Agapé Counseling Blog



Your Brain on Stress (aka Covid-19)

By: Brea Grueneich, MS, NCC, LPC

Ever wonder why people act the way they do under pressure or during a crisis? Wondering what to do with anxiety and stress as we navigate a Covid-19 focused world right now? To answer both of these questions, it’s important to look at how our brains function when stressed and how we are biologically wired to respond to threats. Understanding how the human brain works allows us to better adapt and create healthy habits.

How Stress Affects the Brain

The first step to managing stress and anxiety is to understand how our bodies and brains respond to stress. Anxiety is a biological response to a perceived threat. In the event we have to fight off a bear, this is great! Feeling jittery, racing thoughts, lack of sleep, and little need for food are a few anxiety based behaviors our bodies display in order to help us fight off the bears of the world. Other common phrases for this might include "survival mode" or "fight or flight". The problem is when threats or stressors are more abstract or constant, our bodies and brains don’t know the difference. So in response to stressors like the coronavirus, financial stress, or emotional abuse our stress response can be the same to that of a "bear threat". We can’t fight or run from these stressors, so unfortunately for us, we still go into "survival mode". This also makes it more difficult for us to access the logical thinking parts of our brain. When in "survival mode" people panic, become more impulsive, become more selfish (trying to survive man!), and focus on more essential needs such as food, water, shelter, etc. You may have seen this first hand when going to the store to try and get toilet paper or certain grocery items and the shelves are empty.

With this in mind, the key to fighting threats such as the Covid-19 is to do our best to stay out of survival mode so that we can continue to think clearly. Individually knowing how your body responds to stress can give you clues to when you need to pause and respond appropriately. Common signs your stress is getting too high may include: feeling more irritable, difficulties tolerating everyday things, muscle tension in places such as your face or shoulders, increased fatigue, changes in sleeping and eating, and lots of worrying. When you start to experience these changes, it is important to listen to your body and respond to your increasing stress. Stress itself is not bad, it keeps us safe and helps us prepare for future needs. It becomes a problem when we do not address our stress, we are in a constant state of stress, and/or it consumes our everyday lives making it difficult to function. By controlling our stress levels, we can keep from going into full blown "panic/survival mode."

Responding to Stress

Once we recognize stress, the next important step is to respond. Humans adjust best when their thoughts and feelings are acknowledged rather than buried. Burying thoughts and feelings only leads to mental health challenges, negatively impacts our physical health, and can cause problems in relationships. Good news is, you likely already have several tools in order to start lowering your stress. Just as each person responds to stress differently, each person has different tools that may provide relief. Are there hobbies or activities that you really enjoy and bring you happiness? People you spend time with that you look forward to seeing? By utilizing some of these already existing resources, we can begin to address high stress levels. Other scientifically backed strategies include getting enough sleep, exercising, connecting with others we care about, and expressing feelings through various media such as writing or art.

I know, I know you’re thinking, "but Brea with social distancing we can’t visit others or get out and about." This is where a little creativity comes into place, which is also a great way to relieve some stress. While we may not be able to visit people we care about in person, we can get creative in how we connect. While using electronics to talk and video chat are popular recommendations, there are other ways as well if we take the time to be creative. This could include making pictures or signs to hang in windows, writing letters, and playing games online together. While gyms may be inaccessible right now, youtube workouts, walks outside, and pinterest workouts are not. If your stress is high enough that creativity is difficult, start by simply writing down any ideas to problem solve. It can help to write our thoughts down and this often triggers other ideas. Don’t be afraid to write down ideas you think are "bad" ideas as this can lead to more positive ones as well.

Even with all of these tools to manage stress, sometimes stress can be too much to manage on our own. In these events, it is ok to reach out to a mental health professional just as you would go to a doctor if you broke your leg. Life happens and sometimes we just haven’t learned the tools we need to manage it on our own or sometimes it is too much of a burden for one person. Many mental health professionals (including us!) are also providing telehealth services (services over the phone or videochat) to balance mental and physical health at this time when in person visits are not safe or realistic.

Hopefully, understanding a little more about how the human brain responds can give you increased control over your response to stress, including stress related to the Covid-19 pandemic. If you’re still feeling unsure or in need of more help don’t hesitate to reach out!

 

3 Simple Ways to Practice Mindfulness in Your Everyday Life

By: Brea Grueneich, MS, NCC, LPC

"Mindfulness" is a current buzzword in the mental health and wellness world. And with good reason! Mindfulness is simply the practice of paying attention to the present moment. Often, when stressed or anxious, we tend to focus on the future or past rather than what is right in front of us. By being mindful of the present, we can improve our mental health, find stress relief, and combat daily worries. There are many ways we engage in mindfulness on a daily basis without even realizing it. Did you know that when you pray, stop to smell the rain, or actively listen to your child you are practicing mindfulness? While there are many activities that increase mindfulness, it can be hard to prioritize wellness in our busy schedules to create time for mindfulness. Here are 3 quick and easy ways to practice flexing your mindfulness muscles, making it easier to squeeze into an already jam packed day.

1. Focus on Breathing

Take some time to focus on taking slow, deep, and even breaths. Five minutes a day can be a great place to start, but don't be afraid to customize the time to your needs. Some individuals may only be able to focus on their breathing for one minute, others may prefer fifteen minutes. The other great thing about this technique is you can do it anytime and anywhere, all you need is a small amount of time to focus. Science, time and time again, points to taking deep breaths as stress relieving and good for our overall health. If you want some further guidance or help, there are several great apps that will talk you through various breathing techniques that are free or fairly inexpensive. Tip for children; If you want your child to practice this great self-regulation skill, a stuffed animal can be a great helper. Have your child lay on the floor on their back and place a small stuffed animal on their stomach below their rib cage. It can be a fun game to make the stuffed animal go slowly up and down as their stomachs expand and decompress.

