Sunday, September 9, 2018

Coping with Anxiety and Stress: Information, Tips and Resources - Part 1

Introduction

Anxiety is the most prevalent mental health issue in society for people of all ages. It can become life-limiting and debilitating for some people. Stress and anxiety go hand-in-hand. All of us experience stress, which can lead to anxiety. We must learn to take steps to manage both our stress, but also anxiety. 

The good news is that there are many things we can do to improve our coping with anxiety and stress. The challenging thing is we have to realize we have to take action to change over how we approach life to get to a place where we can manage our anxiety and stress in more effective ways. Once we do, this becomes self-reinforcing and we know we have our own personal 'tool kit' we can choose different coping tools when we need them. 

Top 12 Anxiety & Stress Busters

1. Sleep - Improve your sleep routine, what professionals call 'sleep hygiene', to ensure you're getting as much quality sleep as you can. This involves creating a calming and grounding bedtime routine, creating a regular bedtime, and planning to get enough sleep hours in. 

2. Exercise - Anything we do to get our bodies moving is going to help burn off the stress hormones involved in driving anxiety. Walking, yoga, a gym workout, cycling, Zumba, whatever gets your blood circulating is good for reducing stress and anxiety. 

3. Mindfulness and other forms of meditation
 - This can be as simple as sitting quietly and doing some slow, deep breathing. Count to 5 while breathing in through your nose. Hold your breath for 3 counts. Slowly release your breath through your mouth to the count of 5. Do this cycle 3 times and you should feel a little more calm. See Part 2 of this series for some media resources to help. 

4. Spend time in nature - Go for a nice walk at a local park, the beach, in the forest, or hike a mountain. Listen to the wind rustling in the trees, the birds singing, feel the breeze and sun on your face. Gardening is my favourite stress reliever, soul soother, and hobby. 

5. Create structure, routine and organization in your life
 - To improve feelings of competence, predictability, and feel like you have things more under control, create structure by doing things like creating systems at home, or work (things to do lists, or memos in your phone); use your calendar and schedule notifications for deadlines. 

6. Positive self-talk - We all have an inner dialogue, become more aware of the messages you send yourself and become your own cheerleader, tell yourself "I've got this," "I'll be okay," "I'm safe," "Take a breath," or "I can do this." 

7. Body work - Massage therapy, reflexology, acupuncture, reiki, or other types of energy healing massage, or body work. 

8. 'Feel Good' Activities - Many of us feel good when we engage in activities that make us feel nurtured, taken care of, and satisfied. Take yourself out on a date for a great meal; go for a 'mani-pedi' (yes, guys can do this too); have a spa day; go to a place that nurtures your soul: art gallery, a local attraction; or get out of your town for a day trip, or a few days away somewhere you've wanted to visit. 

9. Spend time with supportive, caring people - This can be family, friends, or people we share activities and interests with. Social connection and engagement is a well established technique to get us out of our own heads and boosting our life satisfaction. 

10. Use media to distract - Listening to a great music playlist, listening to podcasts, watching videos, music, or any content that helps you shift from the stressed, anxious self to a calmer, more grounded self is a good thing. 

11. Create structure, order, routines, and calm in your home environment
 - When we are living with heightened stress and anxiety we need a calm space to come home to, a place we can relax, let our guard down, rest, and re-charge. 
Schedule routine, or seasonal chores to keep on top of things at home. Hire someone to help you with the cleaning, decluttering, or getting more organized if need be. 

12. Create realistic, future-focused goals - Small, or large goals give us something to focus on and work toward. Do you want to go on a local, or international trip? Start reading about your destination, look at accommodations, and places to see, or dine at. Do you have an interest, or hobby you want to explore? Take small steps to learn more about it, or find out if there is a local community for that interest. 

Wednesday, April 4, 2018

Grief, Loss and Bereavement: Resources and Article

Resources

BC Bereavement Helpline - Toll-free: 1-877-779-2223; Metro Vancouver: 604-738-9950

  • Provides support groups, events, information and resources.

Web:  http://www.bcbereavementhelpline.com/

Living Through Loss Society 

  • Individual and group counselling, training, and resources. 

Web: https://livingthroughloss.ca/

GRASP - Grief Recovery After a Substance Passing

  • Community of family members and others who have lost a loved one to substance use. Information for coping, resources, recommended books and materials. 

