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Neuroaffective-CBT
Neuroaffective-CBT is a cognitive-behavioural method developed and refined over the last 12 years by Daniel Mirea, a senior CBT lecturer, writer and consultant psychotherapist. This model evolved alongside the latest generation of CB therapies, in response to a need to better understand and better respond to deeply rooted emotions that feel too complex or too confusing. Often such emotions are difficult to describe and may fall under the low self-esteem umbrella, shame or guilt. Such affects are equally difficult to investigate or diagnose as they cross over into so many psychiatric disorders. Although a new and innovative therapy, NA-CBT is rooted in years of research on cognitive-behavioural techniques like exposure, which have placed CBT in a completely different league when it comes to treatment outcomes.
Author: Neuroaffective-CBT
I am an accredited CBT Psychotherapist, a writer, senior lecturer and clinical supervisor who trained and also trains in different cognitive and behavioural approaches including traditional CBT, Compassion Focused Therapy, Cognitive-Behavioural Hypnosis, EMDR, Schema Therapy, Mindfulness (MBCT), Dialectical Behaviour Therapy, ACT or NA-CBT. With a career spanning over almost 30 years in the mental health field, I dotted many 'i's and crossed many 't's in mental health, forensic and substance misuse clinics as a clinical head, clinical supervisor or just psychotherapist. I have always felt drawn towards complex cases of low self-esteem and childhood trauma but also at the other end of the spectrum by the prospect of enhancing performance and abilities through a positive mindset. As such, over the years I developed my own behavioural approaches.. Neuroaffective-CBT mostly for chronic negative emotions, Emotion-Focused CBT for interpersonal/relationship problems and Sports-CBT for enhancing performance in sports. Through this website I will share some of my clinical experience and my research findings with you but also my passion for the human mind which will never cease to surprise me...
Why EMDR is more than just another therapy with a funny look and a strange name
October 11, 2018 June 6, 2019 Neuroaffective-CBT
When Mel B publicly announced this summer that she was going into treatment for Post-Traumatic Stress Disorder (PTSD), an unusual kind of psychotherapy started to draw attention: EMDR formerly known as, Eye Movement Desensitization and Reprocessing. Talking about her diagnosis in particular, it appears that Mel B had been self-medicating with sex and alcohol, which is otherwise not uncommon with this diagnosis. In an interview during the summer of 2018, she pointed out that "[I am] still struggling but if I can shine a light on the issue of pain, PTSD and the things men and women do to mask it, I will do […]".
More recently comedian Adam Cayton-Holland recounts in his book (Tragedy Plus Time: A Tragi-Comic Memoir) the death of his sister, who took her own life. In an exclusive excerpt from his book, Cayton-Holland reveals that EMDR helped him recover from PTSD following his sister's suicide.
So what exactly is EMDR, why is it getting the headlines, and does it in fact, help with traumatic experiences? If so, is this evidence-based treatment and, is there a connection with Cognitive Behavioural Therapy (CBT) the golden standard in psychological treatments?
More questions than answers..?
For a therapy that is committed to resolving traumatic re-experiencing, PTSD [1] would have been an obvious starting place for the application of EMDR. Most of the earlier work and research into this therapy, discovered by complete accident [2] by Francine Shapiro, would naturally focus on traumatic memories processing. Shapiro`s earlier research (in the late 80's and early 90's) would successfully demonstrate EMDR's efficacy (Shapiro, 1989). Subsequently, numerous research and clinical trials followed, which would have culminated with a meta-analysis of no less than 38 randomised controlled trials (RCTs). The conclusions were very clear: EMDR and Cognitive Behavioural Therapy with a trauma focus (TF-CBT) are the two most effective treatments for adults with this disorder (Bisson et al., 2007). A separate review of the efficacy of EMDR for traumatised children also showed that EMDR and TF-CBT are superior to all other treatments. EMDR however, was found to be slightly more effective when compared with CBT by Rodenburg et al. in 2009.
Two further meta-analyses in 2013 found that EMDR is better than no treatment, it is similar in efficacy to TF-CBT and also that 'the eye movements do have an additional value in EMDR treatments' (Bisson et al., 2013 and Watts et al., 2013). However, due to high drop outs, poor quality of evidence, and significant rates of researcher bias, authors warned against inconclusive analyses and inaccurate interpretations of the results.
In spite of a work in progress understanding of all the mechanisms involved in EMDR, a few strong hypotheses have been proposed over recent years. Those theories coupled with demonstrated efficacy, have been sufficient for EMDR to secure a place alongside CBT, within the treatments recognised by the National Institute for Health and Clinical Excellence (NICE) and the World Health Organization (WHO) as the psychotherapeutic treatments of choice for post-traumatic stress disorder.
EMDR mechanisms explained
So how does it actually work? And what are the mechanisms and approaches involved in the treatment process? Simply put, the patient is asked by therapist to recall distressing images while generating a type of bilateral sensory input, on short bilateral processing or bilateral stimulation (the preferred terms for this article). This basically refers to side-to-side eye movements or hands tapping (though tapping is less common in EMDR). The effect is to desensitise the client to the distressing memory but, more importantly, to process the memory so that the associated cognitions and affects become more adaptive.
The EMDR toolkit is clearly prescribed but to the untrained eye, it can appear almost mechanistically applied, which makes this approach an easy target for many critics from other schools of psychotherapy, usually positioned outside the spectrum of CBT therapies.
A standardised template consisting of an eight-stage protocol is routinely employed with every traumatised patient. The treatment typically starts with comprehensive history taking and case formulation, a process that is very similar to CBT. This is followed by a preparation phase in which the client is provided with the all necessary (internal) resources to safely manage the processing of their distressing memories (e.g. stop signals, etc.).
The assessment phase involves identifying the patient's target memory, the associated negative cognition, the desired positive cognition (this would become a therapeutic goal), bodily sensations and various ratings for the level of distress and the level of belief in the positive cognition (other immediate therapy goals would be to improve these ratings).
The assessment is followed by the desensitisation phase or the actual memory processing [3] through bilateral stimulation. The final phase would involve installing the desired positive cognition (this process is normally referred to as installation) and a final body scanning for any residual physiological symptoms before the final debrief. This work is not usually backed up by real life exposure or other behavioural exercises in-between sessions, which would usually be the case with cognitive-behavioural therapies.
The adaptive information processing model (Shapiro, 2007) suggests that new experiences are integrated into already existing memory networks. Memories are processed and integrated via sophisticated cognitive screening mechanisms based on individuals' past experience and understanding of themselves and the world they live in (also known as schemas and/or schema processes in CBT). However, if the experience is traumatic, the information processing system stores the memory incorrectly, often in the wrong parts of the brain and in a still (rigid or frozen) format without adequately processing it to an adaptive format. Thus traumatic memories fail to become integrated into the individual's life experience and concept of the self. For example, an individual who becomes traumatised as a result of a car accident would experience a much more global sense of vulnerability. In other words, the trauma victim would feel weak and vulnerable across a range of situations not only when he comes in contact with the traumatic stimulus (e.g. the vehicle responsible for the trauma). In PTSD, individuals continue to relive the trauma as if the event is happening all over again, in the present moment. Patients therefore become avoidant of anything that would be connected to the trauma and tend to become hyperaroused and hypervigilant.
The above formulation which simply explains some of the perpetuating and precipitant mechanisms involved in PTSD is strikingly similar to the CBT approach for trauma. In fact, not just the conceptualization of trauma, but also a range of empirically based cognitive-behavioural interventions [4] such as exposure, desensitization, meta-awareness, attention-orientation training, are all at the very core of EMDR also. Professor Paul Salkovskis a renowned UK based CBT researcher and author, pointed out in a 2002 article, that the eye movement in EMDR is completely irrelevant, and that EMDR effectiveness is solely due to having similar properties to CBT, such as desensitization and exposure (Salkovskis, 2002).
It would be fair to describe the side-to-side eye movements or hands tapping as somewhat unorthodox exercises for the traditional psychotherapist, and therefore it should be no surprise that bilateral stimulation has been the target of many debates and studies. To make matters worse, the evidence hasn't always been favourable. Some studies compared using EMDR with and without the use of bilateral stimulation and even a meta-analysis of 13 studies (Davidson & Parker, 2001) concluded that eye movements made no difference to its effectiveness. But on the other hand, Stickgold (2002) proposes that eye movements in EMDR produce a brain state similar to the one during REM sleep. It has been shown that REM sleep serves a number of adaptive functions, including memory consolidation. Observing the parallels between REM sleep and EMDR, Stickgold proposes that EMDR reduces trauma-related symptoms by altering emotionally charged autobiographical memories into a more generalised semantic form (Stickgold, 2002). Interestingly, when investigating the neurobiological processes involved in attention training in third-wave CBT (mindfulness), Philippe Goldin (2009) also observed a shift from a rigid narrative sense-of-self to a more fluid or experiential sense-of-self aided by attention training exercises and focused breathing. Propper and Christman (2008) draw upon research suggesting that retrieval of episodic memories is enhanced by increased interhemispheric communication. Gunter and Bodner (2009) found that although vertical eye movements do not enhance hemispheric communication, they did decrease memory emotionality as effectively as horizontal movements.
It is my opinion that, to the traumatised patient often in distress, such clinical debates and views very little matter. Improved neuroplasticity and cognitive-behavioural changes could be achieved in a variety of different ways as shown by Golden (2009) and numerous other CBT studies. A number of additional covert factors that facilitate change are equally important. For instance, if patients' motivation remains high and expectations from a specific therapeutic intervention are equally high, treatment outcomes would be positively influenced. This further implies that the therapeutic alliance and trust in the clinical skills of the therapist are also essential. As such, these important resources have to be given priority throughout the therapy process.
Who can get training in EMDR
In UK the more advanced cognitive-behavioural training programmes also include training or at least an overview of EMDR in the context of evidence-based treatments for trauma. However EMDR has its own accredited training organisations (via EMDR UK & Ireland) and therefore it does not placed itself under the umbrella of CBT therapies (or BABCP). Training in this method is not usually offered outside the psychological or psychotherapeutic community, which means that one would have to have a core mental health profession or to be CBT accredited before specialising in EMDR. There are three levels of EMDR competences that can be achieved and the highest level would indicate the most skilled level of EMDR application.
[1] Post-traumatic stress disorder (PTSD) is a severe form of anxiety caused by exposure to very stressful, frightening or even distressing events. PTSD victims often relive the traumatic event through flashbacks (memories of the trauma) and they experience states of hyperarousal (intense fear), isolation, shame and guilt in different degrees. Years of clinical research have noted a range of trauma-related psychological problems that were not captured in the DSM framework of post-traumatic stress disorder until recently. PTSD, dissociation, somatization, and affect dysregulation represent a spectrum of adaptations to the traumatic experience. They often occur together, but traumatized individuals may suffer from various combinations of symptoms over time. When treating PTSD patients, it is critical to attend to self-regulation and cognitive integration of traumatic experience and to provide systematic treatment that addresses both intrusive recollections and, all the other symptoms associated with the trauma (van der Kolk et al., 1996).
