Tag: mind-body connection

The NeuroPhysiological Response to Trauma

Posted on by TriWellness in Blog

Trauma, a deeply disturbing or distressing experience, can rattle the foundations of our reality, leaving profound imprints on both our psyche and body. It extends beyond the boundaries of our minds and permeates the very fabric of our being, echoing within our nervous system. This article aims to provide a comprehensive exploration of the physiological repercussions of trauma, catering to a broad audience that includes the general public, trauma survivors, and researchers.
The human nervous system, the body’s intricate communication network, bridges our external and internal environments. This dynamic system includes the central nervous system (comprising the brain and spinal cord) and the peripheral nervous system (consisting of sensory and motor neurons). When we experience trauma, this system is fundamentally disrupted.
Typically, when we encounter a threat, our body triggers an automatic “fight, flight, or freeze” response, orchestrated primarily by the amygdala. Our bodies flood with stress hormones like adrenaline and cortisol, our heart rate increases, and we find ourselves in a heightened state of alertness. This is our built-in survival mechanism, preparing us to confront danger or evade it.
However, trauma can distort this acute stress response, transforming it into a chronic condition with lasting effects on brain structure and function. Key regions such as the amygdala, hippocampus, and prefrontal cortex – involved in memory processing, emotional regulation, and executive functioning – undergo significant changes.
Post-trauma, the amygdala, our emotional alert system, may become hyperactive, escalating anxiety and fear responses. The hippocampus, which facilitates memory and learning, might shrink, leading to memory consolidation issues and an inability to differentiate between past and present experiences. The prefrontal cortex, which manages planning, decision-making, and impulse control, may function less efficiently, impairing these cognitive processes.
The continuous activation of the stress response can disrupt the neuroendocrine system, especially the Hypothalamic-Pituitary-Adrenal (HPA) axis. This disruption can lead to a hormonal imbalance, with possible physical health implications, such as cardiovascular disease, gastrointestinal issues, and chronic pain.
For trauma survivors, it’s vital to remember that these physiological alterations have profound societal implications, affecting relationships, self-perception, and societal interactions. Yet, these effects also create a window of opportunity.
Various therapies such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Neurofeedback, Biofeedback, and Eye Movement Desensitization and Reprocessing (EMDR) are designed to address the neurobiological effects of trauma. They provide strategies to process traumatic memories, manage emotions, and rewire the neural pathways associated with the traumatic response, offering potential paths to healing.

Pari Shah

Pari is our newest multilingual clinician who specializes in adult psychotherapy.

Pari Shah, LCSW, C-PD

Sleep and neurofeedback

Posted on by TriWellness in Blog 
Come Sleep! O Sleep, the certain knot of peace, 
The baiting-place of wit, the balm of woe, 
The poor man's wealth, the prisoner's release, 
Th' indifferent judge between the high and low. 
With shield of proof shield me from out the prease 
Of those fierce darts despair at me doth throw: 
O make in me those civil wars to cease; 
I will good tribute pay, if thou do so. 
Take thou of me smooth pillows, sweetest bed, 
A chamber deaf to noise and blind to light, 
A rosy garland and a weary head: 
And if these things, as being thine by right, 
Move not thy heavy grace, thou shalt in me, 
Livelier than elsewhere, Stella's image see.
-Sir Philip Sidney

The importance of sleep

Sleep is an important function of all living creatures, everyone in the animal kingdom has some variation of a sleep wake cycle. However why is sleep so important in humans? Research has shown that sleep has many functions.

Sleep helps us to consolidate what we have learned into memory through acquisition (information introduced to our brain), consolidation (the process of memorizing the information in the brain), and recall (information being brought up in any mental state). Those who have impaired sleep, can have impacts on memory and learning (Healthy Sleep, 2007).

Another example of the importance of sleep is its impact on mood. Having a good night sleep can lead to feeling energized, motivated, and content. In the reverse, impaired sleep or insomnia can lead to irritability, increased stress, or even the development of a mood disorder (Get Sleep, 2008).

Sleep also has an impact on body restoration. Certain hormones are released during sleep that is responsible for tissue repair and muscle growth. Another restorative factor sleep can assist in cognitive functioning, which may impact in learning and memory. Recent research has also found the importance of sleep on Neuroplasticity.

We previously believed in the idea that if we don’t use certain neurons through practice our brain loses the capacity to use it in the future (use or lose it principle). We now know that it isn’t true, as our brain has what is called Neuroplasticity, which the brain’s ability to form new neurological connections. We do this in everyday life, from learning something new (even if it is small), to sleep, to psychotherapy. We are making new neurological connections without realizing it! Proper sleep helps strengthen and these newer neurlogical connections.

