The Coming Dawn: Paradox of Expectations

It’s been said that the morning comes with expectations and the evening ends with experiences. Have you ever been asked to go on a hike, and wanted to go, but expected the view in the desert to be brown and very hot, and not terribly exciting?  But the hike sounded wonderful?   

As you keep walking the hot, dry desert there are various twists and turns, and you learn new lessons about the desert and what it is like, what you are capable of hiking.  And then there is turn, perhaps around the small mountain to the right, where you will see a whole new view that opens, like this:

The difference reminds me of how my expectations often are short-sighted and only about now.  It can lead to an experience that seems “unfair” or somehow wrong.  As an example, when I got Finley, my one-year-old Australian shepherd, a year ago, I very much enjoyed much of the love the companionship and fun I wanted.  There also were many days of housebreaking and teaching him to walk on a leash and playing with him when I was exhausted.  On one particularly difficult day, he chose to go and dig up a sprinkler line and come in full of mud (and joy) in the middle of an appointment I had with a client.  Not a happy dog-mama at that moment!  But today, all I need to do is call him when I see him out in the yard and suspect he is digging and he runs right in and comes to me.  And it is rare for him to do it.  So I ended up with a well-behaved dog (most of the time) and I’ve learned more patience, but the middle was not always fun and I wasn’t necessarily anticipating some of how I grew in this first year.  😊

Henri Nouwen spoke about this as the paradox of expectation in his writings.  He wrote of many paradoxes, but in this one we may be expecting something wonderful, and yet receive pain, growth, or challenges in the middle, and the gift comes through that experience.  In being open to this potential growth or gifting we can make it through some very painful days more easily.  As Nouwen aid, “those who believe in tomorrow can better live today…those who expect joy to come out of sadness can discover the beginnings of a new life” (Henri Nouwen Society, March 12, 2019 Daily Meditation).  Finley did grow up – and is much better behaved as a one-year-old than he was 9 months ago.  And when I could remember he would mature and grow out of things I had much happier days. 

I have a couple of friends going through very difficult cancer treatments right now.  And you know I see clients who are often going through hard, hard times.  We are all stressed this year by Covid-19 and the changes it has brought to our lives.  When I turn to the expectation paradox, I get through these experiences so much more easily as I truly do believe good will eventually triumph in health, recovery will follow the sickness of chemotherapy, and when a loved one is near the end I truly do believe my loved one will again have a new life.  I also believe that somehow a new normal in living with Covid-19 will come that allows better treatment or vaccine that will allow more contact and connection with others physically as well as through the virtual sources we often use now. 

Am I being a Pollyanna?  Well, I don’t think so.  What I’ve learned over years is that if I expect that eventually things will work out, whatever happens in the middle is just the middle.  It doesn’t mean I don’t grieve if I lose someone in death.  It doesn’t mean I enjoy it when a doctor has a concern.  And it doesn’t mean that I want to offer shallow compassion.  But I do want to help you, and others, to remember this is but one day in our lives, not all of it.  A Jewish proverb I have read is “He that can’t endure will not live to see the good”.   And aren’t we really talking about the essence of hope as expressed on a save to my Pinterest board, “H.O.P.E.:  Hold On Pain Eases”.  So, what to do in the middle?  One part is dealing with what is in the middle.  If there are treatments we must undergo, we do it.  A little over a year ago I needed to have a biopsy in out-patient surgery.  To not address that would have been very unhelpful.  It would have been closing my eyes and ignoring the situation.  That’s not what I’m talking about.  Instead, it was scheduled, and most fortunately, I was able to find out everything was fine quickly.  For others, it’s going through very difficult treatments.  Either way – we come out the other end – pain does, indeed, ease. 

Another thing I recommend includes self-care methods I’ve written about frequently.  But what about just looking for positive things happening in our world right now?  We tend to over-focus on the election, Covid-19, and other concerns that are valid, but when overly focused upon lead to depression and anxiety and constant unrest within.  We cannot ignore those concerns, but we also need to take time to notice what we are grateful for and what is positive around us.  Angie found several things, and I’ll mention three here:

Take a look at “Cook Like a Firefighter”, an event ongoing through October 17 at https://egivesmart.com/events/ibl/.  Quite a few Arizona fire departments are participating in a fundraiser for burn victims.  You’ll find recipes you can make at home and each department has a separate link to a video to watch them prepare the dish!

A baby gets to hear his mother’s voice for the first time and let me tell you, it is adorable and reminds me of the miracles in medical science! https://abcnews.go.com/WNT/year-hears-mothers-voice-time-reaction-precious/story?id=73083089

Finally, a story for both dog and cat lovers alike, a local rescue group brings together an unlikely family: https://www.abc15.com/news/state/rescued-dog-who-lost-her-puppies-adopts-trio-of-orphaned-kittens

Where to find such stories and information when you just need a breath of fresh air?  Check out https://www.goodnewsnetwork.org .  This allows us to also alter some of our expectations by reminding us that, as my grandma used to tell me, “It’s always darkest before the dawn” – and dawn will eventually arrive no matter how bad it feels or is today. 

May you each remember the paradox of expectation and focus on the joy that will come, the healing, the peace.  As Nouwen says, your heart will be full of joy again.  We are wishing each of you some time of lightness, peace, and rest so you may take on the next challenges to come your way with a renewed spirit.

Take care,

Dr. Beth & Angie

Beth Sikora, PhD and Angie Read, B.S.

Making Decisions: A Time of Challenge but All Shall Be Well

It seems there isn’t a week that goes by that doesn’t demand we make decisions about our safety and health as well as that of our families’, elections, finances, how to better show respect for each other, and what to do about school for our children.  While that is always the case in some way, 2020 has certainly brought all of these issues to a much higher frequency and intensity than we’ve had to deal with in the past.  It’s hardly a surprise, then, that both anxiety and depression are rising at a very high speed and being predicted to be the next pandemic we’ll have to address.  In fact, the Arizona Republic today reported that a warm line that is for those struggling with those feelings has gone from an average of 850 to 1500-2000 calls a week since mid-March.  So, with an awareness of how much stress is on individuals with decisions right now and the anxiety and depression increase I’m including a Part 1 and Part 2 to this blog.  The first is on decision making, and the second on anxiety and depression. 

Part 1:  Decision Making   

Weighty decisions can be difficult to make when the options are clear or there are good arguments to be made for either side. And right now, that is proving especially true. It’s tough to know the right thing to do, isn’t it? Mask wearing. Elections. Going back to school or a workplace. How do you make decisions when there are so many unknowns, and the options are not the best? There was a clip on Good Morning America this past week from a pediatrician who was sharing her advice on making decisions. Her focus was on safety of students returning to school but my takeaway was something that could be expanded to broader decisions: there is no “right” decision.  A person just has to make the best decision for his or her family with the information available at the time  and move on. So, let’s take it back to the basics, and start with the decision-making process itself.

1. Identify the decision: Clearly define the nature of the decision you must make.

2. Gather relevant information: Collect some pertinent information from trusted sources. Some information is internal: you’ll seek it through a process of self-assessment. Other information is external: you’ll find it online, from other people, and from other sources.

3. Identify the alternatives: As you collect information, you will probably identify several possible paths of action, or alternatives. You can also use your imagination and additional information to construct new alternatives. In this step, you will list all possible and desirable alternatives.

4. Weigh the evidence: Draw on your information and emotions to imagine what it would be like if you carried out each of the alternatives to the end. As you go through this difficult internal process, you’ll begin to favor certain alternatives: those that seem to have a higher potential for reaching your goal.

