Things have been very scary and anxiety provoking for many people recently. Many people aren't sure what to say or do given all the challenges facing our society. Whether it is dealing with the impact of the COVID 19 pandemic or the current protests advocating for an end to police violence and equality for people of color - it can cause suffering in us no matter what your opinion is. Many of my clients report feeling exhausted and not just from a lack of sleep but from emotional fatigue. The issues facing our world often present us with anger, grief, anxiety, feeling unsafe, and many other emotional reactions. We are also having to make many decisions about how to keep ourselves and loved ones safe. Do I go grocery shopping? Should I drive through that neighborhood? Should I send my children to school? And these decisions are far more taxing than the used to be.
Many clients have asked me, what can I do to feel better? How can I ease my own suffering at this time without being dismissive of the important issues at hand? One of my most common answers is "Compassion." Compassion for the world at large but also compassion for ourselves. Many look at me when I say this with confusion asking first what compassion is and then how could they have self--compassion.
Compassion is a turning towards. It is feeling for someone's suffering. It is a desire within us to ease someone's suffering. It is understanding and kindness even when people have made mistakes. Imagine that you've just seen a homeless person sitting on the side of the road at an intersection in tattered clothes in the summer heat. Compassion is the feeling many people get in wanting to ease that person's suffering and trying to understand how difficult things may be for them. Compassion doesn't mean that we don't acknowledge that a person may have made poor choices or mistakes in teh past that lead to their current suffering. It just means we still have understanding and kindness for them despite this.
Just as you can have compassion for others it is important to be compassionate with yourself. Again, it doesn't mean you have to say you are perfect or free from mistakes. It just means practicing kindness and understanding with yourself. It means acknowledging your basic worth as a human being and that you to deserve to be free from suffering.
Dr. Kristin Neff is a compassion researcher and offers several exercises on her website https://self-compassion.org/category/exercises/ that you can try to strengthen your self compassion. A really simple one that she has listed there is thinking about how you would respond to a close friend who is experiencing the same suffering you are and using that to consider how you are treating yourself. It is definitely something to think about. As you move through your days right now, try to keep compassion in your mind and heart not only for others, but for yourself.
Wednesday, June 10, 2020
Tuesday, May 5, 2020
Strategies to Manage Anxiety During Covid-19
There are many ways in which the COVID-19 pandemic is increasing anxieties for us all. Whether it is because your finances or job are in jeopardy or you are concerned about your health or that of a loved one. We are all faced with different challenges during this difficult time. Some are dealing with full-time parenting and/or homeschooling, some are dealing with working from home, others are dealing with being laid off, and still others are dealing with working on the front lines as grocery clerks or healthcare workers. Many people are facing relationship challenges, financial challenges, and mental health challenges they weren't prepared for. Each and everyone is trying to do their best with all of these challenges but many are struggling. My post-doctoral intern said today "we aren't all in the same boat, but we are in the same storm." And it is true.With that in mind I wanted to share some strategies I have been sharing with clients to help them weather this storm no matter what boat they are in. Here are my top 10:
1. Take care of the basics (food, rest, hydration, exercise) as best you can. Our systems are like a Jenga tower. It is much harder to stay together when the bottom blocks that we base our foundation of wellness on are missing. This may mean resisting the urge to order pizza and sticking with a more balanced dinner. This may mean going for a walk around the block, playing extra with your kids, or using household items to have a workout. Whatever meeting those needs looks like for you right now is okay.
2. Stay connected. Even though we cannot see each other in person it is important to nurture our need for human relationships. Whether that means talking to friends and family on the phone with talk or video calls, using social media to stay connected, using chat rooms or support groups online, or even writing an old fashioned hand written letter to your grandchildren try to do it.
3. Focus on the positive. As much as you can focus on what is going right and not what is going wrong. Our brains tend to form habits and if we constantly think about the negative or what we are doing wrong then that is where our mind will go. If you start to train your mind towards the positive it will go there. A great way to do this is to get a notebook and write down at least 3 positive things about everyday. It can be something as silly as "I am grateful for chocolate ice cream" or as meaningful as "I am thankful to have such a wonderful daughter." Or if you have a family at home you can make it a nightly practice as you go around the table for each family member to say 3 things that they are thankful for the day.
