The 3-minute exercise to manage anxiety while under quarantine

Anxiety has the capacity to be both incredibly helpful and harmful. In the event of finding yourself face to face with a cougar, down to the wire on a final project, or gearing up for a big race, anxiety gives us the "juice" to dig deep, focus, and function at a high level. There are consequences of course to these bouts with anxiety, including adrenaline and its counterpart cortisol - which, studies have shown, can be very harmful in high doses. Similarly prolonged states of anxiety can lead to fatigue, GI issues, heart problems, and memory problems. For brief periods of time, this anxiety can be functional and help us overcome challenges.

 Unfortunately, anxiety isn't always helpful. Often the evolutionary anxiety that would help us in the event of a battle against a wild animal is constantly "ON" as we fight internal fears surrounding things that haven't actually happened yet. In fact, I often find that when anxiety is over functioning it leads us to look to the future and build dozens of different possible outcomes, then mount problem solving against them all. This is overwhelming, often unhelpful, and multiplies distress by focusing on situations that do not yet exist!

 The beauty of practicing mindfulness as an anxiety management technique is that it helps us to stay focused on the present moment. Much of our psychological distress exists when we ruminate about the past or catastrophize the future - both are out of our control and are not happening in the present moment. You do not have to hold the distress of the past, present, and future simultaneously - it is too much!

 My favorite quick trick to bring anxiety down to a more manageable level is a grounding technique that engages your senses. This helps take you out of your mind and into the physical space around you. Here you can remind yourself of what is actually happening - relieving your mind of the burden of holding so many possible realities at once. This has been increasingly helpful to folks as they are stuck in self-isolation due to the growing impact of COVID-19 on our world (a veritable powder keg for anxiety and catastrophic thought).

 Before starting, I encourage you to take a few deep, full breaths - holding at the top of the inhale briefly and slowly exhaling. Then I invite you to turn to your senses and work through the following list. Repeat at least once (more if needed):

 *Name 5 things that you see

 *Name 4 things that you physically feel

 *Name 3 things that you hear

 *Name 2 things that you smell

 *Name 1 thing that you taste

 *REPEAT*

 Extra notes: it is normal to still feel your mind racing and to experience internal dialogue (even critiquing the exercise). Allow those thoughts to come and go and continue to focus in on the exercise - the anxious voice will start to subside as you draw more and more attention to the world around you. Also, I encourage you to try to slow down with each item you name, trying to avoid rattling things off as quickly as possible "PILLOW - COUCH - LAMP - CHAIR"; instead try to also include one detail or adjective along with the item "the faded chair" or the "patterned rug". 

If you are interested in more mindfulness activities, I highly recommend checking out meditation apps such as Calm, Simple Habit, and more. If you prefer a hands-on resource I encourage you to check out A Mindfulness-Based Stress Reduction Workbook by Stahl & Goldstein.

Tips to Survive Working from Home During a Quarantine

By: Kellie Calderon, LPC

(Pictured above: Jax, who just found out that his parents will be working from home)

March 18, 2020 

You finally receive the anticipated email from your boss, “we will all be working remotely until further notice.” You take off your dress clothes, get back into bed, and set up a “work station” consisting of a laptop, some freshly brewed coffee and an endless amount of snacks. Your dog looks at you and beams with joy. This is the day he has been waiting for his whole life. 

Sounds like a dream come true, am I right? In theory, and maybe for the first couple of days, sure. But what happens when you are on day 6 and you start arguments with your dog over who left the dishes in the sink? Some people work from home permanently, so they are prepared. But for those who typically work in an office setting the majority of the time, they may need a little extra help. Here are some tips that help with the adjustment and can possibly save your relationship with your dog, or anyone else you may be quarantined with.

Keep a Routine

It can be easy to sleep in, eat constantly throughout the day, and forget what time it is when you are working from home. In order to maintain your sanity, try to keep the same routine each work day like you normally would. Set an alarm each morning and resist from hitting the snooze button. Shower when you normally would - your dog will thank you. Personal hygiene and sleep hygiene are very important to maintain here. If you completely throw off your routine, when you eventually go back to working in the office it will be a lot harder to get back on track. Eat lunch when you normally would and resist from constant snacking, unless it is something rich in protein or nutrients, such as fruits and vegetables. The closer to your normal routine you are, the easier the transition will be when your days of working from home are over. 

