Category Archives: emotional healing

Back on Track

It is amazing that the year has flown by and I haven’t written since March. Now it’s time for another Holiday Season. I’m not sure what happened, except that I continued to feel angry at the political climate in this country and at the politicians. I grew up in a time when we were taught, if you don’t have something nice to say, then don’t say anything. Maybe that has been operating, because I haven’t had a lot of nice things to say. Or maybe I have been trying to avoid my feelings of anger and frustration, and did not want to raise the issues again, or maybe I have been frustrated by wanting to keep my topics non-political, since my training as a mental health counselor and as a mediator has spent so much time on maintaining neutrality, that I have not wanted to compromise that. I don’t feel neutral. I have strong feelings and opinions. I’m just not sure they are compatible with my intention for this blog – that it be a resource for people exploring their feelings and relationships, not mine.

Politically, I am a liberal or a progressive.  I feel our taxes should be used to protect and support our people. I want people to discuss issues and compromise on workable solutions. I am willing to pay taxes for schools and police and medical services. I do not believe that feeding the hungry causes poverty or sloth.  I don’t believe policies that are legislated by a majority are tyranny.  I am concerned that our political practices are becoming more divisive more self-serving than ever.  I am saddened by the followings that self-serving people spewing hate and prejudice have built, somehow reinforcing the concept that “if you disagree with me, then there is something terribly wrong with you.”

How do we rebuild an environment where people can disagree, discuss their differences, identify the issues that can be agreed to, and seek some resolution that considers both views? We need to move forward in this country, in a way that recognizes the needs of all, and with solutions that consider those.  Instead legislators continue to be willing to cause great harm, even when there is nothing to gain. The sequestration – a solution deemed to dire for anyone to reasonable consider – and the shutdown were irresponsible. If our elected leaders cannot resolve their differences and work toward solutions that serve the people, they need to be replaced with people who will strive to serve – not just obstruct.

We live in an incredible place. Our geography is varied, our resources plenty. Still, our laws and policies favor adding to the wealth of those with resources and increasing the deprivations of those with little.  Are baby-boomers going to be the last generation with a middle-class?  I hope not.

I am grateful to be American, to live in a community that is beautiful, and that usually works toward serving the needs of its people.  I am grateful that my work was satisfying, and that my retirement is possible because of the social systems in place while I was working and now. I feel responsible for continuing to support caring for the poor. I am grateful I have the means to pay taxes, and to purchase the insurance I need for medical care.  I am grateful I had the opportunity to work with many great professionals and to serve great people. I love meeting children and adults years after our working relationship, and see them thriving.  That is the true reward of my work.

I am grateful to approach 70 with few complications and a sense of wonder.  It astounds me.

This week, our nation will gather for Thanksgiving. And while there are still many wrongs to be righted, and battles to be fought, I approach it with a hope that we will find our path again – one toward compassion combined with hard work, a sense of personal accountability and responsibility, tempered with good will.

********

Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you here.  If you have questions or concerns, please leave a comment. I will attempt to address the content if I can.

3 Comments

Filed under behavior, change, emotional healing, habits, healing, patterns, problem solving, relationship, self-care, wellbeing

Tired of being Angry

I’ve been really angry lately. It seems like everything irritates me. No, that’s not really accurate.  I haven’t been bothered by the weather that varies from dark blustery winds and rain to “sun breaks” (brief appearances by the sun in the Pacific Northwest) or that keeps the temperature moving between the low 30’s and high 50’s (°F).  I haven’t been mad at the dog – our 11 year old “grand-pup” who we are fortunate enough to have during most workdays.  She gets me out walking and is a sweet companion.

I’ve been mad at people, particularly people with leadership and organizational responsibilities.  I am angry at folks that posture to promote themselves while concerns of the members or citizens remain unresponded to. I’m angry at people of means and power who rant and snark at the struggles of the people with less. I’m angry at people who say, “Let me know your concerns and how I can help,” then discount the pleas with, “That’s not really a problem. You are not doing enough to help yourself.” I have felt surrounded by these people recently in my organizations and in our government.

When leadership focuses on serving its members and citizens, the connections between people grow and good things happen. Needed change arises out of the inquiry, assessment, analysis, action, and evaluation. The organization stays viable. When leaders see their positions only as opportunities to build personal power and status, the organization becomes stagnant and starts depriving the membership of sustenance and belonging.

What does this have to do with health? Everything. Health comes from balance.

