When Sleep Won't Come

Written by Day Marshall, LMHC (Senior Clinician)

Have you had those nights when sleep is evasive? When you shift in bed and adjust your pillow, throwing off or adding on layers of cover? Apart from general, good sleep hygiene practices such as keeping a regular sleep schedule, setting the tone for sleep with lighting and calming activities, sometimes it can feel like there is little to be done when our minds keep wandering once the lights go out. Based on what clients often tell me, I think that often the anxiety of not falling asleep is the primary culprit keeping us awake.

While there are numerous ways to help increase the ability to sleep, I want to introduce you to one method that is a favorite of mine.

Our brains are remarkably made and incredibly adaptive. Every sensation we experience, be it sound, sight, taste, smell or touch, is communicated to us by our brains. Therefore, if my brain is thinking about stressors, my body will naturally tense up and likely go into problem-solving or worry mode.  However, if I focus my mind on the most serene and relaxing environment I can imagine, my whole body begins to relax. Using anti-anxiety grounding techniques when lying in bed can provide relaxing, sleep-inducing benefits.

I like to begin with deep breathing; long, slow, full breaths and exhales. While I deep breathe, I begin to visualize myself in a relaxing place. I’ll share mine with you, but you’ll need to get your own because my place is relaxing because no one else is around for miles!  My serene place is a warm beach with pristine sands devoid of all bugs and the only human is me.  I lie on my back facing up toward the perfectly warm sun. I feel the gentle give of the sun warmed sand beneath my body. I can drag my fingers over it and dig my fingers into it and feel the cool under the surface. The gentle ocean breeze dances over my skin and I can feel it on my face and on my arms and legs. The trees around the beach quietly rustle their leaves in response to that wind, and there are myriad birds singing in chorus high in the trees. I listen to the waves coming in and going out; a gentle, reliable rhythm. I can taste the mixed sweet and tang of watermelon and pineapple. There is a crackling campfire burning in the near distance. I smell the wood burning as it mixes with the salt air. I am still deep breathing and taking in all the sensory wonders of the beach serenity. If my mind begins to pull away to a worry or stressor, I gently but firmly draw it back to the sensory experience of the beach. The smells, the sounds, the sights, the feel and the tastes of my beach retreat become weightier than the worries and stress that it lulled away. In the midst of all of this, sleep generally comes quietly.

Sleep well!

The New Normal

Written by Dan Brown, MA (Director of Operations, Senior Clinician)

The pandemic has been difficult.  But one of the biggest things that the pandemic has taken from us all is a sense of normal. Normal birthday parties, normal dinners out with loved ones, normal soccer games.  Normal.  

But as we return to normal we have to realize that we will not be fully ourselves either.  Over the course of the last year, we have regressed or adapted to the restrictions or just flat out avoided people using the pandemic as a convenient excuse.  We have been socially conditioned.  We might find ourselves feeling awkward or have heightened anxiety anytime there is a group gathering on our calendars.

Or maybe you’re someone who has some codependent tendencies and are anxious to be around anxious people.  When I say codependent tendencies I mean you might be one that always wonders how you’re being perceived in a group and will ruminate for hours/days on how a social situation went.  So social situations seem like something you’d like to pass on for another year or ten.

Or maybe you’re someone who has used the pandemic to avoid people that seek to control you or overburden you.  And you can see these types of people from a mile away and when you are around them you start to get a knot in your stomach.  Potentially now after the pandemic those people became even more controlling and more overburdening.  I am sure this last year has been better for you getting a year long break from these types of interactions.  

The reality is that life is going to go back to what we remembered as normal. Schools, churches, work places and the like.  So what is next for you in these settings?  Do you just return to those old ways?  As a mental health provider I see this as a unique time in human history to make big strides in your ongoing social anxieties because you’ve had such a big pause in exposure to them.  You might be able to identify people that are just flat out unhealthy for you to be around and might consider not being around them as much.  Or you might be able to draw some boundaries with people that you weren’t able to draw boundaries with before because you’ve had a little distance with them and free from their manipulations.  And for those people that seek to control you or overburden you, you might now for the first time be able to say stop, no more.  

