Thoughts On Why Masks and Phone Calls Are Anxiety-Provoking

Anyone else super anxious when making a phone call? 

Up until I started my own business, I used to have to hand the phone off to someone else to order pizza, make an appointment, etc, because I was too anxious to be on the phone with a stranger. I have heard this over and over again from other people, too. Phone calls are so stressful.

Now that I have some background in how our nervous system functions, I have a theory (emphasis on *theory*, I could be wrong) as to WHY this is the case for so many of us.

It's the same theory for why talking to people with masks on might be creating social stress (other than the obvious stress of living in a pandemic time...P.S. WEAR A MASK).

You've heard about the window of tolerance, also called the social engagement system. (and if you haven't, scroll around my page a bit and you'll find old posts about it). This is governed primarily by the ventral vagal complex (VVC), a big ol' nerve system that runs from the base of your skull all over your face and ears and throat, into your heart and lungs and guts (it's a big one, friends).

The VVC keeps your heart rate regulated. It helps you tune your ears to hear the frequency of human voices over other sounds. It helps you create and appropriately read facial expressions, by noticing the crinkles at the edges of eyes, the shape of someone's mouth, how much teeth are showing, if their nose is moving, crinkled, etc.

When we're able to read facial expressions, we can feel safer knowing whether a person is friendly or aggressive, sad or angry or pleased...in other words--feeling safe is connected to knowing how the other person feels and what their relationship is to us...which is all deeply connected to our ability to see their face. 

Well guess what?! The phone obscures all of the facial expression information. Masks obscure fully two thirds of this information.

We're missing the usual information we would use to help determine safety and how to act in relationship. Anxiety and stress in these situations is NORMAL.**

For those with a history of trauma, this stress might be even more acute and distressing.

Does this resonate with you? Let me know your thoughts!

**WEAR A MASK ANYWAY I'm just validating one potential reason why we might feel more dysregulated lately.

A Love Letter to Meditation (And Mythbusters)

Meditation is not about calming down.

It’s not about clearing your mind. It is not about disconnecting from the world. It is not about relaxing.

It is a practice of just BEING with whatever IS…right now.

Right now is a particularly difficult time to be with what is. Things are scary, overwhelming, downright traumatizing.

So meditation right now is about learning to be with the chaos, sit with the fear, breathe through the uncertainty. Not focusing on making it better or necessarily on feeling better but learning how to feel better. It’s a practice that supports you in learning to tolerate discomfort. It’s a practice of noticing distractions, stressful thoughts, tension in your body, and staying present despite it all.

THIS IS NOT EASY.

I have been meditating almost daily for about 5 years now, and daily for all of 2020. And let me tell you…it is still hard. I still get distracted. I still want to run away internally from discomfort. But you know what? When tension arises in a relationship, or when I get frustrated in traffic, or when a friend is feeling pain…I am way more able to stay present and respond in line with my values. I am less likely to pop off and yell at my husband. I’m less likely to flip the bird at the car tailgating me. I am wayyyy more able to remain calm and regulated when my friend is crying.

It also changes my relationship with myself. Because I meditation when I’m anxious, depressed, angry and fearful, I know what that feels like in my body. I am learning to recognize what those thoughts sound like, and the subtle precursors to emotional changes. This is helpful in preventing deep depressive episodes. It helps me recognize my anxiety earlier and take action to soothe myself. Meditation allows space to get curious about my internal experience, rather than judging, which lets me take more effective action when I need to take care of myself.

In short, meditation helps me get comfortably uncomfortable with pain and discomfort, so that I can sit with it without running away.

Meditation is legit one of the cornerstone skills of my well-being.

I’m not saying it’s the answer to everything, because it certainly isn’t. But it is in my top 5 list of skills to support mental health. (If you’re curious, the others are: exercise/movement, getting good sleep, getting enough nutrition, spending time with other humans.)

Because world events are so scary right now, I find myself valuing my meditation practice more. It’s supporting me in being able to stay present and within my window of tolerance (maybe just for a few more minutes a day) during this trauma.

Again, this isn’t about being calm. It’s about learning to sit with discomfort.

One of my favorite ways to practice this while meditation is with ITCHINESS.

My nose itches.

My back itches.

My head itches.

Don’t scratch. (I know.)

Watch the itch arise, intensify, and fall away. Sit with it and notice how you can actually tolerate how itchy it is. How it goes away. Or you get distracted by a thought and by the time you remember you were itchy, it’s gone, or somewhere else. Notice how things change.

