Understanding Borderline Personality Disorder 12 March 2021 Bliss Team No comments Categories: Book Recommendations, Individual Therapy, Therapy, Uncategorised Please note that every person’s experience of borderline personality disorder (BPD) is different. The symptoms and ranges of BPD run both vertically (the number of symptoms experienced) and horizontally (the intensity of how they are experienced). If we also consider other factors that layer and intersect, such as life events (e.g., t/Trauma) and social positions (e.g., financial security, colour of skin, sexual orientation, gender, etc.), our end result is a very unique tapestry of experiences. “People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.” Dr. Marsha Linehan What is Borderline Personality Disorder? BPD is the most common personality disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). This manual is used by physicians and psychologists to make mental health diagnoses. Someone with a personality disorder typically faces unique challenges in: Relationships and social situations; Managing emotions and thoughts; Understanding how certain behaviours are creating problems and/or; Recurring difficulties in changing a mindset to suit different contexts. 75% of people with BPD self-injure one or more times. 10% of people with BPD take their own lives. What are the symptoms of BPD? The DSM-IV-TR lists 9 categorical criteria for BPD. A person must present with at least 5 of the symptoms in order to be diagnosed with BPD. The 9 symptoms can be summarized as: Frantic efforts to avoid real or imagined abandonment, significant fears of being alone; Unstable and intense interpersonal relationships; Lack of clear sense of identity; Impulsiveness in potentially self-damaging behaviours, such as substance abuse, sex, shop lifting, reckless driving, binge eating; Recurrent suicidal threats or gestures, or non-suicidal self-injury such as cutting, burning with a cigarette, or overdose that can bring relief from intense emotional pain; Severe mood shifts and extreme reactivity to situational stresses; Chronic feelings of emptiness, loneliness and neediness; Intense, frequent, short-lived and inappropriate displays of anger, depression or anxiety; Transient, stress-related feelings of unreality or paranoia. Inconsistent symptoms are the hallmark of BPD, which makes it difficult to define a single set of criteria for a diagnosis. This is further complicated, as research has shown that about 90% of folks with a BPD diagnosis, share at least 1 other major psychiatric diagnosis. What is it like living with BPD? “Prick the delicate ‘skin’ of a borderline and she will emotionally bleed to death.” Kreisman and Straus BPD has been described as emotional hemophilia. In the case of BPD, the client will have difficulties with moderating their feelings. Mood changes can come and go quickly and can shift from extreme joy to the deepest despair. A person with BPD may be filled with anger or despair one hour and then calm the next, with little understanding as to why. This then leads to feelings of insecurity, lower self-worth and inner criticism, which brings about more self-hate and depression. Symptoms, such as dissociation, can also interfere with concentration making it very difficult for folks with BPD to complete their tasks. Feelings of emptiness makes a person with BPD feel as though they have to do anything to escape, such as impulsive and self-destructive behaviours, so that they may feel something. People with BPD may also feel as though they do not have a core identity and to overcome their mostly negative self-image, they will create characters or codes. People with BPD may also experience splitting. Splitting can happen at any time, if they are under enough pressure, stress, anxiety, or anger. Splitting is when a person only thinks about a situation or person in binaries. It is the rigid separation of positive and negative thoughts and feelings about oneself and others. For instance, a person with BPD may only consider a context to be right or wrong, good or bad, or in black and white terms without any room for grey. A person with BPD may struggle to accept human inconsistencies or ambiguities, and as such favour predictability. When there is a miscommunication or when somebody they idealize eventually disappoints them in some way, or acts in a way that they did not predict, a person with BPD may look at them as though they cannot be trusted. When this occurs, the person with BPD has to make a decision to either restructure their strict and inflexible conceptualization of this person or to isolate themselves in order to preserve the “perfect” image they had created. Research shows that there is no definitive cause for BPD, rather it is a combination of genetic, developmental, neurobiological and social factors that contribute to its development. People with BPD may come from family backgrounds with parents who were indifferent, rejecting or absent. They may have also received little to no affection and/or experienced chronic abuse. A person with BPD will also seek out new relationships (i.e., partners and/or friendships) quite often. Once in a close romantic relationship they will both crave and become terrified of intimacy; fearing abandonment, they will cling to their partner, which will then lead to fears of enmeshment, so they push away. Because of this, they end up pushing away those they want to connect with the most. Of all the major mental health diagnoses, BPD is the most stigmatized. Stereotypes include viewing folks with BPD as dramatic, manipulative, unfeeling or lacking emotion, attention-seeking and/or narcissistic. They are consistently suspected of wrongdoing, carelessness, anger, and difficulties with building a regular routine. This leads folks with BPD to hide this part of themselves from others. For a person with BPD there are significant fears of abandonment and they will attach to a favourite person and rely on this person for emotional validation and security. Their favourite person becomes the source of their comfort and devotion. A BPD person’s favourite person can be anybody: a relative, parent, best friend, lover, or somebody they just met. The difference between a best friend and a favourite person, is related to the intensity of the thoughts that