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
What Does it Mean to be an LGBTQ Affirming Therapist?
As LGBTQ Affirming Therapist in Suffolk County, NY we take an approach to therapy that embraces a positive view of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) identities and relationships. We also are intently aware and proactive in addressing the negative influences that homophobia, transphobia, and heterosexism have on the lives of our LGBTQ clients.
How We Ensure That Our Providers are Truly Affirming Therapists
- Self-reflection: All of our clinicians engage in supervision in which we explore and address biases, beliefs and attitudes from their own upbringing. It is important for us as a practice that all of our therapists have either been in therapy and/or are actively engaged in therapy so they are aware of their own biases (not just of the LGBTQ community but also, race, socioeconomic status, ethnicity, etc.).
- Involvement in the community: Our practice engages in many LGBTQIA+ events and networking with other agencies and business owners who work with and/or are part of these communities. Several members of our team are members of the community themselves and our cis gendered clinicians, when needed, consult with them in group supervision to get their prospective on client’s concerns.
- LGBT Affirming paperwork: Our intake documents account for those that do not fit the herternormative boxes. For those planning to bill insurance it must be under your legal name but we do have a “Preferred” name box as well to ensure all staff address you by your chosen name and pronouns.
- Education- We encourage and promote our clinicians attending training related to LGBTQIA community concerns.
What You Can Expect From Our LGBTQ Affirming Therapists LGBTQ in Suffolk County, NY
All of our therapists are extremely interpersonal. They want to know you: Your story. Where you came from. What happened to you. We pride ourselves in being a practice of “above and beyonders” who really want to know our clients and understand them. Part of being an LGBTQ affirming therapist in Suffolk County, NY is being a therapist that does not make assumptions about our clients but being open to hearing their stories and experiences. Every coming out story is different. Everyone’s level of comfort and openness about their sexuality and gender expression is different. We won’t put you in a box because you are part of the community. Your experience as a member in the community is still uniquely your own. We wholeheartedly believe and understand that your sexual identity and gender expression is no where near the only thing that defines your you-ness.
Being affirmative means we strive to treat all of our LGBTQ clients and their families with the respect and dignity they deserve. Our role is to support you, to uplift you, to empower you to make the changes you would like to see in your daily lives and heal from past hurts. We want you to know you are absolutely fine just the way you are.
Ready to See an LGBTQ Affirming Therapists LGBTQ in Suffolk County, NY?
Contact us now to schedule an appointment to meet with one of our amazing affirming therapists. We truly would love to help you through whatever is bringing you to counseling. Our providers have a range of expertise including: couples, trauma, grief & loss, anxiety, OCD, depression and BPD. There are also many modalities used within the practice including: EMDR, TF-CBT, mindfulness, CBT, solutions-focused, and strengths-based counseling. Our administrative assistant will match you with a therapist who is not only affirming but can also address the underlying concern that has brought you to seek treatment.
Sending Love & Light,
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!
For starters, someone’s own gender identity is a process that may come naturally to some, though for others it may not be as easy. Whether it be exploring your own gender identity, sexual orientation, or even just working through your own curiosities, everyone should have a support system to help them along the way. Here we will discuss LGBTQIA+, the different sexual orientations, gender identities, as well as how seeking therapy can support you in this process.
Firstly, here are gender definitions to become familiar with:
● Gender Expression - the outwards expression of gender, typically expressed/observed through people’s names, pronouns, clothing, behaviors, body characteristics, and more.
● Gender Identity - invisible to other people, one’s internal definition of their own gender. Some people may feel comfortable with the gender that they are given at birth, though others may not.
● Sex - oftentimes confused with one’s gender, but someone’s sex identity is more-so biological than anything else. Someone’s sex is the combination of body characteristics (hormones, chromosomes, reproductive organs, etc.), thus being more than just two sexes.
There is a wide range of gender identities that people fall under and identify with. It is crucial to validate the feelings of someone who may be uncomfortable with their gender identity, as it is a significant life event that causes stress. Whether you already know your own gender identity, or if you are currently exploring that area of your life, seeking support can be helpful!
Secondly, here are some LGBTQIA+ sexual orientations:
● Asexual - someone who experiences minimal to no sexual attraction, though may still experience romantic attraction.
● Bisexual - someone who experiences an attraction to others of the same gender as well as people of another gender.
