Fostering Resilience during COVID-19 by Connecting with Our Values

By Annabelle Parr

As we enter Mental Health Awareness Month this year, we are collectively experiencing not only a global health crisis, but also a stressor which has potentially significant repercussions for our mental health. At the very least, we are likely to be experiencing a range of painful emotions as a result of this crisis. On any given day, I find myself feeling at least some combination of the following: anxiety, fear, stress, grief, frustration and/or exhaustion. 

As an Acceptance and Commitment Therapy (ACT) therapist, when I am struggling, I ask myself the question: can I be willing to have this pain, and still choose to move in the direction of what matters most to me? The goal of ACT is to help us to live more vital, meaningful lives even as we struggle with the inevitable pain and discomfort inherent in being human. And goodness knows this pandemic has given us all a whopping dose of pain and discomfort.

But what does a meaningful life look like during a global crisis?

Prior to COVID-19, I felt like I had developed a pretty good sense of how to move toward what matters even when I feel anxiety or fear or frustration. But this pandemic has challenged me. At first, I felt overwhelmed as it seemed the world had turned upside down, and I struggled to find ways to live my values when life suddenly felt so restricted by forces beyond my control.

So I began to consider: how can I continue to move toward what matters most to me, even as life has become more restricted by this pandemic?

A few weeks ago, I was scrolling Instagram and came across a post posing the question: “if someone told you that you could save a life, would you?” The post went on to remind us that we are all being given that otherwise very rare opportunity, and that in staying home right now, we are actually saving lives.

https://www.instagram.com/igo_medical/

After reading this Instagram, it clicked for me: I don’t necessarily have to do anything monumental or new or different right now in order to make significant, values based decisions. Instead, I can consider what I am already doing – like staying home except for essential errands, or wearing a mask and maintaining six feet from others when I do need to go out, or calling and connecting with friends and family – and I can connect these actions with my values.

What are values?

Values from an ACT perspective are a collection of verbs, adverbs, and adjectives that describe qualities of being; a.k.a. who and how do I want to be in the world? For me, a few of my values include being compassionate, conscientious, kind, and loving.

Connecting with our values can infuse the choices we are already making with purpose.

When I connect even the simple action of staying home with being compassionate or loving, rather than becoming fused with thoughts about how terrible, frightening, or overwhelming this all is, I can ground myself in a sense of purpose and meaning beyond my discomfort. And I can bring my values to anything I do: when I call family or friends, I can choose to show up lovingly; when I go to the store, I can offer gratitude to the essential workers I interact with; when I watch my favorite TV show, I can connect with my value of being kind and gentle with myself. The key is being intentional about why I do what I do.

You are enough just as you are.

Navigating a pandemic is exhausting; it demands so much of us already, and additional pressure to do more when just getting through the day feels taxing enough can feel less than helpful. Part of the beauty of ACT is that values based actions are not always huge, monumental gestures; in fact, more often, they are the small, intentional choices we make to show up in a particular moment as the type of person that we hope to be in the world. So rather than beating ourselves up for feeling like we are falling short somehow, we might ask ourselves instead, how can I bring the qualities I hope to embody to the actions I am already taking? How can I connect the things I am already doing back with the kind of person that I hope to be? 

“Those who have a why to live can bear almost any how.”

I keep coming back to the wisdom of Viktor Frankl during this time; as a Holocaust survivor and psychiatrist, he is particularly well suited to guide us through crisis. He noted that “those who have a why to live can bear almost any how,” and I might add that those who have a why to act can bear almost any how. The “how’s” of our day-to-day right now pose a whole host of new challenges for us, but when we can connect with a why behind these challenges, we are likely to meet them with much greater resilience.

CSAM IS HERE TO HELP

If you or someone you love needs support and might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, insomnia, or stress related to COVID-19, or if you would like more information about our telehealth services, please contact us at (858) 354-4077 or at info@csamsandiego.com

Mental Wellness Month: How Do We Define Wellness?

