Category: Blog

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Self-Discipline, by definition, is the ability to listen and to act based on your inner voice, regardless of how you feel, other influences, or the temptations you face. Discipline is the key to self-mastery. So why is this so hard?

So many people struggle with maintaining healthy choices and keeping to their goals. We have misperceptions that we are supposed to be excited and want to be engaged in these wellness practices. The truth is… discipline is hard. It’s rarely anything that we love to do or get super excited about. It’s often something we internally combat and make excuses for. We will find 100 reasons why we should not deliver or more importantly not show up for ourselves. Breaking into a better emotional and behavioral state is work, hard work. We need to accept that this will always be hard work and something that you must employ, daily or regularly, if you want to feel better and be better!

Research shows that people who have a good sense of discipline are less likely to suffer from major mental health issues and more likely to experience overall increased wellness. Some mental health benefits of being disciplined are it increases depressed moods, it creates less anxiety or stress, it combats drugs or alcohol abuse, it decreases potential for develop eating disorders, and it helps manage obsessive compulsive disorders.

Often mental health practitioners will say, “the key to real therapeutic change is when someone finally figures out how to show up for themselves.” It’s the improved habits and disciplines they enforce on themselves that creates positive change. They learn to be healthier and show up successfully.

The benefit of any discipline consistently comes later. It’s not always in the moment of but the sooner or later future. It will show up in the long term and create a new fondness of self. It’s choosing what I want the most. It will get you to the transformative self. Self- discipline creates confidence and motivation. Confidence being the internal stability of self-worth and motivation being the momentum. Momentum will keep the motivation alive. It will increase your focus making you work harder. Discipline creates a drive to succeed and find joy in the success. By being disciplined you will gain tolerance, patience, and a better sense of self-control. All key traits needed for an overall healthy, happy person to be present every day.

Easy steps to create a discipline:

  1. Set clear goals. Clearly outline what your goal means to you and how you intend to achieve it. Meaning is necessary for a discipline to be initiated.
  1. Make a commitment to yourself. You must have meaning and purpose in this. Knowing you are worth the effort and wanting to get back the control of your life.
  1. Make it apart of your daily routine. It is critical to make time each day and figure out where the discipline will fit into your day. Make a place for it, be consistent. Establishing an autopilot routine is essential for the discipline to occur.

Keeping distractions and temptations away will help you to commit and focus on your goals. Being mindful or purposeful of your attention about what your goals are and when your discipline should take place will help you stay on track. Persevering, staying steadfast through hard times will keep you motivated and keep you from self-sabotaging. Executing or carrying the discipline through will keep you in alignment of success and build the journey of your productive self.

Self-discipline is a practice. It is something that you must demonstrate everyday even if you fail or falter. You must put exertion at it and be available to it. You must practice repeatedly until it becomes an automatic behavior and/or thought. Find the courage to put the work in, be patient, and wait with hope.

By: Kristina Tracy, LISW-S

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Julie Foster, LISW-S, RN, MEd

There are many types of eating disorders. The most commonly talked about eating disorders are anorexia nervosa, bulimia nervosa, binge-eating disorder, and avoidant restrictive food intake disorder. National Eating Disorders Awareness Week (NEDAW) is an observance to bring awareness to the seriousness of eating disorders across the United States. It is estimated that over 28 million Americans will have an eating disorder in their lifetime. (https://www.womenshealth.gov/nedaw).

So, what can employers and leaders do to help?

Fatphobia and body shaming are so woven into our workplaces that often it goes unchecked. In fact, it is a microaggression normalized by “wellness” programs in the workplace that encourage weight and calorie tracking, weight loss incentives, and “Biggest Loser” competitions.

There is “evidence that weight stigma is a bigger risk to people’s health than weight itself and what they eat.” (Harrison, 2021)

Weight-loss challenges can actually be one manifestation of a hostile work environment.

And anyway, dieting does not work! 95% of those who diet may lose weight in the short term, but they gain that weight back and more within 1 to 5 years. (Fildes et al., 2015)

Instead of weight loss competitions, how about implementing “No diet/body talk zones” and including weight discrimination in workplace diversity and inclusion efforts. Workplace leaders can start to change the office culture by modeling zero tolerance for body shaming and also by  supporting employees who are actively fighting against diet culture. Leaders can fight weight discrimination by examining their hiring practices and normalize not just Health at Every Size (HAES) but also leaning into the truth that size has no bearing on one’s intelligence or work ethic.

How can you shut down body-shaming? Start with yourself. What kind of things do you say, out loud, at work, about your body and what you are, and are not, eating? Change the narrative and speak up when others are making fatphobic comments. What others are eating or not eating is no one’s business. Commenting on someone’s weight in any fashion is not appropriate any more than commenting on anything else about their body.

