Finding a Psychologist in San Diego

San Diego is a city in southern California known for it’s wonderful year round weather and gorgeous beaches. San Diego has many great attractions, wonderful restaurants and many employment opportunities. San Diego also has a high cost of living, limited public transportation and faces challenges with water scarcity. Even in the beautiful city of San Diego, people struggle with mental health concerns like stress, anxiety and depression. According to the National Institute of Mental Health, more than 30 million Americans need help dealing with relationship problems, depression, grief and loss, and stress. Those problems can at times be significantly debilitating. At times, we might need outside help from a trained, licensed professional like a psychologist.

Psychologists who specialize in psychotherapy and other forms of psychological treatment, are highly trained professionals with expertise in behavior change, mental health assessment, and diagnosis and treatment. Psychologists are licensed in the state they practice and work in various settings such as hospitals, schools, mental health centers and private practice. Psychologists apply scientifically validated strategies to help people change their thoughts, behaviors and emotions. Psychotherapy is a collaborative effort between an individual and a psychologist which provides a supportive environment to talk openly and confidentially about struggles and a variety of concerns.

I’m aware that you have many mental health providers available to work with in San Diego. I recommend you work with a psychologist given their extensive level of training. After graduating from college, psychologists spend an average of six years in graduate education training and possibly research before receiving a doctoral degree. As part of their professional training, psychologists must complete a supervised one year clinical internship in a organized health setting or hospital. Psychologists also spend at least one year of supervised post-doctoral experience before they can practice independently in any health care arena. The combination of doctoral-level training and a clinical internship is what distinguishes psychologists from many other mental health care providers.

If you’re looking for a San Diego psychologist, let’s review some ways to find the right one for you.

Here are some tips to consider while looking for a psychologist in San Diego.

1. Does the psychologist offer in-person and/or telehealth sessions?

2. Is the psychologist’s website helpful in getting a sense of the person and how he or she works with clients?

3. If you leave a voice message or email, does the psychologist respond in a timely manner?

4. What kinds of treatments does the psychologist use and have they been proven effective for dealing with your concerns?

5. Remind yourself that finding the right psychologist for you is worth the effort. A good psychologist can help you reduce your symptoms, and develop confidence and skills to deal with mental health matters for the rest of your life.

6. While all psychologists are trained in compassion and understanding, having a psychologist who is part of your community, or who has experience working with people from your community, can make a positive difference.

I believe a good way to determine the goodness of fit is to be able to chat briefly with the psychologist. Make sure the psychologist offers a free phone consultation. Ask about how the psychologist will address your concerns and how he or she will help you accomplish your goals. It’s a chance for you to ask the psychologist some questions about his or her areas of specialty. Get a good sense of what therapy sessions will be like working with this psychologist. Ask questions that help you determine if you’d feel comfortable working with the psychologist. Therapy isn’t just for chatting weekly, it is about reaching your goals and feeling respected and supported.

If you’re looking for mental health support, please contact me to schedule a free 15-minute phone consultation.

6 Mental Health Benefits of Exercise

Most of us know the many physical benefits of exercise like increased energy, weight control, lower blood pressure, and reduced risk of diabetes. But what about the psychological benefits of exercise? Did you know that exercise can help lessen symptoms of depression and anxiety and keep your memory sharp? Let’s explore six mental health benefits of exercise.

6 Mental Health Benefits of Exercise

1. Exercise and Depression

   Studies show that exercise can treat mild to moderate depression as effectively as antidepressant medication but without any side effects. For example, a study by Harvard’s School of Public Health found that walking for an hour or running for 15 minutes a day reduces the risk of major depression by 26%. In addition to relieving symptoms of depression, research also shows that maintaining an exercise schedule can prevent you from relapsing. Some researchers suspect exercise alleviates chronic depression by increasing serotonin, the neurotransmitter targeted by antidepressants. Furthermore, exercise promotes all kinds of changes in the brain, like reduced inflammation, neural growth, and new activity patterns that promote feelings of well-being and calm. Additionally, exercise helps with good blood flow, improves circulation, and stimulates the growth of new blood vessels in the brain. In addition, physical exercise releases endorphins, powerful chemicals in your brain that energize your spirits and make you feel good. Finally, exercise can also serve as a distraction, since it provides some quiet time to break out of the cycle of negative thoughts that feed depression.

2. Exercise and Anxiety

   Exercise is a natural and effective anti-anxiety treatment. It relieves stress and tension, boosts mental and physical energy, and enhances well-being by releasing endorphins, peptides produced in the brain that block the perception of pain and increase feelings of well-being. Furthermore, moving your body decreases muscle tension, lowering the body’s contribution to feeling anxious. In addition, exercise activates frontal regions of the brain that are responsible for executive function, and therefore helps control the amygdala, our reacting system to real or imagined threats to our survival.

