  

This is also a time of year where we see the good actions of others, and are inclined to good actions ourselves.  everyone seems to want to be a little nicer (except in the sales bin).  Look for kindnesses around you and vicariously allow for yourself to experience a bit of the joy of what you are witnessing. It may inspire spontaneous acts of kindness from you as well.

So have a Happy and kind hearted Holiday Season, and may the spirit of it carry you through the New Year.  

Dr Kevin

www.DrKevinOBrien.com

Aging Well: Your Golden Years

Aging is something we all confront, how we approach it is up to us.  Are we prepared for our aging? Have we followed up with a medical team? How do we feel about spirituality? Have we planned for ourselves financially?  What does growing older mean to us? These are just a few of the questions I want to propose here to help get you thinking about your own aging process and comfort with it.  

Let's start with are you prepared for aging?   What does this mean to you?  Acceptance of the fact that you are growing older, yet managing the process in a way that suits your personality through exercise, cosmetic enhancements, or just acceptance.  What role does your level of self esteem play in any of this?  Probably some role, but acceptance regardless of enhancements, within limits, only enhance self esteem and can help you feel years younger in the process but do not change self esteem.  It is the motivating factor for enhancements that becomes a concern. However if the end result is a happier you, and a more graceful aging process, than so be it.    

Getting frequent medical check-ups and clearance before trying risky exercise routines.  Establishing a medical baseline helps to understand where you are physically but also prevent any unnecessary risks. understanding cardiac health, etc. It is always good to have your vitals checked, and understand where on the continuum of aging you stand.  Depending on the results this may greatly boost your self esteem as well. 

Now the big question of spirituality comes next.  Even Einstein found it in his heart to believe in some form of omnipotence.  So no matter the route you choose, unless your smarter than Einstein find something larger than just yourself to believe in.  Whether it's as open ended as Love for all, or a Higher Power it is beyond your mental grasp to figure it out.   So we let this nebulous spiritual amalgamation grow and develop in as organic a manner as we can tolerate.  Asking questions, that seem to never be answered. Hoping for truth to win out in the end.  

Financially is probably the most challenging and difficult one to talk about.  It requires sober accounting of where we are fiscally at present, and where we want to be in our Golden Years.  Is it possible to get there from here with the large amount of debt we carry? The shallow savings account? Or do we have the opposite situation?  

Measuring your debt to income ratio and consulting a banker or financial planner is sound advice.  But take a look at where you are first.  Try to understand how you got there, and what it will take to get you out of debt if that is the case.  Many Americans retire carrying a debt balance into retirement, and with the significant cut in wages, they are unable to pay their debt and their monthly expenses.  They simply did not budget for the debt.  

So Clean up the debt prior to retirement, find something larger than yourself to believe in, establish a medical baseline and get medical clearance, enjoy your life and your health.  Age as gracefully and and comfortably as you can.   You will remain happier in your choices when they are thought through and measured with your providers; medical, spiritual, financial and mental health care. As always I hope you found this informative and helpful.  Feel free to call for a consultation.  

Dr Kevin

www.DrKevinOBrien.com

Learning really is a lifelong experience: Computer scams

It was a matter of days ago that I received an emergency SOS email from my friend overseas and I became alarmed for his welfare.   He is known to travel, and not careless, but things happen when traveling.  So everything seemed to be legitimate, and on the up and up.  

The e-mail read: "Am so sorry to bother you, I am in Limassol, Cyprus for a week and  I  just misplaced my bag containing all my vital items, phone and money.I am stranded at the moment and may need a little help from you. Thanks "

I replied, "Hi, My number is: 212-539-3710;  Feel free to call or  email."  He responded:

"Thanks, I've been to the embassy and was issued a temporary passport. I just need to borrow about €950, I will pay you back as soon as I get back home. Western Union transfer is the fastest option to wire funds to me. All you have to do is to locate the nearest WU shop to you and they will have the money sent in minutes. See details needed for transfer below.

"Name on my ID: [my friend's name] Limassol, South Cyprus
   
"You will need to email me the Reference number, senders name and address as it's stated on
      the payment slip as soon as you make transfer so I can receive money here."

Not noticing anything fishy, and being concerned for my friend, I scrambled around for some cash. I sent him 700.00 US -- a bit less than he wanted -- but planned on getting the balance off to him later in the week. It was the tone in which he responded to the partial payment that threw me into suspicion. it was trite and ungracious, and out of character for my friend.  My gut told me to try to call him, and he answered his phone here in New York City.  

That is when I learned that his computer was hacked into and thousands of similar emails were sent to others from his contact list.  We talked, filed a complaint with Western Union and above all - realized that there are people who prey on the caring of friends,  realized how there are people who prey on the caring of friends. My friend did all he could to warn his contacts of his of the scam, and I hold him in no way accountable to my generosity and good nature.

