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Sobriety Support: Noted from r/stopdrinking

I want to share something I read recently: an encouraging and brave letter of advice and support copied from: 

https://www.reddit.com/r/stopdrinking/comments/436wzo/4_years_what_has_worked_for_me/ 

Stacks by Noah Sorensen


"My last drink was four years ago. Since I don't post often, I figured I'd use this as an excuse to share some of the things that have worked for me. This is basically just collective stopdrinking wisdom that I've shamelessly stolen adopted over the last 4 years.

Keeping myself busy was crucial in the first month or so. And I don't necessarily mean productive busy. Just having TV shows, movies to watch, mindless projects to work on. Idle hands and all that. It's ok to be bored. Sobriety can feel boring at first. Thankfully it doesn't stay that way.

Staying away from drinking environments as much as possible for the first few months. I didn't go to a party or social event unless I felt 100% confident I wasn't going to drink (and had an exit plan). Staying sober was about making smart decisions, not about making foolish ones in order to test myself or to prove that I'm a special snowflake. I waited until I was really ready, and even now I don't enjoy those types of environments much, so I limit my time in them.

Delaying. It's ok to have cravings and not act on them. Cravings don't tend to last very long, so if I could delay drinking for a short time, they would go away. This is where "one day at at time" or "one hour at a time" can be quite useful. At times I've told myself "I can drink tomorrow if I still want to, but today I won't drink, no matter what". Tomorrow isn't that far away, so that usually helped me get through the day. By the next day, I didn't want to drink and I was always so glad and proud of myself for not giving in. P.S. the important part of this tool is to use the same strategy if cravings return the following day and not actually drink. ;)

Spending a lot of time reading r/stopdrinking: learning from other people's mistakes, observing patterns, watching the people who had the kind of sobriety I wanted and modeling my behavior after them. Commenting to encourage others, even if I felt like I wasn't experienced enough to give advice. You don't need to have a certain amount of time sober in order to be supportive.

Actively creating new associations and habits. Usually leave work, stop at a liquor store, and start drinking? I'd plan a new enjoyable routine for when I got home and drive a different way. Or drive the same way and flip off or laugh at the liquor store as I drive by. Whatever floats your boat. Tend to drink on Saturdays out of anxiety or boredom? I'd designate that as my day for a new or old hobby. I'd make plans and break up old routines to do things I'd been meaning to do but never found the time. I actively tried to reprogram my brain: stopping romanticized thoughts about alcohol as they happen and replacing them with new, more rational, pro-sobriety thoughts.

Openness and willingness to try new tools. If what I was doing wasn't working, I had to be honest with myself and do something different. If I was 9 months sober and having daily cravings, to me that meant something wasn't working and I had to do something different or step it up a notch. While I don't do AA or SMART or any formal program, I was open to using them if SD didn't seem to be enough. I never ended up feeling like I needed that in-person support, but I learned about a lot of AA and SMART tools (mostly through SD members) and incorporated some into my own recovery. The more tools in my toolkit, the better. 

Sober community/friends. I didn't have sober friends IRL so it was a godsend to find this place and specifically the chatroom. I have a place I can go any time of the day to chat with people who get me and understand. Some of them I've known for years. Without my irc people, I don't know where I'd be. (Probably back to drinking... :/ ) I luv you guys.

Perspective/gratitude. It can be easy to forget how bad it was while I was still drinking. Checking in with this community, even though it's not as often these days, helps remind me and keeps things in perspective. Is my life perfect? No. But I don't want to take for granted how much better it is since I quit drinking.

Continuing self-improvement beyond just not drinking. Now that I'm sober, I have the clarity, time, and energy to work on whatever issues I was trying to cover up or avoid with alcohol. This one isn't very glamorous or fun, but I think it's important for long-term success. If I drank because of underlying depression, I need to address that depression eventually. If I notice myself replacing alcohol with other harmful habits, then I have to be honest with myself about those and work on them if I deem that they really are harmful. In early sobriety for example, I think it's fine to eat whatever you want if it helps combat cravings. But I don't want that sort of thing to be a long-term habit I use to cope with life, so I address that when I'm no longer "newly sober" and feel ready for a next step. This is a journey and I'm never going to be perfect, but I don't want to be stagnant either. If I get too stagnant, I'm in danger of apathy and slipping backwards.

