Category Archives: Stress Solutions

How Long is Your To-Do-List?

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Breathe. Let go. And remind yourself that this very moment is
the only one you know you have for sure.” Oprah

My mother used to be famous for telling our family: “It’s hard work having a good time.” I was  remembering that as I sat nursing a bump on the head from forgetting to duck under an open  cabinet door while rushing around setting up camp this weekend. At the same time, I was thinking about writing this column and wondering what to write about.

We used to laugh when mom said “it is hard work having a good time” but the more I live life,  the more I realize the truth of it. Life seems to be all about hurrying to DO things. We seem to  try to pack in as much as we can into each day. The more we put into the schedule, the more stressful the day becomes. For one thing, nothing ever goes as quickly or as easily as we plan,  thanks to things like traffic, the weather, the unexpected phone calls or unplanned things we  simply have to deal with. The meeting we planned doesn’t happen because the Zoom connection was bad, or the other person forgot, or they had an emergency or something.

Life in the fast lane. There is an explosion in one part of the world, and it is world news within  the same hour. What precautions do you take to erase some of that stress daily? Or, do you just let it build up until you realize you are exhausted.

How long is your To Do List? The busier we are the more we think we can add to the daily To Do List. After all, we are very fast and efficient at getting things done. Or, at least, that is what we  tell ourselves.

To change this pattern, you have to be conscious of (aware of) so much from minute-to-minute  in your day. Start by becoming aware of not over-booking yourself and not underestimating  how long it takes to do things. That is a tough one for most of us. If you are honest with yourself, you will recognize that you underestimate most everything from how long it takes to  drive to work to how long it takes to write that report. I spent years estimating my drive to the  office from Mandeville to Metairie was 30 minutes. It is and always has been 40 minutes – even  with no traffic or bad weather.

And, most important, I will bet that none of you think about putting a real break into your To- Do-List, a period where you can just BE for a few minutes, breathe, stretch, drink some water,  and STOP THINKING! Why not put the paper down and take a few minutes right now to just BE.

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Today’s Pregnant Woman Has More to Manage

That the birds of worry and care fly over your head, this you
cannot change, but that they build nests in your hair, this you can prevent.
~ Chinese proverb

A friend who was about to become a grandmother for the first time told me of her fears about her daughter’s pregnancy. The doctor was concerned about an early or premature delivery. My  friend confided to me that she was worried that this had something to do with her daughter  being a Type A personality and continuing to work long hours at her job. “Could someone under  that much pressure,” she asked, “expect to have a normal baby?”

My friend wasn’t worried about whether her daughter’s child would have ten fingers and toes,  two eyes and ears, and a nose. She wondered about the baby’s disposition, ability to rest, and  overall health and wellbeing. Intuitively, my friend understood what research is now  confirming:  too much stress during pregnancy, if not properly managed, can affect the baby’s  development in a number of ways. Stress, for example, is now recognized as a primary factor in preterm birth as well as a number of other later childhood problems.

The notion that modern generations are busier and handle more tasks at the same time than  past generations is not only supported by research; it is common sense. While we may not need to plow the fields and do the wash by hand, we are juggling more variables, processing more  information, and facing increasing psychological demands as our society becomes more  technologically advanced. In our fast-paced lives, things change around us rapidly. Change itself is a significant cause of stress because when something in our environment changes, we are  compelled to change our behavior. And changing our behavior can be an emotional event often accompanied by fear, anxiety, and even anger.

One of the things my friends’ daughter did when she became pregnant was to examine lists of  physical and mental symptoms of stress like the one below. This was the first exercise she did  to become more aware of her reactions to the day’s events. These aren’t the only symptoms of  a stressful lifestyle, but hopefully you will find this exercise helpful to help you recognize when  your tension is mounting.

Considering that many people have a misperception of how well they are handling the rising  stress in their lives, how well do you know yourself? Do you find yourself. .?

__ Holding your breath under tension               __ Rapidly shaking your foot while sitting
__ Now and then taking a sudden deep sigh    __ Being very fidgety or irritable
__ Having a racing heart or sweaty palms         __ Jumping to loud or unexpected noises
__ Clenching or wringing your hands                 __ Trembling all over

 

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Winnie-the-Pooh and Reducing Stress

Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back
of his head, behind Christopher Robin. It is, as far as he knows, the only way of
coming downstairs, but sometimes he feels that there really is another way,
if only he could stop bumping for a moment and think of it.
– A. A. Milne, Winnie-the-Pooh

Most of us are like my friend, Edward Bear. When the stress gets to be too much,
we might not notice. If we do notice, we might say “rough day” and hopefully take
some action to chill out. In general, however, we often just continue down the
stairway in the same way, bumping our heads on every step. We don’t realize
how stressed we are until we overreact to some minor irritation or oversleep
because we don’t hear the alarm. We can all learn a lesson from that “silly old
bear”: If only we could stop bumping for a moment, we might be able to think
more clearly.

As we ponder what we now know about stress and what it can do, I think you will
agree that it is time for a stress-reduction system that will work with our busy
lifestyles. Here are the key points we have to keep in mind when looking for a
good solution:

• It’s not hard to trigger the release of cortisol in our body. Some people have a
busy schedule and a busy mind, which leads to increased and possibly chronic
levels of cortisol in their systems. Others do not have a busy schedule, but their
busy mind never stops, and that definitely keeps a high level of cortisol in their
body and brain.

