Loss Of A Loved One

Loss

We recently lost our family dog from illness. He was old but his death was unexpected and sudden. I was not ready. It seemed as though he was OK one day, and then it was time for him to go. We had him for almost 14 years, and he was truly a part of the family. His sudden death got me thinking about illness and loss on a bigger level. When a loved one gets sick or dies, the mix of emotions can be overwhelming and scary—especially when things happen unexpectedly. We no longer feel in control of our environment, which can cause anxiety and stress.

How You Might Feel When Illness or Loss Occurs

• Anxious because of the uncertainty
• Frustrated about loss of control
• Anger because the loss or illness takes precedence over your life/schedule
• Selfish for wanting things the way they were
• Guilt or shame because of your feelings
• Scared about the future
• Pain and sorrow for the life lost
• Alone in your grief

Avoiding The Pain

When my dog first showed signs of illness and things were not looking hopeful I had trouble sitting with that pain. I found things to do that took me out of my head. I went to the store; I cleaned and straightened—anything to distract myself from the overwhelming, uncomfortable mix of feelings. Although I knew my dog was not getting better, it was hard to accept that he would die.

Lean In To Your Emotions

As I was working so hard to avoid the uncomfortable, I realized that the feelings were not going anywhere and that maybe I would feel better if I paid mindful attention to them. As crazy as that sounds, research has shown that leaning in to our emotions or feelings can actually relieve some of the anxiety and stress that they generate.

Let Go And Be In The Moment

You can find many ways to get in touch with how you are feeling. I like to sit in a quiet place and meditate on the feelings that arise. With meditation, you can acknowledge the difficult emotions without holding on to them or allowing them to define you. Meditation allowed me to acknowledge my mix of emotions and process the fact that our dog’s time was over. 

Some Other Ways To Be With Your Feelings

Mindfulness helps when overwhelmed by anxiety

• Ground yourself with mindfulness. If your thoughts are going a mile a minute, you can practice grounding techniques to bring you back to the here and now.
• Connect with others about your experience. Talk about what you’re going through with family, friends, support groups, counseling
• Practice self-compassion. Grief and loss can bring up a lot of stuff, and there is no right or wrong way to grieve. Read more about self-compassion HERE.
• Acknowledge the Struggle. Reminding yourself that, “We all struggle, I am struggling right now, and illness and loss are really hard,” can help you feel less isolated.

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Remember, feelings aren’t good or bad, and they don’t define who we are. They're just feelings.

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What If You Can’t Get In Touch With Your Feelings?

For some people, identifying or getting in touch with your feelings is very hard to do. Being numb, or being disconnected from your feelings is not uncommon, especially if you have experienced trauma or childhood emotional neglect (CEN). If you have a lot of trouble naming your feelings you might need assistance to access, name and experience them. If you would like help with this process please contact me.

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Elizabeth Cush, MA, LCPC, is an Annapolis therapist helping people manage their stress and anxiety. Progression Counseling, offices in Arnold and Annapolis. 410-340-8469

Turning Tigers Into Kittens: Mindfulness and the Release of the Anxious Mind

Robert Cox, MA, PLPC, NCC is my guest blogger this week. His blog focuses on the body's response to trauma and how trauma affects anxiety and depression. He also discusses the benefits of a mindfulness practice for symptom relief. He has counseling offices in Liberty, MO, where he specializes in the treatment of trauma, addictions and autism.  He writes, "I am trying to change the face of both addictions and autism treatment. "

If you would like to know more about Robert and his practice you can find it HERE. You can also follow him on Twitter-  HERE. Or Check out his amazing Mindful Recovery Podcast HERE.

By

Robert Cox, MA, PLPC, NCC

Trauma can often result in increased anxiety levels and depression.  This is because our brain, already primed to sense danger in advance, becomes overloaded with the trauma and begins to associate all kinds of everyday sensations with that event.  So we can be triggered by loud noises or by certain smells or the feeling of material on our skin.  Something simple and mundane to everyone else can set us into a tail spin of increased heart rate, rapid breathing, sweating and racing, panicked thought patterns.  All because the limbic region of our brain (the little part at the base of the skull just above your neck that is responsible for emotional regulation) is triggered and tells our body that there is danger and we better prepare to fight or to run away.  I call it our tiger response, because it’s a great response to have if you’re being chased by a tiger, but not so helpful in the middle of Wal Mart.  

