New Year, New Transitions

2020 and 2021 have been full of transitions, the need for and deeper practice of patience, the increased need for self-care, stretching ourselves outside of our comfort zones and resiliency; many practices we teach and support within the walls of our offices. Trestlewood Counseling Group and our providers were in there with you like the rest of the country. We grew, stretched, took things week by week, and had to become flexible with technology and learning new things “on the fly.” We were so grateful for each and every one of you as you shared your patience with our transitions to virtual/telehealth and working from home, especially as you were going through your own transitions. What a wild ride!

Due to the current pandemic we had to sit and ask ourselves many questions about the future of TCG and each of us individually. When exploring the future we had to dive deep into the concerns for the health and safety of ourselves, our families and clients. We have had to make personal choices moving forward as clinicians and about how we provide services in the future. Throughout all of the unknowns over the last year, it was important for all to discover ways to flex and do what was best for them. While it does not go without some heaviness, we are happy to announce that we have made choices that will bring about a hopeful view of the next steps in finding the “new normal” and provide on-going support to clients in the future. Heather Lettow and Erin Arwady will continue to provide services both at our TCG office and virtually, while Alessandra Pye has made the decision to remain virtual. Alessandra will not be providing counseling at Trestlewood Counseling Group, however, she is an integral part of its formation and growth as we built our practice side-by-side-by-side.  We are so happy for her that she is taking on her next journey and we will continue to refer and collaborate with her in the years to come.

Trestlewood Counseling Group remains intact and will continue to provide counseling services in the years ahead. The pandemic provided some gifts throughout that helped us grow as providers and explore what we each wanted for the future of our practice. We are all so grateful to continue this work with you and can’t wait to sit with you again.

#SurvivorsSpeak, #WhyIStayed and Dating Violence

October is Domestic Violence Awareness Month

Domestic Violence is one of the most common ways women suffer at the hands of men. It is a topic less openly discussed as domestic violence victims often have safety concerns that keep them from sharing publicly. The #MeToo movement has sparked more conversation and the National Domestic Violence hotline in 2018 reported a 30% spike in calls and other forms of contact quite possibly due to the confidential nature of discussing a history of or current domestic violence. In sharing that one has been a victim/survivor of domestic abuse it not only identifies them and their story but also exposes the other person as the abuser. Often many choose to not speak about the abuse due to victim blaming as the abuse may happen over many months or years and the victims are often asked the question “why didn’t you leave?” Blaming the victim vs holding the abuser accountable is another reason why many chose to not speak up.

While domestic violence may conjure up different pictures from reach life and movies, one form of domestic violence I want to highlight is dating violence. Teen Dating Violence Awareness Month is actually in February but as one form of Domestic Violence I wanted to write about it during Domestic October. One in three young women and girls are victims of dating violence. According to the website ‘Love Is Respect. Org’  dating violence is very common. Stats from the site include:

  • “Nearly 1.5 million high school students nationwide experience physical abuse from a dating partner in a single year.
  • One in three adolescents in the U.S. is a victim of physical, sexual, emotional or verbal abuse from a dating partner, a figure that far exceeds rates of other types of youth violence.
  • One in 10 high school students has been purposefully hit, slapped or physically hurt by a boyfriend or girlfriend.”
  • “Girls and young women between the ages of 16 and 24 experience the highest rate of intimate partner violence — almost triple the national average.
  • Among female victims of intimate partner violence, 94% of those age 16-19 and 70% of those age 20-24 were victimized by a current or former boyfriend or girlfriend.
  • Violent behavior typically begins between the ages of 12 and 18.
  • The severity of intimate partner violence is often greater in cases where the pattern of abuse was established in adolescence.”

The CDC states that there are four types of dating violence:

  • Physical violence is when a person hurts or tries to hurt a partner by hitting, kicking, or using another type of physical force.
  • Sexual violence is forcing or attempting to force a partner to take part in a sex act, sexual touching, or a non-physical sexual event (e.g., sexting) when the partner does not or cannot consent.
  • Psychological aggression is the use of verbal and non-verbal communication with the intent to harm another person mentally or emotionally and/or exert control over another person.
  • Stalking is a pattern of repeated, unwanted attention and contact by a partner that causes fear or concern for one’s own safety or the safety of someone close to the victim.