5. Choose from alternatives: Once you have weighed all the evidence, you are ready to select the alternative that seems to be best one for you. You may even choose a combination of alternatives. Your choice in Step 5 may very likely be the same or similar to the alternative you placed at the top of your list at the end of Step 4.

6. Take action: You’re now ready to take some positive action by beginning to implement the alternative you chose in Step 5.

7. Review your decision & its consequences: In this final step, consider the results of your decision and evaluate whether or not it has resolved the need you identified. If the decision has not met the identified need, you may want to repeat certain steps of the process to make a new decision. For example, you might want to gather more detailed or somewhat different information or explore additional alternatives.

This process may be one you already intuitively use, but if you feel you’re more of a gut reaction person, write down the direction you want to take based on your instinct and then try using the process described above. Do you arrive at the same conclusion? Is there a way to blend both conclusions that feels like a well-informed answer for you? Remember that even in times of uncertainty, we can each only do our best. What is right for today may not be what is right for tomorrow, so take some time, consider all options, and trust yourself. We can only make the best decision for today, and with the information we have today.  Know that and try not to question the decision later.  Reassessing later is fine to see if you need to change direction, but it’s again a decision made from the information you have on that day.  The decisions you make will be the right ones for yourselves for today, and that’s the best any of us can expect.

Part 2:  Anxiety and Depression Increasing

Essentially depression is a feeling of hopelessness, sadness, and/or loss of interest in life or activities you would generally enjoy.  It may be situational, i.e.:  related to a current situation in your life; or, clinical, i.e.:  related to a biological change or malfunction from medical, hormonal, genetic, or other reasons over which you may not have control.  Anxiety is a sense of impending doom or reaction to a stressful or situations perceived as dangerous.  The symptoms of each are specific, and you can get more information on anxiety and depression on our website.

Now that you understand it – what do you think?   Are you suffering a bit from it?  I do encourage you to track it for a while to see where you are with it and how it’s trending.  So, get a piece of paper, a notepad in your device, or use a program, and rate it 1 (none at all) to 10 (you could act on suicide today).  If it is 8-10 you need to call your doctor or therapist.  Or, at the bottom are a few crisis lines if you can’t quickly reach someone for help.  Please don’t let your ego or past beliefs get in your way – depression is a high-risk illness – and potentially can be fatal in a small number of cases.  So, get the help you deserve.  How about anxiety?  I would encourage you to again track for a while – what is triggering it?  If it’s decision making – see above.  If it’s getting sick – work on focusing on what you’re already doing to take care of yourself and family.  And if it’s always stuck in your head, ask for help. 

If you are nervous about dealing with both children and work this fall, sit down and speak with your partner or a good friend and work out a plan for your day.  Sometimes using a calendar helps one in organizing the day so you know what the children need to do and where they need to be – whether at school or online for school, work hours, doctor and other appointments, shopping, etc.  And together also brainstorm all the free services or low-cost services you can call on to help save you time – Instant Cart, Door Dash, individual store shop and pick up options, and others.  Also, who can you share with and split the errands or needs?  Perhaps after reviewing your calendar together your spouse or partner can list all the errands for the week, and each agree to handle some of the work.  The same with work around the house.  Often an hour of planning can help save you hours.  And that will mean decreased anxiety and depression.    

Other anxiety and depression prompts can be larger with less tangible solutions.  Things like, will I be laid off?  How will I survive if that happens?  What will happen in the election?  Worry about a parent in an assisted care whom you cannot visit presently.  Or even a lonely feeling of not seeing friends as you have in the past, the isolation many are enduring.  Interestingly the steps are similar to decision making in that we need to first identify what is triggering the feeling.  Next, look for information about that to identify whether you are worrying or anxious about a reality or something that isn’t real at present.  An example might be a fear of being laid off as fear of the economy is in your mind.  Well, check out your company’s financial condition, see what your boss or Human Resources know about potential lay-offs.  They won’t give you concrete assurances, but often you can identify whether things have even been talked about and check the trade periodicals for the same.  Then consider how to make your position and you more valuable to the company and be sure to improve your position through upgrading skills, identifying your successes to more than just yourself, and challenging any negative thoughts that are not grounded in facts.  Even if you are affected by a lay-off by doing these last things you are upgrading your value to other companies.  Then note this on your calendar for 30 days out and reassess.  Each time you want to worry – take yourself back to the calendar and notice you have a “worry date” made for later.  That written task let’s our brain let go of this more easily.  The steps here are:  a) identify the cause of the feelings; b) get information about the reality of the situation; c) determine if there is someone else who can help you gain more information or perspective (often this is a spouse or friend); d) list options you can take to better the situation for you; e) make a date to next evaluate the situation; and f) reassess it on that date. 

Next time I’ll write about loneliness as it is impacting so very many individuals and I believe it is frequently underlying the current depression.  But for now – you have some concrete tools to deal with situational depression and anxiety and decision making.  I also have to encourage you to call on your spiritual resources, support people, creative outlets, and music.  All can improve or worsen our current functioning.  So, consider a step in each of these areas, you may be surprised how much something as simple as listening to music if you haven’t for awhile will help your mood.  Or coloring a mandala.  Or even just doing a walking meditation or online church service.  We’re not made in isolation, folks, we need others to live successfully.  So, use the creations of others (music), the connection spiritually that you have; the friends and close others in your life as well as family; and creation outdoors to bolster you at these times.  And if it is even too much for those resources, see the resources for immediate help if you can’t reach a therapist or physician.  But take care of yourself and reach a therapist or doctor for ongoing care. 

To close I’ll share a prayer that was written during a time of great difficulty 100’s of years ago: 

All shall be well.

And all shall be well.

And all manner of thing shall be well.  (Julian of Norwich)

Be well and take care of yourself,

Dr. Beth

Teen Lifeline:  (for teens) 602-248-8336 or 1-800-248-8336

Maricopa County Suicide and Crisis Hotline:  1-800-631-1314 or 602-222-9444

National Suicide Prevention Line:  1-800-273-8255 and for Spanish:  1-888-628-9454

Crisis Response Network:  602-347-1100

Decision making process excerpts taken from https://www.umassd.edu/fycm/decision-making/process/

An Exercise for a Time of Adversity

I’ve been working on my thoughts for the blog this weekend – one I promised on growth in adversity. And I’ve written it once, had it edited, and am issuing a fully rewritten one now. Obviously, adversity is hard to go through – and challenging in other ways. The meditation that had hit my inbox on Friday that spoke to me about growth in adversity was from Henri Nouwen in “You Are Beloved.”  And what strikes me today in it is the same and yet different after more meditating and doing a finger labyrinth meditation today.  The quote is: 

“The great conversion in our life is to recognize and believe that the many unexpected events are not just disturbing interruptions in our projects [or lives], but the way in which God molds our hearts[.]…Our great temptations are boredom and bitterness. When our good plans are interrupted by poor weather, our well-organized careers by illness or bad luck, our peace of mind by inner turmoil, our hope for peace by a new war, our desire for a stable government by a constant changing of the guards, and our desire for immortality by real death, we are tempted to give in to a paralyzing boredom or to strike back in destructive bitterness. But when we believe that patience can make our expectations grow, then fate can be converted into a vocation, wounds into a call for deeper understanding, and sadness into a birthplace of joy.” [changes mine]

What my labyrinth walk, a talk with a friend this morning, and the above from Nouwen have all pointed me toward is – – release.  Release is necessary to grow in times in adversity.  In fact, it was just in rereading the quote that I realized that the onus was on God and Spirit to mold – not me to change.  And then release of what?  From what?  To what?  Ahhh – there is the rub at times.  From even knowing that. 

