Author Archives: Whole Person

The Grief Experience

One of the important aspects of grieving that has been largely overlooked is the relational aspect. Each person’s grief is unique because he or she: 

  • Had a unique relationship with the deceased (loving, ambivalent, challenging)
  • Brings a unique personality and coping mechanism to the situation
  • Has a particular world view which will impact how he or she enters the process
  • Has ongoing relationships which may or may not be helpful
  • Has a unique relationship with death
  • Came to this particular loss with a unique history of dealing with earlier losses
  • Has particular expectations about what dealing with the loss means and wonders how dealing with the loss “should” proceed
GriefWork Resources

The grieving process can occur in many types of losses; although we focus on loss by death, the concepts presented can be applied to other losses.

We view the grieving experience as a long, winding path that curves back on itself, traverses hills and valleys, and has many obstacles. It is a path that is challenging to negotiate, time-consuming to travel along and may provide opportunities for personal and spiritual growth. Grieving is a part of the human experience. A person attached to someone will mourn the loss of that relationship and miss that person’s physical presence. We understand this as a simple truth. Remembering this truth does help some people cope with the loss because they are able to be somewhat philosophical.

The process may be more complicated when the relationship with the deceased was either ambivalent or challenging. The reality, for most people, is that relationships are not easy to put into these categories. Most long-standing relationships are at times loving, at times ambivalent, and at times challenging. The degree of challenge will likely add to the complex feelings that the person who is grieving will experience. Along with the death of the person, the bereaved may also grieve the reality of unmet needs represented by the relational difficulties.The death of a loved one is a major life event. When assessing the progress of a grieving client, the facilitator must be aware of that person’s level of functioning in all domains prior to the loss.


BEREAVEMENT refers to the experience of the loss of someone through death.
GRIEF is the reaction to bereavement. It is a universal response to any loss.
MOURNING refers to the expression of grief in culturally specific ways.
LOSS refers to no longer having somebody or something.

Kinds of Losses

Loss is a part of everyone’s life at some point. Each person reacts to a loss in a personal way. As well as the emotional response, loss also has physical, intellectual, behavioral, social and philosophical dimensions. Response to loss is varied and is influenced by beliefs and practices.

People’s losses, no matter what, are important and often devastating to them. They represent the disappearance of something or someone cherished.

Some examples of loss: 

  • Addiction
  • Death
  • Divorce
  • Failed business venture
  • Faith
  • Financial security
  • Home
  • Independence
  • Mental ability
  • Pet
  • Physical health
  • Plans, hopes and dreams
  • Relationships
  • Role in life
  • Sense of safety/security
  • Status
  • Treasured possessions

Many of the handouts in this book will apply to some of the losses and to most people. Carefully choose the handouts given to each person. If handouts are being distributed to everyone in a group, instruct participants to complete only the parts applicable to them.

-From the Introduction to GriefWork: Healing from Loss by Fran Zamore, LISW, IMFT and Ester R.A. Leutenberg

Use the Coupon Code GRIEF2020 at checkout prior to June 1st, 2020, and receive 30% off of the following workbooks (print and/or PDF eBooks) from our GriefWork Series:

About Caregivers

During the pandemic we are making our book, The Complete Caregiver Support Guide, available at a reduced price to help more therapists add this valuable resource to their library. Find the coupon code at the bottom of this blog post.

Former First Lady Rosalynn Carter stated,

“There are four kinds of people in this world: those who have been caregivers, those who currently are caregivers, those who will be caregivers, and those who will need caregivers.”

This includes virtually everyone!

A Brief History of Caregiving

In past generations, it was customary for people to have large families. Members of an extended family often lived within a few miles of each other. Few women had jobs outside the home, so the elderly and infirm were cared for within the family. Both the primary caregiver and care-receiver had the support of nearby relatives, friends and community.

Circumstances are different today. Families are typically smaller and are often scattered across the country and around the globe. A much larger percentage of women work outside the home. People live longer, often with chronic illnesses. These factors make caregiving much more complicated than it was in the past.
The early stage of caregiving is often handled by family members or by friends who live near the person needing help. They begin by simply doing what they can and often, as time passes, assume the caregiver role without realizing it – caregiving isn’t a job that many people choose to sign up for.

The tasks caregivers perform can vary widely, from transporting a child with disabilities to school each day, to doing someone else’s laundry, to helping with medications, to dealing with insurance companies. Caregiving can be temporary, as when someone is recovering from an accident, or long-term, as when caring for a person in need of significant ongoing support.

In an attempt to define family caregiving, the National Family Caregivers Association (NFCA) developed a list called “Caregiving Is.” The text below was inspired by that list.

Caregiving is as diverse as the individuals needing it. It can be 24-hour care for persons who cannot manage daily tasks of living or are suffering a significant level of cognitive loss. It can be preparing for an uncertain future because a spouse has a progressively disabling disease, even though that person is still able to function quite well. It can be temporary, last several years or last a lifetime.

Caregiving means being a person’s healthcare advocate. It requires learning to work with doctors and other health care professionals and to navigate government healthcare programs. It can also be learning what it means to die with dignity and making sure that the care-receiver’s wishes will be honored.

Caregiving is stressful work. Most people have had no training or education regarding the many aspects of caregiving when they begin helping their care-receiver. They discover that caregiving is assuming tasks they never dreamed of undertaking. It can be learning about medications, wheelchairs, lifts and gadgets that help struggling fingers button a shirt. It can involve doctor visits, calls to 911 and long days and nights in a hospital waiting or emergency room.

Caregiving challenges people to go beyond their comfort zone. It is having conversations on topics most people hope they will never need to address. It is grappling with questions that often have no easy answers. It is loving, giving and sharing. It is accepting, adapting and being willing to keep on going.

Caregiving forces individuals to deal with change. They are often required to re-evaluate finances, living conditions and/or their personal work situation. They will need to make compromises and readjust again and again as the circumstances change.

Caregiving is an endless search for balance. It is seeking the middle ground between doing too much for the care-receiver and doing too little. It is trying to find time for personal needs – and hopefully, even wants – while providing for another’s needs. It is recognizing that one cannot do it alone – one can and should ask for help, respite care and time off for a vacation to recharge through activities that help maintain a sense of self.

Caregiving is a strain on relationships. Even the best of relationships can be challenged by the stress of caregiving. The demands on one’s time and energy may leave family members or friends feeling neglected. Moving a parent into a family home – or moving into the parents’ home – can be a source of contention between couples, and between parents and their children. Finances and other emotionally charged issues can also cause tension between adult children of an ailing parent.

Caregiving can be a lonely world. While the tasks and experiences of caregiving may be similar in nature, surprisingly they are not what unites family caregivers. According to the National Family Caregivers Association, the common bond of caregiving is the emotional impact.

Those caring for others often feel lonely, isolated, and unacknowledged for all their work and sacrifice. They can experience anger and resentment toward family members and others who carry on as usual, while they of necessity give up much of their normal life. They grieve the losses in their own lives as well as and the loss of the person their care-receiver once was as they watch him or her decline. They often experience depression, sadness, pain, the need for normalcy and regret for what they might have done had circumstances been different. They also may feel guilty because they sometimes wish it were over.

Caregivers can find comfort in learning that such feelings are perfectly normal and in finding ways to cope with them in support groups and within these pages. They can also find hope in the possibility of connecting on a deep level with their care-receiver and creating closer bonds with family members. In fact, discovering positive meaning in the tasks of caregiving is crucial for the emotional health of everyone involved.

Caregiving can also be moments of joy and fulfillment.

  • Happiness when seeing one’s child with a developmental disability learn a new skill.
  • Joy when a spouse’s face lights up, expressing thanks for being his or her partner on a difficult path.
  • Closeness during nighttime conversations about love, life, death, and what’s most important.
  • Satisfaction in the knowledge that one has provided something for the care-receiver that has made life better.
  • New recognition of one’s inner strength and determination.
  • Gratitude for simple things, for each new day.

-From the Introduction to The Complete Caregiver Support Guide, by Ester R.A. Leutenberg and Carrol Morris, with Kathy Khalsa, OTR/L

Use the Coupon Code CARE2020 at checkout when you order The Complete Caregiver Support Guide before June 1st, 2020, and receive 30% off the workbook. This code can be applied to your purchase of the print workbook and/or the PDF eBook.

Resiliency: A Key to Winning the Battle

Resiliency has been defined as the ability to:

Building Resiliency Workbook
  • manage life’s challenges, stresses, changes, and pressures effectively.
  • cope and adapt successfully to adversity.
  • bounce back to a balanced state after facing a major disruption in life or career.

People have an innate ability to demonstrate resiliency when they have resiliency skills built into their lives. Resilient people are able to adapt successfully under adverse circumstances such as: poverty, mental illness, disasters, terrorism, physical or psychological trauma, divorce, job loss, prison, loss of a loved one, parent’s divorce, prolonged stress, physical or sexual abuse, or a lack of safety. Resiliency, or a positive behavioral adaptation, is critical when people encounter any type of trauma.

Right now, in this current Covid19 crisis, we all need resiliency. Look at the bullet list above. Managing the new challenges, etc. posed by the crisis is crucial to surviving it. Do we need coping skills that are healthy and effective? For certain. Do we need the ability to bounce back from the bizarre lives we are currently facing? Absolutely. It has been vital that people rise to the challenges the pandemic presents. For the most part we came up to the plate and hit a homer. We sorted out the mixed signals that bombarded us from our elected officials. Recovery as a nation will depend, to a great extent, on individuals, families, work groups, and total strangers. The ability to bounce back to our new reality and forge a new normal for our families is key.

Research shows that resiliency offers protection from distress and illness in the face of change or adversity. The presence of high levels of resiliency is associated with these factors:

  • high level of happiness,
  • high level of self-esteem,
  • high sense of energy and vitality,
  • high level of optimism,
  • high level of self-reported health,
  • high sense of meaning and direction,
  • low level of depression.

People who are resilient . . .

  • work because they enjoy it,
  • react in an optimistic way,
  • see problems as challenges,
  • take positive action,
  • think of change as natural and go with the flow,
  • thrive under challenging situations,
  • find it easy to be content in various situations,
  • believe that they can influence events and their reactions to events,
  • recognize that with stress comes growth.

That same research cited above tells us that resiliency can be built.

So, let’s first look at our ability to bounce back from adversity with the following resiliency scale: Ability to Bounce Back Scale.

Next, try this Invest in Yourself exercise.

Good luck to us all as we begin to see an end to this historic effort to save lives.

This material was excerpted from Building Resiliency by Ester Leutenberg and John Liptak, EdD.

Guided Meditation for Shelter-in-Place

With so many of us honoring a shelter-in-place mandate it is only to be expected that stressed out folks are going to feel overwhelmed every-once-in-a-while. Try a family guided meditation, guided imagery, or a simple breathing exercise to encourage calm. After describing the material you will be reading, suggest that the participants find a comfy place they can relax. Tell them if they would like to close their eyes, to do so. Once everyone is settled begin reading the script. Use your regular voice. Don’t over dramatize the content. Choose a slow and steady pace. You should practice reading the guided meditation script alone. Note: read the script yourself a couple of times so you can read it smoothly to others..

Things to remind your family or group:

  1. If the material makes you uncomfortable you do not have to participate. Instead, relax, be in the moment, clear your mind of everyday worries, and go on a self-led guided meditation tour by remembering a place that you love, people you love, and activities you love.  Let them fill your imagination.
  2. Relaxation techniques are like any other muscle memory response. They will improve with practice, so don’t be discouraged if it doesn’t work the first time out. Try different relaxation techniques such as guided imagery, progressive muscle relaxation, or being mindful.  Put yourself in the present moment where you are aware of all the things around you. Experience them, don’t push them away. Remember Coby Bryant didn’t become who he was without hours of practice nor does a concert pianist. Practice.
  3. If your mind wanders during the exercise, don’t be alarmed. Gently bring it back to join with the group.
  4. We are all individuals; our responses to the guided meditation reading will be different. Celebrate that individuality.

This first guided meditation is from 30 Scripts for Relaxation, 2nd Ed. Volume 1

The Sea – Guided Meditation

Don R. Powell

Time: 5 minutes

In this script, participants relax by taking an imaginary journey along a beach, listening to the birds and waves and watching a brilliant sunset.


