Category Archives: Tips

The Importance of Sleep in Stress Management

Are you finding yourself more tired and needing a change in your sleeping routine? Here are some interesting statistics to consider: “26% of women report trouble sleeping at least once a week compared to only 16% of men. 19% of individuals ages 25-64 admit to losing sleep due to stress a few nights per week. 54% say that stress or anxiety increased their anxiety about falling asleep at night. 52% of men and 42% of women reported that stress affected their ability to remain focused the next day.”

According to the American Institute of Sleep, there are about 50 common signs of stress, many of which impact one’s sleep quality. Some of those signs include the following: Frequent headaches, jaw clenching or pain; Gritting, grinding teeth; insomnia, disturbing dreams; difficulty concentrating and making decisions; forgetfulness; lightheadedness; sweating and several others. When we don’t manage our stress well, our body produces more stress hormones that send us into “fight or flight mode”; this can certainly disrupt a restful night of sleep and negatively impact our functioning the next day.

Questions for personal reflection?
How many hours of sleep do you get on average per night? Do you have a regular sleep/waking schedule? Do you feel rested at waking? Do you have any barriers to restful sleep that are likely stress-induced? How has your sleep schedule impacted the next day, your week, and your sense of productivity? Are there any desired changes to your sleep regimen that you need to make in order to improve your sleep?

Here are some tips for bettering your sleep quality in terms of stress management; they address one’s environment, routine and emotional state (provided by CNet). Lower the temperature. Put down your phone or laptop at least one hour before bed. Invest in a comfortable mattress, sheets and pillows. Mask noises. Avoid the news & social media. Wake up at the same time every day, no matter what time you go to sleep. Limit caffeine, alcohol and chocolate (esp. at night). Avoid catastrophizing. Perform deep relaxation exercises. Control your breathing.

Today is a great day to start to make a change and build better habits to improve your quality of sleep. This may mean setting boundaries with relationships and work in order secure a peaceful night’s rest. If you still have further questions or problems, check with your medical doctor to make sure there are no medical issues that are causing issues with your sleep. You can always seek out services with our practice to address stress management and any underlying emotional problems.

Read more about sleep at the following sources:
www.stress.org
https://www.cnet.com/health/how-to-fall-asleep-fast-better-sleep-hygiene-is-crucial-when-youre-anxious/

What’s Your Word for the New Year?

During the end of a year and upon the precipice of another to come, people often reflect on what was and what their hopes and fears are for what will come. This can often be a crucial time of stress for some as they reflect on what did not happen or what went wrong. I would offer the reframe that this could be an opportunity for refreshment and a restart. Taken in retrospective review, one can have a realistic perspective of where one is and make goals to propel self into the future that is ultimately desired. But how does one combat fear in order to organize oneself for such an embarking adventure?

1) Define “better”. Everyone could possibly conceive what better is. In Solution-Focused Therapy (SFT), this is the “miracle question,” the idea of envisioning oneself with the problem(s) solved? Steve de Shazer and Insoo Kim Berg are the therapists who are credited with the name and practice of SFT. “Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, what would be some of the things you would notice that would tell you life had suddenly gotten better?”

What would you be doing, feeling, thinking? How different would your life be? These are some of the questions that come to mind as I work with my clients. Answer those questions for yourself, right now. Get a sheet of paper and begin to write it down.

2) Goal-Setting is taking what is imagined as “better” and creating goals that are specific, measurable, attainable, realistic, and time-sensitive, or otherwise known as S.M.A.R.T. This acronym was commonly associated with “Peter Drucker’s Management by Objectives concept.” The first known use of the term occurs in the November 1981 issue of Management Review by George T. Doran. Since then, Professor Robert S. Rubin (Saint Louis University) has advised of a greater expansion of the S.M.A.R.T. acronym.

Specific (simple, sensible, significant).
Measurable (meaningful, motivating).
Achievable (agreed, attainable).
Relevant (reasonable, realistic and resourced, results-based).
Time bound (time-based, time limited, time/cost limited, timely, time-sensitive).”
The progress should be monitored and re-evaluated in order to assure compliance with ultimate goal(s) and to update due to circumstances that can influence one’s process while creating space for additional feedback. Some authors have expanded it to include extra focus areas, that is “SMARTER, for example, includes Evaluated and Reviewed” for this reason.

