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Taking Control of Distressing Intrusive Thoughts

Our mind is a creative space, filled with thoughts and ideas that suddenly appear without will or intention.  Most often our spontaneous thoughts have little purpose or meaning, dealing with things that are benign and trivial.  Sometimes these intrusive thoughts can be bizarre and fantastical, causing us to chuckle at their absurdity. At other times, we have positive mental intrusions that bring a momentary sense of encouragement and a feeling of blessing, and then there is a rare occasion when we have a truly creative thought that we consider inspirational.  But in the midst of this hubbub of mental spontaneity, one can also experience negative, even dark thoughts, which pop into the mind and cause considerable personal distress when they grab our attention. It is these distressing intrusive thoughts, images and memories that can trigger a fresh round of negative emotion like depressed mood, anxiety, frustration and guilt.

Most conventional forms of cognitive behavior therapy focus on more persistent, intentional forms of negative thought.  Yet, spontaneous negative thoughts can be especially troubling for people because they are involuntary, often appearing against our will.  Because of this we tend to pay more attention to them and think they are more meaningful and significant. If I suddenly have the thought “everyone is looking at me” I am more likely to feel anxious because the intrusiveness of the thought makes it more believable.  The same thing with a depressive intrusive thought like “I don’t want to do anything”.  A person may conclude that the sudden occurrence of this thought means that it’s best if you take it easy and not push yourself.

Often distressing intrusive thoughts cause emotional distress because they trigger more persistent forms of negative thinking like worry, rumination or obsessions.  If this is happening to you, it’s important to learn how to deal effectively with your negative intrusive thoughts, images or memories. There are three key strategies you can use to stem the negative effects of unwanted mental intrusions.

  1. Normalize the IntrusionSpontaneous thought is a normal part of brain function.  In fact, unintended spontaneous thought has been called the brain’s “default mode of operation”.  No doubt some people have more spontaneous thought than others, and these “intrusive thinkers” cannot expect all their thoughts to be positive or neutral.  We all have negative thoughts about ourselves, our personal world and our future that pop into our mind. So, don’t be surprised when you have a negative, even distressing, intrusive thought.  Treat it as a normal part of your creative mind.
  2. Detoxify the IntrusionOur negative intrusive thoughts become distressing when we misinterpret them as having deep personal significance.  If the thought “I’ve been such a failure” pops into your mind, you might conclude that you really are a failure because the thought suddenly came to you.  When we overthink our negative intrusive thoughts, they can become a “toxic” way of thinking. The alternative is to evaluate the validity of the thought, and if it is found to be exaggerated or unrealistic, treat it as a thought and not a fact.  It’s an uninvited mental intruder that can be treated with the same degree of meaningless as the most random, trivial thought that pops into your mind. With repeated practice, you can learn to strip these distressing intrusions of their toxic personal meaning.
  3. Relinquish Mental ControlThere is a paradox when it comes to mental self-control.  The harder we try to suppress, prevent or dismiss an unwanted thought, the more we experience the opposite; that is, we find ourselves paying more, not less, attention to the thought.  If you don’t believe me, try to not think of a white bear for two minutes. If you are like most people, the harder you try not to think about a white bear, the more you’ll think about the white bear.  So when it comes to negative intrusive thoughts, stop trying to control your mind. Let your spontaneous thoughts, even the negative ones, come and go without trying to effortfully direct your attention.  Accepting the intrusion, letting it fade from your mind naturally without effort on your part is the most effective way to deal with these unwelcomed mental intruders.

So if you are an “intrusive thinker”, I encourage you to exercise greater acceptance of your highly creative mind.  You might find that you have many interesting and sometimes highly creative thoughts pop into your mind. But at the same time, you’ll probably have some negative mental intrusions.  If you can accept these “darker” thoughts as the product of your creative mind, strip them of special personal meaning, and relinquish excessive mental control efforts, you can reverse their deleterious effect on your emotional well-being.

David A. Clark, Ph.D. is a licensed clinical psychologist Professor Emeritus, Department of Psychology, University of New Brunswick, Canada.  He completed postdoctoral training in cognitive therapy at Aaron T. Beck’s Mood Clinic in Philadelphia and has published over 150 scientific articles and papers on cognitive theory and therapy of depression and anxiety disorders. He has authored or coauthored several books including The Anxiety and Worry Workbook (Guilford, 2012), The Mood Repair Toolkit (Guilford, 2014) and The Anxious Thoughts Workbook (New Harbinger, 2018).  He is a Founding Fellow of the Academy of Cognitive Therapy and currently has a part-time private practice in Fredericton, New Brunswick, Canada.  For further information visit www.davidclarkpsychology.ca.
This entry is based on intervention strategies for anxious and depressive intrusive thoughts presented in The Anxious Thoughts Workbook: Skills to Overcome the Unwanted Intrusive Thoughts that Drive Anxiety, Obsessions & Depression by David A. Clark, Oakland, CA: New Harbinger Publications, 2018.


Over a Decade of Gratefulness

It is hard to believe that we have celebrated 13 Christmas seasons at the Anxiety Resource Center. Our holiday open house is a special time of year as we are able to reconnect with many people we haven’t seen in years and meet new people just visiting for the first time.

It almost seems like yesterday that we walked into the firehouse. Over a decade ago there weren’t sidewalks or streetlights, we were on the “other” side of town. Thanks to a growing city and booming businesses the ARC is now considered part of “downtown”.

The Center offers weekly support groups for teens and adults. We have three adult groups: two for anxiety and one for Obsessive-Compulsive Disorder. We offer social outings monthly and offer special events and presentations throughout the year. We have creative opportunities to help people manage anxiety and we offer a lending library of books. We invite professionals to speak on topics related to anxiety and we bring our mental health professionals into local schools to offer education.

