15 Steps to Better Mental Health

Walking in the Rain

by L C Neill

Yet another excellent post by Dr. Deb -- A list of 15 Tips for Mental Fitness that she found on a University of Washington publication. It's such a great list, in fact, I had to post it here:

1. Learn to Relax
Allow yourself to let go of inner tensions by giving yourself a “mini vacation.” Give your mind a break by becoming engrossed in a good book, watching a movie, listening to music, taking a walk, working on a hobby, meditating or similar activity that is relaxing for you.

2. Be Kind To YourselfPeople are frequently too hard on themselves when things don’t go right. Tune into your self talk, and counteract your negative thoughts about yourself with positive statements.

3. Eat ProperlyNutrition has a direct impact on feeling mentally positive. Limit your intake of sugar, fat, salt, caffeine and alcohol and help yourself stay mentally fit.

4. Find A Friend
Friendships are very important to mental fitness. Working on developing and maintaining friendships is one of the best ways to continue growing as a person. Expressing feelings and ideas to another person can help us clarify what’s truly important to ourselves.

5. Learn to Say “No”Often people feel the need to respond immediately when a friend or family member make a request. Help yourself set limits by avoiding the quick “knee jerk” response in the affirmative. Instead, let them know you will get back to them shortly. Then do a check of your schedule; ask yourself if you really want to add to your load. Give yourself permission to say “No” when you are too busy to take on additional commitments of your time or energy.

6. ExerciseCheck with your doctor about what level is best for you. Even a brisk 15-minute walk, three times a week does wonders for how you think and feel.

7. Do It NowProcrastination can lead to negative feelings about yourself. One doesn’t have to go to extremes, but it can feel very satisfying at the end of the day to have accomplished a hard task or met a difficult situation head-on.

8. Adapt To Rather Than Resist ChangeChange is inevitable and is a necessary part of life. The important thing is to be patient with yourself when you are going through change, and to give yourself time to go through the phases of transition. Realize it takes time to let go of the old and embrace the new.

9. Test Your Assumptions
Sometimes in our interactions with other people, we make the most incredible assumptions and act as if they are true. Rather than assuming, it might be worth the risk to ask directly what was meant.

10. Express Your Feelings
Emotions are a natural response to life. It is important to find ways to express your feelings. Journaling your thoughts is one way that can help you clarify what you are feeling. Once you have identified your feelings, you may find it easier to share them with others.

11. Grieve Losses
Sadness and grief are natural and appropriate responses to the losses which we all experience. Grief over the loss of a love one can be very painful and may last for some time. By being kind and allowing ourselves the time to grieve, we have the potential to be stronger than ever

12. Rest
Get a good night’s sleep. Not everyone needs the same amount of sleep, but it should be restful sleep. There are many techniques available to help promote relaxation; or, you might want to check with your doctor rather than assuming your restless sleep is simply something you have to live with.

13. Review Your “Shoulds”If you feel stuck by some things you “should” be doing and aren’t, set a time limit by which you will either have them done or get rid of them. Staying stuck in the middle is a good way to punish yourself and cause mental anguish and stress.

14. Have A Laugh
Nurture your sense of humor, especially about yourself. Trying to see the humorous side of things makes even the most difficult situations easier to bear. Laughter is good medicine. Being too serious limits your ability to enjoy life.

15. Ask For HelpIf you need emotional support or just someone to talk to, don’t be afraid to ask for it. There are times in life when everyone must look outside themselves for comfort and advice. If friends can do the job, ask them to help. If not, be assured that professional help is available through your employee assistance program.

I would like to add a suggestion of my own to the list: Look at art. Even better, create some yourself.

How about you, reader? Anything you'd like to add to the list?

Must Love Dogs or At Least Want to Walk One

In previous posts I have talked about the challenge of finding friends and how to make small talk once you meet new people. Cultivating healthy friendships and getting social support are often such an integral part of therapy.