If you have suffered through trauma and anxiety, then you know this feeling.  Dealing with this feeling constantly over a period of weeks, months, even years can lead to serious depression.  It simply wears on us physically and mentally.  The good news is there is hope, and often hope outside of medication.  It’s called mindfulness.  Mindfulness is a very simple practice of regulating the body by watching the breath and allowing that focus on the here and now of basic body functions to bring us out of the anxiety and panic, back in to this moment in front of us.  By slowing the body down, we tell the brain that there is no reason to be afraid or anxious and the limbic region begins to loose its grip on the rest of the brain allowing us the emotional space to begin making rational decisions with the forebrain again. 

In addition to the immediate effect of telling the brain it’s OK when we are in mindful moments, our body and brain react by reducing stress chemicals like Cortisol which increases all those fight or flight responses and increasing good chemicals in the brain like serotonin (a depression fighting drug) and Oxytocin, which psychologists often call the “hug drug” because it’s that feel good, relaxing drug that gets released when we hug each other for 20 seconds or more.  In fact, if you have a friend, or significant other that you trust in very intimate spaces…a good thing to do might be to ask for a hug and simply stand in that moment, completely focused on the sensation of safety you are getting and watching the breath move in and out of your body.  This mindful moment would serve as a double dose of oxytocin to release the anxiety of the brain.

Often, however, when we are in those triggered spaces the last thing we want is to be touched.  In that case it comes down to using some basic exercises to bring ourselves back to the here and now and just focusing on the breath while counting to three slowly as we breathe in, and holding for a second then counting the same three as we breathe out.  When we feel like we are being chased by the Tigers of the past this simple breathing exercise can bring us right back to the present.  If we practice when we are not being chased by Tigers then we can make this response second nature and when they do come, we respond by returning to the breath in the here and now. 

Before we know it we have calmed and we can clearly see that our tigers have become kittens.

For more about this body brain link and a map of the emotional brain you can go to the Mindful Recovery Podcast page and scroll down to Episode 1: The Emotional Brain in Recovery.  The map is just below the podcast artwork and you can follow along during the episode for a fuller discussion of how the brain reacts to trauma along with a brief exercise provided to help you learn how to release the grip of the limbic region and begin your mindfulness practice.  For more about beginning your own practice you can go to my Resource Page to find tools, music and learning programs designed for your needs.

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Elizabeth Cush, MA, LCPC, is an Annapolis therapist helping people manage their stress and anxiety. Progression Counseling, offices in Arnold and Annapolis. 410-340-8469

Spring: A Time To Cultivate And Grow Self-Compassion

Spring is A Season For New Beginnings

Budding trees, baby birds and blooming flowers come to mind when I think of spring. Commercials and the media tell us that spring is a time for weddings, new love, new growth and change.

Depression And Anxiety Make It Hard To Grow And Change

If you feel stuck, the changes spring brings can be a constant reminder of your immobility, which can bring on feelings of overwhelming anxiety and depression.

Maybe you feel stuck because:

• You have no motivation.
• The idea of change or growth makes you anxious or scared.
• You feel you don’t have much to offer.
• Making the first step feels overwhelming.
• You feel disconnected or numb.
• You yearn to connect with others but fear rejection.

Often, the apprehension or fears that keep us stuck stem from feelings of inadequacy or inferiority. Then we feel bad about ourselves because we worry that we will never be able to move forward. The cycle spirals downward.

Let’s Make Spring A Time To Practice Self-Compassion

Instead of beating ourselves up for not making external changes, or not being the person we want to be, let’s make spring a time to change how we think about ourselves!

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If we can learn to see ourselves with compassion, to embrace our imperfections and accept our fears, we can start to embrace differences in others. This can help open us up to the possibility of new connections. Tweet This

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What is Self-Compassion?

Dr. Kristin Neff has done a lot of research and writing about self-compassion. She identified that self compassion has three components—self-kindness, common humanity and mindfulness. You can read more about her findings by CLICKING HERE.

5 Steps To Help You Cultivate Self-Compassion

1. If you make a mistake, remind yourself that none of us are perfect and say, “We all struggle from time-to-time.”
2. Practice self-compassion and loving kindness meditations. You can access some of Dr. Neff’s has guided meditations HERE.
3. When you feel anxious, place your hand on your heart and tell yourself, “I am here and I love you.”*
4. Practice mindfulness. This helps you understand that although right now might be hard, life has ups and downs, and things will change.
5. Imagine what someone close to you might say to you if he or she knew you were having a hard time.

