Overall, I really like this book. Dr. Carmichael is a New York City based therapist who specializes in “high functioning people”. This is actually my only real complaint about the book. Low functioning people she defines as people who struggle to meet their most basic needs (food, shelter, employment), who have mental health diagnoses that prevent them from doing these things, or who have big social challenges. High functioning people, on the other hand, are people who are successfully employed, were successful in school, pay their bills and have some savings, have satisfying relationships, and so forth. She says that while lower functioning people need weekly therapy to learn skills and be in the presence of a higher functioning person, higher functioning people may not need weekly therapy and tend to need more goal-oriented and practical approaches. Maybe I don’t really think this designation is necessary because I do work with more high functioning clients and not at an inpatient or county mental health facility? But I feel like most of us therapists (in fee for service private practice anyway) are seeing higher functioning clients, and it’s such a huge category that I think making any really large sweeping statements about the whole group is insufficient. But be that as it may, this book is for “high functioning” clients who need practical tools for their particular issues.
While anxiety is typically categorized as “bad”, Carmichael explains that some level of healthy anxiety – or “nervous energy” – is what makes a lot of high functioning clients successful. And while this energy/anxiety is great to get through school or be successful at a high paced job, sometimes it is not helpful in their personal lives or inside their heads. So she gives 9 tools that she has found helpful in teaching high functioning or driven clients to cope with excess anxiety or energy. Many of these tools are common mindfulness or CBT tools that many therapists use, with both high and low functioning clients. There were a few things I found here that I thought were new, but most of the information can be found elsewhere. Still, I did really like the organized way that she laid out the information and the examples and step-by-step instructions that she portrayed.
The 9 tools are: 1) a three part breath (a mindfulness technique that is grounding); 2) Zone of Control (making lists of what you can and can’t control); 3) Mental shortlist (a list of things you’d rather be thinking about besides the thing you are ruminating about); 4) a To-Do List with Emotions (adding emotions can help clarify why you’re having trouble getting your to-do list done); 5) Mind Mapping (a visual map of all the thoughts and feelings you have about a certain issue); 6) Worry Time (scheduling worry time so you don’t worry all the time!); 7) Response Prevention (finding alternatives to a behavior you want to stop doing); 8) Thought Replacement (finding a replacement thought for a problematic one); and 9) Anchoring Statements (simple statements to ground you when you are panicky).
I have used almost all of these techniques with clients, but I like the idea of keeping this menu “handy” with certain clients so that I can more easily remember them and decide when they are appropriate. I also think that a lot of clients would really like this book, as it explains very simply and clearly how to do each technique and when/why you would. I’ll definitely buy a copy for my shelves!
This book won’t be out until March 23, 2021, but you can purchase my summary below in order to access some of the information now; or it can also be pre-ordered from the link below. I received my copy through Net Galley for my review.
Disclaimer: The link above is an Amazon affiliate link and I receive a small compensation from purchases made through this link. Summaries are NOT intended to replace purchase of the book, but simply to save you time reading.