Emotional Wellness Month

Small changes can set positive tone

With various ways to express emotional well-being, I like these two definitions.

• Ark Behavioral Health describes emotional well-being as “an awareness, understanding, and acceptance of our feelings, and our ability to manage effectively through challenges and change.”

• The National Institutes of Health defines it as “the ability to successfully handle life’s stresses and adapt to change and difficult times.”

Both definitions point to elements of challenges and adaptability. They do not say emotional well-being is always feeling happy, being optimistic, or even finding the silver lining in life.

We can all agree the past 18 months have been a lot, I mean A LOT, of challenge and adaptation. In fact, as the demands on our ability to stretch continue, we might be experiencing fatigue, restlessness, anger, irritability, depression, anxiety, despair. These are all normal responses, my friends, to feeling like we’ve just run a marathon and then been told the finish line is not here – it is over the next hill!

Reflect for a moment on a recent change you’ve made in your own life (because change is easier to recognize than habit). If you’ve done something more physical – for example, maybe walked in your neighborhood, have you also noticed a change in other parts of your life? Maybe you’ve been inspired to talk more with neighbors (social) or thought you might want to read about or try meditating (spiritual). I don’t know what you’ll find, but the point is we are like mobiles or sets of dominoes – when one thing changes, so do others. As we consider ways to improve our emotional well-being, realize you can have a great impact upon your entire system by shifting a small thing.

Factors relating to emotional well-being

There are a number of areas to consider when you think about your well-being. Think about these as they relate to your life and how you move through it.

Mindfulness – The state of being aware of something. Are you doing all the things without noticing you’re doing them to end your day and wonder where the time went? If you are, that is closer to acting in “habit” than being mindful. Noticing what is happening as it is happening is mindfulness and helps us regulate our nervous system, make better decisions, and not get activated.

Sleep – We probably all need more! Can you put yourself to bed in enough time to get eight hours of sleep before needing to start the next day? Can you begin to shut off all the ways in which you zone out with entertainment in the evening that interfere with sleep? These are important aspects to consider. To rest well we need to get off devices, not ingest alcohol, and allow the nervous system and adrenals to decrease. This takes time, my friends, so back the eight hours in properly so you can rest and heal your mind/body.

Coping with loss – Another area we tend to overlook. As a species we’ve had an enormous amount of loss in the past couple years. Loss of loved ones, freedoms, life as we knew it, safety. We have all experienced traumatic loss, and we need to acknowledge and grieve. Let yourself feel it, let yourself be in it if needed. Trying to “get through it quicker” is a sure-fire way to keep yourself stuck.

Stress reduction – Our bodies need stress to function. We get into trouble when we have too much stress or when we don’t know how to down-shift our stress response (mostly in the adrenals which creates overload, lack of sleep and likely auto-immune disorders) and allow the body to relax. We can release stress through physical movement, losing ourselves in a hobby or something that seems to stop time for us, being in nature, listening to music, and witnessing or creating art – among many other ways. Whatever is your way to reduce stress, please do it – you have a giant pass for doing it more!

Managing emotions – This one can be a bit tricky. It requires that we know our emotions and then respond to them correctly. Said another way, this does NOT mean to ignore our emotions. That is another disaster waiting to happen, so try not to do it. I know it’s a long-held habit for many of us and we were likely told different things about emotions (e.g., boys don’t cry, don’t be a baby, you’re too sensitive, get over it ….) but these are not helpful ways of responding to your emotions and are in fact interfering with your emotional well-being and ultimate life satisfaction. Emotions are present to guide us in our lives, but we don’t get to act them all out on other people either. Delicate balance perhaps – stay in the middle of the boat on this one.

Please reflect when you have opportunity and notice if there is an area you’d like to modify. You can start with what seems most accessible and as always, don’t be judgy or heavy-handed with yourself.

Dr. Gwin Stewart founded the St. Louis Wellness Center in 2007. You can write her at  DrGwin@hotmail.com. Read more about her HERE.