“Dating Violence may also include controlling behavior such as not letting you hang out with your friends, calling you frequently to find out where you are, whom you’re with, and what you’re doing, telling you what to wear or having to be with you all the time.”

It is also stated that long term effects of dating violence may include:

  • Experience symptoms of anxiety and depression
  • Victims are at higher risk for substance abuse, eating disorders, risky sexual behavior and further domestic violence.
  • Being physically or sexually abused makes teen girls six times more likely to become pregnant and twice as likely to get a STI.
  • Half of youth who have been victims of both dating violence and rape attempt suicide, compared to 12.5% of non-abused girls and 5.4% of non-abused boys.
  • Dating violence can negatively influence the development of healthy sexuality, intimacy, and identity as youth grow into adulthood (4)
  • Dating violence can increase the risk of physical injury, poor academic performance, negative body image and self-esteem, and violence in future relationships.(5)

Prevention includes identifying risk factors such as experience in stressful life events/symptoms of trauma (including history of past sexual abuse), poverty, exposure to violence, dating at an early age, sexual activity prior to age 16, low self-esteem or depressed mood, etc. Prevention also includes identifying safe and healthy relationship skills, engagement of influential adults and peers, creative a protective environment at home and school and strengthening supports are some ways take an active role in prevention (7). It is critical to learn to develop health coping, mood management and communication skills as well as boundary setting in younger years (2).

Domestic Violence takes many forms and effects adults and youth. I have included at the end of this blog some resources for our readers to explore for more information. What is important to take away from this is the need for supportive, positive and healthy relationships with peers and adults, to model healthy relationships, to identify risk factors and to address possible dating violence behaviors no matter how insignificant they seem. One third of dating violence victims share their experience with a peer or adult; that does not mean that one third receive support or get help. Although this statistic seems appalling, in a culture where victims are blamed for their abuse or criticized for coming out it is not surprising.

If you are a victim of dating violence or another form of domestic violence please tell a trusted adult, friend, police officer, mental health clinician or medical provider. You may also call the National Domestic Violence Hotline at 7-800-799-7233 or explore resources and information at www.thehotline.org.

Preventing Intimate Partner Violence Across The Lifespan: file:///C:/Users/Heather/Desktop/Trestlewood%20Counseling%20Group/Therapy%20Related%20Paperwork%20-%20Copy/Paperwork/Blogs/ipv-technicalpackages.pdf

Dating Abuse Statistics: file:///C:/Users/Heather/Desktop/Trestlewood%20Counseling%20Group/Therapy%20Related%20Paperwork%20-%20Copy/Paperwork/Blogs/Dating_Abuse_Statistics.pdf

Break The Cycle: http://www.breakthecycle.org/

National Resource Center on Domestic Violence: https://nrcdv.org/dvam/tdvam

National Dating Abuse Helpline  This hotline provides 24-hour national web-based and telephone resources to help teens experiencing dating abuse. Young people (as well as concerned friends, parents, teachers, clergy, law enforcement and service providers) anywhere in the country can call toll free, 1-866-331-9474, text “loveis” to 22522, or log on to the interactive website, loveisrespect.org, and receive immediate, confidential assistance.  

1 U.S. Department of Health and Human Services, 2011
2 CDC, 2010
3 Halpern, Oslak, Young, Waller, Markin, & Kupper, 2001
4 Foshee & Reyes, 2009
5 CDC, 2012

6 Love is Respect.org, 2017

7 Youth.gov, 2019

Playlist Queen

I am the queen of the mix-tape, burned CD’s and Spotify playlists.  Ever since I can remember, music has been playing – at the breakfast table, on the bus on the way to school (thanks to an awesome sport Walkman and a 45 minute bus ride)  and now in the car when I drive, clean the house, work out or an impromptu dance party with my kids.  I believe that music is a powerful mood manipulator.  It has the power to pump us up, raise our spirits, make us smile and let us know that we are not alone in our pain.  There’s a reason all the classic films have iconic soundtracks.  Try picturing Rocky Balboa running up the art museum steps with “Gonna Fly Now” blaring as he reaches the top. 

