Next Group Therapy starts February 6th. Learn More.

A recent study has found that repetitive Transcranial Magnetic Stimulation (rTMS) is effective in treating depression. The results showed that the majority of patients experienced a significant reduction in symptoms, with some even achieving complete remission.

Are you interested in Group Therapy? Groups offer a safe space for sharing ideas, helping others who are going through similar struggles and can promote social skills and group accountability. Click to read more.

The combination of TMS (Transcranial Magnetic Stimulation) treatments and Ketamine Infusions is gaining national attention as a powerful way to alleviate Treatment Resistant Depression. For more information or to schedule an assessment call or text us at 330-754-4844.

Group Therapy

What are the benefits of group therapy? Who should attend? Starting Tuesdays at 5:30pm beginning February 20th for 10 weeks, we’re hosting a growth-focused group at Ascend. Anyone can join, and many have successfully completed TMS, ketamine, and similar treatments here or elsewhere.

Dr. Kreider’s Bio: I have been in the counseling profession for over 30 years and independently licensed since 1998 as a mental/behavioral health practitioner through the state of Ohio. I have been an independently licensed chemical dependency counselor in the state of Ohio since 1988. I am a trained Gestalt Therapist with a specialization in group therapy. I have completed an Advanced Gestalt Certification process from the Gestalt Institute of Cleveland. I have completed a year-long course in Cognitive Behavioral Therapy. Over the past 2 years I have specialized in CBT for Psychosis. I have EMDR level II certification.

Specialties: Gestalt Therapy, Cognitive Behavioral Therapy, CBT for Psychosis, EMDR, Trauma, Anxiety, Depression, Parenting.

hello and welcome to the Ascend Health
show I’m your host Nick Angelis I’m a
nurse anesthetist and one of the owners
of ascent Health Center and I’m here
with Dr Valerie Kreider–how are you

I’m well thanks

so what’s fun today is that one of my contacts is
bothering me so I’ll probably look like
I’m sobbing at certain points during
this and it’ll just be very powerful for
all the viewers at home like he’s really
touched by this this is great work that
they’re doing
which is because we’re talking about
group therapy right which is a little
difficult to do over a WCTV episode but
you know you can get your money’s worth
it’s fine sure and there’s usually a
disclaimer that anything we say here it
shouldn’t be taken as medical advice
just as anything you Google isn’t always
personally applicable to you that sort
of thing so if you had a good day so far

it’s been an excellent day yep hanging
out going to meetings

I went to Columbus to talk to a new
ketamine Clinic about bravado oh yeah I
talked to them for about two hours so I
might build a horse but that’s probably
good because that way we can listen to
your wisdom whatever I come up with
whatever there is of it yes it was
really insightful so I enjoy that sort
of thing cool so I want to start talking
about group therapy okay because you’re
going to start doing some group therapy
for us at Ascend right and uh sorry for
all of you this is basically a planning
session and you can come along and see
what we’re going to do but I’m just so
intrigued by it because we did group
therapy right before COVID started it
was a PTSD group for a woman who had
just suffered various traumas and then
we tried to do it virtual doing covid uh
if you remember that glorious time two
years ago when everyone tried to do
everything virtual right right and we
all realized what works virtually and
what doesn’t right which that in
particular did not I imagine it didn’t
work very well yeah so what does help
group therapy to actually be beneficial
and help people

a lot of what is helpful about group
therapy is that it’s normalizing so
instead of just feeling like maybe I’ve
got PTSD and nobody else does or I’ve
got an addiction and nobody else does we
enter into a group where many people
have similar issues that happen and all
of a sudden we’re not alone that’s
really helpful another benefit of group
therapy is is that we have the
opportunity to get feedback from other
people in a non-judgmental way and so uh
if I’m concerned about something if I’ve had
nightmares that I need to discuss
getting feedback from other people in a
non-judgmental way is really helpful
it’s not threatening and there’s a
facilitator there to interpret and guide
the discussion yeah so lava is a
facilitation a lot of it is the
facilitation right and a lot of it is
the orientation with which the group is
run so a Gestalt group for example would
be very different from a CBT group
for example okay

and I think too because a lot of our
patients find some support from their
loved ones but their loved ones are also
enmeshed in many cases it’s very
complicated where it’s like well this is
the person who hurt me and also the
person who healed me and it’s this gray
area where like a lot of times it’s an
overprotective parent like in part
they’re the cause of the issues but in
another way they’re also why the
person’s getting better and it’s hard to
distinguish all those

