In general people see a therapist when there is a problem. This is true. Most people need some sort of problem that’s uncomfortable enough that they will take the step to begin therapy. It’s of course not comfortable opening up with a stranger and telling them all your deep darkest secrets. It takes a lot of courage and internal motivation to take that step.
Most people also think when they are starting to feel better that therapy has worked and they can now stop coming. For some people this can be true. But with most of our trauma folks, “better” simply signifies not being in constant crisis mode. Yeah, that is an awesome feeling. But because you were in constant crisis mode your therapist likely was helping you develop coping skills and maybe change your behavior a bit so you could stop the cycle.
The truth is that deep work cannot be done when you are not stable. I cannot start EMDR with a client that is chronically suicidal, self-harming and self-sabotaging. I cannot do deep work with client’s coming in with a new fire to put out every week. I can help them learn to manage the moment and self-regulate better. I can help them set boundaries so they are less overwhelmed. I can help them build up their social support so they feel less alone. All of that is still gold. It’s great life changing stuff that ends the roller coaster.
But the deeper stuff that triggers them jumping back on that roller coaster. The inner voice that feels “not good enough”, “alone”, “unlovable”, “responsible”, “guilty” etc. will end up creeping in again and those great behavior changes will likely fade away again and you're back in crisis mode.
Why Stay in Therapy
So that deep stuff. That inner child that still gets “pinged” when you get a critic at work, or your husband says “did you change the diaper genie?”, or your friend cancels plans. That work is best done when you are stable. It’s hard work. But changing that inner voice and those automated thoughts and responses is what truly puts you in the driver's seat of your life. It is also what ends the intergenerational trauma from continuing forward with your children.
That inner voice comes out so often and so unconsciously that it perpetuates us in the cycle. The woman that struggles with self-esteem, ends up criticizing her daughter’s weight and making food comments- that cause her daughter to feel the same as her “unlovable” or that love is conditional or that my value is based on my appearance. It’s surely unintentional and likely not in any way what that mom wants for her kid. But when we don’t have full operational control of our inner voice we end up sending mixed messages to our children, our loved ones and our colleagues.
Why Low Stress Times is When Real Work Happens in Therapy
When it is smooth sailing it’s the perfect time to dive deep. There are less stressors from school, work, life problems which is why you now feel “there’s no stress. I don’t need therapy”. The lack of stress allows for you to now really dive into some deeper issues that are going to bring up some uncomfortable thoughts, memories and emotions. It is the best time to do that work because now that your daily stressors are gone you have the emotional bandwidth to add the work- and healing yourself is work.
When Do I Not Need Therapy
So now you're probably like, “Okay, Jamie. If even when I am not stressed I need therapy, when do I not need therapy?” Valid question.
My answer is when you can easily silence that inner voice that pops up. Whether that be the voice that makes you feel responsible for others, not good enough, unlovable, damaged, guilty, or that you cannot trust your judgment. When you can easily stop playing whack-a-mole and that voice doesn’t pester you- end therapy. When you have worked through and healed that inner child- end therapy. When life is stressful and you don’t want to rip out your hair, or feel your skin is crawling- end therapy. Don’t end when there is no stress. End when you can manage your stress without being in crisis mode.
But if you are a constant crisis mode client that is finally off the rollercoaster. Please talk to your therapist about doing some deeper work. About exploring those core beliefs and truly processing the memories associated with them. We want you to feel better. Truly better and in control of your life.
Looking For A Therapist?
If you are looking for a therapist our counselors at Long Island EMDR would love to help you. What sets us apart from most therapists is that we are authentic humans. Imperfectly perfect I like to say. We are real, down to earth people. We love what we do and who we work with. We do evidenced-based work and are not afraid to challenge you when needed. Because we are down-to-earth genuine humans we truly care about our clients. Even though we will push you, we are probably some of the most compassionate, empathetic, and empowering people you will meet. Give our office a call today to be matched with a therapist who truly understands your concerns. And sleep a little better tonight knowing you took that first step.
What is C-PTSD? How is it Similar and Different from Post-Traumatic Stress Disorder (PTSD)?
Post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD) are both neurobiological disorders that occur when someone experiences or witnesses a traumatic event. Examples include, but are not limited to, war or combat, natural disasters, physical or sexual assaults, and life-threatening accidents.
Almost all of us associate PTSD with veterans. We understand combat is gruesome on the body and devastating to the psyche. We realize war is hell, if only we look at the faces of our veterans when they return. We know, even without words, that they went through something far beyond the scope of normal human experience. In fact, generations before the term “post-traumatic stress disorder” became public knowledge, and added by the American Psychiatric Association to the Diagnostic and Statistical Manuel of Mental Disorders in the 1980s, PTSD was known by other names: war neurosis, shell shock, soldier’s heart, or combat fatigue. Furthermore, much of the research, advocacy, awareness, and treatment options for PTSD have been through means such as the U.S. Department of Veterans Affairs. Thus, it makes sense we as a collective society to visualize a soldier in battle when we think of PTSD.
However, across the general population and in terms of numbers, PTSD is most prevalent in people who have experienced dangerous, life-altering events. It seems to be most frequent in survivors of sexual assault or those who went through or witnessed violent car accidents, both which involve powerlessness, danger, and terror. Furthermore, PTSD can occur in populations that often are forgotten to be traumatic, such as ICU stays.
