Verve Counseling - Blog

Self-Soothing Coping Thoughts

3/27/2020

Thoughts matter. In these strange, uncertain times, it's hard to know what to think. The worry thoughts come easily. The lonely thoughts come easily. The grieving thoughts come easily. The positive thoughts don't come as easily. Below is a list of some positive thoughts to help remember that it's not all bad and there is hope. Perhaps choose one in the morning and use it as your intention or mantra of the day. Be well!

This situation won’t last forever.

I’ve already been through many other painful experiences and I have survived.

This too shall pass.

My feelings make me uncomfortable right now, but I can accept them.

I can be anxious and deal with the situation.

I am strong enough to handle what is happening to me right now.

This is an opportunity for me to learn how to cope with my fears.

I can ride this out and not let it get to me.

I can take all the time I need right now to let go and relax.

I will survive this situation.

My anxiety and fear will not kill me; it just doesn’t feel good right now.

I am not my feelings.

Feelings don’t last forever. It will change.

It’s ok to feel sad/anxious/afraid sometimes.

My thoughts do not control my life. I do.

I can think of different thoughts if I want to.

Just because I think something does not mean it’s true.

I am not in danger right now.

This situation is awful, but it is only temporary.

I am strong and can deal with this.

How to Fall Back Asleep After a Night Feeding - Part 3 of a 3 Part Series

8/13/2019

Your thoughts.

Do you ever have a hard time falling back asleep because you can’t turn your mind off? Mentally replaying events of the day, maybe with a critical voice about how you failed. Or thinking of all the tasks that need to be accomplished in the next day, a mental to-do list, what you don’t want to forget. Or even bigger picture, what is my purpose in life? What kind of parent do I want to be? Major decisions around housing, work, family life. Or, just thoughts simply wishing you could fall back asleep. The way you think determines the way you feel. And if you are thinking anxious thoughts, you will feel tense and have a hard time relaxing. The answer is changing the way you think, also known as cognitive restructuring. Here are some common sleep robber thoughts, and more helpful thought replacements. Add your own sleep robber thoughts and brainstorm some challenge thoughts or thought replacements. The more you practice, the more easily you can access them when you need them.

How to Fall Back Asleep After a Night Feeding – Part 2 of a 3 part series

6/25/2019

Now that you have your completed sleep log, what did you notice? What surprised you? Were there any patterns? Did you make any changes, consciously or unconsciously? Armed with this baseline information, the next step is to work on some tweaks that will help get you back into dreamland more quickly. Following is a checklist of healthy sleep habits (known as sleep hygiene). Go through and put a check on all the ones you are already doing. Now pat yourself on the back. Keep those up. Now review the ones you are not currently doing. There's your to-do list. Look at the next couple weeks as your sleep boot camp. Get strict with this. You're about to do some intensive training and teach your brain that these habits mean it's time to get sleepy. Keep the log going so you can measure change.

☐ Turn off screens one hour before bedtime. I mean it. The light mimics daytime light and messes with your circadian rhythm. No smart phones on the nightstand. No looking at your phone while you nurse. You can use them for an alarm but they need to be across the room so you’re not tempted to look at them.
☐ Have a bedtime and a wake up time. Even though you’re up multiple times, have that time when you’re in your pajamas and in bed.
☐ No caffeine after 1:00 PM. No ifs, ands, or buts.
☐ Limit alcohol to one drink a day, if you must have any, and no alcohol after dinner. Alcohol can help you fall asleep but it leads to fragmented sleep. Your sleep is already fragmented by baby, let’s not make it worse.
☐ Move your body to the point of sweating at least 20 minutes a day. It’ll help you sleep, I promise. But no exercise within two hours of bedtime or it’ll keep you up.
☐ Hot baths – taking a hot bath 20 minutes before bed time can help relax you.
☐ Keep the bedroom a moderate temperature, quiet, and dark. Or, use a sleep mask and earplugs to create quiet and dark (use one earplug if you need to hear baby).
☐ Have a light bedtime snack, such as a slice of cheese or a small bowl of cereal. Having a little something in your belly can promote sleep. Avoid being full or hungry.
☐ Save the bed for sleep and sex. You want to train your brain to associate the bed with these two activities only.
☐ Limit daytime naps to 15 minutes, if you must nap at all. Set an alarm. More daytime sleep will lead to lighter, more restless nighttime sleep.
☐ Expose yourself to light in the day. If you live in the gloomy Pacific Northwest, consider investing in a full spectrum light for the dark days. Light during the day and darkness at night helps regulate your body’s circadian rhythm.
☐ If you can’t sleep for more than 20 minutes, get up and do something else for 20 minutes and try again. Don’t lay in bed not sleeping.

