Uncovering the Roots of Anxiety and Stress

Therapy can be a fascinating process. Some people compare it to peeling an onion. Each layer offers new insights and understanding. Case in point — many of my clients come to me because they want to learn how to manage their stress and anxiety more effectively. As therapy progresses it becomes evident that they’re not just stressed about what’s going on in their lives today. What triggers their anxiety are deeply rooted negative thoughts and feelings they have about themselves. These thoughts often determine the stories we tell ourselves about who we are.

Some of the deeply held negative beliefs that my clients have shared in sessions include:

• I am not enough.
• I don’t matter.
• I will always disappoint those who care about me.
• I am unlovable.
•  I am flawed.
• If they knew the real me, they wouldn’t like me.
• I should not be forgiven.

My clients are often surprised to learn that their situation is not unique. I’m not saying that each individual isn’t unique, but I have many clients who hold similar beliefs about themselves, because of their past experiences.

Doing the Deeper Work

Uncovering these beliefs often takes time because they’re unconscious, barely showing themselves when your anxiety starts to ramp up. As our work together progresses, trust begins to grow, and the deeper work begins. Sharing stories and impressions of past experiences in therapy can open the door to recognizing the messages you received growing up. Often, what I call the critical inner voice (or Negative Nelly), originates from experiences we had in those early years.

Because these messages are so painful and difficult to process, they’re often pushed down below the surface and bubble up through negative self-talk. That inner critic’s message can lead to anxious or depressed feelings. Therapy helps by bringing those negative messages to light. You can determine where they stem from, what drives them, and whether they are legitimate.

When Trauma and Emotional Neglect Aren’t Resolved

If you were emotionally, sexually or physically abused in childhood and that trauma wasn’t resolved or validated, it can leave you feeling inadequate or “less than” when you’re struggling. The same can be true if you were told to buck-up, to get over it, never show to when you’re hurt. These events and messages can also lead to being disconnected from your physical and emotional experience in adulthood, which makes it hard to know how you’re feeling. This can leave you uneasy or numb.

Mindfulness and Meditation Can Help

Mindfulness and meditation can help make you more aware of your negative thoughts and allow you to be more comfortable with your difficult feelings. Finding and practicing self-compassion also plays an important role in letting go of the negative self-talk that comes so easily when we make mistakes, or we embarrass ourselves through our actions or statements. Self-compassion acknowledges that we’re human and often make mistakes and that, although we all suffer, this too will pass. It also creates a space to offer yourself some support and comfort.

Therapy Can Make a Difference

If you’re suffering from trauma-related anxiety or depression, and it feels overwhelming, therapy can help. It’s important to find a therapist you feel comfortable sharing with and opening up to. You want someone who you feel will understand, empathize and support you in your journey forward. If you struggle with anxiety or depression that might be related to past trauma, please call me at 410-340-8469 to begin the journey to healing.

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Elizabeth Cush, MA, LGPC is a therapist and the owner of Progression Counseling in Annapolis, Md. She helps busy, overwhelmed men and women manage their anxiety and stress so they can live their lives with more ease, contentment and purpose.

Photos courtesy of Joshua Earle and Ashley Batz for Unsplash.com

It’s Time To Open Doors, Not Close Them

Hope

A friend recently asked me to write a happy blog to offset all the sadness in the news lately. It’s so painful to see all the hurt, hatred and violence that have become a part of our lives. When each new tragedy occurs, my heart breaks for all the victims and their families. And I am angry that nothing changes.

This is my effort to make sense of our nation and the world we live in. And although I don’t think I can do “happy,” I can do hopeful.

Feeling The Impact Of Racism, Bigotry And Hate In Daily Life

Being a therapist, I know the negative impact that racism, bigotry and hate have on our mental health and our physical well-being. Being a woman, I know the harmful effects of sexism and sexual violence. And I have family, friends, colleagues, clients and classmates who’ve also felt the adverse impact of racist, bigoted, hateful incidents ranging from microaggressions to assault. I also know that I am white and middle class, and as a result, have certain privileges that many people in our country do not.

