Panic Answers

Depersonalisation

Dear Kuchtess,   Thank you for your message and for sharing with me how you've been interacting with yourself, especially how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of becomes traumatized by it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like suffering, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because anything that we do in life that brings us meaning and fulfillment, always accompanies a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid it, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings, and thoughts while continuing to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce their intensity.   Floating is a form of learning to accept these feelings and make room for them.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up the "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

Is there someone who takes Bluecross Blueshield?

Dear Josilla,   Thank you for your message and for sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of becomes traumatized by it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like suffering, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because anything that we do in life that brings us meaning and fulfillment, always accompanies a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid it, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings, and thoughts while continuing to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce their intensity.   Floating is a form of learning to accept these feelings and make room for them.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

When my body begins to feel healthier, is it natural to begin worrying about other things?

Dear Brody,   Thank you for your message and for sharing with me how you've been interacting with yourself, especially how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of becomes traumatized by it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like suffering, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because anything that we do in life that brings us meaning and fulfillment, always accompanies a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid it, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings, and thoughts while continuing to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up the "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   OBSERVE. Bring awareness to the feelings in your body.   BREATHE. Take a few deep breaths. Breathe into and around them.   EXPAND. Make room for these feelings. Create some space for them.   ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

What therapy form do you aoply for OCD? I would like to do CBT/ERP

Dear Markus,   Thank you for your message and for sharing with me how you've been interacting with yourself, especially how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of becomes traumatized by it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like suffering, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because anything that we do in life that brings us meaning and fulfillment, always accompanies a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid it, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings, and thoughts while continuing to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up the "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   OBSERVE. Bring awareness to the feelings in your body.   BREATHE. Take a few deep breaths. Breathe into and around them.   EXPAND. Make room for these feelings. Create some space for them.   ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Does this make sense so far?   As a follow up I'll be sending you another exercise on a few tools that are aiming to help us practice "making room" for these feelings, accept them rather than fighting/avoiding them. Would you like to go through this exercise (now with this new mindset in mind) and let me know how it impacts you? Make sure that when you practice the meditation exercise, you're recalling what you've learned about observing your sensations and make room for them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

How can you work through a bug phobia?

Good morning.  Phobias are common among humans and involve many behaviors, animals, and creatures of diverse types.  The category of "bugs" actually includes insects so throughout this answer, unless I indicate otherwise, the words insect and bug mean the same thing.  Entomophobia is also called insect phobia and acrophobia.  It is an extreme and persistent fear of bugs or insects themselves and is one of the most common types of phobias.  It causes significant distress, anxiety, and irrational fear.  It is more than dislike or fear.  The person with this specific phobia knows that it is not rational to fear the bug or insect but they fear it anyway.  The extent of the consequences of this distress, anxiety, and irrational fear seriously affect the person's quality of life and ability to go about their daily living activities.  Despite knowing that they are in no actual danger, being near an insect can cause the following mental and physical symptoms:   immediate feelings of intense fear or anxiety when seeing or thinking about an insect anxiety that worsens as an insect comes closer inability to control the fears even though you’re aware they’re unreasonable trouble functioning because of fear doing anything possible to avoid insects, such as avoiding parks, basements, or activities where they may be present Entomophobia can also cause additional physical symptoms, such as panic attacks, rapid heart rate, chest tightness, sweating, hyperventilating, dry mouth, shaking, crying (particularly with children). Initial reaction to bugs may be distaste but once it expands to fear it becomes overwhelming to the point of being consistently preoccupied with whether or not an insect or bug is near.  It takes over one's life.  There are certain insects that have their own specific phobias such as scorpions, centipedes, and cockroaches.  Some of the differentiation is due to the venom or the bite or sting of the insect.  Antianxiety medications are in the front line of treatment but by no means the only treatment. A family physician can manage the diagnosis and prescribing such medication.  If you are already seeing a psychiatrist he or she can prescribe as well.  Exposure is another method of treatment with one imagining the presence of the bug or insect that is feared.  One can do progressive exposure in which one is closer and closer to the insect or bg.  .  Any anxiety treatment may be useful as well.  There are also machines that encourage calm breathing which are helpful according to research and promotion by manufacturers.  Any of these methods can be utilized by a counselor to assist you in managing overwhelming anxiety.  A physician, as previously mentioned, is essential to prescribing unless you live in a state where counselors may prescribe medication.  
(Psy.D., LISW-CP/S, CACII)
Answered on 09/24/2021

What can cure anxiety,Panick attacks

Dear Bev,   Thank you for your message and for sharing with me how you've been interacting with yourself, especially how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of becomes traumatized by it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like suffering, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because anything that we do in life that brings us meaning and fulfillment, always accompanies a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid it, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings, and thoughts while continuing to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up the "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   OBSERVE. Bring awareness to the feelings in your body.   BREATHE. Take a few deep breaths. Breathe into and around them.   EXPAND. Make room for these feelings. Create some space for them.   ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

What is the best course of action if I just can't afford therapy right now?

Dear Nic,   Thank you for your message and for sharing with me how you've been interacting with yourself, especially how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of becomes traumatized by it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like suffering, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because anything that we do in life that brings us meaning and fulfillment, always accompanies a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid it, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings, and thoughts while continuing to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up the "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   OBSERVE. Bring awareness to the feelings in your body.   BREATHE. Take a few deep breaths. Breathe into and around them.   EXPAND. Make room for these feelings. Create some space for them.   ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

Am I in a depression or anxiety disorder?