3) For those who would like a more visual and artistic view of “better,” one could try use of Vision boards or setting a “Word” for the year. Vision board include pictures, words/phrases, and images to visualize the “better” in one’s mind on paper, poster board, etc. In setting a “Word” or words for the year, consider the values you’d like to embody for the next year. This sets a goal in mind for how to orchestrate your focus, attention, and puts into practice what behaviors, activities one chooses based on if it falls within the set goals/values of the year.

For example, consider the word: CONFIDENT. If one chose this word for the year, how might this impact how the person attacked their fears of success, healthy relationships, career aspirations, leisure and play. According to Acceptance and Commitment Therapist Russ Harris what we choose as our values are: “your heart’s deepest desires for how you want to behave as a human being. Values are not about what you want to get or achieve; they are about how you want to behave or act on an ongoing basis.”

So consider this as you embark on the New Year. You can choose to focus on what you lost, what is broken, missing, and incomplete. OR You can choose to embrace the opportunity to persevere in spite of the losses. This requires a mindset shift from problems being non-existent in order to have a positive and engaging life. Some things are impossibilities. What you can do is choose to press through, not get over, but live through it. Whatever your “it” is, if it is too heavy for you alone, seek out help and resources in your community, family, and friends. There is no weakness in seeking help; there is only wisdom in that decision.
• Do not isolate. Let your friends and family in.
• Seek professional resources (therapist, crisis line, psychiatrist, primary doctor, for example).
• Exercise and eat healthy foods. Treat your body well.
• Find an activity that inspires you again (painting, journaling, sports, music, etc.)

Who knows? This could be your start to a better year! We at 1Alliance CPS wish everyone a safe and Happy New Year!

Resources:
https://www.psychologytoday.com/us/blog/in-therapy/201001/cool-intervention-10-the-miracle-question
https://www.mindtools.com/pages/article/smart-goals.htm
thehappinesstrap.com

Practicing Gratitude this Thanksgiving

Gratitude does not come easy and often is not the mind’s default way especially in times of crisis and change. Periods of transition can be hard because with change can come uncertainty of outcome. Fear of what’s to come can leave people anxious, stressed and zeroed into or tunnel vision about the identified problem(s). Often times, holidays can be triggering for points of increased depression, anxiety and loneliness, especially during a pandemic where recommendations are to be socially distant which feel/seem counter to our innate human need for connection but necessary for community-wide health for all. Here are some small, but significant ways to keep a positive undertone to your life during the holiday season in the midst of a pandemic.

1) Stay connected with friends, family and loved-ones. Even as you are socially distancing during the holidays, there may be ways to stay in touch with those you love. Examples: virtual meet-ups, Facetime calls, drive-thru visits, etc.

2) Beware of idle time. Idle minds are the breeding grounds for wandering thoughts that can increase negative feelings and thoughts. Identify and implement coping activities of interests in order to occupy your time and give your mind productive focus: journaling, talking to a friend, listening to music, art, exercise, games, volunteering, etc.

3) Make a gratitude list or keep a gratitude journal. Bringing your focus and awareness to positive things in your life, such as your character assets, emotional and physical resources, and any other supports will foster a more positive outlook and highlight your strengths even in dismal situations.

4) Identify your personal values. Do you value self-development, fitness, authenticity, connection, adventure, forgiveness, for example? Make sure that your values are tangibly represented in various aspects of your life (e.g. career, personal health, relationships, etc). According to Acceptance Commitment Therapy, those that live their lives in accordance with their values tend to be more satisfied with their lives. Find productive ways to engage your body, mind, emotions, and spirit that is affirmative and encouraging.

5) If you are having difficulty with this holiday season, please reach out for further support. Speak to a counselor, your doctor, and/or loved-ones. Don’t isolate and keep silent. If you are in crisis, remember there are services available during the holidays and 24/7 that allow for anonymity and promote safety. See below:

National Suicide Prevention Lifeline: 1-800-273-8255    https://suicidepreventionlifeline.org/

Georgia Crisis and Access Line: 1-800-715-4225 https://behavioralhealthlink.com/services/crisis-contact-center/

Other Resources:
Mental Health America of Georgia: https://www.mhageorgia.org/getting-help/

National Alliance on Mental Illness: https://namiga.org/

Substance Abuse and Mental Health Administration Treatment Locator: https://www.samhsa.gov/find-treatment

From our practice to you, Happy Thanksgiving! Have a safe holiday.

