What is Sleepwalking?
I was recently invited to speak to Fox News about sleepwalking from a psychological perspective. Here were my extended thoughts on the issue. We should take any sleepwalking signs seriously and always speak to a provider if we suspect sleepwalking is present!
What is sleepwalking?
I have worked with clients with all sorts of issues, including sleep problems for over a decade. I always partner with medical professionals when this is something a client reports because it could point to a variety of different things that might be happening. A person might have a sleep disorder in which their brain is essentially still 'asleep' while their body is 'up and awake.' This is a terribly frightening thing for many people to experience, as I have seen folks who have woken up with bags of open chips around them and not remembering engaging in night-eating. I have also had clients who have made large purchases or sent texts they do not remember and these things can have negative impacts on their lives. From a psychological point of view, it can create a sense of lacking control and lacking trust in themselves as anyone could imagine.
What causes sleepwalking?
Sleepwalking can be caused by a variety of things. Sometimes a person may be taking a sleeping medication that may be associated with such things as a potential side effect. In this case, if they experience sleep walking, driving, or other actions after trying a new medication they need to immediately inform their provider, as their provider may want to shift the medication or provide additional personalized recommendations. For other people, they may have sleepwalking as a primary issue that is not a side effect of a medication. Often, sleeping issues are 'brushed off' by clients and they are not very specific with medical providers on their symptoms. It is really important to have a sleep diary that you are using to write down everything you are doing around your sleep and symptoms you experienced each night so that when you speak to a provider, they are fully aware of what the entire clinical picture is; it is also important to pair your work with a therapist who can help you manage some of the psychological factors underlying your sleep disorder - as there could be PTSD, depression, anxiety, eating disorders or other diagnoses that could actually be the primary issue and the sleep disorder may be a 'side effect' of the untreated psychological issue. Having a full team in collaboration with one another is key to get the best overall treatment.
How someone can know if they're a sleepwalker, when to see a doctor, and any safety tips regarding sleepwalking?
Sometimes people find out they are sleepwalking because others around them close to them may be the ones seeing it. Listen to them and take it seriously if a partner tells you they saw odd sleep activity or a friend tells you that you called in the middle of the night and you don't remember it. As noted before, I have seen clients wake up with wrappers around them and having no memory of eating in the night or seeing that they charged their credit card without memory. This is serious stuff and it should always be taken seriously because sleepwalking can have dangerous psychological and physical impacts. I always tell my clients to immediately let their providers know what is happening and to ask their provider if a sleep study is appropriate. Sleep studies are excellent ways to have a team of sleep experts monitor a person's sleep and to see what is actually happening. Often it provides information that cannot be found elsewhere and most people do not know those services exist.
Dating ideas to keep things fresh.
indoor dating is the new thing...
I was recently asked to contribute to Women's Health on indoor dating ideas - a particularly important topic since the pandemic times developed. Here were some of my deep thoughts on the topic expanding on what is quoted in the article! I hope it helps some couples looking to rekindle their relationship in a different way!
-Why are date nights important?
Very important topic to discuss. It is less about the specifics of what you do on date night but rather just actually making date nights a priority. Why? Well, this communities to your partner that you care and you are prioritizing your relationship. It is so easy to get caught in the rut of the same ol', same ol' and this can lead to a fizzling of the passion you once had. I also understand how difficult it can be to prioritize your relationship when everything else feels like a priority too - the kids, work, and even sleep! It's very easy to push the relationship to the side and that is how we unfortunately can grow apart over time.
-How can you make indoor date nights romantic?
Anything can be a great indoor date! A bottle of wine and a beautiful dinner at the dinner table (not while sitting on the couch!). I have heard of others actually doing indoor picnics or just something simple like a movie date. I think the key is that is does not need to be over-the-top. It is about setting aside that time for your partner and only your partner. So, set the kids up with a babysitter and put your computer aside and silence the phone. Take a couple of hours for just you and your partner. That is romantic. Maybe think about what used to come naturally to you at the beginning of your relationship and do that. What did you used to do to make the person feel special? Candles? Flowers? A lovely card? All of those things go a long way.
-What are some indoor date ideas that people in relationships can try?
Game night - This is a fantastic option for the couple that needs to have some fun and connect with others. There's nothing like grabbing a silly game and sitting around the table with some fun snacks and just letting go. Often people start getting in touch with their 'inner child,' and the laughter can become contagious. I recently did this with my friends and forgot how fun an experience like that was. What is also great about this is that it allows anyone who might have some social anxiety to have an opportunity for a distraction instead of the focus solely being on conversation.
make a scrapbook - This is a great idea! When you start taking out the old photo albums, digital or print, it is amazing what happens to the brain. You start going down memory lane and you might remember times of fun and experiences you had completely forgotten about. This can be magical for a couple who has forgotten that about how many experiences they've had together. Perhaps it can lead them to thinking about what they want to do next!
breakfast in bed - This idea really stood out to me because I specifically remember how my dad would do this for my mom when we were young kids. It made her feel so special and I can still remember that to this day. There's something about getting up extra early when you don't have to in order to prepare a special meal for someone that really screams 'I love you.' I think it also shows that you want your partner to have self-care time that is all about them. It is a very thoughtful thing to do.
Final points on indoor dating
As noted above, if romance is needed, put the technology away and cook a nice dinner, set the candles and turn off the television. Ask one another questions you used to ask when you wanted to get to know someone. And most importantly - listen and be present. It does not take a lot of money to be romantic. You can do it on any budget - most of the time what creates romance is mindfully tuning into the other person and being present. In our culture, we often are present in body but not mind. Give it a go once a week or once a month and see what happens to your experience of your partner!
What is Emotional Contagion?
Examples of emotional contagion. Emotional contagion is a real thing and it can be dangerous. This is what is associated with the concept 'group think,' which is a phenomenon where we engage in group activity that we would not engage in ourselves. This type of mentality can lead to dangerous outcomes, including riots and other harmful behaviors. In emotional contagion, the person loses sight of their own thoughts and feelings and goes along with the experience of the crowd. This type of phenomenon has been known to psychologists and sociologists for decades, and sociologists generally study this given that they focus on group interactions.
How can you avoid 'emotional contagion'? If you find yourself getting sucked into the feelings and thoughts of others on a regular basis, and changing deep things like values based on others ideas then it's important to take a step back. You may be vulnerable to emotional contagion. We encourage 'reality checking' with people you trust and always seeking professional consult when an issue is bigger than yourself. Many times, when this type of a thing is a challenge for someone, they need a professional to help them figure out what is underneath. On the other hand, any of us can get sucked into 'group think,' so if something does not feel right, don't do it. Remember that the science shows that it is indeed easier to lose yourself and who you are in a pack mentality.
OCD Awareness Week
Did you know that this week 10/8/15-10/15-23 is OCD Awareness Week 2023?
Well it is! Obsessive Compulsive Disorder (OCD) is a highly misunderstood disorder and usually people think it means a very clean person who is worried about germs and washes their hands too much. That is only one small picture of OCD symptoms that falls under 'contamination OCD' subtype. There are many types of OCD - concerns about germs on one hand to hoarding on the other. They are all faces of OCD that all have equally devastating effects in the person's life over time.
