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When someone already struggles with anxiety, a worldwide viral outbreak tends to amp anxiety up into high gear. Whether you are fretting over the Coronavirus or think society is overreacting, the reality is that we may very well be subject to local and national government restrictions in order to prevent the disease from spreading, especially to our most vulnerable populations.

Life is already changing. Schools are switching to online platforms and large crowd gatherings have been prohibited. We have been asked to socially distance ourselves. Grocery stores are contending with empty shelves and worried shoppers trying to provide for their families for at least 2 weeks. Who knows what will happen next week?

Who knows? What if? That’s the birth of anxiety.

For those suffering from specific phobias (germs or crowds) or OCD with its well-known germ obsessions and hand washing compulsions, a new virus intensifies a pre-existing anxiety.

Anxiety’s biggest purpose is to protect us. That is not always bad thing. It can motivate us into action. If we are anxious about losing a relationship, it might motivate us to make some type of change in order to preserve it.

Our minds our constantly scanning for danger to keep us safe. Sometimes it sends us alert signals even in the absence of a threat (as in an example of panic attacks). Communities are naturally and rightfully concerned about the spread of the Coronavirus. That concern propels us to be vigilant about hand washing and social distancing.

I was working with an anxious client who asked, “How do I know if I’m clean enough?” As we examined the question we determined that perhaps a more effective question to answer that worry is, “Have I done all I can to take protective measures today?”

Quite frankly, can we ever be clean enough? No. It is more of a fear based question. Whereas the later question puts us in a more objective viewpoint. It makes us run through a mental checklist. Then we can be at peace that we have done all that is within our power.

A useful technique from Cognitive Behavioral Therapy is called reframing, which is basically challenging a negative belief or thought or worry by asking a series of questions. One of the most important questions is:

Is it really true?

An example of a catastrophic thought might be, “If we go into quarantine our entire infrastructure will collapse!” Is that really true? How do I know that it is true?

A reframe of that worry could be, “While it’s true that I don’t know all the specifics of how a quarantine will be implemented, many cities throughout the world have gone through this before and my community is preparing to face a challenge like this.”

Doesn’t that shift the energy away from anxiety and more toward reality? It is much more empowering. And feeling empowered in a situation where we have little control can be just what we need.

Be aware, Be alert, but don’t be alarmed!

I’m sure you have heard of the benefits of keeping a daily gratitude journal. But just in case you are unfamiliar with this practice here are some benefits:

• Keeps our focus on the good that already surrounds us.
• Naturally decreases complaining and grumbling.
• Turns our seeming lack into abundance.
• Increases positivity that infuses everyday life.
• Improves sleep

Let me illustrate an example of how this infiltrates into everyday life. When I see that the dishwasher is full of clean dishes to unload or there is laundry to fold, I sometimes notice a grumbling sigh inside of me.  But because of my practice of gratitude I am quickly able to turn my grumbling into gratefulness. Grateful that I have a machine to clean my dishes and clothes for me! I think about women generations ago who scrubbed their clothes against the rocks in the river.  How grateful they would have been for these machines and here I am put out over the five minutes it will take me to unload the dishwasher or put my laundry away.

Sometimes writing in a journal can become stale if you repeat the same vague platitudes. “I’m grateful for my health. I’m grateful I have a house to live in. I’m grateful my children are healthy.”  Of course there are many people who would love to be able to write any of these things down in a gratitude journal. People who do struggle with health or homelessness or whose children have dire health issues. These kinds of rote entries happen when we think about our life as a whole. When we’re doing a gratitude journal, were only contemplating the day that just ended.

One technique I use to make journal writing entries more meaningful is something I call “Two easy and a hard”. By this I mean, that as you ponder over your day (not just your entire life) write down two things that are fairly easy to recall that was a blessing in your day. It can be something as big as a promotion or raise, to something more practical like getting a great parking spot in the rain, or when your child tells you that they love you out of the blue.

So what is the hard one? As you reflect upon you day, think about something difficult that happened in your day, perhaps a struggle or a conflict you experienced. Then ask yourself what was the good that came out of that experience? Did that conflict deepen your relationship with that person? That is something to be grateful for. Did losing your job open up an opportunity to start your own business, even though it’s terrifying? That is definitely journal worthy.  Did you realize that by burning the candles at both ends that you were neglecting taking care of yourself? Awareness can be very powerful. It can propel us into action if that is what is needed. Be grateful for the lesson that came from something painful or frustrating during your day.