Just recently we started offering memberships to the Center. This has been a great way for people to show support of the ARC and to help us continue into the future. It also gives individuals the opportunity to use our services at a reduced cost. For many years we didn’t charge for groups but with growth and outreach we can long operate without charging a small fee. The Center still primarily exists because of the support of the Azzar family who we are so grateful for. We ask you to join them and consider giving back to this important resource in West Michigan.

Over the years I have heard so many gracious comments from visitors. Some have expressed how the ARC has been a lifeline for them, how the Center has given them the courage to go places and do new things, how it has been more effective than inpatient therapy. While those are wonderful statements, the truth is it isn’t the Center that provides the support. It is the people. It is each one of you who walks through the door, it is your listening ear, your shoulder to lean on. You are the heart of the Center. You genuinely care about each other, you provide an atmosphere where people can be “real” where they can be “themselves” without judgment. I am grateful for our support group facilitators, our volunteers and each one of you that comes to the ARC.

If you haven’t been to the ARC, I encourage you to set a goal to visit in 2019. If you’ve thought of the ARC but haven’t made it back down, I’d encourage you to try. Perhaps you could extend an invitation to someone who might benefit from our services let’s help them to feel welcomed, encouraged, inspired and supported too.

Thank you for being a part of this journey with us.

Suzette Andres is the Director of the Anxiety Resource Center. 


Seasons of Life

A Holiday Wellness Plan

There are seasons of weather, holiday seasons, or simply put seasons of life. We have them but what do they feel like?

Think with your whole body for a moment what does a season feel like? Maybe it feels like the warmth of cozy socks or a brisk breeze on your cheek. Or does it feel like sunshine and sand on your body, maybe even smells like sunscreen?

Seasons are often associated with how the weather affects our bodies but how does our mind experience seasons? What emotions are felt?

Within my practice, most clients share emotions of sadness, loneliness, or anger. There may be stress within the family, negative memories from the past, or financial challenges. These emotions may lead some people to feel anxious, depressed, or withdrawn.

Experiencing emotions during any month or type of weather is a season; Emotional Seasons may come and go or stay for a while.

During the holiday months, seasons can be especially difficult. With support from a therapist or family and friends, there are ways to combat the many seasons of emotions.

A wellness plan can be an effective tool to support your emotional health and improve relationships with family and friends. To initially create a wellness plan you may need the support of a licensed counselor. The plan will identify signals that indicate a need for support, coping strategies, supportive individuals, and your environment.

The Wellness Plan

(create a section on your paper for each underlined category)

Signs that I may need support (Category 1)

To begin working on a wellness plan start with writing 2-4 emotions/words that describe how you may feel (tired, irritable, sad) that would indicate a need for support. Support includes how you treat yourself.

Coping strategies (Category 2)

Next, identify ways to rest your mind. Coping strategies are different for everyone they can include: reading, music, drawing, limiting commitments, or utilizing a calendar, for example. Define at least 2 coping strategies you are most comfortable with engaging in when you feel like the emotions in category 1.

People, Things, Animals that offer me support (Category 3)

In this section identify specific people and a way to contact them (email, text phone call), Things (iPhone, tablet, radio), and Animals (pets that are accessible and provide comfort). List 2-3 in this category.

Environment (Category 4)

In this final section list at least 2 ways to make your environment calm. This may include a scented candle, new bedding, or low lighting for example.

Together these four categories make a wellness plan. Identifying the emotions and developing a plan may decrease depressive and or anxiety symptoms and allow for a healthier you.

If you or someone you know would like support in developing or using a wellness plan, I provide clinical therapy to individuals and families. Seasons change, and we can too.

Breanne Roberts, LMSW is the owner of Captive Beliefs Counseling Service PLLC in Grand Rapids, MI. Breanne provides clinical interventions and empowers individuals to feel in control of their emotions, behaviors, and lifestyles. She specializes in mood management, improved social relationships, and interpersonal psychotherapy; with over 10 years of experience assessing emotional regulation, family systems, and crisis management. Her professional career started in rural communities of Honduras with children and families who experienced emotional hardship. She founded Captive Beliefs Counseling Services to support individuals of all cultures and ages to live purposely and peacefully.


Carpentry: an Unlikely Asset in Addiction and Anxiety Recovery

Building a Brighter Future

Anxiety and addiction are silent stalkers that can affect even those most seemingly carefree person. Both are caused by a number of factors, including stress, genetics, and chemical imbalance. For an addict, anxiety is also triggered by use and withdrawal, according to Medical News Today. Panic disorders, a severe form of anxiety, are also common in people seeking treatment for alcohol abuse.

If you suffer from these co-occurring conditions and happen to be good with tools, you have a powerful weapon against them literally in the palm of your hand.

Mood-boosting work

Working with your hands is one of the best ways to redirect your mind. Building something, whether it’s a small deck, bookshelf, or backyard treehouse, can give you purpose as well as something tangible to see through to completion. And, as Jim Benson of Personal Kanban explains, finishing tasks no matter how small gives the brain a dopamine rush that can make you feel good in the moment; steady doses of dopamine can also make you crave similar healthy rewards. And your carpentry skills, in addition to opening up job opportunities, can be put to good use in other areas that will bolster your recover.

Skills that heal

The National Council on Alcoholism and Drug Dependence explains that volunteering can boost your self-esteem and make a difference in the lives of others who may be struggling with sobriety, abuse, homelessness, or poverty. As someone with experience in construction, you can use your skills to volunteer framing homes or hanging drywall for Habitat for Humanity. You might also find that carpentry skills come in handy if you want to donate your time to building dog houses or making general repairs at your local animal rescue. Many local charities also have an ongoing need for men and women who can make repairs and upgrades to low-income seniors’ homes. Doing good work for others is a way that you can give back to your community and may help you alleviate some of the guilt leftover from your using days.