As a therapist, particularly with teens and young adults, we talk about and listen to a lot of music.  Music is an extremely powerful coping skill.  For teens and young adults, music provides a sense of identity expression that few other mediums provide.  I encourage my clients to make playlists reflective of their moods; both the emotion they are feeling in the moment and what emotion they want to be experiencing.  We also print out and discuss lyrics of songs that validate how they are feeling or that resonate with them for any reason.  Martha Linehan discusses the idea of “Opposite Action” in dialectical behavior therapy (DBT) as a means to help regulate and manage emotions.  The idea is to change and shift emotions by identifying the current emotion a client is describing and observing, identifying the urges and behaviors associated with this emotion and then performing an action opposite that current emotion.  Music can be a powerful tool in encouraging and participating in that opposite action. 

Below is an example of an activity I do with my teen and young adults’ clients that utilizes music as a coping skill that both inspires and activates opposite action:

  1.  On a piece of paper, we make 4 columns labeled: emotions, urges, opposition action, song. 
  2. Then we identify the emotion the client is currently experiencing through observation and description.  Then we identify the urges and ways to act opposite the current emotions. 
  3. Lastly, we identify song(s) that encourage or reflect opposite action. 

Emotion                      Urge                            Opposite Action                    Song

-Sad                             Be Alone                      Be around friends/Family       Count on Me

                                                                                                                         -Bruno Mars

-Angry                         Yell/Fight                     Be kind                                    3 little Birds

                                                                                                                         -Bob Marley

-Frustrated                  Give Up                       Persevere                                Rise Up

                                                                                                                         -Andra Day

This activity is one of many ways to incorporate music into sessions with clients.  In addition, having access to music platforms such as Spotify, Google Play, Apple Music and YouTube are also helpful. 

Erin Arwady, LMSW is an experienced, creative therapist for individuals, children, and families. Utilizing an integration of holistic techniques such as mindfulness and expressive arts and intentional evidence-based strategies such as CBT and DBT, Erin helps individuals and families identify their goals, express feelings and thoughts, and develop healthy coping skills.

More Than Rest: The Importance of Sleep Hygiene

We all have heard that the goal is to get 8 hours of sleep a night, but do we do that consistently? Most likely not. I will admit that I, too, am one of those people who in the past felt proud that I could operate on minimal sleep, while in reality I really needed no less than 7 hours to actually FEEL good. The National Sleep Foundation updated their recommended hours of sleep in 2015. The recommendations are as follows:

  • Newborns (0-3 months): Sleep range narrowed to 14-17 hours each day (previously it was 12-18)
  • Infants (4-11 months): Sleep range widened two hours to 12-15 hours (previously it was 14-15)
  • Toddlers (1-2 years): Sleep range widened by one hour to 11-14 hours (previously it was 12-14)
  • Preschoolers (3-5): Sleep range widened by one hour to 10-13 hours (previously it was 11-13)
  • School age children (6-13): Sleep range widened by one hour to 9-11 hours (previously it was 10-11)
  • Teenagers (14-17): Sleep range widened by one hour to 8-10 hours (previously it was 8.5-9.5)
  • Younger adults (18-25): Sleep range is 7-9 hours (new age category)
  • Adults (26-64): Sleep range did not change and remains 7-9 hours
  • Older adults (65+): Sleep range is 7-8 hours (new age category)

 Looking at those recommendations and still not hitting the mark? The purpose of sharing this information with you is because sleep is not just about rest. Sleep effects every part of our being. It effects both our physical and mental/emotional health. It assists our bodies systems to work better and most importantly, helps what is perhaps the most important organ, our brain, to function best.

Harvard Health reports “Americans are notoriously sleep deprived, but those with psychiatric conditions are even more likely to be yawning or groggy during the day. Chronic sleep problems affect 50% to 80% of patients in a typical psychiatric practice, compared with 10% to 18% of adults in the general U.S. population. Sleep problems are particularly common in patients with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).” While there are 70 different types of sleep disorders the research supports how sleep can overlap with mental health disorders or at minimum make symptoms worse.

Yeah, Heather, getting sleep is exactly what I try to do but I when I do lay down I lay there wide awake for an hour. Preach my friend! I, too, have been known to struggle with this exact issue and at various points in my life mild insomnia; stress being a HUGE trigger. However, the major thing to then focus on outside of the triggers to what is bothering us at night is consistent sleep hygiene. The Sleep Association defines sleep hygiene as “behaviors that one can do to help promote good sleep using behavioral interventions.” While the National Sleep Foundation defines sleep hygiene as “a variety of different practices and habits that are necessary to have good nighttime sleep quality and full daytime alertness.”

