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

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.

Unfolding: From Shame to Praise

I’ve been sitting here looking at a blank piece of paper, interspersed with time searching for ideas of what to write about for this blog released to be released on Ash Wednesday, the first day of Lent for Christians.  I’ve had a few thoughts pass through my head:

  • The childhood years of eggs and noodles for Friday dinner and tuna fish for lunch – no meat on Fridays was required. 
  • Grade school years of giving up chocolate, candy, cookies, or something else and putting a penny in the missions’ box to collect money for those in need.
  • Junior year religion class when we were challenged to show love to someone each day instead of forgoing a favorite treat (a la Fr. Martin’s blog last year – Be Kind at https://www.americamagazine.org/faith/2019/03/01/fr-james-martin-sj-be-kind-lent
  • Looking out the window this morning and wondering at the cloudy sky and my cold feet while considering how to make this day into something growth-inspired.  This afternoon revealed a bright blue sky, clean and shiny leaves from yesterday’s rain, and beautiful pink and purple flowering shrubs. And this evening it is followed by dark clouds.  Such a metaphor of life – constant evolution.
  • Finley’s facial expression, as I showed in an Instagram post and below – full of joy and expectation.  Which brought me to thoughts of C.S. Lewis via a blog by Dawn Klinge where she talks about  Lewis’s view of joy.  (You can check it out here https://www.dawnklinge.com/abovethewaves/7-thoughts-on-joy-from-cs-lewis).
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  • Searching and finding a book recommended for Lenten journeys by one of my favorite authors related to growth spiritually, Sue Monk Kidd.  She recommended Gifts from Within, written by a group in Texas at Brigid’s Place.  Interestingly, this is also tied back to my ancestral motherland of Ireland. 

What is the common thread in all the musings I’ve had?  I believe it to be there is no perfect way through Lent, or preparation for Easter or Passover.  In reality, no perfect way to reach and experience joy, resurrected hope, true presence in our own lives of and with God.  But it does take preparation, time, energy, and choices daily. 

So, whether it is by 1) sacrifice, i.e.: fasting or giving up something; or giving something like love and kindness; or 2) reading the thoughts of others as shared in Gifts from Within; or 3) reading for my Jewish friends Kurshan in her first person article in The New York Jewish Week, “Preparing for Passover Physically and Spiritually” that reminds us that the history of Passover “begins with shame and ends with praise”  (see https://jewishweek.timesofisrael.com/preparing-for-passover-physically-and-spiritually/); or 4) stretching and committing to really look at something around you (or within) each day like the change in the day from dreary to spring-like to stormy; or 5) watching the joy around you that comes from hope and expectation – they all count.  Each one can take you farther along your spiritual path.  And your psychological healing.  And isn’t this really unfolding – opening up to more of what you want to be, hope to be, are within; but perhaps are unaware of because of something blocking you?  Moving from shame to joy.  So, start thinking – has one of the above ideas struck you as one to use?  I’m using the book recommended by Sue Monk Kidd and a daily thought prompt from another group.  One person I know is using a specific book with a goal of reading the complete book by Easter.  Another person is writing her prayers daily.  And another is just working on breathing – with reminders to himself in his calendar to work on decreasing his anxiety. 

Pema Chodron said, “Nothing goes away until it teaches us what we need to know”.  Carolyn Myss said it a bit differently, “Always go with the choice that scares you the most, because that’s the one that is going to help you grow”.  Lent and preparation for Passover are times for such growth for all.  So…choose wisely this year.

Take care,

Dr. Beth