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Benefits of Yoga and Movement to Mental health

Posted on June 22, 2022 by TriWellness in Blog, Uncategorized

Close your eyes and notice if you are carrying any stress in your body in this moment. Maybe in the jaw or stomach? Now, try to create space around the tension or stress by sending the energy of the breath around the tension. Breath regulation is beneficial in allowing people to slow down into what is happening right now.

When we experience stress or trauma, it can live in the body and can create a stress response in people of all ages. The stress response may be varying in levels such as clenching your jaw, tensing your body, needing to leave the room, or having a panic attack.

While it is happening, it can seem scary. There is some good news. Stress response can be controlled using modalities such as mindfulness, yoga, as well as therapeutic touch such as acupuncture or massage along with therapy.

This gives us the ability to regulate and recalibrate the autonomic nervous system, to control a stress response. In children, similar activity to assist in this release of stress include needing movement, play, and joyful engagement. These are all considered bottom-up methods, which calm physical tensions in the body, and shifts people out of flight/fight to reorganize people’s perception of danger. Basically, it can help you feel better.

Memories of trauma can but not always, lead to physiological symptoms such as autoimmune disorders, or skeletal muscular problems. Why? Because there is a proven mind, brain, and body connection to stress.

“So how can we help that? I am a busy person and life is hard.” When we practice asana (yoga movements) no matter how modified, gentle, or vigorous, a reconnection and ability to warmly love self exists. This then shifts to other areas of life including but not limited to diet, relationships, energy, etc, which helps us to feel better.

Proven studies exist to show the physiological benefits and shifts in breathing exercises which change when a person becomes upset, is having a trauma memory, or is well regulated. Interpreting physical sensations is called interoreception, which allows people to have a relationship with their interior world and self. To be able to understand what the body needs, allows people the ability to tune into nourishing and healing the self.

Studies exist that show after twenty weeks of one weekly yoga class in people who have experienced stress and trauma, there are increases in activation of brain structures involved in stress regulation. These brain structures include the insula, and medial prefrontal cortex. Does this have to be only yoga? No! For some it could be running, reiki, massage, or even gardening.

Feeling safe in our bodies allows people to communicate previously overwhelmed situations that were not easily felt or talked about.

Children and adults can be taught self-regulation skills. The act of educating about physical sensations and becoming friends with our bodies, can assist in healing. Yoga, therapeutic touch such as acupuncture or massage, and breath work in addition to talk therapy may help you feel better. Contact us to start your journey to wellness.

Resources

Chirokas, Dennis, C., & Bradshaw, M. (2021). Phenomenological Reflections of Trauma Survivors on Healing Through Yoga. The American Journal of Occupational Therapy, 75(S2), 7512505186–7512505186p1. https://doi.org/10.5014/ajot.2021.75S2-RP186

Gulden, & Jennings, L. (2016). How Yoga Helps Heal Interpersonal Trauma: Perspectives and Themes from 11 Interpersonal Trauma Survivors. International Journal of Yoga Therapy, 26(1), 21–. https://doi.org/10.17761/IJYT2016_Research_Gulden_E-pub

Van der Kolk. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Publishing Group.

This month’s blog post was written by TriWellness’s newest counseling intern, Rebecca Caliendo, MM, who has been teaching yoga from 2016.

Contact REbecca Caliendo, MM

Women’s Health History

Posted on March 31, 2022March 31, 2022 by TriWellness in Blog

Early History

In the early history of health sciences, the philosopher Aristotle believed that the women were the inverse of men and had suggested the superiority versus inferiority between the sexes. This hypothesis had influenced the ideology of women’s place in society as well as their health. It wasn’t until the mid 1980s that women were beginning to be seen as an independent group as opposed to a “sub-group” of men (King & Paul, 1996).

Another concept that influenced women’s healthcare was the diagnosis of hysteria. In its early conception, hysteria was defined as the idea of a woman’s uterus would wonder throughout her body causing mental and physical dysregulation. This idea continued to morph through the ages, from hysteria being define as “melancholic uterus” to the “workings of the devil” or other forms of demonization. The treatment for hysteria also morphed with the definition of the diagnosis, such as fumigating the uterus, expelling “semen” from the uterus by utilizing fingers to stimulate the internal organ. The concept of women being a sub-group of men had led philosophers and early physicians to believe that the cause of disease. However, at one point in the 18th century the concept of hysteria was separated from disease of the uterus and was suggested it had actually neurological origins and can impact any person (Tasca, Rapetti, Carta, & Fadda, 2012).

In the Victorian Era, Dr. Sigmund Freud had also studied the concept of hysteria and its relation to libidinal evolution. This lead him to the early theory of psychoanalysis with the concept of male and female hysteria involving stages of sexual conflict and fixations. Hysterical neurosis had remained in the Diagnostic and Statistical Manual until 1980 ((Tasca, Rapetti, Carta, & Fadda, 2012) however the ideology and the origination of the concept of hysteria and its relation to the “inferiority” of women still impact our health care systems and cultures.

Leading up to that ideology of woman being an independent group and other components of the Feminist Movement, the Women’s Health Movement (WHM) began to develop in the 1960s with the intention to “…improve health care for all women.” (Nichols, 2000).

Women’s Health Movement

In the Journal of Obstetric, Gynecologic, & Neonatal Nursing (JOGNN) Dr. Nichols, RNC, PhD, FAAN outlined the significant events in the WHM (adapted from Table 1, History of the Women’s Health Movement in the 20th Century; 2000).

1969

The Doctors’ Case Against the Pill by Barbara Seaman was published. It brought the severity of the side effects of the birth control into awareness, resulting in the 1970 federal hearing on birth control pill safety.

1973

Our Bodies, Ourselves was published.

1975

The National Women’s Health Network was established to advocate women across the US. The network continues their efforts for advocacy of all women.

The first International Conference on Women was held in Mexico City, Mexico.

1983

The Commonwealth Fund conducted the first national survey of women’s health. Their latest survey was conducted in 1993.

1984

“Rehabilitation of the female patient after myocardial infarction” (Boogaard) was published, suggesting that women have differing experiences than men and are not a subgroup of men.

1989

The Congressional Caucus for Women’s Issues (CCWI) put into view the serious lack of research on women in the National Institutes of Health (NIH).

1990

The Jacobs Institute of Women’s Health was founded to “…improve women’s health through research, dialogue, teaching, and information dissemination.”

The Office of Research on Women’s Health (ORWH) within NIH was established “… to ensure that women’s health research is part of the scientific framework at the NIH- and throughout the scientific community.”

The national nonprofit, Society for the Advancement of Women’s Health Research (SWHR) was founded to “…[address] unmet needs and research gaps in women’s health.”

Women’s Health Equity Act (WHEA) was introduced and later passed in 1991 increased awareness in women’s health issues.

1991

Women’s Health Initiative (WHI) began the project of long-term studies on several chronic diseases in women of all backgrounds. It continues to provide research in other areas of women’s health.

1993

The FDA pulled back the federal ban of women of childbearing years in Phase 1 and 2 drug trials from 1977 and developed new gender guidelines.

The NIH Revitalization Act was signed into law which “…directed the NIH to establish guidelines for inclusion of women and minorities in clinical research.”