What causes OCD? OCD is a devastating mental health issue and I've heard people misuse the term "I'm so OCD" or "I wish I had OCD" due to not understanding what it really is- please understand this is a serious and devastating disorder. It is not about cleanliness, germs or hoarding - for some that may be a focus of their disorder but these are only symptoms of OCD. People who have OCD have both obsessions (cycling thoughts and fears) and compulsions (things they do to alleviate the obsessional thoughts) and this becomes a cycling highly reinforced brain pattern that gets stronger over time. The underlying fears of what could happen are alleviated by the compulsions for even a moment in their mind so that can produce more and more avoidance of the fear.
Do I have OCD? Well, again - it's not just that you're clean or care about germs. People with OCD are suffering - often OCD symptoms can progress to a way that affects their ability to interact in life, work and family. It can also overlap with many other disorders, including substance use to numb the fears, eating disorders due to the obsessional patterns and depression/anxiety. Sometimes suicide.
OCD treatment - is it possible to get better? It is incredibly important to receive help and the treatment is exposure with response prevention (ERP), often combined with medications to help regulate the brain. ERP for OCD is an evidence-based approach where you face the thing you fear without using your compulsion. This type of work is very hard and often a 'slow and steady' approach is key with a hierarchical progression to conquer the fears and underlying anxiety. Bottom line - there is help and people deserve to get better so find someone you trust and start to take the steps to a better life because you matter, you deserve, and you're good enough.
Are weight loss sites dangerous?
In today's culture, we are innundaed with weight loss messages - weight loss supplements, weight loss drugs, weight loss with ozempic, best weight loss diets, weight loss programs, and the list goes on and on.
There's always a new "fast way" to "find perfection." Unfortunately - it doesn't work (research shows people people are 'successful with dieting' after a year which is why the studies don't show past year. A reporter recently interviewed me about weight loss sites and programs so I am letting you in on my expanded thoughts below. I'm not here to get down on any one particular person or place but to inform you of the reality of what I see every day.
In what way can weight loss sites make an impact on someone's relationship with food?
Take it from me - I have been doing research and direct client work in this area since the beginning of my training in 2003. The diet industry has not changed - it is a constant cycle of promises of a better, more fulfilling life when the research consistently shows anything but those things as the actual outcome. Weight loss sites and weight loss programs may be intended to "empower" people to feel they can have a sense of control over their body and health, but the outcome is generally a sense of lack of control, feelings of disempowerment and a sense of not being able to have the "willpower" to lose weight.
Some weight loss systems separate foods into color categories (green, yellow, and orange) based on caloric density. Can this impact us negatively?
The short answer is yes - it can absolutely lead to a negative relationship with food. This assumes that the lay person simply does not understand calories and that is the issue of why the number on the scale is what it is. That is incredibly problematic because it oversimplifies things way too much. First off, the research shows that most people are actually on chronic diets for most of their lives to begin with - we cannot use another diet to solve the problem that the dieting industry caused to begin with. The reality is that all foods fit in most people's lives (medical-specific issues aside). What is "healthy" is what is considered moderate and balanced for each individual. That means that everyone is different and therefore what their body needs to function optimally is also different.
Can weighing yourself everyday impact your mental health? If so, how?
Short answer again here is YES! The research shows the number one gateway into developing an eating disorder is dieting. There are others, but this is by far the strongest relationship. In addition to this, even if a person does not develop a life-threatening eating disorder, they still may have a life that is centered around trying to achieve something that is unattainable for them. The focus becomes the number being the goal and the behaviors have to shift to reach that number - that's not health! And, unfortunately in our diet-driven culture these things can be reinforced all too often, as people usually feel so validated when people say "wow you look amazing, have you lost weight?" It perpetuates the cycle. Health is eating intuitively in balance, variety and moderation and nourishing the mind, body and spirit. At the end of the day, whatever the number is on the scale IS your healthy range for this moment in time, and it likely will change over time. I have seen clients lose years of quality of life focusing on a number on a scale and then becoming very angry when they realize they sacrificed living for something they could never attain anyway. We have to remember the dieting industry is a business and businesses need to make money to stay in business. This is the only industry I know of that the product consistently fails the customer and the customer believes it's their fault - they just need to try harder. Ditch the scale - focus on nourishing your body, spirit and mind and whatever the scale would say, is the right thing for you.
How can someone know if their mental health is being impacted by a weight loss platform? Are there any signs or symptoms they can look out for?
Look for changes in yourself or others. Are you feeling stressed after you leave the platforms? Do you feel not good enough or that you need to change? Do you feel ashamed of yourself or your body? Are you finding yourself cutting out categories of foods or changing your relationships/outings because your diet could fail? Are you finding yourself changing your "goals" in your diet as you progress into this world? Are you weighing yourself obsessively or finding your day consumed with thoughts of calories and weight? Are you placing value to foods - they are "good" or "bad," "safe" or "unsafe"? These are signs that you are internalizing some concerning things in the diet world and the sooner you receive help the better. If you relate to these issues, reach out to a professional for consultation - there is help! You matter. You deserve. You ARE enough.
Eating Disorders and the Holidays!
We all know the holidays are tough.
Yes they can be fun and filled with magic and the sense of new and fresh starts. However, they are also filled with high intensity emotions and stress. What gifts are the best? Am I going to be able to afford all the expenses of this time of year? etc... Research has actually shown that the holidays are indeed times of higher stress for over 1/3 of us WITHOUT eating disorders. Now, add on an eating disorder and the challenges are compounded. There's excessive amounts of food and lots of pressure to act and look perfect. This can lead to very high intensity emotions for people with eating disorders. Self-care is absolutely KEY in creating a healthy balance during this time. Here are my top tips for managing eating disorders in the holiday season! And click here to see Spectrum News 13 interview clip I did recently on EDs and the holidays!
ask for help - don't do it all yourself, whether it be cooking, cleaning, gift purchases, etc. No one is wonder woman and everyone needs help!
make sure you have a strong support system in place - make sure your support system knows about your eating disorder and how to support you during this time. Mind reading DOES NOT WORK!
Plan your day in the same way as any other - don't skip meals, or overexercise - this day is like any other day. If you have a meal plan, follow it! Make sure you have a structured day so you know what to expect and how you will meet your needs.
Practice self-care - self-care is MORE important (not less) during this time of stress. Make yourself a priority and stick to it! It only takes a minute to take some deep breaths.
Cut out the stress - if being around certain people, triggers or comments is not healthy for you and pushes relapse, then just say no or have a plan B escape plan. It's not worth your recovery!
What is a shadow journal? Tiktok trend? Or the real deal?
Let's talk truth about what shadow journaling is and is not, as well as whether shadow journal prompts are actually helpful. I was recently approached by Healthline to speak about this and I am expanding with a dissertation here! Happy reading friends!
Why is shadow work trending?
I am actually not sure! My speculation is that this generation of TikTok-ers has done a fairly decent job to destigmatize the concept of reflection and therapeutic actioning. I think that's awesome. From there, I would suspect a person with a large following and a great marketing strategy probably started the trend, like all things that "go viral." When it comes to psychological principles though, you have to be careful about all things 'self-help' - some things are intended to be done with a professional who can really help you unpack things in a healthy way.
How did it start/who popularized it initially?