What we often want so much during difficult, really adverse life events or times is to KNOW.  Know what we are to do next.  Know why something happened.  Know how to change it.  Know how to prevent it.  Know how to keep life from changing as it has been comfortable for us. And in the last weeks, months, or even days, we each have had to face down varying levels of demons or challenges in our lives.  Think about it for just a moment – what are you facing right now?  Is it illness?  Is it not understanding your partner or spouse?  Is it not knowing what to do next to help someone?  To help yourself?  Is it financial difficulty?  Go ahead, take a few moments to name the situation for yourself. Write it down if you’re open to doing so before you read on.

Now, what is it that you are trying to control in that situation?  For me, often it is outcome.  I want to be able to create a change or gain an insight in order to grow and move.  Or I want to create that space and hold it for another.  But my goal or method is not the answer; often, it is allowing the answer to unfold.  It is … release.  And yet being with someone or sharing the process with someone without knowing is to walk in darkness alongside them knowing that is enough.  As you are aware of what you are trying to control – perhaps a parent from getting Covid or dying from it alone in an ICU; maybe how you will pay the bills in 3 months when the severance runs out or tomorrow when there is no money; maybe how your employer is responding to changes in life recently; or maybe how you are managing your day-to-day life in the midst of a mild or moderate depression.  Give yourself a moment to pause, and again write down whatever outcome you are trying to control.

Next, I’d like you to find an object that reminds you of that issue.  A penny for a financial one; a rock for a stubborn issue you can’t seem to get around or influence; a Bayer Aspirin bottle for a loved one who is ill; these are some ideas to get your mind going.  If you can and choose to do so, take a few minutes to go find it in your home and return to finish reading. Pause here.

Then take the item you have chosen and hold it in your hand. Gently, as the hand is with the birds in the image above. Consider this item as fragile, even if, at first glance it isn’t. Your emotions about the issue this item symbolizes may be fragile, so treat this item with tender care. As you are meditating, look over the item you’re holding and see what feature you might not have noticed previously.  Release what you think you know, and turn it over and look at it with new eyes.  Consider what it has to show you.  I’ve had a very craggy rock Finley brought in the house that I’m using for my exercise in this.  And as I’m looking at it, I’m seeing an eruption in the top of it that is very sharp and discolored and today am aware of that as the focus – not the rock.  It is helping me to see the pain in something from not a heavy place but from the sensitive, hurting place.  What is different about the item in front of you – what hadn’t you noticed about it previously?  What is the message about the situation from that perspective?  Consider spending a few moments writing about that.  You might think about it in these terms if you get stuck on this part. 

I saw the _________________________ as representing _________________.

What I’d never noticed about the ___________ was ___________________________.

I’m aware now that it is possible that ________________________________.

As you finish the above exercise, what is the takeaway for you?  What have you learned by simply looking for the small factor you hadn’t considered or known about or been aware of as clearly?  Does that allow your view of the adversity you experiencing to shift?  And what does that mean to you about moving forward? Take some time to think about this and make some notes about it before moving on. Pause here.

Going back to Henri Nouwen’s writing – adversity, change, growth, understanding, and finally, joy are the stages of movement when moving through adversity and emerging in a new place.  What we must do is release ourselves from having to understand and know — and then, only then, we can begin moving towards the change, growth, understanding and finally joy that comes from that release.  The baby bird in the above picture wasn’t born with the ability to fly, it needed tending to and nurturing until ready to be released from the nest in flight. Only then, after time, after growth, came the release. I hope you can find your way to it through the above exercise too. 

Peace and calm be yours this week.

Take care,

Dr. Beth

Covid-19: Coping with the Changes 3 Months Later

This week has been again more stressful for many than past weeks as we see the number of Covid-19 numbers going up, hospitals filling, and requirements for masks in Maricopa County and many locations throughout the state.  In addition, this isn’t the first time around – this is into month 4 of dealing with this (although just into it) and I’m hearing tempers flaring, patience waning, and what I’ll term “Covid Fatigue” hitting.  What’s a person to do when this is happening?  And it’s now impacting our relationships, we know people with Covid-19, we’ve lost friends or family to it or they have had a serious case of it, and we haven’t been able to socialize or attend church and/or work in the same ways for quite some time.  And even the possibility of in-school education or dorm life is in flux right now for the fall.  And, to top it off, it’s been at or near 109F. (Good news, though, it may be down to 98F for part of this coming week.)  What a June!
 
Well, we are a resilient people, truly, although the level and speed of it varies by person.  Resiliency is the ability to overcome obstacles and move forward.  Resiliency leads to hope – and so we are to hang in there when things seem desperate.  There is an article I wrote a number of years ago about this and it’s on the website.   So, feel free to go there for more information.  But the essence is that to build hope, we must have people around us, spiritual practices, and be aware of possibility.  I’ve always liked Elizabeth Edwards quote:  “She stood in the storm and when the wind did not knock her down, she adjusted her sails”.   It’s time to adjust our sails a bit.  Here are a few ideas that have come to me lately, some of which I’ve shared here in the past or with clients, some are newer:
 
Realize you are just not accomplishing what you want to do – from something small to large?  Download Apalon’s Productive-Habit Tracker to your phone or tablet and choose just one or two things you want to be sure you do daily or weekly.  Build some success before you add more.  And give yourself a break – it is happening to most people as they live and work at home.
 
Concerned your spiritual life is not where you want it to be?  Commit to one thing a day – maybe a meditative walk; perhaps doing a finger labyrinth; spending some time to do a guided relaxation; say a prayer you relate to – a rosary, a personal talk with God, a psalm, or a pray with others through a compline online, keep a gratitude list, or listen to music that is meaningful to your heart or spirit (you choose!).
 
Fearful about the fall and what it will mean for you?  Teaching at school or via Internet?  Needing to teach your children again or sending them to school?  Sending your young adult to live in a dorm or live at home?  Focus on bringing yourself back to the present.  None of us know what August or September will look like.  So, we must stay in today.  Perhaps using a short affirmation for this will help: “I have only this moment”, “Relax in today”, “I find stillness when I live in the present”, or write your own. 
 
Feeling lonely or alone?  First, find a being in your home with whom you can share a hug, pet them, cuddle, or otherwise connect physically for a bit.  No one there and no pet?  Dr. Peter Levine urges us to hold ourselves.  How?  See Dr. Levine’s methods described and directions for several self-hug and holding exercises.  My favorite is to simply put your left arm across your tummy and with your right reach up and pat your left shoulder.  It will repeat what your mama did to you when she held you – and it is extremely calming.  Then reach out to a friend or family member by Facetime, Zoom, WhatsApp, or another method.  It amazed me again how much closer I felt to a friend last Saturday when we spent time talking by WhatsApp rather than only by phone.  Invite one or two friends over and socially distance in the evening while catching up.  Or do a Zoom breakfast or game night.
 
Uncertain or afraid of vacationing and feeling housebound?  Get your family together to brainstorm.  Two people have told me that they are doing camping trips and/or using RV’s to get time away with family.  Brainstorm a stay-home vacation – and here are a few ideas to get you going – https://www.realsimple.com/work-life/life-strategies/staycation?  The larger hotel chains have information out there on what they are doing, National Parks and Recreation has information on traveling to the parks and AAA has some information.   
 
