Being Present In the New Year

2/17/2020

Being Present in the New Year

Written by Dr. Lindsay Tobin, PsyD

As we find ourselves in month two of 2020 and the winter weather really kicks in we may find ourselves looking back on some of the goals we have resolved to achieve this year. Maybe we want to improve our health and fitness, spend less time on our phones, improve our relationships and deepen our connections. We may even have started out strong in January but find ourselves falling back into old routines and habits. We think to ourselves, “This happens every year. Why can’t I make these changes? What is wrong with me?” From there we spiral down the rabbit hole of self-criticism, reflecting on and reliving all of our perceived failures and short-comings. This year, let’s try something different.

Mindfulness-Based Cognitive Therapy (MBCT) provides us with tools that allow us to be more fully present in our lives, reducing depressive spirals into our pasts and anxious ruminations about our futures. MBCT is an evidence-based practice developed from Mindfulness Based Stress Reduction (MBSR). MBSR was developed by Jon Kabat-Zinn at the University of Massachusetts Medical Center. MBCT helps individuals develop a different relationship with their thoughts and feelings.

Lessons in Mindfulness-Based Cognitive Therapy (MBCT) :

We learn that our thoughts and feelings are not ‘truth’ or ‘facts’, but rather passing mental events.

We learn that we can choose to respond to our thoughts and feelings or allow them to pass.

We learn the difference between ‘reacting’ and ‘responding’.

We learn about the difference between the ‘doing mode’ and the ‘being mode’. In turn, we can stay focused on our goals and develop improved relationships and time-management skills.

For more information or to start your own mindfulness journey following the MBCT approach, I highly recommend the book MIndfulness: An Eight-Week Plan for Finding Peace in a Frantic World, by Mark Williams and Danny Penman. Other resources include:

The Mindful Way Workbook: An 8-Week Program to Free Yourself from Depression and Emotional Distress, by John Teasdale, Mark Williams, Zindel Segal, and John Kabat-Zinn

Mindfulness-Based Cognitive Therapy for Depression, by Zindel Segal, Mark Williams, and John Teasdale

The Mindful Way THrough Depression: Freeing Yourself from Chronic Unhappiness, by Mark Williams, John Teasdale, Zindel Segal, and John Kabat-Zinn

The Mindful Catholic: Finding God One Moment at a Time, by Dr. Gregory Bottaro

IT’S (NOT ALWAYS) THE MOST WONDERFUL TIME OF THE YEAR: GRIEVING THROUGH THE HOLIDAYS 101

12/8/2019

IT’S (NOT ALWAYS) THE MOST WONDERFUL TIME OF THE YEAR: GRIEVING THROUGH THE HOLIDAYS 101

Written by Erin Mitchell MSW, LCSW

To start, let me introduce myself (I promise to make it short). My name is Erin and I am new to OakHeart. I have been doing counseling for 12 years and one of the topics that I am very passionate about is grief. I worked as a hospice bereavement coordinator (a fancy way to say grief counselor/therapist) for 3 of those years. There is just so much that is misunderstood about the grieving process and I would like to share with you some of the ways that people I have worked with have found to survive the holidays.

Many grieving people who are facing down the remainder of December find themselves dreading what the holidays are bringing. We have the cultural expectation that the holidays are a time for unfettered joy and celebration, which creates an enormous amount of added stress when you are grieving. When you feel like getting through everyday forces you to put on a mask to hide your grief, the disparity between what you actually feel and the expectations of “joy” and “cheer” that bombard you during the holiday season makes it feel impossible to get through. You may even feel like you need to hide out and sleep through the next month to emerge once January is upon us.

If this resonates with you, then read on for some suggestions that can help you survive the season.

1. Be gentle with yourself. It is incredibly important to be kind to yourself in your grief. You may feel that you “should” or “shouldn’t” do or experience so many different things. The truth is that grief is a lifelong journey. You don’t “get over it” and there is no time limit. It has the horrible side effect of making it seem like it has been a very long time and just yesterday all at once. If this is your first year of grief or your tenth, grief has a way of leaving its mark.

2. Consider your grief triggers. I’m sure that you probably have some things that you are positively dreading in the upcoming season. Think about what those are and why they seem so painful. Consider if these are things that you absolutely have to do this year and change your plans accordingly.

3. Be flexible. One of the most important things is to follow how you feel. Grief tends to be constantly changing our emotions. Maybe last week it seemed like a great idea to go to that office party, but today it seems like a nightmare. Follow how you feel and be kind to yourself. If you don’t want to go, chances are that you don’t actually have to.

4. Consider changing old traditions. Traditions can be absolutely wonderful. They can be reminders of happier times and a way to connect with the past. However, when traditions become painful there is no reason that you cannot make changes. These don’t have to be permanent changes, but maybe just the next year or two. I have worked with individuals that couldn’t put up a Christmas tree, so they got out a tree they decorated for another holiday and used that instead. Maybe the mashed potatoes that mom always made are just something that cannot happen this year, so just allow those to be skipped this year. Maybe instead of personalizing all of those holiday cards, you can write a general letter letting people know what happened in your life and send that out in all those cards (or just skip them this year). Talk with your loved ones that you celebrate with to let them know that you plan to change things up for this year ahead of time. That way they will know in advance and can possibly help make those changes.

5. Make an escape plan. This is something that is useful during any upcoming events that you are dreading. If you are concerned about having a “breakdown” in front of others or are just worried about what to do in situations where you cannot easily just leave; come up with an escape plan. Have a pre-planned excuse for leaving early. Think of the place that you can be alone if you need to be during that holiday gathering. If you have a planned way to get out of the situation, you will most likely have less anxiety going into that situation about the potential “what ifs”.

6. Create new traditions. Consider ways that you could possibly honor or remember your loved one during the holiday season. Some people volunteer in their loved one’s memory. Some people will write letters to their loved one. Some will attend a memorial. What appeals to you and your family? What new tradition can you think of that would be right for you?

7. Beware of overindulging. Many of our holiday festivities have alcohol readily available and encouraged. While alcohol (and other substances) may seem like the answer to drown out those feelings of grief, it really only delays those feelings until later. If you are going to be drinking, please make sure that you are being safe.

