I’m a therapist who is transparent about seeking therapy for myself, and who believes both teletherapy and therapy is helpful for almost all people, regardless of the circumstances. Throughout my years, I have undergone my own therapy for different reasons, from wanting support for the trauma I experienced, to learning how to gain the self-esteem needed for me to break free from domestic violence, for simple advice about navigating through transitions, as well as for a means to cope as a caregiver for two parents who both were terminal. Sometimes, too, it felt cathartic just to be able to “vent” to a nonjudgmental, compassionate individual.

Unfortunately, as I’m sure you’ve noticed, it isn’t easy to get a therapist! I’ve had to leave voicemails, emails, and private messages for many local therapists – quite a few who never got back to me, and most who said, “sorry, I’d love to help you but I’m full” without any advice about who I could go to instead. Alternatively, for the therapists who did respond, there were issues with the commute (I require public transportation due to a neurodevelopmental disability) or with timing. For part of my treatment saga, I was also in graduate school and working a full-time job on top of balancing a mandatory field placement, which made it seemingly impossible to fit in self-care for myself.

Talk about irony! I remember it so vividly. I was a social work student learning how to be a therapist, employed at a community mental health agency while also interning at a private practice. I made the time to be there for my clients at the expense of ignoring my own needs. I desperately wanted a therapist of my own, but with the transportation issue, an unforgiving schedule, and the lack of available therapists in the area, how could I?

Then the pandemic happened. The world shut down. Overnight, I had to change meeting with clients face-to-face to going online. I will admit I came with a bias. Years before, during orientation for my social work undergraduate program, a rather old-fashioned professor rambled about why online therapy is a “threat” to the field. Mainly it was that she assumed HIPAA could not be honored or that the relationship was not as “real and organic.” However, now after being exclusively a remote-based therapist since the pandemic to the present, I must admit I respectfully disagree with her. Some of my most intimate, heart-to-heart conversations have been over a video screen. I have shared in my client’s sorrows, hopes, fears, joys, celebrations, and hardships. And I have seen glimpses into the very environment where they spend most of their time – their homes. There is something so powerful, insightful, and raw about seeing one’s home which cannot be captured through the spoken word while in a therapy office. It is truly a privilege to be trusted with seeing the private spaces of my clients, and in turn they get to see mine. Furthermore, teletherapy allows for me to work with anyone if their primary residence is New York State, going far beyond the borders of Suffolk County. This means the people who choose me as their therapist do so because they want to work with me, not because of just location. This arrangement has allowed me to blossom as a specialist in turn, having clients who all fit into my niches (grief/bereavement, complex trauma or C-PTSD, caregiving stress, and/or people with debilitating disease).

Thanks to teletherapy, I too got to have my own weekly therapy. After a somber event happened, I needed a therapist to process my emotions. One therapist who replied to me in a timely fashion offered teletherapy to anyone in the state. She offered everything I needed – experience, knowledge, efficiency, she even liked the challenge of having other therapists as her clients! Perfect! Yet best of all, the flexibility of being online allowed me the flexibility I required to remain efficient in my own role as a therapist to the people I serve. It was simple: I only needed to log in to the teleconference platform right before the session start time. This allowed me to never miss a scheduled session, be proactive about my recovery, and let my “therapy time” truly be 45 minutes (rather than adding in commuting time, which of course could be delayed due to an accident or inclement weather!). Plus, this also meant I got to have more time for other commitments in my life.

Still feeling unsure about teletherapy? Here’s some perks.

There are numerous reasons why teletherapy is beneficial. Here are a few in summary.

Privacy (the BIG one!)

Have you ever ran into someone you know while in the waiting room? Worse, was it someone you have difficulty with because you two do not get along? Yep, talk about awkward. Back in high school, I remember being in the waiting room at a therapist’s office when suddenly a girl I knew came in to pick up her younger sibling. She was best friends with a bully who absolutely loved to torment me. Yep… awkward.

Want to hear another unsettling story? That practice was so disorganized with communication that there was always competition for rooms. One time while I was there, one of the therapists came into the waiting room to ask if any of us would be willing to have our session in the kitchen – the public kitchen, where staff and clients alike could come and go to get coffee. Yeah, I’m not kidding. Talk about a HIPAA violation!

Or maybe you have been spared such severe examples, but most of us can relate to at least this experience: Have you ever overheard the entire conversation between the patient and the clinician while at a doctor or therapist’s office? Or have attempts to soundproof the rooms still proven impossible? I’ve been there, too.

Fortunately, with teletherapy you do not need to be concerned about coming across someone you know in the waiting room, parking lot, or restroom. You can schedule your session for a time where you will have optimal privacy and confidentiality, whether that be in your home, your car, or even in your backyard. 

Flexibility

Going to a session is easy when you do not have to drive to and from the therapy office! Clients can schedule their session during lunch break, before work or class, during their baby’s naptime or when the toddler is watching Sesame Street, or any other gap. In turn, it allows me to offer a wider schedule to also suit my clients’ needs.

Flexibility is especially important for clients who otherwise would not be able to fit therapy into their schedules at all. For example, for my clients who are caregivers, it would be impossible for them to commit to in-person therapy because they would need to arrange for care for both the session and the commute. However, with teletherapy, they are only “away” from their loved one for 45 minutes, and they also have the option to step away from the computer to care for them, if needed. Or as another example, say the client has a serious medical issue. They can prioritize their doctors’ appointments without having to suffer from a late cancelation fee because chances are, I can fit them into another time slot for that week. This is not always the case for in-person therapists because they tend to have stricter “on the clock” hours.

Accessibility for People with Illness or Disability

Sadly, although therapists tend to think they are sensitive to those with medical issues, this is often not the case. Their hearts may be in the right place, but they simply do not understand why going to an appointment in-person can be a great challenge. It is one thing for an office to be “ADA-friendly” by having an elevator. But what if the elevator fails? What if the parking lot is full of potholes? What if there is no ramp at the entrance or no automatic door? What if the restroom door is very heavy? What if the person needs their caregiver to help ambulate them but the only appointment times available do not work for the caregiver?

What if the person has IBS or Crohn’s disease? Or maybe they are pregnant? The fear of waiting in line for the restroom is a legitimate concern for such people, in addition to the embarrassment that comes with nosy strangers.

If you have limitations due to an illness, disability, or medical procedure, you may be unable to make it into the office, which will hinder treatment during when it is most needed. Teletherapy removes these barriers by allowing you to “log in” from the comfort of your bed.

Continuity of Treatment for College Students

For some youth, their connection with their therapist is one of the healthiest, strongest relationships they have with an adult. They make great progress, tackling the core beliefs or issues or whatever it is that is hurting them… until they must discontinue therapy because they are moving away for college. In the best-case scenario, the therapist may just happen to know another therapist who is in that area and can take on the referral – but that is almost never the reality. Usually, the treatment is terminated, and the client is left floating, just waiting to hopefully get some help through the counseling center at their college. These colleges may not have enough counselors available to assist every student, lack the training needed for issues that go beyond “typical college stuff,” or other limitations.

On the flip side, with teletherapy, college students can keep their therapist, even those going to a college outside of their home state! In my case, I can keep every student who began with me in high school and has since left for a college that is far away. The only requirement is that their primary address must still be in New York, which usually is the case for college students as they tend to “go home” during breaks.

