Category Archives: anxiety

On intrusive thoughts

A landmark study by psychologist Daniel Wegner found that research participants ironically experienced a surge of intrusive thoughts, known as a rebound effect, when asked not to think about a white bear. They had a significantly higher level of thoughts about white bears when instructed NOT to think about them.Another study in cognitive science, conducted by Drs. Bonanno and Siddique (see ‘at play in the fields of consciousness’, 1999, Lawrence Erlbaum Publishers) found that a sub-group of people could effectively suppress thoughts, even following grief and loss, such as the death of a spouse. Known as dispositional repression, some people demonstrated a knack of not being inundated with intrusive imagery and thoughts. Intervening variables included the ability to distract oneself and receptivity to social support and interaction.

Both of these studies have important implications for people who suffer from intrusive thoughts. Intrusive thoughts are unwanted thoughts and images that can cause anxiety and distress. A global study found that up to 95% of people have intrusive thoughts, from the innocuous “did I remember to lock my door?” to more disturbing thoughts, such as “what if I run somebody over at a stoplight?”

Unlike regular thoughts, intrusive thoughts can be repetitive, uncomfortable, and are often difficult to control.
Clinical psychology research, including the studies mentioned above, indicate that not thinking about something requires first thinking about it. The harder we try to stop thinking about something, we may actually have a surge of thoughts about the undesired topic. Active attempts at thought suppression can have the opposite effect.

Recent research:
A 2020 study on patients with clinically intrusive thoughts (OCD) indicated they may place less trust in their past experiences, leading to greater uncertainty, indecisiveness and doubt. The findings showed that participants with higher levels of intrusive thoughts were less trusting of past experiences. They were constantly questioning themselves. As such, their environment felt consistently unpredictable.

So, what works to reduce intrusive thinking?
* Mindfulness
Research shows that mindfulness exercises can improve attention control, reduce anxiety and reduce intrusive thoughts. There are several variations of mindfulness (or mindfulness meditation). People can learn to reduce the significance of their intrusive thoughts by observing them without judgment. The simplest form of mindfulness is focused on paying attention to the present moment; sometimes by focusing on breath or a specific object.
*ACT-based psychotherapy
Another option, called acceptance mindfulness (ACT therapy) encourages you to look inward, noticing and acknowledging your thoughts and emotions, while choosing ACTION based on personal values (for example, if hurting someone is an intrusive thought, acknowledging that your personal values are not commensurate with that thought can help reduce discomfort and anxiety). 
*Distraction and social support
Having someone to talk to on a regular basis (reality check), whether a friend, mental health professional, clergy/spiritual guide, or trusted family member, can reduce the discomfort of having intrusive thoughts. 
* Managing stress levels
Experiencing a high level of stress can cause intrusive thoughts. According to the American Academy of Sleep Medicine, the genetic factors that cause sleep problems when some people are stressed are the same that can make people with intrusive, ruminative thoughts have a higher rate of insomnia. It’s not a coincidence that many people have intrusive thoughts at night, when they are presumably done with their busy day. This is one of the reasons why some of the most successful methods for battling anxiety and intrusive thinking involve curbing stress and working on effective sleep protocols.
*Therapy, with a focus on cognitive behavioral strategies
In addition to self-statements and personal mantras, I sometimes have clients make a checklist. Did I remember to feed the cat, turn off the stove, lock the door, take my medication? A visual reminder can be helpful.
* Reducing repetitive stimuli
If you are prone to intrusive thoughts, turning off your feed, or even taking a break from Twitter or other social media might be helpful. Social media facilitates intrusive thinking by sheer repetition.

Also see:
How to Reduce Anxiety on the Go: Strategies that Work
Mantras as Self Statements
Bonanno and Siddique, from the American Psychological Association:

How to reduce anxiety on the go: strategies that work

An important question I am often asked is how to reduce anxiety away from home and without a scheduled therapy session. I have always held the stance that psychotherapy (and treatment), in general, is a few hours per month at most. In between, there is a lot of living that happens. It all matters.

Having skills and strategies that work, and are individualized, is incredibly important. I ask patients what feels best (and it may vary even for each person) when they feel a wave of anxiety in the moment, day, or even longer. Contrary to ‘follow a manual’ therapy, everything does not work for everyone.

Here are some things that might seem deceptively simple, but can be adapted for using during moments of severe anxiety, during travel, airports, classroom, campus, work, meetings, deadlines, and social gatherings.

*Listen to your body. What does it want to do when it’s distressed? I have clients who want to walk around, they need to pace. Others need to get out, go outside. Curling up in a fetal position, ‘child’s pose’ in yoga, is also soothing for many folks. Some people want to call a trusted friend, I call this having an anxiety coach. On the other hand, people might need to be in a quiet space with no conversation, and to be left alone. For people who prefer a sense of being grounded, lying on the floor, carpet, grass, earth can be very soothing.

