A Conversation with the Voices in my Head

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Let me introduce you to my new friend.

Went to a yoga class last week. It was awesome, the first one I’ve been to in forever. It also happened to be at the end of a three day juice fast AKA get-off-the-caffeine cleanse. More on that later. It was at the end of class, when we lay down in Sivassana, or Corpse pose, flat on our backs with our eyes closed, that the voice started talking to me.

“It’s no use, you’ll never relax,” the voice taunted. I looked and I saw him, there in my head. A little man, a bit like a gnome, a miniature tweaked out stress freak. Greenish wrinkly skin that accentuated every bone in his wiry body, big bugged out wicked-looking glowing eyes.

I sighed. “You again,” and I felt my body tense up, fighting gravity, resisting the gentle lull of letting go.

Then I remembered something I read once by the Vietnamese Zen teacher Thich Nhat Hanh. I can’t find the exact quote, but the basic idea is to invite your challenging feelings in for a cup of tea, figuratively speaking. Welcome them into your home and embrace them.

“Come on in,” I said, “Have some tea,” and I whipped up an imaginary magical sedating elixir.

He stood motionless, eyeing me suspiciously.

I held his eye contact steadily, consciously working to see past his appalling presentation, because I know he has something of value to offer me. He has to. “You know, you don’t have to be so stressed out,” I said. “I know it’s your job and all, but you don’t have to do it.”

“Lady,” he said, shaking his head, “You gotta stop sending me mixed messages.” And he took a sip of tea. “Yum.” He exhaled and relaxed. I relaxed.

I reflected on that. There is something in my subconscious mind that believes I need to be stressed out, that I need to try so hard all the damn time. And that part of me calls this tweaker to do the job, and he makes my life hell.

The other part is the caffeine habit. I find myself having such an attachment to caffeine, such an impulse to consume it all the time. I sometimes believe I need it to function, that I can’t just let myself get through a wave of tiredness, relax and rest into it. The caffeine summons this little green mean machine, as well. He comes and fills me with energy, which is great. But then, when it’s time to wind down and rest, he’s still there, contracting my muscles and chasing my thoughts around in circles.

Always on. Always up. Always energized.

Exhale. I gave the stressball a refresher on his tea. “You’re right,” I said. “I do need to work that out.”

He drank more tea. I relaxed more deeply. “This is nice,” he said, reclining on my chaise lounge. “I could get used to this.”

My body melted further into the floor. And I remembered that the bliss of relaxation is so much more deliciously fulfilling than the high of adrenaline.

I decided on my new mantra: EFFORTLESSNESS

I poured a cup of the tea for myself and drank deeply. Slow inhale. Long exhale. “It is nice. I could get used to it, too.” I turned to the green man and smiled. He smiled back, a slow lazy smile.

I closed my eyes and all thoughts disappeared.

Awesome photo credit: http://www.tumblr.com/tagged/central%20africa

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7 Ways to Heal from Stress and PTSD

A few weeks ago, I wrote about the damaging effects of chronic, overwhelming stress. Today, I will follow this up with some ways I learned to heal from these conditions. This all came from a very informative PTSD training with John Preston, Psy.D.

1. Hold and be held. Particularly with babies, tactile stimulation does wonders. In one study, a control group held babies for two hours a day while an experimental group held babies for four hours a day. After six weeks, the babies in the experimental group cried 43% less. This applies cross-culturally. Babies who are held more are least likely to develop PTSD or hypercortisolemia. While the first year is so critical for lifelong brain development, I don’t think human touch ever becomes less essential. Sure, maybe we don’t need four hours a day, but hugs, cuddles, and massages go a long way.

2. Medication. I am not one to believe in going straight for the magic pill, but there are several medications that can be helpful if you are feeling very overwhelmed or out of control. Several types of medication can activate Brain-Derived Neurotropic Factor (BDNF), which strengthens neural pathways and can protect the brain from damage by extreme stress. All antidepressants activate BDNF (this is their one common denominator). Others that can be used for this purpose are Lithium, Depakote, Tegratol, Lamictal, and Seroquel. And guess what? Omega-3 fatty acids are also neural-protective. If you think you may need medication, of course talk with your doctor or psychiatrist.

3. Movement. Exercise also activates the neural pathway protector BDNF. It increases seratonin levels as well. Much of the feeling of PTSD is that of being “frozen.” Movement of any kind can immediately snap one out of that feeling.

4. Make choices that increase safety and structure in your daily life. In events of trauma and abuse/neglect, a common theme is powerlessness. Looking at brain chemistry, BDNF decreases when an individual experiences perceived powerlessness. Of course, it is not possible to always be in control of one’s circumstances, but it is possible to make choices that increases the chances of safety. It is also possible to have a regular schedule that increases predictability in your daily life. This will help. If this point interests you, look into the Seeking Safety program.

