Monday, January 7, 2013

Blog has moved!

I have been writing my blog on another site recently.  Please check it out: www.mindfulbalancemd.com
There is also a free guided meditation download, and a schedule of upcoming classes in my office.
Peace,
Dr. Janeen Paul

Tuesday, August 9, 2011

Sadness

Losses take on many forms in our lives. I am dealing with end of life decisions for our 15 year old cat, and feeling so sad about this impending loss. I know we can't expect anyone or anything to be around forever. But I don't believe accepting means denying the pain of parting.

Grief is a normal emotion. We all react in different ways, but the important thing is to allow the grief process to work. Elisabeth Kubler-Ross first formulated the Five Stages of Grief in 1969. Like most universal truths, this model has stood the test of time. The stages of grief are: denial, anger, bargaining, depression and acceptance. They are not linear stages, meaning we finish one and move directly to the next, but we may jump ahead, skip back, or miss some entirely. But most of the stages sound familiar and true to anyone who has grieved.

The loss of a pet can't be put on the same level as the loss of a human family member or friend, however, I know my pain is real. I can't deny my sadness, and I won't hide it from my family. My children will also experience sadness and grief, and we will have to help them through this, too. I will tell them to find the feelings of sadness in their body, to breathe into it and allow it to be real. Sadness is not something to avoid or deny. Cry when you want to, remember the good things and talk about them openly, and be gentle with yourself. Grief takes time, and we won't be over it by tomorrow. Together we will remember our cat with fondness, maybe we'll mark her final resting place with a flowering shrub, or a catnip bush. We know she'll have a place in our hearts forever, even though she's no longer with us.

Monday, August 8, 2011

What's Your Focus?

Last Friday I had a nice day. I was off work, and got to do some things for myself. Since I'm trying to be more disciplined about journaling, I finished the night by sitting down to write. The first thing on my mind was an unresolved issue that I've been worrying about. I started to write about this at length, getting into details about what might happen, how things could go wrong, and how upset I would be. That led me to think about my frustration with someone I felt wasn't doing as much as they could to resolve the situation, and I spun on for pages in anger. I finally stopped to take a breath and realized I felt very anxious and upset! How did that happen after such a relaxing day?
Luckily, I recognized my role in creating this mood, and quickly turned the page. Literally. I started my journal entry over and focused on the positive events of the day, how pleased I was to have time to myself, how grateful I was to have friends coming to visit, and my mood became cheerful and relaxed again. The events of my day hadn't changed, and neither had the worrisome situation, but my focus had shifted completely. Staying stuck on the negative, or mired in future worries, I was allowing my mind to create unnecessary drama which made me feel terrible.
So, the real question is, if I can choose my focus, why would I allow my mind to lead me down that path? And the question is just as valid when thinking about journaling or simply the thoughts in my own head. My mood is affected by my thoughts, and my thoughts are under my own control. Therefore... I think you can see where I'm headed here! So do I choose worries and anxiety, or negativity and anger, or can I look for the silver lining? I'm not saying my worries are invalid, or that my anger is unjustified. But I can choose to evaluate them and decide how to respond, rather than allowing them to spin uncontrollably through my head, affecting my emotions and behaviour.
It takes work to look for the positive, especially with all the bad news around us. I choose to practice gratitude, and that often allows me to reset my perspective. Some days I'm grateful for a roof over my head and enough food to eat. Other days, my list can go on and on. Either way, I start to focus back in a positive direction, and I notice the shift in how I feel. Try it yourself. If you notice your thoughts spinning in an anxious or negative direction, turn the page. Think of 5 things you are grateful for today, and allow your mind to really feel that gratitude. If you're journaling, end each entry with something positive, or write down your gratitude list. How can you shift your focus today?

Thursday, July 7, 2011

The Little Things

I often hear from patients that they don't have time for anything else in their busy schedules. They are usually reacting against my recommendation to do something positive and healthy for themselves, which isn't as high a priority as it should be for most of us! But what if there were really great things we could do that only took a few minutes of time? Things that could help us relax, or improve our mood, or become more present? Maybe we can create enough little moments of self-care throughout the day, that add up to a big shift in how we feel.

