Category: <span>Therapy</span>

Men’s Health: Strength & Courage in Pursuit of Mental Wellness

Written by: Dr. Darren Jones, PhD, LP
Edited by: Dr. Julie Braciszewski, PhD, LP

Currently, men are experiencing mental health distress at alarmingly high rates. This distress may look different than stereotypical anxiety or depression, but causes just as much disruption in life. Research tells us that men tend to focus distress outward, engaging in externalizing behaviors such as initiating more relationship conflict, throwing themselves into work, using alcohol or other substances, and/or increasing time spent on ‘escape’ type activities such as video games.  Despite how disruptive these behaviors might be to their lives, men are far less likely than others to seek help. One of the main reasons is due to the stigma associated with seeking mental health services. Though there has been notable progress in reducing the stigma of seeking mental health services in recent years, there is still much work to be done.

Where Does Stigma Come From?

On average boys receive less social emotional coaching as compared to girls. Throughout childhood, adolescence, and into manhood, men receive messages that often inhibit and even punish genuine emotional expression and help seeking. This creates significant barriers to acknowledging distress and seeking effective help. In fact, we know men are currently suffering from high rates of anxiety and depression. In a 2021 survey, 82% of U.S. men ages 25-45 reported moderate to severe feelings of stress, 73% reported symptoms of anxiety, and over 61% reported symptoms of depression. Given that the last several years have increased most individual’s stress, and mental health distress is at an all time high, we must battle the stereotypes that keep men from getting effective care.

A research article published earlier this year in the American Journal of Men’s Health addresses this important topic. The authors reviewed published research from the past decade on the stigma surrounding men’s mental health. They reported that a consistent finding was that men frequently internalize a stereotyped male identity that assumes that being a man means being strong, self-reliant, and healthy. Internalizing means that men often self-identify with and judge themselves against these ‘standards’. These same stereotypes view men with mental health issues as being weak, inadequate, and unmanly. These stereotypes contribute to stigma that creates a barrier for men to access and engage in mental health treatment.

The good news is that all men can play a valuable role in reducing this stigma. The authors describe three promising strategies to pursue.

Peer Support Breaks Stereotypes

First, the role of peer support is vital. Men who experience mental health issues can serve as important sources of support for other men who need services. Setting up formal peer support networks are one way that organizations and communities can encourage and facilitate these connections. However, on a more personal level, informing your friends, dad, uncles, neighbors and coworkers that you are experiencing mental health distress and are seeking out mental health support can also facilitate peer support. Sharing your experiences draws these peer support networks together and more men in your life are likely to seek the support they deserve.

Mental Health Literacy Among Men

Second, mental health literacy can be improved by creating opportunities for men to have interactions with mental health professionals that include positive messaging. Consider inviting a mental health professional to deliver a presentation to your company, church, or social group. If you have engaged in mental health support, share your knowledge of the process and services.

Help Seeking is Strong and Courageous

Third, when men seek help for mental health issues we should frame that behavior as strength- based and courageous. Let your sons, brothers, friends, and co-workers know that you support them and view their seeking help as a positive and laudatory action.

Men may be socialized to inhibit emotional expression and may be taught fewer or less varied coping skills while growing up. But this doesn’t have to get in the way of obtaining the services and support they need to experience happiness, security, and growth. With rates of mental health distress so high currently, all men have an important opportunity to reduce stigma and play a positive role in helping more people access the care that they need.

 

How Do We Know ADHD is a REAL Disorder?

 

 

Anastasia Skobkareva, MA.
Dr. Julie Braciszewski, PhD.

Some people may think that ADHD is just a set of habits or a quirky personality type, but the truth is far more in-depth and interesting ADHD is a neurodevelopmental disorder that first appears in childhood and continues to affect individuals throughout adulthood. The label neurodevelopmental means that ADHD stems from differences in brain development. These differences in brain development result in difficulties with emotional and behavioral control as well as the brain processes responsible for planning, organizing, and executing tasks. Of course, most people have difficulties with inattention, overactivity, or impulsiveness at times. What distinguishes individuals with ADHD from those without the disorder, is the far greater frequency and severity with which these behavioral and emotional patterns occur, and the far greater impairment these difficulties cause in many areas of life, such as school, home, work, and relationships. ADHD is primarily a disorder of the cognitive abilities needed for self-regulation. These cognitive, or mental abilities are called executive functions and are the fundamental brain processes responsible for organizing goal driven behavior and inhibiting impulses. Individuals with ADHD struggle to remember what needs to be done, make a plan, conceptualize and manage time, remember and follow constraints and rules, identify ways to overcome obstacles, and experience extreme variability in their responses to situations. They also struggle to switch between tasks or situations, inhibit off task or ineffective behavior, and modulate emotional responding. Getting an accurate diagnosis of ADHD can be tricky because several other disorders have overlapping behavioral and emotional symptoms. Because of this, it’s important to understand how we know ADHD is a real disorder, and how we go about making an accurate diagnosis.