If we were struggling for our very survival- literally the threat of death, perhaps these responses would be appropriate. I’m not saying survival isn’t important. But most of the issues today aren’t about threatening the physical survival of the leaders or the groups they represent.  Most of our organizational and political issues are about promoting a personal belief system, maintaining status in power and comfort, or feeding personal pride. We have lost sight of promoting healthy systems of cooperation, collaboration, inclusion, and caring for the whole instead of the special interest.

I have been discouraged by my response to all this, because I want to retreat rather than fight for change. I used to be a crusader. Now I want to just escape it all; to get away from the rhetoric, the blaming, the name-calling, and self-righteous attacks on others.  I’m not sure what to do.  I know it isn’t healthy for me to carry this anger around.  I want to release it but I don’t want to ignore what is happening. I’m not asking for no conflict. I’m asking for openness, honesty, and true assessment of options as people address conflict. I feel like, as my mother used to say, “ I might as well be asking for the moon.”

At this point, I intend to continue to take the actions I believe will lead to improvement. I intend to behave consistently with my beliefs and goals. I will strive for generosity in how I view others and their beliefs and goals.  I will breathe more deeply.  I will take my grand-pup on more walks. I will not eat to calm my anger. (- 42)

********

Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you here.  If you have questions or concerns, please leave a comment. I will attempt to address the content if I can.

2 Comments

Filed under behavior, counseling, emotional healing, habits, healing, mental health, patterns, Penny Milczewski, self-care, wellbeing

Discomfort and Joy – the Holidays

Zowie, I lost track of time. I informally made a commitment to myself that I would post weekly, then things got busy, and I gave myself permission to go to 2 weeks. Then a month – now two.  I have been thinking about writing- even started several posts in my head, but of course you wouldn’t know that. How could you? I have been sticking with my food plan and 13 weeks in I have lost 30 pounds.  I wish I could tell you I had met my goal, but alas it’s further down the road.

The holiday season – the dreaded, beloved, often anticipated (not always happily) holiday season. The ambivalence that accompanied the holidays exists for many people- fond memories of happier times, or maybe frightening memories of terrible times, realizations of hopes unmet, gratefulness, sadness, the joy of feeling childlike, the helpless dread of feeling childlike. These all occur for me as Thanksgiving, Christmas, and New Year’s Eve approach.

Like many adult children of alcoholics, I remember Christmas as a time when the fun and excitement was often dampened by sullen drunkenness, broken promises, someone sleeping it off, or being belligerent. It was a time when parents fought about money. I don’t remember my parents fighting about spending the holidays with my mother’s large family, but my father always refused to go.  That didn’t stop us. I don’t think my maternal cousins knew my dad at all, even though my parents didn’t divorce until their youngest were in junior high. And yet – I still looked forward to it, hoped for the best – that everyone would be happy.

As an adult I often had a dread of not being good enough in my planning, my cooking, my dressing, my gift-giving, whatever… You name it and I worried that it wouldn’t be “right.” It was hard to relax and enjoy times with friends and family. It was hard to play while keeping a watchful eye on all the possibilities that could go wrong.

I am grateful now that most of those fears are gone. One thing that surviving into your sixties does is to give you perspective. There is no turkey so dry or roast beef so rare that a meal needs to be ruined.  There is no need for finances to dampen the joy of being together with people who love you and whom you love.  There is also no need to do that on December 24 or 25, if those days don’t work for you.  The world doesn’t collapse if there is no Christmas tree or if outdoor lights don’t go up or come down on schedule. Or if you don’t get all those different cookies baked.

We have continually increased the commercial demands in the U.S. for this season to be filled with material things. In 1969, pregnant with our first child, I wrote a Christmas song that began “Hot Wheels and Barbie dolls…Visa or Mastercard,” and ended with “where is the baby that lies in the manger?” That was 43 years ago. I was dismayed then at all the commercials and focus on buying things. The products have multiplied geometrically. Instead of growing wiser as a nation, we have focused more on having things to demonstrate our well-being. Things, not peace, justice, serenity, or joy.  That’s what I want for Christmas and for the new year, and if it has any chance of happening, I need to do my part.

My challenge for this season is to urge all the political contributors (the donors of more than $2 billion in the presidential campaign alone) to match their campaign and PAC contributions with donations to charity.  If that happens, 2013 could be a very good year.

