Author: SF Stress & Anxiety Center

WHAT IS ADHD?

Attention deficit hyperactivity disorder (ADHD), previously known as ADD, is a neurodevelopmental condition that affects behavior and concentration. A child or young person with ADHD may seem unusually restless, impulsive, or distracted. In addition, their behavior may seem impulsive, they may need help staying organized, or they may find it difficult to focus and speak without thinking. Even though children and young people with ADHD may also have other conditions or mental health problems, ADHD is not a mental illness or a learning disability. Living with ADHD can be overwhelming for children, adolescents, and their parents and caregivers. The right diagnosis, treatment, and support can make a huge difference to a child’s learning, life skills, and relationships, along with making family life easier.

What Are the Most Common Symptoms of ADHD?

A child with ADHD may display the following symptoms:

• Distracted easily, having difficulty starting or finishing tasks
• Have difficulty concentrating
• Restless or fidgety most of the time
• Often interrupts or blurts out things, very talkative
• Takes risks without considering consequences, impulsive, prone to acting without thinking
• Easily angry or frustrated, unable to cope with emotions
• Has difficulty forming or maintaining friendships
• Lack of organization, such as losing things and being late

ADHD affects each child or young person differently, so they may not exhibit all of these behaviors. It is important to note that many of these traits and behaviors are typical of younger children or can result from a traumatic experience – they do not necessarily indicate your child has ADHD.

It is also possible for age and gender to affect how someone with ADHD behaves. Because of this, ADHD can be harder to spot, particularly in girls, who are more likely to be misdiagnosed or undiagnosed. It is common for ADHD symptoms to emerge in early childhood, and they may become more noticeable when a significant change occurs, such as starting or changing schools

How Is ADHD Diagnosed?

In order to diagnose ADHD, a qualified professional will use multiple evaluations and tests. ADHD cannot be diagnosed through simple observation or a brief interaction. A specialist can only diagnose ADHD after making a detailed assessment. Additionally, other conditions, such as learning disabilities or mood disorders, will need to be ruled out in some cases.

ADHD can be diagnosed using the following guidelines:

• A child experiences symptoms in two or more settings, such as at home, school, and social settings.
• There must be at least six symptoms present in a child aged 4-17 years old.
• The child must show at least five symptoms if they are 17 or older.
• As a result of their symptoms, your child has a difficult time functioning in some of the activities of daily life, such as schoolwork, relationships with you and siblings, relationships with friends, or being able to function in groups such as sports teams.
• A child’s symptoms begin before they reach 12 years of age. In some cases, it may take a child until they are older to recognize these as ADHD symptoms.
• The symptoms have been present for more than six months.

One of our qualified clinicians will follow these guidelines, talk to the parents and the child, take a detailed history of the child’s development, physical health, mental health, and behavior, and carefully consider other information, such as teacher and school reports. The assessment process often involves parents and educators completing questionnaires and checklists.

Additionally, our clinician might assess the child’s memory and attention. Clinicians might also observe a child in different settings, such as school, to determine how they behave in different envrionments.

Click here to learn more about ADHD Assesments at San Francisco Stress and Anxiety Center.

Treatment for ADHD in Kids

Several treatments are available for ADHD, including medication, behavioral therapy, and lifestyle changes.

Medication

It may be necessary to consider medication for children with ADHD to help them manage their symptoms every day. Additionally, it can help children control the behaviors that cause problems at school, with friends, and with family. Several types of medications are FDA-approved for treating ADHD in children, including:

• Stimulants: Chemicals like methylphenidate or amphetamine boost dopamine and norepinephrine levels in the brain. They come in three forms: short-acting, intermediate-acting, and long-acting.
• Non-Stimulants: Non-stimulants do not contain methylphenidate amphetamine; they use different active ingredients that have similar effects on ADHD symptoms and do not work as quickly.

Behavioral Therapy

As soon as a diagnosis is made, behavior therapy can help reduce disruptive behaviors. Behavior therapy aims to strengthen positive behaviors and eliminate undesirable ones. Some parents use behavioral therapy alongside medication to help their children manage their behaviors effectively. At SF Stress and Anxiety Center, we have a team of therapists dedicated to supporting children with ADHD.

It is common for parents and families to be involved with behavioral therapy, support their child in setting goals, and learn techniques and tools from the therapist so that they can apply them at home and school. Also, parents can learn how to deal with their child’s negative behavior effectively. Parents of children who suffer from ADHD notice a clear impact of cognitive behavioral therapy.

Lifestyle Changes

Even though taking the proper medical steps to support your child with ADHD is important, studies have shown that lifestyle changes can also impact their behavior. In order to help your child live a healthy lifestyle, follow these tips:

•     Aim for one hour of physical activity per day. Exercise is associated with numerous benefits for ADHD. Children with ADHD can benefit from regular physical activity by improving their focus, avoiding distractions, and performing better in school.
•     Limit screen time. Those with ADHD are much more likely to become addicted to the Internet than those without ADHD. According to the American Academy of Pediatrics, children under two years old should avoid electronic media use, limit screen time to one to two hours per day, and keep TVs and other internet devices out of their rooms.
•     Encouraging healthy sleep habits. Approximately 70% of children with ADHD have sleep problems. Not getting enough sleep can cause or worsen ADHD symptoms. You can help your child get a good night’s sleep by following a daily routine, limiting screen time before bed, and making sure the room is dark and comfortable.

