Monday, April 17, 2006

HOW TO PROMOTE BABY BONDING


Recently my daughter came to visit me with her one year old daughter, Malia. I was so excited to see them. They came to visit as my daughter was involved in some business matters. Amy was selected to accept a marketing award for her company for a plan she orchestrated involving a high-rise condominium in Washington, D.C.

The night of the awards ceremony, my daughter left Malia alone with me. As Amy walked out the door for the evening, Malia stood next to me and began sobbing. Tears filled her little face as she fell to the floor. I watched with curiosity. Abruptly, Malia shook off her distress, got up and meandered into our family room.

Sensing that she was over her troubled feelings about her mother’s departure, I proceeded to check some e-mail messages in my office. Soon afterwards, as I glanced back across my shoulder, I observed this little figure approaching me with a very big book. Malia was pointing at the book and making sounds that let me clearly know that she wanted it read. She gently handed me the book and then she surprised me. With arms wide open, she was gesturing for me to hold her. I took her into my arms and read her favorite book about spring-time flowers. After we read the story and looked at all the pictures, she nestled into my arms. I put a blanket around us and relished the moments of bonding with my baby granddaughter.

Afterwards, I thought about what my daughter was doing right, and ways in which all mothers can foster their child’s bonding:

Don’t “put the breaks” on your life. As soon as possible, take your baby outside the home. Put your child in a stroller, and resume normal activity. Go shopping, walking, do errands, and take your baby to be around other children.
Don’t react to temper tantrums. Don’t display anxiousness, anger, or a desire to fix things for your child. Maintain a sense of detachment, wait patiently, and move on.
Don’t get hooked into over-dramatizing when your child gets hurt. Kids can “read” a parent’s anxiety and will learn to “awfulize” negative events.
Never do for a child what he can do for himself. Let your baby experience frustration about handling play tasks without interference. Appropriate frustration teaches self-reliance.
Get your baby involved with other children and adults. Don’t worry if your baby is cautious at first. Keep exposing him to new social situations.
If you drop your child off at a day-care center or baby-sitter, promptly leave. Don’t get caught up in worrying about any emotional fallout that your baby might experience.
If you are married or have a partner, make sure that your connection does not get short-changed because of the baby. You need to have alone-time, so hire a baby sitter you trust.
Your partner needs to be involved in every aspect of your baby’s care. If he is unwilling, he should seek counseling to address the issue. It is that important.
Displaying affection to your baby is critical. Put your negative energy aside, and have fun with your baby. Make mundane experiences like changing a diaper a playful event.
Surround your child with stimulating toys, games, dolls and activities. Take your baby to the zoo, ball-games, art fairs, and social events.
Read to your child often, and play soft, soothing music for comfort.
Read up on child-care topics to develop self-confidence and choose your pediatrician wisely.
Remember that parenting is an art, and that mistakes will be made. As the Good Book says, “Love covers a multitude of sins.”

Babies will bond with others when they are given the freedom to do so. Don’t get so caught up in “stranger danger” that you inhibit your child from learning ways to connect with others.

James P. Krehbiel is an author, contributing writer, and cognitive-behavioral therapist. He recently released his new book, Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy. The book is available at http://www.booklocker.com/books/2242.html. James can be reached at http://www.krehbielcounseling.com/.

Tuesday, April 11, 2006

MOMS WHO HAVE THE BABY JITTERS

Although I personally have never given birth to a baby, I have “heard” that it is not an easy task. At least that’s what my wife tells me, and I don’t question her assessment for a moment! It is a profoundly difficult event for a mother.

After the baby is born, how does a mother navigate the equally difficult task of parenting her new child? Even for those of us who have studied child development, or the art of parenting, what plan of action is necessary to make sure that a child is nurtured and cared for without undue anxiousness and stress on the part of the mother?

