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Keeping Your Balance in the Apocalypse

If you have been feeling worried about illness recently, you are definitely not alone. Even people who don’t normally experience health anxieties are affected by news regarding the novel coronavirus, COVID-19. Ships quarantined, cities locked down, schools closing, hospitals overwhelmed. Much of what we hear is the absolute worst of the news, and for now at least the rest is largely unknown.

An endless wave of bad news can certainly increase depression, while facing an unknown can increase anxiety,  so the situation is a recipe for increased stress on everyone’s mental health. In addition, we are carrying the weight of experiencing others’ stress and worries as well. It’s not only a nationwide mental health stressor, but a worldwide one.

It’s common for PTSD symptoms and anxiety symptoms generally to spike during times of crisis, especially for those who are in vulnerable marginalized groups. This is true whether or not you have a trauma history that is specifically related to the crisis itself. So you may be experiencing more symptoms such as insomnia, panic attacks, melancholy or dread, fibromyalgia, hives, flashbacks, migraines, dissociation, suicidality, agorophobia, or obsessions and compulsions, to name a few of the common ones.

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What to do first:

As in any times of crisis, there are four basic elements of self-stabilizing, beginning with the body.

First of all, you need sleep! If you are experiencing insomnia, address this first. Sleeplessness makes everything else hard to manage, both physically and mentally. You may use self-help methods or you may seek professional support from a therapist if your insomnia is entrenched.

Another aspect of stabilization is to make sure you are eating: get enough healthy fuel. If stress has activated disordered eating such as restricting or bingeing, don’t ignore it. Address it directly.

Exercise: If you already have a reasonable exercise program, do your best to maintain it. If you have begun to isolate, try just taking a 10-minute walk daily. Even mild exercise will help both your body and mind feel better and more able to handle whatever stresses are arising. Also, being outdoors and seeing other people can remind you that human life is continuing and you are still part of a mutually supportive, helpful society.

Which leads to another important aspect, that of social support. It’s important to connect with supportive others, in whatever format you can. Even if you must work from home, you can text or email or talk on the phone with someone. Make sure to do this daily!

Maintain Your Routine and Stay Connected

In the broader sense, counteract a sense of helpless disaster by focusing your perception on the many thousands of highly capable and caring people in every possible area of life–health care workers, emergency workers, researchers, spiritual leaders, parents, neighbors, friends–who are planning and preparing to support, save, and take care of all of us as best they can. Maybe you are one of those people!

Remember that your fellow humans feel a sense of care and responsibility towards you, just as you feel towards them. We protect and help one another to get through. And as Mr. Rogers famously described, “looking for the helpers” is a good way to reassure yourself in a crisis. Becoming one of the helpers yourself–even in a small, neighborly way–can help you to feel less powerless.

When you have stabilized your primary needs as best you can

The next step is to do your emotional self-care. First of all, accept your emotions. It is reasonable to feel scared or angry or any other emotion in a crisis. So have acceptance for whatever those feelings may be, and find ways to comfort yourself.

The trick, however, is to not buy into the cognitions that anxiety or depression may generate. Recognize that if your thoughts are becoming dreadful, it’s likely you are experiencing catastrophization or similar cognitive distortions. One way to reframe this for yourself is to recognize what you have control over (sensible interventions and planning) and what you do not have control over (worldwide events).

If it is something that you do have control over (sensible hygiene, having medications and basic supplies available, planning alternate child care / work locations, rescheduling travel), then implement those things. But worrying will not help you with the implementation.

If it is something you do not have control over, then again–worrying will not help. You may feel afraid and it is worth talking through the fear with someone. But you may need to let go of a sense that you must control the situation in order to survive it. Much of this is out of your control and anyone else’s! Seek solidly data-driven, practical sources of information rather than sensationalized or over-minimized sources. This will help you know what to actually prepare for.

The worry protocol includes not only contagion, but another common anxiety: financial fears. For some, this is regarding recent stock market drops, and for others, simply the ability to pay rent each month when society is disrupted or they could become ill. Again, the worry protocol holds: sensibly plan and implement the parts that you can. The parts that are out of your control may happen or they may not. If they do happen, you and others will do your best to recover and repair as soon as you are able. You may or you may not incur losses, but you will deal with those if they occur.

