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Licensed Psychologist

How Long Does Grief Last?

From a Therapist.com Article Whether it’s for work or the rest of life, I like to make a plan and have a schedule. But no matter how hard we try, certain things just aren’t meant to happen in an orderly fashion. One of those things is grief. Logically speaking, the loss I suffered shouldn’t have been that devastating. My grandpa Roger was 92 years old when he passed away in 2020. He lived a very long, full life, and for most of that time he was healthy and happy.  But when he passed away, my grief at losing him was compounded by my grief over the COVID-19 pandemic, leading to a spiral that took a long time to pull out of. As I struggled to recover from the loss, I found myself asking the same questions I’m sure many others have. These might sound familiar to you, too.

Shouldn’t I be past this stage of grief by now?

Whenever we lose someone, the stages of grief inevitably come up. Comments like, “It’s okay that you’re angry, it’s a stage you have to go through,” or “Of course it doesn’t feel real, you’re in denial,” seem to crop up left and right from friends, concerned acquaintances, and other mourners.  The concept of the five stages of grief was created in 1969 by Elisabeth Kübler-Ross in her book “On Death and Dying.” Since then, they’ve become a refrain that most people can recite from memory. As Kübler-Ross defines them, these stages are:
  • Denial: The reality of the loss has not sunk in, and you struggle to process the magnitude of what’s happened. You may find yourself saying things like “There must be some kind of mistake.” 
  • Anger: The pain of loss combines with feelings of helplessness, leading to frustration and anger. Anger can serve as an emotional buffer; when you’re feeling angry, it draws focus away from your pain.
  • Bargaining: During this stage, you try to ease suffering by striking a deal, often with some higher power. It can also involve ruminating on past experiences with a loved one that can’t be changed. For instance, you may think, “If only I’d insisted they go to the doctor earlier, we might have caught the illness in time to save them.”
  • Depression: When the loss becomes real to you, it can feel overwhelming. During the depression stage, you experience the pain of loss acutely and fixate on everything that will now be missing from your life. You may feel helpless, sorrowful, and generally low. 
  • Acceptance: Acceptance isn’t synonymous with “moving on.” Instead, it means you’ve embraced your new reality. You can begin to imagine the future and what this new version of your life will look like.
Kübler-Ross’s colleague David Kessler, a world-renowned grief expert, introduced a sixth stage of grief in 2019:
  • Finding meaning: Kessler defines this stage as the time after a loss in which you can move forward and live in a way that honors your loved one’s memory. You’re able to look back on memories of them with more love and gratitude than pain.
Click to read the full article

5 Ways to Be Your Own Best Friend

Originally published at Psychology Today There is a quote from Ralph Waldo Emerson that reads, “It is one of the blessings of old friends that you can afford to be stupid with them.” Our best friends take us how we are and love us through it all. And in return, we talk out our problems and often speak from a place of truly wanting the best for each other. This is something most of us have in common: We are capable of good advice for our best friends. This advice might sound like, “You deserve better,” or “Apply for the job; the worst they could say is no.” It might even be as simple as, “Let it go.” So, have you ever noticed that it’s harder to speak so lovingly to yourself? The trouble comes from the negative slant the brain favors. It may seem messed up, but often by being negative your brain is trying to help you. Say you are applying for a job, your brain is actually trying to protect you from feeling disappointment by saying, “Why bother? They won’t hire you.” You don’t apply so you won’t feel sad about not getting the job. Of course, the unfortunate side effect is you end up feeling crappy anyway and lose out on new opportunities. In this example, what would your best friend say? They might remind you of how qualified you are for the job, how much the company would miss out on by not hiring you, and if you don’t get it another job will be lucky to have you. Sounds better! How come it’s so easy to say that to someone else? Well, we wouldn’t have very many friends if we talked to them the way we talk to ourselves. Instead, we learned to be supportive, caring, and encouraging in order to maintain meaningful relationships. Here are five ways to develop positive self-talk and treat yourself like your own best friend. Read the full article

Is Depression a Symptom of COVID-19?

