Empowering Yourself with Mindfulness: Attending Intentionally to What Matters in This Moment

By Annabelle Parr

We wake up each day to a new series of updates about coronavirus and its wide reaching effects: perpetually breaking news stories with new research, new statistics, new predictions, new guidelines, new stressors. Our attention is yanked like a yo-yo by the instant and constant stream of news in the palms of our hands. Additionally, attending to what used to be a basic task – grocery shopping – now feels like a massive feat involving lots of planning and caution. For those with kids at home, we are trying to attend to their needs, their schoolwork, and their emotions, even as we do our best to navigate working simultaneously.

Where we used to have separate spaces for separate parts of our lives, at least to some degree, we are now navigating the jumble of integrating every facet of our lives into one space: our home. With so many demands and pressing issues competing for our attention constantly, it’s easy to feel overwhelmed. It’s easy to feel like our minds have been hijacked in the same way that it feels our lives and routines have been.

This is hard, AND…

Yes, this is a scary and difficult time. Yes, there is a seemingly endless list of stressors to occupy our anxious minds. Yes, there is a lot of uncertainty and only so many variables within our control. AND. We are not helpless or powerless. As our hearts are flooded with emotions, our minds retain their ability to make choices about how to proceed when faced with the facts and the resulting feelings. We can choose to empower ourselves within situations in which our control over external variables is limited.

What does it mean to empower ourselves during COVID-19?

When I say that we can empower ourselves, I don’t mean that we can empower our way out of our pain. Our pain – our fear, our anxiety, our grief, our anger – is a natural human response when faced with loss and uncertainty, of which we are all getting an enormous dose. Our pain simply is. It is here for good reason, and it often points directly toward what matters most to us. It deserves to be felt and heard.

Empowering ourselves involves increasing our psychological flexibility in service of greater meaning.

When I say that we can empower ourselves, I am drawing on the wisdom of Acceptance and Commitment Therapy (ACT), which says that suffering is a result of psychological inflexibility. When we increase our ability to think and respond flexibly in the face of pain and stress, we empower ourselves to make choices based on our values. We reduce the struggle that comes from fighting with our pain – as if that were the battle to be won – and we free ourselves up to pursue that which brings meaning to our lives.

In his beautiful work Man’s Search for Meaning, Holocaust survivor, psychiatrist and creator of logotherapy (another form of therapy grounded in meaning), Viktor E. Frankl (1959) stated “that everything can be taken from a [person] but one thing: the last of the human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way” (p. 66).

What if I feel guilty for focusing on meaning when basic needs demand my attention?

It may feel incredibly difficult or even indulgent to consider what brings us meaning when we are facing such a collective threat to our health and our financial stability. It may also feel trivializing to invoke the words of a Holocaust survivor here, as even though what we are facing is difficult, it is nowhere near the level of the atrocities which Frankl witnessed and endured.

Yet he suffered such unfathomable horror, pain, and loss, that the wisdom he emerged with certainly seems worth attending to during our own trying times. Additionally, suffering is not something that is meant to be compared. Frankl (1959) himself noted, “suffering completely fills the human soul and conscious mind, no matter whether the suffering is great or little. Therefore, the ‘size’ of human suffering is absolutely relative” (p. 44).

In other words, we do not have to experience the rock bottom of human atrocity in order to allow ourselves space and self-compassion for our emotional experience in the midst of suffering. This is hard. Your pain makes sense. 

An important piece of the psychological flexibility puzzle is mindfulness.

So, how exactly do we empower ourselves to become more psychologically flexible? A good place to start is with mindfulness, or present centered awareness. Jon Kabat-Zinn (1994), founder of mindfulness-based stress reduction, succinctly defines mindfulness as the ongoing practice of “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally” (p. 4).

In her book, Be Mighty: A Woman’s Guide to Liberation from Anxiety, Worry, & Stress Using Mindfulness & Acceptance, CSAM director Dr. Jill Stoddard (2019) invites us to imagine that when we are not engaging mindfully, we are like airplanes on autopilot. Not fully present to what is happening inside and outside of our skin, we are running on muscle memory. We are still making choices for which we are responsible, but we are not totally conscious of the fact that we are doing so.

It is easy to get lost in this space. When we are running on autopilot, we are more likely to react rather than respond: “if your autopilot has commandeered the cockpit, the space between intense emotion and response is utterly nonexistent, leading to an instant, impulsive reaction. It’s as if the intense emotion is a detonator and the reaction is a bomb” (Stoddard, 2019, p. 45). 