My friend and I have since met to reflect on the experience.  He helped me safeguard my own computer , using the lessons he had learned.  While there are a multitude of safety protocols in place at Google, etc. if you receive a SOS call try to validate it first, and be careful.  Remain alert, change passwords frequently -- the more complex the better.

In the end, I'm a little wiser about responding to Internet pleas, knowing that I am not immune to scams.  I do however remain unapologetially concerned about my fiends - especially if they're in need.  A lesson learned through life experience - shared with you so perhaps you can avoid a similar fate.

As always, I hope you fund this helpful and informative.   Feel free to call for a consultation.  

Dr Kevin

www.DrKevinOBrien.com 

Learning: a liftime experience

Passive learning takes place throughout our lives as we absorb information from our environment. From infancy with a speed that can boggle the parents' mind as she looks on. The ability to absorb information doesn't change over time, the type of information we absorb does however, as we differentiate it to its appropriate  social or defense area; this is seen most in the toddler, and again in the adolescent.

But as we get older we become Active learners, as toddlers, seeking out information and new things with an almost aggressive hunger for knowledge.  We store these memories both good and bad and in between making judgements about ourselves and the world around us based on them. Sometimes they become "ego strengths" that work in our favor as in a positive attitudes, self-esteem, work ethic, etc. and at other times the opposite as "ego deficits" working against our better good in self-sabotaging ways.  Most of our life, is spent striking a healthy balance between these two polar pulls of the ego and making personally and socially acceptable decisions.

We are constantly gathering information passively and actively, from our surroundings, parents, teachers, peers, mentors, social media,etc… and filing them away in our minds as important life lessons, or trivia.  "If so and so is ruthless and gets street cred for it, will I get the same street cred if I'm ruthless?" this is weighed against your years of personal experience, information and ego strength prior to your deciding what action to take.  We determine who we want to emulate. 

All learning is valuable whether passive or active, both contributing to our personal growth and maturity. This continues throughout our life with with every exposure to the world news, every person we meet and every new thing we try. So maintain an open mind, try new things; sushi or skiing just to add active learning to your memories and keep your mind learning new skills and information. As always I hope you found this informative and helpful.  

Dr Kevin
www.drkevinobrien.com

Veterans Day

Veterans Day is not only a time of celebration and remembrance, it is a day to honor the sacrifice of the many thousands of active service members, and veterans from previous conflicts that gave the ultimate sacrifice, putting their lives on the line for our political freedoms.  

We are a remarkable country made up of remarkable men and women and families that serve on a daily basis for our rights to protest, and profit.  These remarkable individuals deserve our respect and honor daily, but most especially on this one day November 11th set aside each year for them and their families.  

So find a moment in your day to attend the Veterans Day Parade in your town, or to at least find it in your heart to say Thank you to a service member and or a veteran.  In fact it is a beautiful habit to develop as a Nation of grateful citizens year round, when you see a returning veteran alone in an airport.  

Regardless your belief about the conflicts or wars this country has been in and is currently involved in, these men and women are the wall that protects us from the outside world.  They sacrifice their lives daily for our well being as a part of their job description.  It's a bit rougher than being a barrister at Starbucks. 

Be grateful that this all volunteer Service is willing to be there on the front lines of conflict, when you are not. often missing college years, the birth of their children, key years of their family life, etc. So Say thank you for your service, and be respectful on Veterans Day if not every day.   

Dr Kevin
www.DrKevinOBrien.com

Listening

Listening is an art and a skill we develop. Far to often we find ourselves caught up in the experiences of our past and our expectations of the future to be present enough to participate in the art of truly listening to the person with whom we are speaking with in the moment.

Being present in the "here and now" requires concentration and ones attention.  We are often to busy to offer that to others, but are quick to expect it from others and here lies the conflict in many relationships.  

So how do we stop the inner self sabotaging of our immediate relationships?  We start by identifying them for what they are.  distractions from the moment at time we are in and a distraction from intimacy from the one we are with. Yes, these thoughts often prevent one on one moments of intimacy because one or both partners gets so caught up in their individual dialogues from past relationships they have no time to think about the needs of their partner.   

A simple exercise is to stop yourself, not answer the phone in the middle of a conversation, or remove your ear buds when talking.  Even the act of taking off your sun glasses to talk can improve your sence of presence.  Try any one of these, or one of your own and see if your intimacy with friends and your significant other improves.  