● Gay - someone, typically a male, who experiences attraction to someone else of the same gender.
● Lesbian - a woman who is attracted to another woman, ‘lesbian’ and ‘gay’ are sometimes interchangeable.
● Pansexual - someone who experiences an attraction towards another person regardless of their gender
● Queer - an umbrella term for anyone who does not identify as heterosexual or cisgendered.
Even though these are just a few definitions, there are many more sexual orientations that people feel attached to. Some people may question why there is a need for so many orientations or why there is a necessity to bring about awareness to this subject. However, it is so crucial to spread the word and to educate on these matters to increase the inclusivity of this community. Many people find plenty of comfort in connecting with one of the above, or many other, sexual orientations. Something as simple as “putting a label” to what one may be feeling can offer a sense of freedom as well as offer someone answers they didn’t have before.
Walking on the path of self-discovery at any stage of life can become too much for some to handle at times. Seeking mental health treatment is a great way to support yourself on this journey. Historically, the LGBTQIA+ community has faced discrimination as well as prejudice which is why our mission here at Long Island EMDR is to be a guide for those who may need it. We believe that therapy should be a place of comfort and safety, therefore we will do our best to ensure that we offer the best support that we can. There’s no reason to change who you are, only a reason to find out who you truly are on the inside!
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.
Self love is a concept that was first promoted by the Beat Generation of the 1950s, and again in the early 1960s during what was known as the “Hippie Era.” self love has gained popularity in recent years due to psychological research finding it an essential component for positive mental health and well-being. Even despite its rise in popularity, self love can be a challenging concept for many, often confused with being egotistical, self-indulgent, or too “touchy feely”. Despite the many misconceptions regarding self love that exist, the truth of the matter is that self love is a critical part of recovering from mental health challenges. Without self love, it will be extremely difficult to believe you are worth implementing the healthy strategies will allow you to feel better. Here are some simple techniques that can assist you on your journey toward unconditional self love.
1. Engage in Self-Reflection.
We often spend much time and energy moving from one distraction to the next. Taking time out of our busy schedules for self-reflection is an important part of learning to love yourself unconditionally. After all, how can you truly love what you don’t know? Self-reflection can be very simple-taking 5 minutes of your day to sit quietly and assess how you are feeling, journaling, meditating, sitting in nature, or deep breathing. Anything that can stop the noise of your mind and connect you to the present moment can be a great way to get in touch with your true self and bring you closer to loving yourself.
2. Be Kind to Yourself.
Be mindful of the way you treat yourself. “Bring the mind, and the body will follow.” This is a common saying that holds true on the journey toward self love. Often this means going outside of our comfort zone and making positive decisions for ourselves despite not feeling that we deserve it. Increase your healthy intake-be it people, conversation, self-talk, food, exercise, or rest. Treat yourself the way you would treat a friend or loved one; with kindness, compassion, and patience. Although this may feel unnatural, by treating yourself this way you are proving that you are worthy of love and respect, and doing so consistently will allow this belief to sink in.
3. Forgive Your Mistakes.
You are human and are bound to make mistakes. If there is a name for what you did, someone else has done it. Giving yourself permission to be human is one of the greatest gifts you can give. Forgiveness is not an easy journey, however letting go of the past allows you room to become the person you are truly meant to be. Someone who forgives and loves themselves is also less likely to hurt others in the future. One strategy is writing down a letter of apology to those you’ve harmed, including yourself. You can make amends to others when enough time has passed, and to do so will not cause additional harm. Most of all, let go and remind yourself that you are much more than a few bad decisions.
4. Maintain Healthy Relationships.
People are not born hating themselves. Oftentimes, a lack of self love comes from life experiences/relationships that cause you to internalize the belief that you are not good enough or defective in some way. Take note of the relationships in your life and how they make you feel. Everyone is accountable for their own happiness; however, some individuals (due to their own flaws) can trigger feelings of unworthiness in us. Work on setting healthy boundaries with these people, and focus the majority of your attention and energy on pursuing relationships that allow you to feel safe, happy, and cared for.
5. Accepting Yourself as you are Right Now.
Everyone is a work in progress. It is easy to fall into the trap of “I’ll love myself when…” and fill in the blank with whatever goal or next level we want to reach. There is always going to be room for improvement, so don’t waste time putting off loving yourself. After all, achieving your goals will be a lot easier with the help of self love. Stop comparing yourself to others, or telling yourself you “should” be a certain way. You are exactly who you are meant to be at this moment. Embrace the journey.
