The Space Between Blog Archives - Page 2 of 7 - Blue Ridge Behavioral Health

The Eight Resting Needs—The Week of 12/26/22

Every week I will be reviewing a reputable news article and engaging with it from a mental health professional standpoint. These will be short posts following a three segment model: 1. The News=short synopsis of article 2. The View= My initial impression of the article, and the news impact in the mental health world 3. The Reflection= Useful ways to engage with this information/applications to caring for our mental health. These posts will be published 8am EST on Mondays!

The News= While this isn’t necessarily a news cycle event..it is a recently published blog post that caught my eye on psychtoday. Claudia Skowron writes on 7 types of rest (referring to Dalton-Smith’s theory of rest). This is a really helpful concept framing how to tend to our different rest needs. There are 7 identified areas of rest that Skowron names: 1. Physical 2. Mental 3. Sensory 4. Emotional 5. Social 6. Creative 7. Spiritual .. Skowron also adds 8. Cellular/Systemic Rest. I will give a brief description of these: 1a. This is one of the first kinds of rest we think about…resting our weary bones, muscles and bodies. Sleep is included in this. 2a. Also could be considered “cognitive rest.” It’s unhooking from our busy minds through mindfulness practices, journaling, or even noticing the busyness of our minds. 3a. This is rebalancing our stimulation needs. What sensory experiences are you feeling overwhelmed in, and what would be good to get some space from? 4a. Allowing ourselves space and time to let down our masks, where we can be our full selves. 5a. Do you gain energy or lose energy from connecting with others? Perhaps you need some balance of the two. This is finding that balance. 6a. This is essentially giving your mind time to wander, or not be occupied by “production.” 7a. This is connecting to something deeper or larger than ourselves, however, you might define that. 8a. Being mindful of the balance of things we put into our bodies, caffeine, processed foods, alcohol, all the stuff that can make our bodies work harder in certain ways. Here is the article in reference.

A picture of four tiles on a white background that spell out “rest” in a green font. — Photo by Sincerely Media on Unsplashed

The View= If you have ever had the experience that you are resting, but you are wondering why you are still feeling tired this article might be a good one for you. The 7-8 ways to rest is good psychoeducation that brings awareness to parts of our lives that our minds don’t often give us credit for needing tending to. Our minds often focus on threat and scarcity, so they aren’t the greatest of steel traps for remembering things that are restorative. Making a mental or physical inventory of these 8 rests can be a good way to retrain our brain to better serve us.

The Reflection= Some of my close friends and family members give me (deserved) flak for how often I refer to being tired, and this article definitely gets me thinking more about what I am actually identifying. If you are like me..working full time, have kids, and try to keep up with home and chores, I find that I am often referring to needing more physical, sensory, social, and likely cellular rest. Maybe that resonates with you.

When you think of the rest you are needing right now, where do you think your biggest deficits are? What are some doable ways you might be able to make some ground in those areas? For example, I know that I won’t have much control of making gains in physical rest with a baby and almost 6 year old, but I know I can do a better job in finding avenues for cellular rest, and social need (could use a little boost in that regard..and have some people to reach out to.) I hope that you prioritize some ways of resting that have been neglected, and notice a difference this holiday week.

If you would be interested in trying a mindfulness activity that helps promote mental rest, try this!

Stress and High Blood Pressure Are Correlational, Not Causal—Week of 12/19/22

The News= It is a common myth that stress and high blood pressure have a causal correlation. This news article covers research that confirms that this correlation is not causation, and often there isn’t even strong correlation to stress and blood pressure. There are stronger links to diet, exercise, genetics, and close follow up with healthcare that show impact on blood pressure. Conversely, this research also shows that stress based reduction strategies also don’t have long lasting impact on blood pressure management.

Here is the article, which also includes further links to good info.

