Decisions…Difficult but Important to Choose and Own

Our current times continue to present challenges in many ways for all of us.  From the smaller decisions of what to purchase at a grocery store and how to do so: online, via delivery, or in-person; whether we’ll follow the guidance to wear masks; to the no-brainers of breathing in and out each day, and to the largest decisions about when to retire and other big life changes.  We can say that some of these decisions are easy, whereas on others we will not reach agreement with everyone.  As Eleanor Roosevelt said “In the long run, we shape our lives, and we shape ourselves.  The process never ends until we die.  And the choices we make are ultimately our own responsibility”.  There are crucial decisions being made by governors and legislators right now related to COVID-19, the economy and businesses, as well as protecting individuals.  At this time, we are also called upon to make our own choices, and decision-making is often challenging and stressful.

Part of this stress is brought on by hearing multiple conflicting ideas about how to open a country back up, what is too soon, what is too long, how much individual health and lives should be considered versus the economy, and whose guidance should be followed in these areas.  I believe, as Eleanor Roosevelt and others have said, that we are responsible to determine what is in our own or our loved ones’ best interest.  Some of the decisions our leaders make we need to assess and determine what to follow and when, such as the recent ones, and ones to come, about reopening.  So, I thought it was time to review a few basics on decision making.    

First, get yourself in a quiet place, without distractions, and relax yourself.  Hard to do in a Covid-19 world, but perhaps these steps will be taken over a period of a day or two, and that’s fine.  This might be doing some meditation, prayer, deep breathing or yoga, or other ideas you might have.  It’s important to have our brain available, and when we are relaxed, we have more capacity to use our full brain without it being impacted by a fight, flight, or freeze change in brain reaction. 

Second, once you’ve done the above, write down what the decision is that you’re trying to make.  Tie it down to one decision, after all we can’t make more than one decision at a time.  Writing it down helps you to focus.

Third, do the research you need to do.  For decisions about work, going out of the house, deciding whether to go to salons or restaurants, or even just whether to grocery shop versus using pick-up services, I’ve found some sources of information and am providing those here.  These links provide various views so you can consider what the pros and cons are.  But seek out your own sources as well.

1.  CDC suggestions/plan on how to reopen

•  CDC guidance documents on various topics relative to COVID-19. 

• WHO ideas on reopening workplaces

• Arizona Department of Health Services dashboard with statistics of what is occurring in each county in AZ.

• Arizona Department of Health Services blog by Dr. Cara Christ

• Governor Ducey’s page with the current status of things as they change. 

• Governor Andrew Cuomo’s guidelines for reopening New York**

•  Governor Newsome’s plan for reopening California**

**I’m providing several Governors’ plans as it will allow you to see what they are considering and that may help you in making your own decisions.

After reviewing the facts and areas to consider from the above or other information you have, the fourth step is to write down your pros and cons on choosing to take various steps, i.e.:  go out to dinner vs. picking up dinner or having it delivered, going to the hair or nail salon, working in these environments and offices, and the others you’ll be faced with in the next week to months.  Then if it is clear to you what you will do, be clear with yourself how you reached the decision.  We can only make the best decision we can on any one day and with the information available to us.  You’ll want to reassure yourself later why you made a decision if later you question it.  If it is not clear, consider talking it through with your spouse, a significant other, close friend, person you respect, or trusted other.  And then follow the above once your decision is made. 

The fifth step, that will seem familiar to all who have studied science – from junior high forward, is to re-evaluate and make sure the decision still makes sense as you go.  Feel free to change your mind if that makes sense to you later.  For example, as many have suggested from a lot of entities and as we’ve seen in other countries, the numbers are going to go up as we reopen, so you may choose to change your decision if they are going up very rapidly, or begin going back down.