Sheltering in place during a pandemic is likely to create some intense emotions and difficult circumstances to which we may react. If we are on autopilot, we are much more likely to react in unhelpful ways, like lashing out at our loved ones and communicating ineffectively. Additionally, when we are on autopilot we may be unaware of what we are actually feeling and experiencing. We may be more likely to numb out in unhealthy ways, and less likely to attend to the things that help care for our minds and bodies. Also significant, we are likely to miss the little nuggets of joy that fly by us as we zone out into the distance.

So let’s flip it around. What does mindfulness empower us to do? When we show up to each moment mindfully, that is, we focus our attention on purpose, in the present moment, non-judgmentally, we are able to….

• Notice and identify our emotions. Our emotions can span the full range of experience, from afraid to anxious to stressed to exhausted to angry to sad to grateful to joyful. Remember, the purpose of mindfulness is not to judge our experience, but simply to notice it.

• Choose how we internally respond to our own emotional experience. Responding gently, with the same kindness and compassion we might have for ourselves as children, for our child, for our friend, or for another loved one is generally a good place to start.

• Choose action in line with the kind of person, partner, parent, friend, employee, citizen, etc. that we want to be. It can be helpful to consider the qualities of being you aspire to embody, such as being compassionate, loving, loyal, diligent, reliable, kind, etc. Then you can purposefully choose to behave in a way that aligns with your personal values.

• Choose what we point our attention towards. This is especially important right now, given that our smartphones are perpetually present and can alert us to every single news update all day long. It’s important to stay informed enough to stay safe and responsible, but that doesn’t mean we are required to be glued to the news all day. When we are more present, we can make a choice about when we decide to update ourselves, how often, and for what purpose. It’s also easy to mindlessly let the day slip away watching Netflix or going down some other rabbit hole of distraction. It’s okay to watch Netflix or to let ourselves be unproductive, but it’s important that we connect with our intention and our reason for our behavior. When we watch our favorite show mindfully, we get to actually engage with it from a place of enjoyment so that we can return to our other tasks more rejuvenated.

• Be present to the things for which we are grateful. When we are more fully present to the moment, we give ourselves the opportunity to appreciate the sweetness in small moments we might otherwise miss. As much as this period of time is full of tragedy, there is goodness to be found if we know where to turn our attention. John Krasinski is working on helping us out here, with Some Good News. But we don’t need a celebrity news channel to tune in to gratitude and goodness. There is goodness to be found in the gift of time with our loved ones, watching our children play together, waving to neighbors from a solid 6 ft. + physical distance, or reconnecting virtually with friends we rarely find time to talk to under normal circumstances. Mindfulness allows us to be present to the joys when they show up and to actively cultivate engagement with the things that bring us meaning; we might just have to be a bit more creative in how we engage those things right now.

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

References

Frankl, V. E. (1959). Man’s search for meaning. Boston, MA: Beacon Press.

Kabat-Zinn, J. (1994). Wherever you go there you are: Mindfulness meditation in everyday life. New York, NY: Hyperion.

Stoddard, J. A. (2019). Be mighty: A woman’s guide to liberation from anxiety, worry & stress using mindfulness & acceptance. Oakland, CA: New Harbinger.

Empowering Women with Acceptance and Commitment Therapy

by Annabelle Parr

According to the World Health Organization (WHO), women are twice as likely to be diagnosed with anxiety and depression as men. Women are also the largest group diagnosed with post-traumatic stress disorder (PTSD). Some argue that rather than some innate, biological predisposition to these disorders, the context in which women exist may be the cause of the gender disparity (see Dr. Robyn Walser’s article and Dr. Jill Stoddard’s upcoming book Be Mighty). The WHO states, “gender specific risk factors for common mental disorders that disproportionately affect women include gender based violence, socioeconomic disadvantage, low income and income inequality, low or subordinate social status and rank and unremitting responsibility for the care of others.” When gender intersects with other facets of identity, such as race, sexual orientation, and socioeconomic status, risk factors and inequities are further compounded. 