For those of you in your early days, I wish I could show you how much easier it gets. It gets better and it gets easier. Keep it up and you'll see for yourself. :) 

Thanks for being here, SD. "




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Almost Anyone Should Start Therapy

What if the responsiblity for increasing the acceptance and frequency of counseling use is really on the community of therapists in Northern Michigan? If yoga or soccer were the best fix for depression, would we find that the number of kids and adults participating would go up dramatically? Something makes counseling harder to begin and more difficult to share with others.  This isn't just about society needing to change, it's also about therapists having to create a more welcoming environment. 

The Walk in the Woods Copay Kickback

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The Walk in the Woods Copay Kickback

Walking is wonderful therapy for both mental and physical health.  To encourage you to walk for your health, we are creating a kickback program where you receive a coupon for the value of your copay if you go for a walk, either for a walk and talk therapy session or on your own.  

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Lifetime Bonding with Adopted Children

With the flood of information regarding the extent of bonding in utero and shortly thereafter, it may influence adoptive parents to believe that they are going to struggle to create a bond that's as strong as that of a biological parent. While there definitely is a loss here, a loss of almost 10 months of physical closeness before birth and possibly weeks, months or years after birth, there are still many ways that adoptive parents can increase and deepen the bond they have with their adoptive children. So let's quit whining about that loss until you have done these concrete things to continue to strengthen the bond you do have to your children.

From Birth:

Hug them longer, and sleep closer to them than other parents do.

Bathe less and hold more. If you do wear scents or need to bathe every day, use the same, gentle smelling soap or lotion every time. Hold off on perfume if you can avoid it and go for lotions or skin creams that use non-irritating ingredients to create a mild scent.  Then mash your body against your young child as much as you can!  Let them nap with direct skin to skin contact. Hold them more than you feel comfortable doing, even after both legs area sleep. Wear them more than other parent's wear their children. Hug them longer, and sleep closer to them than other parents do.  When they take a bath, spend time drying and intentionally applying oils, lotions or other balms to their skin, not because their skin needs it (which it may) but because it let's you gently touch them more.  This also goes along with the next bonding tool. 

Peek A Boo lets children practice looking at your eyes in a fun way.

Peek A Boo lets children practice looking at your eyes in a fun way.

Increase eye contact with your child.  Spend time on the floor with them, in bed next to them and when feeding them.  Especially as a baby, make sure you are combining gentle touch and care with compassionate and intentional gazes and eye-smiles.  Also, don't stop this even as they get older and will not lock on to your eyes for as long each time.  Make it into a game or into a special way you greet each other. As babies turn to toddlers and toddlers to kids, find ways to be silly but also meaningful, paying attention to their interests and making an effort to be imaginative. 

Let them hear you tell others their adoption story, but make sure you're not objectifying their story, them or exoticizing the concept. As the child gets older they should be able to control, limit or help share their story.  From the time they join your family, it's important to let your child hear you tell others about how they came into your family and how it was intentional, sad and also very normal. But it's also important to consider what and how you say things. A good rule of thumb is to ask yourself: Is this the kind of intimate detail I would share about myself or a friend to a perfect stranger? It's easy to accidentally objectify children in general (they're small, they don't talk much themselves yet, you know more than they do and everyone asks prying questions you feel obligated to answer just to be polite), and it's extra important not to. It's just as important for your child to hear you say things like, "You're curiosity makes sense, because our family is amazing, but we're not up for answering lots of personal questions right now. Just trying to get some shopping done!"  Remember that interactions like these are more about your child and your relationship with your child than the lady in line at Meijer.  Let your children hear you tell someone else about them, but make sure you state everything with the objective of making that narrative be the one you want your child to have throughout their life. It should not be simple and should not be without loss. It should be accurate and emotional. And above all, it should be appropriately placed and timed, just like intimate details about anyone else's life. Basically, don't gossip about your kids. But do engage in mutually intimate and mutually sharing conversations with those you know and trust.

Toddler to Pre-Teen

Play physically.  As children get older, it may be harder to spend a lot of time holding them. Reading books, helping with baths and bedtime routines may increase this, but one great way to continue to build attachment is to play physically. Mothers are not usually socially conditioned or supported in doing this but it is very important for both parents to choose to actively engage physically with your child.  Chase and tackle your kid; knock them over; hold them down; let them throw you down too.  This is one of those interaction patterns that can become very helpful as you struggle with connection later on, so make sure you set up safe boundaries and always stop when someone says "stop" but also keep things very aggressive.  Yes aggressive.  Children should feel okay grabbing you and jumping on you and tossing a blanket over your head only to pull you around the house. You can argue with me here about tactics, but I think the strategy is fair: get your children used to trusting that you are going to both be physically dominating and yet gentle with them and that they have power to control you too.  This may look different than other parenting styles, but you have a different task than many other parents so we need to use different skills. This will pay off when your 15-year-old child expects you to grab and wrestle them when they come in the house from school.