Web: http://grasphelp.org/

Article

Understanding Grief
Brody, J. E. (2018). New York Times. Retrieved from: https://www.nytimes.com/2018/01/15/well/live/understanding-grief.html

Although many of us are able to speak frankly about death, we still have a lot to learn about dealing wisely with its aftermath: grief, the natural reaction to loss of a loved one.
Relatively few of us know what to say or do that can be truly helpful to a relative, friend or acquaintance who is grieving. In fact, relatively few who have suffered a painful loss know how to be most helpful to themselves.
Two new books by psychotherapists who have worked extensively in the field of loss and grief are replete with stories and guidance that can help both those in mourning and the people they encounter avoid many of the common pitfalls and misunderstandings associated with grief. Both books attempt to correct false assumptions about how and how long grief might be experienced.
One book, “It’s OK That You’re Not OK,” by Megan Devine of Portland, Ore., has the telling subtitle “Meeting Grief and Loss in a Culture That Doesn’t Understand.” It grew out of the tragic loss of her beloved partner, who drowned at age 39 while the couple was on vacation. The other book, especially illuminating in its coverage of how people cope with different kinds of losses, is “Grief Works: Stories of Life, Death and Surviving,” by Julia Samuel, who works with bereaved families both in private practice and at England’s National Health Service, at St. Mary’s hospital, Paddington.
The books share a most telling message: As Ms. Samuel put it, “There is no right or wrong in grief; we need to accept whatever form it takes, both in ourselves and in others.” Recognizing loss as a universal experience, Ms. Devine hopes that “if we can start to understand the true nature of grief, we can have a more helpful, loving, supportive culture.”
Both authors emphasize that grief is not a problem to be solved or resolved. Rather, it’s a process to be tended and lived through in whatever form and however long it may take.
“The process cannot be hurried by friends and family,” however well meaning their desire to relieve the griever’s anguish, Ms. Samuel wrote. “Recovery and adjustment can take much longer than most people realize. We need to accept whatever form it takes, both in ourselves and in others.”
We can all benefit from learning how to respond to grief in ways that don’t prolong, intensify or dismiss the pain. Likewise, those trying to help need to know that grief cannot be fit into a preordained time frame or form of expression. Too often people who experience a loss are disparaged because their mourning persists longer than others think reasonable or because they remain self-contained and seem not to mourn at all.
I imagine, for example, that some adults thought my stoical response to my mother’s premature death when I was 16 was “unnatural.” In truth, after tending to her for a year as she suffered through an unstoppable cancer, her death was a relief. It took a year for me to shed my armor and openly mourn the incalculable loss. But 60 years later, I still treasure her most important legacy: To live each day as if it could be my last but with an eye 
Both authors emphasize that grief is not a problem to be solved or resolved. Rather, it’s a process to be tended and lived through in whatever form and however long it may take.
“The process cannot be hurried by friends and family,” however well meaning their desire to relieve the griever’s anguish, Ms. Samuel wrote. “Recovery and adjustment can take much longer than most people realize. We need to accept whatever form it takes, both in ourselves and in others.”
We can all benefit from learning how to respond to grief in ways that don’t prolong, intensify or dismiss the pain. Likewise, those trying to help need to know that grief cannot be fit into a preordained time frame or form of expression. Too often people who experience a loss are disparaged because their mourning persists longer than others think reasonable or because they remain self-contained and seem not to mourn at all.
I imagine, for example, that some adults thought my stoical response to my mother’s premature death when I was 16 was “unnatural.” In truth, after tending to her for a year as she suffered through an unstoppable cancer, her death was a relief. It took a year for me to shed my armor and openly mourn the incalculable loss. But 60 years later, I still treasure her most important legacy: To live each day as if it could be my last but with an eye 
Just as we all love others in our own unique ways, so do we mourn their loss in ways that cannot be fit into a single mold or even a dozen different molds. Last month, James G. Robinson, director of global analytics for The New York Times, described a 37-day, 6,150-mile therapeutic road trip he took with his family following the death of his 5-year-old son, collecting commemorative objects along the way and giving each member of the family a chance to express anger and sadness about the untimely loss.
Ms. Devine maintains that most grief support offered by professionals and others takes the wrong approach by encouraging mourners to move through the pain. While family and friends naturally want you to feel better, “pain that is not allowed to be spoken or expressed turns in on itself, and creates more problems,” she wrote. “Unacknowledged and unheard pain doesn’t go away. The way to survive grief is by allowing pain to exist, not in trying to cover it up or rush through it.”
As a bereaved mother told Ms. Samuel, “You never ‘get over it,’ you ‘get on with it,’ and you never ‘move on,’ but you ‘move forward.’”
Ms. Devine agrees that being “encouraged to ‘get over it’ is one of the biggest causes of suffering inside grief.” Rather than trying to “cure” pain, the goal should be to minimize suffering, which she said “comes when we feel dismissed or unsupported in our pain, with being told there is something wrong with what you feel.”
She explains that pain cannot be “fixed,” that companionship, not correction, is the best way to deal with grief. She encourages those who want to be helpful to “bear witness,” to offer friendship without probing questions or unsolicited advice, help if it is needed and wanted, and a listening ear no matter how often mourners wish to tell their story.
To those who grieve, she suggests finding a nondestructive way to express it. “If you can’t tell your story to another human, find another way: journal, paint, make your grief into a graphic novel with a very dark story line. Or go out to the woods and tell the trees.  It is an immense relief to be able to tell your story without someone trying to fix it.”
She also suggests keeping a journal that records situations that either intensify or relieve suffering. “Are there times you feel more stable, more grounded, more able to breathe inside your loss? Does anything — a person, a place, an activity — add to your energy bank account? Conversely, are there activities or environments that absolutely make things worse?”
Whenever possible, to decrease suffering choose to engage in things that help and avoid those that don’t.
A version of this article appears in print on January 16, 2018, on Page D5 of the New York edition with the headline: Understanding Grief, and Living Through It. Order Reprints| Today's Paper|Subscribe