Reduced Wait-Times

In an in-person setting, there may be a considerable wait time to get an appointment with a particular therapist. However, remote-based therapists tend to have more time slots open and allow themselves to be more available. For instance, if someone needs to reschedule a session with me, that is much easier to accommodate because I can log on during a time when I usually do not work. On the other hand, an in-person therapist may only be able to offer times that are bad for the client, or say they are completely unavailable because otherwise they may have to drive to the office for just one session.

Effectiveness (yes, teletherapy is just as good as in-person therapy!)

Evidence-based research supports that teletherapy is highly-effective for most clients, issues, and modalities – and generally, teletherapy is just as useful as in-person therapy. Sometimes it is even more effective since clients may feel more relaxed being in their homes.

It is only a myth that teletherapy is a “diluted” version of in-person therapy. In truth, most modalities (i.e., EMDR, DBT) can be easily adapted to an online version. For instance, there is a website I use for the bilateral stimulation used with my EMDR clients.

For more reasons as to why teletherapy may be the right option for you or your child, click here.

- Valerie Smith, LMSW

Doesn’t it drive you nuts when people tell you to “calm down” when you’re upset, anxious, panicked, or afraid? It drives me insane. I just think to myself, “Okay great…and how do I accomplish that without putting you through a wall?” Of course I don’t act on such thoughts! But I understand the frustration of feeling stuck in a dark, deep hole of anxiety while the bystanders at the top of the ditch are yelling down to me, “calm down!” or “it’ll be fine!” or “you’re overreacting!”. Which is why grounding techniques can be so beneficial when no one else can.

First, we should go over some basics of what anxiety and panic look like so we can better spot them before we feel completely unraveled in our experience with such symptoms. 

Fight or Flight Response

First, quick side note/science lesson…our bodies yield both the Sympathetic and Parasympathetic nervous systems. Housed in the Sympathetic nervous system is our “fight or flight” that prepares us to respond to danger. While fight or flight has always been essential to survival, the body can’t always tell what is a genuine danger versus when we are just emotionally uncomfortable or going through something. The Parasympathetic nervous system helps our bodies restore back to a state of calm when fight or flight is no longer needed. This information is important because it plays a GIGANTIC ROLE in anxiety, panic, as well as other mental health struggles. 

So when we have anxiety, there is constant worry that we can’t seem to shake most of the time in addition to maybe feeling restless, on edge, having a hard time focusing, feeling more irritable, physically tense, having a tough time sleeping and feeling easily fatigued quite a bit. I go through this myself and I can tell you firsthand that ignoring these symptoms will lead to feelings of anger and irritability, scatteredness, constant exhaustion, and like every little thing is an insurmountable task which will negatively affect your life across the board. Trust me, I know. 

What is Panic?

Panic is a bit different and more intense than your typical anxiety monster impeding on your day to day life. With panic, we actually feel like we’re having a heart attack or like we’re going to die! That’s right…there are instances when people have had to go to the Emergency Room because they thought they were having a medical emergency. Completely understandable given the symptoms of panic. If we look at symptoms of panic that include accelerated heart rate/palpitations, sweating, trembling/shaking, shortness of breath, feelings of choking, chest pain/tightness/discomfort, chills or heat sensations, numbness or tingling, feeling detached from ourselves or reality, fearing we are losing control, and fears of dying….it’s no wonder people may want to seek out a medical professional real quick. 

While I have never experienced a panic attack myself…I am willing to bet that if I ever do, I’m getting my butt straight to the Emergency Room because as humans, what are we supposed to think when all of that is going on without any clear medical explanation? I highly encourage anyone experiencing such symptoms, especially if this has never happened before, to seek medical attention immediately and rule out medical concerns before chalking this all up to panic!

However, once we rule out medical concerns and have an understanding of panic symptoms, we can better manage them without seeking unnecessary medical attention or escalating our anxiety/panic due to fear of the unknown. It is essential to understand that panic attacks are just that, panic. They cannot physically harm you and they tend to last about 10 minutes (while I’m sure it feels like forever!). So, we have to remember that it will pass and getting comfortable with discomfort is one of the first steps to getting through panic attacks. I’m sure that’s obnoxious to hear, but it’s true. 

Much of the time, what I’ve caught myself doing to alleviate my own generalized anxiety is to avoid, avoid, avoid. Whether it be avoiding a deadline or an uncomfortable conversation, dodging obligations/tasks all together feels good in the moment, for sure. While my education tells me that avoiding my anxiety like the plague only makes things worse, I admittedly engage in this behavior. And trust me, the education is correct…avoidance only feeds the anxiety monster that lurks beneath.

So what are we to do when anxiety and panic strike?  

Well, a form of coping called grounding skills seems to help many, including myself, to feel more centered in the present moment and ultimately activate my parasympathetic nervous system (that’s what we want). With grounding, we are essentially turning our attention to the present moment so that we can ultimately feel more calm and address potentially anxious triggers.

In grounding, we use our five senses to return to the present moment when feeling overwhelmed and like everything is on top of us. Grounding equips us with several skills to utilize healthy detachment from emotional pain with use of distraction until we feel ready to return to any given problem. The following 5 skills that I will list below can be used any time, in any place, and can be completely discreet. There are many more ways of grounding that will not be covered here but I encourage you to explore ways of grounding with your therapist to find the right fit for you. 

The 5-4-3-2-1 Technique:

This skill invites us to observe 5 things we can see, 4 things we can feel, 3 things we can hear, 2 things we can smell, and 1 thing we can taste. For example, if I am feeling overwhelmed I will stop and look around me, engaging in this technique to focus on something aside from my stressor for a few minutes until I can collect myself and face my problems with my head screwed on right. 

Body Awareness Technique:

Here, we are encouraged to focus our attention on sensations in the body and feeling of calm after the exercise is over. Below, you will find an example cited from Therapistaid.com.

  1. “Take 5 long, deep breaths through your nose, and exhale through puckered lips.
  2. Place both feet flat on the floor. Wiggle your toes. Curl and uncurl your toes several times. Spend a moment noticing the sensations in your feet.
  3. Stomp your feet on the ground several times. Pay attention to the sensations in your feet and legs as you make contact with the ground.
  4. Clench your hands into fists, then release the tension. Repeat this 10 times.
  5. Press your palms together. Press them harder and hold this pose for 15 seconds. Pay attention to the feeling of tension in your hands and arms.
  6. Rub your palms together briskly. Notice and sound and the feeling of warmth.
  7. Reach your hands over your head like you’re trying to reach the sky. Stretch like this for 5 seconds. Bring your arms down and let them relax at your sides.
  8. Take 5 more deep breaths and notice the feeling of calm in your body.”

Grounding Statements:

When having anxiety or panic, a way to cultivate acceptance of discomfort and better managing symptoms, we can be kind to ourselves. Does it seem ridiculous? Maybe… but it can work! Focusing on positive words you say to yourself over and over in the midst of anxiety or panic can help you remember that you are strong, resilient, and can overcome difficult things in this life. Some examples of what you might say to yourself would be, “This is uncomfortable but I can accept it”, “I will let my body do its thing and it will pass”, “I survived this before and can do it again”, “this isn’t dangerous”, “no need to push myself, I can take a small step forward as I choose”, “these are just thoughts, not reality”, or “don’t worry, be happy”. 

Diaphragmatic Breathing:

I’m sure mostly everyone has heard of some form of deep breathing and I often hear clients tell me, “this doesn’t work for me”. Upon closer inspection, I find that people may try this once or twice, and when it's not instantly working, they chuck it out the window. However, this form of deep breathing should be given a fair shot! Let me explain a bit more about how to engage in this skill, then I’ll explain why I feel so strongly that deep breathing really needs to be given a chance. 