4. Learn something new or finish an existing project. Many of us have more free time, either because we aren't commuting or because we are laid off. If that is the case use the time to learn something new or pick something old up. My mentor recently shared with me that she picked up a needle point she hadn't worked on in 20 years. Since this all started I have learned to embroider, started a sour dough bread starter, and am working on converting all my cds to MP3. Learning something new or finishing a project can give you a sense of mastery and control when things feel a little out of control.
5. Practice self-compassion. We can be our own worst critic. Something the things we tell ourselves can be pretty hurtful. Notice how you are talking to yourself in your head (or out loud). Are you saying mean or hurtful things? Are you giving yourself enough credit for trying or doing the things you do? If you aren't being kind to yourself consider working on practicing self-kindness. Think of it much like a parent loves their child. A parent loves their child unconditionally regardless of what they do. They may not like their behavior but they love them. It is healthy to view yourself the same way.
6. Don't "should" on yourself A lot of clients I work with are in the habit of saying things like "Well I should be less lazy" or "I should do better." I often tell them to stop "should-ing" on themselves. When you say should you are implying that you aren't good enough or you are doing something wrong. This can create feelings of guilt or shame and a sense of being being good enough. Try to catch yourself saying "should" and rephrase. Instead of "I should do better" maybe try "I am doing the best I can but next time I will try to do even better." Try saying both of those out loud and notice how you feel.
7. Build your coping kit Use this time to gather all the things that are helpful or might be helpful when you are experiencing times of great anxiety. I often suggest that clients get a Rubermaid plastic bin or file box and put items in it that can be helpful in stressful times. Items might include: adult coloring books, bubbles, play dough, music, books, lists of breathing exercises, a call list of people you can call, and you can even look on the web for more suggestions for your coping box. Who knows, maybe a future PsyOwa blog post could add some more suggestions.
8. Remember that you might not be in the same boat as others A lot of the anger and discontentment that I am seeing out there right now seems to arise when people don't consider that others might be in a different situation then them. We all are dealing with different parts of this situation. One person may want to return to life before social distancing because their business is hurting from the restrictions yet another may want to stay in lock-down because they are worried about getting the virus due to a history of cancer. You don't necessarily need to agree with each-other to understand how stressful things are and to practice compassion for yourself and one another.
9. Take media and social media breaks Let's face it. Scary stories sell news. A lot of the time the media is filled with sensationalized stories or headlines the focus only on the negative. I often encourage clients to take a break from the nightly news or consider just using an online news source where they can scroll through headlines and decide what to digest. For some, they need to swear off it all together. Either way monitor how the news is impacting your mental health and adjust your consumption accordingly.
10. Do something nice for others One of the ways that Viktor Frankl, a famous psychiatrist who survived the Holocaust suggested that we could create meaning in our lives even during suffering was to do something altruistic or something in service of others. Whether that is sewing masks for those who don't have them or donating to a local food bank it can help you to feel better and it also helps others. Everyday it has been nice enough we have went for a walk at my house after work and we take a backpack of canned goods to place in the tiny food pantries in our neighborhood. When we walk buy and see that the food is gone, we feel good knowing that someone is getting the food they need and the world seems a little less dark.
1. Take care of the basics (food, rest, hydration, exercise) as best you can. Our systems are like a Jenga tower. It is much harder to stay together when the bottom blocks that we base our foundation of wellness on are missing. This may mean resisting the urge to order pizza and sticking with a more balanced dinner. This may mean going for a walk around the block, playing extra with your kids, or using household items to have a workout. Whatever meeting those needs looks like for you right now is okay.
2. Stay connected. Even though we cannot see each other in person it is important to nurture our need for human relationships. Whether that means talking to friends and family on the phone with talk or video calls, using social media to stay connected, using chat rooms or support groups online, or even writing an old fashioned hand written letter to your grandchildren try to do it.
3. Focus on the positive. As much as you can focus on what is going right and not what is going wrong. Our brains tend to form habits and if we constantly think about the negative or what we are doing wrong then that is where our mind will go. If you start to train your mind towards the positive it will go there. A great way to do this is to get a notebook and write down at least 3 positive things about everyday. It can be something as silly as "I am grateful for chocolate ice cream" or as meaningful as "I am thankful to have such a wonderful daughter." Or if you have a family at home you can make it a nightly practice as you go around the table for each family member to say 3 things that they are thankful for the day.