How do we know that ADHD is a REAL disorder?

Many people ask, how do you know ADHD is a real disorder? How do you know these difficulties aren’t just ‘bad’ behavior, ‘bad’ habits, or a ‘difficult’ personality? To answer this, we turn to the last several decades of brain research on ADHD. Research clearly and repeatedly indicates that the ADHD brain is developing differently from the non-ADHD brain. When we look at groups of hundreds or even thousands of ADHD brains compared to non-ADHD brains, the differences in brain development between the groups are very clear. This profile of brain development differences is distinct and does not mirror any other disorder or injury. It is incredibly important to dispel any ideas that ADHD is due to an individual simply not trying hard enough or poor behavioral management. Instead, individuals with ADHD, and parents raising kids with ADHD, are often the hardest working people in the room! So why can’t we diagnose ADHD with brain imaging like a CAT scan or MRI? The truth is, ADHD affects several areas and functions of the brain and is a disorder with a wide range of symptoms and presentations. Although we can tell the difference between groups of brains very clearly, when just looking at one individual’s brain imaging results, the information just isn’t enough to ‘see’ ADHD clearly. This is actually the case for many medical disorders and diagnoses that originate or involve the brain. Many disorders can not be detected by brain imaging alone and require further testing, often by a psychologist or medical professional. To diagnose ADHD we use a battery of tests that assess these specific areas of brain functioning, and also rule out all other disorders that have common symptoms with ADHD, such as anxiety disorders and learning disorders. This type of assessment, a neuropsychological assessment, is an accurate way to diagnose ADHD in both children and adults.

What Causes ADHD?

Research suggests that ADHD is a result of one or more issues that affect brain development. In the majority of cases, ADHD brain differences are due to genetics; inherited from parents. In recent years, specific genes and gene mutations have even been identified as likely causing or contributing significantly to ADHD. However, in a minority of cases, brain development delays are due to subtle brain injuries or exposure to substances or toxins that occurs during gestation, birth, or early childhood. We also know that getting the correct treatment helps brain areas affected by ADHD to develop further.

How are ADHD brains developing differently?

We know ADHD is a real disorder and that ADHD brains are developing differently, but in what ways? The brains of individuals with ADHD have structural and functional differences, as well as differences in brain chemistry when compared to typically developing brains.

Brain Activity

Studies using an electroencephalograph (EEG), which measures brain activity, indicate that the electrical activity in brains of children with ADHD is lower than that of typically developing children. Specifically, children with ADHD have an increased amount of slow-wave brain activity which is often associated with immaturity of the brain, drowsiness, and lack of concentration. Children with ADHD have also been found to have less blood flow to the frontal area and in the caudate nucleus, which is important in inhibiting behavior and sustaining attention. Now, you might be wondering how is it that children with ADHD, who appear more active and energetic than children without ADHD, could have brains that are less active? The areas of the brain that are less active in those with ADHD are those areas that are responsible for inhibiting behaviors, delaying responding to situations, and permitting us to think about our potential actions and consequences before we respond. The less active these centers are, the less self-control and self-regulation an individual will be able to demonstrate. Thus, these areas of underactivity result in more difficulty regulating emotional and behavioral responding.

Brain Chemistry

Neurotransmitters are the chemical messengers in the brain that help transmit information from one nerve cell to another. Individuals with ADHD appear to have less of these messengers, or cells in the brain are less sensitive to them. Specifically, evidence seems to point to a problem in how much dopamine (and possibly norepinephrine) is produced and released in the brains of those with ADHD. Therefor, stimulant and non-stimulant medications, used to treat ADHD, work to make more of these chemical messengers available. This helps with communication between brain centers and structures and produces significant improvements in behavioral and emotional regulation of those with ADHD.

