Monday, January 6, 2020

The Elements of Self Care. 6 Things You Should BE Doing Everyday

The Elements of Self-Care: 6 Things You Need to Be Doing Every Day

Self-care is a term that is thrown about freely, but few understand what it really means. When I ask a client, “How do you take care of yourself?” I am often met with the look of a deer in headlights.  Answers can range from “I take bubble baths on occasion” to “I take a vacation to the beach once a year” or “Self-care? What do you mean? I don’t have time to take care of myself, I have too many other things to take care of.” Some clients have even stated that to them, self-care is equivalent to being self-indulgent or “selfish”. It is easy to put off taking care of yourself. I hear such things as “I am so tired after work (school, a day of taking care of the kids), I just don’t have time to do these things like I know I should.” The truth of the matter is, if we are not taking care of ourselves, we cannot effectively take care of our loved ones or the things we need and want to do. Many people I see and talk to, do not understand that self-care is an ongoing, interrelated, daily process, that if left unattended can affect all areas of health, mental as well as physical. Simply stated, self-care means to take care of one’s whole self in a way that contributes to overall health, functionality and well-being. In short, self-care is not optional.  

Over the course of my work as a Psychotherapist, 6 overlapping elements stand out as a foundation for overall mental and physical well-being. All 6 areas must be consistently attended to, and if neglected, will have a domino effect that will begin to affect the other aspects of health and happiness. 

A Healthy and Well-rounded Diet

Most of us know that “we are what we eat”, but did you know that what you eat on a regular basis can have an effect on mood? We don’t always follow through with making good food choices. It is easy to grab a meal on the go, forget to bring healthy snacks to work so we aren’t as tempted to eat whatever is available later, or become so busy that we wind up feeling “hangry” and then overindulge on junk food. Food plays a vital part in keeping our engine running and our mind clear and sharp, so it makes sense that it will have an effect on mood as well. If we are eating healthily, we will have more energy to get through the day and feel less sluggish and irritable later on. Sugar and caffeine will cause our energy to spike and then crash; heavy foods take longer to digest and therefore will make us feel slow. Don’t forget, hydration is also important. Not getting the nutrients and necessary liquids our body needs to run optimally will, over time, leave us feeling run down and susceptible to illness, and fatigue as well. 

It makes sense. If your body and brain are deprived of good-quality nutrition, consequences are to be expected. What’s interesting is that for many years, the medical field did not fully acknowledge the connection between mood and food. Essentially, we know now that the foods you eat affect how you feel. Nutritional psychiatry is a relatively new field, but what they are finding is that there are consequences between not only what you eat, how you feel, and how you ultimately behave, but also the kinds of bacteria that live in your gut. The gut brain connection is often overlooked as a contributor to anxiety and depression in particular. 
Serotonin is a neurotransmitter that helps regulate sleep and appetite, mediate moods, and inhibit pain. We know now that about 95% of the brain’s serotonin is produced in the gastrointestinal tract, which is lined with a hundred million nerve cells, or neurons. Neurons are partially responsible for guiding our emotions. These neurons are strongly influenced by the “good” bacteria that make up intestinal microbiome. This type of bacteria plays a very prominent role in good overall health, physical as well as mental. 
A good start would be to pay attention to how you feel after eating different foods, not just in the moment, but the next day as well.  Begin by consulting a nutritionist or researching nutritional articles about changing your lifestyle to include more whole foods, as well as fermented foods which are loaded with beneficial bacteria for the gut. When we are not eating properly, it may lead to other daily issues, such as less desire to be physically active and experience difficulty sleeping.     

Regular Exercise, Physical Activity and Time in Nature

If you've ever gone for a run, taken a walk or a yoga class after a stressful day, chances are you felt better afterward. There is a strong link between exercise and mood. 
Research repeatedly shows that regular exercise can help alleviate long-term depression.

According to further research, exercise can also be a tool for treating and preventing anxiety. The reasoning behind the research is that regular workouts might help people prone to anxiety become less likely to panic when they experience those fight-or-flight sensations. It makes sense, the body produces many of the same physical reactions in response to anxiety such as heavy perspiration and increased heart rate. In 2008 a study was conducted with 60 volunteers who reported experiencing heightened sensitivity to anxiety. The participants underwent a two-week exercise program. The results showed significant improvements in anxiety sensitivity compared with a control group.  Through regular exposure, the researchers concluded that people learn to associate the symptoms of anxiety with safety instead of danger.

For those who struggle with chronic depression, some researchers believe exercise alleviates symptoms by increasing serotonin (the neurotransmitter targeted by antidepressants) and brain-derived neurotrophic factors (which supports the growth of neurons). Another theory suggests exercise helps by normalizing sleep, which is known to have protective effects on the brain.

Psychological explanations also help us understand why exercise is so important. Exercise may boost a depressed person's outlook by helping him return to meaningful activity and providing a sense of accomplishment. Exercise may also be a way of physically strengthening the brain so that stress has less of a central impact. In addition, the extra oxygen produced while exercising increases blood flow to the brain, rendering it healthier. 

Physical activity when combined with time in nature has double the impact of simply going to the gym. Studies indicate that virtually any form of immersion in the natural world, heightens overall well-being, as well as more positive engagement with the larger human community. Spending time in nature and practicing mindfulness by simply being present, conscious in the moment, observing the flow of your mental and emotional activity; but not being pulled into it. That conscious “now” allows for greater inner calm, clearer judgment, and it enables more focused, creative responses to everyday life.
A study published in the Journal of Positive Psychology examined the specific effect of immersion in nature upon the overall sense of well-being of the participants.  The researchers divided volunteers into three different groups. For one group, immersion in nature was defined as “taking time to engage in some form of connection with the natural world”. That included not just walking in nature, but also observing anything not manmade, such as a houseplant, a flower growing in a crack in a sidewalk, birds, or sun through a window. Another study specifically, found that people who walked for 90 minutes in a natural area, as opposed to participants who walked in a high-traffic urban setting, showed decreased activity in a region of the brain associated with a key factor in depression. The results of both studies suggest that accessible natural areas may be vital for mental health in our rapidly urbanizing world. The findings of each research study showed that we don’t have spend hours outdoors or going on a hiking or camping trip, but simply paying attention to the positive aspects of nature in any form can influence the human mind.