Hello Sakura, I am glad you reached out for support at this time.  I am sorry you are struggling at this moment.  I would encourage you to start to work with a therapist to help you learn skills to help you overcome your struggles.  If we were to meet I would first talk to you about the counseling process through our site and how together we could help you obtain your goals going forward, how I work as a counselor and how I would try to help you through the counseling process.  I would also take the first session to get to know you by asking you a few questions to get a better understanding of your struggles so that I am able to focus on a plan and goals to work on going forward. I want you to know that you are not alone during this time even though you may feel like you are alone at this time.  During the therapy process, you can have support 100% of the time as you are able to reach out and talk to a therapist 24 hours a day 7 days a week.  I am going to send you some skills and tools to help you during this time of struggle you are having.  If we were to work together we would be going over these and more tools to help you through your struggles and be able to ask for support from others. After reading your question, I wanted to send you grounding skills to help you when you find that you struggle with anxiety or overthinking about things going on either in your life or your future? Know that you are not alone, today I am going to send you reading and skills to help you ground yourself when you are struggling.  What is grounding you may ask? Grounding is using skills to help you physically ground yourself when you are struggling with feeling anxious or racing thoughts. Grounding is a practice that can help you pull away from flashbacks, unwanted memories, and negative or challenging emotions and allows you to focus on what is happening at the moment.  It allows for you to focus on real items or things that you can either see, touch or smell at that moment to help you refocus your mind and help to calm yourself down.  These techniques may help distract you from what you’re experiencing and refocus on what’s happening in the present moment.Physical techniquesThese techniques use your five senses or tangible objects — things you can touch — to help you move through distress.1. Put your hands in waterFocus on the water’s temperature and how it feels on your fingertips, palms, and the backs of your hands. Does it feel the same in each part of your hand?Use warm water first, then cold. Next, try cold water first, then warm. Does it feel different to switch from cold to warm water versus warm to cold?2. Pick up or touch items near youAre the things you touch soft or hard? Heavy or light? Warm or cool? Focus on the texture and color of each item. Challenge yourself to think of specific colors, such as crimson, burgundy, indigo, or turquoise, instead of simply red or blue.3. Breathe deeplySlowly inhale, then exhale. If it helps, you can say or think “in” and “out” with each breath. Feel each breath filling your lungs and note how it feels to push it back out.4. Savor a food or drinkTake small bites or sips of a food or beverage you enjoy, letting yourself fully taste each bite. Think about how it tastes and smells and the flavors that linger on your tongue.5. Take a short walkConcentrate on your steps — you can even count them. Notice the rhythm of your footsteps and how it feels to put your foot on the ground and then lift it again.6. Hold a piece of iceWhat does it feel like at first? How long does it take to start melting? How does the sensation change when the ice begins to melt?7. Savor ascentIs there a fragrance that appeals to you? This might be a cup of tea, an herb or spice, a favorite soap, or a scented candle. Inhale the fragrance slowly and deeply and try to note its qualities (sweet, spicy, sharp, citrusy, and so on).8. Move your bodyDo a few exercises or stretches. You could try jumping jacks, jumping up and down, jumping rope, jogging in place, or stretching different muscle groups one by one.Pay attention to how your body feels with each movement and when your hands or feet touch the floor or move through the air. How does the floor feel against your feet and hands? If you jump rope, listen to the sound of the rope in the air and when it hits the ground.9. Listen to your surroundingsTake a few moments to listen to the noises around you. Do you hear birds? Dogs barking? Machinery or traffic? If you hear people talking, what are they saying? Do you recognize the language? Let the sounds wash over you and remind you where you are.10. Feel your bodyYou can do this sitting or standing. Focus on how your body feels from head to toe, noticing each part.Can you feel your hair on your shoulders or forehead? Glasses on your ears or nose? The weight of your shirt on your shoulders? Do your arms feel loose or stiff at your sides? Can you feel your heartbeat? Is it rapid or steady? Does your stomach feel full, or are you hungry? Are your legs crossed, or are your feet resting on the floor? Is your back straight?Curl your fingers and wiggle your toes. Are you barefoot or in shoes? How does the floor feel against your feet?11. Try the 5-4-3-2-1 methodWorking backward from 5, use your senses to list things you notice around you. For example, you might start by listing five things you hear, then four things you see, then three things you can touch from where you’re sitting, two things you can smell, and one thing you can taste.Make an effort to notice the little things you might not always pay attention to, such as the color of the flecks in the carpet or the hum of your computer.Mental techniquesThese grounding exercises use mental distractions to help redirect your thoughts away from distressing feelings and back to the present.12. Play a memory gameLook at a detailed photograph or picture (like a cityscape or other “busy” scene) for 5 to 10 seconds. Then, turn the photograph face-down and recreate the photograph in your mind, in as much detail as possible. Or, you can mentally list all the things you remember from the picture.13. Think in categoriesChoose one or two broad categories, such as “musical instruments,” “ice cream flavors,” “mammals,” or “baseball teams.” Take a minute or two to mentally list as many things from each category as you can.14. Use math and numbersEven if you aren’t a math person, numbers can help center you.Try:running through a times table in your head. counting backward from 100 choosing a number and thinking of five ways you could make the number (6 + 11 = 17, 20 – 3 = 17, 8 × 2 + 1 = 17, etc.)15. Recite somethingThink of a poem, song, or book passage you know by heart. Recite it quietly to yourself or in your head. If you say the words aloud, focus on the shape of each word on your lips and in your mouth. If you say the words in your head, visualize each word as you’d see it on a page.16. Make yourself laughMake up a silly joke — the kind you’d find on a candy wrapper or popsicle stick.You might also make yourself laugh by watching your favorite funny animal video, a clip from a comedian or TV show you enjoy, or anything else you know will make you laugh.17. Use an anchoring phraseThis might be something like, “I’m Full Name. I’m X years old. I live in City, State. Today is Friday, June 3. It’s 10:04 in the morning. I’m sitting at my desk at work. There’s no one else in the room.”You can expand on the phrase by adding details until you feel calm, such as, “It’s raining lightly, but I can still see the sun. It’s my break time. I’m thirsty, so I’m going to make a cup of tea.”18. Visualize a daily task you enjoy or don’t mind doingIf you like doing laundry, for example, think about how you’d put away a finished load.“The clothes feel warm coming out of the dryer. They’re soft and a little stiff at the same time. They feel light in the basket, even though they spill over the top. I’m spreading them out over the bed so they won’t wrinkle. I’m folding the towels first, shaking them out before folding them into halves, then thirds,” and so on.19. Describe a common taskThink of an activity you do often or can do very well, such as making coffee, locking up your office, or tuning a guitar. Go through the process step-by-step, as if you’re giving someone else instructions on how to do it.20. Imagine yourself leaving the painful feelings behindPicture yourself:gathering the emotions, balling them up, and putting them into a box walking, swimming, biking, or jogging away from painful feelings imagining your thoughts as a song or TV show you dislike, changing the channel or turning down the volume — they’re still there, but you don’t have to listen to them.21. Describe what’s around youSpend a few minutes taking in your surroundings and noting what you see. Use all five senses to provide as much detail as possible. “This bench is red, but the bench over there is green. It’s warm under my jeans since I’m sitting in the sun. It feels rough, but there aren’t any splinters. The grass is yellow and dry. The air smells like smoke. I hear kids having fun and two dogs barking.”Soothing techniquesYou can use these techniques to comfort yourself in times of emotional distress. These exercises can help promote good feelings that may help the negative feelings fade or seem less overwhelming.22. Picture the voice or face of someone you loveIf you feel upset or distressed, visualize someone positive in your life. Imagine their face or think of what their voice sounds like. Imagine them telling you that the moment is tough, but that you’ll get through it.23. Practice self-kindnessRepeat kind, compassionate phrases to yourself:“You’re having a rough time, but you’ll make it through.” “You’re strong, and you can move through this pain.” “You’re trying hard, and you’re doing your best.”Say it, either aloud or in your head, as many times as you need.24. Sit with your petIf you’re at home and have a pet, spend a few moments just sitting with them. If they’re of the furry variety, pet them, focusing on how their fur feels. Focus on their markings or unique characteristics. If you have a smaller pet you can hold, concentrate on how they feel in your hand.Not at home? Think of your favorite things about your pet or how they would comfort you if they were there.25. List favoritesList three favorite things in several different categories, such as foods, trees, songs, movies, books, places, and so on.26. Visualize your favorite placeThink of your favorite place, whether it’s the home of a loved one or a foreign country. Use all of your senses to create a mental image. Think of the colors you see, sounds you hear, and sensations you feel on your skin.Remember the last time you were there. Who were you with, if anyone? What did you do there? How did you feel?27. Plan an activityThis might be something you do alone or with a friend or loved one. Think of what you’ll do and when. Maybe you’ll go to dinner, take a walk on the beach, see a movie you’ve been looking forward to, or visit a museum.Focus on the details, such as what you’ll wear, when you’ll go, and how you’ll get there.28. Touch something comfortingThis could be your favorite blanket, a much-loved T-shirt, a smooth stone, a soft carpet, or anything that feels good to touch. Think about how it feels under your fingers or in your hand.If you have a favorite sweater, scarf, or pair of socks, put them on and spend a moment thinking about the sensation of the fabric on your skin.29. List positive thingsWrite or mentally list four or five things in your life that bring you joy, visualizing each of them briefly.30. Listen to musicPut on your favorite song, but pretend you’re listening to it for the first time. Focus on the melody and lyrics (if there are any). Does the song give you chills or create any other physical sensations? Pay attention to the parts that stand out most to you. I hope that these skills have been helpful for you in the struggles you have been facing at this time. I am going to give you my information if you are wanting to start to process through and work on your struggles going forward, please reach out to Betterhelp and ask to be matched with Crystal Westman. If we were to work together we would work on more skills and tools to help you when you are struggling and get back to a positive space.  I encourage you to reach out for support at this time to help you get to the best version of yourself.
Answered on 09/24/2021

I have anxiety when it comes to sex which leads to ED. What should I do about this?