• People acknowledge that stress is affecting them more than it did in past years.
Our lifestyle seems to generate stress due to active minds and busy schedules.

• While there are many stress-reduction techniques available in our arsenal, most
people do not use them actively and regularly. Some may not use them at all
even though they recognize how stressed they are.

• One of the most effective ways to manage the problem of stress is to take
frequent breaks during the day to stop the mental activity and consequent cortisol
production.

All these points bring us to this logical conclusion: we need a simple and
immediately available system that makes it easy to tell when we are stressed and
then helps us get our stress levels under control. The system needs to be flexible
enough to account for each day’s special stresses and hassles. Some of us have
lived with high cortisol levels long enough that our body has changed the way it
deals with it. Others of us still have a body and nervous system that works the
way nature intended it to work-like a good seesaw. Some of us live super-stressful lifestyles while others do not. Some of us have learned to moderate our
daily activities to take regular little mental holidays or breaks in our thinking and
work, and others of us have a hard time stopping what we are doing or stopping
the worrying and thinking.

The bottom line: to be effective, a stress-reduction system needs to account for all
these factors, and it needs to be a system you can work with not just by going to
the yoga class after work if there is enough time left in your day. Instead, you
need a system you can work with in the background all day long. Next month we
will talk about such a system.

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It IS What You Think

I was reminded this week how important our thoughts are. Thinking is the
basis of almost all feeling, and our thoughts are definitely the jumping off
point for building up stress. If we think positive and happy thoughts, we
usually feel happier. Check this scene out, for example. You are motoring
down the highway on a driving vacation; the weather is horrible. You
haven’t been on vacation for a good year and were really looking forward
to a beautiful time. But, it is windy and overcast, raining. Your thoughts get
darker as the frustration of your spoiled hopes roll around in your
thoughts.

Similar scenes are familiar to most of us. In general, people do not
recognize that they begin to feel stressed because of their negative
thoughts. Fear of something bad happening or fear of getting sick is hard
to combat. Getting angry because someone did something that you
disagree with or you are frustrated with a situation can stir up those
feelings and release more cortisol into your system. People can get
trapped in their head with thoughts. The more one stays in their head, the
harder it seems to stop doing it.

Psychologists and other mental health workers see this kind of thing and
related problems all the time. People with high levels of anxiety can reach
a point where they have trouble falling asleep because their minds do not
shut down. The thoughts can become like a dog worrying a bone. Even
people without high levels of anxiety or depression can easily become a
victim of their thinking. And, professionals who spend a lot of time trying to
help other people relax, be less anxious and worried, less depressed, and
so on, fall prey to their less than positive ways of thinking.

Why is it so hard to stop that cycle from negative thoughts to negative
feelings and then the ultimate physiological effects of stress? The first
reason is that most people do not recognize when they are having the
negative thoughts and they certainly fail to understand that they can
change the way they are thinking and therefore feeling. We really are
capable of creating our own reality. And, it all starts with how we think
about what is going on around us.

Once you come to believe you can create your own reality and that you
can master your thoughts by stopping negative thoughts and replacing
them with more positive ones, you become a master over stress.
Learning how to stop and think about more positive things or
reframe your current negative thoughts into more positive ways of
looking at something is the KEY to a longer, happier and more
healthy life.

 

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Just How Stressed Are We Really About Covid?

There seems to be a lot of talk about the “stress” of this 14 to 15-month long pandemic. And, yes, it has caused a lot of inconvenience. It has forced us to stop doing many of the things that make life fun, like visiting with friends and travelling to see family. And, most of us are bored by having to continue to observe all the safety precautions. However, inconvenience and boredom are not really the same as “stress” that has measurable and observable physiological and emotional effects on our bodies and minds.

One way to describe stress could be that state in which our worries, fears, anxieties or simply thinking (targeted mental activity) causes our bodies to produce cortisol and other stress hormones, which can cause physical damage if that state becomes chronic. In other words, true stress comes from the type of mental activity that activates our Sympathetic Nervous System, in particular the “fight or flight” mechanism. It becomes “stress” when our Autonomic Nervous System’s Parasympathetic Nervous System loses its ability to balance or cancel the Sympathetic Nervous System and put the ANS into a state of rest. That occurs when a person is chronically worrying and/or thinking and rarely engages the Parasympathetic Nervous System to rest or unwind. 

Is that happening to most of us because of Covid? Yes, it is for some but perhaps not for all of the humans in the world. Some people who have lost loved ones or friends are likely experiencing bereavement and grief, maybe even deepening into a depression. Others are experiencing isolation, particularly if they live alone and are trying to remain apart from others for fear of catching the disease. The loneliness and inability to talk about our anxieties and fears with others can mushroom into a true physiological stress reaction. Others may have lost their jobs or found their income cut. Fear for personal safety and worry about finances are definite causes of stress.

The CDC has posted information on the ways that the stress of the pandemic is affecting people’s lives. CDC is recommending that people learn to cope with stress in healthy ways, like taking breaks from watching TV news and iPhone information about the pandemic, much of which is anxiety producing. They recommend reaching out by phone and other means, like Zoom, to talk to friends, family and others. And, most of all, take time to unwind, doing things that work for you, like exercising, meditating, listening to music.