8. Find support. This support can come from any area of your life. If those friends and family members are helpful to you in your time of grief, then try to open up with them about what you are experiencing. No one knows what you are currently experiencing unless you tell them. Something to keep in mind is that we tend to believe that those we are closest to and love the most will be the most supportive, sadly that is not always the case. If your closest loved ones are not able to be supportive to you in your grief, or just don’t understand, there are other avenues of support available. You may find that a grief support group is helpful, or a grief therapist, or an acquaintance that you never knew had been through something similar. There also tend to be remembrances or memorials held around the holidays. Contacting local support groups or hospices can be a good start.

9. There will be “grief bursts”. Even if you have evaluated everything coming up on your schedule, you will still have times where the grief just seems to come out of nowhere or you stumble headfirst into an instant grief trigger. Don’t be shocked if this happens to you. Grief is not always predictable and it does not mean that you are “getting worse” or being unhealthy in any way. It is just that our grief is constantly changing and makes us more sensitive to the world around us at times. That is not bad or wrong, it just is.

10. Take care of you. When you are feeling overwhelmed by grief, it can be very easy to ignore your physical needs. Your emotional needs seem to take center stage and make it very difficult to maintain those necessary functions, like sleep and healthy appetite. For many grieving people, your appetite and sleep habits are the first things to be heavily impacted. Grief is an enormous stressor and tends to make you more susceptible to health issues and general illnesses. Try not to be constantly busy and to make sure that you are checking in with yourself physically. If you find that there are small (or large) things that you can do to make your grief a little more bearable, do them.

Hopefully these tips will be helpful in getting through the holiday season. If you believe that you may want to seek professional help getting through this difficult time, contact OakHeart to schedule an appointment to meet with one of our clinicians at 630 570-0050 or email Contact.OH@OakHeartCenter.com.

Helpful Grief Resources:

Dr. Alan Wolfelt article on getting through the holidays. https://www.centerforloss.com/2016/12/helping-heal-holiday-season/

Hospice Foundation of America’s support group list. https://hospicefoundation.org/Grief-(1)/Support-Groups

Share Miscarriage & Early Infant Loss Support website. http://nationalshare.org/

8 Ways to Manage Seasonal Depression

10/13/2019

8 WAYS TO MANAGE SEASONAL DEPRESSION

Written By Dr. Emily Frey, PsyD

Leaves are changing color and there is a cool crisp air circling us now. For many, this time of year is refreshing and lends itself to a culture that involves seasonal activities and getting cozy inside because it is becoming dark out much sooner and it’s a great excuse to turn on the fireplace. On the flip side, these changes may also represent triggers that depressive symptoms are lurking around the corner. This can be confusing because you may really love this time of year while also fear it. It seems unfair that your mind and body can be in such conflict, but you are not alone, as many people deal with Seasonal Depression. Or maybe you just plain hate this time of year. Luckily, there are ways we can prevent and manage it, so please remain hopeful and consider trying some of the following ideas on.

But first, let’s get technical for a minute… Seasonal Depression, clinically known as Seasonal Affective Disorder is often referred to as “The Winter Blues”. It has certainly earned its name and provides a face value definition. Usually, the symptoms start in the late fall, last through winter, and resolve by summer; however, people do experience seasonal depression during the summer as well, it is just less common – still valid though. It is a type of depression that occurs with a specific seasonal pattern, where you experience the same symptoms as Major Depression during that time period, for at least two years:

Feeling depressed most of the day, nearly every day
Feeling sluggish and tired
Changes in appetite or weight (Craving carbs is common)
Feeling hopeless and/or worthless
Having low energy Difficulty concentrating
Feeling restless or agitated Isolating (Desiring hibernation)
Frequent thoughts of death and/or suicide

I make a point to bring up the topic of Seasonal Depression with my clients around the month of September so we can stay ahead of it. Good news! Not only have I witnessed clients prevent these symptoms by being proactive, I have also received feedback that they were able to enjoy the winter without a depressive episode because they worked at keeping them in check. Even if you were able to just “lighten” the symptoms for yourself, as we cannot guarantee an absence of symptoms by following tips below, reducing and lightening symptoms can give you a better experience. Wouldn’t that be worth considering?

Here are the 9 ways I normally bring up in a conversation, to manage Seasonal Depression, it is not all-inclusive, but there may be something listed that could be worth trying:

1. Direct Sunlight:
Our bodies crave sunlight, we need it, bottom line. The change in seasons makes it less available and that certainly has an impact. Obviously, consider your own skin type and sensitivities as you do this, if you need sunscreen and other protection then keep that in mind. Direct sunlight provides us with Vitamin D, plus it has been shown to boost serotonin levels which helps improve mood, focus, and helps keep us calm. The abundance of sunlight in the summer months is likely a protective factor against depression, which is why people are less likely to experience seasonal depression during that time of year.

2. Vitamin D
I recommend that you speak with your primary care provider to receive their guidance and recommendation in terms of the amount of Vitamin D you could benefit from. It may involve having a blood test to check your levels before they can provide a recommendation. Some studies have also shown that Vitamin D can help prevent some Cancers – two birds with one stone here!

3. Exercise
I know, I know, it is very hard to get up and moving when you already feel sluggish. Remember, engaging in exercise also increases serotonin, dopamine, and endorphin levels – all the “feel good” neurotransmitters. May I suggest considering Hot Yoga, it often involves meditation, stretching, strengthening, and a nice warm room which gives you the chance to escape the colder weather. You can pretend you are at the beach, if that is something you enjoy.

It does not have to be rigorous and incredibly challenging for you to benefit. The more movement you can incorporate with your body, the more you are combating fatigue and feeling sluggish. Plus, it can be a nice distraction from the negative thoughts that can pop up with depression. Go for a walk, dance, ask a friend to go to a workout class with you, run with your pup, try out that Pilates DVD you have been eyeballing for a while now, and have fun with it!

4. Light Therapy or a “Happy Light”
If you have not heard of this, that is totally normal and okay. It is a form of therapy that involves a small light box, which emits cool white fluorescent light often 20 times greater than the amount of light found in typical indoor lighting. The beauty is that they are VERY SIMPLE to use. You place the box next to you for about 20-60 minutes a day or a few times a week, while you are doing other activities (i.e., reading, watching TV, meditating, etc.), and reaping the benefits of the little box as it mimics the effects of the sun in a safe way. Research has shown that most people experience larger effects when they utilize a light that emits 10,000 lux. You can find these at stores like Bed, Bath, and Beyond. Another plus is that you can find one that is fairly inexpensive. Here is a link for one that has been backed by research and has multiple versions: https://verilux.com/collections/happylight-therapy-lamps-boxes.

