The Case for a Value-Driven Life

By Lauren Helm, M.A.

“Values are what you want your life to be about, deep in your heart. What you want to stand for. What you want to do with your time on this planet. What ultimately matters to you in the big picture. What you would like to be remembered for by the people you love.” – Dr. Russ Harris

What guides you in deciding how to act from moment-to-moment, and day-to-day?  When you come to a fork in the road, how do you decide which direction to go?

Many of us may be unaware of the processes that underlie our daily actions and the forces that shape how and why we make the decisions that we do. Often we may just go through the motions, paying little attention to what we are doing and what is happening around us. We go through the routines:  get up in the morning, have breakfast, brush teeth,  go to work, come home, make dinner, go to sleep…and repeat. Sometimes we may reflect on the day and wonder where our time went, feeling almost as though we were not really there. Have you ever driven somewhere, only to realize once you’ve arrived that you barely remember driving at all? It can be as though we were merely on automatic-pilot, with little attention devoted to “steering” ourselves throughout our lives.

And yet, there are times when life really DEMANDS our attention; when it quite literally forces us to focus on the issue at hand. Life is full of flux and change; there are sorrows and pain, joys and celebration. What then? How do you decide how to respond?

When we have little conscious awareness of who we are and who we want to be, we can act quite haphazardly. Automatic-pilot does not necessarily turn off.  If something stressful or threatening happens, we may react reflexively. Perhaps a loved-one makes a comment that rubs us the wrong way, and we lash out. Maybe we have been assigned an important project, and the deadline looms in the near-future, but we automatically procrastinate and avoid thinking or doing anything about it until the last minute because it is anxiety-provoking.

In a sense, automatic or reflexive behaviors can be thought of as “mindless.” There is little conscious or intentional thought behind them. They are like habitual ways of responding to life. However, not only does a “mindless” approach not create the fullness of life that many people desire, it also can get us into trouble when challenging situations arise. For example, most of the time we automatically avoid uncomfortable or painful situations. It makes sense that human beings would avoid pain. Avoidance of pain or threat has allowed us to survive as a species –  avoidance of tigers and bears kept us alive. However, in our modern age, we rarely, if ever, encounter predators that threaten our survival. Threat and discomfort tends to show up for us in our jobs, relationships, traffic, social activities, etc. What if “mindless” avoidance of discomfort costs you a sense of meaning in life? What if it interferes with or prevents you from engaging in activities or life experiences that are deeply rewarding to you, albeit challenging or difficult at times?

If this has been your experience, it may be time to pause and clarify your values. Your values help define who you want to be in each moment. What you value is what gives your life meaning. When we are disconnected from our values, we can go through life somewhat aimlessly and “mindlessly.” But when we take the time to learn about what is really important to us, we can give ourselves a great gift. By knowing your values, you can begin to craft your day-to-day experience in a much more conscious, intentional way. In a way, it can be a creative process. You get to decide during each metaphorical fork in the road, who you want to be and what you want your life to be about.

“What if what was at stake is a kind of self-liberation -- the liberation to be about what you most deeply would choose to be about--- not to avoid guilt, or get applause, or otherwise objectify yourself but just to be in the world how you choose to be in the world.” - Dr. Steven Hayes, co-developer of Acceptance and Commitment Therapy

Dr. Jill Stoddard likes to ask, “What is this in the service of?” This is an exceptionally helpful question to ask yourself during the mundane activities of life, and during the momentous ones. Is what you are doing serving to avoid discomfort? Or is what you are choosing to do serving you in living a valued-life? The practical nature of identifying your values is that you can begin to create action-plans and goals that line up with your values, instead of goals that purely focus on fending off the pain that inevitably is a part of life. The fact is, pain IS a part of life, and so is joy. Life is a myriad of experiences. We can live meaningful lives when things go smoothly, and even when life feels like a bumpy ride. It is up to us, however, to decide if we want to consciously respond to life and take back the steering wheel. We can begin with our values. Who do you want to be today?

