Arlene Unger, Ph.D.

This week, Breakthrough provider and author, Arlene Unger, concludes her series on internet counseling in the new millennium. This week she shares about her experience working with clients via video using a variety of techniques.

By combining the techniques of Cognitive Behavioral Therapy (CBT) and Emotional Brain Training (EBT) along with Motivational Interviewing (MI) my video counseling clients facing such stressors as deadlines, relocations, job change, illness, diagnosis, divorce, conflict, marriage, birth, etc. learned tools for managing their stress instead of falling apart.

Since our lifestyle mirrors how we feel/think I made a point of addressing all my client’s health habits. Nutrition, fitness and health play a huge role in our medical, as well as, mental health.

One of my online clients, a 42 year-old female on stress leave from work, was not getting enough rest because of her constant ruminations. Even though her spouse made sure to fill the pantry with healthy items, her diet consisted largely of junk food which made her feel more sluggish and irritable on top of the harassment she was experiencing on the job.

I was able to show how she was sabotaging the very purpose of her medical leave through a series of graduated questions (MI).  She vented about her fears of diabetes.  Once that took place, she was able to acknowledge the benefits of getting at least 7-8 hours of sleep a night and the importance of a healthy breakfast for maintaining homeostasis (EBT).  As she accepted her resistance to change, she was able to achieve the realistic goal of eating at least 2 meals a day of grains, fruit, veggies and protein, which improved not only her metabolism, but mood. Eating right led her to setting a plan for fitness and dispelling her over-generalizations about all exercise being “boring” instead of a fun, stress-busting pastime (CBT).

By the end of our online work, she was up to 30 minutes of cardio exercise every other day, eating a healthy breakfast and reported a much calmer lifestyle.

The most common issues I encounter in my online therapy practice are related to stress, depression and relationships.

In our first meeting, I helped one client realize that stress is all around us, and we also generate a lot of it entirely on our own. I explained that stress is an inevitable part of life and that it will always be with us. So, whether we have financial, work or relationship woes, the client must learn to cope by embracing and releasing the stress rather than trying to eliminate, or hoard, it.

One of the key ways to embrace stress is not to simply talk about it, but to release it using the EBT “feeling ventilation tool”. My client, a traveling executive who was dealing with a reassignment issue, admitted to bottling up his stress by not sharing his apprehensions with the people who mattered most to him. He made a point of just smiling all the time on and off the job (i.e., avoiding the issues with a “happy face”).

I helped him understand that he’s not alone and all of us bottle up our feelings from time-to-time. Once he accepted that the worst thing he could do was to hide his stress, which I was able to illustrate to him via webcam, he was able to arrive at his own solution. Simply speaking his truth out loud, and not worrying about what others were telling him to do, was his best remedy.

I also realized he couldn’t easily calm himself down. Even when he told himself to relax, it only increased his stress level. So, along with helping him get stress release his stress, we moved on to self-soothing and video conferencing allowed him to see where his breath was constricted.

Over a few sessions, he came up with dozens of ways to relax. And, more importantly, he developed the insight to know that he wasn’t allowing himself to actually do any of those things to relax.

Calm breathing was the easiest and simplest way for him to start to learn to relax because he realized that taking some deep cleansing breaths helped him to speak with greater ease. Another thing he discovered through our online sessions was that by using his hands on a project or hobby after work hours helped him keep his mind off of the things that were stressing him out the most at work.

Online therapy helped my client manage the stress of his impending territory reassignment and also gave him hope to maintain healthy habits in spite of life’s unforeseen twists and turns.

With that said, if I had identified him as someone who was struggling with chronic stress, I would have recommended that he speak F2F with a therapist and seek medical help. That would not have been an ideal solution for my client who was dealing with a stressful work environment.  Commuting to my office for a F2F session would have exasperated the situation. However, there was definitely a place for online therapy in his complicated and busy life. He realized that expert behavioral help provided a path through his troubles and allowed him to gain realistic tools and insight.

One size does not fit all when it comes to online therapy. If you, for example, live in a rural community with limited access to mental health care, have a busy schedule, feel comfortable with computers, or prefer anonymity when talking about personal things, then online therapy may be your best option.

Check out my article “How to Stop Worrying and Start Living.” Also, watch for my next book “Mindful Living” to be out in early 2015.

Dr. Unger, a licensed psychologist, has a busy private clinical practice in Dana Point, CA.  Arlene offers clients F2F and internet counseling/coaching. She lives with her spouse, Stefan Unger, Ph.D., Photographer/Web Designer of 34 years. They are blessed with 2 successful adult children and 2 grandchildren.  Arlene believes that no one gets through life unscathed and everyone from time to time needs a counselor/coach to help move toward positive change. Using a combination of neuroscience, mindfulness and CBT, Arlene has helped people with depressive, anxiety, anger, addiction, eating, pain, personal trauma and relationship issues. She is completing her second book on Mindfulness. Her first book is “Presence of Mind – Mindful Affirmations.”  Check out the scores of articles Arlene has authored listed on the Resources page on her website