2. Try a Body Scan

A body scan is simply a fancy word for focusing on various parts of your body and observing any sensations. Often times, I will start at my feet, noticing any sensations such as whether they're tight or relaxed, warm or cold, etc. As I take a deep breath I give the muscles in my feet permission to relax. Then I continue to work my way up by body, focusing on specific sections at a time. This not only helps relax our muscles, it also teaches us where tension is stored in the body. Our bodies store stress and other emotions, by paying attention to the body we can more easily release these emotions. If there are tight muscles that are difficult to relax, try imagining some heat on the area. This can help the muscles relax further. If you would like a script to follow while doing a body scan try googling "body scan". There are many free scripts you can follow along with. Youtube can also be a great place to look if you would like someone else to guide you through a body scan activity.

3. Use Grounding Techniques

"Grounding" is the simple act of paying attention to our surroundings through the senses. To practice grounding, focus on one sense at a time to thoroughly experience a sensation or experience. Each of us have a sense or two we prefer over others and utilizing them through grounding can have a calming effect. Common grounding practices include listening to a favorite song, looking at a piece of art, wrapping up in a soft blanket, or lighting a candle with a favorite scent. The key is to attempt to focus solely on the experience for that moment. Another way to practice grounding is to use the 5-4-3-2-1 rule. Wherever you are at, take a moment to notice 5 things you see, 4 things you can hear, 3 things you can touch, 2 things you can smell, and 1 thing you can taste. Using 5-4-3-2-1 grounding has a calming effect when we are feeling overwhelmed or panicky and pulls us back to the present moment.

While these 3 ways to practice mindfulness are a great place to start, feel free to explore other strategies as well. Mindfulness resources can be found online and there are many books on the subject. While it sounds simple, practicing mindfulness takes effort and focus. These are skills that may take time and practice to develop. When practicing mindfulness, don’t be frustrated if you get easily distracted. It happens to all of us! Simply do your best to refocus yourself whenever you find your mind wandering.

Hopefully these tips are helpful and can offer some guidance on where to start with your mindfulness journey. Taking a few moments in your busy day to practice mindfulness can be rewarding. Health and happiness begin when we make them a priority in our lives. And let's be honest, you deserve to be healthy and happy! Now with a few ways to practice mindfulness, you have some more tools to add to your wellness toolbox.

 

9 Ways to Improve Your Mental Health this New Year

By: Brea Grueneich, MS, NCC, LPC

With the new year here and the start of a new decade, many of us are looking to set new goals or resolutions. 2020 is a great time to focus on keeping ourselves healthy, reflect on our overall wellness, and focus on growth and learning. With busy schedules it’s easy to put ourselves and our mental health on the backburner. Yet, when we do so, we place ourselves at high risk of burnout, unhealthy stress, fatigue, and depression and anxiety. In order to keep ourselves at peak wellness it is important to be proactive in taking care of ourselves. Just as there are many ways to lower our risk for physical ailments such as heart disease, there are many ways to lower our risk for depression, anxiety, and other mental health challenges. Here are nine simple ways to be proactive in taking care of our mental wellness this new year.

Take deep breaths

According to the American Lung Association, humans on average take 20,000 breaths per day. That’s a long of air! Often times our breathing changes throughout the day depending on our activity or stress. During a stressful work meeting our breathing might increase and become more shallow, when we are getting ready to sleep it may be slower and deeper. When we are more stressed we tend to take shallower breaths, which in turn makes us feel even more stressed. Breathing is one of our biological regulatory systems, our breathing can set the tone for the rest of our body. When we practice taking full deep breaths, we signal to our brains and the rest of the body that it’s ok to relax. The more we practice this skill the easier it is to calm our bodies when stress does arise. This also trains our lungs to make better use of our lung capacity. Kinda like playing an instrument, the more we practice the better we get. Don’t be afraid to also look at your breathing throughout the day. Our bodies give a lot of clues to how we’re feeling and how stressed we are. Our breathing often is one of the first things to change.

Spend time Outside

Spending time outside is important to our sleep patterns, vitamin D production, and biological clocks. Without enough exposure to sunlight we often feel more tired and our mood suffers. In South Dakota, it can be hard to get enough sunlight in the winter time due to the shorter days. This makes those small moments we get even more important. Numerous studies have also shown that spending time outside in nature has mood boosting effects. Looking for ways to increase our time outside can be simple such as parking our car farther away and walking a bit further to work, taking the dog for a walk on sunny winter days, or playing outside in the snow with the kids.

Practice Mindfulness

Being mindful simply means focusing on the present moment. Throughout the day we often get bombarded with our past and the future, including worries regarding what the future will bring. While some of this is healthy and normal, it’s easy to get stuck in the past or future and not really enjoy and engage with what is right in front of us. There are many ways we can practice mindfulness such as focusing on taking deep breaths for a few minutes, using your senses to pay attention to what you observe on a walk, praying, and creating music and art. Practicing mindfulness helps us become more intune with our own needs and appreciate the things around us.

Increase physical health

This is often the focus of new year’s resolutions, to increase our physical health! Lucky (or unlucky) for us, our physical health is connected to our mental health. It’s difficult to be in a good mood when we are tired or hungry. Getting good sleep, eating healthy foods, and getting exercise are all mood boosters and help us fight off anxiety and depression. Even small changes in our physical health can help improve our mental wellness. Another tip, when stressed, don’t forget to drink lots of water! When we are stressed or experience a stressful event, stress hormones flood our body. Drinking lots of water is one of the fastest ways to get rid of these stress hormones.

Create Community

As social beings, people need time with other people. This is critical to our emotional well being. While this connection is important, the quality of our relationships and interactions is also important to our health. Spending time with loved ones or with communities in which we feel cared for and valued is important. It is also important to focus on nurturing healthy relationships while also setting boundaries with individuals who are not healthy for us. Making time to spend time with the people you care about or intentionally making time to make new friends has mood boosting benefits. Some ideas to get us out and about include hosting a board game night, calling a family member, and trying a new sport or hobby in the community.

Practice Gratitude

According to Psychology Today, showing gratitude for positives in our life often increases happiness and has protective factors for our health. Practicing gratitude can be as simple as recognizing three things you appreciate in your life at the end of the day. There are many ways to show/practice gratitude throughout the day. Some prefer to write down what they are grateful for in a journal, others prefer to share their thoughts with others, even simply acknowledging appreciation to yourself throughout the day can lift your mood.