It’s time to make yourself as comfortable as possible. You’re invited to close your eyes, becoming more and more aware of which parts of your body are feeling tight or tense…and which parts are relaxed…noticing all the sensations…even where it may feel neutral or blank.

Now take a few deep breaths. Each time, take the air in through your nose, holding it momentarily … and then slowly exhaling through your nose … You’ll find yourself relaxing more and more deeply, more and more completely, with each exhalation.

Taking the air in … letting the air out … allowing yourself to relax, more and more.

In a few moments, I’m going to describe a very vivid scene in which you’ll imagine yourself walking along a beach. Allow yourself to imagine this scene as though you are there experiencing whatever sights, sounds, smells, tastes, textures, and touches you can by using whatever senses and concepts come naturally for you to bring the experience alive.

Using your imagination, bring to mind a bright summer day. It’s late in the day. And you decide to go for a walk along the beach. Notice the sun is radiating warmth and comfort as it shines boldly… The sky is crystal clear without a cloud in sight… The grains of sand at your feet reflect the sunlight, warming and comforting the soles of your feet…The sound of the waves are beating against the shore and echo in the air.

If you would, notice the warm, light breeze brushing against your face as you walk onward… Far off in the distance, you can hear the cries of sea gulls … and imagine them gliding through the sky, swooping down into the sea, and then flying off once again.

As you walk further along the shore, you decide to rest. Sense yourself sitting down on a mound of pure white sand and gaze out at the sea, staring intently at the rhythmic, mesmerizing motion of the waves rolling into shore.

Each wave breaks against the coast … rises slowly upward along the beach, leaving an aura of white foam, and then slowly retreats back out to sea, only to be replaced by another wave that crashes against the shore, works its way up the beach, then slowly retreats back out to the sea. Let yourself bring this alive … hearing the sounds … watching the movement … feeling the sensations.

With each motion of the wave, as it glides in and as it glides out, you find yourself feeling more and more relaxed, more and more calm, more and more serene.

The waves are gliding in and the waves are gliding out … You’re feeling more and more calm … Continue to experience the waves gliding in … and out.

Now, staring off into the distance, you notice that the sun is beginning to sink into the horizon. The sun is sinking down and you’re feeling more and more relaxed as you see its movement going down … down … and down.

The sky is turning brilliant colors of red … orange … and all manner of yellows … blues … and purples … As the sun sets, sinking down … down … down … into the horizon, you’re feeling very relaxed and soothed. And you watch the sun as it continues sinking down.

The beating of the waves, the smell and taste of the sea, the salt, the cries of the gulls, and the warmth against your body—all these sights, sounds, and smells leave you feeling very soothed, very calm, very peaceful.

Give yourself room to relax even more.


In a few moments, I’ll count from one to three. When I reach the count of three, allow your eyes to softly open. And you’ll feel completely refreshed and totally relaxed.
1 … 2 … 3.

It’s time to open your eyes. Stretch … and notice how you’re feeling.

Repeat the above instructions until everyone is alert.

Too grownup for your kids? Try this guided meditation, from
Stress Relief for Kids: Taming Your Dragons

Imagine You’re a Dragon – Playful Exercise

Purpose: stretch your body in seven different ways

Stand comfortably with your arms relaxed at your side.
Let go of the tightness in your knees.
Imagine you’re a dragon who lives up north.
You like cold weather and snowstorms.
Breathe in and lift your arms up over your head.
Move your arms like the cold winds of the north.
Let the snow fly during a big blizzard.
Lower your arms and relax.
Imagine you’re a dragon who lives along the East coast.
You like to play in the ocean.
Breathe in and lift your arms up to waist level.
Move your arms around your body like giant waves.
Let the waves roll in along the shore.
Lower your arms and relax.
Imagine you’re a dragon who lives in the South.
You like warm weather and sunshine.
Breathe in and lift your arms to the side with your palms facing up.
Feel the sun rise over your head.
Lower your hands down over your face and body.
Feel the sun showering you with its warm energy.
Imagine you’re a dragon who lives along the California coast or in Hawaii.
You like palm trees and tropical weather.
Breathe in and lift your arms up over your head.
Move like a palm tree swaying in the breeze.
Feel the stretch in your trunk and limbs.
Lower your branches and let go.
Imagine you’re a dragon who lives in the Midwest You like wide open fields of wheat and corn.
Breathe in and lift your arms up to shoulder level.
Stretch your fingers out as far as you can in every direction.
Reach out over acres and acres of farmland.
Lower your arms and relax.
Imagine you’re a dragon who lives in the Rocky Mountains You like snowy peaks and high elevations.
Breathe in and lift your arms up as high as you can.
Climb up to the Continental Divide.
Reach up to the top of the highest mountain and look out at the view!
Go down to the bottom of the mountain and relax.
Imagine you’re a dragon who lives in the Southwest desert.
You like open skies and beautiful sunsets.
Breathe in and lift your arms up all around you.
Feel the openness of the sky filled with giant clouds.
Stretch your whole body out into space.
Now let go and relax completely.

*Download a printable version of this exercise here.

The Healing Power of Nature

Elizabeth Roberts is a most extraordinary woman. A teacher, philosopher, humanitarian, and social activist, Elizabeth is no stranger to the vanguard of social change. In the early ’60s, she marched with Reverend Martin Luther King to promote civil rights. Years later she launched a crusade for television reform. Her resumé lists her as a former program director for National Public Radio, and it was she who coined the title for the now renowned afternoon news program, “All Things Considered.”

“Most likely that will be my epitaph,” Elizabeth says, jokingly. However, her most lasting legacy may be her awareness of the healing power of nature.

I had been given her book, Earth Prayers, in 1992 by a very dear friend of mine in Vermont. So moved was I by the prayers and poems that I began to use several of them in a relaxation slide show I produced titled, “Mother Gaia: The Healing Power of Nature.” Word circulated about the tremendous impact of the slide show and one day I received a phone call from a conference coordinator wishing to team Elizabeth and I up to do a joint presentation, with Elizabeth reciting the poems from her book. As it turned out, we both live in the same town, so we arranged to meet at her house one afternoon. Over a cup of tea, she shared this story:

“How did the book come about?” she said, repeating my inquiry. “Let me tell you. I had been sick for quite some time with Chronic Fatigue Syndrome. It got so bad that I was bedridden for about nine months. It was horrible. I was so exhausted I could barely lift my hand up to my face. About the only thing I could do was read, but I was too tired to hold a book. The most I could hold up was a piece of paper.

“While I was sick, I had many conversations with God, many times not believing in a God anymore. My theology became a cosmology as I turned to the earth for help. And I got it.

Under a large tree

“Elias, my husband, had sent the word out to my friends not to call because I couldn’t hold the phone to talk. Instead, he said to them, ‘Write letters.’ So they did. Knowing how much I loved poetry, and knowing my love of nature, several friends sent me poems to read. In nine months time, I had quite a collection.”

Elizabeth explained how her dark night of the soul became a womb of creation. She decided to edit the collection of poems into a book called Earth Prayers. The project became her raison d’être and the energy to edit this project became a healing energy itself. “Elias and I sent out invitations for our friends to contribute a poem as well. And oh, the permissions to use some of these poems, you should see the folders in my office,” she exclaimed.

Through her illness, Elizabeth came to see the powerful metaphor nature is. “Nature speaks to us in seasons. There is a time to produce and a time to lay fallow. In hindsight, I saw my down time as that which my body needed to heal. Although I knew of the concept of laying fallow, it took chronic fatigue to make me realize I was not honoring this aspect of life. Now I have learned my lesson.”

In 1990, Elizabeth and Elias formed The Boulder Institute for Nature and the Human Spirit, a social activist organization, which organizes grass root ecological projects as well as small group vision quests in the quiet surroundings of Colorado’s southwest corner. When Elizabeth speaks about the vision quests, her whole face lights up. “We have so much to learn from nature. Nature in all her infinite glory speaks to us, and we must listen.”

Elizabeth is one who walks her talk. It is not uncommon for her to be found in the calls of nature, partaking in a vision quest. There she listens to the wisdom of the rocks, the songs of the trees, the lullabies of the streams, and the energies of the earth. And if you were to hike the many trails in Boulder’s park system, you might see Elizabeth out there. She partakes regularly in the healing process of nature. Her example is one to follow, for in this high-tech age it is all too easy to distance ourselves from our primal environment and lose contact with the heartbeat and resonance of Mother Nature.

There is a right time for everything. A time to be quiet and a time to speak up, a time for keeping and a time for throwing away (Ecclesiastes: 3).
May we often reconnect with the rhythms and healing energies of nature

From STRESSED is DESSERTS Spelled Backward, by Brian Luke Seaward

Coping with Pandemic Fear and Stress

In light of the current COVID-19 pandemic, and the accompanying pandemic fear and stress, we thought a look at some stress and anxiety management basics was in order. In our frenetic society with demands being placed upon people in the workplace, school, community, and home, it is more important than ever for people to find creative ways to cope with and maybe even eliminate distress in their lives. Distress is different than eustress (a name for good stress), which is the helpful type of stress, one that is a burst of energy, telling one’s body what to do. It is the type of stress that can help one accomplish tasks, goals and projects, motivating one to move forward. Eustress becomes distress when it is overdone.


Emotional – Emotional wellness is a deep sense of happiness that comes from understanding personal own feelings and the feelings of other people, accepting personal strengths and weaknesses, and attaining a sense of emotional stability. It is also the ability to maintain effective personal and interpersonal relationships with others. Emotional wellness is the ability to express feelings in an appropriate manner, adjust well to change, and cope with life despite its frustrations and disappointments.

Cognitive – Cognitive wellness encompasses the ability to think clearly and creatively, willingness to continue learning throughout life, ability to apply the things learned in a variety of settings, and readiness to engage one’s mind in interactions with the world. People who are cognitively well are able to absorb new ideas and concepts, understand how thinking affects behavior and emotional reactions, and are to remain steadfast in the face of challenges.

Physical – Physical wellness is associated with living a healthy lifestyle and includes eating a well-balanced diet, sleeping enough, engaging in plenty of physical activity and exercise, maintaining proper weight, and restricting intake of harmful substances such as alcohol, tobacco, drugs, and caffeine. Physical wellness encompasses taking measures to protect one’s physical health, protect against illness and disease, and remain active throughout the lifespan.

Social – Social wellness is the ability to feel at ease and comfortable with oneself and with others. It is the ability to relate well to other people, be outgoing and friendly, and develop and maintain intimacy. Social wellness means one has the ability to handle conflicts while being true to one’s own ideals and beliefs. It is being tolerant of others, especially those who are different. Social wellness means loving oneself in order to be able to love others.


We live in a world fraught with stress. Stress has many sources and can be generated from within a person through self-imposed thoughts and feelings, while others stressors come from the environment:

Stress generated from within a person – Stress can be self-imposed through low self-esteem, anger, feelings of hopelessness, feelings of helplessness, anxiety, perfectionistic tendencies, jealousy and hostility. For example, people who are perfectionistic often bring stress upon themselves by being too careful and worrying about tasks being perfectly accomplished.

Stress generated from the environment – Stress can be felt from the results of environmental catastrophes such as severe storms, earthquakes, tornadoes, hurricanes, floods and acts of war. For example, people who are trying to rebuild their homes and lives after a hurricane find themselves struggling to meet their most basic needs.

Stress generated from conflicts – Stress can be the result of situations in which people are faced with an incompatibility with people, needs, demands, opportunities or goals. For example, a person who does not get along with a co-worker will experience stress on the job.

Stress generated from daily hassles – Stress can be the result of minor irritating annoyances that occur in daily life. Some of these daily hassles may be losing keys, car breaking down, waiting in long lines at a store, waiting for appointments, and getting stuck in traffic. For example, a person having to sit in traffic going to and coming home from work will experience stress.

Stress generated from economic factors – Stress can be the result of economic factors such as losing money in the stock market, not having enough money in retirement, growing inflation, and amassing too much debt. For example, many people have to work later in life because of a lack of enough money to live on in retirement. People may struggle with overcrowded housing, inadequate heating or air-conditioning, dangerous neighborhoods, etc.

Stress generated from changes in families – Stress can be the results of changes in the family such as parents’ separation, divorce, blended families, loss of loved ones, change in residence, birth of a child, adoption, changes in health of family members, and caring for aging parents. For example, people who are forced to care for aging parents often feel guilt, and are stressed because it takes time away from work and other family obligations.

