Getting Some Sleep? Part 1

A question often on people’s mind is ‘How much sleep do I need each night?’ Generally speaking, there is no single amount of sleep that ‘fits’ everyone. Most healthy adults need 7 to 8 hours of sleep per night. However, at the extremes, some people need only 4 hours of sleep and others require 10 hours of sleep. Moreover, a person’s sleep need might change depending upon life circumstances. At this point, it is important to remember that optimal amount of sleep lets us not only feel alert and energetic during the day, but it also allows us to best manage our emotions and reactions to the difficult things going on for us in our lives. It gives us a resilience that helps us navigate the tough things that come up, deal with our stresses, and figure out things we’re struggling to work through. It can also just brighten our spirits and give us relief and positivity during a difficult period of time.

Insomnia is diagnosed when poor sleep is associated with distress and/or daytime consequences, such as impairment in function or mood. Insomnia often begins during periods of stress. About 75% of people with insomnia can identify a trigger that initiated their insomnia. Examples include health issues and/or stress related to family or work situations.

Poor sleep is a common reaction to stress but there are large individual differences in how people react to and cope with stress. These differences likely play a role in the development of insomnia. Most of the time, sleep normalizes after the stress that started it subsides or after the medical condition that caused it is treated. However, in some cases insomnia persists.

This can happen if there are perpetuating mechanisms present such as the following:

  1. The bed and the bedroom become linked with wakefulness, arousal, or negative emotions. This is known as conditioned arousal or conditioned insomnia. The bed and the bedroom become unconscious cues for arousal rather than sleep. For example, many people with insomnia report that they dose off while watching TV or reading in the living room, only to become fully awake when they go to bed. For these people, past experience with tossing and turning while trying to sleep has made the bed a cue for wakefulness rather than sleep. Conditioned arousal can develop even when the main problem is prolonged awakenings in the middle of the night, rather than difficulty in initially falling asleep.
  2. Some people react to poor sleep by trying harder. They extend the time they spend in bed, avoid previously enjoyed evening activities, and spend long periods tossing and turning in bed. These strategies do not solve the problem. In fact, such strategies make it worse. Prolonged time in bed actually promotes wakefulness. The very act of “trying” to sleep produces frustration, increases arousal, and can become a hidden source of stress. This process is akin to a Chinese finger cuff. The harder you try to pull your fingers out, the more stuck they become. When you let go, you can ease your fingers out.
  3. Worry about sleep is another common reaction to having difficulty sleeping particularly in those individuals who are predisposed to worry. After a period of not sleeping well, apprehension and concern that the coming night will be another struggle emerge. When unable to sleep, worries about the negative daytime consequences of insufficient sleep develop and people start to plan their day and evening activities around their sleep. Such worries, though understandable, are mentally activating and end up making sleep even more difficult to achieve.

Many people with insomnia make their problems worse by the things they do to make up for lost sleep. For example, people may go to bed too early or ‘sleep in’ following a poor night’s sleep in order to recover lost sleep. Although these practices seem logical and sensible for good sleepers who are occasionally forced to curtail their sleep (e.g., when sleep is interrupted by a sick child who needs parental attention at night), these same practices often serve to continue or worsen the sleep problems of people with insomnia. In fact, these habits are usually the opposite of what needs to be done to improve sleep.

Some people misjudge their state of sleepiness. They confuse the sense of being sleepy with the sense of being tired, fatigued, and the wish to rest the mind and the body. Being very sleepy means having to almost struggle to stay awake. When you are close to that, you are sleepy. Fatigue and tiredness reflect low energy that signals the need to rest whereas sleepiness signals the need and readiness for sleep.

Sleep scientists have yet to agree on the fundamental biological purpose of sleep. Some sleep experts believe that during sleep the human body restores and repairs cells and tissues that have been damaged or destroyed while we are awake. Other experts think that sleep is necessary to maintain a constant body temperature. Still others believe that sleep is essential to the maintenance of normal human metabolism. Regardless of these different opinions, sleep experts generally agree that to function best we all require consistent, good quality sleep. What is the right amount of sleep? The answer varies from person to person. Moreover, the sleep need of each person may vary depending upon life circumstances and age.