5. Activities and Social Life
It is hard to see people and go out when your body is saying “staying inside” and you just don’t feel like it. You do not have to be the world’s biggest socialite either for this to help you. Since we are social creatures, it is often healing to be around other people who we feel connected to and studies show that too much isolation increases depression, anxiety, and other mental health issues. What I encourage you to consider here is spending time with people who restore you. The same goes for the activities you choose. If you choose people or places that often involve toxicity and drama, you are setting yourself up for feeling badly and that is not the goal here. Close your eyes and think of the people who you feel calm around, who build you up, who you laugh with, and who you are genuinely pleased to be next to. Now, close your eyes and think of the activities that allow you to feel refueled when you are doing them. These are things that may ignite creativity within you, things that transport you to another world through stories or games, things that give you energy rather than drain you. This will vary from person to person. If you are more introverted, then being around too many people will be draining, so consider this and tweak the formula as you go.

6. Mindfulness and Acceptance
The more present you are, the less room there is for depression. Now repeat that to yourself. Seriously, you cannot have two thoughts at once, it is not possible. Therefore, the more mindful and present you can become, the more in tune and connected you can be in your life, which means the opportunity for depression decreases. This does not mean that you must be a master at meditation, but it does help to give it a try. Mediation and mindfulness are about being an active observer of your thoughts, emotions, and sensations without over identifying and attaching too much meaning to them (we can also teach you how to do this in therapy). You can start with lighting a candle and focusing on the flame while slowing down and deepening your breathing. As thoughts enter your mind, and they will, just “show them the door” without reacting to them. Expect thoughts to enter, it’s more about what you do with them. You can also engage your senses by mindfully drinking a cup of your favorite coffee (insert other favorite if coffee is not your jam). While doing this, notice what it tastes like, smells like, feels like, and looks like as you slowly sip. Listen to what is occurring around you and take it all in. Give yourself some stillness. We live in a very busy world and sometimes we are uncomfortable with being still, when in reality it can be exactly what we need. There are several ways to practice this and I have included a link for guided meditation here: https://self-compassion.org/category/exercises/#guided-meditations

The acceptance part of this involves perspective and being honest with yourself. What is in your control here? Can you let go of what is not in your control? Remember, it is possible that you have gotten through this “season” before and it is likely that you can do it again, with better tools. Also, consider the parts of this time of year that you look forward to and enjoy. Keep in mind, this is all temporary. Plan a Vacation: Here is an interesting fact, research has shown that just the act of planning a vacation can be as rewarding as going. It gives you a chance to escape in a healthy way while you plan and distract yourself. Going on a vacation during this time of year may be a better fit than other times of the year to support your mental health. It does not need to be extravagant or costly. A change of scenery could have a powerful effect.

7. Medication
If you are finding that you are struggling with severe symptoms and it is difficult to function, then it is definitely time to schedule with a medication provider and engage in therapy. Medication providers can offer additional help to your regimen and provide additional referrals if needed. There is no shame in incorporating medication into your treatment plan.

8. Therapy
If you have never participated in therapy, the idea of going can be overwhelming and intimidating, and you are allowed to feel that. It is worth consideration for many reasons, especially with seasonal depression, as clinicians are there to help you through this by providing you with support and psychoeducation on coping tools. For some, a higher level of care may be needed. Think about it, it gives you the space to talk about anything you need to in a confidential way, that just focuses on you while you are there. Being a human is hard and when do you really get the chance to have someone solely focused on your needs and care? If you would like to engage in therapy, please give us a call at 630-570-0050 (OakHeart, Center for Counseling, Mediation, and Consultation) or visit our website at www.OakHeartCenter.com.

Just by taking the time to read this, you have made an effort to help yourself and that is wonderful! Attempting to prevent and manage your symptoms are key with seasonal depression. Please keep in mind that this is a snapshot of your options and depending on the person the aforementioned ideas may not fit, which is okay. Take good care of yourself.

References
https://www.healthline.com/health/depression/benefits-sunlight#sun-safety https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml https://self-compassion.org/category/exercises/#guided-meditations https://link.springer.com/article/10.1007/s11482-009-9091-9 https://verilux.com/collections/happylight-therapy-lamps-boxes/products/happylight-luxe

Adulting can Suck, but it Doesn't Have to

9/29/2019

ADULTING CAN SUCK, BUT IT DOESN'T HAVE TO

By Katie Cockrell MSW, LCSW

Adulting. By now, most have heard this phrase and can identify with it. It's a simple word that encompasses the idea of what it means to be an adult; what adult life is supposed to look like, and what adults actually do. It also describes all adult tasks, expectations, responsibilities, milestones, and behaviors typically experienced by adults. Some of the well known examples of adulting are: paying bills, buying or owning a home, getting married, having children, and working a full time job. The phrase also acknowledges the stress that can often come along with some of these experiences.

It seems that in an ever changing world, where expectations develop and adapt all the time, the expectations or pressures of being an adult seem to stay the same. What do I mean by this exactly? Well, there appears to be this idea, especially in western culture, that suggests that adulthood looks like the following: working full time jobs, owning homes, being married, and having families. For some, this idea of adulthood is exactly what they want and they create goals to accomplish this idea. For others however, it may look different...a lot different...and this can sometimes cause feelings of confusion, despair, failure, depression, anxiety, and an overall loss of identity. Does this mean then that those who want the job, house, marriage, and family are wrong? NO, absolutely not! Does this mean that those who do not have or want a house, are not married yet nor want to be married, or do not have or want a family are wrong? No absolutely not! Life can be DIFFERENT for everyone.

Maybe you have just completed college and are starting life for the first time no longer being a student. This can be really scary! The transition is new and can be uncomfortable. No one seems to talk about or identify that this transitional period exists for some students. Living life as a full time student and making the transition to full time work, for some, can feel wonderful and exciting! It has a different focus, new challenges, and different responsibilities. For others, this can feel very negative and may be hard to adjust to. If it does happen to feel this way for you, THIS IS COMPLETELY NORMAL!