it’s really hard
to distinguish that and a measurement
does happen in the family because fam I
mean families were developed so that we
survive right and so we were supposed to
help each other back then and today
families want to help out so much they
end up enabling
or they have their own issues and
there’s a lot of friction that happens
in group therapy we can take a look at
the family Dynamic of anybody that’s in
the group and we can actually sculpt
their family using members of the group
to get a visual
picture of what their family really
looks like in terms of who’s closest to
who who’s allied with who who’s standing
far apart and distant and begin to
look at how this person wants to see
their family maybe wants to create some
change in the family and we can begin to
work with techniques like that

so you’re saying it’s a safe space to
explore the different relationships

because you’re not doing it right there
with your family so instead of the like
over Christmas dinner let’s talk about
why Martha has been such a problem
exactly exactly and role plays
um and all kinds of you know feedback uh
the whole time so it’s very powerful I
find it way more powerful
than individual therapy a lot of the
time yeah see what you’re saying and is
there anyone who it isn’t appropriate
for because I’ve always thought of it
well if you’re extroverted then this is
great but then there’s also the risk of
you have 20 people all trying to talk at
the same time which I realize is the
facilitation that you’re so well trained
in but right well we wouldn’t do a group
with 20 people we’d only do a group with
maybe eight something like that
um and there’s always kind of like
ground rules you know whatever stays in
the group stays in the group you know so
there’s no there’s confidentiality at
play here
but that doesn’t make sense though
because even with not to interrupt you
because I’m sure you’re about to say
something wise uh I want to think of it
as this is something for extroverts but
oh as introverts we’re uh people who are
interviewers are always reading these
articles about how you can express
yourself and I like the joke of like
well why isn’t there anything about
extrovert find them to shut up and
listen a little bit better
well introverts and extroverts you know
they there’s a misconception about them
I think so people who are extroverts get
recharged by being around other people
and that’s where they get their energy
from so when they’re wiped out it’s been
a hard day they want to go be with
people and hang out and talk and express
introverts get their regeneration from
being alone but that doesn’t mean they
don’t have social skills or they don’t
want to interact or they can’t
I’m when I take introversion
extroversion scales I’m at the way far
end of introversion in fact everybody in
my family is and when you walk into our
house like even the kids are studying or
reading or you know my husband and I are
doing research or something like that
we’re like quiet in our house
we’re you know it is not overwhelming to
be an introvert in a group and when
you’re an extrovert sometimes you know
people get overly extroverted and
talkative and stuff and so that’s fine
we just learned to work with that and
learn boundaries and all the kinds of
things that help us all get along
socially in the world and a lot of it
too is about Comfort if you’re an
introverted person you can be next to
someone and you’re both reading separate
books and you’re enjoying their company
they look exactly right it’s okay not to
talk it’s okay to be silent right yeah
and sometimes extroverts because I’m
pretty extroverted and I try hard not to
talk just to fill up space the knowledge
that you know what some silence would be
really a lot better than me prattling on
about nothing important so
that’s great
so the disadvantages uh since I’m always
a devil’s advocate it’s more fun to talk
about absolutely why group won’t work
than why it would be so wholesome and
helpful right uh you know if you have
people who are talking too much or
talking too little bringing that balance
but again it’s you said it’s a
facilitation and I think what you’re
also getting in touch with is that
um part of the reason it works is
because the group members are involved
in discussing problems or coming with
Solutions so it’s not this individual
just this affirmation for an hour that
you’re great you’re special go out there
and live your life it’s not coming
together and as a group of solving
problems and maybe I can’t relate
completely with one person’s issue but
in helping them think through it I’m
training my own brain to think through
the issues that I’m coming with I always
love that Saturday Night Live skit with
Stuart Smalley remember him like I’m
great and everybody’s okay and I like
this best and everybody likes me and
um that affirmation stuff is you know if
you can’t wrap your brain around what
you’re saying whatever affirmation
somebody gave you it’s not going to work
right and so rather than affirmations we
talk about reality based
characteristics abilities
affirmations aren’t really affirmations
a declaration of who I want to be who
I’m becoming you know and holding solid
to that right so you’re saying more of
here’s how we’re growing here’s what the
next step is and even if it is something
of hey here’s something I need to fix
like I’ve been reprimanded by people and
at first it’s always hard but it’s like
oh this is great like we have a
relationship where they feel they can
speak into my life right it’s sort of
how um and I think I’ve mentioned this
before uh I’ve had times in my life I’m
like this is great I don’t have any