And that’s it. Start with 3 entries per day. If you have more, fantastic. Start with 2 easy and 1 hard.  You can do it in the morning but my preference is in the evening while my day if still fresh. I always tell my kids, “If you look for the good, you will find it”

It takes just a few minutes. See what you notice within a week to a month. Happy journaling!

  Are you a little leery to seek out counseling for problems in your life? Perhaps you are reluctant to acknowledge that even believers are not immune to anxiety and depression. Christians tend to have a faulty assumption that they shouldn’t have any mental health symptoms because they hear messages that they should be constantly filled with joy. 

I have even heard that if believers are depressed or anxious that they don’t truly love the Lord. On top of it, they are now burdened with guilt.

Worse yet, perhaps your condemnation is self-inflicted. Maybe you have diligently given your fears and anxieties over to the Lord everyday, memorized Bible verses, and still suffer. 

You feel ashamed and question if you are a “good enough” Christian. 

Or maybe you wonder if God really cares.

Well I have comforting news for you! The Bible mentions fear or anxiety 365 times.That’s one verse for every day of the year! If God didn’t know that his creation would be anxious or fearful then why would he provides so many verses to instruct us to “Fear not.”

In his book, The Purpose Driven Life, Rick Warren talks about how God uses people in addition to prayer and bible study to bring about spiritual growth. In fact, he argues that Bible study and prayer in and of themselves will not be enough to impact some of life issues. 

“He usually prefers to work through people rather than perform miracles, so that we will depend on each other for fellowship. He wants us to grow together.” Rick Warren

A frequent saying heard at my church is, “You can’t do life alone.”  God made us to be interdependent on one another. 

From a mental health perspective that means that God will and can use Christian professional and lay counselors and psychiatrists to bring you back to wholeness. And it’s OK. It doesn’t make you weak, unfaithful, or any less of a follower of Christ. 

We weren’t meant to carry our burdens alone.

Some churches and Christians have a distrust of the counseling profession.  I suspect it is the erroneous belief that psychology is about self-love, self-fulfillment, self-serving.  While that may be how some therapists practice it is not particularly rooted in any one psychological theory.  After all the Bible commands us 8 times to love our neighbor as ourselves. 

That means not only do we need to receive that love so that we may give that love to others, but also love ourselves.  

We need to love what the Father loves.  

When we can be compassionate with ourselves we can be compassionate to others.

Our brain is an organ. Like any other organ in our body sometimes it doesn’t work to its optimum capability. There are times when it will be necessary to treat the organ with medication. We seem to accept this concept more readily in reference to the rest of our body from the ears down.   

Consider a person diagnosed with type 1 diabetes. Their pancreas has ceased to produce insulin. As a result, they must take insulin to compensate for the lack of pancreatic function. However, in addition to insulin they must also make dietary changes. They cannot just take insulin and have a high sugar diet. This is the same dynamic for how counseling and medication work best together. 

Similarly, with anxiety and depression symptoms can get so severe they may require medication  to help balance and restore neurotransmitters, which in turn help to stabilize mood and improve quality of life. Now is medication in isolation the best protocol? Probably not, at least not initially. 

Counseling from a Christian perspective will integrate biblical truths to address the psychological issues that cause debilitating mental health symptoms. 

Medication can help produce the essential mood stabilizing neurotransmitters we need until our brain can do it on its own again.There is a percentage of mental illness that is genetic and organic in nature; meaning there or structural defects or physiological dysfunction of the brain”  (American Family Physician, 1992) 

The contention lies when we confuse spiritual issues with psychological issues.  

They are not one in the same, nor is there always a cause and effect relationship between the two. Sometimes there can be.  When we address our spiritual conflicts often times the subsequent psychological symptoms are alleviated.

In addition to offering support and a non judgmental space, counseling can help you make changes with ingrained patterns of thinking that affect our feelings and therefore our behavior. More to come on this in the blog section.  The apostle Paul has much to say about this!

Let’s not forget that our brains are attached to the rest of our bodies! While most people do not want to live this out, we must take care of our whole bodies in order to prepare the foundation for healing of our minds. Yes, that means eating well (not perfect), moving our bodies often, and getting optimum rest! As a natural night owl, I am speaking to myself here.

When we begin to integrate the mind and the brain into a holistic treatment approach- meaning mind, body, and spirit, then we can reach our fullest potential that God intended so that we can be his servant. Use your mess to be his message!