As always I hope you foud this informative and helpful.  Feel free to contact me of a consultation,




Dr Kevin
www.DrKevinOBrien.com

Grief

Grief is a healthy response to situations such as death, divorce, injury, disability, loss of a job, property or a crisis.  We suffer grief over the loss of loved ones, movie stars, and pets openly but there are other forms of grief we prefer to keep hidden.  Loss of innocence from child abuse be it physical or sexual in nature.  We like to believe that like scars most grief heals with time, after all everyone experiences loss, right?  

Facing the reality of the loss or abuse is critical but not always timely, for a child for instance.  So it takes revisiting that loss in adulthood with a competent therapist, and guide one whom your trust will not be violated again.  Normal grief is not easy, when it is complicated by these other issues, your vulnerability grows and develops with your inability to trust others until you find yourself isolated in a lonely place of self blame and criticism.  

With therapy you can face your reality, learn to grow again and develop less self sabotaging habits.  It requires being honest, facing your pain, dealing head on with your denial, anger, and confused guilt feelings.  These are usually followed by feelings of despondency, and depression and the desire to drop out of treatment: but don't.  It is your mind re-hardwiring positive messages and truths about your experience, and building stronger defenses against the habitual self sabotaging "old fail-safe" behaviors of your past.  

The depression will be followed by new feelings of hopefulness, so fresh and new to you that you will be amazed.  it requires expressing your feelings asking for and accepting help and learning to be kind to your yourself (a new concept for many of you). Throughout this process get plenty of rest when you need it.  Set goals, both short and long term.  these are all workable with a competent therapist.  

As always I hope you found this informative and helpful.  Feel free to contact me for a consultation.

Dr Kevin

Managing Yourself

Why do we seek to manage ourselves? What are the goals one expects  to gain from self  discipline? Without trying to be to lofty, these are the  two key questions to ask yourself.  Next would come  the work of looking at the strengths you believe you possess vs the ones you actually possess, rather than weaknesses.  Peter Drucker's "Managing Oneself"in the Harvard Business review, 1/2005 page 100-109 also speaks to the values and ethics one holds.  

Taking this a step further I believe, successful self-management comes from treating ones self the way we would want a "good parent" to treat us, with rewards and corrections appropriate to the behavior at hand.  This means regardless your history, you now have the opportunity and the ability to "change the tapes" to a more positive inner self dialogue for change.  

We can start this by looking at how we view others, whether we consider them at all.  Then looking at how we want others to treat us we  can begin to treat those we come in to contact a little more graciously.  Helping co-workers solve problems, being a little more patient waiting for someone to understand what we mean when we are giving instructions, being less demanding of the waiter at the restaurant.  It is just as important for the boss to communicate effectively as it is for the subordinate to be productive.  This breakdown often causes undue anxiety, and stress and repeated workload in the subordinate.

The same rules apply at home, communication breakdowns are the primary reason couples come in to see me.  Effective listening and speaking are learned tools and require respecting the time and efforts of the other party involved.  Listening to the simple request for more time together is so often missed by underlying anger and frustration of years of not having been listened to; or ones over involvement with work. 

So in managing yourself, you need to be fully responsible for the effectiveness in your presence of mind in all of your other relationships as well.   We do not live in a vacuum, and are innately social beings that require the affections and acknowledgement of others, as do those around us.  

As always I hope you found tho informative and helpful. Feel free to contact mr for a consultation.

Al the Best,

Dr Kevin 

"New Normal" following PTSD and TBI

My experience running a Vet Center has proven time and again, that the  primary emotional problems confronting returning  veterans  are relating  to both post traumatic stress (PTSD)  and traumatic brain injury (TBI). Often the symptoms are experienced by the men and women who were near Improvised Explosive Devises (IED)  explosions  which in very mild cases  can cause similar  concussion injuries seen in boxers and footballers who been battered repeatedly. I'm speaking mostly to these milder head injuries here although some of these principles can apply to more severe trauma as well.  

Having worked in the field of trauma for more than 18 years and written my doctoral thesis on resiliency following trauma after  9/11.  I have found that a lot of progress lies in ones ability to accept his "new normal." A normal where the baseline is sometimes substantially lower than it was before their injury, but nonetheless is now a starting point from where progress can be made.  Apart from the symptoms of PTSD or TBI there are the co-morbidity or co-occurring issues like hyper-vigilence; and anger management that have received much public attention, as has substance abuse.  All of which are also very stressful and disconcerting to the Veterans with both PTSD and TBI and their families.  

Veterans are often angry at themselves and feel they have no "true" outlet for their pent up rage which often comes out in self destructive ways e.g.; substance abuse, reckless behavior, etc.  This impulsiveness is displaced and obviously misunderstood by their families and let alone themselves.  