surround this person. A person with BPD requires compassion, understanding, acceptance, honesty, patience and love. They may not have grown up with either receiving or learning how to share these characteristics with their formative relationships, so accountability for behaviours that are challenging a relationship and empathy, are key. Of course a person with BPD will need to learn how to give themselves the love and compassion that they crave from others, as well. What can you do if you or a loved one is experiencing BPD related symptoms? It is important to recognize that there is no “cure” for BPD, rather somebody who experiences these traits and is receiving treatment may just have more time between self-harm episodes and/or coping strategies to support emotional regulation. Kreisman and Straus have described a structured method of communication, known as SET that can be used when communicating with a person who is in a BPD related crisis, or emotionally spiralling. Support – Use a personal “I” statement of concern to demonstrate a personal pledge to try to support the person in emotional crisis. For example, “I am really worried about how you are feeling.” Empathy – Acknowledge their chaotic feelings with a “You” statement. For example: “You must be feeling awful/scared/hurt/etc.” Truth – Emphasize that this person is accountable to their own life and that others’ attempts to help, cannot avert this primary responsibility. In this statement, you must acknowledge that there is a problem that exists and offer a solution for what can be done to solve it. This must be done in a matter of fact tone. For example, “Here’s what happened…These are the consequences…. This is what I can do… What are you going to do?” It is possible to have a healthy relationship with a person with BPD, especially if you are the favourite person. You can do this in 5 easy steps. Step 1 : Communicate The first step is to have a discussion, to acknowledge that you are their favourite person, and to determine if the relationship is mutual. Questions to reflect on and consider during this discussion are: What are each person’s needs? Are they currently being met? Has there been an instance where either person’s needs weren’t met, why might that be and how might you both be able to overcome this in future interactions? What are both of your feelings regarding space and emotional boundaries? Step 2: Avoid Assumptions BPD folks generally think in black and white (e.g., “they don’t love me anymore”). In order to avoid this assumption and the potential for an emotional crisis, or “testing” the favourite person to make sure they still do love them or won’t leave them, the BPD person should feel comfortable with being direct and asking for reassurance from their favourite person (e.g., “Is everything alright? I’m just worried because I haven’t heard from you in a while”). Step 3: Develop More Friendships It is comfortable and easy for a BPD person to give all of the love and everything they have to their favourite person, but it’s a lot of pressure to receive and also reciprocate as a single human being. This is why it is important for both the favourite and BPD person to have friends of their own that they enjoy spending time with. This will help the BPD person with the intensity of putting all of their emotional needs on one person, and will also help the favourite person to have other outlets and their own support. It’s important that the BPD person avoids scheduling their plans around their favourite person. Step 4: Limit Expectations This is one of the most difficult ideas for a BPD person to incorporate into their worldview, but it is to cultivate a mindset in which their favourite person may leave, by choice or not, and this is okay. This requires a mindful appreciation for enjoying the day for what it is. No matter what happens. It is not possible to control a person or to demand that they be committed to your relationship or friendship forever. Thinking of the future and the possibility that they could leave, may generate anxious thoughts and feelings of being abandoned. Instead, the BPD person can try practicing gratitude for the current state of their relationships. Step 5: Therapy & Medications Treatment for both the BPD and favourite person usually begins with education; discussing what is known about BPD and its causes, as well as how the BPD person can self-manage and prevent relapses. Therapy and counselling may also be offered at the individual or group level for both the BPD and favourite person. The BPD person may also wish to take prescription medications that align with their specific symptoms (e.g., mood swings or anxiety). There are a number of therapeutic tools that can be used in the treatment of BPD symptoms. The 2 major tools are cognitive behavioural therapy (CBT), which focuses on the present and on changing negative thoughts and behaviours, and dialectical behaviour therapy (DBT) which uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and the client’s emotional state. DBT helps clients to regulate intense emotions, to reduce self-destructive behaviours and to improve relationships. It’s important to remember that like any relationship, the connection you build will be at it’s healthiest if it is constructed on a foundation of trust, friendship, mutual respect and care, honesty and accountability. At Bliss, we want to help our clients navigate the complexities of BPD and help them live balanced, happy, fulfilling lives. If you need additional guidance, please book an appointment with one of our therapists who specialized in this area and will guide you through the therapy process in a safe, non judgemental atmosphere: Sheila Mcdonough Sergius Semuyeh Valentina Messier Josh Rinz Marni Moss You do not have to go through this alone. Bliss is here to support you. Written By: Jess Jess is our amazing office strategist at Bliss Counselling. Jess is a Master’s graduate from the University of Guelph. During this degree, they focused on aging and end-of-life, communication, human sexuality, LGBTQI2S+ health, inclusive practice and policies, knowledge mobilization strategies, research methods, and program evaluation. I would like to learn more about BPD, what other resources exist? For more information and support, please consider the following