Often, a mother who is anxious about parenting will over-function by be overly-protective. A mother who lacks confidence will display her tentativeness with her baby in many ways. A mother may withhold the baby from other children, adults, and social situations outside of the home. Withholding the child from other potential caretakers, such as relatives, day-care programs, and friends may also pose a problem. Often, a mother may over-react to a baby’s symptoms or illnesses through repeated visits to the doctor’s office. Another potential problem may be protecting the baby from exploring his environment and developing natural curiosity. The jitters may show when a mother is excessively reactive to her child if the baby cries or sustains a minor injury. A tentative mother may be afraid to establish logical consequences for a toddler when she misbehaves. Being overly-emotionally attached to the baby or displaying the opposite pattern of detachment can create problems. There are also those mothers who avoid delegating responsibilities to significant others. There may be the jitters about the perception “that others can’t manage my child as well as I can.”

Most of these problems can be alleviated if you have appropriate support. For example:

How much emotional and practical support do you receive from your partner? Telling your partner (if you have one) what you need and want from him in terms of caretaking is important.
Are you giving yourself time for your own personal needs, interests and desires apart from your baby? Carving out time for yourself is important to maintaining a strong sense of self and rejuvenating your emotional battery.
Do you lean on parents, friends, or neighbors to assist you in the parenting of your child?
Do you have a quality pediatrician who will answer your questions and return your calls without making you feel neurotic? The choice of doctors is important in making you and your baby feel secure.

It is not unusual that I find a process of triangulation established when a baby becomes the buffer for a couple’s relationship that is strained. This unnecessary stress may cause a mother to cling co-dependently to her child in order to get her needs met. This pattern is unhealthy for the entire family. I recommend couples counseling in order to promote relationship harmony and unlock partners from this damaging interactional pattern.

The concept that “it takes a village to raise a child” is not far from the truth. Young children need the support of the entire family community. If the family is broken due to strained relationships, fix it for the well-being of your baby. You and your child will need parenting, nurturing, coaching, encouragement, and a host of mentors along the path of your child’s development. There is no need to have the parental jitters if you can utilize all the resources of the village.

James P. Krehbiel is an author, contributing writer, and cognitive-behavioral therapist. He recently released his new book, Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy. The book can be purchased at http://www.booklocker.com/books/2242.html. James can be reached at http://www.krehbielcounseling.com.

Sunday, March 26, 2006

HOW TO MANAGE OUR HARD-WIRED YOUTH

A friend of mine who is a high school English teacher in our local schools has been perplexed by the behavior of some of her current students. She said, "Help me understand why a third of my students can't sit still in their desks? They wiggle, they squirm, they tap their pencils and their feet and are constantly in motion." She is experiencing a dose of today's "hard-wired" youngsters.

Although some of this student behavior is developmentally appropriate, our society has rapidly experienced a metamorphosis that fosters and perpetuates the kind of fidgety behavior that my teacher friend is observing. Our fast-paced, complex culture places stress and strain on all of us. Many times our children feel overwhelmed by the "juggling act" that is performed in trying to keep their lives in balance.

What are some of the factors that create an environment of overstimulation and hyperactivity among our young people? Some clinicians in the field of behavioral health suggest that Attention Deficit Disorder accounts for most of our restlessness in children. However, many of our hyperactive students do not meet the criteria for ADHD. I believe that children are suffering from agitation, restlessness and hyperactivity due to other situational factors.

What is it about our culture that contributes to the restlessness experienced by our youth?
Violent lightening fast-paced movies and videos. I believe that students who are consistently immersed in watching movies and videos filled with acts of violence are much more susceptible to restless agitation. Many children are unable to detach themselves from the overstimulation of violent behavior in the media. As they absorb multiple acts of violent sociopathic behavior, they are unable to process and disengage from the material without it affecting their current behavior.
Excessive use of video games and computers. Many children become obsessively connected to electronic gadgetry and it may have a direct link to the quality of their mood, level of concentration, and quality of sleep. Some children use the electronic media as a means for avoiding more meaningful activity such as socialization with age mates. Electronic stimulation may be referred to as the "companion symptom." Children can carry it around like a friend and the activity takes on a life of its own.
· Loud, hard-wired music. Have you ever pulled up next to a car that was blasting the radio playing heavy metal or rap music? Did it sound like they were having a peaceful experience? Children are not always aware of the affects that certain styles of music can have on the sympathetic nervous system. These children may complain of irritability, moodiness and agitation as a result of this exposure.
· The problem of over-scheduling activity. Many children are unable to find a balance between creative free time and structured activity. Although karate and dance lessons may be important, children need time to play creatively. This may include artistic activity, hiking, camping, cycling, playing board games or doing nothing. The excessive activity level of many students makes it difficult for them to complete school responsibilities, such as homework, creating unnecessary stress and anxiety. Parents may perpetuate the problem by insisting that their children "stay on the move" at all times. Excessive preoccupation with activity creates overstimulation. How many birthday parties does your child need to attend before you say, "enough is enough?"