I ran across this in looking for a poem on choice and decision-making.  And in the end, I loved the simplicity of it:

Source credit: quotesgram.com

Having peace during these times is challenging – but remember that with following all the guidelines we already know from so many sources, continue to:

1.  Wash your hands often, with soap and water, for at least 20 seconds.
2.  Wear a mask in public.
3.  Cover your nose with a Kleenex if sneezing anywhere.
4.  Cover your mouth with a Kleenex if coughing.
5.  Socially distance keeping 6’ between you and the other person/people.
6.  Clean and disinfect touched surfaces regularly and throughout the day.
7.  Do not touch your face or wash your hands after you do.

All of these get tiring to hear about at times – but they will be essential for a long time to come.   And they can provide you with peace within that you are doing all you can to protect yourself and others. 

Finally, remember to take time to relax, enjoy your family around you, reach out to friends in socially distant methods, pray, meditate, and use the tools we and others have provided. 

See our website for general resources.

We also have COVID-19 specific resources as well as blogs on ideas in managing these stressors.

You deserve to take care of yourself, and I encourage you to make your own decisions, and take care in all the ways you need to do so during these challenging days.  We’ll be back to the regular blog again on Sunday, but I wanted you to have these thoughts earlier as things are changing rapidly. 

Take care,

Dr. Beth

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Covid-19 and Brain Conditions

We keep hearing the experts talk about the dangers of Coronavirus especially involving those with preexisting conditions or “comorbidities”. But does that include a brain or neurological condition? There is so much information that’s been written that it can be difficult to sift through. We’ve compiled some good resources from trusted websites just for you. In general, the answer is no, your risk is not greater due to your condition and the current CDC guidelines should be your first steps. Following that, there are a few other things we’re suggesting to take a few additional precautions. We’ve created the graphic above which can be downloaded here. Once downloaded, each of the links are clickable so you can use it as your single page go to for lots of information.

The takeaway? 

1. MS:  Be sure to really focus on stress reduction as both a preventative of exacerbations of your condition and warding off COVID-19.  If you do get sick, treatments appear to be the same as the general public. Be sure to follow your neurologist’s recommendations and closely follow the CDC guidelines on distance, wearing a mask, and staying in due to your lowered immune system. Additionally, it’s a good idea to have 3 months of medication on hand. https://multiplesclerosisnewstoday.com/faqs/2020/03/02/faqs-about-coronavirus-and-ms
2. Parkinson’s:  Since this patient is also usually over age 60, be careful to follow all CDC guidelines and stay in.  See the following link for a letter the Parkinson’s Foundation Association recommends keeping with you:  https://www.parkinson.org/sites/default/files/Hospitalization%20During%20COVID-19%20Letter.pdf  Take a look at some other ideas at: https://www.parkinson.org/blog/tips/Coronavirus. There is also webinar and audio content available at: https://www.michaeljfox.org/news/coronavirus-and-michael-j-fox-foundation
3. Migraine:  Be very careful of your known triggers to prevent worsening.  Monitor and minimize your stress levels, practicing good self-care.  Have enough of your meds on hand for 3 months.
4. Seizures:  If you have been consistently free of seizures with medication for 6 months or more, there is no current indication of a correlation.  But do have a 3 month supply and take it as prescribed.  And, as always, manage your stress and worry to the best of your ability.
5. ABI – TBI :   Good news, there is no known higher risk for those with a brain injury. But you do need to manage all symptoms such as seizures and migraines– see above for details.  If your ABI is stroke related – keep taking the medications you were put on, following your neurologist’s advice and stay in touch especially if you are having more seizures, headaches, etc.  https://www.stroke.org/en/about-us/coronavirus-covid-19-resources  Watch diet, self-care, balance and keep up your exercises for this safely, manage stress, and have any medications on hand preferably for 3 months.  Follow all CDC guidelines for safety for COVID-19.  See https://www.biausa.org/brain-injury/community/covid-19-resources and https://news.shepherd.org/qa-coronavirus-disease-2019-covid-19/ For other information on traumatic brain injury and COVID-19. 