Conditions that effect sleep

Knowing that sleep is very important and its impact that it can have on our brain, mind, and body, what happens when certain conditions impair sleep?

Mental Health CONDITIONS

There are several mental health conditions that can impact sleep. Anxiety, for example, can severely impact sleep. During the first part of the pandemic, many people were experiencing fear, uncertainty, stress, and many other emotions that naturally turned into anxiety. When one is feeling anxious their mind can race, especially while laying in bed trying to fall asleep. As a result of the anxiety, many individuals struggled to get enough sleep which could also further impact their mood.

Another symptom of anxiety that impacts sleep is hyperarousal, the state of being excessively alert. Therefore, when one is trying to sleep while also experiencing hyperarousal, they may be quick to awaken from even the smallest of stimuli (hearing a small thud from the apartment above, for example) and ready to react. 

Certain types of anxiety can also lead to nightmares. Post-Traumatic Stress Disorder and other anxiety and stress disorders can cause night terrors and nightmares that can impact a person’s relationship to sleep. Due to the fear of having night terrors or nightmares, one can also experience anticipatory anxiety.

Depression is another mental health condition that can impact sleep. Depression can impair sleep as well as sleep can impact depression. Due to this relationship, it can be difficult to know which condition caused which symptom. Depression is characterized by experiencing sleep-related symptoms of insomnia, hypersomnia, as well as having abnormal levels of Serotonin, a neurotransmitter that is important for regulation of sleep as well as other bodily functions. 

Medical conditions

There are also several medical conditions that impact sleep. In fact, there are several sleep disorders that can be treated with medication or devices, such as Sleep Apnea, a disorder that is related to breathing disruptions, and Narcolepsy, a sleep disorder related to regulation of the sleep-wake cycle. These are just a few types of sleep disorders, however there are many more conditions that fall under the umbrella of sleep disorders. There are also several chronic medical conditions that impact sleep.

Inflammatory chronic conditions such as, Arthritis, Fibromyalgia, and Inflammatory Bowel Diseases, can impair one’s sleep leading to the symptom of fatigue. Sleep disturbances can be a result of pain impacting one’s sleep, as pain is common in areas of inflammation. When someone is experiencing pain it can lead to mood dysregulation resulting in sleep disturbance conjointly with the the physical discomfort. Furthermore, research has shown that sleep disturbance can result in higher levels of C-Reactive Protein (CRP), a marker of inflammation, suggesting that sleep impairment and inflammation are directly correlated. 

Much like the aforementioned inflammatory conditions as well as cancer can impact one’s immunity. Our immune system is very important in our ability to fight off infections, and for those with a compromised immune system, contraction of infections can be regular occurrence or fear of contraction. Research has also found that sleep impacts immunity; when one has impaired sleep their immune system has difficulty fighting off infections. This also can further compound an already compromised immune system, leading to increased infections and overall feeling of being unwell, increased inflammation, and the cyclical nature of impaired sleep. (Simpson & Dinges, 2007).

Sleep Hygiene

Sleep hygiene is defined by the healthy habits one practices on a regular basis to promote restful sleep. The Sleep Foundation lists some great steps to improve sleep hygiene that is summarized below.

Setting a consistent sleep schedule

  • Go to bed and wake up at the same time everyday, regardless of weekend day
  • If you want to change your bedtime/wake up routine, make changes gradually
  • Try not to take as many naps; if you do take naps, have short 10-20 minute naps in the early afternoon

Have a bed time routine

  • Having a consistent bedtime routine can prep your mind for bedtime
  • Take 30 minutes to wind down before going to bed by doing something relaxing and not stimulating
  • Refrain form using electronics 30-60 minutes before bed, as the screens can be overstimulating to your brain
  • If you haven’t fallen asleep within 20 minutes of lying in your bed, get out of bed, do something relaxing, and then try again

Have healthy daily habits

  • Try and get some sunlight exposure to promote healthy circadian rhythm
  • Build a exercise/movement routine that is right for your ability
  • Limit smoking and alcohol consumption
  • Skipping on caffeinated beverages in the afternoon and evening
  • Try to eat and drink 2 hours before bed (be mindful of heaving/spicy meals); if you need to eat or drink something before bed try to make it small to not wake you up in the middle of the night
  • Regulate activity in bed to only sleep and sex