*Escape hatches. I am rightly asked, how am I supposed to do that stuff in the middle of a long and stressful meeting or other setting? There are strategies that can be used as an ‘escape hatch’ during the requirements of your day. The important thing is to practice them and think about them and what works and what doesn’t beforehand.

*Practice. In mental health, we frequently hear, ‘I had an OK week, nothing bad happened.’ That’s great. That IS the actual best time to maybe think about and learn some strategies in the session. No one has ever learned anything that ‘sticks’ with cortisol and adrenaline coursing through their body, during the very moment of severe anxiety or panic. Learning in between, that’s where you get to practice the best.

*Music is evocative. Put together a specific playlist that is only to be used for moments of anxiety management. I have people do specific playlists for coping with anxiety/stress, focus and attention, relaxation and unwind, feeling powerful, and exercise, among others. The trick is to only use the playlist for those moments, not in general. Our brain creates pathways with specific associations. Just think of how you might crave a childhood favorite food when you’re feeling the need for comfort. When that coping and stress playlist comes on, your brain (eventually) remembers,’this is to help me calm and soothe myself’.

* Placement. Not possible in all settings, but have a small prayer rug or yoga mat with you. Again, it’s the association. This small (physical) space is where you go to breathe for calmness (see diagrams, below), practice meditation or pranayama (controlled breath work), or pray, whatever form that takes.

* Journal. Try to write down any thoughts, feelings, opinions, ideas. A robust body of clinical research shows that getting feelings out of your head by doing this is remarkably helpful in reducing anxiety or depression in the moment. One of the things I come, across with clients is the self critic, what if I don’t know what to say, what if I don’t know what to write, what if it sounds stupid? The technique that I suggest:

First, no one needs to see what you’re writing. It’s for you, and only the other people that you may or may not want to share it with. Write your truth: ‘I don’t know what to say. I don’t know what to do. I don’t know what’s happening. I am confused. I feel stupid.’ It clears your head and creates the foundation for thinking more reflectively. Speaking your truth, as closely as possible, is genuineness, and it’s a superpower when it comes to alleviating anxiety.

Anxiety can see through fancy maneuvers, denial, and numbing behaviors. It is ancient and has seen it all.

Not everything works for everyone. But finding out what helps matters.
For more info please read: Anxiety Toolkit.

On News Anxiety

For as long as people have had widespread access to daily news, there has been news-related anxiety. But the age of social media has dramatically increased the amount of time we spend keeping up on current events. After 9/11, while I was completing my doctoral internship, many clients told me they were watching the news for 8 to 10 hours a day.

Instead of limiting news consumption to once a day, e.g., reading the morning paper or watching the local news before heading to work, many of us are immersed in a neverending news cycle. Alerts throughout the day make it hard to avoid a never ending barrage of information. Neuropsychological research indicates that when we hear a ping on our phone, it may contribute to hypervigilance.

Today, at least 1 in 5 Americans get their news through social media. A conservative estimate is that the average inter-webs user spends more than 4 hours scrolling per day. Every year, that number steadily increases. The term “doomscrolling” describes when the consumption of negative news events leads to information overload and becomes a compulsive habit.

While some amount of worry can be useful for planning ahead, it is easy to cross the line from staying informed to inducing anxiety or exacerbating a dysphoric mood.  Individuals who suffer from anxiety or mood disorders are particularly vulnerable.  The pressure to stay up-to-date on serious topics like COVID-19, civil unrest, violence in every form, and climate change can make it difficult to stop doomscrolling. We are survival driven and searching for information is built into our frontal lobes.

Many empathic people have expressed to me that it might even feel irresponsible to avoid news that is negative. ‘If people are suffering, why am I such a wimp that I can’t even read about it?’ To be informed is important, to be vicariously traumatized saps our energy and will to proceed.

How to Manage News Anxiety; the Clinical Psychology Research:

  • There is no “one size fits all” solution.
    The key is to find an approach that works for you, which starts with recognizing your triggers or personal vulnerabilities. Try to pay attention to what happens right before you feel the urge to reach for your phone or tablet. If your scrolling is brought on by certain thoughts, feelings, or situations, or centers around a particular subject, take note.
  • Acknowledge addiction potential.
    People who experience addiction have a higher likelihood of relapsing when exposed to certain triggers, e.g. walking by the bar they used to frequent, seeing an ashtray, or being near slot machines. The same goes for people with digital addictions like social media or doomscrolling. If you are particularly consumed or obsessed with a specific subject, limit yourself to spending 15-30 minutes reading about it each day. Set a timer.
  • Curate News and Social Media Consumption.
    Swearing off social media altogether can be too big of a leap for most people. Instead, think about ways you can alter the way you use social media. For example, if there are accounts that you notice often cause you anxiety, mute or unfollow them. Also, consider disabling alerts for social media platforms. This way, you will be less tempted to open apps throughout the day.
  • Incorporate Positive Stimuli.
    When breaking a habit like doomscrolling, finding positive activities to supplement the time you spend reading news can make a big difference. Try engaging with something non-educational that simply serves to make you smile. This could be exploring a light-hearted hashtag, like #catsoftiktok, visiting the wholesome page on Reddit, or watching an animated show or movie. Though it may sound silly, empirical studies have shown that watching cute animal videos can measurably lower blood pressure and reduce anxiety.
  • Move and Stretch.
    Disrupting your thought processes with physical movement is another strategy to break a rote scrolling cycle of doomscrolling. Get up and walk around. Set a loud timer that’s across the room, one that forces you to get out of your chair or bed.
  • Seek Professional Help.
    If you are still having trouble gaining control of your scrolling or social media consumption, there are therapists who specialize in helping clients who struggle with social media use and anxiety.

The Takeaway:

  • Timing and dosage.
    Limit your time and the amount of news that you consume. If you tend to have a harder time at night with anxiety, maybe watch/read/scroll news in the morning only. During times of trouble such as the pandemic, insomnia, was a significant symptom of our anxiety and stress. We need to avoid and monitor as much as possible the stimuli that may add to our already dysregulated bodies.
  • QC.
    Pick news material that is factual, thorough, and data driven. Keep it brief and succinct.
  • Balance.
    Mix doom-scrolling with something lighter. watching something that makes you smile is good for you. Those of us of a certain age used to wake up on Saturday mornings and watch cartoons with eager anticipation. They transported us away from the rest of our week, past and upcoming.

How to get motivated when you’re not feeling it

Reasons for low motivation can include:

Avoidance of discomfort.
Sometimes a lack of motivation stems from a desire to avoid uncomfortable feelings. Discomfort could include feelings that a task is too hard, too big, too exhausting, or too complicated (task expectations that are not clearly laid out are one of the biggest motivation killers). Feelings of distress or task aversion are one of THE most common reasons for de-motivation.

Repetitive everyday tasks are often avoided. From doing dishes, laundry, to cleaning up after the kids, every single day feels like Groundhog Day. It feels never-ending. For students, the parallel is ‘busywork’, such as repetitive homework.

When you think you can’t do something—or just don’t know how to get it done. When you lack the tools, skills, or even the training to get it done, it can be very un-motivating.

Being over-extended.
When you are juggling a lot in life, you’ll likely feel overwhelmed. You may not even know what to tackle first and this feeling can zap your motivation.

Procrastination has a positive correlation with perfectionism. Often, perfectionists have difficulty starting or staying on task because the internalized goal of doing it perfectly feels so hard to meet.

Executive Functioning Weaknesses.
Executive function is mediated by the frontal lobe, the conductor of the brain or the Head Chef. What appears to be low motivation is sometimes a direct result of difficulties with planning, organizing, sustained effort, attention, processing speed,  prioritizing, and self monitoring. If you have a bunch of talented musicians who can’t work together in an orchestra, the result is a jarring cacophony of sound no matter the skill level. Learn more: What Is Executive Functioning?

Lack of commitment to a goal.
Agreeing to a task simply because you felt obligated, may mean your heart really isn’t in it. And you are less likely to take action when you aren’t committed to your goal.

Mental health issues.
A lack of motivation is a common symptom of depression. It can also be linked to other mental illnesses, like anxiety. So it’s important to consider whether your mental health may be affecting your motivation level. Read more on how mental health can sap your motivation.

Strategies for Motivation That Work
One Goal.
Probably the most common mistake that people make with regard to motivation: they try to take on too much, try to accomplish too many goals at once. You cannot maintain energy and focus (the two most important things in accomplishing a goal) if you are trying to do two or more goals at once. You have to choose one goal, for now, and focus on it completely.

Find inspiration.
Inspiration can come from all over: clients, mentors, friends, entrepreneurs, colleagues. Read blogs, books, magazines,  Watch movies and shows, talk to people. Write down ideas that you find inspiring. Having an inspiration journal is a boon when it feels like your mind is blank.

Ask for help.
Having trouble? Ask for help. Join an online forum. Talk to a colleague or friend you trust.  Find somebody who can coach you through the rough bits. Having an executive coach or emotion coach can get you back on your feet.

Reward Yourself.
Create small rewards for yourself that you can earn for your hard work. You might find focusing on the reward helps you stay motivated to reach your goals. For example, if you have a long paper to write for a class or a work assignment, you might tackle it in several different ways: Consider whether you are likely to be more motivated by smaller, more frequent rewards or a bigger reward for a complete job. You may want to experiment with a few different strategies until you discover an approach that works best for you.