Stress generated from changes at work – Stress can be the result of changes on a job, loss of work, changes in a role played at work, uncomfortable physical demands in the workplace, a lack of safety, interpersonal demands such as an abrasive supervisor or co-worker, and having too much work to complete. For example, a person who must work with an abrasive supervisor will feel uncomfortable most of the work day.

Developing good coping skills is an important component to living a wellness lifestyle. The following exercise fosters laughter, and excellent mood lifter.

Talk To Your Fear

Write a letter to one of your fears describing your feelings about this fear and how much time you devote to worrying about it. Describe how this fear affects your life and the lives of those around you. Describe what you will do to stop being afraid of this situation.

You, __________________________________________________________________________________________, are my fear.
My feelings about you are_______________________________________________________________________ ______________________________________________________________________________________________________________.
I spend ___________time worrying about you because _____________________________________________________________________________________________________________________________________________________________________________________________________________________________.
This affects my life _____________________________________________________________________________________________________________________________________________________________________________________________________________________________.
It also affects those around me by _______________________________________________________________________________________________________________________________________________________________________________________________________________________.
This is what I am going to do about my fear of you ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________.

Excerpted from Coping with Anxiety by Ester Leutenberg and John Liptak, EdD.

Have a Good Laugh

Laughing and developing a good sense of humor can help you to effectively and creatively deal with the tension and stress in your life. There are several ways to bring laughter back into your life:

Wear a smile. Go ahead and try it right now. Put a big smile on your face. How do you feel?

What kind of reaction will you get from someone to whom you give that smile?

Read a humorous book. What is the funniest book you have ever read?

Watch a funny movie. What are your favorite funny movies?

Talk with a friend who gives you a good laugh. Which friends make you laugh?

Recognize that there are situations that can be frustrating and stressful at the time, but when you look back at them, they can actually be seen as humorous. Name one of those situations.

Excerpted from Coping with Everyday Stressors by Ester Leutenberg and John Liptak, EdD.

Compassion in Action

Compassion in action

At the first sign of stress, my sister Gail would not hesitate to light up. The cigarette dangling from her mouth started as an occasional social habit in college. With the advent of her first job as a graphic artist, however, it soon became an adult version of a baby’s pacifier. Like most people who smoke, Gail tried passionately to quit, but her efforts met with little success. More than once I would hear her quote Mark Twain, “Quitting smoking is easy, I’ve done it hundreds of times.” Eventually, social pressures at work forced her to take her adaptive coping technique outdoors, yet the habit continued.

As Gail explained to me, “Cigarette smoking is horribly addictive. The craving for a smoke, actually it’s the nicotine, is beyond approach. I have had other addictions, which we won’t go into, but this has got to be one of the hardest.”

When Gail was pregnant with her first child, Ashley, she kept the consumption of cigarettes to a strict minimum. “I would catch flack from some people—the non-smokers who haven’t a clue. My friends who smoke were more compassionate.” With the second pregnancy she did even better; yet old habits die hard. Within a month of delivery of her son Ian, Gail went back to a pack a day.“

I am very careful not to light up around my children. I know the dangers of second-hand smoke. I don’t smoke in the house or the car. And you wouldn’t believe the nagging I get from my kids.”

One day her four-year-old son, Ian, asked his mom if he could invite a friend to stay over night. As parents do, Gail called the mother of the child to make the arrangements. The answer was a polite but definitive No!

Gail hung up the phone and called Ian over.“

Listen honey,” she said. “Curtis can not come over to spend the night. In fact, he cannot come over at all. His mom explained to me that he has only one lung and she is very careful not to expose him to any chance of cigarette smoke or anything else that would pose a threat to his health.” At first Ian had a blank look on his face, till the message was fully understood. Then Niagara Falls started.“

The tears from Ian’s face continued for three days. He just couldn’t understand why I couldn’t quit. Looking back, I am sure I probably had a few tears too,” Gail explained. “It was one of those, Dammed if you do, dammed if you don’t, situations.”

“You know you can do a lot for your kids to show them you love them. Most of these require large blocks of time, and a lot of it seems to require money. There are sacrifices and compromises for sure. And to be honest, sometimes there’s resentment with these decisions. Any honest parent will tell you so. In this case, there was none of that. I had simply broken my son’s heart. Broken hearts are mended with love. I knew there was only one thing to do. I had to quit smoking.”

Smoking cessation for Gail was not an overnight sensation. It took several stressful weeks. As any of us can attest, to change habits just for ourselves is hard. Doing it for someone else doesn’t make it any easier. But when our actions are motivated by love—for those we love—then we gain footing to a new level. With a good month behind her of smoke-free lungs, Gail made another phone call to Curtis’ mom. This time she got the green light. Ian was beaming.

In simplest terms, compassion in action is an act of service. Until love is acted upon, it is merely a theory, a seed set upon inhospitable rocks. Fear is the motivating factor of stress. It undermines much of our behaviors. Compassion in action is a conscious act of love. We do acts of service not to make friends, to win brownie points or earn favors from God. When we engage in acts of service, everyone benefits.

Compassion in action is nothing less than an act of unconditional love. When we give in the name of service, we give to ourselves as well.

By Brian Luke Seward, from Stressed is Desserts Spelled Backward

Never Again!

ONE DAY, WHILE STANDING ALONG THE SIDE of the swimming pool to start my workout, a man twice my age walked up to me and, with an accent I couldn’t place, asked if he could share my lane. His smile was genuine and I could have sworn I saw one of those Hollywood twinkles in his eyes. Getting in the water is by far the worst part of swimming, so, in an effort to stall the chilling effects of immersion just a moment longer, I nodded my head and waved him in ahead of me. In he plunged, and for the next fifty minutes he never paused once to rest along the pool’s edge. I was intrigued by his good nature, not to mention his stamina, and hoped to strike up a conversation at the end of our workout. As I approached the wall to do a flip turn, he tapped me on the foot, waved good-bye, and jumped out of the water, heading for the locker room. By the time I finished my workout, he was gone.

Several days passed before I saw him again. Once more he approached me, motioned to my lane, and this time, without saying a word, dove in and started swimming. As he entered the water, I noticed a tattoo on his left forearm. Throughout my workout, I was puzzled by the engraved numbers, distantly familiar, yet beyond my immediate recognition. In fact, it bothered me all day long. Just as fast as he entered the water, he jumped out fifty minutes later, but not without tapping my foot, waving good-bye, and smiling.

My curiosity now heightened, I began an inquiry as to this man’s identity. I learned that, like me, he was a faculty member of the American University. His name was Arnost Lustig. But unlike me, he had a very different past.

Originally from Poland, Arnost was about seventeen when he and his family were rounded up by the German Nazis and sent off to the notorious concentration camp, Auschwitz. Like all prisoners who entered that camp, he was separated from his family, stripped of all his belongings, robbed of his essence, and denied his humanity. I was told by those who knew Arnost that the horrors of Auschwitz can never be put satisfactorily into words. The tattoo I observed on his forearm was his official identification number. About a year after he was interned there, the American Forces liberated the camp and hell came to a gradual end. Arnost was a free man in a world riddled in chaos and grieving lost innocence. Like many Holocaust survivors, he emigrated to the United States to start a new life.

The next time I saw Arnost it was in the pool locker room. He approached me and introduced himself to me. We exchanged names and then he gave me a big hug, kissed my forehead, and, with another big smile and twinkle in both eyes, said, “You are like a son to me!” On that day we started a budding friendship, enjoying several workouts and conversations. I later learned that his last name, Lustig, means humor or laughter in German, a name he wears well. Putting his hand to his mouth, he whispered, “It’s how I got through that horrible ordeal in Auschwitz.” Then he put his arm around me and proceeded to tell me a joke.

Until the day I met Arnost, the Jewish Holocaust was a distant event in history to me. From the film footage I saw in high school to the works of psychologist Victor Frankl to Steven Speilberg’s, Schindler’s List, the stories of the Holocaust were disturbingly moving. Yet on that day, Hitler’s “Final Solution” became a living memory. For those who survived, it is said that the atrocities of the Jewish concentration camps were the worst hell on earth.

The same semester I met Arnost, one of my undergraduate students shared with me this story during a classroom discussion about anger and forgiveness. Her grandmother, also a concentration camp survivor, had moved to New Jersey after the war. She returned to Europe two decades later with her daughter. Crossing a street in Poland, she saw the face of a man she could never forget, a Nazi concentration camp supervisor. Filled with emotion, the woman grabbed her daughter’s hand, and walked over to the man, with the intention of slugging him. As she got within a foot of the decrepit old man, she looked him straight in the eyes and quickly changed her mind. Instead she said “I forgive you,” then slowly turned and calmly walked away.

Recently my intrigue with Holocaust survivors led me to a book titled, The Triumphant Spirit, by Nick Del Calzo, a collection of portraits and stories of Holocaust survivors. Although the common theme of hope, the internal sense of a positive outcome is evident amongst all survivors, there emerges another theme as well—and that is the theme of forgiveness. From the thoughts of many survivors, it is explained this way—we had to learn to forgive and move on. To hold disdain and hatred toward a person or people for such horrible atrocities only perpetuates hatred. There are many lessons to be learned, forgiveness is one of them. In the words of Paula and Klauss Stern, Auschwitz concentration camp survivors, “We didn’t survive to hate—but to hope that the world learned something from the experience, so that atrocities like these will never happen again.”

Yom Kippur is a Jewish holiday, the Day of Atonement. It is a day to make peace with our mistakes, injustices, and wrongdoings. Although not a national holiday, many of my students excuse themselves from class to honor the day. I honor the day too. For me, it is a day of forgiveness, and a day to remember.

By Brian Luke Seward, from Stressed is Desserts Spelled Backward

Applied Improv: The “Type O” of Skillsets

Izzy Gesell

I call Applied Improv the “Type O” of skillsets because of its universal usefulness. Each day my Google Alert (set for Improv) brings new examples of the effectiveness of Applied Improv. One day, furloughed workers are taking Improv to cope during the shutdown. Another day, it’s Improv’s role in a business leadership class. I read how teens on the autism spectrum use it to learn communication skills and why caregivers are encouraged to use it with dementia patients.

It’s certainly eye-opening to see how a simple set of games has been rebranded as the Swiss Army Knife of life-skills curricula. (Yes, I’m hooked on metaphors). How can something so ephemeral be so functional in such disparate arenas? What’s the common denominator that makes Applied Improv relevant for everyone? Can something be a jack-of-all-trades AND master of them too? (Yes, I like mixed-metaphors).

Practicing Spontaneity

Improv groups meet regularly to rehearse. Not to collect the best endings to the games for future use, but to practice playing the games without ever needing to know the ending. By becoming comfortable with not knowing, the improviser changes the way they show up in the game. They learn how to act on things they can control and let go of things they can’t. This practice, carried out of the improv class or rehearsal, changes the way they show up in the world. In a very real way, improv practice trains us to treat life as if it were an improv rehearsal.

The PAT Equation ‒ Taking Improv Skills into the Real World.

Three transferable qualities improvisers develop are presence, acceptance, and trust (PAT). Success in Improv requires the ability to stay in the “now,” (P), deal with what you get rather than what you want (A), and rely on a process you don’t have control over (T). Substitute the word “life” for “Improv” in the previous sentence and you have the answer to “How can Applied Improv be useful for so many different purposes?”

Game to Play

This is NOT a…..(Spatula)

Objective: To develop flexible thinking by listing as many uses, real or imagined, as possible for an ordinary object.
Process: Pick an object at random and find possible uses for it other than its primary function.
Players: 1-5
Time Needed: 5 minutes or more depending on number of participants and their creativity.

Directions: After choosing an object, hold it and say, “This is not a (whatever it really is). This is a …..(give it a different function).” To practice, pretend that you have a spatula in your hand. “This is not a spatula, it’s a stake to hold up small plants in my garden.” Pass the item to the next player or add another yourself. “This is a cat-scarer to keep him off my couch.”

Focus Point: Notice, then let go of judgement, evaluation, or looking for best answer.

Hint: 1. Change your perspective on the item when stuck. Turn it around or get up and move away and look at it from afar. See it from the point of view of a child, space traveler, etc.

Hint 2. Use sensory prompts to see new possibilities. What does it look, sound, taste, smell, or feel like?