Why Early Diagnosis Is So Important 

According to current estimates, up to 50% of children with ADHD also suffer from specific learning disabilities. As a result, they are more likely to suffer from anxiety, depression, and self-destructive behavior. ADHD is associated with underachievement at school, as well as significant behavioral issues. Many children benefit from treatments such as cognitive behavioral therapy. Researchers have described children with ADHD as being several years less emotionally mature than typical peers. To help the child make wise choices, both parents and the child may need additional support. Having an accurate diagnosis will allow your medical, psychological, and educational teams to assist your child most effectively. A thorough psychological evaluation is the key to successfully taking control of ADHD symptoms.
Ready to get your child or teen set up with an ADHD assessment with one of our qualified psychologists? Click the button below to schedule your free consultation with a Care-Coordinator that can walk you through the process and get you started.

Schedule My Evaluation Here

There are four pillars of health:  sleep, diet, exercise and managing your consciousness.  In an era where there is so much competition for your attention, how can you gain mental clarity?

Writing articulates thoughts and ideas in surprising ways

Something extraordinary happens when you write.  If you choose to journal, you may have noticed the gap between what you think you will write and what actually comes through that channel.

This is because writing, at its best, can offer insights into small and large problems.  It appears that the unconscious mind is doing the heavy lifting.  As such, writing can help you clarify your thoughts in a way that brings vague notions in the back of your mind into tangible light.

Through writing, you notice that the stress of work and relationships makes you yearn for some time in the mountains.   Or, you come to understand that fear of failure has been holding you back from taking on that ambitious project at work.  Or, you see the way that your negative self-talk may be something you have internalized from the way your dad spoke to you as a kid. Clarifying what is “on your mind” through writing can feel highly centering and useful.

Writing can provide rich, personal value without regard to whether you choose to share or revisit what you have written.  The writing process can be as valuable, if not more valuable, than the product itself.

Answers that come through distillation or slow-cooking

If you have been wondering how to solve some thorny problem, your unconscious mind may have processed ideas over time.  Writing can pull those ideas together into something coherent and useful.  The eminent doctor and writer Oliver Sacks used to see a patient and then think about what he observed while walking through a Japanese Garden across from his office after an appointment.  When he returned to his office, his patient’s symptoms had coalesced into a diagnosis that he crystalized in writing after letting his thoughts assume clearer form through this forced waiting period.

Scientists and artists have related similar stories for centuries.  Writing solves problems.  The act of writing can help you capture insights that have eluded you for some time.

The power of writing to heal trauma

For several years before Covid, I co-facilitated a creative writing workshop with author Katie McCleary in Folsom Prison (Bridge The Gap).  Given a simple writing prompt and twelve minutes to lay pen on paper, the men in prison wrote vivid, compelling stories that used the Amherst Writers & Artists (AWA) method to explore their consciousness in writing.  In this method, all work is treated as fiction.  Writers may choose to share or not share.  Comments about writing shared do not include criticism or analysis but rather observations about the language or ideas that occur when listening.

The catharsis, forgiveness, understanding and healing that emerged through these workshops were astounding and beautiful.  The common humanity of men in prison became readily visible, as the men felt accurately seen, heard and understood through their own written reflections.

Part of the power of writing has to do with the emotional distance it provides.  You can explore ideas or events from different perspectives, see things through the lens of elapsed time and detach from emotions.  You can disentangle from a breakup, process a move, reconcile yourself to loss, and come to accept unanticipated change.  There’s a reason we say “come to terms with it,” in English.  Often those terms may be found in written reflection.

Your therapist can help you use writing to facilitate your own healing from a break-up, a loss, a jarring event or from deeper trauma.  Your therapist helps you extend the insights you produce in your own journaling.  Your therapist can help you find compassion and forgiveness for yourself and others through writing.

Consider employing the experts at SF Stress & Anxiety Center.  Clear the fog.  Find and expand your center. Improve how you relate to yourself, others and the world.  Click the button below to schedule a time to speak to a Care Coordinator.

 

One of our jobs as therapists is to ask clients to see their experience as a pattern.  To do this requires a shift in perspective.  Whenever we can sideline shame, blame and judgment and regard our experiences as a pattern, we can calm down and see events with fresh eyes.

There is self-acceptance within compassion.  But our brain’s Negativity Bias makes it hard for us to accept ourselves or see our thoughts, actions and decisions in a neutral way.  Let’s imagine your supervisor gives you a review and notes your diligence, productivity, collaborative capacity, and tendency to show up late to meetings.  What take-away will you have from that encounter?  Neurology suggests that your brain will center on the idea that you show up late to meetings.  “I am an unreliable person,” could be one conclusion.

Nearly all the feedback was positive, but your brain dismisses that and attaches emotionally to the perceived insult.  This creates a lopsided view of yourself, which can cause anxiety, self-blame, and even depression.

Compassion provides a different version of events

Now let’s imagine that you are a single mother who is breastfeeding an infant while working remotely from home.  You are sometimes late to meetings because you have been on your baby’s schedule.  That baby just doesn’t respect your meetings!  She has her own schedule.

Seeing your life as a pattern, you can say to yourself, “It’s tough to know when I can be on time, because my baby’s schedule comes first!”  If you are a supervisor who has an employee in this situation, perhaps it is easier for you to appreciate the competing demands.  Can you also apply the latitude you have for your colleagues to yourself?  Easier said than done.