Basically, you can get better, but you are no longer the same as you were before your injury. This this is tough to hear, it is the truth though and that will free you from some of your suffering and the need to go it alone.  One plus one doesn't quite always equal 2 anymore.  Those once simple tasks are now herculean efforts, tying your shoes, to making change for a taxi. Instead of getting angry at yourself for this, accept it as a new baseline and with a therapist get help to better understand where you are at today compared to where you once were and move toward acceptance.  

TBI differs in that it is primarily a physiological disorder, with genuine cognitive impairment that is measurable.  Although it presents often in very similar ways as PTSD, it is best treated early by a neurological psychologist or someone specializing in working with TBI in conjunction with neuro- psychological testing to measure the degree of damage.  

There is no cure for either of these conditions as yet, but with counseling we can teach veterans how to control their reactions to known triggers. Education, normalization, humanization, self-forgiveness, and coming to and understanding of a new normal are essentials to treating Veterans with and helping them move on to far more productive lives.

For more information or a consultation feel free to contact me at DrKevinOBrien@me.com  or visit my webpage DrKevinOBrien.com

All the Best,
Dr Kevin

Resilience and PTSD

Resilience is the capacity to bounce back from a crisis; be it physical or psychological.  We often associate it with trauma, and the impact of trauma which varies from one person to the next.  In my more than twenty years of clinical experience working with HIV and AIDS, bereavement, combat trauma (PTSD) and Military Sexual trauma (MST) and traumatic brain injuries (TBI).  I have a broad experience in working with trauma and grief.  Suffice it to say that I have seen such a wide variety of presentations of how often people face these challenges firsthand and have been impressed by their courage and willingness to fight on.  That drive is the impetus of resilience.  It's encouragement should be every clinicians goal in dealing with all clients, but especially these listed here.

In my work I take these issues very seriously, and plan on helping you to fully understand what it is and whether you need to take additional action to seek help in getting the appropriate care for it. Often further evaluations are needed in addition to treatment.  This blog is in no way is meant to substitute for a clinical workup of diagnosis or treatment.  It is meant to serve as a guide for you to help alleviate some of your concerns about these conditions or those of someone you care about.  Hopefully this will help you raise questions to bring to your existing providers, and ask about ways of improving your own resilience and your care.

For more information or a consultation feel free to contact me at DrKevinOBrien@me.com or visit my web page DrKevinOBrien.com

Dr Kevin
www.DrKevinOBrien.com

Therapeutic Insights

Insights or Gains in therapy are indeed wonderful to witness and a great joy of my profession is when I help Clients achieve them.  However, without full understanding of them contextually, the gain can be short lived or lost.

Gains in treatment are when insights are integrated with the self and withstand the "old tapes" and behaviors.  This is not to say that there may not be any set backs. Therapy is much like life in that it is not a linear process.  The progress of therapy is marked differently for each of us.  I'm sorry to say that there is no fast rule, or fast way to sustainable insight.   There are however combinations of methods that make it smoother to transition along the way.

For more information or a consultation feel free to contact me at DrKevinOBrien@me.com  or visit my webpage DrKevinOBrien.com

Dr Kevin
www.DrKevinOBrien.com

Acceptance

Being in the moment: Acceptance

Some say we are where we are for a reason, a learning experience.  Deriving the lesson however is not always as easy as all that. Self awareness is a great help, but can lead to self absorption.  Balance comes from developing an objective understanding of ourselves, and our place in the world.  This includes the actions and consequences for those actions.  Be empowered to choose how you show up in your life and choose to find the gift that is in each day, no matter how subjectively dark things may appear to you.  Take the time, build your focus to learn to look for more positive outcomes. Simple things that with practice we can all do.

For more information or a consultation feel free to contact me at DrKevinOBrien@me.com or visit my website DrKevinOBrien.com

Dr Kevin
www.DrKevinOBrien.com

How to find a Therapist

Seeking a therapist. Where to start is a reference from a friend who you trust. Get several names and interview them for "fit" with your personality, and concerns. This is New York City and there are as many types of therapists out there as there are interests. So be careful. Credentials help but aren't everything (I can hear my colleagues cringe at this) but I've met some specialists with very limited credentials that were helpful to me at times in my past.

Most of all you want someone with experience, and knowledge about your concerns, issues, etc.  Try to not just pick someone out of a phonebook. Do some homework, read their webpage if they have one.  In summation you want someone you believe that you can work with.

For more information or a consultation del free to contact me at DrKevinOBrien@me.com or visit my website DrKevinOBrien.com

Dr Kevin
www.DrKevinOBrien.com

Day One - Integrating my website with my blog

Welcome to my new blog.

You should check out my website (drkevinobrien.com) and visit me on twitter #@askdrkevin

Feel free to contact me for more information - visit my about me page on this blog for details.

Dr. Kevin