The concept of the "shadow" has been around for a very long time. It was originally talked about by Carl Jung, who focused significantly on the unconscious mind and how the unconscious impacts us. He had some very interesting concepts, including the collective unconscious which helps to explain why we have 'shared fears,' for things like heights, spiders, etc. These are not new concepts and I sort of wonder what Dr. Jung would be thinking right now if he saw his work trending on TikTok???
What is shadow work and what is meant by the “shadow self”?
I always commend young people for taking their own mental health into their hands and advocating for themselves. Gen Y and Z have forced people to listen and make changes - I mean that's pretty cool. However, playing in deep water when you don't know how to swim also has its dangers. Take it from me - I can't swim, so I have respect for the water and the fact that it is more powerful than I am capable of handling without the proper gear like my floaties, lifejacket and and lifeguard. What I am trying to say here is that this trend can impact you more than you think it will. The shadow is only one part of the self that Jung talked about - it's not the whole thing. We all have multiple parts to ourselves - we have various "masks" that we were that allow us to walk through the world and be productive people in work, with our friends, with our family, etc. You might be "the helper" in your friend group and your family, and you might be the "rescuer" in your relationships which could attract unhealthy partners and you could be "the perfectionist" in your work environment or school. These are all parts of the true you AND they are also masks we were to show the parts of ourselves we may feel comfortable with. The other side- the shadow- may be the parts of ourselves we don't necessary like or want to show the world. Some parts might be so unacceptable to us that they are buried deep and out of our awareness all together. Some parts of the deeply buried self may hold our ultimate pains, shame, fears, and trauma. We may use defense mechanisms to keep that pain hidden and cut off from us. Ever heard of denial? projection? rationalization? Well, those are defense mechanisms into to project our conscious self from our buried pains. And guess what? Those are there for a reason. If you start searching for stuff below the surface and you do not know what you are doing or why you are doing it, other than "everyone else is" then you may be in for an outcome you cannot handle. The desire to better yourself is fantastic but the "how" of doing that is the question here. Remember, the "shadow" is not visible to you - it's unconscious. That's the point of it. So, you can purchase a shadow journal with a couple of exercises and you may elicit some interesting thoughts but that's not unconscious work. That type of work takes time, commitment, trust and partnership. The shadow journal prompts are the tip of the iceberg - you then have to take this information and do something with it. That's where the partnerships and trust comes in. If it scares you to let others know your secrets then guess what? That is actually more important at times then your secrets themselves and that's your work to do. Understanding our masks, our shadows, what's below the surface of the iceberg is a lifelong process and it takes a professional who is equipped to help you explore your defense mechanisms that you cannot see. Another amazing way to start to really get under the surface of how you mask yourself is to do group work. In a group setting, you will start to be impacted by the personalities of others - who bothers you? who do you feel immediate connection with? who can you simply not stand even the sound of their breathing? That's the work and it cannot be done on one's own.
What are the benefits of shadow work? When supported by a professional the following is possible....
Understand yourself better. What bothers you and more importantly why does it bother you. Insight on its own doesn't mean anything but it allows you opportunity to do something with it if you take a risk.
Understand patterns in your life. Systems resist change - remember that - it's the most important thing I tell my clients. If left to your own self without self-work you will develop patterns of interacting and you iwll repeat those patterns again, and again, and again. We are creatures of momentum and homeostasis - once a pattern is formed it is resistant to change.
Understand your triggers. Triggers are immediate shifts in emotions and can surprise us. They are usually something being pressed below the surface - the two main triggers are "I don't matter" and "I'm not good enough." That's why something seemingly unconnected like anger for having taking out the trash can trigger you because it may really be you feel unappreciated and like your partner doesn't care about your feelings.
You want to be a person who cares about how they move through the world. Healing is not only about you - it's also about how you treat others. If you are truly willing to do the work, this means you are going to making a lot of amends and showing willingness to hear how your character flaws impact others. That allows for growth as a person, and again means we cannot do this work alone in a journal.
You deserve healing and growth. Inside all of us, there is a younger version of ourselves that has questions of whether they are good enough or if they matter in this world. When we do the deeper work, whether it be through talk therapy, group therapy, EMDR, free journaling, psychodrama, etc - we have an opportunity to engage with that younger "inner child" who still has unmet needs. This is where real growth can take place and where you can create change in the patterns of your life that hold you back.
When should we hit the brakes and say 'no' to the trend?
When people are in the immediate throws of a serious psychological issue - whether it be eating disorder, addiction, trauma, etc., then the first thing is always stabilization. You don't open up more doors that can lead to emotional unraveling. You work on stabilizing the immediate concern and then you look at the underlying issues that are impacting the person on a deeper level. Ultimately, at KML, you will always hear us consistently say the same thing in any space we have a voice, and that is to not participate in trends or psychological things because you see then online. Do your research from credible sources and follow up with the advice of a licensed professional. Your mental health is one of the most important things you have in this life! You deserve it!
Anxiety in kids - what do we do?
Friday gratitude here in relation to POPSUGAR who allowed me to speak on my passion related to children. It's a wonderful article so please click on it. Here's the behind the scenes extended interview you didn't get to see....
What are some common signs and symptoms of anxiety in children, and how can parents recognize these signs? What are some steps parents should take if they recognize anxiety in their kids? Would the kid's age change any of the signs/symptoms/steps to take? How might anxiety show beyond typical kid worries?
The most important thing when talking about mental health in children is to notice changes - whether it's anxiety, depression, or other issues there will be changes in how they interact. This could be physical changes like not sleeping well, changes in appetite, and not wanting to socialize in the same ways they would before. With children especially, we can see a shift in their independence - they may show a sudden separation anxiety and fear of doing things on their own they once did. Those are important changes to notice. School-age children might experience anxiety in terms of working about grades and tests in a manner that is excessive. Typical "kid worries" might be getting some butterflies in the tummy on the day of a standardized test and that resolves when the test is over, however the child with high anxiety might worry about that days or weeks in advance and not be able to let it go after the test ends. They might perseverate on what they got wrong and beat themselves up over a lack of perfection. Instead of some simple butterflies, highly anxious children might experience physical symptoms of headaches, knots in their stomach, tears and at times school refusal may be present. Because children are still developing emotionally and cognitively, they often are not fully aware or able to place in words what they are thinking or feeling. They might need help in being able to connect their worries about grades with the fact that they get a headache every morning as they are getting ready for school.
How can parents create an environment for their kid to feel open to discussing their anxiety? Are there any strategies you can offer for how to help a parent navigate that conversation? Especially if the parent initiates the conversation about anxiety or their concerns. Any specific dos and don'ts for either?