You wouldn’t agree with   a colleague  making racist or homophobic remarks, so the same should be true if employees are body shaming. Here’s how you could respond:

“Why would you think it’s okay to say something fatphobic like that?” Or, “Why do you think it’s okay to discuss ______’s body?”

Another important part of creating a body-size inclusive culture is to conduct a physical audit of your environment. Are there chairs and workstations to accommodate all sizes of bodies? Are your waiting areas or lobbies welcoming to all sizes of bodies? Do your vending machines sell regular and low-calorie drinks for the same price?

Just like “love is love”, “food is food.” Food is neutral, not good or bad. What you eat does not define you as good or bad or qualify as being good or bad. And it’s no one’s business what or how much someone else is eating, so request employees keep their commentary (which is probably related to their own insecurities) to themselves. It is important for leadership to recognize that it is likely that a percentage of their workforce has, or has had, and eating disorder, and comments about food and size can be very triggering for them. What might seem like a neutral comment (“I can’t believe how bad I was! I ate that whole piece of cake!”) reinforces to someone with an eating disorder that food and eating is bad or shameful.  Or talking about how you haven’t eaten all day as some badge of honor reinforces to others that they are somehow weak or wrong for eating regularly.

It is also important to remember that an eating disorder is a disability, therefore the Equality Act 2010 applies. Eating disorders are the most lethal of all mental illnesses. Managers and colleagues should be aware that individuals with eating disorders, as with any long-term health condition, may have changes their performance.

Reasonable adjustments for those suffering with an eating sidorder could include: flexibility in allowing time off for appointments, working hours or extended lunch or other breaks, consideration of factors such as a place to eat in private or avoiding lunch meetings or other work events involving eating socially.

Compliment people without bringing their weight or bodies into it. Find ways to bond, connect and have conversations with people in the workplace that do not involve food, bodies, or weight loss.

Encourage movement for fun, for change of scenery, for better productivity. Play music, normalize dance breaks.

Why not create a routine where everyone has the opportunity to  get up from their desk at least once every hour and takes a 2 minute walk. But avoid tracking steps or putting a lot of emphasis on competition.

The best way for people to be released from diet culture is to have a community of support. The workplace can become a safe space. If you are concerned an employee may have an eating disorder, there is help at the Lindner Center of Hope 513-536-HOPE.

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Binge eating disorder (BED) is the most prevalent eating disorder but remains largely undiagnosed and untreated.  BED is characterized by recurrent episodes of loss of control and consumption of unusually large amounts of food within a short period of time (<=2h).  Episodes are associated with significant emotional distress but are not followed by purging behaviors (vomiting, misuse of laxatives, etc.), which differentiates BED from Bulimia Nervosa.  In addition to psychological distress, BED is associated with medical complications including accelerated weight gain, metabolic abnormalities, functional impairment, and decreased quality of life.  Untreated BED leads to worse clinical outcomes in a variety of medical and psychiatric conditions and poor treatment response in hypertension, diabetes, dyslipidemia, and obesity, which are commonly seen in primary care.  Patients with BED stand to benefit from increased screening, diagnosis, and treatment, particularly patients with type 2 diabetes mellitus (T2DM).

Screening for BED is particularly important in patients with T2DM.  While the prevalence of BED in the general population is estimated around 3%, prevalence is significantly higher in T2DM, where the prevalence of BED is estimated around thirteen times higher than in the general population.  In fact, eating disorders are frequently encountered among patients with T2DM, with prevalence estimated around 20%.  Diagnosis and treatment are important because the presence of binge eating greatly complicates management and is associated with worsened outcomes such as impaired glycemic control, dyslipidemia, and accelerated weight gain.  BED is associated with decreased response to weight loss interventions (including dietary and bariatric surgical procedures), impaired glycemic control, dyslipidemia, and exacerbation of insulin resistance.  Moreover, common pharmacotherapies for diabetes (such as insulin, sulfonylureas, and dietary restraint) have been implicated in the exacerbation of binge eating.

As we have seen, BED is a barrier to achieving treatment goals in T2DM.  It is important to take binge eating into account when selecting treatment.  Reducing the frequency and severity of binge eating can facilitate the achievement of treatment goals in T2DM.  Primary care providers manage most patients with T2DM, but screening and management of BED is still overlooked.  It is necessary to treat patients to decrease the frequency and severity of binge eating to help patients achieve treatment goals for diabetes.  Optimal outcomes in treatment are not possible with untreated BED.  Primary care providers face the challenge of identifying and initiating treatment for this population with complex needs.