Learning to cope with stress in a healthy way will make you and those around you become more resilient.

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Healing the Healers: Stress Among Psychotherapists

Surely, there is no real argument that mental health providers have job stress. This topic has been explored in numerous countries, including Great Britain, India, Spain, and Japan, to name a few. The Japanese Occupational Health department even developed a Brief Job Stress Questionnaire. Unfortunately, it is only available in Japanese.

The British studies by the British Psychological Society (BPS) did a study by survey in 2015. The findings were that 46 percent of psychologists surveyed reported that they experienced a depressed mood and 70 percent said that they found their jobs stressful. Many listed over-work as a primary factor in their burnout.

A study from a state in midwestern USA published by Deutsch, CJ in Professional Psychology: Research and Practice (1984) surveyed 264 therapists about the amount and sources of their stress. The therapists completed a questionnaire on background
information, their beliefs, and a 36-item stress scale. What they found was that irrational beliefs and attitudes held by mental health providers lie at the center of their reported job stress.

The irrational beliefs uncovered are very interesting and can provide a basis for all psychologists and/or mental health providers to explore their own systems of beliefs. So, to that end, I list a few irrational beliefs for further contemplation.

  1. One should operate at peak efficiency and peak competence with all clients and at all times.
  2. If a client does not get better or terminates prematurely, it is the therapist’s fault for not doing a better job of engaging the client.
  3. A good psychotherapist is not likely to get “burnout” because a good therapist is emotionally well-balanced and can manage their own emotions and stress. So, if the therapist becomes “burned out,” it must mean that that person is not a good therapist and is not well adjusted after all.
  4. It is an embarrassment for a therapist to seek therapy for themselves.

As a mini-self-test, do you agree with any of the above beliefs? And, if you do agree with any of the beliefs, what are you going to do about it? Food for thought

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2020: A Year of Stress (Solutions) in Review

And, what a year it has been. I will not bore you with a listing of all the
“stressful” things that have happened this year. Instead, let’s review the
solutions proposed.

In January 2020 the topic was: Train Students in Mindfulness to Reduce
Stress and Improve Grades. Training students, even kindergarten age
students, in Mindfulness is something that holds great promise of making
a difference in our future. Whenever you bring awareness to what you’re
directly experiencing via your senses, or to your state of mind via your
thoughts and emotions, you’re being mindful. And there’s growing
research showing that when you train your brain to be mindful, you’re
actually remodeling the physical structure of your brain. As little as 5 or 10
minutes daily attention to breathing and becoming mindful of your
surroundings will reduce student’s stress levels, improve their grades and
result in fewer absences.

February introduced the concept of Living Long and Stress Free. In an
article by healthline on Habits to a long life, stress reduction was only
mentioned after much talk about foods you eat and exercise. However,
recent research publications speak volumes about the links between
stress and dementia and stress and longevity.

March’s topic was The Zen of Balance. It is important to balance your Do
List and your Be Time. Do’s always increase Cortisol. Being reduces it.
Enough said.

April found us in the throes of the virus and having to shut our office doors
and stay at home. I must admit that I found that a wonderful respite but I
know many found it stressful. It was the Uncertainty of what was going to
happen that builds the fear. A friend sent a copy of a letter from Dr. Jean
Houston to me. Her letter beautifully describes one future that possibly is
growing out from the Covid-19 chaos. That change could be increased
compassion among the peoples in the world. Dr. Houston wrote: “All of my
life I have been dedicated to encouraging the potential that every person
carries within them. I’ve taught about our innate depths, our possibilities,
and our purpose. Now, however, it’s time to live out the promise that we all
carry, to become noble, kind and compassionate people. This week on
television, I witnessed the best and most fearful sides of our natures. On
the one hand, I saw violent videos of shoppers fighting over toilet paper,
and also experienced indiscriminate generosity while shopping at my local
Costco.”

Several months were then spent on the Tapping Solution. Tapping has
research showing it can reduce cortisol by 43%. Tapping was followed by
a focus on Exercise as a good solution for some for reducing the day’s
excess buildup of cortisol. Finally, breathing – either on your own – or by
using a simple machine and program to help you gradually move your
breathing into a therapeutic range. The machine is called Resperate and it
only takes 20 minutes a day.

Wishing everyone a Happy and less Stressful 2021.

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How to Reduce Your Risk of Alzheimer’s Dementia

Stress and anxiety have been linked to possible risk of dementia for a number of
years now. Animal and some human studies have examined brain areas affected
by chronic anxiety, fear and stress, using neuroimaging and stress and fear
conditioning with animals. We now know that there is a “see-saw” relationship
between the amygdala and the prefrontal cortex (PFC) in which an overactive
amygdala (due to fear, anxiety and chronic stress), is associated with an
underactive PFC (thinking areas of the brain that regulate emotional responses).
Further, chronic stress can cause the hippocampus to atrophy. Since that brain
area is important to long-term memory there is an obvious relationship with
dementia and chronic stress.