   One possibility is that exercise buffs up the brain and the body. Physical exercise triggers the release of a protein known as brain-derived neurotrophic factor (BDNF). BDNF encourages the growth of new brain cells, possibly, in the hippocampus, a brain region important in learning and memory. Since the hippocampus tends to be smaller or distorted in people with anxiety and depression, boosting BDNF through exercise might be a way physical activity might help manage these conditions.

3. Decreased Stress
   Another mental benefit of exercise is reduced stress levels, something that can make everyone happier. Increasing your heart rate can reverse stress-induced brain damage by stimulating the production of neurohormones like norepinephrine, which improves cognition and mood and clouded thinking by stressful events. In addition, exercise forces the body’s central and sympathetic nervous systems to communicate with one another, improving the body’s overall ability to respond to stress.

   Think about how your body feels when you're stressed. Your muscles may be tense, especially in your neck and shoulders, leaving you with back or neck pain, or painful headaches. You may feel a tightness in your chest, a pounding pulse, or muscle cramps. You might also experience problems such as stomachache, insomnia, heartburn, diarrhea, or frequent urination. The worry and discomfort of all these physical symptoms can lead to even more stress, creating a vicious cycle between your mind and body.

   Exercising is an effective way to break this cycle. As well as releasing endorphins in the brain, physical activity helps to relax the muscles and relieve tension in the body. Since the body and mind are so closely linked, when your body feels better so will your mind.

4. Increased Self-Esteem and Self-Confidence
   From improving endurance to losing weight and increasing muscle tone, there’s no shortage of physical achievements due to regular exercise. All those achievements can add up to boosting your self-esteem, as well as the confidence that comes with it. You may not set out for a slimmer physique or the ability to climb a hill without getting winded. Oftentimes it happens before you even realize it. It’s just one of the many benefits of physical activity that boost your body, mind, and spirit.

   Regular exercise is an investment in your mind, body, and soul. When exercise becomes a habit, it can foster your sense of self-worth and make you feel strong and powerful. You’ll feel better about your appearance and, by meeting even small exercise goals, you’ll feel a sense of achievement.

   Self-esteem is how we feel about ourselves and how we perceive our self-worth. It is a key indicator of our mental well-being and our ability to cope with life stressors. Physical activity has been shown to influence our self-worth and self-esteem positively. This relationship has been found in children, adolescents, young adults, adults, and older people, and among both males and females.

5. Better sleep
   Studies have found that proper exercise can alleviate sleep-related problems and help you get an adequate amount of rest. If you have trouble getting a good night’s sleep, exercise can help with that, too. Physical activity increases body temperature, which can have calming effects on the mind. Exercise also helps regulate your circadian rhythm, our body’s built-in alarm clock that controls when we feel tired and when we feel alert. Please note that sleep experts recommend not exercising close to bedtime.

   Moderate aerobic exercise increases the amount of slow-wave sleep you get. Slow-wave sleep refers to deep sleep, where the brain and body have a chance to rejuvenate. In addition, moderate to vigorous exercise can increase sleep quality for adults by reducing sleep onset, and the time it takes to fall asleep, and decreasing the amount of time they lie awake in bed during the night. Additionally, physical activity can help alleviate daytime sleepiness. Exercise can also help to stabilize your mood and decompress the mind.

6. Brain Boost
   From building intelligence to strengthening memory, exercise boosts brainpower in many ways. Studies on mice and humans indicate that cardiovascular exercise creates new brain cells, a process called neurogenesis, and improves overall brain performance. Exercise also prevents cognitive decline and memory loss by strengthening the hippocampus, the part of the brain responsible for memory and learning. In addition, studies prove that physical activity boosts creativity and mental energy. So if you need inspiration, your big idea could be just a walk or jog away.

   Exercise offers short-term boosts in cognition. Studies show that immediately after a bout of physical activity, people perform better on tests of executive functions and working memory. This might be in part because movement increases the release of neurotransmitters in the brain, most notably epinephrine and norepinephrine.

   The brain benefits start to emerge, though, when people work out consistently over time. Studies show that people who work out several times a week have on average higher cognitive test scores, than people who are more sedentary. Other research has found that a person’s cognition tends to improve after participating in a new aerobic exercise program for several months.

   Overall, there are many important mental health benefits of exercise. I hope you learned something new in this blog that helps motivate you to make time for exercise and wellness. Permit yourself to prioritize time to exercise. Learn to focus on your schedule and be sure to make time for wellness. You can walk during your lunch break, find some YouTube exercise videos that you’ll do after work or classes, go biking or hiking on the weekends, or join a gym. As exercise becomes a habit in your life, you’ll reap the benefits of exercise.

   If you’re looking for mental health support, please contact me to schedule a free 15-minute phone consultation.

The Problems with Perfectionism

I work with many clients who struggle with perfectionism and thought it would be helpful to write about perfectionism. I will be referring to Brene Brown’s book The Gifts of Imperfection. It’s a great book that I highly recommend. Brene Brown defines perfectionism as “the belief that if we live perfect, look perfect, and act perfect, we can minimize or avoid the pain of blame, judgment, and shame. It's a shield. It's a twenty-ton shield that we lug around thinking it will protect us when, in fact, it's the thing that's really preventing us from flight."