Even though BED is an important comorbidity in T2DM, significant barriers to diagnosis and treatment persist.  First, eating disorders are associated with significant stigma and patients may not readily disclose disordered eating behaviors due to shame.  In many cases, patients are aware that some of their eating behaviors are abnormal, but they do not know that they are suffering from a treatable eating disorder.  In addition, primary care providers may overlook binge eating as a possible factor when patients fail to achieve treatment goals despite intensification of treatment.  In addition, primary care providers face time and financial constraints which limit their ability to diagnose, refer and treat.  Finally, there are not enough trained clinicians who can offer specialized medication management, dietary counselling, and psychotherapy for BED.  Medication options are still limited to an FDA approved agent (lisdexamphetamine), plus a couple of drugs used off-label.  However, providers still have options to start addressing the needs of patients with T2DM and BED, including:

Further research is needed to understand the needs of patients with comorbid T2DM and BED as well as to develop treatments to lessen the occurrence of binge eating episodes clinical care guidelines.

The Research Institute at the Lindner Center of HOPE is conducting a clinical trial of an experimental medication for Binge Eating disorder.  No prior diagnosis is required.  For additional information, contact us at 513-536-0700 or visit:  https://redcap.research.cchmc.org/surveys/?s=TP3C4TEA8J

Bibliography

Harris SR, Carrillo M, Fujioka K. Binge-Eating Disorder and Type 2 Diabetes: A Review. Endocr Pract. 2021 Feb;27(2):158-164. doi: 10.1016/j.eprac.2020.10.005. Epub 2020 Dec 13. PMID: 33554873.

Keshen A, Kaplan AS, Masson P, Ivanova I, Simon B, Ward R, Ali SI, Carter JC. Binge eating disorder: Updated overview for primary care practitioners. Can Fam Physician. 2022 Jun;68(6):416-421. English. doi: 10.46747/cfp.6806416. PMID: 35701190; PMCID: PMC9197289.

Winston AP. Eating Disorders and Diabetes. Curr Diab Rep. 2020 Jun 15;20(8):32. doi: 10.1007/s11892-020-01320-0. PMID: 32537669.

Nicole Mori, RN, MSN, APRN-BC, Lindner Center of HOPE Psychiatric Nurse Practitioner

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By: Sidney Hays, MSW, LISW, DARTT,

Lindner Center of HOPE Professional Associates, Outpatient Therapist

From wild parties in the massive frat houses to stories finding your soulmate in movies and television, many enter college with bright eyes and big dreams. There are expectations of melting into a friend group, dating, gaining experience, and finding your passion as soon as you get to college. All of this, stepping-stones to graduating with the dream job lined up, a group of best friends you’ll vacation with every summer, and that special someone you just might spend the rest of your life with. You’ve heard about the glory days and the football games and the spring break trips. But, what happens when you get to college and the classes are hard, friendships are complicated, partying comes with consequences, and heartbreak hits you?

Many young adults enter college with high hopes and expectations that seem reasonable Unfortunately, the movies and glory day memories from loved ones miss crucial struggles and obligations that come with college. This often leaves college students feeling like they’re “missing something” or failing, which contributes to poor mental health in an environment already rife with challenges. The struggles of large class sizes, living with strangers, easier access to drugs and alcohol, financial stress, being away from home, and lack of structure tend to tax the delicate wellbeing of young adults who have not been adequately equipped with needed skills and whose brains are not fully developed.

Most 18-year-olds step onto a college campus and it’s the first time they will be spending the majority of their time living away from home. Suddenly they are responsible for most every aspect of their life, with minimal adult supervision. Out from the safety net of coming home to parents and the guidance of coaches and teachers, college freshmen spend the majority of their time exclusively with others their same age, facing the same struggles. They navigate friendships, romantic relationships, and living with strangers as best they can, often struggling with codependency, lack of boundaries, and the pervasive anonymity and distance offered by the internet. This group tends to struggle with interpersonal skills and ability to regulate their own emotions, with little guidance on effective skills to use. Many find themselves feeling lonely and in cycles of unhealthy or unfulfilling relationships.

Accountability is a new concept for many college students. The looser structure of college settings requires more self-determination and discipline than high school. College is a place where students are generally free to make most of their decisions. While this can be liberating and a time of beautiful self-discovery, it can also lead to poor attendance, study habits, and moderation of substances and sleep. The negative physical, academic, and emotional effects of these choices tend to pile up, which is why so many college students begin to struggle with anxiety and depression.

What to tell a college student who isn’t having the best time of their life:

Know that you are not alone.

Mayo Health Clinic reported in July 22 that up to 44% of college students reported symptoms of depression and anxiety. The stressors faced by college students are underplayed and the good times overly glorified. It often takes time to make friends and friend groups naturally change; that’s okay. People are trying to understand what they want to do with the rest of their lives, becoming independent adults, and learning about the world. This will likely lead to many shifts in relationships as well.