Use the 10-Minute Rule.
When you dread doing something, like walking on the treadmill for three mile or lifting weights for 30 minutes, you may lack motivation to do it. You can reduce your feelings of dread by breaking it up into short components.  The 10-minute rule can help you get going. Give yourself permission to quit a task after 10 minutes. When you reach the 10-minute mark, ask yourself if you want to keep going or quit. Life, 10 minutes at a time.

Break it down.
I work with a lot of students, researchers, and writers. Having to write or produce a large amount of material is a daunting task for most people.  Learning how to break down a large project or paper into smaller steps, each with its own deadline, requires practice. One of the largest factors in motivation is feeling overwhelmed by the huge-ness of a task.

Ebb and Flow.
Motivation is not a constant thing that is always there for you. It comes and goes. But realize that while it may go away, it usually doesn’t do so permanently. Be patient with yourself on bad days.

Start small.
If you are having a hard time getting started, it may be because you’re thinking too big. If you want to exercise, for example, you may be thinking that you have to do these intense workouts 5 days a week. Do small, tiny, baby steps. Just do 5 minutes of exercise. Organize one cupboard or drawer.  Want to wake up early? Don’t think about waking at 5 a.m. Instead, think about waking 10 minutes earlier for a week. That’s all. Baby steps are powerful. Just think about it, a tiny human learning to walk. That’s a powerhouse.

Manage Your To-Do List.
First of all, it’s impossible to keep everything in your head. When some of my students or clients tell me it’s all up there, I just nod politely. No matter how great your memory, something will slip through the cracks. Having a list is not optional.

It’s tough to feel motivated when your to-do list is overwhelming. If you feel like there’s no hope in getting everything done, you might not try to do anything. Keep in mind that most people underestimate how long something will take them. And when they don’t get it done on time, they might view themselves as lazy or inefficient. This can backfire by causing them to lose motivation, which makes it even harder to get more things done.

Take a look at your to-do list, and determine if it’s too long. If so, get rid of tasks that aren’t essential. See if other tasks can be moved to a different day. Prioritize the most important things on the list, and move those to the top. I like keeping separate notebooks, for tasks that are essential and those that are long-term. You can further divide both categories into work deadlines, social commitments, family commitments, self-care,  and academic or educational endeavors. I actually like to use different color pens for each area. The important thing is to break your to do list down into components that are actually possible or else you will have the same long list day after day.

Mindfulness and Self-Care.
You’ll struggle with motivation as long as you aren’t caring for yourself. Sleep-deprivation, poor nutrition, stress/worry, and lack of leisure time are just a few things that can make trudging through the day more difficult than ever. Learn more about Mindfulness and Self-care.

The Pillars of Self-Care.

    • Exercise regularly.
    • Get plenty of sleep.
    • Drink water, and eat a healthy diet.
    • Make time for leisure and fun.
    • Use healthy coping skills to deal with stress.
    • Find meaningful social connection.
    • Avoid unhealthy habits, like binge eating and drinking too much alcohol.
    • Seek professional help as needed.

Get support.
It’s hard to accomplish something alone. A landmark study in 2016 (Journal of Experimental and Social Psychology) found that not feeling alone was an incredibly potent variable in motivation. Researchers gave out an impossible task, that is, it had no actual solution. The participants were split into two groups and given a complex puzzle to complete. People in one group were told they’d be working in teams, and were introduced to their teammates before being sent off to work on the puzzle alone. The other team was told they’d be working alone, and didn’t meet any teammates. While working on the puzzle, those in the team group were given handwritten notes supposedly from their teammates (they were actually from the researchers). These notes, and the process of meeting their teammates before starting the puzzle had an impact on their experience, despite the fact that they were working on the puzzle all alone, just as those in the non-team group were.

The participants who felt like they were part of a team, worked 50% longer on trying to solve the puzzle. They also reported finding the puzzle more fun and more interesting than participants who didn’t have teammates. The mere idea that one is working with a group and not alone can increase intrinsic motivation, that is, an inner drive to finish the work and increased internal satisfaction working persistently.  Read: How to Ask for Help Without Feeling Weird.

State Your Mantra.
Print out your goal in words. Make your goal just a few words long, like a mantra (“Exercise 15 mins. Daily”), and post it up on your wall or refrigerator. Post it at home and work. Put it on your computer desktop, bathroom mirror, and cell phone. You want to have real reminders about your goal, to keep your focus and keep your excitement going. Learn more about Mantras.

Pair a Dreaded Task With Something You Enjoy.
Our emotions play a major role in motivation level. If you’re sad, bored, lonely, scared, or anxious, your desire to tackle a tough challenge or complete a tedious task will suffer. Boost your mood by adding a little fun to something you’re not motivated to do. You’ll feel happier and you might even look forward to doing the task when it’s regularly paired with something fun.