Take Breaks

Working from home can give you more flexibility on getting up and walking around, but it can be easy to just plop down and not move for hours. Make sure you are getting up and walking around. Studies show for every half hour, you should sit for 20 minutes, stand for 8 minutes and walk around for 2 minutes. Or as Alan Hedge, professor of ergonomics at Cornell University, states, think of 20-8-2. Another good break should be for your eyes. I am sure you have heard from every eye doctor of the 20-20-20 rule. For every 20 minutes, look 20 feet away for 20 seconds - this can prevent eye strain. If you are as bad as I am about staying disciplined for this rule, set an alarm for every 20 minutes and you can knock both of these out at once. Also, don’t forget to hydrate! Remember that water bottle your cousin gave you at Christmas that tracks your water intake? Break that baby out of its packaging and start working on your 8 - 8oz glasses of water a day. 

Create Space and Boundaries

It may be the case that you are not working from home alone. Ever hear of the idea that it may not be the best idea to work with your spouse? Well there’s a reason for that. Too much time with the person you live with can be damaging to the relationship if it is not properly managed. Create work spaces that are in different rooms or areas. Designate specific work times that are in silence and breaks where you can continue conversations. 

Keep your work day consistent with the hours you normally work. It can be very easy to work past your normal work day because you are already at home. It is important to create boundaries so you maintain a healthy work-life balance. 

Be Productive

Although it can be tempting to binge every episode of “Love is Blind” on Netflix because you’re at home and have “all the time in the world,” remember, you are technically at work. The first step is to create a productive work space. As tempting as that bed is, use every ounce of your self-control to stay away. Shut the door if you need to and don’t look at the comforter calling your name. Sit at a desk if you can, open the blinds and put noise cancelling headphones on or play the Soundscapes channel on your favorite music app. 

One of my favorite things to do that helps me to maintain productivity is the Pomodoro Technique. “When faced with any large task or series of tasks, break the work down into short, timed intervals (called “Pomodoros”) that are spaced out by short breaks. This trains your brain to focus for short periods and helps you stay on top of deadlines or constantly-refilling inboxes,” Alan Henry says regarding author Francesco Cirillo’s technique. A great app to use is  “Pomo Done.”  How it works is you pick a task, set the timer for 25 minutes, and take a short 5 minute break. After 4 “Pomodoros” you take a longer break. 

Take Care of Yourself

There is an abundance of uncertainty at this time and it is normal to feel some stress and anxiety. Companies have most likely not had to prepare for their employees to work from home for this amount of time, so be patient with them. It is important to recognize when you are feeling stressed and utilize coping skills to help. Deep breathing, exercise and remaining social with friends and family via video calls can decrease stress. If you are struggling with work, ask for help. Be kind to yourself and others, and remember we are truly in this together!

Resources:

Henry, A. (2019, July 12). Productivity 101: An Introduction to The Pomodoro Technique.        

          Retrieved March 17, 2020, from   

          https://lifehacker.com/productivity-101-a-primer-to-the-pomodoro-technique-1598992730

Storrs, C. (2015, August 7). Stand up, sit less, experts say; here's how to do it. Retrieved March    

          17, 2020, from https://www.cnn.com/2015/08/06/health/how-to-move-more/index.html

© Empowered Connections Counseling

Chicago, IL 60602

Types of Grief

By Kellie Calderon, MA, LPC

"Grief I've learned is just love. It's all the love you want to give but cannot. All of that unspent love gathers up in the corners of your eyes, the lump in your throat, and in that hollow part of your chest. Grief is just love with no place to go."- Anonymous

As if grief weren’t complicated enough to deal with, there are a few different types of grief to be aware of. The importance of knowing these different types of grief is that you or a loved one can understand what you or they are going through to better process the grief and manage the emotions that go along with it. If you would like to get a recap on symptoms of grief, head over to the previous blog here!

Anticipatory Grief

This type of grief occurs when there is either a terminal or progressive illness that causes you to anticipate the grief that will occur when the individual passes away.

What you may experience:

• Anger

• Loss of emotional control

• Helplessness

• Loss of other things, such as dreams, future or family structures

How to help:

In situations where you may be anticipating the loss, it is important to use the time to process the loss with that person. It can be difficult to accept the fact that a loved one is going to pass away, but it gives an opportunity to spend time with them to find meaning in your relationship with that person and gain closure and peace for when they actually pass.