Variations: Add movement to your description. Make believe you are using it for the purpose you describe. Ex: If the spatula is now a microphone, hold it and sing into it when defining it.

By Izzy Gesel author of Playing Along

I’m Exhausted! How Did I Get Here?

A Brief History of Caregiving

Excerpted from The Complete Caregiver Support Guide, by Ester R.A. Leutenberg & Carroll Morris with Kathy Khalsa

In past generations, it was customary for people to have large families. Members of an extended family often lived within a few miles of each other. Few women had jobs outside the home, so the elderly and infirm were cared for within the family. Both the primary caregiver and care-receiver had the support of nearby relatives, friends, and community.

Circumstances are different today. Families are typically smaller and are often scattered across the country and around the globe. A much larger percentage of women work outside the home. People live longer, often with chronic illnesses. These factors make caregiving much more complicated than it was in the past. 

The early stage of caregiving is often handled by family members or by friends who live near the person needing help. They begin by doing what they can, and often, as time passes, assume the caregiver role without realizing it – caregiving isn’t a job that many people choose to sign up for.

The tasks caregivers perform can vary widely, from transporting a child with disabilities to school each day, to doing someone else’s laundry, to helping with medications, to dealing with insurance companies. Caregiving can be temporary, as when someone is recovering from an accident, or long-term, as when caring for a person in need of significant ongoing support.

In an attempt to define family caregiving, the National Family Caregivers Association (NFCA) developed a list called “Caregiving Is.”  The following is inspired by their list.

  • Caregiving is as diverse as the individuals needing it. 
  • Caregiving means being a person’s healthcare advocate.
  • Caregiving is stressful work. 
  • Caregiving challenges people to go beyond their comfort zone. 
  • Caregiving forces individuals to deal with change.
  • Caregiving is an endless search for balance. 
  • Caregiving is a strain on relationships. 
  • Caregiving can be a lonely world.

Caregiving requires a great deal of emotional, physical, mental and spiritual energy. Given all that it entails, it is not a surprise that caregivers suffer from stress. The cost of that stress – whether short-term or chronic – on the caregiver’s health can be considerable.

Stress (or the stress response) is what you feel when your body prepares to meet a challenge. It goes into a fight-or-flight mode, releasing a flood of adrenaline and cortisol. The breath quickens, the heart beats faster, and the senses sharpen. The body readies for action both when the danger is immediate and real and when it is a matter of perception. 

When short term, the stress response is beneficial. It helps us react quickly to avoid accidents. It keeps us sharp. It provides the endurance to keep going beyond our normal strength. When the threat – perceived or real – passes, the stress level lessens and the body returns to normal. Long-term stress is another story.

When a real or perceived threat to well-being or the need for action is ongoing, the stress response remains activated, releasing hormones over an extended period of time. The body acclimates to being in a defense mode. It turns on the stress response more quickly and leaves it on longer. 

Many people in today’s fast-paced, complicated world live with chronic stress. They may come to depend on the accompanying adrenalin lift and feel down in its absence. But chronic stress has health consequences. Studies indicate that the majority of doctor’s visits are for stress-related complaints.

The list is long. Stress exacerbates health conditions such as asthma and arthritis. It weakens the immune system, making us vulnerable to illness. It can cause headaches, high blood pressure, chronic fatigue, digestive tract problems, higher incidences of diabetes, and sleep disorders. It can negatively impact memory and judgment, cause depression and anxiety, and lead to substance abuse.

If you’re a caregiver, your situation can be a perfect storm of chronic stress.

Making Life Easier

Survival Strategies for the Stressed

It may sound simplistic, but it’s true: Taking time to plan your day and organize your environment can go a long way toward reducing stress and helping you feel you have some control over your situation. With your lists in hand, you will not have to wonder what it is that you need to do, whom you plan to call, where you want to go, or what you intend to buy.

If you do not accomplish everything you hoped to in a given day, move undone items to the next day, putting those of highest priority first. If you repeatedly move the same thing forward, ask yourself: Why do I resist doing it? Is it essential or necessary? Can someone else do it for me? 

Strategies for minimizing daily stress and irritations:

1. Organize your environment (cupboards, closets, a place for your keys, etc.) 

2. Go through mail daily (sort, toss or keep.) 

3. Make lists in a portable notebook/calendar you can keep with you (to do, phone calls, groceries.) 

4. Schedule a realistic day (important things first, doesn’t have to be perfect.) 

5. Create a “What If?” plan. (What if my care-receiver wanders off when we’re shopping?) 

6. Prepare the night before (prepare meds, set the table, review to-do lists.) 

7. Rise before your care-receiver wakes (read, shower, meditate, or enjoy a cup of tea or coffee.) 

8. Do one thing at a time (multi-tasking isn’t always effective when you’re stressed.) 

9. Know your limits and learn to say No! (Protect your time, energy, health.) 

10. Be prepared (food and postage in the house, full gas tank, extra house and car keys.)

11. Keep up with maintenance (fix, replace, maintain – yourself or ask someone.)

12. Take care of your health. (Have a physical exam, eat healthy, sleep well, exercise.)

13. Maintain good relationships (apologize if needed, forgive others, and yourself.)

What will I do to make life less stressful?

After reviewing the list above, write down the stress-relievers you think will work for you. Use the space below or your journal. If you can, chat with other caregivers to see what they are doing to cut down on their stress levels. It could be anything from yelling encouragement at your kid’s hockey game, to reading a good book, to meditating for an hour. Choose what will work for you. Then choose two to implement in the next month. Each month thereafter, add a couple of new stress-reducers to your repertoire.

Remember, it doesn’t have to work for anyone else, just for you. 

Is Your Stress Spoiling Your Holiday Experience?

Only 9 more days until December 25th and the stress level is rising. Cortisol is racing through your body, anger is way too likely to erupt into a scene, and burned cookies turn into a disaster equal to global warming. What can be done over the next few days so that the big day is one of joy and celebration and not one of apologizing to your loved ones because you lost your temper when the dog ate a roll of wrapping paper.

Here are some suggestions that may help.

In The Wellness Lifestyle Workbook by Ester Leutenberg and John Liptak PhD, they suggest the following tips for managing your stress.

1.         Seek to change the situation

How is that supposed to work, anyway? You can’t change the situation, the Holidays are coming in only nine days and you have to be ready. Try reframing the issue by saying, “The holidays will be here in nine days. I will complete the most important tasks before me and celebrate that I managed that. I will not fret about what cannot be accomplished.”

2.  Be more organized

Being more organized is a no-brainer. Make a prioritized list of what needs to be done. Put a couple of easy ones at the top so you get the satisfaction of crossing them off quickly. As you write it, remind yourself for example, that twenty different kinds of cookies are not necessary for a happy holiday.

3.  Ask someone to alter his or her behavior

Someone making you crazy? Constantly asking if you got this or that done and bemoaning the fact that you didn’t. Ask them to alter their behavior. Nicely. Don’t scream at them to back off right after they ask you the same question for the tenth time. When your temper is under control tell them that their constant questioning (read nagging) about what is and isn’t done only makes you crabby and slows you down.

4.  Exercise

Get out of the house for a run or go for a swim. If the weather is too bad go to the Y, the mall, or the gym and be in the moment while you are there. Think of how good it feels as the endorphins speed through your body. Notice how much better you feel when you get home after a few hours away.

5.  Engage in deep breathing, meditation, etc.

If you have tried meditation or guided imagery you already know how helpful it can be. If you are a newbie, find someone who will read you a relaxation script or purchase a relaxation CD. They are quite inexpensive and can be an amazing help. Remember, though, if you are trying this technique for the first time it might take a few attempts before it works easily. Here is a link to a good beginner’s relaxation script.

6.  Be assertive

How can being assertive help your stress levels? The thought of conflict makes many folks cringe. However, learning to say no is an important part of maintaining your mental health. Don’t say yes to something you don’t have time to do.

7.  Alter irrational beliefs

This is one of the best stress relievers. During the holidays many people try to replicate what they had as a child. Handmade gifts, tons of cookies and candies prepared to perfection, a huge dinner with all the relatives before the midnight service, a spotless house before the kids wake up in the morning, a gingerbread house that replicates the National Cathedral, or wrapping each stocking gift separately and writing a poem to go on each one. Most of us work full time.  Most of our mothers did not. It is irrational to expect to get the same amount of preparation done in the time we have. Rewrite your expectations of what the holidays should be keeping in mind your limited free time. Get rid of the traditions that are marginal to the enjoyment of your family and go with a plan that is actually possible.

8.  Withdraw from the situation

Withdrawing from the situation doesn’t have to be as drastic as it sounds. Perhaps you sing in your church choir. Maybe you always shovel the snow for your neighbor. It could be that you are the one who prepares the coffee and cookies for after the service. Someone else can do those things. Trust in the fact that as valuable as you are to the organizations you serve there are others who would relish the chance to try their expertise on what you do.

9.         Accept the stressor

You can, of course, simply accept the thing that is stressing you out. Saying to yourself I’m going to be a bit more stressed than usual because I have to finish 20 angel costumes by morning and then hitting the machine and doing it doesn’t really relieve the stress of the moment, but if you insist on doing the task you know is going to make you a bit crazy you can accept the stress that comes along with it. Understanding this will help you get through whatever it is with grace. Finishing the task will give you an immediate lift in spirits.

10.       Maintain good health by nurturing yourself

Don’t forget during this often frantic time of the year to take good care of yourself. You can’t avoid holiday stress if you are overtired, hungry, or have overindulged in your favorite treats. Don’t eat the whole fruitcake, don’t feel you have to finish that last Tom and Jerry,  remember to take your meds on time, and don’t cheat yourself of needed sleep. Limit your day and go to bed at least within an hour or so of the usual time. You will find that you get lots more done if you are fully awake and rested.

Leutenberg and Liptak suggest these coping strategies in The Wellness Life Style Workbook that will help manage your stress.

  • Changing old habits takes time. Do not attempt to change too much too soon or you might get frustrated.
  • Assess the types of support you will get from family and friends before choosing your coping strategies.
  • Remember that you cannot change or control everything. Focus on which you have control.
  • Do not expect a single coping strategy to “fix” the stressful situation.

Suicide and Self-Injury on the Rise

Whole Person Associates announces publication of two new resources: Suicide & Self-Injury Prevention: A Clinician’s Guide to Assist Adult Clients and the Teen Suicide and Self-Harm Prevention Workbook, two outstanding new offerings from Ester Leutenberg and John Liptak, EdD.

Suicide & Self-Injury Prevention Workbook

Suicide rates are on the increase in every state except Nevada. They are rising at an alarming rate: by more than 30% in half of the states and as much as 58% in some. Suicide is the 10th leading cause of death in the United States. Every 28 seconds someone attempts suicide. Retrieved from on 6/17/19.

What can a clinician or trusted mentor do to help end this epidemic? Where does one look to find the right avenues to follow? Will discussing suicide with someone we are concerned about simply place suicide ideation in their minds where it wasn’t before instead of diverting the person’s mind to a safer place?

Not so. In their two new books, Suicide and Self-Injury Prevention Workbook: A Clinician’s Guide to Assist Adult Clients and the Teen Suicide and Self-Harm Prevention Workbook authors Ester Leutenberg and John Liptak, EdD, collaborate to create a resource “…to help clients recognize that many other people have many of the same issues, to which no shame is connected, and that self-injury and/or suicide is definitely not the answer to their problems.” Trained clinicians are given a plethora of assessments to help discover what their clients are thinking and feeling. Worksheets and handouts then provide methodology to guide clients through a process to reevaluate their situation and find reasons to continue the battle and lead them to find their own safe place.

Teen Suicide & Self-Harm Prevention Workbook

Click here for a free worksheet titled Why You Can Be Hopeful.

While self-injury or self-harm are not the same as an attempt of suicide, many of those who self-harm eventually adopt suicidal ideation. A review of some of the myths about self-harm from the teen version of the workbook reminds us that it isn’t just kids who self-harm.

Myths about SELF-HARM
It is important to look at self-harm from an objective mindset. Below are some of the myths and misconceptions that surround the topic of self-harm.

MYTH: Only adults self-harm.
People of all ages self-harm. Self-harm is not particularly meant as a suicide attempt. It is an unhealthy attempt to cope with emotional pain such as anger, frustration, loss, sadness, etc., and physical pain.