Having a restful and Relaxing environment

  • Having a bed, pillow, and sheets that matches your comfort needs
  • Have a cool and dark sleeping environment
  • Have devices that block or drown out noise (i.e. ear plugs, noise cancelling machines, etc.) to not wake you in the middle of the night

Neurofeedback as a treatment strategy for sleep impairment

Now we know why sleep is important, what can affect sleep, and how we can improve sleep with proper sleep hygiene. But what if sleep hygiene isn’t enough to get a good night’s rest and there are more underlying issues that impact sleep. Therapy can be very helpful if the underlying symptom of sleep impairment originates from a mental health condition. However if there is a neurological reason for sleep challenges (either from mental health or medical conditions) a treatment strategy must address the neurological source of the disturbance. 

Neurofeedback is a form of biofeedback that encourages healthy neurological connections through the use of training one’s brain to effectively operate in specific conditions. Therefore, in regards to sleep, Neurofeedback training promotes healthy brain activity during the sleep state by regulating one’s brainwaves. 

In some cases, sleep and brain activity can be effected by the situation. In one study looking at college students with sleep onset insomnia, they found that poor sleepers had difficulty regulating their alpha brainwave. This suggested the use of neuro-regulating therapies to promote neuroflexibility (Buckelew et. al., 2013).

In another study that focused on the Central Nervous System, researchers studied the effects of electromyography tele-biofeedback versus tele-neurofeedback in subjects with insomnia. They found that not only does neurofeedback improved the amount of sleep in subjects, but also the efficacy of remote neurofeedback (Cortoos, 2010).

As previously mentioned, chronic health conditions can impact sleep, such as fibromyalgia, a condition where a patient experiences pain throughout their body and experience several other symptoms (including sleep disturbance and fatigue). In a study that researched the efficacy of neurofeedback in patients with fibromyalgia, researchers found that neurofeedback protocols that focused on alpha brainwave and sensorimotor rhythm regulation in an 8-week program produced significant results. Patients experienced sleep improvement and pain severity reduction (Wu, Fang, et al., 2021).

Neurofeedback is an evidence-based treatment strategy that does not utilize pharmaceutical intervention to treat sleep problems. In some cases, neurofeedback conjoint with behavioral modifications can drastically improve, if not alleviate, symptoms of fatigue due to sleep impairment.

Resources

Anxiety and Sleep, Suni, E., Sleep Foundation (March 2022).

Buckelew et. al, Neuroflexibility and Sleep Onset Insomnia Among College Students: Implications for Neurotherapy, Journal of Neurotherapy (2013). doi: https://doi.org/10.1080/10874208.2013.784681

Cortoos, A., De Valck, E., Arns, M. et al. An Exploratory Study on the Effects of Tele-neurofeedback and Tele-biofeedback on Objective and Subjective Sleep in Patients with Primary Insomnia. Appl Psychophysiol Biofeedback 35, 125–134 (2010). https://doi.org/10.1007/s10484-009-9116-z

Get Sleep– Harvard Medical School

Gorgoni et. al., Is Sleep Essential for Neural Plasticity in Humans, and How Does It Affect Motor and Cognitive Recovery?. Hindawi, 2013. doi: 10.1155/2013/103949

Healthy Sleep– Harvard Medical School

Sleep Disorders, Rehman, A., Sleep Foundation (December 2020)

Sleep and Inflammation, Simpson & Dinges, Wiley (December 2007)

Yu-Lin Wu, Su-Chen Fang, Shih-Ching Chen, Chen-Jei Tai, Pei-Shan Tsai, Effects of Neurofeedback on Fibromyalgia: A Randomized Controlled Trial. Pain Management Nursing, Volume 22, Issue 6 (2021).

Board Certified Clinicians at TriWellness Provide Neurofeedback

Learn more about Neurofeedback
Learn more about remote neurofeedback
Schedule a free consultation for Neurofeedback

This month’s blog post was written by Aarti S. Felder, MA, LCPC, BCN, our Chronic Illness Specialist and Board Certified in Neurofeedback Therapist.

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

Benefits of Yoga and Movement to Mental health

Posted on 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

mental health and diabetes in asian Americans

Posted on by TriWellness in Uncategorized

types Diabetes

Diabetes or Diabetes Mellitus is a chronic condition that is characterized by one’s body’s inability to convert the glucose (sugar) in food into energy and effects about 537 million adults from the ages of 20-70 around the world, and 1.2 million children ages 0-19 are affected by Diabetes Type I around the world. It is projected to rise to 643 million by 2030 (International Diabetes Federation, 2021). There are four common types of diabetes.

