I’ve recently been hearing more and more about an “epidemic” of anxiety in all segments of the population in the United States.  It makes sense, and is certainly reflected in my psychotherapy practice.  Anxiety, after all, is primarily about fear. Fear is rampant right now as we face great uncertainty about how we will bring everything back together to some semblance of normalcy after the pandemic.  Fear can also be contagious so its no wonder that many of us “pick up” on it through our friends and through the “news” and social media. The good news is that, although anxiety can be crippling, it is also very treatable. Its useful first, I think, to look at how anxiety manifests in our daily lives.  See if you recognize yourself, and then I’ll have some tips for self-treatment.

How does anxiety present itself?

A very common manifestation of anxiety is excessive “worry”. People “worry” about small things like weather they will like a new haircut, and they worry about big things like weather they will still have a job to support a family. A hallmark of worry is that it is often about things that have not even happened yet, so our minds go “crazy” imagining what “might” happen.  We “catastrophise about the worst possible outcome and convince ourselves that this “worst case scenario” will occur.

I’m describing Generalized Anxiety here.  

Anxiety is felt in the body

If you are a “worrier”, you will know that when we “worry” we experience a certain kind of “fluttering” in our heartbeat, or just a sick kind of nausea in our stomach.  Along with this, we may feel lightheaded and we may have “sweaty” palms. This is the body response to “perceived” danger.  The key here is “perceived”.  In reality, we are most likely not “in danger”, but our body thinks we are.

Anxiety can “ramp up” into a“panic” that does not subside. It can get worse

This happens when we begin to feel an “anxiety” attack coming on and we “freak out” with fear because we can’t “stop” it.  We actually make our panic worse by having “anxiety about our anxiety”…or “fear of the fear” if that makes sense

Anxiety can bring on specific fears…such as the fear of leaving home

I’ve noticed with the advent of “shelter in place” that some of my more generally “fearful” clients are now feeling unsafe about leaving home. I get it.  First we are told to “stay at home” and be safe.  Now we have to figure out when and under what circumstances it might be ok to mix and mingle and be social again.  Its not so easy .and sometimes it feels safer to stay at home. Fear of leaving home is a form of agoraphobia and there is an uptick of this of late.

So…what can we do about our anxiety?

Here are some steps to consider:

Become aware of and learn to accept that you have anxiety

Perhaps paradoxically, an impediment to getting relief from anxiety symptoms is to admit freely to yourself and others that you have difficulty with anxiety. This refers back to what I was saying about “anxiety about the anxiety”, so that when you “worry” about your anxiety you are adding another layer to the anxiety itself.  Instead try accepting that you are feeling some anxiety, and try to be curious about where it might come from.  Also, have compassion for yourself. Tell yourself its ok not to feel ok.

Try to alleviate the symptoms through deep breathing and progressive relaxation and meditation techniques

Anxiety is felt in the body, so part of the treatment needs to address the body’s stress response.  This can be done through the technique of progressive relaxation, as well as beginning a mindfulness meditation practice. YouTube is full of both of these “relaxation” techniques

Begin To Examine and question your thoughts for “cognitive distortions”

The best “evidence based” technique for changing the negative and catastrophic thoughts we think…(that is the thoughts that cause us anxiety)…is called cognitive behavioral therapy.  Many self-help books are available to help you look at your automatic negative thoughts, and find ways to replace negative thoughts with positive ones. 

Begin To do The things that you have been avoiding

Anxiety manifests often with a behavioral component, For example, if you are afraid of leaving home, you begin to restrict yourself to staying at or near home.  If you are afraid to be around people, you will start avoiding them.  You may find that even the thought of leaving home and socializing brings feelings of anxiety.  Guess what? The only answer is to “test out” your hypothesis that leaving home is dangerous, by actually taking a brief excursion outside your home. If you do this slowly and carefully, you can prove to yourself it’s perfectly safe.  This method is called “exposure” and it works well for specific fears.

I hope these tips have been helpful, and you can begin to tackle anxiety symptoms through your body (meditation and relaxation), your mind (changing negative thoughts) and your behavior (doing the “scary thing”)

It feels unreal somehow to realize that the “virus” has been upending our lives for an entire year. Rates of anxiety in the United States are sky high, and our children are facing a mental health crisis in a way that we have not seen before. We all realize, of course, that kids are having enormous difficulty socially and emotionally because they are not socializing “in person” at school. So…what can parents do to alleviate the stress? Here are a few tips:

1. Realize that going thru an entire year doing “online” schooling has been difficult for your kids. The more you can talk to your children about how they are feeling, and about how these feelings “make sense” the better. Talking about and “validating” a feeling is very important for all of us, so don’t underestimate the power of your presence and your soothing words.
2. Take a look at the relationship you have with your “significant other”, if you have one, and know that the “relational field” between the two of you affects everyone who lives in the house. Children in particular are very sensitive to “communication” issues that are happening between the adults they live with. With the pandemic, these issues are amplified, because kids literally can’t get away from their parents or guardians. Work on communication issues rather than letting them fester. Do your “couples work” privately though.
3. Not only can kids not get away from parental figures in their lives, but also parents are also not getting away from their kids. Being 24/7 with children can be very stressful for parents as well. With this in mind, try to schedule some “respite” time…if at all possible. Think of it as time to rest, refresh, and reset. It’s very important.
4. Last but not least, take heart. Things are changing rapidly, so look to the future and plan your vacation. We all need to have something to look forward to, so make sure that you put something together for your family. Just the activity of planning is healing and therapeutic, so solicit ideas and discuss them.

I hope these tips are useful to you as we navigate this difficult time together.

For most of us, negotiating our primary relationship is difficult in the best of times. If you are living together and raising a family for example, logistics can be challenging and division of labor is always an issue.

What about when you and your partner don’t agree in a “larger” sense? Maybe your politics and “world view” are in conflict. I’ve been hearing about these kinds of relational conflicts recently. Our world does feel more “polarized” now, and we are homebound and “stuck” with each other more than before. Stress is at very high level for many of us right now, and arguments may erupt more frequently.

What can be done to “calm” these relational waters ? Here are some tips:

1. Remember why you and your partner are together. Whenever possible remind each other of what drew you together in the first place. Revisiting your “origin”story can strengthen your bond
2. If you are finding yourself with strong feelings and a need to express them, arrange a time to have a respectful dialog with your partner. Acknowledge that this is not about who is “right” and who is “wrong”. Its about creating mutual understanding of another point of view.
3. When you have the dialog take the time to carefully listen to your partner. Your goal as the “listener” is to listen with curiosity and empathy. Instead of interrupting whenever you hear something you don’t agree with, ask more questions. The questions are meant to give the listener more “clarity” rather than to challenge what you hear. Make sure you each have time to both talk and listen.
4. When at all possible, find common ground in what you both believe. If you can find this common ground, it becomes a basis of a new level of understanding. Your opinions may not be as far apart as you think.

Our extended “shelter In Place” directive has put a lot of strain on relationships. In my therapy practice, for example, my clients tell me that their romantic relationships are going thru a “litmus test” of sorts. It seems that the forced “pressure cooker” of being around one person all the time leads to either “breaking up” or becoming closer. So, what’s the “secret sauce” during this stressful time?
How can we use the “gift” of this time to deepen and solidify our closest relationships?

Listening
I’d like to suggest that a key component to lasting and fulfilling relationships has to do with how well we are able to listen deeply and consistently to what is going on. By this I mean, what is going on emotionally within ourselves and within our partner. These two skills are equally important, but I believe listening attentively to yourself is an important place to start. Why is this?

Listening to yourself is essential to knowing how you feel, what you need, and how you can communicate these needs effectively to your partner.

When we are able to go within ourselves and accurately label our feelings, as well as accepting these feelings and being empathic with ourselves, we can then calmly go to our partner and ask them to “listen” to us….just listen. When another person takes the time to focus on us, and maybe even “reflect back” what they hear us saying we feel heard, acknowledged, and validated. The reflective feedback of a known and trusted person is truly an act of love. We all need this love and understanding right now, when life feels frightening, confusing, and overwhelming. If we have not taken the time to go within to try and understand ourselves first, we can overwhelm our partner, who may be “triggered” themselves by our anxiety. Or, our partner may feel they have to “problem solve” our anxiety…something they are not equipped to do.

What To Do Next Time

So, next time you feel overwhelmed by your feelings and desperate within your “bubble” to be heard and understood by your “bubble” partner, take some time to understand yourself first. Ask yourself: “What is it I’m feeling”? What is it that’s triggering me right now to feel this?” Can I be empathic with myself, and accepting of this feeling?” This exercise will help you build a bridge of understanding with your partner, which will, in turn, strengthen your relationship. The relationship will be further strengthened when you offer to your partner exactly what they have given to you. Successful relationships are a two way street after all.

The holidays approach. We are all coming to terms with what this means in this very unusual and difficult year. How many times do we hear from everyone around us and the culture at large that “it won’t be the same this year”? Of course it won’t. Most of us can’t be around friends and family physically the way we usually are at this time of the year. There is much to feel sad about, and there is also the worry about more sadness to come. In addition to this though, there is also hope. A multitude of feelings co-exist and all of them are a necessary part of the human experience. So how do we navigate the gravitational “pull” of despair that can sometimes accompany the losses we have already felt? How do we not feel “cheated” out of the weddings and graduations that didn’t happen or the visits with family members that only happen over video platforms? And now…the holidays?. It can feel overwhelming.

