I recently spoke with Dr. Amanda Swain, a family medicine physician and sleep specialist. She had some very important and useful information about how important sleep is and how to improve your sleep. This interview has been edited for length, clarity, and style.
HH: I talk to my clients a lot about the importance of getting 7 to 9 hours of sleep. Talk to me a little bit about why that’s important and what may happen if someone doesn’t.
AS: I think he first thing people need to figure out, and people can do this with a sleep diary or sleep app (such as CBT-I coach), is how much sleep they actually need. Because not everybody needs 9 or even 8 hours. People can start to track their sleep a bit and get a sense of how they feel throughout the day on various amounts of sleep. They may note that on 9 hours, it may actually be hard to wake up and their energy isn’t as good throughout the day, but wow, if you hit that 7 hour and 15 minutes, that’s a sweet spot that’s just the right amount. So, first, experiment with how much you personally need.
Adequate sleep helps to support all these important processes in the body. Like the ability to concentrate, retain information, and new memory creation. All of these things that are really important to academics and work and executive functioning. And you have the impact on mood, managing stress, and anxiety and depression management. We also know that risk-taking behaviors are higher in people who don’t get enough sleep.
If you’re not getting enough sleep, you may be using substances as a crutch. Like caffeine to get you up in the morning and alcohol in the evening, when you want to relax and try and sleep. Or tobacco or marijuana. We do worry about people using substances to manage what could be best-managed with getting adequate sleep.
And then there are a whole host of physiologic effects. There have been many studies on people who get chronic sleep deprivation, and you can see that their cardiovascular system is not as healthy, so they’re at risk for coronary artery disease, strokes, diabetes, obesity, and a whole host of other medical conditions. It’s not that sleep is the only thing that people need, but it’s hard to overlook how important sleep is in supporting all these other systems. And sometimes people will look and try to figure out what to do about all these other things when you can just take a step back and say, “if we just help you sleep, you’d feel so much better”. Sleep does a lot!
HH: Can you say a bit more about how it impacts mood and thinking if someone is not getting enough sleep?
AS: Most people can probably think of a time when they were truly sleep-deprived, and they can probably remember that there was just so much more emotional lability. They could turn on a dime, felt more tearful. They were really affected by things that normally wouldn’t affect you. The world just seemed so overwhelming. That’s after only one or two nights or a week of sleep deprivation. But for people who are chronically sleep-deprived, it can really take a toll on their health exacerbating any underlying predisposition to anxiety, depression, or suicidality.
HH: This is good. I often talk to people about how not getting enough sleep can affect your mood and your ability to think and remember. Studies show you can be as impaired as if you were drunk if you don’t get enough sleep.
AS: It’s true. There are studies that show that driving while sleep-deprived is similar to driving with impairment from alcohol.
HH: How do you think COVID-19 has changed sleep for people? Have you seen changes with this pandemic affecting people’s sleep?
AS: More people have had concerns about their sleep, in general. This might be because they are spending more time in the home and have more time to focus on sleep and worry about it. It could be that the rise in anxiety in the general population has disrupted sleep. It could be that many people have lost their normal circadian cues that would usually help keep them on schedule. Or it could be due to how so many people are working in the same space where we sleep. This is very confusing for the body in terms of signaling, as the bed becomes part of so many activities. When this occurs, the bed no longer just has a strong association with sleep. If you’re doing many things on the bed, it’s not good. I think there are a whole host of reasons why people have potentially had trouble with sleep during the pandemic. This isn’t just my experience. I went to a sleep conference last month, and this is a recognized phenomenon. In North America, there has been an increase of sleep disturbance and insomnia in the past year.
HH: What are the things you think are most important for good sleep?
AS: That’s a good question. I think I’ll answer it in a slightly different way. I would say there are a few behaviors that people do to help sleep once it comes apart. If I could do anything, it would probably be to educate people on these few things to avoid doing if their sleep gets off track.