If you'd like to speak with a professional at the Center for Stress and Anxiety Management about clarifying your values and living a more meaningful life, please click here.

Check out these free resources on values and related topics: 

http://media.psychologytools.org/Worksheets/English/Values.pdf

http://www.thehappinesstrap.com/upimages/the_complete_happiness_trap_worksheets.pdf.pdf

http://www.thehappinesstrap.com/free_resources

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References

Harris, R. (2007). The happiness trap: Stop struggling, start living. Exisle Publishing.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

Tags: acceptance and commitment therapy, ACT, Center for Stress and Anxiety Management, values, steven hayes, CSAM, meaning, fulfillment, mindful, pain, life, Russ Harris, personal values, mindless, avoidance, automatic pilot

Unified Protocol: Cutting Edge Treatment (2 of 2)

by Lucas Myers

Today, we continue our introduction to a powerful new therapeutic treatment for depression and anxiety disorders... ALL of the anxiety disorders.

One of Dr. Michelle Lopez's clients was astounded to learn that the very techniques she was using to reduce her anxiety in the moment were actually increasing her anxiety in the long term, making it even more difficult to manage. Her initial reaction “This is so counterintuitive!” was soon forgotten as the multiple anxiety disorders including generalized anxiety, panic disorder, and PTSD that she had been living with for years began to lose their grip on her life.

So how does the UP work? There are a number of skills that a client learns from the therapist that cumulatively comprise treatment. The client will learn to record experiences, set goals and maintain motivation, understand emotions, recognize and track emotional responses, observe emotions and reactions to these emotions, understand how thoughts influence feelings, understand the connection between behavior and emotions, learn to identify and change unhelpful patterns of avoidance, and recognize and master physical sensations. Although this might sound like a lot, the truth is that these skills are all interrelated and as therapy goes on, the client learns to combine new skills in order to face unpleasant emotions in the context in which they arise.

Emotions are responses to our thoughts and environment that motivate us to behave in certain ways. These emotion driven behaviors are adaptive in both nature and function, but can sometimes develop in harmful ways. During therapy, patterns of context, behavior, and consequences are identified. As the therapist and client work together to understand how uncomfortable emotions arise, reactions to these emotions can be replaced with more healthy and adaptive responses.

Next, client and therapist work on building motivation for change. As motivation increases, an increased sense of self-efficacy leads to empowerment and the client is ready to practice non-judgmental emotional awareness, learning to focus on the here and now and observe both the emotion and the reaction which follows it. This increased awareness allows a critical evaluation of the emotionally loaded beliefs and assumptions that lead to problematic behavior. This leads to more flexible thinking and sets the stage for breaking the negative pattern of distress. The client is now ready to actively start countering the maladaptive emotionally driven behaviors. After polishing skills to overcome harmful patterns of behavior, the therapist will prepare the client to start testing and practicing these skills by gradually exposing the patient to stressful situations that evoke distress. In the final stage of treatment, the client and therapist review all the new skills that they have learned and practiced, discuss continuing challenges, and put in place plans to maintain treatment gains.

For many clients, the end of this 12-16 week treatment program is just the beginning of change experienced as a result of the UP. Consistent with scientific research on the UP, Dr. Lopez's clients report that they continue to improve well after they completed treatment.

How can the UP be effective in treating so many conditions? The genius of the UP is that every step is designed to be flexible. An expert therapist like Dr. Lopez can emphasize specific skills to tailor the treatment to every individual client, situation, and range of symptoms. Likewise, the UP targets the shared aspects of emotional disorders, making it effective across anxiety and mood disorders.

The UP can be used as a preventative treatment for those more susceptible (i.e., family history of anxiety or depression) as well as for those with mild, moderate, or severe symptoms of anxiety who have postponed seeking treatment. The point is that it’s never too early or too late to learn the skills necessary to overcome anxiety and/or depression.