Dear Deebz,   Thank you for your message and for sharing with me how you've been interacting with yourself, especially how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of becomes traumatized by it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations, while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like suffering, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompanies a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid it, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings, and thoughts, while continuing to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce their intensity.   Floating is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

I want to find an acceptance and commitment therapy counselor for my anxiety disorder.

Dear TranVu,   Thank you for your message and for sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of becomes traumatized to it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like suffering, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompanies a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid it, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings and thoughts while continuing to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce their intensity.   Floating is a form of learning to accept these feelings and make room for them.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths, and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

What is a good coping mechanism when you can’t stop thinking and you have anxiety and depression?

As rational human beings, we often approach anxiety, fear, panic and worry, with the "just stop it" mentality.  Anxiety, although highly uncomfortable and distressing, It can also provide us with valuable information about ourselves and our assumptive worldview.  It helps our brain indicate that "this is important".  The importance may relate to your values, beliefs, and the general quality of your life.   It is okay to feel if uncertain about the experience of anxiety.  Good things can cause and create stress and anxiety, the same as negative experiences.  Our brains can't predict the future, but that rarely stops us from trying.  There have recently been some research studies that anxiety can become a habit-forming experience for our brains.  The study proposes that anxiety, which comes largely from things outside of our individual control, the brain in an attempt to make sense of things, decide I may not be able to do anything about this situation but I can worry about it, and that helps to satisfy something for which you can control.   You are in a similar process, you are trying to make sense of situations that are "new and different".  Overthinking can come from a desire to prepare ahead for any outcome.  I am sure it can maybe very exhausting at times for you.   The goal isn't to think about the future.  Using goals and plans is a very helpful and healthy practice for giving direction and purpose.   What largely drives anxiety, is the thought surrounding the worry.  I would ask you to consider exploring 3 (three) questions regarding your thoughts (if identifiable) around the anxiety  as 1.) Is it true (meaning are these thoughts true all of the time, or are there variables).  2) Is is Kind. (would you say these thoughts out loud to a friend, coworker, or fond family member), and 3) Do these thoughts give me the power for action.  These questions can give you the opportunity to reflect on the source of anxiety and also it may give your brain time to pause and process the contributor to anxiety reducing reaction and increasing production.   I hope you find this answer helpful.  Best endeavors.   
(MS, LPC, CGRS)
Answered on 09/24/2021

I am dealing with health anxiety(hypochondriasis)