Brene Brown recognizes that “perfectionism is not the same thing as striving to be your best.” Perfectionism is about trying to earn approval and acceptance, not self-improvement. As Brene states, “most perfectionists were raised being praised for achievement and performance” like grades, appearance, sports, and people-pleasing. Perfectionism is other-focused (what will they think?) while healthy striving is self-focused (how can I improve?) Research shows that perfectionism hampers success. Perfectionism has been found to increase the risk of anxiety disorders, depression, and eating disorders.

Brene believes that perfectionism is a “self-destructive and addictive belief system that fuels this primary thought: If I look perfect and do everything perfectly, I can avoid or minimize the painful feelings of blame, judgment, and shame.” What really happens is that the person will actually experience those painful feelings that tend to lead to thoughts of not being good enough.

Furthermore Brene Brown states “Perfectionism is an unattainable goal. It’s more about perception than internal motivation, and there is no way to control perception, no matter how much time and energy is spent trying.” Perfectionism leads to a vicious cycle of wanting others to think highly of you but instead, you tend to feel disappointed and upset with yourself.

Brene acknowledges that “perfectionism is addictive because when we invariably do experience shame, judgment, and blame, we often believe it’s because we weren’t perfect enough. Rather than questioning the faulty logic of perfectionism, we become even more entrenched in our quest to look and do everything just right.” Perfectionism tends to be an exhausting cycle of trying to impress others while making yourself feel horrible in the process.

If you’re seeking to be perfect, you’ll ultimately demotivate yourself. Having ideals that are unattainable, you’ll never feel like you’re good enough and instead, you’ll miss out on rewards of accomplishment.

Another drawback of perfectionism is the way it distances you from others. People may not want to work with you because of your impossibly high expectations and they know they won’t measure up. In addition, if you fall into the trap of believing you’re close to perfect, you also run the risk of intimidating others.

Furthermore, perfectionism can be a barrier to your academic or professional growth because it reduces your ability to do brilliant work. If you’re unable to move ahead or can’t get anything done, you’ll limit your ability to contribute to a project. Furthermore, if you can’t admit mistakes, you won’t be able to learn from the mistakes or understand what went wrong in order to improve.

As Brene Brown’s research indicates, to overcome perfectionism, we need to be able to acknowledge our vulnerabilities to the universal experiences of blame, judgment, and shame. We’ve got to practice self-compassion and develop shame resilience in order to embrace our imperfections. Through the process of embracing our imperfections, we find our truest gifts: compassion, courage, and connection.

If you’re looking for help with your perfectionism, please contact me to schedule a free 15-minute phone consultation.

How to Identify and Challenge Distorted Thinking

Cognitive therapy helps a person learn how to identify distorted thinking in order to change the way you think and feel. These thoughts are automatic and simply pop into our minds automatically. As a result, people tend to respond automatically to these distorted thoughts without pausing to notice whether or not the thoughts are accurate or realistic. Everyone has a flow of positive, neutral, and negative automatic thoughts throughout the day. Unfortunately, negative automatic thoughts tend to lead to irrational thoughts. From a psychological perspective, irrational thoughts:

• are not based on evidence

• mostly operate on assumptions

• are rooted in beliefs based on past experiences either positive or negative

We all have irrational thoughts. Some people will be able to recognize irrational thoughts. Other people may struggle to let go of the irrational thought and give the thought too much time and attention. Thus, irrational thoughts can cause functional impairment in behavior which can negatively impact day-to-day life.

When irrational thinking becomes a pattern, it creates a cognitive distortion. This is an error in thinking or logic that affects the way your mind processes information. Cognitive distortions refer to your mind making judgments and inferences about a situation that are not based entirely on logic or evidence. This is usually the result of past experiences. Cognitive distortions can shape your beliefs, mood, and how you view yourself, others, and the world in general.

The 10 most common cognitive distortions: (adapted from “Feeling Good: The New Mood Therapy”)

1. All-or-nothing thinking: You look at things in absolute, black-and-white categories.

2. Overgeneralization: You view a negative event as a never-ending pattern of defeat.

3. Mental filter: You dwell on the negatives.

4. Discounting the positives: You insist that your accomplishments or positive qualities don’t count.

5. Jumping to conclusions: a) Mind-reading: You assume that people are reacting negatively to you when there’s no definite evidence; b) Fortune-telling: You arbitrarily predict that things will turn out badly.

6. Magnification or minimization: You blow things way out of proportion or you shrink their importance.

7. Emotional reasoning: You reason from how you feel: “I feel like an idiot, so I really must be one.”

8. “Should statements”: You criticize yourself (or other people) with “shoulds,” “oughts,” “musts” and “have tos.”