Several years ago my wife and I toured the nation of Israel with her family. I recall being in the mountainous village of Safed that is home to an artist colony. I remember a young boy who was using an easel to draw some ancient ruins. He looked serene and content. I asked him if I could take his picture and he agreed. He smiled and I snapped the image. I think it was his innocence and creativity that sparked me to want that image. I mentioned the encounter with our tour guide and he replied by saying, "The entrepreneurs in America have ruined a whole generation of children with their electronic gadgetry." Although his point is overstated, his premise is accurate.

As parents, it is important to guide your children in setting reasonable limits regarding exposure to the media and activity. This can be accomplished by monitoring your children's level of electronic exposure and degree and quality of structured activity. Parents can help their children develop an awareness and appreciation for the connection between excessive media stimulation and over- involvement in activity and the symptoms of irritability, agitation, and hyperactivity that may develop.

James P. Krehbiel is an author, contributing writer, and cognitive-behavioral therapist. He recently released his first book, Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy. His book can be purchased at http://www.booklocker.com/2242.html. James can be reached through his website at http://www.krehbielcounseling.com/.

Saturday, March 25, 2006

THE ART OF PARENTING

Parenting is an art. There are no manuals to give us all the answers. Sometimes we learn through trial and error. The key for parents is to not continue doing the same things repeatedly that don't work. Try a different approach. Remember that mistakes are a necessary function of change. The goal of parenting is to help your children develop a sense of autonomy. Teaching them to be self-directed and responsible means that one must learn not to underfunction or overfunction as a parent. Underfunctioning or being an "absent parent" leaves a child feeling alone without support. The lack of encouragement, nurturing, and affirmation can have a detrimental impact on a child's current behavior.

Many parents overfunction in the process of parenting. They get overly involved in every aspect of their child's life. They vicariously live their lives through their children. I always tell my parents, "Never do for a child what he can do for himself." Children learn to manipulate overfunctioning parents to get what they want. Since overfuntioning parents fear the disapproval of their children, they cater and give in to their wants and needs even if they are unreasonable requests. Fritz Perls, Gestalt therapist used to remark, "Kids need to be appropriately frustrated." What he meant was that overparenting creates an environment whereby children do not learn the skills necessary for self-regulation. Sometimes we need to let our kids figure things out without interference.

Parents often tend to parent the way they were disciplined. This may involve some archaic notions about parenting that no longer work in today's world with children. For parents, this may mean giving up the image of parenting that was established during their childhood. Sometimes a parent will swallow the image of parenting that was handed down to them even if that perception was intolerable. Sometimes caretaking for our kids involves doing the opposite of what was done to us. As parents we need to get in touch with the kid within us. We need to remember what it was like to play and have fun. If our childhood wasn't fun, then we need to grieve it and vow to make things different for our own children. If our "inner parent" is critical, we will most likely have unrealistic expectations for our children. The inner critic is full or moral injunctions and is the judge and jury of our behavior. Parents need to get in touch with the critic, understand its contents and then detach from the oughts, musts and shoulds. Parents will want to rationally respond to the inner critic with more reasonable ways of viewing specific issues. This process will assist in clearing up the "muddy water" when it comes to coaching and advising our children.

In parenting, using positive reinforcement when your child gets things right, or using encouragement helps promote involvement. Maintaining consistent consequences, both positive and negative, are more effective than trying to coerce your child to do something for you. Asking kids to make value judgments about choices they make is more effective than moralizing or pontificating about the right way to do things. If a child brings home a poor grade from school, resist the urge to lecture on the value of education. Ask your child, "Is what you're doing in this class good enough for you? How do you feel about this evaluation from the teacher?" Do not accept excuses, such as I hate this teacher, or I forgot to do some assignments. State your disappointment in what has happened and ask your child what he plans on doing to improve the matter. Box him in by making him accountable for coming up with a reasonable plan for improvement. Get it in writing if you wish, or with a handshake, but get a commitment for improved behavior. Never let your child off the hook. Make your child explain how he will change things for the better. Be calm, somewhat detached and persistent. Remember, parenting is an art.