So, how do we do this one? We put one hand on our chest and the other on our belly. Then, we inhale slowly through our nose, hold briefly, and exhale through our mouth. Some follow a formula of 4-6-4; ie. inhale 4 seconds, hold 6 seconds, exhale 4 seconds). Adjust to your comfort level. Make sure that upon breathing in, your belly is expanding out. Notice how your belly expands and falls with each breath. It is recommended to engage in this skill for at least 2-5 minutes daily.

The reason deep breathing works is because it levels out the oxygen and carbon dioxide in your blood. When you have anxious breathing, your oxygen and carbon dioxide levels are uneven, leading to the physical manifestation of anxiety that we talked about earlier. So to help activate the parasympathetic nervous system (the one we want) and ease the physical parts of anxiety, diaphragmatic breathing is a great one to try. Let me know how it goes!

Using Sense of Smell for Grounding:

It has been found that in anxiety as well as trauma, the sense of smell is largely connected to the emotional part of our brains. If you think about it, maybe something that smells oddly familiar to you but you can’t put your finger on it brings a sense of comfort and calm. I know for me, whenever I smell anything that resembles Thanksgiving dinner, I have a sense of ease thinking back to fun childhood memories, enjoying my grandmother’s cooking for Thanksgiving dinner. Her food is always on point!

So when we are feeling anxious and/or triggered in any way, we can use sense of smell to quickly return to the present moment. Ideas that some of my clients have found helpful over time is to keep a perfume and/or cologne soaked handkerchief on them, an essential oil bottle on them, or maybe a favorite kitchen spice. Candles and/or wax warmers at home can also bring a sense of peace and calm using pleasant scents. 

While anxiety can sometimes make us feel like we’re in a moving car with no driver, there are ways we can safely get back into the driver’s seat and navigate our symptoms safely, securely, and happily. Your therapist can help you navigate these tools and find out what may be the best suited for you and your needs. Anxiety will not get the best of us!

- Jaclyn Martinez, LMSW

For some people dealing with the death, illness, or absence of a *significant person, the holidays can be a time of mixed emotions like sadness, guilt, grief, as well as hopelessness. On one hand, we are expected to be festive and merry; on the other, we are reminded that person is no longer here or in the capacity they once were. It can be exhaustive to cope or grieve. Unlike an anniversary or birthday, where the day itself can be dreadful but otherwise there are limited triggers about it, the holiday season is different. The sights, sounds, activities, and gatherings go on for weeks.

Note: I use the term “significant person” rather than “loved one” in recognition that grief is complex. Not all people had loving, supportive relationships with the person who died, but regardless that relationship was still of profound importance. “Significant person” is thus an inclusive term.

Unquestionably, some holidays during other times of the year can be bittersweet, such as Mother’s Day or Easter. Yet as a culture, the holiday season seems to be the most profound in its importance for its emphasis on family gatherings. Thus, it is not surprising that for many people Thanksgiving through New Year’s Day can be especially hard.

The Grieving Grinch

A long time ago, I was close to someone who detested Christmas. He was a classic Grinch. From around September and onward, he would be triggered by reminders. It could not be avoided – every store was already getting decked out with Christmas decorations and toys to sell. By the end of October or perhaps early November, Mariah Carey was already bleating over the speakers at every store. This despair from September through January went on for years, with me making every effort to try to make the months more tolerable for him. Eventually, though, I realized he was too caught up in his grief. I told him that he has no control over the holiday season; that he must radically accept it will come every year no matter what, and that the more he fought against it the more it would breed misery for him. I encouraged him to instead honor his losses, truly grieve, but to still try to enjoy other aspects of the season. He insisted he wanted to avoid it. I asked him to consider, “how exactly would you avoid Christmas?” and he said he would lock himself in his room. My response: “Which would mean you would need to sleep for months. You wouldn’t be able to turn on the TV, go on the internet, listen to the radio, really… anything. Because the point is that no matter how much you try to ignore Christmas, it will come anyway.” I don’t know why, but somehow that dry, matter-of-fact response got him to begin thinking differently – he finally stopped fighting the “hatred” which in truth was grief. He was avoiding his grief.

Grief Coping Strategies

While by no means a complete list, the following are tips you may use to help you get through the holiday season if caught in grief.

Skip the holidays – but with a plan

Yeah, I know. I just got done writing about that person where I gave him the exact opposite advice. Hear me out.

The holidays are stressful enough. Compounded with grief, they can feel downright unbearable. The traditions, shopping, cooking, family, parties… all of it can feel tiring even when thinking about it. I want you to know it is okay to skip the holiday season. You may face backlash for saying no to Thanksgiving dinner, but your self-care comes first.

Remember these points before canceling your holiday season:

1) The holidays will come again. This year you may not have the energy to deal with the holidays, but next year may be different. At that time, you may feel ready to engage again. Do not think you have to be in a rut each year. That is unfair to you.

2) Ask yourself, “am I skipping the holidays to help myself or just to avoid the pain?”. If you need to, take your pen to paper to come to this answer. You may truly want to skip the holidays, or  maybe you are feeling pressured by others (family, society, etc.) to celebrate.

Additionally, ask yourself if you are prioritizing your self-care versus having avoidance. In psychology, avoidance coping is a maladaptive coping mechanism (in other words, an unbeneficial or unhelpful technique) that means to avoid processing the thoughts, feelings, and stressors associated with an issue. In grief, this can mean you are refusing to process the loss of the significant person, procrastinating things that need to be done that remind you of the person, or being in denial of emotions you are feeling. While this seems helpful in the present moment, it only intensifies the anxiety. It festers like an untreated wound.

3) Decide what you will do for the holidays, rather than only what you will not do. Remember that if you say no to going to dinner at Uncle Joe’s house, ultimately the rest of the family will be there. Then what? What is your plan? Before that day springs up on you, plan accordingly. If your idea of self-care is to binge-watch Cobra Kai in your bedroom on Thanksgiving, do so! But do not wait until the holiday arrives to try to plan as that may increase your negative emotions; you may make yourself feel unintentionally worse.

4) You may have regret or sadness if you skipped the holiday. On that day, you may go on social media only to notice the get-together at Uncle Joe’s house looked fun. Maybe there is a funny video of your younger cousin making a snide comment on TikTok. Maybe your sister posted a Facebook video of your three-year-old nephew unwrapping presents with a big smile. Ask yourself if it is worth you skipping the holiday or instead if you may find happiness in being with others.

Did you watch A Muppet Family Christmas special when you were younger? If so, remember when Fozzie Bear and his friends drove to Fozzie’s mother’s house with the intention of spending Christmas with her, only to find out she rented out the home to a man and his dog who wanted to avoid everyone for Christmas while she ran off to Malibu? Although the man was upset at first that his holiday did not go as planned, he ended up having an even better time because he allowed himself to join in the festivities.

5) Or you may have an even better day if you put yourself first! In that same special, Fozzie Bear’s mother was having the time of her life on the beach in Malibu.

Do not make comparisons

It is tempting to see other individuals or families enjoying festivities and comparing their experiences to your grief. You may feel worse, like you “should” feel merry.

It is important to remember that even under the best of circumstances, the holidays are stressful for most people and families. The sappy, magical events shown on television and captured in greeting cards are rarely the reality. For instance, you do not know if the hostess of the dinner was in a vicious argument with her spouse only minutes before the guests arrived, only to hide it all behind a beaming smile. You do not know if the parents are struggling to buy presents for their children. Instead, think about what you do have – you may feel more gracious!