One very common misconception is that spending more time in bed is actually good for sleep. The rationale that people come up with, on its surface, is logical- “if I don’t get enough sleep, but I spend more time in bed, I will get more sleep”. But what often happens is that people then spend more time in bed awake, wishing they were sleeping. And so, the first thing I like to tell people is if you’re having trouble sleeping, you actually want to spend the same amount of time in bed you normally do, or better yet, spend less time in bed. What you want to do is really be sleepy enough to take advantage of your time in bed. Resisting the urge to spend more time in bed is key.
And the other thing that I think people lose sight of is that the bed should actually just be associated with sleep. This goes back to classical conditioning and the idea of stimulus control. If you think about little kids, you can put a child in a crib or a bed and if they’re not sleepy, they will do anything to get out of that bed because for them the bed is only associated with sleeping. As adults, we lose that association, and it becomes a substitute for a couch and for a desk and for a table to eat upon. We really want to preserve the bed as a place for bedtime. And aside from sex and sleep, we shouldn’t be using the bed for anything else. When sleep isn’t going well, you really want to limit the amount of time you spend in bed to remind your body of that association. And that will take a few weeks most likely.
And the third thing is that it is helpful for people to get an idea of how much sleep they need. Again, I think they could do this with a sleep diary and something that tracks how they feel through the day. If people think that 9 hours is the gold standard and that they need to get 9 hours, they may be doing themselves a disservice. It’s far better to appreciate how much sleep is just the right amount. Most people have a sweet spot, kind of like our weight. Most of us have somewhere within half an hour of where our bodies do the best in terms of amount of sleep. It’s helpful to get a sense of that and not attach any good or bad association with it. If you need 9 hours of sleep, that’s what you need. Figure it out. Make it happen. But if you’re someone that needs 7 hours, that’s fine. You don’t need to feel like you’re doing anything detrimental to your health if you don’t get 8. Those would be 3 things that come to mind.
HH: What is sleep hygiene?
AS: Sleep hygiene is just the basics of supporting your body in sleep. Sleeping in a dark cool quiet environment. Having some sort of routine associated with bedtime. Not overheating in bed because it’s going to disturb your sleep. Try not to have a screen in your face before bedtime because the bright light is going to interfere with your melatonin. Don’t eat a big meal before bed. It won’t feel good and it can set you up for acid indigestion.
HH: I find that I’m often talking to my clients about it. And one of the things that I find the most important is having downtime before bed. Allowing yourself to prepare for sleep.
AS: I agree. It’s all going back to that stimulus-control thing. You wouldn’t think of doing something high energy and super stimulating before doing something very restful. Like you wouldn’t go jogging around the block before you try to meditate. It feels a little out of sync, and it’s the same with sleep. You want to do some activities that allow you to start to disconnect and slow down and quiet your mind and your body before sleep. Now, some people find a fairly structured routine helps, but for others, they find that to be anxiety-inducing. It’s just important that people find something that works for them. And it doesn’t need to have a lot of bells and whistles. It may be something as simple as showering before bed. Or turning the screen off 30 minutes in advance, washing up, straightening up the bedroom, and getting into bed. I just never recommend that someone powers down their laptop and gets right in bed because those two activities are very different.
HH: I’ll often talk to people about how you have to prepare your body for sleep. And slow things down. What are your thoughts on sleep meditations to help you fall asleep?
AS: That’s what I kind of reference in terms of people getting focused on a bedtime routine. I kind of like to separate activities that require some concentration, like mindfulness, from bedtime. Just because If people don’t feel like they’re getting where they need to be, they’re anxious about going to bed. I tend to say, “if you want to do a mindfulness activity or a mediation, think about placing it earlier in the evening”. Just because I don’t want people to be like, “I have to relax! I have to relax!” right before bedtime. That said, if people find that’s really helpful, great, I’m all for it. As long as they have the insight about whether or not it’s revving them up or feeling like something they have to accomplish. It just depends on how they feel about it.