Treatment of ADHD: There’s Hope!

Individuals with ADHD posses a great many strengths such as creativity, ability to hyper-focus on tasks and areas of great interest, and less traditional problem-solving approaches. Evidence-based treatment for ADHD often includes medication prescribed by a medical practitioner, as well as Cognitive Behavioral Therapy (CBT) and parent support. Those uncomfortable with medication often engage in CBT alone and experience a great deal of improvement. While CBT helps the individual develop coping strategies and effective patterns of thinking and behaving, treatment also focuses on building personal strengths and positive identity. Although ADHD is a lifelong neurodevelopmental disorder, and symptoms generally persist into adulthood, we do know that children who are treated with medication and therapy (specifically cognitive behavioral therapy with parent support) have the best outcomes in adulthood. Medications and evidence-based therapy appear to improve brain volume and connectivity over time, implying that engaging in treatment may actually help the brain maturation process. The interaction of increased learning opportunities due to proper treatment also has a positive impact on brain growth and connectivity. As an individual with ADHD obtains treatment, they are actually changing their brain! Treatment for pediatric ADHD should also include a parent component. Parenting support focuses on developing parenting practices and strategies, as well as household structure that support the functioning and growth of a child with  ADHD. Kids with ADHD often do not respond to typical parenting strategies and need more ADHD specific support. And finally, treatment for ADHD also involves receiving support and accommodation in the school and/or work environment. Those with ADHD can flourish when they are working simultaneously to use effective coping and capitalize on their strengths.

 

Exploring and Challenging Unhelpful Thought Patterns

 

Written by: Mareena Atala MA, TLLP
Edited by: Dr. Julie Braciszewski PhD, LP

In my last blog post, “Emotions are the Solution, Not the Enemy” I explained the importance of accepting
all emotions, even the most difficult ones, and tuning in to what they might be telling us. In this blog post, I will expand on the mind-body connection and explain how our thoughts impact our emotional experiences and sometimes make us feel worse than we need to. Just like emotions are our constant companions, our thoughts are also always in our mind, telling us stories about ourselves, others, and the world around us. Sometimes, we discover that our thoughts fall into unhelpful patterns that can trick us into believing something that is not necessarily true. These unhelpful thoughts can trigger difficult emotions and interact with emotions to make us feel worse about situations. By learning how to recognize patterns of unhelpful thinking, we can learn how to explore and manage our thoughts. If we can take a step back from our thoughts, we might be able to look at things from a different view and feel better about ourselves, others, and the world around us.

We think in patterns

As human beings, we develop habits and patterns of doing things in our daily lives. Our thoughts tend to
form habitual patterns in the same way! Our brain is built to recognize patterns and themes that help us make connections between new situations and old information/experiences. Recognizing patterns helps us make quicker judgements, predict outcomes, and make informed decisions. For example, this is one way that we determine if a situation seems safe or dangerous, by making connections between the current and past environments/experiences. We learn from our experiences and apply that information to make interpretations and decisions as we approach new situations. Our thought patterns are shaped through our environment, experiences, relationships, and cultural/social beliefs. Thought patterns work as a general framework that impacts and filters the way we tend to think about ourselves, others, and the world. These thought patterns affect the way we interpret situations, which leads into how we feel and what we do about those situations. These patterns can make us habitually interpret situations in a way that causes us to feel badly about ourselves, other people, and the world around us. While some thinking patterns keep us safe, result in healthy relationships, and lead us to make great decisions, others cause us to make incorrect assumptions that negatively impact our feelings, relationships, and decisions. By paying attention to our patterns of thinking, we can learn how to take a step back from our thoughts and try to look at things from a different perspective.

The Mind-Body Connection: Thoughts make our bodies react

In my last blog post, “Emotions are the Solution, Not the Enemy” I explained that our thoughts, emotions, and behaviors are connected, and all interact with each other. Thoughts and interpretations trigger our brain and body to feel related emotions. Imagine that you are giving a speech that seems to be going well, and you see someone in the room laugh. You might think that the person is making fun of you, which would make you feel embarrassed, anxious, sad, or angry. That thought would trigger those emotions in your brain and body, and you might feel your heart start to beat faster, your face flush red, and butterflies in your stomach. That person may have been laughing at something completely unrelated, but the thought you had in that moment triggered your brain and body to feel uncomfortable emotions. By paying attention to our thoughts and feelings,  we can notice how they are connected,and we can recognize when our thoughts may be contributing to our difficult emotions.

