Hello! We're Tzvi Prochnik and Adam Paine, specialists in mental health.

Submitted by enteave_adam t3_xsvmf5 in IAmA

Good morning Reddit!

We are two psychotherapists who have experience working in a variety of settings, including private practice. We both work at Enteave Counseling in Austin, TX., and offer online therapy.

While we cannot provide counseling through reddit, we are happy to answer questions you have about relationships, life transitions, anxiety, depression, general mental health, or counseling (in-person and online). We will be answering questions today from 9am to approximately 1pm CST.

Tzvi Prochnik(enteave_tzvi)

I’m Tzvi Prochnik. I’ve been a licensed psychotherapist in the Austin area for the past year. I work a hybrid model, where I see clients both in person and online. Prior to that, I worked in an acute inpatient psychiatric hospital for the past 3 years. I specialize in working with adults dealing with life transitions and relationship issues. I recently completed the first weekend of EMDR basic training which is a ptsd-based therapy technique. I use a mix of CBT, mindfulness, boundary setting, role-play and goal setting techniques in my work with clients to manage a variety of issues and live more fulfilling lives.

In my free time, I enjoy rock climbing both in the gym and at the crag. I love traveling and recently spent 6 months living and volunteering all over Mexico. I also got into the fermentation game over the pandemic and began making sourdough bread, kombucha, and sauerkraut.

Ask me anything about life transitions, relationship issues, psychotherapy in person or online, rock climbing or the joys of fermentation!

My Proof: https://imgur.com/a/Ngi83XO

Adam Paine(enteave-adam):

I specialize in helping clients with high anxiety; I use mindfulness/meditation, stress management techniques, work/life balance techniques, assertive communication training, and behavioral therapy to help clients learn to enjoy life more by managing their stress. When I’m not working with my clients, I like to read non-fiction, practice yoga, watching Simpsons, and playing Nintendo Switch (Currently playing Monster Hunter Rise/Sunbreak, Inside, TMNT Cowabunga Collection)

My Proof: https://imgur.com/a/2vZcnu2

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Ask me anything about depression, anxiety, counseling, rock climbing, video games or TV shows!

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We plan to be here today from around 9am until 1pm CST.

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Disclaimer: We cannot provide counseling services through reddit. If you or someone you know is in crisis, please call 911 or go to your nearest hospital.

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winston_everlast t1_iqmifec wrote

How much is loneliness at the heart of what you are seeing with your patients?

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enteave_tzvi t1_iqmjepp wrote

I think loneliness plays a big part in the reason people come to see me for counseling. While I can't speak to how it might have been different before the pandemic, I hadn't started practicing as a psychotherapist yet--maybe Adam could speak more to this point. But, at least right now it feels like many of the clients that I see list loneliness as a major contributing factor to their mental health issues. Many people report feeling a lack of camaraderie and sense of purpose that they had when they were going in person to their offices or social events, that now is severely lacking. It seems that many people are having to adjust to the new reality that the pandemic has created and it isn't always a smooth transition.

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enteave_adam OP t1_iqmk42s wrote

Totally agreed with you Tzvi. It's just such a different world now, and we're all still figuring it out.

Even before the pandemic, I would see a lot of people feeling lonely and isolated, especially here in Austin where a lot of folks were working from home even before covid. I think the pandemic just accelerated the issue.

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jjejamora t1_iqmlh8u wrote

Are there common activities or social norms that actually hinder the process?

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enteave_tzvi t1_iqmn6m2 wrote

It sounds like you're asking are there common activities or social norms that hinder the process of connecting with others? I would definitely say that social media can be both a great resource for connecting to others but at the same time can serve to further isolate folks, depending on how it's used. I've had some clients get connected to niche groups in the Austin area like sober social events through IG that they probably wouldn't have been able to find without social media. At the same time, I've had clients who have needed to either take a break from using social media or significantly cut back on the time they were spending on there because they were feeling disconnected and like it was keeping them stuck in unhealthy places. Does that answer your question? Or were you asking something else?

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CurriousRedditor t1_iqms3er wrote

I'm stuck in a cycle of shame (at almost all aspects of life)

Where/How do I start? (to escape this cycle)

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enteave_adam OP t1_iqmwub6 wrote

Hello CuriousReditor,

Shame is always tough one. Sorry you've feeling this, I know it's such an awful way to feel about ourselves.

I've worked on this with many of my clients and dealt with it myself (like I think we all do).

We're usually so much harder on ourselves than we are on others. So the first thing I typically ask my clients is: "what would you say to a friend that was feeling the same thing?". Usually what we'd tell a friend is much more kind, objective, and more constructive.