[2] In 1987, Dr Francine Shapiro (Senior Research Fellow Emeritus at the Mental Research Institute in Palo Alto, California) was walking in the park when she realized that eye movements appeared to decrease the negative emotion associated with her own distressing memories. She assumed that eye movements had a desensitizing effect, and when she experimented with this she found that others also had the same response to eye movements. It became apparent however that eye movements by themselves did not create comprehensive therapeutic effects and so Shapiro added other treatment elements, including a cognitive component, and developed a standard procedure that she called Eye Movement Desensitization (EMD).
[3] The working memory hypothesis proposes that eye movements and visual imagery both draw on a limited capacity of the visual and central executive working memory resources. The demand and competition created by two or more tasks will impair imagery, so much so that images become less emotional and less vivid. It has been established that horizontal eye movements tend to tax working memory (Van den Hout et al., 2011). In support of the working memory hypothesis, studies have found that other taxing tasks during recall also reduce vividness and/or emotionality of negative memories (De Jongh et al., 2013).
[4] The cognitive model for PTSD by A Ehlers and D Clark, the Interacting Cognitive Subsystems (ICS) model by Barnard and Teasdale, the typical Socratic dialogue used, the psychopathological understanding of trauma and various aspects of the therapeutic alliance are common to both CBT and EMDR approaches. Another common mechanism with both approaches would be mindfulness. During the desensitisation phase of EMDR, clients are instructed to 'let whatever happens, happen' and to 'just notice what is coming up' (Shapiro, 2001) which is consistent with mindfulness methods (Siegel, 2007).
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Third-Wave CBT or three waves of CBT ?
July 26, 2018 June 4, 2019 Neuroaffective-CBT
Both are correct! As already explained in my previous article (CBT what's all the fuss about, 2018) Cognitive Behavioural Therapy is an umbrella term for a range of therapeutic models that successfully combine behaviourism with Buddhist philosophy, social learning theories, cognitive psychology and more recently neuroscience/ neuroaffective research (Mirea and Hickes, 2012)1. A number of different CBT approaches have gradually evolved over the last 70 years, in three distinct waves (Mirea, 2012)2.
In spite of some apparent differences, all of these methods have much in common. They are formulation-based 3 and rooted in empirical research, behaviourism and the bio-psychosocial model4. They have a common framework, the working models are simple enough and easy to learn, with clear therapeutic goals, which are agreed collaboratively with patients by employing a SMART 5 approach (Mirea, 2016) 6. Therapy goals would usually involve carefully planned strategies aimed at disrupting factors that predispose and trigger individuals' mental health symptoms and maintains the crisis through rather complex mechanisms usually designed at an earlier stage in life.
Here is an example (published in 2012 article by Mirea and Hickes)1. An excessively jealous and anxious boyfriend came to his assessment and revealed that during his childhood, he experienced significant emotional neglect and an unpredictable and explosive parental relationship including regular fights, arguments, cheating and jealousy. He internalised all these emotional childhood experiences in a particularly disintegrated manner and developed a core-belief (a powerful felt-sense) that he is unlovable (and if found out he would be rejected). This is not usually dialectically expressed with peers or significant others, but it is more of a sense-of-self, a gut-feeling or an identity that the individual has created for himself, based on his early years (emotional) experiences. Over time, the patient would ensure that he is well defended against all of the possibilities that he will be rejected and covers up for his perceived flaw by developing a number of strategies meant to ensure his survival and happiness. Some behavioural strategies will therefore be based on the assumption that "I have to always be on my toes in a relationship…the moment I let my guard down, she would cheat on me", therefore… "It is justified to be jealous; I will stalk her, check on all her movements all of the time, I'll go through her mobile phone records and pockets (and so on…), in order to be better prepared", etc.
Any future therapeutic work, should help the client identify where these complex set of beliefs, associated behaviours and emotions are exaggerated or misguided. During the assessment, the therapist designs a case formulation containing vicious circles (or traps) that help educate the client about the relationship between his early childhood experiences, core beliefs, assumptions, strategies and current critical situations. This formulation or case conceptualisation (which is diagrammatically explained) would act as the basis for a treatment plan.
This article highlights the common ground that all cognitive-behavioural approaches share, the empirical base, the constant focus on change, problem solving and skills development. I have also discussed early treatment processes – the clinical assessment which leads to a case formulation which further leads to strategic treatment planning.
The differences between approaches however, are much more difficult to explain. Fundamentally such differences lie perhaps in the specific design of each method or the original intention. For example, Dialectical Behaviour Therapy (DBT) is a treatment protocol created by Marsha Linehan for Borderline Personality Disorders. Mindfulness-Based Cognitive Therapy (MBCT) is a relapse prevention tool for depression and so on. Of course subsequent research and clinical trials have allowed these methods to be applied successfully with other disorders and this is probably why it may be difficult to figure CBT out at times (especially if one is operating outside of this field).
A historical overview does offer some insights and it shows how dynamic and rapidly this therapy develops. In the very first wave, we have pure behaviourism, highlighted by the reputable and well researched theories of Ivan Pavlov on learning and conditioning, Joseph Wolpe on systematic desensitization, Edmund Jacobson on Progressive Relaxation. The second wave would represent the main body of CBT started off by Aaron Tim Beck's original cognitive-behavioural therapy and Albert Ellis' rational-emotive theory. The model is a simple but effective treatment protocol for depression at this stage (1960's) supported by a range of researched behavioural, learning and cognitive theories. Beck and Ellis had never stood idle but other clinicians such as Donald Meichenbaum (Cognitive Behavioural Modification), Jeffrey Young (Schema Therapy), Adrian Wells (Metacognitive Therapy) or David Clark, to name but a few, have really expanded and pushed the boundaries of CBT in the following 40 years or so. CBT can now be used with a range of disorders, in the short-term or in the long-term. Disorder focused approaches, case formulation approaches, transdiagnostic approaches, have all taken shape during this stage.
Third-Wave, the latest addition, is characterised by the introduction of a new concept which is ultimately going to become very familiar and popular, mindfulness or formally known as Mindfulness-Based Cognitive Therapy. This was introduced to the psychotherapeutic community by Williams, Teasdale and Kabat-Zinn (2007) 7 initially as a relapse prevention method for depression.
In spite of a number of significant developments over recent years, most researchers, authors, and practitioners still draw on the second wave when they describe, challenge or investigate CBT as an approach. This may no longer be sufficient. Studies will have to be more specific about what intervention (e.g. exposure) or method (e.g. MBCT) is being investigated rather than describing CBT in generic terms. I am afraid, this is no longer good enough.
1 Mirea D and Hickes M (2012). CBT and EPT: rival paradigms or fertile ground for therapeutic synthesis. Existential Analysis 23.1, 2012 (p15-31)
2 Mirea D (2012). Cognitive Behavioural Coaching, friend or foe to the existential coach. In Existential perspectives to coaching, edited by Van Deurzen and Hanaway, 2012. Palgrave Macmillan.
3 Formulation or case formulation or (case) conceptualisation can be understood as an alternative to the psychiatric diagnosis, a behavioural analysis firstly introduced in 1965 by Kanfer and Saslow in a seminal paper. Case formulating is part of the assessment process and it is central to providing a coherent and comprehensive treatment plan.
3 The biopsychosocial model (bio-psychosocial or bio-psycho-social) is a broad view that attributes disease outcome to the intricate, variable interaction of biological factors (genetic, biochemical, etc), psychological factors (mood, personality, behavior, etc.), and social factors (cultural, familial, socioeconomic, medical, etc.). The biopsychosocial model counters the biomedical model, which attributes disease to roughly only biological factors, such as viruses, genes, or somatic abnormalities. The biopsychosocial model applies to disciplines ranging from medicine to psychology to sociology.
4 SMART goals: Specific, Measurable, Achievable, Realistic and Timed. A 2014 clinical trial by Waller et al. pointed out that there are clear advantages of the 'GOALS approach'; it is brief and that the frontline mental health workers who are in regular contact with patients in mental health care settings can be readily trained in its delivery. There is therefore scope for developing an effective intervention, which can be made widely available at low cost, improving access to psychological therapies for this client group. See Waller et al. Trials 2014, 15:255
6 Mirea, D (2016). Assessment and case formulation in CBT. Revised 1999 article and re-published in April 2016 in the Family Wellbeing Research and Therapy Journal. Vol.3. 1-24
7 Williams, Teasdale, Segal, Kabat-Zinn (2007). The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness. The Guildford Press.
How to best confuse yourself when you are already stressed…
July 25, 2018 January 30, 2020 Neuroaffective-CBT
In a few words… start googling, binging or ask Alexa !
If I knew nothing at all about 'mental health' and googled for some help with my stress or anxiety levels, I would probably end up focusing on the only criteria I can understand – money ! What is the cheapest therapist out there or how do I get the best value for my money. Nothing else on Google makes any sense, when it comes to psychotherapy, unless you have a degree in research methods.
The answer to the 'value for money question' however, is relatively simple: NHS is by far the cheapest service, because… it is actually free. However, since getting any kind of mental health support from your GP is like pulling teeth, you have no choice but to go private. Unless you are a high risk, it is unlikely that you will get anything else besides leaflets and SSRIs 1 via your local general practitioner.
Incidentally, I am a big supporter of antidepressants and the work GP's are doing on a daily basis is simply award worthy. I know too many cases where lives have been saved by SSRIs and an outstanding GP support however, I am not a big fun of random prescribing without a thorough MSE (mental state examination 2). GP's are not psychiatrically trained and nor should they be – this is a highly specialist area reserved for mental health specialists; though what is worse is that, most are not provided with any mental health support on site.
Now… on the other hand, therapists are not making life any easier for their patients with endless squabbles over supremacy and the never ending 'which school of therapy is more effective' competition. In this process, we tend to lose track of our patients' needs and instead we focus on offering them what we were told in training that works best. All the while, the poor victims of mental illness cannot even tell the difference between psychiatry, psychology, psychotherapy or hypnotherapy and wait… there is at least one more… of course, counselling 3 … and life coaching… and mindfulness therapist.. and existential coaching.. and it goes on and on… Everyone out there seems trained to come to the rescue.
But Thank Goodness for Google! Because when it comes to creating even more confusion it wins the prize.
One of my least favourites Googles is self-diagnosis ! Simply too many patients come to their assessment with an already Google-made diagnosis. As such, here are just some of the problems that I have with that:
It is far too easy to misinterpret physiological symptoms and identify with the incorrect diagnostic criteria; e.g. mood swings do not necessarily equate with a manic-depressive illness !
Patients can throw mental health assessors off with their perception of a medical history which could have been at best influenced, if not completely constructed with assistance from Google or its competition Alexa !
The issue of chronic medical problems. Patients often think they have panic disorder (a very common self-diagnosis) and miss the diagnosis of hyperthyroidism or irregular heartbeats. On the other hand, heart racing does not (necessarily) means that one is having a heart attack.
Confusing one psychological disorder with another. For example, some patients may think they are overwhelmed by agoraphobic reactions which would explain their tendency to socially isolate when in fact, social anxiety or depression or both or even asperger syndrome could be the more likely diagnosis responsible for their social isolation.
Self-diagnosis can also create mistrust and may undermine the all essential therapeutic relationship between therapist and patient.