MYTH: Teens who self-harm are usually open about self-harm behavior.
Self-harm in teens is usually kept private.

MYTH: Teens who self-harm do this as an occasional expression of behavior and only do it once or twice.
Some teens may self-harm once or twice and then stop. However, many teens do it frequently and it becomes a long-term, continual behavior, and possibly a habit.

MYTH: Teens who self-harm use only the cutting behavior.
Teens who self-harm cut or scratch with a sharp object, hit or punch themselves, carve on or pierce the skin, pull out hair, burn, pick at a wound, etc., or continually put themselves in harm’s way, i.e., engage in fights, drive recklessly, abuse substances, etc.

MYTH: Only teens with a mental illness consider self-harm.
Not all teens who self-harm have a mental illness, but they may have emotional, physical, and/or social issues that create unbearable emotions that lead to extreme physical responses.

MYTH: Teens who self-harm are willing to talk about it with others.
Usually, teens who self-harm do not share with other teens. It is vital for the person having self-harm thoughts or behaviors to talk with someone they trust: a therapist, friend, family member, spiritual or religious leader, etc.

MYTH: Self-harm calms the person for a long time.
In fact, the person usually feels guilt, shame, and other painful emotions afterwards.

MYTH: No real damage happens with self-harm.
There is a strong possibility that serious or life-threatening consequences can occur from self-injuring behaviors.

MYTH: Teens self-harm for attention.
Teens who self-harm should not be considered attention-seeking. Teens self-harm for many reasons: to help themselves feel something when they are emotionally numb; to distract themselves from their emotional pain; to punish themselves; or to disfigure themselves.

Although these are only a few of the myths and misconceptions about self-harm, they will provide you with some insight into the thinking that is prevalent about people who self-harm. Encourage individuals to call a trusted person, see a mental health facilitator or medical professional, find a positive support system, and use local or national resources and hotlines.

Click here for the Myths about SELF-HARM handout designed to help clients reframe bothersome incidents.

Erasing the Stigma of Mental Illness

By: Peg Johnson, MA

Erasing the stigma of mental illness. But what is stigma? A stigma is defined by Merriam Webster as “A mark of shame or discredit, a stain, such as she bore the stigma of cowardice.”  Defined like this it makes us cringe. Surely an educated person in the U.S. would not think this way. Not true. In a survey published in June 2009, Vol 40, No. 6,  Sadie F. Dingfelder  found that:

Despite decades of public information campaigns costing tens of millions of dollars, Americans may be as suspicious of people with mental illness as ever. New research by Bernice Pescosolido, PhD, published in the Journal of Health and Social Behavior (Vol. 41, No. 2), finds that 68 percent of Americans do not want someone with a mental illness marrying into their family and 58 percent do not want people with mental illness in their workplaces.

Sadie F. Dingfelder, Monitor Staff
Erasing the Stigma of Mental Illness

Imagine what it feels like to have that stigma applied to you when you are already struggling with mental illness. When the people surrounding you believe that you are socially unacceptable, when they see your illness as an unwanted attribute, it only deepens the sense of unworthiness you are already trying to overcome. 

People who stigmatize and /or stereotype others bring about unfair treatment rather than help. This unfair treatment can be very obvious. For example, people make negative comments or laugh. On the other hand, this unfair treatment can be very subtle. For example, people might assume that a moody person is dangerous or violent. Rather than improving, some attitudes have gotten worse over time: For instance, people are twice as likely today than they were in 1950 to believe that mentally ill people tend to be violent. Sadie Dingfelder reports:

Of course, the vast majority of people with mental illness are not violent—though they are 2.5 times more likely to be victims of violence than members of the general population, according to a study published in 2001 in the International Journal of Law and Psychiatry (Vol. 24, No. 6). And a new study, published in February in the Archives of General Psychiatry (Vol. 66, No. 2) finds that mental illness alone does not increase the chances that a person will become violent.

Sadie Dingfelder

How can we reduce or (better yet) succeed in erasing the stigma of mental illness? Why should we bother? Compassionate reasons aside, one in four Americans will be affected by a mental health disorder in any given year, and many more will have a family member affected. According to the National Alliance on Mental Illness (NAMI), serious mental illness costs the US $193 billion in lost earnings per year. There are ample statistics to underscore the need to remove this extra burden from those already struggling with a difficult diagnosis. Sixty percent of those with a mental illness fail to seek care, many because they fear the stigma.

Erasing the Stigma of Mental Illness Worldwide

The stigma of mental illness is a world-wide issue. What can be done? What has been tried? In Israel Ezer Mizion offers a variety of psychological support services and rehabilitative programs for people suffering from psychological disorders, emotional issues and mental illnesses. These services include:

  • A Big Brother/Sister Program that pairs individuals suffering from mental illnesses with trained mentors who provide companionship, offer assistance with basic daily function, and teach the skills necessary for independent living.
  • Rehabilitative employment centers that provide mentally handicapped people with basic vocational training and employment, and ease their integration into free market employment.
  • A psychological referral team that recommends appropriate psychologists, psychiatrists and counselors to people grappling with emotional disturbances, mental health issues or difficult relationships.
  • A network of psychiatrists and psychologists throughout Israel who provide their services at a discount to patients referred by Ezer Mizion.
  • A 24-hour crisis hotline for non-medical emergencies, including mental health crises such as suicide attempts or severe manic episodes.
  • Click here to go to their website:

In Canada the focus has been on the prevalence of mental illness, as well as the symptoms of the disease. JianLi Wang, Phd, found 75 percent of Canadians could diagnose a depressed person described in a story. A follow-up survey revealed the not-so-good other side of the issue. Forty-five percent of the folks surveyed said they were sure depressed people are unpredictable, and 20 percent believed the depressed folks were dangerous. Wang posited, “You can hold the belief that mental illness is a real disease and still be afraid of people with it.”

The message that mental illness is a disease like any other didn’t seem to work, either, according to Bernice Pescosolido, PhD, professor of Social Science at Indiana University. 

A recent campaign in Scotland called “See Me” tried a different strategy around erasing the stigma. It educated reporters and editors about the harmfulness and inaccuracy of the stereotype that people with schizophrenia are prone to violence. While it succeeded in reducing the number of stories linking violence and mental illness, other unexpected results occurred. Coverage of people with mental illness became more negative. They were often shown as being objects of pity (International Journal of Health Promotion (Vol. 10, No. 1). Neil Quinn, PhD, from Glasgow School of Social Work noted that journalists became afraid to report on mental illness.

A lesson of the Scotland campaign, says study co-author Lee Knifton, Head of Scotland, Assistant Director UK, is that anti-stigma campaigns can’t just focus on eradicating negative depictions of people with mental illness. They need to tell positive stories as well, he says. Read more about the Scottish Mental Health Arts and Film Festival at

The take-away: “If you focus on the competence of people with mental illness, that tends to lead to greater tolerance,” says Pescosolido.

Canada is now telling the stories of people with mental illness. Here in the U.S. more and more celebrities and people in the public eye are coming forward to discuss their mental illness and show how they have been able to succeed even though they had a mental illness. The National Alliance on Mental Health (NAMH) has issued the following:

Navigating life with a mental health condition can be tough, and the isolation, blame, and secrecy often encouraged by stigma can create huge challenges to reaching out, getting needed support, and living well. Learning how to avoid and address stigma are important for all of us, especially when you realize stigma’s effects:

  • People experiencing mental health conditions often face rejection, bullying and discrimination. This can make their journey to recovery longer and more difficult.
  • Mental health conditions are the leading cause of disability across the United States.
  • Even though most people can be successfully treated, less than half of the adults in the U.S. who need services and treatment get the help they need.
  • The average delay between the onset of symptoms and intervention is 8-10 years.
  • Suicide is the second leading cause of death of youth ages 15-24 and the tenth leading cause of death for all Americans.

Click here to go to the NAMI site and sign the pledge to fight mental illness stigma: Let’s work together on erasing the stigma, and unite to relieve those with mental illness from this additional burden.

Sexual Abuse Survivors

Do Victims of Sexual Abuse Survive?

Almost every day we hear about a new case of celebrity sexual abuse. Is this because of things like the #MeToo movement… people feel more comfortable talking about these issues, or is there an overall increase in individual cases? The experts are divided. In a story by Kristy Totten of Nevada Public Radio it was reported that:

Daniele Dreitzer, the executive director of the Rape Crisis Center, told KNPR’s State of Nevada said, “We’re not seeing evidence that this is a result of more assaults happening. We really do believe that it is more people feeling comfortable speaking out.”

Dreitzer said more people are coming forward with their own experience or are calling to ask how to help family and friends. She attributes the rise in calls to people breaking their silence through the Me Too movement and the change in the national conversation about sexual violence.

“More people are recognizing I think that in some cases may be an experience they had that they didn’t necessarily identify as being sexual violence maybe was,” she said.

Here are some common myths about sexual abuse:

  • MYTH: Sexual abuse only occurs to women. In fact, both men and women can be perpetrators and victims of sexual abuse.
  • MYTH: Sexual abuse always occurs between strangers. In fact, most victims of sexual abuse actually know or are related to their perpetrator.
  • MYTH: Sexual abuse is always violent. In fact, many acts of sexual abuse are not violent, but all people have the right to decide what they want to do and what they do not want to do sexually.
  • MYTH: Sexual abuse occurs most often in same-sex relationships. In fact, sexual abuse occurs in both same-sex and opposite-sex relationships.
  • MYTH: Sexual Abuse always involves physical contact. In fact, sexual abuse may not involve any physical contact at all and can include such behaviors as repeatedly using sexual insults to other people, spying on someone, spreading explicit sexts, ogling or leering, suggestive comments, etc.

Just as myths abound about sexual abuse, many people who have been sexually abused develop several critical misconceptions about themselves and their value as human beings.

  • “I’m damaged goods now.” Many survivors feel that the abuse has made them sexually inadequate or inferior to other people. They often feel as if they can never get their adequacy back.
  • “I’m a sexual object.” Many survivors have lost their sexual identity due to the abuse and believe
  • that they must either please others, or see themselves as easily controlled by others.
  • “Bad things happen to bad people. I must be bad.” Many survivors believe this about themselves and think they deserved this abuse. This is not true. Bad things sometimes happen to good people.
  • “I am dirty.” Many survivors cannot push the feeling of being dirty out of their mind and/or body.
  • “I’m a bad person.” “I deserved it.” “No one will ever want or love me.” “I should have known.”

Many survivors experience feelings of guilt and shame. Consequently, they feel like they are worthless and unlovable. Although all of these conclusions are not true, they can cause tremendous mental, emotional, and physical damage. They represent a negative self-concept and can be extremely demeaning to the survivor. If these notions continue, survivors need to see a mental health and/or medical professional.

Common Reactions of Adults Who have Been Abused

As sexual abuse becomes a bigger problem for people on all levels of society, it is important to make note of the specific symptoms people may be experiencing or exhibiting. Because many of the symptoms tend to stay with survivors throughout their lives, it is important to acknowledge these symptoms as survivors work to recover and heal. People who have been abused may exhibit many of the following symptoms:

AngerHatred of bodySexual addiction
Boundary issuesHelplessnessShame
ConfusionInability to control feelingsSuicidal thoughts
DepressionIsolation from PeopleTrust issues
Detachment while having sexLack of interrest in sexUnable to enjoy sex
Disturbing sexual thoughtsLow self-esteemUnrealistic expectations of self
Eating disorderNegative view of sexUnusual response when being touched
EmbarrassmentPanic attacksVictim thinking
Empty feelingPoor self-acceptance
FearProblems with rage and anger
Fear of a physical examRelationship issues
Feeling worthless or “dirty”Sadness

In order to heal and thrive after being sexually abused, people need support, trust, and understanding as they begin their healing journey.

Special Safety Considerations When Working with Survivors of Sexual Abuse

Your professional skills and familiarity with your participants is crucial. Emphasize that participants are survivors. Skills that helped in the past may help now, in addition to new strategies. They are already working toward recovery by attending this session. Reassure participants about their safety, their control, and their empowerment.

Emphasize the following:

  • They decide what to disclose, when, and how, (through writing, drawing, etc.).
  • Their privacy is respected: sharing is voluntary, and what is said in session stays in session.
  • No one must stay in the room or be forced to participate.
  • They may stop, take a break, or request a different activity, etc., if they feel overwhelmed.

