November 6, 2012

Experimenting with Different Breathing Styles

Heart Says Breathe by Laurie Maves
Noting dysfunctional breathing patterns and changing them are two frequent goals of cognitive behavioral therapy.  Breathing exercises are one of the behavioral changes clients can make as opposed to the thought patterns that bring on and maintain the anxious breath.

There are a variety of ways to alter one's breathing therapeutically.  In an earlier post, I described what is often called lower abdominal breathing (LAB).  Many people report success lowering anxiety, stress and anger, for example, using LAB.  Click HERE to review my previous post.

Here, I will post a link to an article where Deborah Rozman talks about a different approach called Heart-Focused Breathing.  Different in that the mental focus on one's heart is suggested rather than strictly on the mechanics of the breath.  Shifting one's focus toward gratitude or a scene that has positive associations is also part of Heart-Focused Breathing.  Click HERE to read Rozman's full post.

So often in therapy my message is  this:  Don't give up.  Experiment with different styles of breath work.  Finding the style that assists in calming your body and quieting your mind is what we're after ... not sticking to any particular, recommended type.

Painting, Heart Says Breathe by Laurie Maves and can be viewed HERE

August 4, 2012

Give Me Five ... Minutes of Meditation, That Is

In this fast-paced society we city folks dwell in, we're often searching for quick fixes.  While it is usually true that meaningful change requires significant time and energy, meditating five minutes a day can be an effective tool in easing a host of problems that effect those of us living in the rush-rush workaday world.

Meditation has long been advocated to help quiet the mind and improve focus.  In the past few years a variety of experts have begun to recommend, and numerous studies suggest, that mediation can be helpful in reducing stress, anxiety and depression as well as help heal or ease the symptoms of many physical illnesses including high blood pressure, inflammation and chronic pain.

But what is meditation?  Many people automatically picture an isolated monk seated pretzel style in a dark, spare room with candles and a large gong.  While there are certainly meditation practices resembling this stereotype, today's post is geared toward familiarizing readers with simpler and shorter forms of meditation that can be incorporated into a typical, time-pressed day.  Meditation, in short, for the hurried, anti-gurus among us.

Below are links to descriptive posts and videos that you may find useful in your quest to learn simple, effective meditation practices that can fit into any busy schedule.

Five Minute Meditation Introduced

Chris Walker calls himself The Anti Guru Guru.  He advocates no-frills meditation. Having practiced long hours of study in India he claims he gets more benefit from paring down his meditation practice to five-minute sessions.  Check out his post, here.

Dr. Alejandro Junger, M.D., cardiologist, discusses the role of stress on the mind and body.  In this video, he talks about the role of constant, automatic thoughts produced by our busy, overloaded brains (monkey mind) and the effectiveness of meditation in relieving physical damage caused by these and other forms of harmful stress.  Along with a video explanation, Dr. Junger gives step by step directions for practicing a five-minute meditation.

Meditation Videos to Get Started

Below is a video of a guided five-minute meditation.  Soothing pictures, music and a calming voice guide you through a simple meditative exercise.  You can view the video, here, or simply push the  white triangle start button below and view right from my blog:

To enlarge the meditation video, simply press the small square shaped symbol at the far right of the bottom black bar.  To return to this smaller size video, press the Escape key or click on that same square symbol.

This video features Deepak Chopra talking you through a gentle, nature-themed meditation.

Three Minute Rejuvenation Meditation

Five minutes sounds too long?  How about a three minute video?  In this video a woman guides you through quiet breathing and relaxing instructions.

If you prefer to try a meditation without being guided, this Breathe - 3 Minute Meditation video provides kaleidoscopic pictures and soothing music.

Meditation for the Darting Mind

If you are feeling up to the challenge of an 11-minute or even a 31-minute meditation, take a look at this video demonstrating Kirtan Kriya Meditation.  This yoga meditation involves vocalizations synchronized with finger movements which may be especially effective for people whose minds wander during more standard meditation exercises.

As this post illustrates, there are many paths toward meditating.  While longer meditation sessions are believed to produce deeper and more health engendering forms of relaxation, many find that short meditation exercises are not only time saving but also effective, especially when done on a daily basis (several times per day, even better).