While a blog post isn’t going to be the quick fix to changing sleep patterns, I want to give some tips to help develop sleep hygiene habits that may assist in getting those ZzZz’s in each night.

  1. Limit technology- Put down your cell phone, tablet, computer or even the TV. There are recommendations to do this an hour before bed but I also realize that for many people that isn’t always possible. So aim for 30 mins MINIMUM each night. The backlight of technology interrupts our body’s ability to produce melatonin and respond to our natural sleep and waking needs/cycles.
  2. Establish a regular bedtime routine: Warm shower or bath, reading a book, listening to relaxing music (Key: relaxing. Throw a little Ray Lamontagne on)
  3. Make sure the room is dark
  4. Make sure the bed (or bedroom) is used only for sex and sleep. Yep, sex and sleep. Not for TV watching or reading- snuggling into that cozy couch for that.
  5. Avoiding stimulating activities like exercise before bed (exercise does promote healthy sleep and overall healthy lifestyles…. Just don’t run 10 miles or pump out reps before laying down. Too much stimulation for your body to rest. Aim to exercise before 2PM).
  6.  Have a comfortable sleep environment
  7. Avoid naps if possible. If a nap each day is necessary limit it to 30 minutes.
  8. Consistency: Setting a consistent bedtime-wake time and sticking to it. Okay, as best as you can on the weekends but otherwise STICK TO IT. Go to bed at the same time. Wake up at the same time. Ideally, your schedule will remain the same (give or take 20 minutes) every night of the week. Maintaining the consistent sleep schedule after a few weeks will improve overall sleep and is helpful in maintaining overall health.


What if you wake up and can’t fall asleep? The Sleep Association recommends to not lay in bed for more than 5-10 mins. Instead they suggest that if your mind is racing or worrying about not being able to fall asleep in the middle of the night to:

“Get out of bed, and sit in a chair in the dark. Do your mind racing in the chair until you are sleepy, then return to bed.

No TV or internet during these periods! That will just stimulate you more than desired.

*** Note: If this happens several times during the night, that is OK. Just maintain your regular wake time, and try to avoid naps.”

Give it a few weeks before judging whether these tips do or don’t work for you. If after a few weeks of consistent focus on sleep hygiene results in continued struggle, it may be important to consult your medical provider for further support and assessment.

Heather Lettow, MA, LPC, LMFT serves individuals (age 10+), couples and families. She focuses on identifying individual or family goals and strengthening self awareness to facilitate change and to meet the goals set; utilizing mindfulness, CBT and solution focused problem solving techniques.

Over Coming the Winter Blues with Sensory Input

In the past 6 weeks, have you or your child(ren)

  • Watched Neftlix or Prime more than you care to admit? 
  • Gone longer than 48 hours before you have left the house? 
  • Reorganized every junk drawer in your house? 
  • Googled/purchased a warm weather vacation? 
  • Cooked many crock pot meals? 
  • Climbed the walls struggling with cabin fever?

If you have answered yes to any or all of the above questions than you likely have been struggling with Old Man winter rearing its ugly head in Southwest Michigan and several other places throughout the country.  Snow days and bitter cold temperatures greatly interfere with daily routines and even at times motivation to go outside.  All of these factors can also certainly affect an individual’s mood.  Unfortunately, the weather is something that is out of our control. 

Severe winter weather like what we have experienced in the Kalamazoo can greatly affect our sensory intake.  We all take in information through our senses, via seeing, hearing, smelling, tasting, and touching and through our body centered senses of touch (tactile/protective), movement and gravity (vestibular), and body position (proprioceptive) and this information in turn gives us important information about various aspects of our environment and our body.  This sensory input affects how we integrate various aspects of daily environments, how focused and attentive we are on various tasks, and how we regulate our emotions.   However, our sensory input certainly becomes limited when we are stuck in the house due intense and severe weather. 