*Sometimes saying loving statements to ourselves is difficult. If you find it too hard to do this, you can say, “I am here and my intention is to love you.”

If you would like help cultivating and growing your self-compassion, you can call me or email Progression Counseling, offices in Annapolis and Arnold.

If you want to know more about me you can CLICK HERE, or HERE .

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Elizabeth Cush, MA, LCPC, is an Annapolis therapist helping people manage their stress and anxiety. Progression Counseling, offices in Arnold and Annapolis. 410-340-8469

The Impact of Shame And Blame After Trauma

Doubting The Victim

I recently listened to The Anatomy of Doubt, episode #581 of This American Life. The first half of the episode was about Shannon, who was sexually assaulted by a stranger who entered her home through an unlocked door.

Growing up she lived in multiple foster homes and became quite close to two of her foster mothers. After the sexual assault she called these two women and some friends to share what happened. Both mothers chose not to believe her. They told the interviewers that, at the time, they thought she was only trying to get attention. They communicated their doubts to the police too. I don’t want to rehash the entire episode (you can listen to it HERE) but not only did the police close the case without an investigation, they also charged Shannon with filing a false police report.

****SPOILER ALERT****

Years later, when the perpetrator was caught for another sexual assault, investigators found Shannon’s ID and photos taken that night in his apartment. He confessed to stalking and sexually assaulting many women, including her.

Doubting Your Memories

This story has stayed with me. It got me thinking, What is the impact on a trauma survivor when the people you trust don’t trust you? Shannon told the TAL interviewers that she began to doubt her memories. Her two primary supports and the police all implied she was lying. Although she was violated in her own home, she began to question what happened.

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So, how do you overcome a traumatic experience when no one believes you, and this leads you to lose faith in yourself?

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Trauma and PTSD

Traumatic experiences can lead some people to developing Post Traumatic Stress Disorder (PTSD).  Symptoms of PTSD include:

• Nightmares or flashbacks
• Avoiding things that remind you of the experience
• Avoiding social situations
• Distrust of the world and others
• Numbing
• Difficulty sleeping
• Trouble focusing
• Easily startled
• Anxiety
• Depression
• Substance use

Other people might look for ways to avoid thinking or talking about what happened. Unfortunately, avoiding difficult emotions is usually a temporary fix, and can result in anxiety and depression.

You Deserve To Be Heard

You might say, this was one woman’s story—not a common occurrence.

Unfortunately, I can state from professional experience that it happens more often than you think. For years I worked as a crisis counselor for abuse victims at a local hospital. I had the privilege to counsel men, women and children who had experienced sexual assault, domestic violence, vulnerable adult abuse or child abuse during their lifetime.

Many survivors told me that when they disclosed the traumatic experiences to family, friends and/or police, it was suggested that they were lying or were partially to blame for what happened.

Many of those who came away from their traumatic experience feeling they were not supported or believed, later in life struggled with significant mental health and/or substance use issues.

Trauma, PTSD and Resilience

Research suggests that one of the key factors in resilience, or the ability to bounce back from trauma, is having a good support network and strong social connections such as family and friends. Psychiatrist Kathryn M. Connor, MD, wrote about measuring resilience after trauma in an article in The Journal of Clinical Psychiatry. Another protective factor is the ability to call on your past experiences for a reference when facing potential challenges in the future.

According to Dr. Connor, “Resilience has been shown to protect against posttrauma breakdown and may help alleviate an individual’s feelings of helplessness…” and potentially keep them from acquiring chronic PTSD.

It’s difficult enough for survivors to share what happened to them, because they often feel they are somehow to blame, or are shamed by the experience. If you were then questioned about the validity of your disclosure, it makes sense that such doubt would have an impact your ability to move on and heal. It would also affect how you handled any future trauma, making it difficult to trust others in a crisis.

How Counseling Can Help

Survivors of abuse have a lot of obstacles to overcome to move on from the trauma. The survivors I worked with who said their stories were doubted, or were told they were responsible for the traumatic experience often didn’t want to talk about the trauma, and avoided therapy, although they were struggling. Well, no wonder! Who would want to face the prospect of not being believed once again?