1998

The New Mothers’ Breastfeeding Promotion and Protection Act was introduced to amend the Civil Rights Act of 1964 to include breast feeding as an activity that cannot be discriminated against. This bill still remains in the House of Representatives and has been passed along through several subcommittees, last action was on April 17, 1998 in which it was referred to subcommittee on Early Childhood, Youth and Families.

Recent History

Whi Studies

The WHI studies continue to expand upon the original data collected along with newer cohorts. In the most recent WHI Annual Progress Report (February 28, 2020), of the number of women that remain in the studies have shown that:

More women develop cardiovascular disease that can lead to death
The older the women who are studied, the high percentages of developing cardiovascular disease, cancer, and hip fractures.
American Indian/ Alaskan Natives have the highest percentage of cardiovascular disease.
Asian/ Pacific Islanders and Non-Hispanic Whites have the highest percentage of cancer.
American Indian/Alaskan Natives have a higher percentage of deaths from cardiovascular disease, cancer, or other known causes.
There are higher incidences of breast cancer (invasive) in comparison to ovarian, endometrial, colorectal, leukemia, lung, Non-Hodgkin’s lymphoma, melanoma of the skin, and pancreas cancers.
There are higher incidences of Coronary-Artery Bypass Grafting (CABTG) and Percutaneous Transluminal Coronary Angioplasty (PTCA) in comparison to other cardiovascular issues.

What are the implication of these studies?

From the WHI study we can learn about how women’s heart attack symptoms may differ from men’s symptoms:

WoMen

according to the Mayo Clinic

men

neck, jaw, shoulder, upper back or upper abdomen discomfort
shortness of breath
pain in one or both arms
nausea or vomiting
sweating
lightheadedness or dizziness
unusual fatigue
heartburn

sudden cold sweat
discomfort or tingling in the back, shoulder, arms, neck, or jaw
chest pain or pressure
shortness of breath
nausea

Prior to this information, women were often misdiagnosed or disregarded as being “hysterical” leading to health complications or premature death. We’re also finding the severity of the lack of health care resources that plague the American Indian/ Alaskan Native populations to the point that it impacts their life expectancy through disease.

Global focus on Women’s health and gender equality

In 2021 the World Health Organization (WHO) are turning to the future to set their sights on women’s health and gender equality. They stated that the agenda will revolve around these key areas:

“Bodily autonomy — enabling women and girls to make informed sexual, reproductive, and healthcare decisions—a human right for all.
Promoting equitable gender norms, including those that make violence against women and girls, including harmful practices such as early/forced marriage and female genital mutilation, unacceptable.
Financing universal health coverage and social protection to cover health costs, child care, paid parental, sick and family care leave and old age pension.
Valuing paid employment and unpaid care work equally and enabling men to share care work with women.
Addressing male bias in the development of vaccines, drugs, and diagnostics.
Strengthening health systems to include safe, decent working conditions for the majority female health workforce including eliminating sexual harassment and violence.
Investing in feminist movements, which have been instrumental in fostering progressive changes towards gender equality.
Ensuring women’s and feminist leadership in governments, health and development agencies, and other global organizations.”
The Future we Expect: Women’s Health and Gender Equality; Joint News Release; June 28, 2021

Women’s health has come a long way from it origins, however it has a lot further to go. Newer research and the understanding of all women can provide insights in the hopes to expand upon the Women’s Health Movement and affect our laws to create equality and the availability of resources in health care.

Resources

UnWell Women: Misdiagnosis and Myth in a Man Made World by Elinor Cleghorn

The Future we Expect: Women’s Health and Gender Equality, the WHO Joint News Release, it also has other resources such as podcasts and videos

National Women’s Health Network

Women’s Health Initiative

Women and Hysteria in the History of Mental Health, Tasca et al., 2012.

The Doctors’ Case Against the Pill by Barbara Seaman

Our Bodies, Ourselves

The Jacobs Institute of Women’s Health

The Office of Research on Women’s Health

Society for the Advancement of Women’s Health Research

This month’s blog post was written by our Chronic Illness specialist, Aarti S. Felder, MA, LCPC, BCN.

Schedule an Appointment with Aarti S. Felder, MA, LCPC, BCN

Mental Health in the hospitality industry

Posted on February 28, 2022February 28, 2022 by TriWellness in Blog

“We’ve got to have a delicate balance of carefully and prudently going towards normality and opening up at the same time that we contain and allow these surges. Staying shut down has economic, employment, health and other negative consequences…”
– Dr. Anthony Fauci

Introduction

Covid-19 is one of the most potent and aggressive ailments our society has seen in a long time. It’s initial spread, to its mutations, have all led to where we are now. In the United States, we’ve had lockdowns, and still have mask mandates, and vaccine boosters coming out to try and stem the tide of this ever-present threat.

While these methods of containment and trying to fight back against the virus are surely justified, they do have their implications. One major implication is economically, with many businesses having to adapt to the ever-shifting changes and government mandates or be crushed underneath them.

No other type of business is impacted more by this than small businesses. Small businesses within the service industry are even more impacted by this virus, as government mandates often limit how many people can be within the store at one time, on top of the recent staff shortages, it makes for a challenging time to operate, and work for one of these businesses.

For the most part, this economic impact has been looked at by most news outlets and reported fairly well. However, while economics are important, the spotlight is not often shone on those working and operating these businesses. How these turbulent times have not just impacted the people in these businesses financially, but on their health, especially their mental health.

In this article, we will be exploring the perspectives and stories of those working within these businesses.

Interviews

The Small Business Owner

Small businesses were once considered the backbone of America, where anyone who put their mind to it could reach their goal of financial independence and a decent way of life. During the age of Covid-19, that dream is hampered substantially.

Trying to entice customers into the store, while offering a decent wage against larger corporate competitors is no easy task. With so many odds stacked against them, it is no wonder many small businesses have had to close their doors. That being said, not all small businesses have become dust in the wind.

Within the Lincoln Park area, there lies a bakery and café that has stood its ground during this turbulent time. We at TriWellness were fortunate enough to be able to get to talk to the business owners who operate the establishment, to get a glimpse into how it is running a small operation in the midst of a global pandemic, and the tole it takes on their mental fortitude.

The first topic we discussed was how covid-19 impacted their mental health. The owners talked about how it has forced them to become more resilient mentally, that they recently had a baby girl, and they need to not just be strong for themselves, but for their child as well.

The owners also spoke about the hiring difficulties, that trying to hire, and retain workers during this time has been more difficult than it has ever been. One of the owners even spoke to working over a hundred days straight, day and night, because no night cooks would be willing to come in and take a shift.

While we were on the topic of working long hours, the question was asked if the owners felt they can even relax when they are not in the store? The owners said that they had to adapt to the added strain, and that they have to often force themselves to take breaks and relax, just so they can keep functioning.

Now, this added strain and strife was not exclusive to the owners of this small business, but also the people who staffed it as well, who we were fortunately able to talk to some of the people who staffed this small café.

We started by asking the same question, “how has Covid-19 impacted your mental health?” The worker described that it has fluctuated, that every day brings a different feeling. The worker described the turbulence that working in the food industry has caused, being laid off from one food service job, and leading them to where they are now. The worker described this process as stressful, on top of the ambient threat of the virus in the back of their mind, worrying not so much for themselves, but their partner and coworkers as well.