Love the Lord thy God with all thy heart, and with all thy soul, and with all thy strength, and with all thy mind; and thy neighbor as thyself. Luke 10:27.

References

American Family Physician. 1992 Mar;45(3):1173-80

Warren, Richard. (2002) The Purpose Driven Life. Zondervan, Grand Rapids, Michigan.

I don’t think most of us like the idea of having to take medication to manage our medical or emotional ailments. From my experience, we even like the idea less when it comes to treating our children with medication to treat long term conditions, especially when it comes to mental health or behavioral issues like anxiety,  autism, ADHD, depression, and even psychosis.

I recently read an article on this very topic that related an analogy that helps to put this issue of medicating our children into perspective. Suppose you took your child for their annual well-visit to their pediatrician and they failed the eye exam. What’s the next step? Typically, you would be  referred to a pediatric ophthalmologist who then runs their own comprehensive eye exams. The diagnosis is that your child is nearsighted or farsighted and the recommendation is that your child be fitted for a pair of simple eyeglasses.

Would you labor over that recommendation? Would you read up on it? Would you Google it? Would you ask your friends and relatives their opinion about giving your child eye glasses so that they can see better? Unlikely. Perhaps you wouldn’t question it at all. Maybe you just insist that your child squint to correct the problem? Now that’s just absurd!

Isn’t that what we do when it comes to treating our children for mental health illnesses? We don’t like the idea that our precious children could even struggle with anxiety, depression, or ADHD or learning disabilities.But our brain, like any other organ, doesn’t always function optimally. Mental health isn’t a linear, cause-and-effect issue.  So many factors play a part, like genetics, upbringing, socioeconomic status, cultural norms, etc.

The stigma against mental health among adults is strong, but it is even more so for children.  I have seen many parents profess that they will never medicate their child for this or that and I watch them continue to struggle along.  To what end? For what gain?

Being a Mental Health Counselor means that I only use talk therapy. That’s it. No bag of tricks to pull from.  No medical equipment or prescriptions to utilize. I am privileged to witness the power of the therapeutic process at work in transforming people’s lives.  I also have to know when counseling and medication will work best when paired together. For some diagnoses medication is the first line of treatment as in neurological disorders like ADHD, autism, Tourette’s Disorder or psychological disorders like severe Obsessive Compulsive Disorder (OCD) or psychosis.

I encourage you to drop the stigma.  Drop worrying about what others think.  Drop your own biases against taking medication. Explore your own biases against medication and see if there are any falsehoods. Sometimes we can be our own stumbling block that gets in the way of progress.

I was having a conversation with a friend who is successfully recovering from a debilitating episode of depression several months ago. She was floating in a sea of hopelessness. She never imagined she could feel as good as she does today.  She was listing all the strategies she continues to implement in order to maintain her progress. Things like, daily exercise, sun exposure, a depression program that includes books and audios, medication compliance, ongoing counseling and psychiatry appointments.  She candidly told me with a chuckle, “Being depressed is a lot of work!”  This was not only funny but always so true.

Unfortunately, so many people want to find relief from their symptoms without doing the work that it entails. Sometimes that involves tangible tools like programs, or journaling, or homework.  Sometimes, it involves being utterly raw and vulnerable with yourself and your therapist.  That is hard! But if you want different results you have to step out of your comfort zone and do something different.

Motivation to change will happen when the pain and fear of remaining the same outweighs the fear and pain of changing.

I suppose it is human nature, especially in this day and age, to expect instant results.  We want to put in the least amount of effort and get the most results. When has that ever worked? And yet we cling to that mentality when it comes to our physical health as well as our mental health.  We want to loose weight and get fit but we struggle to eat right and exercise long term.

Sometimes we can continue to place responsibility outside of ourselves and onto the therapist to say something magical that is finally going to fix everything once and for all, ignoring all the homework that has been assigned or putting in a half-hearted effort inside and outside of session. That approach doesn’t work in dieting and it doesn’t work in therapy.

My friend is investing in herself. Sometimes she has to challenge the thoughts that she is being selfish spending so much taking care of herself. But the truth is without her self-care she wouldn’t be able to take care of and enjoy her family, home, and business.  She sees the value in doing the work because she is motivated to stay better.  She knows how crippling depression can be and doesn’t ever want to go back to that dark place.  She is simply compliant. She does the work. She reaps the benefits.

What about you? Are you ready to reap the long-lasting benefits of counseling?  Let’s get started!