Enough Good Quality Sleep and Rest

We all know that sluggish feeling we have when we don’t get a good night’s sleep. Numerous studies have been done to research the effects of sleep on the mind and body. When people are sleep deprived, they usually feel more irritableangry and hostile. Sleep loss is also associated with feeling more depressed and anxious. In addition, sleep deprivation seems to be associated with greater emotional reactivity. People who suffer from sleep loss are especially likely to react negatively when something doesn’t go well for them. Some research suggests that sleep deprivation enhances negative mood due to increased amygdala activity (a brain structure integral to experiences of negative emotions such anger, fear, anxiety). Sleep loss leads to increased negative mood, and decreased ability to regulate emotions. One of the jobs of sleep is to clear out the “junk” from the brain. Our brain fluctuates between sleep states throughout the night. However, if we do not get to the proper sleep brainwave pattern for long enough (a few hours at least) our brain cannot do its nightly housekeeping.  
We live in a go, go, go society so taking the time to rest our brain and our body is a challenge for many. Not to mention, those who struggle with anxiety, depression or trauma may struggle with sleep in general. It is important to ensure that we are getting the right amount and type of rest, which includes not only sleep, but down time to enjoy quiet activities and connecting with our loved ones as well.  

Good sleep influences a good moodThere is more research however on sleep and negative mood. Researchers have found that people who are more sleep deprived, report feeling less friendly, elated, empathic, and report a generally lower positive mood. Sleep deprivation also seems to put a damper on people’s ability to reap the emotional benefits of a positive experience. In one study, people who were more sleep deprived did not report increased positive affect after an achievement, whereas people who’d had an adequate amount of sleep did feel better after their achievement. Sleep is designed to cleanse and reset the brain and body overnight. Lack of good quality sleeps allows the brain to accumulate and buildup of neurological “plaque” that can lead to increased anxiety, depression and anger. It also creates a foggy brain that can hamper memory, reactivity to danger and appetite. We need to ensure that our brain reaches the sleep state each night when we sleep. Often if we are not eating well or not getting the right amount of activity, sleep often suffers, thus creating an unhealthy cycle. If you find that sleep is an issue for you be sure to talk to your doctor, however several phone apps are available that can assist with occasional sleep issues via ambient sound, relaxation techniques and sleep tracking.  

Feeling a Sense of Meaning and Purpose

Meaning and purpose in life can be described as a sense of physical and mental well-being, as well as belonging and recognition through personally treasured activities. These activities are often things you do that make you feel that what you are doing matters and time sometimes seems to stand still. Other elements of meaning purpose can include a felt spiritual closeness and connectedness, connecting with others, a valued hobby. 
Meaning and purpose implies such big questions as, “Why am I here?” For the most part, we want to think that something that we do mattersSeeking happiness for purely happiness' sake can be fleeting and disappointing.  Having meaning and purpose in life is a factor that leads to ongoing happiness.  While purpose and happiness are different concepts, feeling a sense of meaning in your life can be an important factor in experiencing long term happiness and well-being. The concept of happiness changes as we age.  When we are younger, we associate happiness with excitement, but as we age and have more experience with life, we begin to associate happiness with peace. Shifting our focus from the future to the present and walking mindfully through the world can help us experience more of this peace. 
Those who have experienced long term job loss, disability or retirement report higher levels of depression and anxiety, unless they fill their time with a sense of purpose and meaning, whether through a hobby, volunteer work, or some other meaningful endeavor. For example, during the economic downturn in 2008 when unemployment rates at an all-time high, those who were experiencing long term unemployment were vulnerable to depression, anxiety and suicides. This may be common sense in reference to the above scenarios, but many who are gainfully employed need to feel a sense of purpose and meaning as well. Having a job does not necessarily equate to a sense of fulfillment. However, finding fulfillment in life can be established through meaningful work, hobbies, volunteer work, family or community involvement.  Finding a sense of meaning and purpose in life is shown to reduce suicidal thoughts and depressive symptoms in older adults and all across the age spectrum. When we feel a sense of meaning, we are more likely to do the other things that make us an overall healthier person and our perspective of our life is more likely to reflect a more positive outlook. 