Helping Others

Did you know that helping out someone else in need can actually reduce your stress and is good for your emotional health? Another term for helping others is altruism. Science has long backed up positive mental health benefits to practicing altruism. According to the Mental Health Foundation, helping others even has the ability to extend our lifespans. Not only does altruism improve our communities, but it also brings us ‘warm fuzzies’. Helping out doesn’t have to include large gestures. Try small kind and helpful acts such as offering someone your seat, sending a friend or loved one flowers, shoveling snow for a neighbor, or picking up trash you see when outside.

Laughter

We all know that laughter feels good in the moment, but did you also know it is good at relieving stress as well? Laughter is behavior we often engage in that can slow our heart rate and help regulate our breathing. Laughter also has a way of helping us feel connected to others when we share our humor with others. Those who engage in regular laughter are more successful at fighting burnout at work and at home. So go ahead, feel free to look at those funny animal memes online or share a knock knock joke with a family member or coworker. You might just help them blow off some steam as well.

See a Counselor

Sometimes, even when we are proactive in taking care of our mental health, life throws us some curveballs. When this happens, we may need some additional help and support. If you’re struggling with stress, burnout, anxiety or depression getting professional help can help you get on the right track to healing. Just as we see a doctor when we break an ankle to take care of our physical health, it is important to see a trained professional when we need help with our emotional and mental health.

Regardless of your new year goals, it takes courage and hard work to create new habits. Hopefully the above tips will give you some ideas of where to start. While these tips can be helpful, don’t be afraid to explore and find other ways to relieve your stress and improve your wellbeing this new year. There are many ways to improve physical, emotional, and mental wellness. Regardless of your new year’s goals, kudos to you for putting in the time and effort to improve your overall wellness. Have a happy New Year!


 

Mental Health

May is mental health awareness month. Since 1949 May has been the month that the Mental Health America and affiliates have focused public awareness efforts on mental health. This is done to provide accurate information, reduce stigma, and promote effective treatment for children and adults.

The National Alliance on Mental Illness reports that 1 in 5 adults experience a mental illness in any given year, and 1 in 5 youth experience a serious mental disorder at some point during their life. Mental health issues, like any other physical health issues, are treatable.

Current reports indicate that 59% of adults and 50% of children do not receive proper treatment for their mental health concerns. Many people do not recognize they have a mental health problem. Many do not want to be stigmatized for seeking treatment. Others do not know where to find treatment, and some do not know how to pay for treatment.

Common mental health concerns include adjustment disorders, depression, anxiety, mood disorders and severe mental illness. Mental health becomes an issue when symptoms are experienced that impact the ability to function in major life areas. Those areas include interpersonal relationships, school or work performance, engagement in activities of daily living, such as maintaining a household, and participating in social and recreational activities.

If you or you know someone who is feeling sad, lonely, isolated, has had a change in eating and sleeping habits, no longer participates in activities they once enjoyed, is having trouble at home, school or work please know that help is available. We are here to help.


 

Depression

Today, CBS News This Morning reported that according to the National Institute of Health more than 16 million adults in the United Stated experienced an episode depression within the past year.

Many factors, both biological and environmental, impact who is at risk for experiencing depression. What was interesting about this morning's report was the impact nutrition has on mental health.

Dr. Tara Narula was interviewed about the field of nutritional psychiatry. Nutritional psychiatry explores how diet impacts mental health. Dr. Narula explained that just as in other health concerns, such as cardiovascular disease, diet should be examined as a possible contributor to mental health concerns. For those at risk of experiencing depression and anxiety, diet and food choices should be explored.

Food supportive of healthy brain function as it impacts lower rates of depression include fruits, vegetables, nuts, seeds, whole grains, and healthy fats. Other specific nutrients and vitamins cited as improving mood including vitamins B and D, Omega 3's, zinc, iron and magnesium. Depression and anxiety can be debilitating, robbing your life of contentment and joy. We can help you explore what impacts your experience, and support you in restoring your health and hopefulness.


 


EMDR Training

By: Jen Zerfas

Erin and I recently attended a 3-day long training focusing on learning how to use EMDR (Eye Movement Desensitization and Reprocessing) with clients. We learned about how wonderful this type of therapy is for treating many problems such as post-traumatic stress, grief, fear, and anxiety – just to name a few (there are more listed below). We were also able to participate in practicum throughout the training where we participated as both the client and therapist at different times.

emdr sensors

I have to admit I was a bit skeptical at first. This type of therapy uses a lot of mindfulness and visualization as well as paying attention to what kind of distress you feel and where you feel it in your body. It also employs a technique/tool called DAS (Dual Attention Stimulation), which includes a series of eye movements back and forth, knee or hand taps from one knee/hand to the other, pulsars/buzzers in both hands going back and forth, or tones going from one ear to the other in headphones. Each person decided which DAS was the most therapeutic for them. Erin liked the combination of hand buzzers and headphone tones. I preferred the knee taps. Sounds a little bizarre, right? My understanding is that by pairing DAS with recollection of a disturbing event or memory it allows a person to become less sensitive to the event or memory – the memory is still there, it’s just less powerful. (A more scientific explanation is below). DAS can also be used with happy and/or peaceful memories to make the thoughts stronger in a person’s mind.

emdr eye movement

I’m sure you’re wondering, “But Jen, does it actually work?” And my answer is, “By golly, it does!” Being able to play the part of the client, I did experience relief from the experience as well as a more peaceful feeling. Getting to participate as the therapist, I was able to see the therapeutic effects of using EMDR therapy with others. But don’t take my word for it. The World Health Organization (WHO), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the American Psychiatric Association all agree that EMDR therapy is legit.

But wait! There’s more!

Below I have provided even more information about EMDR therapy from www.emdria.org. I hope the information helps to further clarify what EMDR therapy is and how it works. Happy reading!

What is EMDR Therapy?

Eye Movement Desensitization and Reprocessing (EMDR) therapy is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma. EMDR is a set of standardized protocols that incorporates elements from many different treatment approaches. To date, EMDR therapy has helped millions of people of all ages relieve many types of psychological stress.

How was EMDR developed?