So…in order to keep yourself emotionally stable:

Take good care of yourself, accept your emotions, manage your cognitions, make practical plans that are based on reality, relinquish control of the uncontrollable, maintain your routines as best you can, and find some way to become a helper. If you are struggling with these issues, consider seeing a therapist to help you sort through them!

Intersectional Life Counseling and Psychology offers remote video sessions for PA residents, as well as sliding-scale rates from $70. Please EMAIL if you would like to schedule or have any questions!

 

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Your Loved One Has Dissociative Identity Disorder?

If you have a loved one who has Dissociative Identity Disorder (AKA “multiple personalities”), you may have felt uneasy or even frightened at times. It can be disconcerting to think you do not really know who they are. It may be awful to think of the traumatic experiences they survived that led to the dissociation.

This is partly because for many people, the only understanding they have of Dissociative Identity Disorder comes from sensationalized depictions in movies or TV, showing DID experiencers as unpredictable, deceptive, violent–nearly supernaturally so!

But it’s important to take a pragmatic approach to understanding this experience and not to exoticize or blame your loved one.

In other words, they are not an exotic disorder. They are not their traumatic experiences. They are not possessed. They did not “cause” the disorder. They did not ask for nor deserve the trauma during which it developed. They aren’t “faking.” They are not a case for you to manage. They are a regular person who needs love, acceptance, and healing.

Everyone has “parts” –different personality presentations and experiences that are expressed in different situations. We all act at least somewhat differently at a job interview than at the club, or at church, or with a close friend who is very accepting, or in class, or around a judgmental neighbor, or around a secret crush.

The main difference is that for those who have DID, those different presentations have become dissociated from each other: there is a disruption of the underlying thread of memory and consciousness that most of us have between all our parts.

An important thing to remember is that while you may not like one or some of your loved one’s parts (and you don’t have to!), there are no “bad” parts. Every part’s feelings are a valid expression, even if not every part’s wishes should be acted on.

Nothing your loved one experiences is beyond the understanding of humans generally. You don’t need to be an expert in Internal Family Systems to connect with them. It’s useful to have some information, but primarily, just be a human with a loving connection. ❤

If you are interested in reading more in-depth about Dissociative Identity Disorder from someone who experiences it, here is an essay that is addressed to therapists but may also be useful for others who have loved ones with this type of dissociation:

TEN STEPS TO BECOMING A DISSOCIATION-FRIENDLY THERAPIST

 

 

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Depression Part 4: Just do the little bit that you can.

Part 1: Is It Depression?  Part 2: When Depressed   Part 3: Nurture Yourself Back to Life

Part 4:

Exercise: We’ve been told so often that we must exercise, that now we may hear it as a burden. Who can carry any more burdens when severely depressed? Who can go lift weights when it’s a struggle to get the bathroom and brush their teeth? But exercise is not supposed to be horrible. You can’t go wrong if you focus on exercise primarily as a way to make your body feel a bit better. It’s not some kind of punishment for resting, or for eating, or for existing in a body of any shape or size. It does not have to be within a contest. It is not a “cure” for mental illness, though it can help to improve your mood. It is an activity your body can like if done in a pleasant, kind way!

I often suggest to clients that if they are too exhausted to go to the gym or whatever their preferred exercise may be, just walk around the block. If that is still too much for right now, then just go outside and walk around the house and back in! Just do the little bit that you can.

There are very few texts that “get” how to approach exercise when you’re experiencing severe depression, but this excellent article really helps when you need to ramp up from zero: “Depression-Busting Exercise Tips For People Too Depressed To Exercise” (Sarah Kurchak)

Social Interaction: Maintaining social interaction can be a tricky aspect of depression. You need some level of social interaction to help stabilize your emotions and keep you woven into reality. If you are in a marginalized group, it is especially important to have supportive others to validate your experiences and keep you feeling sane, cared for, and safe. However, there is a HUGE difference between how much social interaction you need if you are more extroverted versus the amount you need if you are more introverted.

Extroverts can more easily harness the power of friends and family to help recover from a depressive episode: being around others will energize you and give you a bit of motivation. It’s straightforward. Seek out others to talk to daily and if possible, to see in person. It may be hard to ask for help, but see if you can ask for help with something simple. This could be something like dishes, child care, or taking you to the grocery store. You can also just ask someone to watch a movie with you or go for a walk. Ask several different people to do several different things. Being able to be in supportive company will be very useful in your recovery.