First, I would encourage parents to be kind to themselves too - just because your child is anxious does not mean you are a bad parent or that you did something wrong. The best of parents can have anxious children. It is far more important that you simply open a safe space for your child to express themselves. When talking to children, get on their level - sit down with them and maybe go into their space where they feel safe. Maybe have a talk in their room or sit outside in a place with little stimulation and few distractions- this ensures that the environment itself is set up for open discussion and safety. Using open-ended questions that encourage your child to open up can be very helpful. Often anxious children might be afraid to upset others, including their parents. So, we could say something like, "It seems like you're feeling a lot of things right now and I want you to know I am here. It's okay to 'feel all the feels.'" It can also be helpful to empathize with your child and let them know you are not perfect either. For example, "I might be a grown up, but I get scared sometimes too," by doing that you are modeling for them that feeling feelings is normal and healthy. Our feelings are not the problem but rather what we do with our feelings can lead to a problem if it's not healthy. When you are first starting to have conversations about these things, start slow and allow your child to slowly open up. Shift the goal from "fixing your child or their problem," to "listening to your child and creating an open space." That makes a world of difference in the reaction over time. One very important thing to certainly always do is to rule out if your child is developing anxiety or if they are experiencing a trauma reaction. Most often, it will be uncomplicated anxiety, but we want to rule those things out. So we can always ask a child directly in a gentle and caring tone, "has anything happened to you directly that is making your feel scared or unsafe right now?" If there is an unsafe situation happening than of course we manage those situations swiftly and with immediate professional guidance. Anxiety is also something that can gain power over time, so we want to help the child feel small wins "wow - you made it to school today without any headaches this morning - that's amazing!" Or "wow, I am so proud of how you used your deep breathing and positive self-talk to pull yourself out of the worry spiral!" Praise the wins so they begin to see how they are improving in time. In terms of "don'ts" - here we just want to stay away from trying to "fix" the child or make something go away overnight. Patience is key with shifting anxiety. I would also recommend never using a forceful or judgmental tone, or closed ended questions. That can increase the intensity of the anxious feelings. And, if you make a mistake in parenting and you could have handled something better, just own that. That can make a world of difference to your child.
If a parent is worried about their child's anxiety, who should they contact? Their family doctor? What about any school resources? Would this be different for older kids or pre-teens?
There are many options these days and often the parent can decide what they feel is best in alignment with their family values. Schools have many options - sometimes kids and teens have anxiety that is so extreme that it can impact their schooling process. Schools are aware of this and there are methods of managing this that can vary from school accommodations, to placement in exceptional student education programs to ensure that the child is helped to make school the safest place possible for them. Some schools also have counseling available and/or group therapy. In addition, therapists can help greatly! Anxiety is very responsive to treatment and the earlier it's caught the better the outcome! Therapy can focus on shifting unhelpful thinking styles, developing coping techniques to regulate one's nervous system (eg., deep breathing, grounding exercises, positive self-talk, etc), and lots of other things. In addition, your family doctor or psychiatrist can assist to discuss potential medication options that can also help to regulate the brain so that the person less likely to be in 'fight or flight' and more capable of using the coping techniques they have learned. The major point is that options exist and anxiety can be helped! With regards to older children and teens, the process is really the same. The differences are mostly going to be in adapting the language we might use to help the child open up about their worries. Older children and teens might also be more aware of what the thoughts are that are fueling their anxiety which can sometimes make it easier to reframe.
What is PMDD?
I was recently interviewed by Yahoo! on PMDD. Here's the full interview you didn't get to see. The writer is fantastic - highly recommend this read!
Why it's still so unknown
In the mental health field I think it is pretty well known! The challenge in this space I think is understanding and deciphering the difference of whether the depressive episodes are specifically associated with one's menstrual cycle or if it is more generalized fitting a different type of depression. I am not sure about the other professions and whether it is unknown in that space!
How to spot the signs
PMDD is serious! This is not "PMS" or "just cramps." PMDD affects people's lives. It will impact functioning in areas of social, romantic and potentially occupational functioning. Often times, I see people with this condition that have no idea what is happening and they think that they just have normal 'PMS' issues. The keys here are that the person's personality really seems to change specially in relation to where they are in their cycle. They may have mood swings, physical symptoms and inability to regulate emotions effectively. They often feel shame and guilt over these experiences.
And how to get help/cope
First, let go of the shame! This is NOT your fault! You have a true condition that deserves help and assistance. As a psychologist, I understand that often the best treatment for such a condition is to work with a therapist for coping techniques, but also ensuring you have a OBGYN who has medically assessed the person and has ruled out anything else that could be happening. The treatment is typically therapy combined with medications like SSRIs prescribed by a licensed provider. With treatment, life can be so much better!
Can stress make you sick? Um - yes....
I am grateful to have been interviewed recently in Forbes as stress relates to health outcomes. Here's the extended interview you didn't get to see.
What Is Stress?
Stress is any state that impacts the nervous system and tells our body we need to act fast - either fight, fight or flee! Interestingly, stress does not always equal negative things. We can be equally stressed in our body by the most positive experiences in our lives, such as a wedding, birth of a baby, success in our business! Our body cannot distinguish between a happy stress or a negative stressor and it is up to our mind to mediate that and tell our body how to respond based on whether we see something as a challenge or a threat.
Chronic vs. Acute Stress
Acute stress is good! The body's mechanisms of fight/flight/flee are intended to protect us from the "tigers and bears" in front of us to keep us alive. Of course, we are no longer in the cave-days and therefore the "bears and tigers" today might be starting a new business or getting into a fight with our significant other or boss. The body responds in the same way despite the bear or fight with the partner - it becomes activated and that is important because it helps us manage the immediate stressor effectively. Our eyes become wide to take in new information, our body becomes energized to run away if needed, our mind shuts off so we just act on instinct. All of that is exactly what we want in the immediate stressor to survive. However, in the long term, these mechanisms lead to burnout and wear-and-tear on the body. Our mind becomes exhausted and our body starts to attack us leading to long term inflammation. This is seen in something called general adaptation syndrome noted by psychologist Dr. Seyle a long time ago!
How Does Stress Impact the Body?
We can end up experiencing general adaptation syndrome (GAD) where the body alarms in immediate stress to pump adrenaline to fight the bear/tiger, then in the resistance stage the body continues to try to repair itself from the pumping stress hormones. In some people, they continue to experience the stress longer than the system is made for and therefore the body is undergoing changes to try to accommodate it. If the stress reactions are not slowed then the body eventually becomes exhausted. This can lead to long term blood pressure changes, body inflammation, anxiety/panic disorder or depression and other conditions that negatively impact our health.
Illnesses and Conditions Caused by Stress
This is no joke! The science strongly supports the link of stress and negative health impacts. Stress has been associated with anxiety disorders, PTSD which has links to memory changes and brain changes, high blood pressure, cardiac changes, body inflammation, and many others!
Tips on Managing Stress
Try to look at situations in terms of a challenge versus a threat. That is very helpful to the body and body. Ask yourself what supports you have to manage this situation. Plan down time in your day as part of your schedule and start to see that downtime as just as important as any business meting you might have. Ask yourself, what would I recommend to someone I care about or how would I treat my child - then do that! We often treat others with more compassion and care than we do ourselves. Finally, simple things like square breathing and grounding (5-4-3-2-1) can be helpful to manage stress in the moment. Seek help if your stress has invaded your life. Professionals are there to assist whether it be psychologists or doctors!
Panic Attack Guide to Understanding
What are common assumptions people have about panic attacks?
People feel like they are causing this and they can "will" themselves out of it too. They often think that they are being weak and they should be able to "get over it". This type of self-talk actually perpetuates the panic and anxiety and does not help the individual who is suffering. You are not to blame for having panic attacks and you deserve help!
What does a panic attack feel like?
Have you ever been stuck in an elevator and felt suddenly the world was closing in on you and you couldn't breathe? That might have been a panic attack. They are often sudden and unexpected - that means you could be doing fine in your day and out of nowhere you have overwhelming physical sensations of being out of control. Your heart is pumping fast, you can't breathe, your head might feel full, you might feel dizzy or like you are going to pass out. That's panic. It is a truly helpless and painful state for people to experience. Once they've had it happen, they fear it happening again which can create a vicious cycle leading to avoidance of things they think will bring on the panic.