My spouse is driving me nuts!  How do I cope?  We’ve heard about this on TV, in the news, and from our friends, right?  So how do we cope when we are living and working together full-time?  First, communication is essential.  And that is very hard when we’re stressed and misinterpreting the intention of others as well as struggling to find a little alone space.  Or perhaps just tired of the way they work as it’s different than ours or conflicts with our methods. CNN had a few ideas worth looking at. I’m most impressed with the couple who, in a 576 square foot apartment found ways to compromise and parent children.  What bothered you 3 months ago will now be driving you around the corner.  So, take a deep breathe, do something to relax yourself, get away from your spouse or partner, and talk to a friend before you try to talk to your partner. 
 
Feeling bored at home?  Listen to a new podcast (or two), review some of the art galleries we put on our website under Covid-19 resources awhile ago, go swimming, or put some music on and dance.  I’m very much enjoying the “Poetry Unbound” podcast each morning (under 10 minutes usually) and playing in the water with the puppy.  Both are new for me – and take me in different places that open my brain and heart. 
 
Ok, there are a few ideas.  Next Sunday I’m hoping to finish the article on growing in times of adversity.  But for now – I’m hoping these ideas help you just get through the tough moments in life.  I commit to acting on the alone and spirituality ideas above – so what is your choice?  I hope you do it even for 5 minutes. 
 
Take care and be well,
 
Dr. Beth
Beth Sikora, PhD, LPC, NCC

2020 – The Age of COVID and Protests – Parenting

I was interviewed on a podcast recently and some of the topics we covered were things I thought may be of interest to you. We discussed how to talk to children about all of our recent heavy headline news. And, are these times fostering more PTSD?

Let’s take a look at Covid and our kids; how do we safely allow them to see friends and be kids? It’s been about six months now and this virus is still in the headlines—in Arizona and some other states we’re even seeing a greater number of both new cases daily and more hospitalizations than we did during the first of the outbreak when we were under stay at home orders. It was tough to manage when the spread was new, but now that it’s continuing for so long it feels nearly impossible to keep our children happy at home away from their friends. So, what do we do? How do we talk to them about these times? Start by ensuring you have trusted and up to date information– take a look at the websites of the CDC, your state public health department, and Johns Hopkins, as examples. Only after you have a clear picture of what the current Coronavirus status is, are you ready to talk to your children. At that point, open up the discussions!

The first consideration is realizing that the conversation varies greatly depending on their age. For children 4 and under, it’s enough to simply say people are still getting sick in our city and we have to change the way we play with friends to help keep everyone healthy. Begin by teaching children to keep their hands away from their faces. Pull their hair back so it doesn’t tickle their cheeks and noses, have tissues ready for runny noses and sneezes, and choose age appropriate, size appropriate toys to keep their hands busy. Rattles, teethers, and soft toys for babies belonging only to them and well sanitized between uses are good options. For older children, choose things that aren’t choke hazards that are good for fidgeting, Rubik’s cubes, fidget spinners and cubes, and similar—keeping in mind that a toilet paper tube is a good size to put something through to test whether it is small enough to choke on.

Another good safety lesson for your kids is to teach them their personal space area, which is really well illustrated by having your older toddler hold a hula hoop around their body. Let them hold it and walk next to someone to see what it feels like to keep that distance from someone else and play. And–what does play look like at this age? The safest course of action is to create alliances with certain friends, setting expectations that each of you will only open your bubble to one another. Along with that, you’re maintaining safety by not going out to stores without a mask, not dining in restaurants, and not seeing people, including family, from outside of your own home other than the other family or families that have created the alliance with. If you decide to see someone outside your bubble, then you wait 2 weeks until you again see your playmate friends. It takes a commitment to uphold this level of conscientiousness, a level of honesty with the other family or families in the bubble, and a good degree of trust.

The next safest way to play is to meet up at a playground. Keep in mind what we’ve learned about the virus, larger, more open-air spaces spread out the germ load making the viral transmission less than in an enclosed space with people closely in contact. Playdates in the park could include not only the playground equipment, but also scooters, bicycles, kites, jump ropes, and hula hoops. Things that promote independent side by side play rather than heads huddled close together sharing Legos as an example. And if you’re not comfortable with the playground equipment, go to a part of the park with only grassy play areas and try the other activities mentioned.

Grade school children conversations can include a bit more information. Remember you’re not trying to encourage worry with your child, so don’t use scare tactics.  Rather, you are sharing with them the reasons their play lives don’t look the same as what they did.   You can ask if they have questions about this sickness that is affecting people, ask them what they know about it. By knowing what they’re thinking it can guide you in what you need to share with them. With this age, you can explain in a bit more detail the reasons behind changes you’ve implemented in your family activities. It’s okay to tell your children there is an illness that is causing some people to get very sick and sometimes need to go to the hospital. You can tell them that using a mask can help not only keep them safe and healthy but also those around them, so it’s important to wear a mask in public. If you’re having trouble getting them to wear the mask, treat it like a dress up accessory. Find or make a children’s mouth and nose covering mask that is in a print or style of a super-hero, maybe add a cape and let them wear the whole ensemble to the store. Or, maybe a princess mask and gown. Remember, children are imaginative and the more you can incorporate the mask into their imaginative play, the more likely they are to embrace it! The information shared on playdates for the younger set applies here too.

Middle and high school children have a much higher level of understanding than the younger set, obviously, yet the premise of creating a dialog remains the same. Open up the talk by asking them what they think about Covid, what facts they know, and what questions they have. This is an age that you can be a relatively open book about how this virus has affected our world. Remember that you are not attempting to create panic or anxiety so frame your words in a way that isn’t an attempt to scare them into submission, rather a factual account of the vast numbers of people that have been affected. From how long the illness is taking to get over, to the extent of hospitalizations and deaths, there is not an area than need be kept from this age bracket. However, know your child.  If he or she is a child who will remain up at night worrying about the lives of all those who are sick, limit your details about of the illness when discussing the symptoms of the very sick.  High school teens are able to get a lot of info on their own, and likely are through friends and social media.  We all know that some of this information is not correct, so it’s especially important to begin with what they know, what worries them about Covid, and what their thoughts are about this disease. 

If you don’t recall the specifics of past pandemics, now may be a time to look at how the influenza pandemic swept through in 1918, or any of the epidemics that have gone on in our country or world’s history. Your children have learned about these times in history more recently than you have and using the examples of the past may help them realize that with time, this will be something we are able to move forward from. Enjoying time with friends for the middle-high school age group looks a bit different than it did for the younger set. This is a time in life that maybe it’s okay to ease up a bit on the restrictions of their gaming devices, recognizing this is an area many kids play games with their friends—and in this case it’s a physically safe way to have some social time. Beyond that, this is where you model the behavior you want to see in your kids. They’re watching you, and if it’s okay for you to gather with friends, go out to dinner or drinks, or go to parties, they’re going to expect to be able to do the same. If you are distancing and your pre-teens or teens want to have a social life resembling what they had prior to the outbreak, you will have to set some guidelines—and remain consistent. If your child has a close friend and you know the family of that friend is also distancing and using the cautions you are at home, maybe you’ll decide it’s okay to let the kids spend time together. If the other friends’ families aren’t distancing, or you don’t know their family expectations, maybe you’d be okay allowing the kids to get together at an outside venue—a pool, or a lake—but not let them ride together in a car to get there. This is where well thought out judgement is necessary. It is a stressful time and will likely require you have conversations with your spouse or significant other to be sure the two of you are aligned in thinking so you can’t be played against one another. Make concessions so each of you feel heard if you’re not in total agreement, and as is always the case with good parenting, consistency is key. Upholding standards so your kids know what to expect each and every time can eliminate a lot of fights.