In 1987, psychologist Dr. Francine Shapiro made the chance observation that eye movements can reduce the intensity of disturbing thoughts, under certain conditions. Dr. Shapiro studied this effect scientifically and, in 1989, she reported success using EMDR to treat victims of trauma in the Journal of Traumatic Stress. Since then, EMDR has developed and evolved through the contributions of therapists and researchers all over the world. Today, EMDR is a set of standardized protocols that incorporates elements from many different treatment approaches.

How does EMDR work?

No one knows how any form of psychotherapy works neurobiologically or in the brain. However, we do know that when a person is very upset, their brain cannot process information as it does ordinarily. One moment becomes "frozen in time," and remembering a trauma may feel as bad as going through it the first time because the images, sounds, smells, and feelings haven’t changed. Such memories have a lasting negative effect that interferes with the way a person sees the world and the way they relate to other people.

EMDR seems to have a direct effect on the way that the brain processes information. Normal information processing is resumed, so following a successful EMDR session, a person no longer relives the images, sounds, and feelings when the event is brought to mind. You still remember what happened, but it is less upsetting. Many types of therapy have similar goals. However, EMDR appears to be similar to what occurs naturally during dreaming or REM (rapid eye movement) sleep. Therefore, EMDR can be thought of as a physiologically based therapy that helps a person see disturbing material in a new and less distressing way.

What kind of problems can EMDR treat?

Scientific research has established EMDR as effective for post traumatic stress. However, clinicians also have reported success using EMDR in treatment of the following conditions:
Panic attacks
Complicated grief
Dissociative disorders
Disturbing memories
Phobias
Pain disorders
Performance anxiety
Stress reduction
Addictions
Sexual and/or Physical abuse
Body dysmorphic disorders
Personality Disorders

How long does EMDR take?

One or more sessions are required for the therapist to understand the nature of the problem and to decide whether EMDR is an appropriate treatment. The therapist will also discuss EMDR more fully and provide an opportunity to answer questions about the method. Once therapist and client have agreed that EMDR is appropriate for a specific problem, the actual EMDR therapy may begin.

A typical EMDR session lasts from 60 to 90 minutes. The type of problem, life circumstances, and the amount of previous trauma will determine how many treatment sessions are necessary. EMDR may be used within a standard "talking" therapy, as an adjunctive therapy with a separate therapist, or as a treatment all by itself.


 


Anger

Let’s talk about anger. Scary thought, huh? Anger is a strong feeling of annoyance, displeasure, or hostility towards others or self. I might add that anger can be towards inanimate objects as well. I mean, who hasn’t gotten upset when the TV remote is lost or the car battery dies?

Anger is one of those emotions that everyone has but nobody likes when it comes around. Anger is a normal emotion that we all feel from time to time – some of us experience it way more often than others, however. Let me say that again:

Anger is a completely normal emotion to feel – it’s what we do with it that matters.

A lot of people struggle with anger – myself included. Whether it’s while we’re late to some event and we’re in traffic and hit every red light or we’re arguing with our friends, loved ones, or co-workers, anger can come up anytime. So how do we allow ourselves to feel anger without letting it get out of hand? Here are eight tips I have found to be helpful with clients and for myself:

Note: The Eight Tools of Anger Control used below was written by Tony Fiore, Ph.D.

Tool 1 - Recognize Stress

Stress and anger tend to go hand and hand. The higher one’s stress level, the easier it is to allow our anger to get out of control. It is a challenge for most of us to manage our stress levels in a complex world with many demands and expectations. Learning stress management techniques is an effective way to reduce the physical, behavioral, and emotional problems caused by too much stress.

Stress is often the trigger that takes us from feeling peaceful to experiencing uncomfortable angry feelings in many common life situations. Whether the stressor is external or internal, scientists have discovered that the major systems of the body work together to provide one of the human organism’s most powerful and sophisticated defenses: the stress response which you may know better as "fight-or-flight.” Before your stress response turns into anger or aggression, use stress management strategies to get it under control.

Tool 2 - Develop Empathy

Have you ever been in a restaurant and noticed that the customers at the table next to you were speaking louder than anyone else? It was as if they had no idea that they were being so loud and intrusive to the rest of the patrons. This lack of awareness is often a sign of not being emotionally or socially alert. Or, have you ever been in a situation where you tried to express your feelings and it backfired in some way?

Some of us are very good at knowing how we feel and expressing it, while others struggle to do so. It is crucial to express emotion in order to relate to those around us. Our ability to know how we are feeling as well as our ability to accurately sense the feelings of those around us help us make positive connections with others. This characteristic is often called "empathy."

To empathize is to see with the eyes of another, to hear with the ears of another, and to feel with the heart of another. Lack of empathy leads to poor communication and a failing to understand others. To manage anger, it often helps to see our anger as a combination of other people’s behavior and our lack of empathy toward them or their situation.

Tool 3 - Respond Instead of React

Many times we become angry because we find people and situations that literally "push our buttons," and we react just like a juke box that automatically pulls down a record and starts playing when you make a selection. Rather than reacting to anger triggers in this fashion, you can learn to choose how to deal with frustrating situations – to respond rather than automatically react like that juke box.

There are many advantages to learning to how be more flexible in dealing with the stresses and frustrations of life. At the top of the list is a sense of empowerment. It just feels good and powerful to know that you are in charge of your response, rather than being controlled by other people or circumstances. Many people notice their anger level going down as their feeling of empowerment goes up.

Tool 4 - Change that Conversation with Yourself

"For some reason whenever I get upset I am always putting myself down" said one woman in an anger management class. "Even my friends tell me I am just too hard on myself", she said. "When I get upset, I will often say things like, 'I'm such a loser,' or, 'if I don't make it on time, everyone will think I'm a jerk,'" the woman explained. "Sometimes I even tell myself that I am worthless and stupid when I make mistakes."

A crucial tool in dealing with angry feelings is that of challenging that conversation with yourself. Like the woman described above, you are constantly telling yourself all kinds of things which cause you to have certain feelings or emotions – even though you may not realize it. Learning to change that "self-talk" empowers you to deal with anger more effectively in terms of how strongly you feel the anger, how long you hold onto your anger, and how you express your anger.