It is believed most people will experience at least one traumatic event in their lives, and a fourth will develop PTSD. It is not known how many people live with C-PTSD.
Symptoms of PTSD
People who suffer from trauma may feel its impact for days; this is called acute trauma. If the symptoms continue for weeks or longer, and if they are disruptive to daily living, that is suggestive of PTSD.
There are three types of PTSD symptoms:
Hyperarousal symptoms. People with PTSD may have sense-of-threat symptoms, as if they are on edge and hypervigilant of their environment. They can have a startled response such as jumpiness.
Re-experiencing symptoms. Nightmares and flashbacks are the hallmark symptoms of PTSD. The individual may “go through” the trauma again via memories, via sensory experiences and emotions. The individual may feel the same smells, sights, sounds of the trauma.
Avoidance symptoms. Those living with PTSD will participate in avoidance symptoms, as in avoiding triggers associated with the trauma. This is broad, and can include places, situations, people, or events (i.e., holidays). They may also attempt to drown the symptoms through self-medicating with alcohol or other substances.
What is Complex Post-Traumatic Stress Disorder?
C-PTSD is a messier, multilayered version of PTSD which involves prolonged or chronic attacks on an individual’s sense of safety, self-worth, and integrity. This is dissimilar to PTSD, which is the result of one traumatic event. The ongoing maltreatment causes a multitude of additional symptoms, which shape neuropsychological development such as personality.
C-PTSD results from situations of chronic powerlessness and a lack of control, such as long-standing domestic violence (whether experienced or witnessed), sex trafficking, or child maltreatment. However, it is most common in those who were subjected to child abuse or neglect beginning in the earliest formative years, especially if the harm is by a caregiver or other significant adult, and there is a lack of hope for escape or that the situation can otherwise improve. Also, multiple traumas increase the risk of developing C-PTSD too.
Symptoms of C-PTSD
People with C-PTSD have compounded symptoms of both PTSD and those from other mental health disorders. These may include the following:
Psychosomatic issues: Psychosomatic issues are physical issues without a medical explanation, caused or worsened by a psychological reason such as stress. It is common for people with C-PTSD to have vague physical symptoms such as dizziness, chest pains, abdominal aches, and headaches.
Emotional flashbacks: A flashback is a vivid, intense experience in which a person will relive some parts of a trauma or feel as if it is happening in the present. Stereotypically, people tend to think of the war veteran who is having a “movie-like” flashback in which the event unfolds again in its entirety. However, a flashback does not need to be so extreme – and usually they are not.
People with C-PTSD are likelier to experience what is called an emotional flashback – that is, the emotions experienced during the trauma, such as shame or fear. Such individuals may react to these events in the present, unaware they are having a flashback.
Difficulty regulating emotions: Those with C-PTSD may experience sharp, vivid emotions which can be inappropriate for the situation. These rapid shifts in mood can be misdiagnosed as bipolar disorder or borderline personality disorder, which can have similar features but are not the same.
Flat affect: People with C-PTSD may also have a flat affect, meaning they appear numb, somber, or emotionless to others. This body language can be misinterpreted by others, making people think the individual is feeling a certain way or is aloof. In truth, the person may have a rich, complex inner world of their emotions and be feeling very differently than how they are expressing themselves.
There are several reasons for a flat affect. One powerful reason is because the individual may not have witnessed emotional expression in their formative years, thus in turn they have been sharpened to be “flat” as an adult. To explain it plainly, imagine a primary caregiver not smiling at their baby. The baby mimics and responds to the caregiver by also not smiling. This is sharpening the baby to respond such a way going forward.
A lack of emotional vocabulary: Finally, individuals with C-PTSD may have difficulty with articulating their emotions or they may not understand what they feel; that is, there is an absence of an emotional vocabulary. They may struggle in therapy when asked “what are you feeling?” and respond with “I don’t know” or they may describe a physiological feeling instead (i.e., tiredness, nausea). This is because in the context of prolonged trauma they had to adapt to shutting down their emotions to survive. For example, they may have been programmed in their earliest years to think “emotions are bad” because they were consistently invalidated or punished for emotional expression by their caregivers.
Dissociation: Dissociation happens to everyone. Dissociation is a sensation of feeling disconnected from oneself and the world through a sensory experience, thought, sense of self, or time. A person who dissociates may feel depersonalization (detached from their body) or derealization (feeling as if their surroundings are unreal). And at one time or another, all of us have dissociated. Getting lost in a daydream, forgetting the details of a car drive, or spacing out during a boring class lecture are all examples of dissociation.
When applied to trauma, dissociation is an innate coping mechanism. It is a protective action taken by the mind to let an individual survive a traumatic experience. At the time of the event, dissociation is beneficial, especially for children as they often lack insight and more sophisticated coping skills. However, the downside of dissociation is that when someone has dissociation and is at risk of developing C-PTSD or another trauma-related disorder, the dissociation does not resolve the trauma. In adulthood, the effects of dissociation can negate the ability to trust, form and maintain healthy relationships, and prioritize self-care. Through the phenomenon of mind-body separation, individuals may develop self-destructive behaviors such as ones that keep them dissociated (“I can’t tell when I’m feeling hungry, so I eat less than I should”) or ones to make them dissociate (“I drink alcohol to numb myself so I don’t have to feel my despair”).