Self-diagnosis can precipitate and perpetuate health anxiety.
SSRIs: Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder and anxiety disorders, Citalopram, Fluoxetine or Sertraline are just three examples of SSRIs that can be prescribed in UK by the GP or a psychiatrist. Even though clinical psychologists, CBT therapists and mental health nurses have extensive training in pharmacology and psychopathology, prescribing falls under the responsibility of a qualified psychiatrist
MSE – mental state examinations: a clinical assessment process in the psychiatric practice. The purpose of the MSE is to obtain a comprehensive cross-sectional description of the patient's mental state, which, when combined with the biographical and historical information of the psychiatric history, allows the clinician to make an accurate diagnosis which is subsequently required for coherent treatment planning.
There is no agreed hierarchy in terms of knowledge or expertise when it comes to the title of counsellor, psychotherapist, psychologist or hypnotherapist. However, each of these titles is backed by an accreditation which is essentially a licence, administered by a very specific regulatory body such as BABCP (British Association for Behavioural and Cognitive Psychotherapies), UKCP (UK Council for Psychotherapy) or BACP (British Association for Counselling & Psychotherapy); these bodies demand a certain standard of training, practice and ethics. The least demanding organisations are those that regulate the field of hypnosis, for example the GHSC – General Hypnotherapy Standards Council. Some of the hypnotherapy organisations register hypnotherapists with as little as 21 days of training, minimum or no supervision, no personal therapy and no compulsory clinical practice hours and no core profession (e.g. psychologist or psychiatric nurse for example). The standards of all other counselling and psychotherapy regulatory bodies in UK are significantly different with accreditation subjected to intensive training between 2 to 7 years, clinical supervision, personal therapy and supervised practice. Unlike counsellors or psychotherapists, psychiatrists are medical doctors trained in psychiatry (mental health diagnosis, pharmacology, etc.) but not in counselling or psychotherapy (or talking therapies). Clinical psychologists are also doctors in psychology trained in talking therapies. All BABCP accredited CBT therapists are post-graduates and/or doctoral psychotherapists (with a core profession) specialising in psychological and behavioural treatments (rather than generic counselling).
CBT, what's all the fuss about ?
Well.. most rumours are actually true. At least according to Frontiers of Psychiatry (the January 2018 edition) CBT is the gold standard in the field of psychotherapy, because of its clear research support and continuous development and improvement based on research findings. It presently dominates the international guidelines for psychosocial treatments, making it a first-line treatment for most disorders, as noted by the National Institute for Health and Care Excellence's guidelines 2 and American Psychological Association.3
This is no longer the new kid on the block, even though it was the latest to join in at the big boys table in the mid-60's. Back then, CBT was merely a treatment protocol for depression written by the brilliant Aaron Tim Beck an analytically trained psychiatrist. The clinical world soon realised that this new kid nicknamed by Beck CBT, is here to stay and might even attempt to take over. So much so that today, we are talking about CBT being an umbrella term for a number of therapies or approaches with many strange names but a clear task to treat a variety of different psychiatric disorders (i.e. Schema Therapy, SIT, PE, MCT, MBCT, DBT, ACT, CFT and a lot of other acronyms).
CBT is a pretty fast paced, short-term, modern therapy with flexible therapeutic boundaries. Yes that's correct fellow therapists, behaviourists have always steered away from traditional psychotherapeutic boundaries – in my humble opinion, these dated boundaries are probably still rooted in an unworkable Freudian-psychoanalytical approach. I am sure this is a gross exaggeration, but nonetheless it does not change the fact that CBT does not necessarily adhere to the traditional therapeutic boundaries. Whilst some therapists still wonder over the usefulness of shaking hands with their patients or comforting someone crying, we stick our hands down the toilet to demonstrate to our OCD patients that germs don't instantly kill.. and then we shake their hands! Sessions can take place in the comfort of a clinic (if we are lucky enough) or in patient's residence or outdoors or at patient's work place. It all depends on the type pf exposure exercises or social experiments that we would have agreed on, in advance, with the patient.
The formal term used in CBT is 'collaboration'. Indeed we collaboratively agree on most (if not all) experiments but in reality, this model is directive, problem-solving and goal oriented, relying on a lot of teaching and a clearly prescribed evidence-based process usually led by an expert therapist (oh yes.. I've done it again). The treatment methods (from exposure to relaxation training) are steeply rooted in behaviourism, learning theories and even physiology. The works of Skinner BF, Watson J, Pavlov I, Jacobson E, Salters A and a few other creative but not always popular (or even ethical by today's standards) behavioural psychologists from the beginning and middle of the 20th century, form a solid foundation for all CBT approaches.
Nowadays cognitive-behavioural practitioners describe methods spreading over three distinct waves of CBT. The first wave is characterised by the above mentioned behaviourists, the second-wave was kicked off by Aaron T Beck and Albert Ellis – this would be 'the CBT' that most people are familiar with ! Third-wave CBT is marked by a slight departure from earlier methods with the arrival of imagery-based and philosophically informed approaches such as mindfulness (MBCT). Even though though mindfulness and compassion based therapies are associated with the Buddhist philosophy it is important to acknowledge that the main drivers that underpin these schools (as developed by visionaries like Jon-Kabat Zinn, Mark Williams, Teasdale J, Segal Z or Paul Gilbert) are not just philosophical aspects of our daily living as much as the focus on training the attention and affect (or stress) regulation.
So what do all these methods in common ? This is a subject worthy of a whole new article…
Introducing NeuroAffective-CBT
July 24, 2018 October 15, 2019 Neuroaffective-CBT
Neuroaffective-CBT or on short NA-CBT is a transdiagnostic and modular therapeutic model developed and refined over the last 12 years by Daniel Mirea. As described in the opening comment this approach was born out of a need to better understand and better respond to deeply rooted emotions that 'feel' too complex and confusing to most people who have never been strangers to painful and unmanageable affective experiences.
Often such affects (or emotions) are difficult to describe and may fall under the low self-esteem umbrella, shame or guilt. But not only… I find in my classes (I teach qualified practitioners at a post-graduate and doctoral level mostly) as well as in my clinical supervisions that psychotherapists are often guilty of assuming too much. Patients or clients (depending on where one is practising psychotherapy) are often confused about their affective states and even appropriate transient emotions such as fear, sadness or fleeting anger can be often misread or misunderstood, which of course leads to an amplification of unwanted emotions.
In any case, to begin with it may be important to define the concept of 'transdiagnostic' and 'modular' psychological treatments. Transdiagnostic approaches evolved in CBT in response to a range of symptoms that often cross the boundaries of a specific diagnostic criteria.
In other words, emotions such as shame, guilt and low self-esteem are consistent with symptoms that can be found in depression, social anxiety, personality disorders or even PTSD. NA-CBT is a transdiagnostic approach because it can be used with any of these psychiatric disorders since it aims to undermine the maintaining mechanisms that reinforce the presenting problems. The diagnostic criteria, although extremely important is not necessarily the main driver during therapy.
NA-CBT is also a modular approach because, just like in the structure below, the treatment can be split into different modules. The reason I have not labelled those treatment phases or treatment stages is simply because in NA-CBT, these modules do not follow a rigid order, modules are intersectable and interchangeable. This means that one can start the treatment with module 3 and then move on to module 2 depending on patient's therapeutic goals, needs and ability to learn new coping skills.
For example with traumatic memories such as that of an emotional abuse (e.g. being humiliated and shouted at during earlier years), such memories may need to be processed more immediately, as suggested in module 3 – The integrated Self, before returning to module 2 – where the focus would be on Physical Strengthening.
Sometimes, it may appropriate to work through both modules in parallel. During the Physical Strengthening module, we ask patients to be more aware of their bodies, their posture and musculature action, since those have a direct and reverse impact on how we feel about ourselves. Our mind instructs the body but the body also instructs the mind. For example, where appropriate I would explain to patients, about the direct impact of shameful feelings onto our physical posture (musculature) and body language overall. Internal self-awareness and managing our focused attention becomes an important aspect of the training at this stage also.
An easy to remember model called TED is also part of the Physical Strengthening module:
Tired (energy levels and sleep deprivation)
Exercising (physical exercises)
Diet (drinking & eating)
You can only imagine my excitement when my son introduced me to a comedy with the same name a few years ago; turns out that TED is a cute teddy bear with a flair for excitement and fun but more importantly he is the main hero's best friend. So Yes indeed… "TED's your best friend" and "When in doubt check with TED" is the type of catchphrases popular with my clients even today. In future posts, I will be writing more about the benefits of using catchphrases, fun relatable stories and metaphors in therapy. And along the same lines, about the benefits of appropriate self-disclosure.
Neuroaffective research points out that an integrated or balanced sense-of-self, an improved confidence and well-being can be achieved through better hormonal regulation. A lot of (psycho)education and training is offered on how to achieve 'balance' and well-being through improving emotional-hormonal regulation.
Recent neuroaffective and neuroimaging research has influenced CBT treatments over recent years and is constantly shaping therapists' understanding of brain wiring and the relationship between brain circuits, hormonal regulation and primary emotions.
An overview of the NA-CBT treatment toolkit:
Assessment and case formulating: the "Pendulum-Effect" case formulation: since all CBT treatment protocols begin with a thorough assessment, where the principle purpose is to arrive at a formulation which will then form the basis for the treatment plan, I do not consider this initial stage a module. The assessment and case formulation plays a pivotal role in the treatment – this is not a 'negotiable' phase but a treatment condition. During this initial stage however, a strong emphasis is placed on building an alliance and a strong therapeutic relationship by using (uniquely to NA-CBT) methods such as emphatic mentalisation.
Module 1 : Psychoeducation & Motivational Enhancement: including building motivation, enhancing self-efficacy, problem solving skills training.
Module 2 : Physical Strengthening: TED's your best friend
Module 3 : The development of an integrated-Self: cognitive reframing (appraisal-reappraisal). Traumatic memories processing (through bilateral stimulation, narrative exposure and/or reliving).
Module 4 : Coping Skills Training & Self-Regulation – including Mindfulness, Self-hypnosis and/or Relaxation Skills Training and also introducing EDRB's (Emotion-Driven Reinforcing Behaviours)
Module 5 : Skills Consolidation and Relapse Prevention – this is all about future plans…
Where can you get training in NA-CBT
In London, NA-CBT is introduced to post-graduate students via CBT modules at Regents University or at the Existential Academy (via Middlesex University) on their advanced post-graduate and doctoral programmes. An introduction or overview of the model is also on offer at other organisations where Daniel Mirea regularly teaches including UK College of Hypnosis & Hypnotherapy (training organisation focused on Hypno-CBT, CBT and evidence-based psychology only). Since this is advanced cognitive-behavioural training and the approach places itself under the umbrella of CBT therapies, it is not presently offered outside the psychological, psychiatric and CBH community which means that one would have to have a core mental health profession or to at least be accredited in Cognitive-Behavioural Hypnotherapy (CBH) before attending training in NA-CBT.
Daniel Mirea
CBT Consultant & Senior Lecture
therapy@danmirea.com
Shame, self-loathing and low self-esteem: assessment and treatment ! WEBINAR on 13th July 21 (new dates in 2022 to be announced)
Winning the mental warfare with COVID-19 (CBT Self-Help for COVID-19 Anxiety)
Beat Anxiety with Attention Training (NA-CBT)
Is 'perfectionism' a deal maker or a deal breaker ?
The underlayers of NeuroAffective-CBT
Articles dates
CBT Clinical, Coaching & Life Solutions
CBT Therapy Today