Originally published at PsychCentral.com Research shows there may be a link between COVID-19 and the symptoms of depression. Here’s why it happens. Whether you’ve lost a loved one to COVID-19, experienced financial difficulties, or had a hard time adjusting to all the changes, the pandemic likely impacted you in some way. If you feel like you’re living with depression resulting from all of this, you’re not alone. Between 2020 and 2021, diagnoses of anxiety and depressive disorders jumped from 36% to 41%, according to the Centers for Disease Control and Prevention (CDC). But are these symptoms of depression a result of external factors only, or is depression a residual effect of the disease? So far, the research is pointing toward both.

Mental health symptoms of COVID-19

Scientists are learning more about the new coronavirus every day. But, for now, there’s limited information about the long-term effects of COVID-19. But there’s some indication that there may be a link between the disease and symptoms of depression. One study suggested that the coronavirus indirectly creates blood clots, which can cause brain damage. Another study suggested that our body’s immune system could indirectly be injuring brain cells while fighting the virus. Indeed, increased inflammation in the body is linked to depression. The coronavirus’s effect on the brain increases the risk for mental health challenges. About 1 in 5 people will develop a mental health condition 14 to 90 days after being diagnosed with COVID-19. For 5.8% of patients, it will be their first one. Mental health symptoms that developed as a result of COVID-19 also seem to persist 6 months after recovery. There also appears to be a link between COVID-19 symptoms and common symptoms of depression. For example, the loss of taste and smell were associated with depressive and anxiety symptoms. More recent research is starting to link depression with COVID-induced headaches. For example, a study published this year found that people with COVID-19 were at a higher risk for depressive symptoms when they reported headaches. Depressive symptoms were also more likely among younger adults than older adults. Read the full article

Dealing with Difficult Feelings to Help Yourself & Your Relationships

Re-posted from an article by Deborah Fox, M.S.W. How to manage difficult emotions may seem counterintuitive to many people. We humans don't like to be uncomfortable or in emotional pain. How many times have you been told or tell yourself the following:
  • "buck up."
  • "don't wallow."
  • "move on." 
  • "don't feel sorry for yourself."
  • "think of how many others have it worse than you."
Plenty, I'm sure. The conventional wisdom of our culture is full of "think positive thoughts." The problem is that this wisdom doesn't chart the path we need to follow to that end. The answer to managing difficult feelings, we have to feel them before moving on and regaining our optimism and good cheer. This isn't easy. What may become common parlance, "oh, it's a total 2020," meaning a downer, things couldn't get much worse, is indicative of what many of you are experiencing. We are still in the middle of an uncontrolled pandemic, climate change, and political conflict. How can you not feel sad, or worry, or despair some days? Maybe your distress isn't about current times. Perhaps you struggle with a host of other uncomfortable feelings such as feeling unimportant, insecure, or anxious on an ongoing basis. For many people, the stress of what's going on in the world now exacerbates those feelings.

Managing Positive and Negative Feelings.

Our emotional system is not designed to feel positive feelings only and remove negative ones. That would be nice, but it just isn't so. To find our joy in simple pleasures and with those we're most connected to, we also have to feel our way through the tough ones. The key is to build your tolerance for feeling these difficult feelings and turn towards each other for connection and support. We are social creatures, and we need each other to go through the middle of turmoil to come out the other side.  Tuning into these difficult feelings will inevitably make you feel more vulnerable simply because you will not push the discomfort away. This is a challenge because feeling more vulnerable is uncomfortable, too. However, it's in that state of vulnerability that you can truly connect with another human being. You'll feel less alone, and you can walk through these uncertain times together, rather than just coping in separate silos.  There are moments--- milliseconds that you can grab before they slip away. These are the moments when you can identify that you're feeling down, worried, or despairing. When you're trying to "move on" or distract yourself, you'll find yourself feeling more and more blah or irritable---the perfect hiding places for vulnerable feelings. If you succeed in identifying that you're feeling sad or anxious at the moment, sit there with it. "Sitting with it" means naming it, feeling it, and not allowing yourself to prematurely make it go away by distracting yourself or starting an argument with a loved one. You will feel uncomfortable and vulnerable--- take a deep breath and stay there in that feeling. This sitting with the uncomfortable feeling allows you to know what affects you that you lose touch with when you shut down on the feelings.

