The New York Times posted a blog recently that examined the ingredients for a happy marriage. As anyone married longer than 6 months can tell you, sustaining a happy marriage is not as simple as it may seem. Ask yourself, “What can I do in 5 minutes today to make my partner’s life better?” For more suggestions, see the New York Times post on “That Loving Feeling”. Meanwhile, in a recent “TED Talk,” world-renowned sex therapist Esther Perel of Belgium talks about the nearly universal experience of couples who find they have less interest in sex after years of marriage. “How can we keep wanting what we already have?” she queries, and answers in an inspiring talk, “The Secret to Desire in a Long Term Relationship.”
At the recent conference of the American Psychiatric Association, Dr Noah Freedman attended a course on the use of melatonin in the treatment of sleep disorders. Here is a summary of what he learned.
Do you have difficulty falling asleep at night, and then difficulty getting up in the morning? Many people, especially younger people, have this problem of “delayed sleep phase.” If instead you rise much too early in the morning, and feel ready for bed hours before others do, you have “advanced sleep phase,” common especially in older people.
When your sleep schedule is off in this way, it can feel like your “body clock” just isn’t working like the clock everyone else follows. In fact, that is exactly what is happening. The body’s “circadian rhythm”, or body clock, is out of kilter. Our body temperature cools at night, when we are asleep, and rises during the day. A hormone called cortisol, produced by the adrenal glands, tends to rise early in the morning, helping us to wake up. If these changes happen at the wrong time, the rhythm of sleeping and waking will be out of sync. The circadian rhythm is triggered in part by sunlight, and in part by melatonin, a hormone produced in the pineal gland.
To re-set your body clock, you can use melatonin in tiny doses of 0.5 mg (500 micrograms). This amount will generally not cause sleepiness directly, but will help re-set your body clock. If you want to fall asleep earlier, start by taking 0.5 mg of melatonin, not at bedtime, but rather 8 hours after you wake up each day. Then, gradually move back the time you take the pill, if possible taking it about 15 minutes earlier each day. You will begin to find that you gradually get sleepy earlier in the evening.
If you find yourself waking up much too early and would like to get some more sleep, you can try taking this same small dose (0.5 mg) when you awaken (as long as it’s after 2 a.m.), and you may be able to fall back to sleep more easily.
Melatonin in larger amounts, such as the 3 mg pills typically sold over the counter, can also be used to induce sleep at bedtime, and will help some people. However, the long-term safety of this use has not been determined. To buy the smaller doses, a good source is Trader Joe’s, where they carry 500 mcg (0.5 mg) peppermint-flavored, chewable tablets of melatonin. This amount is “physiologic,” equivalent to what the body naturally produces, and is a good way to help regulate your sleep cycle if used as described above.
Melatonin is only one natural remedy for insomnia. Other natural remedies for sleep difficulties include the herbs lemon balm, chamomile, valerian, and passionflower. The links will connect you to more information about these herbal supplements on the WebMD website.
This article does not constitute medical advice, and you are encouraged to talk with your doctor or nurse practitioner about your specific sleep problems.
(reprinted from our May 2011 Newsletter)
Are you as kind to yourself as you are to your friends and family?
If not, you may be at greater risk for depression and other health problems, even including weight gain, recent research suggests. Studies show that many people who are supportive and understanding to others tend to score low on tests of “self-compassion”, and tend to beat up on themselves for things like overeating or not exercising. Then, instead of feeling inspired to change their behavior, these folks will likely feel worse, which may lead them to overeat even more.
On the other hand, people who score high on tests of self-compassion seem to suffer less depression and anxiety, and are generally happier. Self-compassion can even help people lose weight. Researcher Kristin Neff at the University of Texas, quoted in the New York Times, explains how self-compassion helps with motivation. “The reason you don’t let your children eat five big tubs of ice cream is because you care about them. With self-compassion, if you care about yourself, you do what’s healthy for you rather than what’s harmful to you.” Her book, “Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind,”was published last year. In the book she explains exercises, such as writing yourself a letter of support, meditation and “compassion breaks,” where you repeat a phrase such as “I’m going to be kind to myself in this moment.”
Dr. Neff also has a website, http://www.self-compassion.org/, where you can read more about her work or purchase her book.
Are you suffering from worries, stress, racing thoughts? Do you struggle with irritable bowel syndrome, or pain that keeps you awake at night? The deep relaxation you can experience with meditation can even lower blood pressure, increase fertility, and boost the immune system. You may want to read this online article about the 7 benefits of meditation. Embedded in the article is a guided meditation using flower imagery to create a sense of peace. http://www.foodmatters.tv/articles-1/7-health-benefits-of-meditation
by Nate Prentice, LCSW and Emily Kahn-Freedman, LMFT
If you are reading this, it is probably because someone suggested that you may benefit from talking with someone about what is bothering you. Perhaps you have tried other avenues, including medication, but feel stuck and are interested in exploring other options. How can “just talking” be helpful?
In scientific studies, we’ve learned that for many mental health concerns, psychotherapy is just as effective as medication alone in reducing people’s symptoms. We’ve also found that anxiety and depression respond even better to a combination of medication and psychotherapy, than to medication or psychotherapy alone. Why is this?