Here are a few of my favorite Little Things:

1. Take a deep breath. Unconscious, shallow breathing is the norm for most of us. Let's face it, we suffer from a lot of stress in modern society, and stress leads to faster breathing, a rapid heart rate, and classic fight or flight symptoms to a greater or lesser degree. The fastest way to reverse this effect is to use the body's natural relaxation response, which can be triggered by a nice deep belly breath. Close your eyes, inhale fully through your nose, and slowly exhale a big sigh through your mouth. On your next breath in, take a deep slow inhale through the nose, expanding into the area below your navel first. Exhale slowly and completely through the nose. Repeat 2-3 times, several times throughout your day, or anytime you start to feel stressed. Your body will remember this relaxed feeling, and you will be able to return to that calm anytime. Your breath is always with you!

2. Turn around negative thinking. Take a few moments to examine your thoughts. Are they pessimistic, blaming, or critical? If so, there's no doubt your mood has changed to match the words in your head! Now, really look at the thoughts. They have likely expanded into something far worse than actual reality, so try to gently nudge your inner dialogue back towards the truth. If you are focused on all the possible bad outcomes of your day, list some things that have gone right. If all you can see is bad luck and bad choices, find something for which you're grateful in your life right now. This is the simplest example of cognitive therapy, but for most of us, it is enough to remind ourselves to come back to the positive, and it only takes a few moments!

3. Come back to the present. I spend a lot of time in my head, thinking, worrying, planning, so much so that I miss things right in front of me sometimes! I am trying to add small moments of mindfulness throughout the day to remind myself to stay present. The easiest way to do this is to let go of the thoughts, and come into the physical body. Specifically, take some deep breaths and feel the sensations of your feet on the ground. Really sense the chair supporting your back, your clothing touching your skin, and the breath moving in your body. In this practice, there is no room for the past or future, only right now. I may forget again later, but it only takes a few seconds of focus to come back to the present, again and again.

4. Stand up and stretch. We are a sedentary society, and a lot of our technology creates bad posture that can lead to physical discomfort (think the hunched shoulders and head hanging forward pose in front of the computer!). Studies have shown that sitting too much is a risk to our health, so it makes sense to stand up at least once an hour. Add to that a delicious stretch, like the Mountain Breath, and feel your energy start to return, your body waking up again. To do the pose: Stand tall in Mountain Pose, with your feet hips distance apart and parallel, your shoulders directly over your hips, your hips directly over your heels. Let your head float atop your neck, with your chin slightly tucked. Allow your hands to hang heavy, straight down from your shoulders. On your next inhale, sweep your arms out and up overhead, reaching the highest point at the top of your inhale. Look up for a slight back bend if that feels comfortable, then slowly lower your arms out and down to your sides on your next exhale. Repeat 4-5 times, using the breath to guide the movement, filling every motion with your inhale or exhale. Finish standing in Mountain Pose, sensing the energy shift in your body.

All of these simple techniques have the same goal: to return to our natural state of contentment. The 4 Little Things are always available, with no special equipment required. All we need is the breath, the mind, the present moment and the body to remind ourselves that our true nature is always there for us. A few minutes a day really can make a difference!

Monday, June 27, 2011

Timely Observations

I am typically punctual to a fault. I am more likely to arrive early than late, and have been known to hyperventilate the entire drive to an appointment if I'm running behind. I always wear a watch and I have several clocks in my office so the time is never out of sight. It shouldn't be too surprising that I often feel short of time. My fixation on the clock hands keeps me on schedule, which is often a good thing. My patients and hair dresser and yoga teachers appreciate punctuality. However, there can certainly be too much of a good thing.

I went on vacation with my family a couple of weeks ago. It was a wonderful, relaxing beach trip without much of a schedule. Since we were around all that sand and water, it didn't seem like a good idea to wear my watch... so I left it in the room. The first few hours I noticed myself glancing at my wrist, wondering what time it was. As the day progressed, that happened less and less. By the end of the week, our schedule was mostly dictated by our own inner clocks. We woke up when we were done sleeping, we ate when we were hungry, and rested when we were tired. There were times we noticed it was quite late to be sitting down to lunch, so the thoughts about an accepted daily schedule were still there. But why would we eat when we weren't actually hungry? Does the time on the clock really get to dictate things our bodies truly know best? It had been a long time since I was really able to recognize those internal cues, since I was so focused on whether it was dinner time.