Tool 5 - Communicate Assertively

Good communication skills are an essential ingredient to anger management because poor communication causes untold emotional hurt, misunderstandings, and conflict. Words are powerful, but the message we convey to others is even more powerful and often determines how people respond to us and how we feel toward them.

Anger expressed toward others is often a misguided way of communicating a feeling we have or a need that is not being satisfied by other people or situations. Assertive communication – as distinct from aggressive communication – is a set of skills to honestly and effectively communicate how you feel and how you are responding to things without getting angry or hostile about it.

Tool 6 - Adjust Expectations

Have you ever been told your expectations are too high? Anger and stress can often be caused when our expectations are too far apart from what is realistic to achieve. In other words, anger is often triggered by a discrepancy between what we expect and what we get.

Learning to adjust those expectations – sometimes upward and other times downward – can help us cope with difficult situations or people, or even cope with ourselves. In marriage, research shows that much anger is caused by trying to solve problems which are unsolvable and perpetual. Successful couples learn to live with each other around these issues rather than getting angry about them.

Tool 7 - Forgive But Don't Forget!

Anger is often the result of grievances we hold toward other people or situations, usually because of our perception and feeling of having been wronged by them in some way. Resentment is a form of anger that does more damage to the holder than the offender. Holding a grudge is letting the offender live rent free in your head. Making the decision to "let go" (while still protecting ourselves) is often a process of forgiveness – or at least acceptance – and is a major step toward anger control.

Tool 8 - Retreat and Think Things Over!

Jim and Mary Jones loved each other deeply, but often went into horrific verbal battles over any number of issues. However, they were unable to give each other "space" during an argument insisting they solve the issue immediately. Even worse, Mary often physically blocked Jim from leaving and would follow him from room to room demanding discussion. Needless to say, this is a dangerous practice as it can escalate levels of anger even further and cause partners to do and say things they don't really mean and may later regret!

Research shows that we are pretty much incapable of resolving conflicts or thinking rationally in an argument when our stress level reaches a certain point. To avoid losing control either physically or verbally, it is often best to take a temporary "time-out" and leave. This tool of anger management works much better if (1) you commit to return within a reasonable amount of time to work things out, and (2) you work on your "self-talk" while trying to cool down.


 

Fair Fighting: Ground Rules

In the past several months, I've had the privilege of working with a lot of couples. They have come to therapy for various reasons, but the biggest issue I have seen has to do with COMMUNICATION. I’ve noticed that this particular issue often arises when addressing disagreements or arguments. Many people would rather avoid quarrels with their partner rather than create what they deem as an unnecessary rift in their relationship. Others welcome conflict, but often go at it in an aggressive and unhealthy way.

It’s never pleasant to 'fight' with your loved one. It takes a toll on everyone involved, not to mention the stress it creates in otherwise healthy relationships. It’s hard to know where to begin when communicating about sensitive issues with your partner.

Below I have a list of 'rules' that I have found to be helpful to couples I have worked with in therapy. I usually have each partner pick one or two 'rules' that they are good at and one or two rules they need to work on. Then I ask each partner to pick one 'rule' they feel their partner is good at and one 'rule' they think their partner needs to work on. We then discuss their opinions and how they can work on their strengths and challenges when involved in disagreements. I hope you find these 'rules' to be helpful in your relationships with others. :)

Side note – I feel like these 'rules' can be helpful in any relationship, whether it’s with friends, family, children, or partners. :)

Remain calm

Try not to overreact to difficult situations. By remaining calm, it is more likely that others will consider your viewpoint.

Express feeling in words – not actions

If you start to feel so angry or upset that you feel you may lose control, take a 'time out' and do something to help yourself feel calm. Some ideas are take a walk, do some deep breathing, play with your pet, write in your journal – whatever works for you. Just make sure to return to the conversation.

Be specific about what is bothering you

Vague complaints are hard to work on.

Deal with only one issue at a time

Don't introduce other topics until each is fully discussed. This avoids the 'kitchen sink' effect where people throw in all their complaints while not allowing anything to be resolved.

No hitting below the belt

Attacking areas of personal sensitivity creates an atmosphere of distrust, anger, and vulnerability.

Avoid accusations

Accusations will lead others to focus on defending themselves rather than understanding you. Instead, talk about how someone's actions made you feel.

Try not to generalize

Avoid words like 'never' and 'always'. Such generalizations are usually inaccurate and will heighten tensions.

Avoid make believe

Exaggerating or inventing a complaint – or your feelings about it – will prevent the real issues from surfacing. Stick with the facts and your honest feelings.

Don't stockpile. Storing up lots of grievances and hurt feelings over time is counterproductive. It's almost impossible to deal with numerous old problems for which recollections may differ. Try to deal with problems as they arise.

Avoid clamming up

Positive results can only be attained with two-way communication. When one person becomes silent and stops responding to the other, frustration and anger can result. However, if you feel yourself getting overwhelmed or shutting down, you may need to take a break from the discussion. Just let your partner know you will return to the conversation as soon as you are able and then don't forget to follow up.

Establish common ground rules

You may even want to ask your partner-in-conflict to read and discuss this information with you. When both people accept positive common ground rules for managing conflict, resolution becomes more likely.


 

Tips to the Grieving Parent

I have and still am finding healing for my heart since the deaths of my twin baby daughters Grace and Bethany who shared their brief lives with our family in May of 2012. I've learned a few things along the way and wanted to pass on 7 pieces of advice that have helped me immeasurably. I need to caution that these things helped ME....I say that because everyone has a unique and individual relationship to those precious individuals whose lives often end far too soon. Your individual grief process will be as unique as fingerprints on your hands.