Manage expectations.

You are in school to get a degree, learn about yourself, create relationships, and prepare yourself for the workforce. You may not find a group of friends during welcome week or even freshman year. The romantic relationships may not work out. You may not graduate with your dream job lined up. This is a step towards your goals and can still be part of a life worth living, even if you don’t get exactly what you want by graduation.

Get support and develop lasting relationship skills.

College is a great time to connect with a therapist to process the changes and have a support to help you identify your goals and live within your values. Learning skills to set boundaries, prioritize your time, communicate effectively, and regulate your emotions will make a world of difference in college and will carry on through your life.

A great option for learning these skills is Dialectical Behavior Therapy (DBT). DBT is a treatment that helps participants learn and practice skills to regulate emotions, tolerate distress, and effectively navigate interpersonal relationships.

If you are interested in learning more, for yourself or someone else, about DBT or individual therapy to help navigate this beautiful and challenging season, contact the Lindner Center of HOPE.

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Lindner Center of HOPE’s Premiere Assessment Residential Programs have a private entrance to welcome patients and families. Both programs operate as private-pay programs.

If you or a loved one is suffering from mental illness or addiction, contact us for information on our residential treatment programs for mental health in adults.

One in four individuals are living with a mental illness, according to the 2012 National Survey on Drug Use and Health: Mental Health Findings1 conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA). It is a leading health problem in the United States, with approximately 61.5 million adults, or one in four, experiencing a mental illness in a given year.

Among adolescents, the same study found an estimated 20 percent of teens ages 13 to 18, and 13 percent of youth ages 8 to 15, experience a severe mental disorder in a given year.

Another major public health problem, according to the National Institute on Drug Abuse, is drug and alcohol abuse. The Closing the Addiction Treatment Gap (CATG) initiative2, created by the Open Society Institute, reports that 23.5 million Americans, or one in every 10 individuals over the age of 12, are addicted to drugs and/or alcohol.

The statistics bring to the forefront the importance of residential mental health facilities focused on comprehensive assessment and intensive treatment in a residential setting, as one effective tool in treating mental health conditions and addiction, including non-substance addictions like gambling.

But for most people, recognizing a mental illness or an addiction, finding the best help to treat it, and knowing what to expect from a residential treatment center can be an uncertain road without the proper guidance.

Click here for more information.

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Anyone born between 1946 and 1964 is a part of the Baby Boomer Generation. This generation is often defined as people born during the post–World War II baby boom, consisting of approximately of 76 million Americans. During the 1950s, 8% of the population was over the age of 65. By 2019, this number grew to 16.5%. By 2050, 22% of the US population will be over the age of 65 (over 1 out of 5). There will be 3.7 million centurions in the United States by 2050. So what does this have to do with substance use? Here are the facts: Most baby boomers in their younger years, smoked more marijuana and did more illicit drugs than any other generation. Many baby boomers indulged in early substance use, but as they reach middle age and retirement, many have continued to abuse alcohol and drugs, are getting arrested for drug offenses, and dying from drug overdoses.

Many older adults, now approaching retirement, were exposed to older peers and the events of the times, who were proud participants in a counter-culture movement. This anti-war, anti-establishment, and pro-experimentation with drugs, appeared to contribute to a more accepting view of the use of substances. The class of 1979 reported the highest level of drug use (over 50%), of any high school graduating class, before or since. For many Boomers, the use of alcohol, cannabis and other substances has continued through the years. With the aging of any generation, there are changes in health and one’s environment. With Boomer kids no longer around the house, the Boomer begins to lean more on old behaviors of the past, as a means of coping with physical, emotional, and mental concerns. With these concerns, come higher risk, and the possible onset of addiction.

Aging Boomers have a higher rate of accidental overdose than 18-45 year-olds. More members of this generation are dying from accidental overdoses than car accidents, the influenza or pneumonia. While the misuse of prescription medication is a major concern, 36% of Boomer admissions to drug treatment centers are for heroin abuse, 22% for crack cocaine, 12% for opioid painkillers, and 10% for methamphetamines. Over 10% of 50 to 64 year-olds are using illicit drugs. Despite these drugs, alcohol continues to be the most abused substance. For older adults, the proliferation for drug and alcohol use is based on their formative years. With continued use of substances, or rediscovering mind-altering substances, older adult bodies will be unable to handle or metabolize alcohol or drugs as he or she once did. Research studies indicate that if an older adult continues with this behavior, he or she will become one of the 5.7 million Americans over the age of 50, who will require substance abuse treatment.