HH: That makes sense. I really like your approach, how you want to meet the person where they are. What are your thoughts on melatonin?
AS: Melatonin is fine for people who use it to support a circadian rhythm switch. It’s not really designed to be used as a sedative, although it can have that affect in people. Often because it’s used in elephant-sized dosages, like 5mg and 10mg doses at CVS. The clinical dosing that’s been studied is .1-.3mg, so we’re talking about much much smaller doses. So people are going to feel sleepy on larger doses, but then that often leads to headaches, some grogginess in the morning
HH: Are there any things that you feel are effective and safe to help someone sleep?
HH: Yes. There are absolutely times when medication can be helpful, like when someone is really struggling with insomnia. Or someone who, the night before an exam, does everything in their power to sleep well but the anxiety keeps them up. That might be a time that they want to use a medication. There are times to use medication. I just worry about, with melatonin or anything else, that you don’t want someone in a situation where they feel that the only reason that they can sleep is this pill or this oil or whatever it is. Because you’re not doing yourself any favors if you convince yourself that you’re unable to sleep without something that’s external. Sleep is a really really basic bodily process.
For most people, they don’t think about their sleep until it goes off the rails, and all of a sudden, it’s a real issue. I would just encourage people to take their sleep seriously, and if they have concerns about it, they should bring it to the attention of their physician, their psychologist, or their coach. It should be low-hanging fruit in terms of a reason to seek support.
Amanda Finegold Swain, MD is a board-certified family medicine physician who has pursued additional training in behavioral sleep medicine. She practices community-based family medicine at Penn Family Care in West Philadelphia and is a Clinical Assistant Professor in the Department of Family Medicine and Community Health. She also provides Cognitive Behavioral Therapy for Insomnia (CBT-I) through her behavioral sleep medicine practice (www.phillysleepworks.com).
This past year was incredibly stressful, as well as full of loss and grief for most of us. However, it also gave many of us the opportunity to do some things that better supported our well-being. For example, I have heard from clients that they have been sleeping more, cooking more and more healthily, exercising more, and spending more time with their families. The limitations of the pandemic also forced most of us to simplify our lives and slow down, enjoying more downtime at home.
I know for myself, there are a couple things I have really appreciated over this past 15 months. I have been pleasure reading much more. And my husband and I have been walking most afternoons to keep me from going crazy and to get us out of the house. These walks have also been a nice time for us to chat and connect, and I have valued them.
As things are reopening, I am as excited as most to start re-engaging with activities that helped my life feel larger and more enjoyable pre-pandemic. I also find myself wondering how I am going to maintain some of these special things I have gained in my life during the pandemic and how I am going to re-enter life going forward.
While there is much we lost and missed from last year, many of us discovered ways of living that we appreciate and which benefit us. I am hoping that we do not just jump back into living our past life because it is familiar and known. Just because something is comfortable and familiar does not mean it is necessarily positive for us.
My hope is that we will re-enter our lives thoughtfully and mindfully. Through the pandemic, we have been given an extremely rare and valuable opportunity. We have paused living our lives and now have the possibility to take a step back, having gained some distance from how we used to live. This will allow us to carefully determine how we want to live now. What activities do we want to keep? What people do we continue to value? How do we feel that spending our time works best for us?
These three steps can help you move forward and re-configure your life in a thoughtful, optimal way:
1) Take some time, even 10 minutes, and reflect on what you appreciated about this pandemic time. What were your grateful for in how you were living? What have you learned that supports your well-being? Have you been exercising more? Eating better? Sleeping more? Socializing less and enjoying having more downtime? Doing more pleasure reading? Playing games or taking walks with your family? Write down the things that you have been grateful for over the past 15 months.