A Snapshot: Diabetes in the United States (Feb 2020, CDC)

Prediabetes

Prediabetes is caused by one’s body not responding to insulin production and resulting in higher levels of blood sugar. A person with prediabetes has an A1C range between 5.7-6.4%, when normally it is less than 5.7%. (A1C is a test that assesses for the percentage of blood that has sugar-coated hemoglobin.) Individuals with Prediabetes commonly exhibit the following risk factors:

  • Overweight
  • +/= 45 years old
  • Immediate familial history of Type II Diabetes (see below)
  • Physical activity less than 3 times per week
  • Polycystic Ovary Syndrome (PCOS)
  • Giving birth to a baby who is more than 9 pounds
  • Gestational Diabetes (see below)

Having Prediabetes can lead to Type II Diabetes (see below) if not managed (CDC).

Prediabetes: Could It Be You? (February 2020, CDC)

Gestational Diabetes

Gestational diabetes is characterized by a pregnant person’s body being affected by insulin production. This can also impact the person’s pregnancy and their baby’s health. Individuals with Gestational Diabetes have a higher risk of developing Type II Diabetes (see below) as well. There aren’t as many symptoms an individual with Gestational Diabetes may experience other than the possibly having increased thirst or more frequent need to urinate. Possible risk factors a pregnant person may be:

  • Overweight or obesity
  • Little to no physical activity
  • Diagnosis of Prediabetes
  • History of gestational diabetes in previous pregnancies
  • PCOS
  • Family history of diabetes
  • History of delivering a baby more than 9 pounds in previous pregnancies

Gestational Diabetes can cause complications in both the pregnant person and the baby. The pregnant person may experience the following complications:

  • High blood pressure
  • Preeclampsia
  • Deliver via C-section
  • Developing Type II Diabetes in the future

The baby of a person with Gestational Diabetes can have the following complications as well:

  • High birth weight leading to complications in delivery
  • Preterm birth
  • Respiratory Distress Syndrome (RDS) which is characterized by experiencing severe breathing difficulties
  • Hypoglycemia (low blood sugar)
  • Developing Type II Diabetes or Obesity in the future
  • Stillbirth

(Mayo Clinic)

Type I DIABETES

Type I Diabetes used to be known as Juvenile Diabetes because it was predominantly diagnosed in children, however it can be diagnosed in adulthood. It is chronic condition that is characterized by a one’s pancreas inability to produce enough insulin. While the causes for Type I Diabetes is still being researched, it is believed that genetics, viral exposure, or environmental factors can cause Type I Diabetes. Treatment is primarily concerned with managing insulin levels, diet, and lifestyle. Common symptoms of Type I Diabetes may be:

  • Increased thirst
  • Frequent urination
  • Unhistorical bed-wetting in children
  • Increase hunger
  • Accidental weight loss
  • Irritability, mood changes
  • Fatigue
  • Feeling physically weak
  • Blurred vision

Individuals with Type I Diabetes can develop further complications throughout their body in the future if blood sugar isn’t managed well:

  • Development of cardiovascular diseases
  • Neuropathy (nerve damage)
  • Nephropathy (kidney damage)
  • Diabetic retinopathy (eye damage)
  • Foot problems
  • Oral complications
  • Dermatological complications
  • Pregnancy complications

(Mayo Clinic)

Type II DIABETES

Diabetes (Type 2) (American College of Cardiology, 2019)

Type II Diabetes is also a chronic condition that is characterized by irregulation of sugar transformation into fuel, resulting in too much sugar in the bloodstream. Type II Diabetes is caused by the pancreas inability to make enough insulin and the body’s cells become resistant to that insulin. While there is no cure for Type II Diabetes, patients can manage the disease with weight loss, proper diet, physical activity, combined with medication. People with Type II Diabetes tend to experience the following symptoms:

  • More thirst
  • Increased urination frequency
  • More hunger
  • Accidental weight loss
  • Fatigue
  • Blurred vision
  • Sores can take awhile to heal
  • Having more infections
  • Numbness or tingling in extremities (hands and feet)
  • Parts of skin are darker than the rest of the skin (often seen on the neck or in the armpits)

Individuals are at higher risk for developing Type II Diabetes if they experience any of these factors:

  • Overweight or obesity
  • Fat distribution is mainly in the abdomen (mens’ waist of 40″+; women’s waist of 35″+)
  • If a person doesn’t use up the sugar through physical activity
  • Other family members have Type II Diabetes
  • High levels of the “bad” cholesterol (triglycerides) and low levels of “good” cholesterol (High-Density Lipoprotein, HDL)
  • The risk of developing Type II Diabetes increases as one ages
  • Prediabetes
  • Gestational Diabetes or giving birth to a baby weighing 9 pounds or more
  • PCOS
Prevent Type 2 Diabetes: Talking to your Patients About Lifestyle Change (February 2020, CDC)

Much like Type I Diabetes, Type II Diabetes can lead to complications throughout the body:

  • Cardiovascular diseases, such as atherosclerosis (high blood pressure and narrow blood vessels)
  • Neuropathy in extremities and other areas of the body
  • Nephropathy
  • Retinopathy
  • Dermatological complications
  • Slow healing; when left untreated, sometimes the cure requires amputation
  • Hearing problems
  • Sleep apnea
  • Dementia

(Mayo Clinic)

Diabetes in the Asian American Community

In the Asian American community, 1 in 3 people are diagnosed with a type of diabetes (CDC, 2022) and is the fifth leading cause of death in AAPI (Joslin Diabetes). At the U.S. Department of Health and Human Services Office of Minority Health published the statistical differences of Asian Americans and their other nationality counterparts. They found that they are 40% more likely to have diabetes than non-Hispanic Whites. From 2017-2018 South-Asian Americans were 70% more likely to develop diabetes in comparison to their non-Hispanic white counterparts (OMH, March 2021). Due to the distribution of fat, primarily the visceral fat (fat distributed around organs), Asians can appear to be at a healthy weight and often under diagnosed with diabetes. As a result, it is recommended than Asian Americans have their A1C checked if their BMI is 23 or greater (CDC, April 2022). As the Asian population is quite diverse, it is difficult to identify the specifics of each subgroup and more research is needed (NIH News Releases, 2015).

Diabetes Impact on Mental Health in Asian Americans

The Mind-Body Connection impacts the individual with diabetes. People with diabetes are two to three times more likely to suffer from depression for various reasons and not many of these individuals are diagnosed and treated. Anxiety and stress can also impact diabetes prognosis (CDC, 2021) due to the manner in which the body burns energy. As diabetes is impacted by diet, individuals can develop Eating Disorders(MHA) and perhaps even Body Dysmorphia due to the weight fluctuations one can endure throughout the disease process. Furthermore the difference in BMI standards to adjust to Asian body types may impact the individual’s view of themselves. Research has noted that the implementation of conjoint intervention of medicine and lifestyle changes (i.e. diet, physical activity, and therapy) can greatly improve the lives of individuals with diabetes.

Resouces

Diabetes Care– ADA’s Standards of Medical Care in Diabetes clinical practice recommendations

Drag ‘n Cook– a resource for Asian food recipes with nutritional information

International Diabetes Federation (IDF)

International Diabetes Federation Diabetes Atlas 10 ed. (2021)

Mayo Clinic The Essential Diabetes Book, 3rd ed., Maria Regina Castro, M.D. (2022)

National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States

Prediabetes– CDC

Prediabetes– Mayo Clinic

Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012. JAMA. 2015;314(10):1021–1029. doi:10.1001/jama.2015.10029

Type I Diabetes

Type II Diabetes

This month’s article 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 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

EMDR and Interoception

Posted on 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:

  1. 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?
  2. 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.
  3. 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.

Dealing with a Chronic Illness During a Pandemic

Posted on by TriWellness in Uncategorized

It’s difficult enough to cope with a chronic illness as well as coping with the stressors of a pandemic, however it can be even more challenging to manage both concurrently. During the pandemic we are faced with many unknowns: Who has the virus? Do I have the virus? When will this all be over? What’s next after this? These questions can cause anxiety, fear, confusion which can further exacerbate a chronic condition especially if the condition is particularly susceptible to the more severe symptoms of the virus. If this describes you, what can you do? As a Licensed Clinical Professional Counselor, I have found some of these strategies to be helpful in alleviating some distressing feelings and thoughts in my clients through the focus of mind, body, and spirit.

Mind

Thoughts, emotions, and the things we do are all interconnected and can impact our bodies. For example, if one has asthma and is experiencing tightness in their chest because they are fearful of catching the virus further intensifying their asthmatic symptoms and ultimately arriving to the decision to not engage in any activities, even in activities that are considered low risk. They can then feel frozen by their fear, leading to more feelings of anxiety and even depression in a vicious cycle.