4. Learn something new or finish an existing project. Many of us have more free time, either because we aren't commuting or because we are laid off. If that is the case use the time to learn something new or pick something old up. My mentor recently shared with me that she picked up a needle point she hadn't worked on in 20 years. Since this all started I have learned to embroider, started a sour dough bread starter, and am working on converting all my cds to MP3. Learning something new or finishing a project can give you a sense of mastery and control when things feel a little out of control.
5. Practice self-compassion. We can be our own worst critic. Something the things we tell ourselves can be pretty hurtful. Notice how you are talking to yourself in your head (or out loud). Are you saying mean or hurtful things? Are you giving yourself enough credit for trying or doing the things you do? If you aren't being kind to yourself consider working on practicing self-kindness. Think of it much like a parent loves their child. A parent loves their child unconditionally regardless of what they do. They may not like their behavior but they love them. It is healthy to view yourself the same way.
6. Don't "should" on yourself A lot of clients I work with are in the habit of saying things like "Well I should be less lazy" or "I should do better." I often tell them to stop "should-ing" on themselves. When you say should you are implying that you aren't good enough or you are doing something wrong. This can create feelings of guilt or shame and a sense of being being good enough. Try to catch yourself saying "should" and rephrase. Instead of "I should do better" maybe try "I am doing the best I can but next time I will try to do even better." Try saying both of those out loud and notice how you feel.
7. Build your coping kit Use this time to gather all the things that are helpful or might be helpful when you are experiencing times of great anxiety. I often suggest that clients get a Rubermaid plastic bin or file box and put items in it that can be helpful in stressful times. Items might include: adult coloring books, bubbles, play dough, music, books, lists of breathing exercises, a call list of people you can call, and you can even look on the web for more suggestions for your coping box. Who knows, maybe a future PsyOwa blog post could add some more suggestions.
8. Remember that you might not be in the same boat as others A lot of the anger and discontentment that I am seeing out there right now seems to arise when people don't consider that others might be in a different situation then them. We all are dealing with different parts of this situation. One person may want to return to life before social distancing because their business is hurting from the restrictions yet another may want to stay in lock-down because they are worried about getting the virus due to a history of cancer. You don't necessarily need to agree with each-other to understand how stressful things are and to practice compassion for yourself and one another.
9. Take media and social media breaks Let's face it. Scary stories sell news. A lot of the time the media is filled with sensationalized stories or headlines the focus only on the negative. I often encourage clients to take a break from the nightly news or consider just using an online news source where they can scroll through headlines and decide what to digest. For some, they need to swear off it all together. Either way monitor how the news is impacting your mental health and adjust your consumption accordingly.
10. Do something nice for others One of the ways that Viktor Frankl, a famous psychiatrist who survived the Holocaust suggested that we could create meaning in our lives even during suffering was to do something altruistic or something in service of others. Whether that is sewing masks for those who don't have them or donating to a local food bank it can help you to feel better and it also helps others. Everyday it has been nice enough we have went for a walk at my house after work and we take a backpack of canned goods to place in the tiny food pantries in our neighborhood. When we walk buy and see that the food is gone, we feel good knowing that someone is getting the food they need and the world seems a little less dark.
Tuesday, February 18, 2020
Hello Again World and Psychological Testing
The PSYowa blog has been on a bit of a hiatus as we have been working to determine what types of posts may be useful for readers and in what way we can use this blog to better provide public education about psychology. A recent question from a client inspired this post and hopefully it will help others who might have the same questions.
Recently, a client asked for more information about psychological testing because her son's primary care doctor suggested that he have psychological testing to determine if he had ADHD or if his problems in school were caused by something else. She wanted to know why he needed testing and where she could go to get it done. She was curious as to why her primary care doctor couldn't just do it at his office.
Psychological testing involves the use of assessments that are very well researched and validated. Before they are used on the general population, the tests that psychologists use are tested on many other people and are compared to other tests that are already used to make sure they are accurately measuring what they are designed to measure. Licensed Psychologists receive special training about how to give and interpret these tests. Many psychologists have years of training in constructing, administering, and interpreting tests even by the time they are licensed. This is one of the reasons why primary care doctors don't do the psychological testing. They haven't received the specialized training to administer and interpret these tests. They count on psychologists to provide them with an accurate diagnosis so that they can provide the best treatment.
