Today's Reading

This book is here to share the tools that I have found essential to my own success, as well as to the success of my clients. Anxiety's healthy function is to stimulate preparatory behaviors, or to signal that there are emotions or situations that need our attention. By giving this extra energy the right format before it becomes frantic, frenetic, or stagnant, it can become a gift rather than an obstacle. Some of the techniques in this book are mine entirely; others are based on common cognitive-behavioral therapy interventions, mindfulness meditation, or even yogic techniques. I hope you will experiment with them, keep what works, and leave the rest. The idea is to discover which techniques help you move forward in a way that feels both joyful and steady, all the while bringing you closer to fulfilling your goals and deepening your relationship with yourself.

2.

What Are "High Functioning Clients" and Why Does It Matter?.

My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style.
—MAYA ANGELOU

Since opening my practice in 2012, it has been my privilege to work with over a thousand bright and successful clients visiting my New York office, as well as many other driven, motivated people around the world via video. I believe the reason my practice has grown so quickly and attracted such a strong following among successful, driven people is that my approach is specifically designed around what psychologists call "high functioning" people. A person's level of functioning is a term used by psychologists to describe a person's ability to meet his or her own basic needs, form meaningful and healthy relationships, and generally navigate life within his or her given culture's norms. Psychologists can assess functioning through a variety of methods, such as numerically scored measures or open-ended interviews; but to get a basic sense of what the term means, check out the lists that follow.

As you read, please know that "higher functioning," while being used as a psychological term by psychologists, absolutely does not equate to being a "better" person. On the contrary, many of my most fulfilling clinical experiences were in my early training days working with cognitively disabled adults who were quite unable to meet their own basic needs of food, clothing, and shelter—but they were wonderful, warmhearted people whose company I very much enjoyed and who taught me many important lessons, both personally and professionally. I'm extremely glad that our society makes allowances to care for those who cannot care for themselves. Conversely, many high functioning people are not necessarily as warm and enjoyable as the lower functioning clients I've described. In other words, a person's functioning is not to be confused with his or her intrinsic value or desirability as a human being. Functioning is also not to be confused with socioeconomic status: for example, although Bernie Madoff was very wealthy, his functioning was likely significantly compromised as demonstrated by a lifelong pattern of blatant disregard for others.

It is also important to know that a person does not have to be in perfect mental health in order to be high functioning. Many high functioning people have diagnoses like generalized anxiety disorder, panic disorder, or dysthymia. Many high functioning people also work hard to manage their substance use or abuse. ("Work hard play hard" is a common motto for those in the high functioning crowd, who often find that a stiff drink feels like the only way to "turn off" their constantly moving mental wheels, unless they have learned specific techniques to wind down.) The distinctive feature is that they are able to manage any clinical-level disorders without having a pervasive pattern of posing a risk of serious imminent harm to self or others, including being unable or unwilling to meet their own basic needs on a habitual basis. In fact, there is almost no diagnosis that would prevent someone from being high functioning. For example, a person with schizophrenia could be very high functioning if they were compliant with medication and did not have delusions or hallucinations that caused them to pose a danger to themselves or others, or to be unable to meet their own basic needs. There should be no stigma in acknowledging any disorder or any level of functioning.

"Functioning" is simply a term that psychologists use to describe people's ability to care for themselves and participate in their community in a full and healthy manner according to accepted norms in the field of psychology. A psychologist's assessment of functioning takes into account cultural, environmental, and socioeconomic factors. (For example, a parent struggling to feed his or her children due to a local shortage of food would absolutely not be considered lower functioning simply for having undernourished children in that circumstance; whereas a parent whose children were undernourished due to the parent's forgetfulness or lack of willingness to feed them would be evaluated differently.)
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