Talking with your children about race relations, protests, and the police all follow the same guidelines. Use your child’s age to determine how deeply you delve into the topic. If your children are young, picture books can be great, dolls with different skin tones can illustrate and model play among people of all colors—remember not to buy only dolls that look like your child. If your kids are older, it’s a wonderful time to ask questions to see how they think, ask what they’d like to see change, and help them navigate how to handle racist conversations with others, including the possibility that racism is coming from somewhere in your own family. If you are a person or a family who protests, go forth in the safest way you can—and pay attention to some of the really excellent graphics circulating on social media about how to protest safely including always wearing a mask and carrying water with you. Recognize that this may be confusing to children who are told they cannot attend a birthday party, yet they then see you or all of your family surrounded by hundreds in a protest. Be prepared to explain your reasoning and your safety precautions.

Some of your older children may be taking in the messaging on de-funding the police. They may have opinions about why it is a good measure, or why they’re afraid of it. Again, be informed yourself by reading up on the topic. Understand what de-funding means, and where the funds are proposed to be allocated instead. Ask your kids questions. Get a good understanding of their level of interest in the topic, their concerns or gaps in knowledge, and if you don’t know all of the answers with this topic or any—it’s okay to tell them that. Research it with them, or on your own and come back to the conversation after you’ve done some more reading. Try not to put it off for too long, lest they think their questions aren’t important to you. Remember that a lot of learning how to critically analyze a situation comes with maturity. Help them learn how to be critical thinkers by posing questions to them that go deeper than the superficial, and really listen when they speak to you.

My theme here has been talking and creating open communication. It is a healthy start to help a person move through these news headlines that are so heavily weighted. Matters of health, social injustice, overhauling our police forces are among the most stressful and highly charged topics in life. So, is all of this exposure to so much right now fostering more PTSD? I don’t believe so in most cases. But the news can potentially trigger PTSD if watched too frequently. By proactively limiting exposure to these events and viewing of the news, social media, and talking through these matters with your children or teens who may also see the coverage, the potential can be minimized.  And, as has been highlighted in nearly every writing I’ve done on stress, take note of what media you’re consuming, both in your sources and in the amount. If you find it difficult to digest, have a hard time sleeping, have ruminating thoughts, and/or find yourself anxious, it’s time to unplug for a while. Rest. Meditate. Be in nature. Check in with friends. Talk to someone you feel really hears you.  If this is not enough, always seek professional help. People are resilient but do much better at handling difficult times using healthy tools. There was more discussion centered on PTSD, trauma, self-care, and stress in the podcase, and we’ll be issuing a part 2 to this blog within the next week or two, so stay tuned!  You can also listen to the podcast, click here.

Finally, as the numbers are increasing so very quickly of COVID in our county and state, please take care of yourself and let us know if you need any assistance.  Grief is sure to be an issue we’ll be dealing with in coming blogs, but in the meantime if you need to hear more about this topic, you can do so here or on stress and COVID here.  As always, I wish you good health–both mentally and physically, and encourage you to take care of yourself daily, moment by moment. 

Dr. Beth


Calming an Anxious Mind

Sometimes it can seem as though our minds never turns off. During these times most recently, we may find that we have ruminating thoughts about the state of our world, our nation, our state, our county, and lastly but certainly not least–our households. Trying to maintain a positive attitude at home or with others may be difficult, let alone being fully present with others.

These are concerns facing many today, and part of a larger theme of anxiety I’m hearing about routinely in my practice. Across our nation, we are seeing re-openings of businesses, and with that comes new decisions of what is truly safe to do. I’ve provided resources in past blogs (found here, here, and here) of reliable sources to look for information as well as tools to get you through this time on my website found here.

Today though, let’s talk about the anxiety itself and how to cope with it. There is a graphic circulating online which shows varying stages of acceptance, take a look below:

This is a great illustration of the process of learning to open oneself up again. In some ways, this re-opening feels a bit like the immediate post-911 world to me. There was fear of going out and resuming “normal” life directly after the attacks because we just weren’t sure it was over. Our nation faced significant losses during that time, and we will never be who we were before that event; but, as time marched on we learned to process the experience and with that, we moved forward. We will do the same with Coronavirus/Covid-19. Take a look at the graphic, see where you think you may fall in the bands radiating off of the circle of Covid–do you see that you’ve made some progress? Or are you still practicing some of the behaviors in the darkest zone, the fear zone? Do you see that some of how you are feeling or acting are examples spread across more than one zone? That is a completely reasonable reaction. Likely where most of us are.

The above graphic also reminds me of the stages of grief, in more than one way. Many of us are familiar with this model of grieving developed by Elizabeth Kubler-Ross and I find the stages apply to more than the loss of a loved one. She defined them as, 1. Denial and isolation, 2. Anger, 3. Bargaining, 4. Depression, 5. Acceptance. Some of those examples look familiar to the handling of this Covid era too, don’t they? The initial denial that this could be happening to the people of our world, our nation; the anger at others who may not be taking the news the same way we have chosen to respond; the bargaining–if only we’d done X, then…; and the isolation which can also bring on depression.

My point to all this? We’ve handled grief likely on a personal basis, but also as a nation before. We’ve been fearful of unknown forces. We have come through it, and maybe we don’t look the same as we did before the catastrophe–on a world or national scale or on an interpersonal, familial one such as after the loss of a loved one–but we humans are resilient and even after a time that feels like it could have been the end of the world, we can again find beauty in things. So, let’s talk about how to move forward.

Mindfulness. Merriam Webster defines mindfulness as: 1: the quality or state of being mindful. 2: the practice of maintaining a nonjudgmental state of heightened or complete awareness of one’s thoughts, emotions, or experiences on a moment-to-moment basis also; a state of awareness. It’s a topic I’ve covered on a recent blog found here because I feel strongly mindfulness is one of our most useful tools in healing.

  • I came across some wonderful “attitudes for anxiety” in a blog post on Positive Psychology–to read the full post, click here. The 10 attitudes to practice for anxiety are towards the bottom but there are a number of other tools to practice she highlights–it’s worth the read. The one I find most essential is to: 1. Notice what is going on in your body. What are you feeling? Where? Is it the discomfort of reflux? The heart-pounding of panic? The headache or migraine of muscle tension? 2. Just stay with that feeling and feel it for a moment. Really let yourself become aware of what is going on internally. 3. Recognize what your thoughts are that either preceded the physical issue or are still present with the physical sensation. 4. Take a slow deep soothing breath into that part of your body that is in pain, taught, or uncomfortable. Hold it. Then blow it out as fast and hard as you can. Imagine that breath out as the difficult thoughts and feelings – blow them all out of your body. Do this several times and then attend to the area of the body with some self-care, i.e.: massage the muscles, notice the heart pounding may have slowed down with the breaths, or the reflux released just a little and if not take the medication you have for it.
  • Learn to meditate. There are countless videos and apps for meditation, some found on our website here, others a mere google search away. But here’s a good one I learned from a nun at an anxiety workshop many years ago. Spend 5 minutes looking into the flame of a candle. A well done video with an introduction to this meditation and a recorded candle’s flame for this process can be found here.
  • Deal with only one day at a time – Jon Kabat-Zinn has discussed this on Oprah’s Super Soul Sunday, the clip may be found here. He proposes checking in on yourself. How do you feel this morning? Are you still upset about a fight last night, or worried about an upcoming meeting? What do you want to achieve today? Understanding how you feel before you embark on your day can help you go through your day more mindfully. “Drop in on yourself and rest for a stretch of time,” Kabat-Zinn says. “And then as you go about your daily life, check in. Once an hour, once a minute. Once a day. You decide”.
  • Another technique a trusted colleague recently reminded me of when dealing with anxiety about the future and what is okay to do now or in a week about Covid-19 is to look at your watch. What time is it? What day? This is all you can make decisions about and deal with in this situation – use your watch as your reminder. See this blog for more information.