When I quit piano lessons at age 14, I felt like a failure and a quitter, and a terrible kid.  How could I just abandon my sweet teacher after 6 years of weekly lessons!  Now that I am older and have spent much of my life as a professional musician, I can see that decision differently. I wasn’t quitting, but rather I was graduating and moving into a more self-driven approach to music.

Post lessons, I started writing my own piano works, bought more advanced books, and continued to invest in my music education.  Having continued to sing, play, learn guitar and perform publicly, I can forgive that 14 year old kid.  I can think of that moment all those years ago as a graduation rather than a failure.  What a relief to shed the shame, guilt and confusion I carried around for so long!

The cleansing power of forgiveness

Finding a more forgiving way of seeing a painful event in your life can allow you to resolve an old wound and come to terms with decisions.  One truism in psychology is that people do the best they can with the information they have at the time a decision is made.  Knowledge is often incomplete.  It isn’t fair to judge ourselves years after the fact using knowledge we have gained over time.  Finding compassion for yourself means moving more slowly through those painful moments in the past and seeing your perceived failures in light of your incomplete knowledge.  Forgiving yourself is hard, but also useful.

Using a compassionate tour-guide to revisit unfinished business from your past

Your therapist can help you find your compassion and use it to gain a new perspective on events in your past.  Your therapist can help you revisit difficult moments with empathy and the ability to see patterns rather than shame, blame or judgment.  Your therapist can help you work through pain to come out on the other side, feeling lighter for your new version of events and yourself.

If you don’t yet have a therapist, consider employing the experts at SF Stress & Anxiety Center.  Clear the fog.  Find and expand your center. Get the help that makes a concrete difference in your life and how you relate to yourself, others and the world.  Click the button below to schedule a time to speak to a Care-Coordinator.

 

What is Toxic Positivity?

Generally, positive thinking is beneficial to your mental health. However, toxic positivity is an exception. Positive thinking can become toxic if you ignore negative emotions and pretend everything is fine. Imagine it as a temporary bandage that covers but does not heal emotional wounds. Ignoring your true feelings can do more harm than good to your mental health.

Toxic Positivity Examples

It’s not always easy to recognize toxic positivity in yourself or others, but you’ve probably run across some common phrases encouraging you to minimize negative emotions. Think about how these common sayings might fuel toxic positivity.

• It could be worse. While this popular catch-all phrase is often true, saying “Things could be worse” could unintentionally come off as insensitive. Consider saying, “I’m ready to listen” or “I’m here for you” and asking how you can help.
• Happiness is a choice. While some aspects of happiness can be managed, everyone experiences emotions differently. You may not always be able to choose happiness when you have a mental illness like depression or are dealing with grief after a traumatic loss.
• Positive thoughts/vibes only. Those who use toxic positivity may ask you to surrender all your negative thoughts and only be positive for their benefit. Both positive and negative feelings are equally valuable. You use your emotions to understand your needs, safety, and desires.
• Things will get better soon. Layoffs and financial stress can trigger anxiety and destroy self-esteem. Don’t forget to acknowledge the present challenge and validate someone’s emotions when you reassure them of a brighter future.

Why is Toxic Positivity Harmful?

• It undermines emotions. Positive thinking and optimism at the expense of difficult emotions are not always good for our mental health. People who practice toxic positivity ignore contentious issues in their relationships and instead focus on the positive. When people are pressured to smile in the face of adversity, they are less likely to seek support out of fear and embarrassment.
• It can come across as insensitive. Bereaved individuals who often receive reminders to move on or be cheerful may believe that others are indifferent to their loss. Telling people who are struggling to focus on positive thinking and a bright future is unhelpful in relieving their suffering.
• It can cause guilt and shame. Toxic optimism encourages people to suppress or dismiss unpleasant emotions to feel more in control. A person may believe they are failing if they are unable to feel happy. This is a typical example of toxic positivity: you share your problem with someone, and they tell you to look on the bright side of it.
• It’s not in our nature to be overly positive all the time. In fact, quite the opposite is true. Humans are pessimistic by nature. It’s an evolutionary adaptation. Humans are wired to constantly look for danger. Our ancestors survived by using this negativity-based survival mechanism.

Avoiding Toxic Positivity

• Be honest about your emotions. Pay attention to how you truly feel. It’s normal to feel different emotions at the same time, and it’s important to honor and accept them. For example, it’s possible to experience joy and grief at the same time.
• Minimize your exposure to toxic positivity. It’s important to surround yourself with positive people. However, spending too much time with people who are fluent in toxic positivity can be problematic—set boundaries with people who shame you for expressing your authentic emotions.
• Take a break from social media. On social media, toxic positivity manifests itself by pressuring you to share the best version of yourself. Next time you browse social media, consider others’ posts as highlights rather than a play-by-play. Even your favorite celebrities and social media influencers experience negative emotions. Consider taking a break if social media brings on more negative than positive emotions.

Approaching toxic positivity

It is human nature not to want to see a loved one suffer emotional pain. Consider your approach when you initiate a conversation or respond to someone’s concerns.

• Welcome all emotions. Each person’s feelings are unique. Recognize that it’s okay to experience negative emotions. In the event that you or someone else is using toxic positivity to cope with negative emotions, encourage them to speak freely.
• Listen and validate how others feel. In the heat of the moment, you may feel tempted to offer a quick fix or say whatever you can to make someone feel better. However, that approach may make them feel ignored, unheard, or upset. Some people just want an open ear instead of advice or an immediate solution. Listening to others who are facing a difficult situation can help them feel heard and understood. Be mindful, avoid judgment, and give them your full attention.
• Don’t shame others or yourself. Toxic positivity can lead to mental health stigma, which can make people hesitate to seek mental health treatment. Respect others’ emotions and learn how you can help stop mental health stigma

and support others.