In the third and final post, we'll discuss sleep robber thoughts and how to combat them.

How to Fall Back Asleep After a Night Feeding – Part 1 of a 3 part series

6/12/2019

“Sleep when the baby sleeps.”

Maybe the most heard piece of advice I received as a new mom. Then when I couldn’t, I added it to the list of ways I was failing as a mother. I’m not one of those people that can fall asleep anywhere, anytime. I’m not one of those people who can just sort of lean their head over and nod off, even in the noisiest and busiest places. I envy that ability. I don’t have it. And I didn’t magically acquire it when I became a mom. When my baby slept during the day I would try to lie down and get a little bit of shut-eye. Nope. Never. Not one time. My body is totally awake during the day, no matter how little sleep I got the night before. Thank you, circadian rhythm of steel. Okay. I can deal with that. I tackle the laundry or cleaning when the baby sleeps, or just park it on the couch and zone out at the TV for a while.

But at night, what I really cannot handle, is not being able to fall back asleep after a night feeding. Those precious nighttime hours that are already disrupted by feedings. Especially in the early weeks when the baby is only sleeping an hour or two at a time, the pressure of using those scant couple hours to sleep is so huge. So when I put my angelic sleeping babe back down and get myself settled back in to enjoy a beautiful snooze, and instead I lie there wide awake, I want to scream, “WHY, FOR THE LOVE OF ALL THINGS HOLY AM I LAYING HERE AWAKE?” Go to sleep! If I go to sleep now, I might have two hours of sleep. If I go to sleep now, I might have 1.5 hours of sleep. Oh no, oh no, oh no. Please let me fall asleep. Just fall asleep already! Tomorrow is going to suck. I’m so tired, why can’t I fall asleep?!?!?! You know, those types of relaxing thoughts.

What can you do when you find yourself in this position of not falling asleep after a night feeding?

Step 1: Keep a sleep log.

It’s some work but the data will really give you good information about your sleep patterns and research shows that the act of logging helps create change. It’s best to keep it on your nightstand and fill it out when you wake up for the day. Create a table with column headers as days of the week and the following row labels: Date, time you got into bed, approximate time you think you fell asleep, how long were you up in the middle of the night adding all the times together to make one number, the time you woke up for the day, the time you got out of bed, your total time in bed (using the previous data), your total time asleep (using the previous data), and then in the final column rate your sleep quality Poor, Fair, or Good.

Stay tuned for part two to learn some concrete strategies and ways to use the sleep log

Self-Esteem Resource Round-Up

4/3/2019

Low self-esteem is something we all struggle with from time to time. Self-esteem is simply our confidence in our own self-worth and abilities. Sometimes something happens in our lives to knock us off our game, and sometimes it's just a chronic struggle. Often our view of ourself was determined by early experiences, either by the way our primary caregivers talked about themselves or how they spoke to us, which then becomes our own internal script. Or teachers, coaches, peers, etc. However low self-esteem comes about, here is a round up of some helpful resources to rewrite that "not good enough" script:

BOOKS
Radical Acceptance: Embracing Your Life with the Heart of a Buddha
Tara Brach, PhD
For many of us, feelings of deficiency are right around the corner. It doesn’t take much--just hearing of someone else’s accomplishments, being criticized, getting into an argument, making a mistake at work--to make us feel that we are not okay. Beginning to understand how our lives have become ensnared in this trance of unworthiness is our first step toward reconnecting with who we really are and what it means to live fully.

The Gifts of Imperfection: Let Go of Who You Think You're Supposed to Be and Embrace Who You Are
Brene Brown, PhD, LMSW
When our embarrassments and fears lie, we often listen to them anyway. They thwart our gratitude, acceptance, and compassion—our goodness. They insist, “I am not worthy.” But we are worthy—of self-discovery, personal growth, and boundless love.

Rising Strong: How the Ability to Reset Transforms the Way We Live, Love, Parent, and Lead
Brene Brown, PhD, LMSW
Walking into our stories of hurt can feel dangerous. But the process of regaining our footing in the midst of struggle is where our courage is tested and our values are forged. Our stories of struggle can be big ones, like the loss of a job or the end of a relationship, or smaller ones, like a conflict with a friend or colleague. Regardless of magnitude or circumstance, the rising strong process is the same: We reckon with our emotions and get curious about what we’re feeling; we rumble with our stories until we get to a place of truth; and we live this process, every day, until it becomes a practice and creates nothing short of a revolution in our lives.