The View= Why is this important news? There is a lot of emphasis on finding ways to control anxiety and our response to stress, which can often lead to feeling even more stress when we feel like we aren’t able to make sustainable improvements in more objective measures, such as, our blood pressure/health. This will often result in us feeling more anxious about not being able to control our anxiety, and our quality of life takes a hit as we feel like we are losing control of our health. In short, it isn’t a mystified route that we need to take to figure out the best way to care for ourselves. We can anchor down in knowns, choices, and resources.

Photo by Mufid Majnun— Found on Unsplashed.com

The Reflection= So what do I mean by we can focus on the knowns, and choices? Here are some questions that help formulate this answer. When we know we are stressed, what do we notice we end up doing more or less of? For some of us we might notice that we feel more fatigued, more sedentary and isolate more. We might eat more things that have higher sodium, or notice our diet changes dramatically. These things are typically not static changes, but ebb and flow with stress in intensity. In general, maybe these aren’t such huge issues, but they might be opportunities to slightly modify how it is we want to treat ourselves. We might pause and be able to make choices that can better impact our health if that is a value we are wanting to focus on. Sometimes this can mean intentionally seeking out our community, even if we are feeling down. Maybe its seeking out our PCP, even if we are scared or unsure of what will be found. Maybe its bringing attention to those moments if we feel like we are binging, or not eating enough, and shift our choices.

This is a more tangible way to manage the part of response to our stress that may have more prolonged impact on our physical health and blood pressure. Overall, the best choice we can make, when we notice that our stress is changing the way we are operating, is to make sure we are making a point to follow up with a primary care physician. They can help us figure out the best ways to manage blood pressure when there are so many variables at play.

College Students Stress— Week of 12/12/22

The News: New research/data analysis shows that college students feel the most stress and negative mental health impact at school related to academic performance pressure. A lot of this stress was identified as being related to evaluation of external measures of success. External measures of success refers to the focus on grade point averages, performance on exams or projects, and graduating with honors. Managing academic workload was the second most stressful part of academic pressures, and college preparedness was third.

Here is the referenced article.

The View: Our group practice serves a lot of college communities, so I was not surprised to see these results. It was noteworthy to also see that these findings were consistent regardless of institution selectivity. In my practice I often hear about the academic pressures that college kids face, and how difficult it is to adjust to the college schedules and workload. As a mental health professional, it is really hard to assert justification for the level of stress we (as a society) put on students in the name of life/career preparation. It feels like this justification comes at a pretty steep cost…The trade off of health for a shot at better opportunity? I guess this is congruent with serving the “American dream.”

“Full Focus at a Coffee Shop”- Tim Gouw 2/25/2016

The Reflection: Colleges and Universities have already been well aware of the stressors on students for some time, and have scarce resources for the level of need. Academia is due for a major make-over, or re-evaluation of values, as, both, students and professors feel the major strain of focusing on external measures of success (grades/papers vs published articles/books). The reckoning might have to look like a dramatic decrease in workload, and a shift with the weight put on grades. This would mean that academia will need to exercise enough creativity to measure achievement through more flexible means. I would assume this would have to be a top down approach with institutions needing to find ways to offload work from their professors. The professors would then be able to make time for more personal assessments of their students.

Secondly, a bottom up approach would be to better address students’ mental health more comprehensively at college. I would assume that this would mean more group work models, which haven’t be a primary avenue of support I’ve seen on campuses. Groups that focus on teaching skills from anything to “Study habits (scaffolded to those with learning disabilities, ADHD or other neurodiversity),” “coping skills groups” for managing anxiety, promoting better sleep schedules, “substance use group support,” and peer lead groups. Of course, individual work will still have high demand and need, but not only would group work be able to reach more students, it is also really effective for skills based teaching and negotiating community based stressors. More programs that follow models like this or this could be highly impactful.

