How to Breathe!

Learning to become mindful about how you breathe is essential to mastering stress.  Unless you are a vocalist or public speaker, you may not have learned how to breathe in a stress reducing manner.  When you breathe with shallow, chest focused breaths, you may be even increasing your anxiety and feelings of stress. When you breathe correctly, using your diaphragm, you will find that your feelings of anxiety and stress are reduced.   It does take practice to learn how to breathe correctly. In this article, I’ll take you through the first steps in learning how to breathe from the diaphragm.  After you’ve mastered the first steps, in my next article I’ll give pointers and next steps on how to become your own expert in deep, mindful breathing to reduce stress.

You have probably heard about mindfulness – a stress reduction intervention that includes diaphragmatic breathing.   Researchers studying mindfulness, including mindful diaphragmatic breathing techniques, are finding positive results for people struggling with stress, trauma, PTSD, anxiety, pain, depression and other diagnosis.  Even if you are not diagnosed with a condition but struggle with managing stressors in your life, mindfulness and diaphragmatic breathing can help you cope and master your stress.

Your first step in learning diaphragmatic breathing is to choose a time and place where you will not be interrupted by noise, people or circumstances.

Next, you will need to find a place where you can lie down on your back. If your disability prohibits you from doing this, position your body in the most relaxing open posture you are able.

When lying down on the floor on a rug or blanket, take on a “dead body” pose – legs straight, relaxed, slightly apart, toes pointed outward, arms at your side, not touching your body, palms up and eyes closed.

Focus attention on your breathing – place your hand on the spot just beneath your rib cage. Note where your body rises when you breathe. If your are breathing from your chest, make note and see if you can instead breathe from below your rib cage.  Scan your body for tension -  your chest, abdomen, throat and neck.

 Begin Deep Breathing.

Draw your legs up so that your knees are bent in a way that is comfortable to you. Your toes should be turned outward.

Scan your body for stress/tension.

Place one had on your abdomen and one had on your chest.

Inhale slowly and deeply through your nose into your abdomen.  The hand on your abdomen should rise as you inhale. Your chest should move very little.

Exhale through your mouth, making a quiet, whooshing sound.   Relax your mouth, tongue and jaw.  Take long, slow deep breaths, focusing on your hand rising on your abdomen (focus just below your rib cage) with each inhaling breath and lowering with each exhale.  Focus on the sound and feeling of your breathing.  Do this 5 minutes at a time to begin with.  As you become more comfortable and familiar with mindfulness breathing, increase your time to 10 minutes or longer.

At the end of each breathing session, scan your body for tension.  Compare your feelings of stress and tension at the end of your session compared to when you began. Journal your progress.  Practice these steps for as long as it takes to master.  You will know you have mastered diaphragmatic breathing lying down -  when your chest rises very little and your abdomen rises most. Your diaphragm is then doing the work it should be doing!

After practice, remain in position, let go of your focus and concentration, relax and congratulate yourself for a job well done.

Tips for Making a Change for the Better!

If you are contemplating making a change for the better, perhaps losing weight, improving your eating habits, getting help for anxiety or depression, or resolving issues in a relationship, you are at a stage of awareness.   But what you need to really move forward and begin doing rather than thinking about change is a level of emotional arousal and emotional energy. Use emotional energy to garner the momentum you need to make the change.  We know from research that knowing facts about a problem or dilemma is not enough to create behavior change. So stir things up a bit.  Here are some suggestions:

Create your own promotional materials.  Film yourself YouTube style and monitor your progress with a succession of videos.  Or paint or draw or create posters that are unique to your goals, post them at home and work and ramp up your emotional energy.

Start a group or join a group. There is a reason why joining and participating with a group of people with similar goals is a successful endeavor for many.  Participation can be emotionally energizing via the support you get from others in the group.

Use meditation, visualization and imagination. Take time out each day be in the moment, to reflect, visualize your goal and imagine how you will feel.   The emotional release you may experience may help you to move forward with the needed momentum so that you will be successful in reaching your goal.

Related articles

• Mindfulness-based Anger Management Online via Skype (psychologytoday.com)

Control your Anger - Control your Stress!

There are actually healthy and unhealthy ways to control anger in your everyday dealings, whether with coworkers, family, friends or the grocery store clerk! Chronic, poorly managed anger may add to your stress levels by increasing the cortisol in your system, which in turn contributes to more inflammation and poorer health.

What are some unhealthy and healthy responses when you get angry? 
Check out these lists and tips.

Unhealthy Anger Responses

• You deny your feelings.  Instead, you lash out and blame others.
• You are defensive and argue with those who try to help.
• You are disrespectful of the other person (name calling, insulting the person instead of the situation).
• You have physiological sensations – increased heart rate, pounding heart, your face heats up, etc.
• You  act aggressive, hit or strike or throw things.
• You give up and see yourself as a helpless victim.
• Your anger becomes addictive – you easily anger at many different situations and circumstances.