By Annabelle Parr

According to the internet, January is Mental Wellness Month. Sounds like a good cause, right? Absolutely! But pausing to consider our definition of mental wellness is important. Because if you spend much time on the internet, it might have you believing that wellness and self-care are defined by bubble baths, weighted blankets, and being perpetually Zenned out. And bubble baths, weighted blankets, and being in touch with your inner Zen are great! But mental wellness and caring for ourselves are not quite that simple.

So from a therapeutic perspective, what exactly is mental wellness? If we define illness based on a list of symptoms, do we define wellness simply as a lack of said symptomology? Or does wellness have its own particular set of characteristics equally worth defining?

If illness is a sense of dis-ease, is wellness a perpetual state of ease?

Psychiatry and psychotherapy developed based on a model which was focused primarily on pathology and illness or “dis-ease.” Beginning with Sigmund Freud’s exploration of the unconscious mind and evolving toward a medical model of treatment centered around the Diagnostic and Statistical Manual of Mental Disorders (DSM), psychotherapy has historically been centered around identifying and diagnosing a problem and working to treat it. And of course, this is a worthy mission, but it is an incomplete picture of the larger whole of life. Life is not simply about absence of illness, dis-ease, or discomfort. It is about engaging in life in a way that brings us meaning, purpose, and hopefully some joy as well.

Wellness is not about the absence of discomfort, but rather the presence of meaning.

From an Acceptance and Commitment Therapy (ACT) perspective, mental wellness is defined by our ability to engage in life in ways that bring us a sense of meaning, purpose, and vitality. Mental wellness is characterized by our ability to, moment by moment, make choices and take action in the service of our personally chosen values. And this might be surprising, but it is actually deliberately NOT defined by a lack of painful emotions, such as anxiety, fear, worry, and stress. Not only are these feelings and experiences an unavoidable part of being human, but they are directly and inextricably linked to our values.

“We hurt where we care.”

Steven Hayes, one of the ACT co-founders, noted that we hurt where we care. As Dr. Jill Stoddard pointed out in her book, Be Mighty: A Woman’s Guide to Liberation from Anxiety, Worry & Stress Using Mindfulness & Acceptance, when we look at the things that keep us up at night, the ones that weigh heavy on our minds and hearts, they probably do not include the fate of Netflix. We might enjoy a good Netflix binge, but whether Netflix will continue to thrive is probably not on our list of worries. Instead, the things that we worry about tend to be the things that matter to us on a deep level, such as our family, friends, work, home, etc.

Pain and values are two sides of the same coin.

In other words, when we look closely, the emotional pain we experience tends to point directly to what’s important to us. If we want a life that is full of wellness – full of those things that truly matter to us, that bring us joy, connection, passion, and purpose – we have to be willing to risk having difficult and painful feelings. We cannot have one without the other because it wouldn’t hurt if we didn’t care and vice versa. When we try to rid ourselves of all painful feelings, we also restrict our ability to engage with the things that we really care about. As much as we might wish otherwise, we cannot have joy without also risking pain. As Brené Brown said so well, we cannot selectively numb emotion. When we are unwilling to have pain, we will also be less able to experience joy.

Our emotions are not problems to be solved; the problem is when our behavior prevents us from engaging in life in functional and fulfilling ways.

From a diagnostic perspective, it is not simply the presence of anxiety that warrants a diagnosis; rather it is the functional impairment that the anxiety creates that helps determine whether someone meets criteria for diagnosis. Said otherwise, a diagnosis includes consideration of whether your experience of your emotions, thoughts, and sensations causes you to limit your behavior such that your life is restricted in significant areas, like work, school, and relationships.

Wellness is about how we respond to pain when it shows up.