friends that I have to help move or take
to the airport that really means I don’t
have any deep relationships in my life
right right I mean I’d help you move I
really would as long as it’s like for a
few hours and I get pizza afterwards I’d
pay you I think I think we’re at that
but there’s something to be said of
sometimes life can be going well but
it’s because we’ve removed all the harp
just because we just aren’t willing to
tolerate them and you’re saying that the
group therapy can help gain some of that
resilience again absolutely and and it’s
it’s not fluffy and it’s not often fun
and exciting it’s hard work it’s really
hard work to
uh get the motivation and to really
work at
discovering who you really are like in
Gestalt actually we say the more you
stay the same the more you change it’s
almost like the more you know yourself
the more you realize how how much is
available to you in in terms of your
characteristics and your abilities and
your strengths so you’re saying like as
you get rooted into who you are then you
have the capability to change because
every wind of life isn’t going to knock
you over that’s exactly right right and
you know uh in learning Gestalt therapy
we all had to go through Gestalt therapy
for quite a long time and
one of the things that I always try to
do is wipe out my anger my anger was
always an issue for me interestingly
because I look like a nice petite little
thing until I put a hole through my
therapist’s wall or until I don’t show
up to help you move
and so what I learned what I have
learned from Gestalt therapy is that
all of the pieces and parts of us are
valuable even the angry dark spaces
the more we get to know those angry and
difficult places that we want to avoid
the better we are able to utilize them
effectively in our life in an
appropriate way so it’s not about
lopping off something that you don’t
like about you it’s about getting to
know it really well and learning how to
make that meaningful and effective in
your own life so is it using negative
emotions as Clues like oh I’m angry let
me hold this up and find out why this so
deeply affected me
first of all anger is not a negative
emotion it’s just an emotion they’re not
bad or good so ask that again uh and
this is for my own therapy sorry again
for everyone watching it’s just about me
so are you saying that instead of
lopping off negative emotions and trying
to be positive instagrammy every day and
filter everything that when we have
those negative emotions we get to hold
it up of okay this is a deep emotion
what is this leading to why am I feeling
this what is this about for me what
strengths do I have that comes from that
anger I used to never be able to talk in
front of groups now I teach all the time
now I go out and lecture and you know
I’m on Zoom I’m doing shows like this uh
it used to scare me to death
so that fear
turned into a big strength for me
because I like a good challenge right
and so I had to find all those pieces of
me to make it work that makes sense like
I was always good at taking tests when I
was younger because I viewed it as okay
this is a challenge to prove myself if
instead it was oh I’m going to take the
ACT and if I don’t do a good job I won’t
get any scholarships then you’re going
to be you know coloring in all those
circles with anxiety and right your
brain’s going to try to survive the test
as opposed to trying to access those
deeper parts of your brain that can sort
through profound problems or yeah that’s
a good analogy yeah we’ll usually I use
that to explain the Kennedy United
Clinic that it’s sort of like
you know when you first are suffering
with depression it’s almost like you’re
trying to run away from a lion and
you’re also trying to do math yeah and
I’m not always sure which one we’re
removing the math or the lion but either
way life is easier to deal with which I
think is actually more important than
just removing a negative emotion because
then you’re fine until the next negative
emotion comes along right right
say that again for me I’m
curious yes it’s usually a problem with
me make up analogies on the spot so a
lot of times with either PTSD or any
debilitating issue depression anxiety
it’s almost like the double whammy of
it’s something difficult and complex
but it’s also triggering the part of us
that wants to run away or fight or Fawn
yeah yeah so it’s that combination that
makes it overwhelming yes right and like
you see that in movies too like oh I’ve
got to defuse this bomb before this
happens and in my line of work of
anesthesia that’s how we’re trained too
that I need to intubate this person
before they die so it’s the combination
of higher brain function and rudimentary
technique right and but for human beings
when we Face something that we’re afraid
of we naturally want to hide right we
would naturally want to get away from
something distressing
um but what we find is is that the more
that we do that the worst thing or gets
the worse the fear gets the more we run
away from it the bigger and badder it
gets and so in therapy we try to
we try to find parts of self that are
willing to stay with the fear stay with
the anger and confront the situation
um without running away
and that makes the trouble and the pain
way more manageable
does that make sense yeah so you look a
little confused oh no I’m trying to
think of it in physical terms since
again right so it’s almost as if some
patients if they have an autoimmune
disorder for example they’ll say I hate
this I I can’t wait to get rid of it and
sometimes it actually fuels the
autoimmune disorder because it’s in
themselves but you’re saying when we see