Girl, Wash Your Face: Stop Believing the Lies About Who You Are so You Can Become Who You Were Meant to Be
Rachel Hollis
With painful honesty and fearless humor, Rachel unpacks and examines the falsehoods that once left her feeling overwhelmed and unworthy, and reveals the specific practical strategies that helped her move past them. In the process, she encourages, entertains, and even kicks a little butt, all to convince you to do whatever it takes to get real and become the joyous, confident woman you were meant to be.

Self-Compassion: The Proven Power of Being Kind to Yourself
Kristin Neff, PhD
More and more, psychologists are turning away from an emphasis on self-esteem and moving toward self-compassion in the treatment of their patients—and Dr. Neff’s extraordinary book offers exercises and action plans for dealing with every emotionally debilitating struggle, be it parenting, weight loss, or any of the numerous trials of everyday living.

You Are a Badass: How to Stop Doubting Your Greatness and Start Living an Awesome Life
Jen Sincero
By the end of You Are a Badass, you will understand why you are how you are, how to love what you can't change, how to change what you don't love, and how to start living the kind of life you used to be jealous of.

TED TALKS
The Power of Vulnerability: Brene Brown
The Space Between Self-Esteem and Self Compassion: Kristin Neff
Lessons from the Mental Hospital: Glennon Doyle Melton

Should I Take Medication?

12/30/2018

This is a question I get a lot, and it makes sense. Depression and anxiety are the two most common mental health conditions. An estimated 31.1% of US adults experience an anxiety disorder at some point in their lives (National Institutes of Mental Health) and an estimated 20.6% of US adults experience a major depressive episode (Journal of the American Medical Association). The two most common ways for treating both are medication and therapy.

When I get this question of medication or no medication, I usually advise that it's worth a discussion with a prescriber to learn about options without making a commitment. Most primary care providers (PCPs) are comfortable prescribing medication for uncomplicated depression and anxiety and are often a great resource for discussing what might work for you.

Some points to consider when thinking about medication vs therapy:

Pros to medications:
- It's minimal effort to take a pill each day or each episode
- If symptoms are severe, medication can get you functioning better to then work on skills in therapy
- Depending on your insurance benefits, it may be cheaper in the short term and maybe even the long term
- You may start to feel better in as little as two weeks with full effectiveness taking up to 2-3 months. Or immediately as is the case with Benzodiazepines

Cons to medications:
- There are side effects to every medication that you may or may not experience
- You often need to try several before finding a good fit
- Benzodiazepines (for anxiety) are addictive
- Benzodiazepines are sedative
- Alcohol tends to worsen side effects of SSRIs, so it is advisable to not drink
- There will be ongoing medication management (do not discontinue on your own!)
- Depending on your medical insurance, it may be costlier in the long run

Pros to therapy alone, such as cognitive-behavioral therapy:
- You often start to feel better immediately
- No side effects
- You learn skills to manage anxiety on your own, so treatment is usually discontinued after a few months
- Risk of relapse after discontinuation of treatment is lower with therapy
- There is some evidence that therapy is more effective than medication in treating anxiety disorders

Cons to therapy alone:
- Effort to learn and practice self-management skills is much greater than just taking a pill
- You need to make time to attend appointments
- Depending on your insurance benefits, it may be costlier in the short term
- It takes courage to be emotionally vulnerable with a therapist
- The first therapist you see may not be a good fit, and then you have to tell your story all over again to someone new

And one final point to consider is that no matter what you choose, if it's not working, you can change your mind later!

Crisis Text Line

10/12/2018

Texting has overtaken phone calls as the preferred method of communication over the past decade. A 2014 Gallup poll found that texting is the "dominant way of communicating for Americans under 50."

So it follows that crisis hotlines are being replaced by crisis text lines.

Enter Crisis Text Line: 741741. I have recommended this crisis text line to countless clients with overwhelmingly positive feedback. All you do is text anything at all, even just "Hello," to 741741 and you get a quick response from a trained counselor.

There are so many reasons texting is preferable to calling.

1. You can think before typing. When you're speaking over the phone, the pressure is on to immediately have a response. Especially when emotions are running high, it is hard to have a clear train of thought. Writing it out and having the ability to edit before hitting send helps you get clear on the message you want to send.

2. It's efficient. Phone calls simply add time. When you make a phone call, you need to dial, wait for the phone to ring, maybe there's some hold time, and then when someone answers you introduce yourselves and maybe exchange some niceties, and then finally you can get to the point. All of that can be bypassed with a text.