Therefore, wellness is not defined by the absence of stress, anxiety, grief, worry, anger, or frankly any other emotion. Instead it is all about how you are able to manage difficult thoughts, feelings, and experiences and still continue to engage in life in a way that is fulfilling, meaningful, and guided by what is important to you. And ACT, beyond emphasizing the importance of values-based actions, has plenty of wisdom regarding how to increase psychological flexibility such that you are able to respond more effectively when discomfort arises.

If you find that your thoughts and feelings are holding you back from living your life in the way that you might want, ACT can help. For some excellent resources, check out our suggested reading and our suggested podcasts. For professional support, an ACT therapist can help guide you on your journey.

CSAM IS HERE TO HELP

If you or someone you love needs support and might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, or insomnia, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

When You Stress About Stress You’re Stressed

By: Jill A. Stoddard, PhD

Image source: https://www.amazon.com/Stressed-Desserts-Spelled-Backwards-Poster/dp/B017C9AZUQ

What is your go-to when you feel stressed out?  Do you like a few glasses of wine, an hours long vent session, or a creative excuse to get out of a social engagement?  These are all examples of experiential avoidance—an unwillingness to experience uncomfortable internal emotions or sensations and active efforts to change, reduce, or eliminate them (Forsyth and Eifert 1996).  Does experiential avoidance work to alleviate feelings of stress?  Yep.  It works or we wouldn’t do it.  But how long does that last?  Look at your personal experience and take inventory:

1.     what do you do or not do when you feel stressed?

2.     what does it get you (i.e., what discomfort does it relieve)?

3.     what is its cost?    

When our reactions to stress result in only temporary relief but come at a cost to our health, our relationships, or other areas of importance, it’s time to reevaluate our relationship to stress. 

Think of it this way (Stoddard, 2019):  Imagine I have you in a little booth suspended above a barracuda tank.  I tell you, “Whatever you do, don’t get stressed and you will be fine.  Unfortunately, if you do feel stressed, the floor of the booth will open, dropping you into the barracuda tank.  But just don’t get stressed and you will be totally fine!” 

What do you think is going to happen?  Right—you’re stressed…and fish food.  Is it because you just didn’t try hard enough to control your stress?  Was the incentive not quite high enough?  Of course not—our most primitive instinct is to survive.  So why did you get stressed and end up swimming with the fishes?  Because when you are unwilling to experience stress, you are stressed about stress so you are stressed (Hayes, Strosahl, and Wilson 1999).  See the trap?  Your relationship to stress becomes one in which you evaluate it as bad, dangerous, and deadly. 

So, of course, you are stressed about having stress. 

So what should you do the next time you hear on Good Morning America or in the Huffington Post “Stress is bad for you!  Stress will kill you!  You shouldn’t get stressed!”  It turns out, stress has been wrongfully getting a bad rap (McGonigal 2013).  While stress does release adrenaline (the hormone thought to be harmful to the body), it also releases oxytocin, the bonding hormone that enhances empathy and motivates us to seek and give care.  Oxytocin is a natural anti-inflammatory—it’s good for our bodies and actually strengthens our hearts.  And, fascinatingly, all we have to do to mitigate the negative effects of adrenaline is simply appraise stress as helpful.

Come again?  Stress, helpful?  YES--stress can motivating!  Stress is what prompts you to prepare for the important job interview, watch over your small children in a crowded place, and get ready for the big game.  If you were totally chill, you’d likely bomb the interview, lose your kid at the mall, and blow the game.  As it turns out, there is an optimal arousal zone when it comes to doing well (Yerkes and Dodson 1908):  when stress is very high or very low, it has the potential to negatively impact performance.  But a moderate level of arousal is helpful. 

