Coping Ahead

The holidays can be a happy and joyous time for some and a stressful and dreadful time for others. We all experience a level of expectation during the holiday season, yet our own inner expectations can frequently result in added stress, anxiety, and sometimes, even depression. The days ahead are filled with many events, including attending family gatherings, buying the perfect gift for the difficult to please family members, attending church events, attending school events, making sure that all feel included in the holiday festivities, etc. I often hear people express complete exhaustion and dread by the time Christmas comes around, because of the amount of time they’ve spent running around making sure that everything is in order for the big day. Coping ahead of the Christmas holiday events and practicing mindfulness skills can help to alleviate stress and anxiety, which also creates a level of peace during such a busy and often chaotic time. Below are some pointers on coping ahead during this holiday season:

1.)   Reduce personal expectations and work on being more realistic about gift buying, holiday party attendance, holiday travel, etc. Set limitations and communicate with others about what you are able to do and what you are unable to do. Open and honest communication is key to reduce anxiety and stress, particularly as it relates to perceived and real expectations during the holiday season. Open and honest communication is also a great way to set boundaries, which is crucial during the holiday season.

2.)   Have a game plan when spending time with difficult people or when confronted with difficult situations. The holidays are a time for celebration and gathering, which also means that you may have to spend time with family members that can difficult to be around. You may also have to travel or spend time running around to multiple family gatherings. Practice acceptance and work towards being mindful of reactions to triggers when around pesky and annoying family members or when confronted with other stressors. Have a game plan to remove yourself from the room if necessary, take a walk, practice deep breathing, practice gratitude for the challenging personality you’ve encountered, and work on reducing reactions by focusing on something positive. Grounding exercises can be helpful when around difficult people and situations. I encourage my client to focus on self-soothing through their 5 senses to reduce their urge to react when in difficult situations. Here are some self soothing ideas: look around for something positive within your eye sight, eat a favorite treat, drink a favorite non-alcoholic beverage, have a favorite scent within reach (essential oils are great for self soothing) watch a favorite show, listen to an audio book, and listen to soothing music. Bottom line is to be prepared to encounter difficult people and difficult situations that will need to be handled effectively.

3.)   Have a plan to decompress after the holidays before getting back into a routine. Some ideas could include reading a favorite book, sleeping in, taking a bubble bath, and taking an extra day off from work if needed. Remember that a lot of time and energy has been spent preparing for the holiday events, so it’s just as important to practice self-care and relaxation before returning to a baseline routine.

Above all, have fun and try to enjoy the holiday season. Most of our stressors come from lack of boundaries and high expectations from ourselves, from others, and from society; focus on what you can control and let all else go!

Have a happy and mindful holiday season!

Stephanie Shirley, LMSW

Anger

Anger is a natural emotion that is often felt by people but is also often not understood or managed appropriately.  Anger is a feeling or emotion that ranges from irritation to fury and rage.  Anger is a response that is natural to feel in a situation when a person feels threatened.  During this time, a person feels that they are in danger or that another person has wronged them in some way.  Also, anger can be an emotion that is triggered when needs or desires are not met. 

                There are several myths about anger that are often believed that need to be addressed.  The first myth is that anger in inherited:  It is often believed that anger is inherited and cannot be changed but this is in correct.  Studies have shown that people are not born with a set specific ways of expressing anger and this is actually learned behavior; which means people can learn ways to control anger appropriately.  

              The second myth is that anger automatically leads to aggression.  There is a misconception that the only way to express anger is through aggression. In fact, effective anger management is done by using learned coping skills that help control the escalation of anger.  This can be done by learning how to use positive self-talk, using behavioral strategies, and challenging irrational beliefs.  

             The third myth is that people must be aggressive to get what they want.  This is actually a confusion between aggression and assertiveness.  The goal of aggression is to dominate others to get what you want while the goal of assertiveness is to express feelings of anger in a way that is respectful to other people.  