Maybe you didn't choose college and have been working since high school. Maybe you are experiencing pressure because you didn't complete the traditional educational life that others feel you should have. Maybe you are feeling guilty because you did not or could not further your education. Maybe you are worried that you will miss out on an opportunity that should have happened if you would have continued with your education. Maybe you have a fear that others will think you are less qualified due to not furthering your education. Education alone, does not always prepare one for the real-world. Many times it is hands on work experience that provides one with knowledge, the ability to practice life-skills, develop responsibility, and produce personal growth.

Maybe your adult life has been shaped by something different, such as an unexpected death, illness, or crisis in which you had absolutely no control over. Maybe this unexpected event has caused some delay in developing your personal goals or plans for your future. Just because one experiences a delayed start on adult life, does not mean that they will miss out on opportunities or that they do not possess the appropriate skills to manage their lives. Circumstances change constantly and things happen unexpectedly which can put one's life on a completely different path. Whatever the case maybe, this societal pressure that suggests that one NEEDS to create or have or live life a specific way, by the time one reaches their 20's, 30's and beyond, is simply not true or realistic.

So then what is adulthood truly about? It's about allowing yourself to stay focused on what is important to you and your happiness. It's about allowing yourself to figure out what goals/accomplishments are providing fulfillment in your life. It's about setting the appropriate sized goals to achieve what it is that you want or need and make sure that these goals match the life that YOU want to have. It's about giving yourself time to find yourself by trying new things, exposing yourself to challenges, and failure. It's about building a life that matches your personal values and that you are personally proud of. Maybe this means owning the house,renting the apartment, having children, not having children, getting married, or living the single life. There is more than one way to experience adulthood and to develop a satisfying life. Life is hard...sometimes it's very hard, and guess what, it doesn’t get any easier!

You cannot Pinterest your way through life and expect good results, it just doesn't work that way. So instead, consider these tips:
9 Tips for Adulting

Practice gratitude.
Be thankful for what you are accomplishing and have already accomplished. Allow yourself to find things regularly to be thankful for regarding your current life, not the life you do not have.
Become comfortable with failure.
Failure is a natural part of life that we will continue to experience throughout your life. Failure can be a great opportunity to learn about yourself, develop your wants and needs, to experience growth and change.
Take more chances.
Prioritize what you would like your life to look like and allow yourself to develop appropriate goals and steps to get yourself there, despite the uncertainty you may experience doing so.
Practice mindfulness.
Life is stressful and can produce a variety of thoughts and feelings. When you focus you awareness on the present moment, while calmly acknowledging and accepting your thoughts and feelings, you are opening yourself up for growth and resiliency. When we become more resilient, you are able to deal with life's challenges and changes are a lot easier.
Develop self-awareness.
Monitoring your thoughts,feelings, and behaviors are very helpful. If something seems different or out of the ordinary, ask yourself why. When we are more self-aware, we are better able to problem solve, make better decisions, make appropriate changes, and set healthy boundaries.
Ask for help.
Just because you have reached adulthood does not mean you need to know all the answers and have it all figured out. ASK FOR HELP. Reach out to family and friends or someone you can trust, who also supports your own beliefs, values, and goals.
Practice setting boundaries.
It is absolutely OK to say NO to someone if they are engaging in behaviors or are asking you to engage in behaviors that do not align with your personal goals, priorities, values.
Own your life.
One of the biggest responsibilities about being an adult is taking ownership and accountability for your own thoughts, feelings, and behaviors. No one will ever be powerful enough to make you think, feel, or act a certain way. You determine what your own path looks like, by the choices you make. You are not responsible to always make the right choices, but that does not mean you are allowed to blame others for the consequences of choices you make. OWN your OWN choice and OWN your OWN life.
Attend Therapy.
Last, but certainly not least, if all these steps feel confusing, complicated, or sound good in theory but are difficult to implement, talk to a therapist! We are here to help you, support you, and guide you! Whether you are 18 and are on your own, 35 and living with your parents, or 80 and married, Life doesn't always go the way we want it to, and it can be helpful to receive some back-up assistance from a non-bias trained professional.

5 Tips When You or Someone You Know is Struggling

9/15/2019

Written By Brittany P. Male LCSW, CADC

1. Acknowledge the struggle.

I often have conversations with clients regarding the difference being being hopeful and being dismissive of “struggle”. Before I can help a client move forward, I help them acknowledge where they are. As a therapist, I have a hopeful nature. I have hope that people can change. I have hope that people are good. I have hope that good things will happen. I have hope that we can overcome the obstacles we face. With all this hopefulness, though, I make it a point to also acknowledge the struggle others are experiencing and encourage them to acknowledge it themselves.
To acknowledge this may mean to simply say to yourself, “I am struggling right now and that is all right.” Life can be difficult and messy and while we can practice gratitude, we can also take time to provide compassion to ourselves through the “struggle” by simply acknowledging it. It is okay to not be okay.

2. Give yourself permission to struggle.

I give you permission to acknowledge your struggle. I give you permission to allow yourself to be both resilient and vulnerable as a result of the difficulties you’re experiencing. You can know that it will get better or easier yet simultaneously be overwhelmed. You can be grateful yet long for resolution of the challenges you’re facing.

3. Accept that the glass is both half full and half empty.

The truth is that the glass can be a little empty and also a little full. Read that again. Instead of trying to see things from only two positions as is our nature to do, you can instead be both. The glass can be half empty and half full at the same time.

4. Provide yourself with validation.

Once you allow yourself to acknowledge the challenges you’re facing and provide yourself or receive validation, you can then begin to move forward. Every session I have with clients includes validating their thoughts and feelings. So many of us don’t experience the validation we should receive from family and friends. Over time, this has taught us to be dismissive of our thoughts and feelings. In therapy sessions, validating someone acts as a corrective emotional experience, allowing them to learn to validate themselves and healing the wound that was caused by being dismissive of their past struggles.

5. Use validating and encouraging language with yourself and others experiencing struggle.

When we share words of encouragement such as “It will get better”, we do a disservice to those struggling. While certain types of encouragement be helpful, instead we need to first remember that encouraging them to acknowledge or validate where they are is necessary. Instead of saying to a friend, “iIt’ll get better'', say, “I see how hard it is for you right now. Please know that it does get better, and I can help you get there if you need.” I am not going to apologize to my clients for being hopeful in session, but I make certain that first and foremost, they feel heard and validated wherever they are presently.