5. Mindfulness-based stress reduction. I love this one. It is a form of meditation and  consists of simple exercises one can do  to increase one’s mindfulness, which strengthens the brain and increases one’s ability to have control over where attention is placed. There is a lot of good science out there showing that this stuff really works.

6. Facing fears. The act of facing fears actually increases the frontal lobe’s ability to dampen down anxiety. It also gives one a restored sense of self-efficacy and control. When I am at my best, I try to face one fear every day. it is amazingly uplifting.

7. Exposure therapy. This can be useful for people who have been traumatized and feel strong enough to face their trauma. It is one of the most common therapies used for PTSD. Research has shown that exposure therapy strengthens the Arterial Cingulate (AC) and expands neural pathways between the AC and amygdala (remember the top-down control dampening down the anxiety/arousal I talked about last time?). Being able to look at the traumatic event while calm and centered in the present gives one the ability to handle stressful situations more effectively. It also minimizes the effect of the trauma. However, this needs to be executed carefully. An individual needs to learn emotional management skills before he/she begins this work in order to avoid re-traumatization.

Did you know stress can cause brain damage?

ImageI went to a training on Post Traumatic Stress Disorder (PTSD) recently. I did learn quite a bit about how to treat PTSD, but the presenter’s information about the effects of chronic and/or severe stress was what really struck me and stuck with me. So, I am going to blather a bit, and it may be somewhat technical, but I need to get this down on the page in order to internalize the info a bit more, if you know what I mean. Hopefully, some of you will find it interesting and learn from it as well.

Many of us have probably heard of the stress-related hormone cortisol. I myself have heard a lot about how it causes belly fat. What I didn’t know was that chronically high levels of cortisol can cause a condition called Hypercortisolemia. Quite a mouthful, right? Here’s the thing: there are two very important structures in the brain that help us to regulate our emotions (the Arterial Cingulate, or AC, and the Hippocampus). These structures are packed with cortisol receptors, and if they care constantly being bombarded with cortisol, they become damaged and unable to do their job properly. This is hypercortisolemia.

I am talking lifelong effects, especially when this occurs in young, developing brains.

Impacts of hypercortisolemia:

1) The Artertial Cingulate (AC) has top down control over the amygdala. You know that reptilian part of your brain that gets triggered in the present because something reminds you of painful memories from the past, even when you know things have changed, but you’re still tripping? That’s the amygdala working. It never forgets, but isn’t always rational. So basically the AC is the structure that tells the amygdala, “Calm down, relax, that was then, this is now.” If the AC is damaged, the amygdala is hyperactive (oh, please, god, no), and anxiety goes up.

2) The risk of depression goes up from a 15% chance (general population) to a whopping 58% chance. Not fun.

3) Some of the other clinical outcomes include severe personality disorders (especially borderline, for you other psych nerds out there), attachment problems, vulnerability to PTSD, and chronic PTSD.

Obviously this is serious. Take a big breath of relief, because most people will not get this condition. It is not generally caused by your run of the mill everyday stress.

Causes/ Risk Factors of Hypercortisolemia:

1) Ongoing trauma or chronic stress

2) Prenatal conditions: Cortisol can cross the placental barrier and damage a developing brain. Depressed or chronically stressed pregnant women need to have their cortisol levels screened and take anti-depressants if they are high.

3) Severe neglect

Now I am going to go on a bit of a tangent and talk a little bit about severe neglect, as the effects are quite tragic. Some of the behavioral symptoms of severe neglect include hypersensitivity (reacting more strongly to stress and taking longer to calm down), self-mutilation, and aggression.

Another symptom of severe neglect is alcohol abuse. Even in studies with primates, all of the monkeys were given alcohol, and it was the neglected monkeys who drank regularly and excessively.

Individuals who have experienced severe neglect also are more likely to have lifelong attachment problems. Studies on primates also show that neglected monkeys are not accepted, as they do not know how to read social cues. Neglected monkeys will have no mates. If they are inseminated, they will not take care of their babies (as a side note, this makes me kind of want to hurt whatever researchers felt the need to so deeply damage these poor monkeys).

Severe neglect can also cause lifelong neurobiological changes. Cortisol goes up (increased anxiety, depression, and lack of deep sleep). Seratonin goes down (more irritability, anxiety, impulsivity). Oxytocin goes down (causing problems with developing healthy attachments).