You won't find all of these in a book or manual and they are certainly not taught to us when we go through high school. They are not found in some parenting manual because these are not lessons anyone wants to learn. Nonetheless these things are critical for people to learn when they have to endure the deep grief associated with the loss of a child. Each one is from my heart, from my experience, and each one was absolutely spot on for me and my "fight" toward healing. The decision to heal is no easy task but is essential if you truly want healing for your heart. I can promise that the reward is 100% worth the effort. Joy and peace are available to you. I am living proof that a beautiful life is possible after such profound pain. I am not chained to my pain. My identity is not in death. I am full of life. I am free to feel all emotions, not just the sad and scary ones. I have joy daily. Even when I long for my sweet babies and cry for them I overflow with compassion and a sense of purpose at the same time. Joy and pain can coexist but you must resolve to fight for it...I did will you?

mother and father with baby

1. Embrace Healing: Healing is a choice. Time does not heal all wounds. The things that you do with the time you have been given will help you to heal. You have to apply yourself. You have to participate in the healing process. Remember, not healing is a choice too. What has caused your grief may not be your fault, but healing is your responsibility. We can’t always choose what happens to us but we can choose how we respond to it. When you are ready make a decision and resolve to move through your grief there will be healing as an end result.

2. Keep your eye on the prize: It won’t be easy. Choosing healing is like deciding to undergo intensive surgery to repair a broken body. It takes preparation, patience, endurance, and a team of "doctors" (supporters) for the journey. You'll discover what you are made of. During the rehabilitation of a surgery there will be set backs, there will be moments where you want to give up, and there will be pain. In the end you will find that you have the endurance, strength, and perseverance to make it to the "other side" of rehabilitation one day realizing that you are in fact in recovery. Healing is an emotional process, not an intellectual one so be gentle with yourself but keep pushing forward. Even the small steps count and often the small steps are the most difficult. "A journey of a thousand miles begins with one small step".

3. You are stronger than you think: You’ll want to quit. Healing is daunting, confusing, and exhausting. It will seem easier at times to stay in your painful new normal than venture into uncharted territory, but don’t give up. Do it anyway. Face your fears. It will lead to joy and peace you thought impossible.

4. Don’t go it alone: Pulling ourselves up by our boot straps won't be good enough. Some pain in life is simply too much. It crushes us under its weight. But while we are weak others are strong. Find those people and lean on them. Let them carry you for a time. Borrow strength from others. When you are strong again you can lend your strength to someone else who needs it. Support isn't optional, it is vital. Use the support available to you. If support is lacking, seek it out without hesitation.

5. Feel: Grief is defined as the emotional turmoil of conflicting feelings after loss. Everyone experiences grief, but not everyone grieves. Grieving is the way in which grief is expressed and resolved. Grief is about a broken heart, not a broken brain. Grieving is an emotional process, not an intellectual one. While some intellect will be involved, the root of healing is mending our heart, not rationalizing our pain. Let yourself feel your feelings. No feelings are wrong or right, good or bad. All feelings are clues into the state of our heart. Feel. Feel fully. Healing requires it.

6. Take care of your heart: Our hearts are both fragile and resilient. Grief is hard on the heart but neglect is even harder. Heart care is essential to healing. For many of us heart care does not come naturally. We have not been taught how to care for ourselves emotionally and grief is often the first time in our lives that we have given the state of our heart much attention. Tuning into how we feel is the first step to caring for our heart. Using our feelings as information helps us figure out what we need. Once we know what we need we can make a plan to get what we need. When our emotional needs are met healing can take place in our heart. Make heart care a priority for life to find healing from grief.

7. Don’t believe everything you hear: Believing that healing is possible is the most important step toward grief recovery. If we tell ourselves that healing is impossible or what has caused our grief is simply too much to ever get over what we are really saying is there is no hope. There is ALWAYS hope. Don’t sabotage your healing by giving up hope. Hope is never lost. Healing is always possible.


 

Blog from Jen Zerfas

Raise your hand if you have kids or interact with children on a regular basis. Ok, so you don't REALLY have to raise your hand, but you know what I mean. :) Lots of us either have our own children and/or interact with kids most days of the week. Kids have A LOT of energy, and take A LOT of energy to raise and relate to. Sometimes, we become so focused on disciplining our kids (making sure they behave, use their manners, etc.) that we forget to concentrate on building them up and noticing their strengths and creativity. Sometimes, it’s really hard to show our children how much we really do care about them as individuals. I've worked with kids of various ages for quite a few years, and during that time I have tried to find creative ways to show them I care. There are a lot of lists out there that give all kinds of fun, easy, and meaningful ways you can show kids you care. I've compiled some of my favorites in a list here. This list has all kinds of little and big ideas to interact with and build up the children in your life. I hope you enjoy participating in the activities on this list! :)


 

Shall we talk about.... GULP...Suicide?

Did you know that September is National Suicide Prevention Awareness Month which helps promote resources and awareness around the issues of suicide prevention. Did you know that suicide is the third leading cause of death among young people and is often the result of mental health conditions that effect people when they are most vulnerable? To this day suicide is a fairly uncomfortable topic to discuss openly but it is essential that we begin to have these conversations with the people that we love. Often we miss the signs and symptoms that loved ones are displaying prior to suicide completion or attempts. It is important that you are aware that suicide can happen even to people you love.

Now that you are aware of some of the potential signs of suicidal thought, it is important to also know what you can do. A suicidal person may not ask for help, but that doesn't mean that help isn't wanted. Most people who commit suicide don't want to die—they just want to stop hurting. Suicide prevention starts with recognizing the warning signs and taking them seriously. If you think a friend or family member is considering suicide, you might be afraid to bring up the subject. But talking openly about suicidal thoughts and feelings can save a life. You can't make a person suicidal by showing that you care. In fact, giving a suicidal person the opportunity to express his or her feelings can provide relief from loneliness and pent-up negative feelings, and may prevent a suicide attempt.

girl with fireworks

This month and always I encourage you to be a light of hope to people who may be feeling hopeless. Don’t be afraid to ask hard questions. Asking if someone needs help is the first step toward breaking the cycle of isolation. If you feel that your loved one needs additional help reach out to a professional for assistance. In our community you can call 211 helpline 24 hours 7 days a week. Just dial 21 from any phone. You can also reach out to NAMI which is the national alliance for mental illness (605) 271-1871.


 

How do you carry your grief?