Supportive adults provide hope

Supportive adults provide hope, can make difference for LGBTQ youths 

While marriage equality now exists, and trans rights are more often talked about in the media and news outlets, there are still daily struggles faced by queer, trans, and non-binary individuals everywhere.

As a community reflecting on LGBT History Month in 2021, many of us have heard the studies and statistics reporting that LGBTQ youths and adults are more likely to experience rejection from family members, more likely to experience discrimination in the workplace, experience bullying in schools, and as a result have negative health outcomes, and are more likely to experience episodes of depression and suicidal ideation.

What is often lacking from these reports and studies are what allies can do to assist the members of the LGBTQ community; what does it mean to be a supportive and affirming therapist or healthcare provider; and what are the small changes I can make today.

During my 8 years at the Los Angeles LGBT Center, what I remember most was hearing about how one supportive and affirming teacher, adult, or parent could make all the difference in a young person’s life. That unconditional acceptance and affirmation provided hope that things could and would get better.

So, when straight and cisgender colleagues find out that I specialize in working with LGBTQ families and individuals, they often ask what they can do to better support the members of this community. I point them in the direction of research done by the Family Acceptance Project in San Francisco. Led by researcher and advocate Dr. Caitlin Ryan, The Family Acceptance Project has done extensive research over 15 years on what acceptance and rejection behaviors look like in family and social settings, and the positive and negative impacts on young adults. The research points to a spectrum of behaviors that directly impact the emotional, social and physical health outcomes of these young adults. The website contains a great deal of information – videos, publications, posters and more – about helping families of all backgrounds (and in several languages) support their LGBTQ kids.

Family behavior can be key

Educating parents and family members about specific behaviors that are known to be harmful or affirming for LGBTQ youths can be a key factor in changing the trajectory of a young person’s life.

To just give a few examples of acceptance behaviors:

  • Allowing a young adult to invite a LGBTQ friend over for a family dinner.
  • Speak openly about your child’s LGBTQ identity.
  • Stand up for your child when others mistreat them because of their identity.

A clear example of a rejecting behavior could be:

  • Pressuring your child to be more masculine or feminine.
  • Asking your child to “tone down” how they look, dress or behave.
  • Tell your child that this is “just a phase.”

For me as a health care provider, a simple affirming behavior can be to ask for preferred names and pronouns, or to ask for parent/guardian 1 and parent/guardian 2 on intake and consent forms. These minor adjustments signal to families that you don’t assume all families include a mother and a father, and that everyone’s preferred name may not current match their legal name. These indicate openness and concrete opportunities for expression and clarification.

Again, while so much progress has been made over the past 10 years in the United States, we are still dealing with discrimination in the workplace, health care disparities and bullying at schools. Any small change you feel comfortable making as an individual, parent, or health care provider can make a big impact. The St. Louis Wellness Center is here to help support you!

Jen Durham Austin, LCSW is a mental health therapist with the St. Louis Wellness Center and is open to free consultations and conversations about how you can best support your parent, friend, child or client. Contact her at 314-323-4775 or jen@openaircounseling.com.

EMDR helps process painful memories

EMDR helps process painful memories

EMDR is a powerful therapeutic tool that helps clients process trauma and live a life less disrupted by fight or flight.You may have heard of EMDR, or Eye Movement Desensitization and Reprocessing therapy, or have seen this therapy depicted in the media. Interest, research and exposure to EMDR continues to grow as more therapists are trained to provide this effective trauma therapy.

Some examples of how it can help:

• EMDR can improve current relationships, as one client learned, after processing memories of a painful childhood.

• Another client experienced less anxiety after using EMDR to process memories of being bullied.

• The memory of a car accident was a problem that a client was able to process. After EMDR, they were able to travel in a car without fear or anxiety.