Hello Mendyy, I am glad you reached out for support at this time.  I am sorry you are struggling in this moment.  I would encourage you to start to work with a therapist to help you learn skills to help you overcome your struggles.  If we were to meet I would first talk to you about the counseling process through our site and how together we could help you obtain your goals going forward, how I work as a counselor and how I would try to help you through the counseling process.  I would also take the first session to get to know you by asking you a few questions to get a better understanding of your struggles, so that I am able to focus on a plan and goals to work on going forward. I want you to know that you are not alone during this time even through you may feel like you are alone at this time.  During the therapy process you can have support 100% of the time as you are able to reach out and talk to a therapist 24 hours a day 7 days a week.  I am going to send you some skills and tools to help you during this time of struggle you are having.  If we were to work together we would be going over these and more tools to help you through our struggles and be able to ask for support from others. Sometimes, when you feel stressed or even overwhelmed, it isn't easy to stay focused. I just wanted to give a few tips on what may be causing this distraction. I am giving you these strategies so you can begin to implement them and consider the triggers/stressors impacting your thoughts, how you feel, and your behaviors (energy, motivation, etc.).High-stress levels - When you have a lot going on and face high levels of stress, it is more likely that your attention span will be shorter and that you'll have trouble focusing on the task at hand. Are there certain things you can recognize that may be causing you to feel stressed out? Have you been ruminating about it and playing this thought in your head over and over again? Let me give you an example of how stress can be distracting and cause negative thoughts. Imagine going to a picnic on a beautiful warm summer day. The wind is light, the sun is shining, and the food is delicious. You are sitting in a grassy field and just daydreaming of this beautiful moment. All of a sudden, these feisty little ants show up and start to ruin the moment. They are crawling all over the blanket, one got on your sandwich, and now your beautiful moment is ruined by these little ants. When you are trying to enjoy the day and focus on being in the moment, sometimes these Automatic Negative Thoughts (ANTS) ruin the moment. If you find that ANTS continues to destroy your peace, we can work on that more in the session. Your environment - Is your workspace or home cluttered with things? Do you have trouble finding what you need when you need it? This could be why you cannot focus and concentrate. Sometimes your environment is a major stressor that contributes to why you are distracted. What right now in your environment might be causing you to feel discomfort? Poor diet - Eating a lot of junk food or not eating enough can cause irritability, and even overeating can be the root cause of distraction. Your brain needs a certain amount of essential nutrients to focus and stop thinking, so depriving yourself of that changes your productivity. That's why it's critical to eat well if you want to focus. Social Media - Do you often find yourself checking your phone, Facebook, or personal emails while you are supposed to be working or spending quality time with loved ones? The constant stream of information coming from technology is a common cause of distraction. Not to mention, it is an easy trigger and could leave you vulnerable to comparisons. How much time do you spend on social media? Lack of sleep - If you're not getting enough rest and sleep at night, you are more likely to concentrate effectively during the day. Have a healthy nighttime routine and give yourself a lI am talking about negative self-talk and reminding you to T.H.I.N.K. Sometimes when you are triggered by something, you will ruminate on it for a while. Rumination can convince you of things that can make you feel anxious and worried about yourself or the things that are happening in your life. Ruminating happens when you try to figure out a solution to a problem and keep getting stuck. Sometimes you may feel guilt, resentment, anger, embarrassment, and even sadness. This may cause a lot of negative self-talk. You may overexplain yourself (emotional vomiting) and obsessive attention to overanalyzing decisions in some cases. You may also tend to overvalue your relationships with other people so much that you'll make large personal sacrifices to maintain these relationships, even if they're not working for you. This can leave you feeling unimportant, devalued, and unappreciated. This is when negative thinking errors and negative self-talk begins. This creates core beliefs about yourself that may not be true. The more you ruminate and think, the more your negative self-talk creates beliefs. Core beliefs are central beliefs that you have about yourself, others, and the world. Many of your beliefs have been created at an early age. These beliefs and negative self-talk present in messages such as, "I am unlovable," or "people can't be trusted," "I am not good enough," "the whole world is bad," etc. When you start to ruminate and have negative thoughts that start to create beliefs, I want you to remember this acronym T.H.I.N.K!!Is it Truthful?·          When you start to have certain beliefs that are ANTS (automatic negative thoughts), you do not have to accept this belief as to the truth about yourself and life. So other than your thoughts, are there other factual things that would contradict (go against) your beliefs? For example, o     Core Belief: "I am a loser; I never do anything right." Accepting this belief would be: I missed a deadline at work (confirming your negative thought/belief) Rejecting this belief would be: Although I missed this one deadline, I am always on time and mostly turn in all of my work on time. Modifying that belief (to change it, so it confirms your negative belief): §   The boss says, "Great job on meeting the deadline." Modified thought: They are just saying that they do not mean it! Is it Helpful?·          If you realize your thoughts are only reaping havoc, do not lay down and take it. Stop getting beat up by your thoughts, even if it is difficult for you to see past your own beliefs about yourself. If the thought is not helpful, just let it go. Try taking action and doing something else. Is it Insightful? Is this thought helping you solve the problem? Or is this thought about creating new problems? Try to find the smallest solution that you can resolve. Try to find out something you can do at the moment while you are ruminating. If all you are coming up with are problems, then this is all you will see. Is it Necessary? What you are thinking about at the moment. Is it something that actually has to be resolved right now? Is this a current problem that needs resolution, or did something already occur in the past, and you cannot let it go? Try to stay present...if it is not a problem RIGHT NOW, then stay connected to things you can do today. Is it Kind? If you realize that most of your thoughts are negative, you know maybe it's just your beliefs. Are you being kind to yourself and treating yourself with respect? Sometimes, when you are in a low mood, you are not even kind to yourself. You self-criticize, self-judge, and self-blame. Sometimes this is suppressed and then projects as resentments to other people and how you view the world. Try to be a bit nicer to yourself! Do you find that you struggle with anxiety or overthinking about things going on either in your life or your future? Know that you are not alone, today I am going to send you reading and skills to help you ground yourself when you are struggling.  What is grounding you may ask? Grounding is using skills to help you physically ground yourself when you are struggling with feeling anxious or racing thoughts. Grounding is a practice that can help you pull away from flashbacks, unwanted memories, and negative or challenging emotions and allows you to focus on what is happening at the moment.  It allows for you to focus on real items or things that you can either see, touch or smell at that moment to help you refocus your mind and help to calm yourself down.  These techniques may help distract you from what you’re experiencing and refocus on what’s happening in the present moment.Physical techniquesThese techniques use your five senses or tangible objects — things you can touch — to help you move through distress.1. Put your hands in waterFocus on the water’s temperature and how it feels on your fingertips, palms, and the backs of your hands. Does it feel the same in each part of your hand?Use warm water first, then cold. Next, try cold water first, then warm. Does it feel different to switch from cold to warm water versus warm to cold?2. Pick up or touch items near youAre the things you touch soft or hard? Heavy or light? Warm or cool? Focus on the texture and color of each item. Challenge yourself to think of specific colors, such as crimson, burgundy, indigo, or turquoise, instead of simply red or blue.3. Breathe deeplySlowly inhale, then exhale. If it helps, you can say or think “in” and “out” with each breath. Feel each breath filling your lungs and note how it feels to push it back out.4. Savor a food or drinkTake small bites or sips of a food or beverage you enjoy, letting yourself fully taste each bite. Think about how it tastes and smells and the flavors that linger on your tongue.5. Take a short walkConcentrate on your steps — you can even count them. Notice the rhythm of your footsteps and how it feels to put your foot on the ground and then lift it again.6. Hold a piece of iceWhat does it feel like at first? How long does it take to start melting? How does the sensation change when the ice begins to melt?7. Savor a scentIs there a fragrance that appeals to you? This might be a cup of tea, an herb or spice, a favorite soap, or a scented candle. Inhale the fragrance slowly and deeply and try to note its qualities (sweet, spicy, sharp, citrusy, and so on).8. Move your bodyDo a few exercises or stretches. You could try jumping jacks, jumping up and down, jumping rope, jogging in place, or stretching different muscle groups one by one.Pay attention to how your body feels with each movement and when your hands or feet touch the floor or move through the air. How does the floor feel against your feet and hands? If you jump rope, listen to the sound of the rope in the air and when it hits the ground.9. Listen to your surroundingsTake a few moments to listen to the noises around you. Do you hear birds? Dogs barking? Machinery or traffic? If you hear people talking, what are they saying? Do you recognize the language? Let the sounds wash over you and remind you where you are.10. Feel your bodyYou can do this sitting or standing. Focus on how your body feels from head to toe, noticing each part.Can you feel your hair on your shoulders or forehead? Glasses on your ears or nose? The weight of your shirt on your shoulders? Do your arms feel loose or stiff at your sides? Can you feel your heartbeat? Is it rapid or steady? Does your stomach feel full, or are you hungry? Are your legs crossed, or are your feet resting on the floor? Is your back straight?Curl your fingers and wiggle your toes. Are you barefoot or in shoes? How does the floor feel against your feet?11. Try the 5-4-3-2-1 methodWorking backward from 5, use your senses to list things you notice around you. For example, you might start by listing five things you hear, then four things you see, then three things you can touch from where you’re sitting, two things you can smell, and one thing you can taste.Make an effort to notice the little things you might not always pay attention to, such as the color of the flecks in the carpet or the hum of your computer.Mental techniquesThese grounding exercises use mental distractions to help redirect your thoughts away from distressing feelings and back to the present.12. Play a memory gameLook at a detailed photograph or picture (like a cityscape or other “busy” scene) for 5 to 10 seconds. Then, turn the photograph face-down and recreate the photograph in your mind, in as much detail as possible. Or, you can mentally list all the things you remember from the picture.13. Think in categoriesChoose one or two broad categories, such as “musical instruments,” “ice cream flavors,” “mammals,” or “baseball teams.” Take a minute or two to mentally list as many things from each category as you can.14. Use math and numbersEven if you aren’t a math person, numbers can help center you.Try:running through a times table in your head. counting backward from 100 choosing a number and thinking of five ways you could make the number (6 + 11 = 17, 20 – 3 = 17, 8 × 2 + 1 = 17, etc.)15. Recite somethingThink of a poem, song, or book passage you know by heart. Recite it quietly to yourself or in your head. If you say the words aloud, focus on the shape of each word on your lips and in your mouth. If you say the words in your head, visualize each word as you’d see it on a page.16. Make yourself laughMake up a silly joke — the kind you’d find on a candy wrapper or popsicle stick.You might also make yourself laugh by watching your favorite funny animal video, a clip from a comedian or TV show you enjoy, or anything else you know will make you laugh.17. Use an anchoring phraseThis might be something like, “I’m Full Name. I’m X years old. I live in City, State. Today is Friday, June 3. It’s 10:04 in the morning. I’m sitting at my desk at work. There’s no one else in the room.”You can expand on the phrase by adding details until you feel calm, such as, “It’s raining lightly, but I can still see the sun. It’s my break time. I’m thirsty, so I’m going to make a cup of tea.”18. Visualize a daily task you enjoy or don’t mind doingIf you like doing laundry, for example, think about how you’d put away a finished load.“The clothes feel warm coming out of the dryer. They’re soft and a little stiff at the same time. They feel light in the basket, even though they spill over the top. I’m spreading them out over the bed so they won’t wrinkle. I’m folding the towels first, shaking them out before folding them into halves, then thirds,” and so on.19. Describe a common taskThink of an activity you do often or can do very well, such as making coffee, locking up your office, or tuning a guitar. Go through the process step-by-step, as if you’re giving someone else instructions on how to do it.20. Imagine yourself leaving the painful feelings behindPicture yourself:gathering the emotions, balling them up, and putting them into a box walking, swimming, biking, or jogging away from painful feelings imagining your thoughts as a song or TV show you dislike, changing the channel or turning down the volume — they’re still there, but you don’t have to listen to them.21. Describe what’s around youSpend a few minutes taking in your surroundings and noting what you see. Use all five senses to provide as much detail as possible. “This bench is red, but the bench over there is green. It’s warm under my jeans since I’m sitting in the sun. It feels rough, but there aren’t any splinters. The grass is yellow and dry. The air smells like smoke. I hear kids having fun and two dogs barking.”Soothing techniquesYou can use these techniques to comfort yourself in times of emotional distress. These exercises can help promote good feelings that may help the negative feelings fade or seem less overwhelming.22. Picture the voice or face of someone you loveIf you feel upset or distressed, visualize someone positive in your life. Imagine their face or think of what their voice sounds like. Imagine them telling you that the moment is tough, but that you’ll get through it.23. Practice self-kindnessRepeat kind, compassionate phrases to yourself:“You’re having a rough time, but you’ll make it through.” “You’re strong, and you can move through this pain.” “You’re trying hard, and you’re doing your best.”Say it, either aloud or in your head, as many times as you need.24. Sit with your petIf you’re at home and have a pet, spend a few moments just sitting with them. If they’re of the furry variety, pet them, focusing on how their fur feels. Focus on their markings or unique characteristics. If you have a smaller pet you can hold, concentrate on how they feel in your hand.Not at home? Think of your favorite things about your pet or how they would comfort you if they were there.25. List favoritesList three favorite things in several different categories, such as foods, trees, songs, movies, books, places, and so on.26. Visualize your favorite placeThink of your favorite place, whether it’s the home of a loved one or a foreign country. Use all of your senses to create a mental image. Think of the colors you see, sounds you hear, and sensations you feel on your skin.Remember the last time you were there. Who were you with, if anyone? What did you do there? How did you feel?27. Plan an activityThis might be something you do alone or with a friend or loved one. Think of what you’ll do and when. Maybe you’ll go to dinner, take a walk on the beach, see a movie you’ve been looking forward to, or visit a museum.Focus on the details, such as what you’ll wear, when you’ll go, and how you’ll get there.28. Touch something comfortingThis could be your favorite blanket, a much-loved T-shirt, a smooth stone, a soft carpet, or anything that feels good to touch. Think about how it feels under your fingers or in your hand.If you have a favorite sweater, scarf, or pair of socks, put them on and spend a moment thinking about the sensation of the fabric on your skin.29. List positive thingsWrite or mentally list four or five things in your life that bring you joy, visualizing each of them briefly.30. Listen to musicPut on your favorite song, but pretend you’re listening to it for the first time. Focus on the melody and lyrics (if there are any). Does the song give you chills or create any other physical sensations? Pay attention to the parts that stand out most to you. I hope that these skills have been helpful for you in your struggles you have been facing at this time. I am going to give you my information if you are wanting to start to process through and work on your struggles going forward, please reach out to Betterhelp and ask to be matched with Crystal Westman. If we were to work together we would work on more skills and tools to help you when you are struggling and get back to a positive space.  I encourage you to reach out for support at this time to help you get to the best version of yourself.
Answered on 09/24/2021