Another uplifting animal study: Infant rats were separated from their mothers for six hours a day very early in life. Another group was also separated, but continued to receive tactile stimulation. The control group was left to bond with their mommies. After a bit of all this, these amazing researchers threw all of the rats in a tub of water. Guess what? Those rats that stayed with their mommies and those rats that continued to receive tactile stimulation both fought for their little rat lives for TWICE as long.

Obviously, it is the very young brain that is most at risk here. However, experiencing trauma also happens to quite a lot of us, more than I like to believe is true.

Take home message? Take care of your baby. Get checked out if you are pregnant and tend toward depression or have a lot of stress in your life right now (but don’t stress!). If you do go through something traumatic, ask for help if you are feeling you are not getting over it after a month or so.

I am going to wrap up this highly uplifting post right now, but I will be back with some ways that you can deal with and heal this fun stuff.

Don’t Take Anything Personally

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I know I’ve mentioned recently that I have been using hypnosis to help me stop grinding my teeth. There are a lot of theories as to why people grind their teeth. The ones I have heard the most are: an unaligned bite, stress/anxiety, and repressed anger.

I think all of these apply to me, but the one I have found myself wanting to explore the most is repressed anger. Earlier in my life, I was pretty passive, and I had to learn through experience to stick up for myself. Part of this was owning my anger. I realized that anger is raw passion, waiting to be harnessed as a powerful creative force. I learned to listen to my anger, to let it tell me where my boundaries lay, to let it teach me how to protect myself from predators.

Time has passed. I have grown older, stronger, and more confident in myself. I have moved beyond individuation and into service. I felt good with myself, satisfied with my own personal quest, and decided it was time to give myself to my career and my family.

I had a baby. And I fell in love looking at his innocent face in those early days, and was sure he could do no wrong, ever. I would look at older kids, making trouble, and knew my kid would never act like that. Nope. Not my angel.

He’s changed. I mentioned before that I think he just got his 4-year testosterone flood a bit early, and I am having a really, really hard time right now. The yelling in my face, the hitting, the throwing. The, “One more chance,” pleas a countless number of times. I have been trying everything I have up my sleeve: offering incentives, using consequences, talking, asking him what he needs, giving more attention, behavior charts…I could keep going. In short, I have used everything I know except physical discipline, but I have to admit, there have been plenty of impulses to use that, too. It is only my personal pledge and plenty of willpower that stop me from going that way. And my husband, of course, who grabs the wheel when I feel myself going off course.

I don’t know if I am being too hard or too soft. Should I just never give him any second chances, maybe? Have I leaned on that too many times, so that he does not respect the limits I am setting? Or maybe I am being too hard. He’s in his room crying right now, way past his bedtime. I put up the gate and let him know that one more hug means one more hug, and he needs to go to sleep now so Mommy can unwind.

I feel so bad, seeing him stressed out and alone in his room, just wanting closeness and comfort, and I wonder if I should just let him come into my room so that he feels completely safe and supported, because, you know, that’s what the attachment parenting method preaches. And I feel incredibly frustrated because I just need some down time, and I am not getting it, because he is testing me to my core.

Back to the repressed anger and the teeth grinding. Yesterday, I was having a great day. Great mood, optimistic, productive, grateful. Last night with the little guy was a wringer. I can’t even remember right now, or don’t want to, but I ended up using every consequence I have yet to use. We are in this standoff right now, it seems, regarding who’s the boss, and I know he needs authority, but I also feel like I am breaking his spirit.

Anyway, by the end of the night, I noticed my jaw was incredibly tight. Talk about repressed anger. I can’t throw my anger at my child, I know, I need to keep a hold on it, and it is ending up in my jaw. I have been getting incredibly frustrating with this little guy who has somehow already learned exactly how to press my buttons.

And then there’s compassion. And taking a step away and seeing things from a different angle. I’ve been thinking (after he finally gets to sleep), that maybe it’s not about finding an outlet for repressed anger. Maybe it’s about not getting angry in the first place.

A while back, I read a book called The Four Agreements. I am sure that many of you know this book. One of the agreements is, “Don’t take anything personally.”

A lot of this getting angry stuff is all about me taking things personally. A lot of the stress and anxiety is about me taking things personally. In fact, I may even go so far to say that ALL of the anxiety, stress, and anger I experience is completely about me taking things personally.

A client at work likes me, or doesn’t like me, or does well, or fails horribly, and I take it all personally. I hold myself responsible for all of this, doubting that I am good enough, skilled enough, knowledgeable enough to be a resource for them. News flash: it’s not about me! And when I indulge in these anxious self-doubts, I am taking away from the absolutely BRILLIANT work that I do with these amazing, totally capable individuals.