Automatic thoughts

An automatic thought is the first thought that pops into our mind. They are super fast and, sometimes, super sneaky because they usually follow our thinking patterns and can heighten unhelpful emotions. Automatic thoughts can also be colored by the emotions we are already feeling. Using the example from above, if you were already feeling nervous about giving the speech, then there was a higher chance that you would have thought that the person laughing was making fun of you. If you are already irritated, your automatic thoughts will fall into anger patterns. If you are feeling socially disconnected… your thoughts will fall into patterns of social anxiety and withdraw. These automatic thoughts can feed into difficult emotions like throwing gasoline on a fire. Automatic thoughts often fall into common patterns of distorted, unhelpful thinking “traps” (also called “cognitive distortions”). Unhelpful, distorted thoughts may not be accurate, or they may be exaggerated, as we assume things without considering all of the possibilities. When we experience automatic thoughts, we often only pay attention to information that makes us believe the thought. As a result, we ignore other information that might show us that the thought is not necessarily true. You can see how this spiral of thought trap, heightened emotion, attending to limited information, and further thought trap can result in intense emotions than can spiral out of control. But, the good news is that we can learn to notice our thoughts and change our thinking patterns. No more unconscious emotional spiraling!

Automatic thoughts and unhelpful thinking traps

People tend to believe their thoughts and feel that they are ‘correct’ or ‘true’. We often believe the first thought that pops into our mind, and we fail to consider all of the possible explanations of a situation. We only pay attention to the information that fits into our thought pattern, and we miss other information that may tell us something different. By believing our thoughts are always right and true, it gives our emotions full reign to direct our moods, decisions, and interactions. However, if we acknowledge that our  thoughts are just our interpretation of a situation or event, based on our life experience, colored by our current emotional state and thinking patterns, then we are free to second guess and even correct our thinking patterns. These thought patterns often fall into easy-to-identify traps.

Examples of common unhelpful thinking patterns/traps:

Below are descriptions of common thinking traps, as well as a related automatic thought that someone might have in response to the following situation: You see your friend walking toward you on the sidewalk. You wave at them, but they don’t wave back. Thought trap: Personalization: Taking things personally when the situation might not have anything to do with you. This can include things like blaming yourself for something that you had no fault in or assuming that someone is purposely doing something to you. Automatic thought: My friend purposely ignored me when I waved at them. Thought trap: Mind reading: Assuming you know what others are thinking or saying about you. Automatic thought: My friend didn’t wave back at me; they must think I’m annoying or weird. They don’t really like me. Mental filtering: Only paying attention to certain information or details in a situation. Automatic thought: They didn’t even wave at me. (failing to notice that they smiled at you instead). Catastrophizing: Assuming the worst possible scenario. Automatic thought: My friend didn’t wave back at me…they must not want to be my friend anymore. Nobody ever wants to be my friend. If you believed any of the unhelpful automatic thoughts in response to your friend not waving back, how would you feel? You would likely feel sad, embarrassed, angry, or anxious. You might then want to ignore them or yell at them. By noticing automatic thoughts and thought traps, we can recognize when our thoughts are causing us to feel unnecessary difficult emotions and act in ways that can hurt ourselves and others.

*Click on this link to see a longer list of common unhelpful thinking patterns/traps:
https://www.animalsamplified.com/thinking-traps/