Uncomfortable Feelings Have a Lifespan. 

It might be five minutes or five hours, and it may come and go. It's sitting with the feelings that allow you to build your tolerance for feeling vulnerable. You build it slowly, bit by bit. The more tolerance you have, then you can allow its life span to run its course. If you distract yourself by grabbing your phone or turning on the TV, it'll just go underground and lie in wait to ruin your mood for days on end.  Sitting with the feeling allows you to express, usually in a way your partner, or a close friend, can hear and empathize. Their ears open when they listen to you speak from that place of vulnerability. Feeling this connection is what can most alleviate the intensity of the discomfort. It won't make the pandemic uncertainties or anything else go away, but it can allow you to feel less alone. Feeling less alone goes a long way to walking through any crisis feeling stronger. Shutting down or arguing happens so easily because it's a momentary relief from the discomfort. The energy of arguing or the numbness of withdrawing doesn't feel great either, but it can be preferable to feeling vulnerable.  If you're already angry or withdrawn, ask yourself, "what else am I feeling, or what was I feeling earlier?" Maybe not immediately, but this question will allow you to pinpoint what feelings are hiding just below the surface. You know you're irritated, but you might be able to identify that you were anxious before you got annoyed. Then you can choose to sit with the anxiety.

Difficult Feelings are a Normal Part of Life. 

This is always true, but these uncertain times are causing tremendous turmoil and challenging our usual coping ways. What's critical is not to allow these feelings to overwhelm us. We're outside of our comfort zone, and we need to grow that zone to go forward and be able to grapple with what comes our way. We can't do it alone. Turning towards one another will serve us well and allow us to come out the other side to experience joyful moments amidst uncertainty.

Managing Loneliness During the Holidays and beyond

Originally posted at Beacon Lens The holidays are upon us, and the irony they bring is the potential for isolation and loneliness. Holidays’ essential identity is getting together with loved ones, but some people do not feel as connected as they would like or expect. In 2020, add COVID-19 and its quarantining dictates, and the potential for such feelings can strengthen. The holidays, therefore, present an excellent time to discuss how we can reinforce connections during a time that requires us to be apart to protect our physical health, a requirement that paradoxically can have a damaging effect on our mental health. We can, however, take charge of improving our mental health.

Loneliness and isolation and our health

What is the difference between loneliness and isolation? “Loneliness is the feeling of being alone, regardless of the amount of social contact,” according to the Centers for Disease Control and Prevention (CDC). Social isolation, on the other hand, is a lack of social connections. Put differently, one can have many social connections but still feel lonely. The physical and mental health risks of loneliness and isolation are significant. They include but are not limited to:
  • Social isolation increases the risk of premature death by 29 percent, rivalling smoking, obesity and physical inactivity.
  • Social isolation is associated with increasing the risk for dementia by approximately 50 percent.
  • Loneliness is connected to higher rates of depression, anxiety and suicide.
A 2020 report by the National Academies of Science, Engineering and Medicine (NASEM) states that more than one-third of adults 45 and older feel lonely, and approximately one-fourth 65 and older are socially isolated. Add the holidays and COVID-19 to an already preexisting condition, and the time is ripe for all of us to take action to protect our mental health.