Remember, if you or someone you know suffers from an anxiety disorder, such as social anxiety, panic, agoraphobia, generalized anxiety, PTSD, OCD, or depression, professional support is available. If you are in the San Diego area and you would like to speak with Dr. Lopez, or one of our other qualified therapists, you may contact the Center for Stress and Anxiety Management at 858-354-4077 or csamsandiego@gmail.com. To learn more about Dr. Lopez, read her bio in the “About Us” section. To see a list of other mental health conditions that we specialize in, click here.

Want more? Subscribe to the CSAM RSS Feed, and follow us on Facebook or Twitter (@CSAMSanDiego) so you don't miss articles on other hot topics such as stress, anxiety, depression, phobias, OCD, PTSD, and more.

Tags: PTSD, San Diego, depression, anxiety disorders, OCD, agoraphobia, social anxiety, panic, generalized anxiety

Unified Protocol: Cutting Edge Treatment (1 of 2)

The can't-miss treatment from psychology's cutting edge (Part 1 of 2) 

by Lucas Myers

Many sources of emotional suffering, such as social anxiety, panic, agoraphobia, generalized anxiety, PTSD, OCD, or depression share common characteristics. One of the challenges of treating psychological distress is quickly diagnosing and effectively treating the patient. Stories abound of friends and family members who found a therapist or doctor with a good reputation but later found that they were misdiagnosed, incorrectly treated, or in the worst of cases, even harmed by a well intentioned but inappropriate approach to care. In an environment where even trained professionals can occasionally be wrong, what chance does the average patient have of finding solutions? No amount of library research, WebMD, or advice from friends and family is likely to yield reliable answers.

Doctors, patients, and healthcare organizations all benefit from ensuring that the most effective care is available for any given problem. In order to ensure that patients are receiving the highest quality care, many professional organizations are now recommending that psychotherapy be evidence based. In other words, the treatments being used should have research backing their efficacy. One such treatment is the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Barlow et. al., 2011).

The UP is a structured, skill-based treatment that works by targeting anxiety and mood disorders simultaneously. This includes all of the anxiety disorders and depression: social anxiety, panic, agoraphobia, generalized anxiety, PTSD, and OCD. Incorporating only the latest and most effective methods of treatment, the UP represents the highest standard of evidence based practice.

Powerful and intense feelings like fear, anxiety, panic and depression can be so uncomfortable they get in the way of daily living, compelling a person to avoid activities or turn to destructive tactics (e.g., drug or alcohol abuse) in the pursuit of relief. Life can feel out of control as unwanted emotions disrupt work, relationships, important events, goals and plans. These symptoms can feel as though they increasingly draw focus away from the things that make life happy and meaningful. The UP is designed to apply to all emotional disorders, even if the symptoms aren’t easily categorized or more than one disorder is present. One of the goals of the UP is to provide the skills necessary to help clients learn to confront their emotions and respond in adaptive ways. With this increased ability to manage emotional reactions, stressful thoughts and situations lose their power and patients are able to stop avoiding and start living.

As one of the first to be trained and certified in this cutting edge therapeutic method, Dr. Michelle Lopez is becoming established as one of the foremost practitioners of the UP in the Southwestern United States:

“Obtaining certification in the UP has been a turning point in my career as a clinician. I feel privileged to help my clients master skills that go beyond coping effectively with anxiety and depression. The UP is really a set of life skills that can bring new balance and meaning to many life events.”

All of the conditions that can be treated by the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders follow a pattern. Some people are born more vulnerable to developing an emotional disorder. When these people are exposed to highly stressful, unpredictable life events they may struggle to manage their feelings . Over time overwhelming thoughts, feelings, and images can become the new “normal.” Sometimes failure to learn to cope with unpleasant feelings results in attempts to avoid, control, or suppress emotions, leading these very feelings to remain and even intensify. The UP responds to these overwhelming emotions and avoidant responses by helping the person in treatment to identify reactions to stress that are not helping and replacing them with coping skills that work.