As Dr. Stoddard discusses in Be Mighty, women are paid less for equal work (Bishu & Alkandry, 2017), are largely responsible for household and caretaking tasks even when working outside the home (Pew Research Center, 2015), are less likely than men to be introduced by our professional title (Files et al., 2017), are evaluated as either likeable or competent as if the two were mutually exclusive (Heilman et al., 2004; Rudman & Glick, 1999), and are seen as less desirable when we outperform men (Park, Young, & Eastwick, 2015). Women are also taught that there is a narrow and rigid standard of beauty to which we must conform. Not only is our inherent worth devalued in all the ways above, but 1 in 3 women experience sexual violence in their lifetime (and little girls are twice as likely as little boys to be sexually abused). And 1 in 3 women have experienced some form of intimate partner violence (domestic violence). On top of the violence women are subjected to, we watch as victims are blamed when they come forward. They are asked to provide extensive hard evidence for the injuries perpetrated against them, questioned on their authority to be the expert on their own experience. Meanwhile, the perpetrator’s word that he didn’t do it is sufficient evidence for so-called justice to take his side, and the victim is demonized for having the audacity to speak up.

Things are changing. In the past few years we have seen a dramatic shift with women everywhere speaking up and sharing their stories, both leading up to and following the #MeToo and #TimesUp movements. But there is still a long way to go. When we really let in awareness of the injustice present in our culture, it can trigger enormous anger – an emotion women are taught we are not allowed to have. Though anger can drive productive action against injustice, it can also become overwhelming and a barrier to movement. And particularly when we are not allowed to have it, it can easily turn to depression.

Some argue that in boiling the problem down to individual mental health problems, we do women a disservice and we miss the bigger problem. What if we had an alternative? What if instead of suggesting she is the one with a problem, we saw her pain as a result of a system that tells her she is worth less?

Yeah, what if? But what now? What do we do with all of this information? Acceptance and Commitment Therapy (ACT) has some suggestions to help empower women in a context of inequality.

First, we get present. We attune to our experience in the here and now. We do our best to cultivate a willingness to feel it, to not turn away from it, despite the larger messages designed to silence us, our experiences, and our pain. This allows us to turn toward doing what matters, rather than focusing all of our energy on turning away from our pain.

Next, we cultivate an observer self. We begin to hold ourselves with compassion, like we might hold our 5-year-old selves. No matter how many negative messages we have absorbed about who we are, what we deserve, and how we have to be, there is a self underneath all of that. We are much more complex and greater than those stories we have been taught to believe. When we are able to take a new perspective on how we see ourselves and our pain –holding ourselves with the compassion we would have for a child or a friend – we become our own ally rather than our own worst enemy. In connecting to a sense of ourselves that is more nuanced and complex than any one story, we are no longer defined as unidimensional. We are free to do what matters, to live life according to our values rather than confined by messages designed to keep us boxed in.

With this observer self awareness, we can learn to examine our thoughts, such as those that tell us we have nothing of value to say, that we can’t make a difference, that we are alone, or that we are to blame. And we can learn to see those thoughts for what they are: words. When we can stop taking our thoughts as literal truths, we can choose to take action that deliberately defies them when they do not serve us. We can think “my voice and my actions don’t matter” and still choose to stand up for what we believe in. 

We show up to our pain because it deserves to be acknowledged and seen. And because within pain is valuable information. Behind our pain lies our values – they are two sides of the same coin. We wouldn’t hurt if it didn’t matter. Pain and values are inseparable and both are vital; we can’t have one without the other. Pain can feel overwhelming, but when we listen to the message it is communicating, we can identify those things that are important to us. And when we connect to our personally chosen, deeply held values, we have a compass pointing toward the direction we want to move. When we know what is important to us, we are also afforded the opportunity to connect with others who share our values. The connection to what is important to us and to others who share our values are the fuel that keeps us going when it gets hard. When our minds tell us we can’t keep going, our values remind us why we will try anyway.

Once we know our values and we are able to show up willingly to our experience in the present, we are able to commit to specific actions that are connected to what matters to us. All those thoughts that we can’t make a difference or that our voice is not loud enough are suddenly not quite so significant, because now what matters in this moment is that we act in service of what is important to us. We don’t get to control the outcome, but we do get to know that we are engaging in life in a way that is empowered by our values rather than dictated by systems determined to keep us silent and small.