Saturday, June 3, 2017

Sliding Scale, Low and No Cost Counselling Services in Metro Vancouver

List of Low Cost, Sliding Scale (negotiable), or No Cost Counselling Services in Metro Vancouver

From Willow Tree Counselling. Retrieved from: http://willowtreecounselling.ca/wp-content/themes/willowtree/reduced-cost-counselling.pdf

Family Services of Greater Vancouver (FSGV) 

To ask about counselling services, call 604-874-2938 or email us here.

Childhood Trauma Counselling for Adults:
VISAC and TASA Programs

Our VISAC program in Vancouver and TASA program in Richmond help people dealing with the effects of childhood trauma and/or sexual abuse.
These programs help people develop their self-awareness, self-protection, self-soothing, emotional regulation, somatic healing, and spiritual growth.

Childhood Trauma Counselling for Pregnant Women:
Healthy Connections — You and Your Baby Program

Our Healthy Connections — You and Your Baby program in Vancouver helps pregnant women to work through trauma-related issues that can interfere with their ability to parent their children. This prenatal program is designed to begin as early in the pregnancy as possible and to continue after birth for up to three years. Learn more about Healthy Connections by watching this six minute video.

In Vancouver:

Family Services of Greater Vancouver
1638 E Broadway (at Commercial Drive)
604-874-2938

In Richmond:

The Caring Place
250 – 7000 Minoru Blvd, Richmond BC
604-279-7100
General counselling inquiries

Techniques for Grounding and Calming Ourselves

There are some simple techniques we can use to help ground and calm ourselves when our bodies are feeling triggered and our central nervous system is around and we don't feel safe. 

Two Simple Techniques That Can Help Trauma Patients Feel Safe with Peter Levine
Retrieved from: https://www.youtube.com/watch?v=G7zAseaIyFA


Friday, April 14, 2017

Clinical: The Enduring Trauma of Sexual Assault

The Enduring Trauma of Sexual Assault

By Ending Violence Association of BC (April 7, 2017). Retrieved from: http://bc-counsellors.org/sexual-assault/