My suggestion may seem paradoxical. Simply put…allow yourself to feel the sadness Yes, it can be painful, but it is also true that” active acceptance” of sadness is part of the healing process that brings us to the other side. I was thinking recently about this very “American” idea that we all have the “right” to pursue happiness. I was realizing that although we may have that “right”, it does not follow that we should “expect” a constant state of “happiness”. In fact, if we were “happy” all the time, how would we even know what happiness is. We would have nothing to compare it to.
Here is what I think of this time in the country, and in the world. I believe it to be a time of looking inward, of slowing down, and of feeling feelings in real time. It can be a time of thinking deeply about who we are and where we are in our lives.

As far as relationships, the feeling of “missing” our loved ones is a sign of how deeply attached we are. That’s a good thing…surely something to celebrate and be grateful for. In my own case, my small family “bubble” will be the place for a few small and meaningful rituals, but I’ll go “all out” on the video chats. I’m thinking also that this is the time to go beyond my usual circle and reconnect with people from my past.

We don’t have the luxury right now of lots of physical touch, but we do have our words, so lets all reach out and touch with our genuine feelings, which includes of course our sadness and our longing for physical re-connection. Lets tell people how we feel and what they mean to us.

The “”sweet spot” will happen later when the world feels physically “safe” again. We will come back together and feel incredibly grateful for the touch that we used to take for granted as part of our everyday lives. It’s not time yet, but it’s coming. It brings to mind the saying “The darkest time is before the dawn”. Although it is still dark….I see the dawn on the horizon.

Why Relationships Matter
In uncertain times, when life feels unpredictable and chaotic we turn to our primary relationships to find security and stability. During these times we need to share our most vulnerable inner feelings with someone who cares about us, and can help us find a way forward. So, how can we fortify these relationships? How do we make our most important relationships work even better in difficult times? Here are some thoughts.

Be the “friend”, “lover”, or partner you want to find.
It may seem obvious, but it bears remembering that you generally “get back” what you are willing to “give” when it comes to your relationships. So, are you willing to “give” the love, acceptance, understanding, and compassion that you long for? If so, here are some tips to guide you.

Show appreciation for the people in your life…especially the ones you feel close to.

When we are stressed and preoccupied with difficult circumstances, it can be tempting to complain to others about how hard we have it. “Venting” can be cathartic, but remember to let people know how much you appreciate that they are listening, and offering support. This support is a “gift” which will be returned to you over and over again

Be Open and Honest and humble with people you care about.
Sharing your thoughts, feelings, and opinions with others can be very powerful, especially if you allow yourself to be imperfect and vulnerable. This show of vulnerability paves the way for deeper and more meaningful relationships based on trust. The message is “I am not perfect, and I don’t expect you to be either. “We both have permission to be exactly who we are.

Forgive the small stuff
Related to accepting people for their “flawed” selves, is the concept of forgiveness. No one gets it right every time, so let the small stuff go. Forgive, and you too will be forgiven.

One last thought…be patient with yourself and your partner. Life is always changing…and this too shall pass

Yesterday I took a stroll through the campus at UC Berkeley. As my “alma mater” this place holds many memories of long ago. This day the air was clear and the campus was virtually deserted due to Covid, so the experience of being there was particularly vivid. As I walked along, feeling blessed by the warmth of the sun and the intermittent sound of birds , my walk became a meditation. With no conscious effort at all, memories flooded me each time I passed a familiar building, or a natural landmark. I was not in any hurry, so I found myself savoring each memory, and in fact re-creating the exact feeling I had experienced a full fifty years ago. Our memories are remarkable that way…just allow the space and the “trigger” of a smell, a sound, or a visual “cue” will bring it all back..

The trick though, as I soon discovered, is that you must be open to all the feelings that rise up when you give them permission to appear. The humiliation I felt after getting back a “D” on an English essay, exists side by side the euphoria of a first “kiss” on that patch of grass near Sproul Hall. You must welcome all the feelings, or none at all. That’s how it works.

As I worked my way back to my car, I began to realize that, at the very core of my being I am in fact the very same person. Yes, I’m older, wiser, more secure in many ways, but the essence of me has been carried forward through all the ups and downs of my life. It’s reassuring to know that there actually is an unshakable core that is me.

When I got back home and checked in with all my “news” sources, I found myself to be fortified with a new kind of reassurance about my own ability to weather uncertainty. Yes, life is unfolding unpredictably right now. I make plans and then have to change plans.. Disappointments abound…for everybody.