9. Labeling: When you label yourself or others. Instead of saying “I made a mistake,” you tell yourself, “I’m a jerk,” or “a fool,” or “a loser.”

10. Personalization and blame: You blame yourself for something you weren’t entirely responsible for, or you blame other people and deny your role in the problem.

How to challenge distorted thoughts:

1. Journal. When you notice a change in mood, journal about what you’re thinking and feeling. Pay particular attention to what you're telling yourself. When you’ve calmed down, review the list of distortions and determine which one fueled your intense emotion. Be curious about what thought triggered you and make note of it. Curiosity will create an opportunity for increasing self-awareness and allow you to grow and learn about what you can do differently next time.

2. Complete a thought record. A thought record is a core tool in cognitive-behavioral therapy (CBT). This is a one-page worksheet that you use in a difficult situation to help you notice your unhelpful ways of thinking and change your perspective to something more realistic. It focuses on the interactions between thoughts, feelings, and behaviors, and how to focus on factual evidence in order to think more reasonably and rationally.

3. Practice mindfulness which is the ability to focus on the present moment. It’s incredibly helpful to practice diaphragmatic breathing which allows you to focus on each inhalation and exhalation which brings you to the present moment. Practice noticing the thoughts and letting them go. Learn to recognize that you are not your thoughts.

4. Practice self-compassion. Learn how to talk to yourself as if you were talking to your best friend. Practice being kind and patient with yourself. Acknowledge the pain you feel and learn to sit with the emotion and let it go.

5. Consider working with a psychologist who is trained in cognitive-behavioral therapy (CBT). The therapist can provide you resources and support, teach you how to challenge your distorted thoughts, reduce anxiety and depression, and improve your mood.

Distorted thinking negatively impacts how a person, thinks about oneself, others, and the world. Be patient with yourself as you increase your awareness of your unhelpful ways of thinking. Learn to make your mental health a daily priority and learn and practice CBT coping strategies that can help reduce your irrational and distorted thoughts. Consider seeking additional support by working with a therapist who is trained in CBT.

If you’re needing help in dealing with your unhelpful thinking patterns, consider setting up a free phone consultation and we can discuss how therapy can be helpful.

The Power of Deep Breathing

According to the Stress in America 2020 survey conducted by the American Psychological Association (APA), Americans have been profoundly affected by the COVID-19 pandemic, and the multitude of factors Americans have listed in previous years as significant sources of stress remain present and problematic. Given the intensity and duration of these ongoing stressors especially the persistence of this pandemic, APA has issued a warning: We are facing a national mental health crisis that could yield serious health and social consequences for years to come.

Given the endless stressors in our lives especially in the middle of a pandemic, I want to suggest that we make deep breathing a daily practice. Deep breathing also known as diaphragmatic breathing is a practice that enables more air to flow in our body. With practice, deep breathing can help to calm our nerves which helps to reduce anxiety and stress. Most of us take breathing for granted since we typically don’t pay attention to our breathing. Learning to pay attention to how we’re breathing can make a positive impact on our stress levels.

Your autonomic nervous system, which controls involuntary actions like heart rate and digestion, is split into two parts. One part, the sympathetic nervous system (the red zone) controls your fight-or-flight response. The other part, the parasympathetic nervous system (the green zone) controls your rest and digest response. These two parts of your nervous system can’t be turned on at the same time, which means if you work to activate one, the other will be suppressed. As a result, when you pay attention to your breathing you realize that you can control your breathing and with practice, you can activate the parasympathetic nervous system.

Purposeful deep breathing can physically calm your body down. Breathing more deeply also allows for more carbon dioxide to enter your blood, which quiets down parts of the brain, like the amygdala, that handles your anxiety response. Per Dr. Rhoads, more carbon dioxide also helps synchronize your heartbeat and breathing. In addition, deep breathing is one of the best ways to lower stress in the body. When you breathe deeply, it sends a message to your brain to calm down and relax. The brain then sends this message to your body.

When you take a deep breath in, your heart rate quickens slightly. As you exhale, your heart rate slows down. Repeated deep breaths will naturally bring your heart rate more in sync with your breath. This leads your brain to release endorphins, which are chemicals that have a natural calming effect. Furthermore, deep breathing allows more oxygen to the brain which can improve cognitive function like problems solving.

Let’s review a few deep breathing exercises, including belly breathing and 4-4-8 breathing.

Belly Breathing:

Ideally practice this exercise a few times a day like before you get out of bed, during a short break at work or school, and during the evening. The more often you can practice this exercise, the more beneficial it becomes.

1. Sit or lie flat in a comfortable position.

2. Put one hand on your belly just below your ribs and the other hand on your chest.

3. Take a deep breath in through your nose, and let your belly push your hand out. Ideally, your chest should not move.

4. Breathe out through pursed lips as if you were whistling. Feel the hand on your belly go in, and use it to push all the air out.