While this relationship has been known, clinical practice has not placed much
focus on preventing chronic stress in order to reduce the risk of dementia. An
October 2020 presentation by Dr. David Bennett at the National Academy of
Neuropsychology (NAN) may change that. Dr. Bennett is the Director of Rush
Alzheimer’s Disease Center at Rusk University Medical Center in Chicago. Dr.
Bennett spoke about early results of 2 very important longitudinal studies
involving participants of religious orders, called the Religious Orders Study and
the Rush Memory and Aging Project. The Religious Orders Study participants are
1500 older nuns, priests, and brothers without known dementia from across the
US who have agreed to annual clinical evaluation and to brain donation. The
project began in 1993; approximately 375 have developed dementia. Over 600
have developed MCI and over 825 brain autopsies have been performed to date.
The Rush Memory and Aging Project began in 1997 and include 2,200 residents
from the Chicago area who agreed to annual clinical evaluation and to donate
their bodies on death. Of that group to date, 375 developed dementia, 625 have
MCI and 925 autopsies have been performed.

Findings from 2 such large studies are immense and will be coming forward for
many years; however, Dr. Bennett’s talk provided a glimpse into prevention that
neatly fits the subject matter of this column. There is a continuum of cognitive
aging from cognitive decline to MCI to dementia. The brain pathology that relates
to changes in cognition are increasingly clear as the research continues around
the world. However, the Rush studies have made a discovery that will allow
people to better maintain cognitive health in old age.

Much of late life cognitive decline is not due to common neurodegenerative
pathologies (brain atrophy, infarctions, NP, NFT, NIA-Reagan, PHFtau temp, and
amyloid, etc.); only 41 % of the variance is explained. In other words, most brains
of elderly people show common neurodegenerative pathologies even though they
do not always have the same degree of cognitive decline (MCI to dementia). The
question became what else contributes to cognitive decline? All participants
were adjusted for age at baseline and for sex. The following variables were
studied: education, early life instruction in foreign language and music, emotional
neglect in childhood, depression, purpose in life, social isolation, social activity,
social networks (number of children, relatives, friends they saw each month and
felt close enough to talk about private matters or call upon for help), tendency to
avoid harm, avoid new situations, chronic distress, anxiety, size of one’s life
space (from 1 bedroom to travel outside of town), and diet. Those that stood out
as lowering the risk of dementia are well summed up in Dr. Bennett’s final
recommendations on how to build a better brain as we age. (Bennett DA.
Scientific American. Special Collector’s Edition. 2017; Summer: 85-91.)

  1. Pick your parents well! Make sure you get good genes, a good education, a
    second language and music lessons. Avoid emotional neglect.
  2. Engage in regular cognitive and physical activity.
  3. Strengthen and maintain social ties.
  4. Get out and explore new things.
  5. Chillax and be happy.
  6. Avoid people who are downers, especially close family members!
  7. Be conscientious and diligent.
  8. Spend time engaged in activities that are meaningful and goal-directed.
  9. Be heart-healthy: what’s good for the heart is good for the brain.
  10. Eat a MIND diet, (Mediterranean-DASH Intervention for Neurodegenerative
    Delay diet) with fresh fruit and vegetables and fish.
  11. Be lucky!

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Exercise Reduces Stress and
Lengthens Your Life

The first thing that drops out of your schedule when work bears down is exercise.
And, once it is out of your daily routine, it may be days or weeks before you notice
it is missing. I don’t know about you but during this 6-month period of isolation or
quarantine, I have completely loss my exercise routine. It started with our health
clubs closing. Yet, this has been a very stressful period. We need to redouble our
efforts to put exercise back into our schedules.

The importance of aerobic exercise was brought back to mind when I saw this
article in Psychoneuroendocrinology (2018). Dr. Eli Puterman is a professor in the
University of British Columbia’s school of kinesiology and lead author of the
article. The study was focused on showing how aerobic exercise can reduce
stress in family caregivers; however, the results generalize to all of us. In fact, a
much earlier paper on exercise and the length of “telomeres” was done at U. of
California. The bottom line is that Puterman’s study proved that exercising at least
3 times a week for about ½ hour over a 6-month period can slow down cellular
aging, which was measured by telomere length.

Telomeres are regions at the end of chromosomes that are active during cell
division. Simply put, telomeres protect the ends of chromosomes. Telomere
length is one of the most commonly used markers of aging. Telomerase is the
enzyme that adds DNA to the ends of the chromosome. Exercise can induce
apparent telomere growth or lengthening. That translates into longer life and/or a
more healthy and active life.

Dr. Puterman’s study design took a group of 68 men and women who were
inactive and stressed caretakers of a family member with dementia. They
randomly assigned the subjects to a supervised aerobic exercise intervention
group vs a waitlist control group for 24 weeks. The exercise routine was 40
minutes of exercise 3 – 5 times per week or 120 minutes/week of aerobic
exercise. The waitlist control group did not change anything in their usual activity
schedule.

The two groups did not significantly differ in telomerase activity across time, but
they had significantly different telomere length changes across time. Of course,
the exercise group also charted significant body mass index reduction and
increased cardiovascular fitness. Oh, and they reported a significant decrease in
perceived stress levels.

