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Mental Health Certification

Miss RinRin works in the medical field and has taken additional certifications to help her kink clients with mental health. One of these courses was called ‘Talk To Me”: Improving Mental Health And Suicide Prevention In Adults. This course was taken online via course lecturer Dr. Ben Milbourn, Senior Lecturer at Curtin University. Below you will be able to read some of the notes she has taken to help you become a better you!

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If you are feeling any of the above, please think about booking a session. Not all of Miss RinRin's sessions are kink/fetish related. Several are therapeutic as well. NOT in PA? No worries, she offers phone and video visits as well.


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Use the button to see her updated calendar and book her today

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When you have a Therapeutic Mentoring Session with Miss RinRin, she will:

  • Recognize her reactions to what the client is telling her.

  • Be non-judgmental and empathic.

  • Show a genuine interest in what the client is telling her.

  • Try to use the language of the client she is interacting with.

  • Validate what the client is telling her and show the client she is actively listening.

  • Find out what else is happening in the client's life (stress, relationship difficulties, etc.)

HANDLING OF WORRIES
(METACOGNITIVE STRATEGIES)

Worries are a normal part of life; for the most part, they come and go. Yet some worries stay for a longer period, or get so intense that they affect a person’s everyday life, their learning efficiency, and personal wellbeing.

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Knowing a variety of ways to cope with worries is vital for mental fitness.

The first step is to work out what kind of worries they are – Type I or Type II?

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TYPE I worries can be worked on using cognitive strategies.

TYPE II worries are usually more complex because they are triggered by Type I worries and are based on

 

Cognitive Attentional Syndrome (CAS). The CAS consists of three overlapping components:

  • A Perseverent Thinking Style (“I need to think about my problems until I find a solution”);

  • Unhelpful Hypervigilance For Threat (‘It is important to look out for signs of danger’); and

  • Counterproductive Coping (‘Thinking about my worries helps to reduce them’).

 

These three components work together in the following way:

  1. Something triggers worry.

  2. Positive metacognitions are activated, such as ‘If I think hard enough about it, I will find a solution’.

    • Either a solution is found and the worrying ends, or

    • No solution is found and the third step follows…

  3. Negative metacognition / Type II worries are activated, and affect:

    • Behavior (example: Turning To Games On PlayStation, Watching Television, Consuming Alcohol)

    • Thought Control (Distraction)

    • Feelings/Emotions (Anxiety, Panic, Depression)

 

This makes it hard or impossible to stop worrying and start doing something about the causes of those worries (e.g. studying for an exam, finding a playmate, etc).

 

So one central process that sustains worrying is the constant focus on those worries, and the feared possible consequences of worrying - not primarily the worries themselves.

REDUCING TYPE II WORRIES

The three-component process of Cognitive Attentional Syndrome (CAS) needs to be changed to reduce Type II worries.

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Wells describes three different strategies that work together towards that goal:

  1. Rumination and worry about the postponement

  2. ATT- Attation Training Techniques

  3. Detached Mindfulness

 

1. RUMINATION/WORRY ABOUT POSTPONEMENT

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Rumination is a way of thinking focusing on distress and its possible causes and consequences, not on possible solutions. Rumination can be reduced using metacognitive strategies. Dysfunctional thoughts are thoughts that have a negative effect on our mood, our behavior, and/or our cognitive performance. Dysfunctional thoughts can be changed through cognitive restructuring.

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Worries and rumination are like uninvited guests; denying their presence or aggressively trying to send them away will not make them go away, but will instead reinforce the anger or frustration they cause by staying.

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So instead of ignoring or fighting their presence, acknowledge the worry, and plan to think about it later. Make an appointment for a time later on the same day. For 15 minutes you can worry as necessary, if you need to, or not at all. Stop worrying at the end of the 15-minute worry period, and then work on any further worries by using Detached Mindfulness (the third strategy below) and carry thoughts over to the worry period of the next day, if necessary.

 

2. ATTENTION TRAINING TECHNIQUE (ATT)

 

The goal of the attention training technique is to move the focus of attention away from dysfunctional thinking and toward the outside world. It is based on three exercises that take a total of 15 minutes and should be trained regularly:

 

  • Selective Attention: Attention should be directed to three or four sounds set in the room at the same time for about five minutes.

  • Attention Switching: Attention should be directed to three or four different sounds inside or outside of the room. Subsequently, pay attention to only one of those sounds, and quickly shift focus from one to another for about 5 minutes.