resources. Books Beyond Borderline: True Stories of Recovery from Borderline Personality Disorder by John G. Gunderson (edited by Perry D Hoffman) Building a Life Worth Living: A Memoir by Marsha M. Linehan Coping with BPD: DBT and CBT Skills to Soothe the Symptoms of Borderline Personality Disorder by Blaise Aguirre I Hate You – Don’t leave me: Understanding the Borderline Personality by Jerold J. Kreisman and Hal Straus Loving Someone with Borderline Personality Disorder by Shari Y. Manning Mastering Adulthood: Go Beyond Adulting to Become an Emotional Grown-Up by Lara E. Fielding The Dialectical Behaviour Therapy Wellness Planner: 365 Days of Healthy Living for Your Body, Mind, and Spirit (The Borderline Personality Disorder Wellness Series) by Amanda L. Smith The Mindfulness Solution for Intense Emotions: Take Control of Borderline Personality Disorder with DBT by Cedar R. Koons This is Not the End: Conversation on Borderline Personality Disorder by Tabetha Martin The Dialectical Behaviour Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation and Distress Tolerance by Matthew McKay, Jeffrey Wood, and Jeffrey Brantley Online Documents Borderline Personality Disorder: An Information Guide for Families by CAMH https://www.camh.ca/-/media/files/guides-and-publications/borderline-guide-en.pdf?la=en&hash=69DE097DD9DC16A66440FCD4573E73358AEEECEC Borderline Personality Disorder by the National Institute of Mental Health https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml DBT Skills Training Handouts and Worksheets by Marsha M. Linehan https://projecticee.files.wordpress.com/2018/12/lin-c-dbt-handouts.pdf The Overlap Between Autistic Spectrum Conditions and Borderline Personality Disorder by Dudas et al., (2017) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590952/
Chronic Wounds and Mental Health – An Overlooked Connection? 19 February 2021 Bliss Team No comments Categories: Guest Post When we think about our health, what often comes to mind are physical health issues like cancer, diabetes, and cardiovascular disease. These conditions do deserve significant attention, and certainly do pose a risk to our health. However, along with many of these conditions, there is another complication that does not garner as much attention, although it does significantly affect our health: our mental health. Chronic wounds are those wounds that do not heal in the expected time frame and do not follow the normal healing process. The result is an ongoing battle to overcome the wound and return to an active lifestyle. Coping with a chronic wound can feel like an uphill battle with no end in sight. This is also why chronic wounds can affect our mental health so dramatically – because they seem like injuries that cannot be overcome. What Is Mental Health? Mental health can simply be defined as the absence of mental illness. However, mental health deserves a much broader definition and more widespread recognition than it is given. It can be the difference between functioning at a satisfactory level and truly embracing and enjoying our lives, especially when it comes to chronic wound care The World Health Organization defines mental health as “subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one’s intellectual and emotional potential, among others.” Ultimately, our well-being includes the realization of our abilities, coping with normal stresses of life, productive work, and contribution to our community. Our mental health also affects how we think, how we perceive the world, the actions we take, and how we feel on a day-to-day basis. It can also contribute to how we handle life’s stresses, setbacks and failures, and our relationships. All in all, mental health encompasses just about everything we experience as humans, which is why it’s so important. According to the Centers for Disease Control, nearly one in five U.S. adults live with a mental illness (46.6 million in 2017), with an estimated 11.2 million adults aged 18 or older in the United States with what can be classified as a Serious Mental Illness. This means 4.5% of all U.S. adults cope with some form of mental illness. Many factors contribute to our ability to maintain our own mental health. These include any biological problems we may have, our life experiences, our family history, and any health conditions we are coping with – such as chronic wounds. How Do Chronic Wounds Affect Mental Health? According to the National Institute of Mental Health (NIMH), the presence of chronic conditions can increase the risk for mental illness. For example, conditions like Parkinson’s disease and stroke cause changes in the brain, which may trigger symptoms of depression. Depression is also common in people who have chronic illnesses such as cancer, coronary heart disease, diabetes, Alzheimer’s disease, HIV/AIDS, rheumatoid arthritis, lupus, and epilepsy, among others. Chronic illness can also cause feelings of illness-related anxiety and stress related to coping with wounds. Moreover, when depression and anxiety are present, the symptoms, as well as those of the chronic health condition, tend to be more severe. The NIMH also says people with depression are at higher risk for other medical conditions. As an example, people with depression have an increased risk of cardiovascular disease, diabetes, stroke, Alzheimer’s disease, and osteoporosis. One explanation for this is that mental illness may interfere with the ability to cope with chronic health conditions. For example, with mental illness present, a person may find it more difficult to seek care, take prescribed medication, eat well, and exercise. Lastly, preliminary research suggests that symptoms of depression and anxiety can cause signs of increased inflammation, changes in the control of blood circulation and heart rate, increased stress hormones, and metabolic changes that increase the risk of diabetes – all of which impact our health and our ability to cope with chronic health conditions. How Can Mental Health Be Improved While Coping with Chronic Wounds? The process of wound healing comes in four stages and it’s imperative to maintain mental health throughout each of them. While the most common treatment strategies for mental illness include cognitive behavioural therapy (CBT), medication, such as selective serotonin reuptake