In order to impact the cycle, one must examine their thoughts through different forms. Some of my clients find it helpful to journal their thoughts to allow a space to keep their thoughts rather than in their head. Others find it therapeutic to mediate and place themselves in a calm space to examine those thoughts.

Body

The body and mind are connected. As previously mentioned, in our mind we may have thoughts and emotions that affect our bodies. Whether it’s an individual with asthma who experiences anxiety in their chest and lungs or an individual with gastric issues experiencing that same anxiety in their gut, their emotions and thoughts impact their body.

This is another cycle that can be affected with physical activity. It can be difficult to get out of the house to go to the gym or maybe it’s impossible to socially distance yourself at the beach. However, clients have found the therapeutic impact of getting some fresh air by going for hikes in the forest where they can maintain social distance while also wearing a mask, if possible. Other clients found a sense of serenity in doing yoga on their balcony in their high rise.

Here is a guided walking meditation by Headspace that can provide a sense of tranquility through engaging the mind through mindfulness, body through walking, and spirit through the connection with the Earth.

Spirit

Each person may define their spirituality differently and may find different ways to incorporate their spirituality through rituals, gatherings, or any other way. Spirituality often involves the connection with someone or something outside ourselves. Engaging spiritual activities can be difficult during the pandemic, especially if you have a condition that makes you vulnerable to the virus.

We live in the age of spectacular technology with devices that allow us to connect with people all around the world in many different forums right at our finger tips! Utilizing such devices to connect with loved ones or to a community of like-minded individuals can be an effective way to connect with other people and embolden the spirit.

If you are introvert, perhaps the idea of connecting with people is not as appealing. However, taking notice of your connection with the earth beneath your feet, the air you breathe, and the beauty all around you and the universe can give you a sense of serenity in your heart.

The cosmos is within us. We are made of star-stuff. We are a way for the universe to know itself.

Carl Sagan describes our connection with the universe.

You may also find other helpful strategies in our previous blog posts, check it out!

Some of the strategies that were discussed here can be difficult to engage without some guidance. These skills can be utilized as training activities in the gym where you are training to be your optimal self. If you find yourself needing assistance or interested in developing more skills, please reach out to us through the Contact Us page or give us a call.

This article was written by Aarti S. Felder, MA, LCPC, to learn more about her you can find her bio here.

This image has an empty alt attribute; its file name is aarti_headshot.jpg

The Mind-Body Connection and The Effect of Mindfulness Exercises

Posted on by TriWellness in Blog

*Disclaimer: This article provides an example that is solely to display the connection between psychological, neurological, and physical health, and is not to be used for diagnostic purposes.

Philosophers have often contemplated the connection between the mind and body. Some philosophers believe that the mind and body are separate entities while other philosophers believe it is connected. However, in psychology, neuroscience, and medicine scientists find evidence that the mind and body appear to be connected.

For example, if the effects of anxiety are untreated, it can manifest in one’s gut through symptoms of gastric distress. Furthermore, it also alters one’s neurological connections. In expansion of the example of the individual that experiences anxiety, her data from an Electroencephalography (EEG) demonstrates the neurological connections that express anxiety are strengthened.

However, as research dictates, the brain’s ability to form new connections is possible through training. Training can be defined by one’s daily life. In continuation of the aforementioned individual, if the individual continued to experience anxiety and leave it untreated this individual will continue to have difficulty alleviating the symptoms. Yet if this same individual trains herself through use of skills developed with a trained clinician on a daily basis, she can experience relief and eventually strengthen the neurological connections to combat the anxious thoughts and feelings.

One such skill that an individual can learn to utilize is Mindfulness exercises. In a type of Mindfulness exercise that a mental health clinician may use called, Guided Mediation, assists individuals in realizing their self-defeating thoughts in a safe and calm space. The mental health clinician will assist the individual in processing these thoughts and emotions that can arise. Through repeated exercises and training, the individual will be able to continue to utilize these practices in their daily lives.

In the previous case of the individual who experienced anxiety, and she enlisted the assistance of a mental health clinician to “re-train” her brain through Mindfulness practices. She continues to utilize these skills outside of session, she can realize her full potential, experience the gastric relief, and is on her journey to wellbeing.  

To learn more about mindfulness-based practices or to schedule an appointment with a clinician please visit our Contact Us page or call the office.

This article was written by Aarti S. Felder, MA, LCPC, to learn more about her you can find her bio here.