This is how you operationalize “sitting with discomfort”. You find a way to practice. Meditation is a great field for this.

So I recorded a few meditations for you.

The first is a general mindfulness meditation. This can be done sitting, laying down, walking, moving. Eyes open or closed. Modify the practice as needed to suit you.

The second is a meditation to help you connect with your body. Again, modify as needed.

Click here to get these meditations!

I hope these can support you somehow during this time. Take care of yourself. I’m here with ya.

-Toni

Attachment, Resilience and Trauma

Therapists asking about your childhood is a cliché. But…it’s cliché for a reason.

Your childhood has a massive impact on who you are as an adult. In my work as a trauma therapist, I know that your childhood experiences have a huge impact on stress resilience. People who had childhoods that fostered secure attachments (or adult relationship that facilitate an “earned secure” attachment style) are better able to recover from stress, and less likely to develop PTSD after a traumatic event.

Let’s back up. What do I mean by “attachment”? It basically means the way that you receive soothing and connection with your primary caregiver(s) as a child. The quality of these early attachment relationships to a large extent influence everything about you.

“Attachment is part of a 3-part motivational system of fear–attachment-exploration. Fear triggers attachment behaviors. The safe haven of secure attachment soothes the fear of the amygdala, and opens exploration….Exploration eventually bumps us into something that triggers fear again which shuts down exploration and triggers attachment behaviors again which soothe the fear again and open exploration cycle of safety-exploration again.” -Linda Graham

Because we have a need for regulation, and as a baby haven’t yet developed the structures to do this ourselves, we rely on our primary caregivers to help us regulate. This is what our attachment system does for us. Attuned attachment typically leads to a wider window of tolerance, while misattuned attachment typically leads to a narrower one.

If our early attachment relationships are safe and attuned, we develop the ability to trust, accurately assess fear and regulate emotions. We can move more easily between fear, attachment and exploration. When something stressful happens to a person with secure attachment, their fear/anxiety peaks, and then over time returns to baseline in the window of tolerance. This happens more quickly and easily for those with secure attachments.

However, if our early attachment relationships are injurious or traumatic, then we might get stuck in any part of the fear-attachment-exploration cycle. This depends on how our caregiver(s) responded to us when we sought soothing after fear, or when we craved exploration. We may become more likely to seek attachment in response to fear (anxious attachment style), or seek exploration in response to either fear or attachment (avoidant attachment style), or oscillate between both (disorganized attachment).

This has a huge impact on how we respond to stress.

With an insecure attachment style (anxious, avoidant or disorganized), the peak of anxiety/fear may be higher, last longer, and take more to return to baseline. In addition, that baseline may be higher than those with secure attachment as well—meaning anxiety without stressful events idles closer to the edge of the window of tolerance.

Because our early attachment relationships influence our ordinary stress resilience, they also influence resilience to traumatic stress.

Those with insecure attachment styles are more likely to develop PTSD after a trauma than those with a secure attachment.

[This DOES NOT MEAN that everything is predetermined. Our attachment systems are quite amenable to growth and change, as is our stress tolerance. This is simply more information about how our early childhood experiences shape our adult selves.]

About 20% of people who experience trauma go on to develop PTSD. There is not a ton of research on how to prevent the development of PTSD after trauma, but this information is an interesting piece of that puzzle. If we can help kids have more secure attachments, then it follows that less kids and adults will experience PTSD after a trauma.

(I know, it would be great if trauma just didn't happen...but we don’t have control over that. However…I'd also argue that less interpersonally caused trauma would happen if more of us had secure attachment...but that’s a post for another time.)

Attachment security being a resilience factor supports the theory that relational experiences are necessary for healing trauma: developing more secure attachments in and through therapy will help widen your window of tolerance, support your nervous system in becoming more adaptive and flexible, and provide new healing experiences.

Want to explore this with one of our therapists? Click here to schedule your free 20 minute consultation today!

3 Crucial Communication Skills

The holidays are often full of strained communication. We’re spending more time with family and friends, and things can get…awkward and uncomfortable and tense.

Is your goal a specific objective? Do you want your uncle to change his mind about impeachment? Do you want your mom to change how many questions she asks you about when you’re getting married? Do you want your friend to show up on time for Friendsgiving? These are examples of objectives as the primary goal of the interaction. Get clear on what those objectives are and stay connected to those goals throughout the conversation so you don’t get sidetracked by other things.