inhibitors, (SSRIs), and, in the most severe cases, electroconvulsive therapy (ECT), there are many lifestyle changes that we can incorporate every day to improve our mental health. Psychology Today suggests the following nine, all of which apply especially to chronic wound care patients: Be positive. While it is easy to overlook the automatic thoughts that run through our heads, when combined, they can add up to a negative outlook. When we see life through a negative lens, we tend to focus more on the things that confirm that belief. On the other hand, when we incorporate positive thoughts, these often lead to positive interpretations. For example, rather than saying, “I can’t do anything right,” try saying, “It didn’t work out this time, but I will try again.” Be grateful and write it down. It’s now clear that feelings of gratitude do significantly affect our mental health. When we can find things in our lives to be grateful for, not only do we feel differently, we also act differently – in ways that often lead to additional mental health benefits. One quick way to start is to keep a gratitude journal, or better yet, try practicing three acts of gratitude every day. Focus on what we can control, and be in the moment. Both ruminating about the past and forecasting the future can cause feelings of regret, depression, and anxiety. We can’t do anything about the past or the future. However, what we can do is stop and choose to focus on what we can control – our actions in the present moment. One easy way to do this is to simply pay attention to your routine activities and the thoughts that accompany them. Get active. Exercise is one of the most palpable ways to gain a sense of control. When you exercise, despite what else is happening in your life, you remind yourself that you can do something positive for your mind and body. Further, exercise increases stress relieving and mood lifting hormones, which have both an immediate and ongoing effect. Exercise can be incorporated in 30-minute blocks, or you can simply look for small ways to increase your activity level, like taking the stairs, going for a walk, or playing with your dog. Eat right. What we eat provides our brain with the ingredients to function well and improve our mood. Carbohydrates increase serotonin, which makes you happy, while protein-rich foods increase norepinephrine, dopamine, and tyrosine, which help keep you alert. Fruits and vegetables provide nutrients that feed every cell in the body, including mood-regulating brain chemicals. Lastly, foods with Omega-3 polyunsaturated fatty acids (found in fish, nuts, and flaxseed) can improve both our cognitive function and our mood. Open up. When we bottle emotions up, we don’t give ourselves an opportunity to cope and find creative solutions. We also dampen our ability to recognize our own habits, which may be contributing to how we feel. On the other hand, when we open up to someone else, we can pinpoint the positive aspects in other people (such as feeling valued or experiencing a sense of trust) and overcome our own biases. Do something for someone else. Like acts of gratitude, being helpful to others has a beneficial effect on how we feel about ourselves. Moreover, being helpful helps us feel valued, which contributes to positive self-esteem and helps us find a sense of meaning in our lives. Chill out. Sometimes in moments of high stress what we really need to do is step away. Often by simply slowing down, we can gain a greater perspective on what is going on, and in the process, find a positive solution. You can start with focusing on something that brings you positive feelings, such as a person that you love, an experience you enjoy, or something you are grateful for. You can also talk a walk, spend a moment in nature, or close your eyes and visualize yourself feeling calm and at peace. Get a good night’s rest. Sleep deprivation has a significantly negative effect on our mood, and sadly many of us don’t get enough sleep. Sleep can be improved with a few daily habits such as going to bed at a regular time each night, avoiding caffeinated beverages for a few hours before sleep, shutting off screens before bed, or incorporating relaxing activities before bed. There are many powerful components of mental health, like enjoying our lives, feeling as if we are striving toward something important, utilizing our skills, and seeking to reach our full potential, to name a few. And while chronic health conditions are often an overlooked deterrent to mental health, incorporating daily habits -i.e. replacing automatic negative thoughts with positive ones, performing acts of gratitude, staying in the moment, exercising, eating well, opening up, being helpful, taking time out, getting enough sleep, etc. – we can combat mental illness even amidst difficult chronic health conditions. Written By: Claire Nana Claire Nana, LMFT, is a Licensed Marriage and Family Therapist who specializes in post-traumatic growth, optimal performance, and wellness. She’s written over thirty continuing education courses on a variety of topics from Nutrition and Fitness, Mental Health, Wound Care, Post-Traumatic Growth, Motivation, Stigma.
Why Integrated Treatment with Co-Occurring Disorders is Essential 13 August 2018 Bliss Team No comments Categories: Guest Post, Individual Therapy, Therapy The national institute of health estimates that half of the patients who are in abuse rehabilitation centers also struggle with mental health problems in addition to their addiction. In the past, treatment centers which deal with these problems have always looked at them as separate entities, and there were no programs which involved dealing with the co-occurring disorders. As a result, patients ended up with an increased risk of poor compliance with medication, relapses, violence and even suicide attempts. Studies that have been conducted in recent years show that patients who receive integrated medication which involves behavioral therapy and other related psychosocial interventions have a higher chance of beating addiction than those who just go to the regular old school rehab. The Components of An Effective Integrated Approach Program There are certain criteria that a certain substance abuse and rehabilitation program must meet for it to qualify as an integrated approach: A