That being said, counseling can offer the opportunity to be heard, without judgment. Counseling moves at your pace, and you should never feel forced to talk about something until you’re ready to discuss it.

Counseling can also provide a safe space to explore the trauma while providing strategies for coping and moving forward.

Other Ways Counseling Can Help

Counseling can provide other tools to support healing, through:

• Relaxations skills to stop your mind from racing, and calm your anxiety
• Mindfulness techniques to keep you present in the here and now, instead of worrying about   past and future events
• Body work to help understand the bodymind experience after trauma and improve self-regulation
• Challenging the negative beliefs that undermine your self confidence, and make you feel “less than”
• Art therapy to explore trauma through creativity
• Play Therapy most often for children, to explore trauma through play
• Group Therapy to share common experiences and get support  

Please share your thoughts below.

If you would like more information on how counseling can help you overcome a difficult life experience you can CLICK HERE to learn more about my Annapolis counseling practice. Or CONTACT ME to set up an appointment.

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Elizabeth Cush, MA, LCPC, is an Annapolis therapist helping people manage their stress and anxiety. Progression Counseling, offices in Arnold and Annapolis. 410-340-8469

The Anxious Traveler

Vacation Anxiety

My family recently took an overseas vacation and it got me thinking about the effects of travel on anxiety. Travel is stressful. Many things are beyond our control, and this can trigger anxiety and stress.

Humans And Life Are Messy

The reality is that we can’t control much of anything in our lives except ourselves. We have even less control over situations when traveling with others to an unfamiliar place. Here are a few things that can take control of our vacations in a hurry:

• Each person has a unique travel agenda
• Hunger
• Being tired and cranky
• Getting lost
• Stuff is closed
• Getting caught in the rain and no rain gear because the Weather Channel said there was only a 10 percent chance of precipitation (this happened to us)

During our trip, when it seemed like all of the above messy issues were in play, I began to feel a looming anxiety. My anxiety usually starts in my chest. I feel tightness and then an increased sense of danger or fear. It is uncomfortable, and my first response is to try to figure out how to make it go away. I started thinking of things I could say to make everyone laugh, and to ease the tension. I wanted to try to accommodate everyone’s needs, in order to make them all happy.

How Our Body Reacts to Anxiety

When we’re in a situation that makes us anxious, our brain then goes into protection mode and gets us ready to fight, flee or freeze. The bodily functions that work to keep us safe, and have been around since forever, start cranking. Our heart races, skin gets flushed, breath quickens and muscles tense. Once the process starts it’s harder to get back to an emotional and physical balance.

If you want to know more about the physical affects of anxiety you can read more about it here

And here is an infographic on the body’s response to anxiety.

Using Mindfulness When Life Gets Uncomfortable

Practicing mindfulness can help us to take a step back and check in with ourselves when the anxiety begins. Mindfulness allows us to notice those physical symptoms and gives us a chance to interrupt the cycle.

If we can learn to calm ourselves before the anxiety kicks into high gear, we can maintain emotional balance even in stressful situations.

Allowing your thoughts to come and go like waves on the ocean, mindfulness calms the anxious mind

7 Steps to Help Recognize Anxiety Before It Takes Over

1. Take note of situations that make you anxious
2. Ask yourself, “What is the first sign of my anxiety being triggered?” Often it is a physical response.
3. Pay attention to your physical symptoms, especially if you know the situation would trigger anxiety.
4. When the physical symptoms appear, STOP whatever you are doing.
5. Take a slow deep breath. Take another… and another.
6. Ask yourself in a kind, non-judgmental way, “What’s going on for me, right now?”
7. Acknowledge the situations that are beyond your control.

So, while we were walking down a beautiful street, filled with shops, people and sights I had never seen before—which I was totally missing because I was so caught up in how to make everyone happy—I noticed I was anxious and took a slow, deep breath and asked myself what was going on for me.

In that moment, I realized that although my family was cranky, hungry, and everyone’s needs were not being met, it was not up to me to make each person happy. Not only was it not up to me, but also it was an impossible task!

Learning to Accept the Things We Can’t Control

As I said, our anxiety is triggered by situations where we feel powerless. In reality, we don’t have the power to control most of the stuff in our lives, and that means we have the potential be anxious a lot. The key to managing the anxiety is to be able to acknowledge that we have no control, and that this is OK.