Anxiety & Coronavirus

If coronavirus scares you, read this to take control over your health anxiety

(*By The Guardian)

A pandemic is fertile ground for those who suffer from anxiety – here’s a short guide on how to manage it.

1) Avoid the (health-related) news: Try having a news detox, or allocating yourself a time limit for reading or watching news. If you’re really worried about missing something crucial, you can always tell friends and family to contact you in the event of an emergency situation in order to keep you informed.

2) Try not to seek constant reassurance: Your brain creates a feedback cycle where you become increasingly reliant on reassurance, which only serves to reinforce the anxiety. It’s natural to want your loved ones to tell you things will be OK, but when you start needing that reassurance several times a day it’s time to take a step back.

3) Introduce an absolute ban on Googling symptoms: Dr Google is not, and never will be, your friend, especially not when you are a sufferer of health anxiety. Nor will message-boards and forums.

4) Try a countering technique: This is a CBT exercise which involves giving a persistent thought the courtroom treatment, by confronting it with a rational counter-statement. For example, if your persistent thought is something like “Everyone I love will die from this virus” you can counter it with factual statements such as “Actually, most people who get Covid-19 are likely to make a full recovery. “Just because you think something, doesn’t make it true.”

5) Do some exercise: Even if it’s just star jumps in your bedroom, exercise will help get the adrenaline out of your system and channel the panic elsewhere.

6) Breathing and grounding exercises: From guided yogic breathing to using a strong smell (I favored lavender oil), grounding exercises can help bring you back to reality.

7) Allocate yourself a daily “worry period”: Give yourself half an hour to worry about this to your heart’s content, and then you have to go and do something else.

8) Treat yourself: Anything that will give you a little boost can help. It doesn’t need to involve spending money: you can also cook yourself something nice, have a hot bath, or listen to a song you love.

9) Remember that your anxious state isn’t permanent: When you are in it, anxiety always feels as though it will never end, but it will. It’s hard to remember this, but do try. Be kind to yourself. It may be a bit cheesy, but this too shall pass.

 

*For complete article go to:

https://www.theguardian.com/society/2020/mar/16/coronavirus-health-anxiety

Just one change

New Years is a time were most of us try to make life changes and promises to have a healthier and happier year. We are fueled by commercials for diet or exercise programs and travel destinations. Those promises often require quite a lot of change in lifestyle and are hard to maintain. By March, folks feel like they have let themselves down and are back to a rut.

Let’s take a new approach. Commit to making one change. Improve one relationship with better communication, better boundaries, more focus. Or, maybe, work 4 less hours a week and use those hours for yourself. Maybe you cook that new healthy recipe once a week. The point is, make success achievable, and then achieve that success. Allow the fruit of this one change to be corner you need to turn for a greater overall life.

On your way to larger life goals, start small and feel good enough with that. Next year the change can be bigger or you can set two achievable goals instead of just one. Life is a marathon, not a sprint. Focus on a hill you can climb now and save some endurance for  bigger hills as your discipline improves.

Keep Calm and Listen to Music

Keep calm and carry on? How about keep calm and listen to music?

Research reported in HEART, a British medical publication, shows that calming music causes the heart rate and breathing to slow down. This often leads to a relaxation response.  Slower breathing also relates to lower blood pressure.

The next time you need to relax, consider listening to some slow music and see if you notice your breathing and heart rate decrease.

Presentation1

Source: HEART Journal

Sleep Hygiene

Insomnia is a common issue so I wanted to give you a tip sheet on good sleep hygiene.

Sleep hygiene is a combination of your behaviors and environment surrounding sleep.

Lack of quality sleep affects your mood. It also lowers your pain threshold, increases your blood pressure, and interferes with your memory. It harms your immune system, elevating your chances of getting sick. It diminishes your ability to concentrate, and makes you more impulsive. It can also cause weight gain.

How to improve the quality of your sleep?

Here is a summary of 14 suggestions given in Fix Your Sleep Hygiene by Dr Korb.

1. Go to bed at the same time every day.

The reason for going to sleep at the same time is that your brain releases melatonin about 30 minutes before it thinks you want to go to sleep. If it doesn’t know when you’re gonna go to sleep it can’t do that.

2. Avoid bright lights after the sun goes down.

The melatonin that prepares you for sleep is inhibited by bright light so when it’s getting close to bed time turn off most of the lights in your house .