Diversity Mask, used by CC license - George A. Spiva

Diversity Mask, used by CC license - George A. Spiva

Paint faces. Paint your child's face for sure, but make sure they get a chance to paint your face and / or body.  It gives them a sense of creation and manipulation that helps them feel like they are able to influence you, not just be influenced.  Also it's another great way to spend a lot of intentional time very close with your child.  Look at their eyes while they paint you and get them to look into your eyes by asking them questions, making weird faces or just by trying to give them sloppy, painty kisses. 

Give your child more control. How much control do you give them now? Can you double it? Do they get to make choices about clothing, bedtime stories, bath toys, breakfast foods, the order of chores, what room to pick up first, how long it's okay to leave toys lying around?  Don't worry, being a child means being constantly reminded about who is really in charge.  This is not to say that you should let your child change your mind about things, because they also need to believe that you really do have a good grasp on this life thing. Adopted children are especially susceptible to feeling a lack of control or direct responsibility for how their life is unfolding, so make sure you aren't part of that problem by building up their sense of efficacy. 

Remember your goals. Is it to force them to bed at promptly 7pm or is it to make sure you continue to build your attachment?  Have your priority hierarchy set up and written down. Even put it right on the fridge or somewhere your child can see it.  Make sure they know that your highest priority is to be a secure family and that the other things you do are facets of this. Remind yourself of this when the times get tough and you are going to be late to work, late to school, or are just seemingly not at the same place that other parents or children are.  Daily responsibilities will get you to defocus unless you find a way to continually remind yourself of these priorities. 

Find ways to share something special. Your favorite ice cream flavor is now your child's. Learn to love it. Don't be completely false, but be strategic. Creating ways that you can have special similarities between you and your adopted child is a powerful way to remind them emotionally that they are part of you and they belong right where they are.  Does your child come out of her room with a red sock and a black sock? Go change your socks to match if you can. Wear those socks all day and giggle to each other about it.  Imagine how happy a six-year-old would be if you show up to pick them up from school wearing the same shirt as them or with a set of matching hats for you both to wear. It matters. 

Adolescents and Young Adults

Continue your touch. This is why you made family hugs, holding hands, kisses, all-smashed-into-one-chair book reading, and goodnight snuggles the norm for years. Your child and your child's friends should know that you are the touchy-feely parents. Play soccer, basketball, water tag, sardines, and other physical games to keep your kid expecting your closeness and touch. 

Reverse Roles. Let your child cook for you or pick your clothes out or take care of you when you are sick. Ask for hugs because you could use one. Figure out a way that your child can teach you something and ask to have them help you learn it and then ask them how you are doing later. Ask for their validation and approval sometimes. 

Join with them about the things they value. Going vegan, saving water, watching videos of Minecraft, whatever it is, figure out what you can do to not just encourage them but to join with them in this meaning. 

Make a big deal out of family traditions. Try to set this up earlier of course, but set your traditions and keep them.  I'm not sure what direction to go on forcing children to participate, but part of the utility about it is that your child should know to rely on them regardless of whether or not they choose to participate.  It could be the way you make pancakes, the way your family delegates responsibilities when you go shopping, or how you celebrate holidays. 

Stop your routine to bond with your child. Children need to be reminded about what is important and even as a young adult they need to see it directly.  If possible, take a day off and take your child(ren) out of school to just do something together, maybe as a response to a tough time for them or to recognize their development.  Maybe it could be for no reason at all. 

Be more and more honest as your child can accept it. Your child needs to know that they belong, even if the reasons for why they came to join your family were messy. Maybe a three-year-old can't fully understand choices about infertility, religion, opportunity, beliefs at the time, or even happenstance; but a fifteen-year-old chult (child/adult) can handle it and needs to understand it because if you don't share with them they will fill in the gaps with their own, possibly negative guesses. 

Adult Adoptive Children. 