Links for everyone: 
To maintain this self isolating, we will all do better with managed stress, good quality and amount of sleep, and maintaining relationships with friends and loved ones using technology. For some suggestions, take a look at the links below!

1.  Down Dog – https://www.downdogapp.com/ free until May 1^st to all; free to teachers, students, and healthcare to 7/1
2.  Music to calm and relax:  https://advancedbrain.com/shop/music-to-relax/ easy download as well.
3. Headspace:  https://www.headspace.com/covid-19
4. Browse our recent blogs
5. 5 quick tips:  https://www.npr.org/sections/health-shots/2020/03/03/811656226/pandemic-panic-these-5-tips-can-help-you-regain-your-calm
6. The resources page of our website (we try to keep this updated with news, shopping tips, and some fun!)  https://www.thewholenessinstitute.com/covid-19-resources.html

 I hope you have a safe and healthy April. Please reach out if you need additional support, this is a stressful time for most. I’m here if you need me.

Take care,    Dr. Beth

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

Managing our Emotional and Physical Health through the Holiday Season

Is your holiday season different this year?  Maybe you must work and can’t be at events with family or friends.  Perhaps you are feeling depressed and anxious already, and as you are learning to manage it, with holidays upon you, you are feeling you’ll never get hold of the emotions.  It’s possible someone close to you died this year, and the point of holidays seems removed from you.  Or maybe you are struggling with an illness and so the thought of holidays, food, or get-togethers just isn’t as important to you as you deal with the illness.  Whatever may be different this year for you, perhaps we can simplify it a bit and make your holidays seem more possible, more manageable, and doable.

1. Keep Calm and Take 3 Deep Breaths

So, the idea here is to just stop – slow down – breath.  For those of you who have anxiety, pain, or need to take a bit more time, I love this practice and recommend it regularly.  For the breaths:

1. Breath in slowly through your nose to the count of 4;
2. Hold that breath to the count of 7;
3. Release the breath to the count of 8.

Dr. Weil has a demonstration and discusses it at https://www.drweil.com/videos-features/videos/the-4-7-8-breath-health-benefits-demonstration/.

2. Give Up Perfectionism

This is one of my weaknesses, if not the one that is most difficult to deal with during the holidays.  I may want to do it all, have all the gifts perfectly wrapped, have the exact right gift for everyone, and then also have the perfectly cleaned home, decorated beautifully and completely, and still get cards out to everyone, plan and prepare meals that I find either new and healthy or older and traditional, be at each of the events I’m invited to, and then also be sure that for each group I am a part of also be at their activities as well.  Well, those who know me know that those things don’t all happen, in fact, over the years I’ve reduced what I aim for and then work on the most important first, then drop what I can’t get done as I keep moving through the holiday season with enjoyment.  Brene Brown’s quote sums up what happens when we are not diligent in evaluating what we can do (healthy striving) and perfectionism:

So, stay out of paralysis, exhaustion, reduce anxiety and depression, and work toward healthy striving.  One year it may be a minimal holiday season, another more involved.  Either way, the healthier you move through the Thanksgiving through New Year’s holidays, the better and healthier you are on January 2.

3. Adjust how you shop

This is very important, particularly if you are ill, short on cash and want to be solvent in January, or just don’t have the energy to go out into the shopping malls for Christmas or Hanukkah gifts.  You don’t need to put miles on your car to do so.  What about simply ordering on-line from stores?  What about catalogues?  Or, you could consider ordering gift cards and making a wonderful card to enclose them in.  I love to do this for families, in particular, and get the gift certificate towards a family activity, be it bowling, a pizza night out, a movie, or their local favorite activity like a zoo.  All of this can frequently be done via computer or tablet or phone call.

The other thing you can do is share from your heart.  You might consider making their favorite baked good and writing a personal note on it.  Or, write out your most precious memory about your time with them.  One year I bought a calendar and put little notes throughout the year in it of what I appreciated in the person, reminders they are loved, and wishes for important days in their life.  My friend loved it – and felt closer all year although we lived hundreds of miles apart.  And I still have a gift my niece made for me when she was just a little girl:

Finally, you can get creative.  Check out Pinterest for ideas.  Ask your friends for their thoughts or what they’ve done.  The goal here is to keep it simple and low stress whatever you choose to purchase or make.