There's typically a big discrepancy between the client's self talk and what they would say to someone else that was having a hard time.

Once we've identified the kinder and more supportive things they would say to a friend, I ask them to turn these statements towards themselves, and make them "I statements".

For example, if the client is saying "I am a awful person", but would tell a friend "you are only human and made a mistake" for the same situation, I get the client to get into the habit of using this kinder response for themself.

Shame is often the result of repetitive negative self talk, but if we begin to slowly change our inner dialogue, our emotions and eventually our behaviors often begin to change as well. It's not an easy thing to do, and takes time, but it can be done and can make a huge change to how we feel about ourselves.

I would encourage you to find some kindness for yourself, the same way I'm sure you would find for someone you care about.

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IAmAModBot t1_iqmkn56 wrote

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susitoni t1_iqmsviv wrote

Hi!

Thanks for doing this Ama.

A lot of people online swear on changing your diet and avoiding coffee and other things to reduce symptoms of anxiety and adhd for example. Is that just a trend or is there some evidence behind it?

Is there a difference between intrusive thoughts and thoughts that have something to do with OCD? I don't know the proper term .

Thanks and I hope you are having a nice day!

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enteave_tzvi t1_iqmvu2o wrote

Hi u/susitoni! Thanks for joining us today. These are great questions!

I definitely believe in the power of lifestyle changes in reducing mental health issues. I take a holistic approach to my therapy and believe that you need to treat not just the mind but also the body. Psychiatry too often tries to create an arbitrary distinction between the two areas, when the more studies that are done the more is revealed about how the things you put into your body affects how you feel. Did you know that there is an estimated 90% of our serotonin (which is one of the neurotransmitters responsible for positive mood) is located in our gut? Which means that the things we eat play a big role in how we feel.

Consuming caffeine can set off a lot of the symptoms that we typically associate with anxiety especially in folks who are more sensitive to it like a fast heart rate, jitteriness, racing thoughts, insomnia, stomach upset, etc. For my clients who have anxiety, I will ask them about their caffeine consumption and bring more awareness to the link between caffeine and anxiety. In terms of dietary changes, there is also an increasing body of evidence that eating a diet high in processed foods can contribute to low mood, low energy, and inflammation of the immune system over the long term. While I'm not a nutritionist, and don't make recommendations to my clients about specific dietary plans, I do discuss this in our sessions with clients who struggle with healthy eating and I try to help them bring more mindfulness to their food choices. There's a great book on this topic called Eating Mindfully by Susan Albers that I recommend.

In terms of the difference between intrusive thoughts and thoughts that have something to do with OCD: intrusive thoughts can be a component of OCD they are the "O" in the OCD because it stands for obsessions. However, intrusive thoughts can also be a component of a number of other mental health disorders including generalized anxiety, depression, trauma, among others. The key thing about how they operate with OCD is that people have intrusive thoughts and then they have some sort of compulsion they engage in that helps them momentarily try and make the thought go away. This can include rituals like handwashing, checking doors, counting, but can also be more subtle like googling symptoms or asking for reassurance repeatedly.

Hope that helps!

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mikansang t1_iqo66fr wrote

How do you help clients who struggle to make meaningful connections with people? It seems it can be a destructive cycle of feeling lonely because they can't connect, due to for example lacking skill, which then makes them lonelier and less capable of connecting.

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[deleted] t1_iqpemnn wrote

I have (moderate) diagnosed PTSD. Acquired through numerous combat situations over a 23 year military career. Is anger management an achievable aim?

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Madmallard t1_iqqbmwj wrote

What is the psychology surrounding individuals that seemingly are unable to take care of themselves, even if they're not like old and decrepid? Like putting their own lives in danger unable to take care of themselves. It seems very counterproductive evolutionarily.

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Other_Exercise t1_iqw5re4 wrote

Is a lot of mental health advice for people who really need it over-rated / not useful, purely in the sense that if you are say, in an abusive relationship, all your self-care will likely be undone by staying in that relationship?

I say this after doing lots of work on my mental health - and realising I needed to kick the bigger problems to enjoy better mental health, if that makes any sense?

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Bunny_Remarkable t1_ircak9n wrote

Hi both :)

I’m wondering if you’ve had any psychotherapy sessions with patients who have psychotic illnesses, such as schizophrenia , as a treatment in addition to the medication they are taking. If so, is this something you have found has helped them , and if not , why are you not seeing such patients ?

Many thanks ☺️

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