This added stress and anxiety has even impacted this person’s ability to work as well, with dealing with customers, and the world around them, harder. The worker described this added weight when having a negative interaction with a customer, even as something small as a customer complaining that “you put onions on my sandwich when I asked for none.” The worker went on to state that working during this period has “made hard things harder.”

The worker was then asked as a follow up to the concept of working during this time, “is feeling safe at work a luxury?” To which the worker then said, with a definitive, “Yes!” The luxury of some people having the ability to feel safe by working from home is not available to someone who works in the service industry, and that as difficult as it can be, the worker must take the feelings of safety where they can get it.

The worker then reflected, and stated they have this dreadful feeling, that during this time, working and interacting with people who are not taking this pandemic seriously, and act so callously towards people just trying to work. The worker described this lack of common humanity, when customers refuse to wear masks, or when customers complain about just wanting things to go back to normal, all things that impact their ability to work, and their feelings of burnout.

The worker elaborated on this feeling of burnout, that they often feel that they go in this cycle of feeling better about working, then over time and so many negative interactions, it brings them back around to feeling burnt out, not just with work, but with everyday tasks as a whole.

We then switched gears a bit, and started talking about self-care, and being able to relax outside of work. The worker then chuckled slightly and stated, “I am good at relaxing.” The worker then went on to say that now more than ever, they take the time outside of work to relax, they take bubble baths, read, and do fun projects with their partner. All that to the goal of being able to keep functioning in the world they find themselves in.

So, what can we take from this?

For the many people working within this industry, it can often feel that there is no room to breathe, that one has to work so much that there is no time at the end of the day to relax.

One thing that we can glean from these interviews, is that it is important to carve out any amount of time for self-care, even if it is limited. Although this begs the question, even if we do set aside some valuable time for ourselves, how do we spend it?

A major part of self-care we can do for ourselves is to make sure that keeping on top of proper nutrition, and sleep. It can be easy to forget that our minds and bodies are so closely linked, and that they have so much influence over the other. When we stop and take the time to care for our bodies, we care for our mind as well

A tried-and-true method of self-care is exercise. Exercise is a multifaceted approach to helping our body and mind. Not only does a little bit of movement help build our muscle and endurance, but it also helps our brain as well. When we exercise, a neurotransmitter gets released, called an endorphin. Endorphins aid our brain release some stress and help us to feel a little happier. Research has also shown that exercise can be a factor to activate the parasympathetic nervous system, after stressful event or even during chronic stress (Tsatsoulis, Agathocles & Fountoulakis, Stelios; 2006). So, be it a nice run, lifting weights at the gym, or even a long walk, a little bit of exercise goes a long way.

Resources

Articles on Excercise!

https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469

https://health.usnews.com/health-care/patient-advice/articles/best-exercises-to-ease-stress-and-anxiety

https://www.everydayhealth.com/exercise-photos/exercises-that-relieve-stress.aspx

The Protective Role of Exercise on Stress System Dysregulation and Comorbidities

References

Robinson, K., Jesner, L., Rapaport, L., Bedosky, L., Byrne, C., Millard, E., & Asp, K. (2022, February 18). 8 exercises that Relieve Stress – Women’s Guide to Stress Management – Everyday Health. EverydayHealth.com. Retrieved February 26, 2022, from https://www.everydayhealth.com/exercise-photos/exercises-that-relieve-stress.aspx

Howley, E. K. (2020, June 19). 12 Best Exercises to Ease Stress and Anxiety – US News Health. USNews. Retrieved February 26, 2022, from https://health.usnews.com/health-care/patient-advice/articles/best-exercises-to-ease-stress-and-anxiety

Mayo Foundation for Medical Education and Research. (2020, August 18). Exercise and stress: Get moving to manage stress. Mayo Clinic. Retrieved February 26, 2022, from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469

Olpin M, et al. Healthy lifestyles. In: Stress Management for Life. 4th ed. Cengage Learning; 2016.

This month’s blog post was written by Christian Moresco. Christian is an intern and attends graduate school at DePaul University and aspires to be a counselor who specializes in health and wellness.

Schedule a consultation with a clinician

Chronic pain and mental health

Posted on January 31, 2022January 31, 2022 by TriWellness in Blog

It has been said that time heals all wounds. I don’t agree. The wounds remain. Time – the mind, protecting its sanity – covers them with some scar tissue and the pain lessens, but it is never gone.
Rose Kennedy

Pain is something that everyone experiences. It is a signal that there is something wrong in the body. According to the CDC, 20.4% of adults had chronic pain and 7.4% of adults had chronic pain that frequency limited life or work activities. This data also found that chronic pain increased as people got older. And while we are still recording data, we have preliminary reports about long-term effects of Covid-19, we find that different types of pain is one of those effects. This study found that chronic pain was highest in women at 21.7%, and that women are less likely to be believed about pain by their doctors. This is something that is also seen in physician’s responses to people of color, as they are often acting on unconscious bias about how minoritized individuals feel less pain or feel pain differently than white people.

What is Pain?

There are many ways to define pain, and how you define it impacts how you approach it. Do we consider physical pain? What about emotional pain? Social pain? Psychological pain? Here are some common types of pain:

Acute pain
Chronic pain
Neuropathic pain
Psychogenic pain

Acute pain is a sudden pain that has a limited duration, usually a few minutes to three months, sometimes up to six months. Chronic pain is more long-term pain that can be constant or intermittent, even after healing is complete. Neuropathic pain is pain caused by nerve damage and is often described as shooting or burning pain. Nociceptive pain is pain caused by tissue damage. Psychogenic pain is pain that might have started physically, but is prolonged by fear, stress, depression, anxiety, or is caused by a psychological condition. Often psychogenic pain is a type of pain that doesn’t match the symptoms a person is experiencing, and is diagnosed after everything else has been ruled out.

How is Pain Processed

The gate-control theory of pain was developed to look at three systems involved in the perception of pain. These systems are the peripheral nerves that first receive pain signals, the spinal cord which receives the signal and sends it to different areas of the brain. In the brain there are different areas that can be impacted by pain such as the limbic system developing a memory of pain, and some emotional areas. This process can be inhibited at different points in the pathway, and through other pathways that responds to deep touch and inhibits the release of pain signals. While this is an abstract look at how pain is processed by the body, it is important to look at how pain affects everyday life.

How pain impacts life

Pain can have a profound impact on a person’s life; from limiting the things a person can do, to decreasing the quality of sleep, to leading to mental health issues, pain can bring about a lot of changes. Chronic pain specifically can impact physical, psychological, and social functioning. Often pain management is primarily handled through pharmaceuticals, but we are now seeing how that overmedication is leading to increased substance abuse. Studies have shown that people with chronic pain are four times more likely to have depression and anxiety than those without pain.

Common chronic pain conditions

There are many different things that can cause chronic pain, but some of the most common are:

Arthritis/joint pain
Back pain
Cancer pain
Headaches/migraines
Muscle pain
Nerve damage

This pain can lead to what is known as the “terrible triad.” The terrible triad happens when pain interferes with the normal activity of life leading to depression and irritability, which can lead to insomnia. This state of being in pain, being depressed and being sleepless create a triad of suffering.