Physical fitness and activity are vital components of a healthy lifestyle. Not only does physical activity contribute to healthy weight, but a whole host of other health benefits including reduced risk for type 2 diabetes, reduced risk of some cancers, improved muscle and bone strength, improved mental health and mood, improved ability to complete daily activities and fall prevention for older adults and increased chance of longer life, according to the Centers for Disease Control and Prevention (CDC).
2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week.
1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e., jogging or running) every week.
An equivalent mix of moderate- and vigorous-intensity aerobic activity.
For some people, these recommendations may seem overwhelming. Perhaps this is because many people associate physical activity with only one or two specific types of exercise like running or lifting weights, or feel physical activity must take place at a gym facility. While these are great forms and places for exercise, we are not limited to those things! The type of physical exercise you do is completely up to you, and should be something that you enjoy doing.
Walking is a form of physical exercise that may be underestimated, but can be done by most and is still very beneficial to the body. A study on Nordic Walking, or walking with poles, showed that participants who adopted Nordic walking three times a week demonstrated a decrease in Body Mass Index (BMI), cholesterol, and waist circumference. The study concluded that Nordic walking exerts beneficial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases, and ultimately recommends Nordic walking to a wide range of people for regular physical exercise. Other everyday physical activity like gardening and lifting are helping you to work your muscles and increase your heart rate.
Find an exercise that you love and are excited to do over and over again. Be open to trying new forms of physical exercise, and work towards meeting the CDC recommendations for physical activity. Meeting with your primary care physician at Revere Health can be a great place to start making goals towards a healthier lifestyle that includes daily physical activity. Visit us at the Weight Loss and Nutrition Center to learn about healthy and long lasting weight loss.
Abbey Reyes completed her BS in Public and Community Health at Utah Valley University, and plans to complete a Masters in Public Health (MPH) in the future. Abbey is a Health Education Specialist that's passionate about helping others achieve their vision of wellness. Contact Revere Health's Weight Management department today to learn more!


