Monday, August 30, 2010

Negative Nellie

I saw a statistic today saying over 80% of our thoughts are negative. Now I have to admit, I don't know what kind of study this statistic came from but I think it's probably fairly accurate for most people. I spend a lot of energy trying to counteract this tendency in myself most days! For example, I started today with a lot of crisis phone calls to answer. My thoughts immediately spiralled into doom and gloom: "Oh, this is a great start to a Monday;" "It's going to be a terrible week;" and "What else could go wrong?!" I even told my yoga teacher I was pretty sure I'd have to leave class to answer phone calls at some point. Talk about negativity! That didn't actually happen, by the way, and I felt much more centered after class. If I had turned my thoughts around before they went sour, I could've saved myself a lot of angst this morning.

Apparently negative thinking has been a problem for humans for centuries. It's even addressed in the Yoga Sutras of Patanjali. Verse II:33 says "To counteract destructive attitudes one should cultivate thoughts of the opposite kind." That sounds pretty simple, right? We all know in practice that it's not so easy. The first step is actually recognizing the thoughts as they come up. We can't do anything to change them if they stay largely unconscious, wreaking havoc on our emotions without our knowledge! One way to start to observe the thoughts is in meditation. Sitting in silence demonstrates very quickly how negative and ugly our thoughts can be. The goal then is to sit and observe and silently remain unattached to the stream of madness that flows through our brains in any given moment. Eventually the mind is quieter (or so they tell me, I'm still waiting!), and the angry or sad or anxious thoughts don't affect us as much.

Cognitive therapy uses the technique of writing down the thoughts as we notice changes in mood. This allows us to track how the "stinking thinking" brings us down, to recognize patterns, and begin to change the thoughts and behaviors to break the cycle. One of my favorite cognitive tricks came from a psychologist friend of mine: you can't say anything to yourself that you wouldn't say to a friend. This helps us observe the thoughts (bye-bye name-calling), and forces us to change the thought immediately. This is also hard work! These patterns have taken decades to form, and operate largely without our help. We have to step into the driver's seat and take control, all of the time. It's exhausting. Once again, it becomes pretty obvious how deeply the negative thought patterns are ingrained.

This sounds pretty negative so far... Ok, the good news is that the negative thoughts can be recognized and changed. Meditation and therapy really work. For less serious cases, such as a bad case of the Mondays, we can try Patanjali's route and simply change our attitude. It's helpful for me to recognize the ridiculous nature of my negativity. Of course I'm not doomed to a terrible week, my life will not be miserable because of a lot of phone calls, and a couple of pages don't equal a ruined morning. It's almost laughable how worked up I can get, but it may take me a while to shift the balance. I am constantly working on letting go of expectations of how things ought to be. I'm finding that reduces the negative attitude to begin with, because there is no "should be" to live up to. I will try again next Monday...

Thursday, August 26, 2010

Fix You

When I hear about problems, my tendency is to want to fix, find a solution, provide an answer. This is part of my job, of course, and comes with being a parent, a friend, or a partner. If my child comes home in tears about something, first I want to go mama bear on whoever made them cry, then I want to find a solution to their issue. If a patient has anxiety, I want to offer sound ways to overcome it. But sometimes, that's not what the person needs.
I have learned to recognize when someone is asking for help finding a solution and when they simply want an ear to hear them. This isn't always easy, because I have had to sit on my hands when I had good advice to offer, but the time wasn't right. In the case of grief, telling someone about a grief support group can be very helpful. But if all they want is to tell the story of their loss, it could be intrusive and unkind to cut them short to talk about counseling. Better to listen and respond to their words, maybe hand them a card with a phone number as they leave, and let them think about it another time. This is listening and responding to the need in front of you.
The same is true with my children. Not every friend drama requires a dissection of how they could have responded differently. Most of these things work themselves out over time, and offering advice when they only want to be hugged is not the best use of my mothering. I am still working on this one, because I want the best for them, and don't want them to repeat mistakes that I've made growing up. Sometimes they need to learn their own lessons, sometimes they just need to be distracted by a fun game, and sometimes they just need a cuddle. I have to learn to navigate these tides a little differently if it's my son versus my daughter (yes, the drama runs in the family...). Their needs also seem to change on a weekly basis, and I'm certain what I've learned to do this week won't work next month!
Sometimes there simply are no solutions for the problems we face. I cannot fix my patients' unemployment, bad marriage or history of childhood abuse. I can help them heal and cope, but I can't make it go away. I also can't help everyone. I have found myself repeating the same suggestions to the same clients time after time, knowing they will never follow through, and also knowing that my advice could truly help them. Today, I shelved the suggestions and just listened. My patient seemed to relax more as we talked, and she left looking lighter. I think I finally gave her what she needed from me. Attention. Kindness. Understanding. Without judgement. She didn't leave with a fix for her problems, but she left feeling better. I felt better afterwards, too. Sometimes silence and an open ear are all the solutions we need to offer.