As I’ve written about before, practice good self-care. Not only the physical in good hand washing practices or wearing masks; but also, the mental self-care. Remember to limit your media consumption, be gentle with yourself, and get outside daily. If you’re dealing with OCD, it can be a tough time to manage your symptoms. If your current techniques aren’t working or you’re becoming worse through this, here’s an article written first person by someone who is handling OCD related to our current pandemic. Take a look at her tips, and if they’re new to you consider implementing the ideas. Even if they were routine previously, it may be time to up your game on using them. There are also some basic self-care principles written about here.

The same basic ideas apply to how to best care for your children during this time, but I cannot underscore this point enough, talk to them. Ask questions about how they’re feeling in an age appropriate way. If they’re older, see if they have questions on the state of things related to the illness and the ability to go out in the world or what your emergency preparedness plans would be. Ask them how they’re really doing at this time, and if they’re isolated from their peers–and consider supporting them in some things you previously may not have been as open to such as gaming on a device. In limited doses, it may be a great way for your kids to stay connected to their friends–it’s often a group activity yet can be played from individual houses. Watch for behavior changes in them–and if you’re seeing signs that are worrisome get them help. At this time of tele-therapy, they may be more open to the idea of talking to someone from the comfort of their own space rather than having to go into an office for counseling. If your children are younger, don’t overlook playtime as moments that feelings surface. Role playing with dolls, or even putting names to favorite play cars and trucks may bring out “feelings” the toys may have–but could really be the feelings your child may be dealing with. Remember, just like it can be hard for us as adults to put a name on a feeling or be forthright when we are having a hard time, children feel that too. Play with your kids when you can make time. No moment is too small–from the bathtub to a walk around the neighborhood, remember to take moments to check in on your littler people. Here’s a quick read from Seattle Children’s hospital on helping children and teens cope with anxiety.

I hope this provides some tools to each of you to calm the anxiety you are facing. Remember that this, too, is just a season. It will pass, and even if we have some longer lasting changes to adapt to, as was said by the late great Maya Angelou, “I can be changed by what happens to me. But I refuse to be reduced by it.”

If you need some professional help, know I’m only a phone call away. Get ahold of Angie, my practice manager, and get yourself scheduled. I’m here for you, reach us by phone at 602.508.9190.

Wishing each of you an easy mind today, a restful night tonight, and a more peaceful tomorrow,

Dr. Beth

COVID-19, Control, & Compassion: Choosing Our Attitudes and Being Compassionate

We can’t control our world, our family’s lives, even our own life right now, can we?  We can’t know when or where the Coronavirus will hit.  We can’t know if we’ll get it, or our neighbor, or our best friend, or our coworker.  We can’t know if we’ll come through this time financially whole or if the financial condition of the country and world will collapse. And this is scaring many of those I see or those I read about in the news or that I hear from on Facebook or other social media accounts.  And I get it – there is much uncertainty.  This morning, though, I wondered to myself – but can we ever?  Can we truly ever have power and control over all that happens to us?  All that we experience, think, and feel?  All that we so often trudge through life trying to control.  Our boss?  Our job? Our health? Our financial condition?  Or is it possible, just possible, it’s an illusion of control?  And that the truth we are living right now – that we cannot control the spread of COVID-19 more than following the suggestions of medical professionals and mandates of our government is the reality we live each and every day? 

Dr. Viktor Frankl was a psychiatrist who was put in a prisoner camp in Germany during the time of Adolph Hitler.  A man of Jewish faith and lineage, he was in the group abhorrently victimized and often killed by those under Hitler.  And from him came some of the most profound writing in the area of existential psychology – or the psychology of meaning and experience of life.  He survived the camp, a feat beyond my imagination, and stated, “When we are no longer able to change a situation, we are challenged to change ourselves”.  Ah – here is the kernel of hope we do have, we can always change ourselves, our reactions. He went on to elaborate: “Everything can be taken from a man [person] but one thing:  the last human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s way”.  And this is how he survived the experience in Auschwitz.  And helped many others to do so – to choose their attitude to keep trying, one step, one day at a time; and to assist others by noticing them, handing them a crust of their dried bread, or a sip of the tiny bit of water they were given. 

A choice – we, too have choices.  Are we going to share with others compassion and love and a safe place to share what isolation is like?  Or what living at home 24 hours with children and/or spouse is like?  Either can be very challenging.  Are we going to be supportive of the grocery store clerks and employees – or grumble that we didn’t find what we wanted?  It’s a choice, isn’t it?  I will say I can sometimes be tired and grumble when someone doesn’t acknowledge what I’m experiencing – but how would they?  We’re each unique and experiencing this time differently.  So, I need to back up and possibly share it and ask for understanding or at least respect for my experience and apologize for the grumble. 

Kristen Neff talks about self-compassion, and Viktor Frankl about compassion towards others.  But Neff makes an excellent point – if we don’t have it and show it to ourselves first, how will we ever share it with others?  So, as we are facing days that are long, with limited control but room for personal choice in attitude, perhaps a little self-compassion would be a good first step.  Especially through this next week when many who are Jewish cannot celebrate Passover as they are accustomed to and Christians cannot celebrate Easter as they are.  We will need to choose attitude and show compassion. 

Kristen Neff discusses this from a place of self-compassion, Brene Brown from a place of shame and working to change that and let go of that, and Viktor Frankl from a place of making a choice in our experiences about our attitude.  All three, interestingly, have similarities in what to do.

  1. Notice what you’re feeling.  Be with it in the moment.  Be present and mindful so that you are aware and do not act out, hopefully, towards another.  So, for example, when I am feeling lonely facing Easter without the family and traditions we usually share, I need to sit with that.  Feel the pain, the disappointment, the loneliness. 
  2. Being kind to yourself in language is also important.  Rather than the voice that might say, “Oh grow up, it’s one holiday.  You’re fine.  At least you’re not in the hospital and dying of Covid-19”; we need to instead say, “I’m having a hard time. This is something I haven’t experienced so it feels new and lonely.  And it’s a change – I struggle with change in family tradition.  So, I need to be even kinder in planning and deciding how and what I will do Easter Sunday”. 
  3. Name the feeling and share it with some safe person in my life.  It might be in prayer.  It might be in text to my best friend.  It might be a call to a family member to connect at least that way and share and listen to what they are experiencing as we face the next 7 days.  (This is unique to Brene Brown’s idea of coming out of the shame spiral by facing it and sharing it.)
  4. Decide how with what attitude to face the next 7 days and what choices are available.  For example, reaching out to others is something Viktor Frankl recommends as we reach out in love.  Not in guilt or caretaking or shame.  But as he says, “Love is the ultimate and the highest goal to which [we] can aspire”.  This means both the love in self-compassion above, but also the love in reaching out.  Perhaps something special to do with the children over the coming weekend.  Perhaps sending cards of love to family we cannot see. Maybe planning our own special day of ritual and celebration and sharing it in love for the other(s) we might be with – even if that is ourselves.  Nurturing the sense of self-compassion, and care. 