Peace to you all

Take Care and Be Well

********

Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Leave a comment

Filed under behavior, change, childhood trauma, emotional healing, habits, healing, mental health, patterns, Penny Milczewski, relationship, self-care, wellbeing

Bad habits die hard…good ones start even harder

I wish knowing what you should do was as helpful as doing it. I know what a healthy slender person eats. I know the traps to avoid. I know the counterparts to many unhealthy behaviors. I know how to exercise appropriately. I know the needed actions to lower cholesterol, to improve BMI, to improve balance, muscle tone, and core body strength. I know I should floss daily and brush at least twice a day.

Knowing isn’t enough. Knowing what to do and how to do it doesn’t make it happen. Practice makes it happen. Intent makes it happen, until it becomes ingrained as a habit.  I don’t know what happened to my grooming habits.  I remember as a child the required morning and nightly tooth care, the daily bedmaking, the weekly put your room in order.  Somehow I didn’t take that with me – at least not permanently, when I left home.  Perhaps as I grew to reject the shame and chaos of my childhood, I also set aside the good things.  About 8 years ago,  in my mid 50’s, I was replacing my eyeglass lenses because the old ones were to0 scratched. The optician recommended I clean them each day with warmwater and liquid soap. I complained that was hard to remember. He suggested, ” Just wash them as often as you floss your teeth.” If I washed my glasses as often as I flossed my teeth,  I’d miss out on lots of reading!

I always floss the day I go to the dentist. I remember seing a cartoon strip where the character shows up at the dentist with small bandaids crossed all across his gums.  The dentist remarks, “Adam, I see you flossed this morning!”  I don’t think we fool our dentist or her hygienest.  We only fool ourselves.  I always report in questionnaires that I floss – ashamed to admit I don’t follow this simple effective dental hygiene protocol.   I’ll do it for a week or two – always after a cleaning. I like the feel of those clean teeth with minimized plaque. But one session missed is usually enough to revert to the old default of neglect and drop the new pattern of self care.

Sometimes to carry out a healthy regimen, I need to pretend I’m caring for someone else.  If this person in the mirror were my child, I’d want her to develop the habit of brushing and flossing routinely; of always using sunscreen; of good sleep habits; of making healthy choices when eating and exercising.  I’d be firm but loving- helping her develop the habits and self discipline as a way to care for herself . And I’d want to do it without shaming or bullying. That’s not usually how I talk to myself.

Most, if not all child rearing practices encourage the development of good habits and routines. I remember all the parenting and child psych training about establishing routines, bedtime, meal time, after-school homework, etc..  If a child has poor sleep patterns, the solution is to develop routines that link activities (bath, bed, story, light out)  repeated consistently over time. The child learns and integrates the pattern.  The mind associates one step wit the next, and a habit is formed. Routines create predictability.  Predictability provides a sense of safety and reduces anxiety. Routines soothe us. They allow us to relax, to let go. They give us a consistent platform from which to start or end the day.  They are built with repetition, over time.

I’m planning on introducing some new simple routines. There are several tasks I would like to convert to habits.  I know I’m capable of developing habits – I have several that are not very helpful!

Take care, be well –

*******

Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you here.  If you have questions or concerns, please leave a comment. I will attempt to address the content if I can.

2 Comments

Filed under behavior, change, counseling, emotional healing, habits, healing, mental health, patterns, Penny Milczewski, psychotherapy, Uncategorized, wellbeing

Elections and Wellness – an oxymoron?

I don’t know if it’s really possible to write a wellness post about an election, but I’m going to try.

I am struck by the attacks, negativity, fear, and blame that fills the convention speeches and the political ads, and the partisan rhetoric from much of the media while cloaking it in the name of news.  And I believe it is pervasive on both sides.

I am concerned about the energy all this spewing puts into our emotional environment.  We are surrounded by words and ideas aimed at creating fear and defensive responses.  Public relations /Advertising research shows that negative messages work. Why? Because they grab our attention where it is most sensitive and highly developed – responding to perceived threats.  So election of each candidate is described by the other as “the worst thing that could happen to -,” “the collapse of ­­–,” “the destruction of ­–,”  and so on. You get the picture.  We aren’t being asked to elect a president who will lead us reasonably and with good intentions.  We are being called to protect our families from ruin, death, and destruction.

To make matters worse, the claims of pending disaster have been accompanied by statements of “fact” that are clearly distorted, if not entirely fabricated. Why?  Because when humans are on alert for their safety, they tend to remember the information that comes with the threat.  You can always take back a false statement, maybe even apologize publicly for it.  But the original content remains in the mind of the listener, connected to the threat that accompanied it.