Challenge your thoughts: Calm your mind

When we get used to acknowledging our automatic thoughts and identifying thought traps, we can challenge those traps. This enables us to look at all possible sides of a situation, to determine whether certain thoughts are exaggerated or inaccurate, and help us to think in a more balanced way. This is not to say that all of our thoughts are incorrect, but we gain a great deal of power when we can identify ones that are. When we can decide if the thoughts fit into a thinking trap, we can explore and challenge them. We can challenge and reframe unhelpful thoughts guiding our emotions, decisions and relationships to a healthier place. Some general questions you can ask yourself to explore your thoughts and see if there are any steps to take to gain more information: Are there any other ways I can look at this situation or myself? What evidence do I have to support this thought? Am I looking at the situation from all angles? Am I assuming the worst? Am I assuming I know what they are thinking or feeling? What can I do to see if my thought is true? Let’s return to the same example from above. Maybe your friend didn’t see you or maybe they were having a rough day and did not feel like waving at anybody. Maybe they smiled at you instead of waving back, and you didn’t notice them smile so you thought they ignored you. Perhaps if you asked your friend what happened, they would tell you they didn’t see you, they were having a rough day, or they smiled at you instead. After thinking about the different possible explanations or taking action to find out more information about what happened, instead of feeling embarrassed, angry, or sad, you would probably feel much better about the situation. You would see that they didn’t ignore you on purpose and that there was nothing to worry about. Exploring and challenging automatic thoughts can alleviate a lot of anxiety, mood troubles and relationship distress.

Putting it all together

Combining the physical coping strategies from our last blog post, “Emotions are the Solution, Not the Enemy” and the thought-related strategies from this blog post can help you calm your body and mind. It can be difficult to think clearly when your body feels so worked up! When your emotions feel strong, it is often helpful to first use the physical relaxation skills to calm your body, and then explore your thoughts to calm your mind. Don’t be discouraged if you find it difficult to practice any of these strategies. It’s important to be patient and compassionate with yourself and keep practicing! Practicing these skills is like building a muscle; the more you use them, the stronger they will get! If you ever feel like your emotions and/or thoughts are becoming too much to handle on your own, don’t be afraid to seek professional help. It takes a very strong person to admit they are struggling and to ask for help, and we are always here for you!

Emotions are the Solution, Not the Enemy

Written by Mareena Atalla, MA, TLLP
Edited by Julie Braciszewski, PhD, LP 

Emotions are our constant companions, ever present and impacting us. We spend a lot of time trying to manage them, push them down, and fence them off. However, emotions are hard-wired in our brains and bodies. This hard-wired system is designed to keep us safe, motivate us, and connect us with others. If we are open to shifting our perspective and accepting that all emotions are useful and important, not just the pleasant ones, we just might be able to accept them, manage them, and hone our ability to use them as a guidance system. If we experience all of our emotions we gain more of what we want and need in life.

 Shifting Perspectives: Emotions can be difficult, but they are not “bad”

Emotions are often labeled as “positive” or “negative.” Most people learn very early in life that emotions like anxiety, sadness, and anger are “bad”, are signs of weakness and/or are to be avoided. We are told that the ‘good’ emotions are the ones we must strive to feel and show to others. However, the perspective that only ‘positive’ emotions are ‘good’ leads to shame and embarrassment, which then lead us to ignore or suppress more difficult emotions. However, this usually makes the feelings and situations worse. What if I told you all emotions are of equal value? Really think about it; consider that your sadness is just as important and valuable as your happiness. How would this perspective change your experiences? We think that in a perfect world, people would feel positive emotions such as happiness, excitement, joy, love, or curiosity all of the time. However, it is the vast experience of emotion, and the contrast between pleasurable and difficult emotions that paint the landscape of our lives. Emotions motivate and guide us through situations, interactions, and decisions. We must have a full range of emotional experience to engage in life. All emotions are equally valuable because they tell us very important information about ourselves, others, and our experiences. We know that many emotions are difficult and painful to deal with, but it is important to allow ourselves to feel all emotions in order to be able to learn from and cope with them. By accepting all of our feelings as equal in value and importance, we can better learn to express and cope with them.

Alert! Alert! Emotions are a signal

All emotions serve a purpose, and if we understand them as signals, telling us what to be aware of and what to do next, we are much more effective in getting what we want and what we need. What we call emotions are actually a cascade of thoughts, brain reactions, and bodily reactions. First, our brain reacts to a situation, we may or may not have an interpretive thought, and this reaction or thought then result in signals sent to our body. For instance, when we are faced with difficult situations, our brain’s stress-response system sends a signal to our body that something might be wrong, so that we can decide what to do next. If our brain thinks we might be in danger, it sends stress hormones through our body to protect us. These hormones translate directly into bodily reactions. For instance, our heart beats faster to get more blood and oxygen to our body, in case we need to run or fight for our lives. Our breathing also becomes faster as our lungs work to get more oxygen into our body. Our pupils dilate to help us scan our environment better. We label these bodily sensations as emotions, such as nervous or irritated, and we are motivated to act. We might fight, freeze, or run away. When we are feeling sad, our brain signals to our body that we need to rest and recover. This is why we often feel tired and drained when we experience sadness or grief. Paying attention to what we feel in our body can help us understand what our emotions are guiding us to do to meet the demands of a situation. When we are disconnected from our emotions, we are disconnected from solutions.

