COVID-19: Teletherapy & Resources

As a result of the COVID-19 virus, PCS is now providing teletherapy by phone or video for individuals, couples, and families. We want to continue supporting our current Arizona clients and welcome new clients who are looking for a safe alternative to in person therapy.
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Affirmation

“This is my day and I am not going to let anyone or anything take away this day of expression, love and celebration-not another person, experience or thought – I will have a beautiful wonderful day”

Often times I have wondered why some addicts who have struggled for so long have been able to establish long term sobriety while others have not. I have been working 12 step recovery long enough to be surprised by those who can create consistent sober living and those who have not. What I believe is that there are certain habitual skillsets that must be mastered in order for the recovery foundation constructed to produce long term consistency.

These skillsets are practices that demand daily training. I have discovered that at time this training can become a grind. Yet, it is invaluable toward building long term positive results. One of those skillsets is the practice of affirmations. It is my belief that long term sobriety requires a commitment to practice regular affirmations. It becomes like routine bathing or brushing your teeth. Some days just flow while other days are horrific.

What provides stability is the practice of affirmations. There are times I wake up feeling “shaky tender”. I need to steady myself, so I go to my affirmations. On difficult days, I read them out loud. At times, I will place pillows on the floor- stand on them and repeat the affirmations out loud. When that is not enough, I will ask my partner to stand in front of me as I go from pillow to pillow verbally repeating the affirmations. When that doesn’t work I call support people and repeat the affirmation over the phone, asking them to simply agree with me.

Some days and even weeks are a battle. Yet, I have discovered that long term sobriety requires that I forge a belief system that counters the negative chatterbox that relentlessly spews lies about who I am and what I cannot do. Slowly, over time I have begun to change the way I see myself and empower the possibility of ongoing long term sobriety, I do this simply by the practice of affirmations. No one can rob me of the way I choose to think which empowers the positive choices I make toward long term sobriety.

Dare to Be Average

Aaron Rodgers, the revered Green Bay Packers’ quarterback once commented “I’ve been to the bottom and been to the top, and peace will come from somewhere else”. Many people measure their sense of brilliance in terms of outward results and how they measure up to others. As a result, it is common for many to be as fearful of the word average as they are of the word failure. Even though there are more people who are average than any other categorical description. Taylor Swift, America singer-songwriter shared that she was intimidated by the idea of being average. In truth, the word average touches the lives of everybody.

What would you say if someone told you it’s better to be average than to push for perfection? Dare to Be Average- Finding Brilliance in the Common Place is an attempt to help folk transform everyday common place experience into opportunities to find and cultivate their own brilliance. It has been my awareness that common place occurrences in life can be transformed into healing, peace and self-acceptance and can bring you back to your center. Besides seeing the beauty and meaningfulness of average, this book will challenge you to discover than within every day experience- you are enough!

If you are ready to at least look at what it means to be average, you’ll have the opportunity to discover what it has done for me and my clients, and what it could do for you.

Dare to be Average can be a life changing book if you are willing to explore the beauty of being average. You can benefit reading this book in the following ways:

1. Can help you to find meaningfulness and brilliance in the common place of everyday interaction

2. Can show you how to find purpose, focus and acceptance of human limitation.

3. Can introduce you to revolutionary techniques to experience physical and emotional pain in a healthy way in order to find a new approach to life.

Dare to be average is as paradoxical as it is to embrace Velvet Steel. Personal growth and long term recovery engages these two concepts that seem counterintuitive. Hope you enjoy the read. You can purchase Dare to be Average from Amazon. Happy New Year.

Who Is The Alpha Dog Of Your Life?

People who struggle with attachment issues, addiction, trauma and mood disorders may have a difficult time with a true sense of self. This may be due to growing up in a family of origin where, for various reasons, there wasn’t room to explore identity, process feelings and thoughts or share one’s experiences with others. Trauma, whether in childhood or adulthood can also diminish a person’s sense of self. Trauma can shatter the ego, reinforce the idea that the world is not safe and leave the individual isolated from community. The struggle to reconstitute a shattered ego can be overwhelming.

In addition, depression and anxiety are often fueled by the tension we feel between what we value at our core versus how we behave on the outside in order to please others. If I don’t have a true sense of self, I am not the “alpha dog” of my life. An alpha dog knows who he/she is in the pack and everyone in the pack has an understanding of the alpha dog. In this metaphor, the alpha dog is not a bully or trying to one up anyone else. This dog just knows who he/she is and isn’t afraid to share it.

“I don’t know who I am or what I want or need in my life.” This is a common refrain that adult clients share on a regular basis.