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text:
Lieutenant-General William Staveley  (29 July 1784 – 4 April 1854) was a British Army officer who fought in the Peninsular War and later became Commander and Lieutenant Governor of Hong Kong.

Military career

Staveley was born in York, the son of William Staveley and Henrietta Henderson. He entered the British Army in 1798 as an ensign.  Staveley fought in several conflicts in the Peninsular War (Battle of Talavera, Battle of Fuentes de Onoro, Battle of Vittoria, Battle of the Pyrenees, Battle of Toulouse, Siege of Ciudad Rodrigo and Battle of Badajoz and many other minor actions).

At the 1815 Battle of Waterloo, Staveley was present as a captain in the Royal Staff Corps, afterwards receiving the Companion of the Bath (CB) and a promotion to brevet Lieutenant-colonel.

He went to Mauritius in 1821 and served in various roles (deputy quartermaster-general and commandant of Port Louis) before becoming Commander and Lieutenant Governor of Hong Kong in 1847.

After leaving Hong Kong in 1851, he was given command of the Bombay Army. In 1853, he was made Colonel of the 24th Regiment of Foot and appointed commander-in-chief of the Madras Army (with local rank of lieutenant-general). He died in the Nilgiri Hills, and was buried at Ootacamund.

Staveley Street

Staveley Street () is a street in Central on the Hong Kong Island, Hong Kong, named after Staveley. The street is for pedestrians only and parallel to Peel Street.

Family
He married Sarah Mather in 1817.  Their children included Charles William Dunbar Staveley, Harriet Frances Staveley, and Caroline Octavia Emma Staveley, who in 1847 married Talavera Vernon Anson RN.

References

External links
Jackson, Louis (1935). "One of Wellington's Staff Officers: Lieut.-General William Staveley, C.B.". Journal of the Society for Army Historical Research 14 (55): 155–166.
Bibliography in Staveley genealogy
His son's bibliography in Worcestershire Regiment

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1784 births
1854 deaths
British Army generals
British Army personnel of the Napoleonic Wars
Commanders of Hong Kong
Companions of the Order of the Bath
Military personnel from York
Royal Staff Corps officers

redpajama_set_name: RedPajamaWikipedia


A renewed focus on international news has led to the relaunch of DW's English channel. But other channels have been updated as well. DW's international television programming combines breaking news with features, magazines and documentaries covering politics, business, culture and sports on five channels in four languages delivering the right content for each broadcasting region. Our viewers benefit from programming that is tailored to individual regions while providing an exceptional overview of events from around the world. DW also creates platforms for intercultural dialogue between Europe and the Arab world, such as the very successful co-production Shababtalk – a talk show about youth culture. The audience DW attracts are mostly global leaders in business and politics who form a financially-strong, influential demographic. They are opinion leaders with buying power representing an interesting and clearly-defined world that we reach with precision.
sponsorship opportunities for our TV magazines as well as major events like Global Media Forum.
DW continuously commissions nationally and urban representative media studies for DW's evaluation and strategic planning purposes.