Next week, I will explore some of the reasons why we sleep. If you’re looking for some tips on getting better sleep in the meantime, I shared some tips with Reader’s Digest recently that you can get started with.

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A Simple Tool to Help Reduce Posttraumatic Stress

Recently, I shared some information on the impact of trauma with a closer look at how posttraumatic stress disorder, or PTSD, affects us. There have been some questions as to whether these effects can be mitigating. In the last few days, I released a new Topic Expert article for Goodtherapy.org discussing one practice for helping to decrease the impact of traumatic stress.

By practicing Mindfulness for even a few minutes each day, we may begin to quiet PTSD’s hallmark alarm signals and ground ourselves in the present moment. Read the full article HERE for more information!

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How Can You Connect More In Your Relationships?

Relationships can be some of the most incredible experiences of our lives. They can also be hard.

You want to feel connected to your partner, but it feels like there is a wall up between the two of you.

You want to understand your partner, but sometimes it feels like you’re speaking two different languages.

You have the same argument again and again. You can predict exactly how it will go, yet can never come to a resolution.

You may be facing a crisis, like infidelity, in your relationship and you’re trying to figure out if you even want to stay.

Maybe you find yourself listening to your partner, but focusing more on what you want to say next. And maybe you find yourself holding back on what you want to say out of a fear that it will cause a bigger issue.

One of the most important skills in relationships is effective communication. We may not ordinarily have trouble communicating and exchanging ideas or information with our partner, but find that when difficult situations come up, we can’t seem to get on the same page.

Most of us are guilty of these mistakes. In fact, these kinds of communication challenges can sometimes become so ingrained that many of us don’t even notice when we’re guilty of them. However, the consequences of ineffective communication take a toll. Feeling unheard can lead to resentment, frustration, and pain.

I want to point out that, sometimes, the best communication will still end with the acknowledgment: “We disagree.” But that’s OK‐it’s far better than the alternative: “I’m right, and you’re wrong.”

The ability to express your own ideas effectively is only half of what it takes to be a good communicator. Listening is the second half. This means more than simply hearing words. It means hearing, thinking, interpreting, and striving to understand. If we’re thinking about the next thing we want to say, we aren’t really listening. We’re just hearing.

Reflections are a powerful tool to improve communication between you and your partner. Using a technique called reflection can quickly help you become a better listener. When reflecting, you will repeat back what your partner has just said to you in your own words. Those who haven’t used reflections fear that it’ll seem like they’re just parroting the other person without contributing to the conversation. However, reflections typically result in a positive response.

Those who haven’t used reflections fear that it’ll seem like they’re just parroting the other person without contributing to the conversation. However, reflections typically result in a positive response.

So, what do reflections actually do? They act as confirmation that we heard, and more importantly, understand, what our partner has said. Reflections validate a person’s feelings by showing that we get it.

Often, a concern I hear is that it might seem like a reflection would kill a conversation ‐ there’s no new question to answer. Paradoxically, though, the opposite is generally true. Reflections encourage more sharing because our partner can trust that we are listening.

Learning to use reflections does take practice. As you first begin to practice it’s typical for reflections to feel a bit forced. But if you implement reflections regularly, they’ll quickly start to feel natural once you and your partner begin to notice how helpful the responses are. Oh, and start with less serious or neutral topics, at least in the beginning!

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A Closer Look at PTSD

One of the areas of work I feel particularly passionate about in my practice is facilitating recovery after a traumatic incident. Last week, I began a discussion of trauma and PTSD, or posttraumatic stress disorder, one of my areas of specialty.

We often think of veterans when we think of PTSD. In large part, much of what we do know about trauma and PTSD is a result of the experiences of Vietnam veterans. Prior to that, while trauma responses existed, there had not been a whole lot of focus on understanding traumatic reactions. Although PTSD tends to be the issue that most often comes to mind when we consider trauma, there are a number of other responses to trauma, including things such as depression, anxiety, substance abuse, and difficulties in relationships. We will address some of these elements but, in our multi-episode Looking at Trauma series, we will mostly focus on PTSD. Most of these other issues are embedded within the constellation of PTSD and will make more sense as we understand PTSD.