           The fourth myth is that venting anger is always desirable.  It was a thought for many years among mental health professionals that expressing anger by screaming or beating a pillow was the most effective way to manage anger.  This is not so, and studies have shown that expressing anger this way only leads to becoming better at being angry.

                The first step in learning to manage anger appropriately is to become aware of the anger which includes triggers and cues.  A trigger is an event, circumstance or behavior of others that caused a person to become angry.  A cue is how a person’s body identifies the anger they are feeling such as; increased heart rate, knots in stomach, and the body feeling flushed.  In addition to learning how to recognize anger, a person needs to learn skills to manage their anger.  These skills should include immediate skills to reduce anger when it increases and preventative strategies to help not become angry.  A few immediate skills could be taking timeouts, deep breathing exercises, and thought stopping.  An example of preventative strategy is learning how to interact appropriately with others and being assertive instead of aggressive. 

                Anger is a natural emotion that everyone feels but people can learn skills to be able to prevent their anger from increasing or manage it appropriately so it does not become a problem for them in their lives. 

Dave Homer, LCSW

How Can I Move Forward?

Have you been experiencing negative feelings for a significant amount of time, or are you experiencing negative feelings as the result of a crisis or traumatic event that don’t seem to pass on their own? Do you feel that you have internal obstacles that prevent or inhibit you from advancing and breaking through, even though in theory you know what needs to be done? Have you noticed that you exhibit patterns of behavior that hinder you in your personal or professional life that awareness alone does not prevent you from repeating?  Do you have unpleasant feelings, fears, or concerns that prevent you from speaking before an audience, cause you to feel uncomfortable being the center of attention, and block you from advancement in your personal or professional life?  The good news is that those conditions are reversible.  Even better news?  Through a novel form of psychotherapy call Eye Movement Desensitization and Reprocessing (EMDR), the rate of change is faster than ever thought possible.

     EMDR is a psychotherapeutic treatment that yields meaningful results within weeks in cases where other methods take months or years to go into effect.  Many studies confirm the effectiveness and success of the method within just a few therapy sessions.  Millions of people have been successfully treated by this method.  EMDR can help you heal your life, one memory at a time, and live the life you are meant to live. 

     Many of our therapists here at RHS have been trained in EMDR therapy and use it as a therapy tool for treating major trauma, as well as other traumatic memories you may have experienced in life that have had a lasting negative effect on you and often impact your daily level of functioning.   If you’d like more Information about EMDR therapy, you may contact one of our trained therapists at Rehabilitative Health Services.

Cindy Quinn, LCSW

Worrying Is Worthless

It is not uncommon for people to worry about the many different stressors in their life. We usually worry about something when it is important to us or when we are nervous about or want to change the outcome. Most of the time, in these situations there is not very much we can do and so we feel very helpless and like we lack control. When we worry, we feel like we are doing something, but this only zaps us of our energy, does not change the outcome, and increases our anxiety.

I like the metaphor of worry being a weed. The more you feed, take care of it, and water it, the more it grows. When you take such good care of something you will find that it begins to produce sticky leaves, painful stickers, creeping vines, and becomes so big that it will take over the whole garden, yard, and even begin to entwine itself up and over the house. If we don’t nurture and feed the weeds, then they will soon be less and less likely to grow and flourish and become dry and even disappear. No one wants to have so many weeds (worries) that they feel like they are being held down, overwhelmed, helpless, and become more and more anxious.

Here are a few pointers to manage worry and in turn decrease anxiety:

·         Be aware of your thoughts.

A thought is just a thought: We do not have to keep it or own it.

Thoughts are very powerful and although we may not realize this, our thoughts create our feelings. We need to be aware of our thoughts and check on them to see if we need to change what we are telling ourselves. Positive self-talk is very important.

·         Put the worry in a container, up on a shelf, or in a drawer.

Imagine what the container looks like and only you are in control of opening and closing it – For example: a chest under the ocean with chains around it and a mermaid guarding it or a locked safe and you are the only one that knows the code and can get in.

·         Get busy doing something and try to be mindful of what you are doing in that moment.