Complicated Grief

This type of grief lasts longer than “normal” grief (I put normal in quotes because there really is not a normal way to grieve, so use this term lightly), and may affect your daily living if you are not receiving help. If someone has an underlying mental health diagnoses such as depression or anxiety, it can also make the grief feel more intense. Someone who has depression or anxiety may have a harder time finding coping skills that are effective without additional help from a therapist.

What you may experience:

• Grief lasting a long period of time with no improvement

• Delayed grief (experiencing grief long after someone passes)

• Extreme or intense reactions to the loss (self-destruction, changes in behavior)

How to help

Since complicated grief is just how it sounds, complicated, the best route to process it would be to speak with a counselor. It may also be beneficial to set up an appointment with a psychiatrist if you feel you may have an underlying mental health condition as well.

Disenfranchised Grief

This type of grief occurs when a society, family member, friend or community invalidates the grief. This could be if the death is a suicide, overdose or something similar. This may also be if the death is someone that was not necessarily a close part of their life such as a coworker. These can be tough because although you may not be a close friend or family member, you still can feel the loss. Friends or family may wonder why you are experiencing grief, but it is important to remember that grief can manifest itself in different ways within different people. It could also be a trigger of a another time someone felt grief.

What you may experience:

• Feeling isolated

• No validation of your grief/feelings

• Feeling shameful or guilty for grieving

• Suppressing the grief

How to help

It can be helpful to find others who may have experienced that type of grief to help normalize the feelings (support groups, etc.). It may also be a good idea to talk to a counselor to find support and an outlet for your feelings of grief. Remember that everyone experiences grief differently, and just because others do not validate your grief, does not mean what you are feeling is not real.

Other types of grief

Along with the types of grief mentioned above, there are other types that may not be as common but still should be discussed.

Traumatic Grief - When a loved one dies in a traumatic and/or violent nature. This could cause nightmares, flashbacks (if witnessed), etc.

Cumulative Grief - Experiencing a loss while still grieving a different loss

Masked Grief - Experiencing grief that affects daily functioning but is not recognized by the person grieving. This person may be masking the symptoms with other behaviors (overeating, physical symptoms, self-sabotaging, etc.)

Collective Grief - Refers to grief experienced by a group. This is becoming more common with school shootings, natural disasters or if there is a death in a close knit community.

Absent grief - When the person is not showing any signs of grieving and is in denial of the loss. This might look like someone who goes about their normal life as if the person had not passed away. This person may be in complete shock and unable to recognize the loss.

There is no “right” way to process grief. However, if you notice that the grieving process is affecting your daily life and functioning, we encourage you to seek out counseling. This will help with processing the grief as well as learning how to manage the emotions that come along with it.

Types of Grief. (2017, March 28). Retrieved from https://whatsyourgrief.com/types-of-grief/

Understanding Grief: Symptoms and Ways to Cope

By Kellie Calderon, MA, LPC

Everyone experiences grief at some point in their lives. This can be through the death of a close loved one, or through other losses such as the loss of a job, the loss of a pet, or even the loss of a lifelong dream or goal. When a loss occurs, there are many different emotions someone can experience. Reactions can range from crying and sadness, to anger and disbelief. The difficult part about experiencing a loss is that there is not a one-stop-shop solution. Grief is not linear. There is not a specific set of things you can do to make it better, and what works for one person may not work for another.

The first part of this series is going to be covering the symptoms of grief as well as a few ways to cope. It is important to be able to identify these symptoms when you may be grieving yourself, or when someone you know may be grieving. By identifying the symptoms, you can begin the healing process, or help guide someone going through it.

There are many different symptoms that can manifest when someone is grieving. They can be separated into feelings, cognitions, physical symptoms and behaviors, and many of them are listed below. (Freeman, 2005; Worden, 2005). 

