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Nick Holt, LCSW
Certified Cognitive Behavioral Therapy, CBT Psychotherapist in West Los Angeles | Sawtelle | Santa Monica | Mar Vista | West LA
Certified Cognitive Behavioral Therapy, CBT Psychotherapist in West Los Angeles | Sawtelle | Santa Monica | Mar Vista | West LA

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The recent celebrity suicides have hit me pretty hard especially as someone who has lost to suicide.

I connect to those left behind. When we have losses like this, for me, suicide loss acts as a cheese grater on my soul, slowly peeling back my own layers of grief. I imagine what those left behind face and are enduring, and, no matter how hard I try to forget, the losses always bring back memories, thoughts and feelings of those I've loved and lost to suicide.

In my time at Didi Hirsch's Suicide Prevention Hotline, I remember staff would talk about call volume spiking, and the need for more counselors to come in to support the many callers who connected to the recent celebrity suicides. These deaths, and the media coverage of the events, always reminds us of our own and others pain.

Please go to for links.

If you are someone who is struggling with suicidal thoughts, depression or has lost someone to suicide, this will be a difficult time. Please treat yourself well. Reach out to a friend, a loved one. Take that walk or extra time in the gym. Be gentle and kind to one another. It is a good time to invest in ourselves.

If you are struggling with thoughts of suicide or planning to kill yourself, PLEASE take a moment, a breath and remember that if you can delay suicidal impulse, research shows the impulses WILL decrease. There are some incredible volunteers and paid staff that would love to talk with you about what you are struggling with. Please reach out to the National Suicide Prevention Hotline (1-800-273-8255).

From my website:

Losing a loved one, family member, friend or even an acquaintance can be devastating. The feelings are complex, the thoughts overwhelming. Everything seems to trigger memories of the person gone, and all memories seem tainted by the nature of death.

The process of losing someone can make us feel alone. Grief, loss and bereavement are incredibly difficult things to experience, but there are many amazing people and organizations out there for support:

Please go to for links.

#suicide #prevention #call #celebrity #support #suicidal #ideation #intent #empathy #love #connection
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I had the immense pleasure of catching Dr. Susan David on The Mental Illness Happy Hour this past week.

She has a wonderful conversation with Paul -- starting at 21 minutes -- about thoughts, feelings and ways of approaching a healthier, more consistent lifestyle. She touches on many vital concepts, which are emerging with greater and greater scientific support.

Link to Podcast:
Link to Blog:

Two key concepts and reminders I took away from the podcast:

- Thoughts and feelings are "data not directives." You are not subjected to your thoughts and feelings and does not represent our entirety in a given moment. Rather, thoughts and feelings are "a sign post," which provides us with an opportunity of doing things differently.

- Our world view and how we live our lives are simply stories we tell ourselves. Instead of asking if the story is right or wrong, a better question is to wonder if the story is congruent with our desired life. Is our story serving our ideal self? What are steps we can take to better align our ideal and current self? Is our story a prison or is it serving us? "Discomfort is the price of admission to a meaningful life."

Have you listened to this podcast already? If so, what were some of your takeaways?

So many beautiful possibilities in this chat. I highly recommend it.

#thoughts #feelings #mentalhealth #support #love #compassion #beauty
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Given recent violent events, the tenor of political discourse and the deep divide within our country, I've been searching for a way to better understand what is going on and how to move forward personally and professionally.

I recently came across an article called "Can We Have Compassion for the Angry?" by Laura L. Hayes, Ph.D on from 2016.

I love how she differentiates amongst people who are struggling with mental health issues and people with anger issues. I also think it is important to highlight the link between unregulated anger and rage, and the connection to violence.

I've had my share of rageful "conversations" on Facebook, and I find it incredibly helpful to remember that the true issue in play is anger. Unregulated anger and rage is a major issue in our society and one, I believe, few people consider as an significant issue.