Friday, August 20, 2010

Body Talk

I spend a lot of time listening to my heart, my intuition, my thoughts (which never stop), but have not ever gotten proficient at listening to my body. As a yogini, I know this revelation is going to out me in a negative way. I've been in classes where the teacher instructs us to choose our own version of a pose, going by what our body needs on that particular day. I am really not good at this!! It makes me anxious, and then it gets worse when she follows it by saying not to look around at what everyone else is doing, because that is just what I was going to do next. So, how do we know what our bodies need?
I get confused, because low energy, as I've experienced the last week, could mean I need to step it up and do an energizing practice. It could also mean I need to rest and take it easy. I try different things and eventually discover that one practice feels better than another. I can't say I decide this easily or quickly. In fact, this whole week I've been going down the wrong path, apparently. I have been fatigued, not sleeping well, and my joints have been acting up in irritating ways. I assumed I'd overdone it, and proceeded to take a couple of days off of yoga. Then I did a home practice that was not up to my usual level. And I felt worse and worse. Today, I finally said to heck with it and headed to my usual intermediate yoga class. And lo and behold, I instantly fell into the groove. We worked our core, and I realized that my third chakra needs some firing up. I also discovered that my wrists felt better after a bunch of vinyasas, and my mind finally shut up for 5 seconds by the end of class. Huh.
So how can I tune in more quickly and recognize my needs? I think I discount my body's cues because I expect limitations from it. I was not a strong person physically for the first 35 years of my life. I get aches and pains, and it takes me a long time to work the stiffness out of my joints in the morning. I have spent time scanning my body for pain and swelling, but not for clues to what I can do to nurture it. I have a fear of my body failing me, yet I don't listen to it and respond in a healthy way. Spending some time every day doing some basic body sensing, my energy level, any restlessness, fatigue, aches and pains, and then listening from the inside will help me to recognize the cues, I hope. I am going to experiment with this and see if i can become more mindful of my physical self, when too often I neglect it in favor of the emotional/spiritual body. If the body is truly the vessel for the soul, as I've read, then the care and nurturing of the physical shell can only enhance the spirit within.

Tuesday, August 17, 2010

Changes

There are a lot of changes this time of year. Summer turns to fall, and the fun of camp makes way for the classroom. My daughter will be starting first grade at a new school, and riding the bus for the first time. She is as change-averse as I am, so we are trying to work through the transitions together. I have enlisted her older brother's help in walking her through some school activities, like getting her lunch in the cafeteria and saying the Pledge of Allegiance, which was not part of Montessori school. She is nervous, but seems to be excited, too.
My own changes are also approaching. I will be cutting my hours at work and turning over my practice in one office to another provider. Someone new, whom I don't know. I have a lot of ambivalence, even though this is a change I initiated, and that I know will allow me to move forward in exciting ways. I feel an obligation to my patients, understandably, and want to know they are well cared for. Underlying this, I'm certain, is a desire to control the transition. I have to trust that the new person will treat "my" patients well.
Both transitions will require an element of letting go. Change means that we adapt to new situations and continue to move forward, releasing our grip on the past. My daughter will have to learn new ways in first grade, things that will be very different from her former school. In my own transition, I have to accept letting go of some patients so I can incorporate new techniques into my work. My daughter hasn't known another way, and will have to trust her teacher and the other kids in her class. I am forging my own way, and have to trust my intuition that I will find my direction. Change can be scary, but we can't reach our full potential if we stay stuck. I am expecting some growing pains for myself and my daughter, but I'm certain we will move ahead with the support of family and friends.