Not long ago I read a blog post on the topic, 13 Ways to Make Friends. You can read the full post, here.

There are a few additions in the 13 Ways that I hadn't talked about in my posts so I thought I would mention three of them here.

Volunteering: Not only will you come into contact with other caring, proactive fellow volunteers, but receptive and appreciative individuals at the receiving end of your efforts as well. Research has shown that engaging in meaningful work and activities helps alleviate depression, for example.

In short, good feelings can come from helping others.

I should know.

In my city of Austin, Texas, checking out the Get Involved section on the KUT public radio website is a great way to explore volunteer opportunities.

You might check out the websites of your local radio stations, newspapers, churches, or simply ask around. In addition to finding worthwhile volunteer work, asking someone to share their volunteer experiences is a great way to get someone to open up to you.

Get Cyber-Social: Though not as beneficial as face-to-face interactions, joining internet support groups and social networking sites have been shown to help lift a person's spirits and decrease feelings of loneliness. Sometimes that sense of "not being alone" via online discussion forums and emails can add to one's positive wellbeing. Feeling validated in one's thoughts, opinions, and experiences is described as helpful by many.

Whether you explore medical conditions, mental health issues, books, art, music, energy conservation, the list is virtually endless these days, there's a good chance you can find like-minded individuals who are willing to connect online.

Social networking sites, the ones where you can search and reconnect with old friends scattered far and wide, are seemingly the new wave of staying in touch.

But remember, spending time close up and personal, such as having lunch together, taking a walk, meeting face to face, tends to yield more benefits that limiting your interactions to the electronic screen. And second, when moving from an internet-only relationship to meeting in person, please take precautions and observe safety rules.

Get a Dog: Having completed my doctoral dissertation in the area of the health value of pet ownership, I learned there are many benefits, including lowering blood pressure. Increasing social opportunities is another. For example, I worked with someone who met his girlfriend at a dog park.

Studies have shown that people walking a dog tend to be viewed as more approachable and friendly. It's similar to the baby stroller effect. People are drawn to babies and pets, especially dogs.

I cannot say for sure that walking an iguana, say, would have the same effect, but maybe.

Man Pauses While Walking His Iguana

by Matthew Eastmond

I mean, an iguana is a curiosity and there are those that think iguanas are the cat's meow. But there are others who would run in the opposite direction if they saw a small, horny-backed creature scurrying their way. So factor in the social likeability factor when choosing a pet to parade in public.

Puppies probably rate highest but that doesn't mean you should run out and buy a new puppy when you've already got a dog. The expense and effort of too many pets could backfire.

I recently finished a cute book, Must Love Dogs, where the heroine borrows her brother's dog to meet a man from the personal ads and he, too, shows up with a borrowed dog.

The book was made into a really funny movie of the same title, starring Diane Lane and John Cusack, if you'd rather watch it on your home screen. Laughter is the best medicine, right?

Better yet, watch it with a friend. The two-footed or four-footed variety.

Making Marriage Work - A Recommended Book

Speaking of marital therapy, one book I really, really like to recommend for couples, one that has helped many that I've worked with, probably more than any other (in my experience), one that both partners seem to easily buy into (very important), is The Seven Principles for Making Marriage Work by John Gottman, PhD.

This couples self-help book is fairly easy to understand, fairly straight forward. Gottman uses very common, everyday speak. It's largely research / outcome /evidence based advice, which means he bases his suggestions on findings in a lab, instead of touchy-feely, abstract, unituitive, flowery language that leaves readers feeling good and hopeful but without any explicit tools to apply to their relationship, and thus, no true or lasting impact.

Gottman's Seven Principles deals quite a bit with anger and how a high degree of anger can negatively impact a marriage, whether the anger is externalized - yelling, blaming, name-calling, stomping, hitting, having an affair; or internalized - stewing, turning away, shutting oneself off, silent treatment, self blame, martyrdom.