When to Seek Support for Toxic Positivity

Although overcoming negative situations can build resilience, asking for and accepting help is okay. Whenever you find yourself using toxic positivity, drugs, or alcohol to cope with stress, anxiety, depression, or other concerns, consider seeking profession

al mental health support. When you’re ready, you can connect with a mental health  consultant in person or virtually. We have therapists who are skilled at helping you deal with these issues, so you can receive the support you need. Contact us today to schedule a free call with our Care-Coordinator: we’ll get to know each other and see if we can help!

 

What Can Therapy Do?  

 

Expectations Management for Leaders, by Douglas Newton, LMFT

Few phenomena can shift emotions quite as powerfully as expectations.  According to Buddhism, suffering comes from expecting what we don’t get or getting what we don’t expect.  Life circumstances have a way of delivering both situations on a daily basis, personally and professionally.  A part you need doesn’t arrive on time due to supply chain issues, holding up production.  A phone call from a close friend delivers the news that a loved one has been diagnosed with a debilitating disease.

Seeing expectations everywhere

Expectations are woven into the way our brain attaches to rewards and avoids potential dangers.  Understanding what we can reasonably expect has a basic survival use that is woven into our experience and reinforced over time through our DNA (genetic heritage).  Expectations layer into almost everything we do.

All our travel plans, for example, rely on functional cars and airplanes, amenable weather, robust infrastructure and people showing up to help us get from place to place.  Life is tricky, as we all know.  One accident on the highway, one flat tire, one atmospheric river or one airline strike can change our plans and trigger various emotions.  Frustration, pain, consternation, angry phone calling, high blood pressure and the stress hormone cortisol flow through us.  Stress can become anxiety and anxiety can lead to panic.  Acute stress is tolerable, but can lead to physical health problems without regular and adequate recovery.

Awareness of expectations in a workplace culture

In the workplace, understanding what we can expect from employees and colleagues influences delivery schedules, product launches, overall reputation and client satisfaction.  Do your reports know when they can and cannot contact you?  Do you have a clear idea of what you can expect from them?  Are those expectations flexible enough to account for unforeseen issues or complex dependencies on partners and processes?

Do what you say and say what you do.

Communicating what you expect and what others expect from you can exert a soothing influence on your relationships.  Clear expectations can increase a feeling of safety that informs a workplace culture.  This in turn can diminish stress, burnout and confusion, improving the internal value proposition for employees and increasing retention.

A focus on expectations can provide useful data, such as subjective and objective measures that define focus, priority, work-flow, and team logic that optimize structure and processes to get things done.  At the same time, anticipating how things may go wrong can provide the elasticity people need to deal with the adventures and lessons along the way.

Pay attention, harvest lessons, and stay flexible

In the publishing world there is an expression, “When you’re 99% done you’re halfway there.”  There’s the bug in the program, the part that didn’t arrive, the colleague out with Covid or the need to seize a new opportunity and shift priorities.  When it comes to expectations, perhaps a leader needs what a body needs, according to Thomas Richardson, “dynamic structural flexibility.”

Learning lessons, and remaining agile requires flexible expectations.  So does your relationship with yourself, others, your business, your job, and society in general.

Your therapist can help you understand the relationship between healthy boundaries and expectations.  Your therapist can help you explore how rigidity in your thinking may be impacting your colleagues and your culture at work.  Your therapist can help you foster psychological safety at work. By reflecting on expectations, and the dynamics that inform them, you can increase your influence as a responsive, respected leader at work.

If you don’t yet have a therapist, consider employing the experts at SF Stress & Anxiety Center.  Clear the fog.  Find and expand your center. Get the help that makes a concrete difference in your life and how you relate to yourself, others and the world.  Click the button below to schedule a time to speak to a Care-Coordinator.

 

Conflict in a relationship is normal and even necessary because it can help us feel more connected and known by our partner if we handle it well. However, unhealthy conflict can lead to distance, disconnect, and unhappiness. If conflict is tearing your relationship apart, it’s time to bring more positivity into your conflict discussions and everyday life by bringing more positivity into your daily interactions.

Common Causes of Relationship Conflict

So why do couples fight? When couples fight, it’s because they are two very different individuals with different perspectives, beliefs, personalities, and values. Those in a healthy relationship embrace and even welcome these differences and learn how to fight fairly. However, in an unhealthy relationship, people try to change one another, and the relationship suffers as a result.

When Conflict Is Healthy in a Relationship

The important thing is how you handle miscommunications and inevitable differences between you when they occur. Conflicts in healthy relationships help the couple feel more connected and understand one another better because they are able to talk about the issue, listen to one another, and repair when necessary. World-renowned marriage psychologist John Gottman explains, “Happy relationships aren’t relationships where there is no fighting. They are relationships where repairs are made after regrettable incidents happen – and where a couple connects daily.”

In healthy conflict, couples are also respectful of one another. They stick to ‘I’ statements instead of ‘you’ statements. They communicate how they feel and what they need without blaming each other. If one partner feels criticized, they can repair the situation in the moment and get back on track. Compromise is possible when they allow their partner’s perspective, feelings, and needs to change their perspective.