Be honest about your failures. Maybe you should have sought to have a doctor that looked like them, or to find out more about their birth father before he died. Maybe you wish you were better at talking to their teachers while they were growing up.  Don't say "I did the best I could" because that is bullshit. We do the best we do, not the best we can. 

Help them with their search for meaning, belonging and fulfillment. Comparing them to others' achievement may be helpful or it may just be damaging.  This is not to change expectations, but, instead to base them off of a person's own abilities and past successes.  Kanye West's new album should be compared to his last albums, not what I can do with a saxophone and two hours in a studio.  


These ideas were adopted from the tons of ideas and lists in Parenting the Hurt Child by Keck and Kupecky. They are made to be informative but not declarative and may not work for every situation.  Individual experience, such as a history of abuse or other trauma may bring about a need to have other, specific skills. The one thing that is very universal is that when raising a child through adoption it is important to only slightly glance at what other parents are doing to raise their children. As an adoptive parent, you are working overtime to learn not only the nuanced layers of basic parenting, but also all of the adoption-specific nuance and skills. You are learning, potentially, to get comfortable sharing, but not oversharing; appreciating and celebrating your child's race while not objectifying or exoticizing it; wrestling with mental health issues while not letting those struggles define your child or your relationship to them; and a whole lot more.

 

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Hearing Voices: New Ways of Relating to Our External Self-Talk

I just finished listening to a really powerful podcast. It's long, but for me it was impressive enough that it kept me from doing much else while I listened, so maybe not a good idea unless you have the full 53 minutes to devote.  A great car trip piece more so than something while cleaning the house. 

Our world is full of words but some people have their internal dialog externalized.

Our world is full of words but some people have their internal dialog externalized.

One thing we know now more than ever is that people hear voices at a much higher rate than we have thought previously existed. One reason for this, probably THE reason for this is that until recently we believed that hearing voices was one of the primary "symptoms" (I'll mention why this is in quotes later on) of being "crazy." In fact it is one of the primary positive symptoms of schizophrenia still. What was once thought of as extra-normal is now seen as sub-normal.  It was once seen as indicative of extreme emotional and psychological awareness and is now seen as paranormal or unexplainable and unnatural. 

So our culture put up a great big billboard reminding everyone who hears voices or knows someone that hears voices to never mention this unless they are absolutely forced to.  That admitting you hear voices is the same as admitting you are Crazy with the big C; that you are schizophrenic. 

So when, on a UK radio program, a woman mentioned she heard voices but did not show other signs of being classically mentally ill, it challenged a lot of people's thinking.  The radio program received over 45 phone calls during and after the program from people who reported also hearing voices.  These were not 45 people with schizophrenia.  What came of this was a new way of looking at these voices and a new way of relating to them. 

We first develop our own inner dialog by being talked to by an external voice, that of our parents or caregivers. Eventually we develop a dialog with those voices and then somewhere around this time we start thinking in words. We start Hearing Voices internally.  Think about it right now.  What is it that is a mixture of the colors red and blue? Do you visualize this color only or do you also say the word for it?  It gets even more problematic as we get older.  Here's another question: How do you feel when a close friend forgets to invite you someplace special?  . . . Give yourself time to feel about this.  No. Give yourself more time. Has it been even 10 seconds? Fine. Good enough.  Did you feel the answers or did you think about the words for the answers? Maybe Hurt, Angry, Lonely, Upset, Disappointed.  Words have supplanted the actual emotion for most of us. 

This inner monolog may then have originated from our principle dialog (which itself was one-sided until we could talk).  It doesn't take much of a jump to deduce how a person's external dialog would soon become our inner monolog. 

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#Istandwithahmed: The Psychology of Physical Safety

After reading about Ahmed Mohamed's clock on UpNorthLive, I was confused and concerned with the treatment of a young child by a set of educators and others charged with child safety and well-being.  Then I read the letter sent out by the principal at Irving ISD, Dan Cummins.  It opened with:

In Irving ISD and at MacArthur High School, your child’s safety and well-being is always our top priority and we want to maintain open, honest and timely communication with you. If there was ever an imminent threat to your child, we would take immediate and necessary precautions, and we would inform you immediately.

I seriously thought this was an apology letter to Ahmed's and all students' parents who were astonished or worried about how the school had handled the situation.  Then I read more: 

Also, this is a good time to remind your child how important it is to immediately report any suspicious items and/or suspicious behavior they observe to any school employee so we can address it right away. We will always take necessary precautions to protect our students.