These videos and links are chosen as examples not as any definitive or preferred method.  Different meditation experiences appeal to different people.  The important thing is for you to find a method that works for you: that produces feelings of calm, quiet and peace-of-mind.  Try exploring several of the meditation videos posted on YouTube or your favorite online video site.  Experiment with different styles and then practice on your own.  It will probably take time and repeat practice to achieve the desired effect.  And by practice I mean trying again and again until you feel your mind grow lighter and your thoughts slower and your muscles relax fully.

July 3, 2012

Coping with Social Anxiety

When we work with social anxiety, one of the most widespread forms, we learn that meeting new people is a highly distressing task.

Introducing oneself, starting up a conversation, keeping small talk going, indeed, merely showing up, any or all of these scenarios evoke considerable anxiety for socially anxious people.

Cognitive therapy explores negative thought patterns that increase anxiety and lead one to shy away from talking to someone new or starting a conversation with an acquaintance.

A very typical dysfunctional thought pattern or cognitive distortion that plagues people with social anxiety is mind reading:  assuming we know what the other person is thinking and, more important, assuming those thoughts are negative; that they are negatively judging us.

At least two broad options are encouraged as a counter to mind reading.  The first is to decide to stop mind reading --  to instead tell ourselves that mind reading is futile, probably inaccurate, that we are unlikely to ever get the real truth.  In other words, our assumptions about the other person's thoughts will never be truly verified.  Because of this, it is an act of folly to mind read and base our own behavior on those assumptions.

How do we stop?  Distract ourselves with another subject altogether.  The weather.  The food selection.  Reciting the alphabet backwards.  The baseball game you're looking forward to watching.  Whatever comes to mind that lets you think of something besides mind reading.

The second option we have is to replace negative mind reading with something more positive and probably more accurate. Assume that the other person is interested in getting to know us, is also feeling anxious about starting a new conversation, and would welcome our small talk.  We are, as a rule, social beings who want to get to know people.  Somebody needs to break the ice and it might as well be me.

So that backyard barbeque you've been dreading?  Go.  But first?  Take a few deep breaths followed by long exhales.  Loosen up those smile muscles.  Brush up on some small talk pointers.  Decide to introduce yourself to at least one new person.  Choose someone who is standing alone or otherwise not engaged in conversation. Hi, I'm Susan usually works great.  Followed by, I know Dave and Karen (the hosts) through work.  How about you?  

If they don't help the conversation along, decide to give it a try.  It doesn't hurt to practice in your head before you go or before you approach a particular person.  (Cognitive behaviorists call this covert rehearsal.)

Ask how long they've known the host.  Comment on the weather.  Or the food.  The rule of thumb with small talk is this:  Start with the general and move on to more personal topics but only if the person seems interested.

Second rule?  Ask them a general question about something you have in common.  What do you have in common with this stranger at a barbeque, you ask?  Well for one, you are both at the same barbeque.  You were both invited by the same host.  You are both standing in the heat, or under the shade tree, or inside the air conditioning, or in line at the bathroom.  You are both listening to the same music, can see the same television, are surrounded by the same paintings on the wall.  Move from the general (even boring) to the more personal once you see the person is willing to converse.

Examples of starters:

How long have you known _______ (the host)?
It looks like you're drinking the iced tea.  Is it sweetened?  
Do your kids go to school together?
Have you lived in this neighborhood long?
What kind of dressing was on that salad?  Did you taste it?

If you are not getting much of a response after one or two starters, allow silence.  Maybe that will prompt them to say something.  If not?  Wait a little longer and then excuse yourself with a smile, I'm going to get something to eat now.  Nice to meet you.  And away you go.

Even if the attempt didn't go very far you can pat yourself on the back for trying.  For getting in some practice.  For concluding it wasn't all that bad.  And maybe deciding to give it another try.  The next person is bound to be more social.

June 8, 2012

Fear of Flying? Driving? Read Here from the Comfort of Your Chair

     When someone presents with a highly specific fear, or phobia, that is interfering with life in a big way, such as a fear of driving (vehophobia), flying (pteromerhanophobia) or vomiting (emetophobia, more common than you would think), behavioral psychologists will often treat with specialized techniques that research has shown can work very well.