Want more? Subscribe to the CSAM RSS Feed, and follow us on Facebook or Twitter (@CSAMSanDiego) so you don't miss Part 2 and articles on other hot topics such as stress, anxiety, depression, phobias, OCD, PTSD, and more.

Remember, if you or someone you know suffers from an anxiety disorder, such as social anxiety, panic, agoraphobia, generalized anxiety, PTSD, OCD, or depression, professional support is available. If you are in the San Diego area and you would like to speak with Dr. Lopez, or one of our other qualified therapists, you may contact the Center for Stress and Anxiety Management at 858-354-4077 or csamsandiego@gmail.com. To learn more about Dr. Lopez, read her bio in the “About Us” section. To see a list of other mental health conditions that we specialize in, click here.

References

Barlow, D.H., Ellard, K.K., Fairholme, C.P., Farchione, T.J., Boisseau, C.L. Allen, L.B. & Ehrenreich-May, J. (2011). The unified protocol for transdiagnostic treatment of emotional disorders: Client workbook. New York, NY: Oxford University Press.

Tags: PTSD, San Diego, depression, anxiety disorders, OCD, agoraphobia, social anxiety, panic, generalized anxiety

Blue Christmas? 10 Tips to Fight Low Mood Over the Holidays

by Lucas Myers

The holidays are a particularly difficult time of year for many people. The stress and pressures that surround the season can cause a spike in anxiety, stress, and low mood that can be difficult to manage alone. In order to protect yourself from becoming overwhelmed, find ways to reach out and reconnect with those who care and will help. It can be more important than ever to have a strong network of friends and family to turn to in these times. Feeling down, stressed, or anxious  can make it really difficult to reach out for help. However, isolation and loneliness lower mood even more, so making time for social activities and maintaining close relationships is very important. To get started here are 10 Tips for Building Supportive Relationships.

1. Call or email an old friend. You might be surprised to discover who has been waiting to hear from you.
2. Talk to one person about your feelings. Your trust can strengthen your relationship.
3. Have lunch or coffee with a friend. Even if you keep it light, sharing time will keep connection.
4. Ask a loved one to check in with you regularly. He or she will appreciate having you reach out.
5. Help someone else by volunteering. Everyone needs help sometimes; there's no better way to feel good about yourself than to help someone else.
6. Go for a walk with a workout buddy. Talking is optional, exercise is always quality time.
7. Meet new people with common interests by taking a class or joining a club.  www.meetup.com is a great way to find people with similar interests.
8. Schedule a weekly or monthly dinner. Take turns picking restaurants or preparing the meal. This can become a tradition everyone involved looks forward to.
9. Invite a buddy to the movies, a concert, or a small get together. Fun activities are a great way to connect.
10. Confide in a counselor, therapist, or clergy member. They are good listeners and are invested in helping you to overcome life's challenges.

Lifting the weight of a heavy or anxious mood and keeping it away can be greatly impacted by getting the support that you need. Connecting with others can help to maintain perspective and reinforce your efforts. If you are suffering, the thought of reaching out to even your closest friends and family members may seem overwhelming. You may feel too exhausted to talk, ashamed, or even guilty for neglecting the relationship. This is your mood talking. Remind yourself that you are not the only person to feel this way. If you saw someone you care about suffering, you would want to help. In the same way, your loved ones care about you and want to help.

Even small steps toward recovery will add up quickly. For all the energy you put into your relationships, you'll get back much more in return. Here are some final suggestions to leverage your relationships and social activities as a weapon in the fight against emotional suffering:

Even if you don't feel like it, try to keep up with social activities. When you're down or overwhelmed, it often feels easiest to retreat into your shell. It is important to remind yourself that being around other people will make you feel better.