James P. Krehbiel is an author, contributing writer for familyresource.com, and a cognitive-behavioral therapist. He recently released his new book, Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy. His book can be purchased at http://www.booklocker.com/books/2242.html. James can be reached at http://www.krehbielcounseling.com/.

Tuesday, March 07, 2006

MY BOOK: A NECESSARY PART OF ME

Several years ago I had some time on my hands. I was trapped in working in a mental health agency that was not functioning well. I was merely one of many therapist’s trying to make a living – but I was unhappy. The overall business environment was struggling and I was apart of it.

Since I was a part-time provider, I began to think of ways that I could manage my time between patients. I remembered that my Uncle Eddie had written a manuscript, but never had it published. I recall my parents talking about “the dream that never materialized.”

I always loved to write, and as long as I can recall (like Eddie) I had a desire to write a book. I felt that it was a “calling”, a passion, and apart of my legacy to accomplish the publication of a book.

So, in those lonely moments in my office that I despised, I started writing. This was a journey of self-discovery. I wrote about the nature of what I do best – help people manage their problems. Not only did I write about others’ problems, I chose to write about my own. I felt that it was only fair that my patients and readers knew the “real me.”

My writing was a pilgrimage that took me through the wilderness of human suffering and healing. I tapped into the resources of my clinical expertise, and wrote about how life looked for those who struggled and confronted everyday challenges. I wrote about the courage, the risk, and the passion that is necessary for personal growth and development to occur.

Redeeming my time was important to me. I began to build confidence in my writing and sensed the emergence of a manuscript. I put the finishing touches on my work and submitted it for publication. Rather than endure the long wait for a traditional publisher, I decided to self-publish through http://www.booklocker.com.

I am grateful that I did not wait. The rewards of self-publishing have been worth it. Many now know the story of who I am as a therapist and some of the issues that I have overcome in my struggles with life. I am so thankful that this aspect of my legacy is now complete. Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy is finally a reality.

I am now self-employed as a private practice counselor in a new office and I have never looked back. I continue to write frequently. I am pleased that I had the time during a gloomy season in my life to finish a necessary part of my personal and professional history.

Often people play out their lives without ever completing their dreams. People will live in the world of their regrets – “if only”, “I should have”, or “why didn’t I?” But life is too short. The fear of passing time may create an urgency about finishing the tapestry of our life. We must listen to that urgent voice and complete our unfinished business. It is imperative that we don’t wait, don’t procrastinate, or make excuses, but act on our inner convictions to accomplish all that we are capable of being.

James P. Krehbiel is an author, a contributing writer for familyresource.com and a therapist practicing in Scottsdale, Arizona. He recently released his first book, Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy. His book can be purchased at http://www.booklocker.com/2242.html. James can be reached through his website at http://www.krehbielcounseling.com.

REFLECTIONS ON AUTHENTICITY

Stepping out of the bubble and learning to be transparent is an important step in personal growth. One may say, “I want you to accept the part of me that appears unacceptable, because that is all I have.” The healing comes when the person realizes that their less than admirable side can be integrated into the whole of their personality. “I am good enough. I can live within my own skin.”

Authentic people demonstrate integrity. They are honest with themselves and others and are respected for their values and convictions. They are not afraid to tell you who they are. There is a transparency about the way they communicate. You really know these people. You don’t have to try to get to know them. They radiate enthusiasm and positive energy. They understand their limitations and utilize their strengths. They are a joy be around. Authentic people are relaxed because they are not afraid of what other think of them. They recognize that their inner voice is more convincing and important than all the other clamoring voices in their sphere of influence. They are not afraid to make difficult decisions, after recognizing what the consequences might be. They stay out of the bubble because life is more enriching and fulfilling.