Another significant factor, contributing to this boom with Boomers, is the massive focus on chronic pain in the U.S. and the subsequent spike in opioid prescriptions. Americans take more prescription painkillers than any other country. The U.S. contains about 4.4% of the world’s population, but is responsible for consuming over 80% of the world’s opioid use. Women of all ages, especially older women are drinking alcohol more often and using more drugs than ever before. According to the National Survey on Drug Use and Health, the rate of binge drinking among older women has increased from 6.3% to 9.1%. Rates of female Boomers abusing alcohol and developing dependency have doubled.

As any generation becomes older, the realities of aging begin to settle in. The combination of loneliness, isolation, chronic health conditions, depression and excess free-time may be leading older adults to abuse drugs and alcohol at higher rates. The total number is expected to reach 15 million by 2030. A Duke University study surveyed 11,000 people over the age of 50, and found a correlation between being separated, divorced or widowed and binge drinking.

What about mental health? One in four adults currently struggles with mental illness. Older adults are more likely to have experienced the traumatic loss of a partner, a close friend, and/or a family member. Loss can also come in the form of retirement, and how the very identity of what defined a person for so many years is now gone. The daily existence of boredom and a lack of structure become problematic. When these factors combine with the likelihood that many older adults use alcohol and experimented with drugs as teenagers and young adults, the result is a population vulnerable substance abuse.

There is help.

If you feel that you are struggling with mental health issues and/or substance use, there is help. The majority of individuals with a substance use issue, 84%, also have a co-occurring mental health issue. For many, sobriety is not enough. An individual may need to see a therapist to resolved past issues, find healthier ways of coping, examine their distorted thinking which perpetuating the unhealthy behavior. Most importantly, substance abuse is not about an issue of character, morality, weakness or bad behavior. Mental health and wellness is deserved for all, especially with My Generation (cue music – The Who).

By: Chris Tuell, EdD, LPCC-S, LICDC-CS
Lindner Center of HOPE, Clinical Director of Addiction Services

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Anna I. Guerdjikova, PhD, LISW, CCRC
Director of Administrative Services, Harold C. Schott Foundation Eating Disorders Program
Lindner Center of HOPE

 

 

 

 

Emotion regulation refers to the process of generating and maintaining an emotion, as well as the ability to modulate its’ intensity and frequency in order to achieve socioemotional competence and sustain mental health. In modern society, from early age, we learn inhibition to downregulate our emotions (for example, to not cry in public or to not say anything when angry) which often results in emotional restraint. True emotional regulation is reached through focused monitoring, evaluating, and modifying of our emotional reactions and depends on the person’s age, temperamental characteristics and environmental circumstances. Some examples of successfully practicing emotional regulation include being able to calm self-down after something exciting or upsetting happens, sustaining focus on repetitive tasks, refocusing attention on a new task and controlling impulsive behaviors. The skill to emotionally regulate depends significantly on the persons’ age and brain maturity and thus understanding that some of the time the individual is not difficult or spoiled, but developmentally or circumstantially unable to control their emotions can help build empathy and strengthen family systems and relationships.

DOs in Emotional regulation

  • Do create safe space for all emotions- the good, the bad and the ugly. Being happy should be equally accepted in the family as being angry or sad.
  • Do model emotional regulation for your children and peers every time you can. Work on naming your emotion (ex.” I am very upset with you now..”), the reasons for it/ the trigger, if you know it (..”because you hit your sister..”) and the solution you have (..”so I will take a moment to regroup and then we will talk about how I am feeling and what helps me go through it”)
  • Do practice awareness of your reaction to the emotional dysregulation in others. The goal it to learn to respond to their outburst (observe, acknowledge, empathize and work through it) rather than react (yell back or slam the door and leave).
  • Do prepare and reflect. When a challenging situation lays ahead, take the time to prepare yourself and the child for it and afterwards reflect on how preparation and having a rescue plan had helped to minimize emotional outbursts.

DON’Ts in Emotional regulation

  • Don’t expect emotional regulation if the person is hungry, thirsty, tired, lonely or in other way physically unsettled. Emotions are felt in the body and learning how the body reacts to them is a crucial step in recognizing and further regulating them.
  • Don’t ignore or minimize kids’ emotions. They might see overly dramatic, or unnecessary, or inconvenient (airport tantrums, anyone?) but for the child they are real and often intense. Work on acceptance that even if we don’t get it, it is real for them and our job is to validate their struggle/excitement and teach them how to better self-regulate.
  • Don’t pretend you “feel it for them” if you do not. It is ok to state that “I don’t know what you are going through but I am here for you and I am willing to help you out in any way I can”.
  • Don’t try to “fix it” or make it go away or focus on it for too long. Emotions are fleeting, they can feel very intense when they occur, but most of them resolve or lose their overpowering force if the person “stays with it” (recognizes it, tolerates the distress for negative emotions and responds, rather than reacts) for long enough. Learning this skill early on can be truly helpful in adulthood

Practical skills to help with emotional regulation

Mindfulness techniques. There are many ways to focus on the “now” to help tame an emotional outburst. A simple example is the 5-4-3-2-1 Grounding Exercise. It can distract from the anxiety trigger, focus the person on the present moment, and help them relax in their body. Ask the person to : name 5 things they can SEE in the room (have them list them out loud) ; name 4 things they can FEEL (sock on my feet, knots in my belly) ; name 3 things they can HEAR (my voice, radio); name 2 things they can SMELL right now (my coffee) ; name 1 thing they can TASTE (if not in the moment, what did they taste last night) . This can be shortened to 4-3-2-1 or even 3-2-1, depending on the circumstances.