5. Do this breathing 4 to 8 times and take your time with each breath.

6. Notice how your mind and body feel.

4-4-8 Breathing:

As mentioned above, ideally practice this exercise a few times a day such as before you get out of bed, during a short break at work or school, and during the evening. The more often you can practice this exercise, the more beneficial it becomes.

1. Put one hand on your belly and the other hand on your chest as in the belly breathing exercise.

2. Take a deep, slow breath from your belly, and silently count to 4 as you breathe in.

3. Hold your breath, and silently count from 1 to 4.

4. Breathe out completely as you silently count from 1 to 8. Try to get all the air out of your lungs by the time you count to 8.

5. Repeat 4 to 6 times or until you feel calm.

6. Notice how you feel at the end of the exercise.

Be kind and patient with yourself as you practice deep breathing. Most people tend to breathe from the chest so be patient. Recognize that you might not notice results immediately, and that’s OK. Be sure to give yourself credit for trying, and keep practicing even just for a few minutes at a time. Once you reach a point where you notice it’s helping, keep practicing until you make deep breathing a daily habit. Remember that you have to practice deep breathing on a regular basis in order for it to be helpful.

If you are needing help in making self-care a priority in your day-to-day life, please consider setting up a free phone consultation and we can discuss how therapy can be helpful.

Anxiety Attacks vs Panic Attacks

Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year. (Anxiety and Depression Association of America). Given the high rates of anxiety disorders, It’s common to hear people talk about anxiety attacks and panic attacks interchangeably. This is understandable given that anxiety attacks and panic attacks share common symptoms like increased heart rate and shortness of breath.

Close to 11% of Americans experience a panic attack. Approximately 2% to 3% of them go on to develop panic disorder, per the Cleveland Clinic. According to the DSM-5, a panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes. Common symptoms during a panic attack include physical and mental symptoms.

physical symptoms: pounding heart, sweating, trembling or shaking, shortness of breath, feelings of choking, chest pain or discomfort, nausea or abdominal distress, feeling dizzy, light-headed or faint, chills or heat sensations, numbness or tingling sensations (paresthesia).

mental symptoms: feelings of unreality (derealization) or being detached from oneself (depersonalization), fear of losing control, or fear of dying.

A panic attack is the hallmark feature of a condition called Panic Disorder. Furthermore, panic attacks can occur in the context of any anxiety disorder as well as other mental disorders. Panic attacks can occur suddenly and without warning. The symptoms usually peak within 10 minutes and tend to disappear soon after.

The term ‘anxiety attack’ is not defined in the DSM-5 but is used to describe a core feature of anxiety disorders. Anxiety tends to intensify over a length of time. Anxiety is significantly correlated with a potential danger (real or perceived) or excessive worry. If the anticipation of something escalates and a significant amount of stress becomes overwhelming, it might feel like an anxiety attack. The symptoms of anxiety tend to include the following symptoms:

mental symptoms: restlessness, irritability, difficulties concentrating.

physical symptoms: dizziness, fatigue, muscle tension, increased heart rate, disturbed sleep.

While some of the symptoms of anxiety are similar to panic attacks, the symptoms are generally less intense. The symptoms of anxiety may be persistent, short-lived, or long-lasting.

Psychotherapy especially cognitive behavioral therapy (CBT) is very effective in treating panic attacks and anxiety disorders. CBT helps you understand how your thoughts, feelings, behaviors, and physical symptoms are all inter-connected. In psychotherapy, you can learn various CBT skills that can help feel in control of your anxiety rather than anxiety controlling you.

If you are needing help in dealing with your anxiety, please consider setting up a free phone consultation and we can discuss how therapy can be helpful.

Navigating Anxiety During Unprecedented Times

Current stressors in this country are increasing more worries given COVID-19, physical distancing, social and racial injustice, riots/looting, financial hardships, climate change and divisiveness.  It’s like the perfect storm. Given the extreme circumstances we currently face, it tends to trigger much uncertainty, loss, anxiety and worries. When we are anxious, we seek a need for safety, predictability, and control which is very challenging given these hectic times.

Many kids, adolescents and adults are impacted by these stressful times in various ways:

• Emotionally: worried, sad, angry, scared, impatient, exhausted, bored.

• Socially: isolated; increase in arguments and frustrations at home and at work; more time on social media.

• Physically:  problems with sleep; tension in body (neck, shoulders, jaw); sitting most of the day at work or school so experiencing limited movement; headaches; limited concentration.

• Behaviorally:  avoid things that cause anxiety; overcompensate; eat more or eat less; increase in substance and alcohol use.

Given the increase in anxiety during these unprecedented times, it’s important to understand the difference between normal anxiety and an anxiety disorder.

Normal anxiety:

• Is related to a specific situation or problem.

• Lasts only as long as the situation or problem.

• Is proportional to the situation or problem.

• Is a realistic response to a realistic problem or situation.

When someone experiences an anxiety disorder:

• Anxiety may come up unexpectedly, for seemingly no reason.