2) Prioritize these activities and determine the 2 or 3 that you most value and want to keep in your life. Schedule them in your life, on your calendar. Hold space in your life for these activities. Perhaps they will not occur as often as they did during the pandemic, but how can you schedule and keep them? For example, perhaps you were walking daily. Can you now schedule 3 walks in your week? Maybe you enjoyed game-night with your kids several times a week. Can you now make a ritual or routine where one night, perhaps Fridays, will be game night? Hold time in your weekly schedule for these 2 or 3 things that you value and want to maintain as life opens up. Put these priorities in your schedule first.
3) As options and additions come up and you have more activities you can attend- eg. social events, sports for your children- consider in a mindful way what you want to add back in. Will this activity or person feed your spirit or support your health, mentally or physically? Also, learn to say no and value yourself and your time. You do not need an excuse. You can say, “Thanks so much, but that doesn’t work.” Or you can give yourself some space to consider the invitation and say, “Let me check my schedule and get back to you.” And do just that- check your schedule and your gut and determine if you have time and desire to add this activity back in to your life.
This global pandemic was a once-in-a-lifetime event, that changed the world at a global level, and changed each of our lives in a very individual way. While there has been much loss and suffering, it is OK to acknowledge that some of the changes in your life might have been valuable and even necessary to your overall well-being. By being mindful and reflecting honestly on the changes you’ve experienced in the last year, you might discover new habits or hobbies that you wish to keep as a part of your life, even as the world begins to reopen. Take some time to follow the steps described above thoughtfully. Allow yourself to add experiences into your life that you truly want to welcome back, while prioritizing and valuing the pandemic-inspired habits that you want to keep. This unique time of re-engagement allows us to rebuild our lives in a deliberate way that can be even better and more fulfilling than the unexamined lives we once had.
I would love to hear your experiences. Reach out to me in the comments below or on Facebook or LinkedIn and tell me what one pandemic-inspired habit or hobby you would like to keep in your life.
I love plants, and my house is full of them. Plants make a place feel more like a “home”. They bring life, peace, and color to a space. I also enjoy the process of caring for them, watering them, removing dead leaves, and determining how to help them thrive.
For several years, I have had a plant that was doing fine. It was in a small 4” pot. Recently, I realized that I had a larger 9” pot and thought that moving the plant into it might be beneficial. As soon as I moved it, the plant exploded! It grew rapidly, and it was quickly twice as high as it had been. It expanded outward, and it sprouted many new leaves. Definitely, a happier plant!
I’ve been reflecting on this plant and how this growth can really mirror our growth as well. Once restrictions are removed, we can also blossom, grow, and thrive!
For more than a year, our lives have been severely restricted, as if we’ve been put in a too-small pot. We are just beginning to step outside of these artificial, narrow, and diminishing limitations as things in the world begin to expand and vaccinations are on the rise.
While we, and our lives, are starting to open up in this way, I am reflecting on limitations that may come from our world, our families, or ourselves. Our constraints may be self-inflicted, with doubts or fears getting in our way. Or they may be external, with a job or a life situation restricting us. Once we are able to remove the things that bind us, we can learn, grow, and express more of ourselves.
I found this to be true when I started my own business. I had the fortunate ability to leave my last job when I realized that I wanted to work in a different and expanded way, offering options to support people to move forward in their lives. As I started my business, I began to use parts of myself that were long-neglected or that I had never used before. I began in inhabit a new identity as an entrepreneur. I learned new ways to connect with clients and to market myself. I used technologies I had never used before, and I had so much fun working on my logo and building my website. Most importantly, I was able to work in new and different ways with my clients, providing education and support that excited and engaged me. As I speak about resilience, I talk about how we are most able to grow and learn when we take risks and try new things. I clearly saw this in action with myself.
Consider the life lesson from my houseplant. What is your too-small pot? What things constrict you in your life? Are they internal or external? How can you remove them or give yourself more space to grow and learn?