     Desensitization Training and Exposure Therapy are two such techniques.

     Watered down versions of these two treatment methods are often used in some form or fashion when treating more diffuse or generalized forms of anxiety disorders, such as social anxiety.  The essential mechanisms are the same:  learn relaxation skills and then pair with the feared event or object.

     I am going to play lazy today and give you a link to Michael Murrell, Psy.D.'s blog post (click here) where he describes Desensitization for Anxiety.  So please check our Dr. Murrell's post if you are looking for help with a specific phobia.  It's important to be guided through the correct procedures by a trained professional in order to find treatment success.  Reviewing these techniques and then asking the psychologist you are interviewing whether she or he uses them to treat phobias is a great way to insure you find the proper treatment for your fears.

     The core of desensitization involves first pairing, and then replacing, feelings of anxiety with feelings of calm.  Learning to relax is a necessary first step toward applying desensitization.  Deep breathing is one type of relaxation exercise often recommended.  You can check out my previous post which describes a particularly effective form of deep breathing that I most frequently suggest, here.

     Using deep breathing exercises throughout the day, two minutes here - ten seconds there - can help keep anxiety and stress levels lower, can help rid our bodies of the stress signals that often accumulate by the end of a typical work or school day.  And can also help be more successful when engaged in the actual exposure to a fearful event.

Additional resources:

Some good advice here that applies to driving phobia.

Anyone who has seen me for any length of time 
will agree I should hang this cartoon on my wall 
(thank you, Natalie Dee).

April 30, 2012

Advice Your Mother Probably Never Gave You

Sit up straight!  Go outside!  Take a nap!

What do these three statements have in common?  Things your mother said when you were a kid?

Maybe so.  But they're also part of a list of Twenty-Eight Scientifically Proven Ways to Boost Energy Instantly.

Need a mid-workday energy lift?  Here are a few other suggestions that your mother probably did not tell you:

Turn up the volume.  Listening to music and tapping your feet can help you feel more alert.

Eat chocolate.  Cocoa contains flavonoids which have been found to boost cognitive skills and elevate mood.

Take a break. Put your work on pause and get a change of scenery.  Leaving your desk can help you feel more energetic and improve your focus.  Even if it's just to look out the window.  Getting outside for fresh air and sunshine? Better.

Click on the link here to read more than twenty additional ways to energize.

And then leave a comment with your personal tips for beating the mid-afternoon blahs.

Turn your face to the sun 
and the shadows fall behind you.
 -  Maori Proverb

The Park Bench by Karsten Stier

April 2, 2012

Weight Loss Strategies from the Experts

A long time ago in a galaxy far, far away I completed my predoctoral internship in Clinical Psychology at a wonderful institution, The Medical University of South Carolina (MUSC) in Charleston.  One of my rotations was at the MUSC Weight Management Center.  As co-leader of medically managed weight loss groups I was able to learn a lot of up-to-the-minute weight management tools from the head psychologist and dietician.

Now, these many years later, I am following MUSC's Facebook page.  In this way I get the benefit of summaries of the latest research findings in the area of weight loss presented in a pared down, easy to read format.

Today I signed up for their daily weight loss tips sent by email HERE.  You can also get these tips via text, HERE.  A few recent examples:  

Enlist the support of family and friends in your weight loss efforts; be sure to let them know exactly how they can be most helpful.

Start the day with breakfast, especially one high in fiber and moderate protein, to help control calories for the rest of the day.

It's a fact, people who read nutrition information on food labels eat less fat than people who don't.

Try to eat something every 3-4 hours to avoid hunger. You'll be less likely to overeat if you're not too hungry.

A "Light" food means that it has 50% less fat or 1/3 fewer calories than the original product Light can still be fairly high in calories or fat.

Up to the minute research can sometimes make a difference.  Back in my intern days, a registered dietician on our program team told us that daily weighing was counter-productive to weight loss. Standing on the scale once a week, we were told, was the best behavioral strategy for keeping tabs on the pounds.  However, thanks to MUSC's daily tips, I now know what is currently recommended:

Weigh and graph your weight at least once a week and preferably daily; research shows daily weighing is very useful.

Graphs you can download and print can be found HERE.