So how will you face your own attitudes this week?  How will you remain mindful of what you are experiencing?  What change can you commit to?  What are the steps you might take to show yourself and others compassion?  I would encourage you to write them down.  Post them, put them in front of you, and lovingly remind yourself of them each day. 

Warmly and with compassion,

Dr. Beth

PS:  Want to learn more about these 3 theorists and clinicians?  I suggest the following books:

Daring Greatly:  How the Courage to be Vulnerable Transforms the Way We Live, Love, Parent, and Lead by Brene Brown

Man’s Search for Meaning by Viktor Frankl

Self-Compassion:  The Proven Power of Being Kind to Yourself by Kristen Neff

Caring for Yourself in Times of Fear and Illness

This week has been a stressful one for many people.  The combination of the coronavirus, the stock market, the grey skies and rain, school and college closures, and the world news each day has been very hard.  But . . . in all of this, did you catch any of the good news?  It’s a bit hard to find, I learned, as I went to locate some for you to try to balance the week.  I did finally find a couple of pieces: 

            The La La Land Kindness Café in Dallas has hired 9 foster kids who aged out of the foster care system and were having trouble locating jobs.

            How about the House and the President agreeing, within just a couple of days, to relief legislation for victims of the coronavirus? 

            The Dow started a rebound today – that’s very good news for most!

            All of the fast action employers and schools/universities are taking to protect their employees and students – it seems unprecedented to me, although it may not be.  From Amazon in Washington to ASU to Ford to many others many are limiting exposure by providing employees with laptops and having them work and study virtually.  

All of these are truly ideas that are very positive news – and get covered in the anxiety so many are feeling, and the care for family that is often at the root of this.  Just tonight I learned one of my sisters-in-law may have been exposed to it, and her father likely has it.  Yet of the 16 members of my family nearby, she is the only one, which is good news thus far. (Edit 3/15/20: Good news! Her father’s test results reflected negative results.) See how we can flip it?  In psychology it’s called reframing the bad or difficult situations by looking at life a bit differently, without denying the hard does exist as well.

We sent out notices about Covid-19 procedures for our office this week.  Now it’s time to also offer some concrete help along with the above reframe tool.  The American Psychological Association and the National Association for the Mentally Ill are the two sources I’m using for the ideas that follow.  I wanted you to have some resources to print or click for the coming weeks.  What I know from 911 and other events is that when we are faced with being bombarded on social media and news media with information that is difficult, we tend to seek out more information and stay focused on the difficult situation.  This merely drives fear and anxiety up further.  We do need to know what we can do to try to protect ourselves; but once we know, i.e.:  wash hands to count of 20, do not shake hands and stay a further distance from others, and isolating someone with clear symptoms including fever, cough, and shortness of breath, we need to also look at how we care for our family and selves in a way that minimizes the fear and focuses on good things in life.  And, in the situation we have right now, we also need to know how we can cope with isolation whether from working at home, not going out for social events, not being able to travel to family or friends on trips we have had to cancel, or other reasons.  And we must have a method to deal with the uncertainty, fear, loneliness, depression, resentment, and challenges we face trying to secure things we may need.  So, here goes!

  1.  Make sure you have some games to play that are age appropriate for you and your family, and especially if you have children.  If isolated, the family will need ways to entertain themselves, laugh, enjoy each other’s company, and get through the days together.  We know that closeness breeds irritation, so have some things that can break up the days and draw you together, not apart.
  2. Have a plan with your doctor.  My physician sent out a text announcement to all of his patients tonight just letting us know he’s there, where to go for trustworthy medical information on the virus, and what to do if we are having symptoms.  Reach out to your pediatrician, cardiologist, pulmonologist, or primary care to know ahead what to do and how their office is managing this.
  3. Use the tools that help your mental health on a regular basis.  So…do:
  4. Keep up your physical activity – there are some great YouTubes on how to do yoga, walk along with you to keep your steps up (I like Leslie Sansome’s https://www.youtube.com/watch?v=m9yI2LGZRE0), and many others depending on what you prefer to do.
  5. Make sure you have enough medication or supplements like Rescue Remedy, Vitamin C and B, and other things around to keep you feeling better and less anxious. 
  6. Stay on a schedule.  We can get very loosey-goosey when at home too long or too much.  So make sure you keep an agenda to normalize your life and not fall into the doldrums too much.
  7. Make sure you can connect with Messenger, FaceTime, and the others available.  It helps for you to actually see friends, not just text.  We’re learning that the more texting that is done, the lonelier people are becoming.  So, in this time of increased stress – reach out even more and if you can’t touch one another, at least see one another.  I know someone who was separated from a loved one for quite some time, and they would watch a favorite show while connected on Facetime.  Another dad who was away who would play checkers with his children.  Get creative in your connection!
  8. I know you get tired of it – but remember to breathe when anxious.  Or start a mindfulness app during this time.  The website has a number of these on the Links page, and this is a great time to learn to do it and practice.
  9. Listen to music that uplifts you – for me that might be one thing – but what is it for you?  Listen!  Music does a lot to impact our moods.
  10.  Keep some numbers available if you need to reach out to a warm line, i.e.:  you’re not suicidal but you are feeling isolated and need to connect.  See SAMSHA’s line for disasters at 1-800-985-5990 or locally at 602-347-1100.  And remember AA, Al-Anon, and many other groups have online and phone meetings.  Take care of your sobriety as well! 
  11.  Pay attention to your spiritual practices.  I love labyrinths and downloaded the Mount Mojo Labyrinth Journey app to my cell phone quite some time ago.  I can walk it by finger on the phone even if I have only 5 minutes and can’t get to one locally.  Or, call a friend to pray.  Watch a Joel O’Steen, Beth Moore, or even your own pastor or rabbi may have something online to watch or even just listen to. 
  12. Humor, humor, humor!  You have to laugh!  I go to Bob Newhart videos, Carol Burnett, or Tim Conway as well as Friends and Frazier.  My mom loved SpongeBob Square Pants (I did not ever figure that one out!)  How about funny movies often free on Amazon Prime, Netflix, and other places you may have membership. 

All of these are tools – now you just need to use them.  As I said in my letter to current clients, I’m here and I am available.  Feel free to call and schedule an in-person or video therapy session.  The teletherapy appointment is on an encrypted service that meets HIPAA standards, we don’t use FaceTime or other things that might seem easier – but don’t offer the privacy.  So, if you can’t come – we’ll walk you through how to set it up. 

May you find these ideas helpful – and know there is a hand to reach out to.  And keep reaching out to friends as well.  Do you have other ideas?  Let us know and we can share those on our Facebook page. The disasters end.  The illnesses come to an end in such large proportions.  The blue skies come out again.  Something my mama told me growing up is that “it’s always darkest before the dawn”.  Obvious, right?  But it kind of normalizes problems and difficult times.  And reassures us – that “Joy will come in the morning!” (Psalms 30:5).  And so it will!

Take good care of yourself!