I have since noticed other situations when the clock is hindering me, rather than helping. One of the biggest ones is when I'm driving somewhere. If I leave slightly late, I spend the entire drive looking at the clock over and over again, worrying whether the stop light is going to add an extra 2 or 3 minutes, and what that means for my arrival. I came to the realization (you'll laugh, this is so obvious) that the time doesn't matter if I can't do anything to get there faster. Traffic, stop lights, construction, the weather, these are uncontrollable variables that will affect my transit time whether I'm running late or not. Looking at the clock is distracting and doesn't make me move any faster, so why not let it go and just drive safely? The time doesn't matter.

The middle of the night is the other time I have learned to let go of the clock. I wake up during the night almost every night. I used to always immediately look at the clock. If it was early, phew, I have 4 more hours to sleep! If it was already 500am, it was a disaster. My mind would go into catastrophe mode, worrying that if it took me 10 minutes to fall asleep I'd only have 50 minutes left to rest, or what if I didn't fall back to sleep, that means I'm an hour short, on and on until I was wide awake and anxious to boot. Then I read an article that talked about digital clocks, and how the bright light of the numbers actually tricks the brain into thinking it's daytime. I turned the clock away from me at night and started to sleep better right away. Then I came to another realization: it doesn't matter what time I wake up at night. Whether it's 2am or 5am, I should calm my brain and try to go back to sleep right away. Maybe I only get another 30 minutes before the alarm goes off, but that 30 minutes can make a difference. I can guarantee I won't get that extra rest if I start to stare at the clock!

Clearly we need the structure of time in many situations. We couldn't have a developed society without some type of schedule. However, there are also many times the clock doesn't need to matter so much. I find I'm much more at ease if I don't look at the clock. The initial tension of being without my watch eventually gets replaced by freedom and a better sense of my own internal cues. The only time that truly matters is the present, anyway, and no clock on earth will direct to my own mindful presence. I am looking for peace in letting go of the hour and focusing on the moment.

Wednesday, May 25, 2011

What's Next?

This time of year gets busy for a lot of us. School is ending, and spring sports are in full swing. It seems there's something on the calendar every day, on top of all the usual stuff! It can get very overwhelming. I know I've stared at the family calendar and wondered how on earth we were all going to get where we needed to be, let alone be in clean clothes and have food in our bellies. I've learned some ways to keep my sanity when the commitments pile up, the trick is to use them myself, rather than just offering them as advice to others...

1. Prioritize. I know there are things that have to get done today, and things that can wait. I found a brilliant to-do app for my iPhone that helped me think of things differently. You get to prioritize your list according to what has to be done today, and the rest can be put off until tomorrow. It actually moves the items to the next day's list, so they're not sitting there staring at you, making you feel guilty. It even allows you to create a "long-term" list of things to do someday in the future. So, technology neatly gives me permission to label some things as more important than others. If only our brains allowed us the freedom.

2. Cut corners. Not everything has to be done perfectly all the time. This one is particularly hard for us type-A personalities, because I am actually advocating doing things half-way. Or even less! Buy the pre-cut carrots. Sweep under the table but leave the rest of the floors for a less busy day. Be at peace with the messy mud room, because it really doesn't matter in the long run. Eventually things will settle down and you can return to your usual standards, but when something has to give, the extra housework can wait.

3. Plan ahead. I keep a calendar so I know what's coming up. I can ask for help the days I need to be in 2 places at once, and buy the cookies I volunteered to bring to baseball ahead of time. I would love to say I have fully prepared meals waiting in the freezer to be pulled out when I'm too busy to cook, but that's on my "someday" to do list. That is clearly a fantastic idea, though!

4. Plan to say no. There are a lot of demands on the whole family. The kids could be in a different activity every day, and I could drive or volunteer at every one of them after work. However, eventually I have to start saying no. After all, one more sport isn't just one more hour a week, is it? Let's practice a few helpful phrases: "I am not be able to volunteer this week, but I will put it on my calendar for next month." "No, I am not able to head the planning committee of whatever next year." No excuses, no I'm sorries, just no in a polite but firm way. It can be very liberating!