Turn to family members and trusted friends. Share what you are going through with the people in your life that you love and trust the most. Allow yourself to accept their help and support. You may find that you have retreated from your most treasured relationships – it is these relationships that you should turn to now to get you through tough times.

Join a support group. The company of others  can go a long way toward decreasing feelings of isolation. You can offer one another advice on coping, share your experiences, and provide encouragement. The National Alliance on Mental Illness is a good resource for finding a support group in your area.

If your feelings of low mood, stress, or depression begin to interfere with your normal functioning and persist for an extended period, you might want to consider reaching out for professional help. If you would like to speak with a professional at The Center for Stress and Anxiety Management, you may contact us at 858-354-4077 or csamsandiego@gmail.com. To see a list of other mental health conditions that we specialize in, click here.

Tags: cognitive behavioral thearpy, CBT, treatment, stress and anxiety in san diego, Cognitive Behavioral Therapy, CBT San Diego, therapy for depression in elders, psychotherapy,Christmas stress, Hanukkah stress, depression, therapy in san diego, Mindfulness, stress, low mood, holiday blues

10 Tips to Stop Sleep Anxiety: More Rest, Less Stress (Part 3 of 3)

by Lucas Myers

With people juggling work, school, friends, families, and the 1,001 other things we've got to do everyday, Americans are not getting enough sleep. This week we continue our 3 part series 10 Tips to Stop Sleep Anxiety: More Rest, Less Stress.

Tips 8-10:

8. Don't cheat

Although a quick powernap can be a great way to boost energy during the day, don't over do it. Limit daytime naps to 10-30 minutes at the most. Naps that go on any longer can interfere with your nighttime sleep. This is especially important to those who suffer from insomnia or poor nighttime sleep quality.

9. Stay active

Incorporating physical activity into your regular routine promotes better sleep. Those who are active tend to fall asleep faster and to sleep more deeply. Be careful when you choose to exercise though – some people notice that exercising too close to bedtime can cause them to feel too energized to relax. A stretching routine is relaxing for some. Note how exercise affects your body and plan accordingly.

10. Master your stress

As we discussed earlier, too many demands on your time and thoughts can make sleep difficult. Learn healthy ways to manage your stress. One good one is to make time to get organized, arrange priorities, delegate tasks, and focus on managing time effectively so you don't get overwhelmed. Remember, it's ok to take breaks. Make time for a hobby you enjoy, or spend time with someone you care about. If you have trouble slowing your thoughts at bedtime, jot down whatever is on your mind so you can relax knowing that it can be addressed in the morning. If anything in the environment is triggering stress, such as looking at a bedroom clock and fretting about how many hours are left before morning be sure to remove it from sight.

REMEMBER: Having an occasional sleepless night is normal, but if you are experiencing a pattern of restless or sleepless nights, don't hesitate to seek an expert, especially if lack of sleep is beginning to interfere with your normal daytime functioning. Contact your doctor to determine whether physical causes may be contributing to sleep problems. If your physical health is sound, contact a psychologist with experience treating sleep problems. Cognitive behavioral therapy and other evidence-based treatments are highly effective for improving sleep. If you are in the San Diego area and you would like to speak with one of our other qualified therapists, you may contact the Center for Stress and Anxiety Management at 858-354-4077 or csamsandiego@gmail.com.

Want more tips? Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego) so you don't miss Parts 2 and 3 of our 10 Tips to Improve Your Sleep and articles on other hot topics such as stress, anxiety, depression, OCD, PTSD, and more.

References

Dement, William C; Vaughan, Christopher (1999). The promise of sleep: a pioneer in sleep medicine explores the vital connection between health, happiness, and a good night's sleep. New York: Delacorte Press. ISBN 0-385-32008-6.

Dement, WC (2005). "Sleep extension: getting as much extra sleep as possible". Clinics in Sports Medicine 24 (2): 251–268, viii. doi:10.1016/j.csm.2004.12.014. PMID 15892922.