What causes a person to have a panic attack? Is it something that can be controlled with practice? Why or why not?
There's no known scientific reason why. What I have seen in my practice is often people who are prone to panic attacks are those people that are actually very strong. They are independent, they take care of all their responsibilities and they value being driven. They often do not share their feelings a lot, which lets them build up in the system. I see a panic attack almost as an explosion of the built up feelings over time. They often happen in down time of being in the car or getting ready to rest for the evening.
At what point should someone seek medical attention for a panic attack?
Something becomes a problem when it is impacting the quality of your life in some way -- either taking away from your social life, work-life, etc. If you have had more than one attack and you see them increasing in intensity and frequency then being seen is a good idea. First, panic is very treatable, and second it responds best to immediate treatment. The longer we let it go, the more the mind wraps up other conclusions that make the anxiety worse (e.g., I am weak, what's wrong with me, I'm defective, etc). It is a good idea to see a panic therapist specialist and a psychiatrist/primary care so that medications and therapy can be used as needed. There is help out there and you don't have to live like this!
How can you tell if something is a panic attack or something physically more dangerous?
Sometimes you cannot and if you are not sure, don't chance it! If it is your first panic attack and you cannot breathe, or you become weak and are sweating profusely, you should go to the doctor to ensure everything is okay. People who have had panic attacks before get to know them better and do not need to seek medical help in the midst of the attack when they learn to manage it themselves. Sometimes panic disorder occurs alongside of a medical disorder, so any strong therapist is going to want you to have a medical work up to rule out anything that could be impacting or underlying your panic.
What practices do you personally recommend when someone experiences a panic attack?
Grounding and deep breathing are key! This gets us in the present and out of the future/past of the panic (I should be able to or I wish I did something....etc). In 5-4-3-2-1 we list five things we see, four things we hear, three things we can touch, two things we can smell and one thing we can taste. This quick trick paired with square breathing can help us cool down our nervous system a bit. Your physician may also prescribe a medication(s) for short-term and long-term control of you panic. And, of course therapy like EMDR and CBT can help you get ot the underlying root and reframe your thinking. I have personally used these techniques, as I am a psychologist who has had panic attacks most of my life and I use these daily practices to keep my nervous system in check! :)
What should you NOT do when having a panic attack?
Do not use escape behaviors like avoiding or leaving somewhere as that reinforces the anxiety. Do not surround yourself with high stimulation - remove stimulation when in panic because your system is already overwhelmed. Stay away from energy drinks and other stimulants that can increase your anxiety.
How long do panic attacks typically last?
Usually about 20-30 minutes. They can last longer (usually the mind will create more thoughts in response to the body reaction and this will speed up the reaction!) and less if the person knows how to manage them.
How can people prevent panic attacks in the future?
Get help! Learn about your anxiety and becomes friends with your anxiety. That goes a long way. Be compassionate and kind to yourself - you didn't ask for hits but you do have to manage it. Treatment is available - KML has expertise in anxiety and panic so don't hesitate to reach out!!!
What does ADHD mean?
What Is ADHD
Many people do not understand that ADHD is essentially a neuropsychological issue in which a person's nervous system is under-stimulated and therefore they may need stimulant medications in order to regulate it (counter-intuitive I know!). There are four components - inattention, hyperactivity, impulsivity and poor timeliness. ADHD can affect all or just a couple of areas. When it is not regulated, we may see inattention that impacts schooling and workplace outcomes. It can also impact one's relationships. If we cannot take in information correctly, then we cannot process that information in our lives. Attention is managed by our executive functioning processes which also control and regulate our emotions. That is why we sometimes see challenges with impulsivity, anger outbursts or overall mood swings in this population too. So learning to regulate these systems is incredibly important!
ADD vs ADHD
So this is confusing to many of us. In the pop culture world, we usually distinguish these two with ADHD being used for hyperactive people and ADD being used for inattentive subtype. In the psychological world, it's all ADHD and then we specify which subtype, whether it's inattentive or hyperactive/impulsive.
Is there an ADHD test?
Well, yes! Testing can absolutely be done to confirm an ADHD diagnosis. You should not self-diagnose based on an online survey. Those can be a nice start to confirm some of your concerns but they are not diagnostic. A full psychological evaluation battery can be used to determine this. KML completes high level fully integrated diagnostic assessments to determine what exactly your issue is - memory? Executive functioning? selective attention? long-term memory? There are many factors that can be involved. They can be completed on both adults and kids. If you go outside of KML, make sure they are using a CPT test as part of their diagnostics. Many people do not and the results of your testing will not be as comprehensive.
ADHD Treatment
Medications (usually stimulant based but there are others!) are the gold standard treatment for treating ADHD due to the nervous system dysregulation. In addition, non-pharmacological approaches can complement this to ensure the best outcome possible. The nonpharamcological ADHD interventions that can be helpful are things like eliminating distractions in your environment while you are doing a task that requires mental effort. Think about when you are most productive and schedule your hardest tasks for those times. Testing in small groups or preferential seating in a classroom or an office space can be helpful to eliminate additional information competing for space in your attentional capacity. It is also important to ensure that you are taking care of the basics in life like balanced nutrition, physical activity, and getting plenty of sleep to ensure your neurological system is functioning at ideal capacity. In this population, we also encourage frequent breaks to refresh the computer of the brain and to "chunk" information together. Opportunities for additional movement, like walking desks, doing work in a standing position or being able to fidget with toys can also improve focus. For some having music on or sound in the background is also a strategy for success! There are programs such as "brain training" and nuerofeedback that have some promising results on impacting the outcomes of attentional capacity as well. Finally, I would say placing organizational skills in your life to help you organize the information of your daily needs is also a really effective strategy.
Can Apps help with ADHD?
Yes - absolutely! There are many apps out there. There are apps intended to help people with ADHD manage their poor organizational skills or to remind them to do certain things at certain times. There are also apps that can be used to improve overall executive functioning skills, which is a major deficit for these folks. Typically those types of apps are game-like and can feel like puzzles or fun!
When to See a Doctor
Often I see people struggle with thinking they are not smart and that is not true! People with ADHD are often very bright. If you have done some of the above and you are still struggling at work or school, then you likely need more. That is okay and nothing to be ashamed of. This is a neuropsychological disorder and requires lean in from a multidisciplinary team who can often help create a specialized plan for success! That includes a dietitian, psychiatrist, therapist and sometimes study skills coach, life coach and neurologist. There is help out there and life can be better!
Is halloween candy bad?
Happy Halloween 2023!
First off - be safe. Read my articles on how to protect your while having fun this Halloween. Second - the big question - is halloween candy bad? Should I limit my child's Halloween candy consumption. This is tricky - understandable you don't want your children to eat three million pieces of candy over the course of three days and get sick. I get it. But you also need to be aware of how limiting children impacts their relationship with food. Here are some quick tips on some things you can do to keep healthy boundaries while also allowing kiddos to enjoy the holiday!