Healthier Responses to Anger

• You admit your denial - You work at expressing your thoughts and feelings (using “I” not “You”) without denial and blame.
• You try to understand the other person’s viewpoint
• You have an attitude of respect even when you feel angry
• You do something constructive and find ways to keep your anger under control
• You are open to learning new things
• You examine your own behavior.
• Your commitment to others grows stronger
• You eventually let go of the anger and feel fine

Sometimes controlling your anger takes real effort and practice

Here are 5 tips for controlling your anger:

• Talk slowly
• Wait - “Take 10” - count to 10, 20 or 30, take deep breaths and think before your react.
• Take a walk; go for a run; workout, instead of reacting poorly to a situation.
• Find humor in the situation.
• Respond with assertiveness; respond don’t reac.

Work on your Assertiveness

When you communicate in an assertive manner, your assertiveness is actually incompatible with unhealthy anger (and the accompanying anxiety).

           

Tips on Assertiveness; use when communicating your anger!

• Use steady eye-to-eye contact but not staring or glaring.
• Stand or sit tall with good postur.
• Maintain a firm steady tone without yelling or drop in tone.
• Use “I” statements – I feel, I need, I would appreciate.
• Use short sentences.
• Use pauses for feedback.

Related articles

• Study Highlights How Moms' Depression, Anger Stresses Kids (nlm.nih.gov)

Holiday Joy!

One of the major causes of stress for most people is a sense of uncertainty. Uncertainty can be rather exciting at the onset and most people actually begin a relationship or set about making new plans with this sense of excitement and possibility.   However, after a short while, for many, the uncertainty about a close relationship, finances and our future can lead to worry and anxiety.   Eventually, this feeling of anxiety may become chronic and can lead to clinical depression, anxiety, anger responses and over-sensitivity.

For many, the Holiday season brings on a heightened sense of uncertainty, especially around relationships. This is a normal response and can lead to worry, anxiety or feeling especially sensitive to others comments and actions.

This Holiday Season, acknowledge your uncertainty and accept that it might lead to some feelings of anxiety.  Instead of allowing the worry to overtake you and rob you of feeling any of the joy and pleasure of the season, do something about it!   Find ways to stay in the moment.  And do not set your expectations so high that no one can fulfill them! Instead, identify ways that you can enjoy the season without setting up high expectations of others.  Find even small ways to feel good.  Give an anonymous gift. Write a note to someone you have neglected.  Find a sense of humor! Volunteer.  And let go of your worry and anxiety by de-stressing – get exercise, take time for your own peace of mind.  And remember – as much as you are able - surround yourself with others who are positive.

Newest research on Stress

At the American Psychological Association National Convention, August, 2010, Dr. Janice K. Kieolt-Glaser presented some of the newest behavioral medicine research on stress entitled "How stress kills: Assessing the damage and various remedies."
(Janice K. Kiecolt-Glaser, PhD, Jean-Philippe Gouin, MA, Nan-Ping Weng, MD, PhD, William B. Malarkey, MD, David Q. Beversdorf, MD, Ronald Glaser, PhD; Institute for Behavioral Medicine Research, Ohio State University College of Medicine).

The study investigated the effects of stress on individuals who reported having experienced childhood adversity in a sample of adults who are caretakers of a parent or spouse diagnosed with  Alzheimer’s disease. Conclusions based on this research suggest that childhood adversity worsens effects of stress, adding to current hardships. In other words, children who experience trauma  - be it physical abuse, sexual abuse or neglect, may be more prone to entering a cycle of negative emotion, i.e., depression and anxiety that may lead to problems in later life and possibly precipitate early death.

For example, children who experiences highly stressful events – such as death of a parent, witnessing severe marital problems or experienced abuse, may be more vulnerable to stressors as adults.
The research suggests that childhood adversity may for some,  have a long term, negative affect on health.  These childhood stressors may also contribute to inflammation and cell aging much earlier than for those who did not experience the stressful events in childhood.

The average age of the men and women who participated in the study was 70 years.  The participants were a community sample of 58 caregivers for a spouse or parent with Alzheimer’s disease or another progressive dementia.  The participants depression levels,  report of childhood trauma and biochemical markers of stress were analyzed and compared to a control group.


The researchers measured several blood inflammatory markers: cytokines interleukin (IL-6), tumor necrosis factor-alpha (TNF-a) and telomere length. (Telomeres are the ends of strands of DNA. Shorter telomeres have been linked with aging, age-related diseases and death. IL-6 and TNF-a have also been linked to a number of cardiovascular, including diabetes, autoimmune and infectious diseases).

