Category Archives: Uncategorized

Creating personal traditions in the holidays

This morning, one of my dear friends, Maryam Shirojan, who is Iranian, came to my home with a gift of some of the most delicious baked pumpkin I have ever had. I felt her nurturance and love, which is itself the essence of celebration. Like many truly kind people, she has been through much, often at the hands of people who are less than kind. She retains her joy, warmth, humor, perseverance, inner beauty, and lack of judgment, characteristics I consider to be of the highest intelligence. She has created personal rituals and habits that are absolutely rich and beautiful.

Today is the ancient Persian celebration of the Winter Solstice, known as Yalda. Yalda is a recognition of the ‘longest night,’ and that the sun will also rise after the darkness and provide a new beginning. It is celebrated with delicious fruits, seeds, nuts, music, dancing, poetry, and drums. The day after the Longest Night was an homage to the Zoroastrian god of wisdom.

A food indigenous to Iran, pomegranate is believed to be a symbol of life and resilience, for it blossoms during the harshest climate of winter. Persians also believe that eating summer foods, such as watermelon, will keep the body healthy through the winter, and that dried seeds like pumpkin and sunflower are a reminder of the cycle of life – of the rebirth and renewal to come. Ancient wisdom that prevails.

Although I am a psychologist, I am by nature an anthropologist who wants to learn from the World, through story and practice. In my work with patients over the years, the primary therapeutic theme of holidays I have emphasized is of creating personal rituals with those we care for and forming new memories that may overlap with family and religious traditions, or not. All the traditions we have internalized started somewhere. I propose that we also make our own.

May we have Lightness of heart and being. 🌹


On Self Care

I’m 55 and I’m frequently asked about self care. First, genes and luck are a huge deal. I don’t care about youth. I believe in ancient roots. I love being half a century old plus five. Especially the century part. I’ve seen a lot and not enough. Don’t let anybody who wants to sell you a $150 moisturizer tell you otherwise. I don’t do a great job at self care and I’m always learning. I am surrounded by great people who know more than I do.

After genes, I think passion for whatever your endeavors, eating delicious and natural foods, movement, touch, being outdoors make a great difference. Love makes you glow. That includes love for partners, friends, chosen family, and the world (our ultimate partner). I have nothing against people getting “work” done. More important is doing the Work.

This is a bit different. I believe grief makes you beautiful. Our heartbreak and losses are part of us. They form us as much as joy. Compassion for self and others, that’s the beauty secret of the world. The second one: don’t care about others’ opinions.

Comfort Animals and Mental Health

My English Lab, Asia, and Riddle, a beautiful Chesapeake Bay retriever, Washington, DC

In my profession, I sometimes get asked to write a prescription for someone to have a therapeutic dog/companion to help them with anxiety, depression, and other neurological and mental disorders.

Some of these dogs are trained to know when their owner is about to have an anxiety or panic attack, a post-traumatic stress disorder flashback, or another type of mental health issue. They are taught to make physical contact with their owner to interrupt their attack and distract them from their own issues. The dog can be trained to put pressure in certain areas of the body known to comfort them. In addition, certain dogs are able to go get help from someone when their owner needs assistance.

What Types of Conditions Are Treated with Therapy Dogs?
Only those with serious mental health disorders are able to get a therapy dog, and it has to be approved by a medical doctor to be covered by your insurance. Some of the criteria you need to meet to be eligible are the following:

  • Have a serious disability or illness that disrupts your daily life
  • Ability to care for and command the dog
  • Participation in your therapy dog’s training process
  • Have a stable home for you and your therapy dog
  • You also have to be diagnosed by a physician/psychologist with one of the following disorders:
  • Post-traumatic stress disorder
  • Fear/Phobia
  • Panic attack
  • Mood disorder
  • Bipolar disorder
  • Depression
  • Anxiety disorder

How Did Therapy Dogs Get Started?
Therapy animals have been used since the1600s when an English Quaker health retreat had their mentally ill patients interact with the animals they kept at the retreat. The animals used were not just dogs. Even horses and pigs were found to be cathartic to those experiencing mental health disorders. In fact, Sigmund Freud brought his dog with him to psychoanalysis meetings with patients.

How Does Having a Therapy Dog Help?
My mentor, who has Parkinson’s, would not be functioning, if it were not for his dog. His Chesapeake Bay retriever literally pulls him out of bed when he can’t move.