So how do we deal with good old mother nature and her unpredictability?  A regular sensory diet, as defined by OT Patricia Wilbarger, is a personalized activity plan that provides sensory input to an individual to help them stay focused, regulate emotions, and function throughout the day.  Sensory Input and sensory diet are two terms strongly associated with Occupational Therapy and individuals with sensory processing disorder.  However, we all can benefit sensory input when our options to engage with our senses our limited by our inability to leave the house.  Generally speaking individuals all have unique sets of sensory needs.  When our nervous becomes either over aroused (climbing the walls with cabin fever) or under aroused (hibernating in bed because it’s too cold to get up), a sensory diet helps to regulate the nervous system. 

There are many ways to incorporate a sensory diet into a regular routine; chances are you are likely doing some of these activities already.  I am just going to highlight some of my personal favorite sensory diet activities and also provide some resources to stimulate your creative juices. 

  • Start a dance party.  Create a playlist of you or your child(ren)’s favorite songs and cut a rug. 
  • Messy Play- Play-doh, paint, clay, glitter glue.  As long as it’s messy and you are using your fingers, you are good to go. 
  • Cooking and Baking – similar concept to messy play which also incorporates heavy work activities of stirring and carrying any heavy recipe ingredients. 
  • Food and Drink- Use a straw in anything you drink.  The thicker the texture of the drink the better.  Focus on foods that require a lot of chewing, including gum. 
  • Pillow forts, obstacle courses, and tug of war.  Get creative and if applicable involve your kiddos. 

I often frequent Pinterest for creative sensory ideas so that is a great starting point.  In addition, I frequent the following websites:

            – www.sensorysmarts.com.

            – www.theottoolbox.com.

            – www.sensorymomsecrets.com

I believe we can all benefit for sensory input particularly during the dregs of winter.

Erin Arwady, LMSW is an experienced, creative therapist for individuals, children, and families. Utilizing an integration of holistic techniques such as mindfulness and expressive arts and intentional evidence-based strategies such as CBT and DBT, Erin helps individuals and families identify their goals, express feelings and thoughts, and develop healthy coping skills.

Welcome to Winter! Identification and Treatment of SAD

hhttps://www.youtube.com/watch?v=BOWgMW9Zjfg

SeasonalEffect Disorder (now referred to as Depressive Disorder with Seasonal Pattern)commonly effects about 5% of the population commonly beginning between the ages18-30; more common among women than men. While most of us in the northernregion are effected by lessening of light (vitamin D) during the fall andwinter months and change in our circadian rhythms due to the increase indarkness, SAD is different than “the winter blues.” Common symptoms of SADinclude fatigue, even with too much sleep, and weight gain associated withovereating and carbohydrate cravings. SAD symptoms can vary from mild to severeand can include many symptoms similar to major depression, such as:

    Feeling of sadness or depressed mood

    Marked loss of interest or pleasure in activities once enjoyed

    Changes in appetite; usually eating more, craving carbohydrates

    Change in sleep; usually sleeping too much

    Loss of energy or increased fatigue despite increased sleep hours

    Increase in restless activity (e.g., hand-wringing or pacing) or slowed movements and speech

    Feeling worthless or guilty

    Trouble concentrating or making decisions

    Thoughts of death or suicide or attempts at suicide

The APA recommends diagnosis of SAD through the following criteria:

  • Depression and other symptoms that have occurred for at least two consecutive years, during the same season every year.
  • The periods of depression have been followed by periods without depression.
  • There are no other explanations for the changes in mood or behavior.

Treatment:

While SADsymptoms can lessen without treatment with the change of seasons into spring treatmentsfor SAD include light therapy using a UV light that simulates the sun. It isrecommended to sit within 2 feet of the light in the morning from fall throughwinter months for min. 20 minutes per day. Therapy (especially CBT) can assistin identifying and managing symptoms. Use of SSRI medications(antidepressants). Spending time outside- fresh air! Eating healthfully. Othersuggestions include taking supplements including multivitamins, vitamin D,B-Complex Vitamins, fish oil or use of essential oils including lemon,lavender, chamomile, rose, etc. While symptoms have the potential to last up40% of the year, the change in season into spring and later into summer canbring relief, increasing energy and boosting serotonin.

Heather Lettow, MA, LPC, LMFT serves individuals (age 10+), couples and families. She focuses on identifying individual or family goals and strengthening self awareness to facilitate change and to meet the goals set; utilizing mindfulness, CBT and solution focused problem solving techniques.