-Feelings:

- Sadness

- Numbness

- Anger

- Guilt

- Anxiety

-Cognitions:

- Obsessive Thinking

- Intrusive Thoughts

-Physical Symptoms:

- Tight Chest

- Lack of Energy

- Muscle Weakness

- Dry Mouth

-Behaviors:

- Sleep Issues

- Changes in Appetite

- Social Withdrawal

- Absent Mindedness

Many of these symptoms are very normal when it comes to the grieving process. However, one thing to be aware of are symptoms of depression versus grief. There are some similarities between the two but they are also very different experiences, and if left untreated, depression can become very serious. Below are some symptoms of major depression:

- Worthlessness

- Exaggerated guilt

- Suicidal thoughts

- Low self-esteem

- Powerlessness

- Helplessness

- Agitation

- Loss of interest in pleasurable activities

- Exaggerated fatigue

 Coping with Grief

 As mentioned earlier, grief is not linear. This is very important to remember because someone’s grieving process may take a few weeks, while others may take a few years. It is essential to be sensitive to someone who is grieving and to not force them through the grieving process. Below are a few strategies that may help when going through the process of grief (Note: many of these reference death; however, as we have stated loss can take many different forms).

 -Talk about the death. Many people deny the death which can cause isolation and may make it more difficult to accept the death and move on with life.

-Experience and accept feelings. It is important to remember that feelings of sadness, anger, numbness, etc. are all normal. In order to process the loss you must accept these feelings and try to experience them.

-Prioritize Self-Care. Many people neglect themselves while grieving. There is a lot happening and it can be distracting. Make sure you focus on your eating habits, exercise and sleep. Try Mindful Meditation to help as well. Apps such as “calm” or “headspace” can help with this.

-Accept support and help from others. It can be easy to feel like a burden to people when you are grieving, but the people around you are there for you to lean on. Surround yourself with your support people and accept the help they offer.

-Remember your loved ones in a positive light. It can be difficult to think about the positives in a time where everything seems so negative. Celebrate the life of the deceased and remember them in ways that make you feel good. Sometimes it can help to memorialize them in ways such as planting a tree, creating a memory book or advocating for a certain charity that is in their name.

 If you or someone you know is experiencing grief and is having a difficult time, please seek out professional help from a mental health counselor.

Sources:

Freeman, S (2005). Grief and Loss. Understanding the Journey. Belmont, CA: Thompson Brooks/ Cole

Grief: Coping with the loss of your loved one. (n.d.). Retrieved from   

        https://www.apa.org/helpcenter/grief

Schwartz, A., LCSW, PhD. (n.d.). The Difference Between Grief and Depression, The DSM V. Retrieved

      from https://www.mentalhelp.net/blogs/the-difference-between-grief-and-depression-the-dsm-v/

Worden, J.W. (2005). Grief Counseling and Grief Therapy: Handbook for Mental Practitioners (3rd ed.).

      New York, NY: Springer Publishing Company

Becoming a Therapist- My Personal and Professional Journey

I’ve often been asked by others, how did I become a therapist? What motivated or attracted me to embark on this long and intensely challenging professional journey? Throughout my lifetime, both personal and professional experiences contributed to my choice of practicing psychotherapy and specializing in complex trauma.  

I was born in Poland during the 70s, the era of the communists' regime. As a child, it came naturally to me to be a caring, empathetic and compassionate person. I often tuned into my feelings and expressed myself well. I would spend time alone to attune to these passing feelings and the state of my body trying to figure out why I felt this way, often expressing them through art and writing poems. This growing self-reflection in me lead to my curiosity towards what other people think and feel as well as why they behave in certain ways. I often wondered about why some people were so loving and caring while others so authoritative, abusive, or self-absorbed?

In school, I became aware of my abilities to listen and have empathy towards others' suffering. Friends and others often came to me to unburden their wounds or to share their deepest secrets - we would sit there and puzzle on the best way to resolve or to cope with their struggles. I was the person who stood up for others, was concerned for my peers' well-being, even being there for bullies to help them see the hurt they were causing to others. Science, art, writing, reading novels, poems, and war stories were my daily inspiration. I remember being able to visualize so vividly characters from books, draw nature, and write poems about self and others. Listening to my grandma's heroic war stories was the most inspiring experience, and I learned that even in the most atrocious times there was always room for helping others. She was the first source of inspiration for the trauma work I do today.

At the age of 11, I experienced and witnessed relational/parental separation, which had become a norm in my country, by overwhelming migration and adjustment struggles of losing a parent or a caregiver. My mother also immigrated to the USA to search for a better life for us (my two brothers and me). As a middle child and the only female in the family, it came to me naturally to acquire the role of a mother to my both brothers, especially to youngest one. I grew close with my brothers and often soothed their distress and grief. I found a ''safe haven'' in my grandmother’s and auntie's arms.  I grew in strength, resiliency, and understanding of the importance of being there for my brothers. These relationships helped me to value the quality of family connection and strong bond on children's well-being.