It saddens me to see that we as citizens and consumers accept these practices;  that we allow – perhaps even require our politicians to attack each other with lies and catastrophic predictions.  We reward this system by watching and contributing to the campaigns and PACs championing our cause. We have grown as desensitized to ranting politicians and media personalities as we have to the violence of today’s video games, television shows, and movies.   It has become normal. When did we lose all attempt to keep the claims truthful, to base our competition on true differences, and to welcome differences as something we can learn from?

My greatest concern is that this environment of fear and anger creates an emotional environment detrimental to our individual and collective wellbeing. What kind of energy are we creating in this country?  Our moods, our thoughts, our physical well-being respond to positive and negative input.  Do we truly believe that all this negativity has no impact on us?  I don’t.

There is significant research showing the varied impact of external stimuli on our brain waves, and consequently our mood, thoughts, and behaviors.   In the same way, we respond to negative words, negative moods, angry tones of voice, an intimidating presence, and threats of harm. Cooperation decreases, satisfaction decreases, creativity declines.  At a time when the U.S. needs to channel its accumulated wisdom, creativity, and cooperation to addressing the needs of the country and its people, we are engaged in vilifying those that disagree with us, building walls between groups that need to cooperate, and cultivating agitation.

We need to calmly collect ourselves and engage in meaningful problem solving. Our wellbeing depends on an internal sense of being able to creatively cope with the difficulties life presents: recognizing we can change some things and survive others. Seeing the world or the future as only a choice between annihilation and success creates an environment of unceasing tension and anxiety.  It is time to move from a fear-based view to a competency-based view, assured we can find solutions through cooperation, creativity, wisdom, and practice.

Think about turning off all political ads, not just the ones for the candidate you don’t support.  Turn off your candidate’s ads, too.  You do not need that negative energy in your life. You need support, rest, opportunity, creativity, and peace.  Vote for the candidate that will contribute to your well-being.

Be Well, Take care.

*********

Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I will be required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you through this forum.  If you have questions or concerns, please let me know. I will attempt to address them if I can.

1 Comment

Filed under emotional healing, healing, mental health, psychotherapy, relationship, wellbeing

Holding On And Letting Go

I was preparing the house for visitors the other day, and had decided I needed to thin out the “stuff” around, on, and in my desk.  As I sorted into shred, recycle, file piles, I reflected on how much “stuff” I have, how much comes in each day, and how it seems to be harder to dispose of than to accumulate. These experiences aren’t just restricted to miscellaneous paperwork, or material items. They also occur emotionally. How much do I hold on to that is neither necessary nor helpful?

I grew up feeling like I needed to always be prepared to defend my feelings and behaviors.  I gathered evidence and stored in memory details of nearly everything, in case I needed to explain something later. Imagine an 8-year-old CSI agent.  It wasn’t ok to take a position without being able to explain why, so I learned to present my cases in a way any jury could understand.  Sometimes I overwhelmed others with my explanations of why I liked something. I remember as a new professional trying to identify accurately and completely why I didn’t like some wallpaper sample suggested by a designer for my new office.  Finally she said, “I don’t need to know why. I just need to know if you like it or not.  It helps me narrow down the selections to offer.”  What a concept!  My likes and dislikes provided information about me.  It wasn’t a contest or a test. There were no right or wrong answers.  I did not need to justify my preferences. They were … my preferences.  I began to let go of the explanations and the attempts to justify, and began to recognize and accept that I had preferences. It was ok to recognize and express them.  It was actually helpful to be aware of what I liked and didn’t like.  It saved time when sorting through options.

When it comes to stacks of emotional paperwork, I used to have a more difficult time sorting them than with actual paper.  It was difficult to let things go.  Painful, hurtful memories were as likely to be held on to as were the moments of joy, peace, and belonging.  A loved one of mine often kept her painful reminders readily available, literally as well as virtually.  At times of distress, she would say, “ Did I ever share that terrible hurtful letter my neighbor sent me long ago?”  She would remove it from an envelope in her desk and read the hurtful shaming remarks again – reopening her wounds.  Why would someone do that – relive the injury? Perhaps to feel the pain anew as punishment or as a reminder to not be “too happy,” or as a reminder she was alive, or as a way to feel something again- anything, even if only shame.  I don’t know her reasons. I’m pretty sure the process reinforced her critical view of herself. I know there must have been a better ways to emotionally care for herself.