My Asia, an English Lab, is certified to detect somebody starting to have a panic attack, and will nudge them to a sofa or chair and put her head in their lap. Sage, my Doberman, has calmly helped countless kid and adult patients with ADHD and anxiety disorders in my office crying and even screaming into her fur. She is a Buddha with fur.

Daily Schedules
Having a dog to take care of also gives the patient a daily schedule that they have to follow, which has been proven to be good for all mental health conditions. When an individual is depressed or anxious, they sometimes do not feel like there is any reason to get out of bed and do anything. However, if they have to get up to feed their dog or take their dog for a walk, they have no choice but to get up and do these things. The routine helps the patient stay on track and feel more stable.

Social Interactions
Having a dog means the patient will have to go outside at least sometimes to walk the dog, go to the dog park, or go see the veterinarian. This can encourage the patient to have social interaction with others even though they may not feel like doing so. In turn, this will help them feel more positive and social.

Health Benefits
According to research, having a dog not only makes the mind feel better but can also improve the patient’s physical health. Studies have found that dogs can lower your heart rate, decrease blood pressure, reduce stress, and boost endorphins. Those are the chemicals in the brain that make you feel good. One study even showed that dog owners slept better and got sick less often.
*Embolden Psychology is a dog friendly practice. We also have a separate suite for individuals with allergies.

On Jealousy

Burlington, Vermont, Summer 2018

Even despite its universality, jealousy – like so many other emotions labeled as “negative” – has long had a bad rep. From being listed as one of the seven deadly sins to pop culture references such as “Green Eyed Monster,” jealousy has long been been viewed as “bad” and mythology and history have overflowed with examples of evil queens and murderous rivals who did awful things, thanks to the roots of jealousy.

No wonder so many of us experience shame and humiliation when we admit to ourselves we’re jealous of what we see others having. Let’s face it: jealousy doesn’t always feel good to feel but that doesn’t mean it’s a “bad” emotion.

Jealousy, like so many emotions, can be a good teacher. Here are three ways and ideas about how and what jealousy can teach you if you tune into this clue:
– A clue towards your inner or true desires.
Instead of shaming or blaming yourself for feeling jealousy, I invite you to consider that jealousy is actually trying to get your attention and make you aware of what you truly want, what your deep desires are, and possibly take action on those desires. If you’re not getting what you want, and you’re feeling jealous, this is important information.

– An opportunity to notice what’s going well.
As counterintuitive as it may seem, I actually think that jealousy can give you a chance to notice what’s actually working well in your life. Jealousy can actually provide a chance for us to practice gratitude if we’re willing to untwist our thinking and change our perception about the situation. It shows you your capacity for love, loyalty, and honor.

– A chance to practice being with what is.
Finally, I think that acknowledging and accepting our feelings of jealousy can give us the proverbially ultimate personal growth opportunity: a chance to practice being with what is.
This is the work – the real work we’re always aiming for in psychotherapy: expanding our emotional containers so that we can feel all the multitude of feelings life contains. This personal growth work isn’t about eliminating or numbing out certain emotions; it’s about practicing feeling all of them so we can live our most enlivened life.

At the end of the day, jealousy is a great opportunity for us to practice being with what is and expanding our capacity to tolerate uncomfortable feelings.

It’s absolutely OK to have desires. To want. Without judgment.

How to be more introverted

You read that correctly. While traditionally Western culture has minimized the importance of introversion, most people have a mix of extroverted and introverted tendencies. We have a lot to learn from introverts when it comes to mental health.

1. Reboot
Don’t confuse being an introvert with being shy. An introvert acquires psychological energy or a “reset” after expending energy, by time spent alone.

2. Create
Nurture your individual creativity: Art, music, poetry, writing. Somehow, we lost track of the fact that the arts are important to our cognitive and social growth. When kids play they like to pile blocks, mold a sandcastle, fingerpaint, make a fort, build a treehouse, bake cookies with lots of sprinkles, draw on the walls. We derive an inherent joy in creating that rarely gets built into our adult schedules.

3. Enjoy solitary tasks
We live in an easily bored society. From an early age, learning to master the arts of self-engagement and self-soothing is invaluable. For example, I encourage parents and children to work together to put together a small backpack of goodies to take with them wherever they go; books, sketchpad, favorite pens and pencils, coloring materials, a small stuffed animal or action figure, word finds, squeaky toys for stress, and so many other possibilities. Being able to entertain yourself requires practice. And it’s great for your brain.

4. Practice mindfulness
Have you ever driven past your own exit or street? Mindfulness is the opposite of auto pilot, and it requires practice. Notice what is around you. I have teens practice walking into the kitchen (or any room) and observe/notice five things. Use all of your senses when you’re eating something delicious; when you’re washing the dishes, when you’re making a bed.