Here are some examples:

  • Listen to music while you run.
  • Call a friend, and chat while you’re cleaning the house.
  • Light a scented candle while you’re working on your computer.
  • Rent a luxury vehicle when you travel for business.
  • Invite a friend to run errands with you.
  • Listen to audiobooks or interesting podcasts while commuting.
  • Turn on your favorite show while you’re folding laundry.

Give yourself a time out.
Giving yourself breaks throughout a large task can be very energizing. The average person can only sustain attention for30 to 45 minutes and often less. Get up, stretch, move, see below.

Include physical movement.
Although you might be getting ready to do something that’s not physical, like working at a desk, your schedule routine should include some movement. Exercise oxygenates your brain and can do wonders for your motivation and energy.

Get outside.
Walking or spending time in nature can be very beneficial. A 2013 study published in the British Journal of Sports Medicine found that walking half a mile through a park or working in a garden for thirty minutes reduces brain fatigue.

Write it down.
Numerous studies have shown that you are more likely to achieve your goals if you write them down. A guided day planner with a daily list of goals will give you the motivation to achieve your objectives step-by-step. When you know what steps to take to achieve your goals and you see them in writing, you’re more likely to get motivated to complete them.

Practice Self-Compassion.
You might think being hard on yourself is the key to getting motivated. But harsh self-criticism doesn’t work. Research shows that self-compassion is actually much more motivating, especially when you are struggling with adversity. For example, a 2011 study conducted by researchers at the University of California found that self-compassion increases the motivation to recover from failure. After failing a test, students spent more time studying when they spoke to themselves kindly. Additionally, they reported greater motivation to change their weaknesses when they practiced self-acceptance (a key component of self-compassion). Self-compassion may also improve mental health (which can increase motivation). Having a kind inner dialogue is a key component of avoiding discouragement, the motivation killer. Learn more about Self-Compassion

The Late Night Call

For many of us in psychology/mental health, when the phone rings or a text pings late night, there is an immediate frisson of worry and concern. It’s a cold shiver in your spine. Bad news is going down. I work with a lot of young people, teens through 30s, and I am readily accessible most of the time. No one abuses this. When people call you late at night, it’s usually not to say hello.

One of my mentors is a top authority in suicide research in the world. When I asked him, as a doctoral student, why he got into this painful area where he has done so much to help, he said we pursue what we fear. It might seem counterintuitive but there is no greater courage than facing the fears we have by helping others with theirs.

I started my own company several years ago after being Clinical Director elsewhere because I believe that mental health is for all. It is often excluded for many people because of financial constraints, stigma, lack of cultural competence, lack of hours to actually go see someone, and a potentially ‘authoritative’ relationship that is anathema to many.

I will tell you this.
NO doctor or therapist can do anything without their team. The team is: found or biological family or parents, other medical providers, friends and social supports of the person that you are working for and with, chosen spiritual beliefs, community, teachers (as burdened as they are are, they are very often the person that young people turn to), genuine Internet connections, ancestry/culture, companion animals, and fostering self-compassion relentlessly.

We are always so shocked and horrified to hear about someone taking their life. But when most ask people how they’re doing, they expect to hear ‘fine’.

We need to facilitate conversation where somebody can say they feel absolutely lousy. It’s been a terrible day. Right now, people at your job, your neighborhood, your home, feel absolutely lousy.  They don’t know what to do. We need dialogue about mental health so it becomes a natural thing.

It takes a village, the most trite and true statement.


Kanji: Gratitude as Action

The philosophy we follow at Embolden is to add seemingly small but significant things to your life. Instead of taking things away; which actually leaves a vacuum that often fails to be sustained. Our strategy is Stones Across The River. Adding a few small things every day, every week, every month creates new ways of being (neural pathways). It’s important to think of things that personally speak to you.

Here are some ideas for our New Year:
-Drink more water. Most of us are more dehydrated than we know.
Not drinking enough water causes fatigue, headaches, muscle tension, attention and concentration difficulties, even hunger pangs. Get a water bottle that you love. You can prepare it in the morning and add fresh sliced fruit, lemon, lime, or cucumber if desired. Start with drinking that throughout the day. Once it becomes more of a habit, you can even refill it halfway through the day.

-Support local restaurants. If you’ve always been drawn to the familiarity of larger or chain restaurants, get to know your neighborhood businesses. You will meet some great folks, and probably establish relationships, not to mention eating some delicious food that you may not have experienced otherwise. You can try new spots every month. As a bonus, you are helping sustain businesses that may need it.

-Make specific playlists. This is actually a mindfulness exercise. What songs or music make you feel energized? Sleepy? Relaxed? What helps you work? Music is a very powerful medium that can evoke different moods and activities. When you use specific playlists, your brain goes into a certain mode, from working out to unwinding. Listening to music actually makes you exercise or work for a longer duration.