Just as research shows us the ways that women are treated as “less than,” it also shows us what happens when women are empowered and are present in spaces that were traditionally not open to us. In Be Mighty, Dr. Stoddard notes that patients show health benefits when they are treated by female physicians – including lower mortality rates and fewer hospital readmissions (Tsugawa et al., 2017); corporate finances improve when women are present in leadership (Hunt, Layton, & Prince, 2015) and boards become more effective when women bring our skills to the table (Daehyun & Starks, 2016). Women’s presence in decision making improves the environment (Cook, Grillos, & Anderson, 2019) and helps facilitate more effective and enduring peace agreements (Paffenholz, Kew, & Wanis-St. John, 2006; O’Reilly, Súilleabháin, & Paffenholz, 2015). And when women are involved in politics, the lives of all women and mothers improve as their interests are represented and advocated for (Swers, 2005; Anzia & Berry, 2011).  

The world is a better place when women are represented in positions of power and leadership. And just as it is important to acknowledge that things improve for everyone when women are empowered, it is also important to acknowledge that women deserve equality and empowerment as individuals whose worth is not gauged based on the collective value we offer, but is based on our individual humanity and inherent worth. Our worth is not defined by what we can give to others, but is instead based on the fact that our existence alone is enough to mean we matter. 

So how do we move toward empowerment? We start by holding our pain the way we might hold something precious. It deserves our attention and our care. Once you know your pain, you can begin to consider what it says about what is important to you. And then you can start to take actions, large or small, toward what matters.

For more information on using ACT to empower women, check out Praxis trainings, particularly the upcoming Fierce, Fabulous, and Female online training. Also, check out Dr. Jill Stoddard’s book, to be released January 2020: Be Mighty: A Woman's Guide to Liberation from Anxiety, Worry, and Stress Using Mindfulness and Acceptance and Dr. Janina Scarlet’s upcoming book, release date TBD: Super-Women: Superhero Therapy for Women Battling Anxiety, Depression, and Trauma.

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, 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

References

Anzia, S. F., and C. R. Berry. 2011. “The Jackie (and Jill) Robinson Effect: Why Do Congresswomen Outperform Congressmen?” American Journal of Political Science 55: 478–493.

Bishu, S. G., and M. G. Alkadry. 2017. “A Systematic Review of the Gender Pay Gap and Factors That Predict It.” Administration & Society, 49: 65-104.

Cook, N. J., T. Grillos, and K. P. Anderson. 2019. “Gender quotas increase the Equality and Effectiveness of Climate Policy Interventions.” Nature Climate Change 9: 330–334.

Daehyun, K., and L. T. Starks. 2016. “Gender Diversity on Corporate Boards: Do Women Contribute Unique Skills?” American Economic Review 106: 267–71.

Files, J. A., A. P. Mayer, M. G. Ko, P. Friedrich, M. Jenkins, M. J. Bryan, S. Vegunta, C. M. Wittich, M. A. Lyle, R. Melikian, T. Duston, Y. H. Chang, and S. N. Hayes. 2017. “Speaker Introductions at Internal Medicine Grand Rounds: Forms of Address Reveal Gender Bias.” Journal of Women’s Health 26: 413–419.

Heilman, M. E., A. S. Wallen, D. Fuchs, and M. M. Tamkins. 2004. “Penalties for Success: Reactions to Women Who Succeed at Male Gender-Typed Tasks.” Journal of Applied Psychology 89: 416–427.

Hunt, V., D. Layton, and S. Prince. 2015. “Why Diversity Matters.” McKinsey and Company Annual Report. https://www.mckinsey. com/business-functions/organization/our-insights/why-diversity- matters. Accessed March 24, 2019.

O’Reilly, M., A. S illeabh in, and T. Paffenholz. 2015. “Reimagining Peacemaking: Women’s Roles in Peace Processes,” New York: International Peace Institute.

Paffenholz, T., D. Kew, and A. Wanis-St. John. 2006. Civil Society and Peace Negotiations: Why, Whether and How They Could be Involved. Paper presented at the International Studies Association Conference, March, San Diego, CA.

Park, L. E., A. F. Young, and P. W. Eastwick. 2015. “Psychological Distance Makes the Heart Grow Fonder: Effects of Psychological Distance and Relative Intelligence on Men’s Attraction to Women.” Personality and Social Psychology Bulletin 4: 1,459–1,473.

Pew Research Center. 2015. “Raising Kids and Running a Household: How Working Parents Share the Load.” Accessed November 10, 2018. http://www.pewsocialtrends.org/2015/11/04/ raising-kids-and-running-a-household-how-working-parents- share-the-load/.