When Conflict Is Not Healthy

Conflict becomes unhealthy when the negativity in the discussion outweighs the positivity. In healthy conflict, more positive emotions occur due to repairs being made, partners feeling heard, and emotions and feelings being accepted. Additionally, there are types of negativity that can occur in conflict that are more damaging than others.

Gottman has found four behaviors that he says can seriously damage the relationship and lead to its demise if not addressed. He calls them the four horsemen:

• Criticism- When we criticize the person and don’t deal with our complaint, we take the focus off the issue. Personal attacks can be hurtful and prevent meaningful communication.

• Defensiveness- It can be directly linked to criticism but also happens at other times. Partners can become very defensive, which can escalate the conflict even further. Defending can be a way of avoiding taking responsibility for your own actions.

• Contempt- Mocking or making fun of a partner at any time is not a great idea and can leave a partner feeling belittled. This can be extremely damaging to relationships.

• Stonewalling- The final horseman is stonewalling. When a partner withdraws from the discussion, it can literally mean they walk away, but it can also mean they emotionally distance themselves from their partner.

How Relationship Conflict Can Bring You Closer Together

Often, conflict in a relationship is seen as a sign of trouble. It is something to be avoided. However, this is not so. Conflict is a normal part of a relationship and can help us understand one another better and make us feel safe and important. Disagreements are opportunities to learn from one another. By listening to our partner and sharing our side, we can learn something new about one another that we may not have known had the conflict not occurred.

Conflict also brings us closer by providing a sense of safety and importance when we are able to repair. We feel safe when we know that, despite challenges, our partner will be there for us, and we will be able to repair the relationship. You don’t have to get it right all the time. You can both feel safe if you can resolve the conflict and repair the damage with your partner, you can both feel safe. Having the assurance that our partner will always be there for us, even when things get tough, helps us feel close, connected, and secure in our relationship.

Tips for Dealing with Relationship Conflicts

Couples Therapy

For many people, the concept of positivity in conflict is foreign. Many of us lacked role models for how to have a healthy, successful conflict discussion. As a result, most of us have no idea how to do it or even where to start. Getting help from a qualified professional is the best way to ensure that you are successful.

Individual Therapy

Many times, one partner wants to seek counseling, but the other is not yet ready to do so. If this is your situation, don’t give up entirely on the idea of therapy. Individual therapy can be a powerful tool in improving a relationship. A therapist can help you understand your role in the relationship dynamic and provide tools and insights to help you shift your relationship in a positive direction.

Self-Soothe

You must be able to stay calm and engaged in order to be able to hear your partner’s emotions and respond to them. Pay attention to your body during conflict discussions. Do you feel relaxed and at ease or tense and stressed? If you notice tension in your body, take a few deep breaths and try to calm your body and mind so that you can tune back into your partner.

Repair During Conflict Discussions

Nobody is perfect, which is why having the ability to repair during a conflict discussion is so important. Even happy, stable couples get off track at times during conflict discussions. The most important distinction between happy and unhappy couples is their ability to get back on track or not.

So what does a repair during conflict look like? A repair is anything you say to de-escalate tension in a discussion. Here are a few examples:

• Tune your partner into their feelings: Perhaps your partner says something that makes you feel criticized. Instead of responding defensively (which will escalate the situation), you can share that you feel criticized. You may say, ‘I feel criticized.’ ‘Would you mind rephrasing that?’

• Take responsibility when you mess up: We are all human, and sometimes we say things we regret or that we know were harsh. Many of us, however, do not acknowledge that in the moment. However, taking responsibility in the moment can be a powerful way to de-escalate the situation. You can apologize for your actions by simply saying, ‘My reaction was too extreme.’ Sorry. Let me try again.’

• Humor: Many people find it difficult to access humor during conflict discussions, but if you can use it, it can be the most effective form of repair. You can express humor in a playful manner by sticking out your tongue, making a joke, or giving a goofy smile to encourage laughter and lighten the mood.

Take Breaks as Needed

If you are unable to calm your body and remain engaged in the conversation, it may be time to take a break. Once we become flooded and our physiology changes, we cannot hear our partner, solve problems or have empathy for them until we can calm down, which requires a break. Tell your partner that you are feeling overwhelmed and need a little time.

You may want to go into another room and engage in a relaxing activity for a while. Try deep breathing or progressive muscle relaxation. Other activities, such as listening to music, taking a bath, or going for a walk, maybe more relaxing to some people. Calm down at least 20 minutes before resuming the conversation with your partner.

Date Nights

It may seem strange to include friendship skills in an article about conflict, but the strength of your friendship determines your ability to manage conflict well. Date nights are encouraged by marriage therapists for a reason. It’s because they work! Date nights give you and your partner time to connect, have fun, and talk about things other than everyday tasks, responsibilities, and schedules. Date night is often associated with an evening out at a restaurant, which can be expensive and the last thing you want to do after a long day.

However, date night can be anything you want it to be. It’s a set time for couples to spend together and focus on their relationship. There are countless ways to accomplish this (and it doesn’t have to be at night or cost you anything!). For example, you could have a picnic on the living room floor, sit outside after the kids are asleep and just talk, take a walk around the neighborhood, or take a cooking class together. The ideas are endless. The key is to get creative and make it a priority to ensure it happens.

 

As Nina Simone first sang it, “I’m just a soul whose intentions are good.  Oh Lord, please don’t let me be misunderstood.”  Why can it feel so difficult to convey who we authentically are to others?