multidisciplinary team will be involved. This includes rehab experts and mental health experts. The patients will get stage-wise interventions with comprehensive access to the services. There are motivational interventions and participation in self-help groups. Pharmacological treatments and interventions whose aim is to improve health are also common. Dual diagnosis The treatment starts with a diagnosis. The diagnosis comes after the patient admits that they have a substance abuse problem. It is good that most of the substance abuse therapists are now asking the right questions which lead up to a dual diagnosis. It is now quite standard to have the practitioners asking about a patient’s mental and emotional health when they are approached for a solution to substance abuse. When it is established that substance abuse is coupled with an emotional health disorder, practitioners come up with an integrated treatment program which does not separate the addiction from the mental health issue. Why Dual Diagnosis Is Important Statistics show that people with schizophrenia or bipolar disorder are five times more likely to have substance abuse problems than their mentally healthy counterparts. 37 percent of people who abuse alcohol and 53 percent of people who abuse other drugs also suffer from a co-occurring mental condition. These statistics show that mental health issues cannot be ignored when offering treatment for substance abuse. Other mental health issues which co-occur with substance abuse include anxiety, PTSD, borderline personality disorder and major depression. These people normally abuse drugs like alcohol, opiates, nicotine, prescription drugs, sedatives, hallucinogens and stimulants. With close to ten million Americans struggling with co-occurring disorders, according to SAMHSA, it is important to adopt an integrated approach in treatment. Benefit of An Integrated Approach It is essential to note that when a patient has these two co-occurring disorders, and one is left untreated, it will hamper any progress that would be made with the other one. Also, in most cases, the two conditions end up being related to each other in complex ways and treating them together gives the health care practitioners insights on how to handle both on a day to day basis. In addition to these benefits to the patient, the society benefits in the following ways: Reduction of arrests and incarcerations among the patients. Reduced rates of hospitalization over substance abuse or mental health episodes. Fewer service costs and reduced instances where services are duplicated. Patients have also been proven to increase their ability to afford and maintain independent living, stable housing, improved quality of life and achievement of continuity of care. The Treatment Process Followed There are a number of steps that are followed in the addiction treatment process for people who have received a dual diagnosis. The steps include: Encouraging the patient to get psyche for the treatment process. Identifying how severe the addiction process. Offering rehabilitation and psychotherapy sessions which are appropriately intense to the patient. Providing follow up support after the main treatment and giving referrals to community-based support groups that the patient can count on as they recover. This approach is, therefore, a better way of dealing with substance abuse than the traditional setup where the two were dealt with as separate entities. The evidence clearly indicates that patients will gain more from an integrated treatment approach than when they deal with these two issues separately, which means that the program is worth a try. About the Author Ruben Lopez is a freelance writer from Atlanta, Georgia with a passion for addiction treatment. He is committed to helping those who are in recovery, and he occasionally writes for The Recovery Village.
Good News: There’s No Such Thing As “Bad” Feelings 30 July 2018 Bliss Team No comments Categories: Communication, Individual Therapy, Self Care, Therapy Have you ever screwed up in your relationship, or have done something that you immediately felt terrible about? Perhaps your stomach started doing backflips and you were filled with a sense of dread, anxiety, and maybe even anger or shame. However you choose to describe the feeling, it probably didn’t feel awesome. Many folks might immediately label these feelings as, “bad.” We hear this a lot in our therapy work with clients, and our response is almost always the same: Feelings aren’t good or bad—they just are. These feelings? They’re distinctly uncomfortable. Not bad, wrong, or inappropriate, but simply not comfortable and an important aspect of being human. Feelings give us information that’s impossible to perceive in any other way than with judgment. However, we can only use this valuable information when we stop pushing them away, ignoring them, or becoming numb to them. To help the difficult feelings feel better, people sometimes turn to the blame game, pointing a finger at someone else for what happened. People often place blame on others to ease the pain in the moment, but it hardly works in the long run. In addition to blame, we often want to stop the uncomfortable feeling right away and move on to a better-feeling one, searching for a quick fix to our feelings. Just feel it Whether it’s distracting, minimizing, or turning our backs and sprinting away from uneasy feelings, this could be causing more suffering. Instead, just feel your feelings. It may feel a little overwhelming at first, to feel them all at once, because it might feel too heavy. However, you can give yourself the permission to feel them, do what you need to do, wallow for a while and then move on. It can be all too easy to pretend something didn’t happen, or even ignore our feelings entirely. However, this doesn’t serve us well in the future because our feelings need to move through us. We can sit in the discomfort of an unpleasant feeling and feel our way through it, staring our feelings directly in the eye in the name of being able to move on. Feelings can also give us clues about our current physical and emotional well-being. They offer us insight into what feelings bring us closer to, or further away from joy, helping us spot problems before they happen. Feelings can also help provide us with