The Importance of Resilience

It’s that time of year again.  Penciled are sharpened, backpacks are clean and empty, and you are about to send your child or children off to school for either the first or umpteenth time.  Every year around this time, I talk with my clients, their parents, and even my own children about the things they want to be intentional about for the upcoming school year.  Take a moment and reflect – What goals do you as a child, adolescent or parent want to accomplish this year– Increased organization, better grades or maybe just a peaceful school year?   While all of these aspects of school and life are quite important, they require an awful lot of hard work and at times can be difficult and stressful to manage in our day to day.   In this day and age, our children and adolescent face several stressors: grades, friends, parents, bullying, over scheduling, social media, school shootings, 24 hour news cycle etc.  So how do we foster resilience or the ability to bounce back and recover from adversity in life in our children and adolescents?

Dr. Kenneth Ginsburg with Martha Jablow in their book Building Resilience in Children and Teens identify resilience as “giving kids roots and wings” in their book subtitle.   At the core of this philosophy is the idea that the important adults, whether as a parent, aunt, grandparent, mentor, teacher or coach, affect a child’s resilience.  As parents, caregivers and loving adults we offer unconditional love and create security, we set and encourage our children to meet our expectations for better or worse, and we model behaviors on how to meet these expectations and manage the challenges along the way because according to Ginsberg and Jablow, (2011)“children watch what we do much more than they listen to what we say” (p.22).

Ginsberg and Jablow (2011) identify seven crucial C’s as the “ingredients of resilience”

  • Competence – the ability or manage situations effectively through the development of skills making healthy choices through actual life experience.
  • Confidence- the solid belief in one’s own abilities and is rooted in confidence
  • Connection- close ties with family, friends, school, and community that create a sense of security and produce strong values.
  • Character- fundamental sense of right and wrong that allows children to make wise choices, build self-worth, contribute to the world and become stable adults.
  • Contribution- the belief that the world is a better place because my child is in it and that each and every one of them has something to offer the world on a regular basis.
  • Coping- the ability to manage stress and overcome obstacles in life in a positive, healthy way.
  • Control- helping children to identify that they have the ability to impact their lives through their decisions and actions and there are some extenuating circumstances in his or her life that are out of his or her control (divorce, loss etc.). (Ginsberg & Jablow, 2011, p.24-30).

So Perhaps this year as you and your child head back to school for the 2018-2019 you can review the crucial C’s and identify intentional ways to build on each of these tenets of resilience.

 

Ginsberg, K.R. & Jablow, M.M. (2011).  Building Resilience in Children and Teens:         Giving Kids Roots and Wings (2nd ed.).  Elk Grove Village, IL: American   Academy of Pediatrics.

Inner Critic vs. Inner Best Friend

Over three years ago I became involved in my first mom group. A drama free group with positive, uplifting women who have the same shared goal; to raise our babies the best as we can, be the best mothers we can and have a village behind us for the good, the bad, the celebrations and the heartbreak. Every once in a while we would share some things that challenged us not just as mothers, but to dig deep in who we are as individuals. So, this blog is birthed from the work shared by my dear friends Ashley and Erica.

Last month, my friend shared the podcast episodes “Inner Critic Pt. 1” and “Inner Critic Pt. 2” in our mom group community by Rachel Brathen (Inner Heart: Conversations with Yoga Girl). If you are reading this, I promise this is not just a mom focused thing so don’t let me lose you. We discussed these shared podcasts from the lens of “what does your inner critic say?” and “what does your inner best friend say?” The results? Women poured their hearts out and later were able to see how similar they were to those around them but also women were able to see how other people see them… because of course our inner critic tells us a distorted reality.

As a mental health provider it was also eye opening for me. I don’t tend to use these terms; the critic vs the best friend. I have used textbook terms, buzz words, “positive/negative self talk” but nothing as clear and as simplified as this. This new view humanized those parts; the critic and best friend within all of us. Since this work, I have made it a mission to use these terms instead. Now I can’t share what others have shared but as a human first I can say that I was surprised at how much just looking at our negative thoughts vs positive thoughts from this re-frame challenged me, opened me up and made me come face to face with realities I didn’t know how to express previously.  It was hard! I also noticed that when I speak to other people I speak from my “inner best friend,” the kind helper… and how when it comes to me it is so hard to do the same.