Kryger, Meir H; Roth, Thomas; Dement, William C (2011). Principles and practice of sleep medicine (5th ed.). Philadelphia, PA: Saunders/Elsevier. ISBN 978-1-4160-6645-3.

Sleep Tips: Seven steps for better sleep. Mayo Clinic Staff. Retreived on November 25th, 2013 from: http://www.mayoclinic.com/health/sleep/HQ01387

10 Tips to Stop Sleep Anxiety: More Rest, Less Stress (Part 2 of 3)

by Lucas Myers

With people juggling work, school, friends, families, and the 1,001 other things we've got to do everyday, Americans are not getting enough sleep. This week we continue our 3 part series 10 Tips to Stop Sleep Anxiety: More Rest, Less Stress.

4. Practice good habits

Having the same bedtime ritual night after night teaches your body when to expect sleep and eases the transition into a drowsy, bed-ready state. Bright lights, especially those from TV's computers and other electronics promote alertness, so try to avoid them before bedtime. Instead, try reading a book, taking a soothing bath or shower, listening to relaxing music and dimming the lights as you get ready for bed.

5. Eliminate distractions

The bedroom should be your sanctuary for sleep, so avoid watching TV in bed, bringing the laptop to bed, or engaging in any other activities. You want your mind to associate this setting with relaxation and rest rather than stimulating daytime activities. Consider setting limits on children or pets sleeping in your bed with you.

6. Get comfortable

Find bedding that feels comfortable to you. If you share your bed, make sure it is large enough for both of you to sleep comfortably. Most mattresses last 9-10 years; make sure to replace them when they exceed their life expectancy because a good mattress should be comfortable and supportive. Your pillow should support your head without straining your neck. Make sure your bedding is allergen free.

7. Set the mood

Dark curtains can help prevent light from inadvertently resetting your internal clock. Even the tiny light from an alarm clock can be disruptive so seek ways of limiting light pollution. Even small noises can interrupt sleep. Earplugs are helpful for some. A fan, or a free white noise app on your phone can help cover the sounds of noisy neighbors, car alarms, traffic and other disruptive nighttime noises. To keep your bedroom from becoming too hot or dry for comfort consider a fan, air conditioner, or humidifier.

REMEMBER: Having an occasional sleepless night is normal, but if you are experiencing a pattern of restless or sleepless nights, don't hesitate to seek an expert, especially if lack of sleep is beginning to interfere with your normal daytime functioning. Contact your doctor to determine whether physical causes may be contributing to sleep problems. If your physical health is sound, contact a psychologist with experience treating sleep problems. Cognitive behavioral therapy and other evidence-based treatments are highly effective for improving sleep. If you are in the San Diego area and you would like to speak with one of our other qualified therapists, you may contact the Center for Stress and Anxiety Management at 858-354-4077 or csamsandiego@gmail.com.

Want more tips? Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego) so you don't miss Parts 2 and 3 of our 10 Tips to Improve Your Sleep and articles on other hot topics such as stress, anxiety, depression, OCD, PTSD, and more. 

References

Dement, William C; Vaughan, Christopher (1999). The promise of sleep: a pioneer in sleep medicine explores the vital connection between health, happiness, and a good night's sleep. New York: Delacorte Press. ISBN 0-385-32008-6.

Dement, WC (2005). "Sleep extension: getting as much extra sleep as possible". Clinics in Sports Medicine 24 (2): 251–268, viii. doi:10.1016/j.csm.2004.12.014. PMID 15892922.

Kryger, Meir H; Roth, Thomas; Dement, William C (2011). Principles and practice of sleep medicine (5th ed.). Philadelphia, PA: Saunders/Elsevier. ISBN 978-1-4160-6645-3.

Sleep Tips: Seven steps for better sleep. Mayo Clinic Staff. Retreived on November 25th, 2013 from: http://www.mayoclinic.com/health/sleep/HQ01387

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