Anxiety and brain fog

Hi Gulu,  Thank you for your question. I'm so sorry that you had such a negative experience with trying edibles. Unfortunately, you're not alone in what's happened to you. There are sometimes real and significant impacts on mental health from ingesting large doses of cannabis. For those who have a negative reaction to edibles, the symptoms can include a racing heart, excessive sweating, anxiety, paranoia, hallucinations and delusions. Edibles sometimes have more severe toxicity than inhaled forms and the effects are psychiatric in nature. When you use cannabis, certain compounds in it, including THC, the psychoactive compound in cannabis, bind to endocannabinoid receptors in various parts of your brain, including the amygdala. Your amygdala helps regulate your response to fear and related emotions, like anxiety, stress, and paranoia. When you use cannabis that’s rich in THC, your brain suddenly receives more cannabinoids than usual. Research suggests this excess of cannabinoids may overstimulate the amygdala, making you feel fear and anxiety.  Research suggests lasting paranoia can happen as a symptom of cannabis withdrawal syndrome (CWS) with mood and behavioral symptoms tending to be the primary effects of cannabis withdrawal. For most people, withdrawal symptoms seem to improve within about 4 weeks. Again, other factors can also play a role in paranoia, so it’s important to talk to your healthcare provider if your paranoid thoughts: become severe, don’t go away within a few weeks, affect day-to-day function or quality of life, lead to violent or aggressive thoughts, like wanting to hurt yourself or someone else. Consider seeking professional help as there is some evidence that suggests people with an existing sensitivity to paranoia and anxious thoughts have a higher chance of experiencing both when using cannabis. Paranoia can overwhelm you to the point where it becomes difficult to interact with others. You might avoid talking to friends, going to work, or even leaving your house. A therapist can help you explore these feelings and other potential contributing factors as well as teaching coping methods to help you manage anxiety symptoms at the moment. Self-care is also an important part of managing mental health in general. There are some general questions you can ask yourself and reflect on the last week that you've been experiencing this overthinking. Are you hydrated? Have you been getting enough sleep? Have you been exercising? Have you changed your medication or skipped any doses? Who have you been interacting with? Have you been overexerting yourself at work or in school? All of these things impact our overall mental health and our thinking. Take time for yourself. Intentionally set aside time to spend doing the things you enjoy and try to cultivate those moments of enjoyment and peace- however small. Try yoga, listen to music, meditate, get a massage, try practicing new relaxation techniques (grounding exercises, progressive muscle relaxation, mindfulness, etc.) Spend time away from the problem and try to gain some perspective on the situation and what you have control over. Eat well. Try to be mindful of nutrition and eating when you're hungry. If you're not hungry, try setting reminders to make sure you're getting enough energy to fuel your body and spirit. There are specific foods that are known to manage anxiety and others that are better to avoid (https://www.healthline.com/nutrition/6-foods-that-reduce-anxiety) Limit alcohol and caffeine. Both of these can worsen your symptoms and make you feel more out of control. Too much can even trigger panic attacks. It can be tempting to self-medicate but it's important to avoid that temptation. Move your body. Getting exercise each day does wonder for your overall mental health. It doesn't have to be anything particularly strenuous or taxing but you should try to engage in some kind of activity every day. This also helps with sleep- one of the only things that can help you STAY asleep is making sure you get enough exercise to tire your body. Our behaviors during the day, and especially before bedtime, can have a major impact on our sleep. They can promote healthy sleep or contribute to sleeplessness. Follow these tips to establish healthy sleep habits: Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations. Set a bedtime that is early enough for you to get at least 7-8 hours of sleep. Don’t go to bed unless you are sleepy. If you don’t fall asleep after 20 minutes, get out of bed. Go do a quiet activity without a lot of light exposure. It is especially important to not get on electronics. Establish a relaxing bedtime routine. Use your bed only for sleep and sex. Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature. Limit exposure to bright light in the evenings. Turn off electronic devices at least 30 minutes before bedtime. Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack. Exercise regularly and maintain a healthy diet. Reduce your fluid intake before bedtime. I hope this helps and that your symptoms improve. If it persists much longer, it's probably time to see a doctor.  Good luck!
Answered on 09/24/2021

Every morning I wake up with panic attacks. What strategies would you recommend to avoid this?

Deep belly breaths as soon as you awaken may be helpful.  I suggest feeling deep into your body upon awakening.  As soon as you open your eyes, close them and start to breathe deeply, from your belly.  Lay still and do this for as long as is comfortable.  When you feel ready, swing your legs to the floor and feel your feet on the ground.  Called "grounding ", feel the bottoms of your feet on the ground, then move your consciousness up your body.  As you stand, do the same.  Hopefully, the grounding process will alleviate the panic and anxiety. Practicing mindfulness throughout the day is also grounding.  Direct your awareness to the task at hand, trying to focus on/ in the present moment.  Maintain attention to your body as you go through the day. Meditation practice will help you monitor your thoughts.  There are many different meditation practices.  I'd suggest a fairly simple approach. Find a quiet place where you won't be disturbed.  Sit in such a way that your spine is straight.  Now, close your eyes and breathe deeply, from your belly.  Begin to simply watch your thoughts.  Just watch.  You will forget to observe and become wrapped up in thoughts.  When you notice this, bring your awareness back to watching.  This can feel frustrating at first but the longer you continue the practice, the easier it will become.  As you learn to watch your thinking, you can begin to identify what kinds of thoughts lead to increased anxiety and feelings of panic.  In learning the thought patterns that lead to increased anxiety, you can begin to manage them and thereby reduce your anxiety.       With this body consciousness, I'd suggest psychotherapy to address the root of your anxiety.  Often, ways of coping which we developed in childhood in response to influences outside our control continue into adulthood but no longer serve us.  We may find anxiety building in response to stimuli that began in childhood.  As we begin to understand these patterns, anxiety and panic will begin to lessen.  We find that the source of the anxiety becomes manageable.  
(MSW, LCSW)
Answered on 09/24/2021

should i take a leave of absence from work?