  • Divided Attention: In the end, attention should be directed to all sounds at the same time. Ideally, this task should be quite difficult.

 

3.  DETACHED MINDFULNESS

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  • Detached Mindfulness is a state of mind in which impressions and thoughts are perceived, but they do not influence a person or require them to act on them.

  • Mindfulness means having an awareness of thoughts (specifically metacognitive awareness), and the ability to distinguish a negative thought from a subsequent worry or rumination response to that thought.

  • Detachment means stopping or disconnecting any response to that thought and eventually experiencing the self as separate from a thought, and as simply an observer of it.

 

If you are interested in this topic and would like to read more about it please read Wells, Adrian (2011): Metacognitive Therapy for Anxiety and Depression, Guilford Publications, New York.

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Use the button above to read a PDF version of the book mentioned above.

The ABC model

A-  ACTIVATING EVENT

  • An activating event is a triggering event. It may be external or internal (e.g. the possibility of failing an upcoming exam).

B- BELIEFS

  • A person’s ‘beliefs’ or ‘belief system’ is what they use to filter their evaluation of an event. It occurs based on certain conscious or unconscious beliefs (evaluation patterns, attitudes, or rules of life) which are activated in the triggering situation by the individual.

C- CONSEQUENCES

  • Consequences are the emotional and behavioral responses that follow the activating event (e.g. sadness, worry, anxiety).

ABC MODEL KINK/FETISH EXAMPLE

The following scenario is made up. However, Miss RinRin has heard similar stories over the years from kinksters.

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Activating Event: John, (18) has failed to find an ABDL caregiver (Mommy/Daddy).

Beliefs: John thinks, “I must be doing something wrong since I can’t find a caregiver”.

Consequences: John feels depressed and angry.

 

The central assumption is that the emotional and behavioral consequences of the person (C) are not directly caused by activating events (A).

 

Rather, they are caused by the nature of the evaluation of these events (B).

 

A, B, and C always influence each other; this is not a simple linear relationship.

 

So, looking at our last example, John’s feelings of depression and anger are not directly caused by failing to find a caregiver. They are caused by his belief that not finding one implies certain things about him as a person.

 

Negative emotions and associated dysfunctional behaviors are activated in A by ‘irrational beliefs. Irrational beliefs lead to ‘inappropriate’ emotions and behaviors (such as strong anxiety, depression, and anger), which are self-defeating convictions.

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To learn more about the ABC model please use the button above watch a video

adding d & e

By contrast, ‘rational beliefs’ lead to more useful emotions and behaviors that help us to achieve our goals. They are rational in the sense of being helpful.

 

Albert Ellis has added D and E as an intervention; D for DISPUTATION and E for EFFECT.

  • Disputation means the questioning of dysfunctional thoughts, and Effect means the creation of alternative thoughts due to disputation – new thoughts that are based upon more reasonable, ‘rational beliefs.

  • The restructuring of irrational beliefs (D) takes place in REBT with the help of a broad range of cognitive, emotion-related, and behavioral techniques.

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thinking errors

Ignoring the good

You pay more attention to bad things, and ingnore when somthing good happen. 

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Examples: 

You get one answer wrong on a long test, all you can think about is the mistake.

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You score two goals in your soccer game, but all you can think about is the shot you missed.

feelings As Facts

Believing that if you feel something, it must be true. 

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Examples: 

"I feel ugly, so i must be ugly".

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"I feel like i'm a bad friend, so i must be a bad friend". 

Negative labeling

Having a negative eblief about yourself  and thinking it applies to evertying you do. 

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Examples: 

"I am a loser so my artwork stinks"

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"I am so studpid. Everything I say is dumb"

Self-Blaming

Blaming yourself for anything that goes wrong around you, even if you had nothing to do with it. 

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Examples: 

When your basketball team loses a game, you think it is entirely your fault. 

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Heather is sad today, i probably did something to upset her. 

fortune telling

Thinking you know what will happen in the future, and that it will be bad. 

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Examples: 

​I know if i ask her to be my caregiver she will say no".

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"I bet no one will come to my birthday party"

Setting the bar too hight

Thinking that you must be perfect in evertything you do, otherwise you are no good. 

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Examples: 

"If I don't get an A on every test i am not smart".

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"I have to win every tennis match I play, otherwise I am worthless".

bLOWING THINGS UP

Making a really big deal out of something small, or making something a little bit bad seem like the worst thing ever. 

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Examples: 

You get a stain on your new shoes and you think they are ruined and can't be worn anymore. 