-Journal. If you dislike writing, there is a new strategy that I’ve been recommending called one line a day. Buy a journal or notebook that speaks to you; whether it’s a sleek black leather-bound one, pictures of cats or dogs, or just beautiful photos/art. At the end of the day, write a sentence or three about how you’re feeling or what’s on your mind at that moment. Doing this consistently is good for your mental health.

-Go outside. Go for a stroll or even a hike. You can pick a time of day that works for you. Do you like sunrises or sunsets, do you prefer to be alone or with somebody? You can find a walking partner, canine or human. If you don’t love being outside, start by simply being on your own street or block, and back.

-Compliment someone. This actually neurologically creates a boost in endorphins both for the giver and the receiver. It doesn’t have to be creepy. Just think of something you genuinely admire or observe about that person and try it out. Very often we are trained not to speak to somebody’s traits or strengths because we will “turn their head, seem fake or a brown-noser, or make them vain.” A compliment given properly is a gift and can actually make somebody’s day better. Yours and theirs.

-Clean/organize one thing. If a closet or an entire room is too daunting, start with a drawer, a cupboard, or your car. This is an area where people become easily overwhelmed especially if they haven’t cleaned or organized in a while. Each time you accomplish one goal, it builds self-efficacy. Self-efficacy expectations are your own ability to believe that you can accomplish something. Like working out, it requires one step at a time. You literally build your own confidence.

-Grow or tend something. If you are daunted by gardening, start with a house plant or two. Many are low maintenance. If you like to cook, you could start a small kitchen herb container garden.

-Read. Start with one book a month. It can be a graphic novel, fiction, or something that you’ve wanted to learn more about. You can have a reading buddy if you don’t believe that you can sustain being in a larger book club.

-Do as you go. If you are someone who ends up with large piles of laundry, a sink full of dishes, and copious amounts of pet hair on your floors, it often becomes a Herculean task. Taking care of a few dishes after a meal, putting things back where they should go, and completing and folding laundry regularly actually ultimately saves time and helps unclutter your mind.

-Pay off one bill at a time. As you notice your interest rates and penalties going down, it increases mental flexibility and a sense of freedom.  For three months at a time, see what it’s like if you give up one thing, whether it’s Starbucks or saying no to that extra pair of shoes, and pay off a bill instead.

-Keep in touch. From a group chat, to a couple of friends that you care about or text/email regularly, connection decreases anxiety and depression. If you don’t have the energy for a phone call, keeping in touch even briefly creates a sense that you’re not alone.

-Pick your battles. Although it might create a brief adrenaline rush when you vent online, argue with relatives, or comment on somebody’s seemingly astounding content, you just lost an hour of your life, probably raised your blood pressure, and the psychology research indicates the chances are extremely low that you made a dent in their thinking. If you want to vent, get an online therapist, commiserate with friends, or journal.

-Ask for help. This is often something that’s very hard to do. Vulnerability is not easy. Like anything else, practice helps. Here are some practical tips: How to Ask For Help Without Feeling Weird.

-Rest. People have reported feeling unusually tired. It’s a pandemic. We have an all time high allostatic load (elevated stress levels and hormones, without sufficient alleviation). We require sleep for consolidation of memory. We use REM and deep sleep for metabolizing experience (day residue). We must have rest for muscle recovery, no matter how fit we are. We need downtime from work or else our attention is going to wander anyway. We can’t focus efficiently without rest. Yes, we can muscle through temporarily, or take medication. When it wears off, you will be completely worn out. Sleep disorders are at an all-time high. Your body is going to force you to rest eventually. Make it a conscious decision.
See Making Sleep Your Best Friend for more info.

-Ride your best horse first. I learned this from a friend of many years. She emphatically believes you should always use your good candles, your best lotion or skin products, drink your favorite wine, use the gorgeous glasses or mugs, buy that great food at the market, enjoy your softest blanket/wear your fancy outfit/get that massage/ use the special jewelry, use the stunning purse you generally store in its bag. As humans, we want to hoard what feels special. For what?

-Where you can, make your life easier. One client who is very frugal, struggled with his laptop that was creating a lot of problems in his daily schedule. He spent hours daily fixing kinks and slow speeds, leading to frustration and even tears. He finally invested in a fairly modest but extremely updated life machine, as I term it. Not everyone can afford it, but where you can without creating hardship, make life a bit easier. If you truly despise cleaning bathrooms and you can afford to have somebody clean for you once a month, the mental relief is worthwhile.

Small but powerful.