Relaxation techniques– teach yourself and your young ones deep breathing. Yoga Dragon breath and the Camel pose can be a fun quick way to release tension.  Explode like a volcano/ Balloon technique can be practiced anywhere and most children under 10 years of age find is helpful (pretend you explode like a volcano/popped balloon- you can jump up and model the eruption with your hands and make a lot of loud dramatic volcano sounds). Using movement, music and sensory activities can help further relax and refocus one’s brain.

Diligent self-care – emotional regulation is impossible in a body with unmet basic needs, namely being tired, hungry, thirsty, lonely or sick. Daily self-care, particularly getting enough rest depending on the person’s age, should be encouraged and taught by parents, especially to teens and young adults who have more autonomy and can make the connection between being overly tired and overly emotional and further

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For many families, the start of the school year means the start of activities, socialization, and helpful structure. For others, it signals the start of anxiety – anxiety about grades, socializing, separation from loved ones, and the like. Anxiety is very common in childhood and adolescence and often does not require mental health intervention.

Common childhood fears include:

  • loud noises
  • costume characters
  • the dark
  • separation from parents
  • social anxiety

However, some children may develop clinical levels of anxiety, warranting attention from a mental health provider. It is estimated that 9% of youth ages 3-17 have had an anxiety disorder. The prevalence rises as children move into adolescence.

If mild anxiety is normal and expected, how do you know when it is a problem?

It might be a problem if anxiety is…

…getting in the way of school.

…getting in the way of friendships or personal goals.

…negatively impacting their mood.

…causing significant strain on the family.

So, what can I do as a parent?

It can be highly distressing to witness a child suffering. Parents may also find it frustrating if their child cannot or will not engage in developmentally appropriate activities due to anxiety (e.g., go to school, complete chores, sit at the dinner table). This can make it hard to know what to do to help

First, identify whether the fear is based on a true threat. Use your judgment here, but if there is clearly a threat or the anxiety is in proportion to the situation, validate and support your child. And just because a fear is valid, it is not always solvable or preventable. Encourage your child to tolerate the anxiety and convey your confidence in their ability to cope.

For anxiety that seems out of proportion to the actual threat, it can be helpful to educate your child. Many young children are still learning about what is dangerous and what isn’t. However, if your child comes to you repeatedly to get reminded or reassured that they are okay, this may no longer be helpful.

Encourage approach coping. Research tells us that overtime, with repeated exposure to feared situations, anxiety will reduce. Avoidance can reinforce anxiety in the long run. Try encouraging your child to engage in activities that they are avoiding. Don’t allow them to avoid doing what is expected in your house or given their developmental level.

This may involve facing your own distress. When you see your child in distress repeatedly, it is normal to become overprotective. You may start anticipating what they fearand protect them. Parents do this because seeing your child in distress is HARD, and it can feel cruel to maintain expectations (e.g., child to sleep alone in their own bedroom) when they are visibly upset.

Just remember that overprotectiveness is NOT helpful because:

  • it can promote avoidance
  • it reinforces the belief that the world is dangerous
  • it reinforces the belief that your child is not capable of managing distress

Positive reinforcement. Acknowledge how difficult it is to be brave and praise your child when they go outside of their comfort zone. Implementing tangible rewards can also be helpful in motivating children to face their fears.

Differential attention. Sometimes, families can get into a pattern where the anxious child gets more attention when fearful. This can inadvertently reinforce anxiety and dependency. By providing relatively more attention when children are engaging in brave or expected behavior, you can help to reverse this pattern.

Modeling. Children learn by watching you, so keep an eye on what you are teaching them through your actions. When you can, demonstrate bravery and willingness to mess up.

Scaffolding. Scaffolding can be a very useful technique when the behavior change needed is too challenging to be expected all at once. It involves providing enough support for your child to engage in a desired behavior (e.g., school) and then slowly reducing that support overtime.

If you think your child may have an anxiety disorder, talk to your pediatrician or a mental health provider. And if you need extra help, seek advice from a professional. Many providers also offer tailored education and parenting support.