The portion in the book I refer to most often is the section Gottman refers to as the "Four Horsemen of the Apocalypse" -- four communication patterns to eliminate from your relationship:

1. Criticism - or as one psychologist described them, ad hominem personal attacks. Rather than make a complaint about a specific behavior, followed by a request for positive change, habitual criticisms and verbal attacks are toxic in a marriage or partnership.

2. Contempt - I like to describe this as saying one thing with your words but saying something entirely different, and critical or derogatory, with your voice tone and/or body language. Some researchers believe that 90% of communication is non-verbal. So ugly, harsh voice tone tends to be the loudest of all. Gottman's research has also suggested that men, in particular, are highly sensitive to women's voice tone. Maybe the condescending or critical female tone reminds them of being scolded by dear-old-Mom, the powerlessness associated with those unpleasant memories. I don't know. But it bears reminding that a shrill tone of voice is a huge turnoff.

3. Defensiveness - When faced with a partner's complaint, taking a super defensive posture can be a fast track to getting nowhere. So often in an arguement we see the pattern of complaint, followed by the partner's defensiveness, followed by the same partner's cross complaint.

example:

Partner 1: You don't help enough around the house.

Partner 2: Me? I do plenty around this house! What about you? You never make the bed in the morning and you're always leaving a mess on the bathroom counter!

Defensiveness followed by cross complaint followed by defensiveness followed by cross complaint. It can be an endless, vicious cycle. No one is listening. No one is taking responsibility. No one is offering to make changes.

4. Stonewalling - Shutting down communication is the cornerstone of stonewalling. Refusing to talk, basically. And it isn't only verbal. Meeting a spouse's complaints with a blank stare or a hostile glare or other forms of aggressive body language (arms crossed, jaw jutted out), walking out, otherwise known as storming out, slamming doors, staying gone, pouting, sullen expression, avoiding the spouse who dared to voice displeasure.

Gottman is widely published in professional, peer-reviewed journals. He has been doing research on marriages for more than twenty years, looking at what helps marriage last and what behavioral trends are associated with divorce. He touts that he and his researchers are able to predict what factors bring couples to divorce court 95% of the time. Excessive anger is one communication pattern and behavioral style at the top of the list.

Many troubled couples come from families where a lot of anger was freely expressed and heartily justified. Individuals with this background often come into therapy looking for validation that anger is healthy, that anger is good to express.

Gottman's work cuts right through these justifications. Instead of loud, ranting discontent, expressing wants and preferences in a calm and respectful voice tone is at the heart of healthy communication. Disagreement is healthy, yes. Expressing disagreements is healthy, yes. In fact, Gottman points out that marriage with the least amount of conflict are often the most at risk.

But aggressive attacks and screaming matches? Not good.

Communicating in a healthy, assertive way isn't always natural and seldom is it easy. Gottman's work helps show the way in simple, concrete terms. In a world full of bookstores full of relationship self-help books, this one is a keeper.

Is Therapy Effective for Highly Distressed Couples?

Inquiring psychologists want to know. Our clinical instincts tell us it must be true. Although we've probably all had days where we have wondered.

Now a large study, the largest of it's kind, in fact, indicates that yes, therapy can help even severely distressed couples, so long as both partners want to save the relationship.

Nearly 135 couples were included in this study. They were provided twenty-six sessions of therapy. Then they were followed for five years after the therapy. Not followed in the creepy stalking way. But assessed at six month intervals for a period of five years to see how they were doing.

"The couples all participated in one of two kinds of therapy. The first, traditional behavioral couple therapy, focuses on making positive changes, including learning better ways of communicating, especially about problems, and better ways of working toward solutions. The second, integrative behavioral couple therapy, uses similar strategies but focuses more on the emotional reactions and not just the actions that led to the emotional reactions. In this approach, couples work at understanding their spouse's emotional sensitivities."

Encouraging results were found. At the end of the study, approximately two-thirds of the couples showed significant improvement.