Extend yourself to others

If you have the time, consider volunteering your time to someone who needs the extra support (Long Island Volunteer Opportunities). This could be spending the holidays at a hospice, nursing home, hospital, soup kitchen, or shelter. Your love and support toward a stranger may make their holiday memorable and bright, while benefiting your own mental health by taking your focus off the grief. Volunteering is very helpful in the healing process of grief!

Alternatively, reach out to a family member or friend who may need some help right now.

Remember that the anticipation can be worse than the day

In my work as a grief therapist and as someone who has experienced significant losses, I have noticed the phenomenon of anticipation being worse than the holiday itself. My hypothesis is that by experiencing the surge of emotions beforehand, we are thereby allowing ourselves to think the day itself will be awful, which will make us feel better when that day arrives, and we find we are okay. In essence, it is making us “cope ahead” by going through the storm beforehand.

Find support

You may reach out to friends and family for emotional support with your grief, but are worried about doing so because they may be preoccupied with the holiday season. Consider joining a grief support group.

Let yourself feel your emotions

Your emotions are valid. Do not think you must feel happy because it is the holidays or otherwise there is something “wrong” with you. If you feel angry, let yourself vent. If you feel sadness, allow the tears to flow. If you feel lonely, reach out to a friend.

Ask for help

We as a culture tend to be cautious of asking those who are grieving if they need help. We may assume it would be an unwanted reminder or we simply do not know what to say. Other times we may think that the bereaved are doing okay.

Please speak up if you need help from a friend, neighbor, or family member. Perhaps that entrusting someone else to make a particular favorite dish, cleaning up the house, or getting some other tasks done. People tend to feel satisfaction when they know they are caring for someone they love.

Other ideas

Are you looking for more ideas for coping through the holiday season? If so, go here.

- Valerie Smith, LMSW

In couples counseling, many cite communication issues as being at the forefront of relationship challenges. Giving/receiving the silent treatment, experiencing defensiveness, criticizing one another, and feeling misunderstood by your partner are a few signs that communication issues are present in a relationship. Every person has a different communication style based on several factors, including upbringing, personality, previous relationships, and beliefs regarding self and others. While communication styles can be varied, there are some common threads that unite effective communication.

Here is a list of 4 simple strategies to improve communication with your partner. Notice I said YOUR communication; not necessarily their communication with you. You cannot change others; you can only change yourself. However, in implementing these steps, you are ensuring that you are expressing your needs in a healthy manner.

Step One: Actively Listen

Sounds simple. However, it is easier said than done. Rather than listening, oftentimes we are waiting for our turn to talk. We may be nodding our heads, but inside we are formulating our responses, or in some cases, rebuttals. A lot of information can be missed by doing this. We hear what we think the other person is saying based on past experiences and not what is being said. You can improve your listening skills by pausing, exhibiting open and relaxed body posture, avoiding interrupting, reflecting back what the other person has said, and asking questions for clarification. Make it easier to actively listen by eliminating any distractions from the environment.

Step Two: Foster Empathy

Humans are self-centered by nature. We see things from our point of view day in and day out, so putting ourselves in someone else’s shoes and viewing things from their perspective takes work. Fostering empathy often allows you to see a situation more clearly, it allows you to broaden your perspective and reduce anger, which has been proven to cloud logic and reasoning. This does not mean making excuses for their behavior. You are simply acknowledging that everyone has their own emotional and behavioral reactions that may differ from your own. From this place of understanding, validation, and acknowledgement, positive change can be made.

Step Three: Do Not Personalize

It is hard not to personalize someone’s actions when they affect you or even worse, they are directed AT you. However, how someone treats you reflects how they treat themselves. It has little to do with you, and everything to do with them. It is only personal if you make it personal. Do not let the words or actions of another determine how you feel about yourself. When you take yourself out of the equation, you can see things in a more neutral and realistic light, therefore moving you away from emotion and closer to logic.

Step Fourth: Use "I" Statements

The use of “I” statements helps decrease blaming while increasing self-awareness and personal responsibility. “You-statements" tend to cause the other person to feel defensive and/or shameful. An example of reframing a “you” statement to an “I” statement goes as follows: “You never listen to me” changed to “I am feeling alone and misunderstood; I want to know how I can communicate with you to gain a closer connection.” Reframing your language in this manner helps move toward a solution in a quicker and more meaningful way.

Remember, communication is not a one-way street!

These suggestions can be counter-intuitive. It also may be difficult to put these into practice if your partner is not receptive, or continues to communicate in a non-productive manner. However, by implementing these strategies, you can begin to empower yourself; ensuring you are communicating in the most effective manner possible to get your needs met.

If you find you have tried these strategies and are still having difficulty in your relationship, it may be time to try couples counseling. Couples counseling can be used as a great tool to address relationship issues before they escalate to causing irreversible damage. Contact our intake department to learn more.

- Alexandria Baxter, LMSW

After a long day, rushing to get your work done, put dinner on the table, and solve the crises everyone runs to you for, you finally get a moment of peace while laying down to sleep. Unfortunately, for many of us, this time can be full of distressing thoughts including memories of the past, fears for the future, and analysis of ourselves. Some even find themselves unable to fall asleep due to these ruminations, making their next day even more tiresome.

Why Do I Overthink at Night?

Our nighttime thoughts are often a reflection of our daily lives. To a degree, thinking at night is our mind’s attempt to reflect, adapt, and prepare for challenges to come. What this means is that if our days are full of stress then our minds will try to anticipate future stress and prepare us for that stress in our only moment of respite.

Some people find that giving themselves a time, during their waking hours, to feel their stresses and accept them, have less of a tendency to think of these thoughts later on. This can be a difficult task to do, but a number of clinicians at Long Island EMDR can be there to help you get started. Learn about them here.

Overthinking Affecting Sleep

People who suffer from overwhelming life stress, anxiety, depression, and associated insomnia will often say that their unwanted thoughts make it harder for them to get to sleep each night. This insomnia can lead to decreased work or academic performance, depleted mood, low energy and fatigue, or many other functional impacts.

How to Focus on Trying to Sleep

As silly as it may seem: count sheep. More specifically, there is research that suggests repeating a word or phrase at specific rates (usually 3-4 repetitions a second) can impact our brain’s ability to think of other thoughts. This is called articulatory suppression. This phrase should be neutral so that it doesn’t trigger thoughts of other things to come to mind. Some people find syllables or articles (“the”, “an,” or “a”) as helpful choices.

Others find imagery to be exceptionally helpful in maintaining sleep and getting to sleep. Try this exercise: in your mind, craft a story around yourself doing something that you enjoy most. Do your best to picture the details: sights, sounds, smells, or tastes. By practicing this imagery, you are training your brain to use your imagination to distract yourself from your thoughts. If those intrusive thoughts come to mind, accept that they are there, and push them aside as you author your tale.

Remember, this is a learned skill. It may not come naturally and it may not work the first few tries.

Other things that you may be able to do to focus on your sleep include:

  1. Staying off of your electronics at least 30 minutes before bedtime.
  2. Not utilizing your sleep space for non-intimacy or non-sleep-related activities throughout the day.
  3. Eliminating caffeine or other stimulating substances.
  4. If you struggle to fall asleep within an hour and a half, get up and do something for 15 minutes. Then try again.
  5. Exercise in the day to drain excess energy.