Encouraged by education

It doesn’t matter how good you are, if you enjoy your work, there is always room to learn new methods and add to your skillset. You might, for instance, combine your knowledge of carpentry with business classes to launch your own handyman or construction firm. You may even be encouraged to earn a new degree or finish what you started as a teenager. Completing your education can help you take care of “unfinished business” if you dropped out due to drugs or alcohol.

While your traits and talents can help, there are still plenty of others ways to further your recovery efforts. A few of these include:

  • Exercising. Taking care of your body can help you overcome both addiction and anxiety. This is another area that tells your brain to release chemicals that lead to feelings of mild euphoria. Consider visiting the gym if you’d like access to a variety of different equipment – most also offer group fitness classes such as yoga and dance and team sports opportunities.
  • Cooking. The food you eat is vital to your health and recovery. Cooking meals for your family is a great way to fill your time while bonding with your spouse and children. Rehab Village notes that cooking doesn’t have to be expensive and suggests grilling and baking.
  • Spending time in nature. The outdoors is so much more than a cutscene of our busy lives. Health explains that being outside can ease depression, improve focus, and even strengthen your immunity to disease. If you live in a highly populated area, time away from the concrete jungle may be even more important. People who live in the city are more likely to develop a mood or anxiety disorder.
  • Writing. Writing down your thoughts and feelings is a great way to purge your mind and body of negative emotions. It gives you ownership of your reactions and can help you recognize what triggers your anxiety. This is important during drug recovery as the same actions and situations may also lead you toward relapse.

No matter what career or hobby you choose, make sure it is something you enjoy. And if carpentry happens to be your expertise, use it to your advantage and you’ll build yourself a brighter future.

Monica Smith has struggled with addiction her whole life. She discovered a passion for carpentry which helped her overcome her struggle. She created recoveringworks.org in order to help others struggling on the path to sobriety.


The Pain Beneath the Smile

As I said in the “About” page on my blog, my heart’s cry is to share my story of mental illness as honestly as I can to spread awareness on this prevalent but often hidden issue and to better enable people to come around those suffering. I want to shed light here. What I write below is hard, but real. I have been doing so much better since I started LENS Neurofeedback treatment with an amazing therapist 8 months ago. My life has changed and I am so grateful and continue to grow and get stronger. It has brought me to the point of now being able to look back over the years with perspective and speak up about my story.

For YEARS, I struggled intensely.

Life was a warzone. My brain was set against me. Darkness was my closest friend. Though I had good days and good months, so much of my life was lived in torment and misery from age 15-23 with challenging struggles even before that. OCD- all forms of it, but especially scrupulosity (religious OCD)- suffocated me. Anxiety and piercing panic coupled with depression left me scrambling on the ground, trying to just keep breathing, to just keep taking one more baby step forward in life each day. I’ve engaged in various kinds of self-harm.

My OCD morphed into acute, severe mood swings that looked like bipolar disorder. For a good couple years, I was “manic” one hour only to dip into deep depression the next hour for no apparent reason, doing impulsive, dangerous actions on both extremes. It got so scary. SO SCARY. I was afraid of what I would do.  I didn’t know what to expect each day or each minute. I lived in terror. I’ve had night terrors where panic would shoot through the very center of me, creating this fear that is unlike anything else. I would not wish it on my worst enemy. And with my panic attacks often came this intense fear that God was going to hurt me (part of scrupulosity). There were days I couldn’t eat and days I ate way too much.

People carry invisible burdens, they fight battles that the naked eye can’t see. I’m not the only one. I share my story because I KNOW there are others who suffer or have suffered like me. And we need to talk about this. I battled in silence for too long. Someone who is swept under by this tidal wave doesn’t have the voice to speak up for themselves- they are literally fighting for their life. But it is incredibly hard when so often they have to do it alone because people just don’t understand. Or they can’t see the monster they’re up against. I speak because I can now. And because this cannot go on. It is hard enough for someone bearing up under the weight of this cross, but to have to fight when the war is often invisible to those around them is close to unbearable.

First we need people to SEE.

To learn and have their eyes open to exactly what this suffering is. And then to walk with us through it. I’ve been blessed to have some of the most caring and supportive people with me on my journey. I wouldn’t be here without them. They have understood as best as I could explain it to them, but this illness is still so invisible- it happens in someone’s brain. It’s not like a broken leg. And there’s only so much that support people CAN understand in the midst of it. Though people really cared and at times got clear glimpses of my struggle, I still felt so alone a great deal of the time. Internal screams, invisible tears, mustering up every ounce of strength I had to keep going.  The nature of mental illness is still not a very known thing, unlike diabetes or cancer. That’s why I’m passionate about talking about it.

It is hard for me to write this. It is hard to be open about the things that have torn my life apart. It hurts, and it’s scary too. But it hurts, even more, to think about the countless individuals struggling alone right now. We need to come around them. We need to hold them up. Please, just listen. Listen to my experience. Listen to the experience of others who are willing to share. Don’t assume you know someone’s suffering before you’ve heard them out. Open your heart and your mind to what someone might be going through even if they look relatively “normal” on the outside.

Those of us who are up against mental illness are the unsung heroes, in my opinion, the “warriors in the dark.” We fight ‘til we have nothing left. And we keep fighting after that. Life sometimes feels forever out of our reach, yet we keep reaching. Hoping for new realities, believing a better day will come. Give someone a hug who you know battles with anxiety, depression, OCD, an eating disorder, PTSD, bipolar disorder, or any mental health issue. Ask them to share an insight into their story. Love them. Support them in any way you can. And if you are the one struggling, please know I feel your pain. And I see your strength. YOU are fierce and you are gentle in all the right ways. You are the face of hope. Keep fighting. There are always new treatments out there to try. Life will get better. Don’t give up. Hang in there. We need you, and you matter

I found this poem last night in a collection of special papers I’ve saved. I don’t know when I wrote it but it was sometime in the last two years. It depicts the agony I lived in and also the resistance, the refusal to give up, that defines those of us who wage war in this darkness but look it straight in the eye and say, “I am stronger.”