One aspect of EMDR that I appreciate is that this therapy does not require someone to narrate their trauma experiences in detail. Instead, the focus is on moving through the memory toward healing and recovery in a way that provides relief.  Once the EMDR script is established, the process works the same each time (using specific target memories), which can reduce some anxiety related to the process. The greatest benefit I appreciate about EMDR is that the therapy works in the brain to heal itself.

Its beginnings

EMDR was developed in 1987 after psychologist Francine Shapiro noticed that her distress in thinking about painful memories was significantly relieved when paired with rapid eye movements. She then spent years developing the treatment and process.

An evidence-based psychotherapy, it uses the brain’s natural ability to recover, with therapist-directed lateral eye movements, hand tapping, or audio stimulation to facilitate this process. EMDR helps to process memories from the overwhelming part of our brain to the cognitive part of our brain. In this way, we move out of fight, flight or freeze and into a less stressful way of remembering the trauma.

There has been a lot of positive research showing EMDR to be effective in treating PTSD and trauma symptoms, as well as treatment of anxiety, panic disorders, depression. EMDR is practiced only by therapists who undergo specialized training.

What does an EMDR session look like?

Some of the preparation to begin an EMDR course of treatment resembles a psychotherapy session. The therapist will gather information about the participant’s past experiences and will help to identify coping skills for use in the session or after the session as needed. During the active phase of EMDR, the therapist and participant will use a scripted process to move through targeted memories, using either eye movements or tapping as bi-lateral stimulation until the target memory no longer produces a distress response.  During the end of session, the participant will identify a positive belief that they incorporate into future healing and recovery. If this is hard to imagine, I encourage you to watch this video showing an EMDR session in progress.

One of the most recognizable tools in EMDR is a light bar, which allows participants to follow a light from side to side.  However, any method of bi-lateral movement can be effective in the process of processing memories. In my own EMDR practice I use both therapist-directed eye movements or TheraTappers (hand-held devices that move a pulse from hand to hand, see photo), depending on the participant’s preference.

If you would like more information about EMDR, here are two websites with lots of good information:
EMDR International Association
EMDR Institute

Melody McArthur, MA, LCP, is a Licensed Professional Counselor. She has a Master of Arts in Clinical Mental Health Counseling. You can contact Melody at 314-309-9515 or melody@treeoflifecounseling-stl.com.

Pushing through shame, or using it in journey to resiliency

Pushing through shame, or using
it in journey to resiliency

My life has been touched by addiction since my beginnings. Probably because of this, I see many people in my therapy practice who are using drugs or alcohol to their own detriment. Of course, not everyone who uses chemicals suffers negative consequences. In reflecting on National Recovery Month, I’ll focus on those who seek change in that area of their life.

When clients come to me for issues related to addiction, the conversation starts where they experience themselves to be. Often the person who comes to the couch has mixed feelings. Substance use has had a negative effect on their lives (or someone in their life) but substance use also has at least one functional benefit to those who use. This can seem paradoxical to those on the outside, but there is a benefit to using as there is to many behaviors people think of as “bad” (self-harm, over- or under-eating, recklessness). Asking about both what is not working and what is working, without judgment, is paramount for the evidence-based treatment I – and many other therapists – use in our practices.

The role of shame

In addition to physiological addiction to a substance, the addict experiences considerable shame that intoxication dulls. Shame can help keep some users sober. Whether the shame was present before their foray into use or not, shame is a common experience of those who use and want to stop. No matter the origin of the shame, substance use can temporarily mask it or at least make the user less focused on their shame and thoughts that surround it. This explains in part why attempts to quit can falter. People trying to get clean and/or sober often experience a wave of emotions that have been tamped down by the regular use of substances. As these feelings abruptly or gradually plague the person in early recovery, it compounds the other painful aspects of quitting.

Shame begets shame. Individuals who use substances to their detriment do not need to be told that they are messing up their lives. Unfortunately, the start/stop quitting cycle can add more negative emotion to what is already present.