4. Plan first for down time, for a break, for the rest you need.

It seems so vanilla to plan for the rest before you plan for the day or week.  However, the biggest problem we have is with fatigue.  When we are tired, not resting, over-done, we do not deal with the rest of life as well.  According to Mental Health America we need rest not just to regrow our energy reserves, but also regulate some of our hormones, repair muscles, enhance cognitive processes including memory, and help keep depression and headaches at bay.  Have you ever noticed dogs?  They love to go and do and be with us.  However, they also love to sleep.

They are generally better than we are at assuring they get what they need in rest.  I was recently reminded by my dog’s trainer that Murphy needs downtime with me, but I need downtime and rest to best be alpha to him, and so allow him to keep relaxing.  So – for your own sake, please remember to book this first.

5. Make some time for feelings. 

It’s hard to allow feelings during holidays if we feel that we must be “up”, “happy”, “excited” and instead feel tired, are grieving, or are depressed or anxious.  It’s much easier to move through this time of year if you take the time to acknowledge what you’re feeling on a regular basis.  You can journal, talk with a close friend or loved one, see your therapist, draw a picture, cry, or simply acknowledge to yourself what you are feeling.  When we own what we are feeling it becomes easier to then move forward and make a decision about how we are going to deal with our feelings at the time.  Sometimes just writing it down or saying it aloud to ourselves or another allows the intensity to reduce and lets you move forward to something else.  Remember that when

From:  http://wantirnawellnesscentre.com

we avoid feelings we just delay experiencing them and the usual result is expressing them in ways or at times we wish they hadn’t come out.  Five minutes of journaling or quietly being still with oneself can do a lot to overcome the feelings back up that often occurs.

6. Finally, remember to watch your exercise and foods/drinks you consume.

Although we may give ourselves permission to eat and drink more at times during the holidays, do remember that we need to also make the choice to keep up on water, exercise or take a walk if possible, put limitations on sugars and alcohol, and keep the vitamin and self-care rituals we generally use in our days.  We all tend to know these things, and it can be hard to follow through, but remember that even one day that we follow our guidelines the healthier we’ll be the next time we choose to allow ourselves to try the desserts, have a hot toddy, or don’t walk. Obviously if you have an addiction, be sure protect your sobriety.  An extra meeting might be just what you need on a particular day or days.  For Christmas, did you know that many areas have 24 hours of meetings in one location for those struggling on Thanksgiving and Christmas?  If you’re in Phoenix, try this on over Christmas:

Christmas Alcathon:  Marathon meetings every hour Noon – Noon (except during speaker meetings)

12/24

3:00 pm   Old Timers Meeting
8:00 pm   Speaker Meeting

12/25
10:00 am  Speaker Meeting

It is held at American Royal Palace Banquet Hall – 1915 W Thunderbird Rd, Phoenix  85023

You can also always call the 24-hour line for meetings 602-264-1341. 

This is a time of year that the above quote is very meaningful – it’s not how much we are dealing with in life during the holidays, it’s how we are carrying it.  And this includes all of the ideas above and others that you may find are even more meaningful to you.  Remember that spirituality goes a long way this time of year.  Reading, meditating, going to church or temple, or otherwise getting in touch with our faith and connection to a higher power is essential.  I need more candles and music this time of year, in addition to being sure that I’m taking time for church and quiet on Sundays.  The sabbath is an essential part of life, as those who are Christian and Jewish learn.  A day of rest, taken away from other activities to allow for focus on one’s relationship with God, Yahweh, Christ, is something that can be adjusted for in any faith walk.  And even without faith, one essentially can choose to take a day apart to rest and refresh.  This is so important through the holiday season.  From Thanksgiving when we may want to take 15 minutes to write a gratitude list, to Christmas and Hanukkah services, to new year’s moments for reflection and thoughtful processing of one’s goals and accomplishments, these moments allow us to be more grounded, fully alive, and connected with our spiritual force.  Be sure not to cut your holidays short by not taking this time regularly.