Last spring, I wrote about how the pandemic had constricted and diminished our lives and well-being so that my life’s orchestra now felt like a trio. Things are now starting to expand and open up, and that is both exciting and anxiety-provoking for me. We are living in a complicated time in which we can see the light at the end of the tunnel; however, we really don’t know when we will get there or what it will look like. We are at various vaccine statuses, with some people able to be with friends and family again and others still not protected. Different states are opening up in a variety of ways. Things feel complicated and uncertain in new ways.
A year ago, when I envisioned returning to “normal life”, whatever that means anymore, I was only filled with excitement. I imagined jumping right back into my “old life” enthusiastically. However, after living in masks, socially distant, and in fear for so long, I am changed and possibly a different person. I actually feel uneasy and uncertain also about what it will be like to re-engage with the missing parts of my life.
Some things fill me with unabashed excitement and enthusiasm. My husband and I have tickets to a drive-in concert next month. I am so happy to have something positive to look forward to! Having things to anticipate with joy has been really missing in my life, and I love seeing live music so much! It feeds my spirit and soul, and I’ve felt parched without it. I think I may be so happy that I will cry when Greensky Bluegrass starts to play!
But then, consider hugs. I have barely touched or been touched by a person outside of my husband and hairdresser in a year. I sorely miss hugging my friends and family; however, hugs now seem almost as intimate as sex! Although I’m somewhat joking, I feel like there will need to be a conversation and full consent before I start hugging my friends. And this seems crazy to me, that hugging would feel anxiety-provoking, but it is. The idea of touching friends casually or being near people without masks makes me nervous. I don’t like the person I’ve become, but this year has changed me. I think it will take time and exposure to adjust to the next stage of “new normal”.
So, if you are feeling mixed emotions while imagining things to come, realize that this is normal. Be kind to yourself and determine step-by-step what you need. It is perfectly acceptable for you to do things differently than others or to take your steps at a slower pace than your peers. Be gentle with yourself. Check-in on how you are feeling and what you need. Honor your boundaries and communicate in a clear healthy way what you need- and if you are not ready for certain actions yet.
This past year has really demonstrated that we are all in this together. We need to act together to take care of each other and to be able to move forward. We have all been changed and impacted by this past year in ways we probably cannot even see yet. It is very important that we honor each other and support everyone as we move forward in our own, individual ways.
I talk to groups and individuals about stress quite frequently, and one of the things that people find interesting is gaining a better understanding how it affects the body. If we have a sense of how stress affects us, we can then make choices to help minimize its impact.
Our Autonomic Nervous System acts largely unconsciously and regulates bodily functions, such as heart rate and digestion. It has two branches: the Sympathetic Nervous System and the Parasympathetic Nervous System.
The Sympathetic Nervous System (SNS) gets activated when we respond to a perceived threat. You have probably heard of the “fight, flight, or freeze response”, and that is what happens when our SNS kicks in. Stress is the neurological and physical shift that occurs when a threat is detected. If you were alive a long time ago, living on the savannah, the threat could have been a lion. When you perceive the lion, your heart rate rises, and blood gets pumped to your muscles. You are ready to run or fight! Your muscles stiffen and are ready to respond. When you are prepared to respond to a threat, your higher thoughts disappear. Your thinking narrows and focuses on the here-and-now threat. Your frontal lobes are used less, which can impact your self-control and willpower. (You might notice you eat worse or make poorer decisions when you are stressed.)
The stress hormones are now coursing through your body, preparing you to take action to save yourself! Your ability to feel your body decreases, as your full attention is needed for the perceived threat. Other responses happen in your body as well. Your digestion slows, and your immune response diminishes to save energy. Your sexual responses (such as erections and lubrication) and your libido are also decreased.
Once the threat is over, and you have run away or successfully fought off the lion, your Parasympathetic Nervous System (PNS) is activated. This is our “rest and digest” response, and this should be our baseline. While the SNS prioritizes problem solving, the PNS is more engaged in reflection, a key component of our humanness. The PNS is essential for our health and well-being. It is the state needed for deep thought, connection to others, creativity, sexuality, and digestion.