At this point I am aware that this isn't an apology letter. It's a letter aimed at starting both a defense against litigation and at validating the initial justification for allowing the arrest of a student for nothing other than being a good student.  The principal was either creating a shield of defensibility with a thought towards it showing up in court, or he has completely bought in to the concept that the greatest threat to our children is terrorist bombers and rogue gunmen in our schools.  This sounds like anxiety talking.

To me the real threat is in the development of an education system that is guaranteed to minimize the emotional and psychological well-being of our children as well as their natural willingness to learn and find meaning.  Let's break this down, because I think this is important. 

Just like anxiety works on an individual, we are starting to be taught to buy into this concept of group risks. Anxiety tends to expand the belief in both the possibility of an unwanted event and the severity of the consequences of that event.  So instead of being slightly worried about being late to the dentist and leaving early to account for this, anxiety tricks you into believing that you are necessarily going to be late and that they won't see you and you won't be able to get help for tooth pain ever again. 

Much in the same way, we are now being conditioned to believe that school attacks are commonplace and that when they happen our child will be harmed or killed. This thought pattern usually comes along with the tag line "better safe than sorry" or "you can't be too careful."  These are lies brought to you by your brain's inability to perceive incremental, universal changes while being specialized at predicting and preventing large, dangerous changes. 

Dan Cumming's perception of the situation shows what his and the school's priorities are: prevent catastrophic events through any means necessary.  When I read the letter I thought he was actually concerned about what affect on the students it would have to bring the police in and arrest someone for what would soon be known as a complete non-issue.  I thought he was concerned for their psychological safety.  I am not surprised that the real priority never involved the feelings of safety and caring, they involved reassurance of an imagined danger.

When you give up emotional and psychological safety and create an adversarial relationship between students and staff, you guarantee that students will be less open to learning and will spend more energy worrying about their own safety.  Aside from the legalities of detaining a 14-year-old child without letting him call his parents or speak with an attorney, there is the real consequences of stating, on paper, that the school believes that looking for reasons to arrest students is one of it's priorities.  "You can't be too careful." Oh, yes you can. By trading the perception of physical safety from a catastrophe, you are causing damage to all the people involved with the "careful" means used.  

Photo of Ahmed Mohamed's clock (as reported by twitter poster @naheedrajwani

Photo of Ahmed Mohamed's clock (as reported by twitter poster @naheedrajwani

 

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Grand Traverse Needs Addiction Treatment Not Testing

So I'm cleaning my gutters while standing on the top of the ladder. Sure I know, bad idea.  I didn't fall . . . until I was almost done.  I was taken to the hospital by the ambulance for a pretty nasty gash that I got from falling onto the juniper stump that was right under me.  It wasn't pretty.  At the ER they said that because the fall was my fault, they weren't going to treat me and instead I was to be sent home with a requirement that I go talk to other people who had injured themselves.  No medical treatment for me because I was an idiot to fall off the ladder. While I was still confused from this, they released me but also told me they needed me to come back every day for them to look at the wound.  They couldn't do anything for it (again because it was my fault) but they wanted to look at it to make sure I didn't mess up my job of healing myself.  If I didn't show up to have it checked, or if they didn't like how it looked, they said they would have me committed.  

This didn't really happen to me but it may start happening to those charged with a drug related crime in Traverse City because they are being monitored without being treated.

In a recent article by Patrick Sullivan in the Ticker, there is a report of upcoming increased testing and oversight of people awaiting trial in Grand Traverse County.  In it Sullivan reports that the court may implement a process by which defendants will have to undergo a schedule of check-ins and testing similar to those who have been convicted of a drug or alcohol-related crime.  The idea is that it is both a way to monitor people so they don't disappear before trial as well as being a route towards getting them the services they need sooner in the process. 

Even though this brings up a very troubling problem, that of implementing conviction sentencing before a trial or verdict, I am more interested in the practical result of this new policy. 

My concern is more about follow-through and resources than it is about the legalities behind the change.  The reason for my concern is illuminated by a quote in the article from the community corrections manager:  "I want them to want to go to recovery meetings and to start engaging in recovery so they start to do better before they are sentenced".  This isn't treatment.  To me this is similar to an ER doctor telling a client that is deathly overweight and with diabetes that they must attend Weight Watchers. It avoids responsibility and efficacy for the change.  