The best way to manage stress is simply to change your relationship to it.  So stop struggling to avoid and reduce your stress (how’s that working for you, anyway?), and instead work on accepting that to be human is to know stress, and stress need not be our enemy.  You can do that by remembering:

1.     stress is motivating and can improve performance at moderate levels

2.     stress prompts us to seek connection with others and this is good for our health

3.     stress is only damaging when we evaluate it as damaging

4.     when we are stressed about stress we are stressed

Now, don’t get me wrong—I’m not suggesting you give up your meditation practice because it makes you feel less stressed.  There is nothing wrong with getting your bliss on—as long as your strategies don’t come at the cost of other meaningful and important pursuits.  So go ahead and yoga-it-up—just don’t neglect your friends and family while you’re at it.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, depression, stress, PTSD, insomnia, or chronic illness, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

References

Forsyth, J. P., and G. H. Eifert. 1996. “The Language of Feeling and the Feeling of Anxiety: Contributions of the Behaviorisms Toward Understanding the Function-Altering Effects of Language.” The Psychological Record 46: 607–649.

Hayes, S., K. Strosahl, and K. Wilson. 1999. Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York: The Guilford Press.

McGonigal, K. 2013. “How to Make Stress Your Friend.” Filmed June 2013 in Edinburgh, Scotland, video, 13:21, https://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend/transcript

Stoddard, J. 2019. Be Mighty: A Woman’s Guide to Liberation from Anxiety, Worry, and Stress Using Mindfulness and Acceptance. Oakland: New Harbinger Publications.

Yerkes, R. M., and J. D. Dodson. 1908. “The Relation of Strength of Stimulus to Rapidity of Habit-Formation.” Journal of Comparative Neurology and Psychology 18: 459­–482.

Mental Health Awareness Month: Fitness #4Mind4Body

by Annabelle Parr

May is Mental Health Awareness Month. Every year, Mental Health America designates a particular theme for the month to highlight an important aspect of mental health. This year’s theme is Fitness #4Mind4Body, and it focuses on acknowledging the connection between mental and physical wellbeing. #4Mind4Body explores the role of nutrition, exercise, the gut-brain connection, sleep, and stress in our overall wellbeing and examines the ways each of these areas impact our functioning. Below is a summary of the topics covered in the Mental Health Toolkit from Mental Health America.

Diet and Nutrition

Eating a well-balanced, nutritious diet is an integral part of health. Diets high in processed, fried, and sugary foods can increase the risk not only for developing physical health problems like diabetes, heart disease, obesity, and cancer, but are also linked to mental health problems, including increased risk for depression symptoms. A healthy diet consists of a variety of fruits, vegetables, legumes, whole grains, fish, nuts, and olive oil. Maintaining a balanced, nutritious diet is linked with a lower risk for depression and even an improvement in depression symptoms.

Exercise

Regular exercise not only helps control weight, increase strength, and reduce the risk of health problems like high blood pressure, cardiovascular disease, and some cancers, but it also helps boost endorphins and serotonin, among other important proteins and neurotransmitters that impact mental health. Endorphins serve to mitigate pain in the face of stress and increase pleasure in the body. Serotonin affects appetite, sleep, and mood, and is the target of SSRIs, a class of antidepressant commonly used to treat anxiety and depression. Just thirty minutes of exercise per day can help improve mood and mental health.

The Gut-Brain Connection

The gut, also known as the “second brain,” communicates directly with the brain via the vagus nerve and via hormones and neurotransmitters. The communication goes both ways, so anxiety, stress, and depression can impact the gut and result in gastrointestinal symptoms, but changes in the gut microbiome can impact the brain and mood, exacerbating or even resulting in symptoms of anxiety and depression. Eating a nutritious diet that includes prebiotics and probiotics is an important part of maintaining a healthy gut and a healthy mind. 

Sleep

Quality of sleep impacts the immune system, metabolism, appetite, the ability to learn and make new memories, and mood. Good sleep for adults means getting between 7-9 hours of mostly uninterrupted sleep per night. Problems with getting good quality sleep can increase the risk of developing mental health symptoms, and symptoms of anxiety and depression can negatively impact sleep, creating a negative cycle. Cognitive Behavioral Therapy for Insomnia (CBT-I) can help clients reestablish healthy sleep patterns through addressing negative thoughts and worries as well as behavioral patterns that are impacting sleep habits.