What should happen after you run away from the lion and are safe is that you then rest and recharge. This is the state in which you should live much of your life. Instead, as often happens in our modern world, everything is seen as a lion.
The relentless nature of modern life and technological stimuli encourage SNS activation regularly. Work deadlines, crowded spaces, unpaid bills, cars that cut us off, or bicycles that almost hit us can all trigger the same nervous system response as a threat from a lion. Even the notifications on our phones lead to a stress response and release of stress hormones, such as cortisol (so please think about turning most notifications off on your phone and having phone-free time each day- and especially at night!). When you are in this state, you start to perceive more threats, and this creates a vicious cycle.
If the SNS cannot be switched off, this can lead to anxiety, insomnia, IBS, muscle tightness, or longer-term physical and mental health issues. Continually elevated cortisol levels are correlated with negative health outcomes such as obesity, Type 2 diabetes, fertility issues, dementia, high blood pressure, heart attacks, and strokes. Chronic stress can even shut down the SNS, leading to symptoms associated with depression: persistent low mood, lack of motivation, and lower sex drive and energy.
Given all this, it is important for you to reflect on how stress takes place in your life. What leads to stress in your everyday life? What can you change or address? Taking a good look at this will allow you to determine what you can let go of, or minimize, to lower your levels of stress.
Something my clients find helpful is to list everything that causes them stress. Take some time to make this list and add to it over days. Once you have a decent list, consider each item on it and think about one way- even a very small way- you can decrease your exposure to this stress, avoid it entirely, or handle it differently in a way that will work better for you.
You can also consider what you can to do to calm yourself and engage your PNS more frequently- to bring you to a baseline of rest and digest. Many activities can help us activate our PNS, such as breathing/relaxation exercises/meditation, physical exercise, expressing ourselves creatively, connecting with those who support us, writing, and experiencing art/music.
Taking all this into account, what is one way you can lower your level of stress, either by decreasing your stress response or by engaging your PNS?
Lately, there have been several articles written about how many of us are hitting the pandemic “wall”. As you probably know, the wall concept comes from marathons. While I’m not crazy enough to run marathons, my husband is, so I have learned about them from him. Marathons are 26.2 miles long, and the “wall” comes for most runners around the 18-mile mark. This is the point at which our bodies have used up most of their resources and cry for us to stop running; however, we are still capable of pushing on, if we ignore the pain and keep a positive mindset, cheering ourselves on. We are still able to cross the finish line if we battle the fatigue, suffering, and doubt. We can do this, in part, because we know where the finish line is, and we know it is not that far away, compared to the distance we have already run.
We have now been in this damn pandemic for a looooooooooong time. While a marathon has a definite end, this pandemic does not have a clear finish line. We know/hope we will get vaccines soon. Or this decade. And we know/hope life will return to some semblance of “normal”. We long for hugs, concerts, traveling, leaving the house regularly, etc.
What we are experiencing is like a crazy phantom marathon out of a sci-fi movie, where you don’t know how long you will be running for or what you need to do to cross the finish line. It is like one of my nightmares, where I am trying to get somewhere, and I am trying to get somewhere, and I am trying to get somewhere, and I never seem to get there. Do you have these dreams too?
Well, I think I’ve hit my pandemic wall- again. For me, it feels like it has been a cycle. I feel like I do well for a while. I use my coping skills. I exercise and meditate. I connect with my supports. I hug my husband and take pleasure in the small things. I keep my gratitude journal nightly.
And then, once again, I am cranky and irritable. I am so sick of wearing masks!! I am so sick of my constricted small life!! I am so sick of my home!! And I don’t feel great, emotionally.
There is no easy answer or solution to this wall-hitting-cycle. I am not going to tell you to just go take a bath or a walk, and it will all be better. This pandemic is taxing and testing all of us, regardless of our coping skills and self-care.