Wednesday, August 11, 2010

Good Mornings

I recently saw a long-time patient who is struggling with a lot of negative thinking. She described her mornings as dreadful, not because of sleep issues, but because she wakes every day thinking of all the things she must do, how difficult it will be, how much she dislikes her job, so on and so forth until she is nearly in tears. These thoughts are definitely part of her chronic dysthymic disorder (a long term, mild depression that is often difficult to treat), but this type of negative thinking is very common outside of depression or dysthymia. I know I've heard the alarm clock and spent the next 9 minutes of snooze time dreading my day.
My patient wanted ideas to help improve her mornings. The good news is, she easily recognized that her thoughts were affecting her emotions. I shared with her a few simple suggestions to try to start her mornings off in a more positive way. These are things I've learned from various sources, including Cognitive Behavioral Therapy, my yoga teacher, several inspirational blogs I read, and probably Oprah is in there somewhere :) The suggestions are overly simple, and designed to be tailored to fit each person, and they are certainly only the tip of the iceberg! If you decide to try to change your own routine, commit to the new practice for at least a month. There is research that says it takes 20-30 days to create a new habit, then it becomes second nature.
1. Get up around the same time every day. Seriously, even on weekends. Try to go to bed around the same time every night, too.
2. Get out of bed the first time the alarm goes off. This prevents the extra time spent stewing and dreading getting up. Put the clock across the room if needed, to make this more likely.
3. Start the morning with a positive thought. Anything will do: "This will be a great day" or "I can't wait to begin," anything you like. You don't have to believe it the first hundred times you try this, but eventually I think you will!
4. Get out of bed on the right foot. Literally. I have read that Ayurvedic science recommends this as part of a morning routine. Hey, every little counts, and so long as it doesn't get all OCD, give it a try!
5. Start the morning with a gratitude practice. Think of things that are great in your life, even if you can only get to "I'm breathing today," choose that and be grateful for it.
6. Consider starting the day with meditation. This has been a huge day saver for me. The peace I find in meditation affects my attitude and reaction to the whole rest of my day.
7. Try some energizing or balancing pranayama (yogic breathing exercises). Yoga Journal is a great resource for more information on these practices.
8. Try to do something active in the morning, like exercise or yoga. Morning yoga loosens up my tight muscles, but I also feel a great sense of accomplishment for having completed my exercise for the day. I can check that box off my to-do list!
9. Eat breakfast. Most important meal of the day, just like mom used to say. A body needs fuel to make it through the day.
10. If all else fails, do what my 8 year old son does, and play an inspirational song. Like I Gotta Feeling by the Black Eyed Peas or Don't Stop Believing by Journey. Something that makes you smile, sing along and move your body.
I will have to wait a month to see if my patient takes my suggestions, but I use some or all of these most days, and I have seen a huge difference in how I feel as I'm getting going in the morning. It took a while to create an actual routine, and I won't say I pop out of bed with a grin every day, but the odds are much greater than they used to be!

Wednesday, August 4, 2010

Sleep #2

Someone who has no trouble sleeping...



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Sleep

Our bodies are designed to sleep at night, to allow our mind to enter a state of complete withdrawal where we can rejuvenate. Yet as natural as sleep is, it is very difficult for a lot of us. Insomnia plagues millions of Americans, and sleeping pills are some of the most prescribed medications available. We label insomnia in different ways, such as initial or early (can't fall asleep), middle (can't stay asleep) and late (wake too early). All are maddening in their own way. I have struggled with insomnia at various times in my life, usually the early type, because I'm worrying and stewing about something. Lucky for me, I can empathize with others going through the same issues. Unfortunately for me, those others have often been my children.
My 8 year old son DJ had a long run of bedtime fears. He started to hear every noise in the house and create elaborate scenarios about the possible source until he was sobbing in the hallway. I tried everything I could think of, including teaching him some "tapping" therapy (google EFT for an explanation), all to no avail. We finally allowed him to turn on his iPod with a sleep mix (prepared by me) that is mostly James Taylor. This has worked well, but he clearly has inherited my worrying mind.
Zee, on the other hand, has had sleep issues since she was born. She was colicky as an infant. That resolved after what seemed like an eternity, only to be replaced by mild night terrors as a three year old. She would start wailing and crying around midnight. She looked awake, but was totally unresponsive to us. In the morning she had no memory of it. This got less and less frequent, until now it happens maybe once every few months. Now her mind is starting to whirl at bedtime, as she processes her day. She often calls to me wanting to discuss some friend or conversation. I am certain this is all just the beginning!
So what's a mother to do? I do use the tapping/EFT that one of our therapists taught me. First of all they like it, it's simple, and it does seem to make them drowsy. I have also tried yoga nidra (a kind of guided meditation), but I need to find a more kid-centered script, so I think it's just my soft voice that helps. I have an alpha wave cd that is designed to bring your mind to a relaxed state, and I can vouch for its effectiveness after falling asleep on the floor to it one night. I have also had them do some simple supported yoga poses, including legs up the wall and child's pose, and taught them three part breathing. So I have tricks up my sleeve, that I have found beneficial for myself, too.
I am slowly trying to incorporate this teaching into patient education because insomnia is so prevalent. It is a symptom of multiple mental illnesses, as well as grief, substance abuse, and just modern day stress. If a particular technique is helpful, it can even assist in weaning off sleeping pills. I keep searching for more techniques to add to my arsenal, since I never know when I'll need something new to try in my house, too!



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