See Stones Across the River, Or Mindfulness As Practice

The Power of Texting

Beautiful artwork, P. Cochrane

Sending a supportive text has been shown to be of significant benefit for someone struggling to cope.
What to say to a loved one:

8 Texts For Mental Health Support

  • The specific offer of help text
    Hey, I’m going to the store shortly, what are some things I can pick up for you? I’m taking the dog to the park later, can I come by and pick up yours to take with us?
  • The you are not alone text
    Why don’t we go for a walk this afternoon? Would you like to watch a movie together tonight from our own homes? Let’s FaceTime later today.
  • The checking-in text
    Just wanted to check on you, no rush to reply. I’m here.
  • The gratitude text
    I really appreciate you and having you in my life.
  • The thoughtful gift text
    I wanted to let you know I swung by and left some beer/wine/coffee and snacks at your front door.
  • The timing and dosage text
    I’m here to talk when you feel like it and as little or as much as you want to say. Or, I can come by and we can both sit quietly together.
  • The photo text
    Here’s a picture of this beautiful beach… It’s so soothing to imagine being there with you.
  • The solidarity text
    You are not alone.  I can come with you to…

Seven Natural Anxiolytics We Love

What do psychologists personally use to manage stress and anxiety?
Like any other strategy or tool, individual preference matters.

Weighted Blanket
I use one that is 20-25 lbs. It’s for grounding through weight and pressure. Pressure preferences are highly variable. Start low.

Vibrating Foam Roller
I use one that’s blue tooth enabled. Releases muscle tension with a variety of massage routines included in an accompanying app.

Leather-bound Writing Journals.
Moleskine is a brand that holds up well over time, no matter how many times you stuff your notebooks in your tote or suitcase.

Soothing Playlists
I like piano and trip hop. Find what clears your head. Important: only use the specific anxiety coping playlist you put together when you are in self-soothing mode. This creates neural associations.

Acupressure/Acupuncture Mat
Lying on a spiky mat may sound more like torture than treat, but once you get past the initial discomfort, the ancient relaxation of acupressure creates deep well-being. I like the Shakti mats.

Brown Noise Machine
We are all familiar with white noise machines. Brown Noise is a deeper version of sound, one that has a much lower pitch. Think of a heavy waterfall or distant thunder.

Golden Milk
Golden milk, also known as ‘haldi doodh’ in Hindi/Urdu or as turmeric milk in western cultures, is a drink with a lot of history. The basic recipe involves combining warm animal or plant milk (coconut, almond, cashew), turmeric, cinnamon, ginger, and some kind of sweetener. It has soothing properties that range from the gastrointestinal to the soporific.

(*Embolden Psychology has no third party interest or financial stake in any of these products).
Coming next week: top meditation and relaxation apps, based on the research from neuropsychology.

Also see:
Making Sleep Your Best Friend.
Anxiety toolkit

When you have anxiety AND depression

Sculpture: Warriors’ Circle, National Museum of the American Indian, Washington, DC, 2019

Anxiety and depression have a complicated relationship. The chances of acquiring depression is much higher when an anxiety disorder already exists. Nearly half of those with major depression also suffer from severe anxiety. A biological vulnerability for both of these conditions is often present. Depression and anxiety are caused by a combination of genetic, biological, environmental, and psychological factors.

Symptoms that might indicate that both anxiety and depression are present:

  • Persistent worries or fears that won’t go away.
  • Physical symptoms including fatigue, headaches, gastrointestinal distress, and muscle aches and pains.
  • Difficulty relaxing.
  • Trouble going to sleep or staying asleep.
  • Intermittent eating habits- might be too much or too little.
  • Loss of interest in activities or previous pastimes.
  • Feeling overwhelmed or having a sense of losing control over things.
  • Trouble concentrating, making decisions, or remembering things.
  • Feeling irritable and cranky including about seemingly little things.
  • Constant feelings of sadness or worthlessness.

Having both anxiety and depression can mean

  • Fearing failure, but no motivation to be productive.
  • Wanting to be left alone, but not wanting to feel lonely or abandoned.
  • Avoiding social situations, but desiring close connections.
  • Being afraid and exhausted at the same time.
  • Feeling restless, but immobilized.
  • Feeling everything acutely, but feeling numb.

See also my post on how to talk to loved ones about depression and anxiety.

What is Low Self-Esteem?

Your self-esteem is the opinion you hold of yourself. When you have healthy self-esteem, you tend to think positively about yourself, and optimistically about life in general. When you encounter challenges, you feel confident that you will be up to the task. People with healthy self-esteem know that they are valuable and will be able to name at least some of their positive characteristics such as “I am a good friend”, “I am kind”, “I am honest”, or “I am a good parent”.

When you have low self-esteem, you tend to see yourself, the world, and your future more negatively and critically. When you encounter challenges, you doubt whether you will be able to rise to them, and you might avoid them. You might talk to yourself harshly in your mind, such as telling yourself “You’re stupid”, “You’ll never manage this”, or “I don’t amount to anything”. Individuals with low self-esteem often feel anxious, sad, overwhelmed, or unmotivated.