What if you could virtually eliminate any distressing feeling you have in the span of 60-90 seconds?  Sounds too good to be true, doesn’t it? But consider what you do now when you are anxious, upset, or stressed? We all tend to avoid our negative feelings through distraction or denial.  It is our human nature to seek pleasure and avoid pain. Freud got that much right! We want to do more of what feels good and avoid hurt and pain as much as we can.

While intellectually we might know that it is not always possible or good for us to avoid pain, instinctively it is our natural tendency.It is because of our tendency to avoid feeling upset that we suppress these feelings.  I mean, who wants to feel bad right? So we distract ourselves with our phones, food and drink, music, TV, or facebook, to push the feelings away.

Here is an example of how we do this and the outcome that it has. Imagine being in a pool with an inflatable ball. It is light and full of air while the water is heavy and dense. Have you ever tried to hold a beach ball under the water?  You can do it right?  But it takes a great deal of effort and strength.

Now what happens when you release the ball?  Does it float gently to the surface?  No, it erupts through the surface of the water. This is precisely what many of us do when we are triggered by a strong emotion. We try to suppress it for as long as we can exhausting ourselves, but it never really goes away does it? Then with the slightest trigger, we spew all over those around us, those that don’t deserve it.

Our children and loved ones are on the receiving end of our emotional outburst.  We all have been there, myself included. So how can we make ourselves feel better, not just temporarily, but experience real relief from the negative feeling?

Enter in The Pure Awareness Exercise.

Here’s a little therapy secret.  A felt feeling dissipates.  A suppressed feeling will always pop up, somewhere else again. I promise.  Because it is still there.  It didn’t go away. I propose to you to invite your feelings in. To do what is counter intuitive and sit with those feelings. Experience them to their fullest.  Is this going to feel good?  No. But are you interested in feeling better in the long run? Yeah, me too! The good news is the exercise only lasts a minute or so.

How does this work exactly?

• Get alone somewhere quiet for just a couple of minutes. Literally, like 2 minutes. That is all you need.  I know how hard that can be with little children around or noisy work cubicles. But just find a place you can be undisturbed. I have escaped to a locked bathroom on numerous occasions!
• Begin to conjure up the feeling in your body. You do not need to relive the upsetting experience or rehash it in your mind. That becomes a mental exercise (and not a very useful one at that). Just start to get in touch with the feeling. How your felt when the triggering event happened. Experience it on the fullest level you can imagine. (Spend about 30 seconds on that)
• Let it grow, expand, get bigger. This is where it will be at its worst. You are OK.  You are perfectly capable of handling this. (30 seconds)
• Then notice any experiences you may be feeling in your body. Is your chest tight? Is your stomach in knots?  Are your hands tingling? Put your attention there.  Notice the sensation in your body.  It is Ok if you don’t feel anything physically.  Your not doing it wrong. (30 seconds)
• Most importantly, just stay with it. Notice that your mind might want to distract you from it. Just bring yourself back to what you are feeling emotionally.

And that’s it. How do you feel after?  Did the feeling dramatically decrease or was it eliminated entirely?

This is not a cure for a major depression or anxiety disorder.  This exercise is for heavily charged emotional reactions that we experience as a result of a situation we deem as stressful, negative, or, upsetting. You can do it again and again…in only 90 seconds.

I can help walk you through this process. Call or Email today for a free consultation.

 609-576-2586

hilaryakman@onlinecounselingsolutions.com

You’ve heard of physicians using tele-health with patients and maybe you have even heard of online counseling. Most service professions seem to be crossing the internet boundary. How does it really work? Is it really possible to get the same top notch service as you would in a counseling office? The answer is a resounding yes.  Here is how to determine if it is right for you.

After moving from New Jersey to Florida I converted my traditional office based practice to an online-based practice. The reactions from my clients were resoundingly positive.  They enjoyed not commuting to appointments or sitting in crowded waiting rooms. They found that nothing was lost in the quality of therapeutic rapport.

So what are some other benefits to online therapy and is it right for you?

• Flexibility– Appointments can be scheduled at the convenience of busy professionals and parents. Most of the appointments I offer are in the evenings to accommodate busy schedules.
• Convenience– Sessions can be done within the comfort of your own home or office. No commuting to and from appointments. As long as you have 4 walls and a door your sessions can be conducted anywhere.
• Increased level of privacy- no awkward moments running into others you know in the waiting room.
• Increased level of comfort during the session because you are in a familiar setting versus a professional’s office. This often helps you to feel more relaxed which improves rapport and trust.