Our society needs friendship.  Our society needs grace in those friendships.  Our society needs positive social interactions that allow people to be “off” and not our best.  Our society needs normal again.  

Good thing Jesus continues to be seated and the right hand of God the Father living in perfect unity, in perfect friendship with the Father and the Holy Spirit.  There is no overburdening of the other going on there.  No guilt tripping going on in the Godhead.  They see the end of this and allowed the beginning of it to happen.  And I believe they want people to start being normal again too.

Mental health starts with realizing your own mental unhealth.  Then you can move to make a change with your therapist and then realize those changes with friends, family and those around you in your community. We all have our weaknesses.  But we don’t all admit those weaknesses.  I am proud you have admitted yours or are starting to admit yours and are ready to make changes.  Maybe you will not just return to normal but to a new normal.  

Too Many Bath Mats

Written by Megan Farcas, LMHC CMHIMP (Clinical Supervisor, Senior Clinician)

The other week I found myself in need of a new bath mat. I decided to search online for this purchase—as one does in pandemic times—and what should have been a 5 minute task turned into a 45 minute ordeal. I quickly found myself down a rabbit trail of questions I had never thought about in previous years of buying the occasional bath mat. Here’s how some of those thoughts went: 

"Well this bath mat is cheaper but this more expensive bath mat has more suction cups…how many suction cups are enough suction cups? Should I get the one with big suction cups or little suction cups?…This one has 1,000 4.5 star reviews but this one has 6,000 4 star reviews. Which is better? This review says the mat had a strong plasticky smell…what kind of plastic is this made out of anyways? *searches Google for different types of plastic and toxicity levels*…should I even have a bath mat? Is it dangerous? Do I need to ventilate it before I use it?…"

As I began to catch myself in this spiral of thoughts, I was reminded of the book The Paradox of Choice by Barry Schwartz. In his book Schwartz argues that, rather than being helpful, having too many of choices can lead to feeling overwhelmed and paralyzed in making a decision. This "analysis paralysis" results from spending too much time analyzing all of the possible choices we are faced with which then leads us to feeling stuck, often taking a longer time to make a decision than needed.

Not only that but once we do finally make a decision we frequently then experience regret with the decision we made. Because we are faced with so many choices we begin to think that there must be a "perfect" choice to make, and so when we experience disappointment with our decision we assume we chose incorrectly. Studies show us that when we have less choices to pick from we often feel more satisfied in the final choice we make.

So how can we apply some of this information to our day to day life? Well, as a starting point you could try to identify ways to reduce the number of choices you make. Maybe it’s deciding to shop at the same grocery store and buy the same brands each week regardless of what ads you see that might tell you otherwise. Perhaps it is deciding to go to the restaurant with the smaller menu to choose from. Maybe you minimize your wardrobe a la Mark Zuckerberg and Steve Jobs and wear the same type of clothing every day. In identifying small ways to reduce choice each day you might find an increase in your satisfaction of choice and a decrease in time spent making decisions.

Oh and yes, I did buy a bath mat :)

God is Here

Written by Heather Thornburg, MA (Clinician)

“The Lord is at hand; do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.” Philippians 4:5b-6 ESV (italics added)

I could tell you that I love this verse, but I would be lying.  Mostly, I find this verse confusing – how in the world do I “not be anxious about anything?” Especially right now?  In 2021…that followed 2020?

Life in a fallen, broken world can easily produce anxiety, and this past year has really hit many of us hard.  Almost every single client that I see is experiencing anxiety symptoms to one degree or another.  And in truth, it impacts me as well.  Anxiety symptoms appear in different ways.  Physically, we can have muscle tension, nausea, hot or cold sweats, headaches, shortness of breath or tightness in our chest.  Emotionally, we can become easily irritated, easily startled, tearful, impatient.  Mentally, we can have difficulty focusing, become spacey, or have intrusive or racing thoughts.  This is not an exhaustive list, but whatever symptoms we experience can be difficult to live with.  So, what can we do?

Believe or not, managing anxiety can begin with some relatively simple steps.