In the wake of the recent killing of recent shootings of young black men by police officers, and the five police officers who were killed at a peaceful Black Lives Matter rally in Dallas, it’s hard to make sense of what’s happening in the world or to find any hope that things will get better.

History Offers Hope For Change

Fortunately, history tells us that change can come from difficult times. Peaceful and violent demonstrations have brought about significant changes in our society.  

I believe that real change can come. But before it can happen, those of us with power and privilege (like me) have to be open and ready to have uncomfortable conversations about the existing problems and to accept that many inequalities persist in our society.

Incorporating Activism In Daily Life

How can we become open and ready? I am no activist, but here is what I believe I can do:

·      I can make an effort to listen all my clients, family, friends, colleagues and strangers. I can try to understand their experience from their perspective, and be truly empathetic.

·      I can be aware and acknowledge that real problems exist and to be ready to learn about them with an open mind and heart.

·      I can learn about the differences of all cultures and races, and their differences, with curiosity and compassion, instead of with judgment and hatred. 

·      Lastly, I can communicate and educate others about how the messages of racism, bigotry and hatred that I hear, see and witness each day impact all of us.

It’s Time To Open Doors, Not Close Them

Instead of closing borders and closing our hearts, I think it’s time to open them. Instead of the “us” versus “them” refrain that we continue to hear on the news, from politicians, and on social media, I believe we need a real, two-way dialog and a stronger more unifying message. We are all “us,” and we can learn to embrace, appreciate and value our individual differences.

It’s Up To Us

I believe that each individual voice, open heart and open mind can make a difference, and I will continue to have hope that these trying, difficult times, in which racism, bigotry, violence and hatred are so prevalent, can lead to lasting changes in our society and in the world.

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Elizabeth Cush, MA, LGPC is an Annapolis therapist helping people manage their stress and anxiety.

Wider Ripples: The Stanford Rape Case And Orlando Mass Shooting Affect All Survivors Of Violent Crime

The Stanford rapist’s sentencing, the rape survivor’s letter and the mass shooting at Pulse, a gay nightclub in Orlando, have recently dominated news headlines, and social media. I hesitated to add my voice to the overall noise of the conversation, but I thought it was important to speak to the survivors of rape, mass shootings and hate crimes.

Surviving Isn’t That Simple

To outsider observers, survivors of violent crime have, by definition, survived. Those who haven’t experienced the trauma might see survival as a thing of celebration, or as a reason to move forward. After all, the survivor made it; he or she is alive; the experience is over. Unfortunately, it’s rarely that simple. Survivors of violent crime are left with many conflicting feelings and thoughts. Years after the event, they might continue to struggle.

It’s hard for any of us to avoid the images, written text and video of the recent events. For survivors of violent crime, that information overload can bring back the thoughts, images, and feelings related to their past personal experience.

For survivors of rape or hate crimes, these feelings can include:

·      Shame because they believe that maybe somehow they deserved this.

·      Self-blame because “if only” they done that one thing (stayed home, skipped that last drink, worn different clothes...), it might not have happened.

·      Anxiety because they no longer feel safe.

·      Guilt because of the impact on family, friends and themselves.

·      Anger towards the perpetrator, the victim, the system and themselves.

·      Frustration that they can’t get over it, or that the perpetrator went free.

·      Sorrow from the loss of their former selves.

·      Relief because it was someone else this time.

·      Hope that now others will understand how devastating the rape or hate crime can be. Or maybe, that the publicized incident will finally drive lasting societal change.

·      Numbness because they can’t bare to think about what happened.

For survivors of mass shootings the feelings are similar but for slightly different reasons:

·      Shame that they were targeted.

·      Guilt that they survived and others didn’t.

·      Anxiety because the world doesn’t feel safe.

·      Anger towards the perpetrator, or the system.

·      Frustration that this is happening again.

·      Sorrow from the loss of those who died.

·      Relief because they weren’t there this time.