Stress

Stress is a normal part of life, and the body is equipped with a fight or flight response designed to help mobilize internal resources to manage stressors. After the stress has passed, the body can return to its regular equilibrium state. However, when stress becomes chronic, it can cause inflammation, impaired immune system functioning, muscle aches, gastrointestinal problems, sexual dysfunction, changes in appetite, and increased risk for heart disease. Too much stress can also impact mental health.

Mental health involves a complex interplay between numerous factors, including but certainly not limited to the areas listed above. Furthermore, though maintaining a healthy diet, regular exercise routine, good sleep habits, and utilizing stress management techniques can help prevent or improve existing mental health symptoms, if you are struggling with mental health issues, it can be difficult to attend to these areas.

If you are struggling with anxiety, stress management, depression, chronic illness, or insomnia, seeking professional assistance can be helpful. Evidence based therapies like Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) can help to address problematic thoughts and behaviors that are contributing to emotional distress. Therapy offers a warm, supportive, safe environment to explore painful issues. A therapist can also provide support in helping the client to develop good self-care habits, like those mentioned above.

This year’s mental health awareness theme reminds us of the importance of recognizing the multiple avenues through which we can approach mental health, and the variety of tools we have at our disposal to improve overall wellbeing.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, depression, stress, PTSD, insomnia, or chronic illness, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

References

Mental Health America. (2018). 2018 Mental Health Month Toolkit. Retrieved from http://www.mentalhealthamerica.net/sites/default/files/Full_2018_MHM_Toolkit_FINAL.pdf

Most Americans Are Stressed About the Future of Our Nation

by Annabelle Parr

Have you found yourself feeling especially anxious or stressed out in the current political climate? You’re not alone. This particular election and transition of power is unique for many reasons, not least of which is the widespread stress it is creating in Americans across the political spectrum.

According to the American Psychological Association’s most recent Stress in America survey, two-thirds of Americans report feeling stress regarding the future of our nation.

This stress is bipartisan.

Prior to the election, stress may have been divided more along party lines. Back in August, Democrats were significantly more likely than Republicans (72 percent vs 26 percent) to feel stress regarding the outcome of the presidential election. However, according to the most recent study conducted in January, 59 percent of Republicans and 76 percent of Democrats reported that the future of the nation was a significant source of stress.

Overall stress levels have increased since the election.

In the ten years since the inception of the Stress in America survey, Americans’ stress levels had been gradually decreasing. However, between August 2016 and January 2017, Americans’ average reported stress level increased from 4.8 to 5.1, on a scale where 1 represents no stress and 10 represents enormous stress. This was the first statistically significant increase in stress since the survey began 10 years ago.

We are not the first cohort to feel stressed about the future of our country.

It is important to remember that this APA survey has only been conducted for the last decade, and to keep in perspective that our country has been through numerous tumultuous and stressful times. We are not the first group of citizens to be very stressed and concerned for America’s future. History shows us that we have inevitably and cyclically encountered dark times as a nation, and that hopefully, after each struggle, we emerge stronger and maybe a little bit wiser and more just.

However, currently we are very much in the midst of the anxiety and uncertainty. We are deeply stressed, and we are not alone in that experience. There is comfort to be found in the “me too,” but it is also important that together we learn to find balance during this time.

How do we manage our stress?

Engaging in democracy.

One of the beautiful things about our country is that we are part of a democracy, where we are empowered to use our voices to speak up regarding those things that do concern us. In order to properly voice our concerns, it is important that we use our access to information to stay informed about what is going on. (However, we must also recognize when we need to disconnect. More on the importance of limiting our information intake below).

One way to try to assuage the stress we feel is to use it as fuel for action. We can spend a few minutes calling our local representatives and communicating our concerns. We can get involved volunteering for or donating to an organization whose efforts are in line with our values. We can participate in protests or marches to literally stand up for the things that are important to us. There is something very empowering about engaging in community and collective action with other Americans who share our views.