While a sexual assault survivor’s physical injuries may not always be visible, the unseen psychological impacts of trauma can be severe and profoundly debilitating. In providing effective, respectful, and appropriate support to survivors, engaging in trauma-informed practice is crucial. Whether in your professional life or your personal life, a trauma-informed understanding of and approach to sexual assault will serve to benefit your ability to meaningfully support survivors. Considered through this lens, sexual assault survivors’ actions and behaviours are understood as normal responses to abnormal experiences, rather than as ‘symptoms’ of a ‘problem.’ Instead of asking, ‘What is wrong with this woman?’ we shift to asking, ‘What has happened to this woman?’
Trauma-informed practice puts forth an understanding of trauma as an adaptive response to a serious external threat, rather than an individual pathology or injury. All of a survivor’s responses to sexual assault are adaptive attempts to survive this traumatic experience. During a sexual assault, a survivor’s sympathetic nervous system (SNS) becomes activated, fighting for survival by flooding her body with stress hormones. Survivors respond to trauma in one of three ways: fight, flight, or freeze. A survivor may tell you that she fought back (fight) or that she tried to get away (flight). The vast majority of sexual assault survivors experience the freeze response, also known as ‘tonic immobility’; these survivors describe being unable to move or speak during the assault. Understanding the neurobiology of trauma and sharing this information with survivors can be beneficial in supporting their resilience. Providing simple, concise, and plain language explanations to survivors can assist them in making sense of their own responses during a sexual assault. Survivors often hold themselves fully or partially responsible for what happened; this is particularly pronounced for survivors who experienced the freeze response. Learning that this response is automatic and protective (i.e., meant to minimize harm) can help survivors move away from tendencies to blame themselves. When asked about what they were thinking or feeling during a sexual assault, many survivors will share that they feared they may be killed; recognizing this fear, and their body’s protective response to it, can help survivors make sense of what they might initially view as a passive response.
During a disclosure of sexual assault, you might hear a range of experiences and observe a range of emotional responses to this trauma. Whether she is disclosing immediately following the sexual assault or after some time has passed, the impacts of trauma are multifaceted; you may hear a survivor describing anxiety, fear, anger, sleep disturbances, nightmares, invasive memories, changes in appetite, depression, self-isolating, self-blame, panic, and difficulty trusting others. It is also not uncommon for a survivor to appear calm and collected, which stands in contrast to the emotional reactions many would expect a survivor to display, even though she is likely experiencing these emotions internally. If a survivor is disclosing soon after she was sexually assaulted, it is common for her to express confusion, shock, or disbelief. She may also appear numb or seem disoriented. Additionally, it can be beneficial to examine the impact of shock on a survivor’s immediate cognitive processing of what happened to her. Helping the survivor to name and understand her responses can benefit her process of recovery. Additionally, when a survivor discloses sexual assault, a trauma-informed approach emphasizes that the hormones released during a traumatic event – which serve a protective function during a sexual assault – impact how the brain encodes memory. A survivor may have clear memories of the assault and how it unfolded. Conversely, she may remember only fragments of the assault, primarily recall sensory details (e.g., sounds, smells, tastes), and/or lack a sense of chronological order. Through trauma-informed practice, you can assist a survivor of sexual assault in recognizing her reactions to and recollections of what happened as normal responses to trauma.
A trauma-informed approach also emphasizes the capacity for overcoming trauma, recognizing survivors’ strengths and resilience in their path toward healing. Every survivor copes with sexual assault in a different way, based on numerous factors that include her support system, any prior abuse or violence, past experiences of disclosing and/or reporting, and the context of the sexual assault itself. Being sexually assaulted can compromise a survivor’s ability to earn a living, feel safe and secure, and maintain relationships with friends, family, and partners. Survivors may feel that being sexually assaulted has permanently damaged them, or they may struggle with the belief that there is a ‘correct’ way to heal from sexual assault. In the immediate aftermath of a sexual assault, the experience and resulting trauma can be a central aspect of survivors’ lives. It is important that a survivor knows that how she feels and how the assault is affecting her will likely shift over time. Recovery from a sexual assault is not a linear process. At times, survivors may feel as though their healing has regressed to an earlier time and feel discouraged by what they interpret as a lack of progress; it is critical to normalize this, and help survivors understand the assault will come to encompass less space as she moves forward in her healing.
How you react to a survivor’s disclosure can have a significant impact. The first person a survivor discloses to is a key person in their experience. A judgmental response can be discouraging and damaging, while a trauma-informed response can help a survivor feel heard, believed, and empowered to make their own decisions about what to do next. A trauma-informed approach is invaluable in that it can deepen your understanding of the impacts of sexual assault, survivors’ strength and resilience, and the path toward healing.
Survivors of sexual assault can access support services through the Ending Violence Association of BC and through VictimLink BC’s multilingual, 24/7 telephone service at 1-800-563-0808.
Sources

Monday, February 13, 2017

10 Life Hacks for Coping with Anxiety and Depression - Part 1

10 Life Hacks for Coping with Anxiety and Depression

Young, T. (2017). Mental Health BC.