Nobody is born with low self-esteem – it develops as a result of experiences throughout our lives. At the center of low self-esteem are the internalized beliefs and opinions we hold about ourselves.

Longterm Effects of Low-Self-Esteem
The cycle of self-criticism can sap a person’s joy in life. They may stop doing hobbies they once enjoyed for fear of judgment. Feelings of anger, guilt, or sadness may keep them from enjoying what activities they do try.

Self-doubt can interfere with productivity at work or school. A person may worry so much about others’ opinions that they don’t focus on the task at hand. They may avoid taking risks or making goals out of a certainty they will fail. A person with low self-esteem may lack resilience in the face of a challenge.

Self-esteem issues can also impact one’s social life. Someone with low self-esteem may believe they are unworthy of love. They may try to “earn” the love of others and accept negative treatment. Others may bully and criticize others to compensate for their own insecurities. A fear of rejection can prevent people from seeking relationships at all. Social isolation can further feed into a negative self-image.

Forms of Low Self-Esteem
Imposter Syndrome: A person uses accomplishments or false confidence to mask their insecurities. They fear failure will reveal their true, flawed self. The person may use perfectionism or procrastination to deal with this anxiety.

Rebellion: A person pretends they don’t care what others think of them. Their feelings of inferiority may manifest as anger or blame. They may act out by defying authority, confrontations, or breaking laws.

Victimhood: A person believes they are helpless in the face of challenges. They may use self-pity to avoid changing their situation. They often rely on others to save or guide them.

What Causes Low Self-Esteem?
Negative early experiences are very important for the development of low self-esteem. Some of the factors that make it more likely that a person will develop low self-esteem include:

  • Early experiences including punishment, neglect, or abuse.
  • Children who suffer these kinds of experiences often form the belief that they are bad and must have deserved the punishment. Shame is often a companion of low self-esteem.
  • Failing to meet other people’s expectations. People may feel that they are not good enough because they failed to meet someone else’s expectations – this might have meant your parents’ unrealistic standards – note that this does not mean that the expectations were fair or balanced in the first place.
  • Failing to meet the standards of the peer group. Being different or the ‘odd one out’ during adolescence, when identity is forming, can powerfully impact self-esteem.
  • Not receiving enough warmth, affection, praise, love, or encouragement.

It is possible to develop low self-esteem even without overt negative experiences, but just through a deficit of enough positive ones. Without enough reinforcement that they are good, special, or loved, children can form the impression that they are ‘not good enough’.

What Keeps Low Self-Esteem Going?
Dr. Melanie Fennell, clinical psychologist, developed a cognitive behavioral model of how low self-esteem is maintained. Fennell’s model posits that throughout life, people form negative beliefs about the self, called the ‘bottom line’. The bottom line is a description of self and might be summarized as something like “I’m worthless” or “I’m no good”. For a person with low self-esteem, the bottom line is always there, dormant, but becomes activated in particular situations. When it is activated you are more likely to use some maladaptive strategies:

  • Speaking to yourself in a critical way. Often intended as a way to motivate yourself, more often this ends up paralyzing you, and it reinforces your bottom line.
  • Setting inflexible rules about how you should be. People may set personal rules that are not very flexible, and breaking the rules can lead to more self-criticism.
  • Making anxious predictions about what might happen. When people don’t see themselves as competent and capable, the world often feels full of danger. The anxious mind tries to help by predicting potential threats, but this just makes us feel even more incapable.
  • Avoidance and escape.  Avoidance is the hallmark of anxiety. People with low self-esteem often refuse to put themselves in positions where things could go poorly and their failures would be potentially exposed. By not taking a chance, they remain ‘safe,’ but their capabilities remain untested.

Psychological treatments for low self-esteem
A number of psychological treatments have been developed which directly target low self-esteem. These include cognitive behavioral therapy (CBT), Mindfulness, and Acceptance and Commitment Therapy (ACT).

Strategies include:

  • Testing your anxious predictions, approaching situations that you have been avoiding, reducing your safety behaviors (behavioral experiments)
  • Identifying and challenging your self-criticism (thought records)
  • Retraining yourself to focus on the positive (self-statements)
  • Challenging your bottom line and building a new one. If your bottom line is “I’m a failure” then you are much more likely to pay attention to your struggles than your successes
  • Using mindfulness strategies to calm the anxious mind
  • People with low self-esteem often have a harsh and critical inner voice.
  • One way of overcoming low self-esteem is to change the way we speak to ourselves, or to have a different relationship with your inner voice (self-talk)
  • Embracing all aspects of the self without judgment (self-compassion)

Also see Brain Lies: Internalized Negative Thoughts.

Embolden Psychology

Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

Thank you for contacting us.