Another thing that is often not considered is how pain affects younger people. In a study from 2016, it was conservatively estimated that 20-35% of children and adolescents are affected by chronic pain worldwide. In children, pain is often under-recognized and under-treated, especially when they might not have the language skills to express what they’re experiencing. Common causes of pediatric chronic pain include:

Headaches
Recurrent abdominal pain
Limb pain
Back pain
Pain without any known cause

In children this pain can impact their development because it can lead to the inability to participate in age-appropriate social activities, missing school, isolation, difficulty forming interpersonal relationships, and mental health issues.

Treatment for pain

So as stated above medication the the primary treatment for pain, and should be continued but there are other treatments to keep in mind, that should be monitored by a medical professional. This includes:

Physical therapy
Acupuncture
Transcutaneous electrical nerve stimulation (TENS) therapy
Hypnotherapy
Behavioral Therapy
Biofeedback
Neurofeedback
EaseVRx virtual reality system

Some therapeutic modalities, specifically Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) have been shown to help relieve some in managing the pain and discomfort.

Neurofeedback and pain

So what is neurofeedback. Neurofeedback is a kind of biofeedback that has been in use for decades based on direct, behavioral training of the brain using an electroencephalograph (EEG). We place electrodes on the scalp to observe the different brainwaves and learn different information based on where, the frequency of, and when certain brainwaves occur. This technique allows us to observe the brain in action as the brain learn to function more efficiently.

For pain management, the theory is that neurofeedback works by teaching self-regulation. Studies suggest that neurofeedback can be used to affect the processing of pain perception, such as in the gate-control theory discussed above. Some chronic pain conditions neurofeedback has been used to treat before include:

Trigeminal Neuralgia
Headache and migraines
Fibromyalgia

Resources

https://www.aamc.org/news-insights/how-we-fail-black-patients-pain

Click to access db390-H.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888311/

Acceptance and Commitment Therapy for Chronic Pain

Ibric, V. L., and Dragomirescu, L. G. (2009). “Neurofeedback in pain management,” in Introduction to Quantitative EEG and Neurofeedback. (New York, NY: Elsevier Inc.), 417–51. doi: 10.1016/B978-0-12-374534-7.00016-2

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892319/

https://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-virtual-reality-system-chronic-pain-reduction

https://www.ninds.nih.gov/Disorders/All-Disorders/Chronic-Pain-Information-Page

Here at TriWellness we do offer neurofeedback and a pediatric chronic illness support group.

This month’s blog post was written by Jessie Duncan, MA, LPC, one of our trained specialists in Neurofeedback and chronic illness specialist.

Schedule an appointment with Jessie Duncan, MA, LPC

Neurofeedback and Tinnitus

Posted on December 19, 2021December 19, 2021 by TriWellness in Blog, Uncategorized

What is tinnitus

Tinnitus is a condition characterized by ringing or other noises in one or both ears. Tinnitus can be caused by hearing loss, ear infection, head or neck injuries, certain medications, or symptoms of other health conditions. Tinnitus can also cause other complications from sleep problems, social problems, and other mental health issues.

Tinnitus effects on mental health

anxiety and Stress

Often people pondered the “chicken-or-the-egg” conundrum, does anxiety cause tinnitus or tinnitus cause anxiety? Research continues to try and answer that question. In a longitudinal study examining the correlation between anxiety and tinnitus, the researchers found that those with tinnitus had a high incident rate of anxiety. They further noted that the correlation could be due to anxiety causing tinnitus, tinnitus and anxiety effect each other equally, or that there is another factor affecting both anxiety and tinnitus. Other factors may be genetic or neurological dysfunction (Hou, Yang, Tsai, Shen, Lan, 2020).

There are neurological networks that share commonalities between anxiety and tinnitus. The Limbic System and the Dorsal Cochlear Nucleus (DCN) are thought to be neurological contributors to anxiety and tinnitus. One of the functions of the Limbic System is to manage emotional states. While one of the functions of the DCN converting auditory stimuli in the brain. The proximity of these two neurological networks can possibly affect each other in times of stress.

Regardless of the correlation of anxiety and tinnitus, the end result is still feeling a sense of anxiety and stress. Individuals have noted that they feel more stressed and anxious when they experience increasingly louder ringing in their ears (due to the tinnitus) and in a cyclical fashion they find that the symptoms of tinnitus are further exacerbated, creating significant distress.

Depression

Similarly to anxiety, depression and tinnitus correlation is still being researched. In a scientific review, the researchers arrived to a similar conclusion: depression affects tinnitus, tinnitus causes depression, or depression and tinnitus are symptoms of another condition (Geocze, Mucci, Abranches, de Marco, Penido, 2015). Furthermore, depression and tinnitus can be correlated due to the the neurological proximity and the functionality of the Limbic System and the DCN.

Due to the symptoms of tinnitus being unrelenting, individuals may feel hopeless in achieving relief. These symptoms may also affect sleep, causing fatigue and low energy. Furthermore, it may impact people’s motivation to engage in social activities, resulting in social isolation. All of these secondary symptoms can cause one to become depressed.

Neurofeedback As a treatment for Tinnitus

As previously established, tinnitus has neurological origins. With that understanding, researchers have studied using Neurofeedback as a treatment strategy for tinnitus. In a study, researchers found that Neurofeedback training can assist individuals in controlling their attention to the auditory stimuli, and thusly experienced a reduction in symptoms (Busse, Low, Corona-Strauss, Delb, Strauss, 2008). In another study, researchers found that utilizing Neurofeedback training to modify specific brainwaves, patients with tinnitus has experienced major to complete symptom relief (Dohrmann, Weisz, Schlee, Hartmann, Elbert, 2007).

Neurofeedback is also an affective non-pharmaceutical treatment strategy to treat the aforementioned complications of tinnitus. Studies have shown that Neurofeedback training can reduce anxiety through brainwave regulation. Studies have also shown that Neurofeedback training can assist in establishing normalized neurological activity in individuals experiencing depression.

Resources

Tinnitus

Tinnitus Among Patients With Anxiety Disorder: A Nationwide Longitudinal Study

Systematic Review on the Evidences of an Association between Tinnitus and Depression

Depression in Patients with Tinnitus: A Systematic Review

Tinnitus and Hearing Loss in 15–16-Year-Old Students: Mental Health Symptoms, Substance Use, and Exposure in School

Neurofeedback by Neural Correlates of Auditory Selective Attention as Possible Application for Tinnitus Therapies

Neurofeedback for Treating Tinnitus

Alpha Suppression and Symmetry Training for Generalized Anxiety Symptoms

A Review of EEG Biofeedback Treatment of Anxiety Disorders

Clinical Use of an Alpha Asymmetry Neurofeedback Protocol in the Treatment of Mood Disorders: Follow-Up Study One to Five Years Post Therapy

Neurofeedback with anxiety and affective disorders

This month’s post was written by Aarti S. Felder, MA, LCPC, BCN. Aarti is our chronic illness specialist and is a Board Certified Neurofeedback practitioner.