Simple steps for better mental health during the holidays

Specific to the season and the times, there are common-sense tips that we all can practice to help manage loneliness. For example:
  • Talk to someone about your sense of loneliness and isolation. There’s stigma around loneliness so it can be hard to do. However, you may well find that you’re not alone in those feelings, and sharing them can help lessen their effect.
  • Manage your holiday/COVID-19 expectations. The holidays can fall short of expectations, but this year it may be worse. Understand that the pandemic won’t last forever, and that we’re all in this together. Indeed, many people’s holiday gatherings will likely be different this year.
  • Remember to take care of yourself, now more than ever. Sleep, exercise and good nutrition — with the proper amount of holiday indulgence — go a long way in addressing mental health.
  • Avoid social media, such as Facebook or Instagram, especially during the holidays. It’s easy to negatively compare one’s life to the “perfect” lives posted on social media, forgetting that people mostly post only the positive.

Loneliness and isolation as its own pandemic

The holidays don’t last forever, and we will get through the COVID-19 pandemic. However, loneliness and social isolation may persist, which presents a challenge for behavioral health providers. The recent NASEM report explores interventions that the healthcare system can take to address loneliness as a societal condition, such as engagement in support groups, cognitive behavioral therapy and mindfulness, social determinants of health, social prescribing and more. Social prescribing is arguably one of the more interesting interventions in that it puts a clinical lens on non-clinical solutions. While there is no hard-fast definition of social prescribing, it is generally accepted as a way to connect people to non-clinical sources of support, according to the NASEM. Specifically, it is a “non-medical referral, or linking service, to help people identify their social needs and develop wellbeing action plans to promote, establish or reestablish integration and support in their communities, with the aim of improving personal wellbeing.” Examples of secondary services that improve social concerns affecting health include housing and food insecurity services. While known to varying community-based organizations, social prescribing is not common among practitioners, but it’s a common-sense solution. An analysis of one pilot program from the NASEM report — albeit a small one — found that social prescribing reduced inpatient admissions by as much as 21 percent and emergency room visits by 20 percent. A modern world — without COVID-19 — is more connected than ever due to social media and other technology. However, studies have shown we are more lonely now than in any other time in recent history. It’s time to think out of the box as we realize more and more how non-physiological conditions — such as issues ranging from a public health emergency to social media — can affect our health.

Are You Having Sleep Problems During the Pandemic? 5 Likely Reasons

As a psychologist and as a human being, I am receiving this message from every direction and all sides. It’s rampant these days. People are having a hard time sleeping during the COVID-19 pandemic. Some people lie awake unable to fall asleep. Some wake up in the middle of the night and their brain starts racing. Other folks say they wake up in the early morning hours and lie awake for a long time before the alarm goes off. Then there are the ones whose sleep pattern has been thrown totally off. They’re awake when they should be sleeping and sleeping when they should be awake. What is it about this pandemic that is making a good night’s sleep so hard for so many people? In talking with many people about their sleep problems during the pandemic, particular struggles have emerged as common patterns. So, I think I have some answers that I’m going to share with you today. First, let’s review the primary causes of the problems. They will probably not all apply to you but, in reality, all it takes is one. Read the full article at PsychCentral.com...

"Shelter In" for COVID-19 Does Not Mean Sit Around

Link to an article written by Ashley Anderson, PsyD, CEDS In the wake of COVID-19, we have come to find our actions restricted slightly. It is possible that you live in one of the many states that have implemented some form of a “shelter in” plan, where public activities are limited to necessities and other essentials. While it may be easy to focus on what we cannot do, I encourage you to focus on things within your control and what you can do. Our routines have changed, temporarily. So it is important to create a new structure or routine, filled with various activities. Create a schedule, where each day has at least one different activity for the day. Work, school work, meals, social time, family time, individual time, creative/artistic time, relaxation time, and movement can all be worked into your weekly schedule. Blocking time for each of these helps reduce the likelihood that you will tire or get bored of an activity. Read the full article here...