• The anxiety response to a situation or problem may be much stronger than they would expect.

• They may experience unrealistic anxiety, such as fear of a situation that likely will never happen.

• Anxiety may last for a long time, even when the situation or problem has been resolved.

• Anxiety may feel impossible to control or manage.

• They may avoid situations or things that they believe will trigger anxiety symptoms.

• Anxiety is fueled by avoidance.

• Intolerance of uncertainty and distress.

The following are various coping strategies to practice in navigating and tolerating anxiety:

• Pay attention to the content of  thoughts (can help or hurt).

• Challenge negative distorted thoughts.

• Practice rational thinking. 

• Talk back to fears with rational thinking.

• Focus on personal expectations:  are they realistic or unrealistic?

• Practice flexibility in thinking.

• Practice mindful moments.

• Practice deep breathing exercises (inhale for 5 exhale for 5; inhale for 4, hold for 4, exhale for 8.

• Rather than avoid learn how to break tasks up into smaller tasks.

• Practice tolerating emotions.

• Practice identifying your feelings and rating them 1 - 10.

• Create time for daily movement and exercise.

• Eat healthy and colorful food.

• Write by expressing your thoughts and feelings via journaling or poetry.

• Practice creativity:  baking, music, theater…

• Practice random acts of kindness.

• Practice daily gratitude: Before going to bed focus on 3 things you are grateful for during the day.

If you are needing help in dealing with your anxiety, please consider setting up a free phone consultation and we can discuss how therapy can be helpful.

3 Ways to Reduce Anxiety with HeartMath

HeartMath is a research based system of scientifically validated techniques, tools and technology to increase mental and emotional self regulation.  You can learn various HeartMath techniques that can create a sustainable emotional shift by shifting the heart rhythm into a coherent pattern.  Coherence is when both branches of the autonomic nervous system, the parasympathetic and sympathetic, become synchronized.  Shifting our attention to the physical area of the heart, combined with generating a sincere positive feeling like love, gratitude or appreciation, is how the heart rhythm pattern creates coherence. 

HeartMath has also developed user-friendly simple techniques to help you make quick, positive emotional shifts.  HeartMath tools can help release anxiety as well as transform familiar anxiety patterns into healthier baseline patterns.  As with any tool or technique, the key is to practice daily.   

3 HeartMath techniques for reducing anxiety:

1. Notice and Ease  

This basic tool helps you admit and name what you’re feeling.  Once you honestly admit you're feeling anxious, you start to diminish its power over you.  Even a  bit of ease can help bring a more balanced perspective.  You can learn to reduce anxiety or other stressful feelings which helps stop their energy drain.

Step 1:  Notice and admit what you’re feeling.

Step 2:  Try to name the feeling.

Step 3:  Tell yourself to e-a-s-e as your gently focus on your heart,relax your breath, and e-a-s-e the stress out.

2. Power of Neutral

This tool helps you learn a simple yet powerful tool for refocusing emotions.  This tool teaches you to use the rhythmic power of your heart to bring your mind, emotions and physiology to a state of neutral which can lessen many anxiety triggers.  This tool helps you to clear your mind and see more options with clarity. 

Step 1:  Take a time-out, breathing slowly and deeply.  Imagine the air entering and leaving through your heart area.

Step 2:  Try to disengage from your stressful thoughts and worried feelings as you continue to breathe.

Step 3:  Continue the steps until you have neutralized the emotional charge.

One thing you can ask yourself is “Do I really want to keep draining my energy and stressing about the situation?”

3. Attitude Breathing

This tool is designed to help you shift out of a negative emotional state into a positive emotional state. Attitude breathing helps you to learn to clear and replace negative attitudes in the midst of feeling stressed or anxious to gain a more intelligent perspective.

Step 1:  Recognize an unwanted attitude; a feeling or attitude that you want to change.  Some feelings or attitudes could be anxiety, anger or guilt.

Step 2:  Identify and breathe a replacement attitude.  Select a positive attitude slowly and casually through your heart area. Do this until you can experience the new feeling.  

Source:  Transforming Anxiety by Doc Childre and Deborah Rozman.

If you’re looking for mental health support, please contact me to schedule a free 15-minute phone consultation.

The Power of Self Care During Uncertain Times

During this COVID-19 health crisis it is normal to feel stressed and anxious.  Every day we hear about more problems and concerns that are impacting everyone everywhere.  Our daily lives have been disrupted by being in quarantine and we are navigating uncharted territory.  

In order to find some order in our lives we really need to focus on creating a daily schedule that allows us to take better care of ourselves given the multiple responsibilities with family and work.  I think one of the greatest gifts we can offer ourselves is self care.

Suggestions for daily self care:

• Focus on what is in our control every single moment of the day which is how we choose to think and behave.  It helps remind us that in the moment we are ok and we do have control of our thoughts and behaviors.