Binge Eating disorder verseS emotional eating

8/18/2019

by Megan Rosecrans Psy.D. LCP
Licensed Clinical Health Psychologist

What is Binge Eating Disorder?

Binge eating disorder (BED) is the most common eating disorder, but is the least talked about of the eating disorders. It has been gaining more attention over the past several years since the addition of the diagnosis to the DSM-V. A binge is classified as an episode occurring within the last 3 months where the individual ate a larger amount of food, within a 2 hour time period, that is definitely larger than what most people would eat in a similar time period under similar circumstances or a loss of control over one’s eating. For example, overeating at a family barbecue does not count as a binge episode since everyone is definitely eating larger amounts of food than they typically would consume. The other criteria that occur with a binge episode include eating until uncomfortably full, eating more rapidly than usual, eating large amounts of food when one is not physically hungry, feeling embarrassed about how much one is eating, feeling disgusted, depressed, or guilty after consuming the food, and feeling distressed that a binge episode occurred. These episodes can happen multiple times per week. Many find it surprising how little the amount of food consumed is needed to be classified as a binge episode but this is because higher calorie foods, like chips and candy, are easy to over-consume. A binge episode can look like eating an entire box of cookies or entire bag of chips in one sitting, or one can consume small amounts of food each time they grab an item but over the 2 hour time period it would be a larger amount of food than what one typically eats. For example, this can look like grabbing a handful of peanuts, then grabbing some cookies, then grabbing popcorn, and so forth. There are multiple reasons a binge episode can occur and part of treatment is understanding these mechanisms.

What is emotional eating and how is it different from a binge?

Emotional eating does not share the criteria of a binge episode, however, emotional eating can lead to a binge episode. Emotional eating is used to aid in coping for a wide range of emotions. High calorie foods can trigger the release of dopamine, a feel-good neurotransmitter in the brain, which is positively reinforcing. If we are feeling sad, anxious, frustrated, stressed, etc. then eating food that makes us feel good is one way to cope, but this is not a healthy method of coping. Treatment for emotional eating includes learning to identify the emotions and increase positive methods of coping that do not include food.

How do we treat BED?

Psycho-education about BED and the psychological and physiological mechanisms, creating strategies around food and the binge, problem solving, addressing behavioral patterns, investigation into underlying causes for the binge episode, learning relaxation techniques, and utilization of coping skills to aid in reducing the frequency and intensity of the binge episode.

If you would like to learn more about BED, emotional eating, and eating behaviors please give us a call at 630-570-0050

Resources:

https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed

https://www.womenshealth.gov/mental-health/mental-health-conditions/eating-disorders/binge-eating-disorder

References:

American Psychiatric Association. (2013). Feeding and eating disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. Author.

Harmon. K. (2010). Addicted to fat: Overeating may alter the brain as much as hard drugs. Scientific American. https://www.scientificamerican.com/article/addicted-to-fat-eating/

Helping someone who's grieving

4/28/2019

Written By Brittany P Male LCSW, CADC

When I was 20, my father died in a motorcycle accident on a late spring afternoon. I had just finished my sophomore year of college and was preparing for a busy summer as a lifeguard back home. It’ll be 12 years this May, and I still remember vividly the moments leading up to, and following, finding out that he had passed. My life shifted in a way that I couldn’t have seen coming, and for the next several years I spent my time picking up the pieces that had been shattered on the floor of my family’s living room that day.

That may not have been where my experience with grief started, but it sure was the first significant death in my life. Since then, I have experienced the death of one of my best friends as well as a very close aunt. I’m not sharing this with you for sympathy or to compare grief experiences, but instead giving you context for what I’m about to share. Although there were so many people that offered their condolences and support to me throughout those early years, there were also those who left me feeling disappointed, and even hurt unknowingly. It was only years later, after some distance from the rawness of grief, that I realized the avoidance and lack of knowledge our society has surrounding death and grief was what made it difficult for people to empathize with me.

I find that death initiates a form of grief that for many people is too difficult to acknowledge. Acknowledging someone’s death means that we also have to acknowledge our own inevitable death, and when someone close to us experiences a death it also leaves us to acknowledge that people close to us could also die. In general, we do not like to think about those things happening. This desire to avoid thinking about our own mortality as well as the mortality of those we care for often times motivates us to avoid those who are experiencing this loss.
I should mention that grief isn’t just reserved for death, but can also be experienced after any significant “ending”. Most of us have experienced losses such as moving, ending of relationships, leaving jobs. For the purpose of this post, I will be directly referring to the grief experienced after the death of someone close to a person, but much of what I’m about to share could apply in any of the above examples. The primary goal of this post is to help provide some guidelines for those who know someone experiencing deep grief.

Below, I have identified several points to keep in mind when you know someone who is grieving. In no way is this an exhaustive list of things to consider, but I do believe it is a list that will get you started and give you some direction when trying to help the person you care for navigate through their grief. In addition, please keep in mind that everyone’s experience of grief may be different so the points shared below should be applied with that in mind.

Have Patience

Sometimes the person may not be ready to talk about their grief or may not even acknowledge that they have grief (this was me for about the first six months). It wasn’t that I didn’t cry about his death or didn’t talk about it, but it just didn’t quite sink in until several months later. I hadn’t fully allowed myself to acknowledge the significance of this loss in my life. When I’m talking with clients about this denial stage, I share with them that this is a protective stage that our brain allows us. Keep this in mind please.

What’s interesting about this is that for most people around someone who’s lost someone, after six months they may “assume” that the person is better and moving forward from the loss. In reality, though, they may just be beginning to acknowledge the grief they’re experiencing. This is where the patience comes in. We often want to “fix things” and make them better quickly and what I’ve found with grief in both my own experience as well as having counseled those experiencing grief, is that grief is not “quick” and therefore can not be “fixed” quickly. In fact, grief is not something to be fixed at all because when someone has lost someone significant---they are changed forever. They will never be as they were before.

Humans don’t do discomfort well as a whole and difficult emotions create discomfort so we have a tendency to try to fix or resolve them. Grief requires that we just allow the person to sit in that feeling instead of trying to fix it. The only solution to their grief would be to not feel it anymore which is an impossible solution considering that the loss can not be undone, so instead of trying to fix it----just provide support and comfort. It’s important to keep in mind that although those early days and weeks may require a little more support and comfort, ultimately they will need your support and comfort for many weeks, months, and years to come.