Couples Covid Resilience

These are trying times. Our lives have been upended. We’ve been mandated to stay at home and work from home; our social outings have been drastically reduced, as have our social interactions with others. We’re faced with 24/7 interaction with our partners. The result is a unique form of cabin fever, which when combined with the stressors of an invisible enemy), (covid 19) creates profound uncertainty (When will this end? How? Will it return? Will I or my loved ones get sick?), major changes to our routines, and economic concerns, and becomes a stressful burden on even the happiest couples. These are times that call for our best—but how can we be our best when the natural human response is an uptick in anxiety and/or depression levels? Most of us have “COVID-brain”: It’s hard to think clearly when we are so worried and scared or feeling like molasses from our blueness. There’s just too much going on! We’re living in unprecedented times, locked out from the outside world and somewhat locked out of ourselves; we are unable to digest and reflect. This lessening of our cognitive function can impact our ability to ride the choppy waves in our couple relationship. Cindy Baum Baicker PhD,a clinical psychologist, interviewed senior psychoanalysts and described 5 factors which can be guide posts for couples during this stressful period. Pragmatism: Now is not the time for minor irritations. Let things go.  If you have had some alcohol and are annoyed or angry at your partner, let it go and if you’re still angry the next day, bring it up for discussion. We’re myopic when we drink, and nothing good can come from conflict resolution when we’re in an altered state. Think existentially: Who do we want to be when all of this is over? What will it have meant for us? Balanced Paradox: We’re separate, and we’re attached. Allow for each of these realities in your relationship. Make space to spend time together and apart, even though you’re living in the same space. Cognitive-Affective Differentiation: Allow for difference! A couple’s resilience during this time will depend on the state of the two people who are in the relationship. Stress affects each one of us differently and we each cope differently. Affect Optimization: The act of naming your emotions has been found to benefit wellbeing. Let yourself experience the range of all that you’re feeling and share it with your partner. That said, wise relators allow for “emotional blend,” but have also learned to lean towards or focus on their positive emotions. These are difficult times and also times to deeply feel one’s gratitude for what one has, and perhaps even for who one is. Emotional Generosity: Kindness, patience, humility, and deep regard for the other are all aspects of emotional generosity that you can bring to your relationship. Find that olive branch if there’s a disagreement, and extend it. When asked what they thought was required for a good long-term relationship, these wise elder clinicians said one word more than any other: tolerance. During the COVID-19 crisis, when we can all get underneath each other’s skins a bit too often, remember that word. Tolerance. And while you’re at it, remember why you fell in love with that person in the next room or in the room with you, and reconnect with those feelings.

Helpful Thinking During the Coronavirus (COVID-19) Outbreak

From the U.S. Dept. of Veterans Affairs: During the COVID-19 outbreak, you might have concerns about safety, feeling unable to cope, helplessness, guilt and anger. While it is understandable to feel this way, focusing on such negative feelings can make coping even more difficult. You may find it useful to become more aware of unhelpful thoughts and consider focusing on more helpful thoughts. Use the table at this link to identify thoughts you might be having now, and helpful thoughts you can try instead. Then, it's important to practice using more helpful thoughts as often as you can.

Anxiety, Depression and COVID-19: Now's the Time to Feel Our Feelings - Here's 8 Ways How To