When you’ve got blinders on walking through life

And there is a rock sitting on your brain,

You learn to go by feel and not by sight.

You navigate life with handicaps that no one can see.

To everyone else you look like a normal person.

People don’t see the tragedies you’re walking through,

The physical and mental chains holding you down.

What might they say if they could walk in your shoes for just one day?

Survivors, that’s what we are.

We are the ones with quiet strength.

We whisper at night and say we’ll try again tomorrow,

The lion in us roars and we wake up and rise.

This post was republished with permission from Alexandria Wonser. You can find the original here. Alex has suffered severely with scrupulosity (religious OCD), anxiety, and depression and desires to spread awareness on mental illness while sharing her story.  She wants to offer hope and help people better support those afflicted with this suffering.


The Pendulum of Seasonal Change

Understanding the Connection to Anxiety

The Anxiety and Depression Association of America reveals that around 18.1% of the US population suffers from anxiety. There is a wide range of reasons that can trigger anxiety. Some of these include culprit genes, a stressful situation or as a side effect of some medication. Anxiety also pairs closely with depression and both plant seeds of dementia.

The seasonal ticking clock that turns leaves from green to gold also has a significant role to play. It chips in anxiety that comes when some fret about the upcoming winters or seasonal change altogether. A more specific term for such anxiety that is backed by the pendulum of seasonal change is Seasonal Anxiety Disorder (SAD). Other common terms used for such a mental health concern are seasonal depression and winter blues.

What are Seasonal Anxiety Disorders?

The National Institute of Mental Health defines Seasonal Anxiety Disorders as, “a type of depression that comes and goes with the seasons, typically starting in the late fall and early winter and going away during the spring and summer.” While summer depression is prevalent, it is not as typical as the winter blues.

A Google report confirms that all mental illnesses get worse during the winters. It also shows that the searches concerning psychiatric issues and anxiety peak during the winters. For instance, the searches related to suicide decline by 24% in the US during the summers.

In Northern Europe, the seasonal affective disorder takes approximately 12 million people within its folds. Annually, there are around 5% of folks in the US that experience seasonal depression. 4 out 5 of these tend to be women. Moreover, an extra 10-12% of US citizens suffer from mild episodes of winter blues.

Seasonal Swing and Patients with Psychiatric Disorders

Although MCI symptoms may only be the first step to mental health issues, the seasonal sensitivity may take a toll here too. For patients with psychiatric disorders, seasons can worsen their plight. 64% of people with a diagnosed mental disorder complain about deteriorating symptoms with seasonal changes.

A case in point is people with anxiety who find their condition worsening with the weather. The seasonal impact extends to make them feel claustrophobic, which hits the notes of cabin fever for anxious individuals. Also, air molecules exhibit a tightness in winter that poses a strain on breathing normally. Such a factor, however, induces panic in patients with anxiety disorder.

With the onset of winter, people with anxiety face increased mood relapses and greater irritability. This is paired with changes in their sleep cycles. Research also indicates the people with panic disorder become more fragile with changes in seasonal factors.

Weather changes make matters difficult for patients with Bipolar Disorder (BPD) too. Two relevant implications surface as the season dons a different temperature. These are manic and depressive episodes. Manic episodes culminate in impulsivity, insomnia, and high-energy. On the other hand, BPD depression resembles with clinical depression except that it may be more volatile.

Seasonal change impacts the occurrence of these episodes. Clarissa Silva, a behavior scientist, elaborates. She says, “The biological effects of a lack of sunlight can produce disruption in sleep cycles, decreased and depressed mood […] the changes in the season and temperature are mirroring the changes in their bodies that help adapt to the climate change which can exacerbate and manifest as manic and depressive symptoms.”

Symptoms of SAD

Seasonal sensitivity yields several symptoms. Manfred Kaiser holds changes in the temperature, air pressure, and humidity responsible. He sums up the effects as, “increased irritability and aggressiveness, anxiety, depression, listlessness, fatigue, lack of concentration, sleep disorders, headache and migraine, heart and circulation irregularities, nausea, dizziness, scar pain or phantom pain, and rheumatic pain.”

The winter pattern of SAD shows signs such as hypersomnia, weight gain, carbohydrate craving, low energy levels, and overeating. Social withdrawal also characterizes winter blues. On the flip side, the less common face of summer SAD show symptoms like agitation, anxiety, insomnia, and restlessness. A poor appetite that leads to weight loss and amped up occurrences of violent behavior are also common.

Causes of Seasonal Anxiety

There is a consensus that the scale of anxiety aggravates as a person moves upward from the equator. This emphasizes the role of sunlight as a cause of SAD. A change from summer to winter translates into disruption of the circadian rhythm, which is the internal human biological clock.

It is disturbed as the hourly distribution of the daylight and night time change with seasons. Days tend to shorten during the winter and are accompanied with longer nights, which confuses the biological clock. This triggers anxiety along with disturbed sleep schedules.  

Additionally, the decline in sunlight may affect serotonin levels in an individual. Serotonin is a neurotransmitter that impacts mood. Lower serotonin levels are associated with depression and anxiety. Brain scans reveal that people with SAD in the winter exhibited lower levels of serotonin.

Furthermore, melatonin markers also have a role to play in the seasonal anxiety. Melatonin is a hormone that determines sleep mood and patterns and is produced in dark hours. As the daylight is limited during the fall and winter season, melatonin production swells. This sleep-regulating hormone also implicated the internal biological clock. During seasonal swings, the internal clock fails to fall in sync with the external clocks climaxing in unusual sleep patterns. Subsequently, birthing anxiety.