Even without other people sending guilt their way, people who are using and wanting to stop continue with painful scripts in their heads about themselves. Because of this, I find people who used and quit to be people with whom I am proud to be acquainted. I appreciate a person’s ability to move beyond their darkness, or at least to incorporate their shadow into their ownership of themselves.

Reforming recovery

Earlier eras of treatment demonized not just addiction, but the addicted individual. They were considered damaged and considered “the addict” or “other.” Early treatment centers resembled asylums and took away decision-making power to the extent that many did not receive treatment at all. The result was sanctuary harm, where the place that was supposed to provide respite and calm led to more damage.

We are now living in a time of reform with the potential for improvements. We can change the lens through which the treatment community and community members see addiction and those who experience it. An increasing number of people hold the idea that the addiction can be successfully treated, and the person can get better. Thank you to those who are in solidarity with the person who still suffers and welcome to those who are recent joiners of the recovery movement.

People can change, and witnessing their resilience can be a powerful reminder of that. Let us all continue to develop our understanding and use it to hold space and respect for those in recovery.

Knowing yourself is the beginning of all wisdom.
– Aristotle

Kim Warden, LCSW, CCDP-D, is trained and experienced as a licensed clinical social worker and a substance use disorder counselor. You can contact her at imagine.peace.k@gmail.com or 314-737-6848

Your approach to adversity

Your approach to adversity holds clues to success

Throughout history there has always been difficulty, and no one can escape it entirely. For a lot of us, the past 18 months have brought challenges to the top of mind. How we each experience and move through troubles or adversity in our lives is an interesting consideration.

Wisdom traditions tell us there are five major ways to cluster our reactions to distress: We might ignore the situation, become angry, fall into low self-esteem, obsessively try to grasp something, or become competitive or do too much. While we might use more than one of these styles, we often have a favorite. Reflect for a moment on how you respond when something stressful is presented in your life. How did you respond when the country was told last spring to shelter at home? What thoughts did you have when your children were home for online schooling? These questions are meant only as prompts for you to gather information, so if they don’t work, try out others.

The reason I bring up our neurotic styles as this topic today is for the antidote, the remedy to these ways of responding. Neurotic is a general word I’m borrowing to describe our negative expression of our positive qualities, our less-than-ideal responses, the ones we probably repeat, sometimes even believing they are correct. We all suffer in one form or another, and in my work as a psychotherapist I hear people’s expression of it. When I ask people what they want out of therapy, it’s almost always some form of “peace.” One person might want to use less alcohol, while another wants to be calmer or less anxious. A different person wants to feel less depressed, and others wants to find purpose in life, or have more time.

The remedy is inside

As we look more closely at the common therapy goals above, we can see neurotic qualities embedded in people’s aspirations. Wanting less alcohol might be related to obsessively grasping, desiring more calm can be about having too much anger, hoping to get out of depression can be the fall into low self-esteem, the person wanting to find purpose might be challenged with avoiding or ignoring situations, and the one who wants more time could be struggling with doing too much.

Remember, these columns are not intended to be psychotherapy so please don’t go out diagnosing yourself or anyone else. This is meant only to give you more boots-on-the-ground tools for working with your own mind.

Now for the good news

Each of the five neurotic qualities are simply obscurations of actual wisdom qualities that we already innately possess. In my office I have a fun snow-globe type thing that when shaken up obscures what is inside. Once we let the glitter settle, it is clear, and we can see the words “Be You To Full.” Most of us spend copious amounts of time chasing glitter only to not realize our true beauty. By chasing glitter, I mean, reacting in an angry manner, ignoring situations, obsessively trying to grasp things, lamenting our horribleness, and over competing.

The corresponding wisdom and neurotic traits are: ignoring/open and peaceful, anger/perceptive and intelligent, low self-esteem/resourceful and generous, grasping/warm and empathetic, and overly ambitious/productive and swift. Take a moment now to reflect on the wisdom aspects of your favored trait and notice how you feel, recognize this is your truer nature, your genuine self. The neurotic display is simply a shaken-up snow globe version of yourself. While it is generally easier to identify the neurotic traits in people, I’m inviting you now to search for wisdom traits in yourself and others – and specifically notice the difference in how you feel.