Whether you are an introvert or an extrovert, more social or more solitary, you have a deep need to feel seen, heard and understood by others.  It is as fundamental a need as the thirst for water. So if this need is so central, it can be frustrating not to feel seen, heard and understood by those around you.  And when this need isn’t met, there are costs. Loneliness, isolation and sadness can get woven into your days.  Your identity can feel walled off from others, leading to depression, anxiety and feelings of failure.

Fortunately for all of us, there is a way to move beyond our isolation and get into a state of mind where we feel recognized for who we are.  Acceptance, belonging and intimacy are possible, and help to push past this loneliness and the other feelings that surround feeling misunderstood.

What can you do to bridge the gap?  

1. Clarify your thoughts and feelings through writing

If you have never kept a journal, consider allowing yourself this space and place to go.  When we write we clarify our thoughts and feelings.  Putting words down truly can help us come to terms with how we feel or what we want and need.

Writing connects the unconscious to the conscious mind and, through that connection, can integrate and articulate thoughts and feelings that may be otherwise hidden from view.  The power to reveal yourself in writing can feel somewhat magical and centering.  Once you write something down, reading what you have written can feel like receiving a letter from a long, lost friend.  You may come to recognize aspects of yourself that you value or needs that haven’t been adequately met.

Writing privately creates a safe space for you to express yourself without concern for others’ thoughts and opinions.  You can always choose to disclose what you write to someone, but not having to do so can give you permission to open up to yourself and “come to terms,” literally and figuratively, with what is on your mind.

2. Give your time and talent away to others who need you

Covid has been profoundly isolating.  So many people have unfulfilled needs, and there are plenty of problems, large and small, to which you may connect your talents meaningfully.  Do you code and care about social justice?  Volunteer your talents to a nonprofit doing important work.  Are you a writer and frustrated about climate change?  Explore ways to help locally, according to your time and inclination.  There is a problem out there for every talent.  You may find it meaningful to connect your passions and talents to the problems that need you.   Helping others according to your specific talents and interests will connect you to a community of like-minded people.  Those relationships can flow out of the center of your interest.

3. Use Assertive Communication to Convey Your Needs

Assertive Communication comes from a therapeutic approach called DBT (Dialectical Behavioral Therapy).  When in conflict with someone, you can use Assertive Communication to express your needs and report from your emotions after you have taken the time to process them.  Here’s the framework:  “I felt _________ (identified emotion) when you _________ (said or did something).  It is a way to own your emotions and express them to someone else, in a respectful tone and manner.  This contrasts with aggressive or passive aggressive communication.  Either of these forms can escalate a conflict rather than presenting a safe way to explore emotions and relationship dynamics.  Assertive communication allows you and a friend to explore a conflict and learn from the pattern, ideally free from the shame, blame and judgment that fuels conflict.

Your therapist can help you clarify and deepen the insights you get from writing.  Your therapist can help you explore your talents and service ethic, including directions you might take.  Your therapist can help you understand the grounded nature of Assertive Communication and how it can help you feel heard, seen and understood in ways that matter.

If you don’t yet have a therapist, consider employing the experts at SF Stress & Anxiety Center.  Clear the fog.  Find and expand your center. Get the help that makes a concrete difference in your life and how you relate to yourself, others and the world.  Click here to schedule a time to speak to a Care-Coordinator.

 

Many individuals experience anxiety-induced panic attacks. Panic attacks are sudden, unexpected episodes of intense fear or terror. Individuals who experience reoccurring panic attacks may have Panic Disorder, a DSM anxiety disorder that affects around 6 million adults in the United States. Panic attacks are often sudden and reach their peak within minutes. They can occur spontaneously or be triggered by a situation or feared object. An individual experiencing a panic attack may develop a fear of future attacks, increasing their anxiety and causing them to avoid situations or locations where they experienced the attack. Some symptoms that occur during a panic attack include:

• Chest pain, heart palpitations, and shortness of breath
• Sweating, trembling, and dizziness or light-headed
• Numbness or tingling
• Chills or hot flashes
• Nausea or abdominal pain
• Feelings of impending doom, detachment, losing control or dying

What causes panic attacks?

When faced with danger, real or imagined, your brain kicks into gear with a fight-or-flight response. Chemicals like adrenaline flood your body and cause hormonal reactions, such as increased heart rate and heavy breathing. Panic attacks happen when you have the hormonal response of fight or flight, but there’s no immediate danger.

There are different factors thought to play a role in causing panic attacks:

• chronic and ongoing stress
• experiencing a sudden traumatic event
• a change in environment (like walking into a crowded store)
• too much caffeine
• being a person who’s sensitive to stress or negative emotions
• illness (like inner-ear problems or diabetes)
• genetics i.e., if a close family member has suffered from panic attacks in the past

Panic attacks are jarring and terrifying, so here are some tips on how to cope with them:

1. Educate yourself about panic and anxiety.Knowing the causes of panic and the fight-or-flight response can help you understand that unexplained panic is generally a false alarm. It is a trigger that lets you know you are uncomfortable, either because of the physical sensations you are experiencing or your situation; there is nothing worse than that.
2. Notice the sensations.Identify what is happening in your body by nonjudgmentally labeling your physical experiences. Observing calmly, “I am experiencing a faster heartbeat and feeling warm in my face and neck,” can be helpful for slowing down what is happening without jumping to conclusions like, “I must be having a heart attack.”
3. Recognize panic for what it is.When you recognize that you are having a panic attack, you can remind yourself that it is temporary and will pass. Take away the fear that something worse is happening.
4. Take deep breaths.Breathing in deeply through your nose for a count of 4, holding for 1-2 seconds, and breathing out for a count of 5 not only can start to slow your breathing but also gives you something else to focus on that you have some control over. Diaphragmatic breathing stimulates the relaxation response and turns off the fight-or-flight response.
5. Relax your muscles.A muscle relaxing technique called Progressive Muscle Relaxation involves squeezing or tensing a specific muscle group and then releasing that area. One option is to start at your toes and, after tensing and relaxing there, gradually move up your body until you reach your neck and head.
6. Ground yourself in the present moment.Using a strategy called mindfulness can help focus your mind on something specific other than your panic. One exercise involves noticing and experiencing 5 things around you that you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. Don’t just name the things; immerse yourself in the experience using each of your senses.
7. Close your eyes.Sometimes we are overwhelmed by the multitude of things happening around us. Closing your eyes can reduce much of the input, making it easier to think clearly or work on relaxation strategies.
8. Repeat a calming phrase.By focusing on something like a mantra or statement, you can help focus your mind, but also remind yourself that you are thinking clearly and that everything will be okay. It could be something like, “this will be over soon” or whatever phrase speaks to you. Pick your phrase before you are panicking, however, as it will be much harder to choose when stressed.
9. Go to your happy place in your mind.Visualize a safe, comfortable, or calm place (real or imaginary). Maybe you start with what you see but be sure to explore and experience the place using all five of your senses. If you are imagining swinging in a hammock between trees, also take note of sounds (e.g., birds chirping, water running nearby), smells (e.g., sap from pine trees), feelings (e.g., the breeze as you rock back and forth), and tastes (e.g., a lemonade with ice and a sprig of mint).
10. Drink cold water.Take a drink of water and feel the coolness radiate down your throat, through your chest, and throughout your body. When you feel anxious, you may feel warm, so drinking cold water, running your hands under cold water, or putting a cool washcloth on your neck can help.

Talk Therapy Can Help

Talk therapy (CBT) can help you understand and manage panic episodes. In therapy, you will learn how to:

• Understand and manage skewed perceptions of life stresses, including other people’s conduct or life circumstances.
• Recognize and replace panic-inducing ideas to reduce feelings of powerlessness.
• When symptoms appear, manage tension and relax.
• Consider the sources of your anxiety, beginning with the least concerning to the most anxiety-provoking.
• Conquer your anxiety by practicing gradual exposure to real-life scenarios that typically trigger your anxiety.

You don’t have to live with constant fear of panic or avoid situations where you feel anxious. Therapy can help you overcome panic and anxiety and escape its constricting grasp. Anxiety treatment works. You can feel better.

 

What Can Therapy Do?  By Douglas Newton, LMFT

The Idea:  Diminish your anxiety to let your goals grow up together 

Many of my clients experience anxiety because the goals and objectives they have in their lives have been put off.  “I’ll get to dating as soon as I lose some weight,” or “I have to move out of this apartment before I think about getting a new job.”  This kind of thinking places artificial barriers in front of the flow of one’s life.  It is common among many of us and I have entitled the placement of hurdles as artificial sequencing.  Artificial sequencing establishes priority that favors one objective arbitrarily over another.  Is it reasonable to begin dating while also working on getting into shape?  How does moving out of an apartment become a reason not to look for a more satisfying job?  Understanding why we sometimes think this way helps to identify the pattern and then look for ways to use our awareness to let our goals grow up together.

What is going on here?  The brain acts to protect you from challenges that increase anxiety

Artificial sequencing is a way of placing obstacles in your path.  The adaptive reason to do this comes from our brain’s need to insulate us from anxiety.  If there is something that we want that involves risk, our brain can often exaggerate that risk and stop us in our tracks.  This intuitive reaction warps the way we understand our experiences.  We miss out on a more grounded understanding of calculated risk.  Would your supervisor actually fire you if you asked for a promotion?  She likely wouldn’t.  But your brain exaggerates the risk, possibly because of childhood experiences that made you feel unsafe in some way.  Maybe asking mom or dad for a privilege as a child was met with put-downs or harsh words.  This could lead you to fear confrontation with authority figures as an adult, even if the stakes are low.  Such trepidation may be totally off your radar.  And yet this unconscious protective instinct influences what you see as acceptable risk as an adult.  You might think, “I will see if I can ace my next project.  If it is flawless, maybe my supervisor will give me a promotion.”  The project and the need for perfection may be exaggerated because imperfection opened you to criticism or derision as a kid.  The thinking may be delusional as an adult, but the roots are strong that inform your way of perceiving potential conflict.  Asking directly may feel like an untenable risk due to deeply entrenched fear.  That pit in your stomach tells you to wait until the right time, and that it is safer to defer your needs, maybe even indefinitely.

What to do?  Navigate your patterns with Forgiveness and Mindfulness 

Forgiveness can sound like letting someone off the hook.  But forgiveness has more to do with how we process emotions from difficult experiences rather than accountability. Forgiveness offers a way to let go of things that are weighing us down.  We may not even know these things exist until we use our awareness to scan our mind for what we might be carrying.