(Dissociation is a complicated phenomenon which cannot be fully explained in a few paragraphs. The article writer will make a detailed blog entry dedicated solely to dissociation in the future.)
Negative core beliefs: Individuals with C-PTSD may have the core belief “I am not safe” or “the world is unsafe.” Alternatively, they may have other core beliefs (“I am unlovable” or “I am not worthy of respect”, for example). These core beliefs are deeply ingrained, at the pool of their identities, which can mean the individual is unaware they even carry such beliefs until they develop more insight.
Relationship difficulties: Individuals with C-PTSD can struggle with developing and maintaining healthy relationships. Such individuals struggle with feeling able to trust others due to their traumatic histories; thus, they may isolate themselves or feel intensely uncomfortable with “opening up” to others. Or they may respond inappropriately in a social situation. Unfortunately, these factors only enhance their risk of disapproval or misunderstanding by others, which makes them more susceptible to social isolation or ridicule.
Additionally, people with C-PTSD are more susceptible to entering and remaining in abusive relationships – especially those who already experienced abuse.
Treatment for C-PTSD
C-PTSD is a treatable condition. However, clients (patients) should be cautious when selecting their therapist. The treatment of complex trauma is a specialty, and not all therapists have the knowledge, skills, or experience to adequately support those who have C-PTSD. Thus, it is encouraged to “screen” the therapist during the consultation session by asking for their background in treating C-PTSD. Much like we may make thoughtful, careful choices about our medical doctors, the same should be done for therapists too!
Ask the therapist about their intervention styles (treatment approaches) as well.
The following treatments are frequently employed for C-PTSD treatment:
- Eye Movement Desensitization and Reprocessing (EMDR) Therapy. In EMDR, the individual reflects on a trauma while following a bilateral stimulus that results in the eyes moving back-and-forth. EMDR is considered a “hallmark treatment” for PTSD and C-PTSD.
- Trauma processing therapies.
- Exposure therapy, in which individuals re-experience their traumas in a safe, controlled environment.
- Cognitive Behavior Therapy (CBT), which focuses on the relationship between cognitions (thoughts), emotions, physiological sensations, thereby changing the resulting behaviors.
- Dialectical Behavior Therapy (DBT), an off-set from CBT which also includes interpersonal effectiveness (relationship skills), emotional regulation, distress tolerance, and mindfulness.
- Cognitive Processing Therapy (CPT), a behavioral therapy that challenges and changes unhelpful beliefs associated with the traumatic events
There is hope for healing from complex post-traumatic stress disorder!
Looking For a Therapist?
All of our counselors here at Long Island EMDR specialize in trauma work. We have a variety of sub-specialities within that including sexual assault, domestic violence, infertility, childhood abuse/neglect, loss of a loved one and bullying. Contact our office today to schedule with a therapist who meets your needs and start living the in the present.
Citations/further information:
Websites:
American Psychological Association (APA) – PTSD Treatments
https://www.apa.org/ptsd-guideline/treatments
CPTSD Foundation: https://cptsdfoundation.org
Healing From Complex Trauma & PTSD/CPTSD
(Complex) Post Traumatic Stress Disorder
Mind – Complex post-traumatic stress disorder (complex PTSD)
https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/complex-ptsd
U.S. Department of Veterans Affairs – National Center for PTSDhttps://www.ptsd.va.gov/index.asp
WebMD – What to Know About Complex PTSD and Its Symptoms
https://www.webmd.com/mental-health/what-to-know-complex-ptsd-symptoms
Books:
Pete Walker – Complex PTSD: From Surviving to Thriving
Arielle Schwartz – The Complex PTSD Workbook
Bessel van der Kolk – The Body Keeps the Score
Although more recently popularized at the turn of the millennium, meditation was first documented in 5000 B.C. via cave art, which depicted people sitting crossed legged with their eyes halfway closed. During recent years as scientific advancements have made the study of meditation more accessible, therapists and doctors are suggesting it be implemented into your daily routine.
This is no wonder given the scientific benefits of meditation. There is evidence to show that it actually changes the chemistry of the brain, which leads to improved physiological and psychological reactions to stress. Brain-imaging studies reveal that meditation not only changes the brain’s structure, but it also changes the brain’s activation patterns, altering activation of brain regions involved with emotional regulation, attention, and self-awareness.
Despite the numerous proven benefits of meditation for mental health, this coping skill can be challenging to put into practice for a number of reasons. Based on my own personal experience and experience as a therapist, some of the common challenges to implementing regular meditation practice include difficulties finding time to slow down, the lack of a non-distracting environment available, the challenge of slowing down thoughts while meditating, and the frustrations with lack of progress. The majority of these challenges can be mitigated with one simple suggestion-managing our expectations about meditation.
Meditation is counterintuitive to our culture. We are constantly on the go, priding ourselves in our ability to multitask and fit as many activities as we can into one day. When we are not “doing,” we are on our phones and other devices and rarely engaging in the present moment. Even entertainment throughout recent years reflects our limited attention spans, as movies and television have gotten increasingly more action-packed and faster moving. However, although these factors may make meditation seem difficult to put into practice, they actually serve as proof that we need meditation more now than ever.