3. During the day stay in a brightly lit environment.

The melatonin cycle is part of a hormonal package collectively called circadian rhythms, controlled by a region of the brain known as the suprachiasmatic nucleus of the hypothalaums , which projects to the pineal gland to release various hormones. These rhythms are synchronized by bright lights during the day. So take a few minutes to go walking in the sunshine. This has the added benefit of boosting your serotonin, which may be why it helps sleep, as melatonin is derived from serotonin.

4. Sleep for 8 hours straight.

Your brain needs to cycle through various stages of sleep (Stages 1 to 4 and then REM sleep). Each cycle takes about 90 minutes, so in about 8 hours you get the appropriate number of cycles. If you wake up in the middle of a cycle you don’t feel rested. Your brain needs to know how much time it has to get everything done it needs to. In general the older you are the less sleep you need. In college you need about 8 hours and 24 minutes (approximately). When you start drawing Social Security you might only need 7.

5.  Use your bed/bedroom for sleeping, not doing work.

That way your brain associates your bed only with sleep, and it will induce sleepiness like Pavlovian conditioning.

6. Make your environment comfortable.

Sleep requires down-regulation of the sympathetic nervous system, which is harder if you’re uncomfortable. If your room is too cold, or too hot, or too noisy, or too smelly, then do something about it. If it’s something you can’t change, then just accept it.

7. Don’t take naps.

Taking a nap will often make it difficult to fall asleep at your bedtime. If you must nap, keep your nap between 20-30 min. This may surprise you, but if you actually consistently get quality sleep, you won’t even feel the need to take a nap.

8. Create a routine for preparing for sleep.

Do it every night. This helps you separate yourself from the hectic nature of the rest of your day. It prepares your brain for sleep.  A bedtime ritual might be brush your teeth, wash your face, go to the bathroom, and then read for a few minutes. These should be non-stressful activities. If you have a really hard time falling asleep, then include some meditation as part of your routine.

9. If you find you’re stressing over all the things you have to do, then write them down.

Your prefrontal cortex is responsible for keeping all these things in your working memory, and worrying about forgetting them is stressful. That stress inhibits sleep. Write it down so you don’t need to keep your prefrontal cortex working overtime.

10. Just chill.

Just relax, and lie still in a comfortable position. If after 20 minutes or so you’re still not asleep, then go to another room. Do something relaxing for a little bit (no more than 20 minutes), then try again.

11. Avoid caffeine near bed time. Duh.

12. Don’t eat a large meal less than 3 hours before bedtime. 

Indigestion can interfere with sleep, and acid reflux is more common once you’re horizontal.

13. Don’t use alcohol as a regular sleep aid.

While it may help you fall asleep, it disrupts the patterns of brain activity while you’re asleep. That means your sleep is not as restful as it could be.

14. Exercise.

Exercise is pretty much good for everything. Make physical activity a regular part of your life. The exact role of exercise in improving sleep though is not well understood. It may be due to increased levels of the neuropeptide orexin, which is essential for appropriate sleep regulation. It may also be due to the effects of exercise synchronizing circadian rhythms, or stress reduction, or some combination of several factors. Regardless of the reason though, it is clear that aerobic exercise helps improve sleep. Exercising too close to bedtime may make it difficult to fall asleep though, so try to do it a few hours before.

New Secure Messaging System

1 Alliance CPS is proud to introduce our new Secure Messaging System.

You can send a secure message directly to your therapist via our website under the Contact Us – Messaging.

This is part of our constant effort to be available to you and easily accessed. We continue to improve our website to fit your needs. Please keep in mind this is a  Beta version and feel free to provide us with any feedback.

Thank you for choosing 1 Alliance CPS!

 

 

 

Progressive Muscle Relaxation

Progressive muscle relaxation (PMR), also known as deep muscle relaxation, is a technique for reducing anxiety by alternately tensing and relaxing the muscles. This technique is based on the idea that one can reduce anxiety by learning how to relax the muscular tension.

To use this technique one has to use both body and mind. The muscle groups of the body are tensed for about 10 seconds and then relaxed for about 20 seconds in a sequential order. At the same time, the mind concentrates on the difference between the feelings of tension and relaxation. If the mind wonders to different thoughts, one just has to bring it back to how the body feels at that moment.

Practicing PMR teaches one how to relax and manage feelings of anxiety. Please see the script bellow as an example of PMR. Feel free to record yourself reading the script. Then play it back and follow it along.