So, go and enjoy the turkey and cranberries and pie this Thursday on Thanksgiving.  And remember to take the above ideas into consideration if things get hectic during the week.  Then approach each day through December in a similar way, taking care of yourself within what is healthy for you – not as you “should” or “shouldn’t” need to do.  And have a most wonderful 5 weeks!

Blessings warmly sent to you,

Take care,

Dr. Beth

 

 

 

 

Bullet Journals- for your Mental Health

Guest Blogger: Danielle Counihan

Readers, I asked Danielle to write this as she uses a bullet journal regularly, and has

found it very helpful. Consequently, I thought, who better to write this for us? Enjoy!

Dr. Beth

 

Have you ever had problems picking a planner because it never suited your needs? Then, once you had one, you ended up with a separate planner, to-do list, and journal, and never had the one you needed when you needed it? Fortunately, there is a new system that has been taking the Internet by storm. Bullet journaling is a system of writing that is a combination planner, to-do list and diary all in one; and the best part about it is that it is completely customizable to your individual needs! This makes it an awesome tool for anyone, from students, to housewives, to military personnel, as it can be adjusted to fit anyone’s needs and, because you design it as you go, it can be re-designed every day, week, or month. I use mine primarily as a to-do list, a planner to keep track of obligations such as doctor’s appointments and meals with friends, and a meal planner to stick to my food budget, but it is also a great tool to help with mental health.

 

One of the greatest parts of the bullet journal is that all you really need to start one is a pen or pencil, and a journal (again, whatever kind you like, the “most recommended” is the moleskin dotted journal as it gives you the flexibility to draw your own lines or charts (although I have not tried one yet, I think it might be my next one)). If you look up “bullet journal” on the Internet (or Pinterest), you can find TONS of ideas and ways to make yours beautiful, but frankly the most important thing about it is that it works for you and is real (in other words, don’t get all caught up in trying to make it pretty and forget to make it useful). Just start with an index and a key, then move onto whatever works for you. I put an extended view that shows the whole year (or period of time until a major change), then my logs, which we’ll get to later, then into my monthly, weekly, and occasionally daily views. So how, you ask, can this awesome system of planning help with mental health? Many, many ways!

 

The bullet journal is a great way to track habits. Now, because it is so flexible you can choose to do this on a monthly, weekly, or daily basis. I typically do it on a weekly basis. For me the monthly is just too much room in the journal, and so a little overwhelming to look at, and the daily is too much detail that it can also get a little overwhelming. Don’t be afraid to experiment and see what works for you, my journal now looks very different than the setup I started with six months ago.

 

The main thing about this kind of habit tracker is that you can track everything that Dr. Beth talked about in her September/October Newsletter in order to be in balance (see here http://www.thewholenessinstitute.com/uploads/5/1/1/6/51166175/sept-oct_2015_newsletter.pdf) : physical, mental, contextual, spiritual, interactional, emotional, sensual, nutritional, and intellectual health. By tracking these things, especially if you do decide to do a monthly spread, you can see patterns and so make connections. You can see what kind of exercise, interactions, and meditations help your day be better, and what kinds don’t help as much. From this, you can more easily identify things that weigh you down and set goals to help you. Another great thing about a habit tracker is that you can track your goals. Just be sure to make reasonable goals (don’t be like me and try to start out running 2 miles after not exercising for three years, it’s just not going to happen and will just make you feel bad about yourself, trust me). And don’t get discouraged if you have a bad day, they happen and they don’t have to ruin the goal, they’re just a minor setback.

Here is a fairly simple daily view option.

Here is another daily view option, this one is a little more detailed. I typically use the more detailed one when I have more to keep track of.