Meditation does not have to involve sitting cross legged with hands in prayer and chanting for it to be effective. Meditation should fit the individual, starting with small and reasonable objectives. The purpose of meditation is to bring your body and mind to the present moment. A good way to start is by counting your breaths. State to yourself, “Breathe in….breathe out….1; Breath in…breathe out…2.” See how high you can count without getting distracted. In the beginning, you may only reach 5 or 10, but with time and commitment you will see your progress. Be patient with yourself.
Another technique that can be beneficial is implementing the use of guided meditations. There are many applications and YouTube videos that offer free guided meditations for a variety of topics. Start with a 2-minute meditation, and work your way up to a 5-minute meditation. It is better to start small and be successful than to set your standards too high and fail to achieve them.
A third strategy that can get you started on your journey is what is referred to as “moving meditation.” This involves engaging in an activity while being fully engaged in said activity, such as walking, dancing, riding a bike, cooking, or any other task that engages your five senses. While completing the activity, focus intently on what you are doing rather than your internal dialogue. This will take constant redirection back to the present until you gain the ability to do so.
Meditation can be challenging, however the more you practice the more you will build up your mental muscle. The most important thing is to be open minded and kind to yourself along this journey. The amount of peace and feelings of well-being waiting for you on the other side is worth the wait.
Relaxation is defined as the state of being free from tension and anxiety. Relaxation has many health benefits, both mental and physical. Some examples include reducing symptoms of anxiety and depression, lowering heart rate and blood pressure, improving concentration and mood, reducing fatigue, reducing anger and frustration, and boosting confidence to handle problems. So, what are some simple things you can do to help feel more relaxed? Here are some ideas!
1. Breathe
We’re always breathing, but sometimes when we’re stressed or overwhelmed our breathing rate is affected. You may find yourself holding your breath, taking shallow breaths, or even hyperventilating. When this happens, you’re most likely adding to the stress response in your body, or in other words, making things worse.
Breathing exercises are one of the easiest relaxation strategies and there are many different ways to do them, but here’s one example. Sit or lay in a quiet, comfortable space. Breathe in to a slow count of three, hold for a slow count of three, and then exhale to the same slow count of three. Repeat this five times, or as long as you need to feel relaxed.
2. Meditate
During meditation, the goal is to focus your attention and eliminate any jumbled thoughts that may be causing you stress. Meditation is a great way to bring yourself to a deep state of relaxation. And thanks to the internet, tips and resources for meditating are always readily available at your fingertips. Check out some guided meditations on YouTube, or research some apps like “Calm” and “Insight Timer.” There’s also a series on Netflix called “Headspace” where you can find some useful information about meditation and being mindful!
3. Write Down Your Thoughts
If you’re feeling overwhelmed with your own thoughts, it may help to get your mind off things by writing them down. If you prefer handwriting, get yourself a notebook or some scrap paper, but you can also do this on a computer or smartphone if that’s easier for you. When you’re feeling stressed, take a few minutes to write down short notes about how you’re feeling or how your day is going. And you don’t have to worry about things like grammar and spelling. Just focus on expressing yourself to help release some of that stress!
4. Get Outside
Being outside in nature has many health benefits, and helping us relax is one of them. When you’re feeling stressed, spending even a few minutes outside can help you feel better. You can go for a short walk, read a book at the beach, or simply find a comfortable place to sit outside and take in all of nature’s beauty.
5. Listen to Your Favorite Music
Music can affect our emotions in different ways, and it has been shown that just listening to music has relaxation benefits. If we listen to calming music, we can expect our mind and body to follow suit and feel more relaxed. It has also been proven that upbeat, cheerful music causes our brains to produce chemicals like dopamine and serotonin, which makes us feel happy. So if you’re feeling stressed out, put on your favorite playlist and turn it up. Go ahead, sing along! You know you want to.
6. Laugh
We’ve all heard the quote, ‘laughter is the best medicine.’ But why is that such a popular phrase? Science has shown that laughing not only decreases stress hormones, but can also increase immune cells and infection-fighting antibodies. Quite literally medicine! Laughter triggers the release of endorphins, the body’s natural feel-good chemicals. So, if you’re not feeling so good, call up a friend who you know will make you laugh, or put on a funny video that you know will get a few giggles out of you.
7. Start Planning a Trip
Take a break and start browsing some vacation spots. We all need to take a vacation from work every once in a while, but taking a break from life is just as important! Even if it’s just a day trip somewhere local- schedule some time to disconnect from all of life’s stressors and be in the present moment. You won’t regret it!
In the chaos and rush of the modern world, do you feel stressed, tired, and disconnected? Do you experience racing thoughts, feel “on edge” to meet the demands of a deadline, or yearn for a break? If so, forest therapy is for you! Forest therapy is found to reduce the production of cortisol, a stress hormone.
Do you experience depression or anxiety?
Forest therapy can help. It is clinically supported to improve cognition and mood.
Do you struggle to concentrate or pay attention?
Forest therapy is shown to improve directed attention and boost executive functioning skills.
Do you love the outdoors, but have limitations due to mobility challenges or a significant health issue?
Yes, forest therapy is for you, too. Unlike hiking, forest therapy is a slow walk, generally in an accessible area, which makes it suitable for various populations. Forest therapy can even be done remotely, only requiring access to a window.