motivation—to make a change, try something new, or make a decision. They can be a helpful “heads up” for figuring out our lives. Keep in mind, they don’t always give us answers. We need our cognitive skills for understanding what feelings mean, and to do this, we need to first register what the feeling is so that we can feel it fully. Once we do this, then we can get to the business of figuring out what this clue means. The good or bad measuring stick Many people grow up judging our emotions as either “good” or “bad.” Maybe it looks a lot like this: “Good” feelings: Happy Glad Funny Calm “Bad” feelings: Sad Angry Lonely Displeased Think about some of the labels you’ve applied to feelings in the past. Perhaps you could add some to this list. Instead, celebrate your feelings Here’s a fresh take on how to look at your feelings, no matter what they are: your feelings are proof that you have feelings and that you’re a feeling person! That’s fantastic! It means you’re present, you’re here and living out a rich human experience. Life as a human means that we get to experience a full spectrum of emotion, not just good and bad emotions. Sure, some of these sentiments will feel more uncomfortable than others, but once you recognize this simple truth, it can be easier to move on. Therapy isn’t about fixing feelings When you tap into the power of your emotional system and put the information to proper use, this can give you an advantage when it comes to making decisions. Many people see their emotions as something they have to control or keep in check, rather than something they could capitalize on to strengthen their lives. Visiting a therapist isn’t about helping clients to stop feeling their feelings, learning how to manage them, or going through emotions previously described as “bad” or “wrong.” Instead, consider therapy as a practical, judgment-free space to help people feel safe enough to allow the feelings to pop up and incorporate the less comfortable feelings. As therapists, we’re not here to “fix” anyone, but rather, set up a space to just feel and explore feelings. Amp up your emotional intelligence Using your feelings as a learning opportunity is the key to making better life choices. What would happen if you decided to see your feelings as information? What might that change in your life? The next time you notice an uncomfortable or distressing feeling knocking on your door, try pivoting from thinking, “this is bad” to “this feeling is uncomfortable,” and notice what happens to your demeanor and interactions with others. Are you ready to dig into your feelings and learn the clues they might be offering you to help live your best life? We’d love to hear more! Get in touch and book an appointment here. Written by Bliss therapist Kelly McDonnell-Arnold. Learn more about Kelly and get her secret “Tips From the Couch” here. If you enjoyed this article, you might like these too: 12 Reasons It Might Be A Good Idea To See A Therapist So Your Partner Thinks You Need Couples Therapy It’s Not What You Say, It’s How You Say It
The Power of Me Time 16 July 2018 Bliss Team No comments Categories: Guest Post, Individual Therapy, Inspiration, Self Care, Therapy In today’s fast-paced, digital world, it’s nearly impossible to be alone. We’re always connected. School, work and relationships all have a major impact on the way we live our life, and ultimately on our state of well-being and happiness. A critical part of finding peace and happiness is accepting yourself just the way you are. We as people are not perfect, yet we often times lose sight of this and demand things from ourselves we simply cannot do. And being constantly surrounded by others intensifies this sensation. There’s so much pressure to “be someone,” and it seems like we’re always being judged or compared to others. Enter “me time”. This small change to your lifestyle can have major effects on your self-esteem, self-confidence and self-worth. But what exactly is it? Well, it’s pretty much what the name says. It’s time you take entirely for yourself. It can be just a few minutes, or it can be a few hours, and it doesn’t really matter what you do. The only requirements are that you be alone and that you do something you love to do. Why is this so important? Simply put, carving out some time of the day just for you is an opportunity for you to show yourself that you can be happy without others. Of course, sharing yourself is a critical component of wellness, but when we’re out in the world, we’re constantly being fed messages that indicate happiness is something to be found outside of ourselves, something we need to acquire. Yet long-lasting happiness cannot be found externally. It’s not even something that can be found. It’s already inside of us; we just need some time to realize it. And this is exactly what “me time” is for. It’s a chance for you to forget about the situations in life where you’re asked to do things you perhaps don’t enjoy or that bring you stress. These are unavoidable, so by balancing them with moments of true bliss, you are giving yourself the strength you need to make it through the day. “Me time” can also serve as a great motivator. If you know your day is going to end with you sitting in your room meditating, or that it’s going to begin with a novel and a cup of delicious coffee, you’ll begin to approach the rest of your day differently. Undesirable tasks will take on new meaning since completing them will mean you get to enjoy this wonderful time with yourself and the things you love to do. When you decide to add “me time” to your day, take it seriously. Tell those around you—your partner, children, friends, etc.—the specific time you’ve cut out of your schedule. Inform them to only disturb you in the event of an extreme emergency and consider switching off your phone and/or tablet so that you can’t be distracted by the outside world. In the beginning, it may even be helpful to put this time on your calendar so that you and those around you can understand this is not a fad or a whim but a real component of you maintaining a healthy lifestyle. Once you start doing this, you won’t be able to stop. You’ll be able to see the impacts almost right away. You’ll find new energy and motivation, and you’ll begin to feel better about yourself. If you’re looking to make bigger changes in life, this is a great way to find the drive and confidence to do so. Start taking some “me time” today and see how it can change your life for the better. About the author: Caroline is a freelance writer and entrepreneur. When she entered the working world, she quickly became a self-proclaimed workaholic. While this brought her some financial success, it nearly ruined several relationships and left her in a truly dark place. After seeking some help, she began realizing how important it was to take life a little less seriously and to reserve time for what she loved to do. This has helped her create a work-life balance that supports both her professional and personal goals. She writes frequently about her experiences to help other ambitious women (and men) prioritize their life in the right way so that success at work doesn’t come at the expense of health and well-being.