At the five year follow up, half of the couples remained improved. One third even went from significantly distressed to "happy." Most of us would agree that is a sign of real progress.

Not everyone was helped, however. One quarter were separated or divorced. One quarter stayed the same.

As for the two different types of treatment, long term gains were about the same whether couples participated in the traditional Cognitive Behavioral Therapy or the Integrative Behavioral Couple Therapy.

You can read more about the study in a summary posted at Science Daily, here. Or to read the study in it's entirety by following this link.

Journal Reference:

1. Christensen et al. Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy.. Journal of Consulting and Clinical Psychology, 2010; 78 (2): 225 DOI: 10.1037/a0018132

One more thing, Dr. Andrew Christensen (UCLA) and Dr. Brian Doss are developing an online training program for couples. If you are interested in signing up for their online study, you can sign up at OurRelationship.com, here.

Tips for Easing Chronic Pain

Contemplation, I Guess
bas relief painting

Robert Terrell, Lubbock, Texas

Relaxation exercises. Deep breathing, meditation, recalling pleasant memories, progressive muscle relaxation, letting your mind go completely blank, these are all methods for achieving relaxation. For more examples, click here.

Visualization is a powerful relaxation tool. Learn to visualize a peaceful and calming place. This exercise is sometimes called visualizing "special place" or "vacation place." It is especially therapeutic when you use deep breathing tools before you visualize and during.

Pleasurable Activities Choose activities that are pleasureable and take your mind off the pain: listen to music, paint or draw, meet up with an old friend, watch a movie that you associate with good feelings.

Keep a Diary of your pain. Also known as a pain journal. The more aware you are of when the pain intensifies the more in control of the pain you will be. (This will be of value to both you and your doctor.)

Cognitive Skills Try to minimize negative thought patterns. For example if a normal feeling is, "I don't want to do this project." Try changing that to, "I will feel much better when this project is done."

Stop and Rest. Listen to your body when it is telling you that it is tired or in pain. Try to get 7-8 hours of sleep a night and be sure not to over or under sleep.

No Umbrella Needed

If you are like me and find the sound

of a gentle rain or a distant thunder storm comforting,

you'll love this internet site:

Rainymood.

Turn on your computer, turn up the volume, and allow yourself to be lulled by one of nature's most soothing sounds by clicking here.

RainyMood sound track is a nice accompaniment to my relaxational deep breathing instructions, posted here.

Make it a part of your relaxation or meditation experience. Or turn it on before you go to bed. Relaxing sounds or music at bedtime can often help people overcome insomnia.

And perhaps the best part? No umbrella needed.

How about you, reader?

What sounds in nature do you find soothing?

Do you have a similar site you can share?

Small Talk, Big Skill

Very often in therapy, building friendships becomes a behavioral goal. Two of my earlier posts talk about finding oneself with too few friends and some general strategies for finding friends. This post will give some suggestions on what to actually talk about once you have found people worth getting to know.

Putting yourself in a situation where you can meet people is an important step in the friend-building process. A next, big step and helpful skill is the art of initiating a conversation. A step many people find very anxiety producing. A step many believe they are no good at. A step many people are too afraid to try. A step the leaves people avoiding social situations altogether.

It may be a comfort to know that many people experience social anxiety and many people report having trouble coming up conversation starters. So it never hurts to remind yourself that you're not the only person who struggles to break the ice and make small talk.

But when two people are standing next to each other, and the idea is to socialize, somebody's got to do it, right? And it may as well be you. Especially if you're motivated because (a) you want more connections in your life and (b) someone has caught your eye.

And you never know, the person you're eyeing could be more shy than you. Could be hoping you talk first. Could welcome an end to the awkwardness. This is when you can take a deep breath and tell yourself that your attempt at small talk might just be appreciated.

There are three main types of small talk that I will cover: (1) Ice Breakers (2) Introductions, and (3) Follow Ups. Today's post will concern itself with Ice Breakers. In a later post, or two, we'll talk about Introductions and Follow Ups.