Aerobic exercise is also known as cardio. It includes brisk walking, running,
cycling, hiking, dancing, swimming, and kick boxing. (I added that last to make
sure you were awake.) If your choice of aerobic exercise is walking, you need to
step up the pace and also the length of time you walk. The key is to get your heart
rate up. You should notice your breathing, but you should still be able to carry on
a conversation. An Australian study indicated that walking briskly for 30 minutes
five days a week can improve aerobic fitness. But even walking for 10 minutes
three times a day is as beneficial as walking for 30 minutes one time a day.

Happy Trails to each of you during this Pandemic. Stay healthy.

––––––––––
Puterman, Eli, Weiss, Jordan, Lin, Jue, et al. Aerobic exercise lengthens telomeres and reduces stress in family caregivers: A randomized controlled trial – Curt Richter Award Paper 2018. (2018). Psychoneuroendocrinology, 98, p.245-252

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One Simple FDA Approved,
Non-Drug Therapy
That Reduces Stress AND
Blood Pressure

RESPeRATE is actually the first medical device that has been
clinically proven to lower blood pressure AND stress. And, if
you don’t have high blood pressure, it is still a very effective
and easy to use method to reduce your cortisol levels and
relieve tension due to stress.

What is RESPeRATE? It is a small device that was originally
designed for pilots and other people that needed to reduce their
blood pressure but could not afford to take medication because
of their job or other health issues. This gadget is like a
“breathing coach” because all the work of reducing stress and
blood pressure is done by helping you reduce and calm your
breathing such that you spend 5 to 10 minutes a day (or more)
in slow gentle breathing.

RESPeRATE does the work of matching your breathing and
then gradually slowing it down and lengthening your
respirations until you get into a “therapeutic range.” Once you
reach that range, it keeps you there with a soft chiming to
signal intake of air and exhalation

The kit contains the RESPeRATE device, an elastic belt that
goes around your diaphragm and plugs into the device, and
earphones to allow you to hear the gentle tones that signal the
timing of your breathing. The cost is minimal, and the company
allows for it to be purchased in 3 easy installments.

Many of our patients promise that they will practice breathing
techniques for relaxation, but we all know how easy it is for
such promises to be put off until tomorrow. RESPeRATE helps
with the routine of doing the breathing exercise and it is a
pleasant 10 minutes that can easily become a habit. The same
benefit can be gained by the “doctor” who prescribes the
method.

It is fair to say that breathing is one of the most important
exercises one can do for your health – physical and mental.
The research indicates that daily use for 3 to 4 weeks is all it
takes to significantly reduce blood pressure. The stress
reduction and improved sleep are “side-effects.” Check out the
website for more information on how to order and for
information on the “Clinical Proof.” www.resperate.com

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Tapping Reduces Cortisol by 43%

That is what Dr. Peta Stapleton on Bond University in Australia found when she replicated Dawson Church’s 2012 cortisol study. In the original study, Church et al examined salivary cortisol levels in 83 subjects who were randomly assigned to either an emotional freedom technique (EFT) group, a psychotherapy group (SL for Sympathetic Listening) or a no treatment group (NT). The EFT group had a 50-minute session of tapping with a certified EFT coach. The NT group waited 50 minutes in the waiting room and the SL group had a 50-minute session with a licensed therapist. Cortisol was assayed just before and 30 minutes after an intervention. Emotional distress was assessed using the Symptom Assessment-45 to measure the subject’s level of anxiety and depression. The EFT group measured a significant decrease (p<0.03) in mean cortisol level (-24.39%) compared to a decrease of -14.25% in the SI group and -14.44% in the NT group.

Dr. Stapleton replicated the original Church study almost exactly. However, her results were even more dramatic. The EFT group reduced cortisol after 1 hour of EFT by 43%. There were 53 subjects in this study randomly assigned to one of the three groups. The Symptom Assessment-45 was again used to assess psychological distress. Salivary cortisol assessment was performed 30 minutes before the intervention and 30 minutes after.

Cortisol is considered to be an important biological marker of stress. EFT or acupoint stimulation is shown to be an effective method to reduce stress-related cortisol in a person. In an experimental situation, this is “interesting” and often that is all that happens with a reader who has an interest in stress reduction. In a real life situation, however, where someone has a history of not dealing well with stress, finding a short, easy to apply method that reliably reduces the amount of cortisol circulating in their body, the importance cannot be over-stated.

Creating a list of people who have a history of “not dealing well with stress” is an important first step. These are people who for some reason tend to hold the stress producing situation in their minds and continue to think about it, such as people who are more likely to have anxiety disorders like GAD or PTSD. The list should also include people who because of their physical condition, such as being pregnant, do not want to maintain high levels of cortisol in their blood.

An important second step as clinicians is for us to introduce them to various techniques to help them reduce their stress related cortisol. The Tapping Solution is possibly NOT the best technique. That remains to be seen. However, it is surely experimentally proven to reliably reduce cortisol and it is easy to do.

It might make a good tool for your therapy box if you see and treat people with anxiety.

––––––––––––––––––––

Stapleton, P., Crighton, G., Sabot, D., and O’Neill, H.M. (2020). Reexamining the effect of emotional freedom techniques on stress biochemistry: A randomized controlled trial. Psychol Trauma.doi: 10.1037/tra0000563 (epub ahead of print.)