Good Social Connections and Support. Being a Part of a Community
Social support refers to the psychological and material resources provided by a social network that are intended to help individual's cope with stress and it can come in different forms. Sometimes it might involve a group of people who do regular activities together, or it could simply be people you value and talk to or see regularly. In other instances, it could simply be helping someone, giving advice to a friend when they are facing a difficult situation or providing caring, empathy, and concern for loved ones. Whatever the situation, social connectedness is something we are wired for. Loneliness on the other hand, is a phenomenon that is well documented to have a negative effect on the mind, body and spirit. 
Social connectedness is often identified as an important component of solid relationships and strong mental and physical health. Essentially, healthy social support involves having a network of family, friends and community that you can turn to in times of need. Whether you are facing a personal crisis and need immediate assistance or just want to spend time with people who care about you, these relationships play a critical role in how you function in your day to day life. Keep in mind that social support is certainly not a one-way street. In addition to relying on others, keep in mind that you also serve as a form of support for many people in your life. In addition, we need to feel a sense of belonging, feeling valued and validated, and feeling like others "get" you.  When trying to reach our goals or deal with a crisis, experts frequently implore people to lean on their friends and family for support. On the other hand, poor social support and loneliness has been linked to depression. Among other things loneliness is shown to increase the risk of depression, suicide, alcohol use, cardiovascular disease, and altered brain function, including dementia. In one study of middle-aged men over a seven-year period, those with strong social and emotional support were less likely to die than those who lacked such relationships.
Researcher Sheldon Cohen of Carnegie Mellon University suggests that there are two essential aspects of our social worlds that contribute to health: social support and social integration. Social integration is the active participation in a variety of social relationships, ranging from romantic partnerships to friendships. This integration involves emotions, intimacy, and a sense of belonging to different social groups, such as being part of a family, a partnership, a social activity, or a religious community. The research suggests that being integrated into these types of social relationships creates a protective benefit against unhealthy behaviors and consequences. By having a solid social support network, you are more likely to receive the type of support that you need when you really need it. According to Cohen social support generally comes in 3 ways: emotional support, instrumental support and informational support.  Emotional support can be a good friend, family member, clergy members or therapist. Instrumental support are those who take care of your physical needs and offer a helping hand when you need it. Informational support is usually someone who provides guidance, advice, information, and mentoring. 
Another benefit to being more social is that it can encourage healthy choices and behaviors. As the old saying goes, “birds of a feather flock together.” Participation in social groups has what Psychology and Sociology call “a normative influence” on behaviors, which often influences whether people eat a healthy diet, exercise, smoke, drink, or use illegal substances. On the other side of this, social groups can sometimes have a negative influence when peer pressure and influence leads to poor or even dangerous health choices. In the best sense however, group pressure and support can also lead people to engage in healthier behaviors. 
Social support also helps people cope better with stress and fend off loneliness. Excess stress has been shown to have serious health consequences ranging from reduced immunity to increased risk of heart disease and dementia. Loneliness is showing to be a growing factor in our society. In 2018 Cigna health insurance surveyed more than 20,000 adults, where concerning facts about loneliness in our society came to light. Nearly half of Americans report sometimes or always feeling alone. One in four Americans rarely or never feel as though there are people who really understand them. Two in five Americans sometimes or always feel that their relationships are not meaningful and that they are isolated from others. One in five people report they rarely or never feel close to people or feel like there are people they can talk to. Americans who live with others are less likely to be lonely compared to those who live alone. Interestingly, this does not apply to single parents/guardians, even though they live with children, they are more likely to be lonely. Only around half of Americans have meaningful in-person social interactions, such as having an extended conversation with a friend or spending quality time with family, on a daily basis. Generation Z (adults ages 18-22) is the loneliest generation and claims to be in worse health than older generations. Social media use however is not a predictor of loneliness; respondents defined as very heavy users of social media have a loneliness score that is not markedly different from the score of those who never use social media. The survey also revealed some important helpful food for thought. The findings reinforce the social nature of humans and the importance of having communities. People who are less lonely are more likely to have regular, meaningful, in-person interactions. More specifically, the survey showed people who engage in frequent, meaningful, in-person interactions have much lower loneliness scores and report better overall health than those who rarely interact with others face-to-face.
Being surrounded by people who are caring and supportive helps people to see themselves as better capable of dealing with the stresses that life brings. Research has also shown that having strong social support in times of crisis can help reduce the consequences of trauma-induced disorders including PTSD.

An Active Spiritual Life

Spirituality can play an important role in helping people maintain good mental health and live with or recover from mental health problems. Those who struggle with substance abuse and addiction overwhelming report that along with good social support, a strong spiritual connection is the key to recovery.  
Spirituality means different things to different people. People express their spirituality in a variety of ways. Spirituality may be a religion or faith, or it may simply describe meaning and direction in life. Sometimes spirituality is described as a personal 'journey', a way of understanding the world and our place in it, for others it is a belief in a higher being or a force greater than any individual and is often a core part of personal identity. Spirituality can also be a feeling of belonging, connectedness or interconnectedness, a quest for wholeness, hope or harmony. Ultimately, spirituality is usually described as a sense that there is more to life than material things. Spirituality as far as we know, is unique to human beings, and is an important aspect to being human and finding fulfillment in life. 
People who are active members of a spiritual community are more likely to describe themselves as “very happy” than those without strong religious ties. Keep in. mind however, that going to religious services is not directly responsible for improving people’s lives. It is more likely that certain kinds of people tend to be active in multiple types of activities, which may provide physical or psychological benefits. People who are overall more active tend to be happier and healthier.  
Spirituality can help people maintain good mental health. It can help us cope with everyday stress and can keep us grounded and resilient. Spiritual communities can also provide valuable support and friendship. There is some evidence of links between spirituality and improvements in people's mental health. Because of the foundation that spirituality plays in our lives, one red flag to depression is a loss of interest in activities, such as anything connected to spirituality or religion. Spirituality can bring a feeling of being connected to something bigger than yourself and it can provide a way of coping because it can help people make sense of what they are experiencing and feel grounded. Those with a spiritual orientation exhibited less physiological reactivity toward stress and expressed greater feelings of overall well-being.
People report that they feel comforted using spirituality as a coping mechanism for stress. Spiritual involvement, along with the gratitude that can accompany spirituality, can be a buffer against stress and is linked to greater levels of physical health. translated into less stress reactivity, greater feelings of well-being, and ultimately even a decreased fear of death. Prayer, meditation and spiritual practices have been linked to better overall health, less hypertension less stress, more positive feelings, less depression, greater psychological well-being, increased ability to handle stress
Self-care comes in many forms, and holds different meanings depending on your lifestyle and values, however the 6 elements as described here are the fundamental basics for the day to day. By attending to your diet, getting enough sleep and rest, staying active and spending time in nature, having good social support, feeling a sense of meaning and purpose and maintaining a strong spiritual life, you will begin to notice that managing ongoing stresses and maintaining a healthy attitude is a whole lot easier. We all need a break or a relaxing vacation from time to time, but if we aren’t attending to our day to day wellness, sooner or later we will be forced to attend to our illness. 