Schedule an appointment with Aarti S. Felder, MA, LCPC, BCn

Attention Deficit Hyperactivity Disorder

Posted on October 29, 2021 by TriWellness in Blog

What is Adhd?

Attention Deficit Hyperactivity Disorder is a complex neurodevelopmental disorder that is characterized by low production of dopamine in the prefrontal cortex. The prefrontal cortex is in charge of what we call executive functions; planning, organizing, decision-making–all of the directing parts of the brain. Emotional regulation and reward pathways in the brain are also affected by individuals with ADHD. The diagnosis is further broken down into three different presentations: primarily inattentive, primarily hyperactive, or the combined type. Here’s a list of some of the symptoms to look for:

The inattentive symptoms (previously referred to as ADD) in the Diagnostic and Statistical Manual 5^th edition (DSM-5) are:

Often fails to pay close attention to details or makes careless mistakes in schoolwork, at work, etc.
Often has trouble holding attention on tasks or activities (e.g., easily distracted)
Often does not seem to listen when spoken to directly
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, gets side-tracked)
Often has trouble organizing tasks and activities; has trouble finishing tasks
Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time
Often loses things necessary for tasks and activities (e.g., school materials, wallet, phone, keys).
Often forgetful in daily activities
Often distracted by stimuli (e.g., sounds, movement)

The hyperactive/impulsive symptoms in the DSM-5 are:

Often fidgets with or taps hands/feet or squirms in seat
Often leaves seat in situations when remaining seated is expected (e.g., leaves place in the classroom, in meetings, etc.).
Often runs about or climbs in situations where it is inappropriate. In adolescents or adults, this may manifest as feeling restless
Often unable to play or engage in leisure activities quietly
Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to remain still for any extended time without significant discomfort; others may say that the person is restless, fidgety, or difficult to keep up with).
Often talks excessively
Often completes other people’s sentences or blurts out an answer before a question has been completed

Often has difficulty waiting for their turn (e.g., while waiting in line, while speaking in conversations).
Often interrupts or intrudes on others. For adolescents and adults, may intrude into or take over what others are doing (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission)

The combined type is diagnosed by the presence of an even mix of the symptoms. There are other criteria for this diagnosis which include symptoms lasting for a specific duration and having an impact on various domains of an individual’s life.

What are the Statistics

Approximately 5% of children and adolescents are affected by ADHD globally. In the U.S. 6.1 million children (9.4%) between the ages of 2 and 17 are estimated to be diagnosed with ADHD, with boys more likely to be diagnosed than girls (11.7% compared to 5.7%). The difference in the diagnosis of girls and boys is often due to the presenting symptoms and socialization of children. Girls are more often diagnosed with the inattentive presentation which is often missed in a classroom setting where most referrals for ADHD testing occur.

While ADHD is considered a childhood disorder, 139.84 million adults have persistent ADHD with childhood onset (2.58% of the global population) and 366.33 million adults have symptomatic ADHD regardless of onset (6.76% of the global population) as of 2020. Because ADHD affects brain development, it manifests in all aspects of life and can significantly impair educational achievement, relationships (romantic, familial, friendships), employment, finances, etc. There are many common symptoms of ADHD (inattention, inability to focus, poor time management, weak impulse control, exaggerated emotions, hyperfocus) which are often seen as character flaws or bad parenting when the underlying cause is due to an individual’s specific brain functioning. This is also seen in difficulty with emotional processing.

Emotional dysregulation

One aspect of ADHD that has been recognized as a symptom for diagnosis in Europe and noted in research for at least two decades but is still not considered in the Diagnostic and Statistical Manual version 5, has been the emotional component of ADHD. About 70% of adults with ADHD report emotional dysregulation (ED), which has led to the term, DESR, or deficient emotional self-regulation, popping up in ADHD research, and other mental health conditions in which emotional dysfunction is a major component. This refers to a deficiency in the four components of self-regulation. These four components are the ability to inhibit behavior triggered by strong emotions, the ability to self-soothe and regulate strong emotions, the ability to refocus from events that cause strong emotion, and the ability to organize emotional responses. This emotional dysregulation greatly impacts a person’s ability to recognize and control the emotions that they are feeling which can lead to issues connecting with others, putting feelings aside to focus on something, and processing a difficult situation. This can be seen in rejection sensitive dysphoria.

Rejection sensitive dysphoria (RSD) is a common manifestation of emotional dysregulation that is defined by an extreme emotional sensitivity and pain that is triggered by the idea that someone is being rejected or criticized by important people in their life or by the idea of failing to meet an expectation. While RSD is not caused by a trauma, the pain from it can be felt as a traumatic experience. When these feelings are internalized, they can imitate a mood disorder, and often leads to misdiagnosis of a major mood disorder. When these feelings are externalized, they can be like a sudden rage at the person or situation causing the pain. This can be a devastating ordeal that can lead to feelings of alienation.

Comorbidities with adhd

People with ADHD often have other co-occurring mental health conditions. According to the CDC almost 64% of children with ADHD have at least one other mental health condition: 52% have behavioral health or conduct problems, 33% have anxiety disorders, 17% have depression, 14% have been diagnosed with autism spectrum disorder, and 1% have Tourette syndrome.

In adults as many as 80% of people with ADHD have at least one co-occurring mental health condition. It is estimated that rates of comorbid bipolar disorder in adults with ADHD are between 5.1% and 47.1%, about one-fifth to one-half of adults with ADHD have major depressive disorder/dysthymia, about 50% of individuals with ADHD have some type of anxiety disorder, personality disorders are present in more than 50% of adults with ADHD, and research shows that 25% to 40% of adults with substance use disorder also have ADHD. Having multiple mental health conditions can make it harder to identify the source of a condition and the best way to approach treatment. When talking about ADHD, we expect it to present as primarily hyperactive/impulsive and this can also lead to issues in beginning treatment. Women and girls are often misdiagnosed or underdiagnosed in ADHD because they primarily present in the inattentive type. The classroom setting is most often where ADHD is first noticed, but with the inattentive type it is often less disruptive to the classroom so is less likely to get someone referred for treatment. Also in female students the behaviors that would often get male students categorized as ADHD get labeled as “airheaded” or a “chatterbox” or “flighty.” They also are socialized to behave in ways that more easily mask their symptoms, such as spending more time on school work, which can lead to other problems when they are unable to manage emotionally or socially in the ways they are expected to. This can be stigmatizing when they are unable to perform the way they are expected to and can lead to perfectionism, social withdrawal, low self-esteem, and negative self-talk.

The future of adhd

In current ADHD research there is looking into changing the name to better reflect the complex of the condition. One proposed future name is variable attention stimulus trait (VAST). This name comes from Edward Hallowell, M.D., John Ratey, M.D. who are leading researchers and wrote the book ADHD 2.0. Other areas of research are looking into better understanding the emotional aspects of the condition.

Treatment for adhd

When approaching treatment for ADHD, medication is the most well known and most stigmatized. It is an important treatment approach, because when people are on the right dosage of medication it greatly improves their lives. RSD can be greatly improved by medication management.

Another treatment approach is ADHD/executive functioning coaching. This is a behavioral training that focuses on finding ways to deal with/externalize the executive functioning skills that are lacking.