Do you want to improve your physical health?
Forest therapy is evidenced to lower blood pressure, improve cardiovascular health, boost immune system function, and even combat cells associated with cancer risk.
And finally… do you want to try forest therapy, but fear the possibility of injury, illness, or accident?
All forest therapy guides (or “guides”) are required to be certified in Wilderness First Aid and Infant/Child/Adult CPR, at minimum. They also have training in herbalism, thus can teach you of edible and medicinal plants.
At Long Island EMDR, we proudly have a certified forest therapy guide, Valerie Smith, LMSW, who's been trained by the world’s leading school on the topic pf Forest Therapy.
Join Valerie in experiencing simple yet powerful techniques to help you feel whole and well again, while celebrating our kinship with the earth. Mindful and bodyful practices that bring about serenity and can foster a newfound awakening for what is most significant to you. Valerie will lead you through sensory encounters which allow for care, compassion, and connection toward yourself and all other beings in this world.
What is a Forest Therapy Walk?
A forest therapy walk (hereon also referred to as forest therapy for simplicity purposes), is a platform for fostering wellness, healing, and wholeness through engagement in natural settings. Forest therapy is inspired by the Japanese practice of shinrin-yoku (“forest bathing”), but they are not synonymous concepts.
Research indicates forest bathing carries a myriad of health advantages in the immune and cardiovascular systems, as well as psychological benefits such as mood improvement. From this foundation, forest bathing seeks to move beyond the health benefits alone and to instead celebrate that humankind is in kinship with nature, not above or separate from it.
Forest therapy is a practice; a gateway to allow a relationship of reciprocity to develop and strengthen, whereby the guide and forest (or other setting) partner together to allow for both to feel complete. The guide is useful in that they can navigate the participants through a particular sequence of events that provide a foundation for the experience. However, there are no set expectations of what should or could happen – participants are given freedom to interpret the experiences as they desire.
Forest therapy is about creating relationships between humans and the more-than-human world, in which the relationship itself becomes a source of healing and joyful well-being. Besides being a deeply healing practice, Forest Therapy is also an emerging community of friends and activists who are making a global impact. As we learn to love the forests, this connection leads naturally to an ethic of tenderness and reciprocity, we become more engaged in working for their well-being.
Most importantly, such walks are focused on the heart rather than the brain, and they celebrate the significance of the kinship between humans and nature. Forest therapy walks are effective, non-prescriptive, and simple, which encourages each participant to have the experience on their own terms and to bring meaning to it all on their own accord, rather than expecting the participant to feel or think a certain way. As a result, forest therapy should never be mistaken for psychotherapy, which is about the treatment of a diagnosis and/or life issue.
Ultimately, the aim for all forest therapy guides is to serve as the “doorway” between humans and other beings, in which the relationship becomes the source of healing and serenity. And so by having a reciprocal relationship with the more-than-human world, we all benefit in increased connection and wellbeing — from the smallest mushroom to the grandest of trees.
“And into the forest I go, to lose my mind and find my soul.” – John Muir
Forest Therapy is Not...
Forest therapy should not be confused with hiking. When a person hikes, they tend to have a set destination in mind. They want to ascend to the summit of the mountain, reach that hidden beach, or traverse that one crevice at the top of the mesa. Hiking also tends to be a timed event, with people competing against each other for the newest record.
Forest therapy is different because it uses the aspects of nature in a way that amplifies our senses to let us know the forest in a new way. For one, a forest therapy walk is slow and usually is restricted to a small area. A walk can last for up to 3 hours and the entire experience can be held in a few acres. Furthermore, beings are not things to be passed by on by, but rather to be recognized and explored. Beings are not only organisms, such as the birds and the plants, but also include abiotic entities such as rocks, sunshine, and weather.
Thus, it is more appropriate to think of such forest therapy walks as sensory immersions to foster mindfulness and body-fulness in a natural setting. Whereas mindfulness is about awareness of the present moment without judgment, body-fulness is for harboring that awareness through the senses and experiences within the body. The immersion is done through a sequence of invitations (activities) that participants are allowed to adapt if needed.
Finally, forest therapy should never be mistaken for psychotherapy, which is about the treatment of a diagnosis and/or life issue.
Health Benefits of Forest Therapy
As was previously stated, forest therapy is inspired by shinrin-yoku.
Shinrin-yoku is a wellness practice that came from Japan in the 1980s by the Ministry of Health to promote improved health across the urbanized, changing population. At the time, Japan was transforming into a technological leader, which the government noted was resulting in diseases related to sedentary lifestyles and chronic stress.
Over the next two decades, Japanese research has showcased the myriad health benefits of forest bathing. These include, but are not limited to:
• Lower stress
• Reduce blood pressure
• Improve metabolic and cardiovascular health
• Weight loss/weight management
• Lower blood sugar levels Improve memory and concentration
• Improve mood disorders, especially depression
• Increase pain tolerance
• Boost energy
• Improve the immune system with an increase in natural killer (NK) cells
In more recent years, research across the United States and the United Kingdom has supported the association between time spent in nature and directed attention. Directed attention is one of the primary functions of the frontal lobe in the brain, which is also in control of other executive functions like critical thinking and problem-solving. The stressors of modern living burden us with attention demands that are more exhausting versus that of mankind in the past. This is a reason why we may “space out” when trying to complete a task, feel sluggish, or struggle to concentrate. Much like a computer needs to be rebooted when it freezes, so too, do our brains.