Sometimes people ask me why we can't just ask questions or use a questionnaire to determine if someone has ADHD or other problems. Testing gives us a more accurate picture of a client's diagnosis. For example, someone might check enough symptoms on a checklist that makes it look like they have ADHD (distracted, can't sit still, looses things) but after a comprehensive assessment we find that the attention problems are caused by a specific learning disorder or severe depression. Giving that person ADHD medication would not solve their problem and in some cases may make it worse.
Psychologists often will utilize multiple tests in something called a battery to make sure all the tests consistently support the same diagnosis. For example, one test that is utilized to measure inattention (a symptom of ADHD) is the Continuous Performance Test (CPT). Sometimes individuals who are very depressed may be struggling with inattention related to their depression and score very poorly on the CPT, much like someone struggling with ADHD. Because of this typically we will assess for symptoms of ADHD, depression, and anxiety at the time of testing to rule out any other causes. We also will do additional tests of attention to ensure that the person is consistently having difficulties across tasks and it wasn't just an anomaly that they did poorly on one test.
If you are referred for psychological testing it is important to know what to look for to make sure that you are receiving the best care possible. Psychological testing should only be done by someone who has specialized training and experience in administering and interpreting assessments. In general, you can be sure that licensed psychologists have appropriate training because in order to receive their license they had to have attended a program that provided specific training for testing. Many other mental health professionals do not take specific coursework on psychological testing as a part of their training. They also often do not receive training or supervision on testing that gives them the experience to give and interpret tests reliably. Unless the provider is a licensed psychologist there is no guarantee that that they have received this training or have the appropriate experience. It is okay to ask your provider what their qualifications are, what experience or training they have, and what types of testing they are using.
Psychological testing can be an important part of the process of receiving the correct diagnosis and receiving the correct treatment. Making sure that you are educated about the process can help you to be able to ask the right questions and receive the best services.
Recently, a client asked for more information about psychological testing because her son's primary care doctor suggested that he have psychological testing to determine if he had ADHD or if his problems in school were caused by something else. She wanted to know why he needed testing and where she could go to get it done. She was curious as to why her primary care doctor couldn't just do it at his office.
Psychological testing involves the use of assessments that are very well researched and validated. Before they are used on the general population, the tests that psychologists use are tested on many other people and are compared to other tests that are already used to make sure they are accurately measuring what they are designed to measure. Licensed Psychologists receive special training about how to give and interpret these tests. Many psychologists have years of training in constructing, administering, and interpreting tests even by the time they are licensed. This is one of the reasons why primary care doctors don't do the psychological testing. They haven't received the specialized training to administer and interpret these tests. They count on psychologists to provide them with an accurate diagnosis so that they can provide the best treatment.
Sometimes people ask me why we can't just ask questions or use a questionnaire to determine if someone has ADHD or other problems. Testing gives us a more accurate picture of a client's diagnosis. For example, someone might check enough symptoms on a checklist that makes it look like they have ADHD (distracted, can't sit still, looses things) but after a comprehensive assessment we find that the attention problems are caused by a specific learning disorder or severe depression. Giving that person ADHD medication would not solve their problem and in some cases may make it worse.
Psychologists often will utilize multiple tests in something called a battery to make sure all the tests consistently support the same diagnosis. For example, one test that is utilized to measure inattention (a symptom of ADHD) is the Continuous Performance Test (CPT). Sometimes individuals who are very depressed may be struggling with inattention related to their depression and score very poorly on the CPT, much like someone struggling with ADHD. Because of this typically we will assess for symptoms of ADHD, depression, and anxiety at the time of testing to rule out any other causes. We also will do additional tests of attention to ensure that the person is consistently having difficulties across tasks and it wasn't just an anomaly that they did poorly on one test.
If you are referred for psychological testing it is important to know what to look for to make sure that you are receiving the best care possible. Psychological testing should only be done by someone who has specialized training and experience in administering and interpreting assessments. In general, you can be sure that licensed psychologists have appropriate training because in order to receive their license they had to have attended a program that provided specific training for testing. Many other mental health professionals do not take specific coursework on psychological testing as a part of their training. They also often do not receive training or supervision on testing that gives them the experience to give and interpret tests reliably. Unless the provider is a licensed psychologist there is no guarantee that that they have received this training or have the appropriate experience. It is okay to ask your provider what their qualifications are, what experience or training they have, and what types of testing they are using.
Psychological testing can be an important part of the process of receiving the correct diagnosis and receiving the correct treatment. Making sure that you are educated about the process can help you to be able to ask the right questions and receive the best services.
Subscribe to:
Posts (Atom)