Busting Stress 6 July 2017 Bliss Team No comments Categories: Guest Post It’s a question I ask during every initial visit: “Tell me about your stress.” Oftentimes, people don’t even recognize their stress as stress. We are so conditioned to think being “go-go-go” all the time is ‘normal’ that we don’t even realize it’s not. More and more, I am convinced that stress is the epidemic of our time. Back to the Basics During hunter-gatherer days when we would see a wild animal our stress would peak, our adrenals would put out adrenaline and cortisol, our bodies would shunt blood from our inner organs to our limbs and muscles, and we would run away. This is fight-or-flight, also known as Sympathetic Mode. The sympathetic nervous system increases heart rate, increases blood flow to extremities, diverts sugar to the blood (increases blood sugar levels), increases blood clotting, increases inflammation. We would get back to the fire and safety, our stress would decrease, our adrenals would relax, our bodies would deliver blood back to our inner organs, and we would rest. This is rest-and-digest, also known as Parasympathetic Mode. The parasympathetic nervous system stimulates digestion (enzyme production, stomach acid production), peristalsis (the movement that moves food the intestines), regulates deep sleep (stage 4), and stimulates sex organs (libido and fertility). Cortisol is known as our stress hormone, and we should have a regular rise and fall in cortisol throughout the day, which is countered with melatonin. In the morning, cortisol peaks while melatonin hits it’s lowest. Then throughout the day cortisol slowly decreases and hits it’s lowest before bed, while melatonin starts to spike which signals sleep. This constant interplay between cortisol and melatonin creates our circadian rhythm. Our ideal cortisol graph would look something like this: After each stressor we are able to return to a relaxed, parasympathetic state, and the stress resolves. However, more and more this rhythm is disrupted with stress. Usually when I am told that, “I’m not stressed, I’m just a busy person. I like it though, I can’t just sit there,” I follow up with, “okay, tell me about your day.” The response usually looks something like this: “Well, I wake up at 6 am, I get the kids up, make them breakfast, pack their lunches, drop them off at school, head over to the office. We are really busy at work so I usually work through the day, sometimes I forget to have lunch or I’ll just have a quick snack at my desk. Then after work I pick up the kids, get them a snack, drop them off at hockey/music/dance/soccer/etc. Then I go to the gym for a bit, then I pick them up, we have a quick dinner, I clean the house, put the kids to bed and I sit down to watch something but often times I fall asleep right away. Then I’ll wake up and go to bed.” (Imagine this said as quickly as possible with few breaths…) That go-go-go is stress. Aging, food, alcohol, coffee, other stimulants, working long hours, and lack of bonding is all stress as well. That is being in sympathetic mode all…day…long. With a graph that tends to look more like this: This means we are rarely getting into parasympathetic mode, and that will take a toll on our body. Stress and the Body It probably comes as no surprise that chronic stress will take a negative effect on the body, but some of the stats and facts might actually surprise you. 79-90% of all visits to primary health care practitioners in North America are due to stress-related illnesses. (Perkins 1994, Saving Money by Reducing Stress. Harvard Business Review 72(6):12) 68% of women say they are chronically stressed, yet only 25% say they are doing anything about it. (Statistics Canada) 11% of Americans age 12 or older report taking antidepressants. (CDC data) Both effects (acute and chronic stress) increase HPA stimulation and result in greater hippocampal and amygdala atrophy, biphasic alterations in structure increasing swings from depression to anxiety in women as compared to men. (Without clinical diagnosis of bipolar). (Bruce McEwen, Glucocorticoids, depression and mood disorders: Structural remodelling in the brain. Metabolism, May 2005, Vol 54, Issue 5, page 20-23). The last fact regarding anxiety and depression may be the most ‘shocking’, but under chronic stress our bodies and adrenal glands get taxed and coping decreases, which includes regulating mood. So, what should you do? It would be awesome if we could all just quit the stress in our lives, move to Mexico, and lay on a beach. But unfortunately that’s not reality, so it’s about finding ways to cope and manage stress. As a Naturopathic Doctor, I will often use nutrition, herbs and nutrients to help support your body and correct depletions. Chronic stress takes a serious toll on the adrenal glands and those don’t bounce back quickly as they won’t ever get a real ‘break’. However, without the tools to mange stress, even supplements are a bandaid and not a solution. My main recommendation for combatting stress is working on getting your cortisol down and into parasympathetic mode. Thankfully, there are a bunch of different ways to do this. Here are my top 5 easy to incorporate ways to manage stress: Yoga: In yoga, physical postures and breathing exercises improve muscle strength, flexibility, blood circulation and oxygen uptake as well as hormone function. In addition, the relaxation induced by meditation helps to