Fortunately, through immersion in nature, the executive functions of our brains are allowed to rest and become replenished. This results in improved directed attention later. In addition, nature experiences offer other psychological benefits such as overall improvement in mood, including in people with depressive disorders.
Perhaps most fascinating of all, ongoing research from Nippon University suggests that phytoncides, the chemicals found within conifers and some other plants, may be effective in cancer prevention. When breathed in, the phytoncides fight infection while also increasing the number of NK cells, which increase anti-cancer proteins.
For more information on the health benefits of shinrin-yoku, along with links to the studies to support the research, please click here.
Want a Forest Therapy Walk?
Valerie Smith hosts forest therapy walks throughout Suffolk and Nassau. These walks are open to the public; thus, you do not need to be a client at Long Island EMDR to participate. Bring your friends and family!
Please note: All walks require prior registration, payment, and completion of paperwork. Valerie cannot accommodate “walk-ins”.
To learn more and/or to arrange a walk, contact valerie@ericam206.sg-host.com
California was the first state to legalize marijuana for medical purposes in 1996, having come a long way since marijuana was placed as a Schedule 1 drug in the Controlled Substances Act of 1970. Since then, there have been many debates surrounding the medical benefits of marijuana.
While many states have legalized marijuana for medical purposes, the FDA has only approved the use of medical marijuana for two rare forms of epilepsy, Dravet syndrome and Lennox Gastaut syndrome. With regards to mental health, some states have approved medical marijuana in the treatment of PTSD. While research into medical marijuana and its effect on PTSD is underdeveloped, clinical trials and anecdotal evidence from PTSD sufferers demonstrate the positive impact of the drug on their symptoms. This may be due to the fact that cannabis can reduce activity in the amygdala, the brains “fight or flight” center. There is also some evidence that demonstrates the plant’s cannabinoids could play a role in extinguishing traumatic memories.
Advocates for the drug claim it has therapeutic benefits for a variety of mental health conditions, including insomnia, depression, anxiety, stress, and schizophrenia. An internet search on the topic will lead you to believe that medical marijuana is a “cure all”; a natural remedy that has endless benefits. However, when you take a closer look at the information available, one thing becomes clear: there is just not enough research to draw any substantial conclusions regarding the benefit of medical marijuana for mental health.
Research on medical marijuana extremely limited in the United States. This is due to the fact that it is still not legal on a federal level. From 1968 until now, researchers have only been allowed to use cannabis from one source for research, a facility at the University of Mississippi. However, as of May of 2021, the DEA stated its plan approve more growers, which will allow for more widespread research to be conducted.
Until then, here’s what we know when it comes to marijuana as it pertains to mental health. The main psychoactive ingredient in marijuana, THC, stimulates the part of your brain that responds to pleasure. This results in production of the dopamine, a neurotransmitter that results in relaxation and euphoria. Subjective experiences and limited research indicate marijuana may have a positive effect on anxiety and insomnia. However, not everyone’s experience with marijuana is the same. Some users experience increased anxiety, fear, panic, or paranoia. Using marijuana also has the potential to increase the likelihood of clinical depression, or worsen the symptoms of any mental health challenges you already have.
Due to the above risks and lack of evidence of the benefits, self-medicating with marijuana to manage your mental health symptoms is not advisible. However, whatever you chose to do, the most important thing is to talk openly with your doctor, psychiatrist, and/or therapist about your usage and how it impacts your mental health. If you believe medical marijuana to be of benefit for your mental health, ideally it would be prescribed and regulated by a doctor. Due to current laws in the state in which you reside, this may not be an option. In the meantime in addition to being honest with your providers, be sure to explore alternative techniques to manage your symptoms, including mindfulness, psychiatric medications, meditation, herbs/supplements, and exercise.
Because therapy and mental health are much more than just showing up every week!
What we know and understand about mental health has come a long way in recent years. Between that and everything else going on in the world, it’s no surprise that many people have been more open to receiving mental health treatment. This is great news, but it can also be hard to know where to start and how to get the most of this to improve mental health, especially if this is your first time in therapy. So, where do you begin?
1. Do your mental health related research
It’s always a good idea to do a little bit of research to find a therapist that best suits your needs. Although most therapists are educated and trained on a wide range of issues, some therapists have spent a lot of time working with specific populations and consider that to be their ‘specialty.’ If you’re seeking help for a specific issue, it may be beneficial to see someone who already has experience in that area.
In addition, it’s very important that you feel comfortable with your therapist. People usually go to therapy to discuss challenging things in their lives and mental health issues, and if you’re not comfortable with the person sitting across from you, it will only make talking about those things more difficult. Most therapists post a little bit about themselves in a bio online, or even write blog posts like this one about things that interest them! Doing research about different therapists can give you an idea if he/she would be a good fit for you.
And if you find yourself working with a therapist that you feel isn’t a good fit, speak up about it! Chances are your therapist will be understanding and can even provide referrals for other therapists in the area.