Here is a monthly tracker. Color coding things is not necessary, but it does help keep track of which categories are going well, versus which cogs are getting stuck and need some more help.

Here are two weekly view options, one a fairly simple one and the other a little more detailed.

Another great thing about the bullet journal is that it can be your to-do list. I used to have little sticky notes floating around everywhere with things I was supposed to do, which only resulted in me losing one and forgetting something. With the bullet journal, you can keep all those little things to remember and things to do in one place. The only thing better than that is that you can give yourself permission to make a “done” list. That means that I will write down and mark off things that I did throughout the day. This is something I shamelessly do, especially on days when I’m tired and want to prove to myself that I actually accomplished something. There is something very uplifting about crossing something off of a list to me, and making a done list helps to give this sense of accomplishment, as well as helping you to know that something is done.

 

The bullet journal is a great place to keep logs as well. Gratitude logs are huge in the bullet journal community for a reason. They help to keep things in perspective, and let you look back on the week and appreciate what is good in your life.

Keeping a longer-term goal log helps you to see where you have improved and where needs some work. A self-care idea page could be helpful; just fill it in with what you know helps you to start, and as you learn things from tracking all aspects of self care and see what helps, add them. That way if you’re having a bad day you have a go-to list of things you know will help.

If you have a hard time thinking of things to journal about, a go-to journal prompt page is a great idea.

Or, if you are an artist at heart and doodling helps you clear your mind, make a doodle page or section in your weekly/daily view (you can see that I added one in one of the weekly options).

 

It’s not called a bullet journal for nothing! The bujo is a great place to be able to journal what you’re feeling and thinking. Rant boxes can be a great way to release the tension of the day and let go of any anger or hard feelings. Just be careful not to overdo it and let the rant turn into just harmful rumination. And if you’re still upset but see that it’s about to turn into obsessing, turn it around and ask yourself “what can I do to help address this?” Even if the answer is “just let it go”, writing it down will help you to accept that that is the best way to address it and move on.

The bullet journal is just for you, not anyone else, and as such can be a great asset in helping to process therapy sessions. Here is a template for a therapy debrief.

This is a great way to be able to reflect later on what you talked about in therapy and so helps you work through it on your own time between sessions. It also gives you space to write down things to bring up in the next session, and could even be modified for any other doctor’s appointments.

 

A bullet journal is a useful and helpful system of planning that can be incredibly helpful when it comes to mental health. I’ve given you some tools to get started both with general bullet journaling, as well as customizing it for use to help with mental health. Happy journaling!

 

I want to thank Danielle for her efforts in providing us some great templates to begin tracking what might help in your daily life, as well as what might be useful in tracking moods, therapy ideas, and feelings. Give it a try – for those who don’t like to “journal” because it takes so long, this is a helpful, short chunk idea for journaling, although certainly you could add your own pages to write further or have a separate journal for that. As this busy holiday season begins I hope you’ll use this as a way to help you get through it more peacefully. Take care, all, Dr. Beth

 

 