If you’re unsure what kind of support and comfort they may benefit from, there are a few things to consider. You could ask them what they need. Sometimes however the answer you may get is “nothing”. That doesn’t mean do nothing. That means they don’t know what they need because no matter what you do, their loved one will not return to them. If they say “nothing”, I encourage you to reflect back on that person and ask yourself what kids of comfort and support they’ve valued in the past. Maybe they’re someone who appreciates being alone but would benefit from having meals sent to their home or groceries delivered. Maybe they’ve valued time spent talking with them and you could plan to get together with them if they’re willing to allow them the time and space to talk. Maybe they’ve got pets or children that, at this time, are added stressors and they could use a few hours to rest and you could offer to watch their children while they do something for themselves.

Be Forgiving

As a whole, we can be a little self-involved, and are often guilty of personalizing things even when it has nothing to do with us. It’s important to remember that when someone is experiencing grief, sometimes this may motivate them to say or do things they may not do otherwise and therefore leave you feeling like you’ve done something wrong.

Moving past denial and sadness, there exists anger. When someone close to you dies, “social rules” go out the window. Not to say it’s “right”, but there is a sense of entitlement to do whatever the heck you want because well, you earned it. Politeness and courtesy seem unimportant and on top of that, you’re struggling with being angry that someone you loved is gone. The anger is not just being angry at the loss but can impact everything you do. Maybe you notice that the co-worker who just returned to work after her partner passed is being a “crab” or your neighbor who’s been dealing with the loss of a family member also seems to be in a rush and doesn’t even wave. Whatever the impact to you, please remember that the person’s grief may be displaced onto you or those or things around that person. This is where forgiveness comes into the play.

In some ways, I’ve needed to forgive myself for the anger that I displaced onto others around me after my father died. I was just so angry and there was no way to fix it---it just needed to run its course. I was young and was experiencing emotions I hadn’t before. I’m not saying that this is the case for everyone, but I’ve experienced it to be true often, and therefore being forgiving of those experiencing grief has made my list of things to consider. That said---dealing with a loss does not give someone the right to just be mean for an unidentified amount of time. If you’re observing someone close to you grieving and being angry or sad I would encourage you to talk with them about meeting with a therapist so they can actively work through their grief in a productive way. Their grief may have evolved into depression. If they’re not open to talking with someone, just continue to be supportive and encouraging and maybe they’ll be ready to talk with someone at a different time.

Say Something

Generally speaking, saying something is better than saying nothing. Instead of thinking that you need to have all the answers, or tell them something very profound, understand that there is nothing you are going to say that will take away their grief. Your purpose as someone who cares for them is instead to allow them to feel what they are feeling and provide comfort through listening and validating those feelings. Everyone grieves differently and sometimes what that person needs can change from day to day. Allow them to communicate what it is they may need from you, or better yet offer a few things to them and allow them to choose what they’d like from you. Below is a list of things to say as well as things not to say.

What to say:
1. I am so sorry for your loss.
2. I wish I had the right words, just know I care.
3. I don’t know how you feel, but I am here to help in any way I can.
4. You and your loved one will be in my thoughts and prayers.
5. My favorite memory of your loved one is…
6. I am always just a phone call away
7. Give a hug instead of saying something
8. We all need help at times like this and I am here for you
9. I am usually up early or late, if you need anything
10. Saying nothing, just be with the person

What not to say:
1. At least she lived a long life, many people die young
2. He is in a better place
3. She brought this on herself
4. There is a reason for everything
5. Aren’t you over him, yet he has been dead for awhile now
6. You can have another child still
7. She was such a good person--God wanted her to be with him
8. I know how you feel
9. She did what she came here to do and it was her time to go
10. Be strong
(https://grief.com/10-best-worst-things-to-say-to-someone-in-grief/).

No timeline

Despite the fast paced time we live in, grief does not have a timeline. While a year may seem like a long time to someone who hasn’t experienced grief, for those who have, a year is simple a blink of an eye. While others have moved on, and oftentimes don’t even think about someone’s loss the previous year, that person is likely very much still in their grief. Depending on the significance of the loss, it can take several years for the intensity of that loss to dissipate and for someone to begin finding meaning and acceptance of their loss. That said, even years later the anniversary of their death, holidays, birthdays, or other personally significant days can often trigger grief reactions as if it had just happened.

To both clients who I have worked with as well as loved ones, the idea that there is not a “normal timeline” of grief comes as a surprise. People’s expectations of when they should be feeling better are often skewed. They believe that in a matter of weeks they should be feeling better. This can often lead to secondary stress related to feeling like something is wrong with them---that they’re not over the loss and doing better than they may be only a few weeks later after a loss. Time does allow us the opportunity to heal but there is no specific time assigned to grief. The complexities of the relationship and the person grieving, the circumstances in which the person died, and the current stage of life the person grieving is in, all influence their process of grief. When my father died, I had just finished my sophomore year of college. My relationship with my father was complex, and there was a lot to sort through after he passed. I had family members that were also grieving and because of that, had to navigate through grief on my own. It took me years to find myself on the other end of grief and then I got pregnant with my first son and the grief wave hit me again. I had to reprocess my father’s death all over again. That said, it didn’t take me nearly as long and at that point, I had the awareness to know that I needed help doing so. A few therapy sessions later, I had come back to a place of acceptance. While the frequency of emotions may reduce over time, the intensity of the grief does not alter and may be triggered by circumstances out of our control or awareness.

I hope that this post serves as a practical guide to help you navigate through being a support to someone experiencing grief in your life. If you have any comments, concerns, or are looking for therapeutic support of your own to help you navigate through the grief you may be experiencing, please do not hesitate to call us to schedule an appointment today at (630) 570-0050 or email us at contact.OH@oakheartcenter.com.

Practicing Self-Care

3/31/2019

Author: Brittany P. Male LCSW, CADC

As a society, we continue to struggle to give ourselves permission to practice self-care. Our country values hard work and, in turn, we fail to allow ourselves the time to pause, catch our breath, and nourish our bodies and souls with rest. We’re fearful that if we stop to rest, we will fall behind and be unable to catch up. We’re fearful that those around us may look at us as “lazy” if we take the needed day off, limit our access to work emails and calls while we’re home, or say “no” to offered overtime.