I have to apologize as it has been several weeks since my last blog. As life sometimes does…it got in the way lol. I have also been avoiding writing this next blog because it is intense and full of difficult information to hear. Nonetheless, here it goes.
How do you carry your grief? This past week I had the honor and privilege of working with Lois Hall a trainer with the Grief Recovery Institute®. Together with 10 other individuals we began to process this very topic. We determined that grief is more than what meets the eye. In fact, our country is literally dying because of the grief we carry.
How can this be possible you ask? We are dying because of grief? People will argue that they haven't lost anyone close to them or that their loss took place 20 years ago or that their loss was not as bad as their friend’s loss. The truth is that grief hurts and we pick up that pain and we carry it around with us. Some grief is heavy and some grief is light. Either way by not addressing our grief we are literally making ourselves sick and our country is wearing it like a badge of honor.
By this point I may have "lost" you because you don’t feel that grief is your aliment. But hold on, I want to challenge you to dig a little deeper. Do you struggle with Depression? Anxiety? Alcoholism? Drug Addiction? Are you struggling to communicate with your spouse? Feel misunderstood at work or around peers? You might be dealing with an unresolved grief issue. If you have ever lost a friend, a pet, a job, a home, a dream, a hope, a relationship…YOU ARE A GRIEVER! This information is for you.

man on bench

Here is some food for thought:

These lists go on and on. We are carrying our grief in the form of depression, anxiety, stress, divorce, suicide, addiction, physical health issues etc. etc. etc. We are a sick nation because of the massive amounts of grief we chose to carry on a regular, consistent, daily basis. So how can you be carrying grief when you may not have ever lost anyone to death? The answer is that grief is not what you think.
Grief as defined by the Grief Recovery Institute® is the body’s normal and natural reaction to a loss of any kind. If you are like me you will immediately see a light bulb flash from that statement. You will say to yourself "Oh my goodness I have had countless losses, I truly am a griever and this stuff is meant for me!" If you have lost ANYTHING that meant ANYTHING you are going to experience grief. So now that we have established that you are a griever what can we do about it? Is there recovery? Is there hope for a different path? The answer is absolutely but you have to do the difficult work to unpack that grief and deal with it. I can help you all you have to do is reach out and ask for help. Call me and we can set up a time to meet.


 

You've Got Mail

Text me...PM me...are you online...did you see that Facebook post...I have to check my mind craft…I’m blogging…did you see twitter...I saw that on the internet…did you google it...snap chat me. Do these phrases sound like ways you are communicating with others? Are you trapped in an online game that you just can’t stop? How do you think it is affecting you... really? This week I read a quote from Steven Spielberg that had me thinking...Is our technology becoming more of a problem than we think? The quote read, "Technology can be our best friend, and technology can also be the biggest party pooper of our lives. It interrupts our own story, interrupts our ability to have a thought or a daydream, to imagine something wonderful, because we’re too busy bridging the walk from the cafeteria back to the office on the cell phone." In my own life we have decided to set boundaries around our cell phone use, internet time, and video games. We began to realize just how much it was affecting our lives a little over 2 years ago. It happened while my husband and I were on a date. He was playing a game on his phone and I was "face-booking". I looked up from my phone and noticed that we were not alone. Almost half of the people in the room were on their phones. That day I realized something…we are never alone anymore. Our world has become a constant stream of technology. As a "fast food society" we are a culture of "I want it now’s" and "I can’t waits". Our kids are watching us and learning from our lead. As I continued to notice this tragedy in our society I began to see it everywhere. Families at the park...on the cell phone. Friends at the mall...on the cell phone. People in waiting rooms, restaurants, Walmart...all on their phones. laptop Once upon a time phones hung on walls and phone calls were actually made that involved picking up a phone and hearing one another talk. I am not saying that technology is entirely bad and to this day I still have to use my phone and the internet daily. But I do believe that there is a huge problem that has surfaced in our homes. I am concerned that if we don’t address our relationship with technology we may be in store for more emotional pain than we might think. In my office the past several years I have heard more and more about how technology is hurting the family unit. Complaints about spouses cheating using online dating sites. Frustrations about children not doing their homework because they can’t pull themselves away from "gaming". Issues with text messages being misinterpreted and very basic communication going completely awry because of the lack of nonverbal communication, tone, and context. Student’s dependent upon google searches to do homework for them. The definition of addiction as described online by Webster’s dictionary states that an addiction is : A strong and harmful need to regularly have something (such as a drug) or do something (such as gamble) : an unusually great interest in something or a need to do or have something So I ask you...are you addicted? Do you need to evaluate and take personal inventory about how much time you are spending mindlessly surfing the net? If you say no...I want to challenge you to take an internet “fast”. Meaning, stop using the internet for anything other than necessity (paying bills, reading work emails, reading my blog etc.). If you can’t or won’t do it maybe you have a bigger problem than you think. Maybe it’s time to take back some control over your online time and direct it toward more valuable things such as the relationships around you.


 

AA-isms and what they could mean for us?

coins Several people in my life are recovering alcoholics and "by the grace of God" have been sober..."One day at a time". One of my favorite alcoholics is my father who has been in recovery for almost 30 years...words can’t express how grateful I am that he is sober! I love these "broken" people and I have been thinking about the daily decisions that they have to make to keep their sobriety. Growing up with a father in recovery I can recall spending several evenings (most notably New Year's Eve) at AA club houses. I can vividly recall the smell of smoke and the sound of many people embracing a common truth...Hi, I’m such and such and I’m an alcoholic (I’m broken). Not only did I hear these kinds of statements at the club house but they were common sayings in my home...One liners like "Keep coming back, it works if you work it" and "Easy does it". In fact, to end our dinner prayer we would all say "keep coming back it works". It wasn’t until I became a counselor that I began to think about the importance of these "one liners". These statements have deep meaning and value and they serve as a healthy reminder to the alcoholic...and they can also remind you. So take a look at some of these statements and determine how they can be helpful in your life...whether or not you have an addiction. Take some time to journal what they mean to you and watch for future posts about what they mean to me.

KEEP COMING BACK IT WORKS!