text:
The RBI Report: "The Role You Were Born to Play"
Goodness, but Glee has a lot of characters in the mix. There were roughly sixteen at play in this episode, in varying measures of frantic purpose, and so naturally things were a bit hectic. But what better way to unite a whole group of singing teenagers than a musical? Preparing to stage Grease provided the backdrop - and launching point - for most of the night's storylines.
"The Role You Were Born to Play," written by Michael Hitchcock, directed by Brad Falchuk.
So, in an effort to breeze through each character's relevant points as swiftly as Glee does, I'll be doing a bulleted list with commentary.
Finn provided the backbone for this episode, as he struggled with life's disappointments on the heels of being booted from the army and also from NYC and also his relationship with Rachel. Poor guy. I'm actually on board with this storyline for Finn, although I wish he were playing a more active role in it. Historically, Finn's the guy that stuff "happens to" - but he's also the first one the writers send into other people's storylines. This episode was really no different, as Finn was encouraged into new opportunity by Artie and Will, and repeatedly showered with praise to help his wounded ego. Show me, don't tell! You're wasting screentime by giving multiple characters slight variations of the same dialogue: Finn, you're special and my hero and a leader please don't be sad. Especially since the episode actually showed Finn being special and a hero and a leader, in some regard - multiple times, with Ryder and Wade and Sue. Altogether, it was overkill.
Look, I know that the plot point that kicked off glee club's magic was Finn joining. I know that grants Finn Hudson some narrative swag. But somehow this idea has extended into the fact that glee club needs a conventionally masculine male lead to be successful. The lineage begins with Will and Finn, and is now precipitating to Ryder and even Jake. Apparently, all you need to make a glee club successful is a trip to the football field. Meanwhile, it's never even considered that someone like Mike or Mercedes or Artie or Tina or even Marley is that "magic element," the "missing piece." It's not the real music students, or theatre geeks, or dance gurus who are special enough to merit all that attention. It's the guy who didn't know he had it in him. So I guess I mean to say, in all of this, that I don't know why we need Ryder. He's Finn 2.0, who is Will 2.0, and this strange Manarchy is becoming the true backbone of Glee, threatening to overshadow the follow-your-dreams-be-yourself mainstay. Turns out there really is no greater joy than to help a young boy turn into a man... except maybe watching it happen, apparently. Over and over and over... and over again.
Finn's involvement with Wade's storyline was both surprising and yet completely expected. As mentioned, he's the go-to guy for encouragement and heroics and generally just making decisions for other people that should be the main characters in their own storyline. (Paging "I Kissed a Girl" and also "Goodbye.") So Finn being the main crusader for Wade-being-cast-as-Rizzo-despite-the-gender-swap is not shocking. Truthfully, it would have been nice if Wade were more involved in the episode-long discussion that revolved entirely around her. Having Finn go to the mat for her was a nice gesture, but a bit misguided. I will say, though, that the episode did a nice bit of nuance to suggest why Finn was insistent on fighting for Wade's casting. Their final conversation specifically brought up the pain of not knowing if there's a place for you in this world - which is very relevant to Finn right now. For me, it was a nice way to hint at a specific motivator for Finn (beyond "he's such a hero!!!") as well as provide a little connection between their storylines. And it was sized appropriately - there was no overwrought and offensive attempt to make Wade's experience as a black transgender teen actually comparable to Finn's fairly cushy straight white male experience. That moment really did belong to Wade, because we finally got to see her POV, and some pretty solid acting from Alex Newell. So, I was pleasantly surprised by that.
But basically, I wish that Finn himself had a lightbulb about trying his hand at teaching - especially unrelated from Will. Because Will is actually a terrible teacher. Remember when he resigned from the Spanish teacher position he'd been filling for over two years because he couldn't really speak Spanish? Good gravy. Not to mention all his yelling fits and blatant favoritism. But whatever! Water under the bridge that I'm clearly a troll under. My main quibble here is the overly broad job description Will gave teachers: they help kids achieve their dreams. I mean, I guess that's true. But, speaking as a person who was raised by teachers not unlike how Mowgli was by wolves... I find it much more resonating to say that teachers are simply trying to get through to kids. To make a difference in their lives, when that difference can mean opening their eyes to the world and everything there is to learn about it. Helping kids "achieve their dreams" seems slightly left of center, or at least poorly summarized, on most teachers' list of goals. But that's just me, and it's not terribly relevant to the episode. Just my brief turn on the soapbox. Moving on!
Oh, yeah - one last thing. Finn's gonna be the glee club teacher-not-teacher now? I mean, sure. I'll go with that. He can write buzz words on the whiteboard with the rest of them. Maybe after Will's stint in Washington, Finn can start working towards his certification. The academic nerd in me would be weirdly excited to see that, actually. Maybe community college will open his brain up just like glee club did!
Will and Emma
Speaking of Will and Washington, we were treated to a continuation of this conflict from "The Break-Up," and the only non-Grease storyline of the hour. To recap: Will's going to Washington to ensure the achievement of every child's dream, and he wants Emma to come with him for the few months. Emma does not want to. Conflict! Beiste tries to coach them through it, and when Will basically begs Emma to accompany him, she concedes. But, in another example of characters telling other characters what decisions they need to make (because how else would they fit all these characters into the narrative otherwise?), Shannon basically calls Emma out on defining herself as Will's wife, and implores her to tell the truth about what she wants. She also says something about how Will loves Emma like a farmer loves his Blue Ribbon pig, which I really hope is not true, for so many reasons. (Seriously. Let your brain go in all directions, and realize that every aspect of this comparison is not ideal.)
In the end, Emma tells Will she doesn't want to resent him if she succumbs to his pressure about Washington. Then they have a conversation they should have had ages ago, in which they sort out what values are important to them in their relationship! How... adult. Will says trust, Emma says acceptance, and they realize that those priorities transcend physical distance for a few months. (Meanwhile, every broken-up couple who succumbed to long distance looks at Will and Emma and says, "Really? You had this crisis over a few months apart?") At first I thought this storyline was a bit pointless, considering it boomeranged back to Emma's original opinion from the previous episode. But there were a few important kinks worked out of their dynamic in the process, especially in regards to Emma's role as "The Girlfriend" or "The Wife." I'm always here for specific delineation that Emma is not just an accessory in Will's world! Now, can we get her some scenes without him? Maybe something that shows us she loves her job and helping kids like she says she does?
Speaking of long-distance relationships, we got an update on Blaine, post-NYC break-up. To be honest, I'm not sure why we needed one, because we didn't actually gain any new information. (Except that Blaine's apology gifts involve boxed DVD sets of Gilmore Girls.) The episode barely remembered just why Kurt and Blaine broke up, finding it totally reasonable to give Blaine a "Hopelessly Devoted to You" solo. I mean, I'm all for showing Blaine's POV in this scenario, but let's call a spade a spade here, and also give us some details about that spade. What exactly happened with this cheating business, and can we please remember that it actually did happen? We don't need to flog Blaine for a transgression that countless other characters on this show have committed, but how about a little reality check on the Olivia Newton-John solos? Seriously, unless "Hopelessly Devoted to You" was meant to be ironic... it's rather an out-of-touch choice given the circumstances.
I also can't decide if the writers intended Blaine's post-audition crying jag to be dramatic or comedic. I can totally see it being either one, given that Blaine's comedy tends to come from exaggeration and also Glee is no stranger to comedic crying. (Sorry, Tina.) But mostly I just felt confused about what I was meant to be feeling.
One final quibble: we got updates on Blaine's situation with Kurt, and references to Finn's falling out with Rachel - but not one single throwaway mention of Brittany's break-up with Santana. Sigh! Could they not think of something dumb enough for her to say about it? All snark aside, one teensy reference would have been appreciated, for the sake of balance and continuity. (I'm pretending Glee holds those two concepts dear.)
Mike and Mercedes
And, here we are to another aspect of tonight's episode that was terribly underexposed. I missed these kids, dammit! They breezed into town to help out the Grease gang with choreography and vocal training, which makes enough sense to fly. But there was absolutely no update on what the hell Mike and Mercedes' lives are like now. Nothing about their schooling, their professional opportunities, their creative projects, or any possible energy exchanges they may have had!!! (I still think the phrase "energy exchange" is the dumbest and most endearingly hilarious way to describe looking at someone and smiling. Bless you, Santana. You have strange definitions when it comes to the world of dating.) No, Mike and Mercedes did the Hand Jive, and that was about it. No Mercedes interaction with Sam, and only one free-floating interaction between Mike and Tina. It was nice to get the screentime for the latter pairing, but having almost no information about their current status made the scene somewhat startling. We hadn't seen Tina all episode, and only obliquely heard that she refused to audition for Grease because of Mike. Not only that, but we only knew about their break-up from dialogue references. I literally have no idea what to make of Mike and Tina's relationship status, and "The Role You Were Born to Play" didn't provide a whole lot of insight either.
The takeaway here: if you're going to haul back two graduated seniors for an episode, then use them.
Ryder and Marley and Kitty and Jake
The New Generation are getting lumped together here. I don't mind these kids, frankly, although I'm a bit wary of all the Love Square nonsense. I don't particularly want to be reminded that these four are basically a transposed Finn-Rachel-Quinn-Puck for the younger class. For my taste, I'm already exhausted with the longing looks, the thinly veiled jealousy, and Kitty's dour bitching. I do find her dynamic with Jake intriguing, though - they're broken up but on decent enough terms, so they have a snarky, truth-telling, bro-type relationship which amuses me. Plus, their audition of "Everybody Talks" was strangely charming - and they actually did more than just stand there and sing! Sure, it was basic walk-around choreography, but hey, they're high schoolers. I appreciated the effort.
As for Marley, I rather enjoyed her part in the "One Last Kiss" performance. It was a Marley colored outside the lines a bit, which is key to making her character interesting. There's a reason Sue can't come up with a mean nickname for her! There's almost nothing to uniquely identify this girl, except perhaps her driving caps. It occurred to me the other day that I almost wish Marley were a cheerleader. The exact same character, but on the Cheerios. Then you'd have a cheerleader who's in it for the sport of it, and not the high school bitch factory that Glee seems to think it is. On top of that, it'd create natural conflict for Sue Sylvester that doesn't require her to get involved in random storylines like Wade's simply to fill the role of villain. But alas! This is not so, and so mostly I'm hoping for a Marley who shows a little punch and gusto. (On a shallow note: her hair looked damn good during her duet. Why hide it under Newsies caps?!)
Finally, Wade. Or Unique, I suppose. Glee's not being all that specific in communicating how exactly Wade identifies. They've bounced back and forth between portraying Unique as a "drag persona" and a real permanent identity for Wade, without delineating the difference. This episode finally made the distinction, from Wade's own mouth - she feels more herself when she dresses in women's clothes and uses the women's restroom, but it's not easy to do that every day. On top of that, she says that people see her performances as Unique a drag stunt only - not as genuine identity expression. (Alluding to the fact that they actually are.) So! Hopefully Glee will continue to tidy up this muddled representation of Wade's identity, and start to afford her the opportunity to have her own screentime and POV as a transgender teen.
As for Sue's part in Wade's storyline... it was basically a hot mess. Kudos to the writers for remembering Sue's place in the Karofsky storyline of Season 2, although boasting about gay Cheerios doesn't seem all that worthy. (Did she go to the mat for Santana during the campaign scandal? I can't remember.) Anyways, Glee always has problems finding appropriate villainy for Sue, without making her an actual terrible human (which she's proved not to be, on occasion), and this opposition to Wade playing Rizzo feels a bit sloppy and contrived. Not only that, but she's setting her sights on Finn Hudson as an enemy, which is a little sad. I can't imagine this will play out any differently than Sue's original wars with Will, in the long run.
In all, there was a lot going on in "The Role You Were Born to Play." Most of the parts that were emphasized strongly could have been scaled back or redirected - particularly in Finn's, Will and Emma's, and Blaine's sections. Then there was definite underutilization in Mike and Mercedes' parts, and only a few moments where they hit the beats just right. Truthfully, there are just too many characters to really create well-developed storylines on an individual level. Moments of choice are rushed and contrived, dialogue is sloppy and expository, and specificity is sacrificed. Corners must be cut, and "The Role You Were Born to Play" definitely showed that.
Musical Numbers: B
Dance Numbers: B
Dialogue: D
Plot: B
Characterization: C
Episode MVP: Wade
Posted by DR SHE BLOGGO at 1:59 AM
Anonymous November 9, 2012 at 11:55 AM
Something else bothered me with Finn : Artie asked him to be codirector, didn't he ? Because it seemed like Finn vaguely said something about not being worthy of that, then spent the rest of the episode telling everyone "I'M the director, I make the calls" and Artie was totally forgotten... Oh well.
I manage to avoid being too disappointed in Glee by telling myself that this is the "transition" season (remember Buffy s4 ?). They have to find a way to make the new "formula" work. I hope by the end of the season things will have fallen into place...
Yes but Buffy had an awesome S3 and could afford to waste a season for transition. Well Glee S3, I think I don't need to comment on that.
True. (Actually I don't even know why I compared Glee to Buffy.)
Thank you for taking the time to review this show. I was only tempted to watch it for the Mike and Mercedes update. Glad I didn't waste the time because it appears there was no update. Mike and Mercedes just dropped everything to fly to Ohio for a school play. A school play directed by the guy that gave Mercedes the shaft last year. Because whatever is going on in their lives is totally unimportant compared to a high school play.
And that year long chase between Mercedes and Sam? Evidently that never happened because they barely know each other now. I'm not even tempted to tune in next week because I'm not a big fan of Grease and am not interested in watching boring people do random things. I'll read your recap, just to see if I should catch it on hulu.
The RBI Report: "Thanksgiving"
The Belated RBI Report: "Dynamic Duets"
The Belated RBI Report: "Glease"
Buffy, She Bloggo: 1x06 - "The Pack"

redpajama_set_name: RedPajamaCommonCrawl


text:
Q: Trick Mavericks into letting me use Windows 7 for Boot Camp I would like to set up Boot Camp with Windows 7 on OS X Mavericks 10.9.2. I am using the new Mac Pro (MacPro6,1), in case that is relevant. (Perhaps the PCIe flash drive is just not capable for whatever reason.)
When I point Boot Camp at a Windows 7 ISO, I get this dialog, of course:

Your bootable USB drive could not be created
Boot Camp only supports Windows 8 installation on this platform. Please use an ISO file for Windows 8 installation.