Outside of the workplace, we find ourselves guilty of this as well. Whether you find yourself saying “yes” to going out with friends despite feeling exhausted from work and could really use a night in, or you’re a mother who doesn’t go work-out because she feels guilty leaving her children at the gym’s child care center. We often put our own self-care needs on the back-burner for others. We convince ourselves that we must keep going no matter the cost. If this sounds like you, keep reading. If this doesn’t sound like you, continue being your best self and use this as validation for the commitment you’ve already made towards yourself and those around you. The truth is that in order to be your best self, you must practice self-care.

The definition of self-care is the practice of taking action to preserve or improve one’s own health. Simply put, it’s what you do to stay healthy. Despite the definition, we still treat self-care as something that is unnecessary and something that only the privileged have the opportunity to do. Privileged, meaning those that can financially afford to get massages, take trips to tropical climates, or who can even afford to take time off work. First off, self-care is absolutely necessary. Taking the time now to commit to self-care saves you time in the long run. When we’re burnt out and stressed, we’re more likely to make mistakes, be unproductive, and get sick than we are when we’re rested and rejuvenated. Though it may seem counterproductive to take a day off work when you’re feeling burnt out, it is exactly what you need to do. Taking that day off to relax, do something you enjoy, or sleep, allows you to increase the energy you need to go back to work and focus on the job that you need to do more effectively. You don’t need to take a trip to the Bahamas or get weekly massages in order to practice self-care. Self care could looks like making sure to eat breakfast even if it’s on the go. Self-care could be listening to meditative music on your way to work or taking a minute each day to stretch. Don’t make excuses. Don’t over complicate something that doesn’t need to be complicated. Identify a reasonable commitment you can make towards practicing self-care and actually do it. See how you feel and how self-care affects and lends itself to your everyday and work life.

Just this past week, my colleagues and I decided to focus our attention on self-care and have benefited immensely. We worked together to identify both personal and professional goals for practicing self-care. At the conclusion, we identified the importance of self-care and made a commitment to checking in on self-care quarterly professionally and encouraging each other personally to practicing good self-care. For myself, self-care looked like saying no and giving myself permission to put away my work at night to spend time with my husband or enjoy a good movie. As a business owner and a mother of two young children, I can always be doing something, so giving myself permission to just rest and be still felt incredible. Since becoming a business owner, I have gotten into the habit of bringing my laptop to bed. It was a nightly routine: put the kids to bed, grab a snack, crawl into bed, and open up my laptop. Despite my fears, not doing work after the kids were asleep did not lead to me falling behind at work. Instead, I was motivated to get my notes done earlier or found time elsewhere in the day so that I could fully enjoy the time at night to just rest and recharge for the next day. What started as something I was going to do during self-care week, has now become something that I’d like to maintain as a regular self-care practice. I know that I am a better mom when I’ve had my time to rest. I’m telling you this for the purpose of encouraging you to look for the simple ways in which you can practice self-care. Sometimes these simple acts of self-care can lead to significant change.

The list below shows categories to evaluate your self-care and potentially explore ideas for yourself to practice self-care. To evaluate your current self-care, go through each category of and rank each from 0-5 (0 being that you never engage in that activity towards self-care and 5 being that you engage in it often). Calculate your average for each category in order to fully assess what your self-care “grade” is for each. If you’re not interested in a grade, simply use this evaluation for reflection. When you’ve reviewed all the categories, identify two things you can do in the next week to practice self-care. At the end of the week, reflect on your time practicing self-care. Did it take up time? Did you fall behind on the work you needed to do? How did you feel after engaging in self-care? Did anyone notice anything different about you? Did you notice anything different about yourself?

Physical Self-Care

Eat Regularly and Balanced
Exercise
Get Regular Medical care for prevention
Get medical care when needed
Take time off when needed
Get massages
Dance, swim, walk, bike, play sports, run, sing, or another enjoyable physical activity
Get enough sleep
Wear clothes you like

Psychological Self-Care

Make time for reflection
Go to therapy
Write in a journal
Read for fun
Let others know different aspects of yourself
Notice your inner experiences-listen to your thoughts, judgements, beliefs, attitudes, and feelings
Engage in new experiences (got to an art museum, history exhibit, sports event, or music/performance event)
Practice asking for and receiving help
Say “no” to extra responsibilities and sometimes.

Emotional Self-Care

Spend time with others whose company you enjoy
Stay in contact with important people in your life
Give yourself affirmations, praise yourself regularly
Practice self-love
Re-read favorite books or re-watch favorite movies
Identify comforting activities, objects, people, relationships, places and seek them out
Allow yourself to cry
Find things that make you laugh

Spiritual Self-Care

Make time for reflection
Spend time with nature
Find a spiritual connection or community
Be open to inspiration
Cherish your optimism and hope
Be aware of nonmaterial aspects of life
Try at times not to be in charge or the expert, be okay with not knowing
Identify what is meaningful to you and notice its place in your life
Have experiences of awe
Read inspirational literature
Pray and engage in valued living

Relationship Self-Care

Spend time with others whose company you enjoy
Set time limits for yourself
Say “no” when you don’t want to do something, if you are asked something on the spot, have your go-to answer be “I need to check and get back to you”
Set boundaries, relationships thrive off of clear and concise expectations of how we can and cannot treat one another
Take time for yourself that benefits only you
Practice vulnerability and honest sharing of your feelings and internal experiences
Process your concerns and fears with those you trust and allow them to support you

Workplace Self-Care

set/maintain professional boundaries
Balance your work schedule and life demands so no one day or one week is too much
Make time throughout the work day for intermittent self-care breaks (i.e. lunch or afternoon walk; social time with co-workers; listen to relaxing music
Create a healthy work space
Develop a short list (2-3 items) of top priorities each day
Before committing to a project, first consider your needs and available resources, and whether it will lead to overextending yourself - a sure way to compromise your self-care
Take time off when you need it

I hope that you’ve found this information both informative and motivating to begin prioritizing your own self-care. If you find that you’re having difficulty taking the steps discussed in this post don’t hesitate to contact us at (630) 570-0050 or email us at Contact.OH@oakheartcenter.com to schedule an appointment to meet with one of our therapists.