Impodster Syndrome

“Heyyyy…!” *in meek and ashamed while slowly entering the room…*

Okay, not to get too meta here, but I am acknowledging that (yet again) I am restarting my blogging endeavors. Ironically enough I am kicking off by talking about “imposter syndrome.” While I write this I am feeling exactly what I am going to be getting into in full force. “How do you actually think you can call yourself a blogger/writer when you don’t generate content but once a year?” “There is no way you are going to keep up with this…see you in another year.” “You don’t have the focus or creative energy to produce something worth reading.” Oof…that last one was especially cutting… I don’t know about you, but when I am steeped in this hot water there is no pleasant tasting tea that will come out of it. It’s also not something I can easily fight off. These cutting doubts will come back to find me if I just tell them to “fuck off.”

As I mentioned in my podcast episode of the same name…I don’t think “imposter syndrome” fits the description of this experience in a helpful way. “Imposter syndrome” conjures up something of more gravity and pathology than an experience that might have more spectrum to it. Doubt can actually be pretty beneficial. It is a stance that allows us to be self reflective and critique our own impressions and biases. It is close to curiosity, but, perhaps, with a little more scrutiny. It is adjacent to uncertainty, but, perhaps, with more edge. It is nearly questioning, but, perhaps, closer to a harsh conclusion. You get the point…

I am sure there are a million and one blog posts (see psychtoday.com probably) that address how to cope with imposter syndrome. I know that I actually chose this theme at the same time that Ben Benhen published a podcast on it. That is how much it is in the ether… By the way..check out his episode! It’s great, and we are kinda besties after I reached out to him to laugh about this:

In this post I will be focusing on this particular form of doubt’s function and how to shift our relationship with it. So with our further ado, here we go:

Functions

“Imposter syndrome” is often a way that many people describe insecurity or doubt in a particular role. It can be experienced as a red flag or threat that needs to be addressed. When we feel it in this visceral way, we are often already engaging our thoughts and sensations, tied to this doubt, as judgements and commands. Our relationship to our doubt is fused. We can begin listening to our doubt as truth or commands.
Ultimately, I wonder if a part of the function is that this anxiety often has us check-in with our peers, community, and others who might be able to reflect to us if what we are experiencing is normal/true. If shame accompanies this experience we might yearn for that connection, but find it too threatening to connect and face those potential mirrors. This function is, arguably, more true for people with identities that are marginalized in our society. For example: For hundreds of years psychotherapy has been gatekept by white cis men..meaning that feeling like an imposter is not just an internal experience, but also an internalization, or reaction to direct oppression for those who have been marginalized in our professions/society. Connecting with that larger context is part of the needed community in addressing this aspect of doubt.

Shifting the Relationship

If we were to shift out of this rigid response (especially, if you have noticed it is a pattern) it would start with being willing to experience this cluster of emotions in a role that we find challenging. This doesn’t mean we have to be okay with it, rather allow it to be with us. Allow ourselves to hold this. So here’s the big question for you. Are you willing to feel all of this?
If you are are willing to make space for this kind of doubt, what emotions come with it? —insecure, anxious, weak, inadequate, inferior, excluded, exposed, embarrassed, hesitant, disappointed, etc?
Oof, lots of heavy emotions that camp out in that kind of doubt…what do we notice here? What is important to take away from clocking all of these experiences? Pain and isolation feel pretty present. What would tending to these deeper cuts feel like here? As we take that emotional elevator down from the higher flying anxiety/doubt…it might feel harder to identify these sensations and pains while continuing to rub salt in those wounds. How do we actually want to tend to these hurts? What might be helpful in addressing this internal impasse?

So, again….lets identify with our pain. It is a lot to feel, but the cost of trying to keep up with the anxiety part is pretty steep. Our pain connects us back to us. If we can engage with what values are important to us in our relationship to ourselves and others in pain..we stand a good chance of offering ourselves that antidote of compassion. I promise that we can be compassionate to ourselves and take action to feel more competency in whatever role we are struggling with. In fact, gaining competency is best found with compassion. Ask me how I know.