5. Reflect
Contemplate the mysteries of existence; the universe, quantum physics, nature, why your companion animal does what they do. The natural curiosity we had as children can be nurtured and stirred at any age.

6. Day-dream
One of my teen clients has an elaborate imaginary life, a running story with nuanced characters, dialogue, and interactions. Others I work with mentally design their dream house, sketch designs or patterns, collect a bucket list of things to do, solve problems. One young person I know has come up with an art theme spread across 12 different works/mediums of art to show how social media impacts the self-esteem of girls.

In a loud and bustling world, we have a lot to learn from introverts. See also Quiet.

Loneliness is Dangerous

Loneliness is the new smoking. Meta-analysis of over 300,000 patients found that social isolation poses as high of a mortality risk as chronic smoking. Thanks to the interwebs and the widespread use of social media, we are supposedly more “connected” than ever before. Yet as a nation, we are also more lonely. In fact, a recent study found that a staggering 47 percent of Americans often feel alone, left out and lacking meaningful connection with others. This is true for all age ranges, from teenagers to older adults. The number of people who perceive themselves to be alone, isolated, or distant from others has reached epidemic levels both in the United States and in other parts of the world. In the United Kingdom, four in 10 citizens report feelings of chronic, profound loneliness, prompting the creation of a new cabinet-level position (the Minister for Loneliness) to help combat the problem.
However, exactly how the subjective sense of loneliness (experienced by many even while surrounded by others) is a threat to health, may be less intuitive.

While this “epidemic” of loneliness is increasingly recognized as a mental health issue, what’s becoming more recognized to researchers is the role loneliness plays as a critical determinant of health.

Loneliness can be deadly: it has been estimated to shorten a person’s life by 15 years, equivalent in impact to being obese or smoking 15 cigarettes per day. A recent study revealed a surprising association between loneliness and cancer mortality risk, pointing to the role loneliness plays in cancer’s course, including responsiveness to treatments. Biologists have shown that feelings of loneliness trigger the release of stress hormones that in turn are associated with higher blood pressure, decreased resistance to infection and increased risk of cardiovascular disease and cancer. There’s even evidence that a perceived sense of social isolation accelerates cognitive and functional decline and can serve as a preclinical sign for Alzheimer’s disease.

More than ever, during and post-pandemic, combating the mental and medical health deficits of loneliness appears to be a crucial goal for public health. Also see 13 Ways to Fight Loneliness.

What is Mental Health?

Foundations of Wellbeing
May is Mental Health Awareness Month, and I am frequently asked by interviewers and websites about what defines mental health.

I believe there are seven interrelated foundations that underlie mental health: Physical, Intellectual, Environmental, Vocational, Social, Emotional, and Spiritual health.

Physical Wellbeing
Move More. Eat Better.
This dimension of wellbeing focuses on practicing healthy daily habits. It is important for building strength, flexibility, and endurance. Many of us have a genetic loading for chronic health conditions, including pre-diabetes, high blood pressure, or cholesterol. Starting early with self-care makes a huge difference. When it comes to exercise, variety and individual preferences are key. The biggest variable: Consistency.

Intellectual Wellbeing
Boost your Brain.
An active and open mind (mental flexibility) leads to a life filled with passion and purpose. To engage in a variety of creative and stimulating activities is ideal, helping to keep your mind sharp and your brain healthy and happy. In fact, when a patient suffers a brain injury or trauma, I prescribe a regimen of word and strategy games, reading, art, trying new recipes, and other activities to stimulate our juices. You can also challenge your brain with a thought-provoking seminar or class, learning a new language, or engaging in interpersonal topical activities, such as joining a photography club or reading group.

Environmental Wellbeing
Love the Earth.
Help the planet and bring a sense of accomplishment and wellbeing to your own life. Have you asked how your daily habits can affect the world around you in a positive way? One environmentalist, my mother, Salma Siddique, I have worked with in this area, cultivates small personal and family habits that have a cumulative affect on our niches in this world; not wasting resources, recycling, sharing with neighbors and community all protect our planet and contribute to our collective mental health.

Be in Nature.
From going for a daily walk, to raising house plants as green babies, to spending time with companion animals, nature is good for our mental health.
Have a personal environment that resonates.

Whether it’s an apartment, house, garden, office, or even a single room, create a space that is soothing and rejuvenating.