Therapy is another approach that helps build coping strategies, builds greater understanding of the areas in which a person is struggling, and can help a person learn ways of dealing with the emotional issues of ADHD.

Neurofeedback is another treatment that has been proven effective for ADHD. Neurofeedback, or EEG Biofeedback, is a technique that uses operant conditioning to train the brain to be more efficient (and is a service that we provide).

As we continue to learn more about ADHD and how to improve the quality of life of people who have the condition, we will continue to approach it by looking at the strengths that can be found in it. Here at TriWellness we can help.

Sources

The Prevalence of Adult Attention-Deficit Hyperactivity Disorder: A Global Systematic Review and Meta-Analysis

ADHD Statistics: New ADD Facts and Research

DESR: Why Deficient Emotional Self-Regulation is Central to ADHD (and Largely Overlooked)

Emotion Dysregulation in Attention Deficit Hyperactivity Disorder

Emotion Dysregulation in Adults with Attention Deficit Hyperactivity Disorder: a Meta-Analysis

How ADHD Ignites Rejection Sensitive Dysphoria

Attention Deficit Hyperactivity Disorder (ADHD)

Data and Statistics About ADHD

Adult ADHD and Comorbid Disorders: Clinical Implications of a Dimensional Approach

Does the Continuous Performance Test Predict ADHD Symptoms Severity and ADHD Presentation in Adults?

ADHD Looks Different in Women. Here’s How — and Why.

ISNR and ADHD

This month’s blog post was written Jessie Duncan, MA, LPC, a specialist in Chronic Illness and Neurological Treatment modalities.

Schedule an appointment with Jessie Duncan, MA, LPC

Black History in Psychology

Posted on February 24, 2021 by TriWellness in Blog, Uncategorized

“The fact that we are here and that I speak these words is an attempt to break that silence and bridge some of those differences between us, for it is not difference which immobilizes us, but silence. And there are so many silences to be broken”
Audre Lorde

History is important because it connects us to a context greater than ourselves, as well as the larger community that helps us process things better and be greater than the whole. This is part of the reason why Black History Month was created. Black History Month was officially recognized in 1976 as a national event after decades of efforts to recognize the often-neglected accomplishments of Black Americans in United States and global history. This exclusion from history is seen in so many aspects of life, including mental health. Within the African American community there is a lot of skepticism about seeking services, which is a result of years of unethical treatment that continues to the current day. From racial eugenics and forced sterilization, to Henrietta Lacks whose cells were taken without her permission and used (to this day!) for medical research, to the Tuskegee syphilis experiments (which were continued in Guatemala after being deemed too unethical for the United States), to the history of gynecology, to the increased risk of complications and death due tocovid-19, there are many examples of how the medical field hurts Black Americans. Due to this deep history of abuse by the medical field and erasure of the contributions made by these individuals, it makes sense that there is mistrust by the community. Being disconnected from one’s history and contributions can lead to a sense of isolation and not belonging/not being wanted by the culture around you/excluded and exploited by a society that steals from your culture and dehumanizes you.

Connecting to the History of Psychology

Often Black, Indigenous, and People of Color (BIPOC) feel that they are excluded from mental health spaces. Part of that is because of the earned mistrust in the medical and mental health fields, and part of it is because the field often excludes issues that are major concerns for these communities. Psychology and mental health issues are primarily seen as white, Western traditions that do not prioritize the things that are important to people outside of the dominant cultural narrative. But if we look at and understand that counseling is a healing practice, it becomes clear that it includes BIPOC. With that being said, let’s first look at the contributions BIPOC have made in the field of psychology and counseling.

Black Psychologists

“In the future, as in the present, as in the past, Black people will build many new worlds. This is true. I will make it so. And you will help me.”
N. K. Jemisin

Dr. Francis Cecil Sumner, PhD: Father of Black American Psychologists (1895-1954)

The first African American to receive a Ph.D. in psychology in 1920 from Lincoln University
He focused on refuting racism and bias in Eurocentric theory and research of psychology

Dr. Inez Beverly Prosser, Ed.D (1895-1934)

The first African American woman to receive a doctoral degree in psychology in 1933 from the University of Colorado
Her work focused on the education system and the different outcomes of students in integrated vs. segregated schools

Dr. Ruth Winifred Howard Beckham, PhD (1900-1997)

Received a PhD in psychology and child development in 1934 from the University of Minnesota
Dedicated her career to the advancement of women and children in her community

Dr. Herman George Canady, PhD (1901-1970)

Received a Ph.D. in psychology in 1941 from Northwestern University
The first psychologist to examine the role of the race of the examiner as a bias factor in IQ testing
Spearheaded the movement to organize Black professionals in psychology

Dr. Joseph L. White, PhD: Godfather of Black Psychology (1932-2017)

Received a Ph.D. in clinical psychology in 1961 from Michigan State University
Proposed the seven major psychological strengths of African-Americans (2005)
- Improvisation
- Resilience
- Connectedness to others
- Spirituality
- Emotional vitality
- Gallows humor
- Healthy cultural suspicion

Dr. Robert V. Guthrie (1932-2005)

Described by the American Psychological Association (APA) as “one of the most influential and multifaceted African-American scholars of the century”
Wrote Even the Rat was White: A Historical View of Psychology
- Exposed that long history of racist work in psychology
- Profiled overlooked Black psychologists
First African-American to have his papers included in the National Archives of American Psychology

Dr. Robert Lee Williams II, PhD (1930-2020)

Received a Ph.D. in clinical psychology in 1961 from Washington University in St. Louis
Created the Black Intelligence Test of Cultural Homogeneity (BITCH-100) in 1972
- Created to demonstrate how cultural content on intelligence tests may lead to culturally biased score results
- Set a precedent for the critical examination and rejection of Eurocentric intelligence testing

Dr. William Cross (1940–present)

Received his Ph.D. in Psychology in 1976 from Princeton University
Proposed one of the first models of Black racial identity development in psychology

Dr. Janet E. Helms (present)

Received her doctorate in psychology with a specialization in counseling psychology in 1975 from Iowa State University
Her work focuses on how race, culture, and gender can influence one’s personality and participating counseling styles
Challenged inherent racial bias in construction of assessment tools
Racial Identity Theory

The Association of Black Psychologists (ABPsi)

Established in 1968
Original goal was to have a positive impact upon the mental health of the national Black community by means of planning, programs, services, training, and advocacy
Current goal is to promote social justice, cultural psychology, racial/ethnic identity and multicultural competencies, and addresses challenges facing the black community

Association for Multicultural Counseling and Development (AMCD)

Division of the American Counseling Association chartered in 1972
Part of its mission is to enhance the development, human rights and the psychological health of ethnic/racial populations and all people as critical to the social, educational, political, professional and personal reform in the United States and globally

Since the early days of psychology BIPOC individuals have been present and advocating for the issues that concern their communities.

What are specific needs of BIPOC individuals?

There are many issues that impact communities of color’s physical and mental well-being. These include lack of access to resources such as healthcare, steady employment, nutritious foods due to food apartheids, and housing due to the continued effects of redlining on the housing market. There is also the stress of the continued global pandemic and increased cultural awareness of racial trauma.