With Ice Breakers, here are some suggestions to keep in mind:

(1) You're not trying to make a deep connection the first time you meet. You don't need to dazzle or impress. You're just trying to get some conversation, any conversation, started. So keep your opener short and simple.

(2) The less you know the person, the less personal your comment or question. Keep your comments neutral and general. Focus on something around you, not about you.

(3) Likewise, the more conventional your location, the more conventional you will want to keep the conversation topics. Conventional means neutral, common, general, maybe even boring. Don't ruffle feathers. Don't try to be profound. Keep it light and upbeat.

If you are in an edgy nightclub, at a rock concert, or watching performance art, taking risks might work. But in general, it's safer to keep your comments bland. You don't know this person yet, or very well, so you don't want to startle, pry or challenge. You want to keep it comfortable. And the less you know about a person, keeping it bland is the safest bet.

(4) Look for something you have in common with the person you're trying to talk to. You may be wondering, what if I don't know this person very well? How you can I possibly know what we have in common. Well, here's the answer. At a minimum, what you have in common is your location.

So look around you. Whether you're in the same room or standing on the same sidewalk, at a minimum you've got your physical surroundings in common. And always? There's the weather.

Here are some general topics along these lines:

4The weather (again, it works).

4Traffic (everybody hates it).

4The building.

4The club, organization or group that is holding the function.

4The sports team that's on the television above the bar (but only if he is paying attention).

4The music that's playing.

4The people you both know.

4The class you're both taking.

4The store in which you're standing in line.

Here are a few examples of Ice Breakers:

At a house party: "Who do you know here?" Or, "How do you know Jon and Cara?" "Do you know this neighborhood very well?"

At a wedding: "Are you here with the bride or the groom?" "How long have you known her?" "Their vows were so unusual. Do you know if they wrote them?" "I know the bride but not much about the groom. Do you know how they met?"

At a neighborhood barbeque: "Do you live in this neighborhood?" "I can't believe how overcast it is today. I hope it doesn't rain." "I see Donna has put in some new landscaping over there. She's really keeping her yard nice." "It's been ages since I've had barbeque. I definately brought my appetite with me today. How about you? Are you much for beef brisket?"

At a restaurant or nightclub: "Have you eaten here before?" "Did you have to wait long for your glass of wine?" "What do you suggest on the menu?" "Have you tried the sushi here? Is it any good?" "Where do people park in this town? It took me forever to find a place."

If you look back at the Ice Breakers I suggested, they mostly tend to focus the topic of conversation away from the personal, away from the individuals involved. Instead they direct the questions to people and things around them.

When someone doesn't know you very well, they may not be interested in discussing anything very revealing about themselves. So wait a good while before asking questions of a personal nature.

Sometimes the person you approach will respond to your ice breaker in a talkative way. But there's also the chance of a lengthy pause, an awkward silence. So a future post will talk about the next step, conversational Follow-Uppers.

Meanwhile, picture yourself in a recent situation where you wish you had tried to start a conversation. Or you did make an attempt but didn't get very far. And now refer back to my suggestions and see if you can come up with a few Ice Breakers of your own. Practicing in your head, or covert rehearsal in CBT language, is a good way to up your chances of success the next time around.

A few links you might find helpful:

Tips for Starting Conversation with People you Don't know by Laurie Pawlik-Kienlen

The Shy Person's Guide to Conversation by Susie Cortright

Small Talk on the Job

And there are books on the topic:

The Fine Art of Small Talk by Debra Fine

Small Talk: The Art of Socializing by Kathy Schmidt, Louise Jordan, and Marisha Rogers

The Art of Mingling by Jeanne Martinet

Conversationally Speaking by Alan Garner

Painting: The Conversation by Shelley Grund

Sandy Andrews, PhD is a Clinical Psychologist and Psychotherapist in Austin, Texas