Building Resilience Through the Winter

1/29/2019

Author: Brittany P. Male LCSW, CADC

The holidays are over, and if you're in the Midwest, the longest part of winter looms ahead of us. Snow covers the ground, chilling cold takes our breath away, and the outside is void of any remaining life. At the time of this blog being posted, Illinois is actually the coldest place on the planet. If we’re lucky, we’re warm inside our homes, under blankets, drinking warm beverages, and dreaming of warmer days. If you’re from the midwest, you’re also aware that although it may feel like this season will last forever---it won’t. We know that daylight will remain with us for longer and we’ll soon be enjoying the warm breeze as we sit outside sipping lemonade. We remain hopeful in winter, knowing that summer will return.

In the “winters” of our lives, it’s harder to remain optimistic. But if we look back at past evidence, we find similarities in these “winters.” Much like the changing seasons, the previous challenges we’ve experienced have passed, too, and we know that our present challenge will do the same. The “winters” of our lives, though they may feel like they last forever, thankfully do not.

The challenge that the winter brings also conditions us to tolerate its harsh conditions. The winter builds resilience in us and so do the challenges we face. The American Psychology Association (APA) defines resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress” (2019). Going into winter, we’re soft from summer’s sun and relaxing days. But winter hardens our skin and leaves us resilient and able to overcome adversity with greater strength than before. As spring approaches, winter has prepared us for future challenges. Have you ever wondered why when the weather begins to transition to spring we’re quick to forget our jackets and enjoy the sun even though the temperature may still only be in the 30’s? Just a few months prior, we ran back inside to grab our jackets at the same temperature. We gain resilience and determination in the cold. Somewhere between September and April, we find toughness.

Thankfully, everyone is capable of developing resiliency. When it comes to the challenges we face, the APA outlines 10 ways you can build resilience:

Make connections with others.
Avoid seeing crisis as insurmountable problems.
Accept that change is part of living.
Move towards your goals.
Take decisive actions.
Look for opportunities for self-discovery.
Nurture a positive view of yourself.
Keep things in perspective.
Maintain a hopeful outlook.
Take care of yourself.
Engage in writing, meditating, and spiritual practices.

So if you’re finding yourself in the season of winter in your life, know that it is temporary. New growth will start, the softness and warmth of summer will soon be upon you and because of the winter, you will be ever more prepared for the next winter. As a bonus, you’ll be able to enjoy summer’s rays even more than you would have without your winter. You’re building resilience through this winter of your life. If you’re finding the present challenge you face, difficult to get through, don’t hesitate to call OakHeart and schedule an appointment to meet with one of our clinicians at (630) 570-0050.

American Psychological Association (APA). 2019. The Road to Resilience. https://www.apa.org/helpcenter/road-resilience.aspx

accomplishing Your goals this year

1/14/2019

Author: Brittany P. Male LCSW, CADC

The beginning of the year always motivates me to be reflective on the past year and motivated to identify the goals I have for myself in the coming year. That said, it may be easy to identify the things we want to change for ourselves, but harder to make those changes a reality. If you're struggling with accomplishing the goals you have for yourself, ask yourself the following questions:

What are the barriers to making this change?

Are there solutions to these barriers?

What will help me stay accountable to these changes?

Who can help me stay accountable to these changes?

For the purpose of moving forward, sometimes we have to take a look at the past. In previous attempts at accomplishing our goals, there may have been barriers that prevented us from accomplishing them or maintaining them. It's important to identify what has gone wrong in the past, when attempting to have a different outcome. Barriers may include a number of things, including our own fear of accomplishing the goal or of failing at accomplishing it. As a therapist, I often see clients scared to fail, and therefor make the sometimes, unconscious decision to not try, or sabotage their success. In our minds, we think that we’re saving ourselves and preventing a failure, but instead we’re only guaranteeing the outcome by not giving ourselves the chance. For example, if you want to begin eating healthier in the new year, but are afraid that you’ll end up picking up your old habits in week two, you may decide to never get started in the first place. So now, you have guaranteed that you won’t be eating healthy. Another example of a barrier, may be that your routine or schedule doesn't allow for the opportunity to work towards the goal. If that is the case, a solution may be that you need to identify where in your schedule or routine you can incorporate working towards the goal you have. Identify at the beginning of the week and block out the time you'd like to dedicate towards working towards that goals.

I have found that the difficulty is not in finding a solution, but instead utilizing the solution. Sometimes we just would prefer the easy way. We would love to say, “I want to stop smoking”, and the next day, stop smoking and never pick up a cigarette again. The reality is that we can not have this be our expectation. To make changes we need to have a plan and prepare for taking action. We don’t have to do it perfectly, but change does require effort despite our preference to simply will it to be so. Desired change does not just happen, we have to make it happen. If you are having trouble finding solutions, ask a friend, family member, find a group of those desiring the same change, or begin seeing a therapist. Brainstorming solutions with others is extremely helpful, because someone else with alternative experiences and ways of thinking may offer ideas you haven't thought of, in addition to being a great source of accountability and encouragement.

A third question to ask yourself towards the pursuit of your goals; is what can I do to help keep myself accountable? These are things that you can do on your own to help yourself be successful. You can create personal accountability in a number of ways depending on what your goal is. These may include: setting alarms on your phone reminding you to work towards your goals or to mentally "check in" with the progress you're making toward the goals, creating a reward systems that you’d actually like to receive, or reminding yourself regularly what the consequence of not changing is. It’s important to find out what works for you when it comes to personal accountability and stick with it. At any point, if you get stuck, go back to the beginning and walk through each question again.

The last thing to consider is who may be able to help hold you accountable. Although we may like to think we're independent and don’t need other people to be successful, the truth is that we do. Simply knowing someone is aware of the goals we've set, can be a powerful motivator. In addition, knowing someone else can be there if you need them to be, is helpful.

From here, I encourage you to take some time to reflect and write down the four questions and begin making steps towards the goals you have for this new year. When you find yourself struggling to make progress towards your goals, simply go back to the questions. Notice how I said, when and not if. It is important to remember that there is almost a guarantee that you'll meet barriers along the way towards change. I want you to normalize barriers. I want you to expect them. If your mindset is that barriers are a part of the journey you will not spend your time trying to pretend barriers aren't there. If you've met a barrier that you can't quite overcome or you're having trouble navigating through these questions, don't hesitate to call and schedule an appointment to meet with one of our trained clinicians today at (630) 570-0050 or email us at Contact.OH@OakHeartCenter.com.

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