1. Have healthy boundaries around candy - do not try to eliminate the candy all together. This will really reinforce problematic relationships with foods. Boundaries are OK! Maybe saying okay let's have a few pieces a day (without be so specific or overly rigid). It's also OK for them to eat too much candy a feel a little full. They will survive and next time they probably will eat a little less. That creates an intuitive relationship with food! Kids who are used to extreme rigid boundaries around candy are usually the ones who go overboard when they see it.
2. Do NOT label foods as good or bad! Labeling foods as good or bad, healthy or unhealthy is a sure way to really mess with the natural food intuitive relationship. Stay away from strong labels around food. When 'all foods fit' it actually really allows us to regulate ourselves and we will find a natural balance of candy and vegetables!
3. Do NOT use candy as a reward! Stay away from 'earning' the candy at the end of a certain tasks. Rewards are great for kids -but food rewards are tricky. You want to keep food about food; not about good or bad or earning something. Trust me! Find other rewards for positive daily behaviors other than food.
4. Enjoy the moment with your kiddos! The cute costumes, excitement for life and running around the neighborhood can be so fun. Remember to enjoy that moment as they go by too quickly. Don't worry so much about the candy.
Happy Halloween folks! Be safe! Dr. Kelsey :)
What is Projection?
How do clinicians define psychological projection?
Projection is defense mechanism, and defense mechanisms are ways a person protects themselves form things that they are possibly unready to hear or manage. That means that these defenses are out of the awareness of the individual. Projection is when we take feelings that we might not want to acknowledge in ourselves, such as jealously or anger and we "project" them onto someone else. Think about what a projector does - it takes an image in a movie theater and places it on the screen so you can see it. The image is not coming from the place we seen it (ie - the screen), it's actually coming from the lens of the projector onto the screen. This is the same thing here.
What causes it?
The person sees parts of themselves in others that they cannot stand in themselves. They may be overly upset when they see someone who might be showing jealousy or anger, when in fact they too may feel those same things. For whatever reason, the person has sort of cut this part off, and potentially placed it in the "shadow self" (another trending term) but this part of them is not gone - it's now taking the wheel when they are unaware and creating reactions that might cause them issues in relationships.
Are there signs or symptoms?
I think signs to look further into are "triggers," meaning when your emotions escalate extremely quickly in response to someone you might not know well or haven't reacted to in that manner prior. This is an indication to take a step back and ask what might be deeper here.
How does it affect your mental/emotional health and physical health?
This defense mechanism is normal to an extent in all of us and therefore it might not affect you at all, other than random fights with friends or your partner. However, for others it is a totally different story. This might lead to cutting off relationships, dramatic fights and feeling out of control with emotions. This is when you really need help sorting things out.
How can you stop if you recognize the behavior in yourself?
As noted above, this is extremely hard to do on one's own because it is often out of one's awareness. You need help exploring this and that can be done in individual and group therapy.
What should you do if someone is projecting on you?
Apologize if you have something to apologize for - that's an important quality for anyone to have! However, be careful to over-apologize for things you know you have not done. Instead maybe express concern for the person and let them know you really have not intended to do what you are being accused of and that you are willing to hear them out, but you do not believe you have actually acted in such a manner so you want to be heard too. At the same time, it is important to have boundaries for yourself and not just accept projections of others as this can be dangerous.
Holiday Drinking Tips
I frequently work with the teens and young adults in the college age that deal with the outcomes of drinking too much.
The stories are extremely upsetting and the costs can be more than a bad morning with a handover. I have seen drinking games and binge drinking episodes lead to experiences of sexual assault (never means the victim is to blame - you aren't!), alcohol poisoning and failing out of school or losing one's job. For some individuals, the partying turns excessive and becomes more about having to drinking than even wanting to. It changes the brain over time and can impact other mental health disorders, such as intensifying depression, anxiety and suicidal thinking. Often it can be paired with an eating disorder as well. My immediate tips as we move into the holiday times where everything is about excess is to do the following.
1. PLAN for your safety - If you are a young adult going out, do everything you can to increase the safety around drinking. This includes having a sober driver either in your group or a plan ahead of time of how you will get to/home from the party. Be extremely careful about shared ride experiences, as these are not always going to guarantee your safety. If you choose to take those rides, never ride alone. Have someone with you and remain awake and alert in those rides, know where the safety button is on your phone to alert the shared ride carrier if you are unsafe in the vehicle (these exist adn are extremely helpful!). Check the license plate and driver before you enter into the car. There have been numerous times in the past where the worst has happened because someone was not alert and went into the wrong car. It is safest to have a sober-sister or friend that will agree to ensure that the entire group is safe and accounted for both in ride and in number. This person will remain alert and aware of where everyone is and that no one is leaving the crowd.
2. Monitor your drinking - Make a plan before hand of how much you will drink. This may sound funny, but it's important for many people. The reason for this is that many of us when nervous may just sit and sip to decrease the social anxiety. This can lead to losing track of your consumption quickly. In addition, choose drinks that allow you to know how much alcohol is in it. That means staying away from the "unknown punch." Watch your drink being made and never, ever leave your drink unattended. I have come across many sad stories of people's drinks being spiked without their knowledge. It is also incredibly important to eat normally throughout the day and snack while drinking as well. College age people will frequently have the "drink your dinner" mentality and again, this can lead to bad things happening. You will be impacted by the same drink much more when you are not eating throughout the day.
3. Get help! If you notice you're doing these things and your friends can stop drinking or not think about it until the weekend and you can't - then you might have a problem. There's nothing to be ashamed about. There are many people who suffer from addiction. The earlier you get help the better. Addiction is a progressive disease and will take more and more over time.
Love is Blind Reality Television Breakdown
I recently spoke to Yahoo News regarding the reality TV craze of Love Is Blind. Here's the extended interview you didn't get to see.
Is love really blind? What were your thoughts on this season?
This season showed many issues and dynamics that can occur in relationships that we all experience and reality television can be used to either mindlessly "tune out" from one's life or to actually "tune in" and become aware of how we relate in our own lives. There are always I few things I strongly push in understanding these shows. In reality television shows, often the casting is geared toward trying to pull for those dynamics as the audience generally is more engaged with high intensity interactions. In addition, even if the taping of the shows are done in a fair way, the editing team may be completely separate and showing us only the parts of the recordings that support the storyline they are interested in portraying. It is always important to keep that in mind when watching these shows and to remember that any one of us could appear to be a 'certain type of person' if our lives were filled and boiled down into an hour show. I saw this because I saw many people online making snap judgements about these people's overall character, saying Lydia was a 'stalker' and JP is an 'abuser,' etc. We have to remember these are people not characters and in their lives, there is likely far more to them than the pieces of film we saw. I always try to remember that when watching these shows. Here's a few specifics I took away:
Healthy vs unhealthy communication - This season really highlighted some excellent examples of healthy communication using the factors of the empowerment triangle where each person has equality and the ability to express themselves fully and be heard by the other person. I saw this immediately in the relationship between Milton and Lydia, which was a stark contrast to the relationship dynamics of Uche and Lydia. In that relationship dynamic, there appeared to be a fight for power and control and it was highly intense (from the scenes that were aired at least). Anytime a relationship dynamic is based on intensity and power struggles, we have the ingredients for drama. Remember, casting and editing teams are wanting this for good television so we are not always seeing the entirety of a situation, we are seeing the edited version of what really happened. Having said this, we can take a look at the specifics of the filming we did see and really learn a lot about relationships. We can see that when dynamics are healthy in a relationship, it can bring out a totally different side to that same person. Look at how different Lydia appears in her relationship with Milton versus Uche. All of us could benefit from self-reflection in our own lives and looking at who are the people that fire us up and we seem to lose control of ourselves with, and who are the others who balance us in a healthy way and create a sense of vulnerability and safety.