Instead, why don't we tell these people, who have not been convicted of a crime, that they should connect with a real treatment program, such as Addiction Treatment Services, Munson Behavioral Health, or this fine counseling practice, so they can find peer support, licensed mental health assessment and professional treatment oversight.  At least if someone is forced to go to 25 Weight Watchers meetings there is an easy way to see if it has resulted in any change: a bathroom scale. For people with serious addiction and mental health problems, what should be treated as a medical problem treated by professionals with tested methodology is instead treated as a personal choice that should be tested to make sure the person doesn't "screw up."  

Part of the Affordable Care Act legislation requires that mental health and drug addiction be treated like other medical problems.  Part of that method for treatment is based on treating the problem irregardless of the source.  It doesn't matter who is at fault or how your leg became broken or your head concussed; doctors work to heal and treat conditions based on the best scientific methods. Treatment for all people suffering from mental health and addiction problems should be as concerned with healing rather than blaming. 

 

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Reviews: Therapy apps

The core principle of cognitive reconstruction is to find your preferred version of reality, which is based on your own values, and then act on your brain to change how you view the world so you can change how you act in the world. 

What this looks like: I want to be less controlling of situations where my top value in the situation isn't to influence or guarantee a specific outcome.  

Specifically: When interacting with my partner, treating them like the friend I value and love is more important than picking out the right movie or making sure dinner includes the pine nuts that are specified in the recipe. 

So you can do this cognitive reconstruction or reframing with a therapist, you can practice it on your own, and you can even find an app or two that can help (which, if you're a tech enthusiast like me, is exciting). 

The Wish Outcome Obstacle Plan is a poorly named app that attempts to be cognitive therapy in a box. It's fun to try but not to continue.

The Wish Outcome Obstacle Plan is a poorly named app that attempts to be cognitive therapy in a box. It's fun to try but not to continue.

WOOP

The first App is called Wish Outcome Obstacle Plan and is for Android and iOS.  It describes itself as : "the systematic way to motivate yourself. Through the app, you will learn the self-regulatory technique Mental Contrasting with Implementation Intentions, also called Wish Outcome Obstacle Plan".  In practice it is a decent yet incomplete method of helping you plan for and deal with the problems that keep people from achieving personal goals.  It has a lot of focus on mindful meditation and envisioning your preferred outcome. It's just not fun.  The process gets a bit stale after a few repetitions, even though you know that what you are working on is very important.  This is an interesting phenomenon.  Should change, especially self-guided change, be fun and self-rewarding? It certainly seems as if it would help. 

If you do get into the app, you will find it to be good at targeting cognitions more than behavior, which I think is a very good sign.  Behavior will change after the cognitions and emotional content change. 

 

Just like having this guy as your therapist

Just like having this guy as your therapist

Annoyster (iOS) and Randomly Remind Me (Android)

These two are lumped together here because they effectively work in the same manner.  They are designed as reminder tools, but because they have the ability to show these reminders randomly, they can be wonderful tools as a cognitive therapy add-on or even as a self-help stand alone program. 

The basic functioning of the apps are the same. You set up a schedule by telling it how often and what you want reminded of.  I can have it remind me to spend time thinking about how I want to be kind to those I care about and I can set it to tell me 8 times during the day.  Randomly Remind Me also lets you keep track of how often you actually follow through on any prompts, such as preferred cognition repetitions or kindness gestures.  

The process with cognitive change is not complicated, but catching yourself in the right situation is very difficult because when you are agitated or otherwise stuck in a negative emotional situation you instinctively resort to older, more practiced habits.  Either of these apps have the ability to catch you in those situations and help you build new experiences.  

Personally I have had good success with Randomly Remind Me, though I rarely have more than one change active at any time.  It is really wonderful to see it pop up and to be able to make small cognitive changes right then and go back to doing other things.  

Any of these three apps can be very useful, especially if you are working with a therapist to implement changes to your thoughts.  Some therapists want you to do quite a lot of work outside the office and having a reminder tool gives you more likelihood of being able to make your practice count much more than if you set aside time only when it is convenient to you (which almost always means when your negative emotions and cognitions are not activated). 

In combination with these I have also created a practice repetition device that operates much like a prayer rosary, which brings up a very interesting conversation about what the similarities between prayer and cognitive therapy end up being once you boil each down into it's constituent parts. 

But that's content for another post. 

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