Individuals who experience SAD sleep 2.5 hours more in the winter than in the sunny season of the year. These people sleep 1.7 hours more in the winters relative to 0.7 hours of increased zzz fetched by the general population.

At the same time, shorter days cannot keep up with the long list of activities to accomplish. Limited daylight hours also leave little time for social meetups and gatherings. These add as other secondary causes of SAD.

Key Takeaway

Seasonal changes exacerbate the mental condition with patients with anxiety and other mental disorders. However, the impact doesn’t halt here but grows to sink its teeth in other people to cause anxiety. It is essential to take essential steps to manage stress and anxiety as the seasons alter.

Erica Silva is a blogger who loves to discover and explore the world around her. She writes on everything from marketing to technology, science and brain health. She enjoys sharing her discoveries and experiences with readers and believes her blogs can make the world a better place. Find her on Twitter: @ericadsilva1


Demystifying and Healing from Postpartum Anxiety

Eyes filling with tears, Mary recounted to me the symptoms that prompted her to call the office.

Ever since she was born I’ve had terrible anxiety. We wanted a baby so badly but the panic and anxiety after having her has been unbearable. I feel fluttery and shaky and my stomach is always upset. I can’t leave the house anymore and I keep my 6-month-old daughter cooped up in the house all the time; I feel like a terrible mom. I am not an angry person but I’m on edge all the time and catch myself yelling a lot. I have panic attacks where I have to put her in her crib and I lock myself in the bathroom and cry. The doctors say my labs are fine and they recommended counseling and medications. I want to keep nursing and so I’m afraid of medications. I just don’t know where to turn.”

Most people have heard of the baby blues, but we also need to talk about other symptoms that can arise after giving birth to a child. This can include: depression, anxiety, suicidal thoughts and even psychosis. Mary is suffering from a condition called Postpartum Anxiety. Postpartum anxiety affects at least 17% of women (1) and symptoms can range from mild to severe and debilitating.

There are many different causes of postpartum anxiety and treating the root cause will not only help relieve the anxiety, but improve your overall health and prevent future occurrences of anxiety and/or depression.

In this article I will share with you my top three solutions for postpartum anxiety. These will work best when used in conjunction with fabulous counseling with a clinician you trust, and optimal medical care from your local physician.

Dr. Cain’s Top 3 Postpartum Anxiety Solutions:

Liver Support

Your liver is the control center when it comes to regulating your hormones and impacting detoxification. During the postpartum period, hormone levels working towards equilibrium and these fluctuations can contribute to or cause depression and anxiety. Supporting your liver can facilitate this process. My favorite supplements for the liver are: Selenium, Alpha Lipoic Acid, and Milk Thistle.

Heal the Gut

Did you know that 95% of your serotonin is made in your gut? This is why our digestive health often ebbs and flows in connect with our emotional well-being. Healing the gut will profoundly impact not only your mood, but it will also increase your energy, motivation, improve sleep and help eliminate that brain fog. My favorite ways to heal the gut are to take out foods that are pro-inflammatory (breads, sugars, alcohol), and to focus more on whole foods, healthy fats, and proteins. I also typically recommend a good broad spectrum probiotic and digestive enzymes if needed. To learn more about how to eat to heal your gut go to www.gutpsychology.com.

Natural Anxiolytics

The word anxiolytic means to reduce or eliminate anxiety. Many mothers who are nursing are reluctant to take pharmaceutical medications because of the risk of the drug passing into the breast milk. But don’t fret! There are wonderful, effective natural options that might just be the ticket to helping you feel more calm and relaxed. Here my top favorite recommendations: (Remember, always talk to your doctor before starting any new supplement, diet, or medication)

  • Rescue Remedy: These flower essences by Bach Flower are safe to take all day and you can get them dispensed as lozenges or in a liquid.
  • L-Theanine: This is my favorite go-to for anxiety. Some people do quite nicely on 100 mg but I’ve given my patients upwards of 400 mg if the anxiety is more acute.
  • Homeopathy: An effective and a well- prescribed remedy by a trained physician is more powerful than any other medicine I have encountered.
  • Scutellaria lateriflora: This wonderful little herb is considered by the eclectics to be a safe herb to take for anxiety while the mother is nursing. I like to recommend the alcohol-free extract and typically mothers take 3 dropperfuls up to 3 times per day.

As always, talking to someone who is compassionate, trained and available can be profoundly impactful. Here is a must-know resource: The Postpartum Support International Phone Number: 800- 994-4PPD (4773). You are not alone and you can feel like yourself again. The body is incredibly effective at healing itself and all it needs is the right guidance and support.

(1) Ian M. Paul, Danielle S. Downs, Eric W. Schaefer, Jessica S. Beiler, Carol S. Weisman. Postpartum Anxiety and Maternal-Infant Health Outcomes. Published by the American Academy of Pediatrics. (March 04, 2013) doi: 10.1542/peds.2012-2147. Retrieved from: pediatrics.aappublications.org/content/early/2013/02/26/peds.2012- 2147..info

Dr. Nicole Cain NMD, MA is the founder and chief medical officer of Health For Life in Grand Rapids, Michigan and Scottsdale, Arizona as well as Natural Mental Health Supplements. Her expertise is in naturopathic and integrative treatment of depression, anxiety, bipolar disorder, postpartum disorders, and conditions affecting children and adolescents. Dr. Cain is the author of the Gut Psychology Diet, which is based on the most comprehensive analysis of the gut and the brain to date, www.GutPsychology.com. To learn more about Dr. Cain go to www.DrNicoleCain.com. Office Phone: 616-200-4433. She sees patients in Arizona, Michigan and remotely via phone and VSee.