Discuss and legitimize concerns. Telling too much too soon can be overwhelming. A slower pace may be safer. People may have told them “It’s no big deal.” It is a big deal. Explain that emotional reactions are unique to each person, and reactions may range from numbness to panic. Discuss that cultural factors affect responses to abuse and to attitudes toward seeking help. Alternate between coping skills activities and trauma-related work. Plan to end each session with deep breathing, guided imagery, or another relaxation technique. Allow people to select their seats (some may want to be near an exit, etc.). Opt for the maximum distance between seats for privacy and personal space preferences. Prepare participants for exposure to others’ emotions, disclosures and sexual content. Tell people to share if they feel uncomfortable or need a time-out from an intense situation. Ask whether the majority of participants prefer brighter or dimmer lighting.

Safety Plans

Encourage group participants to request private sessions as needed. Emphasize the importance of telling the facilitator if anyone has thoughts of violence or self-harm. Create a climate of collaboration. Demonstrate that facilitators are partners in the recovery process, not authority figures.

Encourage peers to support each other by engaging in these ways:

  • Sharing thoughts and feelings within their comfort zone.
  • Modeling coping skills.
  • Asking for help.
  • Demonstrating self-care and assertiveness.
  • Setting boundaries, e.g., what one will and won’t disclose to the group.
  • Reinforce resiliency by assisting participants to achieve these goals:
  • Develop a support system of people, places, and resources that promote recovery.
  • Help others.
  • Focus on strengths.
  • Recall positive experiences.
  • Gain perspective through spirituality, religion, higher power, peace in nature, etc.
  • Nurture hope for a healthy future.

These worksheets will help your clients begin to verbalize and explore their experiences. Click here for printable versions.

The information above was excerpted from Coping with Sexual Abuse by Ester R.A. Leutenberg and John J. Liptak, EdD.

What is Mindfulness?

Mindfulness is about developing the basic human ability to be fully present, aware of where you are and what you are doing, and not overly reactive or overwhelmed by daily hassles. Mindfulness is a tremendous technique, one that is powerful for snapping you back to where you are in the present and what you are doing and feeling. While all people possess the ability to develop mindfulness, it is rarely activated and utilized when daily hassles build up and begin to cause stress and frustration.

Mindfulness Skills Workbook

Mindfulness has been described as a state of mind in which people can observe mental activity without attaching to it or evaluating it. Mindfulness is about becoming aware of your natural tendency to sleepwalk through life. When on autopilot, you navigate through the day totally unaware of what you are doing. This happens when a driver arrives at work and does not even remember traveling there, or the person who is so busy thinking about the future that the beauty of the present is overlooked.

Through mindfulness, people can recognize when they are operating on autopilot and step into the present moment free from worry, anxiety, and stress. It is paying attention on purpose, being present in your surroundings and with people, and enjoying and appreciating life more. Mindfulness is about paying attention to what is going on with the body, mind, and environment which leads to an understanding of how you are getting stuck in autopilot. By developing mindfulness, people can build a fresh perspective and start to become more aware of personal habits that cause stress, fear, dissatisfaction, frustration, and anger. With this awareness comes the ability to stop reacting to daily hassles and start to begin to make more effective life choices.

Although mindfulness is not automatic and does not occur spontaneously, it can be learned and practiced so that it can be accessed intentionally when needed. Some of the characteristics of mindfulness include non-judgmental awareness, paying attention on purpose, remaining non-judgmental, staying in the present, being non-reactive, and remaining openhearted and compassionate.

  • Increased acceptance—By not making evaluations, participants can accept the internal thoughts in their mind and see these messages as simple mental processes rather than pure truths.
  • Greater awareness—Participants will be able to experience expanded awareness and a clearer vision of the world and its processes.
  • Less intense reactions—Participants will be less inclined to react when experiencing the stress of daily hassles. Instead, they will develop an observer stance through which they are free from evaluation, attachment, and frustration.
  • Relaxed approach—Participants will learn to relax to be better able to cope with worry, anxiety, and stress related to daily hassles in life.
  • Calm demeanor—Participants develop a state of mind in which they are mentally and physically at peace. They will be prepared to deal more effectively with the daily worry, anxiety, and stress caused by everyday hassles. They will experience greater overall well-being.
  • Mental functioning—Participants will experience greater concentration, focus, and self-awareness that will promote greater personal and professional growth and development.

What are Your Daily Hassles?

Negative big-life events such as losing a job, death of a loved one, and moving to another location can be extremely stressful and can cloud every moment of the day. On the other hand, it is the daily annoying or troublesome concerns that cause enough worry, anxiety, and/or stress to wear people down over time.

Select your daily hassles from the list below. Journal about why they are hassles for you.

Big life events
Future concerns
Getting ahead
Home maintenance
Losing things
Past events
Sleep issues
Social obligations
To-do list
Volunteer job
World affairs

Click here for printable worksheet: What Are Your Daily Hassles?

Are you operating on autopilot?

Living on autopilot means to do something without focusing on it or thinking about what is actually happening. Many people live their lives doing the same things over and over regardless of the results they receive. When this occurs, people lack awareness of what is occurring in their lives, and they operate from habit.

Respond to the questions below by journaling about your day yesterday to see how mindful you are.

What time did you wake up in the morning?
What did you eat for breakfast?
What did you eat for lunch?
What did you eat for dinner?
What snacks did you have throughout the day?
Who did you see throughout the day and what did you talk about?
What was your most pleasant moment of the day and how did you feel?
What was your most stressful moment and how did you feel?
Who was kind to you? Explain.
To whom were you kind? Explain.
How did your day end?
What time did you go to sleep?

The more you remember about your day, the more mindful you tend to be. On a separate sheet of paper, or in your journal pick one or two items and expand your reflections in detail.

Click here for printable worksheet: How Mindful Are You?

*Excerpted from Mindfulness Skills Workbook: Remedies for Worry, Anxiety & Stress

Celebrate Social Workers: National Social Work Month

Celebrated each March, National Professional Social Work Month is an opportunity for social workers across the country to turn the spotlight on their profession and highlight the important contributions they make to society…. We celebrate the contributions of social workers during National Social Work Month in March.

Elevate Social Workers

Who are Social Workers, and what do they do?

Social workers are responsible for helping individuals, families, and groups of people to cope with problems they’re facing to improve their lives. Child and family social workers protect vulnerable children and support families in need of assistance. Social workers help people solve and cope with problems in their everyday lives. Clinical social workers also diagnose and treat mental, behavioral, and emotional issues.

Advocacy is an important aspect of social work. Social workers advocate or raise awareness with and on behalf of their clients and the social work profession on local, state, and national levels.

Social workers typically do the following:

  • Identify people and communities in need of help
  • Assess clients’ needs, situations, strengths, and support networks to determine their goals
  • Help clients adjust to changes and challenges in their lives, such as illness, divorce, or unemployment
  • Research, refer, and advocate for community resources, such as food stamps, childcare, and healthcare to assist and improve a client’s well-being
  • Respond to crisis situations such as child abuse and mental health emergencies
  • Follow up with clients to ensure that their situations have improved
  • Maintain case files and records
  • Develop and evaluate programs and services to ensure that basic client needs are met
  • Provide psychotherapy services

Social workers who are licensed to diagnose and treat mental, behavioral, and emotional disorders are called clinical social workers (CSW) or licensed clinical social workers(LCSW). They provide individual, group, family, and couples therapy; they work with clients to develop strategies to change behavior or cope with difficult situations; and they refer clients to other resources or services, such as support groups or other mental health professionals. Clinical social workers can develop treatment plans with the client, doctors, and other healthcare professionals and may adjust the treatment plan if necessary based on their client’s progress. They may work in a variety of specialties. Clinical social workers who have not completed two years of supervised work are often called master’s social workers(MSW).

Requirements to be a social worker vary by state, but most states require social workers to be licensed, registered, or certified in their field. For example, it generally requires taking an exam and completing at least two years of supervised clinical experience.

Retrieved on March 5, 2019 from The Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Social Workers, 

Are you working with a social worker? Do you know someone who is in the field? Make a point of giving them a shout out and a big thank you for all they do to benefit others.

Myth or Fact

Continuing our focus on social workers, here are some myths and truths about mental health issues.

Myth: Mental health issues are rare.
Fact: Mental health issues are not rare and affect nearly everyone either directly or indirectly.

Myth: People with mental health issues are unable to lead productive lives.
Fact: Most people with a mental health issue respond to treatment, learn to cope with and manage their problems, and go on to lead productive and fulfilling lives.

Myth: People who have mental health conditions will not get better.
Fact: Once diagnosed, mental health issues are treatable. While they are not always cured, they can be managed effectively. Most people with mental health conditions live productive and positive lives while receiving treatments for their mental health issues. As is the case with any illness, individuals with severe or persistent mental health conditions who respond poorly to available treatments may require more support and may not function as highly as others.

Myth: People with serious mental health issues are violent and unpredictable.
Fact: While some people who suffer from serious mental health issues do commit antisocial acts, mental health issues do not equal criminality or violence – despite the media’s tendency to emphasize a suspected link. People with mental health issues are no more likely to commit violence than anyone in the general public, but they are more likely to be victimized and are more likely to inflict violent behaviors on themselves.

Myth: Mental health issues happen because of bad parenting or personal weakness.
Fact: The main risk factors for mental health issues are not bad parenting or personal weakness but rather genetics, severe and prolonged stress (such as physical or sexual abuse), or other environmental influences (such as birth trauma or head injury).

Myth: Treatments for mental health issues are not usually effective.
Fact: The effectiveness of any treatment depends on a number of factors including the type of mental health issue and the particular needs of the individual. A combination of psychiatric medication and psychotherapy, or social interventions is the most effective way to treat mental health issues.

Myth: Mental health conditions are caused by everyday stressors.
Fact: It may seem that stress is responsible for mental health conditions; however, there is no one clear cause of mental health issues. Rather, it is a result of complex interactions between psychological, biological, genetic, and social factors. Stress, stigma, and lack of support can make it worse on the individual.

Myth: Mental health issues are always hereditary.
Fact: Some mental health issues include a genetic component, which results in a predisposition or vulnerability toward the mental health problems among children and siblings, but environment also plays a key role in the development of certain conditions. If someone in one’s family has a mental health condition, that person will be a higher risk.

Managing Moods

People become sad for a variety of reasons including disappointment, grief, frustration at not being able to accomplish a project or not getting what’s desired, experiencing despair during holiday seasons, etc. When these feelings of sadness and/or dysphoric moods last for hours and even days, they may not be a cause for concern. These feelings are part of the normal “ups” and “downs” of life. It is common for people to feel blue or down, become frustrated and/or experience a sense of emptiness from time to time.

However, a sad mood which won’t let up can change the way people think and feel and may be a sign of a more serious mood problem. When people find themselves for several weeks taking little joy in activities they have previously enjoyed, appear irritable a majority of the time, and feel fatigue and a general loss of energy, they may be experiencing the symptoms of more serious problems.

These more serious mood problems stretch far beyond the normal limits of disappointment, loss, frustration, and joylessness. Mood problems can be accompanied by an inability to cope with everyday life issues and stressors. Rather than temporary feelings of down in the dumps, these extreme feelings tend to last for more than a few hours or days. These feelings tend to affect all aspects of a person’s life and leave the person feeling empty, unable to move, and hopeless for weeks, months and even years.

People who experience problems in maintaining a balanced and healthy overall mood are often incapable of functioning well in daily life. They often experience extreme emotional states, negative feelings, and self-defeating moods that are inconsistent with what is happening in their environment. People struggling with this mental condition find that they are unable to conquer their moodiness in the workplace, at home, with family and friends, at school, and in their community. People who experience moodiness have problems in interpersonal relationships, ability to work effectively, study and concentrate, and in the ways they eat, sleep, relax and live their daily lives.

Types of Serious Mood Inconsistencies for the Facilitator

Many different types of mood disturbances are conveyed and expressed in different forms.

  • Major depression (often referred to as unipolar depression) involves a profoundly sad mood and a high probability of distorted depressive thinking that occur over time.