1.      Breathe – Seems too simple, right?  But anxiety can cause us to hold our breath or breathe shallowly and rapidly, and this can make our symptoms worse.  Instead, take five minutes to do some deep breathing.  Breathe slowly in through your nose for a count of 4-6, hold your breath for a count of 4-6, then breathe slowly out through your mouth for a count of 6-8.  Repeat.  Deep breathing reverses the anxiety response and signals your brain to begin calming the body (from TherapistAid.com).

2.      Ground – Do you find yourself worrying about things that haven’t happened yet?  If your thoughts have a repeated refrain of “what if…” then you are.  The future hasn’t happened yet; it doesn’t exist.  The present moment is real, and grounding yourself in it will help you step back from the tyranny of your thoughts.  Look around you - what do you see?  What do you hear?  What do you smell, taste, feel?  Take it in slowly and deeply.  Describe your surroundings to yourself; notice your feelings.  Pause, and let yourself be present in the moment.  Breathe a thank you to God for something in your surroundings.  By the time you’ve done all this, the “what ifs” shouting in your brain will have quieted down and given you the space and the strength to choose your next thoughts, to speak the truth about who holds your future.

3.      Prayer – Do you ever get caught in a thought loop about things that worry you?  Racing thoughts or thinking about the same things over and over are frequent responses to anxiety.  These thoughts can also be some of the most difficult anxiety symptoms to address.  When you experience this, immediately turn your thoughts to prayer. Don’t necessarily try to change the content, just begin directing your thoughts to Jesus.  It looks something like this.  I think, “I have this blog to write, and it’s my first one.  What if people don’t like it and think it sounds dumb?  What if my colleagues don’t like it?  Will it be professional enough?  Is my writing up to par?” …and we’re off to the races.  Now switch to prayer.  “Jesus, I have this blog to write and it’s my first one.  God, what if people don’t like it and think it sounds dumb?”  …etc., etc.  In the first example, my thoughts are spinning inside of myself with nowhere to go, and I don’t have the power to do anything about them.  In the second example, I have directed my thoughts up and outside of myself to one who loves me and created me.  To one who has the power to encourage and direct me, and provide some objectivity. 

To return to our verse, yes, Paul tells us “do not be anxious about anything”, but before he does so, he reminds us that “the Lord is at hand.” God, himself, is the reason we have hope to overcome our anxiety. When you feel a tension headache coming on, rest your hand on your chest and remind yourself, “God is here.” When you’re lying in bed and can’t stop thinking, rest your hand on your chest and remind yourself “God is here.” When your irritated and don’t know why, rest your hand on your chest and remind yourself, “God is here.” Whether you feel him or not, God is here!

Cultivating Gratitude

Written by Megan Farcas, LMHC CMHIMP (Clinical Supervisor, Senior Clinician)

"We’re a nation hungry for more joy: Because we’re starving from a lack of gratitude" — Brené Brown

Have you ever had a day where it seems that the world is against you and everything that could possibly go wrong has? If you were to step back and try to assess the day from an objective point of view, would that still be your conclusion? In our human nature, we tend to reflect on the negative, the frustrating, the disappointing. We wonder why we feel grumpy, angry, or irritable and often look for detailed, extravagant, sometimes expensive ways to help ourselves feel better. Yet the antidote to our lack of joy can often be found in the simple practice of gratitude. This practice of gratitude is one that is accessible to all yet rarely used in day-to-day life without intentionality.

Numerous studies have found gratitude to have significant positive impacts on anxiety, depressive symptoms, relationships, and physical health and well being. In their study, Wood et al had participants practice gratitude, which was defined as an orientation "towards noticing and appreciating the positive in the world.” In one portion of the study, they asked participants with high body dissatisfaction to spend each day practicing gratitude. By doing so 76% of the participants experienced a reduction in their body dissatisfaction compared to those who did not practice gratitude. Similarly, when studying those with high anxiety, participants who practiced gratitude were found to have a significant decrease in their worries (Wood, Froh & Geraghty, “Gratitude and Well-Being: A Review and Theoretical Integration,” Clinical Psychology Review). 