Re-living slights, shame, or emotional pain does not necessarily help us grow or thrive. We have to learn to sort through and discard experiences that do not support our health and wellbeing. It is difficult to do without practice.   It’s like going through your sock drawer. Black socks might be good to have – but do you need 6 pair, the pair with the heel torn out, the pair that no longer fits, or the pair that hurts your feet whenever you wear them? You get the point. Keep what is useful, keep what you love, and keep what helps you become the person you strive to be. Recycle or discard the ones that no longer work for you.  Let go of them after they have served their purpose.

Holding on to your pain may be helpful for a while, but when it has outlived its usefulness, let it go.  Many processes have been developed for releasing negative energy from your life. They include things like burning the items and watching the concrete and material become air, burning paper with the items identified on it, Casting the virtual items into the sea or the wind, creating a vault where they pain can be locked inside and then buried, releasing balloons.  You probably have releasing visualizations/ rituals of your own.  The important action is to intentionally release the pain and its associated memories. Thinking negatively is a habit that requires an effort to change.

Hold on to your moments of peace, belonging, and recognizing all is right for the moment.   Keep them available to you to draw from when you are distressed.  Practice breathing, holding on and letting go of the breath.  It will make a difference.

********

Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you here.  If you have questions or concerns, please leave a comment. I will attempt to address the content if I can.

4 Comments

Filed under childhood trauma, counseling, emotional healing, healing, mental health, Penny Milczewski, psychotherapy, PTSD, therapy

Creating and Nurturing Change

I just returned from a few days “off the grid” and have been amazed at the conflict between my desire to hold on to the feelings and mood of my respite and the pull to fall immediately into the habits and patterns I was so glad to leave behind.  I worked a little yesterday to put myself back into the tempo and peace of being back at the island park we visited. I imagined feeling the rocking of the boat, hearing the water lap the shore, the birds, the smelling the wind, the woods, and the beach. For a moment I was there, then my cell phone played its tune; I saw a virtual stack of email waiting to be sorted, read and answered; and I was reminded I need to call the appliance repairman because the refrigerator isn’t working right.  The serenity of the previous moment was gone.

Neuroscience has shown repeatedly that our imagined experiences are as “real” to our brain as our physical experiences.  We have the ability to use visualization to improve physical functioning. It takes focus and repetition, but even an athlete can improve performance by repeatedly imagining her successful moves.  This kind of practice can assist us emotionally as well as physically. Imagined experiences can also inhibit or otherwise impair our functioning.

One of the difficulties with anxiety and depression is that we create and repeat emotional scenarios that feed the fear and certainty of rejection and loss.  Our self-talk is increasingly pessimistic or critical. We lose sight of possibility, of alternative explanations, of changes toward the positive. Anxiety takes on a life of its own, so that our fear is about the feelings of anxiety, rather than the specific circumstances or triggers.  With depression, we lose memories of previous better times, and create a belief that things never were better and never will be.  But there can be change, and it can be change for the better.

I remember many years ago when visualizing and affirmations were being taught in management classes. I was a state social services administrator, and we were experiencing severe funding and staff cuts. Remaining staff members were becoming discouraged and burned-out. The agency provided a motivational speaker at a management conference, and he worked hard to pump us up.  After a morning of identifying example after example of the power of affirmations, visualizing success, and modeling success, we broke for lunch.  My director turned to me and said, “This is really good stuff. It’s just not for situations as bad as ours.”

Yes, it is. We might actually need it more than the people who use it to deal with inconvenience and discomfort. The thing is, it’s hard to do.  It’s hard to get started and it’s hard to keep practicing. It takes discipline. It takes action. It takes repetition.  It helps to have support, to share your goals, to help you see options.  But it is ok to start with just a little at a time.

Choose one thing to change: be specific, be focused.  Reward approximation when it occurs.  Approximation is the process of getting closer to what you want to have happen. Think of teaching a child to talk.  You don’t wait until they can say, “Could I have a drink of water, please?” to reward them.  WaWa or LaLa is close enough to start with. That’s approximation – you are rewarding movement toward the goal. Do the same for yourself.

********

Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you here.  If you have questions or concerns, please leave a comment. I will attempt to address the content if I can.

Leave a comment

Filed under childhood trauma, counseling, emotional healing, healing, Penny Milczewski, therapy