Do an activity or something that you know helps you feel more positive – (For example: Go for a walk and notice everything you see, hear, and smell around you, listen to upbeat music, watch a funny TV show, talk to someone you care about, or do something nice for someone else.)

·         Take one thing at a time.

Many times we have so much to do that it can become overwhelming. We can break these things down to smaller steps so they do not seem like such big tasks.

·         Give yourself a break.

Everyone makes mistakes and can have off days. The man at the store does not ask others if he needs a pencil with an eraser or without one. This is because we all make mistakes and now and then. It is how we talk to ourselves and what we choose to do with this that makes the difference.

Sue Rosenbaum, LCSW

Throwback Tuesday: The Art of Control

(This post has previously been posted on Rehabilitative Health Service's Blog, but we felt it had relevance this month.)

Often time’s young adults come into my office and say things like “no one cares about me” “I feel controlled by my parents” and “I never have a say in what happens in my life.”

 

As kids are reporting this to me during sessions I start to wonder “Is this really happening or are they making it up to hopefully get what they want”. What I have found is that parents and or (adults) tend to seek and gain ALL control of those whom they are responsible for.

 

Sharing control with your kids is an art that takes time, patience, love and lots of empathy. Some people may say things like “If I don’t tell my kids what to do and how to do it then they will never do anything right. This technique sounds good and may work from time to time however, it is important to CONSULT with your kids and allow them the opportunity to think for them self’s.

 

Parents who consult with there kids create a open door for communication that will develop an even playing field in which the child will feel comfortable expressing there true thoughts and emotions. Kids want to be heard and know that what they have to say is important. What may seem trivial for you as the parent maybe huge or life changing for your child.

 

As parents, a goal should be to understand and know are children’s true feeling so we can help them with issues or difficulties they may face in there life’s journey.

 

Brett Hampton LCSW

Therapist at RHS

SUICIDE PREVENTION 101: Let’s Talk About It

Post Register: Crisis Center

Congratulations to Hailey Tyler and our friends at the Crisis Center! They are doing a great job providing invaluable services to our community. 

Check out this link to the digital copy of the Post Register! 😊

http://www.postregister.com/past-editions/201706/20170630

Why In The World Do We Treat Ourselves So Poorly?

    Have you ever been asked to identify your strengths or things that you like about yourself?  This seems to be a very difficult question for most people.  It seems that if we ask individuals to name things that they don't like about themselves then they can give us a list a mile long and the attributes come to them quickly.  Here are a few suggestions that we can use to help us increase our self-esteem and quiet the negative voice lurking in our heads.  

     Instead of using black and white thinking practice self-compassion and allow for shades of gray.  This will help us accept our short comings and still help us work toward being our best self.  

     Instead of using inflated praise look for feedback that fosters a growth mindset and will inspire us.

     Stop comparing ourselves to others.  We are as unique as our thumbprint.  Look for opportunities to help others get back on their feet which in turn gives us a sense of self efficacy.  

      We cannot derogate the success of others and instead look at their success as a boon rather than a threat can help us bask in reflected glory.  

       Seeking social approval can also decrease our self-esteem.  We can instead remind ourselves that no matter what we do or don't do, someone is likely to disapprove.  Being true to ourselves is more likely to lead to healthy self-esteem than pleasing others.  

       I love the song by Alessia Cara, Scars to Your Beautiful, "But there's a hope that's waiting for you in the dark.  You should know you're beautiful just the way you are.  And you don't have to change a thing the world could change its heart.  No scars to your beautiful, we're stars and we're BEAUTIFUL".  

April Moedl LCSW

Bullying

Often we think of bullying as something that happens only at school, however we should not overlook the fact that bullying can also, and often does, happen at home between siblings. It is not normal or healthy for one sibling to persistently terrorize his/her brother or sister.  Kids will fight and disagree, and this is not bullying necessarily, but if one is always terrorizing another we need to focus on and address this issue with them.