5. Take care of yourself. When I'm busy, the first things I'm likely to ditch are my own needs. I eat on the run, stay up too late and my yoga and meditation practice becomes an after thought. Eventually it catches up to me, and I notice my irritable mood and impatience in every area of my life. We are taught to give and think of others' needs first. But if I am not grounded and healthy, I am not able to give my best to anyone else.

6. Just do the next right thing. I got this lovely gem from a person in recovery. It works for people overcoming addiction, and it will work well for the rest of us, too. When I see the tasks before me, it's easy to become overwhelmed. If I remind myself of this phrase, I realize that I can't do everything at once, I have to choose one thing. Also, I don't have to choose the right thing, only the next one. I get to choose again later. I can work my way through my tasks knowing I'm making the best decisions.

Every day is a new chance to do the next right thing, so I'm moving forward instead of beating myself up for allowing myself to lose sight of some of these ideas. I will start by keeping mindful today. The right things are so much easier to recognize if I've kept myself grounded and present!

Tuesday, April 19, 2011

It's All in Your Head

Have you ever misread a situation and created a whole big drama in your head that later turned out to be false? Our human minds are constantly at work, trying to explain the world around us. Thoughts come at us from all directions, defining situations or people as good or bad, judging everything so we can form a conclusion that makes sense of it all. We use our knowledge, however it was obtained, to help us decide how to feel about things. So we feel good or bad about any given situation based on our thoughts.

That makes great sense in theory, but it's not so simple when we're busy living our lives. For example, I just picked up the dry cleaning, and there was an envelope attached to it. My thoughts immediately went like this: envelope=bad news, they're closing, I will have to call the neighbor and see who their dry cleaner is, I don't have time for this, . All this before even opening it. So, of course it was no big deal, the dry cleaner was just giving information about their services, but my thoughts had already created a catastrophe that sapped my energy and good mood. An envelope is not inherently bad, but my thoughts judged it to be so, and my emotional state dove right in, despite multiple other logical scenarios.

Other times our thoughts create a long-standing judgement that affects us on a regular basis. I saw a patient yesterday who is often on call for work. When he is on call, he works 24 hours a day responding to technical emergencies. He regards his pager as a curse. I can't say I blame him, because I have my own emotional reaction to a pager beeping. We explored his thoughts and feelings about his job to see if we could change his emotional state. He likes his job, which provides the livelihood for his family. His pager could be a reminder that he is employed by a company he likes, doing work he enjoys, or it could be a reason to become anxious and upset because it might go off at any time. The pager hasn't changed, but the thoughts and emotional reactions to it have.

So how can we patrol our thoughts to keep them from ruling our mood?

1. Remain mindful.

Like a lot of people, I live on autopilot. I am multi-tasking and unaware of things going on around me. In this state, my thoughts are as automatic as my fingers on the iPhone. I don't notice the scenery, and I don't notice thoughts until an emotion takes over. Why am I suddenly so irritable? If I'm unconsciously going through my day, I will have no idea. On the flip side, if I take time to check in with each moment, noticing the input from my senses, observing my thoughts and reactions, I can see the conclusion waiting to be jumped before I do it. This makes #2 much easier.

2. Recognize your triggers.
I have unresolved insecurities, and worry whether I'm liked by others. I know this is true, and by remaining conscious of this trigger, I can avoid an emotional pity-party when someone doesn't return my phone call right away. This leads directly to step #3.

3. Evaluate each situation logically.
Remember that every situation, person or thing is not either all good or all bad. Just like my patient's dreaded pager, the emotional label comes from our thoughts. Cognitive therapy advocates an almost "scientific" analysis of our thinking with every emotional state. When a friend doesn't return my call, I start to evaluate possible scenarios. I stay mindful, recall my triggers, and suddenly I can think of other reasons for the delay. I understand that my assumption, that my friend doesn't like me anymore, isn't the only explanation (or even the most logical one!).

Thoughts are powerful, but we can remain in control of our own emotions by staying mindful. Over time, we can be more conscious of the emotional baggage that distracts us from the moment, and we are more steady. Then we get to choose how to react instead of bouncing from crisis to crisis all day long. I am striving for equanimity and balance. I think these steps can lead the way.