Spring – Time to be Revived

Spring!!!  My two favorite seasons are fall and spring – so I was thrilled to realize spring was so close and we would be soon enjoying the final celebration of Easter (for those who are Christian).  There are always a lot of articles written about spring and Easter and how both bring new life and hope after a time of darkness.  For those of us in the valley we did have shorter days, but very little cooler weather and lots of warm days once we hit the 70’s on February 6 and it’s never cooled down again according to AccuWeather.com.  So, we are moving into spring with hope for longer days and closer to average temperatures here!  If I consider this in my approach to my life it would be for days full of more of what I hope and want to do with people I love; and average work/life balance.
Recently I was struck again when I was reading about people interviewing for jobs.  The fact that many in Gen X will ask about how employees are able to manage work/life balance is notable.  According to Workplacetrends.com employers are trying to respond to this newer demand with more flexible hours and settings.  Still, 20% of employees are still reporting that they are working an average of 20 hours a week at home in addition to their regular hours at work.  Technology appears to be driving this as employees are no longer working “regular hours” but are expected to be available by phone and/or email even on weekends and evenings.  I hear this often when I see people.  While it varies, I’ve seen it limit severely a client’s ability to do anything due to excessive demands placed on her to the point she became ill from working 7am to 10pm most days with weekends requiring 4-6 hours of her time answering her boss’s emails.  I’ve also heard of individuals who are not required to work at all on off hours, although very few when in a professional position.  Most of us may cry for work/life balance, but are now working longer hours and finding our serenity and balance compromised.  Gen X and Gen Y both tend to use the flexibility offered through many companies, i.e.:  days to work at home, 4 day work weeks, vacation time, etc. better than others.  So if you’re not doing that, begin there.  Then after using these employment flexibility tools, what to do?
Plan Activities for Yourself:  Seems like an old idea, right?  Well it’s amazing how many times I hear that people are not planning an activity that they enjoy very often, if at all.  If you have a family, be sure as a family that both a fun activity is planned that you all enjoy (movie night) as well as couple time (walk and coffee, dinner, go out dancing).  Also create planned time for yourself (take a bath and pamper yourself, take a yoga class alone or with a friend, paint some pottery, take a walk with the dog).  Having those activities on your calendar (yes, enter them on your calendar – don’t just keep them in your head) will help you begin to see there are other parts of your life and you’ll maintain awareness.
Make Time for Spirituality:  Whether it’s a church service or daily journaling or prayer or walking the labyrinth once a week, find what fits for you.  I’m always amazed when I talk with one young woman who is finishing college and taking 15 units including her final project, doing 2 internships which each require a full day’s work, volunteering for a group, maintaining an active social life, completing her job search, and yet she also finds the time to journal and pray each night.  At her age (22) she has developed habits that would do all of us quite well regardless of our age.  Aristotle said, “We are what we repeatedly do”.  So to be balanced, and include a dimension other than work and household chores, we must begin including those activities on a regular basis.
Limit Electronics:  This is the toughest for so many people – myself included.  It is the electronics that have brought the end of the 8 or even 10 hour work day.  And also brought much in the way of ease of reading, access to information, and kept us in closer contact with loved ones.  But much is in how we manage them – or they will not manage our lives, but take them over.  I found it interesting that when I did a quick search for limiting electronics all that popped up were sources related to children.  So, we know we need to or we are looking for ways to limit children at times – a good practice, for sure.  I found an excellent article in which the author wrote her goals for limiting her own time, and I loved it because all of the guidelines were also expanding her life!  Melissa Monahan wrote on Global Business Hub at Boston.com ideas like planning half-hour periods during which she will not even look at electronics, taking time during her travel weekly to read a book and not look at her email and phone, and phone a friend rather than text three times a week, etc. (see http://www.boston.com/business/blogs/global-business-hub/2013/09/screen_time_rul.html – it’s worth the read!)  While you may have work related concerns, it’s important to also take time away – even those of us on 24-hour call for crises take breaks and it’s incredibly important to your health and that of your relationships to do so.
If you do some of the above, you’ll actually find you’re bringing some life balance back.  Winter is a time of hibernating and slowing down.  Spring is a time for new adventures and growth.  As Harriet Ann Jacobs said:  “The beautiful spring came; and when Nature resumes her loveliness, the human soul is apt to revive also.”    So go outside and soak in the sensory experiences of walks, bike rides, working in the garden, or having a picnic at a park.   And go within and with family and broaden your experiences each week.  It’s time to bloom!

Highlight on Health; The Whole You

As the flu virus spreads throughout our nation and wellness is a goal for many of us, I thought today I’d consider health in a broader sense, and the benefits of some alternative therapies. How is your back feeling? Have those migraines started up again? Did you just have your first hot flash? Or perhaps it’s a pulled ligament from a workout? Seems we all face physical aches and pains at times and often we can’t figure out from whence they came.