Some of the additional symptoms:

• A persistent, sad mood most of the day accompanied by feeling empty
• Experiencing a significant reduction in appetite and weight loss when not dieting, or increased appetite and weight gain
• Sleeping too much (hypersomnia) or an inability to sleep (insomnia)
• Feelings of inadequacy
• Racing thoughts and impulsive behaviors
• Hostility or aggression
• Feelings of agitation or feelings of restlessness
• Fatigue, loss of energy or feelings of being slowed down
• Feelings of worthlessness and hopelessness or excessive or inappropriate guilt
• Diminished ability to think or concentrate, remember things or be decisive
• Constant feelings of anxiety or feelings of irritability
• Loss of interest in activities, or a decrease in pleasure in activities once enjoyed
• Physical symptoms such as headaches, pain, digestive problems
• Thoughts of suicide and /or danger to others

  • Bipolar depression involves an alteration (like a roller-coaster ride) of down feelings (depression) and up feelings (excessive and often inappropriate euphoric), rapid speech and hyperactivity.

Some additional symptoms:

• Cycles of elation and depression
• Thoughts of suicide and /or danger to others
• Inflated self-esteem or grandiosity
• Decrease in the need for sleep
• Flight of ideas
• Distractibility
• Increased engagement in risky behavior

  • Milder forms of depression carry detectable symptoms and impact daily activities in ways that demonstrate a diminished interest in things people usually find interesting or enjoyable.

Some of these types of mood disturbances:

• Dysthymia – Person has a mild depression that lingers for more than two years. For people with dysthymia, life has little pleasure and they tend to be cranky, irritable, and testy.
• Postpartum Depression – Person experiences depression after childbirth. Sometimes called baby blues, this type of depression may be associated with psychological and physical factors.
• Seasonal Affective Disorder – Person experiences depression with seasonal changes in climate and light.

Depression from unknown origins includes feelings of sadness and emptiness, low energy, and a lack of interest that occurs naturally when experiencing change or stress in life. Unlike the feelings of sadness and moodiness that are part of everyday life, many people are often unable to deal with their feelings of sadness and moodiness and their feelings last much longer. The mood is accompanied by feelings of irritability and hostility, a growing sense of fatigue, and a sense of hopelessness about the future.

Sources of Serious Mood Inconsistencies (Click here for a reproducible handout)
Where do disturbances in mood originate? Why do some people experience changes in mood and moodiness, while others do not? That is not an easy question to answer. Because mood inconsistencies are very complex in nature, they usually do not originate from one source. Rather, many things can lead to mood disturbances in people, and often it is not one of the following sources, but a combination of several sources.

Negative Thinking
Distorted, maladaptive, and irrational thinking can cause and enhance feelings of sadness and moodiness. A thorough examination should be conducted of a participant’s thought processes as they relate to and affect feelings.

Genetics and Biology
Family history can influence one’s predisposition to moodiness. A complete medical and psychological history should be completed to identify family members who may also have experienced periods of sadness.

Uncontrollable Situations
Situations in which people find themselves unable to control the outcomes can enhance feelings of sadness, a loss of interest, and a sense of hopelessness and helplessness. An examination of the situations in which participants experience feelings of moodiness should be conducted by a medical/psychological professional.

Life Events
An inability to cope with major stressors can be a factor in moodiness. Some of the major stressors that often precede mood disturbances include separation and divorce, traumatic shock, legal troubles, feeling stuck in a situation without an exit, loss of a loved one, and loss of a job. An examination of the life events that may be causing sadness and moodiness should be conducted by a medical/psychological professional.

Medical Conditions
People who have medical conditions often experience mood disturbances as a secondary symptom. A participant’s medical history can reveal conditions that might induce a mood problem and should be examined by a medical/psychological professional.

People often experience mood problems from chronic use of alcohol and drugs. An examination of a participant’s drug and alcohol abuse should be examined by a medical/psychological professional.

Lack of Social Support
People who have access to a social support system are much less likely to experience severe and extended bouts of sadness. An examination of participant’s support system should be conducted by a medical/psychological professional.

External Causes of Moodiness

Moodiness develops from a variety of external causes. By becoming more aware of some of the external causes of depressed moods, a plan can be developed to overcome them. Some of the external causes of depressed moods are:

  • Loneliness
  • Lack of social support
  • Recent stressful life experiences
  • Family history of depression
  • Marital or relationship problems
  • Poor self-esteem
  • Financial strain
  • Early childhood trauma or abuse
  • Unemployed or not satisfied with job
  • Health problems or chronic pain
  • Loss of loved one(s)

Click here for an exercise to help clients recognize external causes of depression.

*Excerpted from Managing Moods by Ester R.A. Leutenberg and John Liptak, EdD.

Mindfulness for Emerging Adults: A Blog Series, Part IV

Finding Belonging in the Digital Age

By Donna Torney, MA, LMHC, RYT

If you had a magic wand, and could build your ideal community, what would it look like?  Clarifying who you consider your “people” will help you discover a deeper sense of belonging.

Picture this scene:  It’s a warm, sunny day in a small city or town. You are strolling by an outdoor café. The tables are full of people sipping coffee and nibbling pastries. Some people are talking to one another, but most are looking at their hand-held devices. Are they feeling connected, or lonely?  It’s really hard to tell isn’t it?  And what about you?  Are you, as you walk by the café, feeling a sense of belonging?

Finding social connection today is a different process than it was even a decade ago. But the fact is, like our ancestors, we are social animals and in most cases experience a stronger sense of well-being when we travel in a group versus flying solo. So what does it mean to feel like you “belong” in the digital age? 

Finding Belonging in the Digital Age

Technology is wonderful! I am after all writing this article on my laptop, on a program that helps me catch typos and make my points as clearly as possible. However, the pervasiveness of technology can trick us into thinking that we are physically evolving just as rapidly as our digital gadgets. We are much more than walking, talking, processing systems. Our nervous system is the same as our grandparents and our great-great grandparents. This slow-to-evolve system that we all share needs to be cared for and tended to with connection to community and the natural world.

You may be thinking, “Well, I’m an introvert,” or “I get enough time with my friends online.”  But just imagine that you have zero connection to other humans and zero connection to nature. A bit unsettling, isn’t it? Remembering that you are a social animal and part of the natural ecosystem will help you build motivation to stay connected. But we need more than this reminder. To build our ideal community we also need to feel safe in this ecosystem.

If you are feeling stressed by daily life or even struggling with anxiety or low energy, it’s going to be difficult for you to connect with your people. When I talk to clients about building community, I first talk about emotion regulation skills. If you are anxious, do you know how to calm yourself down?  If you are tired or overwhelmed, do you have the skills to shift your energy just enough to accept an invitation to go for a walk with a friend?  We need to find physical/emotional balance. After we do that, finding belonging becomes much, much easier.

Once you are feeling safe, you can start to build compassion for yourself and for others. Here’s one way to flex your compassion muscle:  Remember that everyone around you wants and needs a community just as much as you. My husband and I recently planned a holiday party. When it came time to get ready, we were faced with an all-night rainstorm.  My internal dialogue started sounding something like this:  “Nobody is going to want to make the effort to come out in the rain…. What were we thinking?”  As it turns out, people did show up – a small but lovely mixture of old and new friends. I may have cancelled the party and missed out on a very pleasant event if I hadn’t continued to remind myself that I was building community by creating an opportunity to connect. Keeping this in mind is a form of compassion and self-compassion. We all want and need to connect. It’s okay if we don’t do it perfectly – or if we get stuck in the rain on the way to the party.

“Who the heck am I anyway?  It would sure help to know the answer to that question before I try to find my ideal community.”   This is a universal and timeless question. Problems arise when we think we have to be some fully formed version of ourselves before we pursue friendships. After all, everybody seems to have it all together on Facebook, right?  Rest assured, we are all works-in-progress. We are allowed to grow, mature, and change through the decades of our lives. If you honor this truth about your human existence, you are giving others the opportunity to do the same. Score another point for self-acceptance and compassion.

People hiking finding belonging in nature

There are some experiences that just can’t be digitized, but a sense of belonging doesn’t necessarily have to come from other people. You can also foster a greater feeling of belonging by paying attention to your physical surroundings and cultivating a sense of place. This develops through directly experiencing and learning about a particular area. You can cultivate a sense of place by having direct exposure to the history, geographical features, natural elements, and culture of a place. What is your favorite natural element of your home base?  Where are your favorite places to sit? Developing a sense of place will help you feel connected to a community and less alone even if you are by yourself. You can take this a step further by assessing the needs of you community and becoming an active member of a local organization.

Remember – don’t give up. Continue to honor your nervous system, your work-in-progress identity, and your community.  Even if it feels unnatural or if you tend to lean toward the introverted side, try to connect one of your people or your physical surroundings every day. If you hate small talk, remember the saying, “There is no small talk.” You never know when a “meaningless” interaction might be profound for the person you are talking to, or for yourself.

To read more about mindfulness check out Mindfulness for Emerging Adults by Donna Torney, as well as Mindfulness Skills Workbook: Remedies for Worry, Anxiety & Stress or the Teen Mindfulness Skills Workbook, also available from Whole Person Associates,

Largest Trial of Mindfulness and Relaxation Techniques

A recent article in the New York Times had a headline that read, “Schools in England Introduce a New Subject: Mindfulness”. In reality, the British schools have launched a study to discover in today’s world of rapid change what mindfulness and mental health relaxation techniques will be most beneficial to students as they grow up under the pressures of the modern world.

Damian Hinds, the British education secretary, said in a statement, “Children will start to be introduced gradually to issues around mental health, well-being and happiness right from the start of primary school.” The National Health Service found that one in eight children in England between the ages of 5 and 19 suffered from at least one mental disorder at the time of their assessment in 2017. Another British study, released in November, 2018, indicated a slight increase in mental disorders in five to 15-year-olds, which rose to 11.2 percent in 2017 from 9.7 percent in 1999. Disorders like anxiety and depression were the most common. (New York Times, Feb. 4, 2019)

Mindfulness Techniques

As you will read if you the click through to the UK press release from the British Department of Education, the Department of Health and Social Care, and two current members of parliament, schools there are in the midst of the biggest trial ever of mindfulness techniques and other relaxation skills. 370 of England’s 20,925 primary schools will indeed be rolling out mindfulness as a new subject. While the value of mindfulness techniques has been tested extensively, this is the largest look at how it might make the lives of elementary students better, and how it will influence participants as they age.

Donna Torney in her book Mindfulness for Emerging Adults gives a great example of how mindfulness techniques can influence further development by imagining the brain to be a set of nesting Russian dolls:

If one of the smaller dolls has a chip or a gap, it may not be able to fit easily into the next doll. It may require going back and reshaping the smaller doll for the entire set to fit. Far better if we can avoid the chips or gaps in the first place.

Another benefit to exposing children to mental health issues is easing the stigma of mental illness. “Fear of judgment and ridicule about anxiety [mental health] issues often compels individuals and their families to hide from society rather than face criticism, shunning, labeling, and stereotyping. Instead of seeking treatment, they struggle in silence.” (Leutenberg, Liptak 2016). Kids are more likely than adults to speak out about mental health issues just as they do about just about everything else. Who hasn’t been embarrassed by a child saying something like, “Mommy, look at that giant!” just as your favorite NBA star passes by at the mall. Napoleon Bonaparte said, “Ten people who speak make more noise than ten thousand who are silent.” Informed children will speak out. Children who have a basic understanding of mental health and bullying will help their classmate who is being taunted by others.

Becoming Upstanders

In schools and out, bystanders who had simply stood there and watched a fellow student being bullied can become upstanders. Witnessing bullying is upsetting and affects the bystander, too.  These children have the potential to make a positive difference in a bullying situation. An upstander is someone who sees what happens and intervenes, interrupts, or speaks up to stop the bullying. Children who learn about mental health issues are more likely to become upstanders simply because exposure to mental health and what mental illness is demystifies if for them. Kids are less likely to make fun of what they understand. Furthermore, when youth who are bullied are defended and supported by their peers, they are less anxious and depressed than those who are not. ( retrieved 2/4/19).

Portions of this article have been excerpted from:

Focus and Mindfulness

But it sometimes happens that I cannot easily shake off the village. The thought of some work will run in my head and I am not where my body is, I am out of my senses. In my walks I would fain return to my senses. What business have I in the woods, if I am thinking of something out of the woods?