What to do to Control Thoughts

Our brains are very much like a river: the water represents our thoughts and the land represents our mind. If we can place ourselves firmly in the river, and not get carried away with the current, then we can improve our wellbeing. For some, the current, or our intrusive overthinking, will carry us into anxiety, depression, and other negative mental places. So, we look to take some control back and stand up.

Some brief activities can help us to control our thoughts and thus improve our nighttime routines.

  1. Mindfulness meditation.
  2. Breathing exercises.
  3. Positive affirmations and rejection of self-judgements.
  4. Taking a meaningful break from daily stress.
  5. Identify what causes unwanted thoughts and our focus on them.
  6. Journal your thoughts and feelings.
  7. Talk with your therapist about Mindfulness and Acceptance based Cognitive Behavioral Therapy.

-Nicholas Costa, MSW Intern

Losing a parent is a life-changing, profound experience that almost everyone will go through at least once. In fact, the death of a parent is one of the most common types of death, and as a society, we expect we will outlive our parents. As a result, while the grief that accompanies the death of a parent can quickly be recognized with the inundation of flowers and sympathy cards, this commonality seems to minimize the loss and makes us think we should “get over” it soon. The truth is, it can still be a tremendous loss – and this sense of “get over it” can make the healing even more difficult because it comes with guilt.

While the death of a parent regardless of one’s age is universally a colossal experience, the death of a mother or father as a young adult can be even more devastating because it is compounded with unique obstacles. For instance, there are milestones that the parent is expected to be present for, such as college graduations or weddings, and it can seem impossible for anyone else to fill that space. Plus, for young adults, this type of loss can be especially difficult because they are on the cusp of dependence versus independence. While they strive to depend on themselves, they still may turn to their parents for financial assistance, emotional support, or the wisdom of lived experience.

And we know this much: When a parent dies suddenly or expectedly, there is an absence – an emptiness, perhaps – that arrives with the realization someone so significant is gone. Regardless of the relationship dynamics, whether it was balanced and warm versus chaotic or cold, the death will have a huge impact.

Some beliefs among young adults who have dealt with the death of one or both parents

“I feel so alone and misunderstood.”

“My best friend says she ‘get its’ because she lost her grandma. But I lost my mom. It’s just not the same.”

“I will never feel loved that way again.”

“Everyone is telling me I need to ‘get over it’ and start living my life. But how am I supposed to move forward knowing I’ll never hear Mom’s voice ever again?”

“Dad’s gone. Who is going to walk me down the aisle?”

“I’m so sick and tired of my friends complaining about their silly problems! They have no idea what it’s like to be in this much pain!”

“I’ve always wanted to be a mother. I wanted so desperately to have a family of my own. Now that I’m pregnant, I should feel excited. But instead, I’m just thinking about that my baby will grow up without grandparents.”

“Thanksgiving is going to be weird this year. Dad always sat at the head of the table. He always carved the turkey. He always said grace. I just don’t even want to go.”

“Mom has been an absolute mess ever since Dad’s been gone. I want to help her, but she doesn’t seem to care that I’m hurting too. It feels like she’s gone too even though she’s here.”

“They say they’re ‘here for me’ but they’re not. No one wants to talk about Dad anymore now that the funeral’s over. If I say something, I’ll sound negative.”

“My friends have told me I need to start ‘living my life’ again. They’re sick of me being so mopey and depressed. I’ve noticed they’re pulling away from me. Now I feel like I’ve not only lost my parents, but even my own friends, the same people who said they’ll always be there for me no matter what.”

“I hate to admit it… I feel guilty saying it… but yeah, I’m jealous of my friends. While they’re looking forward to happy things like getting married or graduation, I’m taking care of my mother who is terminal. She’s going to die and that’s that.”

“It pisses me off when people tell me ‘She’s in a better place now.’ It invalidates how I’m feeling.”

Above: Me on my wedding day, trying to replicate my most favorite photograph of my mother on her wedding day in an effort to feel her presence again.

The adult orphan syndrome following the death of a parent

For most people, they have known their parent(s) longer than anyone else in their lives. Whether the relationship was positive or negative, or there were additional issues like separation, parents still shape their children.

The identity of “son” or “daughter” is the first identity upon us all. Most people were cared for by their parents as they grew up, even if not done well, and their parents witnessed all the obstacles along the way – seeing all the rises and falls, all the happiness and despair, all the pulling in and pushing away for guidance.

By adulthood, we have formed far more identities while carrying over some from childhood. Yet the age never matters – we continue to be a son or daughter, the role carried from since the beginning.

To lose a parent thus brings about a role loss. When I lost both of my parents, I realized my first role – “I am a daughter” – was destroyed too. And my first sense of constancy, of a promise something will always endure, had died too. We all seem to realize we will likely outlive our parents, but the idea of them dying is so often shaken off until it happens. We see the relationship as permanent as the sun rising with every dawn.

Losing a parent in adulthood can bring about complicated emotions, one of them being abandonment. Even people who are very independent from their parents can still feel abandoned because the sense of constancy has been disrupted.

For young adults who were the main caregiver for an aging, disabled, or ill parent, the grief can be exacerbated since two roles are now lost: the role of being one’s child but also serving as their “parent.” It may also mean having to adopt new roles in the family going forward, such as needing to help the surviving parent with paying bills because they feel overwhelmed and that was always done by their spouse.

All of these issues are recognized by some researchers as what they call “adult orphan syndrome” in that the feelings of abandonment, confusion, role changes, lack of support, and idea of being alone are universal regardless of age. For some, the idea of being an orphan as an adult may sound insensitive to children who are orphaned, but it is not meant to compare or dull that pain – only meant to show that the feelings and complications can still exist.

It is interesting, too, that this type of loss has no such word in English. An orphan literally means a child whose parents are dead. A widow is a woman who lost her spouse; a widower a man who lost his spouse. Yet why not a word for those who lost a parent in adulthood?

Challenges faced by young adults experiencing parent loss

Although parent loss can be painful at any age, there are differences that are driven by our age brackets.

First of all, most young adults have parents who are alive and likely well. They may be mostly independent, but they know they can still rely on their parents when needed (obviously there are exceptions, but I am speaking in general). They and their friends will be “going home” for the holidays during college breaks to stay with their parents. They know their parents will be there at their commencement ceremonies, sharing in their joy for their successes. They excitingly call their parents when they get engaged, wanting them to be the very first people to know. Then during the engagement months, their parents are involved too, with the mother helping with choosing the dress and adorning her daughter on her wedding day, and the father walking her down the aisle. Parents, too, are also usually the first to learn when their child and the child’s partner are expecting a baby. And they are there for the baptism or other ceremonies, there for the birthday parties, the holidays, for help with childcare.

While these above milestones can still occur despite the death of one or both parents, it feels different. I will honestly admit I skipped my commencement ceremonies from college and graduate school (the pandemic did postpone the latter ceremony by a year, but regardless, I still did not go even when it was happening). I did not want to be “that person” who was there without their parents, that adult orphan. And while I was proud of myself, having been summa cum laude both times, I did not feel there were others to share in that sense of accomplishment.

I can also say that among my friends and family members, most of them do not understand what I have gone through as a parentless young adult. That is not subjective; it is factual. Some are fortunate to still have their parents. Others have lost their parents, but that was not until their mothers and fathers were in their geriatric years. My grandmother died at the advanced age of 93, an age considered a “life well lived.” My mother died at 57. While the adult orphan syndrome happens at any age, and pain is pain, it still does not feel the same. There is the lingering thought, “she should be here.”