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.
Many of my clients have difficulty living the life they want and need to feel truly happy. They struggle with expectations placed on them by others, feelings of guilt if they put themselves first and most days feel like they cannot catch their breathe. Trauma therapy can help you to end old patterns and put yourself first. Self-care isn't selfish- I know it's a clique but it is true. You need to take care of you to be your best self for your family, friends and career. If this is speaking to you, strap in- I have some Pro-tips for you.
1. Evaluate Your Values
What is most important to you? List 3 things. Could be family, honesty, integrity, compassion, trust etc. Then you need to start seeing if your actions actually align with your values. Those that do keep at them- those that don't make an effort to change them. For example, if you choose "family, compassion and health" and you are offered an additional work shift. Is taking this shift detracting from your family time? Do you need a mental health break or day off to take care of you? If so say no. If it's to help a colleague who is going through a rough time and you feel you have enough time on another day to take care of you and spend time with family and you want to honor that "compassion" value you can also say yes. Seeing how our actions are in align with our values helps us to begin living a life that makes us happy- not a life that is spent trying to appease or please others.
2. Set Some Boundaries
In set with setting those values is setting up some boundaries with those around us. When we have no boundaries- meaning we having difficulty saying no or often do things out of pleasing others even if it's not what we want- we continue to feel exhausted, unhappy and overwhelmed. Boundaries despite what childhood may have taught you are actually healthy. Saying "No I'm sorry I can't go out tonight", "No I won't be able to take on that extra project with my current workload as it stands",or "I would appreciate if you refrained from "xyz" in front of my children" is the first step to reducing our triggers, reducing your stress load and giving yourself the time to focus on you and do what makes YOU happy.
3. Let Go of the Guilt
Often times my clients struggle with boundaries because of the guilt they feel in saying no to others. They feel responsible to take on the problems of those around them. They are accustom to the role of "fixer". Those around them, often family members but sometimes even colleagues or bosses sometimes push back on boundaries set and plead or ridicule them if they don't get what they want. I'm not going to say setting boundaries is an easy task when you are accustom to saying "yes" to everything because your role has always been to put others before you. But I will say the more you stick to your boundaries, the less others push back over time. It helps to see if keeping those boundaries is in alignment with your values or the type of person you are aspiring to be. Simple answer my look like "yes, I value helping others". With a closer look though it's easy to see it is hard to be our best self for others when you are running on empty. As I often tell my trauma therapy clients, and as they say on the air plane "put your mask on first" before you help those around you. It also helps to make a list of the short term positive gain of letting others violate your boundary and the long term consequences. For example, lets say you have difficulty saying no at work and are constantly taking on additional tasks asked of you.
| Short Term Positive of Not Holding My Boundary | Long Term Consequences of Not Holding My Boundary |
| -Don't feel guilty | -I am overwhelmed and burning out |
| -My boss is happy | -It's hard to complete additional work assigned in my work hours so I am constantly bringing work home |
| -I get positive praise | -I am working so hard that when I am done I have no energy to engage meaningfully with my husband and kids |
| -I feel taken advantage of and under appreciated | |
| -My workload will never decrease if I do not voice concern with the disproportionate work I get in comparison to colleagues |
After making this list you may decide to have a conversation with your boss and say "I would love to be able to help with that project but I already have 3 other projects I am currently working on. I will need to finish those first before I can take on any more. It's important to me that the quality of my work meets the standard and I am afraid I won't be able to complete all projects to our client's expectations." Starting an honest dialogue can help you feel more in control and will likely make you a better employee. Same with friends and family, when you are happier and more relaxed you can be your best self for your spouse, children, parents and friends. If this seems daunting, trauma therapy can surely help you work through your fears and doubts.
Need Help?
If this sounds daunting, you may need some extra support in navigating beginning to set boundaries and taking back control of your life. This is really common with clients who have trauma, are children of alcoholics, were parentified children (children that functioned more as parents), and those with low self-esteem and attachment difficulties (as they often fear boundaries will push others away). Trauma therapy can help! Just like my clients you can take back your life, begin to feel in control, less overwhelmed, more peaceful and joyful. You deserve happiness too. If you need the extra support in getting there give our office a call. We would love to help you on that journey.
Sending love & light,