To begin with, it’s important to understand what exactly a trauma is…

If we think about the definition of a trauma, it’s generally defined by dictionaries as a deeply distressing or disturbing occurrence. Often, in medical contexts, it’s described as a disruption. Different experts and different fields describe trauma in different ways, which can be confusing and even intimidate if we are looking to do our research.

However, there are some common elements in thinking about what a trauma specifically is. From the lens of mental health or psychology, trauma, as described by the American Psychological Association, is typically an emotional and somatic response to a terrible, overwhelming, situation.

According to the International Society for Traumatic Stress Studies, traumatic events are shocking and emotionally overwhelming situations that may involve actual or threatened death, serious injury, or threat to physical integrity. While the World Health Organization describes trauma as more of an emergent/disaster based situation.

There are a number of different events that can be traumatic. Some examples of these situations that may immediately come to mind include a serious and potentially life-threatening accident, assault, natural disaster, or combat. Other types of experiences can be traumatic as well such as surviving or witnessing a crime or physical, verbal, emotional, and sexual abuse, as well as bullying or even a big move. Sometimes, trauma responses can follow any major change or disruption in a person’s life.

Many people are exposed to traumatic events. In the time immediately following a trauma, most people will have the experiences of PTSD that we will talk about. However, over time, for many people, those experiences naturally decrease, and they are not diagnosed with PTSD. In other words, they naturally recover from the traumatic event. There are some people who do not recover and are later diagnosed with PTSD. Based on that, it is helpful to think of PTSD as a problem in recovery. Something got in the way of you having that natural process of recovery, and the work of therapy is to determine what got in the way and to change it so that you can recover from what happened. You and your therapist will be working to get you ̳unstuck.

Let’s look at this in more depth…

Because we know that PTSD experiences are nearly universal immediately following very serious traumatic stressors and that recovery takes a few months under normal circumstances, it may be best to think about diagnosable PTSD as a disruption or stalling out of a normal recovery process, rather than the development of a unique psychopathology. A therapist needs to determine what has interfered with normal recovery. In one case, it may be that someone believes that they will be overwhelmed by the amount of emotional reactivity that will emerge if he stops avoiding and numbing himself. Perhaps s/he was taught as a child that emotions are bad, that s/he should just get over it.‖ In another case, someone may have refused to talk about what happened with anyone because s/he blames herself for ―letting‖ the event happen and she is so shamed and humiliated that s/he is convinced that others will blame her, too. In a third case, a person may have seen something so horrifying that every time s/he falls asleep and dreams about it, s/he wakes up in a cold sweat. So, in order to sleep, s/he drinks heavily. Yet another person may be so convinced that s/he will be victimized again that s/he refuses to go out anymore and has greatly restricted his/her activities and relationships. In still another case, in which other people were killed, a person may have survivor guilt and obsesses over why s/he was spared when others were killed. S/he feels unworthy and experiences guilt whenever s/he laughs or finds himself enjoying something. In all these instances, thoughts or avoidance behaviors are interfering with emotional processing and reshaping our beliefs. There are as many individual examples of things that can block a smooth recovery as there are individuals with PTSD.

There are several categories of experiences that tend to follow a traumatic event. Last week, we more closely examined each of the categories.

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What’s for Lunch?

It’s almost lunch time for most of us!

What are you having for lunch today?

And HOW are you having it?

Did you know that Mindful eating can help you keep your weight loss goals, build your confidence, and get more out of your lunch hours and dinner dates?

Mindful eating helps us build a better relationship with our eating habits, the way we consume our food, and its impact on not just our bodies, but also our mood! It’s one of the more popular sessions of my Mindfulness Matters group because it brings so much value – members have shared weight loss triumphs, greater self-esteem, and more gratitude for their food with this tool!

For a brief sample, listen HERE!

If you’re curious about how Mindfulness Matters can help you start your path to a healthier relationship with food and with yourself, click here: http://www.subscribepage.com/c6q6s5

Want even more information? Get access HERE!

What Does a Typical Group Look Like?