Introverts, however, may have a harder time with this. Since interacting with others can drain you of energy, you may need to be choosy about whom you contact and how you interact with them. It’s still a good goal to speak with another human at least once a day. But it’s okay if this is just talking to a friend on the phone, getting your change from the clerk at the corner store, or even calling a help line. If you have the energy to tolerate having someone in your space, it’s good to ask a friend for a little help. But make sure it’s someone who understands your limits and does not expect you to be entertaining or emotionally fulfilling to them. You can offer that later when you are not in a depressive episode! If it is still very hard to see people or even to just talk on the phone, you can start with just texting or emailing with someone(s) daily. But try not to let a day go by without communicating with others. And keep doing it.

Furthermore, you may also be considering medication.

Medications: There are a lot of non-medical things you can do to manage your depression, and medication is certainly not mandatory. However, medications can be a useful part of managing depression. They will not make you immune to sadness, but if you are especially low or “flat” or suicidal they may pull you up enough to get to your self-management.

Other people in your life may have a lot of strong opinions about medications, but this is your decision, not someone else’s. If someone tells you that you should take medication but you don’t want to, you do not have to. If someone tells you that you should not take medication but you want to try it, you may try it. That decision is between you and your physician, and you need to do what will help YOU to recover.

Most antidepressants and anti-anxiety medications are prescribed by people’s primary care physicians, though often your PCP will require that you are also seeing a therapist if they are to prescribe psychoactive medications. A psychiatrist can address more complex psychoactive medication issues than your primary care physician. A psychiatrist may be necessary if you have resistant depression or other mental health issues, such as hypomania or psychosis. It may take up to three months to get an appointment with a psychiatrist, since they are in short supply everywhere. So if you think you may want a psychiatrist, don’t wait to start looking.

Now you have stabilized yourself as best you can! You have examined the four crucial life aspects influencing mental health (sleep, nutrition, exercise, and social interaction), you have considered whether you’re interested in medication, and you have begun doing what you can to develop a healthy rhythm in those areas.

For today, you are doing the little bit that you can. And you will keep doing it. It’s very hard to manage your mood at all when even one of these aspects is disrupted, so stabilizing them all is the basis of recovery.

Next part: Emotional Aspects: Mood Management

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Just do the little bit that you can. And keep doing it.

 

~You may qualify for our new sliding-scale fee discount.~
~Please contact us for an application.~

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Immigrant Families Finding Therapy

Because of the many layers of stresses and even traumas associated with immigration, immigrants and their families may face high levels of mental distress. This includes things such as traumatic events that were severe enough to make them leave their home country in the first place, as well as the great difficulties in adjusting to a new and sometimes hostile environment.

In today’s social and political climate, stresses and traumas are higher than ever, making mental health support even more crucial. But as challenging as getting started with therapy can be, it can be even harder for immigrants and their families.

This piece by Lauren Hodges explains why, and offers MANY great suggestions to help you or a family member get mental health support!

 

 

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You Are Not Your Trauma

 

An early experience of trauma can have effects that you may not start experiencing until adulthood. It can feel “crazy”! But having PTSD symptoms doesn’t mean that you will always feel that way. It means that you have emotions and reactions that are ready to be processed so that you can begin healing.

While healing from trauma can be a lifelong process, you can often start feeling better in many ways right away! You are still a whole, worthy human being, rich in the capacity to enjoy life in your own ways.

If you are ready to start processing, please review our quick chart to see how you can access our therapeutic services from anywhere in Pennsylvania!

 

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You Are Already Worthy!

 

Calling yourself “lazy” or “unproductive” is usually an internalized message of shame from your formative years. The message is “If you would just ‘will’ yourself to do more, then you would be acceptable and worthy. Otherwise, you must just be a bad, unworthy person.”

The fact is, you are already acceptable and worthy, without doing anything to “earn” that worth. Now, you might feel better or happier if you were doing certain things, and they are certainly worth trying, to see if that is the case.

But feeling terrible about yourself is not a good motivator for anyone! In fact, it is likely to worsen your exhaustion, depression, anxiety, insomnia, and concentration, which will make it even harder to do whatever it is you would like to be doing.