Those who are authentic understand their limits. They perform within a set of reasonable boundaries. They are not unrealistic about expectations for themselves and others. They do not get caught up in the burden of other’s feelings. They are able to stay appropriately detached. They are neither too weak nor arrogant. They are not overly impressed by their own success and material possessions, and do not compare their worth or financial status with others. They treat people with respect regardless of one’s economic status or financial resources.

Sheldon B. Kopp, author and psychotherapist used to say, “No one is any stronger or any weaker than anyone else. The moment we think we are, we have deceived ourselves.” Authenticity means learning to accept our place in life. Authentic people live rather effortlessly, without striving, anticipating, or comparing themselves to others.

James P. Krehbiel is an author, contributing writer, and cognitive-behavioral therapist practicing in Scottsdale, Arizona. He recently released his new book, Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy. His book can be purchased at http://www.booklocker.com/2242.html. James can be reached at http://www.krehbielcounseling.com.

Thursday, January 19, 2006

The magical beliefs of childhood

As children, we think we have the magical powers to change all that is wrong with our world. We need to believe that we can control problems in order to survive emotionally. For example, we may have parents who are not emotionally healthy. They may lack the capacity to be nurturing, supportive and affirming. In such cases, we perform to please, trying every means to get our parents to act like functional adults. When our efforts fail in getting what we need from our parents, we turn our feeling inward and believe that somehow we are the one's who are defective, not our parents. That way we can minimize the pain that results from dealing with them. Many people turn to self-blame as a way of coping and hold the image that our parents will someday change and become the loving people that we always wanted. As we transition to adulthood, many of us mantain this psyhic image, believing that people ought to behave the way we want them to repond. Many of us keep striving, pursuing, performing, and fixing in order to fulfill the fantasy of what we want from others. By taking responsibility for our parent's failures, we let them off the hook and minimize the pain regarding how they treated us.

As young children, we need the comfort of feeling safe. We tend to gravitate toward that which is familiar and comfortable even when it is dysfunctional. We maintain behavior patterns established by our parents. The safety of our support system makes us feel secure in the midst of an insecure world. Those who experience appropriate parental support and comfort feel grounded. However, as we transition to adulthood, we continue to look for external validation to make us feel secure, while we live in the midst of insecurity. Eventually, the notion of trying to stay secure breaks down as we are faced with ambiguous and challenging problems. Allan Watts, author and philosopher, alludes to this paradox. the more we try to grab onto security, the more we actually feel out of control. "Grabbing for security is like trying to hold water in our hands." Paradically, it is ony when we accept and embrace insecurity, that we actually become more grounded.

James P. Krehbiel is an author, contributing writer, and cognitive-behavioral therapist. He recently released his new book, Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy. His book can be purchased at http://www.booklocker/books/2242.html. James can be reached at http://www.krehbielcounseling.com.

Thursday, December 29, 2005

dealing with panic

Although medication may be helpful, there are other ways of dealing with panic on a long term basis. Sometimes the things we tell ourselves while we are panicking can intensify the panic. "Oh my God, here comes that nasty panic - it's unbearable, I feel like I am going to die!" It's the catastrophizing during panic that makes panic more panicky. Try refocusing your thinking when you are about to panic and try doing something ridiculous like doing jumping jacks, or singing your favorite song, etc. Some people find it helpful to schedule a panic time. Find a quiet place, relax and try to bring a panic attack on. You will find that it is impossible. It is the fighting with panic that makes it more troublesome. Embrace your panic with all of its symptoms and you will learn to minimize its impact on your life. Say to yourself rational thoughts like, "Here comes that panic again - just calm down and take those deep breaths and it will eventually calm down. These feelings won't last forever - they are time-limited- they'll be gone soon." If you are moving into an activity that makes you panicky, take it slowly. For example, if you are afraid of elevators, experiment by doing one floor at a time and then getting off and evaluating your experience and feelings. Then get back on a do another floor. Keep doing the activity slowly until you feel more comfortable. Good luck to you!

James P. Krehbiel is an author, contributing writer, and cognitive-behavioral therapist. He recently released a new book, Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy. The book can be purchased at http://www.booklocker.com/books/2242.html. James can be reached at http://www.krehbielcounseling.com.