Healing from parent loss as a young adult

The goal of bereavement therapy is not to “get back to normal.” That is impossible, for life has forever changed due to the death of the parent. The idea of having to “move on” is counterproductive, and in fact can make someone feel worse because they are burying the emotions they need to process. Instead, the goal after such a loss is to learn to redefine one’s life and to feel fulfilled despite the loss. It also not only the loss itself that must be explored, but also the update in roles, the severance of expectations, and all other things that come with death.

Losing one’s parent can unearth disturbing thoughts. It can make someone question their own mortality with the realization they too will die someday. They may think things like, “since Dad died at 45, that means I’ll die at 45 too” even if they realize that is irrational. Additionally, it can make one reflect on the importance of other relationships in their lives. One person may become closer to their siblings or friends, while others may distance themselves, and still others may decide to focus solely on their spouses and their children.

Such a loss can also be an inspiration to make newfound changes in one’s life – some for the better. For me, I was smacked with the realization of, “I must rely on myself. I am an adult” the moment my father died. This realization did not strike me when I moved out at age 19 to live across the country. It did not fall upon me on my wedding day. Hell, it did not even come up during the discussions with my husband about starting our own family. No, it really took him dying for me to have this fricken’ epiphany. Only a month after his death, I was on job interviews to have greater opportunities. Right now on the weekends, I am house-hunting with my husband rather than doing the same ol’, some ol’ things we did with our friends. We are trying to conceive.

I was already following a plant-based and low-alcohol lifestyle, but after my father died, I made the full commitment to being healthy. I make selective, nutritious choices, and I do not drink at all. A healthy lifestyle is my priority now, my sworn vow to myself, because I don’t want to die the way my parents did if I can help it. I want to live. One profound effect of the loss of one or both parents is the opportunity for positive changes.

The next step

Long Island EMDR recognizes the aftermath of a death is a significant, life-altering process. Some of our clinicians specialize in grief and bereavement, including having specialized training in this important field. We offer individual therapy and group therapy for this topic. In fact, we are even starting a group called Millennials in Mourning, which is specifically for Millennials and older Zoomers who have experienced parental loss. It will be led by me, Valerie Smith!

Reach out today to learn how we can help you navigate through this challenge while building a brighter future.

About the author, Valerie Smith, LMSW
Valerie Smith, LMSW, CFTG, is a therapist, social worker, and certified forest therapy guide at Long Island EMDR under the supervision of our clinical director, Jamie Vollmoeller, LCSW. Valerie possesses a bachelor and master’s degree in social work from Adelphi University and Fordham University, both from which she graduated summa cum laude. Valerie is also a certified forest therapy guide through the Association of Nature and Forest Therapy (ANFT), where she trained in the Rocky Mountains to master sensory-based, mindful activities through a biophilic perspective. Valerie is passionate about the health benefits of a plant-based diet as well as holistic wellness. Valerie is trained in EMDR and TF-CBT, with experience in DBT-informed skills. She focuses her treatment on adolescent girls and young women with C-PTSD and PTSD. Additionally, she helps people with life-threatening disease and their caregivers. Finally, she works alongside those experiencing grief and bereavement, especially young adults who lost one or both of their parents/guardians.

Everyone ruminates. Whether it’s thinking about something we said to someone, something we did wrong, or some recent event that is stuck in our mind. Ruminating thoughts can be defined as repetitive and recurrent, negative, thinking about past experiences and emotions (Michael, et al., 2007). However, while everyone experiences ruminating thoughts at some point in their life, for some, rumination can be distressing, difficult to stop, and can lead to dysfunction in their day-to-day lives.

Why do we ruminate?

When we think about ruminating, it’s important to acknowledge that it often comes from an effort to cope with distress. For instance, analyzing an experience can better prepare us to encounter a similar experience in the future. Or it can help us mend some relationships that were negatively impacted by an event in the past. But, when these thoughts aren’t leading to any productive change we can see individuals obsess over these thoughts, become anxious and depressed, isolate, or begin using / increasing their use of mind-altering substances.

Types of ruminating thoughts?

Ruminating thoughts can be very diverse. For some, they may ruminate about their hands being dirty and that they may get sick. Others may ruminate about suicidal thoughts, including existential themes about the meaning of life. Some may continually think about a traumatic experience, like an assault or some form of abuse. As well, some of these ruminating thoughts may be untrue distortions of events. For example, repeatedly thinking about being sexually assaulted may come with false thoughts that the victim somehow provoked their assailant or deserved to be assaulted.

Are my ruminating thoughts true?

Our experiences mold our self-esteem, or the way we perceive our behaviors, abilities and traits. A traumatic experience can leave individuals with warped perceptions of themselves that can have a detrimental effect on their day-to-day lives. Especially the formation of a negative self-esteem, or negative self-concept, is associated with feeling disempowered, hopeless, and helpless. Ruminating on these experiences, or even these self-beliefs, has been shown to exacerbate and prolong negative moods, and hinder social interaction and problem-solving skills (Wang, et. al, 2018).

Are ruminating thoughts part of a diagnosis?

Ruminating thoughts can be associated with a number of mental health diagnoses, including:
● Depression 

● General and social anxiety 

● Substance abuse disorder 

● Bulimia 

● Binge eating disorder 

● Obsessive-compulsive disorder

● Post-traumatic stress disorder 

● Personality disorders, like borderline personality disorder 

There is hope!

Ruminating thoughts are treatable and manageable. Treatment often aims to interrupt the thought processes and improve coping skills to replace rumination. Some individuals find relief from medication management, cognitive-behavioral therapies, and mindfulness techniques. 

If you experience ruminating thoughts and are looking for a way to move forward, please call our office and schedule an appointment. Our licensed clinicians and therapists on staff would be more than happy to work with you.

-Nicholas Costa, SFT Social Work Intern

Being a parent is not easy. Being a mom is pretty rough too. I recently watched a show called “Better Things” about a single mother (working in Hollywood) raising her 3 daughters. At some point in the show, one of the daughters made a comment about single mothers. Another character said, “All mothers are single mothers.” That hit me hard. As supportive as my husband is, and as an amazing father he is to our two perfect little children, it wasn’t always like that. Today I can confidently say that I do not feel like a single mother. I feel like my partner contributes many things he once did not, whether it be with the children or with household responsibilities. At some point in my life with children, I felt like if I had to leave the house, I had to set my husband up like a babysitter and have diapers, wipes, cream, outfits, bottles, blankets, etc., all ready for him so he would have no hiccups during those times with the baby/toddler. 

That and along with the million other tasks I was responsible for, it became exhausting to say the least. I felt like I was on autopilot and not enjoying my life anymore. At that time, I was craving for my husband to just do and not be asked. It took a lot of therapy (individual and couples) for me to feel confident enough to communicate what I needed from him, and it took effort on his part to meet me halfway. We tell our children that we are a team, and everyone must do their part for each of us to feel happy and safe. My husband and I forgot what it meant to be a team to each other for a long time, and thankfully, today, I do feel like I have a trustworthy team member when raising our children. I do not leave my house with instructions for him like I would for a babysitter. I just leave knowing that he’s got this, and he does. In fact, he always was capable given the chance. 

We often feel overwhelmed and burnout because we feel like the only one on the team who is participating.  We plan most things, we are the ones packing for more than just ourselves for vacations. In the mornings, we get ourselves and 1,2, or 3+ people ready for the day, and then ready for bedtime at night. Learning and practicing ways to effectively communicate with confidence can help alleviate this feeling of burnout and make more time for us to be ourselves. 