Vocational Wellbeing
Live and Work with Purpose.
This aspect of wellbeing focuses on enriching your life and that of others by sharing your special gifts, skills, and talents. Whether through work, your craft, or volunteering, you can make a positive impact and reap the documented health benefits of adding purpose to your life.

Social Wellbeing
Connect with Others.
Personal connections contribute to a long and fulfilling life. When you nurture relationships with family and friends, you create healthy support networks that I call a scaffolding for good and bad times.

Sustain caring relationships.
Humans are social creatures, and having ongoing meaningful relationships is crucial for mental health. Be intentional about regularly FaceTiming,  texting, or Zooming with your close friends and family. You don’t even need to talk explicitly about personal problems. You can connect deeply on anything—from your week at work to a fantasy trip or home project you are planning. Research is unequivocal that a not-so-secret path to a long and healthy life is through human attachments.

Connect with Self.
You also have a relationship with yourself, your most important connection.Celebrate your self-image. Real confidence is being true to yourself and recognizing your strengths and vulnerabilities. Give yourself space for those moments and remember you’re a unique, multidimensional person. Self-image affects every aspect of well-being.

Spiritual Wellbeing
Nourish your Soul.
Is your mind at peace? A set of core beliefs or values that shape you and how you live your life often creates harmony. Personal prayer, meditation, volunteering for those in need all contribute to a positive mental health.

Emotional Wellbeing
Incorporate stress-free activities.
Practicing relaxing activities such as yoga, meditation, or Tai Chi can serve as powerful tools to diminish stress and regulate emotions.

Decrease screen time.
Unplug from work, social media, web surfing, and anything that may be distracting you from being centered.

From Journaling, to poetry and creative writing, to just keeping a list of wins and losses for the week, writing helps you understand and ventilate emotions.

Surround yourself with positive people who bring out the best in you, encourage you, believe in you, and occasionally scrape you off the floor when needed.

Be kind to others.
Volunteering and community service can be the most powerful feel-good actions.
Promote knowledge and safety.

Microaggressions, racism, financial hardship, vicarious trauma from images on social media and screens, and an inability to access resources can create a pervasive state of internal danger and emotional dysregulation.

Spiral Up

You are driving on the Washington DC beltway, and somebody cuts you off abruptly. You slam on the brakes as hard as you can. A near miss. A moment later you get a surge of almost electric energy, followed, often, by feeling weak at the knees.

Stress is a natural physiological reaction to perceived danger. The body reacts immediately with physical changes, and a cascade of hormones causes increase in heart rate and a surge of energy. The stress response occurs in the face of things that matter to us: our health, our safety, our loved ones, our livelihood, our passion, our causes.

What do we do with the energy we get from stress?
I’m exploring a personal new intervention with clients, called spiraling UP. In physics, because I am a science geek, a spiral is a plane curve on a graph. It winds around a point, while moving ever farther from that point. Spirals are functional in nature, and used by humans for architecture, design, and machinery. When we talk about spiraling, in therapy terms, it generally has negative connotations. A downward spiral. However, spirals move in both directions- laws of physics.

It’s not the stress that hurts you, it’s how you react to it. Yes, stress, is harmful for the body over long periods of time. What if you cannot avoid it, especially in the short term? How can it be used effectively ? We can take a burst of stress related energy and put it to good use. Overall, stress is a curvilinear relationship: A mild or moderate amount of stress can be motivating; whereas unremitting stress can be debilitating.

On Loneliness and Valentine’s Weekend

The American Psychological Association recently declared that loneliness is a bigger health epidemic than obesity and smoking combined. Because it doesn’t just impact our emotions, it impacts our health in an extraordinarily negative way. Research shows that people struggling with chronic loneliness have up to a 14% higher chance of experiencing an early death and are more vulnerable to other health conditions.

Our emotional evolution makes us want to avoid pain. Loneliness hurts. Valentine’s weekend is a time when trying to avoid pain can lead to poor decisions and additional hurts from unmet expectations, unhealthy behaviors, and a sense of loss or grief. Most mental health professionals receive an uptick of phone calls from clients on V Day.

Strategies to use when the loneliness feels too much:
Connect with a close friend
The marketing of Valentine’s Day usually refers to a romantic connection, but it can also be viewed as a day to celebrate the “power of relationships of all kinds.” Ask yourself: who would I like to spend some time with today?