 The Mind-Body Connection

Emotions are the lens we view the world through; hence the saying, seeing something through ‘rose colored glasses’. The physical aspects of emotions influence our thoughts and behaviors a great deal. This may seem obvious, but often times it’s not so obvious in our daily experiences. When we understand that emotions are interconnected with our bodily sensations, thoughts, motivations and behaviors, we can, in turn, learn how to manage these different experiences of emotions. For instance, when we are angry, we tend to think angry thoughts. Thinking angry thoughts then feeds and fuels our emotion further, and leads us to want to act on our anger. The stronger the emotion, the more intense the motivation, sometimes leading to decisions or actions that don’t work for us, or that we regret. Now here’s were the work comes in! We learn to identify the emotion, increase awareness of bodily sensations, and use this insight to guide us toward what we need. Coping skills can be used to manage the physical feelings and behavior urges that come with intense emotions. We can then effectively explore the thoughts that might be colored by those emotions, and consider what actions best meet our needs or wants. We can’t control how our body reacts or what thoughts initially pop into our heads, but we can control how we look through the lens.

 The Mind-Body Connection

One way of gaining insight and control over emotions is to increase awareness and control of bodily reactions. Although some people are skeptical about breathing and grounding exercises, science shows us that using these strategies can send a signal to the part of the brain that turns down the “stress-response system” (sympathetic nervous system), and turns up the “calm down system” (para-sympathetic nervous system). Active strategies that use your whole body help to regulate stronger bodily responses to emotions, especially frustration and anger. These techniques aim to help you focus on something else, while calming and shifting your bodily responses and sensations.

The 4-7-8 breathing technique: Slowly breathe in through your nose for 4 seconds, hold your breathe for 7 seconds, and breathe out slowly through your mouth for 8 seconds. Repeat this sequence until you feel your body calm down.

Five senses grounding: Acknowledge 5 things you see around you. Acknowledge 4 things you can touch around you. Acknowledge 3 things you hear. Acknowledge 2 things you can smell. Acknowledge 1 thing you can taste.

Move your body! Sometimes, our emotions feel so strong that the calming techniques above are not enough to release that emotional energy. Instead, moving your body around can help release that built up energy. Play one of your favorite fast-paced songs and dance around! Go for a run or bike ride! Kick or throw a ball around! These strategies are meant to help you focus on the activity, while moving your entire body, to release the built up energy that emotions give us.

 Put it all together

When we see emotions as equally valuable, we can harness the power of a full range of emotional experiences. These experiences provide us with incredibly important signs and signals, guiding our expression, behaviors, and choices. This leads us to be more effective in getting more of what we want and need.  However, to ensure we don’t feel overwhelmed by these experiences, we also must attune to our bodily responses and learn to turn the dial up or down.  Stay tuned for more on recognizing and managing thought patterns.

*Click on this link to view a “Feelings Wheel” which can help you identify and express your emotions using different terms that describe different levels of the common emotions humans feel.

https://feelingswheel.com/

 

Your Relationship & The Pandemic: Map a Course for Change

Courtney Zullo, MA, LLP

If you are struggling in your relationship, you aren’t alone! During the pandemic, while we have simultaneously been changing roles at home and work, and dealing with constant transitions, stress has come at us from all directions. For many, this stress and disruption has brought to light markers of change they wish to make in their relationships. These markers create a map, guiding movement forward toward a happier, healthier, and more resilient relationship. If we are able to construct, read, and follow this map, it can lead us to a place in our relationship of greater connection, stability, and intimacy.