If you are ready to start healing your self-worth, please review our quick chart to see how you can access our therapeutic services from anywhere in Pennsylvania!

 

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A Peaceful Meditation Day to All!

The physical and health benefits of meditation have been noted for years and repeatedly validated by science. You don’t have to switch to an entirely new lifestyle in order to practice meditation! There are many ways to begin practicing, a little at a time.

Many people with anxiety do very well with the structured approach taken by Headspace (Andy Puddicombe). With simple graphics that clearly explain physical, cognitive, and emotional aspects of meditation, you will find the process easy to understand and implement. Even if you do not get a subscription and only use the first sessions that are free, it is well worth a look:

Another meditation tool that many clients report being highly satisfied with is Insight Timer:

And if you’re ready to go a little deeper into the emotional aspects of meditation, I highly recommend anything at all by Tara Brach!

 

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Yoga Through the Lens of Western Science

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Our physical, emotional, and cognitive aspects are interconnected and interdependent. This is the case whether we use a psychodynamic approach or a cognitive-behavioral psychological approach. If we are experiencing (noticing) dysfunction in one area, the whole system is actually affected. The good news about this is that by changing things in one aspect, we can affect other aspects as well.

This does not mean that we can simply “think away illness” or that if we can exercise “perfectly” (whatever that would be!) then our thoughts and feelings will just “snap out of it” into rationality and/or bliss. What it does mean, however, is that when we gradually move our habits towards health and balance in one aspect, the other aspects will also move more towards health and balance.

That means when behaviors become healthier, thoughts and feelings become healthier. When thoughts become healthier, feelings and behaviors become healthier. When feelings become healthier, behaviors and thoughts become healthier. A change in any one of them changes all of them!

When we consider the interconnected areas of behavior, cognition, and emotion, the most easily and directly influenced aspect is behavior. We can change what we do, which can help to change what we think and how we feel.

Remember, with any behavior change, the idea is not instant change, but rather successive approximation: doing things a bit more like the goal behavior, and then when that sticks, we do it a bit more like the goal behavior. Attempting drastic changes is less likely to create long-term change than creating and conditioning gradual habit change.

This really interesting clip discusses some ways in which developing–for example–a yoga practice can influence not only thoughts and feelings but also our bodies down to the cellular and chemical level:

 

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Mental Health: Accepting Healing Over Time

 

Valarie Ward has written a good breakdown of how pop mental health writing is often not only unhelpful, but perpetuates stigma and judgment. Treatment–whether chemical, cognitive, or situational–can support and help to heal mental health, but it’s not a magical instant “cure.”

It’s useful to find the type of treatment or intervention that is most helpful and supportive to YOU. It doesn’t mean you’re “doing it wrong” if you still have symptoms or flare-ups. It means that humans are biological, not mechanical objects that can have new parts swapped in for an instant fix. [See: PTSD as chronic illness]

There is nothing wrong with trying to find things that help you feel better and function better. We encourage you to explore treatment modalities!

But the danger in chasing a “cure” can be the idea that if it’s not “cured,” then we just aren’t trying hard enough. Plenty of people with mental illness and injury hear this message from well-meaning friends, family, and loved ones, though sometimes in different words.

“You’ve been in therapy for weeks/months/years, why isn’t it helping?”: If it’s truly not helping, then of course try something else, or something additional!

But often this really means “I’m upset that you’re not ‘cured’ yet.” Unfortunately, we may also internalize these messages ourselves, which just means that we have found another “should” with which to beat ourselves up; another way to use perfectionistic standards against ourselves.

Instead, notice how far you’ve come since you started working on your healing. Even if it has only been a few days, I bet you already learned some things that help you to comfort yourself or to reframe your thoughts in a healthy way that hurts less!

And if you’ve been working on healing for a while, I bet you are experiencing more days during which you can get out of bed. Or get out of the house. Or days you can do some meaningful work or play. Or days you can spend time with your children. Or fewer days spent in the hospital. Or a better ability to see yourself having a future. Or a few more relationships that are going a little better than they used to. I bet you’ve already done a lot more healing than you think!

So instead of beating up on yourself for not suddenly being “cured” or “fixed,” take stock of how your healing really is progressing, and be proud of yourself. ❤