If you are one of the millions struggling to lose weight, why not sign up for these daily tips.  Like me, you may already know many of these tips, but daily reminders help keep us focused on our weight loss strategies.  Frequent reminders help us prevent the typical "drift" that occurs:  First we forget, then we relapse, then we regret.  Staying focused is one key to success of lifelong lifestyle changes in our eating and exercise patterns.

Do you have any tips to manage your weight?

February 16, 2012

See the Stars

When it gets dark enough, you can see the stars.
Charles A. Beard

It may come as a surprise to few that many people present for therapy during the darkest of times.  New patients may feel powerless to change their circumstances, hopeless to overcome their problems.  We clinicians like to point out that, through therapy, people often gain the tools necessary to first cope and then to feel stronger, maybe stronger than ever, and then ultimately to overcome the difficult obstacles they face.   

It can help to believe that dark points in our lives may be fulcrum moments, the very point at which we gain the help we need to make substantial life changes.  To find the power within ourselves to take action and change.   

It would be foolish to suggest that we should look forward to low moods and hardship.  But it is worthy to suggest that when they arrive we can learn to accept them  as temporary turning points.  Maybe even necessary turning points.  To embrace the potential adversity presents.  As an end to stagnation.  The pivotal shift we need to grow.   Stronger.  To learn. To succeed.  To  flourish. 

As this quote suggests, we can learn to look beyond the clouds.  Look into that darkness.  Look for the stars.  We might just find incredible, life fulfilling opportunity.  

February 1, 2012

Your Brain on Sleep

Seems we cannot talk enough during therapy sessions about the importance of getting the right amount of quality sleep.  So much research is pointing toward the role of sleep deprivation in mental health problems are surfacing.  And more and more we are becoming a sleep deprived nation.

Many factors interfere with getting a quality night of sleep such as anxiety/worry/stress, alcohol and caffeine use, medications with stimulating side effects (for example, decongestants and ADHD stimulants such as Ritalin), and late night activities including video game playing, internet surfing, and television viewing.

 When I saw this excellent graphic on the OnlineCollege website, I decided to post it here.  A lot of information packed into one colorful visual can be a helpful tool.  And especially appreciated when someone else put the work into it.  So thank you OnlineCollege.  You may want to enlarge the graphic - on my PC I click Ctrl +

January 6, 2012

Feeling Low? Make a Pleasant Events List

In honor of the New Year and good intentions to make improvements in our lives, I am re-posting a revised Pleasant Events List.  Those of you who read the previous post will be glad to see I've made a few changes, out with some of the old and in with some new ideas.

For those reading this list for the first time, what is it all about?

When someone is experiencing a sad, down, angry, lonely, or otherwise lowered mood, one tip that can help is to consult your own personal Pleasant Events List.

Below is a lonnnnnng list of Pleasant Events. It was compiled from a variety of sources, some of which I no longer recall. But I do remember a co-therapist telling me she gathered lists generated by clients in a former therapy group she ran. I kept most of the list intact, even when I was puzzled by the content. Different people find different activities uplifting (cleaning the bathroom, being one that I find a real stretch, but... different strokes).

The list is meant as a starting point: A list of ideas that will help you generate a list of your own. So that you can write your own personalized list of activities and thoughts you find pleasant, fun, funny, joyful, entertaining, relaxing, soothing, or in some other way, mood-lifting.

So I post this list in the hopes that readers will be inspired to read it, to do some of the things on the list, or to merely think about doing some of the things on the list, to leave a comment with some new pleasant event that can be added to the list, or to generate a new list of your own. Best of all, generate your list with as many readily do-able, easily accessable, easily affordable events as you can come up with.

As one exercise, I often suggest before reading the list that you rate your mood on a scale of 1 to 10, where:

1 = feeling very down or "low"


10 = feeling really happy or "up"

Then, after you have finished reading the list, rate how you feel once again. Any change?


1. Soaking in the bathtub   

2. Looking at the stars       

3. Feeling the wind in my hair

4. Collecting things (coins, shells, etc)

5. Listening to fun, educational programming, such as TED or NPR podcasts

6. Thinking how it will be when I finish school

7. Working a crossword or sudoku puzzle

8. Trying out a new hair style

9. Sitting under a shade tree

10. Going to a movie in the middle of the week