Search your heart for resentment or unresolved emotions from your past.  Maybe you are still angry about something that happened when you were young or hurt from unkind remarks people made in high school or college.  Your awareness can locate these moments and then bring self-compassion into service aimed at your painful memory.  Imagine how hard it is for a kid to stand up to an adult.  The person you may need to forgive could be that confused 6 year old you used to be.  Write a letter to your former self and think about how you did the best you could with what you knew at the time.  This shift in thinking can change the way you see your upsetting experience.  Invest yourself fully into how good it feels to forgive yourself or someone else.  Then you can harvest what you learned, such as your ability to overcome challenges or how tough experiences have helped you become independent minded.  Take a moment to take in the usefulness of those qualities and how you value them in yourself.  Then use your awareness to let go.  Imagine taking resentment and folding it into a paper boat that you place into a river.  You wave goodbye to it, with love and gratitude for your new understanding of yourself, as you watch that paper boat head to the sea.

This is not to imagine there are truly traumatic experiences that require further processing and more advanced techniques.  But for many of our resentments and wounds, reframing can give you a different perspective and allow you a newfound presence in your life.

Your therapist can help you explore this kind of tool and many others to help you reframe your past and put painful memories into perspective–what I sometimes call “a smaller box.”  Using your ability to be mindful (observation without judgment) can help you eventually see these experiences as patterns.  Thinking in patterns can reduce feelings of shame, blame and judgment.  This is hard work!  But eventually, with the stewardship of therapy, you can free yourself from the eclipsing power of difficult memories and use this footing to advocate for yourself, embrace the opportunities as they come, contextualize challenges and absorb them with grace, and find more compassion for yourself and others in your life.

Once you encounter less situationally-driven anxiety, you can open your heart to those goals and objectives that will nourish your life without getting in your own way.  There is so much to explore when we feel a new sense of purpose and self-efficacy.  Finding your footing through mindfulness and forgiveness can expand your sense of safety to allow more breathing room for all your agenda.  It’s hard enough to work into a place where we get much of what we want.  But the path is made easier when we clear our own hurdles out of the way.

If you don’t yet have a therapist, consider employing the experts at SF Stress & Anxiety Center.  Clear the fog.  Find and expand your center. Get the help that makes a concrete difference in your life and how you relate to yourself, others and the world.  Click the button below to schedule a time to speak to a Care-Coordinator.

 

The Idea:  Map Your Strengths to Moments That Cause Anxiety

How can we use our strengths to help us?  When you stop to think about it, are you clear on what your strengths are?  When you identify strengths you already have, you become more aware of what is working well in your life (perhaps shifting your focus from what you feel isn’t working).  Your strengths represent tools already available to you–not new habits that you have to learn to deal with stress and pressure when it comes.  To quote Rick Hansen, “Pain is inevitable.  Suffering is not.”

Awareness is the ocean and thoughts are the fish.

When you list your strengths, you are inviting them forward into your awareness where you can call them into service.  Are you often generous?  Can you step into a room with confidence?  Is your mind creative enough to help you contemplate different facets of a situation or problem?  Perhaps you are deliberate, or loyal, or strong-willed.

How to identify and leverage your strengths

To identify your strengths, take a sheet of paper and number one to five on the left side, with a few lines of space in between.  Then list five qualities that describe your character.  If this seems daunting, imagine laying this out in a job interview. Once you have identified five, enrich your understanding of your strengths by adding aspects that magnetically adhere to those core qualities.  For example, you might write “detail oriented.”  Next to that, list other strengths that nourish your capacity to be detail oriented.  This might include “deliberate” or “able to sustain focused attention” or “methodical.”

Keep asking yourself questions like this until your strengths feel more defined and authentic.  (Let’s leave aside for the moment the question of how others see us and how we interpret that for another time).   Onward.

On the right side of the page, list five situations that typically cause you to feel stress or anxiety.  They could be general, such as “social situations,” or specific, such as “presenting research conclusions to my colleagues,”  or “talking with my in-laws about whether my partner and I are planning to start a family.”

Once you have populated your page with strengths and situational stressors, you can start exploring how strengths you already possess can be applied to specific situations to support you and lower your stress and anxiety level.

This may feel awkward or inexact at first.  That means you’re a human.  It’s okay to add items to your list or recall other strengths that may have been off your radar and add them later.  It’s not a test of urgency or recall.  Expanding your list over time is up to you, according to how broadly you can elaborate your onboard support system.

What’s the difference between my strengths and areas of growth?

How does using your already existing strengths contrast with adding “coping skills” that may feel novel or hard to adopt?  It feels organic–less of a stretch–to use strengths you already have.

The act of writing down your strengths plants these ideas into your awareness.  Stay with me on this one.  If you are aware of a strength and clearly identify it as such on paper, you feel an increased sense of ownership.   You can use your strengths intentionally, with activated, conscious thinking.  While you may have to get used to calling your strengths into action at first, repeated efforts to do so in trying moments becomes easier over time.  Practice makes progress. . .

If you already have a therapist to help you enrich your experience and unpack what you have learned, you can gather other insights in session.  Was it difficult to own your strengths?  Anything holding you back?  Were there surprises writing things down on paper?  A therapist can help you articulate your success to own your increased sense of control over stress and anxiety.  Your therapist can add context and help expand your insights and point to how to leverage your strengths elsewhere in your life.

If you don’t yet have a therapist, consider employing the experts at SF Stress & Anxiety Center.  Clear the fog.  Find and expand your center. Get the help that makes a concrete difference in your life and how you relate to yourself, others and the world.  Click the button below to schedule a time to speak to a Care-Coordinator.