Dr. Beth

Yoga and Your Brain

Yoga. It can feel like an intimidating word for the uninitiated, can’t it? Visions of perfectly chiseled bodies in spandex holding positions that look impossibly difficult. But yoga is so much more than that. I’ll leave it to the countless experts who explain that the physical movements of yoga are only a tiny part of the whole practice (google will lead you to lots of resources if you’re interested). But the physical piece which ties into the mental component and so many other benefits is a great way to move forward and “deepen” your healing.

After an accident or an acquired brain injury the sheer volume of appointments of follow up care can feel like a full-time job. But yoga is a practice that can be added at any time in the recovery process and shows great promise at helping those who have sustained a brain injury with balance, balance confidence, range of motion, pain control, strength and mobility. Studies have shown the practice to improve balance by 36%, balance confidence by 39%, lower extremity strength by 100%, and endurance by 105%. Those statistics speak volumes for the benefits of such a gentle exercise and practice. In addition, it can be helpful to so many who suffer from anxiety related to post-traumatic stress disorder after an injury or even a car accident without injuries. One study done at two centers involving a Canadian location and Brigham and Women’s Hospital in conjunction with Harvard University found a 10% reduction in PTSD anxiety symptoms following only an 8-session program of Kundalini Yoga.  Another study through Boston University and the Trauma Center found significant reduction in PTSD symptoms after 5 weeks of yoga, and individuals held an improvement for at least another 5 weeks.  So, it seems that we should be thinking about yoga much more frequently in the field of PTSD and brain injury!

There are studios throughout the country which offer yoga classes geared toward those with brain injury through the Love Your Brain Foundation and rehab centers. You can find some resources online at https://www.loveyourbrain.com/yoga though if you do a search right now you’ll find that in AZ, classes are not yet available (check back soon as a provider training is happening in April and is already full—so we should see some offerings coming!) The other place to check is the outpatient rehabilitation program through your local TBI hospital. In the Phoenix area, Barrow has some yoga classes with details found here. Although they have no specific yoga offerings at this time, Ability 360 is also a great resource for those with brain injuries and changes. A recent search of google for trauma and yoga in Phoenix brought up several studios with classes specifically for traumatic stress or PTSD. So, there appear to be some options, but take caution with these studios, doing homework to ensure their credentials are what you’re looking for and are the best choice for you.

These in-person classes are a great resource and whenever possible, I do recommend that people attend with an instructor present. That hands on advice and adjustment to a position can be very beneficial, but if it can be intimidating to try something new, can’t it? A big barrier to entry for an untried activity is the lack of understanding what the cultural norms are, what’s to be expected, and not wanting to look foolish doing something for the first time. Rest assured, the classes that are geared towards beginners, and specifically for those with brain injury, are not going to include the difficult poses that you see highlighted in yoga articles or images. Everyone in the class will enter with about the same level of expertise, that’s why there are classes for a variety of different audiences. Also, there are modifications that can be made to make this gentle stretching available to anyone, in any condition. If you’d like to see what a class may include, or would like to try something at home without an audience, there are some videos of classes for brain injury you can try at your own risk (check with your physician first to be sure you’re ready for these). Love Your Brain says it best, and I agree with their statement, “I cannot assume responsibility for any exercise and/or subsequent injury you may incur, “Yoga is for everyone. However, when online, it is up to you to assess whether you are ready for the class you have chosen. The techniques and suggestions presented here are not intended to substitute for medical advice. LoveYourBrain assumes no responsibility for injuries experienced while practicing these techniques.” And we cannot assume any responsibility for injuries experienced either through their program or others. That’s why it’s best to check with your doctor or physical therapist first. Classes online are an option for you to try if you cannot find anything available near you and once cleared by your medical health provider. Take a look at https://www.loveyourbrain.com/yoga-videos for some classes geared toward healing from a brain injury.

As we move through 2020 and we continue to explore our word for the year, deepening, I hope you’ll give some of the ideas I propose a try or use these suggestions to look for ways to incorporate new ideas into your life. I will be offering a workshop for you and your partner or spouse in April that will discuss the changes brain injury has on your work and home life. For more information, click here, and together let’s incorporate strategies to help you heal to be the very best you can be.

“Silence the mind to hear the whisper.”

I was at a meeting recently with a guest speaker, the topic unknown to me prior to attending. On my way, music on in the car, I found myself turning it down so I could let my mind wander, mulling over a few of life’s stressors. Due to some scheduling changes, I was going to be walking into the meeting just before the speaker began, not having my typical time to say hello to everyone and chat before the meeting. I sat down just before she was introduced, and among the first couple of sentences about her, she was quoted, “Silence the mind to hear the whisper.” It felt like such a timely topic for me, a divine intervention of sorts, putting the reminder directly into my stream of consciousness that I had been subconsciously working towards on my drive. The use of such a simple yet powerful sentence by way of introduction –our speaker caught the attention of all of us in the room. The concept of quieting the mind has been around for a long time and while meditation is something I practice routinely, there is always room for learning, improving, changing the practice for oneself and so, I listened, and I learned.

Mindfulness is a topic I’ve been wanting to write to all of you about for some time. The word of the year for the practice is “deepening”, as I’ve shared before. We are working towards that with greater and different offerings from the practice based on the feedback from you, wanting to offer services that are relevant and meaningful to each of you. But also, deepening is creeping into my subconscious and my own life. I want to embrace this time of evaluation and growth and would like to share some reminders with you on how to be a better steward of your mental focus and energy.

Online you’ll find a wealth of meditation resources, several apps you can download with a click, a few of which I’ve even featured under the links tab of my website and in previous blogs. But. Did you know that taking a walk can serve as a meditative experience? Taking a bike ride, being outside, a scenic drive, gardening, laying in the sun or the shade of a tree, a round of golf, going to the batting cage, going to the practice green or driving range are all activities that can promote mindfulness and meditation. It doesn’t take sitting in a pretzel shaped position on a rubber mat to qualify as meditation. It can take place wherever you feel moved to practice as long as it’s in an environment in which you feel you can relax and unwind. The idea is not the act of stillness, it’s about quieting the noise of the demands of life and taking moments of quiet.

Beginning isn’t as hard as you may make it out to be. Set low expectations for yourself, planning to spend 3-5 minutes at your first attempt–you’ll increase your level of focus and lengthen the duration with routine practice. Begin in the space of your choosing, allowing any thoughts that enter your mind to simply move past your attention as if they were a billboard you pass on a highway. Notice the thought and allow it to move on. Practice breathing exercises. Deep inhales, lungs full, holding the breath and a slow, deliberate exhale. There are exercises that guide you to count your way through breathing and those can be helpful but generally, if you exhale for longer than you inhale you are lowering your blood pressure. These breathing exercises alone are a way to calm yourself and even can be used to drift off to sleep.

A drive that previously may have brought stress due to traffic I’m now looking forward to. The forced time alone in the car is a good time for me to quiet my mind. To listen for the whisper—of intuition and my higher power which is such a help to me in times of growth. “Be patient with yourself. Self-growth is tender; it’s holy ground. There’s no greater investment.” – Stephen Covey. As a part of mindfulness and deepening, let these ideas be a start for you. I’ll be sharing more on this topic in blog posts to come as well as in an upcoming workshop. Stay tuned!

PS: Looking for a great way to open relationship discussions and mindfully listen to loved ones? These would be a great way to start: https://www.shopsundaypaper.com/Sunday-Paper-Table-Topics-p/tabletopic.htm