 

Lindsey Collins, Lindner Center of Hope new studio portraits. UC/ Joseph Fuqua IIBy: Lindsey Collins Conover, PhD
Lindner Center of HOPE, Staff Psychologist

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By: Laurie Little, PsyD 

Lindner Center of HOPE, Staff Psychologist

Plants that have psychedelic properties have been used across all continents for centuries to aid in rituals, recreation and in healing. Over time, researchers have found that psychedelic medicines can also be profoundly effective in treating mental illnesses such as depression and anxiety and in ameliorating the effects of trauma.

Although a psychedelic medicine can be derived from a plant or created in a lab, the user will experience what can be described Laurie Little, PsyD as non-ordinary or altered states of consciousness. These states may include hallucinations, unusual perceptual or sensory experiences or an altered sense of space and time. Many users of psychedelic medicines also report profound experiences of inner peace, compassion towards themselves and others and deeply meaningful spiritual realizations. When combined with psychotherapy, psychedelic medicines have the potential to heal in ways often not seen with traditional therapies.

The psychedelic medicines that are most often being studied with mental health conditions are psilocybin (derived from mushrooms), LSD, Ketamine, Ayahuasca and MDMA. There have been numerous studies showing the effectiveness of psychedelic medicines on treatment resistant depression, end of life anxiety, Obsessive Compulsive Disorder, eating disorders and substance use disorders.

One of the most rigorously studied medicine is MDMA for the treatment of Post-Traumatic Stress Disorder (PTSD). In studies conducted by the Multidisciplinary Association for Psychedelic Studies (MAPS), 88% of participants with severe PTSD experienced a significant reduction in their symptoms and 67% no longer met criteria for PTSD only two months after their treatment.

The question remains, why is the treatment so effective? What is it about the combination of psychedelic medicine and psychotherapy that is so profoundly healing?

One possible theory is that psychedelic medicines offer the user an opportunity to look at difficult or traumatic experiences through a new lens that they have never had before. A psychedelic experience can potentially slow down the experience of time, engender feelings of safety and compassion, provide profound experiences of meaning and purpose and foster or deepen a connection to a higher power. Many of these experiences when applied to processing an old wound or trauma can have a profoundly healing impact.

Case Vignette:

John Doe is a veteran who has seen horrors that most of us cannot imagine. He has spent the better part of his adult years struggling with recurring nightmares, intrusive thoughts and strong feelings of survivor guilt and shame. He lives alone, avoids most people when he can and spends most of his time ruminating about what he should have done differently in his life.

At the behest of his family, John has tried traditional psychotherapy, but has gotten so overwhelmed by symptoms of panic and flashbacks, that he quits. It is too painful to talk about and he assumes it won’t help.

However, when John was given the opportunity to participate in an MDMA assisted therapy session, he was intrigued. He had been hearing more and more about how psychedelics could help with trauma but was afraid to feel hopeful. He had been resigned to feeling this way for so long. He agreed to give it a try.

While taking MDMA, John felt an alert state of consciousness, yet he felt calm and safe in a way that he had not felt for years. He felt at peace and relaxed. When he was gently guided to recall aspects of his past, he did not resist or feel panic like he had before. He was able to recall the events with a certain kind of distance. He could understand now that he was just doing what he could to survive. He could see now for the first time in his life that his so called “enemies” were also doing what they could to survive. He began to realize how true that was for all of the world. After that initial session of MDMA assisted therapy, John was then able to engage in traditional therapy in a way he never could before.

Although many researchers and therapists are aware of how profoundly helpful these medicines can be, there is still a great deal of stigma associated with these medicines. Because these medicines are still illegal in the United States, desperate patients are either travelling to other countries or are finding therapists who are privately using these medicines through “word of mouth”.

The Food and Drug Administration gave approval for certain psychedelic medicines to be researched, as long as they were held to the same standards as other pharmaceutical medications. This has led to a resurgence of new studies showing the safety and efficacy of psychedelic medicines for a multitude of mental health conditions. It is projected that several psychedelic medicines (including psilocybin and MDMA) will become legal and available for therapeutic use within the next one to two years.

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Kristy L. Hardwick, EdD, LPCC-S Lindner Center of HOPE, Outpatient Therapist

 

 

 

 

 

 

 

 

The sun is shining; the days are longer. Summer is approaching. For some, summer is a break from study or work. For others, it may be an opportunity to take a week of vacation to relax and rejuvenate. Whether it is a two-to-three-month break, or simply more time in the evening to enjoy the sunshine, it is a time for which most look forward. It is often a time of joy, laughter, and reprieve. Summer is associated with rest and play, all of which can promote positive well-being. And I embrace all of it.