My kid acts out, testing limits, as is completely developmentally appropriate, and I think, “He is doing this to me.” A car cuts me off in traffic, and I get pissed about them disrespecting me, instead of thinking maybe they’re just in a big hurry, or maybe they’re just generally inconsiderate, and does it really have to ruin my moment, this moment that I will never have again? Do I really need to miss this speck of time when my son will be this small, because I am busy brooding about how he is acting disrespectfully? Maybe, just maybe, can I give him limits without engaging in a power struggle in which no one can win?

So, I pledge it now, and I will hold myself to it. Do Not Take Anything Personally. Nothing. It is not about me. Even if someone has a problem with me, it’s not me. It’s just one of the traits that I exhibit. Constructive criticism is merely a tool I can use to refine my character. It is not about me. It is not about me. It is not about me.

By the way, in the middle of this post, I did finally go make peace with my son, and I think (dear God, hope!) he is sleeping.

Wish me strength, readers, and lots of patience. 🙂

Perfectionism

I’ve been studying the Bible of treatments for anxiety and phobias lately (also known as the Anxiety and Phobia Workbook), for my work, but the thing I love about my job is how much everything I learn along the way can be applied to my life, or just about anyone’s for that matter. What I would like to share from that book, over a few posts, are the four personality traits most linked to the experience of anxiety. Tonight, folks, it’s all about perfectionism.

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“Forget your perfect offering. There’s a crack in everything. That’s how the light gets in.”  -Leonard Cohen

Perfectionism is all about having high sky-high expectations (that are never met), and the inevitable disappointment that comes from focusing on small flaws and mistakes. Perfectionists tend to become so critical, that they are not able to see the positive. Perfectionistic thinking leads to low self-esteem. You try sooo hard, but always fail (because of that one small mistake you made on the way to glory), and therefore are a good-for-nothing nobody. Perfectionists will also completely stress themselves out and often become completely burnt out, just trying to be good enough, constantly fighting this inner critic that will never be satisfied.

Sound familiar at all?

If your answer is yes, here are some steps for shifting your attitude. 

  1. Let go of the idea that your worth is determined by your achievements and accomplishments. That’s right, you are good enough, just being you, doing absolutely nothing at all. Say that to yourself now. “I am good enough. I don’t have to strive to be anything. I am inherently good and worthy.” Stop comparing yourself to others. We all have unique gifts and it only takes the right circumstance to bring them out. Consider this quote by Alice Miller, who wrote the Drama of the Gifted Child. “One is free from depression when self-esteem is based on the authenticity of one’s own feelings and not on the possession of certain qualities.” 
  2. Recognize and overcome perfectionistic ways of thinking. Get a notebook, and listen to the way you talk to yourself. When you hear yourself “shoulding” on yourself, write it down. If you hear yourself using all-or nothing thinking (such as, If I can’t do this all right now, I’ll never get it done.), write it down. Finally, if you find yourself overgeneralizing in a negative sort of way (I messed up, just like I always do, or I made a mistake, which means I can never ever do anything right.), write it down. After you have a good idea of the specific ways you beat yourself up, write down some statements that counter these negative ones (Everyone makes mistakes and learns from them. I did one thing wrong, but I did alot of things right; I will do the best I can; I don’t have to finish this all now. I can do part of it now, and the rest later.) Post these new, more forgiving statements where you will see them. Write them down over and over. Say them out loud to yourself, very slowly, every single day.
  3. Focus on Positives. Take inventory every day of everything positive you accomplished. Notice when you disqualify a positive statement, with a “but…,” and stop yourself.
  4. Stop magnifying the importance of small errors. Seriously, how important is it? Enough to lose sleep? Enough to drive yourself crazy? We all make mistakes. I make one at least every minute. Haven’t you heard the famous quote? “The road to success is paved with failure.” -Unknown
  5. Work on goals that are realistic. If you’re not sure what realistic is, do some reality checking. Talk to people around you. Ask them if it seems attainable to them. If you continuously set goals you fail to attain, it’s time to break them into smaller pieces and give yourself more time. We all have limits. Accept yours.
  6. Cultivate more pleasure and recreation in your life. My favorite!!! Perfectionism tends to make us rigidly focused on attaining goals, denying our need for unstructured time, and as a result, our luscious creative life-force becomes stifled. Who wants that? Not me. So, take a break. Make a list of things you like to do just because they bring you joy or comfort. Do one of those things every day!
  7. Develop a process orientation. That old cliche about the journey being more important than the destination? It. Is. So. True. If nothing else, remember this. Everything continuously evolves. There will be a-ha moments when everything feels perfect and clear, and then there will be challenging lessons. Mostly, there will be challenging lessons. Focus your hunger on the growth, the learning, instead of the finished product. You will be much more satisfied that way. You will be more content, more relaxed, and more accepting of your mistakes. I promise.