Understanding Hypnosis for Anxiety

Talking about hypnosis isn’t easy.

There hasn’t been common agreement on a definition, and there’s been ample disagreement on whether it’s better understood as an altered state of consciousness or as enactment of a social role. (My own understanding draws on both perspectives. Enacting social roles alters consciousness.) The worst popular writings on hypnosis resort to extravagant claims or reflexive skepticism. And those stage hypnosis comedy shows—although highly entertaining—foster impressions of hypnosis as something silly if not sinister. In fact, hypnosis amounts to a naturally occurring phenomenon (or collection of phenomena) that almost everyone has experienced, perhaps even daily, even if it wasn’t formally induced or explicitly labelled. Examples of everyday experiences that resemble hypnosis include daydreaming, intense concentration, strong emotion, meditative states, the placebo effect, conditioned reflexes, “losing track of time,” and—at the more troubling extreme—the effects of trauma.  (Some older literature refers to being “in shock” as a hypnoidal state, i.e., a state that resembles hypnosis.)  People experienced or exhibited all of these phenomena long before the 19th century when James Braid coined the term “hypnosis.”  

Hypnotherapy is a procedure in which qualified practitioners help clients achieve a state of focused attention in order to resolve an issue or reach a goal.

This state—also known as “trance” or being “in hypnosis”— is not sleep, but it usually involves deep relaxation.  Misconceptions about hypnosis abound, but its therapeutic effects have been amply documented. Two examples will suffice: Kirsch, Montgomery, and Sapirstein’s (1995) meta-analysis of 18 studies comparing cognitive-behavioral therapy (CBT) to the same therapy supplemented by hypnosis showed that adding hypnosis significantly enhanced treatment outcome with various clinical conditions, including chronic pain, insomnia, obesity, and phobia. A study by Ginandes, C. et al. (2003) reported in the American Journal of Clinical Hypnosis indicated “that use of a targeted hypnotic intervention can accelerate postoperative wound healing.” Still, therapeutic hypnosis remains an underutilized intervention. This is unfortunate. Hypnosis is a non-invasive procedure that requires no medication, has no detrimental side effects, and potentially empowers its recipients to discover their innate ability to use their minds for a change.

The dominant tendency in much present-day mental health care is to attribute psychological or emotional problems, including excessive or problematic anxiety, to hypothesized brain abnormalities or “chemical imbalances,” to view the mind reductively as “what the brain does,” and to prescribe medication to correct whatever neurotransmitters are thought to be “imbalanced.” I recognize that psychiatric medication helps some people sometimes with some things. But I also find it deeply troubling that many persons with mild to moderate anxiety “disorders” receive psychiatric medication as first-line treatment without first receiving encouragement to pursue psychotherapy, hypnotherapy, or healthy self-soothing practices. In my opinion, this runs the risk of disempowering people by removing their opportunity to discover and develop their natural capacity for effective self-care. There is also a risk that the diagnosis itself will become one’s conceptual identity and a self-fulfilling prophecy: “My anxiety disorder makes me worry.”

Hypnotherapy isn’t a magic fix, but it does help many people reduce and even eliminate problematic or excessive anxiety.

As noted above, it can do more than that, but even if promoting relaxation were its only beneficial effect, hypnosis would certainly have a role in anxiety reduction and addiction treatment. Through working in addiction treatment, I have encountered many clients with co-occurring anxiety. Many others have no idea how to relax in the absence of drugs and alcohol. For these persons, hypnotic relaxation training (whether or not they pursue further, issue-specific hypnotherapy) is empowering because it provides an actual experience of obtaining voluntary control over tension and autonomic arousal. In this sense it offers something that “talk therapy” alone cannot.

Hilgard (1970) found that the capacity for imaginative involvement is crucial for hypnotizability. Such involvement can be employed intentionally to induce or deepen hypnosis. One example is employing “favorite place imagery” to bring about feelings of relaxation and well-being: Intentionally engaging one or more sensory modality—e.g., sight, sound, sensation—to imagine as vividly as possible a scene, situation, or event that one associates with a desired physical or emotional state. Many people who struggle with anxiety seem to possess a remarkable capacity for imaginative involvement or absorption in their own thoughts, but they are misusing it in what Daniel Araoz, Ed.D. (1985) called “negative self-hypnosis.” After all, much anxiety involves vividly imagining everything that could wrong and then reacting emotionally as if it were already happening.

Your nervous system can’t tell the difference between what you actually experience and what you vividly imagine.

At least that’s what Maxwell Maltz (1960) said. Decades later, Winerman (2006) summarized fMRI research on hypnotized subjects that essentially confirmed Maltz’s assertion. When instructed to perceive gray-scale printed patterns in color, hypnotized subjects showed activation in the same area of the brain as when they viewed actual color prints. Hypnotically induced pain activated the same brain area as “real” pain. It would not be too much of an extrapolation to say that this research implies that, through hypnosis, it is possible to alter perceptions and sensations in either detrimental or beneficial ways. If we think of worrying as a form of negative self-hypnosis that instigates or exacerbates anxiety, then it becomes apparent that hypnotherapy could be used to redirect the same skill required to worry into reducing or relieving anxiety. What skill or ability does it take to worry? It takes a vivid imagination and sufficient absorption in one’s thoughts to produce changes in sensation, perception, and physical arousal.  In a sense, then, if you know how to worry, you already know something about how to meditate and how to use hypnosis!