Introduction

Most human beings will go through periods of our lives in which we experience feelings of anxiety from stress in our lives. Most people will not be officially diagnosed with an anxiety disorder, but if we do feel anxious, that impacts our functioning in a variety of ways.

Experiencing feelings of depression can also a be a normal part of the human condition. Most of us will experience things in our lives which will leave us feeling sad, upset, and down. Sometimes we might feel so depressed that we have a difficult time recovering from this state of mind and emotion that depression becomes a clinical issue for us as it leads to more serious problems of functioning.

Rarely will anxiety and depression just spontaneously stop. At times, our symptoms and the impacts they are having on our global functioning can get worse. Fortunately, there are strategies, or what we can call "life hacks" that can actually can make a real difference in helping us cope and recover from our anxiety and depression.

Your Tool Kit

In my clinical work as a counsellor working with clients, I find it helpful to use the analogy of a tool kit to describe the different types of coping strategies and tools we have to help us manage our feelings of anxiety and depression. These can also be referred to as our "life hacks." Many of these are no cost, or low cost interventions. Some life hacks may cost more, but their effectiveness in helping us shift out of ways of being that aren't helpful to us, or which create barriers to better functioning, are worth every penny.

10 Life Hacks for Coping with Anxiety and Depression

1. Sleep 

The single most important intervention that assists people with anxiety and depression is improving the quality of our sleep. Most of us know we do not function at our best when we experience disrupted sleep patterns. In fact, this is so important, this is one of the first questions I ask clients when I am conducting an intake assessment, and ongoing assessments with them. Here are some of the questions I ask:
  • What is the quality of your sleep like? 
  • How many hours of sleep do you typically get? 
  • Has this changed recently? 
  • Do you have any ideas why your sleep pattern might have changed recently? 
  • What impact do you think the change to your sleep has had on you? 
The answers I receive to these important questions tell me a lot about how my client is functioning. Depending on the person's answer, this will lead to other questions about their sleep patterns, such as bed time routines, activities leading up to bedtime, whether the person takes naps, and many other questions.

What I am getting at when I am assessing sleep quality is often related to what is called "sleep hygiene." This is a bit of a fancy way of finding out what kinds of routines and strategies the person is using to prepare for sleep, because with some changes, improvements can be made that contribute to decreases in anxiety and depressive symptoms.

Sleep is also impacted when people experience insomnia. Some of us have a pattern in which we either can't go to sleep, or we wake up, and we're ruminating, or thinking about things too much when we want to be sleeping. Some of the other life hacks on this list can help with this too.

2. Exercise

One thing I have come to understand about exercise is that it is not one-size-fits-all. Functional capacity, interest and commitment to exercise is a very individualized thing.  But, it is at the top of the list as a tool to fight anxiety and depression, because it has so many spin off benefits.

Exercise helps get oxygen moving in our blood. It boosts the chemicals in our brain that are related to anxiety and mood. The right kind of cardio exercise (or sometimes even just any exercise) boosts our endorphins and serotonin levels, which are key hormones and chemicals that improve our mood.

Exercise also plays a key role in supporting our overall health, helping us sleep better, gets our physical body and important organs functioning, rather than just remaining sluggish, or stagnant.

Because depression can demotivate us from engaging in many activities, including exercise, I talk with my clients about taking baby steps. If a client saying they haven't been feeling motivated, and/or comfortable leaving their house, I ask them, or assign them homework, to start off small. Walk one block and back to your home. If you can do that, each day of that week, try to go a little bit further, or, if it is a real struggle, just keep trying to walk that one block until you can build it up.

I will ask clients to also keep a log of the exercise they get each day. Some apps for our smartphones, or things like fitness trackers can also keep track of our walking, and other data. I find those things can be really helpful, as once people start using them it can add to their motivation to track their exercise and help create an external motivator for them.