I encourage you to check out the rest of Series 1: On my podcast 2. Free worksheet 3. Premium blog post for clinicians. I look forward to rolling out more series soon! Catch you in The Space Between!

NYC Mayor Pushes to Hospitalize Those Experiencing Homelessness—Week of 12/5/22

The News: New York’s Mayor, Eric Adams, has decided to allocate resources towards assessing NY’s population experiencing homelessness for acute psychiatric care. 50 more psychiatric beds will be opened up, and he has stated that he is wanting these patients who get admitted to be held inpatient until ongoing care can be established. This move will include involuntarily hospitalizing people who are not posing a risk to others. This means police bringing in an individual for treatment against their will. In Virginia this is called an Emergency Custody Order (ECO). The individual is then evaluated in the Emergency Room and potentially placed on a Temporary Detention Order (TDO) where an individual is committed to the hospital for up to 1-5 days until a hearing can be held. He voiced that he wants compassionate care to be shown to the homeless who are admitted, but that they will bring in homeless against their will if assessed that their mental illness is of harm to themselves. Here is the article for reference.

The View: Addressing homelessness compassionately and competently is something many countries struggle to do. Data on homelessness has been impacted by the pandemic, but here is some data that has been consistent or most up to date in America. Over 500 thousand Americans are homeless. The state of NY accounts for almost ⅕ of this population. NYC alone accounts for approximately 50k of the homeless population. Native Americans and African Americans (demographic names used in the captured data) have higher rates of experiencing homelessness. Temporary Shelters only offer space to over 300K people on any given night in our country. The unsheltered homeless population had been trending down since 2007, but from the 2015-2020 there has been a surge that has almost eradicated progress since 2007.

The Reflection:

Addressing homelessness is a difficult task, but research has consistently shown that housing first with wraparound services is the most effective. Approximately 25% to ⅓ of the homeless population experiences severe mental illness. We know that the trauma of experiencing homelessness can exacerbate mental illness, but untangling correlation/causation is difficult. Involuntary commitment is inherently traumatic in that use of force is required, and autonomy (that was already in short supply given the experience of homelessness) is further stripped away.

So here are some things that should concern us as a community. If we just prioritize emergency mental health resources in opening up an insufficient number of psychiatry inpatient beds, we are not being good stewards of community resources. We are also not fully addressing the issue, and further traumatizing an already marginalized community. There is no mention of how resources might be allocated to outreach or comprehensive wrap around services (which would likely be significantly cheaper than inpatient hospital stays.) Lastly, it is completely unethical to hold an individual on TDO, who has regained capacity, against their will…even if it is in the name of finding a better discharge plan.

Dehumanizing people experiencing homelessness contributes to our society feeling more cruel and unjust. Witnessing others experiencing injustice and harm impacts our own mental health, as well, as we feel more helpless and hopeless in tending to others. Here is a great post capturing how we need to find movement as a community to address these injustices and find healing together.

Additional articles from which data was retrieved: 1.https://endhomelessness.org/homelessness-in-america/homelessness-statistics/state-of-homelessness/ 2. https://www.bbrfoundation.org/blog/homelessness-and-mental-illness-challenge-our-society 3. https://www.treatmentadvocacycenter.org/evidence-and-research/learn-more-about/3629-serious-mental-illness-and-homelessness 4. https://www.psychiatrictimes.com/view/never-ending-loop-homelessness-psychiatric-disorder-and-mortality 5. https://journalofethics.ama-assn.org/article/four-ways-limit-use-force-care-persons-experiencing-homelessness/2021-11

The Eight Resting Needs—The Week of 12/26/22

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Stress and High Blood Pressure Are Correlational, Not Causal—Week of 12/19/22

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Impodster Syndrome

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NYC Mayor Pushes to Hospitalize Those Experiencing Homelessness—Week of 12/5/22

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