3. It's more private. When you talking on the phone, anyone with functioning ears nearby can overhear you. Speaking in a hushed voice might actually call even more attention to you. Trying to get to a private place takes some effort. Whereas by text, you can be anywhere, anytime discussing the most sensitive information and people around you are none the wiser.

4. It's less awkward. For some of us, social interactions are painful and anxiety-producing. Texting all but removes that.

5. It's easier to reveal harder stuff. When you speak your deepest, darkest thoughts, it's almost like you're the lead role in a live performance. Most of us have a much easier time writing it down or filling in a bubble on a survey than actually saying the words out loud.

You don't have to be suicidal to text a crisis line. You just have to be in a "hot moment" of emotions and could use some help cooling things down. Program it in your phone under a fake name. Share it with your friends.

More information at www.crisistextline.org.

Succeed at Your New Years Resolution

1/21/2018

Here we are, three weeks into the new year. A time of renewal, rebirth, and optimism. We're leaving the old behind, and looking forward to living the life we want for ourselves. Many of us use this changing of the calendar to set goals for the coming weeks, months, and year.

Around 40% of us make new years resolutions, but only about 9% of us are successful.

So how do you become one of the 9%?

Readiness
First, let's do a little self-assessment. Are you actually ready to make a change, or is it that you think you should make a change? Ask yourself the following questions:

1) On a scale of 0-10 where 10 is high, given everything on your plate, how important is it to you to make that change?
2) On a scale of 0-10 where 10 is high, how confident are you in your ability to make that change?

If you cannot rate both of those questions at least an 8, then you're not ready to make that particular change. Does that mean scrap the whole thing? No. It might just mean that you start with a smaller goal that gets you closer to the larger goal.

For example, if your resolution is to quit smoking, but you can't rate importance and confidence at least an 8 out of 10, then set a smaller goal that is in the direction of quitting. Maybe it's reducing how much you smoke each day, or switching to a brand you don't like (menthols?), or eliminating places you can smoke (no more smoking in the garage), or delaying your first cigarette of the day to 9:00 AM instead of 7:00 AM. Keep working on a specific plan until you can get to that 8 rating. Once you conquer that, then you can move onto another step toward the ultimate goal.

Planning Ahead
Second, are you white knuckling it and relying on sheer willpower? Was the plan to simply wake up on January 1 and not smoke anymore? Then, when you fail, you think, "I just have no willpower. I'm weak," and you feel pretty bad about yourself. The reality is: Most of us fail when we rely solely on willpower! What we need is skillpower, not willpower.

So what skills are those? Depends on the resolution. One thing we all need to do is plan ahead.

1) Research. What will it take to achieve my goal? What are the necessary steps? What resources do I need? Who can I talk to that has already been successful in achieving my goal? When is a good time in my life to tackle this goal? What do I have coming up in my life?

2) Plan. Use that research and make a plan. The more specific you can get, the more likely you are to carry it out. When? What days of the week and what hours of the day? How will you remember to do it? What might get in the way, and how will you overcome those obstacles? Whose help do you need? What is your reward if you're successful?

3) Dealing with triggers. Triggers are anything that make you want to go back to the old way and ditch your resolution. Could be people, situations, places, certain times of day, a mood, a smell, feeling tired, derailment of your routine by illness or some other stressful event. Learning the skills to deal with those triggers will help you overcome them and continue on with your resolution. There are three ways to deal with any trigger:
a) Avoid it. This is the one to use as much as you can, at least at first when you're first working on your resolution and are at your most vulnerable to go back to your old habits. As much as you can stay away from triggers, even temporarily, do it. If you're quitting sugar, don't go to your colleague's office birthday celebration where there's cake.
b) Replace it. If you can't avoid a trigger, replace the old habit with a new one. If your resolution is to quit sugar, and you are confronted with a birthday cake during a required staff meeting, replace the cake with something else. Quickly pop a sugar-free mint or gum in your mouth.
c) Change it. If you can't avoid it, and you can't replace it, change it. Change the way the trigger looks and feels. If you normally have a cigarette with a cup of coffee on your porch, wait until you get to work to have that coffee. Go somewhere you can't smoke to have the coffee. Change the order of your morning routine.

4) Write it down. Write all of this down and keep it with you. Something solidifies in the mind when we write things down. Keep it in a visible place where you'll see it daily. Out of sight, out of mind. And, your own words are more powerful than anyone else's.

Happy New Years!