I'd love to know if anyone has any hacks to lower the minimum required version to Windows 7. Most of the posts I see talking about Boot Camp and Mavericks say that the wizard offers you Windows 7. I assume, then, that this change has happened in one of the updates since Mavericks was first released (or a bunch of people hastily updated their Lion/Mountain Lion blogs with Mavericks / 10.9 just for Google juice).
Oh, how I would love to follow the dialog's advice, and "use an ISO file for Windows 8 installation." That's only half sarcastic; I hate Windows 8 with a passion, but I honestly did try to make it work, and couldn't (see below). Still I am more interested in getting Boot Camp to allow me to install Windows 7, because that's what I'm really trying to do. Of course any suggestions for bypassing the below problems will be appreciated as well.
I've seen other posts where they explain how to get the bootable USB drive working by editing the minimum machine required in Boot Camp's info.plist, but I couldn't find anything in that file to mess with to lower the minimum Windows version supported - that all seemed to be about hardware requirements. I actually have had absolutely no problems creating a bootable USB drive for Boot Camp (once I realized that Windows requires about 40 more bytes than typically found on a 4GB thumb drive), or getting Boot Camp to offer me the option to use a bootable USB drive. Now I just want Boot Camp to allow me to use Windows 7.

Background: Why Windows 8 isn't working for me
I was actually trying to get Windows 8.1 and Windows Server 2012 R2 to work, but encountered errors in all attempts. For 8.1 I received the following error message  well into setup and long after the BOOTCAMP drive was formatted (evidence: exhibit A):

Windows installation encountered an unexpected error. Verify that the installation sources are accessible, and restart the installation.

Error code: 0xC0000005

For Windows Server 2012 R2 I got this error message after formatting the BOOTCAMP partition but before hitting Next (evidence: exhibit B):

We couldn't create a new partition or locate an existing one. For more information, see the Setup log files.

I looked at this Apple KB article, but it's a joke. The "answer" is to format my USB drive using FAT. So that Boot Camp Assistant can immediately format it all over again. Genius.
I then tried the instructions listed here, which sounded quasi-promising:
http://forums.macrumors.com/showthread.php?t=1671442
But this made things even worse. I ended up with the following error message upon choosing the BOOTCAMP partition and clicking Next (I forgot to take a picture of my monitor here, sorry):

Windows cannot be installed to this disk. The selected disk has an MBR partition table. On EFI systems, Windows can only be installed on GPT disks.

I tried all of these techniques multiple times with ISOs from MSDN; and even re-downloaded all of the ISOs in case any of them were damaged along the way. To further prove to myself that the ISOs were not the problem, I created stand-alone VMs using each one in Parallels, and they were created without issue.

Really, though. I just want Boot Camp to let me use Windows 7. Really.

A: This one:

Windows cannot be installed to this disk. The selected disk has an MBR
  partition table. On EFI systems, Windows can only be installed on GPT
  disks.

Can be worked around like this:

Using the Bootcamp assistant, revert the HD to a single OSX partition
  layout. Then use the Disk utility to shrink the OSX parition, leaving
  "free space" for the planned Windows installation.

Then, boot from yor Windows USB stick ("EFI boot") and select the free space as target for the installation.
This worked for me.
Regarding Windows 7: I don't know. I'd like to install Windows 7 as well...

A: So I discovered a couple of things:

*

*Windows 7 simply isn't supported under Boot Camp on the new Mac Pro (see the Mac Pro table here). I suspect this may be related to drivers - perhaps the PCIe or GPUs? So I don't think there's any way to "trick" Boot Camp into doing it (initially I just suspected that Microsoft may have paid Apple to raise the support floor to get Win8 numbers up, and that the restriction was artificial).

*One of the errors I received, We couldn't create a new partition or locate an existing one, was due specifically to having a Thunderbolt device connected. Once I disconnected that I could get a little further, but still am not able to fully install Windows. The error I get now is Windows could not update the computer's boot configuration. Installation cannot proceed.

Support is useless.

*

*Apple support: "Oh, Windows installer can start? Call Microsoft; at that point it becomes their problem."

*Microsoft support: "Oh, this is a Mac? Call Apple; we can't help you fix problems with their software/hardware."

Wonder who Apple would tell me to call if my problem was installing Mac OS under Boot Camp? Hmmm, maybe I should try that...
Guess I will have to bring it in. Wonder if any of the geniuses have set up Boot Camp on this machine yet...

redpajama_set_name: RedPajamaStackExchange


In America, almost 1 million farmers—about 30 percent of all U.S. farmers—are women. In Loudoun County, the percentage is higher at almost 36 percent.
The county's more than 500 women agricultural leaders are invited to the Virginia Agri-Women's regional meeting on Tuesday, June 20 from 2-4 p.m. at Dominion Tea in Purcellville.
Cassie Walls, of the Loudoun County Department of Economic Development, said the meeting is part of the state chapter's efforts to encourage membership growth and networking among women in agriculture. She manages the Virginia chapter.
The June 20 event is free and open to women farmers from across the commonwealth.
"We'd love to see participation from any woman who works on a farm located anywhere between the Potomac River and West Virginia," Walls said.
Those interested in attending should register by calling 703-737-8458, or emailing cassie.walls@Loudoun.gov.


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Aww! Nate has given 3 members the warm and fuzzies.
Impressive! 2 members find Nate's services strikingly unique. How refreshing.
This country (and world) has become too focused on money. I have a lot of knowledge and talents that I am eager to share with like minded people. I could always use a hand around my farm (putting up fences, etc).
I'm a friendly middle aged man with a lot of talents. Professionally, I am a software engineer (I can write apps, build databases, make websites, build computers, develop entire corporate networks, intermediate level graphic design). I can fix your computer problems (virus/malware removal, broken hardware, installations, etc), Personally, I am a landscape designer, a farmer, a handyman, a runner, a writer and editor (sci-fi and fantasy, technical documentation, end user manuals, installation procedures, etc), a boardgame designer and player, a dungeons and dragons player, an entrepreneur and inventer, and more. I can tutor in math or just be like a big brother for the right kid. I live on a very small farm with goats, chickens, and ducks. I also make the very best barbecue grilled pizza in rhode island (possibly the world). I am interested in making long term friends with like minded people.
He was very nice and even though I ended up canceling the service from lack of need it, I appreciate his generosity.
Willing to work on what's essential to the language, focused and determined. Glad to be able to start speaking in Mandarin!
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I'm going to try to post smaller snippets and experiments, more frequently. I've been struggling with creating images in code for a game I'm working on and had some successes lately that I wanted to share. Along the way we get to play with Categories, which allow existing Cocoa classes to be extended with new methods at runtime without access to the source code. Categories are in the latest release of PyObJC, but the example I'm giving uses a fresh checkout from the Subversion repository because I turned up a bug which Ronald Oussoren was kind enough to identify and immediately fix. Since this example is already on the bleeding edge, I'll also dabble with Python2.4 descriptors.
The specific problem I was faced with is that it is easy enough to create images programmatically, or to read them in from a file, but there was no obvious way to save them to a file. A bit of googling led me to Mark Dalrymple's quickies which has lots of tips and tricks for programming Cocoa in Objective-C and which I got the basics for writing to an image to a file from. I pythonified it and turned it into a method of NSImage through the magic of Categories, adding a bit more along the way.
I probably should have just elided the imageWithFilePath: method, since it is the only part which is really bleeding-edge, but I was so happy to get it working that I couldn't bring myself to drop it. In any case, it's the writeToFilePath: method which I was looking for. In case its not obvious, this will grab the extension of the path you pass in and determine the right type of file to save. The key to saving images in Cocoa is that they have to pass through a subclass of NSImageRep and of NSData before they're ready to write. This just encapsulates is all in one place.
Next up: Teaching NSBezierPath new tricks.