Rudman, L. A., and P. Glick. 1999. “Feminized Management and Backlash Toward Agentic Women: The Hidden Costs to Women of a Kinder, Gentler Image of Middle Managers.” Journal of Personality and Social Psychology 77: 1,004–1,010.

Stoddard, J. A. (2020). Be mighty: A woman’s guide to liberation from anxiety, worry, & stress using mindfulness and acceptance. Oakland, CA: New Harbinger.

Swers, M. L. 2005. “Connecting Descriptive and Substantive Representation: An Analysis of Sex Differences in Cosponsorship Activity.” Legislative Studies Quarterly 30 (3): 407–433.

Tsugawa Y., A. B. Jena, J. F. Figueroa, E. J. Orav, D. M. Blumenthal, and A. K. Jha. 2017. “Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians.” JAMA Internal Medicine 177: 206–213.

Trauma, Panic, and EMDR: Eye Movement Desensitization and Reprocessing

by Annabelle Parr

When you search Google Images for “therapy,” the first thing that comes up is a client laying on a couch talking, while the therapist listens and takes notes. Therapy typically does involve a fair amount of talking and listening, but rarely is it that simple. For example, cognitive behavioral therapy (CBT) is a talk-based form of therapy that involves an active approach where therapist and client work together to change unhelpful thoughts and behaviors that affect the client’s mood.

Though most psychotherapy is talk-based, there are a few exceptions. One form of therapy that is particularly unique and relies on little talking is known as EMDR, or Eye Movement Desensitization and Reprocessing.

What is EMDR?

EMDR is a form of psychotherapy often used to treat trauma, where the therapist asks the client to imagine the distressing event while simultaneously engaging the client in some sort of bilateral stimulation. Typically, this involves therapist directed eye movements from one side to another, but it can also involve taps or tones.

How and why does EMDR work? 

It can be difficult to imagine how therapy might work without relying on much talking. But sometimes we cannot access all of the information that our brain has stored. If we can’t access it, we can’t talk about it. And sometimes, we can rationally understand something, but still feel stuck in painful emotions.

Trauma can be particularly difficult to process because the frontal lobe (the part of the brain involved in higher level processes, like thinking and language) is not always able to fully access the traumatic memory. So we can try to wrestle and reason with it, but find ourselves frustrated by a lack of progress as far as our emotional response goes. EMDR purports to help us approach trauma from a different angle, so that the brain actually reprocesses the way the trauma is stored.

EMDR changes the client’s relationship to the trauma.

Clients tend to find that their thoughts and feelings around the traumatic memory change fairly quickly with EMDR (EMDR Institute, Inc., 2016). There is often a deeper sense of being able to cope with trauma on an emotional level.

EMDR is now offered at CSAM.

CSAM is excited to announce that Dr. Terra Fuhr is now certified in EMDR. Dr. Fuhr explained that she decided to pursue certification because she saw several colleagues find great success using EMDR. Then she began to occasionally refer clients for simultaneous EMDR treatment, and saw firsthand the remarkable healing that it facilitated. She found that EMDR helped clients break through in places where they got stuck using only CBT. This effect was so powerful that she felt inclined to add EMDR to her mental health tool belt as a modality to help her clients, so that now she can offer EMDR in conjunction with CBT and ACT.

What can EMDR be used to treat? 

EMDR was originally used to treat trauma and PTSD, but today is applied to numerous other issues. Dr. Fuhr describes how helpful it can be in treating panic disorder. One reason for this is that clients’ most severe panic attack is stored as a trauma. Using EMDR to heal the trauma of panic can be enormously helpful in helping the client break out of the panic cycle. It can also be applied to “small traumas,” like an embarrassing moment, negative thinking patterns or feelings such as low self-esteem (EMDR Institute, Inc., 2016).

While there is some debate in the scientific community regarding the how and why EMDR helps, studies have offered support for its efficacy, and over the 25 years that it has been in existence, millions of people have been successfully treated using EMDR (EMDR Institute, Inc., 2016). EMDR can be offered on its own, or in conjunction with CBT or ACT. For some clients, it can be a helpful adjunct to their healing process.

CSAM IS HERE TO HELP

If you or someone you love might benefit from eye movement desensitization and reprocessing (EMDR), cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), 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.

For more information about Eye Movement Desensitization and Reprocessing, visit The EMDR Institute.

References:

EMDR Institute, Inc. (2016). What is EMDR? Retrieved from: http://www.emdr.com/what-is-emdr/