Racial trauma, a form of race-based stress, refers to BIPOC reactions to dangerous events and real or perceived experiences of racial discrimination. In the past year, many causes of race-based stress were highlighted, including the continued police brutality and murder of BIPOC individuals, the increased lack of support from the government, and the lack of access to basic needs. This stress can cause many health problems because of what stress does to the body. This can include physical affects like headaches, muscle tension or pain, chest pain, fatigue, stomach issues, and sleep problems; mood issues like anxiety, restlessness, lack of motivation or focus, feeling overwhelmed, irritability or anger, and sadness or depression; or behavioral issues like over- or under-eating, angry outbursts, drug or alcohol misuse, and social withdrawal. There can also be long-term problems like higher rates of diabetes, substance use, high blood pressure, cardiovascular disease, and autoimmune disorders.

So what about mental health?

“All that you touch, You Change. All that you Change, Changes You. The only lasting truth is Change.”
Octavia E. Butler

When dealing with all of these stressors, it is important to find ways of approaching healing. Here are some suggestions to begin in that healing:

Eating healthy and getting 7-8 hours of sleep
Staying physically active and making space for moment in your life
Connect with others who reaffirm your humanity
Practice self-care routines
Seek out healing practices consistent with your beliefs
Take breaks from technology and social media
Explore relaxation techniques such as deep breathing
Learn to understand what you can and cannot control

This process can be difficult but important for one’s wellbeing and functioning. You have the skills to heal, and we can help.

“Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
Audre Lorde

Resources

https://pubmed.ncbi.nlm.nih.gov/30652895/

https://www.history.com/topics/black-history/black-history-month#section_2

https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html

https://www.history.com/news/the-father-of-modern-gynecology-performed-shocking-experiments-on-slaves

https://www.cdc.gov/tuskegee/timeline.htm

https://www.apa.org/pi/oema/resources/communique/2012/11/black-psychologists

https://psychology.okstate.edu/museum/afroam/bio.html

Food Apartheid | Why we should change the way we talk about food deserts

Celebrating the Life of Dr. Joseph L. White

https://www.apadivisions.org/division-35/about/heritage/ruth-howard-biography

https://www.tandfonline.com/doi/full/10.1080/09515070.2020.1766420

https://www.cbsnews.com/news/redlining-what-is-history-mike-bloomberg-comments/

https://eji.org/news/history-racial-injustice-racial-eugenics/

This month’s post was written by Jessie Duncan, BS.

Schedule an appointment with a clinician

Politics and Mental Health

Posted on October 31, 2020October 31, 2020 by TriWellness in Blog

Politics is a very exhausting, ever changing field. The current American election seems to be the most high stakes event with no way to escape hearing about it. We are in a state of media oversaturation where very few places are free from the looming spectre of the political machine. This adds to the stress of the continued global pandemic due to covid-19. The compounding of this stress can have many effects on the mind and body including nausea, chest pain, weight gain, anxiety, and depression.

So where to start?

A place to begin is understanding why politics are so stressful. To begin let’s understand the stress response. When you encounter a perceived threat or fear, the amygdala reacts. The amygdala is a part of the limbic system that is responsible for anxiety, aggression, fear conditioning; emotional memory and social cognition. The amygdala leads to the activation of the hypothalamus which activates the sympathetic nervous system leading to the release of adrenaline and cortisol which regulates the flight, fright, or freeze response. This response is the reason for most of the physical symptoms of anxiety and fear. These include short-term symptoms like racing heartbeat, fatigue, upset stomach, spikes in blood pressure, and shortness of breath; or long-term symptoms like decreasing the immune response, memory issues, increased signs of aging, changes in personality, and cardiovascular disease.

© 2015, Korean Society for Biochemistry and Molecular Biology

So what is it about politics that causes such an intense response? Well, part of it has to do with how the information is presented. Politics is a highly changed topic because personal is political. The things that a person values are directly related to the policies that they would be willing to endorse. This means that people often view political policies as directly relating to their identity which makes them more likely to have an emotional reaction to anyone who opposes a policy.

Another way politics are tied to emotions is how a policy is presented. An example of this is how Proposed Amendment to the 1970 Illinois Constitution is framed. This amendment, referred to as ‘Fair Tax for Illinois,’ proposes to change the flat rate income tax rate to a graduated rate similar to federal tax rates. When looking for information on this amendment how it is framed depends on the bias of the website discussing it. For example, certain sources against the amendment mention that while it is proposed that it will decrease taxes for 97% of people in Illinois, the elected politicians cannot be trusted with the money and will continue to increase tax rates when this fails. This is an example of catastrophizing, which is when there is a prediction of a negative outcome for a situation and then jump to the conclusion that if that outcome happened it would be a catastrophe. These websites use catastrophizing to look at the ways in which this amendment could fail to increase the fear response of the people that read their information. This framing of the situation in a way that elicits fears about specific things prevents people from critically examining other concerns that they may have about the new amendment.

Political journalism, including the news, is intended to present political information in an unbiased manner, that is thoroughly fact-checked. However, many opinion-based websites and tv shows frame themselves as if they are political journalism and it is hard to tell the difference. There is also the bias often pops up on different news sources based on the parent companies and other sources of income from the source (this information can be found by searching through the About Us section of a website). All of this happens in politics before addressing the 24-hour news cycle, social media, increasingly partisan politics, racial tensions, and the continued global pandemic. Politics are often framed as an individualistic system where everything that can happen or go wrong is based on the decisions of individual people without looking at the systems that are in place to perpetuate this system. This is a compex, intersectional topic that is multifaceted and affects Black, Indigenous, and People of Color (BIPOC) disproportionally more than other populations, and leads to a lot of stress, anxiety, and depression. Mental health needs cannot be forgotten when approaching politics.

So what can you do?

When it appears that the system is set up in a way to exhaust us physically and mentally, how can we approach this seemingly unending political season.

Here are some suggestions to take care of yourself.

Be mindful and aware of how you’re affected by politics is to acknowledge and take steps to adjust as you need
Accept whatever feelings are brought up in you when politics are brought up
Unplug from the 24 hour news cycle and social media
Good sleep hygiene
Eat healthy
Exercise
Journal
Practice meditation
Find spaces that validate your humanity
Get involved (if you can)

“Our democracy cannot be left in the hands of those who would rather watch or participate in a train wreck than stop it.”
–Kimberlé Williams Crenshaw

Stress can be debilitating, here at TriWellness our clinicians are skilled in assisting each individual in managing stressors. Contact us today to start your journey to wellness.

References

https://www.healthline.com/health/stress/amygdala-hijack#overview

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917081/

https://www.hartigdrug.com/blog/effects-stress-body

https://psychcentral.com/lib/long-term-effects-of-chronic-stress-on-body-and-mind/

https://ballotpedia.org/Main_Page

https://ballotpedia.org/Illinois_Allow_for_Graduated_Income_Tax_Amendment_(2020)

Click to access sia-mental-health-crisis.pdf

This month’s post was written by Jessie Duncan, the TriWellness intern. You can learn more about Jessie here.