The Mental Load

Kelly Gonsalves from mindbodygreen.com writes about The Mental Load that women typically go through in which she defines as: “The mental load is a term for the invisible labor involved in managing a household and family, which typically falls on women's shoulders. Also sometimes referred to as "worry work" or "cognitive labor," the mental load is about not the physical tasks but rather the overseeing of those tasks.” This comic explains it the best:   https://english.emmaclit.com/2017/05/20/you-shouldve-asked/

Breaking the Cycle

It’s easier said than done- for sure I’ve lived this life. But putting in the work I promise is worth it. Here are some tips that have helped me to improve communication with my spouse.

1. Listening

Listening to what the other person is trying to say. As well as listening, not only to my children and my partner, but to myself. Listening to your feelings, triggers, warning signs, body sensations, or anything that might tell you that you need a break. Tips to Help You Actively Listen:

Focus fully on who is talking. This means not multitasking mama. Put the phone down, stop doing the laundry, stop thinking of the 20 other things you need to do.  Engage. Make eye contact and be fully present with that person. If you find it hard to concentrate on what they are saying, repeating their words in your head it’ll reinforce them. Or check in on yourself- maybe you are not in the best emotional state to be having this conversation. If that’s the case take a break and tell them you will talk in an hour when your calm so you can be really present for them

Avoid interrupting or trying to redirect the conversation to your concerns. If you are coming up with a rebuttal or how to get the conversation back to your main concern- you're not really listening to them. You cannot listen fully and be thinking about what you will say next. If your doing this it can show through your non-verbal cues like your body language and facial expressions. 

Show you understand what they are saying. Ask clarifying questions. Repeat a summary of what you heard so they can clarify for you. A lot of time miscommunication is what happens when we think another person is inferring something or we get fixated on the words they use- losing the message behind the words. Clarify. Some examples: “when you said ‘x’ are you saying that you feel ‘xyz’”.”what do you mean when you say…” “is this what you mean..” “Sounds like you are saying…”

Focus on understanding not judging. When we judge others there are a lot of value statements about what is right and wrong. Understanding is trying to see why they think the way they do, even if we don’t agree with it. It’s about empathizing with their position and understanding their pain-points- that’s how you find solutions. NOT the blame and shame game.

2. Paying attention to the non-verbal cues. 

Both your body language and theirs. Make sure you are “open” with your body language. No crossing of arms or legs. Face should be understanding or neutral and your tone is important. If either of you are showing non-verbal cues that you're angry or anxious- table the conversation till you are both calm.

3. Managing your emotions

Being a mother means repeating yourself, having tiny voices repeat themselves around you, making messes everywhere, and invading your personal space all day everyday. It is easy to feel as though you might explode with frustration. Learning how to manage those explosive feelings and reactions can not only help you to feel sane, but can teach your children by example how to control themselves. Learning how to manage your emotions may come in the form of daily meditation, individual/couples therapy, or even with medication as prescribed and monitored by a psychiatrist. This also means paying attention to your triggers and warning signs and “tapping out” when you need a break. Walking away and taking space, even if it’s in the bathroom for 5 minutes, can help you to recenter yourself so you are not losing it on the family.

4. Be assertive

Being assertive to get what you want is not always easy, especially if you feel the burden of being the primary caregiver/housekeeper/shopper/activity planner, you know the be-all-end-all? Learning how to and practicing how to be assertive can change your life for the better and alleviate some of the pressures in life. It can also instill self-confidence in your children when you hold your boundaries and empower them to learn how to do for themselves!  Honestly- same goes for the spouse. 

5. Surround yourself with positive people that lift you up!

 Having the right circle of support is key to really beginning to make these changes! Let’s be honest, for most of us we have been conditioned from childhood to help and please others. To neglect ourselves, our feelings and our needs. If you don’t get some people around you who are cheering you on to break the cycle- so that your kids don’t have that inner voice that says “my feelings and needs don’t matter”- it’s just going to be constant criticism from the people around you who instilled that value! And that coupled with change being so uncomfortable to begin with is not a good recipe for success. 

Sound Like You?

It takes a lot of work and consistency for oneself to feel confident and empowered enough to set boundaries and expectations that are reasonable for everyone involved (including you momma!!). Joining a support group with people going through similar struggles can be a helpful way to join forces and empower each other to take back our voice, our alone time, our self-care, our guilty pleasures, and most importantly, the confidence to achieve these things in an appropriate and reasonable way.  We all deserve this, and the saying “it takes a village” doesn’t just mean to raise a family, it also means to support the caregivers and mothers in our lives in different ways. If you are interested in receiving individual therapy from a woman who has truly been there, schedule with me today. If you feel you need a support group of like minded-woman join inquire about our “Don’t Know How She Does It Group”. I would love to help you become the woman you were born to be!

Sending Love,
Kristy Casper, LCSW

When we experience trauma, our brains don’t function like they normally do. We go into survival mode: think fight, flight, or freeze. Our brains automatically direct all of our energy toward dealing with this immediate threat until it’s gone. In most situations, this feeling of being in danger fades over time. Maybe it takes a few hours or a few days but you eventually start to feel better and less on edge.

But sometimes that initial trauma sticks, and you just can’t seem to shake the feeling that you’re still in survival mode. Trauma can change the way we think, act, and feel for a long time after the initial event occurred. Things like flashbacks or nightmares, constantly feeling on edge, anger, intrusive thoughts, and self-destructive behaviors are all very normal responses to trauma. You might feel as if you’re stuck living with these symptoms for the rest of your life, but the good news is these patterns can actually be reversed. With the right approach and knowledge, you can shift your brain towards overcoming past trauma and begin your healing journey.

The Brain's Response to Trauma

Trauma’s impact on the brain is complex. Let’s talk science for a minute to review some parts of the brain. Trust me, I’m not a fan of science either. But I promise this is helpful to know in terms of healing, so stick with me.

To simplify things, let’s break it down into two parts: the subconscious system vs. the conscious system. Do those terms sound familiar? Your subconscious mind is responsible for any involuntary actions, and your conscious mind is responsible for rationalizing and logical thinking.

Okay, let’s take this one step further. The subconscious part of your brain involves the Limbic System (think automatic) and the conscious part of your brain involves the Frontal Lobe (think choice). Both of these systems work together to help you survive and stay safe. If you’re in trouble, the frontal lobe says, ‘yes, this is dangerous’ and allows the limbic system to react in either a fight, flight or freeze response. On the other hand, if your frontal lobe realizes you are not in any danger, it works to calm down the limbic system’s reaction.

You might be asking why this is relevant. Well, here’s why. Trauma can disrupt the ability of your limbic system and frontal lobe to work together, and this causes you to either go numb or into overdrive.

When we talk about feeling ‘triggered’ in terms of trauma, we are referring to the subconscious response. The limbic system becomes extra sensitive to our triggers (sights, sounds, smells, feelings, etc.). And even though you aren’t in any current danger, the limbic system overreacts and overwhelms the frontal lobe by triggering survival mode. As a result, your frontal lobe either undercompensates or overcompensates (cue feelings of numbness or going into overdrive). You do not know how to move forward and stay safe at the same time. 

There are many different ways these two parts of the brain work together when we talk about trauma and healing. Everyone’s experience is different, but many of the changes we see in the brain are similar. Here’s one common example.