What I would suggest is to have some acceptance and compassion for yourself, to recognize that you are in a rough space. That this pandemic sucks. That we have all lost and missed so much this past year-and that we do not know when or how things will improve. Allow yourself to cry or scream or have a glass of wine. Be gentle with yourself. And then, in a day or two, or more if you need, step back and figure out what will help you at this point in the phantom marathon.
I recently read a book I really enjoyed and found useful called Burnout: The Secret to Unlocking the Stress Cycle by sisters Emily Nagoski, PhD and Amelia Nagoski, DMA. They write about how our emotions are like tunnels, and we have to go through them to complete the emotion we are experiencing. Some of the best ways to complete the stress cycle and release feelings are things I recommend to my clients all the time: breathing, exercise, connecting with your support, creating or being around creativity, writing, cooking, etc.. They also name laughing, crying, and getting/receiving affection as helpful ways to release your feelings and exit the tunnel.
So, once you have exhaled and accepted that you are in a rough place- again!- step back and determine what will help you regain your footing and move forward again. What is it that you think you need right now to make it to the phantom finish line? Or at least until your next wall.
Several months ago, I was speaking with a coaching client, “Tom”. Tom was a STEM graduate student, and his advisor was pretty emotionally abusive and critical. My client was understandably struggling with anxiety and self-confidence, and he acted like someone in an abusive relationship. He would tell himself that if he just got certain things accomplished or worked seven days a week, his advisor would finally become supportive and help him move forward with his academic career. However, because his advisor has never displayed kindness or emotional support, Tom’s thinking was irrational. This led to frustration and pain as he kept hoping for support and a response that would never come from this particular advisor.
While working with Tom, I was reading a wonderful book, Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind by Kristin Neff, Ph.D., as I was preparing a self-compassion workshop. In the book, I came across an equation that reminded me of Tom:
Suffering=Pain x Resistance
As Dr. Neff writes, and as Buddhism teaches, suffering occurs when we compare our reality to our ideals. When we keep wishing and hoping for a different reality, and when this reality does not match our desires, we suffer. We can’t avoid pain, but we can avoid suffering – if we accept “what is”. We suffer emotionally because we want things to be different than what they are and by not accepting our actual situation.
I think about this concept with respect to the pandemic, and I can see how I personally struggle with it. At times, I find myself frustrated and angry by the pandemic and how it is impacting my life. I focus on all the things I cannot do, all of the things that I have lost, and all the ways that my life has shrunk considerably since March. When this is my focus, I am upset. On the other hand, when I can accept my current situation and work within my life’s current boundaries and find its COVID silver linings, I actually feel calmer and more positive.
Tom and I spoke about these ideas, and we looked at how his lack of acceptance was contributing to his anxiety and distress. This concept was really eye-opening to Tom and stopped him temporarily in his tracks as he thought about it. We looked at how he could approach his relationship with his advisor with acceptance, acknowledging that the advisor could not be anyone other than they were.
As Tom began to shift his focus, his anxiety and self-confidence began to improve. He was able to stop internalizing the negative messages from his advisor and protect himself from this hurt. Tom developed more of a “screw them” attitude, which improved his resilience and inner strength, and gave him distance from the abuse. He also began to recover emotionally much more quickly from toxic encounters with his advisor. Tom’s advisor has not changed, but Toms’ ability to deal with his current circumstances and build a better future has.
Breakthroughs do not have to be thunderclaps from the clear blue sky; sometimes they can come from small shifts in perception, like this one. This move towards accepting the situation- that his advisor was not going to change his behavior- helped Tom take ownership of the aspects of the relationship he could control: his own responses to the negativity and stress.
Our reality may not always be what we want or what we dreamed, whether it is dealing with the pandemic or struggling with a challenging relationship. However, with a little bit of acceptance, we can always find joy and happiness in the present and work toward a better tomorrow.