As a therapist, I try very hard to practice what I preach but I will admit that the homework I assign to those I sit with isn’t always easy for me. It doesn’t come naturally even if the way I communicate it makes it seem seamless; I wish it were. Many of us question whether we are doing something right. Is it good enough? Am I setting my kid up for success? Is my child’s delay due to something I did? Am I lovable? Does my partner love me? Am I worthy of these relationships?  That, my friends, is the critic. Yes, I think that as humans we should evaluate our decisions and challenges some thoughts but when they become overwhelming to our day to day knowing of ourselves… that is when that critic is speaking. The critic is also the one that tells you things to make you feel less than… like an inner bully. “You suck. You’re worthless. Not good enough. You are a failure. You aren’t smart enough. No one cares”. The inner best friend is supportive and loving and kind- the encourager.

So, I have homework for you….

  • Take out a piece of paper.
  • Title one side of it “My Inner Critic”
  • Title the back of the paper “My Inner Best Friend”
  • Under each title, write what each part says. I prefer to start with the critic because my best friend is much kinder and much more of what I believe and know to be true.
  • What did you come up with?

*Please note, if this brings about tears or difficult emotions it is also bringing awareness to those areas. Seek counseling if the inner critic is loud and distressing days after the activity.

Speak to yourself from your inner best friend. Be kind to yourself.

 

You can find more information about “the inner critic vs the inner best friend” by exploring Rachel Brathen’s website,  her podcast, blog or one of her many books (Rachelbrathen.com).

 

Heather Lettow, MA, LPC, LMFT serves individuals (age 10+), couples and families. She focuses on identifying individual or family goals and strengthening self awareness to facilitate change and to meet the goals set; utilizing mindfulness, CBT and solution focused problem solving techniques.

The Practice of Gratitude

I was having one of those mornings. I overslept, spilled coffee on myself and was running late.  The babysitter arrived at 8:45 and I threw my lunch into the my work bag and was greeted with a flat tire on my car.  I had approximately 9 minutes to get to my 9am appointment and was stuck in more ways than one.  Fortunately, my babysitter kindly offered to pack up my 6year old and 3 year old and drop me off at my office around the corner so I could make my appointment on time.  And my husband stepped up and offered to pick me up after work and deal with getting a new tire when he got home from work himself.  Needless to say it was a rough morning and despite benefiting greatly from the kindness of others, I was feeling very joyful or grateful.

Gratitude is a topic that often comes up in my sessions.  One of my favorite conversations to have with clients is discussing what they are grateful for in their lives.  And while those conversations are invigorating and warm my heart, I believe from both personal and professional experience that there is a difference between feeling grateful and practicing gratitude.  The concept of gratitude as a practice comes up in many of Brene’ Brown’s writings, but especially in “The Gifts of Imperfections: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are.”  In the book, Brown introduces the idea that gratitude is a practice.  If in our darkest times when we are feeling most vulnerable physically, emotionally or spiritual we can identify what we are grateful for in our lives than it can make all the difference.  Gratitude helps us to access joy in the ordinary every day moments in our life.   Joy is what makes our lives worth living and when we practice gratitude we add more to our lives.  Joy and gratitude help us to build resilience to manage those dark and vulnerable times in our lives.

So what specifically does the practice of gratitude of look like? Let’s go back to my 5 star morning that included the kindness of others.  Instead of  starting the day off ungrateful and cranky and focusing on all the things that went wrong, I could have acknowledged that I was feeling vulnerable and overwhelmed and identified that I was grateful for my babysitter driving me to work and my husband stepping up to deal with the tire.  The take away from the practice of gratitude is to identify ways we can stop and identify the ordinary every day things in our life we are appreciative of.  These ordinary moments are fleeting and always changing.   When we acknowledge and share them with ourselves and others, we offer a glimpse to others inside our life and a way to be genuinely seen.

 

Erin Arwady, LMSW is an experienced, creative therapist for individuals, children, and families. Utilizing an integration of holistic techniques such as mindfulness and expressive arts and intentional evidence-based strategies such as CBT and DBT, Erin helps individuals and families identify their goals, express feelings and thoughts, and develop healthy coping skills.