Map Marker 1: Acceptance

For many, managing life during the pandemic has meant a sharp increase in stress, job change or loss, and never ending changes at work, school and home. Any one of these added stressors to our lives would affect our relationship, let alone all of these at once! So, the first marker we must see on our map to relationship change is acceptance. We must accept that some degree of disruption, conflict, and unmet needs in our relationship is reasonable right now.  When we feel that conflict, distance or disruption is not reasonable, given our circumstances, we attribute the difficulties to our relationship (e.g., “Maybe we just aren’t meant for each other”, “We can’t get through this”). Or, we personalize the difficulties (e.g., “S/He/They Don’t love me anymore,” “S/He/They are such a negative person”, “S/He/They need way more than I can give”). Instead, we must say to ourselves and our partner, “It’s ok that we are fighting, feeling distant, irritable, or angry right now. This is reasonable, so much has happened this year.”   But, we don’t want to rest in acceptance as our only marker on our map to relationship growth and change. We must continue to move forward to gain true relationship connection and peace. We must also know we have the insight and power to change in response to these needs.

Map Marker 2: Shifting Roles

One marker on our map to relationship change may point to our need to investigate how roles have shifted during this pandemic.  Most Americans report shifting roles at work, at home, or in the family in the last 18 months. As our roles in life shift, so do our relationship needs and dynamics. It is important to account for these shifts, and ensure our relationship is shifting to support these new roles. In your new role, or additional role you’ve taken on, what else do you need from your partner? What else can you be giving your partner? The ship always rocks when encountering new waves, but you can find the balance with insight and communication.

Map Marker 3: Old Patterns Emerge

Many couples are realizing that their less helpful or less-than-healthy relationship patterns have been amplified during the pandemic. Many markers on our map of relationship change may actually direct us to recognize and develop insight around relationship patterns that were not serving us before the pandemic, but have unfortunately been pressurized and brought to the forefront. As we feel stressed and overwhelmed, as most have during the pandemic, we fall back on old patterns of reacting, thinking, relating and communicating. We do this quite automatically, often not recognizing the havoc it wreaks on our relationships.  However, we have the power to develop insight around these patterns and get what we want and what we need from our relationship in much more healthy, adaptive, and long-lasting ways. To start the journey of insight, go ahead and fill in the blanks; “When _______ happens, I tend to react by _________, which is actually me trying to get _________ need met. But I don’t think it’s working for me.” From here we can rethink our patterns of relating, communicating, engaging in conflict, sharing emotion, receiving and/or expressing affection.

Map Marker 4: Retell Your Love Story

When I’m first working with a couple, I like to sit down and and ask the couple to share their love story. What brought you both together? What makes you still love your partner today? What I have found is that regardless of why couples enter counseling, every couple has a unique love story worth hearing. Some couples are stuck, some couples are lost, and some couples have been so unhappy for so long that happiness seems unreachable. When stuck in the midst of the storm it seems impossible to see the sun. That’s where exploration and open and honest communication comes into play. This is even more important in our current circumstances, in which stress due to the pandemic has overshadowed our daily lives. Indeed, many of daily reminders of love we often provide have been overwritten by the burdens of the last 18 months.  Perhaps a marker on your relationship change map is to revisit your own love story. Remember and openly discuss what made you fall in love and why. Being in a relationship is a choice each and every day. Openly and honestly discuss what can help you feel love toward your partner, even in small ways, each and every day.

Map Marker 5: Additional Support & Guidance

And finally, there might be a marker on your map of relationship change that leads you right into my office. The pressures and changes of this past year may feel overwhelming to address on your own, and that’s alright.  Seeking couples therapy shows dedication to your relationship. It is a non-judgmental space so you can work to make your marriage or relationship exactly what you want and need it to be; a stronger foundation from which you may build amazing things in your life. After all, the map markers mentioned above are really just a starting place for your journey. With help and support, you can set a course on your map of relationship change that will help you and your partner get exactly where you want to be in life.

Courtney Zullo, MA, LLP

 

Managing Back to Work Anxiety

Dr. Julie Braciszewski PhD, LP

Michiganders are headed back to in-person work this week, and while some are feeling a renewed sense of freedom, others are facing significant anxiety. ‘Back to Work Anxiety’, as some are calling it, is part of the larger experience of ‘Re-Entry Anxiety’. We have been expressly avoiding many situations, interactions, and contexts for over a year to keep ourselves, and others, safe.  However, when we avoid a feared situation, our perception of danger increases, as does our bodily response to this fear. So now, as we venture out into the world, it is reasonable to feel a little wary, or even downright intense anxiety. The closeness of others, enclosed spaces, people touching things… it might all be a bit overwhelming. It’s imperative to highlight what we can do to manage back to work anxiety and make this transition a bit easier.