The job of a functional adult is to teach people who we are, but when we aren’t sure who we are it creates a void in relationships. Even if we have a sense of self, we might find ourselves keeping secrets or lying out of an inherent fear that, “If I told you who I really am, you might not like me.” We might feel anxious about abandonment and go along to get along.

When I was an undergrad at the University of Michigan I lived with a brilliant woman who seemed to change her major based on who she dated. One semester she was pre-law, the next semester she was a math major, then an engineering student. She changed her interest and possibly career choices just to stay in relationship to her boyfriend(s) and his interests. She was a “tofu girl” and took on the taste of whatever was in “boyfriend pot.” Sadly, I am not sure if she ever graduated but she probably had enough credits for a PhD. She abandoned herself in order to overcome her fear of being abandoned by others.

The old saying that nature abhors a vacuum is true when it comes to one’s identity. If I am unable to teach you who I am based on what I value; sharing my wants and needs and ultimately setting functional boundaries to get them met, I can appear to be a metaphorical blank slate to others. As a result, the people we are in relationship with may begin to tell us who we are and how we should operate in life. In effect, because we are not our own alpha dog, they become the alpha dogs of our life. They make assumptions about what we think and feel because we do not express what we think and feel – at least not with authenticity. Eventually, we can become resentful of people telling us who they think we are. If we hang out in resentment we may eventually develop shame and guilt which is a perfect environment for us to act out in order to get our needs met. We often numb our true feelings and thoughts through compulsive/addictive behaviors. This can take the form of substance addiction, sex addiction, gambling, shopping, eating, working, emotional dysregulation regulation, etc. This numbing behavior keeps us even further away from our values, wants/needs and functional boundaries.

How to become your own alpha dog? There are a series of steps that can help in developing a healthy sense of identity.

1. Values clarification

We all have an internal set of values. These develop in childhood and are taught in the family, schools, church, culture, etc. Everyone’s values differ somewhat based on experience. As we age we may find that some values no longer fit and we may discard them while others seem to resonate more with us. A knowledgeable therapist can work alongside a client to define the client’s values – what is important to you? What do you stand for? How do you want to be remembered? An example, Sara values emotional stability. It is important for her to have a sense of well-being, emotional regulation/tolerance and resiliency in her life and relationships.

2. Needs and wants defined

Once a client has a sense of what they truly value, the real work begins. For example, if emotional stability is a core value, what does Sara need and want to support that value? Sara knows 7-8 hours of sleep each night plays an important role in her ability to keep her emotions in check, support her self-confidence and interact with others in a functional way. Her need/want is 7-8 hours of sleep each night.

3. Boundaries

Sara has identified here value of emotional stability. She knows an important part of supporting this value is to get a good night’s sleep and she needs/wants at least 7-8 hours in order to support her value of emotional stability. In order to honor her value of emotional stability and meet her need/want of 7-8 hours of sleep, Sara will set some boundaries to facilitate this. For example, she may ask her partner not to approach her with problems/issues after 7:00 in the evening. She may also turn off her phone to reduce texting and email and let work and friends know that she will not respond. She might be sure to be in bed my 9:30 with lights out at 10pm.  

Sara has embraced her own alpha dog – she is in charge of herself and her well-being and knows what she needs and wants in order to support it.

If you are struggling with authenticity, setting boundaries, clarifying your needs/wants, dysregulated emotions/thoughts/behaviors, PCS therapists can support you in finding the real you – the alpha dog of your life.

Hunting Shame When in Isolation

I remember as boy of 5 or 6, the attic in my house was a mystery. We would only climb the stairs occasionally to find old boxes and keep sakes that had been left to gather dust. There were treasures to be found. It was a place of adventure — a place of fun.

However, during the dark of night I could see from my bed, across the hall, to the attic door. This mysterious, fun, place of adventure, became terrifying. I was alone to face the monsters that surely haunted those cluttered, dust filled spaces, and — I was convinced — would creep across the hall to grab me in my sleep.

Most of us have had similar experiences of fear and loneliness. As adults, the monsters may be different, but they feel just as real. One of the monsters that threaten us is shame. And shame revels in isolating its victims. It haunts us in our quiet moments with messages of “not good enough,” “who do you think you are,” and “you don’t deserve.” We no longer are staring at the attic doorway, but inside, into our emptiness.

The current state of our planet and our communities has necessitated a need for social distancing. One of the consequences has been isolation and this fuels shame. Although some of us may have family members to stem the tide of isolation, many of us do not. Most of us have lost many of the supports that sustain and encourage us: faith communities, 12-step groups, therapy groups, and friendship gatherings. In this isolation shame can stalk us.