I am not suggesting that misuse of the creative imagination is the only source of anxiety. Other contributors or causes include unprocessed trauma, blocking or “stuffing” one’s emotions, and anxiety sensitivity (AS). (Anxiety sensitivity refers to a tendency to over-interpret the bodily arousal associated with anxiety as threatening or harmful, thereby intensifying the anxiety or fear and the resulting arousal.) Arguably, each of these involves a feeling of being “out of control.” Like biofeedback, hypnosis or hypnotherapy promotes voluntary control of one’s sensations and perceptions, including those associated with anxious arousal. This behavioral understanding of hypnosis is not the only way to conceptualize it, but it might be the most readily understandable, accessible, and measurable way to experience its benefits and to use your mind—and body—for a desired change!

Michael K. Kivinen, MA, LLP, C.Ht. has a master’s degree in counseling psychology and a Michigan limited license as a psychologist. He is also a certified hypnotherapist. He works as a therapist at West Brook Recovery Center, a private addiction treatment program in Grand Rapids, Michigan, and he teaches psychology courses as an adjunct instructor at Grand Rapids Community College (GRCC) and Aquinas College.  If you have questions about hypnotherapy, anxiety- and trauma-related disorders, or addiction treatment, you may contact him at (616) 957-1200.

-Araoz, D. (1985). The New Hypnosis. New York, NY: Brunner/Mazel.
-Ginandes, C., Brooks, P., Sando, W.,  Jones, C., & Aker, J. (2003). Can medical hypnosis accelerate post-surgical wound healing? Results of a clinical trial. American Journal of Clinical Hypnosis, 45(4), 333-51.
-Hilgard, J. (1970). Personality and Hypnosis: A Study of Imaginative Involvement. Chicago, IL: University of Chicago Press.
-Kirsch, I.,  Montgomery, G.&  Sapirstein, G. (1995). Hypnosis as an adjunct to cognitive-behavioral psychotherapy: a meta-analysis. Journal of Consulting and Clinical Psychology, 63(2), 214-20.
-Maltz, M. (1960). Psycho-Cybernetics: A New Technique for Using Your Subconscious Power.  N. Hollywood, CA: Melvin Powers Wilshire Book Co.
-Winerman, L. (2006). From the stage to the lab: Neuroimaging studies are helping hypnosis shed its ‘occult’ connotations by finding that its effects on the brain are real. Monitor on Psychology, 37(3), 26-27.


Slow Down, Find Your Inner Calm

Noticing Breath

I would like you to close your eyes and observe the weight of the body and the spine nice and tall. Feel the heaviness drawing you down grounding you and connecting to this moment this body and this breath. Now turn your attention inside and observe any sensations in the body. Noticing breath….slowing down. By using breath and yoga you are working from the outside in to help find a more calm and relaxed state. The physical body has a direct effect on the emotional body. As we slow down and soften our minds we become more relaxed and calm. Breathing in slowly through the nose allowing yourself to take more space and soften as you exhale. The breath can help us relieve tension and soften the physical body helping to find some expanded space.

Breathing through just the nose is a calming breath which helps to regulate the nervous system. Often our breath become erratic when the mind is full this can produce stress and anxiety. Give your mind permission to let go of unnecessary thought or worries, and unhelpful thought patterns of anxiety or stress. According to Saleem (2015); powerful effects of meditation and/or mindfulness on the brain are often subjects of medical studies and new scientific research which is released daily about the practice’s neurological benefits. 

The breath can help us relieve tension and soften the physical body helping to find some expanded space.

Yoga is a mind-body practice that combines physical poses, controlled breathing, and meditation or relaxation. In times of high stress and anxiety, our bodies tend to constrict and tighten. When we experience the relaxation benefits of yoga; we can lower our physical tension, which helps release the grip that anxiety can have on us. Yoga increases body awareness, relieves stress, reduces muscle tension, strain, and inflammation, sharpens attention and concentration, and calms and centers the nervous system.

Studies have shown that yoga and meditation decrease stress, depression, and anxiety while increasing happiness and the overall quality of life. The most important benefits of yoga is its application in relieving stress, fatigue, invigoration and vitality and its anti-aging properties and its application for relaxation therapy. This is because concentrating on the postures and the breath acts as a powerful form of meditation. Yoga helps to increase strength, endurance, flexibility, and balance, which also translates into an increased ability to perform activities, have more energy, and get a more restful sleep.

Yoga and meditation slows down the mental loops of frustration, regret, anger, fear, and desire that can cause stress. Since stress is implicated in so many health problems from migraines and insomnia to lupus, MS, eczema, high blood pressure, physical imbalances, and heart attacks; if you learn to quiet your mind, you’ll be likely to live longer and healthier. The beauty of Yoga and meditation is that it can be practiced by anyone. Consult with your physician if you have medical issues prior to starting a yoga practice.

With Gratitude,

Sarah Ryder, Manager of The Hammock LLC

Saleem, R. (2016). Yoga Benefits for Health. The International Journal of Indian Psychology, 3(3), 2nd ser. Retrieved June 9, 2018, from http://oaji.net/articles/2016/1170-1461153468.pdf

Sarah is a registered occupational therapist at The Hammock LLC. With over 30 years of OT experience and extensive training, Sarah continues to expand her education and is currently pursuing Health and Wellness Coaching at Maryland University. In her personal life, she enjoys spending time with her family outdoors but also enjoys life’s little pleasures of pedicures, massages and chocolate.


Understanding Why People Pick and Pull

A Closer Look at Body-Focused Repetitive Behaviors

Body-focused repetitive behaviors (BFRBs) are a classification of disorders where a person’s actions are directed towards one’s own body often focused on removing or grooming parts of the body. These behaviors can become habitual and disordered when they happen frequently enough to lead to significant distress or impairment in school, work, or social functioning or cause damage to the body.

Who is Afflicted?

There are no reliable statistics on BFRB prevalence. However, smaller studies on individual BFRBs suggest that up to 4% of the population is afflicted by one of them throughout the lifespan (Chamberlain & Odlaug, 2014). Evidence also suggests that a majority of those afflicted with BFRBs are women with symptoms staring during adolescence at the onset of puberty.