·      Hope that maybe this time something will change, and it won’t happen again.

·      Numbness because to think about what happened is too painful.

Coping Tools For Survivors

If you are a survivor of violent crime, take the time to remind yourself that it’s normal for your feelings to resurface, and for you to feel conflicted about what’s happened. It’s also normal to be triggered, or activated, by the recent events. If you are feeling overwhelmed, here are a few coping tools to help you manage this extremely difficult time and to take care of yourself:

·      Give yourself permission to feel whatever it is you are feeling.

·      Reach out. If you are in counseling, have a support group, or have supportive friends and family, talk to them about what’s going on for you.

·      Turn off the news. You know what happened. Watching 24/7 news coverage can increase your feelings of danger or threat and leave you feeling more anxious.

·      Take the time for self-care. Exercising, sleeping, reading, and spending time alone or with loved ones can create a sense of well-being.

·      Take a walk in nature. Natural settings can help calm your nervous system. According to a scientific study that was reported on in the New York Times, “…volunteers who had strolled along the quiet, tree-lined paths showed slight but meaningful improvements in their mental health…They were not dwelling on the negative aspects of their lives as much as they had been before the walk.”   

If you are feeling overwhelmed by the recent events and would like help please call or email me for a free 15-minute phone consultation.

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Elizabeth Cush, MA, LGPC, is an Annapolis therapist helping people who feel overwhelmed by stress and anxiety. Progression Counseling in Annapolis and Arnold, MD- 410-340-8469

How to Take Control of Your Fatal Flaw

I recently communicated with Dr. Jonice Webb, the author of Running On Empty. I was inspired by her book, asked if I could share one of her article abouts Childhood Emotional Neglect (CEN). She generously offered to share this article about "the fatal flaw," one of the psychological effects of CEN. Let me know your thoughts in the comments below, and visit Dr. Webb's website if you'd like to know more.

By: Jonice Webb, PhD

The Fatal Flaw:

A deep-seated feeling that something is wrong with you. You are missing something that other people have. You are living life on the outside, looking in. You don’t quite fit in anywhere.

If you grew up with Childhood Emotional Neglect (CEN), chances are, The Fatal Flaw is at work in your life. If you pushed your feelings away as a child, you now lack access to them as an adult. You sense deep down that something is missing (it’s your emotions).  And your life lacks the richness, connection and meaning that your emotions should be bringing to you. This is the basic cause of the Fatal Flaw. Most people who have it are not aware of it, and this gives it incredible power.

Seven Effects of the Fatal Flaw:

• You are not in touch with your gut feelings, so you don’t trust your gut (even though in the majority of CEN folks, it’s most often right).
• It undermines your confidence to take risks.
• It makes you uncomfortable in social situations.
• It keeps many of your relationships at a surface level.
• It makes you question the meaning and purpose of your life.
• It makes you fear that if people get to know you well, they won’t like what they see.
• Therefore you are quite fearful of rejection.

These seven effects will gradually wear away your contentment and your connection to life and happiness. So it is vital that you take control of your Fatal Flaw.

Six Steps to Break Down Your Fatal Flaw

1. Recognize your Fatal Flaw: This will take away its power.
2. Know that your Fatal Flaw is not a real flaw. It’s only a feeling.
3. A feeling can be managed, so start to manage it. Pay attention to when you feel it, and how it affects you.
4. Put it into words and tell someone about it.
5. Override it every time that you possibly can. Do the opposite of everything your Fatal Flaw tells you to do.
6. Start breaking down the wall between you and your feelings. Welcome them as the vital source of information, guidance, and richness that they are (even the painful ones).

Yes, your Fatal Flaw is powerful. But so are you. You have a great deal of personal power that is being drained by your Fatal Flaw.

So today’s the day. Declare war upon your Fatal Flaw, and start using your weapons of awareness, your emotions, your intellect and your words.

This is a battle that you can win. I promise.