ourselves in these negative emotions
it’s almost self-sympathy where we can
like see ourselves instead of just
something to eradicate at any cost
right right yeah we judge ourselves yeah
right exactly and I think a lot of times
too that’s where therapy talk when it
goes into the mainstream gets confusing
because people hear oh I need to affirm
myself I need to tell myself that this
is great I’ve got to do what’s right for
me but that’s originally meant for
people who are depressed and maybe have
some self-loathing it’s not meant for
the majority of us High self-esteem
Americans who sometimes have too much
opinion of ourselves you know you go to
grocery line when someone thinks they’ve
been cut in line and you’ll see like
what a big deal it is yeah so
right but yeah yes so you were talking
when you were talking before I was I was
having a great thought and I went right
out of my head
so uh we were talking about holding up
different emotions we were talking about
how you see yourself in the fear or you
see yourself in the anger and you can
process it and it becomes part of you as
opposed to just lopping off that part of
the body yeah yeah you get the whole
rainbow not just the Cappy colors you
get the Indigo too and that makes it a
more full and complete rainbow you are
more full and complete when you have
ownership of everything that happens
inside of you rather than lap lopping
something off but that is
counter-cultural because especially in
Psychiatry uh a lot of the marketing is
you don’t have enough serotonin take
this drug or you’re feeling down all the
TV commercials you see the the sad
Zoloft cloud and it’s not saying you
need the full expression it’s oh we need
to get rid of the sadness at any cost
what you’re saying is let’s concentrate
on having the full rainbow of emotions
and resilience so we can have more ways
to cope with things and often
antidepressants uh like uh you know
Zoloft or effects or what have you
even the ketamine
helps people have the strength and the
tolerance and the endurance to get
through therapy and group therapy
because it’s really hard work it’s right
it’s really hard work and once the
person has experienced doing that like
we can’t just talk and say you know let
me tell you what it’s like to ride a
roller coaster and have you really
understand that right you have to really
experience it
um so once people have experienced that
in their life in person it changes
it changes everything yeah and this will
ruin the wisdom you just shared but
there’s an old joke where there’s two
groups of people in one group that is
told to mind that they’re on a roller
coaster and the other group is told all
these people are constipated so it’s a
great Riot because it’s just people
don’t like this but you’re right it’s
just something that we cannot explain
and when we try to interpret it so and
that is one reason for the group you
know a lot of our patients have gone
through ketamine therapy or
transcriptional magnetic stimulation or
even EMDR or good counseling that’s
radically changed them but then the
issue is well what do we do like what do
we do with the ability to get up in the
morning or the ability to do more and I
told you I went and talked to a place in
Columbus earlier today about ketamine
and I reminded them like well the
purpose is not so that these patients do
this bravado that insurance will pay for
that doesn’t cost them anything and then
now they’re getting higher scores on the
video game that they’re playing in the
basement all day like the purpose is we
have more brain capacity in how we can
make ourselves more useful right not
necessarily economically but just being
able to be in in communication with
others being in relationship with others
and be in relationship with self right
to be to have a good solid relationship
with yourself and be comfortable in your
own skin so then when I have
relationships with other people I’m not
worried about what if I say something
wrong or what if I do something wrong or
you know or if the boss says come on in
my office we’re not like biting our
nails immediately right
right and we can even the idea of
constructive criticism which is a lost
art we can take something that someone
says without being defensive immediately
or trying to excuse ourselves that’s
about helping each other it’s not about
judging each other right because I’m now
that our office is much larger I think
there’s about a dozen of us working
there that’s something I’ve had to work
on of a way I’m trying to explain why
I’m doing to everyone but it comes off
as defensive and sometimes it has to be
well here’s what we’re doing for now we
evaluate it and then go from there
that’s what I was going to say is is
that a lot of uh to a lot of issues
really have to be looked at in context
like coming into the office and talking
about something is different than living
through it right and and in a group
there’s a whole context there that kind
of mimics the outside world in many ways
like the group becomes a family kind of
so we can begin
to really
I can’t boy to really change things when
when things are seen more in context as
opposed to you know just sitting in an
so you’re saying it’s sort of like when
you go on a first date and it’s just the
two people they’re not really getting
any context you can go on several first
dates or you can have even interviews
with people I’ve done that before like
well that’s an amazing person and then I
hired them and then I realized nope no
they’re not no they’re not right
yeah so whenever when I was dating I
would try to my group of friends with
their group of friends because you can’t