Lisa King, Ed.S., LPC, CPCS, CCTP is a Licensed Psychotherapist in private practice in Carrollton, GA. She is a graduate of the University of West Georgia’s Psychology and Counselor Education programs. Her specialties include anxiety, depression, substance abuse, life transitions, trauma and self-harm. Lisa is a Certified Professional Counselor Supervisor and a Certified Clinical Trauma Professional. She has been on the Board of Directors for the Licensed Professional Counselors Association of GA (LPCA-GA) since 2012. She is the 2018-19 President of LPCA-GA. Visit to find out more about Lisa and her work. 


Monday, September 10, 2018

The Space in Between: How Developing Neutral Thinking Can Bring Us More Contentment 

By Lisa King, Ed.S, LPC, CPCS, CCTP

When we are not “happy” most often we think something must be wrong. Our minds will race and wander, churning up thoughts that ultimately push us toward thinking negatively. Alas, this mentality leaves little room for what lies in the middle. The space between happiness and sorrow, joy and pain. This is our neutral space. Feeling neutral, okay or just fine is undervalued in our society. Remaining neutral or turning a negative thought into one that is neutral, seems foreign to many. “Think happy thoughts” we are told. “Be more positive”, they say. However, this approach is inauthentic because it is not very realistic. Going from negative to positive is a big leap, but going from negative to neutral is more attainable. If we can turn our mindset to the space in between, we are much more likely to find contentment, peace and perhaps even positivity. I frequently remind clients that every occurrence is neutral, until we put meaning and emotion to it. Our life experience, spiritual perspective, temperament, and health will inevitably shape our emotions. Even the weather, current season, or time of day can determine the meaning we obtain. A tornado can be terrifying to someone in its path, exhilarating to a storm chaser or simply a “weather event” to a meteorologist. 

Our thoughts really do help create our reality. 
According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental health struggles in the United States, affecting 18% or approximately 40 million adults. Although anxiety disorders are very treatable, only 36% of those diagnosed actually get treatment. Many who struggle with anxiety disorder also battle depression. Given enough time to ourselves we are more likely to think ourselves into a funk or a high-speed worst-case scenario thought train. Consciously bringing our thoughts back to center can help maintain a more even keeled mindset, and we are then less likely to become anxious or depressed. Neutral thoughts can effectively help us manage symptoms of depression and anxiety. 

Pay attention to your thoughts. 
We have a running dialogue in our mind all day long. While we cannot always control the thoughts that come up, we can control what we do with those thoughts. “Are my thoughts mostly negative?” Many would say yes. Intentionally tracking your thoughts, and then turning those negative thoughts to something more neutral is the goal. For example, if the thought that arises is, “I always make dumb decisions”, the neutral thought might be “I didn’t think this through very well” or “I made a mistake this time, but I can learn from it”. Our inner dialogue and negative thinking are habits. In order to change a habit, we must be intentional about making small changes that we can consistently adhere to.  From this neutral space you will find it much easier to maintain what the Buddhists call equanimity and have the ability to work from a space of possibility instead of limitations. When we limit ourselves to only happy or some form of not happy, we close off the opportunity to flow through a state of balance, compassion and peace. 

Paths to the space in between
How do I cultivate a more neutral mindset? As mentioned earlier, tracking your thoughts and consciously making an effort to reframe those thoughts into something more neutral is an effective way to find this middle space. Research also indicates that the ancient practice of mindfulness meditation prayer can also be highly beneficial in creating a calmer, more centered mindset. Studies have shown that mindfulness meditation can assist with an array of conditions both physical and mental. Research done with functional MRI’s show that the brain actually changes its activity in the amygdala, where our fight or flight instincts stem from, when subjects regularly used mindfulness meditation. Before and after MRI scans of the research subjects showed a significant reduction in activity in this area of the brain after 8 weeks of mindfulness meditation training. To begin to practice mindfulness meditation, start by sitting quietly and focusing on your body. Pay attention to the feelings that arise, be curious about those feelings without attaching to them. Next allow your thoughts to come up, but again, don’t attach to them, allow them to be what they are. Some people find it helpful to incorporate a visualization of their thoughts such as clouds passing by, waves in the ocean, or bubbles popping. All of this sounds much easier than it is for most of us. Practice and consistency are the key. There is also a variety of mobile apps and Bluetooth wellness devices available to assist with learning and practicing mindfulness meditation, as well as some that also help track heart rate, deep breathing, focus and relaxation.  

Neutral is not apathy, it is openness. 
Not attaching to an emotion, thought, situation, outcome, or mood, and maintaining some sense of neutral will allow us the space to reflect and respond more appropriately. It is normal to think and feel when things happen. It is what you DO with those thoughts and feelings that matter. Don’t try to put a happy face on a sad day. When we resist things, we wind up making them bigger. Detachment or non-attachment is simply letting go of our outcomes and expectations. By being selective about using emotion energy we are better able to make choices that will bring us a better sense of inner peace. Some things we cannot control. Accepting what we cannot control and paying attention to what we can will make a big difference in finding a more neutral attitude. Letting go does not mean we don’t care, it is simply realizing that we only have control over so much. Remembering that everything is temporary, including emotions, will help free us from the prison of whimsical thoughts and feelings. Thoughts, feelings and emotions are like passing clouds or cars on the highway. Deciding to find a place in the middle will help us find more joy and feel less pressure to “be happy.”      