Conclusions from the study found that " childhood adversity was associated with shorter telomeres and increased levels of inflammation even after controlling for age, caregiving status, gender, body mass index, exercise and sleep," said Kiecolt-Glaser.
"Inflammation over time can lead to cardiovascular disease, osteoporosis, arthritis, Type 2 diabetes and certain cancers.“  Childhood abuse and caring for an ill spouse or parent was also associated with higher levels of depression, she said.


Clearly, results of this study suggest the importance of early intervention to prevent the stress effects as well as undertaking immediate  interventions in those affected - for the  reduction of symptoms and increased ability to cope.  These interventions should include psychological treatment for depression and anxiety as well as the building of coping skills, encouraging regular exercise and instruction and practice in mindfulness.

How to overcome anxiety

Help with Anxiety!

Are you struggling with anxiety or panic attacks? Do you worry excessively about your work, your family, your relationships or your health?  Do you think that when you feel bad and experience symptoms of anxiety, then your feelings “make” you think negative and sad or angry thoughts? 

Actually, what psychologists know is that often, people who are experiencing depression or anxiety have the negative thoughts FIRST and that these fearful thoughts are not really based in reality. These distorted, negative, pessimistic thoughts then begin to produce the ‘bad’ feelings; the feelings in turn produce more distorted thinking, making the symptoms even more difficult to overcome.  

The important thing to note here is that the distorted thoughts are usually ‘automatic’ in nature. This means that the person is probably not even aware of his or her automatic, distorted thoughts, but that these thoughts automatically enter the thinking patterns in a continual manner and across different situations in life.

Put more simply, your automatic thoughts and interpretations of a situation or circumstance can have a very big - and negative impact on how you feel.

Cognitive-behavioral psychologists have identified several negative thinking patterns - distorted thoughts - that are common to people who struggle with feelings of anxiety and depression.

How to begin to understand your own distorted thinking?  Review these 3 common types of distorted thinking that frequently lead to anxiety or depression.  Now list at least three examples of your own thoughts that lead you to feeling depressed and anxious. First, describe the event that prompted you to feel anxious or depressed - and then de­scribe the thoughts that promoted the bad feelings. Once you identify your negative thoughts - your automatic thoughts - you have made the first step to overcoming your anxiety or depression. 

Type	Definition	Example
Mind reading	You make negative assumptions about other people’s thoughts and motives.	Sheila asked her friend Mary to join her for lunch.  When her invitation was refused, she thought “Mary never wants to go to lunch with me. I know she doesn’t really like me.”
Forecasting	You predict that an event will not turn out well.	Gina finished her audition for the play. She immediately pre­dicted that she would not get the part. “I’ll never get a good part. My audition was really bad news.”
Feelings are facts	Whenever you feel a certain way, you decide that the feeling is your reality.	Jim was not invited to join any of is friends after work on Friday. He felt left out, inferior and lonely. . He thought, “No one likes me. I am such a loser.”

 

How to BEGIN to Think SMART and Feel BETTER

Many people think that when we feel bad and experience symptoms of depression or anxiety, then our feelings “make” us think negative and sad or angry thoughts. Actually, what we now know is that often, people who are experiencing depression or anxiety have the negative thoughts FIRST. These distorted, negative, pessimistic thoughts then begin to produce the ‘bad’ feelings; the feelings in turn produce more distorted thinking, making the symptoms even more difficult to overcome. The important thing to note here is that the distorted thoughts are usually ‘automatic’ in nature. This means that the person is probably not even aware of his or her automatic, distorted thoughts, but that these thoughts automatically enter the thinking patterns in a continual manner and across different situations in life.

Put more simply, your automatic thoughts and interpretations of a situation or circumstance can have a very big impact on how you feel. Psychologists have identified several negative thinking patterns that are common to people who struggle with feelings of anxiety and depression.

Three common types of negative thinking patterns are identified and described below. Review these and begin to identify which ones may be impacting how you feel.

1. Catastrophizing: When something happens, you blow it completely out of proportion and think of the worst possible outcome.

The boss told Jenny that the budget is tight and there would no longer be funds for hiring an intern. Mary thought, “This is awful. She probably wants to fire me and this is her way of prepping me for the bad news.”

2. Black or White Thinking: You view people or situations, or even yourself as entirely bad or entirely good—nothing in -between.

When Mark presented his proposal to his dissertation committee, they interrupted so many times with questions, he went over his allotted hour for the presentation. Mark immediately thought, “They didn’t like my ideas; I barely got to finish the presentation.”

3. Judging:  You are overly critical of your self or others; your use of should have, ought to, must, have to, and should not have is very frequent.

Jan made a sales presentation to a client. The client was very attentive and made comments about being impressed with the product. Jan thought, “I spent too much time trying to explain myself. I should have been more prepared.”

Remember to review these and begin to identify which ones may be impacting how you feel. Knowing how and why you feel bad is a first step to feeling better!