           Here are some steps that are suggested in the book Bullied by Carrie Goldman. Helping kids learn how to “re-frame” situations and not take everything personally is a great first step that would help them to 1- not let the teasing upset them and 2- learn that the content of the teasing may not be true and not worthy of their time and energy to stress over. Re-framing is learning to apply alternative meaning to things.

In addition to re-framing, bullying should always be addressed when children are in a safe place and able to talk with an adult about what is going on between them.  The kids should learn that they need to address these things or that the bullying will continue and neither themselves nor the bully will get the help they need in order to change the situation.    

Another tip is the use of “I messages.” An I message is when you state “I feel…. When you….  I need you to …. Etc.”  However, using I messages doesn’t work when done in an unsupervised situation, because this will give the bully the reaction that he/she is seeking.  We need to teach kids to use I messages when talking with adults or while in a structured setting.  This is where learning to re-frame things in positive ways helps.  For example: if one sibling calls the other four eyes, the recipient can thank them for noticing his/her glasses and taking the time to comment. This is very upsetting for the bully, because he was trying to get a negative reaction and didn’t get one when the recipient didn’t become upset but happy instead.

Additionally, a receiver of sibling bullying can learn to agree with the teaser.  Such an instance might be if the bully says their brother/sister is short. The bullied sibling can agree “yes I am a short kid for my age.”  When using this tip there is not much arguing and it ends the conversation quickly

          Along with this tactic is the great skill of saying “So.” The bully may take time to point out that his/her sibling messed up on their art project. The teased child may simply reply “So, it’s not a big deal.”  Doing this removes the emotional response the bully is after and, if done without attitude or anger, turns it back on the bully, who must now wonder why they made such a comment in the first place.

Another tip that seems to stump bullies and give some power back to the bullied sibling is complementing. Complementing the bully throws them off and takes away what they are after, i.e. a negative emotional response.  If one brother tells the other that he plays like a girl the bullied brother can say “You are right and you are so good at [the game] that I was wondering if you would take the time to teach me.”  This is not the response that they are after, so it will often end the teasing.  

The last tip that I am addressing here is using humor. Humor is any way we can make others laugh and not leave us feeling taken advantage of or put down.  If the receiver of the teasing is told that they “smell worse than the dog”  they could say “Good, we were competing and I am glad to know that I am winning this time.” If the child can get others laughing this will change the emotion and end the teasing.

           I hope that these skills help with stopping the verbal bullying at your home through the summer.

By Kristy Goodson, LMSW

Sources: Bullied by Carrie Goldman

Three States of Mind: Reasonable Mind, Emotion Mind, and Wise Mind

Have you ever wondered why people make poor decisions over and over again, even when they know there will certainly be a negative outcome? Often times we are ruled by certain states of our mind without having the knowledge or tools to cope with distressing emotions, thoughts, and compulsive behavioral patterns. DBT therapy teaches clients to learn to distinguish between different parts of the thought and emotion process before making decisions that could potentially be harmful and compulsive. The three states of mind include: reasonable mind, emotion mind, and wise mind.

Reasonable mind is the state of mind that is rational. Reasonable mind is needed for tasks such as, planning, evaluating, solving logical problems, balancing a checkbook, and so forth. Reasonable mind is necessary, but can prove to be detrimental if one stays stuck in purely logical thinking patterns. If emotions are overlooked when making important decisions, such as, choosing a place to live, applying to colleges, and finding a job then one could potentially settle and end up unhappy with their decision.

Emotion mind is the state of mind that is hot and emotion ruled. When one is in their emotion mind, logic is overlooked and behaviors are purely based on the state of how one feels. In this state of mind emotions are in charge and impulsive decisions often follow. Emotions are very powerful motivators for behaviors, but decisions based on negative emotions without thinking about the logical consequences can prove to be detrimental.

When emotions are strong and the urges to act on them are also strong, behavioral patterns are typically out of sync with one’s core values.