be different when you’re with your
friends because they’ll be like hey Nick
why are you being normal we all know
you’re weird yeah
I know it’s supposed to be the opposite
of why you’re acting weird it’s supposed
to be normal but I’m I’m with the not
normal exactly yeah so you’re saying in
a group therapy it quickly helps so it’s
not this performative oh here’s how I’m
doing therapists and but it’s
immediately everyone becomes their self
because it’s a whole group yeah the
invitation is to be self and and really
it does kind of become a microcosm of
their world of everybody’s world and and
you can bring that in that that whole
outside world into the group and work it
with everybody else in the group and
it’s just the coolest thing it’s just
cool I love group so you’d all better
sign up for this group or having
otherwise I’m I’m signing up I already
told our all the employees like okay uh
we’re gonna open this up for our
patients for people who’ve never been
patients here but if they don’t come
it’s us we are totally doing that very
good that would be so fun so either way
because that is that is part of it like
we when we talked about this that was
our main uh decision that like this
sounds like it’ll be really fun to do
and in our culture sometimes we lose
that and you can tell you’ll go to a
doctor’s office you’ll go somewhere
you’re like oh nobody’s here because I
enjoy it right and and again even if you
come for kind of just personal growth
there’s some challenge to it and there’s
hard issues that will come out and
that’s wonderful that’s wonderful right
to get to know those issues that maybe
you didn’t know were hanging out in
there before and it does take some
sacrifice too like At first we’re
looking at doing this through insurance
and then we realize group therapy
through insurance it’s sort of like a
Groupon that may work or may not work
but it’s a whole lot of work right which
I’ve done those before it’s you know in
fact one time I went to I drove 40
minutes to a hospital cafeteria because
that’s where it turned out the Groupon
was from because I’m very stubborn I
went there both times to get my money’s
worth was literally driving 40 minutes
wow for cafeteria food for my 20 off wow
that shows you how I explain Insurance
to people right that’s how it works kind
of right
uh but it is starting on September 20th
until Thanksgiving uh it’ll be 50 a
session or 295 for all nine which I
think ends up being about 30 bucks each
cool and then I thought well we should
talk about this uh on the show because
that way people kind of know what
they’re getting into yeah yeah that’s
great the one last thing I wanted you to
explain is a lot of times when I’ve
heard about Gestalt therapists I nod and
smile but how is that different from
other types of therapy
you’ve probably heard the expression
um the whole is greater than the sum of
its parts right and so we all have Parts
in us
um our angry part are happy part or
student part or wild part whatever
and uh it’s Gestalt for me is about
learning about all of those different
parts of self and being able to be more
effective with them and now a lot of it
is body process too so in Gestalt I’ll
ask people where in their body they’re
experiencing something and will help
people actually to identify emotions by
the sensation and then putting a name to
it given the situation because a lot of
people don’t even know what they’re
feeling exactly
and research shows that once you
verbalize an emotion the intensity of
the emotion immediately drops right and
so even just identify it and expressing
getting to know these parts of self
um so I use a lot of my own
proprioception and my own physicality
and doing group that’s how we learn to
do this what’s happening in the
therapist and what does what does that
mean and am I what are you doing as the
client and what does that mean and we
work we work off of that right because I
skipped the part where I talk about how
you’ve taught it you know you’ve met and
all of your accomplishments and how you
basically taught most of the Akron
therapist about gusttal but I mean it
kind of goes without saying this is such
a prestigious show that we have here
actually I teach everybody about CBT
I I teach everybody in Ohio CBT for
so I am it with the academy I’m a I’m a
diplomat from the cognitive Academy of
cognitive therapy but I’m also an
advanced Gestalt therapist as well so
orientation wise I’m bipolar I guess but
it’s helpful because um it’s always
better to have more than one tool oh my
God because that’s why you’re like oh
this is exactly what’s going on with you
just because it’s what we know the best
so that’s all that we can see and oddly
they the two orientations FIT
beautifully together absolutely so so if
anyone wants to uh join you for group
therapy they can go on our website
Ascend they can call us
330-754-4844 we’re also on Facebook and
Instagram and YouTube which is typically
a poor way to find your way somewhere
but you know it’s fun if everyone has
their own way that they like to
communicate so oh and you can also text
us which is fun oh cool yeah that’s
right because I have a lot of patients
who are like do I really have to go
through this phone tree and press one
and so yeah you can text us it’s easier
yeah so well thanks very much for being
on the show well it’s a pleasure to be
here thanks for everything yeah now I
have to go coach soccer practice so I’ll
try to use everything I’ve learned today
there you go to help those six to eight
graders cool beans well thanks again for
coming on you bet Nick thanks
that was really helpful
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