So, how do we turn the tables on shame? Typically we expose it to the light of day. We share it with a safe person or community who can remind us who we are. However, with social distancing it can be difficult to find these safe places.

Fortunately, there are other ways we can hunt the shame that haunts us — even when we are alone.

  • Start a gratitude list. Every day write 5 things for which you are grateful. Commit to it for 90 days and see what happens.
  • Connect with God or “higher power.” Implement healthy faith reminders and rituals in your home and daily life: prayer, meditation, breathing, lighting of candles, music. You can find ideas by googling resources in your community of faith. 
  • Get into nature. This may take some creativity with the closure of parks in some areas. But, even stepping into the sun on an apartment balcony for 30 minutes can change mood.
  • Write affirmations. For every year you have lived, write one affirmation. For some of us it may seem a rather large task but just start with one. After you’re done, you can read them to yourself aloud. If you are especially courageous, send them to a trusted friend.
  • Using meditation apps. Many mediation apps have meditations targeting self-esteem.
  • Journaling. Note your negative messages and identify the counter positive message. When  venting in journaling it can at times lead to a shame spiral. If this is your pattern, end your daily journal with an affirmation and encouragement (i.e. “I am enough” “I am capable”).
  • Connect with social media.
  • Find an online therapy or 12-step group.

Hunting shame can be difficult when we feel isolated. However, there are many resources at our disposal if we will use them. After all, although the messages of shame feel real, ultimately they are figment of our imagination. Each one of us is a unique, amazing, expression of creation.

This is Grief

The global pandemic has created a new reality for loss and grief. From physical distancing, to working from home, job loss, school closure, and canceling of major life events we have all entered into a world of collective ambiguous loss and grief. We are all grieving the safety and security we once felt in our world.  

Ambiguous loss is a loss that occurs without closure or clear understanding. This kind of loss leaves a person searching for answers, and can complicate the process of grieving and often results in unresolved grief. Some parts of ambiguous losses we are collectively enduring as a result of COVID-19 are, but are not limited to:

  • Job Loss
  • Loss of Safety
  • Loss of Physical connection
  • Loss of Routine
  • Loss of Security
  • Loss of predictability
  • Loss of a sense of Freedom
  • Loss of future and past plans
  • Loss of Traditions

Any type of loss can trigger grief. There is no right or wrong way to grieve and it is important we nurture our humanness as we connect with the losses.

  • Name the feelings and emotions
  • Acknowledge the feelings associated with grief
  • Give yourself time
  • Remember your feelings are valid
  • Communicate with your support system
  • Check in with others
  • Practice self-care
  • Search for meaning in the losses
  • Practice gratitude
  • Practice self-compassion and empathy

I hope in your own grief process, you allow yourself to grieve in a nonmethodical way. I hope you will not repress, or deny the diverse emotions you are feeling. I hope you release the tight hold to unnecessary “strength,” and feel what you feel, however heavy. Give yourself permission to be in the process as long as appropriate

I hope as you let in the grief, the heaviness, the overwhelming emotions you remember to come back to yourself. Be present with those around you. Have an awareness of the love existing in you. I hope you don’t base your actions or words in fear and begin search for hope and meaning in the process. I hope you hold space for yourself. Remember you are human, you are fragile, you are safe, and you are adaptable. We are built for this.

This is grief.

Can’t slow down? Try going faster.

I often move fast because I have things to do, places to be, dreams to achieve. As I move faster, at a certain point my effectiveness reduces. The quality of my efforts go down. I need to slow down to be more grounded, settled, and to make better decisions. So why is it so tough to slow down from going fast?

Transitioning from one speed to another in and of itself can be hard (i.e. getting out of bed in the morning, coming down after an exciting game, etc.). There can also be a compulsive or addictive quality to being busy, going fast, feeling like you are being productive. Much of American culture is about doing, and doing more. There can be a “high” associated with doing. The habit of doing becomes even more ingrained if you grew up in a family culture and or are in a work culture that champions productivity or achievement.

When I try to go from a fast pace to a slower one, it can feel irritating, annoying, like I am wasting time. I believe in mindfulness, not as a buzzword, but as a state that is useful to access. I am able to do this to varying degrees throughout my day. It helps to become more aware, and when I am more aware I am closer with my intuitive side. But when I am going fast and I think of slowing down, I just want to hurry up and slow down to get that out of the way. That approach has not worked all that well for me.