Boundary setting - Milton is an excellent example of how a person can attempt to pull us into a power struggle in communication and we can choose to step right out of this by not engaging in the 'bait.' Throughout the season, he shows a strong level of maturity to see that 'one's perception is their realty' and therefore there is no one way to see things. He diffuses situations by acknowledging, "I hear you even though I might not agree with you." I think his reaction style is often not one seen on reality television, and he can teach many of us how to not engage in the drama triangle of dynamics we are able to fall into on a day to day. It seems that he is capable of taking this approach because he seems fairly confident in who he is. When a person has more internal stability of knowing who they are, they are less likely to be shaken by other dynamics that may make them question themselves and become defensive. What's also very cool, is that people loved seeing this on reality television, so hopefully casting crews will remember this!
Opening up about sexual assault - We also got to see a very interesting storyline with Chris who spoke about his first sexual experience being one of assault. I wish there had been more media attention to this story, particularly during October's domestic violence awareness month. It showed how his partner in the pods, Johnny, just listened and was there - she didn't need to say anything, but just being there provided a safety that allowed him to open up for the first time ever about the trauma he experienced. It also showed that men can experience assault too - this is incredibly important to break the stereotypes of what sexual assault is.
The impact of the real world on relationships - We also got to see how the stressors of the real world impact any relationship. In the pods, there are no distractions - just talking and trusting your own gut. When the couples go on the honeymoon, there's fantasy like the fairytale many romantics desire. When they move back into the real world and start living with each other, we can see how people may truly bond and have the start of love, but struggles of finances, different ways of living, and family doubts can place a strain on real world relationships. Sometimes those things are outweigh the passion and feelings of internal love a couple may have for one another.
Yes, people have gotten engaged and married through the show but do you think the experiment really works on a mass scale?
It's important to remember it is an experiment. They note this multiple times throughout the show and the cast members also state this. Can it work? Sure it can - but on a mass scale? My answer as a psychologist to that is likely no. We have to remember that the people who even apply to be on the show are likely 'romantics' in their personality style - they believe from the start this could work and that's powerful! I am not that way and would not ever consider applying to a show like this. So the pool of candidates here is biased since they have a "placebo effect" of believing it could work to begin with. Having said this, there are some wonderful aspects to the show. In the real world, we start often with the physical chemistry that pulls us together (passionate fatuous love), and then we move to developing a deeper bond on our values (romantic love) and eventually we commit to a long-term bond with this person (companionate love). On this show, the script is flipped to first focusing on teh deep bond and romance, then adding in and determining fi there is passion to back the values bond, and then finally whether the commitment is going to be made. It is a TON of pressure on these young people to make over a very short period of time. Most couples average over 2 years before they consider marriage and these folks are making lifelong decisions in 4 weeks. It's admirable they would even consider that possible and for many couples, they are still together! And, given that so many people watch the show, I think it speaks to the 'romantic' that lies in each of us that the fairytale is possible and we could be loved for who we are. In a true healthy relationship, that is what holds people together and true love is blind, but it is also okay for love to have physical chemistry and a passion on the outside too!
Teens and Sexy Halloween Costumes?
OK parents, I feel for you on this one. Your adorable little child that used to want to know what you thought the best costume was, used to have you help them getting ready to go out and collect giant heaps of candy. They were adorable little ghosts, superheroes or cartoon characters. Suddenly, they are teens and everything has changed. If you haven't already had to have this convo, it might be one you will someday. I was recently asked to contribute Parents Magazine about teens wanting sexy halloween costumes and how to manage these conversations. The article is fantastic and I highly recommend you read it fully. Below is my expanded thoughts on the topic.
What if I totally disagree with a sexy halloween costume???
I think in today's times this is an awesome opportunity to have a loving and open conversation with your teens that provides a sense of you aligning with them and supporting them for the remainder of their teen years into adulthood. If you see them wanting to get one of those costumes and you disagree as a parent, first i would probably validate their feelings. Remember the old movie Mean Girls and the halloween party scene? This has been a thing for a long time and there's nothing to be ashamed of. I would encourage your teen to talk about why they want to wear a certain costume and what they are hoping to get from it. You might find them opening up deep concerns of not feeling good enough, or needing validation of worth from others, or just a sense of fitting in. Those are all very important things and normal things teens want to feel. Hopefully, you have laid the foundation of other times you have talked about self-esteem and validation.
So what does a parent actually do?!
You can then validate their feelings and say "of course those things are normal, and I totally wanted the same thing when I was your age." You can ask them what else they might communicating to others by wearing a particular outfit - I don't mean to send a message that a flirtatious costume means a person is asking for something bad to happen because that is not correct. What I do mean is that we might be sending a message that we are looking for external attention in a negative place and is that the message your teen wants to be sending. The key here is creating curiosity and openness, not shame for wanting attention or for showing one's body. WHat are other messages do they want to send into the world about themselves and their personalities - is it that they are fun? Creative? Exciting? What about using the Halloween holiday as a time to express those things and to enjoy being a teen. I think the main things here are to really lean in with understanding and to connect with your teen during these challenging times of wanting to fit in. Tell them you really do support them and that's why you want them to be able to enjoy this time in their lives of fun and freedom, as there is time to make more grown up decisions about how they feel about these same things in the future. If they want to still dress in a particular costume when they are no longer a child, then that is their ability to do so and you will support their adult choices at that time because they will be equipped emotionally to see the whole picture. Ensure that any choices you make as a parent are to provide them with safety and ability to have a live a life of freedom, not emprisonment, since that is what teens may think the motivation is. Let them know it is your job as a parent to help them reinforce healthy boundaries until they are ready to take the reins when they are adults. Your teen might hate you until they are 25 (kidding, not kidding!), but eventually they'll probably understand you were trying to protect them until they are adults who can make healthy decisions for themselves.
How to get over someone you love.
would erasing our memories protect us from pain?
I spoke with Cosmo about breakups and erasing memories - here's the longer convo you didn't get to hear :)
How important are memories of past relationships?
Even though memories can be difficult and challenging for us when they are not seemingly positive in nature, we need to remember that we have a memory for a reason and that it is protective for us and promotes survival. Negative memories feel hard of course, and to 'erase' them might in the moment seem easier because we wouldn't have to deal with or cope with the emotions that accompany them. However, they are also protective for us, as they help us learn from the challenges of the past and learning is protective in nature so that we do not keep repeating the same patterns over and over again. From an evolutionary perspective, negative memories are actually even more important and protective for us than are positive memories. So to erase those would likely be more dangerous and prime us for more negative things to happen in the future. This doesn't mean we have to just allow ourselves to continuously live in the negative and scary memories of the past, as we need to learn how to cope with them and contain them in a way that allows us to reflect on the negative of the past as a way to build us up for the future.
How do past relationships help us build our expectations and goals for future ones?