Some people find participating in yoga an effective and gentle way of getting their body moving. People might be able to find low cost yoga sessions available at a local community centre. The local library might have some yoga DVD's that can be rented for use at home. A search for "yoga videos" on Youtube will also yield a lot of different resources for every level, from beginners to more advanced yoga enthusiasts.

For people with mobility changes, exercise can be more of a challenge. This is where support from medical and community professionals who specialize in your specific physical and health conditions, can provide input into individualized exercise interventions.

3. Relaxation techniques

Almost every one has some sorts of techniques, or activities they engage in which they find relaxing. This is a very individual thing.

I know many people, including myself, who find spending time in nature very relaxing. This could include taking a walk,going for a hike, visiting local lakes, or spending time at a beach. This is one of my favourite, low, or no cost, life hacks. If you have a local park nearby, or can take transit somewhere this accomplishes several different hacks: getting out of the house, getting some exercise, and if you do it with others, this adds to your social support.

Some of us find gardening very helpful as an anxiety and depression buster. If you don't have any space to garden where you live, maybe your community has some community gardening opportunities. Some people can put their name on a list and then can be selected to receive a garden plot they can use.

One thing I recommend to clients is to reflect on and consider activities they have found relaxing in the past, and whether this is something they can see themselves getting involved in again.

There are also some relaxation techniques that people can engage in.

Listening to music that people find calming. 

This is a really individualized thing. Some of us like calming, quiet music, with, or without words. I have also known people who find listening to different types of heavy metal to be calming. None of us in a position to judge what works for another person.

Youtube provides people with endless sources of different types of music, and channels, that specialize in music for relaxation. I don't have any particular favourites to offer. Just type in 'relaxation music' into their search engine. With some trial and error, you will find something that works for you.

Guided Relaxation techniques

There are also various techniques, or guided relaxation resources, which can also support people. These vary from engaging in a guided practice of progressive muscle relaxation which includes tensing and releasing each muscle group, to mindfully focusing on the body and sensations in the body. We will get to the latter in the next life hack. These techniques vary greatly in terms of the length of time involved.

Here is a nice guided progressive muscle relaxation video to try out.


4. Mindfulness and Other Types of Meditation 

Almost every person I have ever worked with, or talked to about meditation has told me something like, "I tried it, but it didn't work for me..." Most of the time I'm not going to argue, or challenge the person about their perception. People just tend to dig their heels in and their resistance grows if you do try to help them shift from that perspective.

However, there is a large and growing body of research and evidence that mindfulness, and other types of meditation practices, provide individuals with many different biopsychosocial benefits.

The reason that mindfulness-based techniques have become some of the most common strategies and interventions that are used with individuals who experience symptoms of anxiety and depression is that THEY WORK REALLY WELL!

There are different definitions of mindfulness. The ones I like best include:
  • the quality or state of being mindful.
  • the practice of maintaining a nonjudgmental state of heightened or complete awareness of one's thoughts, emotions, or experiences on a moment-to-moment basis; also :  such a state of awareness.
  • a state of active, open attention on the present. When you're mindful, you observe your thoughts and feelings from a distance, without judging them good or bad. Instead of letting your life pass you by, mindfulness means living in the moment and awakening to experience.
The reason these techniques work is that they create a defined time and space for the individual to focus on their internal experience of their feelings, emotions, thoughts, and how these impact us in the moment, and specific situations.

As we continue our meditation practice(s), it becomes easier for us to identify the sources of our anxiety, and/or depressive symptoms. We can then begin to learn to become more detached by becoming observers and witnesses of these internal feeling and thinking states. This also helps us step out of our typical learned response, and start to re-wire our bodies and our brain, and add new strategies to our tool kit that we can pull out when we need them.

When we have someone else tell us about some sort of situation that evokes feelings and anxiety, or depression, even when we are really empathetic, supportive, and caring about that person and how they feel, we also have a level of detachment from their narratives, because their lived experience is not ours. It doesn't internally evoke the same types of feelings and thoughts for us that it does for them.

Here is an example of how this works.