If we can acknowledge that life and humans are messy and imperfect, and understand that we can’t control a lot of what happens, then we can allow events to unfold naturally and this can reduce our anxiety. By letting go of the need to “fix-it” or control it we can be there fully and appreciate what is happening in the moment.

For the rest of the journey I worked to let go of the need to take charge of everyone else’s experiences. To recognize the value of being together as a family, in a beautiful country, and to take note of the good and the stressful times together allowed me to enjoy each moment as it came along, and made for an incredibly memorable experience.

I will be leading mindfulness groups for women beginning in October. If you're interested in signing up, or learning more please drop me a line.

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This blog post was featured in the Health & Fitness section of the Severna Park Voice.

Elizabeth Cush, MA, LCPC, is an Annapolis therapist helping people manage their stress and anxiety. Progression Counseling, offices in Annapolis. 410-340-8469

shhhh, Quiet Down Negative Nelly

Getting Stuck

Often, when I consider doing something outside my comfort zone I start to get anxious, feel a tightness in my chest and I instantly think, “Nope I’m not doing that.” This critical inner voice stops me in my tracks and keeps me from growing personally and professionally. I named this inner voice Negative Nelly.

What Keeps Us Stuck?

• Anxiety?
• Social anxiety?
• Worry?
• Fear of failure
• Fear of rejection?
• Lack of self-confidence?

What Is The Discomfort Telling Us?

Where do these uncomfortable feelings come from? It could be our inner critic—that voice that judges, criticizes, ridicules, tells us how scary life is, focuses on our mistakes, tells us we are "less than." These negative messages alert our instinctual fight, flight, freeze responses. This tells our body there is a potential danger, and we stop, avoid or flee the situation. (Some people push forward but we are not those people.)

The Critical Inner Voice

Our critical inner voice comes from life experiences. Maybe our parents were hypercritical, or our best friend pointed out all the times we lost a game, or we had a verbally abusive partner who found fault in everything we did.  We take those messages from loved ones to heart. But we don’t often recognize that Negative Nelly continues whispering them to us, even when they no longer apply, leading us to feel:

• Sad
• Lonely
• Disconnected
• Afraid
• Unlovable
• Depressed
• Anxious
• Overwhelmed

I could go on and on.

It’s Time To Quiet Your Critic

The wonderful thing is that we don’t have to sit idly by and listen! We can challenge and quiet the inner critic who keeps us stuck. With counseling, we can learn to be mindful and begin to recognize the negative messages, and why we hear them. When we begin to pay attention we can then challenge our unhelpful, negative commentator. We can learn self-compassion and to embrace our imperfections.

4 Steps to Recognize Your Inner Critic

1. Take note of your physical sensations when a new situation or opportunity presents itself.

2.  Sense whether you're feeling uncomfortable, anxious, or stressed out.

3. Pause and take a few slow deep breaths.

4. Ask yourself with curiosity and without judgment, "What is the message my body is telling me?"

• I’m scared.
• I can’t do this because________.
• Others will judge me if I don’t succeed.
• Why try, I will fail.
• I am not worthy.
• I will be rejected.

Respond With Care

As you recognize these negative internal messages you can start to question their validity. Is the threat real? A creepy guy or girl? A physical or emotional harm? If it's your inner critic that’s keeping you from moving forward, respond with care and self-compassion. Then you can begin to challenge your Negative Nelly. It’s not always easy to understand what the inner critic wants us to hear, but meditation and mindfulness can help.

Tara Brach’s R.A.I.N. meditation can help you recognize the negative message and respond with care.

How Do We Get Unstuck?

Feeling uncomfortable is necessary if we want to move decisively towards our goals. Those tasks that make us feel unsettled create new opportunities to push beyond our everyday experiences. You might still feel anxious, scared, or worried in new situations. The key is to be able to put those uncomfortable feelings into perspective and to respond from a positive place. 

It’s Time To Grow

Counseling can help you understand how your inner critic holds you back, how to acknowledge the negative thoughts and find the path towards growth.

Are you ready to move ahead, to makes some changes, to challenge your Negative Nelly, to get unstuck?

Elizabeth Cush, MA, LCPC, is an Annapolis therapist helping people manage their stress and anxiety. Progression Counseling, offices in Arnold and Annapolis. 410-340-8469