To learn more about the Fatal Flaw, what causes it and how to overcome it, visit emotionalneglect.com and see the book Running on Empty. (link to: http://www.drjonicewebb.com/the-book/)

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Elizabeth Cush, MA, LCPC, is an Annapolis therapist helping people manage their stress and anxiety. Progression Counseling, offices in Arnold and Annapolis. 410-340-8469

Loss Of A Loved One

Loss

We recently lost our family dog from illness. He was old but his death was unexpected and sudden. I was not ready. It seemed as though he was OK one day, and then it was time for him to go. We had him for almost 14 years, and he was truly a part of the family. His sudden death got me thinking about illness and loss on a bigger level. When a loved one gets sick or dies, the mix of emotions can be overwhelming and scary—especially when things happen unexpectedly. We no longer feel in control of our environment, which can cause anxiety and stress.

How You Might Feel When Illness or Loss Occurs

• Anxious because of the uncertainty
• Frustrated about loss of control
• Anger because the loss or illness takes precedence over your life/schedule
• Selfish for wanting things the way they were
• Guilt or shame because of your feelings
• Scared about the future
• Pain and sorrow for the life lost
• Alone in your grief

Avoiding The Pain

When my dog first showed signs of illness and things were not looking hopeful I had trouble sitting with that pain. I found things to do that took me out of my head. I went to the store; I cleaned and straightened—anything to distract myself from the overwhelming, uncomfortable mix of feelings. Although I knew my dog was not getting better, it was hard to accept that he would die.

Lean In To Your Emotions

As I was working so hard to avoid the uncomfortable, I realized that the feelings were not going anywhere and that maybe I would feel better if I paid mindful attention to them. As crazy as that sounds, research has shown that leaning in to our emotions or feelings can actually relieve some of the anxiety and stress that they generate.

Let Go And Be In The Moment

You can find many ways to get in touch with how you are feeling. I like to sit in a quiet place and meditate on the feelings that arise. With meditation, you can acknowledge the difficult emotions without holding on to them or allowing them to define you. Meditation allowed me to acknowledge my mix of emotions and process the fact that our dog’s time was over. 

Some Other Ways To Be With Your Feelings

Mindfulness helps when overwhelmed by anxiety

• Ground yourself with mindfulness. If your thoughts are going a mile a minute, you can practice grounding techniques to bring you back to the here and now.
• Connect with others about your experience. Talk about what you’re going through with family, friends, support groups, counseling
• Practice self-compassion. Grief and loss can bring up a lot of stuff, and there is no right or wrong way to grieve. Read more about self-compassion HERE.
• Acknowledge the Struggle. Reminding yourself that, “We all struggle, I am struggling right now, and illness and loss are really hard,” can help you feel less isolated.

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Remember, feelings aren’t good or bad, and they don’t define who we are. They're just feelings.

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What If You Can’t Get In Touch With Your Feelings?

For some people, identifying or getting in touch with your feelings is very hard to do. Being numb, or being disconnected from your feelings is not uncommon, especially if you have experienced trauma or childhood emotional neglect (CEN). If you have a lot of trouble naming your feelings you might need assistance to access, name and experience them. If you would like help with this process please contact me.

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Elizabeth Cush, MA, LCPC, is an Annapolis therapist helping people manage their stress and anxiety. Progression Counseling, offices in Arnold and Annapolis. 410-340-8469

Turning Tigers Into Kittens: Mindfulness and the Release of the Anxious Mind

Robert Cox, MA, PLPC, NCC is my guest blogger this week. His blog focuses on the body's response to trauma and how trauma affects anxiety and depression. He also discusses the benefits of a mindfulness practice for symptom relief. He has counseling offices in Liberty, MO, where he specializes in the treatment of trauma, addictions and autism.  He writes, "I am trying to change the face of both addictions and autism treatment. "

If you would like to know more about Robert and his practice you can find it HERE. You can also follow him on Twitter-  HERE. Or Check out his amazing Mindful Recovery Podcast HERE.