One of the guiding principles from which The Wholeness Institute was born was the need to care for a person as a whole–physically, spiritually, emotionally, and mentally. Many of us have gotten a handle on one area of life to find the other areas amiss. It seems a constant struggle to balance all areas.

Philosophers, psychologists, medical doctors, and healers have for centuries argued and theorized about whether the body and mind can and/or should be separated. It seems current research is proving what many have theorized–the body does affect the mind and the mind affects the body. Many, if not most, sexual abuse survivors will tell you of migraines, stomach problems, chronic fatigue and the pain of fibromyalgia. MRI’s are now showing us that early neglect or lack of nurturing prevents neural connections from being made. Chiropractic physicians are able to clear emotions through kinesiological interventions in some cases. Body and mind are intimately connected.

In addition to considering psychological care there are many avenues of care now able to adjunct and even quicken therapeutic results. From optometric to chiropractic to neurological to psychopharmacological to herbs to massage–the possibilities are endless. Here is a brief review of some of the therapies available today.

Chiropractic and Kinesiology can both offer help for not only sore backs but sore minds. Boris Pasternak in Doctor Zhivago so eloquently discussed the body/mind connection years ago:

“The great majority of us are required to live a life of constant, systematic duplicity. Your health is bound to be affected if, day after day, you say the opposite of what you feel, if you grovel before what you dislike and rejoice at what brings you nothing but misfortune. Our nervous system isn’t just a fiction, it’s a part of our physical body, and our soul exists in space and is inside us, like the teeth in our mouth. It can’t be forever violated with impunity.”

Although many of us aren’t able to understand exactly how these sciences work, it is clear that kinesiology is able to bridge between the physical body and the emotions.

Nutrition is an area absolutely essential to our overall state of well-being but is one many find difficult to manage. High fat, low carbohydrate, no sugar, low sugar, no fat, low calorie, gluten free, and vegan are all types of diets most of us have watched cycle through in terms of popularity and nutritional value. It’s important that the person you are working with evaluate your body type, ancestry, and emotional habits to best prescribe an eating plan.

Massage is often thought to be for “special occasions” or pampering. In actuality, it is a wonderful method to treat not only muscular aches but remove toxins, increase energy, and encourage body systems to work more effectively. In addition, the impact on anxiety and stress are profound.

Aromatherapy also offers scents for health! Try some vanilla or lavender candles or oils next time you’re depressed. Lemon and peppermint can increase energy. And rose can increase passion. There is a reason for the recent trend in use of essential oils – consider it next time you’re stressed or not feeling well.

Optometry has therapies such as vision and academic to assist in strengthening not only eye muscles but also address early developmental deficits. Many children, as well as traumatic brain injury survivors, are being found to also have eye coordination problems which can now be identified and treated.

Medicine: We have to remember that many cases of depression are actually due to medical problems such as hormonal imbalances, thyroid disorders, sleep disorders, and neurological impairments. In most cases we consider this in every intake and ask if depression or anxiety have worsened. But it’s important to also recall this when your physician asks questions or wants to evaluate your mood. Working together we can provide better, more integrated, care.

Integrated health providers are abounding. In fact, in a recent search for concierge doctors I discovered a vast majority of those who came up in the Google search were actually integrated health providers. These individuals, regardless of naturopathic, osteopathic, homeopathic, or traditional medical backgrounds also focused on the methods above as well as herbal treatments, eye color and characteristics, homeopathic treatments, and in some cases even spiritual care. Further evidence that as our health issues increase in the US, as well as the more we understand the head/heart and body/mind connections, the more we are considering balanced care from various methods and sources. These are but a few of the treatments available to you which we’ve found to be powerful adjunctive therapies to psychotherapy. With more awareness and a bit of perseverance we can heal both our body and our mind. Wynona Judd said a few years ago: “I learned again the mind-body-spirit connection has to be in balance”. So, too, must we consider our care providers and methods of treatment.