Hi Kim!  It sounds like coming back into the workplace has presented several challenges for you. It also sounds like your boss might not fully understand the extent of what is going on for you.  Panic attacks can feel completely overwhelming and often feels like there is nothing you can do to stop the flow of thoughts and feelings that are contributing to the panic. They also often come out of nowhere, which can absolutely make them more challenging to handle. There are a few things that might be beneficial for you to explore as you begin to process what might be going on for you and contributing to these panic attacks.    The first thing I would encourage you to do is to begin exploring a self-care routine. I like to look at it this way- We all have things in our life that grow our capacity to handle stress and overwhelming events, we all also have things in our life that decrease our capacity to handle stress and overwhelming events. Self-care is a great way to begin increasing your capacity to handle stress. Self-care is not just a mental or emotional thing, it can also be physical, spiritual, social. Self-care activities are the things we do intentionally throughout our day to help "fill our cup" in order to help us not have that feeling of being totally depleted at the end of our day. When we feel drained or depleted at the end of our day, it is much easier for anxiety symptoms to spin out of control. If you think about how your emotions or even your behavior present when you feel tired, I am sure it is easy to think of times when it was easier to become frustrated, or easier to become overwhelmed due to your body simply needing more rest. Something I often encourage my clients to do is start their day by checking in with themselves and identifying if there are any needs that need to be met. Going through a Body, Soul, Spirit check in the mornings gives you a baseline of where you are starting in your day and allowing you to practically take care of your own needs. I also encourage this check-in throughout the day as well, maybe around lunchtime, and at the end of the day. So for example, if you say "How is my body feeling" and you recognize you have a headache or you are feeling extra fatigue, you can begin to figure out what you might need in that moment. If you say "Emotionally, how am I doing? How is my anxiety or depression currently?". If you notice that you are feeling a low level of anxiety or no anxiety at all -GREAT! But if you notice throughout the day, you are beginning to feel anxious, you can go back and look at what has happened throughout the day and begin to identify if something has triggered your anxiety. Maybe it was something you began to think about, maybe someone said something to you that felt overwhelming, Maybe you have had too much coffee or too many energy drinks and it is having a negative effect on your anxiety. It is almost like being a detective into your own life and your own mental space. When you find the cause, you can begin asking yourself "What do I need in this moment". Sometimes it is challenging to figure out what we need but the more we practice identifying our needs the better we get at it! It is like working out a new muscle - It gets stronger the more you work it out! An additional area I would encourage you to explore is what your nighttime routine might look like. It is so important for our mental and emotional well-being to have an appropriate amount of restful sleep. Finding a sleep routine almost sets your body up for success when it comes to sleeping because as the routine becomes solidified, your body knows what to expect. There are some great tips you can look up for "Sleep Hygiene" that might give you some good ideas of things to incorporate into your routine. It is also important to be mindful of your self-talk and what thoughts you have about your upcoming shifts. Our thoughts drive our emotions and our behavior. When we leave our thoughts left unchecked we can find ourselves spiraling into a place that feels as though we have no control. This might be something good to explore with your counselor as well, but taking note of any anxious thoughts you might be having about your upcoming shifts will give you a good place to start when it comes to exploring the triggers for this panic you experience.    Lastly, I would encourage you to explore with your boss what you might need in these moments of feeling overwhelmed at work. If you have some regulation skills that you know work well for you, communicating this with your boss and exploring if there is a plan you can have in place for the times you feel overwhelmed.    I hope some of these tips were helpful and made sense. I know that anxiety can be quite the journey of understanding what is contributing to the experience and what is helping decrease the amount of anxiety we feel. Mental health is like a marathon, not a sprint. Celebrating little victories and finding the little ways that grow that capacity to handle anxiety, stress, overwhelming events will ultimately lead you to long-term success!    Take Care! 
(MSW, LCSW)
Answered on 09/24/2021

How do speakout and be an open person?

Hello,   Thank you for your message and for sharing with me how you've been interacting with yourself, especially how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of becomes traumatized by it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like suffering, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because anything that we do in life that brings us meaning and fulfillment, always accompanies a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid it, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings, and thoughts while continuing to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up the "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   OBSERVE. Bring awareness to the feelings in your body.   BREATHE. Take a few deep breaths. Breathe into and around them.   EXPAND. Make room for these feelings. Create some space for them.   ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

How can i stop negative thoughts in my head?

Dear Lostgirl,   Thank you for your message and sharing.   I understand how difficult it is to try stopping your thoughts. I could imagine how hard you have been trying and how frustrating to feel that nothing is working.    We can't stop our thoughts, but the more we practice being mindful of the present, the better we can catch ourselves with our thoughts and develop an alternative response to them, and learn to let go.   During moments like this I remind myself the teachings regarding worries, it is consisted with a 2 part questions:   1. Is this problem within my control? If so, then this problem will be solved given time and the right intervention. 2. Would worrying about it make any difference? If not, then is it worth it to sacrifice our time and mental health worrying over something that (1. can't be solved anyway / 2. will be solved anyway)?   This is definitely easier said than done, therefore as a fellow human being, I am working with you to pay attention to what is good, what is kind rather than our worries.   Obsessive or consuming thoughts can make living miserable when you are plagued by them, but this very situation can become the invitation to transcend the mind and be free of suffering forever.   Can you stop obsessive thoughts? - If you could, it would be great, but the truth is that it's slightly more complicated than just suppressing your thoughts which at most you can do for a few seconds. Plus suppressing thoughts is even worse than enduring thoughts. It builds up a lot of negative energy inside.   So how to stop these stops thoughts? The secret to stopping these thoughts is to detach from the mind because You cannot fight the mind with the mind. Let's look at this in more detail.   What Causes Obsessive Thoughts?   If you generated the thoughts, you could've controlled them too.   The truth is that you don't generate thoughts, the mind does. And the mind is on auto-mode most of the time.   You can see this for yourself; can you predict what you will think 30 seconds from now? If you can't how can you assume that you are generating the thoughts?   If you believe that you are your mind, that's a false notion again.   If you are your mind then how can you observe the thoughts? So you must be separate from the mind to see what the mind is doing.   The mind generates thoughts, which are mostly just energy forms. These thoughts pass through like clouds. We identify with some of these thoughts and obsess over them.   So in truth, all thoughts are just neutral energy forms; it's your interest or association with the thoughts that make them obsessive. If you can understand this truth, you have taken the first step towards getting rid of obsessive thoughts.   How to Stop Obsessive Negative Thoughts?   If you are asking this question, ask yourself another question - "is this question not another thought? It's a thought about killing thoughts".   All your attempts at suppressing and stopping thoughts fail because you are using the mind to stop the mind. The policeman and thief are both the mind; so how can the policeman catch the thief?   So you cannot kill the mind by force. The mind dies its own death by the poison of disassociation.   What gives power to a thought? - Your interest. If you have no interest in a particular thought then it loses its hold over you.   You can try this out now. Let the thoughts flow through your mind but don't take interest in them. Just stay as a bystander or a watcher and let the thoughts float.   Initially, you might have a hard time watching thoughts because of your inherent habit of associating with each thought that arises.   It helps to know that you are not your thoughts, that thoughts are just energy forms created in the mind. Why does the mind create thoughts? No one knows - it's just something it does, why bother. Do you ever ask why does the heartbeat?   With a little practice, you will get really good at watching thoughts and not involving yourself with them.   You will stop giving power to thoughts by not giving them your interest. Thoughts die immediately when they are deprived of this fuel of interest. If you don't associate with the thought or give power to the thought, it will wither away quickly.   What Are Thoughts?   Past events get stored as memories. Your mind conditioning and beliefs are also stored as memories. All this is unconscious storage; the mind does all this in auto mode.   Perceptions and interpretations are created in the mind based on its past "external" conditioning and also its natural conditioning (genetics). These interpretations, perceptions, and judgments come up as thoughts in the mind, and they can be positive or negative depending on the mind's conditioning.   Thoughts are generated based on past incidents/memories, future projections, and interpretations of the present life situation. It's like a computer trying to predict or conjure up projection based on the data it has collected so far.   When thoughts are negative in nature (thoughts of worry, anxiety, stress, lack, resentment, guilt etc.) they produce resistance to the movement of your life, and this resistance is felt as suffering. Negative thoughts will always stand in resistance to the movement of your life, like blocks of stone in the midst of a swift current of water.   Life is a stream of pure positive energy and hence any negative thought will stand in opposition to it, causing friction which is felt as suffering in the body.   The thoughts in your mind gain power from your attention and interest. Your attention is the fuel for your mind. So when you give attention to consuming thoughts in the mind, you are unconsciously fueling it and thus attracting more momentum for these negative thoughts.   The momentum of negative thoughts in your mind will slow down, and ebb away, automatically when you stop feeding your attention to it. Stay as an open space of awareness without focusing your attention on the negative thoughts of the mind, and soon they will lose their momentum.   You can focus on the positive thoughts generated in the mind, and thus develop a positive momentum in your mind. Every time your mind produces some positive thoughts, e.g thoughts of love, joy, excitement, abundance, beauty, appreciation, passion, peace, etc, focus on it, milk it, and give attention to it.   This will cause your mind to attract more positive thoughts and thus build positive momentum.   Whenever the mind thinks negatively, don't give it attention or interest, this will cause the ebbing away of the momentum of negative thinking. It's really that simple. Once you understand the mechanics of how thoughts gain momentum in the mind, you will be in total control of your state of being.   The Practice of Watching the Mind   All you need to do to get rid of obsessive thoughts is to watch the mind without getting involved.   You will get really good at this with just a little practice. This practice, or "sadhana" as called in Hindu scriptures, is the root of awakening from the illusion of the mind.   Without trying to understand this practice just implement it. The more you try to understand the more mind gets involved. Just watch the mind and you will soon see that you are not the mind at all.   That the mind is like a machine in your head that generates thoughts based on your attention/interest. Be free of your mind by depriving it of your interest. This is the only direct path of becoming free of the mind.   Please let me know if this is helpful, looking forward to talking with you more :) Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