Remember to always listen to your body and consult a physician if you are not sure you can safely perform those actions in the script.

Progressive Muscle Relaxation Script

Get comfortable on floor or in a chair and close your eyes. Breathe into your diaphragm deeply and slowly. In and Out. In and out.

We are going to begin with you arms. Curl your fingers into a tight fist, bend your elbow and flex the front and backs of your upper arm.

Count:

  • Hold it…5…4…Notice the sensation of tension…3… feel what it is like to be tense…2…1 Release.
  • Now relax. 10…let the tension flow out of your arms…9…8…7…notice how the burning of the tension is flowing out…6…5…4…3…notice how relaxed and loose your arms and hands feel…2…1.
  • Flex your fists and arms again. Hold it…5…4…3… feel what it is like to be tense…2…1 Release.
  • Now we are going to move on to the head and face. Scrunch up your face as tight as you can, flex all the muscles in your face. (Repeat the counts again. Hold for a 5 count relax for a 10 count. 2 repetitions for each body part.)
  • Next the neck. Bring you chin as low to your collarbone as possible. Leave your chin there but also push the back of your head back as much as possible. (Repeat the counts again. Hold for a 5 count relax for a 10 count. 2 repetitions for each body part.)
  • Next the shoulders. Try to touch your shoulder blades together. Now shrug your shoulder up so that you shoulders are near your ears. Make sure that your fingers; lower arms, upper arms, face, head and neck are all still relaxed. (Repeat the counts again. Hold for a 5 count relax for a 10 count. 2 repetitions for each body part.)
  • Not you’re going to tighten up your torso. Take in a deep breath and hold it. Tighten up your stomach muscles as though you are about to be punched. (The counts are faster because you are holding your breath. Repeat the counts again. Hold for a 5 count relax for a 10 count. 2 repetitions for each body part.)
  • Now we will do your legs. Lock your knees, flex your thighs and buttocks and point your toes. (Repeat the counts again. Hold for a 5 count relax for a 10 count. 2 repetitions for each body part.)
  • Once again breath deeply and slowly, relaxing your entire body. Make sure that your fingers; lower arms, upper arms, face, head, neck, shoulders, stomach, chest, and legs are all still relaxed.
  • Now imagine that you are in a safe place. Picture that place as clearly as you can. Look around yourself at this place. Listen to the sounds that are there. Pay attention to the smells; try to actually imagine the smells that would be there. Feel with you hands what this place is like.
  • I am going to count back from ten. With each count imagine that you are becoming more and more relaxed. 10…9…8…more relaxed…7…6…5…Even more relaxed…4…3…2…1
  • Enjoy where you are and open your eyes whenever you are ready.

Stress Management Basics

What is Stress?

Stress is a reaction to any change to which we have to adapt. It is a natural and important part of life. Stress becomes a problem when it is too much and/or for too long.

Too Many Demands on Energy and Resources over a Long Period of Time + High Expectations for your Performance and Deep Commitment to Your Work + Few Actions Taken to Replenish your Capacities = BURNOUT

How to Manage Stress?

We can cope with stress by reducing our perceived stress level or increasing our ability to cope with stress. Common stress management techniques are deep breathing, muscle relaxation, visualization and meditation (e.g. mindfulness).

Stress Management Quick Tip:

TO RELAX. Deep Breathing

Throughout the day, take “mini-breaks”. Sit down and get comfortable.
Slowly take in a deep breath counting to 3; hold it counting to 6; and then exhale very slowly counting to 6. See picture for correct inhaling and exhaling body mechanics. At the same time, let your shoulder muscles droop, concentrate only on your breathing. Concentrating only in your breathing and clearing your mind is the key to this exercise. By controlling your breathing you control your heart rate and your body’s response.

Because we tend to take shallow breaths when anxious, deep breathing can make people feel lightheaded because of the increased oxygen intake. Please make sure you remain seated for at least 1 minute before getting up.

Notice your anxiety cues and use deep breathing as soon as possible. The sooner you use this stress management technique, the easier it is to prevent your anxiety to escalate.

Deep breathing is a powerful technique that with practice and guidance can even help you stop a panic attack. As with most things, with daily practice it gets easier to successfully apply this technique.

Resource and Reference: Write Your Own Prescription for Stress by Kenneth B. Matheny.