According to Dr. Hayes:

"An adult who is able to effectively regulate anger uses it to alert himself to a problem situation. Managed well, it is an extraordinarily effective warning system. Unregulated, impulses are stronger, and thinking is less clear. The poorly regulated adult with enhanced reactivity, impulsivity, and a constant state of fight or flight sees in every interaction the potential for being harmed and the necessity to defend himself. The angrier he feels, the less clearly he will think. His reactions will often be out of proportion to the situation, and he will be prone to violence. Because he sees the world as a constant source of danger, he externalizes blame, to his spouse, children, neighbors, government, and 'others' in race, nationality, religion, or culture. Angry, blaming, aggressive, and unable to modulate his emotions, he can become a danger to others."


"Violent crimes are committed by people who lack the ability to regulate and modulate their response to perceived danger. This is not a hypothesis; it is a fact. The individual who lacks the essential skill of using more sophisticated reasoning, perspective-taking, and emotional stabilization to regulate his more primitive fear and aggressive impulses will fall into the pattern of aggressive overreaction again and again, often with escalating levels of violence.

In the end, it is helpful for me to remember that these reflections are just thoughts and feelings we have about ourselves, others and the world. Our brain, self-empowerment and discipline are much stronger, more resilient and adaptable to change, and more powerful than our automatic thoughts and emotional reactions. We are able to change our responses to these provocations.

Check out the rest of the article and resources at

#anger #rage #issues #mindfulness #thinking #thoughts #reframe #deflection
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Below I've included text from the article, "Why Cognitive Behavioral Therapy Is the Current Gold Standard in Psychotherapy."

Research article:
My take:

This link is a recent research opinion article within the field of cognitive behavioral therapy and, to me, has a lot of diverse considerations and implications.

I think the article highlights the importance of considering differences amongst providers -- certification, adherence to fidelity within treatment, resilience and more. But, even more important, I read this research as acknowledging where we are as a field. By accepting CBT's scientific basis, years of research and structured modality, I do not see it as diminishing or "throwing shade" at other modalities.

There are a lot of skilled practitioners with diverse modalities within the psychotherapy field and most do important, passionate work. I think this truth will remains irregardless of background -- CBT, analytic, ISTDP, etc. -- or conceptualization of the human condition. Instead, I read this article as a consolidation of numerous scientific efforts within the field of psychology. CBT is not a panacea, but it's a good marker in our evolution in what we know works in therapy.

As practitioners, let us continue to join together to improve our services for our clients, and remember that difference is NOT deviant.

A few key highlights I found interesting:

Cognitive behavioral therapy:

"(1) ... is the most researched form of psychotherapy. (2) No other form of psychotherapy has been shown to be systematically superior to CBT; if there are systematic differences between psychotherapies, they typically favor CBT. (3) Moreover, the CBT theoretical models/mechanisms of change have been the most researched and are in line with the current mainstream paradigms of human mind and behavior (e.g., information processing)."

...continued at

David D, Cristea I and Hofmann SG (2018) Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Front. Psychiatry 9:4. doi: 10.3389/fpsyt.2018.00004

#cognitivebehavioraltherapy #cbt #psychotherapy #research #goldstandard
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For me, the end of the year is a time of reflection, appreciation and gratitude. It's when I carve out time to be proud of myself and my accomplishments of the year. It's when family rejoins, and tradition and ritual come to a focus. During this process of reflection, I find it natural to reflect on areas for growth, development and change.

However, over the years as I've progressed through my experience as a certified Cognitive Behavioral Therapy, CBT therapist in West LA, I've noticed difficulty in executing some of the New Year's goals I set for myself. I know I am not alone in this. Much has been written about the importance of setting SMART (Specific, Measurable, Attainable, Relevant and Time-bound) goals. In thinking about my past goals and in remembering discussions with friends and family, identifying goals is rarely the main barrier.

Too often I think our year-end reflections get filtered through a negative filter. Instead of dwelling on my accomplishments and successes, I tend to set goals that tap into my perceived inadequacies and dissatisfactions over the past year. Sadly, the outcome of this type of filtration is that I leave myself with a sense that I am, and/or my life, just isn't good enough.