I would be remiss not to mention the disadvantages of online counseling, technology being among them.  Most notably, screens can freeze, internet connections can be sketchy, video resolution can be fuzzy.  These are all drawbacks for therapist and client alike.

Both traditional and online therapy are imperfect.  Both have their limitations. Online therapy is effective for many types of problems and people.  It is an ideal fit for those with social anxiety, agoraphobia, and panic disorder as well as mild to moderate depression where getting out of the house is often a huge obstacle to treatment.  It can also be a lifesaver for couples or single parents who can have a session after their children are in bed and can’t afford a babysitter on top of the expense of counseling.

However, online therapy is not a good fit for everyone, particularly those with Major Depression and suicidal thinking.  For those types of issues a face-to-face in person counseling session is better suited.

Online counseling has shown to “have a similar impact and capable of replicating” face-to-face counseling sessions (Richards and Vigano 2013).  It is becoming more and more prevalent as another effective avenue to provide services to those who cannot access more traditional types of care or who prefer not to.  See if counseling online could work for you.  I would be happy to speak with you to answer any questions you might have.  Call today for a free phone consultation!

Richards, Derek (09/01/2013). “Online Counseling: A Narrative and Critical Review of the Literature”. Journal of clinical psychology (0021-9762), 69 (9), p. 994.

So I promised that I would show you how to move through your feelings instead of being ruled by them. The pathway is through the title of this series. It is  in noticing when we are being driven by our unconscious.  For it is in that moment when you realize that you have been lost in ruminations of your thoughts and old behavior patterns that you have become conscious!

I’m going to delve right in and give you a practical exercise that you can walk yourself through whenever you find yourself experiencing an intense negative emotion. This is an exercise I use myself and often walk my clients through during sessions. Once the awareness is there, you have made a a huge leap in taking charge of the emotion. So many times, we find ourselves heading to the kitchen cabinets or reaching for the bottle or other substances when we are in the grip of strong feelings.

The beauty of this exercise is that is only takes about 60-90 seconds! So no excuses! I have done it with my kids around. You can do this in your office, with others around if you have to.  Ideally, you should be somewhere where you can be alone and without distractions.

1. Close you eyes and begin to take slow deliberate breaths. On the inhale, expand your belly like a balloon and on the exhale push all the air out.  Continue this deep, slow, belly breathing through the entire exercise.
2. Allow yourself to feel this feeling you are having.  Don’t think about the thoughts or situation that contributed to it.  Just focus on the feeling.  Allow yourself to feel it fully.  Ask  yourself on a scale of 1-10 how intensely am I feeling this feeling? (10 being the strongest you can imagine)  Go inside of it, explore it with an open, curious mind and with out judgement.  At this point it will intensify- it will become stronger and get bigger and more intense.  Your body is completely safe to do this.
3. Begin to notice where you are feeling this feeling in your body.  It is motoring through your body somewhere.  Key into this and really feel where in your body you experience some sensation.  Is there a knot in your stomach? Are your shoulders tight?  Maybe your hands are tingling? Focus all your energy  into this physical manifestation of your emotions. Allow it to expand. Keep breathing into it.
4. At this point approximately 60-90 seconds have passed.  What are you noticing? Ask yourself now how strong your feeling is? Has your feeling  lessened?  Did your number go down? It is beginning to subside isn’t it?

You have just experienced a truth- that a fully felt feeling dissipates. It is released.  Accumulated negative feelings come out somewhere.  They have to surface somewhere in the body.

We live in a society in which giving ourselves the permission to pay attention to what our feelings are telling us is discouraged by phrases such as, “get over it”

Have you ever tried to hold a beach ball under water in a pool?  You can only do it for so long before it pops up to the surface.  It doesn’t just slowly rise to the surface.  It erupts!  That eruption in our lives can look like screaming at our kids, impulsively quitting a job, or road rage.

The health risks of suppressing feelings are numerous. Increased stress leads to an increase in  anxiety and depression, heart disease,  gastrointestinal problems, and sexual dysfunction to name a few.

Are you willing to start doing something different in order to get different results? I promise you if you do nothing, nothing will change.  You’ll continue in your same momentum of behavior that is not serving you well. So, I ask you, would you be willing to take 60-90 seconds to take care of yourself? You are worth that much!