• Take 5 minute breaks a few times a day to practice diaphragmatic breathing.  It allows us to focus on a deep inhalation through the nose and a deep exhalation through the mouth. Deep breathing calms our mind and body and helps us to be in the moment.

• Make sleep a daily priority by trying to go to bed at the same time and wake up at the same time, if possible.  Prior to going to sleep, spend some time doing something relaxing that does not involve a screen. 

• Before you get out of bed in the morning practice a short guided meditation via YouTube or a free app like My Life or Calm.  

• Take 10 minute breaks a few times a day to stretch, walk around and do shoulder rolls, especially if you are sitting on your computer for extended periods of time.  

• Given the stressful circumstances, please practice more self compassion and patience with yourself and others.

• Be mindful of what you are choosing to eat and focus on adding more color to your diet. Also be sure to drink plenty of water. 

• Make time for joy and laughter during the day and learn to laugh at yourself.

• Limit the amount of time reading the news to the morning or afternoon since too much focus on the COVID-19 health crisis can fuel more worries and anxiety.

• Make time to exercise ideally outside if possible.  Being in nature helps us feel better emotionally and it can help reduce blood pressure, heart rate, muscle tension, and the production of stress hormones.

• Given current quarantine restrictions and physical distancing, take time to connect with family and friends virtually on a regular basis to limit the feelings of isolation.

• Limit the amount of time on a screen (phones, Ipads, laptops,...) and instead listen to music, play cards, board games or do a puzzle.

If you are struggling with self care, consider setting up a free phone consultation and we can discuss how counseling can be helpful.

 

How to Navigate Test Anxiety

Most students experience some level of anxiety when taking an exam.  When the anxiety is intense and interferes with test performance, it is known as test anxiety.  Test anxiety is considered a performance anxiety since there is pressure to do well in a given situation.  

The stress over the exam produces the body’s “fight or flight” response. Your body releases adrenaline but the energy used to access short term memory gets diverted into being on high alert. As a result, the brain prepares for the worst, and it becomes very challenging to imagine being successful in answering questions.

The symptoms of test anxiety include cognitive, physical and emotional.  Cognitive symptoms include mind blanking, racing thoughts and difficulty concentrating.  Physical symptoms can be sweating, increased heart rate, nausea, or tense muscles. Emotional symptoms include worry, frustration, fear or  disappointment.

How to reduce your test anxiety:

1. Practice deep breathing exercises daily.

2. Eat well balanced meals. 

3. Keep hydrated.

4. Exercise to reduce anxiety and stress.

5. Keep organized and maintain a realistic study schedule.

6. Go to bed at a reasonable hour so you can get at least 7 hours of sleep a night.

7. Be proactive and ask your teacher, friend or counselor for help.

What to do on the day of the test:

1. Practice deep breathing as you are walking to your exam and during the exam.

2. Practice positive self talk such as “I’m prepared,” “I can do this,” “Relax and breath.”

3. Be sure to read each item carefully and answer appropriately.

4. If your mind goes blank, put your pen/pencil down, sit up straight and take a few deep breaths.  If you don’t recognize the question, go to the next question.

5. Occasionally stretch so that your body stays relaxed.

6. Remind yourself that some anxiety is normal and that you know the material.

If you need additional support please set up a free phone consultation to discuss how counseling can be helpful.

8 Suggestions for Navigating Anxiety

Anxiety is very prevalent in today’s society given the endless responsibilities, expectations and divisiness in our country.  According to the Depression and Anxiety Association of America, nearly 18% of the population has an anxiety disorder. Common triggers of anxiety might be unrealistic expectations of ourselves, negative thinking, stress, public speaking and conflict in a relationship .  

Helpful strategies in navigating anxiety:

1. Pay attention to your self talk.  Usually the thoughts are negative and distorted which fuel anxiety.  In cognitive behavioral therapy (CBT), these thoughts are called cognitive distortions. Usually these distortions fall within the categories of exaggerating, catastrophizing, overgeneralizing and ignoring the positives.

2. Learn and practice how to challenge your distorted thoughts with more rational and balanced thinking (“Although I feel overwhelmed, I am working hard and I am completing my school/work responsibilities to the best of my ability.” )   

3. Use a thought stopping technique to lessen your automatic catastrophic thinking. Try and visualize a stop sign and say STOP to yourself.  Replace the anxiety thoughts with realistic and self soothing statements. (“I can get through this, I’ve done this before.”)

4. Practice diaphragmatic breathing such as inhaling through your nose for a count of 5 and exhaling for a count of 5.  With daily practice, you can learn how to calm your nervous system.

5. Distract yourself with visual distractions.  Some suggestions include counting the leaves on a plant or tiles on the ceiling.

6. Auditory distractions can be another form of distraction.  Some ideas include talking with someone on the phone or singing your favorite song.  

7. Movement is another excellent way to lessen your anxiety.  Try going for a walk outside, doing jumping jacks or playing with your pet.   Commit to yourself to exercising at least 20 minutes a day to help lessen your anxiety. 