Jane is out shopping and passes someone in the store who is wearing cologne. The smell of that cologne reminds her limbic system of her past trauma, and the limbic system now believes Jane is in danger. Jane feels her heart race, her mind starts spinning, and she feels like she wants to run away to be anywhere but here. 

This is a completely normal reaction for Jane’s body and brain to have to a potential threat, even though she wasn’t in any danger. It’s an automatic reaction. And that’s not necessarily a bad thing. In the past, the smell of cologne was associated with a threat, so the brain triggered a response thinking it had to do something to keep Jane safe. If you think about it, your brain is doing exactly what it should be doing. It’s just still thinking the smell of that cologne means danger, even though Jane knows otherwise.

You might be thinking, ‘great, so I’m stuck like this?” In short, no you’re not! It is possible to help your frontal lobe and limbic system heal and work together more efficiently. 

Healing the Brain

You may have heard the term neuroplasticity before. This simply means our brains are able to modify, adapt, and change throughout life. Some things changed in your brain when you experienced trauma, and we can appreciate that as it was necessary for survival at the time. But now that that experience is behind you, you probably want to leave it there and stop feeling such strong emotions at simple reminders. And I don’t blame you! The good news is, that is very possible. Maybe your triggers are similar to Jane’s triggers, or maybe it’s completely different for you. Either way, it is possible to rewire and retrain your brain again.

So, where do you begin? For starters, it’s always a good idea to process any past trauma in therapy. If you haven’t already, find yourself a trusted therapist to support you through your healing journey. 

The next step here is really going to be identifying where you’re having difficulty. Is it similar to Jane’s experience where you see or smell something that triggers you? Or maybe your past experiences are affecting your ability to focus, make decisions, and resist impulses. These are all things that can be worked on and improved with practice. 

During the healing process, your brain can create new pathways, increase function in some areas (like your frontal lobe!!) and strengthen connections. There are many different ways you can work on improving brain function. I’m sure you’ve heard of ‘brain games’ before, right? They’re basically games that stimulate your mind and help you practice certain cognitive functions like memory, problem solving, or critical thinking. 

There are similar exercises you can do on a daily basis that will be ‘training’ one or more parts of your brain. Here’s one example. We’ll call this exercise ‘Planning Ahead’.

Is there something you want or need to get done this week? Picking a day or time to sit down and accomplish that task can help to actually push yourself to do it, but it’s also a really simple exercise for your brain. When you write down even one reminder of what you want to focus on, you’re strengthening the connection between your limbic system and frontal lobe.

You can practice this by using the calendar or reminder app in your phone, or print out a good old-fashioned calendar from google. Maybe start by penciling in any appointments you have, and scheduling some of your household chores around them. Or maybe you want to schedule some time to sit down and read a book. Whatever it is, make a plan to do it, and follow through with that plan.

When you make conscious choices by planning, tracking, and following through, you’re strengthening your frontal lobe. This added strength builds new connections in your brain and creates positive experiences for you to look back on and feel proud of. 

With time and practice, these connections will get stronger and you’ll continue to feel empowered to act on your plans and dreams. And if those plans and dreams include overcoming your past trauma, you’ll feel empowered to take continued steps towards healing. 

If you’re interested in learning more about how to reverse the impacts of trauma, I’m facilitating a group called Finding Hope for women survivors of childhood sexual abuse this fall. Visit our website or call (631) 503-1539 for more information!

-Jennifer Tietjen, LMSW

Art therapy is a newer form of therapy. It is an integrative mental health practice that is designed to improve the lives of individuals, families, and communities through the process of art-making, creative process, applied psychological theory, and human experience within a therapeutic relationship.

Art therapy should be done by a trained professional of art therapy. This will improve the  effectiveness as art therapists are trained to create art therapy exercises that are designed to not only support you but also to help move deeper into your therapeutic goal.  Art therapists are trained to use their knowledge to support your personal and therapeutic treatment goals throughout treatment. Art therapy has been used to improve cognitive and  sensorimotor functions, help support a better relationship with self-esteem and self-awareness, produce emotional resilience, promote insight, enhance social skills, reduce and resolve conflicts and distress.

Art therapy is a wonderful tool therapists use to help patients interpret, express, and resolve their emotions and thoughts. This is a newer type of therapy and was first established in the 1940s however the practice did not become more widespread till the 1970s. Like other expressive arts therapy, such as dance therapy or music therapy, it draws on creativity.

Inaccurate Use of Term 'Art Therapy'

Often people mistake  “Art therapy” for things that are not necessarily due  to a lack of knowledge about the profession. However these situations provide an opportunity to offer accurate information and educate the public. This modality must be done by a trained art therapist or it is technically not art therapy. Some products that are mistaken for art therapy are adult coloring books and paint by numbers. Art therapists are not art teachers, their goal is not to make you a better artist but to help you improve your mental state through the use of art.

How Art Therapy Works

Many people ask "What is art therapy and how does it work?" It is all about  expression. The process of creating is the most important thing, not the end product which is why anyone can do it. Often many people shy away due to a fear of not being an artist but this type of therapy is for anyone. It is designed to use the expressive arts as a way for people to understand and respond to their emotions and thoughts with a valuable new perspective, not only that artistic expression is good for mental health as it is often related to relaxation.

During a session, an art therapist works with clients to understand what is causing them distress. Then the therapist guides the client to create art with an art directive that addresses the cause of their issue or explores it further. During a session, art therapists may:

Through different mediums and art techniques art therapy engages the mind, body, and spirit in ways that are not dependent on verbal articulation alone. Due to the way it engages the body and mind it causes various symbols to be created through the art process, this process also invites modes of receptive and expressive communication, which can benefit those who have limitations of language.

Who are Art Therapists

Art therapists are clinicians who are trained both in traditional clinical therapy and art therapy. Art therapists work with people of all ages and various populations. All art therapists are required to follow an ethical code. All art therapists are also required to have a master’s level education, as well as engage in supervision hours under a trained professional in order to obtain their license. This prepares them for various populations and gives them the ability to perfect their work.

Where Art Therapists Work

Art therapists work with individuals, couples, families, and groups in diverse settings. Some examples include:

Does Art Therapy Work?

There is growing evidence that art therapy helps conditions such as anxiety and depression, trauma, low self-esteem, PTSD, Bipolar  and similar disorders. It has also been used with those facing terminal illnesses such as cancer and those hospitalized experiencing pain, as well as it has been used with people working to develop effective coping skills, including prison inmates

Many clients are reluctant to explore art therapy because they think that they have to have artistic talent for it to work or see it as "arts and crafts" rather than see it as an effective tool. This mindset can be very limiting and can hinder the  effectiveness for these clients. It is important to go in with an open mind.

Is Art Therapy a Good Fit?

There's no way to tell for certain whether art therapy is a good fit for any given person. Therapy is not one-size-fits-all, and a client and therapist may need to use multiple different approaches and techniques in order to find what works best for you. However, if a patient is drawn to art or has had trouble expressing with traditional therapy, art therapy may be a wonderful fit for you.

When choosing a therapist it is good to consider the following. As a potential client, ask about:

Often you should be able to tell in 1-3 sessions if this works for you.

Think Art Therapy Would Benefit You?

If you feel like art may be a good avenue for you to work through your mental health concerns please call our office and ask for Jillian Martino. Jill is our art therapist on staff and would be more than happy to help you work through your concerns through art. Jill specializes in LGBT issues, trauma, children and couples. Contact our office today to set up a free 15 minute consultation.

-Jillian Martino, CAT-LP

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