I might be a person who feels anxious when confronted by a particular situation. Because I know I have felt so much anxiety about this situation in the past, I start to over-generalize and catastrophize. I train my brain and body to anticipate that I will feel anxiety if I go into that situation. I also anticipate that I will feel overwhelmed and unable to cope with this situation. Most often, when we're not cognitively aware (not mindful) of the level of distress we experience, we will just start to avoid the people, places, situations, and things that trigger our feelings, thoughts, and symptoms of anxiety.

To help me shift this, I need to set aside some time and find a physical space where I can minimize distractions. I begin by doing some deep breathing, centering and grounding myself in the present moment. As I start to do this, my brain will bring all sorts of thoughts and body sensations into my awareness which distract me. Instead of shutting them out, or getting annoyed about this, I can just gently acknowledge the thought, or sensation, and then release it.

Once I feel more grounded, I can then start to think about the anxiety-provoking situation and what has happened in the past when I was confronted by that situation. I will no doubt start to experience and feel the feelings and thoughts in the present moment. That is okay and to be expected. I just need to keep bringing myself back to the present by breathing very deeply. Concentrate on what the physical breath feels like as I breathe in and out.

One thing I find that helps to step outside of the impacted person into the observer, or witness role, is consider what it might look like from an outside perspective (outside of myself), and describe this in third person terms. For instance, I might say to myself, "wow, when Tracey was even just starting to think about that situation, she was starting to feel her heart pounding. As she continued thinking about it, she was feeling more and more stress and tension in her body. These sensations were getting worse as she was getting closer to being in that situation."

This is a more cognitive-mindful approach. I can also be curious about my feelings and thoughts. I  might ask myself, I wonder why Tracey feels so anxious about that situation? What are all of the different feelings and thoughts Tracey has in these kinds of situations? I might want to explore what each feeling feels like and why I might have that feeling triggered by the situation. I might be curious how Tracey has coped with those feelings and thoughts in the past? I might ask what Tracey found helpful and what worked to help her detach from those feelings and thoughts in the past?

As we get used to detaching, exploring, and starting to understand our feelings and thoughts, we will find it easier to begin to do this with the different types

Other types of meditation practices include the following:

Buddhist and/or Zen meditation - These tend to focus on core concepts and spiritual beliefs related to Buddhism. This includes mindfulness and other techniques, such a lessons and teaching on specific topics.

Hindu and/or Vedic meditation techniques - These often combine the use of specific mantras, words, or phrases that are repeated to create a spiritual connection within oneself, and with a particular god, or goddess. Chakra meditation is a form of this type of mediation in which people focus on particular energy centres, or chakras, that may be blocked and causing problems in certain areas of ones' life.

Sound meditation and healing techniques - Different types of sounds are used by enthusiasts of this form of meditation. It is often paired with breathing and mindful presence. Some may use music with certain levels of frequencies of tones that claim to help with focus, and healing. Some may use techniques such as sound healing with the use of certain musical instruments, such as bowls,

Here is a nice, short mindfulness meditation to test out the techniques involved.


Here is an article that provides 5 Meditation Tips for Beginners who are just getting started. 
Boyes, A. (2013). 5 Meditation Tips for Begginers. Psychology Today. Retrieved from: https://www.psychologytoday.com/blog/in-practice/201303/5-meditation-tips-beginners.

5. Spending time talking with and being with people

The tendency to socially isolate ourselves when we are experiencing heightened symptoms of anxiety and depression is pretty common. Our reasons for doing this vary, and can include:

  • We want to keep our personal struggles to ourselves and consider them private. 
  • We could come from a culture that sees mental health struggles as very stigmatizing, for the individual, or the family.  
  • We might feel shame for not being able to cope better. Our socialization in our families may have instilled shame about mental health issues. We might have even experienced others trying to shame us into "getting better." 
  • We might feel like if we share our struggles this will be a burden to others. 
  • We feel negative, and even hopeless, about our situation, and wonder whether things will ever improve. Things seem bleak and we don't want others to really know how bad we are feeling. 
  • We don't want to be seen as a "Negative Nellie," or "Downer Doug" to others. 
  • We might even observe that when we try yo talk to others they aren't really supportive, empathetic, and/or we become aware that they aren't sure how to be helpful, or supportive of us. As a result, we might to start to feel like others are avoiding us, which reinforces our feelings and reasons for socially isolating ourselves. 

Even if we come come up with a long list of reasons to avoid spending time with people, and prefer to socially isolate ourselves, this is one of the most important life hacks we might even have to force ourselves to do.