Many people do get a sense of relief from taking medication. However, without a skill set for dealing with underlying issues, the symptoms may continue or recur. In addition, some people may have tried ways of coping that create their own problems, such as substance abuse, yelling at family members, workaholism, etc. Psychotherapy can help people learn more effective strategies. If you are computer-savvy, you may understand it this way: Medication helps with the hardware. But therapy helps with the software!
How do you choose a psychotherapist? There are several kinds of professionals trained to do psychotherapy. These include psychologists, psychiatrists, clinical social workers, and marriage & family therapists, among others. The specific degree a person has may be less important than how experienced and skilled they are, and how comfortable you feel with them.
What is a typical psychotherapy session like? Gone are the days of lying on the couch. Today the sessions are usually held face to face. In the first session you may be asked a number of questions to help the therapist understand your issues and what outside influences are impacting on your issues. During or after that session, a plan for addressing these issues will be created.
Therapy sessions will then focus on how you are coping with your issues, as well as reasons why you have the issues. Some therapists will be more concerned than others with helping you explore “why” you have a problem. When I work with people who are desperate to find the root of a problem, they often end up in “analysis paralysis” because just knowing the root of a problem doesn’t always solve the problem. You may need to learn how to put out the fire before you try poking in the embers!
If you’re not sure whether therapy can be helpful, it may make sense to speak with a therapist once or twice just to see how it feels and what you think. Many people “shop” for a little while, trying a session or two with several different therapists until they find the right fit. If you’d like to make an appointment with one of the professionals at Psych Choices, just call our office at 610-626-8085 and press Extension 205 to speak to our intake coordinator.
by Emily Kahn-Freedman, Licensed Marriage & Family Therapist
It’s been a long day and you’ve had another long argument with your spouse. You’ve aired all your grievances and made crystal clear all the ways he has to change. Finally you’ve decided that it’s about time to look for help – marriage counseling might fix the problem! A therapist might convince him that he has to change!
But are you really ready for couple therapy?
You may find that in couple counseling, you are asked to do something more than list your partner’s faults. In fact, you may not be asked to list them at all. Instead, you may have to take a long hard look at yourself – and at the ways you, yourself, might have to change, in order to be a better partner for your partner! Because for marriage counseling to be successful, BOTH partners have to do 100% of the work.
Psychologist Erich Fromm wrote in his book “The Art of Loving” that love is comprised of 4 elements: care, respect, responsibility, and knowledge. If you care, your partner’s feelings matter to you – as much as your own. If you respect, you are acknowledging your partner’s right to be who he or she is – even if that means they are sometimes disagreeable or annoying. If you take responsibility, you admit that your words and your actions have an impact on your partner, and you take responsibility for those words and actions. And knowledge implies that you have taken care to really get to know your partner and to understand as deeply as possible what it is like to take a walk in his or her shoes.
If your relationship is hurting you both, and you are ready to think about your own words and behavior, then maybe it’s time to schedule that appointment.
by Nathaniel S. Prentice, MSW, LCSW
Feelings of overwhelming anxiety can be very uncomfortable. When I was in graduate school, I found myself easily overwhelmed by the fact that I would have 2-3 20 page papers due a week, and I would have problems sleeping as a result of worrying about the schoolwork that was due. Falling asleep was a chore, and I would wake up in the middle of the night wondering how I was doing in school.
Fortunately, I discovered a method that is very helpful for dealing with anxiety, stress, and overwhelming worry. I don’t have a name for it, but essentially it localizes the anxiety and shoots it out of you, then gives you a space to receive strength and courage that you may need to cope with the situation that creates anxiety. It is based in part on hypnosis protocols and “grounding” techniques used in therapy with people who have posttraumatic stress disorder (PTSD), as well as a therapy technique called Focusing, created by Eugene Gendlin.
I’m sharing it with you in the hopes that you will benefit from it. In sharing it, I hope that you will contact me and let me know what you think of it. I can be reached at email@example.com if you have questions or comments about it.
These are the steps that I use when I do it and when I teach it to clients of mine.
Notice your anxiety and rate its uncomfortableness on a scale of 1-10, 10 worst.
Localize your anxiety: If it was in a place in your body, where would it be? What shape would it have? Would it be a solid, liquid, or gas? What color is it? Does it have a texture?
Imagine hooking up tubes, or a line of light, or some other similar image to it. Imagine the tubes going from the object you identified to your shoulder and out through your index finger to the furthest spot on the horizon that you can imagine.
Imagine the object of anxiety moving along the tube on its own (you don’t have to force it–it wants to go of its will) until it is at the tip of your index finger.
Flick your index finger in the direction of the spot on the horizon and imagine the object of anxiety or worry flying out beyond the horizon to the furthest spot in the Universe.
Repeat steps 1-5 as needed until you feel the anxiety is pretty much gone.
Put your palm up in a receiving gesture and ask God, your Higher Power, the Universe, or your Best Self to give you the strength and courage you need. Sit and wait for it until you feel at least some change.
When you are ready, notice how you feel and rate its uncomfortableness on a scale of 1-10, 10 worst to see if there is some change from your first score.
Notice any new insights you may have now that you are more free of anxiety.
This technique is best used when you are feeling overwhelmed by anxiety or worry for a quick break from the anxiety creating thoughts and feelings. I hope you enjoy it and would love to hear your feedback on it.