Where Do BFRBs Originate?

More research is needed to provide an accurate explanation of why people have BFRBs. There is evidence that BFRBs are more likely to occur in families where first-degree family members have obsessive-compulsive disorder compared to the general population (American Psychiatric Association, 2013). Neurological causes are harder to determine. The presentation of symptoms of these disorders vary widely from person to person, but the theory is that response inhibition is a likely culprit (Grant, Leppink, & Chamberlain, 2015). Most people pick at their skin or pull out hair at some point in their lives, however, those who do so in a disordered manner may have a malfunction in the part of the brain that inhibits specific behaviors or the part which can interrupt behaviors once they begin (Grant et al., 2015).

What Are They?

There are several behaviors considered as BFRB’s but the most common include trichotillomania, excoriation disorder, and nail-biting. Trichotillomania is the recurrent compulsion to pull one’s hair. Hair is pulled from any part of the body, but the most common areas are the scalp, eyebrows, and eyelashes. Excoriation disorder is repeatedly picking at the skin. It could be healthy skin or unhealthy skin, targeted to scabs, lesions, pimples or other blemishes and some people use tools to poke, squeeze, or lance the skin.

The compulsion to pull hair, pick at the skin, or bite nails can be focused or automatic. Those who engage in the behaviors in a focused way do so as a way to regulate emotions or soothe themselves. It can be in response to a physical sensation such as an itch or tingle, or it can be in response to a perceived physical defect such as a blemish or a hair out of place. Sometimes the behavior results in a feeling of gratification or pleasure, while for others it is a focused method of experiencing a sensation. For those who engage in BFRBs without full awareness, they may pick, pull or bite while “zoned out” and only notice they are doing it when they start to bleed or experience pain.

Bad Habit or Disorder?

Diagnosis of BFRBs is challenging. First, disordered behaviors need to be distinguished from bad habits. Second, as part of the obsessive-compulsive spectrum of disorders, a clinician also needs to differentiate when the compulsion to engage in these behaviors is part of a broader obsessive-compulsive disorder or whether it occurs on its own. Similar symptoms can also occur in patients with a stereotypic movement disorder, which is a neurodevelopmental disorder that starts in childhood (Chamberlain & Odlaug, 2014). Therefore, careful assessment is the first step toward treatment.

Several conditions need to exist to meet the diagnostic criteria of disordered. The existence of a Body-Focused Repetitive Behavior needs to be accompanied by significant impairment and distress which usually looks like spending a considerable amount of time, several hours per day, on the behavior or covering up the behavior. The person also isolates, withdraws socially, and misses school or work by either engaging in the behavior, covering it up or avoiding judgment. Also, there is a pattern of unsuccessful attempts to stop the behavior. Finally, the behavior results in physical damage. For example, people with trichotillomania will get to the point where there are patches of hair missing and may not grow back, scabs where hair is pulled out, or inflammation such as in the condition of blepharitis which results from pulling out eyelashes. People with excoriation disorder will have lesions, skin infections, or scars.

Not Just Physical

The mental and emotional toll of behaviors that do not fit into society’s concept of “normal” is significant, and a lot of work goes into hiding them. A majority of people who have BFRBs are aware of what people think, and they are very sensitive to the reactions of others. The behaviors are usually done in private, and as the consequences become visible such as bald spots or sores, the person spends a lot of time covering it up or withdrawing completely. A person with a BFRB feels unattractive, ashamed of what they do and how hard they have to work to cover it up to blend in. On a social level, sometimes it is better to avoid people and not go out in public. Constantly barraged by the paranoia of someone seeing or detecting the cover-up, the person internalizes subtle nonverbal cues that further separate them from what is “normal.” The person is left to deal with their disorder alone, often accompanied by depression and anxiety. Increased depression and anxiety often feed back into the compulsion cycle by making symptoms worse.

Recovery and Treatment

As a chronic, compulsive disorder, BFRBs are not “cured,” but there is treatment. The first step is recognizing that BFRBs are treatable disorders and support is available. Treatment is designed to meet the needs of each person’s experience. Providers who specialize in BFRBs are equipped to discern what is going on diagnostically as well as to help with the unique combination of co-occurring disorders such as anxiety and depression. There are several evidence-based therapies available including cognitive behavioral therapy, habit reversal training, acceptance and commitment therapy, and dialectical behavioral therapy. Whichever is chosen, expect a combination of learning to increase self-awareness, identify triggers, regulate emotions, manage stress and anxiety as well as learning to create routines that focus on reclaiming the power to choose to engage in the BFRB or not.  

Many people who suffer from BFRBs do not seek treatment because of the stigma involved or because of previous negative experiences. While these disorders last a lifetime, there are many success stories of people in recovery who learn to manage their behaviors and symptoms, so they do not interfere with life anymore. The good news is that even if there are no BFRB specialists in your area, there are online resources that offer therapy and social support. If you or someone you love is dealing with BFRBs, encourage them to explore their options until something works.

Trudi Griffin is a Licensed Professional Counselor putting her clinical knowledge, experience, and passion for research to write about mental health, She’s part of the trichstop.com team.

-American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, Fifth edition. Arlington, VA: American Psychiatric Association.
-Chamberlain, S. R. & Odlaug, B. L. (2014). Body-focused repetitive behaviors (BFRBs) and personality features. Current Behavioral Neuroscience Report, 1, 27-32. doi: 10.1007/s40473-013-0003-9
-Grant, J. E., Leppink, E., & Chamberlain, S. (2015). Body-focused repetitive behavior disorders and perceived stress: Clinical and cognitive associations. Journal of Obsessive-Compulsive and Related Disorders, 5, 82-86. doi: 10.1016/j.jocrd.2015.02.001


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