2. Think about you’re mental health goals and what you're hoping to get out of therapy
You will most likely start your first appointment by discussing what brings you to therapy and some of your history. It can be helpful if you’ve already put some thought into the issues you’re hoping to address. Are you looking to change some negative behaviors, or learn healthy coping skills? Maybe you want to improve your interpersonal relationships by learning better communication skills, or manage symptoms of anxiety or depression. Whatever it is you’re looking to address, being prepared with clear goals can help keep your sessions focused so you’re getting the most of your time each week. It can also help to think about any significant experiences from your past that may be impacting you currently, as that can be helpful information that therapists will want to know about you.
3. Don’t be afraid to ask questions
Therapy is a safe place where you should feel comfortable sharing your deepest insecurities or struggles. You should also feel comfortable enough to speak up and ask questions if something isn’t making sense to you or isn’t working for you. Your therapist can only work with the information you bring to the session, so if you feel like those breathing exercises you keep talking about each week just aren’t working, be honest and say that. Then we can try to explore what isn’t working with the breathing exercises, or maybe even discuss different calming techniques altogether.
Therapy is also a great place to practice things like communication skills, setting or enforcing boundaries, and being assertive (like saying ‘hey, these breathing exercises aren’t working for me!’). If these are things you struggle with, discuss it with your therapist so they can be sure to address these issues during the session.
4. Be positive but also realistic
It’s a pretty common misconception that you’ll receive some advice from a therapist in one or two sessions and you’ll be able to apply that advice to your life and move on. It’s important to understand that therapy is a process that often requires some patience. For some people it takes more than one or two sessions to even feel comfortable enough to discuss some of those deepest insecurities, and that’s okay. Treatment will be ongoing. There’s no set number of sessions and it can differ for everyone.
It can be helpful to approach therapy with curiosity. Be curious about the ways you currently behave, think, and feel. Have you experienced anything in life that may be contributing to these behaviors, thoughts, and feelings?
5. Do your homework
Therapy is much more than simply showing up for your session each week. Some therapists may give ‘homework assignments’ hoping to keep you engaged in between sessions. Homework could be asking you to journal and reflect on certain areas of your life. It may be simply noticing when something you discussed in session comes up, or even practicing certain skills like breathing exercises, grounding techniques, and self-care, all which help improve mental health.
Even if your therapist doesn’t assign you specific tasks, you should still be putting in work outside of session. Therapy is a great place to receive tips, guidance, and education about things you’re struggling with, but the actual change takes place when you start applying those tips to your everyday life.
Poor mental health can affect so many parts of your life including your relationships with others, your
performance at work, and even day-to-day tasks such as daily hygiene. Daily hygiene such as
taking a shower, brushing your teeth, and doing your laundry may seem like simple tasks for
some, but for someone struggling with mental illness these same tasks can feel like pushing a
300-pound boulder up a hill. But why?
Why does mental health make it so hard to take a shower?
For starters, depression is often characterized by diminished interest in activities and feeling
fatigued. In other words, you probably have little motivation or energy to maintain your hygiene
when you’re feeling depressed. But depression isn’t the only mental health diagnosis that affects
daily hygiene. Schizophrenia, Bipolar Disorder, Anxiety, and PTSD have all been linked to
negative impacts on daily hygiene.
So what can you do when mental illness is affecting your hygiene?
For starters, you can try some of these techniques:
If taking a shower seems like a lot of work, try starting by just standing under the water for a
minute. Yes, you may not be as clean as if you used soap, but it will make the task of showering
seem less intimidating and can help you both physically and mentally.
Think convenience! Use things like antiperspirant, dry shampoo and wipes regularly. You can
buy cleaning wipes (usually made for kids) almost anywhere, and they don’t require any water!
If you have days where taking a shower seems like too much work, there’s no shame in doing
what you can to maintain hygiene.
If you absolutely cannot bring yourself to brush your teeth, use mouthwash with extra fluoride
and rinse liberally for as long as you can. You can also take more preventative measures such as
using a toothpaste with extra fluoride so you have extra protection when you do brush, and visit
the dentist for more consistent checkups (say every 6 months versus every year).
If you’re struggling to do your laundry, ask for help. A friend or family member may be willing
to help you tackle the overwhelming pile of laundry that’s been building for the last few weeks.
If you have social supports, utilize them! You can also use this as a time to catch up with your
loved ones.
What if all of these are still too overwhelming?
If you’re struggling to practice hygiene even when you know you should, you may need help.
In general, you should reach out for help if an issue is making it difficult to function. If your poor
hygiene is starting to affect things like work, school, personal relationships, or your health,
consider contacting a professional. A therapist can help you further explore your struggles with
hygiene, and provide you with appropriate skills to make managing your hygiene a little bit
easier. If you think psychotherapy may benefit you, feel free to reach out to our office to
schedule an appointment.
I often hear form clients frustration about so many things beyond their control. Believe me, I am also frequently annoyed at things beyond my control. But knowing what things are within and out of our control can help us to feel more in control. Sounds strange but I promise it’s true.
What Happens When we Focus on Things Outside of Our Control?