Lisa King, Ed.S., LPC, CPCS, CCTPis a Licensed Psychotherapist in private practice in Carrollton, GA. She is a graduate of the University of West Georgia’s Psychology and Counselor Education programs. Her specialties include anxiety, depression, substance abuse, life transitions, trauma and self-harm. Lisa is a Certified Professional Counselor Supervisor and a Certified Clinical Trauma Professional. She has been on the Board of Directors for the Licensed Professional Counselors Association of GA (LPCA-GA) since 2012. She is the current President of LPCA-GA for the 2018-19 term. Visit www.csosolutions.netto find out more about Lisa and her work. 

Monday, July 11, 2016

Happiness vs. Joy: Finding Gratitude During Stressful Times

July 7, 2016

Could striving for happiness actually be making us less happy in the long run?

We spend a lot of our time working toward things that we think will make us happy: pursuing a better-paying job, searching for an ideal spouse, saving up for that dream trip to Europe or a number of other experiences and material objects.

However, once we achieve those things, the feeling of happiness we experience is often short-lived, and not as satisfying as we expected.

Even winning the lottery, something nearly everyone has fantasized about at one point or another, will not make you as happy as you might think. A classic 1978 experiment by researchers at Northwestern University and the University of Massachusetts asked people of two very different groups, recent lottery winners and recent victims of catastrophic accidents, to rate the level of pleasure they received from simple, yet enjoyable moments in life such as receiving a compliment or laughing at a joke. Surprisingly, both sets of people reported similar levels of happiness, with the paraplegic accident victims actually reporting slightly higher levels of happiness.

Sure, the lottery winners probably experienced very high levels of happiness when they first heard their winning numbers announced, but happiness, like all human emotions, is temporary and eventually fades away.

Some psychologists have attributed this phenomenon to something called hedonistic adaptation, which suggests that everyone has their own individual baseline level of happiness. When something good or exciting happens, our happiness level increases, but only for a short time before reverting back to our baseline. It’s why we have a tendency to get tired of things that once made us happy, such as a new house or car, and desire to reach that same level of happiness again, by moving to an even bigger house or buying an even newer car.

This pursuit of happiness is like being stuck in a hamster wheel. We’re constantly moving toward the next thing that will make us happy and never actually reaching a place where we can stop moving and say “I’ve made it! I’m happy!”

That’s exactly why we should stop striving for happiness and strive for joy instead.

What’s the difference between happiness and joy?

Though they seem similar, there are some profound differences between these concepts. Perhaps the most significant difference between the two feelings is where they come from. Happiness is external. It is brought on by outside experiences, worldly pleasures, material objects, etc. Joy, on the other hand, is internal. It’s a state of mind. Joy has elements of many pleasant feelings, including happiness, but also contentment, hope and peace. Joy is happiness on a much deeper and more meaningful level. While happiness brings a smile to the face, joy brings warmth to the heart.

Imagine coming into a large sum of money by chance, such as winning the lottery. How would you feel? Probably pretty happy! Now imagine that you just earned that same amount of money after working hard to start your own business doing what you love. You would feel joy. The end result is the same (the money), but it’s the way you get there that determines the final emotion you experience.

As mentioned earlier, happiness is a temporary emotion, whereas joy tends to last much longer and have a deeper impact. You are likely to remember moments of joy more vividly than moments of happiness. A delicious meal at a restaurant will make you happy, but having the exact same meal prepared for you at home by someone very special to you will bring you joy, and you would likely remember the moment for much longer.

Joy does not always come from our own experiences, but the positive experiences of others as well. Seeing your child smile and laugh for the first time, or hearing a loved one’s exciting news would likely bring you a great sense of joy. That’s one of the best things about joy: it can be shared, and often becomes more powerful when shared with another.

How do we find joy during difficult times?

Life doesn’t always seem sunny and bright. There will inevitably be stormy days, and happiness is not always present amidst these life “storms” but joy can be.

So what’s the key to finding joy in less than ideal circumstances? Practicing gratitude.

Sometimes being joyful means committing to having a positive outlook on life and an appreciation for the moment, despite the circumstances. Making a conscious effort to focus on what you have to be grateful for in life instead of what’s going wrong can actually increase that baseline level of happiness mentioned earlier and bring feelings of lasting joy.

Next time you’re stressed or unhappy with something in your life, stop and take a moment to think of three things you’re grateful for. Too often, we take things like health, a home, employment, family or friends for granted and neglect to appreciate them when they matter most. In order to find joy in the midst of a life storm, it’s important not to lose sight of the many great things we have going for us.

Even take a moment to be grateful for the challenges you are facing because every challenge is a lesson that will allow you to grow. It can be difficult, but try to see challenges as opportunities to learn and build a better life.

Practicing gratitude can help you live a more joyful life even when you aren’t going through difficult times. It’s easy to get jealous of what our peers have, especially in today’s social media age when we are constantly scrolling through streams of other people’s accomplishments. Remember that what you see on Instagram or Facebook is just the highlight reel of other people’s lives. You don’t know what challenges your neighbor who’s posting beautiful photos from her Caribbean cruise could be facing behind the scenes. There will always be those who have more than us, but it’s important to remember that there will also always be those who have less.

How can we practice gratitude in our daily lives?

Start by practicing interior gratitude, which is the act of giving thanks internally. Make mental notes about small things you’re grateful for throughout the day and try to find things to be grateful for even in annoying or less than ideal circumstances. For example, you may think “I really don’t want to go to the DMV to renew my car registration, but I’m grateful to have a car and to be healthy enough to drive it.”