It is important to remember that we cannot change what happens to us in the world as we are not in control of others and the unknown; however, we are in control of ourselves and the way we react and respond to the things around us. This is called cognitive appraisal, and essentially how we respond to the things around us is largely based on whether we look at the things around us as threats or challenges. If we appraise a situation as us being capable and realizing we can shift our thinking and be more realistic in the way we are speaking to ourselves. It is also important that we incorporate mindfulness into our day and recognize that we are capable of moving forward and learning from our past experiences in our to create a better outcome for ourselves in the future. That allows us to stop repeating cycles that are harmful and start building positive momentum in our lives.
Eating Disorders and the Holidays
The holiday season can be particularly challenging for individuals managing an eating disorder (ED) due to the emphasis on food, family gatherings, and social pressures. If you're dealing with an eating disorder, maintaining your well-being during this time requires extra care, self-compassion, and mindful strategies. Here are some helpful tips to navigate the holidays while managing an eating disorder:
1. Set Boundaries Around Food and Social Situations
Communicate your needs: If you're comfortable, talk to close family or friends about your struggles so they can support you. You don’t have to go into detail, but simply sharing that you need help can make a big difference.
Plan your meals: If you’re attending a holiday gathering, try to plan your meals in advance to reduce anxiety. Consider bringing a dish that you feel comfortable with or ask the host about the menu beforehand. For many - this is the time of year they go back to a specific meal plan even when in recovery for a long time. That's okay! It's still recovery!
Avoid social comparisons: Social media, family, and friends can often create unrealistic food expectations. Focus on your own journey and try not to compare yourself to others at the dinner table.
2. Practice Mindful Eating
Slow down: Focus on eating slowly and mindfully. Pay attention to how the food tastes, smells, and feels in your body. This helps you be more in tune with your hunger and fullness cues.
Listen to your body: Trust your body’s signals of hunger and fullness. It may be helpful to remind yourself that it’s okay to eat when you're hungry, even during the holidays, and that food is not something to fear or feel guilt about.
3. Don’t Overcommit to Events
Limit social pressure: It’s okay to decline invitations or take breaks from gatherings if they feel overwhelming. Prioritize your mental health over social obligations.
Give yourself permission to leave early: If you're feeling uncomfortable or overwhelmed, it’s perfectly okay to excuse yourself from a situation. Set a time limit for yourself in advance if you anticipate being stressed.
4. Focus on Non-Food Traditions
Create new traditions: Shift the focus from food to other activities that bring you joy—like holiday walks, board games, or watching festive movies with loved ones. Doing something that nurtures your mental and emotional well-being is key.
Engage in self-care: Set aside time for self-care activities during the holidays, such as journaling, yoga, reading, or engaging in creative hobbies that help you relax.
5. Have a Support System in Place
Talk to a therapist or counselor: If you’re seeing a therapist, try to schedule sessions during the holidays to help manage any emotional stress that may arise.
Call someone for support: If you feel overwhelmed, it can be helpful to have a trusted person to talk to, whether it’s a friend, family member, or someone in your support network.
Create a “grounding” routine: Have a mental or physical routine in place for when things feel intense—this could be breathing exercises, a grounding meditation, or a quick walk outside.
6. Be Kind to Yourself
Forgive yourself for slip-ups: The holidays can bring up complex emotions, and it’s okay to not be perfect. If you have moments where you feel you’ve "overdone it," practice self-compassion. Guilt and shame can only fuel negative behaviors.
Avoid all-or-nothing thinking: Try to let go of the belief that if you "mess up" once, it means the entire holiday is ruined. Eating "perfectly" is not the goal; balance and self-care are.
7. Focus on Enjoying the Moment
Shift focus away from food: While food is often central to celebrations, try to shift the focus to other aspects of the holiday season, like the joy of being with loved ones or the beauty of the season.
Focus on connection: Make efforts to connect emotionally with others—share stories, laughter, and experiences instead of focusing on the food or how much you’re eating.
8. Have a “Plan B” for Stressful Moments
Anticipate challenges: Identify potential triggers or stressors in advance and come up with a "Plan B" for managing them. For example, if you feel anxiety around a certain event, you might prepare by planning a self-care activity afterward.
Coping strategies: Have specific tools in your toolkit for dealing with stress, such as deep breathing, distraction techniques, or writing in a journal.
9. Limit Alcohol Consumption
Be mindful of alcohol: Alcohol can lower inhibitions and increase the likelihood of disordered eating behaviors or emotional overwhelm. Keep in mind that moderation is key, and it’s okay to opt out of drinking if it feels triggering for you.
10. Honor Your Feelings
Acknowledge emotions: The holidays can bring up a range of emotions, including sadness, grief, or anxiety. If you’re feeling upset, allow yourself to feel and process those emotions instead of suppressing them with food or behaviors tied to your eating disorder.
Journal your feelings: Writing down your thoughts and feelings can be a great way to process any emotional difficulties that arise during the holiday season.
11. Avoid Food Talk
Limit discussions about body or food: In some settings, conversations about weight loss, dieting, or appearance can trigger anxiety. If these topics arise, it’s okay to change the subject or excuse yourself from the conversation.
Final Thoughts: The holidays don’t have to be a source of stress or shame around food, even if you’re managing an eating disorder. The key is to prioritize your mental and emotional health while allowing yourself the space to enjoy the season in ways that feel safe and nourishing. By setting boundaries, practicing self-compassion, and staying connected to your support system, you can navigate the holidays with greater ease and self-respect. If you need further support, please contact our team and the National Alliance for Eating Disorders is an excellent resource for free support groups!
Treatment for Sleeplessness
I can't sleep - what can I do?
Why is phone use at night such a problem?
Phone usage at night has become a natural way many people 'wind down' their day. They may view it similar to watching a television show or thinking it is going to make them feel sleepy. Unfortunately, that is not at all what happens. Your brain needs to release melatonin in order to help you get ready to fall asleep and rest, and in order to do that one of the triggers is a decrease in light. So, any light is bad for this and will counteract our brain's natural ability to help us wind down from the day. In addition, the science has shown that bluelight in particular is extremely powerful at suppressing melatonin as compared to other light wavelengths. This means that our desire to 'wind down' by turning on the phone and scrolling is actually keeping up longer and disrupting our sleep cycle. It is one of the first things I coach my clients on when they struggle with sleep quality and quantity.
The good news is the solutions to sleep problems are simple!
1. Catch up on your phone activities early in the night and commit to putting the phone down when you go into the bedroom. You need to associate your bed with rest - not stimulation - so we want to break the 'craving' of the phone being associated with the sleep routine. Put the phone out of your sight so you are not tempted to pick it up.
2. If you need to, start cutting down on the amount of time you spend so you take a stair-stepped approach to decreasing the bluelight time - write down how you feel as a result and keep a sleep tracker to see how it affects you after 30 days. You might find yourself sleeping a lot better in a short time!
3. Create a new sleep 'wind down' routine - find things that create a sense of relaxation and peace that you want to engage in before bed. Perhaps a warm shower, nice cup of herbal tea, calming music, being aware of the feeling of comfy sheets, etc. All of those things prep our bodies for a restful night so we are ready for the next day.
4. Most important - BE PATIENT! Change does not happen overnight and conditioning in our behaviors takes some time. Just because initially you may sleep worse, does not mean it is 'not working'. Practice patience and expect slow change in anything you do.