1. No matter where I go, there I am-
2. Resentment is a poison I drink to kill the other person-
3. Pain is in the resistance-
4. Do I want to be happy or be right-
5. I only have to change one thing - EVERYTHING! -
6. You are 3 people: Who you think you are. Who other people think you are. Who you really are.-
7. Sit down, shut up and listen.-
8. First Things First-
9. Try God-
10. Get a sponsor-
11. 90 meetings in 90 days-
12. Keep coming back it works…if you work it-
13. What step are you on? -
14. We've got a chair here with your name on it. -
15. It's always easier to take someone else's inventory. -
16. I'm really grateful to be here.-
17. Easy Does It -
18. One Day at A Time -
19. If you fly with crows, you'll get shot at -
20. I got sick and tired of being sick and tired. -
21. It's easy to talk the talk, but you have to walk the walk.-
22. Get an attitude of gratitude or Gratitude is an attitude.-
23. You have to give it away in order to keep it.-
24. If you hang around a barber shop long enough, you'll get a haircut-
25. Don't try to recruit people before they're ready -they'll have you drinking before you'll get them sober! -
26. Fake it till you make it-
27. It's a selfish program-
28. Keep coming back-
29. Just For Today-
30. Let Go and Let God -
31. Trust your Higher Power-
32. KISS: Keep It Simple, Stupid -
33. HALT: Hungry, Angry, Lonely, Tired-
34. God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. -


 

The "Happy Pill"....what do you want to get out of this?

don't just stand there Recently I have been talking to a lot of people who just aren’t happy. They have been hurt, mistreated, offended, and feel others have abused them in some way. Sometimes these people really do have reasons to feel jaded but I wonder how helpful is it to stay in self-pity and discouragement? I encourage you to take a quick personal inventory and determine if you are one of these people who are in a desperate search for happiness. If it seems that you can’t quite find personal contentment...maybe you could use some of the following tips instead of the highly sought after...undiscovered "happy pill".
1. Take responsibility for finding your unique happiness ... for creating happiness ... for allowing happiness to become a part of your life. Own your part in the process of becoming happy! There is no pill that can make you feel happy but there is a choice to become happy.
2. Determine what is important to you and your future. What do you want? Where would you like to be in 5 years? What do you want your future to look like and how will you get there? Are you taking action steps toward creating a new future for yourself?
3. Create a plan of action...outline small steps you can take each day toward reaching your personal goals. These steps need to be achievable and measurable so that you can look back and see your progress.
4. Stay focused on your goals...keep on task...look for ways to keep yourself motivated and on track.
5. Find healthy support people on your journey. Surround yourself with people who are encouraging, motivating, and inspirational. Look for people who "seem to have happiness in their life". Notice what they do different and try to incorporate some of those things into your daily interactions with others.
6. Find the good verses the bad in people, places, and things. Have you ever been around people who for lack of better explanation "suck the life out of you"? These people often have similar traits including overall dissatisfaction in their lives, negativity, and poor self-esteem. These people rarely smile or laugh and they often look for ways to drag you down with them. Choose not to be one of these people. Look for the silver lining and stay positive in your interactions with yourself and others.
stuart smiley 7. Be grateful! That’s it...just be grateful. There are thousands upon thousands of people who are experiencing things that are worse than what you are going through. Be grateful for a new day, for new beginnings, for the people in your life, for your sense of touch, for shelter, for the ability to laugh or cry, for your freedom etc. etc. etc. The list goes on and on but being grateful for your life and this moment is your choice! Make a gratitude list for the times when you just can’t seem to find anything good about your life.
8. Find contentment in yourself. You are not perfect and will never be perfect because it's not possible. I absolutely love the Saturday Night Live skit with Stuart Smalley where he talks to himself and concludes, "I’m good enough, I’m smart enough, and doggone it, people like me". Stop picking on yourself. There are many wonderful things about you and it’s time to embrace those things instead of constantly picking on yourself about what you "are not".
9. You can’t wish for happiness and expect it to happen. You have to make a decision to be happy. Start by saying "yes". Say yes to new friends, say yes to new experiences, say yes to change. New experiences can be scary and intimidating but you will never find happiness if you don’t take some personal risk. However, with great risk there is often greater reward.
10. Start now...right now. Don’t wait for tomorrow, don’t wait until your older, thinner, smarter, more confident. Ask yourself, "What do I want to get out of this life" and go for it. NOW!



 

Blog Beginnings…Every good thing starts with something new

girl sitting I have decided to begin a "blog"...honestly it is a bit scary for me because believe it or not therapists are also human and have normal emotions of fear, insecurity, and doubt. Nonetheless, I feel that it could be a major asset to my patients and my hope is that you can find it inspirational and encouraging during the time between our meetings. Writing is not a strength of mine but I do enjoy putting my thoughts to paper and often find it helpful and healing in my own personal life. (Please don’t judge me on my grammar...it could turn out to be a major let down. lol)
One of the main things I do with new patients is encourage them to journal and journaling is nothing more than a private blog. The goal of journaling or blogging is not to impress anyone. The goal is not to be meticulous on grammar, spelling, punctuation or even keeping thoughts organized. Rather, the goal of journaling is to get your thoughts and ideas out and onto paper so that you can begin to process your feelings in a new way. I am confident that this tool will empower my patients to "dig deeper" with their personal thoughts, feelings, questions, concerns, fears etc. I am hopeful that as you read my posts you will find some things that are helpful on your life journey and leave what doesn’t seem to fit for you. I will be including some biblical scripture, you-tube videos, articles, quotes and other material as food for thought. Again, take what is helpful and leave the rest! Please feel free to talk with me during our sessions if you have questions, comments, or if my writing stirs up something inside yourself. I encourage you to begin your own "blog"...spend time with your thoughts instead of allowing them to come and go without giving them the time and attention they deserve. Start something new!

Bio

Erin holds a Bachelor of Science degree in psychology and sociology, and a Master’s Degree in Counseling. She is a licensed professional counselor of mental health and holds a professional license to practice in the state of South Dakota.

Services

Counseling and therapy services include marriage, parent and teens, depression and anxiety, weight and body image, spirituality, and life transition counseling.

Testimonial

"I provide Erin with interpretation services for her international patients. This has allowed me to observe the way she treats the individuals she works with. I found her to be caring, helpful, and passionate about her patient's wellbeing."
Mac