Some people find that keeping a gratitude journal helps them stay positive and increases feelings of joy over time. Not only does this give you a chance to routinely acknowledge things you are grateful for, but you will have a collection of these things to look back on when you are feeling stressed or unhappy.

Next, move on to exterior gratitude, or the act of giving thanks publicly. Take time to let your loved ones, friends and colleagues know that you are thankful for them and the impact they have on your life. Even go out of your way to thank someone you may see regularly but not normally speak to, such as your mail carrier, your doorman or the custodian that cleans your office building. Not only is expressing your gratitude for others good for your own well-being, you may bring unexpected joy to someone else’s life too!

Final thoughts:

Just because happiness is a temporary emotion doesn’t mean we shouldn’t still pursue it. Doing the things that make us happy can help us live more joyful and fulfilling lives. We should always be celebrating the moments in life that make us happy, even the small ones that may not be as profound as our big moments of joy. What’s important is not letting happiness become our ultimate goal, because we will only get stuck in the hamster wheel. Instead, we should strive to practice gratitude as often as we can, so that our outlook on life is one of positivity and joy.

Breaking the Anxiety Habit

June 30, 2016

It’s no secret that people are more anxious now than ever before. Reported levels of anxiety have been steadily on the rise since the end of World War II, and today, anxiety disorders make up the most prevalent mental health disorders worldwide, affecting about 40 million adults age 18 and above in the United States and 1 in 8 children.

That’s 18% of the population that suffers from one or more of the many disorders that fall under the umbrella of anxiety, including generalized anxiety disorder, social anxiety disorder, panic disorder, obsessive-compulsive disorder and specific phobias.

Women are twice as likely as men to develop an anxiety disorder, and anxiety disorders often set it much earlier for women than men.

The good news is that anxiety is highly treatable, however, only about one-third of those who suffer from it seek and receive treatment. While the severity of anxiety levels can vary quite a bit from person to person, and more debilitating cases require medication and professional treatment, there are a number of ways we can manage general symptoms of anxiety on our own.

We can manage our anxiety, but it’s a process, and an important part of that process is understanding why we get anxious and where our anxiety is coming from.

So why do we get anxious anyway?

As humans, our brains are wired to look for what we are missing in our environment. It’s a basic survival instinct. Think of the earliest humans, the hunter-gatherers who constantly had to be aware of what the next thing they needed for survival was, whether that was food, water or shelter.

The physical symptoms of anxiety we experience stem from this same survival instinct. When we encounter a threat, real or perceived, a part of our brain called the amygdala starts releasing stress hormones (adrenaline and cortisol), triggering the familiar fight-or-flight response: increased heart rate, quickness of breath and tense muscles. In women, this response is triggered more readily and stays active longer than in men, which is part of the reason women are more prone to anxiety problems.

When we really are faced with danger, this response is a good thing; it helps us get out of harm’s way or defend ourselves. Even in non-life-threatening situations, these hormones can actually help us perform better and improve our lives. A big job interview or presentation may have our stomach in knots, but the instinct to protect ourselves motivates us to prepare, and the adrenaline rush can give us the energy we need to perform under stressful circumstances.

But too much of these hormones can have negative effects on our bodies, such as higher blood pressure, sleep problems, appetite problems, difficulty concentrating, weight gain and even stroke.

Even though this fight-or-flight instinct is critical for survival, sometimes our brains can get stuck in this place of searching for what is missing and worrying even when we aren’t in immediate danger. This way of thinking becomes a habit we don’t even realize we are developing until we are already so comfortable with it that it can almost seem scary and unfamiliar not to be in a place of constantly thinking about what needs to happen, what could happen or what’s next.

We’ve essentially tricked our bodies into thinking we are in danger when we aren’t, and that’s when anxiety becomes a bigger problem.

How can we manage anxiety?

The key to managing anxiety involves changing our thinking patterns by challenging negative thoughts and training our brains to tone down that automatic fight-or-flight response and evaluate if the feelings of danger we are experiencing are serious or not.

It sounds difficult, and it can be, but it is possible with practice. Just as our brains have trained our bodies to be hungry or sleepy at certain times of the day, we can train ourselves to be less anxious.

Start by challenging negative thoughts and worries. Asking yourself questions can help put thoughts and situations into perspective and calm the mind. Next time you’re worried about something, ask yourself:

  • “What is my evidence for thinking that this could actually happen?”
  • “What can I do to find out if my thoughts are true?”
  • “Is there another way of looking at this situation?”
  • “Is there anything positive about this situation?”
  • “Will this matter a year from now?”
  • “Is this a productive thought?”
  • “Is thinking this way helping me achieve my goals?”

When we stop to question our thoughts, it not only gives us a sense of control over our thinking when we are feeling anxious, it also gives us the opportunity to step back and really reflect on the way we are thinking to identify where in our thought processes we can make changes to prevent these anxious thoughts from getting out of hand in the future.

Because a large part of anxiety involves trying to control things we can’t, and getting lost in infinite “what ifs?” another technique that can help is mindfulness. Practicing mindfulness can help us be present in the here and now and remind us that all we really can control is how we are handling this exact moment in time.

A popular and helpful exercise used to practice mindfulness is called grounding, which is done by taking a few deep breaths (inhaling through the nose and exhaling through the mouth) and identifying three things you can see, hear, smell and touch in your environment. Taking a moment to consciously identify these external things and be aware of our physical senses can help bring us out of our heads and back into the present moment.

Of course, we can’t rewire our brains overnight; these techniques have to be practiced and repeated often before they can become a good habit that replaces the harmful habit of anxious thinking that we have developed.