Evaluate What Has & Has Not Been Working For You

Over the past year we have adjusted to working at home by developing new routines and patterns of life.  Inevitably, some of these changes have brought additional stress. We can make a list of what new routines, situations, or responsibilities are causing more stress, reducing work engagement or satisfaction, and target these for change.  For instance, most people feel like ‘Zoom Zombies’ after a couple of hours of video conferencing. As you go back  to in-person work, specify a time threshold for video conference meetings and work toward shifting to more in-person meetings. However, for some the ability to take a break from work and do household tasks or errands has been a very positive shift while working from home. Additionally, people with families are reporting engaging in more meals together. Perhaps these are things you want to hold on to? Just as importantly as working to address added stressors, make a list of what is bringing more connection, relaxation, balance, and satisfaction and fight to keep those routines in place.

Communicate

This might seem like a no-brainer, but many struggle to really communicate what they need and what they want.  When we are stressed, our ability to communicate often declines further.  This makes the transition back to in-person work a potential black hole for communication.  About 60% of people report already feeling burned out, and are thus less likely to communicate their needs.  Once you’ve sat down and clarified what is working and what is not, translate this into actionable steps. Formulate assertive statements around what you want, why you want it, and how it will actually benefit your team, the business, or your work quality. Communication during this transition will pay off long-term for you and your employer.

Boundaries, Boundaries, Boundaries

For many, as work moved into their homes, it became difficult to separate work life, home life, and all our other responsibilities/roles in life. Our separate roles no longer fit neatly into their contexts and have compounded stress as we try to meet these intersecting demands. For instance, many people are simultaneously working, facilitating their children’s schooling at home or in a hybrid model, and providing support or care for other family or community members. It’s all a bit much, isn’t it?!? As we shift back to in-person work it’s important to think about boundaries between work and home, and reassess how to be sure you get time to relax, connect, and recharge. When will you NOT be available for work. If you return to in person work, practice putting down your phone, ipad, laptop, ect., and unplugging from work once you are home. If you are returning to a hybrid work model, you might have to work even harder to set your boundaries. Reclaim your home as your sanctuary, reclaim your family and friendship connections without the constant distraction and pull from work, and reclaim your balance.

Get Clear Answers

Returning to work in person is going to result in a lot of ambiguity at first. This will take a lot of planning on employers’ parts and at first, it might be hard to get answers to your questions. However, now is the time to speak up and ask important questions around expectations, policies, flexibility, and work roles. Do you have a firm sense of what the policies are around office safety and sanitizing? Do you have questions around flexibility of work schedules? It’s important you give your employer the opportunity to grapple with these questions at the outset, so that you, in turn, have the opportunity to get what you want and what you need.

Support Your Mental Wellness

The pandemic has caused a mental health crisis of the likes we have never before seen. Usually 15 – 20% of people are experiencing mental health challenges at any given time. But right now, about 40-60% of people are struggling with their mental health, before even contending with back to work anxiety! The importance of this increase in mental health difficulties cannot be overstated. The majority of individuals returning to in-person work are already feeling anxious, depressed, stressed, and burned out. We can not really switch into a ‘full steam ahead’ attitude at work. Instead, we must make room for how mental health is impacting our well-being. Identify what you need to prioritize your mental well-being during this transition. Many are asking to start back in stages, so that they can adjust their household needs, such as childcare, and get used to their new schedule. Should you ask to take walks on your break or lunch? Do you need to shift your work day to address sleep disruption? Can you seek out additional communities out of your office? Groups like recreational sports teams, moms groups, religious meetings, crafting group, sober living group, super-niche-car-guy group, provide connection and positive sense of identity. We can be purposeful in creating our own mental wellness. If you need support, don’t hesitate to reach out to us.

It’s OK To Not Be OK

Be aware that you will have a stress response to this transition. Because mental health IS medical health, you will feel back to work anxiety in your body as well. This may present in the form of headaches, gastro-intestinal distress, body aches, sleep changes and fatigue. Be attentive to this reaction. If your stress reaction, anxiety or mood difficulties are worsening, or have not gone away in a couple of weeks, give yourself the gift of professional support. You deserve it!