What has worked is using movement as a way to more gradually settle and be more tuned into myself and my surroundings. It starts with awareness. Can I be aware of the pace I have been going? If so, I have the chance to do something differently. Mindfulness is about attention; where am I placing my attention?

When I awaken to the moment, and find that I am racing, I have options. I can actively slow down, become aware of my breath, become aware of my movements. When I have struggled with slowing down, I have often continued the same pace while noticing my breath, noticing my movement, paying attention to the 5 senses. From this place I can gradually taper my speed to settle back into my body, back into the moment. Having a regular and frequent practice of mindfulness (with movement or being still) helps with being able to settle in this way. My mind is more apt to go back to a more mindful state if it is a recent and familiar mind space.

If I am struggling with slowing down, there are times I have sped up. Sometimes it is ok to just get the energy out and move fast. Once I have done that, I have noticed that my awareness is pretty thin at those higher speeds, and I am usually able to begin to slow gradually. This can be done through walking, art work, writing or other kinds of movement.

Self-regulation is largely about awareness. I believe in anchoring to the present moment through awareness of normal breath (not deep breathing necessarily), and through movement as needed. From this place of awareness, movement of different types and speeds can be used to come to a more settled place.

Efficiency and Connection

I was visiting a nursery with my family, exploring what plants we might like in our yard. I am not exaggerating when I write that we looked at over 100 plants. I made sure that fact was known as I let out a frustrated sigh when my family members stopped short of the exit to check out one more. My uncle stopped to bend a flower to my husband’s nose- literally stopped to smell the roses- and I realized how I was the one who lost sight of the goal.

Efficiency is the ability to achieve a goal without waste. Efficiency is a prized talent in our fast-paced world. It saves us time, makes us money, pleases our bosses, and gets our dreams accomplished. I would not have many of my life’s successes without my efficient approach.

Relationally, a goal to be efficient can create a pressured, transactional nature to relationships. I do not want my family members to feel rushed to communicate their ideas. I do not want those around me to feel the pressure of having to express their emotions so concisely, for subject matters to be closed and off the docket, to feel like they’re another one of my checklists. What I ultimately seek is to enjoy my time and space with others and have them feel relaxed enough to enjoy it with me.

So, I must make peace with the fact that I need to leave efficiency out of my relationships. My relational goal is connection, and there is no wasted time, effort, or energy in connection.

I will leave with a quote from Winnie the Pooh:

Piglet sidled up to Pooh from behind.

“Pooh” he whispered.

“Yes, Piglet?”

“Nothing,” said Piglet taking Pooh’s paw, “I just wanted to be sure of you.”

Spread Quality Time This Virus Season

“There’s a lot of fear out there right now. If this virus spreads anything, I hope it’s love and compassion, and not the actual virus! With a lot of closings, cancellations, and people staying home, it’s an opportunity to connect and embrace love and belonging. Stay well.” — My hopeful colleague

For the sake of our physical health we have been receiving recommendations about “social distancing.” For the sake of our mental health, I hope we also keep in mind the need for social connection. I am understanding that medical research supports the need for “social distancing” in this time, and I know that mental health research strongly supports the need for social connection as a part of wellbeing. Thankfully, I don’t think these are mutually exclusive.

Many of the events we were looking forward to have been cancelled, which may include your group yoga practice, the concert you were looking forward to, and the suspension of professional sports. I think fondly of A League of their Own- a fictional movie about the nonfictional rise of The All American Girls Professional Baseball League during WWII. Even then we knew we needed our sports, or other means to unite. It is no less true today. In this time of canceled events, school, maybe even work, we need to find other ways to connect. Stay safe, and begin brainstorming ways to spread quality time. To help you get started…

Quality time with loved ones:

  • Barbeque
  • Enjoy slow meals at the table
  • Check-ins. Tell me a “high point” and “low point” of your day/week/year/life
  • Family board game night (my favorites are “Heads Up” or “Guess Who” for younger kids, and “Cranium” and cards for teens-adults)
  • Is your child into gaming? Have them teach you one of their games and play alongside them. Or dust off your Wii and play virtual Frisbee golf.
  • Backyard games/sports

Quality time with self:

  • Read for pleasure
  • Begin an adult coloring book
  • Journal
  • Pick up a new hobby (might I suggest a youtube video to teach you how to knit)
  • Practice an existing hobby that’s boxed away in your garage
  • Write a letter
  • Get creative!

Article by Catherine Lowrey, PsyD
Licensed Clinical Psychologist

Endless Possibilities When You Follow Your Heart

Sometimes we spend far too much time analyzing every aspect of our lives. Since the day we are born milestones for our lives are predetermined. Take your first steps by age one, tell stories by age four, think about the future by age 13, have a degree by age 22, have children before 30, retire by 60. Our lives are on a timeline and often times we do what is expected of us.