As a 13 year old I experienced revolution, known as the ''Fall of Communism''. The post-communism times brought on economic turmoil, declining of the well-being of the country and the quality of life of many families, dramatically spreading poverty. In the face of collective suffering, political imprisonment, censorship, Martial law, cruelty, absurdity, and misery, relational closeness and support was the only ''safe haven'' for many - comforting others become an essential part of all human life.

At age 16 I was able to join my mother in the USA, where I began a time of a huge transition and adjustment as an immigrant - aspiring to fit into a new culture and communities was challenging, but also rewarding. Meeting people with similar experiences brought up for me this lingering drive of wanting to do more and to be able to help others in a similar situation. Relating to one another as immigrants was helping us to move forward, and we would meet on a regular basis to unburden our grievances and challenges. My new friends often found me genuinely supportive and encouraging, always there for them and listening to their stories and secrets.

Living as an undocumented immigrant for over 12 years brought a lot of fear in my life. I tried to lead a normal life; I did my GED in preparation to go to college to study psychology, I got married, had a child (daughter) and got divorced. I re-married and had a second daughter. As both my children were U.S. citizens, I feared that one day my husband or I might be removed from them. I did not know my country anymore, and the idea of going back was scary.  My family and I left the USA in 2005 to await legalization of our status. For the next 13 years, we embarked on a journey of trying to give our children a similar life as what they had in the USA, so we relocated to different countries such as the Czech Republic, the United Kingdom, Canada, and eventually back to America. It was a challenging period of readjustments, personal transformation, and an incredible opportunity to connect with people from various cultural and ethnic backgrounds.  The move to the United Kingdom presented an excellent opportunity for me; I finally enrolled in a higher education program in psychology and community studies as a prerequisite for the BSc in Counseling and Psychology, and then onto an MSc Counseling and Psychotherapy.

My curiosity was growing, but it wasn't until my practicum where my passion for psychotherapy and specializing in complex trauma come to light. During my 17 months of volunteering at the National Health Services in the UK as a support worker, I primarily worked with individuals diagnosed with borderline and anti-social personality disorders, who presented as complex and at times exhibited challenging and risky behaviors. Providing emotional, practical and crisis support for these individuals came naturally to me. I thought a great deal about their wounds and the overwhelming effect they had on their lives. I have learned that regardless of the importance of diagnosing these individuals based on DSM (Diagnostic Statistical Manual) criteria which are used by many professionals, every individual deserves to be treated as a person of worth with compassion, empathy, validation, and integrity. Today, as a psychotherapist and trauma professional these values represent my professional identity and practice.  

Like many others, I have experienced and witnessed distressing events that have impacted my family and myself. In my journey to become a therapist I suffered and hoped, I have experienced anxiety, distress and satisfaction, I developed a unique relationship with my true self, found meaning and the purpose in suffering - providing me with an opportunity for self-growth and self-actualization.  As Carl Rogers who inspired me both professionally and personally once said ''the organism has one basic tendency and striving - to actualize, maintain, and enhance the experiencing organism. The good life is a process, not a state of being. It is a direction, not a destination''.

I was one of those fortunate people who had close family members who were always there for me, who helped me to process my distress, and develop healthy ways of coping - they were my healers. Even though they left this earth, they still live in me, in my memories, they become a part of me. Today I am a therapist, a healer, a person who is devoting her life to help others find the meaning and purpose in their life within their struggles. I listen acceptingly and attentively to my clients, I struggle, puzzle and am curious with them and we search together for ways to help them heal and reach their potential in life.

Becoming a therapist combines both my personal and professional experiences. Through those, I grew in genuine love for all people regardless of their cultural or ethnic background. They shaped my personality and professional identity as well as practice. I find being a therapist specializing in trauma as an enriching career, even though at times it can be mentally and emotionally exhausting. I enjoy every aspect of it, the honor of being entrusted with deepest secrets or overwhelming experiences, the incredible human connection/intimacy, the possibility to be authentic and present and to actively listen, empathize and validate their wholeness is invaluable. To experience with and to ''hold'' another human being through the process of struggle, changes, healing, and transformation is the greatest reward one can experience. To witness a person’s face light up in hope for the future and witness their wounds becoming their strengths and meaning for the future are the greatest rewards for me as a therapist.