8. Try practicing mediation with an app or a YouTube video of your choice.  Research shows that meditation can be very effective in reducing your anxiety.

Occasional anxiety is common but chronic feelings of fear, worry and perfectionism are not common.  If you are looking for help with your anxiety, please contact me to schedule a free initial consultation.

Counseling For Anxiety: Cognitive Behavioral Therapy (CBT)

What is Anxiety?

Anxiety is the anticipation of a future threat and one of the most distressing emotions that people feel. According to the National Institute of Mental Health, anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18% of the population.  Anxiety disorders affect 1 in 8 children. Anxiety disorders are treatable and Cognitive Behavioral Therapy is highly effective in treating various anxiety disorders.

What is Cognitive Behavioral Therapy (CBT)?

CBT is a theoretical orientation that focuses on how our thoughts, feelings and behaviors are influenced by one another.  CBT highlights that each person has a choice as to how to think and behave which directly increases his/her coping skills in dealing with daily life challenges.

A Cognitive Behavioral Profile of Anxiety:

Common Physical Reactions:  sweaty palms, muscle tension, racing heart, flushed cheeks, light headedness.

Anxious Thoughts/Cognitions:  overestimation of danger, underestimation of your ability to cope, worries and catastrophic thoughts, underestimation of help available.

Typical Anxiety Behaviors:  avoiding situations where anxiety might occur, leaving situations when anxiety begins to occur, trying to do things perfectly or trying to control events to prevent danger, shutting down, restlessness, fidgeting.

Anxious Moods/Feelings:  anxious, panicky, nervous, , worried, overwhelmed.

Coping Strategies for Anxiety Using a Cognitive Behavioral Approach:

Coping Strategies for Emotions/Feelings:

Some helpful anxiety coping strategies include the following:  identify the feelings, rate the feelings, learn to let go, daily journaling, and talking with a friend, family member or therapist.

Physical Coping Strategies:

Some of the most helpful physical anxiety coping strategies include diaphragmatic breathing, progressive muscle relaxation, guided imagery/visualizations that focus on your senses, physical exercise, yoga and walking in nature.

Coping Strategies for Cognitions/Thoughts:

The following list includes helpful coping strategies for challenging our distorted anxious thoughts:  healthy distractions (counting, crossword puzzles), scheduled worry time, various cognitive exercises (thought records, cognitive restructuring, worst/best/realistic case scenario) and mindfulness.

Behavioral Coping Strategies:

Behavioral coping strategies to lessen anxiety include: exercise, yoga, meditation, acupuncture, massage, making time to socialize (friends, hobbies, sports), a healthy diet and a healthy sleep hygiene routine.

If you are looking for help with your anxiety, please contact me to schedule a free initial consultation.

10 Tips to Get a Better Night’s Sleep

Do you struggle with insomnia? If so, you are not alone. So many people have trouble getting a good night’s rest.

Like exercise and a healthy diet, sleep is an essential component of mental and physical health. A solid night sleep is important for restoring energy, repairing injuries or illness, growth, concentration, memory and mood.

According to the National Sleep Foundation, the following hours of sleep are recommended for various age groups:

School age children: 9-11 hours

Teenagers: 8-10 hours

Adults: 7-9 hours

Older adults (65+): 7-8 hours

In order to get a better night’s sleep, it is important to pay attention to improving your sleep habits, known as sleep hygiene (or sleep habits).  Thankfully, there are some proven methods for sleep hygiene that will help you fall asleep faster, stay asleep during the night, and wake up feeling refreshed.

Here are some helpful suggestions for improving your sleep habits:

1. Try and go to bed and wake up at the same time every day (even on weekends). The body tends to get used to falling asleep at a certain time, but only if this is relatively fixed.

2. Avoid napping during the day. If you do choose to nap, make sure you limit the nap to 20-30 minutes.

3. Exercise during the day, but not within two hours before going to bed.

4. At least one hour before you go to bed, turn off all electronics and practice relaxation techniques such as guided imagery, yoga stretches, meditation, prayer and deep breathing exercises.

5. Avoid caffeine and alcohol 4 to 6 hours before you go to bed.

6. Use comfortable bedding and a good, cool temperature to keep your bedroom well ventilated.

7. Block out all distracting noise and eliminate as much light as possible in your bedroom.

8. Reserve your bed for sleep, sex and sickness only. Habits like reading or checking your phone while in bed will create an association that keeps your mind alert.

9. Try a light snack before bed. Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you feel sleepy.

10. Try not to toss and turn in bed. If you think you’ve been lying in bed awake for more than 30 minutes, get out of bed and do a relaxing activity such as light reading for about 20-30 minutes. Then get back in bed and try again.

As with any habit, these things take practice and consistency so decide that you will implement one of these strategies today.

Happy Z’s!

If you’re looking for mental health support, please contact me to schedule a free 15-minute phone consultation.