Sunday, December 18, 2005

Dealing With Our "Anxiety About Anxiety"

The key to dealing with anxiety and panic is not in dealing with the primary symptoms, but in attacking the nonsensical things we tell ourselves about our anxiety. Everybody suffers from anxiety, but not everyone catastrophizes about it. For example, let's say you are taking a midterm exam in college. You open the test booklet and realize immediately that you are not familiar with some of the material and appropriate answers. You can respond in one of two ways: "Oh man, none of this looks familiar to me; I'll never get this, I'll never pass this test; if I dont't pass this test, I'll fail for the semester; my parents will just die if I flunk out of school." Or you can respond rationally by thinking, "Now just hold on a second, some of this material looks a little unfamiliar, but I'll just calm down, take some deep breaths and start working on the questions I do know. I can always go back later and tackle the more difficult ones." The primary anxiety is not the focus here, but rather it's the secondary thoughts that we keep telling ourselves about anxiety that paralyzes us. Our "anxiety about our anxiety" or our secondary thoughts about anxiety are the focus of behavioral change. It is important in dealing with anxiety that people stay focused in the here and now, and do not get caught up in the "rear view mirror" or the anticipation of future worries.

James P. Krehbiel is an author, contributing writer, and a cognitive-behavioral therapist. He recently released a new book, Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy. His book can be purchased at http://booklocker.com/books/2242.html. James can be reached at http://www.krehbielcounseling.com.

Monday, December 12, 2005

Common Threads Link Addictive Behavior

Many people have features of an addictive personality. They heed the call to the "pleasure center," located in the frontal lobe of the brain. As many of us yield to the urges and cravings of the pleasure center, our negative beliefs and behaviors reinforce the need to continue self-defeating addictive behavior.
Beneath the addiction, one finds personality characteristics that sustain the addiction. According to Charlie Whitfield, these characterisitics are common to all addictions. People most likely experience problems with trust, dependency, abandonment, shame, guilt and the expression of deep feelings. Once the addiction is uncovered, these issues must be addressed through group addictions meetings or individual therapy.
Often adults, whose parents were alcoholics, choose to attend Adult Children of Alcoholics meetings in order to resolve the fallout from family behavior. Family members can be affected by addictive behavior and may adopt behavioral characteristics similar to the addict.
Addictive behavior lies on a continuum. For some of us, our tendency to compulsively engage in a particular behavior may not affect our everyday functioning. For example, many people engage in a pattern of ritualistic jogging. This may be considered a positive addiction because the activity promotes physical fitness and can release endorphins that elevate one's mood and behavior. If, however, the jogger begins to dismiss friendships, social activities and responsibilities in order to sustain the jogging pattern, then the activity takes on a different meaning. Furthermore, many joggers may become so obsessive about their interest, that they begin experiencing significant weight loss, making them appear too thin and fostering body misperception problems.
People struggle with addictive patterns such a weight gain, gambling, sexual addictions, eating disorders, compulsive shopping and self-cutting. I am merely providing a brief list of addictive behaviors. A comprehensive list is too exhaustive to print.
Many people ask me, "Are there any common characteeristics or features that likn various addictions into a pattern? The following is my perception of the common threads that link all addictive behaviors.
  • Most addictive behaviors are an attempt at avoiding unpleasant and painful experiences.
  • Most addictive urges and underlying self-defeating beliefs trigger cravings.
  • Most people with addictions experience masked emotional problems such as anxiety, depression and obsessive-compulsive characteristics.
  • Most addictions are fueled by thwarted anger and self-blame, particularly among adolescents.
  • Shame-based feelings are at the core of all addictions.
  • Most people who experience addictions complete a "repetition cycle" of abuse. The cycle starts with an experience or urge, yielding to cravings, feeling numb with a decrease in anxiety, manifesting guilt and remorse, followed by an escalation of anxiety and a repeat of the cycle.
  • The primary goal of addictive behavior is to decrease anxiety.

If you think you might have a problem with addictions, listen to your partner, listen to your friends and listen to your own inner voice. Don't wait until you "hit rock bottom." Demonstrate courage by addressing your problem now.

James P. Krehbiel is an author, contributing writer, and cognitive-behavioral therapist. He recently released a new book, Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy. The book can be purchased at http://www.booklocker.com/books/2242.html. James can be reached at http://www.krehbielcounseling.com.