Wise mind is the state of mind in which one can synthesize the reasonable mind and emotion mind to make a decision that is based on intuition. Wise mind decisions require that one can learn to trust their intuitive state of mind, learn to utilize mindfulness skills to get into a wise mind state before acting and/or reacting, and learn to experience a state of peace rather than basing decisions on surface experiences.

“Wise mind is a deep, centered place where a person knows something very clearly. Wise mind is receptive and open. It accepts rather than judges.  It is patient rather than impatient” (Safer, Telch, & Chen 2009).

If you are struggling with getting to know your wise mind and feel that you are making decisions that are harming you more than helping, please contact our office to schedule an appointment with one of our trained therapist. At Rehabilitative Health Services we offer both individual and group DBT therapy to ensure that the needs of our clients are being met. Contact our office at 208-523-5319 to schedule your appointment.

Stephanie Shirley, LMSW

Sources

Safer, L. S., Christy, F. T., & Eunice Y. C. (2009). Dialectical Behavioral Therapy for Binge Eating and Bulimia. New York, NY: Guilford Publishing, Inc. 

Bipolar

Bipolar is a brain disorder that affects about 5.7 million Americans every year (2). Bipolar causes abnormal shifts in moods, energy, and activity levels.  These shifts can cause a disruption in a person’s ability to carry out daily routines. 

Bipolar was first discussed in the Nineteenth Century by Jules Baillarger and Jean-Pierre Falret who both presented their description of the disorder to the Académie de Médicine in Paris. It wasn’t until in the early 1900’s that German psychiatrist Emil Kraepelin studied Bipolar and discovered that there are periods of symptom-free intervals between the manic and depressive episodes and because of this he coined the phrase Manic-Depressive Psychosis.  The terms Bipolar and Manic-Depressive Illness are both used to name the same disorder but Bipolar disorder was thought to be less stigmatizing so it is the term used today. (3)

Bipolar disorder is usually diagnosed by a doctor or mental health provider. There are four types of Bipolar that can be diagnosed: Bipolar I Disorder, Bipolar II Disorder, Bipolar Not otherwise Specified, and Cyclothymic Disorder.  Bipolar I disorder is defined as manic or mixed episodes that last at least seven days and depressive episodes that typically last two weeks. Bipolar II Disorder is defined as depressive episodes with hypomanic episodes but not full manic episodes.  Cyclothymic Disorder is a mild form of Bipolar disorder with hypomania and mild depression that last at least two years, yet the symptoms don’t meet requirements for the other forms of bipolar. (1)

The symptoms of bipolar are periods of mania followed by periods of depression; these are distinguished by how people act while in each respective period. During the manic phase a person may talk fast, have racing thoughts, be easily distracted, have increased activities, be overly restless, have little to no sleep, have unrealistic beliefs in their abilities, and become impulsive.  During the Depressive period a person is usually overly tired, have trouble concentrating, have trouble making decisions, be irritable, have changes in eating, sleep more, and have increased thoughts of death or suicide. (1)

With the right treatments, Bipolar can be managed over a long period of time.  The treatments for Bipolar disorder are medication management and psychotherapy; these are best used in conjunction with each other. Mood stabilizer medications are usually the first choice to treat Bipolar and can help reduce the manic and depressive episodes that are caused by Bipolar.  Psychotherapy is another form of treatment that helps a person with Bipolar learn to manage their symptoms. (1)

Bipolar effects millions of people every day but with education and the right treatments it is able to be managed so that people can live a full life

Dave Homer, LMSW

Sources

(1) Bipolar Disorder in Adults. (2012). Retrieved November 30, 2015, from http://www.nimh.nih.gov/health/publications/bipolar-disorder-in-adults/index.shtml#pub18

(2) Bipolar Disorder Statistics. (2015). Retrieved November 30, 2015, from http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_bipolar_disorder

(3) Burton, N. (201, June 21). A Short History of Bipolar Disorder. Retrieved November 30, 2015, from https://www.psychologytoday.com/blog/hide-and-seek/201206/short-history-bipolar-disorder