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"I'm not able to see my friends on friday, my life is horrible". 

Mind Reading

believing you know what someone else is tinking, or why they are doing somehting without having enough information.

 

Examples:

"People are looking at me. They probably think my shirt is ugly".

 

"Cathy didn't invite me to her party. I bet she thinks i am weird". 

"Should" Statments

Believing things have to be a certain way.

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Examples: 

"I am a cute little, everyone should be nice to me. 

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"I should always be happy. I should never be sad. 

COGNITIVE RESTRUCTURING

Retraining our brains requires ‘Cognitive Restructuring’.

 

Cognitive restructuring involves four steps:

  • Identify your negative thoughts

  • Interrogate/question your negative thoughts

  • Develop more helpful thoughts

  • Practice the new, helpful thoughts

 

STEP 1: IDENTIFY NEGATIVE THOUGHTS

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Many of us think a lot, replaying events in the past and worrying about the future.

 

In this first step, you need to ask yourself a series of questions to help you identify the negative automatic thoughts you have that affect how you feel and behave. You acknowledge the thoughts, write them down, and then consider your underlying assumptions and conclusions. This is the first and most important step towards change.

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To recognize the negative thoughts, you have to ask yourself:

  • ‘What happened?’

  • ‘How did I feel?’

  • ‘What thoughts went along with the unpleasant feeling/behavior I want to change?’

 

Below we will be referring back to John’s example from the ABC model.

 

POLARISED THINKING/BLACK-AND-WHITE THINKING:

  • You may be seeing everything in one way or another, 'black or white', without any shades of grey in between. It's all or nothing. There is no middle ground. You are either perfect or a total failure.

    • Example: ‘I am stupid. I will never find a caregiver.’

 

CATASTROPHIZING:

  • This occurs when a person assumes that the worst will happen. Your belief in your own ability to handle a situation is zero.

    • Example: ‘I will fail to find a caregiver!’

 

OVERGENERALIZATION:

  • This involves thinking in absolute or exaggerated terms, where you apply a general rule as a result of a few or minor experiences. Overgeneralizations are easy to recognize, as they usually include one of the following words: never/always, everything/nothing, got to, or should.

    • Example: ‘I’ll never be good at this. Nothing ever works out for me.’

 

JUMPING TO CONCLUSIONS:

  • Believing that you can predict the future like a fortune-teller. You believe that you ‘know’ what is going to happen.

    • Example: ‘I already know what will happen. I'm never going to find a caregiver.’

 

PERSONALIZATION:

  • This distortion involves taking everything personally or blaming yourself without it being logical to believe that you are to blame.

    • Example: ‘Everything bad that happens is my fault.’

 

Here are other thoughts you may be internally expressing. REMEMBER THESE ARE NOT TRUE! If you are feeling any of the above thoughts please reach out to Miss RinRin. She has several types of sessions that you could benefit from. Remember not all her sessions are kink based. She does offer therapeutic sessions as well.

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  • I Can’t Cope Anymore

  • I Don’t Know What To Do

  • I Will Never Make It

  • Nobody Can Help Me

  • They’re Laughing At Me

  • Nobody Likes Me

  • What Do The Others Think?

  • I’ll Embarrass Myself

  • Why Is It Always Me?

  • I Lose Control

  • I Am Completely Paralyzed

  • I Can’t Stand The Fear

  • Nobody Ever Helps Me

  • I Will Be Alone Forever

  • Everyone Leaves Me Completely Alone

  • I Have To Pretend That I Don’t Mind

  • Everyone Else Is Better Than Me

  • I Will Never Find A Partner/Mate

  • Everyone Has Found Friends Except For Me

  • I Am Unloved

 

You are welcome to explore more categories of cognitive errors/distortions written by Beck & Buns 

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STEP 2. INTERROGATE/QUESTION YOUR NEGATIVE THOUGHTS (DISPUTATION)

 

You identified your negative thoughts in Step 1, and now in Step 2, you need to question/interrogate/dispute them.

 

The following techniques help you to slow down the revolving carousel of thoughts in your head, and address the kinds of typical negative thoughts we discussed in the last section, like, ‘That's all stupid’, ‘They don’t want me anyway’, ‘That always happens to me’, ‘I'm a born loser’, and ‘I always do everything wrong’.

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PART A: REALITY CHECK QUESTIONS

First of all, let’s take a close look at the thoughts, and give them a reality check. Do you have evidence that proves your negative thoughts?