Martin Seligman, a professor of psychology, has found similar results in his research as well. In his studies he developed one practice called a "gratitude visit" in which one writes a letter of gratitude to someone who has made a difference in their life and then visits the person and reads the letter to them out loud. In doing so, Seligman found that the person writing the letter had lasting positive feelings and felt happier up to a month after the visit. 

Are there ways you can begin cultivating gratitude in your own life? Perhaps you can try Seligman’s exercise of a "gratitude visit." If this feels too uncomfortable, as an alternative you could consider writing a thank you note to someone you appreciate. Other ideas might be to end the day reflecting on three things to be grateful for, no matter how difficult the day was. Some find ways to break up their day to pause and gratefully reflect, such as "1,2,3,4" where at each hour you stop to identify a moment of gratitude. For those who pray, starting prayer with gratitude first can be a helpful way to reorient to a mindset of thankfulness rather than the frenzy of supplication we often approach prayer with. 

The ultimate goal in cultivating gratitude is for it to become second nature, a natural reflection throughout the day. Realizing that you are grateful for the sunlight even if the weather is cold, that you are thankful your spouse helped with dishes even if it’s not how you would do it, that you had a great hair day even if nobody else saw it. You may find that over time you have retrained your brain to become more aware of positive moments, however seemingly mundane they may be.

(Scriptures that may be helpful to orient towards a reminder of gratitude and thanksgiving: Psalm 100, Psalm 118: 24, Psalm 103:2-5, Philippians 4:6-7, 1 Thessalonians 5:16-18)

The Benefits of Boredom

Written by Megan Farcas, LMHC (Clinical Supervisor, Senior Clinician)

In 2018, a technology company completed a study which found that Americans check their phone on average 80 times a day, roughly once every 12 minutes, including when on vacation (Asurion, 2018). While this number may seem startling, the addition of "screen time" limits within smart phone settings in recent years show just how much our lives have been taken over by the use of screens, social media, and apps. It doesn’t end there—use of screen time is not only limited to smart phones but also other devices like computers and televisions. Distracting yourself can look like turning on the television every evening and zoning out until bed time or scrolling through emails on the computer even though they have all been replied to.

Most people are aware of the dangers of screen time use in regards to things like distracted driving. The National Security Counsel documents that cell phones are involved in 27% of all car crashes and are the cause of roughly 3,000 distracted driving deaths every year (NSC). Yet there are other more subtle ways that constant distraction can cause us harm. For example, screen use even distracts us from using the bathroom properly—90% of people admit that they take their phones with them to the bathroom and studies have found that people spend up to 40 minutes using the bathroom when they are on their phone even though from a physiological perspective it shouldn’t take more than 7-10 minutes (Fulton, 2017). Such a shift in a basic function can lead to physical problems and ailments, simply because we are too glued to our technology. 

So why is this? Why are we constantly distracting ourselves? In sessions with clients I often find that distraction is a way to avoid a deeper issue. It pushes off feelings of anxiety, depression, fear, sadness, or frustration to name a few. We engage in distraction because it works—but only temporarily. Eventually those feelings come back again and thus we engage in another distraction to avoid thinking about or feeling them (usually via screen time) that just perpetuates the cycle. Certainly there are times in sessions where part of the treatment plan is to utilize distraction techniques, but this is generally the case when the feeling or experience is insurmountable during an important moment (for example someone who is struggling with panic attacks while giving a presentation at work). Overall, the goal is not to always distract yourself, but to work towards managing the feelings and symptoms in other ways.

In my work with clients I have found that one way this can be done is by putting down the distractions and allowing yourself to be bored. 

Being bored is often correlated with laziness or a lack of motivation. In fact, the Merriam-Webster Dictionary defines boredom as "the state of being weary and restless through lack of interest". Despite this definition, studies have found that boredom is often beneficial—maybe even necessary—for problem solving and creativity. A 2019 study found that boredom actually helped increase productivity on activities that followed periods of boredom (Park, Lim, & Oh). Boredom also often leads many to daydream, which can boost problem solving ideas and creativity (Ducharme, 2019; Mann, 2014). Boredom has also been found to help boost and motivate us towards creating new goals (Elpidorou, 2014);when we are bored we often start to think about the future and ideas we have or changes we would like to make. Additionally it has been shown to increase social identification, positive memories, and nostalgic feelings (van Tilburg, 2011). 