We are in an anxious time. We are worried. Fearful. And ill at ease. Things are changing. Our schedules and routines. The ways we engage with others. And things are staying the same. The exact same. Day after day. Without going to work and having social calendars to adhere to, we’ve all found ourselves with more time in the day. More time to relax. To think. To stand still. And stillness is exactly what we need. Stillness in our communities. In our households. In ourselves. For being still is when we learn the most. When we connect the most. To others and to ourselves. It’s when we’re still that we feel our feelings. When our feelings surface the most. Perhaps why some of us stay so busy. For it’s easy to avoid your feelings when you don’t have a free moment. When you don’t take the time to do nothing. And now that is exactly what we must do. We are being called upon to stop what we are doing and to listen. Listen to what our bosses tell us. To what our community tells us. To what our doctors tell us. To what the government tells us. So why not use this time to listen to what we tell ourselves. The truths and the lies. The things that we’ve refused to see. Now is the time to address our mental health. To address our feelings. To admit them to ourselves. To acknowledge them. Sometimes all a feeling needs is to be acknowledged in order to be released. For those who don’t like to address their feelings, I realize it can be uncomfortable. Sometimes it feels easier to hide our feelings. Even to ourselves. Tricking ourselves into thinking we’re okay. When we’re not. I know what it’s like to keep your feelings hidden. I used to be a master at hiding mine. But I’ve learned that it did much more harm than good. And that identifying my feelings and talking about them is part of what helped me understand them. To acknowledge them and to let them go. Be sure to take this time to talk to yourself. Yes, I said talk to yourself. Through journaling. Or heck, out loud. Why not. I do it all the time. Notice how you feel with each thing that you do. Take time to reflect on the day. On the week. On each interaction you have and how it makes you feel. What a TV show or a book brings to the surface for you. A conversation with a loved one. A correspondence with a coworker. And why. Why certain things make you angry, anxious or sad. What makes you feel good and brings you joy. We don’t always have the time to address our feelings. But we’ve been given time. Possibly for the first time. It’s a gift. So it’s only wise to use this time to connect back to ourselves. To what’s happening within us. To our feelings. Here are some steps to take to helping you feel your feelings:
  1. Spend time in silence. Even if you only take 10 minutes a day, spend time alone in silence. Silence yourself and the things around you. And let your mind relax. Daydream. Unwind. Observe your body. Your feelings. And pay attention to what messages you are receiving.
  2. Observe your experiences. Since everything has slowed down, we can take the time to be more present in what we do. To observe the world around us. To notice others. And to notice what feelings come up in ourselves when we interact with others.
  3. Pay close attention to the things you say to yourself. Are you telling yourself you’re anxious? Depressed? Angry? For whatever feelings come up, instead of feeding into them, stop and listen to them. Observe them. Identify why you are feeling the way you are and what you can do to make it better.
  4. Do non-screen activities. Read an actual book or magazine. Color (yes adults, you too). Put together a puzzle. There are so many things that bring us joy that we too often neglect to do because so much of our time is spent staring at screens. Start by committing to one non-screen activity a week. If you don’t enjoy it, stop. If you love it, do it again soon. Tangibly connecting to things helps us feel our feelings too.
  5. Be playful and move your body. When we’re playful, we allow ourselves to be free, which allows our feelings to surface. Movement unlocks feelings stored deep within our body’s tissues. Doing both every day helps us explore our feelings.
  6. Journal your feelings every day. It can be as simple as adding a note to your phone with inconsistent thoughts and incomplete sentences. But be sure to record what comes up for you each day. In order to help you explore all the things you feel. Read here for tips on journaling to improve mental health.
  7. Talk to a loved one or to a therapist. Hopefully you have someone you can trust to share your feelings with, but if not, find someone you can. While starting with a new therapist may not be possible right now, talking to one still is. For example, Psych Central has an Ask the Therapist page where you can ask therapists questions and see previously asked and answered questions. You could also join an online support group.
  8. Find a teacher. I realize we can’t literally go out and find teachers right now, but that doesn’t mean we don’t have access to them. After you determine the feelings you’re having, and maybe even why you’re having them, conduct research. Find doctors, therapists and experts who have written and spoken about what is ailing you. Also keep in mind, anything can teach you what you need to learn. All you need to do is to observe, to listen and to acknowledge how you feel.
Remember to find the stillness in yourself: to connect to and to acknowledge your feelings and to heal the parts of yourself that need to be healed. I hope you are all safe and well. For those who are sick or who know someone who is suffering, may you feel better very soon.
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