Along with these mental exercises, physical exercise has also been shown to improve anxiety levels and help with stress management. Regular exercise’s benefits to the body are well-known, but it also benefits the brain by improving cognition, concentration, alertness and mood.

Vigorous exercise also improves our ability to sleep well, which is another very important part of anxiety management. Trouble falling asleep (and staying asleep) is one of the most common anxiety-related problems, yet not getting enough sleep actually makes anxiety worse, creating a vicious cycle.

Setting and sticking to a relaxing bedtime ritual can help with sleep consistency. Avoid watching TV (that includes Netflix!) half an hour before bedtime to give the brain sufficient time to wind down before sleep. Watching the news or violent programming too close to bedtime only worsens anxiety and makes it harder to slow down a racing mind.

As attached as we are to our smartphones, staring at our screens too close to bedtime can also cause sleeping problems. Smartphone screens emit bright blue light which can interfere with the brain’s ability to make melatonin, the important hormone that lets our bodies know when it’s time to sleep. iPhone users should take advantage of a new feature called Night Shift that when enabled, automatically shifts the screen’s color temperature to a yellowish hue, which is more soothing on the eyes and brain.

Get into the habit of asking yourself “what am I doing to take care of me?” Whatever the answer is, whether it’s taking the time to read, daily meditation or long walks, do more of it. Self-care is a critical step toward taking control of anxiety.

What if there is a bigger problem?

Although many people who suffer from mild to moderate anxiety are able to function in social and professional situations, those who find that their anxiety is preventing them from performing simple daily activities should seek professional treatment, which may include medication.

Anxiety disorders are highly treatable, and seeking help is key to taking charge of your mental health and moving forward with your life. It may seem scary or intimidating to seek help, especially if you’ve never had experience with any sort of therapy or counseling before. Doing some research about treatment methods and knowing what your options are may help you feel more empowered. The Anxiety and Depression Association of America is a great online resource for learning about treatment options and even finding a therapist nearby.

None of the techniques mentioned in this article are 100% effective and they cannot replace professional treatment for those suffering from severe anxiety disorders. It is important to understand that everyone’s anxiety is different and not everyone responds to treatment in the same way or in the same amount of time.

Final thoughts:

Unlike illnesses such as the flu or pneumonia, anxiety can’t be completely eradicated. There is no true cure for anxiety, only methods designed to alleviate symptoms and techniques to keep it under control. Anxiety is very manageable, but because of the way the human brain is designed, it can never completely go away.

Simply being able to identify what triggers your anxiety and being aware of what physical symptoms you may experience before an anxiety attack can go a long way in preventing anxious thoughts from escalating into full-fledged panic attacks. The sooner you can recognize that an attack is coming, the sooner you can take measures to prevent it.

Stress is a part of life, and some anxiety is inevitable, but knowing how to manage those feelings and keep them from becoming a habit of thinking will help you stay in control of your thoughts and handle whatever life throws at you in the future. Remember that you have the power to take control of your anxiety and that you aren’t alone in your fight for peace of mind.

Sunday, August 17, 2014

Relationships & The Task of Looking Within

“I see when men love  women. They give them but a little of their lives. But women when they love give everything. “  ~Oscar Wilde

“When you have once seen the glow of happiness on the face of a beloved person, you know that a man can have no vocation but to awaken that light on the faces surrounding him. In the depth of winter, I finally learned that within me there lay an invincible summer.”  ~ Albert Camus

"We are never so vulnerable as when we love." ~ Sigmund Freud

Being in a private practice under the direction of a Licensed Marriage and Family Therapist, I am referred my fair share of couples to work with. I have to admit, I have disliked couple’s counseling right from the start. Initially doing couples counseling begged the question "How in the world am I going to be a helpful and effective counselor to struggling couples, when I myself have a poor track record and don't even have a decent relationship of my own?" As a therapist, who encourages my clients toward growth, I had to take my own medicine and ask myself this question,“ Why do I dislike this so much? What is my aversion trying to tell me about myself? How can I grow from this?”

As part of my own questions about couple’s counseling, and relative lack of experience in doing it, I began to seek out resources to help me do it better and with a little more confidence.  Love Sense: The Revolutionary New Science of Romantic Relationships by Dr. Sue Johnson is a book focusing on how attachment theory plays into our romantic relationships. I am intensely interested in attachment, and found this a great place to start. Dr. Johnson is also the originator of Emotionally Focused Therapy, an attachment based relationship therapy.  The next book I read focused on a more Jungian approach, The Art of Love the Craft of Relationship by Dr. Bud Harris. In this book, Dr. Harris and his wife Massimilla weave in the myth of Eros and Psyche, with the stories of 4 couples, while blending in the Myers Briggs personality typology.  I have read other books focused on maintaining healthy relationships and healing those that are falling apart, but so far I found these 2 books to be the most helpful for me, and more in line with my style of counseling.  With time I am becoming better at couple’s counseling, and at the same time, I am becoming better at understanding a more well-rounded view of what makes a healthy relationship. Yet, I still find myself dreading the sessions on some level, to the point that I sometimes feel a little anxious about them. I have to wonder why. I think it goes back to my own sense of failure in relationships and that was a tough one to admit. I have lately spent some time thinking and writing about my experience in relationship and have slightly withdrawn into my head a little more than usual in order to wrestle with this. An event about a year ago which popped back up about 3 months ago also triggered something within me I hadn't known was there, and had me thinking about this as well. As a therapist, I have to constantly work on myself in order to be better at what I do, the same is true in long term romantic partnerships.