 

*Please note: Not every question below is equally suitable for every negative thought.

 

Questions:

  • How often has this happened in the past?

  • Is there evidence for or against this fear? How much for and how much against?

  • How sure are you that this is true? On a scale of 0-100%, how probable is it?

  • What confirms this thought?

  • What denies this thought?

  • What are some alternative perspectives?

  • How probable is this thought? Rate the likelihood from 0-100%

  • And now, how sure are you that this is true? On a scale of 0-100%

  • How do you know that?

  • How can you be so sure that this will always be the case in the future; are you psychic?

  • How do you know that Person X thinks that about you; are you a mind reader?

  • Is the term ‘always’ true when…?

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Example:

Negative thought: 

  • ‘I always do everything wrong.’   

 

Questions to ask yourself: 

  • Is the term ‘always’ true?

  • How many times have you done something wrong?

  • How many times have you done something right?

  • How was everything this week?

  • What did you do wrong?

  • How many things did you do wrong?

  • In addition, how many things did you do right?

 

PART B: SOMETIMES ASKING QUESTIONS ABOUT THE PURPOSE/FUNCTIONALITY OF THE NEGATIVE THOUGHT MAY BE MORE EFFECTIVE.

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This is useful for typical statements like: ‘If only I knew what I should do’, ‘First of all I have to find a caregiver, then I'll see’, and ‘I don’t even know why I should bother getting up in the morning’.

 

Questions:

  • Does this thought help you to achieve your short-term or long-term goals?

  • Do you want that outcome? What will happen if you do that particular thing?

  • If you do that, is the outcome what you want, or what others want?

  • If you do that, will it get you closer to your goal?

 

PART C: IF YOU FEEL TOO CAUGHT UP IN YOUR FEARS, QUESTIONING THE COST-BENEFIT OF A NEGATIVE THOUGHT CAN HELP TO GET RID OF IT.

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The goal here is to test what long-term effects your attitudes or actions have on your well-being, and your motivation to abandon dysfunctional cognition ('bad’ thoughts). Are the costs and benefits in conflict?

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Questions:

  • How do you feel about this particular negative thought?

  • What does this thought help you with?

  • How does this thought hinder you?

 

Remember: It is important to ask yourself at the end of any question:

  • What do I THINK about this now?

  • How do I FEEL now?

 

STEP 3. DEVELOP MORE HELPFUL THOUGHTS

 

This step is about developing more appropriate thoughts that you experience as coherent and helpful. These thoughts are sentences that you could say to yourself in a stressful situation. It is not about trivializing or playing down your problems, but rather about developing constructive thoughts that help you to clear your head and bolster your courage.

 

Now that you have realized that there are no good arguments that support your negative point of view (for example ‘I always do everything wrong’ or ‘nobody likes me’), you can use ‘self-talk’ (Meichenbaum, 2010) to help you gather helpful thoughts. You can generate helpful thoughts by talking to yourself and answering several questions.

 

  • What could you say to yourself next time you find yourself in a similar situation?

  • What would be a helpful and realistic approach?

  • What do you have to say to feel the way you want in the situation?

  • Formulate helpful thoughts concretely and write them down for yourself.

 

Here are a few suggestions for helpful, stress-reducing thoughts.

  • I Will Get Through It!

  • There Are Worse Things

  • The Probability Of Getting A Caregiver Is 20% (Not: I Never Will…)

  • One Thing At A Time

  • Keep Calm

  • Others Also Make Mistakes

  • I Am Not Alone

  • Studying More Would Be Helpful For Me (Not I Should Be Studying More)

  • I Know I Can

  • I Have No Reason To Doubt Myself

  • I Do Not Always Have To Do Everything 100%

  • Ok, I’m Not Good At This Now, But With Practice, I Could Get Better

  • I’m Not Putting Myself Under Pressure

 

STEP 4: PRACTICE THE NEW, HELPFUL THOUGHTS

 

In this final step, you practice the new, alternative thoughts (which you developed in the third step) as a new way to cope with problematic situations.

For cognitive restructuring to occur, changes through not only intellectual insight but also ‘emotional’ insight are necessary. Therefore, to develop this new skill, you have to practice by:

 

  • Telling yourself helpful thoughts repeatedly. First, say them aloud, and then quietly pronounce the sentences to yourself.

 

  • Writing the helpful thoughts down. Write them on sticky notes and attach them to things you use every day (for example, the mirror in the bathroom, on your fridge, or as a background image on your mobile phone)

 

  • Imagine using the sentences in certain situations. Imagine how well they help you to cope.