There is a lifetime of study and practice we could do around this topic so if you are interested feel free to reach out and ask for resources to help support you as you explore. In the meantime, I offer this for each of us to have a bit more clarity. When we notice our own neurotic display or someone else’s (let’s face it, it’s far easier to see another’s than it is our own), perhaps occasionally we’ll remember there is wisdom below. When we notice our own or someone else’s wisdom display, it is a time to rejoice. Think how the world can change if we routinely feel the joy, relief, peace.

May you enjoy getting to know yourself more deeply, below the waves of glitter.

Dr. Gwin Stewart founded the St. Louis Wellness Center in 2007. You can write her at DrGwin@hotmail.com. Read more about her HERE.

Change often requires more

Change often requires more

I listened to a podcast recently that helped me make sense of how therapy works and why sometimes it doesn’t seem so effective. The speaker was describing Cognitive Behavioral Therapy (CBT as it’s often known) and the prescribed formula for therapeutic change. She said “thoughts lead to feelings, which lead to behaviors.” The idea is that if we want to change behaviors we need to intervene at the level of thoughts or feelings.

Then it hit me like a ton of bricks, these prescribed three steps begin in the middle of the recipe! In other words, there are important aspects that precede our thoughts and feelings. For example, someone telling me that I can use synthetic oil for my car and I only need to change it every year rather than every three months is a pretty simple statement. Now that I have the new information (thought), I can easily (feel) confident in my decision to get the car in every year (behavior).

But my friends, I think most of us are a bit more complex than this simple exercise depicts. If I had been told this news by someone I didn’t trust, if I followed the annual oil change schedule and my engine suffered, if I had a family member that worked in the oil fields and told me synthetic oil is not good for my vehicle … the list goes on and on. I specifically picked this example of changing one’s oil because it seems so very clear and easy. Now let’s try this on with something more multi-dimensional.

Consider for a moment some of the behaviors you’ve wanted to change lately. Have you wanted to limit your alcohol consumption, lose weight, feel less depressed, relax your muscles … now apply the thinking, feeling, behaving formula to your desired change and I bet you’ll notice something like resistance! That resistance, or confusion, or whatever we want to call it is the part of the recipe that pre-exist the CBT module.

What’s below your surface?

This is the realm of subtle work that requires teasing apart and helping us all understand more clearly the age-old patterns that fuel our irrational or unconscious behaviors. Yes, I know if I want to lose weight, I need to reduce my calorie consumption. But that knowledge (thought) generally does not stop me from grabbing a piece of chocolate (behavior) after a difficult day thinking I “deserve” (feeling) it.

Don’t get me wrong, there is a time and place for CBT, it has helped many people and is a worthy behavioral change formula. I also think it is often not enough and our complexity as humans in an ever-changing world requires more subtle exploration and a great deal of compassion in understanding what is discovered. After all, the obstruction to change is often an old habituated, painful, even unconscious pattern. We might have embarrassment, or even shame, about it – which keeps the information even more isolated and hidden from ourselves and others. Translate this to mean, we can’t make the desired changes if it remains hidden.

If you’re interested in transforming an aspect of your life you can try the thought, feeling, behavior recipe and then notice if something interferes with your behavioral change. If it is something you understand, then explore that more on your own. If you don’t understand it or can’t get any traction by yourself; please reach out for one of us at the StLWC to offer support and guidance, an outside view, compassionate understanding, and assistance with getting you closer to your goals. Enjoy this internal exploration and all that it brings to your awareness. And remember, tread gently!

Dr. Gwin Stewart founded the St. Louis Wellness Center in 2007. You can write her at  DrGwin@hotmail.com. Read more about her HERE.