You may have heard the buzz about my upcoming Mindfulness Matters group and might find yourself wondering what a typical group is like. I thought I would give you some details so that you can see how this might help serve you in learning to more deeply connect with what you want in your life, create more satisfying relationships, and improve your sense of self-worth and love!

I start by doing an activity for the members to get to know each other so we can keep building our skills together over the course of the 12 weeks. I then begin introducing a new skill each week and using an activity or handout to help the particpants get a clearer understanding of that skill and make it applicable to them in their daily lives.

Then, I open it up to the members to:

1) provide feedback on the skill being taught that week

2) give an example of how they had successfully used a skill previously learned during the week

3) talk about a time during the week when they were unable to implement a skill and get feedback from myself and/or other group members on how they could have handled themselves/their emotions differently

4) receive feedback from the group on any other pressing issue that came up during the week and is causing distress so we can troubleshoot together and come up with ways to help them cope

Want even more information? Check out the details here!

P.S. Groups are an amazing way to lean how to express oursevles and understand that we are not alone. The Mindfulness Matters Group will run on Tuesdays from 5:30pm to 6:30pm beginning on July 11th and running through September 26th.

If this group looks like a good fit for you, contact me for more details. 

Ready to talk more about how the Mindfulness Matters group can bring you greater focus, deeper confidence, and finally quiet that inner critic? Get access HERE!

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Do You Have an Inner Critic Berating You?

Give Yourself Permission to Show Up Fully In Your Life!

In my practice, I see many people in the office who struggle with depression and low self-esteem who also want to get “perfect” work evaluations and be liked by everyone.

They have the idea that keeping up the image of perfection on the outside will give them the validation and praise they need to feel good on the inside. But what happens is that this positive acknowledgement is being poured into a leaky cup.

And it’s never enough.

And the very concept of relying on outside sources to fuel inner confidence becomes dangerous because then any perceived criticism or rejection becomes one hundred times more harmful.

And then they start to feel like they’re falling apart.

You CAN quiet your inner critic!

One of the first tasks we work on in my Mindfulness groups is showing participants how to recognize their self-judgments and inner critic. I use concrete and creative techniques to teach members how to recognize these judgements as a story they’ve been telling themselves that’s untrue and unhelpful.

Then, we work on practical skills to challenge these judgements and rewrite the story as a more accurate and empowered one to create confidence and improve self-esteem so that they leave the office feeling better about themselves than when they walked through the door.

And they’ve let someone see behind the mask and help them, which is critical to the healing process.

How can you begin to notice and shift judgments to improve self-esteem?

There are three steps to helping improve your confidence by practicing a non-judgemental stance:

Notice self-judgments. Gently point out to yourself that statement like “I’m a failure” or “I’m an imposter” is a judgment and not a fact. Perhaps ask yourself: “Is that true or is it a judgment?” Just notice it and let it go. Don’t judge yourself for judging – this is a natural thing and you are learning how to change it.

Encourage yourself to track judgments. In my Mindfulness groups, we use a “judgment jar” and move a marble into the jar anytime we notice ourselves or each other using a judgment. Invite yourself and perhaps even your loved ones to count or track judgments to recognize how much they are coming up for you during the day. The very act of noticing is promoting Mindfulness and will automatically help you shift from judgemental to more aware and compassionate.

Restate your judgments in a factual way. When you evaluate people, emotions, or things as good or bad, restate them as facts when you repeat them back to yourself. For example, if you say “She looked so ridiculous at work today,” you might rephrase this as “She had a different style than I do.” Describe what you see without placing opinions or emotions in the observations.

Learning to take a look at ourselves and tune into our inner critic and learning how to be non-judgemental CAN be hard. And it takes time to learn how to be self-compassionate.

Start practicing today and begin to build up your non-judgemental and self-compassionate muscles because they are SO worth it… and you will believe that too! It is one of the reasons we begin this skill so early in our Mindfulness groups!

P.S. Groups are an amazing way to lean how to express oursevles and understand that we are not alone. The Mindfulness Matters Group will run on Tuesdays from 5:30pm t0 6:30pm beginning on July 11th and running through September 26th.

If this group looks like a good fit for you, contact me for more details.

Curious what I can offer you to help build the life you love? Get in touch!

Get access to more valuable content weekly here!