 

The new, helpful thoughts need to be practiced until they are internalized. Repeated practice is designed to automate functional cognitions, and replace dysfunctional ones. This means that active training and practice are important!

References and additional readings

Ackerman, C. (2017). Cognitive distortions: When your brain lies to you (+ PDF worksheets).  Retrieved from https://positivepsychologyprogram.com/cognitive-distortions/

 

Behar, E., Dobrow DiMarco, I., Hekler, E. B., Mohlman, J., & Staples, A. M. (2009). Current theoretical models of a generalized anxiety disorder (GAD): Conceptual review and treatment implications. Journal of Anxiety Disorders, 23(8), 1011-1023.  http://dx.doi.org/10.1016/j.janxdis.2009.07.006

 

Burns, D. D., & Beck, A. T. (2004). Feeling good: The new mood therapy. New York, NY: HarperCollins Publishers

 

Döpfner, M., & Suhr-Dachs, L. (2015). Leistungsängste: Therapieprogramm für kinder und jugendliche mit angst- und zwangsstörungen (THAZ) – Band 1. Verlag, Göttingen: Hogrefe.

 

Dr. Russ Harris - Acceptance Commitment Therapy.  (2015). The struggle switch - By Dr. Russ Harris [Video]. Available from YouTube. Retrieved from https://www.youtube.com/watch?v=rCp1l16GCXI

 

Dr. Russ Harris - Acceptance Commitment Therapy.  (2017). Sushi train metaphor by Dr. Russ Harris [Video]. Available from YouTube. Retrieved from https://www.youtube.com/watch?v=tzUoXJVI0wo

 

Ellis, A. (1994). Rational Emotive Behavior Therapy approaches to obsessive-compulsive disorder (OCD). Journal of Rational-Emotive & Cognitive-Behavior Therapy, 12(2), 121-141.  http://dx.doi.org/10.1007/BF02354608

 

Ellis, A. (1996). The humanism of Rational Emotive Behavior Therapy and other cognitive behavior therapies. The Journal of Humanistic Education and Development, 35(2), 69-88.  http://dx.doi.org/10.1002/j.2164-4683.1996.tb00356.x

 

Ellis, A. (1997). Using Rational Emotive Behavior Therapy techniques to cope with disability. Professional Psychology: Research and Practice, 28(1), 17-22.  http://dx.doi.org/10.1037/0735-7028.28.1.17

 

Ellis, A., & Windy, D. (2007). The practice of Rational Emotive Behavior Therapy (2 ed.). New York, NY: Springer Publishing Company.

 

Meichenbaum, D. (2010). Child and adolescent depression and suicide: Promising hope and facilitating change 14th Annual Conference of the Melissa Institute for Violence Prevention and Treatment, held in Miami, FL: Melissa Institute.

 

Pinnacle of Man TM.  (2016). Cognitive Behavioral Therapy (CBT) is simply explained [Video]. Available from YouTube. Retrieved from https://www.youtube.com/watch?v=WhMmZJ3H1E8

 

TEDx Talks.  (2014). Feeling good | David Burns | TEDxReno [Video]. Available from YouTube. Retrieved from https://www.youtube.com/watch?v=H1T5uMeYv9Q

 

TherapistAid LLC. (2013). ABC Model [Worksheet].  Retrieved from https://www.therapistaid.com/worksheets/abc-model-for-rebt.pdf

 

TherapistAid LLC. (2016). The Cognitive Model [Worksheet].  Retrieved from https://www.therapistaid.com/worksheets/cbt-model-worksheet.pdf

 

TherapistAid LLC. (2017). Putting thoughts on trial [Worksheet].  Retrieved from https://www.therapistaid.com/worksheets/putting-thoughts-on-trial.pdf

 

TherapistAid LLC. (2018). Thinking errors [Worksheet].  Retrieved from https://www.therapistaid.com/worksheets/cbt-thinking-errors.pdf

 

Tyson, G.  (2016). Attention Gym 5-minute training [Video]. Available from YouTube. Retrieved from https://www.youtube.com/watch?v=cr6bMHfNUCg

 

Wells, A. (2011). Metacognitive therapy for anxiety and depression. New York, NY: Guildford Press.

 

Wessler, R., & Wessler, R. (1980). The Principles and Practice of Rational-Emotive Therapy (1 ed.). San Francisco, CA: Jossey-Bass.

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