stabilize the autonomic nervous system with a tendency towards parasympathetic dominance. (Europe PMC) In one study, researchers evaluated the effects of yoga in females subjects who participated in a 3-month yoga program compared to those on a waitlist and found that those who participated in the yoga program demonstrated pronounced and significant improvements in perceived stress, anxiety, well-being, vigor, fatigue and depression. Physical well-being increased, headaches and back pain decreased and even salivary cortisol decreased significantly after participation in a yoga class (compared to before the class). (com) Guided Meditation/Breathing: This is an easy one to incorporate throughout the day. I will often recommend a quick 2 minute breathing exercise before each meal to help move towards parasympathetic mode and improve digestion. I also love guided imagery. A subscription to Apple Music or Spotify will provide you with a HUGE selection of various guided imageries that can be downloaded and listened to. This type of mindfulness has been shown to improve mood, decrease stress, boost the immune system, and even improve fertility. Studies are also showing there is huge benefits in children as well. My own daughter has a full playlist on Apple Music of children’s guided imagery that we will use after school, before bed, or any time we need a bit of calm. Adult Colouring: I know it’s all the rage right now, but for good reason. In a recent study, participants had their salivary cortisol measured before and after 45 minutes of adult colouring/art making. The results showed a statistically significant decrease in salivary cortisol levels and participants reported feeling much more relaxed with lower stress. It makes you wonder why we adults ever stopped colouring in the first place! Sleep Hygiene: We can’t look at stress and cortisol without also looking at sleep and melatonin. If cortisol becomes unbalanced/spiking improperly then the interplay between melatonin and cortisol will also become unbalanced, and sleep often gets affected. A good sleep routine helps to keep those circadian rhythms in check and allows your body to know when it should be producing more cortisol and when it should be producing more melatonin. Make sure you are following these basic sleep hygiene practices: Keep a regular sleep and wake time (as much as possible) to keep your circadian rhythm regular. Keep your room completely dark – remove clocks, use black out blinds etc. This helps signal your body that it’s time for sleep and to produce melatonin. Avoid electronics before bed – this plays into the dark point above but even more, electronic screens (tvs, phones, e-readers, etc.) emit blue light, which further disrupts melatonin production. So make sure you are avoiding it before bed. You can also download blue light blocking apps, or on iPhones you can set your screen to “night mode” which removes the blue light. Assemble your team: You’ve heard it before. “It takes a village.” And this rings true for your stress and mental health as well. The majority of our stress these days is kind of unavoidable – we have to get to work (traffic), we have to take care of kids, we have to have jobs, etc. Completely removing stress is unrealistic, but it is important to find people who can help you to manage your stress. Find a counsellor or therapist that you click with. I know there is still some lingering stigma around seeing a therapist when there really shouldn’t be. These are skilled practitioners who are well trained to provide you with an outlet to work through stress, as well as an array of coping mechanisms and tools to help manage or reframe stresses. Get a massage. Multiple studies show the benefits of massage. It has actually been shown that massage can decrease cortisol levels and actually increase dopamine and seratonin levels! Participate in mindfulness. Whether through a yoga class/instructor or finding a mindfulness or meditation coach, working on retraining your body to get into parasympathic mode is a huge step in reducing stress and cortisol. There are even group meditation classes in Uptown Waterloo! Talk to your Naturopathic Doctor. Optimizing diet, nutrients and lifestyle goes a long way in dealing with stress and coping. Herbs and supplements can also help support those adrenal glands and give them the nourishment they need after chronic stress. However, it’s not just finding tools, it’s also allowing yourself to make self care a priority. How many people feel ‘guilty’ sitting down in the afternoon or evening, thinking about all the ‘other’ things they should be doing (dishes, laundry, errands, emails, tasks, etc.)? Many times, these moments of just relaxing are thought of as ‘wasted’ time. Working on shifting that mindset to view those times as important moments of self care will be an important way to allow yourself to truly get into parasympathic mode. Remember, self care is never wasted time. If you are feeling stress or overwhelmed, it is never too late to reach out and start making changes. In Health, Dr. Jessica, Naturopathic Doctor at The Coach House Therapeutic Centre This post originally appeared on The Coach House Blog Disclaimer: The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. This information shouldn’t take the place of seeing a Naturopathic Doctor or your primary care provider for individualized health recommendations. Dr. Jessica Gurske completed her Bachelors of Science at the University of Waterloo. After her third year of studies, she traveled to Central America with International Service Learning Organization where she spent three weeks providing healthcare to under-serviced areas throughout Costa Rica and Nicaragua. It was a life-changing and educational experience. Jessica went on to complete a four year Doctor of Naturopathic Medicine program at the Canadian College of Naturopathic Medicine in Toronto, Ontario. She has successfully completed two national board exams through NABNE (North American Board of Naturopathic Examinations) and provincial licensing through the Board of Directors of Drugless Therapies-Naturopathy (BDDT-N). Jessica also has additional training in facial rejuvenation acupuncture. Jessica is also a mother which has sparked her interest in pregnancy and newborn care, women’s health and paediatrics.