By

Robert Cox, MA, PLPC, NCC

Trauma can often result in increased anxiety levels and depression.  This is because our brain, already primed to sense danger in advance, becomes overloaded with the trauma and begins to associate all kinds of everyday sensations with that event.  So we can be triggered by loud noises or by certain smells or the feeling of material on our skin.  Something simple and mundane to everyone else can set us into a tail spin of increased heart rate, rapid breathing, sweating and racing, panicked thought patterns.  All because the limbic region of our brain (the little part at the base of the skull just above your neck that is responsible for emotional regulation) is triggered and tells our body that there is danger and we better prepare to fight or to run away.  I call it our tiger response, because it’s a great response to have if you’re being chased by a tiger, but not so helpful in the middle of Wal Mart.  

If you have suffered through trauma and anxiety, then you know this feeling.  Dealing with this feeling constantly over a period of weeks, months, even years can lead to serious depression.  It simply wears on us physically and mentally.  The good news is there is hope, and often hope outside of medication.  It’s called mindfulness.  Mindfulness is a very simple practice of regulating the body by watching the breath and allowing that focus on the here and now of basic body functions to bring us out of the anxiety and panic, back in to this moment in front of us.  By slowing the body down, we tell the brain that there is no reason to be afraid or anxious and the limbic region begins to loose its grip on the rest of the brain allowing us the emotional space to begin making rational decisions with the forebrain again. 

In addition to the immediate effect of telling the brain it’s OK when we are in mindful moments, our body and brain react by reducing stress chemicals like Cortisol which increases all those fight or flight responses and increasing good chemicals in the brain like serotonin (a depression fighting drug) and Oxytocin, which psychologists often call the “hug drug” because it’s that feel good, relaxing drug that gets released when we hug each other for 20 seconds or more.  In fact, if you have a friend, or significant other that you trust in very intimate spaces…a good thing to do might be to ask for a hug and simply stand in that moment, completely focused on the sensation of safety you are getting and watching the breath move in and out of your body.  This mindful moment would serve as a double dose of oxytocin to release the anxiety of the brain.

Often, however, when we are in those triggered spaces the last thing we want is to be touched.  In that case it comes down to using some basic exercises to bring ourselves back to the here and now and just focusing on the breath while counting to three slowly as we breathe in, and holding for a second then counting the same three as we breathe out.  When we feel like we are being chased by the Tigers of the past this simple breathing exercise can bring us right back to the present.  If we practice when we are not being chased by Tigers then we can make this response second nature and when they do come, we respond by returning to the breath in the here and now. 

Before we know it we have calmed and we can clearly see that our tigers have become kittens.

For more about this body brain link and a map of the emotional brain you can go to the Mindful Recovery Podcast page and scroll down to Episode 1: The Emotional Brain in Recovery.  The map is just below the podcast artwork and you can follow along during the episode for a fuller discussion of how the brain reacts to trauma along with a brief exercise provided to help you learn how to release the grip of the limbic region and begin your mindfulness practice.  For more about beginning your own practice you can go to my Resource Page to find tools, music and learning programs designed for your needs.

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Elizabeth Cush, MA, LCPC, is an Annapolis therapist helping people manage their stress and anxiety. Progression Counseling, offices in Arnold and Annapolis. 410-340-8469

The Impact of Shame And Blame After Trauma

Doubting The Victim

I recently listened to The Anatomy of Doubt, episode #581 of This American Life. The first half of the episode was about Shannon, who was sexually assaulted by a stranger who entered her home through an unlocked door.

Growing up she lived in multiple foster homes and became quite close to two of her foster mothers. After the sexual assault she called these two women and some friends to share what happened. Both mothers chose not to believe her. They told the interviewers that, at the time, they thought she was only trying to get attention. They communicated their doubts to the police too. I don’t want to rehash the entire episode (you can listen to it HERE) but not only did the police close the case without an investigation, they also charged Shannon with filing a false police report.

****SPOILER ALERT****

Years later, when the perpetrator was caught for another sexual assault, investigators found Shannon’s ID and photos taken that night in his apartment. He confessed to stalking and sexually assaulting many women, including her.