Boredom can be hard to start if we are used to constantly distracting ourselves in order to push aside thoughts or feelings we are not ready to deal with. Sometimes the best way to work towards this is to allow ourselves momentary breaks from our constant distraction. Try taking a walk without listening to music or talking on the phone. Sit outside and let your mind wander without any agenda. Avoid looking at your phone when you are waiting in line or on public transit or sitting in a waiting room. Stop taking your phone to the bathroom. Instead, in these moments, allow yourself to be bored and see where your mind takes you. Do you start to come up with a creative solution or idea? Maybe you begin to daydream and reorient some of your goals. Do you find yourself becoming anxious? (Studies have shown that separation anxiety can be a response to not using technology, as 31% of people feel anxiety when separated from their phone (SWNS, 2017)). How long are you able to tolerate this feeling of discomfort? Can you work towards slowly decreasing the amount of time you spend desiring distraction vs. allowing yourself to reap some of the benefits of boredom? 

References

Ausurion (2018, May 17). Americans Don’t Want to Unplug from Phones While on Vacation. Retrieved from https://www.asurion.com/about/press-releases/americans-dont-want-to-unplug-from-phones-while-on-vacation-despite-latest-digital-detox-trend/

Ducharme J. (2019, January 4). Being Bored Can Be Good for You—If You Do It Right. Retrieved from http://time.com/5480002/benefits-of-boredom/

Elpidorou A. (2014, November 3). The Bright Side of Boredom. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyg.2014.01245/full

Fulton, W. (2017, June 25). iPhones Have Changed the Way We Poop... for the Worse. Retrieved from https://www.thrillist.com/entertainment/nation/smartphone-toilet-health-risks

Mann, S. (2014). Does Being Bored Make Us More Creative? Creativity Research Journal, 26 (2), 165-173. 

NSC. Retrieved from https://www.nsc.org/home

Park, G., Lim, B.C., & Oh, H.S. (2019). Why Being Bored Might Not Be a Bad Thing after All. Journal of Academy Management, 5 (1). 

vanTill, W.A.P. (2011). Boredom and Its Psychological Consequences. University of Limerick. 

SWNS (2017, November 8). Americans Check Their Phones 80 Times A Day. Retrieved from https://nypost.com/2017/11/08/americans-check-their-phones-80-times-a-day-study/

Anxiety and Faith

Written by Day Marshall, LMHC (Senior Clinician)

Anxiety is one of the most common reasons people enter a therapeutic setting. The symptoms of anxiety can be as varied as the individuals it affects, but generally, it shows up as jumbled, racing thoughts of worry and negativity about self or others, resulting in an impaired ability to focus, process options, problem solve, or make decisions. Anxiety often manifests physically as sweaty palms, increased heart rate, lightheadedness, and either lack of purposeful motion or excessive activity.

At times, Christians who come to counseling with a hope to resolve anxiety can express a sense of failure or disappointment in their walk with God. There is a belief that their anxious thoughts and feelings are somehow related to a lack of faith or ability to rest in God’s goodness. And though resting in God plays a part in the management of anxiety, it is often relieving for clients to recognize that anxiety is very often closely related to values, beliefs and coping strategies established in early childhood, usually long before a comprehensive understanding of God is formed. This means that learning how to apply faith and God’s truths to anxiety responses can take some coaching and skills building: learning proper application of God’s healing balm, if you will.

Since many neurological pathways are solidly established for anxious responses early in life, it is helpful to have the capacity to apply critical thinking and reason to practical skills building in order to carve new pathways for responding to stressors. Faith and God’s truth can be powerful components in establishing these new responses. For example, applying Scripture and God’s promises during grounding and self-soothing techniques can often be very effective at mitigating the impacts of anxiety. One possible application of this is the practice of breathing in deeply while thinking, “He is my refuge” or “Rest for the weary”, and then visualizing breathing out worry and fear.

Rather than experiencing guilt or a sense of failure, those with anxiety can be encouraged that peace and rest for the anxious mind is closely related to learning how to apply the healing balm of God to those affected areas.