Our human nature tells us to remain in routine and often times by doing so we neglect the best parts of ourselves. Stepping out of our comfort zone builds up new skills and allows parts of ourselves to heal that we didn’t even know needed healing.

The truth is we live in a world where possibilities are endless; we don’t have to follow the time line; we can follow our hearts. I have discovered that when I follow my heart, it has guided me to what I really needed. There was always one clear answer for me, when I slowed down and allowed myself to listen. I have yet to feel regret or doubt when I acted on the choices from my heart. There was a consistent sense of acting in alignment with my true self.

The fundamental basis for functioning in a heartfelt way is mindfulness. Mindfulness means “Sinking down” below the turbulent surface of our thoughts, projections, fears, and perceptions that all clamor for my attention. It means having a still center from which we can be aware of the quieter, subtler signals in the body and emotions which can be our greatest source of information. We become non-judgmental and separate our thoughts and emotional reactions. we discover that our heart and body can safely and fearlessly guide us.

Mindfulness is the practice of letting go. Letting go of attachments to desires, fears; expectations of self, others, and the future; Attachments of what others may think and feel about us. When we can mindfully make decisions from a connected place and let go of the stress, indecision, and doubt that is rooted in fear; Fear of the unknown.

Mindfulness is essential in that it trains us to detach from the narrative of fear-based thoughts. By being mindful and accepting the emotion and feeling as is, we teach ourselves to be “feeling the fear and doing it anyway,” trusting this and letting the process guide you.

With mindfulness-based decision making, we develop an incredible sense of freedom to authentically move through the world. As the Buddhist teachings read, it helps to cultivate courageous “self-acceptance” and a “fearless heart.”

The more we open up and follow our heart the greater the opportunities. Deep in us we have the greatest meanings, we gain a different type of knowledge; One that is spontaneous and unconcerned with outcomes, we just have to be mindful to see it. What we concern ourselves with is our internal experiences that can carry us to new levels of self-discovery.

After all, isn’t self-actualization what we are after or is that just Maslow?

Article by Jessica Lamar, Psy.D.

Brain Health

For many years, research has shown that the practice of pro-active self-care will lead to better physical and emotional health. We have more control over our health outcomes than many realize. The mind and body are closely linked. Therefore, we can exert control in various areas to improve our health and well-being.

The following items are areas which indicate that we can improve our health, thus improving our daily functioning.

  1. Blood Pressure: Control of blood pressure has significant positive impact in lessening the development of physical illness and cognitive disability.
  2. Exercise: Studies show that aerobic exercise increases blood flow to the brain helping maintain healthier brain tissue and lessening cognitive decline. Exercise is an invaluable addition to aiding ability to concentrate, focus, and improve executive functioning.
  3. Cognitive Training: Research show that higher levels of education or cognitive self-improvement increases the development of cognitive reserve which assists the brain’s ability to slow neurologic damage.
    Suggested activities to lessen brain shrinkage are:
    • Reading
    • Connecting with people
    • Developing and engaging in hobbies
    • Volunteering
    • Practicing spirituality
  4. Diet: Food with low level of fats and added sugars are shown to promote both physical and emotional health.
    Some special diets that promote good physical and emotional heath can be found online. They are as follows: the Mediterranean Diet, the Dash Diet and the Mind Diet.
  5. Sleep: Studies indicate that sleep strengthens some brain synapses(connections) while diminishing others. Another theory suggests that sleep eliminates toxic substances that can cause disease.
    Healthy sleep habits contribute to improved brain health.
  6. Meditation and Mindfulness: To enable a person to be more at peace with themselves, and to be positive in daily living will promote clarity in brain functioning.
  7. Spirituality: Helps individuals find hope and meaning in their lives.

Developing healthy habits has shown to preserve brain health. Ongoing studies emphasize the value of proper nutrition with diminished sugar intake, weight and blood pressure control. Computer brain training can challenge the brain and help improve memory.

The above contribute to improving mental acuity and executive functioning.

Remember, these are guidelines that individuals can use to improve well-being in a positive and pro-active manner in order to achieve brain health.

Sources:

  1. Anne Tergesen “What Science Tells Us About Preventing Dementia”, The Wall Street Journal, November 18, 2019
  2. Meghann Finn Sepulveda “Transform your Well-Being,” Arizona Republic, May 2017

Article by Sheldon P. Wagman – DO, FACN, DLFAPA

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