My suggestion is to take time to go within. Set aside devices that bombard you with “noise” and rediscover who you are and have always been. If you can find a “place” that holds memories…go there and invite them in. Or…reconnect with old friends, or favorite books. Do whatever it takes to remind yourself of who you are, so you can move forward.

For a number of years after my mother died I found myself dreading the winter holiday season. When I was growing up, the “Christmas” season at my house was always a big deal so I had many warm and nurturing memories of that time of year. Then when my mother was gone , my instinct was to avoid all reminders of the season…including all the festive decorations and allusions to “The most wonderful time of the year” I wanted to escape and go “numb” Unfortunately, “going numb” was exactly what happened. I discovered that when I shut down feelings of grief and loss, I also shut down the possibility of feeling anything at all. I began to feel empty and lonely. Eventually I dealt with my grief, and I “reimagined” the holiday season.

As the holidays approach in the time of Covid, I’m discovering that I have similar feelings of wanting to escape…to just “go away”. I’m aware that these holidays will not be the same. There will likely be no large gatherings of friends and family, and no physical contact.

This time though, I’m making a different decision about how to handle my emotional life. I’m naming the grief and I’m feeling the grief. All feelings are allowed and acknowledged as I make plans for Zoom get togethers and “socially” distanced events. I’m gathering together and sharing pictures and memories of holiday parties from the past. Now I’m sharing my feelings and finding great comfort in the reality that I am not alone. In these uncertain times in particular…none of us are alone.

So, here is the interesting thing I’ve discovered once again. Its not the “feelings” themselves that are unbearable. Its actually the “fear” of feeling the feelings that create an anxiety that is unendingly unbearable. This is because anxiety feeds on itself…especially when feelings are repressed and avoided.

So…I invite you to welcome your feelings. Write them down, or allow them to arise in meditation. Most importantly, share them. As I discovered, escaping feelings through self- isolation never works.
The expression “what is shareable, is bearable” was never more true than it is today

The workshop series is co-led by Health and Life coach Jeanette Shaub, and therapeutic relationship coach Leslie Kays.

If you are finding yourself overwhelmed lately as you navigate finding your “ new normal” during the pandemic, this workshop series is for you.

During the course of the series, Leslie and Jeanette will be offering specific tools for handling anxiety and the stress that often manifests in our bodies.

We will also be offering specific communication tools that can be used to facilitate effective authentic communication between you and your family members, friends, and co-workers during a time when everyone is stressed.

You will come away with a renewed sense of confidence, armed with new skills that we will have practiced in the group.

Jeanette and Leslie envision the workshop series as supportive, lively,and interactive . Please join us!

Zoom meetings
Aug 13, Aug 20, Aug 27, Sept 10
Time.. 11:30- 1pm

Please email lkaysmft@gmail.com for more info and the Zoom link
Workshop attendees will be offered opportunities to work with either Leslie Kays or Jeanette Shaub at a discounted rate If they should so choose at the completion of the series.

Why Relationships Are Important To Your Health

The latest AARP bulletin identifies  “loneliness” as a growing epidemic among our elder population.   During the holidays, when the emphasis is put so squarely on connecting with family and friends, its important to remember that not all of us are spending time in the safe and warm cocoon of these vital connections.  Research on physical and emotional “well being” and longevity strongly points to the importance of human relationships as the glue that holds us all together. This “glue” refers to our friendships, our families, and our most intimate romantic connections. Simply put…humans are “social” creatures from cradle to grave.  When we are deprived of close physical and emotional relationships, the body begins to shut down and there is a “failure to thrive” that is evident at a cellular level in humans.  Our immune systems are compromised and we may succumb to opportunistic infections and maladies. 

What Can Be Done To Combat Isolation in Others and Ourselves?

1. The first step is just simple awareness of feeling “alone” and isolated.  The definition of “loneliness” does not necessarily mean that you are always lonely when you are alone. The subjective “feeling” of loneliness is much more about feeling disconnected and misunderstood even when you are physically connected to another person. We are familiar with the concept of a “lonely” marriage for example.

• If you find yourself consistently lonely weather or not you have people around you…start researching groups or locations where you might find like-minded people.  It could be anything…doesn’t matter.  If you’re finding it difficult to find your “tribe”…it might be because you have not spent enough time building a relationship with yourself.  Who are you? What do you like? What kinds of activities bring you joy and fulfillment? Begin slowly conversing with people as you engage in activities.  It gets easier and easier.

•  Are there people from your past who you’ve lost touch with?  If so.. Spend some time rediscovering them.  In the process. You will rediscover yourself.

•  Last but not least…offer yourself up as a volunteer with others who are lonely.  Volunteer in a Senior Center or Assisted care facility.  You will find it enormously rewarding.

Just remember…its never too late to nurture an active and fulfilling social life.  You won’t regret it!