Goals of this nature can become a checklist of tasks I "need" to or "must" do, and become a basis for my own feelings of inadequacy, lack of confidence and esteem, and tend to gain momentum throughout the year. Conducted through this lens, in the generation of goals, I struggle to finalize a thorough list of SMART goals and commit to executing them.

Read the full post at

#realistic #goals #newyear #change #psychology #inspire #reflection
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I believe being in an intimate, connected and committed relationship is one of the most difficult things to do on the planet. Divorce rates in California have been estimated to be as high as 60%.

In my Master's in Social Work coursework at University of Southern California, one of my favorite courses was Couples Therapy -- the interplay of seen and unseen dynamics, complexity of internal and external factors on the relationship, historical intimate relationships playing out in the present. Relationships are as fascinating as they are challenging.

One of the biggest challenges in my own marriage has been cultivating a shared story that carves a path of true North. Esther Perel's "Where Shall We Begin" has been incredibly helpful in seeing my marriage, and all of my intimate relationships, differently.

I think her ability to highlight the shared stories of humanity and relationship are so calming and reassuring, they bring us to a place of sameness, safety and support...

Finish the post and get the links to content at

#couples #therapy #masculinity #relationships #intimacy #love #support #psychotherapy #psychotherapist
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" order to serve this group of individuals fully we must not neglect to acknowledge the rumbles of thunder that follow in the wake of their brilliance."

You can read this article a few ways -- all relevant. As the research focused on self-reporting mental health diagnoses, I see this research as a reminder of the omnipresent mental health challenges within our society as a whole and a reminder to do my part to reduce stigma across the board.

#stigma #mentalhealth
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I love thinking the majority of my thoughts are worthless without action. That I am an observer of, not subjected to, the electrical storm within my mind. A growing gale nurtured through my focus and attention.

I love thinking I can choose to engage and ignore my thoughts -- to give life to my deepest passion and exile my darkest anxiety.

"...5% of our thoughts are actually meaningful and relevant..." What an empowering reminder.

Click here for blog and article links:

#thoughts #thinking #shift #mindfulness #meditation #anxiety #givelife
Embrace your thoughts
Embrace your thoughts
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It took me a long time before I realized the depths of my anxiety. For much of my life, I self-managed my discomfort by doing -- sports, hobbies, education, friends, family, writing and more. My checklist of "to-do's" helped regulate an early experience of feeling out-of-control, and gave me a sense of empowerment over my life.

It has taken me even longer to breakout my nuanced thoughts and feelings encompassing my anxiety. I am still learning, and still reminding myself of the importance of psychotherapy. Psychotherapy can be an important space of safety for exploration, understanding and compassion, and in rekindling my awareness and intention.

With clients, I sometimes share a lighthearted prompt: "I'm not only the hair club president... (I'm also a client)." It's meant to be a reminder that mental health and psychotherapy is not only about knowing but remembering.

We all drift from our good-enough selves. Being adaptable, resilient and committing time to reconnecting with our passions, purpose and cultivating a process to do so is most important.

We (men) struggle to do this ...


#men #masculinity #love #caring #anxiety #psychotherapy #thoughts #feelings #empowerment #reachingout #trust
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I've spent a large part of my life living within core beliefs of not good enough, inadequacy and incompetence.

Out of an almost obsessional pursuit to disprove these internal fallacies, I have been driven to do more, hold myself to "higher" standards and take full responsibility for many neutral-negative encounters I have. As I reflect on a lifetime spent in this default mode, I recognize it's had a significant impact on my contentment, confidence and self-compassion.

In my personal life, I've had moments of desperately seeking validation from the external world, which rarely comes. It's taken a long time to build reserves from within, find peace with uncertainty and be confident within my voice.

Read the full Blog Post here:

#competence #work #relationships #burden #incompetence #inadequacy #therapy #therapist #beliefs #ocpd #perfectionism
The Burden of competency
The Burden of competency
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