I want to try to keep my self disclosure relevant, so I will try to keep it short. Counseling anyone can bring up any issues that aren't worked through for a Counselor. Even when an issue is worked through, what our clients bring to us can sometimes be difficult to hear. I often draw not only on my training and education, but also on my own  and others' experiences when doing my well as my self care and getting my own counseling. Through my struggle to feel like I am effectively providing something that looks like "good" couples counseling, I realized through my own self-reflection a few things. First of all, my divorce was a huge blow to my self-esteem and self-worth, and it took me some years to recover from it. Although I won't go so far as calling it re-traumatization, when presented with a relationship of my own or helping someone else work through theirs, I sometimes wonder if I am recovered.  Second,  I am not currently in a relationship, and my last 3 have ended for a variety of reasons, while my ex-husband seems to have found someone with whom he can be in a seemingly solid healthy relationship. I know intellectually that “comparison is the thief of joy”, but it still eats at me every now and then. I never wanted to be single again and I still don't. Perhaps it’s poor timing, maybe it's me choosing the wrong person to be in relationship with, maybe I haven't found the right person yet...or perhaps not...maybe it's just ME. One of my last relationships after my divorce lasted the longest which was off and on and lasted for about 3 and a half years, but it was going no where, not very healthy, and ended in a way that had me not only questioning him and his fitness to be in relationship with anyone, but my own as well for staying so long, and that leaves me feeling not only anxious, but deflated.  It’s normal for anyone to feel a sense of a loss of self-esteem when a relationship ends and I know this, so keeping it in mind has been very important, but difficult for me. I have to keep reminding myself to learn from this and not let it define me, but at the same time, being vulnerable enough to love fully again is scary.  Based on attachment research we seek out a partner for a variety of reasons, but one of those most important reasons is that deep need we all have for attachment to a safe and secure base. Although I am doing “alone” OK for the moment,  at the same time, not having that right now gives me a sense of floundering to some degree because having a healthy long term romantic relationship is something I want for myself. Knowing that I will be a full on empty nester in 2-3 short years highlights that even further.  I have felt that secure attachment to another as an adult early in my marriage, so I know exactly what it looks and feels like, but the end of that relationship (the last 5 years at least), were years of anxiety and trauma, and thus an anxious attachment style on my part developed toward my then partner. How it ended only adds to that.  I think I have carried that into other relationships since, and for a variety of reasons I won’t go into here. The third thing that came up for me is this gnawing feeling that I am somehow not worthy of, or perhaps even afraid of forming a deep bond with someone again. Maybe there is something wrong with me? Maybe it's that I fear failure or hurt which in turn is only going to hold me back. Going back to a previous post on fatherlessness, I can see how some of that would play into these thoughts. Although there has been a significant time lapse since then, the trauma of how my marriage ended comes into play on some level as well I think. I am afraid to invest so much after the way my situation ended. Yet at the same time, I have this thought at the back of my mind that I don't want to end up alone due to barriers and fears I can overcome. So when I counsel couples, most of the time, all of this comes up for me at one time or another, and I have to sort through that as I am working and set it aside. Sometimes I can get right to the heart of the matter with a couple and do good work and other times, I leave the session feeling drained...and that is when I question what this couple is bringing to me that dredges up my own issues and junk, and I have to sit with it and do some sifting. I like to think that in the end this is making me a better and more whole person.

 Understanding my needs, wants and expectations in a relationship is the key to building a solid relationship, not only with someone else but with myself.   This is something I often tell my couples clients and I routinely have them write those down and exchange them to foster conversation. The homework sounds easy enough, but try doing it yourself, it’s quite challenging.  Understanding who I am in this stage of my life has also been exceptionally helpful for me in doing my work but also in understanding what I want, need and expect. In addition, it has also brought me to the attention of the fact that I am not willing to settle, as I often see people do after a divorce (especially in middle age) just so they aren’t “forever alone”.  Many of the couples I see come to see me at a point in their marriage when one partner has “checked out”. Some even go so far as to romanticize divorce and being on their own and/or dating again (it is difficult, I admit, to stay neutral when that comes up). When I assign them the task of writing down their wants, needs and expectations of their relationship, more often than not I wind up seeing that "deer in headlights" look from at least one of them. The reason? Most people do not take the time to think about that. It seems to be a given that our partner will fulfill all of that without having to ask for any of it, much less recognizing it for themselves.  I often see it as challenging enough to help these clients understand the dynamics of their relationship, what went wrong (whether it’s shutting down, feeling criticized, losing sight of the relationship in preference to the children and/or career, substance abuse or addiction, mental illness, attachment, trauma, infidelity, etc.), finding ways to reconnect, how to repair it, helping them determine if it is salvageable and in helping each partner in understanding themselves, but when one or both do not even have the basics thought out, it's even more of a challenge.  I often have the couple each see their own counselor, if they are not already. It is my belief that each half of a partnership must be a whole person to begin with, or the unit/relationship will not work in healthy ways. In turn, 2 whole people forming a solid healthy relationship will then be better partners, parents, happier, stronger people, etc. I know that I am doing my best toward working to become a better, more solid person myself, but finding a partner who has in some way done the same has been a challenge.  Being a therapist leaves its mark, I admit, I can no longer see people or relationships  without that lens. I can tune it down, but I cannot turn it off. I am gradually getting better at couples counseling, and I like to think that in the process I am also becoming a better more whole person myself who is ready to move toward a healthy relationship of my own. The good news is, although I am not perfect at relationships or at life, like most healthy people, I have a lot of life experience, I learn from my mistakes, and I try to grow from each one, and this has proven to be invaluable to my work as well. It is also something I help my clients to do. As I continue to grow and work on my own issues, I hope that I can also become a better counselor to couples. As it stands now, I know I am improving, but I definitely do not have all of the answers.