Is your goal to maintain your own self-respect? How do you want to think and feel about yourself after this conversation? Do you want to make sure you spoke your truth honestly, clearly and kindly? Do you want to be an advocate for what you believe in? Do you want to feel grounded and proud of how you composed yourself? These are examples of self-respect objectives. If this is your first priority, get clear on how you want to look back on yourself in this interaction.

Is your goal to maintain the health of the relationship? Do you want the other person to perceive you as well-informed and calm? Do you want the conversation to remain peaceful because you know fights lead to months of silence? Do you want to be seen as kind and thoughtful, even in disagreement? These might show that the relationship is your first priority. Spend some time getting clear on how you want the relationship to be after this interaction. Yes, you only have control over half of this, but it can help you make sure you are showing up in the way you want to.

These are all skills from DBT (dialectical behavior therapy) focusing on interpersonal effectiveness. They’re super helpful to revisit this time of year for some reason…

So, your goal might be to achieve an objective, to maintain your own self-respect, or to maintain the relationship. (It might also be, and often is, all three). DBT has some great acronyms (Dialectical Behavior Therapy; they love their acronyms!) to help you have more effective conversation.

-

For objectives effectiveness, DEAR MAN

Describe the situation objectively and clearly, using only the facts. Imagine you're a fly on the wall or an impartial observer, and use *that* to describe. Not "you're being an asshole", but rather, "you haven't been home for a week and when you get here you work instead of spending time with me."

Express how you feel with an “I statement”. Be honest about how you are feeling, and make sure to speak from yourself using actual feeling words. Not "I feel like you're ignoring me", rather, "I feel lonely and angry."

Assert your need/request clearly and unequivocally, don’t sugarcoat or beat around the bush. Clarity will really help you here, to be sure the other person understands exactly what you're asking for. "I would like you not to work when you're home and spend time with me."

Reinforce the person meeting your request by explaining why they should. Give them a reason to meet your need, rather than pushing them away. "I really think we would both enjoy spending more time together, and you would probably be less stressed."

Mindful of what you’re going for, don’t get distracted by other things. If they bring up a different topic, or if you feel drawn to bring up another issue, stick to this single topic. "I don't want to get off track, let's talk about that other thing tomorrow."

Appear confident, even if you’re not, make eye contact, don’t mumble, stand up straight, speak clearly and calmly. Breathe.

Negotiate if needed. You may not get exactly what you are asking for, remember to compromise if appropriate to find something that works for both of you.

For relationship effectiveness, GIVE:

Gentle in your approach

Interested in what the other person has to say and what they feel, practice listening to them as much as you are talking.

Validate the other person, let them know you understand how they feel (even if you don’t agree).

Easy Manner--don’t approach with too much intensity, let the conversation be light, possibly bring in some humor.

For self-respect effectiveness, FAST:

Fair--be fair to both yourself and the person you’re talking to. Consider the other person and incorporate that into the conversation.

(no) Apologies--you are allowed to ask for this or to set this boundary. Don’t apologize for how you feel or what you’re requesting. It’s okay to have needs and express them, and it’s okay to disagree.

Stick to your values. Don’t compromise what you value to please the other person or avoid conflict. Stand by what you believe in and what is important to you, while keeping these other practices in mind.

Truthfulness. Don’t lie, exaggerate, or judge harshly. Stick to the facts and be honest about what you need and how you feel.

What are your thoughts? Let us know in the comments!

The 10 Principles of Intuitive Eating

There is so much to say about Intuitive Eating, where do I even start?!  To me, Intuitive Eating is based on two ideas:

1.      Diets don’t work. (Voluntary starvation, aka dieting by restricting calories, and famine feel the same to our biology.)

2.      Our bodies have an innate wisdom and can regulate themselves, if only we will start to listen.

We live in a world over run by “diet culture”. That is: we are taught certain foods are “good” and should be eaten often (i.e. kale, celery juice) and other foods are “bad” and should never be eaten (i.e. donuts, fries). We are taught that our health outcomes rely MAINLY on our diets and exercise habits. We are taught that being fat is “bad” and we must diet to lose the weight. Oh, and if the diet doesn’t work and you don’t lose the weight? We are taught that there is something wrong with US, that we somehow failed.

Well, what if I told you all of this is just a pile of garbage?

What if it’s all a 60-billion-dollar industry created to make you feel crappy about yourself so you’ll give more money to them even though dieting fails 95% of the time but people are still being prescribed it by their well-meaning doctors who are also teaching that being fat will lead to inevitable death and you must avoid it at all costs and don’t eat the candy from the front desk on your way out because that will kill you also.