How do i heal from ptsd on my own, I can't go to a therapy now

Dear Hevo,   Thank you for your message and for sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of becomes traumatized by it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like suffering, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompanies a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid it, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings, and thoughts while continuing to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce their intensity.   Floating is a form of learning to accept these feelings and make room for them.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up the "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 09/24/2021

What is the best way to manage my trichotillomania?

You have done a lot of research on this and are correct that it is amenable to habit reversal therapy (HRT).  It is also amenable to Acceptance and Commitment Therapy (ACT) and other forms of Cognitive Behavioral Therapy (CBT) such as Dialectical Behavioral Therapy (DBT).  The behavior you speak of is but one of many Body-Focused Repetitive Behaviors (BFRB's).  Rather than go into all of the methods of treatment, I am going to focus on the primary treatment methods which are used with BFRB's in order to modify and change those behaviors.   Anxiety is often a trigger that brings about behaviors that are less than effective at solving the "problem" such as hair pulling.  Anxiety may also cause others to scratch or pick at their skin or itch their skin.  Some skin conditions, such as eczema, can cause the skin to become dry. Dry skin, acute eczema flares, and other skin conditions such as urticaria are often itchy and this can understandably lead to behaviors such as scratching/ rubbing and/or picking the skin to cope with the skin flares that arose as a consequence. There are also conditions that do not involve itch that, for various reasons, elicit these or similar behaviors.  Anxiety can also lead to biting nails and other behaviors.   Eventually, the behaviors can become habits.  The problem which evolves is that habits develop over time as a result of life stressors or medical conditions and behaviors are formed that damage one's skin, hair, or nails. The first few times a person uses a behavior like scratching, picking, biting, etc. it is most often a conscious reaction. However, after repeating this behavior over time, the response can become habitual and hence unconscious. By this point, the person, therefore, has little control over the behavior that is creating the visible evidence or consequences of the behavior.  The visible evidence worsens and with time the result is a vicious cycle of itching, scratching, and damaged skin, hair, and/or nails.  Eventually, no matter if the behavior is scratching or something else, it becomes driven at least mainly by habit instead of by the source. Habit Reversal Therapy consists of two types of therapy (1) awareness therapy and (2) behavior modification.  Each of these types of therapy is essential to recovery but one generally precedes the other.  One needs to first be aware of what is going on i.e., what the cycle is that created the behavior we observe and don't want.  This means keeping a record of what leads to pulling your hair, scratching your skin, picking your skin or nails, etc. Then one needs to analyze the diagram created from the awareness therapy stage.  Second, one needs to analyze and experiment with behaviors to learn which behavior change(s) interrupt the cycle we observe.    Through a regular process of awareness and behavior modification, change occurs.  I would recommend that you contact someone and explain to them what you need so that they find you either someone already trained in HRT, ACT, or CBT/DBT or someone willing to engage in one of these methods of treatment with you with appropriate ethical supervision.  
(Psy.D., LISW-CP/S, CACII)
Answered on 09/24/2021

I don't know how to stop feeling anxious and stressed ?