When we get fixated on thing beyond our control such as: the behavior of others (i.e.bosses, colleagues, family, friends), thoughts and opinions of others, our limitations placed by physical or medical disabilities, (i.e. mobility issues, infertility concerns, loss of independence), or any other items out of our control it can make us feel really hopeless, anxious or even angry. These feelings usually lead to negative thoughts and behaviors. They very rarely help us feel at peace, at ease or happy. Looking at items within our control help us to feel more at peace, it gives us something to work towards to possibly change our situation and makes us feel more at ease. So here are some reminders of things within your control:
Your Actions
You can always control how YOU respond to others. So let’s say your friend continually is violating your boundaries (yes very annoying!) You are able to make it clear that they are violating a boundary, tell them how it makes you feel and if it continues remove this person from your circle. You are not in control of how they act but always how you respond. You are in control of your choice of words and your tone of voice. You are in control of the boundaries you set and whether or not you enforce those boundaries.
Your Schedule
You control what you do. Yes I do know you need to work and that those hours may be set, but you can always look for another job if that schedule is not what you want in your life. You decide who you see in your free time, what extra circulars you do and most importantly your routine. Creation of a routine is a great way to manage and regulate stress and anxiety, as when we know what to expect- we are less stressed and anxious.
Your Meals
What you put in your body effects how you feel. Eating healthy meals helps to decrease fatigue and increase our energy levels. Meal planning and prepping can be a pain- yes I know. But it is a good way to keep your physical-self (and your budget) healthy. It’s also great stress relief to cook food that you actually enjoy eating- and no Karen not all healthy meals taste bad.
Your Socialization
You control who is in your social circle. If you have toxic people who don’t’ make you feel good- you can weed them out of your life. Surrounding yourself with people that bring you up and motivate you is within your control. Yes plans may be cancelled by others- but you can always reschedule, call another friend or make another plan that you can look forward to. Socialization is key to positive mental health- click here to see why, and click here for tip on how to improve your social circle.
How Much Media You Consume
By media I mean news and social media. You are in control of what news channels you what and how much news you intake. Lately politics have everyone all stressed so if that’s you maybe cut back on how much your consuming? Same goes for social media. The comparisons are crazy now that everyone posts their “best lives” on social media platforms. If you find yourself constantly wishing you were more like Cindy on TikTok or wishing you had hair like Sue on Insta- you may want to start restricting that consumption. Also just remember people spend crazy time taking perfect photos and editing them to be even more perfect. Rarely do people post about their difficulties and hardships so try not to compare.
How Prepared you Are
You may not be able to avoid Covid-19 or giving that presentation at work via zoom but you are in control of your preparedness to handle those situations. Having a plan if someone gets sick can help you feel more in control. Same as being prepared for that big presentation will make it a bit easier to muddle through come the big day.
How Mindful You Are
Practicing mediation, guided imagery and yoga can be a great way to relax your nervous system and feel more at peace. It can help you feel more aware of your emotions and thus less likely to impulsively react on them.
What to do if you do not Feel in Control of The Categories Listed Above?
So if you feel like okay I may have control over some of that but I don’t have the motivation to do it right now, or it’s really hard for me to switch up when I am in that negative mindset- you may be struggling with anxiety or depression that is keeping you stuck in what I call “the hamster wheel”. Which is basically when even though your rational brain knows ruminating on this negative topic is not helpful and it is beyond your control- you just keep running on the wheel spinning the same thoughts over in your head no matter how hard you try. At that junction it may be best to speak with a trained therapist who can help you work on strategies to challenge those thoughts, get out of the loop, increase your coping skills and supports so that you can go back to enjoying your life.
Stay Shining,
While depression and anxiety are two very separate mental health issues, they often go hand in hand with one another. They fuel one another: anxiety can lead to depression; depression can lead to anxiety. When these two play off one another it can feel debilitating for the individual struggling with these ailments. In this article we will look at how these conditions play on one another and how to get treatment for them.
Why Depression and Anxiety Go Hand in Hand
It has been estimated that about half the people struggling with either depression or anxiety have both conditions at the same time. For each person experiencing this the cause can be different. Some individuals struggle with both disorders simultaneously, others have one condition trigger the other. For example, if you are struggling with anxiety and worry is preventing you from completing needed tasks or being productive, this can easily lead to negative thoughts and feelings of hopelessness about your situation. In this instance, over tie your anxiety can lead to depression.
Here are some signs you may be suffering from both:
- Irrational fear and worry about the world around you
- Physical symptoms, such as headaches, fatigue, difficulty breathing and rapid heartbeat
- Insomnia and other troubles sleeping
- Loss of interest in activities you once enjoyed or those activities cause panic attacks
- Difficulty remembering things and making decisions
- Inability to relax, even under normal circumstances
- Panic attacks
Everyone experiences mental health concerns differently. If you are experiencing any of the above symptoms, it may be time to check in with your doctor and get help. Early intervention is the best way to ensure these concerns do not begin to interfere significantly with your every day functioning.
Anxiety and depression are both very treatable forms of mental illness. With medication, therapy, and other forms of intervention, you can overcome your symptoms and begin to feel like yourself again. Whether you struggle with depression, anxiety or both simultaneously, a qualified therapist can help you begin to regain your life. A therapist will help you to: identify symptoms, triggers, and learn healthy ways of coping. With time, practice and some self-exploration therapy can help you to begin to live a life that you enjoy living. If you need help, please feel free to contact our office for a consultation and more information on how we an assist you.
Keep Shining,