Therapy Tools
Local therapist creates a "toolbox" for professionals.
Ruthan Brodsky
Special to the Jewish News
arolyn Daitch's intent for writing
Affect Regulation Toolbox was to
provide professional therapists
with a technique they could use when
working with over-reactive clients.
"I developed a number of concrete
strategies that help clients retain a degree
of mastery of their thoughts, feelings and
communications skills that they found
while in session with a therapist," says
Daitch, a Ph.D., licensed psychologist and
director of the Center for the Treatment of
Anxiety Disorders in Farmington Hills.
Daitch found that her focus on anxiety
disorders and relationship issues in her
private practice could be applied to a
variety of issues related to over-reactivity
and painful for many people. She uses the
term "over-reactivity" to describe respons-
es that are distorted and unnecessarily
intense and overwhelming.
"Many people are aware of
their behavior problems and
come to therapy to fix their pres-
ent and work on the future, not
to fix the past;' says Daitch. "But
insight isn't enough and clients
need tools to transfer what
they learn in the office to their
everyday lives. That's when the
Toolbox functions as an adjunct Carolyn
to therapy. It helps people gain
control over their emotions:'
The study of emotion and the affective
domain has a long history in psychology.
Affect regulation, or controlling one's emo-
tions, is a term frequently used in therapy
when dealing with such issues as excessive
feelings and behaviors.
"The affective domain refers to emo-
tions as well as to their outward expres-
sion," says Ruby Kushner, clinical
social worker with a private
practice in Farmington Hills.
"Although lay people often use
the words interchangeably, the
affect is the expression of the
emotion, the action that accom-
panies an emotion and is the
observable part of the emotion."
Daitch
Daitch's Toolbox provides tech-
niques to control and normalize
those excessive and emotions. Chapter 1
and 2 are explanations of over-reactivity,
how it impacts lives and how the interdis-
ciplinary field of neuroscience supports
alternative approaches to talk therapy.
Chapter 3 provides therapists guidelines
for using the tools, including how to man-
age roadblocks, such as resistance and
poor response.
Chapters 4 through 7 present the
Toolbox itself, which is divided into four
tiers:
• Tier 1 — fundamentals of the Toolbox
including the Time Out tool
• Tier 2 — how to establish or deepen a
state of calm
• Tier 3 — descriptions of the tools with
scripts
• Tier 4 — rehearsal and transfer
Chapters 8-11 apply the tools to a
variety of case studies covering common
and severe anxiety disorders, couples in
conflict and other interpersonal relation-
ships. Chapter 12, the final chapter, deals
with roadblocks and challenges, such as
The Facts About Degenerative Lumbar Stenosis
Degenerative Lumbar Stenosis is a narrowing in the lumbar spinal
canal, a very small space in the lower spine that carries nerves to the
legs. After many years, this space can become even smaller, if the
surrounding bone and tissue begin to grow.
Neural Claudication is relatively easy to diagnose. Physicians can usu-
ally determine if a patient has the condition by asking a battery of
questions. However, special tests and x-rays of the spine are often
required.
Arthritis, falls, accidents and wear and tear on the bones and joints
in the spine also play a part in Stenosis. As the lumbar spinal canal
shrinks, the nerves within it become squeezed and can cause chronic
back and leg pain, as well as leg weakness.
STENOSIS VS. RUPTURED DISC: "Many patients confuse Stenosis
with a ruptured disc," says Dr. Radden. "However, they are not the
same thing." A ruptured (or herniated) disc usually pinches one or two
nerves at a time. The resulting pain, called Sciatica, is caused by a
pinched nerve in the lumbar spine and causes back pain that shoots
down one leg. This pain can happen any time, not just when standing
up or walking.
The pain and weakness associated with Stenosis is usually described
as a burning or prickly feeling which begins in the buttocks and
spreads down to the feet when standing up, walking or exercising.
Unfortunately, many adults suffer from this condition.
OTHER FACTORS: "Legs might also feel cramped, tired, or weak,"
says Dr. Louis Radden, D.O., a St. Joseph Mercy Oakland orthopedic
surgeon. "This usually points to a condition known as Neural Claudi-
cation of the legs. For patients with Stenosis, the Claudication starts
when standing up. Pain may worsen when walking, but will most likely
get better when walking stops."
Also, crouching down or lying in a fetal position has been shown to re-
lieve symptoms, since it's believed that these positions open the lum-
bar canal and take the pressure off the nerves that go to the legs.
52
TREATMENT OPTIONS: Several treatment options are available for
Stenosis and Neural Claudication, depending on the extremity of
symptoms. If the pain is mild and hasn't been present for long, an
exercise or physical therapy program to strengthen back muscles and
improve posture is usually effective. A physician may also prescribe
medication for inflammation in the backbone.
Dr. Radden notes that with severe back pain and Neural Claudication,
however, spinal surgery may be required to take the pressure off the
nerves in the lower spine.
6621 W. Maple Rd.
West Bloomfield
SPINE SPECIALISTS OF MICHIGAN P.C.
248-661-4700
RECONSTRUCTIVE SPINE SURGERY
September 27 2007
Dr. Louis N. Radden
30055 Northwestern Hwy. Suite 270
Farmington Hills
248-865-4262