Church, Dawson, Yount, G., and Brooks, A.J. (2012). The effect of emotional freedom techniques on stress biochemistry: A randomized controlled trial. J Nerv Ment Dis., 10, 891-6.

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Sleep – More Important
Than Ever

Research says the average American misses 200-300 hours of needed
sleep each year. This is known as a sleep debt.

Studies suggest that healthy adults have a basal sleep need of seven to
eight hours every night. Where things get complicated is the interaction
between the basal need and sleep debt. For instance, you might meet
your basal sleep need on any single night or a few nights in a row, but
still have an unresolved sleep debt that may make you feel more sleepy
and less alert at times, particularly in conjunction with circadian dips,
those times in the 24-hour cycle when we are biologically programmed
to be more sleepy and less alert, such as overnight hours and midafternoon.

What do obesity, chronic high stress, heart disease, diabetes,
hypertension, and depression have in common? If you guessed sleep
deprivation, my hat’s off to you.

While there is no “magic number” of hours that we should sleep, it is
now firmly established that you cannot lose weight if you do not sleep a
solid 7-8 hours a night.

Cortisol is not the only factor that inhibits weight loss but it is a big one.
Some physicians are willing to flatly state that you cannot lose weight if
you do not get to bed early and get a solid 7 or 8 hours.

What getting a good night’s sleep can do for you:

  1. A good night’s sleep has a positive effect on your blood pressure,
    meaning that for most of us it goes down at night. If your hours of sleep
    are interrupted or too short, your blood pressure may never fall low
    enough.
  2. Insulin resistance is reduced by good sleep. Dr. Michael Breus, a
    psychologist and sleep specialist, emphasizes the fact that even short-term sleep loss (being awake for approximately 36 hours) can cause
    blood glucose levels to be higher than normal.
  3. A routine schedule for sleeping will help your body keep its internal
    biological clock running smoothly. You will be more alert, with good
    reaction time and physical ability, in other words, less accident-prone.

How psychologists can help
Many psychologists are focusing on sleep habits in the patients they are
treating. A study in the Journal of Clinical Sleep Medicine, looking at
adults with insomnia, found that more than 85% of the study sample
who completed 3 or more sleep-focused treatment sessions were able to
nod off faster and stay asleep longer. A 6-month follow-up revealed that
those patients who had 3 or more sessions spent significantly less
money on health care and had fewer doctor visits – compared to the 6
months before their therapy sessions focused on sleep habits. The
weekly therapy sessions included relaxation exercises and education on
topics such as activities to avoid doing 2 hours before bedtime (like
exercise, heavy meals, and smoking).

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More on The Tapping Solution:
A Basis in Ancient Chinese Medicine

Tapping evolved out of work that Dr. Roger Callahan, a psychologist treating a
woman with a severe water phobia, developed in 1979. Dr. Callahan had been
studying meridian points at the time he was treating this woman. Since he had
been making no progress with her, he hit upon an idea of tapping on the
endpoint of the stomach meridian as the client said that whenever she thought
about water, she got a “terrible feeling in the pit of her stomach.”

Meridians are the basis of the Chinese medicine system of acupuncture. They
are defined as energy channels that run thru the body and carry the “qi” energy
to the organs and other systems. Each meridian is associated with a different
organ system. The map of the meridians is known and easy to find even though
no one has ever actually measured or proven the existence of them as far as I
know. Nonetheless, the meridian system is hundreds of years old and to this
date Chinese medicine relies on it. The meridians are mostly named for the
organ system they feed or energize, like the Stomach Meridian, the Gall Bladder
Meridian, and so on. The Stomach Meridian ends at a point just below the eye.
Dr. Callahan asked his client to tap on that spot with her fingertips and after a
few minutes, her horrible feeling in the pit of her stomach was gone and the
story is that it never came back.

Dr. Callahan had a student named Gary Craig who worked out a way of making
tapping easier. Craig created a single sequence of tapping which became
known as EFT, Emotional Freedom Techniques. The EFT sequence was
designed to hit all major meridian endpoints and thus was more of a general
solution to whatever was the problem. The EFT sequence starts tapping on the
hand, moves to the eyebrow, under the eye, under the nose, the chin, the
collarbone and the side of the rib cage. It ends at the top of the head.

Since stress and its near-relation, anxiety, affect our organs and many aspects
of our nervous system, it stands to reason that it would reduce stress and
anxiety. One thing about a system like the Tapping Solution that may put some
therapists off is that it seems on first look to be fairly mechanistic. However, that
may not be fair. The current evolution of the Tapping Solution has grown
substantially and now there is a large literature including studies which deserve
a review.

In short, research over the past 10 to 20 years has shown that one can
measurably decrease limbic system (amygdala, hippocampus) activity by
stimulating selected meridian acupoints. PET and fMRI brain scans show the
amygdala calming when acupoints are stimulated. Studies have also shown
reduced cortisol levels when tapping is done during a stress response. In fact,
the level of cortisol reduction has been labeled “dramatic and unprecedented.”

The growth of this technique among others is now in an area of psychology
called, Energy Psychology. Evidence is coming from many countries now that
suggests that Tapping is not only fast and effective, but also the effects are
lasting. The discussion of this technique is broaching on a concept that is
making a lot of news: you CAN change Your brain.