Resources:
https://www.statisticbrain.com/new-years-resolution-statistics/
Motivational Interviewing, Miller and Rollnick

Holiday Blues

12/18/2014

Commercials during the holiday season lead us to believe that everyone else is joyously sipping on egg nog by the fire, snuggling up with their perfect families. Husbands are buying expensive gifts of jewelry for their wives, who squeal with delight in the perfect reaction while their adorably innocent children peer around the corner feeling safe and fulfilled watching their loving parents. Large sums of money are being spent on gifts and travel and parties and party dresses. Santa has spared no expense. Everyone is getting along, surrounded by loved ones, and sipping on no more than two festive cocktails. These portrayals of holiday cheer are no one's reality, and high expectations can actually result in a lot of stress and sadness, particularly for those who are prone to depression.

The holidays can bring up a lot of painful feelings for a lot of people. Disappointment in not having a life like the commercials, loneliness from not having family nearby or loved ones with whom to celebrate, anxiety from financial struggles, painful memories from an imperfect childhood, or renewed grief from a loss that is felt by an absence from gatherings. With a little planning ahead, the pain may be avoidable with these tips:

1) Remember that commercials and movies are fiction. Most of us do not have a Norman Rockwell life.

2) Avoid family conflict. You may need to be around that family member who drives you crazy. Keep your contact limited and cordial. This is not the time to settle a beef.

3) Let go of perfection. The right food, the right gifts, the right outfit, the right activities, the right conversation.... are not as important as just spending time together. Try to relax into the moment and enjoy it for what it is.

4) Accept painful emotions as much as you accept pleasant ones. The quickest way from pain to joy is through. Embrace, allow, experience, and move through them.

5) Prioritize your workout and sleep routines. These are two self-care basics that have a huge impact on mood and our ability to cope with challenges.

6) Seek support if you need it, whether that's a friend or a professional. Now is a time of year many people seek extra support.

Happy Holidays!

Are You Taking Care of Yourself? A Basic Needs Checklist

9/29/2014

Most people who enter therapy for depression improve. It's a diagnosis whose prognosis, with treatment, is very good! We use measurement instruments to diagnose depression and also to assess progress and treatment effectiveness. Almost all of the time that correlates to people saying they feel better, happier, more hopeful about the future, and that their lives are just working better overall. Usually, after a sustained positive shift in mood, that's the time we end therapy. In that last session I like to reflect on progress, what changes were most effective that a person wants to continue, and, very importantly, how to know when things are starting to slide. Unfortunately, for most people with depression, it is episodic and there will likely be another episode in the future. Therapy helps to reduce the frequency, duration, and intensity of these episodes by building effective management strategies and coping skills. When the cloud of depression starts to creep in - or we are just in a challenging period in our lives - our basic self-care starts to slip. When self-care slips, we are even more vulnerable to low mood. It can be a downward spiral.

So how do you recognize when you're not attending to your needs? I like the following checklist:

1. Sleep. Are you sleeping more or less than usual? Are you going to bed at roughly the same time and waking up at the same time every day? Have you started taking daytime naps? Tweaking your sleep habits can make a world of difference in your mood.

2. Eating habits. How's your appetite? Are you eating more or less than usual? Have you had any sudden unintended weight gain or loss? Has there been a change in your eating habits? Are you drinking enough water? Pay particular attention to relying on substances to "get going" or "relax" such as caffeine, sugar, or alcohol as these can get you in a cycle that is hard to break.

3. Leaving the house. Are you making sure to leave the house at least once during the day, if only to walk around the block? Stay-at-home parents, retirees, and people who work from home in particular can get in a rut of not leaving the house, which we know can negatively impact mood.

4. Project or task. Do you have at least one agenda item every day? Most of us do better with some level of daily structure, so be sure to schedule something each day. Accomplishing even the smallest of tasks boosts self-esteem and mood.

5. Showering. This is one that tends to slip when we're really not doing well. Are you bathing, brushing your teeth, and putting on clean clothes each day? Is that happening before noon? These behaviors signal a fresh start to our brains and improve mood.

6. Move your body. There is evidence that moving your body in some way for at least 10 minutes a day is just as effective as antidepressant medication in improving depression. It doesn't matter how intense or for how long. Find something you like and are more likely to actually do.

7. Seeing other people. Has it been a week since you made social contact with anyone outside of your household members? Are you isolating? Strive to be around others at least once a week. Make a lunch date with a friend, or just go to a free talk at the local bookstore. Being around others helps distract us from self-defeating thoughts in our minds and provides support, even when not talking about mood.