-Henry David Thoreau
Woman Painting Focus Mindfulness

Focus can be improved

Focus can be improved using mindfulness-informed tools that are designed to increase mental concentration and inner calm. The art and science of focusing has many faces. It may look like a man sitting in solitude on a meditation cushion, or a woman sitting in a café slowly sipping from a paper cup, mindfully watching her thoughts. At other times the face of focus is a person absorbed in an art project, or a group of friends on a ten-mile run, or a teen absorbed in her favorite music. Of course, all of these activities can be done unmindfully – without focus – but they are infinitely more rewarding when performed with attention to the present moment. When we focus on our present moment experience, the brain rewires itself in such a way that it makes the experience more satisfying. With practice, we can gain the ability to focus on demand. Take a minute to think of an area in your life that could benefit from more focus.

Focus can arise when we are moving just as easily as when we are sitting. Stilling the mind is what matters. If you are feeling especially physically or mentally agitated or if the busyness of your life is getting you down, try these suggestions calling for stillness or internal focus. Building mental focus will benefit each one of the four domains of your life: balance, belonging, focus, and meaning.

Take note of what is distracting you – if you don’t feel ready for a meditation practice it’s okay. Start by noticing what is distracting you.

  • Are your distractions fear-based – are you worrying about some future outcome?
  • Are your distractions fantasy-based – is there something you don’t have that is stopping you from living your life in the here and now?
  • Start by noting what takes you out of the present moment – just taking note of what is keeping you in a state of distraction is a step toward mindfulness.

Perform a single routine task mindfully – fold laundry, wash dishes, feed the dog without slipping into autopilot. So often, we get up in the morning and do our routine in zombie mode.

  • Get out of bed and stretch for half a minute. What is the first thing you usually do in the morning? Can you do it with all your senses engaged?
  • Resist automatic thoughts and mentally rehearsing your to-do list.
  • You might find that the routine task is actually enjoyable, or you may decide to change the start of your day so that the very first task is something that feels pleasant, like reading a few pages in a good book versus checking your email.

Take a slow walk or run – routine exercise is another place where we can easily check our focus.

  • Take your walk or go to the gym as usual, but consciously slow down your pace.
  • Notice something new about the gym or the walking/running route you are on.
  • Refrain from projecting into the future or thinking about the past. Sure, you may burn a few less calories by slowing down, but what you gain in tranquility and calm will more than make up for it.

Pet or play with an animal – if you have one, your dog or cat can become your Zen master.

  • Take time out today to be with your pet and just with your pet. Animals are experts in being in the present moment.
  • Get down on the floor and get on your pet’s level. Gaze into their eyes as you play with or pet them.
  • Thank them for being your Zen master.

Belly breathe with a baby or small child – babies and young children can also anchor us to the present moment in a special way.

  • If you have an infant in your life, take some time to watch them while they nap. Babies have not learned the bad habit of taking shallow breaths. Take long, slow breaths like a baby.
  • If you have a toddler in your life, ask him or her to lie on the floor next to you. Place pillows on your bellies. Watch them as they float up and down on your belly as you take
    long, deep inhales and exhales.
  • Take some time to giggle with your toddler as the pillows rise and fall.

Walk barefoot – if the temperature allows, kick your shoes off and walk in the grass for a few minutes.

  • Walking barefoot requires mindfulness to avoid sharp objects or other outdoor goop.
  • It is also immensely grounding and healing.
  • Focus on how it feels to connect directly with the earth.

This is a good start to using mindfulness techniques to increase your ability to focus. Remember, without mindfully focusing on the present you will miss much of the experience.

Mindfulness for Emerging Adults Book Release

Excerpted from Mindfulness for Emerging Adults by Donna Torney, MA, LMHC, RYT.

Holiday Stress Habits

‘Tis the Season to be Jolly!

Christmas, St. Lucia Day, Chanukah, Kwanzaa, St. Nicholas Eve, New Year’s Eve, December Solstice, Boxing Day, St.Stephens Day, St. Ambrose Day,  and   we can’t forget December 15th – National Cupcake Day!

So, this is a time of joy, family, and good will to all…right? For lots of folks, it is. Many of us, however, find this season stressful. We expect good tidings of great joy, but end up feeling stretched to the max and unfulfilled. The holiday we remember from our childhood just isn’t there.

  • Are you struggling to complete shoulds?
  • Do you feel guilty because others are loving the holidays and you aren’t?
  • Are you overindulging, overscheduling, overspending, and still feeling unsatisfied?
  • Do you feel emptier at the end of the holidays than you did at the beginning?
Holiday Stress Habits

Holiday Stress Habits

If you answered yes to these, you are probably trapped in some negative holiday stress habits. Now some stress is good for you and pleasurable. It can fire you up; give you energy, supply zest and excitement. Too much stress, however, can wear you down, sapping your energy.

What about last year? Make a list of the positive things you enjoyed such as caroling, midnight church services, Chanukah get-togethers, and reunions with friends and family you rarely see.

Now make a list of the other side of the coin. What wore you out? Was it last-minute gift shopping, lack of sleep, planning an open house for 50 and having 75 folks arrive, dealing with Great-Aunt Grizzelda?

To some extent, the same events can provide both good and bad stress. Your open house was a raging success, but you were really worried about running out of food. You loved seeing the rest of your family, but if you had to hear Great-Auntie say one more time, “Well, in my day it was better,” you might actually do her harm.

Popular wisdom says that negative stress is simply the way we are reacting to circumstances. You might freak out with 25 extra people while others find it stimulating. You might love baking 30 kinds of cookies for the party while your sister buys them at the bakery. Take a quick look at a couple of stressors lots of folks find difficult and make a plan to avoid having to hide in the attic with the cocktail shaker.

Holiday Traps

The Santa Claus Trap, often known as the “I’ve got too many people to buy gifts for and not enough time or money to do it.”

Make a list of the folks with whom you truly want to exchange gifts. Be honest with yourself. To pick on Auntie Grizzelda again, if you are stressing out buying her old-lady notepaper just to have her disparage your choice; take her off the list. Contact your friends and see if they are enjoying gift giving with your group or dreading the cost and effort. You might decide to give each other time and get together after the holidays for a celebration of absolutely nothing.

Once you’ve made an accurate list of those you really want to gift with something special develop a budget and stick to it. Many are great at the budgeting part… sticking to it is another story. Promise yourself you will be tough and won’t overspend. Plan a post-holiday reward for yourself when you succeed.

Budget and list in hand either hit the local stores or the internet. Today with free shipping readily available it is tempting to stay home and click away your shopping duties. Remember the sights and sounds of your community at the holidays. It might be worth scheduling a day to enjoy the bustle, street singing, and bell-ringing and to pick up some unique gifts at the same time.

The Activity Trap. We aren’t always good at checking our calendars before we say no and find ourselves due at a party, a dance recital, a kid’s sports event, and a date with our spouse all at the same time. On the other hand, some folks find themselves with little to do and miss the interaction with others. Again, make a list of what you need to do and what you really want to be part of. Don’t say yes without time for thought. Do you really want to go to your kid’s coach’s wife’s tea? Are you looking forward to the all high school Holiday Concert where you will sit in the same auditorium seat for four hours?

If you are over scheduled get out a pencil and delete those things that you don’t want to do. If you don’t have enough contact with others, call the Salvation Army, your local soup kitchen, the local volunteer coordinator, your mosque, church, or synagogue, or check in with your neighbor who lost her husband this year and schedule some time helping others. Nothing feels better!

The Tradition Trap. Okay, I admit it, this is my personal stressor. I want to do everything that I’ve been part of all my life, and I’m a grandmother! I want to provide the kind of environment my stay-at-home mom did. I want to have all the same decorations I had growing up. I want my kids and their kids to show up when I want them, not when it works for them because, “We always went to church together. It won’t be Christmas without everyone being there.”

Choose the traditions that really mean something to you. Accept the fact that you work full time and can’t bake sixty different kinds of cookies, have three open houses, decorate the synagogue, decorate your home, and still be alive when it is over. Traditions are great as long as they contribute to the enjoyment of the season. If they don’t, be brutal; toss them out. Find new and interesting ways of celebrating. Enjoy the process of learning something new.

Kind of in the same vein, we often fall into The Life Script Trap. When the holidays roll around we fall into feelings and roles remembered from the past.

No matter how old we are, the holidays give us permission to be childlike. Festivities become magic and full of meaning as we bring the past up to the present, still enjoying the familiar sights and sounds of the past. Celebrate your heritage, but look out for the pitfalls that have caused problems in the past. Cherish those events you hold dear. Stay away from those that cause you pain.

The Magic Trap: expecting the perfect holidays. We expect to feel just as we did in the third grade when we got new skates, or on that first holiday with our first child. If we don’t feel the way we remember feeling we are disappointed. What are we missing that the feeling isn’t there? Try to limit your expectations of others. We can only control ourselves. Think about the things that enrich the holidays for you now, and experience them to the fullest.

As Nancy Loving Tubesing andDonald A Tubesing who wrote Kicking Your Holiday Stress Habits said,

Your holiday preparation agenda resembles the space shuttle prelaunch checklist. Holiday trap or holiday treasure? It’s up to you!

You could put on your martyr’s cloak and try to fulfill your grandiose expectations in suffering silence. You could work your fingers to the bone cleaning and sewing and cooking and wrapping and writing and orchestrating and pleasing others.

OR you could take this opportunity to relinquish your stranglehold on the holidays, inviting others to share in the burden (and benefit) of getting ready.

OR you could assemble the clan for some values clarification, polling family members about what they really treasure about the holidays, and then making a plan that includes everyone.

OR you could decide that this is theyear for some kind of alternative celebration.

Tubesing and Tubesing

What moves you to choose a holiday treasure instead of a holiday trap? Often it is your belief system – your views about yourself, the world, and what makes life worthwhile that is guiding your choice.  If one of your values is the value of work above all else, no wonder you are running yourself ragged. If you really want to kick your holiday stress habits you will have to decide what is really important to you. Once you’ve figured that out, the rest is pretty easy.

Ask yourself three questions:

  • What’s of major importance to me?
  • How do I hope to accomplish it?
  • If that doesn’t work, how else could I meet the need – or what would be a satisfactory substitute?

Take the time to make a list of what you need to make your holiday season meaningful. Be specific… just listing holiday joy doesn’t count. What do you need to feel that joy? Then look at what values those things encompass. You will recognize what will fill your holidays with what you need. (Not what Auntie Grizzelda needs! What you need.) Ask for what you need. Don’t expect your family and friends to intuit it. Tell them. If the answer is no, give yourself permission to find an acceptable substitute.

  • Refuse to suffer. Do the “have tos” quickly and efficiently and get them out of the way.
  • Keep the things you enjoy for yourself. If you love wrapping gifts, don’t farm that out to Cousin Bill.
  • If you hate the whole Christmas Card thing don’t do it. Surprise folks you care about with a phone call. Not just an email or a text, but a chance to hear the joy in your voice when you reach them.
  • Make positive contact with folks you didn’t know. At a party seek out those you haven’t met. At the church social find someone sitting alone and get to know them. Just chat with the clerk at the store in a pleasant and friendly way. You’ll make their day.
  • If your list of friends and family is disturbingly short, look for others in the same boat. Reach out to the crisis shelter, local hospitals, a halfway house, homes for the elderly, etc.
  • Make your gifts meaningful. Rather than just tickets to an event plan to go along and share the experience together.
  • Write something special for those you love. Tell them how much they mean to you.
  • Give to some of the charities that are trying to make others’ lives better.
  • Don’t forget to give yourself something.

One thing especially important: Take time to laugh. Laugh at yourself, at silly things you see and hear, look for the humor in holiday dilemmas. Put the wrong color in the cookie dough? Make purple trees. Enjoy telling the story about how you did it to everyone eating them.

When all is said and done, pay attention to your spirit. Take the time to reflect. Listen to your core. Think about what you believe. What’s really important to you?  Where did those values come from?

Light a candle every evening. Focus on the flickering flame and allow your thoughts and prayers to rise shimmering upwards into the silence.

Tubesing and Tubesing

Focus on the flame and allow your thoughts and prayers for others to rise up into the silence. Sit in a chair for a few moments while your family and friends are busy around you. Cherish the sounds and smells and essence of your holiday.

Make a plan. Reflect on the Tubesing’s suggestions. Choose the things that resonate with you and yours.

Happy Holidays!

Excerpted from Kicking your Holiday Stress Habits by Nancy Loving Tubesing, EdD, and Donald A. Tubesing, MDiv, PhD.