J. Fang et al. “The Salient Characteristics of the Central Effects of Acupuncture Needling: LimbicParalimbic-Neocortical Network Modulation.” Human Brain Mapping 30, no. 4 (April 2009): 1196-
1206.

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The Tapping Solution To Release Stress and Find Balance

Years ago when working with very anxious infants and toddlers, I discovered a good calming technique was to pat or tap the child’s back gently in a continuous pattern. The child would calm and finally go to sleep. Actually, moms have been doing that for centuries. I taught clients with high anxiety little children to do that as a means of calming the child. It always worked but I never thought of it as a technique that could be used with older children and even adults.

Recently, an old friend who had become highly anxious after a head injury attended a seminar on the Tapping Solution and referred me to it. I am excited to learn about it and that there is a theory behind how it works to balance the nervous system. And, to make it even more available, Nick Ortner and his siblings developed an App called Tapping Solution App. During this superstressful period of Covid-19 they have been offering a special for the healthcare workers, including mental health care workers, and first responders. The special is a 6-month free access to the premium version of their Tapping Solution App. The basic app and a few of the tapping meditations are free.

An example of a basic tapping meditation works like this. You download the app on your smart phone. You start the anxiety tapping meditation which begins with music and a way of measuring your anxiety before starting the tapping. The meditation is 9+ minutes long and begins with a nice deep breath in. The phone shows you where to start tapping on your body (side of hand). The app guides you with a positive statement to repeat to yourself as you tap.

The app tells you where to shift to the next place to tap. Each place of tapping is done for a few seconds before moving to the next spot. The places to tap are lit up with a blinking star. There are approximately 10 or more places on your hand, face, head, collar bone, under the arm to tap. As the app continues, you are asked to think about what makes you anxious or stressed as you tap. If you are in a group or more public place, earphones will make you unobtrusive as you use the app.

There are over 100 tapping meditations on a wide variety of topics to choose from. Basic topics include Releasing Stress, Releasing Anxiety, Releasing Fear, and Releasing Grief. Now, they have added specific tapping meditations for Covid 19. There is a really valuable one entitled Quiet My Racing Mind, which is a major cause of anxiety. Some of the meditations are in Spanish as well

There are over 100 tapping meditations on a wide variety of topics to choose from. Basic topics include Releasing Stress, Releasing Anxiety, Releasing Fear, and Releasing Grief. Now, they have added specific tapping meditations for Covid 19. There is a really valuable one entitled Quiet My Racing Mind, which is a major cause of anxiety. Some of the meditations are in Spanish as well

Normally, the use of the app costs about $50 a year, paid monthly or annually. However, the current offer of 6 months free for healthcare workers is a great deal. To explore further, you can order Nick Ortner’s book, The Tapping Solution, at Amazon.

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A Map for Dealing with the Uncertainly, Chaos, and Change

More trying times than this one is hard to imagine. Most of us remember Katrina. The last pandemic was the Spanish Flu in 1918 and none of us remember that. It is cited as the most devastating epidemic in recorded world history killing between 20 and 40 million people in about 2 years, more people than were killed in WWI or in 4 years of the Bubonic Plague. We were not helpless then and we did survive it. It did come to an end. And, we know so much more now than we did then. We have more tools with which to fight now

A key ingredient in this bitter stew we are all in is Uncertainty. Uncertainty is the Mother of Fear. And, fear gives birth to anxiety. The rules for how we are supposed to live and conduct business change daily. We are frankly being bludgeoned 24 hours a day with fear producing information over the TV and internet. Friends, family, colleagues, patients and clients are calling, texting, emailing to express their fears about the Unknown. No rules govern this global crisis, least of all how long it will last. Or, who will survive?

Everything about our way of life is threatened. People are afraid of dying should they test positive for Covid-19 – or maybe people they love will die. People are afraid they might not be able to pay their bills, might lose their home, or lose their job. They fear a shortage of provisions that they need to survive. The isolation, loneliness, is even harder to manage for many.

Over fifty percent of the American population are estimated to have significant worry and anxiety and most everyone would agree that they are stressed. We face a distinct danger of not staying emotionally healthy if we are unable to manage our fears and Cont next pg stress. There is danger to our immune system if the stress and anxiety are allowed to blossom and grow unchecked. In a nutshell, stress weakens your immune system. This new virus is particularly dangerous to those with a weakened immune system because of a reduced ability of the system to fight off antigens. And, cortisol suppresses the production of both Tlymphocytes and antibodies, which leaves body more vulnerable.

Of course, it is important during this period to use all the stress reduction techniques you have in your toolbox. On a daily basis, get good sleep, eat more natural foods, monitor your thoughts, take time for things like meditation and exercise. However, the epic scale of this coronavirus calls for more. Major chaos calls for significant and conscious change. Reducing the impact of the Covid-19 requires a new map, one that plumbs the depth of what matters to us. All over the world, people are being asked to shelter at home or to quarantine yourself if you have been exposed. Use this time as an opportunity to pause, push in the clutch, and reevaluate how you are living your life. Think about more deep questions, like what matters most to you. During your shelter at home days, consider taking one or two days to completely disrupt your schedule and routine, like doing a retreat in your own living space.