Years ago, I was working with a bright computer science grad student, “Sheryl”. She really struggled with anxiety and then, when she was anxious, she would get down on herself for feeling that way. Sheryl would beat herself up for struggling and say things to herself, such as “how can I feel so anxious?”, “this sucks!”, and “I hate feeling this way. Why can’t I be “normal”?”.
As we got to better understand her anxiety and the thoughts she would have in response to it, I was really struck that she was having anxiety about having anxiety. Distress about having distress. We looked at how the thoughts/feelings she was having about her anxiety made her feel much worse. She named this anxiety about having anxiety “meta-anxiety”.
I began talking with Sheryl about acceptance. Acceptance is looking at what is and treating it and yourself with kindness. Having open eyes and not focusing on how you want things to be or feel different. I think of the Serenity Prayer, from Alcoholics Anonymous, often when I am trying to explain acceptance: “God grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference.”
I started helping this client have more acceptance for herself and her feelings. When she was feeling anxious, she would begin saying, “It’s ok that I’m feeling anxious. It makes sense with all that’s going on right now.” Turning to herself in this manner, with kindness and openness, lowered her distress and helped her anxiety feel more manageable.
When we accept our distress, instead of beating ourselves up for it, we actually feel somewhat better. As Sheryl began treating herself and her anxiety this way, she found the levels lowered as she gave herself space, as well as acceptance and kindness. Sheryl then was more able to use the anxiety management techniques she had gained during her treatment with me.
So, the next time you are struggling with painful feelings, turn with an open eye to what is and treat yourself as you would a friend. Using acceptance and compassion will reduce your distress, and it will give you an opening to figure out how to best help yourself.
When my husband and I first talked about getting married years ago, we agreed that we would get a dog. Life and job prohibited this for many years. However, because we are both working at home due to the pandemic, it seemed like a perfect time to get a puppy! In particular, we decided to get a Bernese Mountain Dog, which I have become totally enamored with.
In March, we found a breeder who loves her dogs, passed her extensive interview to qualify, and then we waited for our girl to be born. With our breeder, she sent us 30-second videos of the possible puppies, and you choose your puppy in the order in which you sent in your deposit.
Selection day in July was very stressful! We knew we wanted a female, and fortunately there were seven available. I was sure we had a good draft pick because we had been waiting for so long; however, we discovered we were fourth on the puppy list. We rushed to see the remaining puppy videos and faced a conundrum.
One of the things that I love about these dogs is the brown fur around their eyes, which gives them such a kind look. When we saw the remaining four puppies, one had these classic marks and symmetry on her face, and the other three had faces that were half-white without the brown markings around the eyes on one side.
At first, I assumed we would pick the classic symmetrical puppy, but when I saw the video of her, my heart fell. In my gut, I was not thrilled and felt disappointed. Somehow, she was not cute, and she did not speak to me. One of the half-white face puppies, however, was adorable, and I could feel the excitement for her in my gut.
This was a strange position for me, and I found myself confused about what to do: which puppy should I pick? I battle perfectionism, as I am sure many of you do. I like things to be symmetrical and look good. It is important to me that I look nice and “put together” when I go out. I also often value being right and doing things in the “right” way. Somehow this choice was highlighting several of the things that I struggle with in my ongoing work to let go of the perfect and to enjoy life in the moment, with all its imperfections.
Additionally, as embarrassing as this is, I was worried about what people would think or say about a puppy with asymmetrical markings. Would they make negative or critical comments? Would I have to keep defending her uniqueness as a positive attribute? I talk to clients all the time about empowerment that comes from within, and that is not centered in the opinions of others – and here I was worried about how my potential puppy looked to the outside world!
The main question became: should my husband and I choose the dog that “looked right” or should we go with our hearts?
This decision was one we thought about and talked about a lot, and we slept on it overnight. In the morning, we knew who our Penny was. We went with our gut and our hearts, which life has taught me is always the right direction in which to go. She has asymmetrical coloring on her face, - but she is adorable – our perfectly imperfect puppy - and we love her!