The 2018 Program Guidelines set out the basic eligibility criteria for the grants, and also explain what kinds of projects can and can't be funded.
Please ensure sure that you review the guidelines carefully prior to making a nomination or suggesting a project or group that would benefit from a grant.
For full terms and conditions download the 2018 Official Rules and the Program Guidelines.


text:
New York Times Columnists Gail Collins and Bret Stephens With Predictions for the New Year
From a conversation between New York Times columnists Gail Collins and Bret Stephens with some predictions for the new year":
Gail Collins: How about some predictions for the new year, Bret?
I'll start: House Republicans will flunk all their deficit-decreasing promises. The skyrocketing sales of those Trump digital trading cards will collapse and plunge streaking back to earth.
Bret Stephens: C'mon, Gail — those are safe bets!
Gail: OK, how about a pre-new year prediction? This week, the Jan. 6 committee will recommend criminal prosecution of Donald Trump, but the man's never going to jail.
Bret: Another pretty safe bet.
Gail: Back to the future: What do you have in the way of thoughts about what's going to happen in 2023?
Bret: I'll go bold, or semi-bold.
First, the crypto collapse will continue and the whole crypto phenomenon will be exposed as the tulip bulb mania of our day.
Second, President Biden will announce, after considerable holiday reflection, that he will not run for re-election, especially since he's increasingly unlikely to face a rematch with the former guy.
And third, Kevin McCarthy will not be the next speaker of the House.
Gail: Well, I'll give you number one — would never want to be known as a crypto collaborator. Sure hope you're right on two: As I've said before, I'd love to see Biden follow Nancy Pelosi's lead and give up the top leadership job for some other useful-but-not-in-charge-of-the-world gig.
And on three: Fine, but who exactly are the Republicans going to pick?
Bret: Well, nobody in the current House Republican leadership. All of them are election deniers. And Elise Stefanik, Republican of New York, gets special awfulness points because her ethics are purely situational. Also, nearly every House Republican who voted to impeach Trump after Jan. 6 is gone, so that further reduces my options.
Gail: The woes of rational Republicans …
Bret: I guess the House has the option of electing a speaker who is not a member. In that case, I'd probably look to a Republican I could respect, like Rob Portman, the outgoing senator from Ohio whose seat is being taken by J.D. Vance. Though, really, I doubt Portman would want the job. Today's definition of a sane Republican is a retired Republican, a former Republican, or both.
Gail, let's look back on the old year, too. What do you rank as the best moment? And what was the worst?
Gail: As a political person I'd have to say the elections were the best. Not just that the Democrats did much better than expected, but that many of the loathsome Trumpian Republicans were rejected in races a rational member of their party would have won.
Bret: We are in total accord in the politics department. But I'd expand the categories a bit. The best moment, in terms of statesmanship, was President Volodomyr Zelensky's Churchillian riposte to the American offer to get him out of Ukraine in the face of Russia's invasion: "I need ammunition, not a ride."
Gail: I agree — that's a keeper.
Bret: The best moment in terms of courage has come from the magnificent women of Iran, leading a revolution against their misogynistic rulers. The best moment, cosmically, were the images of deep space and distant time taken by the Webb telescope. And probably the best moment, as far as future generations are concerned, was the fusion breakthrough by the brilliant scientists at the Lawrence Livermore National Laboratory. It gave me faith not only that human ingenuity will ultimately solve our long-term energy and climate challenges, but also that the United States can continue at the frontiers of discovery.
Gail: Now we've got to tackle the worst. And I'm sorry to say that pretty much every year it's a story about mass shooting. Actually, many stories about mass shootings: innocent citizens mowed down when they're shopping, or going to school, or working at extremely nonviolent jobs or just out having a good time. Who can ever forget that student slaughter at Uvalde? And it was just a month ago that a gunman in Colorado killed five people and injured at least 18 others at an L.G.B.T.Q. nightclub.
Bret: Not to mention the everyday gun violence that barely gets reported because it's so ubiquitous.
Gail: And unlike some of our other political crises — say, the Supreme Court ruling on abortion — the gun situation just doesn't seem to get the political push it needs to get better. Will try to block the memory of Representative Marjorie Taylor Greene's recent quote-unquote joke about how it would have been so much better if the folks attacking the Capitol on Jan. 6 had been better armed.
Bret: Agree again. I'd add that repulsive dinner between Donald Trump, Kanye West and the Holocaust-denier Nick Fuentes.
Gail: Mixed feelings on that one. True, Trump's guest list was remarkably repulsive, even for him. But that kind of behavior shows he's dreadful in ways even some of his previous supporters can appreciate. Which is kinda useful, given his already announced candidacy for a return to the White House.
Bret: As in, "the worse, the better"? Not sure I agree: I think it was yet another case of "defining deviancy down," as Pat Moynihan famously put it.
Switching topics, Gail, we've got a huge migration crisis at the southern border, and it looks like it might get a lot worse as soon as the Title 42 policy permitting immediate deportations ends this week. Democrats seem … pretty nonchalant about this.
Gail: Bret, since the Republicans' big new idea seems to be impeaching the secretary of Homeland Security, I don't think you'll win with a partisan critique.
Bret: Impeachment is a dumb idea, but it wouldn't hurt Biden to consider new management in that department. How about Bill Bratton, the former police commissioner of New York City and Los Angeles?
Gail: I don't have a good solution, but my immediate action plan would be to radically increase staffing at the border, raise the salaries of border patrol agents, expand and improve detention facilities and, on our side, get the Dreamers a clear and simple path to citizenship.
Now, I'm very interested in your thoughts — except you already know we're going to fight about anything involving the building of a wall.
Bret: The administration and the courts have a point that Title 42, as a public-health measure, is an awkward legal tool to control the border. Problem is, it's what we've got. And we already have a crisis as far north as New York City as officials deal with a migration crisis on a scale we've never seen before. If we don't control it — not over the coming years, but right now — we're going to have a full-scale humanitarian crisis here in the United States, along with a cudgel that nativists will use for a generation against those of us who support a generous but controlled immigration policy.
Gail: I guess we're at least in agreement that something must be done.
Bret: The other thing to worry about for next year is a possible recession. The housing and manufacturing sectors are already in a big slump. Job cuts in our own industry, too. Even Goldman Sachs is laying off thousands of employees, which can't be a good sign. Your advice?
Gail: Well, a good time for the government to create some more jobs — including maybe some in border security, as I was saying. And a very bad time to dillydally about funding basic operations in the new year.
Bret: You know, I wouldn't be against restarting something like the New Deal's Civilian Conservation Corps.
Gail: I can understand the Republicans wanting to flex their muscles — even itty-bitty muscles — when they take control of the House. But they're going to be so distracted by showboating over crime, immigration and Hunter Biden that they'd be well advised to let the Democrats do as much as they can on budgetary matters now.
Bret: Gail, what else? Cut government red tape when it comes to permitting and other barriers to doing business in America. Cut taxes to offset the effects of rising interest rates. Increase the number of EB-5 visas tenfold, to 100,000 a year, to attract job creators to the United States. Allow large infrastructure projects like the Keystone XL pipeline to create thousands of blue-collar jobs and enhance our energy security in North America.
I know these suggestions must come as a total surprise to you ….
Gail: I'm shocked! Guess we'll be going into the new year continuing to disagree about what's red tape and what's critical protection of the consumer, the environment and —
Well, we've got all of 2023 to argue about that. But there'll be no more World Cup debates! Before we go, tell me your thoughts about Argentina's big win.
Bret: Goooooooooooooooooooooooooooool!
Greatest. Game. Ever.
Gail Collins is an Opinion columnist, is a former member of the editorial board and was the first woman to serve as the Times editorial page editor, from 2001 to 2007.
Bret Stephens has been an Opinion columnist with The Times since April 2017. He won a Pulitzer Prize for commentary at The Wall Street Journal in 2013 and was previously editor in chief of The Jerusalem Post.
Leave a Comment • Filed Under: blog Tagged: Predictions for the New Year
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Helps manage the comfort and clarity of lips as well as skin around the mouth, and on chin + jawline. Dye, fluoride and flavor-free. Very gentle on teeth and gums.
Children: For Children under 12 years of age, ask your pediatrician for guidance (your child may still need fluoride in her/his toothpaste).
100% Dye-Phthalate-Paraben + Preservative-Free. Gluten-Free.
Non-Comedogenic. Usage + Patch-Tested. For Men, Women, Children.
Before using any product, test by trying on a tiny amount of it on skin (we omit allergens, but you may be sensitive to an ingredient that isn't an allergen).
Introduce new products one at a time, with at least 3 days in between to make sure you are not allergic.
As with all things baby + child, consult your pediatrician.
As with all things teeth, consult your dentist.
If contact with eyes occurs, flush out with plenty of water. Keep out of reach of children. While safe for its intended use, ingesting large amounts of this product - as unattended children may do - is potentially harmful. If large quantities of this product have been ingested, get medical help right away.
Calcium Carbonate, Aqua/Water/Eau, Glycerin, Xylitol, Sorbitol, Disodium Cocoyl Glutamate, Sodium Cocoyl Glutamate, Chrondrus Crispus (Carrageenan), Glyceryl Laurate, Calcium Lactate.
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I have been getting toothpaste that tastes like hand lotion. Every 2 or 3 tubes are horrible. VMV is nice enough to replace them, but I am not sure anyone is paying attention to the problem. Otherwise, toothpaste is great for my very dermatologically sensitive lips.