However, I am also keenly aware of the various tragedies we have collectively experienced over the recent months. With the “last day of school” and the “first vacation of the summer” pictures also come news of mass shootings, war, and other difficult events. There is exposure to pain and suffering on multiple levels, whether indirectly or directly.

Thus, I get the sense “the sun is shining, but it is also dark!” I find it necessary to acknowledge the current conflicting duality of our reality and the distress which many are experiencing, while sharing a few reminders to help us navigate through.

First, during times like this, it is crucial to recognize it is normal to have a plethora of intense thoughts and feelings, as well as an urge to act. It is also expected there will be differing viewpoints and ways these events affect individuals based on a variety of factors.

Second, it is important to highlight there are times when words are insufficient to convey the depth and intensity of feelings or to comfort adequately. Perhaps we don’t know anyone personally who has been directly affected by one of the current tragedies. Yet, we have been impacted. We may find ourselves juggling varying thoughts and feelings and struggling to put these into words. I would invite us to lean into what we are experiencing in our bodies. Accept there may not be “right words.” However, we can give space for our thoughts and feelings, accepting them as we experience them.  Sitting in silence might be necessary. It might also be helpful to focus on possible actions. For example, if we are feeling helpless, we might brainstorm a way we can make a difference or identify an area where we do have control. We can also find ways to show care, concern, support, and express meaningful presence with others amid the current tragedies.

Perhaps we do know someone who has been directly affected by one of the various tragedies or observe others being more deeply impacted by our current shared experiences. Again, we may not know the “right words” to say to those who have suffered directly from a tragedy or are in more distress. That is okay. There is a reason why words fall short; it is because ultimately, they often do. Thus, instead of getting caught up in “saying the right words,” we can focus on embracing being a meaningful presence. We offer authentic support through honest connection. Even saying, “I don’t know what to say; however, I am here for you,” or “I don’t understand or know the solution, but I am here to listen.” Offering just to be with someone is powerful.

Next, we may experience discomfort when we feel “caught in the middle” of opposing circumstances or even opposing feelings. On the one hand, it is summer. We have plans to relax, find joy, rejuvenate. Yet, we find ourselves surrounded by various tragedies. The degree of impact may vary. We are both impacted and aware of the suffering; yet also are navigating daily lives. We are both excited about summer plans, but also angry and sad about world events. Or we may be struggling with different stressors or difficult life circumstances, but also must continue to function. In these situations, it can be powerful to embrace “both/and.” Often we are influenced to exist in an “either/or” mindset. Either we are happy, or we are sad. Either we are fulfilled, or we are discontent. Yet this negates the complexity of both the outer world, and our inner worlds. Joy and pain can coexist; celebration and grief may show up hand in hand. Vacations are happening in the middle of world conflict. We are both celebrating our young adults graduating college and mourning for those killed in a mass shooting. Embrace and hold space for “both/and.” Multiple, often conflicting, thoughts and feelings can be true at the same time. It is necessary to accept all of them.

Lastly, we can utilize healthy coping skills to navigate these “distressing-at-a-loss-for-words-embracing-both-and” times. Consider strategies which have been helpful in the past, as well as those we may not have utilized previously.

Find ways to express our thoughts and feelings, giving ourselves permission to hold several thoughts and feelings simultaneously, while also releasing them. (Allow time for “both/and.”) Resist the urge to hold them in. Even if we have moments of “no words,” we must find ways to release them in nonverbal ways and then be willing to let words flow when they do come, without judgment. Releasing feelings is an important skill to practice.

Get moving, be active. We cannot separate the various parts of our bodies; they are all interconnected. Moving is good for all areas of our health, increasing endorphins. Research also supports various activities such as yoga, which activates the parasympathetic nervous system, decreasing stress and muscle tension. We can engage in physical activities we love, whether it be swimming, kayaking, or biking.

Be creative. Engaging in novel and creative activities increases dopamine. Make art; write, create music. Simply listening to music has been found to decrease anxiety and stress. (We can even combine the coping skill of releasing and expressing feelings with this one!)

Seek social support. Make connections. We increase the oxytocin (the “love hormone”) in our brains by spending time with family, friends, and pets. We are inherently built to be in relationship with others.

Stick to routine; take the vacations we have planned. Routine helps us stay motivated and organized.

Maintain healthy habits. Sleep/rest. Eat well, hydrate.

Limit social media/news exposure when current events become too distressing.

Seek ways to advocate and get involved in organizations created to assist survivors of events or those which support issues we find important.

And lastly, let us not hesitate in seeking professional help if levels of distress increase, we are unable to function or fulfil roles, unhealthy coping has increased (drug/alcohol use), there is difficulty sleeping or change in appetite, and if experiencing severe hopelessness and suicidal thoughts. We are here to help when the sun is shining but it is also dark.