EMDR and Interoception

Posted on August 11, 2020 by TriWellness in Blog, Uncategorized

Have you ever noticed that a certain thought, memory or experience can cause a physical reaction in your body? Our emotions are tied to this process. Noticing our body’s physical reaction is an important first step in learning emotion regulation. When you can identify it, you can begin to apply techniques to manage the distress (See April’s blog, When “Just Breathe” Isn’t Enough). Awareness and sensitivity to the connection between cognitive activity, or negative cognitions as we refer to them in EMDR, and the body’s internal signals that accompany those thoughts or memories are an important part of the EMDR process.

Interoception is the ability to identify physical sensation in the body, including the functioning of organs such as heartbeat, respiration and satiety, as well as the state of the autonomic nervous system (rest & digest, fight/flight or freeze). Take a moment and notice if your body feels pleasant, unpleasant, or neutral. How do you know? Have you felt some tension in your shoulders ever since that guy cut you off in traffic? Did you just come back from the gym and notice that your heart rate is faster? Maybe you just spent some time doing one of your favorite things and now you’ve noticed that the muscles in your face have relaxed.

For a little practice “noticing,” the Pendulation technique created by Dr. Peter Levine, is a good starter exercise. To “pendulate” is to shift back and forth from one thing to another. Give the following a try:

Do a body scan from head to toes and try to identify a part of your body that is distress free/neutral and focus on that for a moment. Does your breathing become more regulated, or your heart rate slow down?
Next identify a part of your body that is uncomfortable or perhaps painful and focus on that for a moment. You may notice your breath, heart rate change or perhaps an increase in intensity as you bring your attention to it.
Now shift your attention from the neutral part back to the uncomfortable part a couple of times. The uncomfortable part will likely begin to change, lessen in intensity or go away completely.

Now that you’ve practiced interoception, let’s move on to how this is an integral part of EMDR treatment for trauma. In October’s blog, Uncovering the Mysteries of EMDR and Trauma, I explain in detail how a traumatic event and the negative cognition associated with that event (exp. “I should have done something.”) leaves an imprint in the nervous system. The result is a whole slew of bodily reactions and sensations that can be activated in the future. Perhaps a completely unrelated and non-traumatic situation generates that same cognition of “I should have done something.” Due to the imprint that the previous trauma left, that negative cognition can conjure all of those same physical reactions, even when there is no danger. During EMDR, in addition to treating the traumatic memory, it detaches the associated negative cognition and discharges all of those physical changes in the body. During treatment I will frequently ask the client to do a body scan and tell me what they are noticing. Then we focus on clearing out the sensations that the client is noticing in their body. It may be a heaviness in their chest, nausea or a lump in their throat. Part of preparing for EMDR (phase 2) is teaching the client how to identify even the slightest changes in their body. The skill of interoception is incredibly useful in day to day life. Paying attention to how your body responds as you move through your day, from environment to environment and from one encounter to another. Listen to those cues and use those as a roadmap to create change and a lifestyle that is healthy and happy for you. And of course, seek out a skilled EMDR therapist to help you with the big stuff.

Resources

To learn more about Dr. Peter Levine and his work on Somatic Experiencing visit: https://traumahealing.org/about-us/

To learn more about EMDR visit: http://www.emdr.com/

To learn more about our practice or wanting to connect with an EMDR clinician? Please contact us to set up an appointment.

This post was written by Tonya Nowlin, MA, LPC, to learn more about her please see her bio.

Healing in a Difficult Time

Posted on June 22, 2020October 31, 2020 by TriWellness in Blog

Understanding what is going on

To begin taking care of your mental health, you need to understand the things that are affecting it. The two biggest events happening right now are the Black Lives Matter protests and COVID-19, and it is important to understand why these factors are affecting the mental health of many individuals.

The current protests began due to the murder of George Floyd in Minneapolis, MN on May 25, 2020, after a police officer kneeled on his neck for 8 minutes and 46 seconds. George begged for his life and pleaded that he was in pain, could not breathe, and could not move, but the police officers ignored his pleas. The recent protests seem to be much louder and more widespread than they have been in the past and as a result, many are confused as to why there has been such a large worldwide response. This is because of a combination of factors, including the social isolation due to COVID-19 and the continued unjust deaths of Black and Brown individuals during the stay-at-home order (Ahmaud Arbery, Breonna Taylor, Nina Pop, and others).

It is worth noting that COVID-19 disproportionately affects people of color according to preliminary data released by the CDC. A couple of the reasons for this is the disparity in economic and social conditions that primarily affect people of color. This is due to how systems of education, government and the media celebrate and reward some cultures over others in ways that are often invisible. An example is how bandages come in “flesh-color” as pink/beige and this was unquestioned by a majority of people because white is the assumed default. A less benign example is the history of medical experimentation and poor treatment of black, indigenous, and people of color (BIPOC) that lead to higher rates of diabetes, substance use, high blood pressure and maternal death during pregnancy.

Years of this injustice, along with social media as a means to reach others and organize, have led to the development of the Black Lives Matter movement. This movement began as a hashtag on Twitter in response to the acquittal of Trayvon Martin’s murderer George Zimmerman in 2013. This organization, started by Alicia Garza, Patrisse Cullors, and Opal Tometi, developed into a global movement that is spearheading our current protests. The purpose of the organization is to connect communities, intervene when there is violence against Black communities, and provide a space for women, queer, and trans people to be recognized for their leadership in the work of liberation.

Now how does this relate to mental health?

Due to everything that is happening, some people might be experiencing retraumatization from centuries of intergenerational trauma, especially Black individuals. This retrauamtization can have a significant negative impact on the mental health of those in the BIPOC community. Others may be affected by compassion fatigue or burnout when dealing with the grief and shared pain of other’s suffering. This can lead to shutting down or avoiding any distressing information or news. It is especially important that BIPOC take care of their mental health to be strengthened as a community and continue the fight for liberation. It is just as important that others who are sharing in the grief and pain felt by the Black community also find ways to manage their mental health to effectively be allies in the fight for liberation. This is a challenge, and many may feel lost and have no idea where to start. Here are some useful tips that can help with finding where to start your mental health journey.

So how can I approach mental health?

“You may not control all the events that happen to you, but you can decide not to be reduced by them.”
-Maya Angelou

In this challenging time it is important to find ways to practice self-compassion and allow yourself to find moments of peace. Some suggestions for approaching this are:

Cultivate hope, love, compassion, and joy
Listen to your emotions and accept what is there
Examine the greater cultural context and how your fit within it
Connect with others
Reconnect with your mind-body connection through healing practices

Another approach is through radical healing. Radical healing is a form of healing for people of color that recognizes that true healing happens when we are connected and aim for wellness at the individual, family, community, and societal levels.

Here are suggestions of ways to utilize radical healing to build connection and community:

Learn more about the issues that are affecting your mental health
Work on self-care and individual healing/Engage in Mind-Body Healing/Nurture your spirituality and practice self-compassion
Connect to others and be affirmed in your humanity and increase emotional intimacy
Connect to the deeper roots of your identity and culture
Learn more about your cultural and become curious about other cultures
Take action and actively work towards social justice; Take action to address racism and inequities when you can

By staying psychologically and physically healthy during this time we are able to direct our focus where it is truly needed without distraction. You have all the pieces, we are here to give you the tools to connect to them. Contact us today to begin your journey to wellness.