What would that look like? Take off your professional psychologist’s hat and clear your schedule or list of your usual routine. Maybe you do this with a significant other who is socially isolating with you. This is a time to dream about what changes you would like to see in the world. Possibly the coronavirus pandemic is presenting us with an opportunity to make major change. Maybe you do your dreaming and pondering alone and later connect by phone or internet with a small support group to discuss your thoughts and share your dreams and visions with others.

Consider what this virus might mean, might symbolize about our world. Many of our philosophers have commented on how compassion is growing more and more absent in the world. Oh, not everyone lacks compassion, but it is in short supply. Turf wars still light up the skies with new and better ways to kill each other. We notice the turbulence, but in this busy world, we rarely stop to feel compassion for those who are involved. So many people who are in pain need our compassion. We all have patients or clients that are more anxious and fearful than ever.

How might Covid-19 change our world? Don’t just focus on the negatives and the fears when considering this question. Of course, the negatives will come up first. Write them down and then look beyond. What good things might come from Covid-19? A friend sent a copy of a letter from Dr. Jean Houston to me, which is currently trending on the internet. Jean Houston earned Ph.D.’s in both psychology and religion. She is a writer, lecturer, a leader in the Human Potential movement, and was a close friend of Margaret Mead. Her letter beautifully describes one future that possibly is growing out from the Covid-19 chaos. That change could be increased compassion among the peoples in the world. Dr. Houston wrote: “All of my life I have been dedicated to encouraging the potential that every person carries within them. I’ve taught about our innate depths, our possibilities, and our purpose. Now, however, it’s time to live out the promise that we all carry, to become noble, kind and compassionate people. This week on television, I witnessed the best and most fearful sides of our natures. On the one hand, I saw violent videos of shoppers fighting over toilet paper, and also experienced indiscriminate generosity while shopping at my local Costco.”

Dr. Houston is not alone in what she reported. We have all witnessed firsthand or heard on the news of the juxtaposition of the best and the most feared sides of human nature coming out in this crisis. The fights over toilet paper are in direct contrast to the kindness and caring shared by people waiting in line. Restaurants turning into soup kitchens and being willing to feed hungry people in the area is happening in urban areas. Generous donations by famous people, like Drew Breese for food for those who have lost their livelihood during this crisis.

In the past, I have personally witnessed an entire bus load of 5 o’clock commuters in NYC yelling at the driver to wait and to reopen the bus door to let in one person so that they could escape the foul weather. Is it possible that Covid-19 will bring more of that kindness and compassion to the world? I believe that if we spend some of our retreat time contemplating how we can each show more compassion in our own communities, that our own burdens will become lighter.

So, what else could you think about when you take time to retreat? Spend time contemplating what really matters to you. We are all different and there is no “correct” list. But, maybe try to write down things that really matter to you and then try to pick out those that are most important to your growth and well-being.

Another important thing you can do is to spend some time thinking about your beliefs. Too many people are falling into the trap of believing all the negative things that are on the news. Make it a point to monitor and limit the amount of time you spend watching network news or searching the internet. Search out your destructive and negative beliefs. Change them to include the positive information that is less publicized. For example, here is some positive information. Most cases are not that serious and now there are over 100,000 full recoveries worldwide. China and South Korea are reporting a huge drop in new cases as a result of their tough restrictions. The Covid-19 death rate is actually lower than WHO estimated. Research and experimentation to find drugs and treatment for this new virus is making good progress and that should reduce the number of deaths. This would help bring back sanity. Apple stores are reopening in China; other stores are expected to follow. Cleveland’s MetroHealth Medical Center has developed a test that can give results in 2 hours, not days. A pharmaceutical giant announced a test that will take 7 minutes and the FDA gave permission for it to be mass produced and distributed.

Along the same lines, take control of your thoughts. Practice some of what we all preach: Cognitive Behavioral Therapy – we know how to argue and challenge the logic of our fears. Monitor your thinking so that you can stop worrying about things over which you have no control and no voice. Stop worrying and change what you are thinking about. If you cannot do that without help, then pick up a funny or exciting book, or watch a Disney movie, or experiment with the magic of your imagination. Decide upon a project that is long been on your list and start working on it. This is an opportunity to make new choices and find new directions. Activate your imagination, dream and explore those dreams and visions in your mind. Consider these next weeks like an unexpected vacation and use it to work on things you have on your “to do list.” Or, take this time to play and make sure you keep humor in your thoughts. Watch cat videos on YouTube; they are guaranteed to make you laugh.

Have you ever pondered this mystery? “Somehow things always seem to work out.” Look back in your own life and find a time when you were sure things would end badly but they magically seemed to work out. Or, recall similar stories from your clients. I remember one client who was sure they were going to lose their home after Katrina. But, in the end, they wound up with an even better one.

I know we are all feeling the pain of disrupted work and career, the drama of possible critical supply shortages, the boredom of staying home and socially distant from others. Keep in your mind that it is what you think about and what you do that determines your mental and emotional health. Recently a friend met me for coffee wearing a tshirt that read: “If you can be anything, be kind.”

Jean Houston closed her letter with these words:

“Take all the precautions that are recommended and at the same time, be bold in your love, and constant in your faith that together we will pass through this challenging time. On the other side of it, we will look back and realize that we were part of an epic time in history when caring triumphed over fear, and goodness prevailed!”