Regardless of our political views and beliefs, our stress seems to be collective. The details of our concerns may differ, but we all have the opportunity to use our voices and engage in the future of the nation.

Finding a balance between staying engaged and allowing ourselves to disconnect.

However, as much as it is important to stay engaged, we must also recognize the limits as to what we can do to help foster change. When we come together, we are strong. But individually, we cannot carry the weight of the nation on our shoulders. And as we work to remain informed, it is also important that we allow ourselves the time and space away from news.

Limiting technology and news consumption.

Between all of our technological devices, 24-hour news cycles, and politically saturated Facebook news feeds, we could allow our eyes and minds to be occupied all day long by the constant, stress-inducing updates. We need to limit our news consumption in order to allow our minds and bodies to rest. Allowing ourselves to be overwhelmed by the news will leave us feeling powerless.

Practicing self-care.

Maybe the most important thing that we can do at this time of great national stress is to take care of ourselves. Self-care is vital to our mental, physical, spiritual, and emotional well-being. And if you have felt that your nation (or perhaps its commander in chief) has failed to care for you, or sent you the message that you are unworthy of care, maybe your greatest act of protest and defiance will be to choose to take care of yourself in spite of this.

Self-care will not fix the national situation, of course. However, wouldn’t it be powerful to have a nation filled with citizens who know how to care for their own well-being, and as a result they have the energy to stay engaged in their democracy?

How can we practice self-care?

Good self-care is unique to each individual. What is relaxing and healing for one person may not be as helpful to another. It’s important to pay attention to those things, those rituals, that calm and center us. That signal to our psyche a time of rest or peace. Here are some ideas to help inspire you:

1. Set aside some time to walk each day and focus on breathing the fresh air in your lungs and feeling the ground under your feet with each step.
2. Practice yoga.
3. Find a mindfulness meditation to practice every day. This doesn’t have to take more than five minutes. Check out this link for some suggestions: http://marc.ucla.edu/mindful-meditations
4. Not a fan of meditation? Try focusing on your breathing. Take a minute to practice some mindful breaths. Check out our blog post on breathing for some tips: http://www.anxietytherapysandiego.com/blog/2016/6/8/the-power-of-breathing
5. Turn off your devices. Allow yourself to unplug entirely. Maybe consider deactivating your automatic news updates, or deleting the Facebook app from your phone. Set limits on your news consumption by mapping out a given time to check the news each day.
6. Find time for humor. Is there a show that makes you smile or laugh? Laughter is healing and helps relieve stress.
7. Spend time with loved ones. Share your experiences and your feelings, but also make sure to find time to talk about things unrelated to the current political situation. It’s healing to talk with others who feel the same way that we do and to know that we are not alone. But it is also important to have fun and to remember that we can still enjoy the sweet things in life even when there are reasons to be concerned.

In conclusion,

In order to manage the stress that so many of us are feeling, seek balance. This means finding ways to be proactive about the things that you can change or that you have control over, but also accepting the things that are beyond your control. And in the midst of it all, remember to take care of yourself in the ways that work best for you.

Source URL: https://fundingforgood.org/fundraising-and-the-serenity-prayer/

If you find yourself feeling overwhelmed by the stress or anxiety that you feel, and you need some extra help, a therapist can help you to process your feelings. They can give you a space to feel heard, which in itself can be healing and empowering. They can help give you tools to manage your stress so that it doesn’t leak into other areas of your life or prevent you from leading a healthy day-to-day. Sometimes the best form of self-care is knowing when we need to reach out for external support.

CSAM IS HERE TO HELP

If you or someone you love might benefit from acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), or biofeedback for anxiety, depression, stress, or PTSD, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at csamsandiego@gmail.com.

References:

(2017, Feb. 15). Many Americans stress about future of our nation, new APA Stress in American survey reveals. Retreived from: http://apa.org/news/press/releases/2017/02/stressed-nation.aspx