Hello Mo, I am glad you reached out for support at this time.  I am sorry you are struggling in this moment.  I would encourage you to start to work with a therapist to help you learn skills to help you overcome your struggles.  If we were to meet I would first talk to you about the counseling process through our site and how together we could help you obtain your goals going forward, how I work as a counselor and how I would try to help you through the counseling process.  I would also take the first session to get to know you by asking you a few questions to get a better understanding of your struggles so that I am able to focus on a plan and goals to work on going forward. I want you to know that you are not alone during this time even though you may feel like you are alone at this time.  During the therapy process, you can have support 100% of the time as you are able to reach out and talk to a therapist 24 hours a day 7 days a week.  I am going to send you some skills and tools to help you during this time of struggle you are having.  If we were to work together we would be going over these and more tools to help you through your struggles and be able to ask for support from others. Do you find that you struggle with anxiety or overthinking about things going on either in your life or your future? Know that you are not alone, today I am going to send you reading and skills to help you ground yourself when you are struggling.  What is grounding you may ask? Grounding is using skills to help you physically ground yourself when you are struggling with feeling anxious or racing thoughts. Grounding is a practice that can help you pull away from flashbacks, unwanted memories, and negative or challenging emotions and allows you to focus on what is happening at the moment.  It allows for you to focus on real items or things that you can either see, touch or smell at that moment to help you refocus your mind and help to calm yourself down.  These techniques may help distract you from what you’re experiencing and refocus on what’s happening in the present moment.Physical techniquesThese techniques use your five senses or tangible objects — things you can touch — to help you move through distress.1. Put your hands in waterFocus on the water’s temperature and how it feels on your fingertips, palms, and the backs of your hands. Does it feel the same in each part of your hand?Use warm water first, then cold. Next, try cold water first, then warm. Does it feel different to switch from cold to warm water versus warm to cold?2. Pick up or touch items near youAre the things you touch soft or hard? Heavy or light? Warm or cool? Focus on the texture and color of each item. Challenge yourself to think of specific colors, such as crimson, burgundy, indigo, or turquoise, instead of simply red or blue.3. Breathe deeplySlowly inhale, then exhale. If it helps, you can say or think “in” and “out” with each breath. Feel each breath filling your lungs and note how it feels to push it back out.4. Savor a food or drinkTake small bites or sips of a food or beverage you enjoy, letting yourself fully taste each bite. Think about how it tastes and smells and the flavors that linger on your tongue.5. Take a short walkConcentrate on your steps — you can even count them. Notice the rhythm of your footsteps and how it feels to put your foot on the ground and then lift it again.6. Hold a piece of iceWhat does it feel like at first? How long does it take to start melting? How does the sensation change when the ice begins to melt?7. Savor ascentIs there a fragrance that appeals to you? This might be a cup of tea, an herb or spice, a favorite soap, or a scented candle. Inhale the fragrance slowly and deeply and try to note its qualities (sweet, spicy, sharp, citrusy, and so on).8. Move your bodyDo a few exercises or stretches. You could try jumping jacks, jumping up and down, jumping rope, jogging in place, or stretching different muscle groups one by one.Pay attention to how your body feels with each movement and when your hands or feet touch the floor or move through the air. How does the floor feel against your feet and hands? If you jump rope, listen to the sound of the rope in the air and when it hits the ground.9. Listen to your surroundingsTake a few moments to listen to the noises around you. Do you hear birds? Dogs barking? Machinery or traffic? If you hear people talking, what are they saying? Do you recognize the language? Let the sounds wash over you and remind you where you are.10. Feel your bodyYou can do this sitting or standing. Focus on how your body feels from head to toe, noticing each part.Can you feel your hair on your shoulders or forehead? Glasses on your ears or nose? The weight of your shirt on your shoulders? Do your arms feel loose or stiff at your sides? Can you feel your heartbeat? Is it rapid or steady? Does your stomach feel full, or are you hungry? Are your legs crossed, or are your feet resting on the floor? Is your back straight?Curl your fingers and wiggle your toes. Are you barefoot or in shoes? How does the floor feel against your feet?11. Try the 5-4-3-2-1 methodWorking backward from 5, use your senses to list things you notice around you. For example, you might start by listing five things you hear, then four things you see, then three things you can touch from where you’re sitting, two things you can smell, and one thing you can taste.Make an effort to notice the little things you might not always pay attention to, such as the color of the flecks in the carpet or the hum of your computer.Mental techniquesThese grounding exercises use mental distractions to help redirect your thoughts away from distressing feelings and back to the present.12. Play a memory gameLook at a detailed photograph or picture (like a cityscape or other “busy” scene) for 5 to 10 seconds. Then, turn the photograph face-down and recreate the photograph in your mind, in as much detail as possible. Or, you can mentally list all the things you remember from the picture.13. Think in categoriesChoose one or two broad categories, such as “musical instruments,” “ice cream flavors,” “mammals,” or “baseball teams.” Take a minute or two to mentally list as many things from each category as you can.14. Use math and numbersEven if you aren’t a math person, numbers can help center you.Try:running through a times table in your head. counting backward from 100 choosing a number and thinking of five ways you could make the number (6 + 11 = 17, 20 – 3 = 17, 8 × 2 + 1 = 17, etc.)15. Recite somethingThink of a poem, song, or book passage you know by heart. Recite it quietly to yourself or in your head. If you say the words aloud, focus on the shape of each word on your lips and in your mouth. If you say the words in your head, visualize each word as you’d see it on a page.16. Make yourself laughMake up a silly joke — the kind you’d find on a candy wrapper or popsicle stick.You might also make yourself laugh by watching your favorite funny animal video, a clip from a comedian or TV show you enjoy, or anything else you know will make you laugh.17. Use an anchoring phraseThis might be something like, “I’m Full Name. I’m X years old. I live in City, State. Today is Friday, June 3. It’s 10:04 in the morning. I’m sitting at my desk at work. There’s no one else in the room.”You can expand on the phrase by adding details until you feel calm, such as, “It’s raining lightly, but I can still see the sun. It’s my break time. I’m thirsty, so I’m going to make a cup of tea.”18. Visualize a daily task you enjoy or don’t mind doingIf you like doing laundry, for example, think about how you’d put away a finished load.“The clothes feel warm coming out of the dryer. They’re soft and a little stiff at the same time. They feel light in the basket, even though they spill over the top. I’m spreading them out over the bed so they won’t wrinkle. I’m folding the towels first, shaking them out before folding them into halves, then thirds,” and so on.19. Describe a common taskThink of an activity you do often or can do very well, such as making coffee, locking up your office, or tuning a guitar. Go through the process step-by-step, as if you’re giving someone else instructions on how to do it.20. Imagine yourself leaving the painful feelings behindPicture yourself:gathering the emotions, balling them up, and putting them into a box walking, swimming, biking, or jogging away from painful feelings imagining your thoughts as a song or TV show you dislike, changing the channel or turning down the volume — they’re still there, but you don’t have to listen to them.21. Describe what’s around youSpend a few minutes taking in your surroundings and noting what you see. Use all five senses to provide as much detail as possible. “This bench is red, but the bench over there is green. It’s warm under my jeans since I’m sitting in the sun. It feels rough, but there aren’t any splinters. The grass is yellow and dry. The air smells like smoke. I hear kids having fun and two dogs barking.”Soothing techniquesYou can use these techniques to comfort yourself in times of emotional distress. These exercises can help promote good feelings that may help the negative feelings fade or seem less overwhelming.22. Picture the voice or face of someone you loveIf you feel upset or distressed, visualize someone positive in your life. Imagine their face or think of what their voice sounds like. Imagine them telling you that the moment is tough, but that you’ll get through it.23. Practice self-kindnessRepeat kind, compassionate phrases to yourself:“You’re having a rough time, but you’ll make it through.” “You’re strong, and you can move through this pain.” “You’re trying hard, and you’re doing your best.”Say it, either aloud or in your head, as many times as you need.24. Sit with your petIf you’re at home and have a pet, spend a few moments just sitting with them. If they’re of the furry variety, pet them, focusing on how their fur feels. Focus on their markings or unique characteristics. If you have a smaller pet you can hold, concentrate on how they feel in your hand.Not at home? Think of your favorite things about your pet or how they would comfort you if they were there.25. List favoritesList three favorite things in several different categories, such as foods, trees, songs, movies, books, places, and so on.26. Visualize your favorite placeThink of your favorite place, whether it’s the home of a loved one or a foreign country. Use all of your senses to create a mental image. Think of the colors you see, sounds you hear, and sensations you feel on your skin.Remember the last time you were there. Who were you with, if anyone? What did you do there? How did you feel?27. Plan an activityThis might be something you do alone or with a friend or loved one. Think of what you’ll do and when. Maybe you’ll go to dinner, take a walk on the beach, see a movie you’ve been looking forward to, or visit a museum.Focus on the details, such as what you’ll wear, when you’ll go, and how you’ll get there.28. Touch something comfortingThis could be your favorite blanket, a much-loved T-shirt, a smooth stone, a soft carpet, or anything that feels good to touch. Think about how it feels under your fingers or in your hand.If you have a favorite sweater, scarf, or pair of socks, put them on and spend a moment thinking about the sensation of the fabric on your skin.29. List positive thingsWrite or mentally list four or five things in your life that bring you joy, visualizing each of them briefly.30. Listen to musicPut on your favorite song, but pretend you’re listening to it for the first time. Focus on the melody and lyrics (if there are any). Does the song give you chills or create any other physical sensations? Pay attention to the parts that stand out most to you. I hope that these skills have been helpful for you in your struggles you have been facing at this time. I am going to give you my information if you are wanting to start to process through and work on your struggles going forward, please reach out to Betterhelp and ask to be matched with Crystal Westman. If we were to work together we would work on more skills and tools to help you when you are struggling and get back to a positive space.  I encourage you to reach out for support at this time to help you get to the best version of yourself.
Answered on 09/24/2021