Journal For Your Mental Health

https://i0.wp.com/cdn-images-1.medium.com/max/2000/1*hXoAKUEgKa3o6CfuXTwKMQ.jpeg?resize=525%2C350&ssl=1(Image from: Medium.com)

 

As a therapist I suggest journaling often. Now before you roll your eyes… or if you have… I can wait…

Journaling in a tool for introspection. What is introspection? It is [the examination or observation of one’s own mental and emotional processes]. In short, it is how we examine ourselves emotionally. It’s how we perform our own analysis of the things we feel, the things we are wrestling with, and finding the meat of who we are and what we think. Journaling is a tool for reflection. It is a way of exploring the way we feel but truly… making the intangible thing… the thing we can’t feel with our hands or see with our own eyes, tangible. Journaling helps you process your emotions to help your mental and physical health- yes, physical health, because our emotions and our bodies are connected and influence each other.

According to Psychology Today, writing can strengthen your immune system, lower your blood pressure, and improve your lung and liver function. It can also reduce depression and improve your emotional health as you work through problems on paper. It can support recovery from addiction by providing a positive behavior and replacing the previous old or unhealthy behavior. It is a way for planning ahead, processing the past, having a conversation with yourself or exploring questions that are stumping progress or your ability to get to know yourself. It helps track patterns and growth over time. It is a way of getting in touch with your left brain to analyze and to allow for your right brain to create. It helps to get to know and understand yourself more, to process and understand and explore emotions better and deeper, reduce stress, clarify thoughts and feelings, problem solve, and is a step to resolving interpersonal conflicts with others. It is a place to be self aware, not self-critical.

Where Do I Start?

You don’t need to write in a classic journal or diary or notebook (although I find that this, the putting pen to paper, helps me process things better). There are online journal options where you can create a username and password or pull up your word or notes section on your computer. Whatever works best for YOU. There are other forms of journaling out there, including bullet journaling, art journaling, etc. Explore what feels best for you. If it’s a few words, great. If its bullet points, awesome. If it’s a stream of thoughts- way to go. Whatever works and feels best to you is the way to go.

Write for 10-20 minutes. Your journal should be a private place for you to write and not feel as if you need to sensor yourself. Write quickly- sort of like “word vomiting” onto a page. Just get it out. Don’t worry about whether you should or shouldn’t …. Your feelings are valid and are telling you something so allow for them to be there, explore them instead of ruminating on them.

Not sure what to write? No worries. Pinterest has loads of options for journal prompts for those just starting off. Anything from self-discovery questions, to journaling tips for anxiety, depression or self-esteem.

Ask. Dig. Explore.

If you are wrestling with something very specific but don’t know where to start, write out a question. “Why am I so angry with my best friend?” Answer it. Ask another question. Answer it. Write how that answer makes you feel. Why? Sometimes that’s all we need to unlock that stuckness. Ask more questions to open up more doors. Get deeper. What does this remind me of? Why is this a big deal to me? What am I afraid this will do for my future? Is this what I want? Why do I stay when I am so unhappy? What you may notice in journaling is that it feels almost circular. It goes back to the feeling or the starting point, but as you journal and get deeper the circle gets bigger and wider giving you a sense of what is really happening. Whether it’s more to the issue than what you thought or deeper issues that are arising from this event… explore it. It is a way of exploring your dreams, your interests, what you want for your future, where you are struggling in your marriage, where you find strength in yourself. It organizes the clutter of our thoughts and feelings by our sorting through the mess.

Journaling is one of the cheapest forms of therapy, which is why I ask people I sit with to journal. Because one hour of your life sitting with me isn’t going to get you to your goal alone. The work happens outside of therapy, whether it’s in behavior changes, self-exploration or self-care. Journaling helps maximize the benefits of therapy… I mean… we are already paying a fee, what if we could get more for our money? That’s exactly it. It extends therapy beyond the last session. More for your money. More opportunities for introspection and growth. FREE THERAPY! And as a therapist, it helps me help you better too.

Try it out for a few months- if not daily a couple times per week and explore the benefits you find in journaling.

 

Heather Lettow, MA, LPC, LMFT serves individuals (age 10+), couples and families. She focuses on identifying individual or family goals and strengthening self awareness to facilitate change and to meet the goals set; utilizing mindfulness, CBT and solution focused problem solving techniques.