Doubting Your Memories

This story has stayed with me. It got me thinking, What is the impact on a trauma survivor when the people you trust don’t trust you? Shannon told the TAL interviewers that she began to doubt her memories. Her two primary supports and the police all implied she was lying. Although she was violated in her own home, she began to question what happened.

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So, how do you overcome a traumatic experience when no one believes you, and this leads you to lose faith in yourself?

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Trauma and PTSD

Traumatic experiences can lead some people to developing Post Traumatic Stress Disorder (PTSD).  Symptoms of PTSD include:

• Nightmares or flashbacks
• Avoiding things that remind you of the experience
• Avoiding social situations
• Distrust of the world and others
• Numbing
• Difficulty sleeping
• Trouble focusing
• Easily startled
• Anxiety
• Depression
• Substance use

Other people might look for ways to avoid thinking or talking about what happened. Unfortunately, avoiding difficult emotions is usually a temporary fix, and can result in anxiety and depression.

You Deserve To Be Heard

You might say, this was one woman’s story—not a common occurrence.

Unfortunately, I can state from professional experience that it happens more often than you think. For years I worked as a crisis counselor for abuse victims at a local hospital. I had the privilege to counsel men, women and children who had experienced sexual assault, domestic violence, vulnerable adult abuse or child abuse during their lifetime.

Many survivors told me that when they disclosed the traumatic experiences to family, friends and/or police, it was suggested that they were lying or were partially to blame for what happened.

Many of those who came away from their traumatic experience feeling they were not supported or believed, later in life struggled with significant mental health and/or substance use issues.

Trauma, PTSD and Resilience

Research suggests that one of the key factors in resilience, or the ability to bounce back from trauma, is having a good support network and strong social connections such as family and friends. Psychiatrist Kathryn M. Connor, MD, wrote about measuring resilience after trauma in an article in The Journal of Clinical Psychiatry. Another protective factor is the ability to call on your past experiences for a reference when facing potential challenges in the future.

According to Dr. Connor, “Resilience has been shown to protect against posttrauma breakdown and may help alleviate an individual’s feelings of helplessness…” and potentially keep them from acquiring chronic PTSD.

It’s difficult enough for survivors to share what happened to them, because they often feel they are somehow to blame, or are shamed by the experience. If you were then questioned about the validity of your disclosure, it makes sense that such doubt would have an impact your ability to move on and heal. It would also affect how you handled any future trauma, making it difficult to trust others in a crisis.

How Counseling Can Help

Survivors of abuse have a lot of obstacles to overcome to move on from the trauma. The survivors I worked with who said their stories were doubted, or were told they were responsible for the traumatic experience often didn’t want to talk about the trauma, and avoided therapy, although they were struggling. Well, no wonder! Who would want to face the prospect of not being believed once again?

That being said, counseling can offer the opportunity to be heard, without judgment. Counseling moves at your pace, and you should never feel forced to talk about something until you’re ready to discuss it.

Counseling can also provide a safe space to explore the trauma while providing strategies for coping and moving forward.

Other Ways Counseling Can Help

Counseling can provide other tools to support healing, through:

• Relaxations skills to stop your mind from racing, and calm your anxiety
• Mindfulness techniques to keep you present in the here and now, instead of worrying about   past and future events
• Body work to help understand the bodymind experience after trauma and improve self-regulation
• Challenging the negative beliefs that undermine your self confidence, and make you feel “less than”
• Art therapy to explore trauma through creativity
• Play Therapy most often for children, to explore trauma through play
• Group Therapy to share common experiences and get support  

Please share your thoughts below.

If you would like more information on how counseling can help you overcome a difficult life experience you can CLICK HERE to learn more about my Annapolis counseling practice. Or CONTACT ME to set up an appointment.

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Elizabeth Cush, MA, LCPC, is an Annapolis therapist helping people manage their stress and anxiety. Progression Counseling, offices in Arnold and Annapolis. 410-340-8469