Social connection calms our physiology, so when we feel lonely, we are walking around in fight or flight mode, which can put tremendous strain on our hearts and immune system. Even a conversation with a friend over the phone or FaceTime has a calming effect

Be careful how you speak to yourself
Self esteem is like an emotional immune system that protects you from emotional pain and strengthens your emotional resilience. An effective way to increase self-esteem is to practice compassion for yourself. When you hear that inner voice telling you, you’re not worthy of friendship or a loving partner, or that you deserve to be treated without respect, imagine what you would say to a close friend who is feeling bad about themselves. Offer yourself that same encouragement.

Avoid Attaching a Story to Your Loneliness
Loneliness is a strong feeling, but we need to be careful not to attach a story to that emotion. “I am lonely because I am unlovable,” or “ I am not good at relationships,“ are examples of stories that are not accurate, but can become internalized if we repeat them to ourselves.

Engage in healthy distractions
When you’re caught up in negativity and can’t stop replaying painful scenes in your head, interrupt the negative self-talk with a task that requires concentration. Do a challenging crossword puzzle, lose yourself in a complicated recipe, play a video game, watching an engrossing movie, or take an online exercise class. Studies show that even two minutes of distraction can reduce the urge to focus on the negative.

Practice Self-Care
Be kind to yourself in a way that feels comforting. Treat yourself with a warm-scented bath, an uplifting movie, a special treat to eat, or a snuggly blanket. Also see The Tenderness Ritual for ideas.

Look for purpose in loss
Deriving purpose from loss can promote recovery from it. It may be challenging but try to imagine the changes you could make that will help you live a life more aligned with intention, values, and purpose.

Help others
When we volunteer or take time to help others, it helps to build our social connections and to make us healthier and happier. In one study, participants reported greater happiness if they spent money on someone else (as opposed to spending it on themselves). In another study, teenagers who volunteered for community service had lower levels of risk factors for heart disease than those who didn’t volunteer. Colleagues of mine have given out roses and candy at women’s shelters for Valentines, and described having a wonderful experience.

Plan a Zoom Date With Single Friends
If you have single friends, plan a party night for a Zoom date with them. Be sure to keep the evening upbeat. Activities that the group could do might include the following:

  • Play online games as a group
  • Watch a movie together
  • Cook the same meal or prepare the same cocktails together over Zoom

In addition to feeling less lonely, spending some quality time with your friends will keep your social skills strong and will provide you with feelings of love on this day.

Mental health benefits of having a companion animal

Living with a companion animal is certainly good for your mental health, sometimes in surprising ways. A brief survey of recent studies:

– Within five minutes of playing with a pet, our stress hormones, especially cortisol goes down. Our levels of the “feel good” hormones: serotonin, dopamine, and oxytocin go up. Companion animals increase happiness and decrease stress.

– In one study, a group of adult participants who scored high on stress measures, were told to pet a rabbit, a turtle, or a toy.  Touching the toy did not have any effect. However, stroking and playing with a rabbit or turtle reduced stress and anxiety. Interestingly, even people who said they did not like animals experienced the same benefits.

– The sensory act of stroking a pet lowers blood pressure, providing a health benefit in addition to mental health.

– Having a pet supports executive functioning development. Pets require planning, organizing, staying on schedule, prioritizing, immediate recall, sustaining effort, and task completion.

– Studies have shown that dogs can help calm hyperactive or aggressive children. In my own practice, both my dogs work with children with behavior disorders, and I have seen anecdotal evidence for this repeatedly.

– A large study by the CDC, in 2015, found that children who grew up with pets in the household had lower anxiety and stress levels. The study controlled for screen time, medical health, and physical activity. Having a pet is a protective mental health variable for children, extending through the teenage years.

– Individuals with companion animals are more mindful. Feeding, walking, veterinary care, schedules, are all prominent in the daily lives of pet owners.

– Our animals help us feel loved. One recent study asked teenagers to write about a time when they felt excluded or bullied. Then they were asked to do one of three things: write about their pet, write about their best friend, or draw a picture of their house or school. Writing about their pets was AS effective as writing about a close friend in reducing feelings of rejection.

-Companion animals support self care.  From getting up in the morning no matter what, to spending time outside in nature, to physical activity and exercise, to reminders of self-care: our animals require these things, and bring us along with them.

– Pets help people with chronic mental illness. A meta-analysis, which is also known as a synopsis of multiple studies, found significant evidence that having a pet benefits people with severe mental health conditions. One study was conducted at the University of Manchester in 2016 with patients who had been diagnosed with schizophrenia, bipolar disorder, and severe depression. 60% of the participants identified their pet as one of their strongest support systems. They reported that their animals distracted them from severe symptoms like suicidal thoughts, hallucinations, and ruminative worry.

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.