There is no doubt we may not be at our best during these times of struggle, but spending time with others can provide a very important distraction from our anxious and depressing thoughts and feelings. Think of it as a mini-vacation from your struggles. Give yourself permission to take a break for a couple of hours. Even tell yourself, "Hey, anxiety, I'm going to go to a movie with my friends for a couple of hours today. I will be back later."

We will most likely have to kind of "fake it" a bit (or a lot) that we are the person we used to be, or a person who genuinely cares about what is happening with the people we engage with, or that we want to be where we are. When things are really bad, we often just don't have the emotional energy to support, or care about others, as much as we normally might. However, we have to find a way to step outside of that. Doing so, even for brief periods of time, is helpful.

Some of us are very fortunate to have people in our lives who offer, unconditional positive acceptance, regard, and love. It doesn't matter what we share with them, they will stand by and support us without fail. They are our rocks. They are the first people we think of calling, or do call, when we encounter difficulties, or just need a supportive voice, or a virtual, or real hug.

We do have to be mindful (yes, that word again), to not get caught up in just focusing entirely on ourselves, and our struggles. When we are struggling with anxiety and depressing, our feelings and thoughts can take on an epic, all-encompassing life of their own. When we pair this with the kind of self-centred focus that often happens when we are in this stuck place, this can prevent us from being there for others.

Even in the midst of our personal struggles, we need to consciously engage our support people. We need to ask and find out how they are doing and what's going on in their lives. We need to muster up whatever empathy, care, concern and support we can so that even though the balance might be off, we are still engaging in relationships that involve reciprocity, to some degree. If we do not do this, we may find ourselves burning out the people in our lives who are most supportive, loving and caring to us. Sadly, I have worked with many individuals and family members who have reached this point, and it is not a good place for anyone to be in.

Make an effort to get out to social events, celebrations, and spending time with people. Dress up and show up, even if its mostly just a physical presence for/to you. Often, you may end up having a better time, or even fun, when you started out dreading the entire social situation.

There isn't a person alive who hasn't had to "fake it" that they were interested in being at a certain social, or family function. Draw on that previous experience. You can absolutely know you are going through the motions, others might even sense that too. It doesn't matter. Instead of sitting around at home, being/feeling isolated, emotionally stuck, and maybe bored, or unstimulated, being around people and engaging socially with others, is generally better than the alternative.

In Part 2, we will continue to look at 5 more Life Hacks for Coping with Anxiety and Depression.

Saturday, February 11, 2017

Resources: The Complex PTSD Workbook



The Complex PTSD Workbook: A Mind-Body Approach to Regaining Emotional Control & Becoming Whole!
Retrieved from: http://drarielleschwartz.com/the-complex-ptsd-workbook-dr-arielle-schwartz/#.WJ_ZJmfavOV

Available on Amazon: click here to order.

Those affected by complex PTSD (C-PTSD) commonly feel as though there is something fundamentally wrong with them-that somewhere inside there is a part of them that is broken. Though untrue, such beliefs can feel extremely real and frightening. Difficult as it may be, facing one’s PTSD from unresolved childhood trauma is a brave, courageous act…and with the right guidance, healing is possible.

In The Complex PTSD Workbook, you’ll learn all about complex PTSD and gain valuable insight into the types of symptoms associated with unresolved childhood trauma. Unlike other books, this workbook applies a mindful, strength-based perspective to develop and integrate your positive beliefs and behaviors.

Within, you will find information about common misdiagnoses and explore a synthesis of therapeutic methods for healing including somatic therapy, EMDR, CBT, DBT, and mind-body perspectives. Importantly, this book creates opportunities for personal reflection using writing exercises to explore how you feel as related to the material presented.

“Complex PTSD is defined by a set of symptoms that are the result of pain and stress that often began at a very early age—they could be all you’ve known. Naturally, these early experiences shape your perspective of yourself and the world. Healing asks that you turn toward your past to find relief from the weight of trauma. As a result, you become less defined by your history and have greater choice about your future. Take comfort in this: your symptoms are the result of learned ineffective beliefs and behaviors and they can be replaced by a positive mindset and health-promoting behaviors.” - Dr. Arielle Schwartz

Read Excerpts from the Book and Related Posts: