Understanding and Soothing the Anxious Self

By Lisa Catania, LCSW

 

Anxiety is one of the primary reasons individuals come to counseling. Everyone deals with anxiety in some capacity.  For some it is an infrequent experience, and for others it is a lifelong companion.  For most, it tends to be an uncomfortable feeling suggesting risk in near and potentially unmanageable.  For this reason, anxiety can turn into real panic and can render a person feeling powerless.

 

Believe it or not, anxiety in its’ basic form serves a positive function, as do all emotions.  Anxiety is your sympathetic nervous system sounding an alarm that danger is present.  This creates a “flight or fight” response.  When this alarm system gets triggered, your brain creates “circuitry” to tag situational related events to give you an early warning system the next time a similar threat is present.  This is where problematic anxiety can set its’ roots – if you experience an adrenaline charged alarm while engaging in an ordinary event (like driving your car in snow), you can misperceive the benign experience as a dire threat to your safety and well-being (alas, developing a fear of driving in winter).  When you respond to these false alarms by reacting as if it is real (by flight: avoiding; or by fight: over-reacting), you can deepen your fear response and a reoccurring anxiety reaction can result.

 

Compassion and self-compassion are of primary importance as distress dominates, and sometimes shame can develop as self-criticism and a misconception of weakness can occur.  Here are some beginning ideas to help begin to “soften” the anxiety experience.

 

First, look for the beginning signs of stress or anxiety; for example: a worried thought, a quickened heart beat, or butterflies in the stomach.  Label it as what it is: the anxiety response. Begin right away with “turning down the alarm system” by practicing relaxation and calming.  Take deep belly breaths.  Use positive, reassuring, calming self-talk, such as “relax…. I can handle this”. This first step is important: when you calm yourself and self-soothe, you are activating your parasympathetic nervous system which is a “rescue” system that restores a calm physical state. In other words, you remind yourself that you can handle the experience of the moment, as well as the actual situation.

 

Anxiety-ridden moments can be ferocious, especially when they have been reinforced by avoidance or over-reaction. To be able to thwart these moments, you need to build up the “muscles” of your relaxation response.  Practicing deep breathing and relaxed feelings daily, especially when you are not triggered, will help you build and access this helpful “circuitry” when you need it most. It is also helpful to recognize and change any thoughts or beliefs related to your anxiety reaction, especially thoughts that reduce your sense of safety or control.  Instead of believing “I can’t drive in the snow”, reframe the thought: “I am scared, but can breathe into my real strengths. I can handle this”. Practice thoughts that include patience, self-compassion, forgiveness, and self-empowerment, such as “I can acknowledge my anxiety, and have compassion for my fear.  I am more than one feeling/experience.  I have real strengths I can bring to the situation.  I can ask for help, understanding, and support. I am safe.”

 

Also, develop routines of self-care to increase general health and well-being.  Exercise and healthy eating help to release pent-up energy and frustrations, and physically build up inner strength, hardiness, and self-worth.  Practices of meditation, mindfulness, and prayer help settle the mind and connect to a higher source or the bigger picture.

     

 Once you feel calmer, you can more readily access the problem-solving frontal lobe area of the brain.  At this point, you can address situations in their real form and develop a strategy plan.  Problems are more solvable or navigable if you can calm your anxiety, take things a-step-at-a-time, implement strategy plans and practice self care and self-compassion. 

Relationship Help: the Power of Appreciation

by Monica Hagerty, LCSW

Judgments and criticisms are all around us.  We make judgments about others and ourselves every day.  That is, in fact, the nature of the human ego.  As long as we are human, we will judge and be judged.

While the simple act of having a judgment or criticism about others may be inevitable, we have full control over what we do with our judgments.  We can decide to share them or we can keep them to ourselves.  Or, we can go one step further; we can look at our judgments closely and find out what they may have to say about us. 

Frequently, we assume that criticism is helpful.  It is easy to think that your partner will appreciate it if you point out their mistakes and give them suggestions on how to improve.  As a result, it can become a habit of mind to look for what others are doing wrong and to make criticisms accordingly.  However, when a person feels criticized or judged, they often make more “mistakes” and become defensive.  This negatively affects the relationship. 

Many of us know how it feels to have a boss give us “constructive criticism.” We often don’t feel better after hearing this.  In fact, we feel worse, and we often don’t want to do better next time.  It is the criticism in the statement that stings badly.  In his book, The Seven Principles for Making Marriage work, Dr. John Gottman discusses the results of his research regarding the impact negative statements or criticisms. He found there to be a 1 to 5 ratio of critical to positive statements.  That is, for each critical statement we make, we have to make five positive statements to cancel the impact of our criticism.   This is because negative words hurt more.  We can all remember the impact from a criticism we received, even one said years ago; however, we often have a harder time remembering an appreciation we received. 

Undoubtedly, there will be times when we fail to contain our judgments, times when we aren’t our best selves.  The good news is that there is a remedy for this: sharing appreciations. It is far more valuable to learn how to appreciate the things your partner does well and to ask them to do more of those things, than it is to tell them that what they are doing is wrong.

Often, we may  like the things that our partner does in the moment, but we don’t share this valuable information with them.  Your loved ones need to know what they are doing well on a daily basis.  This acknowledgment is important.  It feels good to feel appreciated and “seen” in the relationship.  Plus, sharing appreciations can also serve our own interests.  This practice causes our loved one to do the things that we like more often.  

When it comes to sharing appreciations and gratitude, here is a good rule to follow: the more specific an appreciation is, the more valuable it feels.  While it is easy to say “thanks”, the dividends from that simple expression of gratitude are relatively small.  Fortunately, very little effort is required to turn “thanks” into something more meaningful.  Next time, try giving a bit more:  “thank you for taking the dog to the vet today.  I had a very long and  stressful day and it made me feel cared for to know that you took care of this so that I could relax when I got home from work.  I really appreciate it.” 

It is important to make time every day to connect emotionally with your loved ones.  One way to do this is to create a culture of appreciation in the context of your most important relationships.  Try sharing one thing with your loved one that they have done in the last week that you appreciate. Also, if you have kids, remember to tell them something that you appreciate about them too.  

Creating a Culture of Kindness

By John Andrich, LCSW

 

A colleague told me this story: “A few months ago, a friend gleefully told me about a surprise she found on her windshield; a note with a big smiley face with the message, “You are wonderful. Thank you for being a shining unique beautiful light in the world!”  On the bottom it said, “Practice Random Acts of Kindness. Pass it on.”

When you are kind to others, it not only changes you, it changes the world. – Harold Kushner

Kindness is the virtue which gives rise to a variety of other highly valued qualities: compassion, generosity, empathy, tolerance and acceptance. The ability to consider the needs and desires of others in our interactions is central to our happiness. Psychologist and author Gordon Livingston notes that kindness reflects a belief in the basic decency of others, and so it must be balanced by the ability to recognize those who are unable or unwilling to give in return. It would appear that the capacity for kindness can be overwhelmed by our own self interests.

 

Research has shown that children do not need to be taught or trained to be kind, and acts of kindness can be observed from a very early age. Babies will often join in when they hear another baby cry, and researchers conclude that this is not an expression of distress, but rather an expression of sympathy for the crying baby. Children have been seen offering a toy to a distressed child, patting them on the head, or finding an adult to help.

 

However, by the fourth grade children have been socialized to think more about themselves than others. It is important therefore that children be actively encouraged to maintain the virtue of kindness. A recent research study at the University of California, Riverside, named Kindness Counts, revealed that performing deliberate acts of kindness made pre-teens more popular with classmates, gaining an average of 1.5 friends over the four week study period. The study showed that being kind to others benefits the giver, and earned the children in the study a greater sense of well being, increased popularity, and acceptance from their classmates.

 

To help children to become more mindful about doing acts of kindness, the concepts from the Kindness Counts study can be easily applied at home. The following four steps can help to increase happiness for children:

 

1) Plan a family activity. Create a month long activity where the entire family (including parents) record one act of kindness or one pleasant activity per day. You might call it your “Happiness Project” or “Happiness Diary”. These activities might include letting someone else go first, going out of your way for a friend, taking care of an animal, hugging someone to make them feel better, helping with dishes etc. They might include visits to places and experiences that make us feel good, like visiting relatives or going to the park.

 

2) Share what you have learned. Take time to share as a family each week. It’s not essential to share everything in one’s diary. What’s important is to share enough so that everyone learns from each other’s acts of kindness and begins to understand the kinds of experiences that bring gratitude to life. Sharing can encourage reflection and help bring meaning to our actions.

 

3) Practice, practice, practice. It may not be practical to keep up a “Happiness Diary” and share it on a consistent basis for much more than a month at a time. But is it possible to choose one month a year for this project? Are there other opportunities to strengthen and encourage kindness throughout the year?

 

4) Educate yourself about kindness. The Random Acts of Kindness Foundation website is a great place to begin.  You can learn about the importance of benefits of kindness and become inspired with activity ideas. Better yet, participate in Random Acts of Kindness Week, February 11-17, 2013. Come visit us on Facebook that week and post your inspired good deed or random act of kindness!

 

Forgiveness

by Patricia Harthun, LCPC

After the holiday season, we gather up the last of the bows and the wrappings, and find little niches for all the new presents.  Every now and then, there can be emotional baggage that is hard (and detrimental) to store away. 

“‘Tis the season?” The classic picture of the holiday season includes families and friends getting together in peace and harmony.  That happens… sometimes. At other times, old hurts get triggered and unhealthy patterns of interaction resurface.  Sadly for some, there is no interaction. When estranged from family members, the cultural focus on family togetherness highlights the divisions. 

In these cases, family relationships and friendships can be injured by misunderstandings or angry words.  An individual may feel slighted, and may “write off” the offender. Suddenly, all the positives that have occurred previously are forgotten, and all future actions are viewed through a negative lens. The hurt person may gather evidence for the conclusion they have decided on. 

There are times when abusive relationships and dysfunctional family dynamics make distance necessary for self-protection.  Creating supportive environments through friends or “adopted families” helps fill important needs for support and connection.  Even if situations require distance from family, individuals can still work internally on their wounds to create more room for forgiveness in the future or from a distance.

So how or why should we forgive?  The why is clear.  Unresolved anger and resentment eat away at our well being and intrude on our peace of mind.  The how involves taking into consideration that people are human and make mistakes.  Very often, the hurt caused by ignoring or retaliating is greater than the original injury.  We have the right to express what we would like to see change, but we lose the opportunity for change when we “write off” someone because they have wronged us.  No one is all good or all bad. Can we recognize that the missteps co-exist with the good deeds? If we can focus on the positive aspects of a person and speak up or step back temporarily when the negative creeps in, then we get the best of both worlds. We have the opportunity for improved relationships. 

The fill-in-the blank phrase “when you did _____, I felt______, next time  please_______” can provide a framework for expressing what changes you want. We do possess the capability for healing and change. If we can allow for the imperfections of the people in our lives, we can move past the hurts and enjoy the richness of the relationships around us.

Coping with the holidays

by Lisa Catania, LCSW

 

As we all prepare for what the holiday season means for us, it is important to remember that one size doesn’t fit all.  We are barraged by constant ads showing excitement, festivities, and gift-giving.  Whether we realize it or not, advertising is trying to ramp us up to feel something that will motivate us to try to create the advertiser’s pictures in our own lives.

 For some, this is motivating and inspirational.  For others, they are warmed by happy memories and look forward to the current holidays as a chance to feel that same “warm blanket of happy traditions”.  For others, there is a sadness and disconnect as their life doesn’t look like the images portrayed.  Recent or past losses can come to the surface, and cause real pain.   And still for others, the expectations stack high and stress mounts as the holiday season becomes about “more” and endless lists and the need to be everything to everyone.

The holidays are a time of increased stress, no matter if they are filled with happy anticipation or with concern.  At particular risk for stress are individuals who are: coping with the loss of a loved one, experiencing family problems that create divisions/separation, far away from home, and caregivers.  If you find yourself in one of these groups, take extra care to be kind, patient and caring with yourself.  Engage in stress reducing exercises such as physical exercise, talking to someone, and/or meditative activities such as mediation, yoga, or prayer.  Find sources or affirmation and support, starting with loving self-statements for yourself.

Here is a holiday “coping guide” for all of us, with the hope that you can honor “wherever you are” and make this holiday season meaningful to you:

Use your feelings as a barometer to measure pressure inside and around you.  Acknowledge how you feel, and make adjustments.

Love yourself as much as you love others.

Talk to someone who is trust-worthy.  Be real, especially if you are hurting.

Release the belief that there is such a thing as “perfect”.

Look for things to “feel right” and authentic for you.  Look for things to be “good enough”.

Remember the importance of what this season means to you.  Honor that in your actions.

Love and connection are some of the most powerful gifts we are capable of giving.

Balance taking care of yourself with taking care of others.

Realize you are enough.

Know your boundaries and limits.  Practice saying no.  Practice saying yes. 

Ask for help when you need it.

Remember to breathe.  Breathe deeply into your core and say to yourself, “Relax”.  Breathe out slowly and say to yourself, “Let Go”.

Hold onto whatever feeds your soul.

Practice gratitude.

Practice faith.

Practice tolerance and acceptance of those who feel and think differently than you.

Enjoy moments. 

And laugh as often as you can.

Make this list your own, adding on whatever inspires or grounds you!

 Last, but not least, remember to reach out to someone who seems vulnerable this holiday season.  It’s the best medicine for the soul.  As the Dalai Lama says, “If you want others to be happy, practice compassion.  If you want to be happy, practice compassion.” 

Wishing you peace,  Lisa

You are worthy of love and belonging. As is.

Deepok Chopra says that every feeling has a physical molecular presentation in our body, throughout our body.  Feelings of depression, anger, anxiety can mount into illness that effect the body, mind and spirit.

Conversely, feelings such as tranquility create the equivalent of valium, and exhileration creates the equivalent of powerful anti-cancer molecules in abundance. 

We have the powerful ability to effect our health through our feelings.  Try the above quote as an affirmation.  Allow yourself to feel the feelings of love, acceptance, well-being.  Imagine a beautiful white light radiating around you, and inside you.  Practice this as often as possible.

Below are some links to Brene Brown's inspirational TED talks on understanding and healing shame.  Spoiler alert - vulnerability and acceptance of yourself are key to the experience!

I think everyone should see these:

Brene Brown: The Power of Vulnerability

Brene Brown: Listening to Shame

Peace,  Lisa Catania, LCSW

About insurance companies benefits

Someone recently emailed and asked about how to understand insurance benefits, and what to expect to pay.  This is a very common question, so I thought I'd post my response:

Each insurance policy is different.  Usually you will get better benefits if you see someone in-network, however some out-of-network benefits are quite good especially if you have met your deductible.  Some insurance companies manage mental health benefits, and may require your therapist to provide clinical information after they have seen you. You can call your insurance company and ask them to tell you about your outpatient mental health benefits. 

 

Your insurance company should provide this information for both your in-network and out-of-network benefits:

deductible (and what amount has been met, year to date),

 

copayment or coinsurance amount per session,

 

limit in number of sessions per year (if you work for a company that has more than 50 employees you should have unlimited sessions per the Mental Health Parity Act), and

 

whether they cover the modality (individual, family, couple {frequently not covered}, or group) of therapy you are seeking.

 

Once you have this information, you can talk with a therapist and they should be able to help you anticipate what your session fee would be.

 

Hope this helps - feel free to ask other questions in the comments section, or call me if you have more questions.

 

Peace, Lisa Catania, LCSW
773-719-1751