A HOT. STEAMING. PILE OF GARBAGE, MY FRIENDS.

Insert Intuitive Eating: A set of principles that have been researched and peer reviewed and created to help you heal your relationship with food. The days of banishing fast food, candy, and other “junk foods” are GONE, and the days of food freedom are HERE.

Intuitive Eating functions via 10 principles (read the book, Intuitive Eating (3rd edition or bust!) or check out their website for a more complete breakdown of each):

1.      Reject the Diet Mentality:

Break up with dieting and get angry at the lies you were fed. Accept that dieting doesn’t work and sets you up to fail. Remember that voluntary starvation (aka dieting) and famine feel the same to your cells.

2.      Honor Your Hunger:

If you are hungry, EAT. Doesn’t matter if it’s after 6:00pm or if all you have available to you is half of your kid’s lunchbox. Give your body the fuel it needs to keep going. Bonus points: Learn to identify what hunger feels like for you. Maybe the first sign is becoming tired, or a headache, or being grouchy.

3.      Make Peace with Food:

All food is good food. Give yourself permission to eat ANY food. Yes, even that deliciously, greasy thing that you’re scared will kill you. The more you tell yourself you can’t have something… the more you are going to want it! It’s typical scarcity mentality. Also, pay attention to what foods you “binge” on (or treat like you are eating the Last Supper) and consider that maybe these binges are caused by banning them in the first place.

4.      Challenge the Food Police:

Get rid of the belief that you are “good” for eating “healthy” foods and “bad” for eating cake. You are not what you eat. Our mental Food Police exist courtesy of diet culture, so don’t shame yourself for having these thoughts. Challenge them!

5.      Respect Your Fullness:

Listen to your body when it says it is not hungry anymore. Know what it feels like when you are full. Check in with yourself throughout a meal and ask yourself how you are feeling. And if you are full but the food is really good? Remember that you (most likely) have UNLIMITED access to this food! You can get more ice cream later! It is not the Last Supper, although if you’ve been on many diets, it may feel this way.

6.      Discover the Satisfaction Factor:

No food is going to taste as good as when it was off limits. That doesn’t mean food has to be boring from here on out! Eating can be a fun and satisfying experience.

7.      Honor Your Feelings Without Using Food:

It is ok if food is a coping skill, it just shouldn’t be the only one. Learn how to resolve your feelings without using food. Food will not fix your anxiety, boredom, loneliness, or anger. Only you can do that.

8.      Respect Your Body:

Accept your genes, whatever size they leave you at. We don’t shame people for their foot size, so why for their body size? Celebrate the diversity in body shape and don’t put expectations on yourself that are unrealistic. Get rid of anything that doesn’t fit your body for how it is NOW, even if it means restocking your entire wardrobe.

9.      Exercise – Feel the Difference:

Stop exercising with the goal of losing weight or compensating for calories. Focus on what it feels like to move your body, and choose movement that makes you happy. If you hate running, stop running! Start playing basketball, going for a swim, or something else you find fun. If you’re trying to make yourself do something you hate by shaming yourself with weight loss… psychologically speaking it probably won’t work.

10.  Honor Your Health:

You can use Gentle Nutrition and make food choices that honor your health and taste good! Some foods have more nutritious content than others, it’s true! However, I believe this is last for a reason: If you try to do this while still subscribing to “good” and “bad” foods and shaming yourself, you probably aren’t going to want any healthful foods. Or you will feel like you are forcing yourself. And if you’ve been dieting, chance are it will be a while before you’re craving a salad (if ever!). AND THAT’S OK. Remember, your body is smart and can regulate itself. After having so many burgers you will just feel… done. And move on to something else!

It’s a lot of info. In therapy we break it down little by little. We talk about your past with food, where your food rules came from, what foods are “good” and “bad” and fears of allowing all food into your diet. We talk a lot about identity and self-compassion. And most importantly: What your life would be like if food weren’t the biggest focus of your day. That’s a lottttt of time and mental energy that could be redirected into other things!

Still not convinced? That’s ok! You don’t need to come to therapy 100% convinced that Intuitive Eating is the answer. It’s completely normal to be hesitant. What I ask is this: You’ve already tried dieting and it hasn’t worked, so what’s stopping you from trying this?

Come see me and let’s talk.

Best,

Emily

(Intuitive Eating principles adapted from https://www.intuitiveeating.org/10-principles-of-intuitive-eating/)

(Studies on intuitive eating https://www.intuitiveeating.org/resources/studies/)

Curious and want to learn more? schedule your free consultation now!