Tag Archives: mental health

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.

The Neuropsychology of Gifting

Present: A Gift/In the Here and Now/To Give or Offer
A noun, adjective, and verb all in one.

  • Giving gifts creates a tide of oxytocin, the neuropeptide that signals safety, connection, and affection.
  • Receiving a desired present from a loved one and giving a gift to a loved one actually produces the same brain rewards.
  • The oxytocin effect is in motion during each step of gift-giving, from planning, shopping for the gift, wrapping it, and anticipating the response of the giftee.
  • Brain scans using fMRI technology showed that giving a present indicates simultaneous activity in the brain area associated with processing social interactions and the part of the brain that feels pleasure. Gifting is a pleasure-full interaction. (Learn more about the neuropsychological link between generosity and happiness.)
  • The monetary value of the gift was unimportant. Gifts do require sacrifice: thought, creativity, time, and money; but they don’t have to be expensive. One of my favorite gifts was a recipe, handwritten by a friend who was a renowned chef accompanied by a ‘voucher’ to cook it for me.
  • A present does not have to be a tangible object. Similar brain rewards were found by giving the gift of time (babysitting, helping cleaning out closets, dog walking), assistance (help with a project, home or office), or experience (a weekend away, spa time, a special exhibit).
  • Presents accompanied by a thoughtful message, letter, card, or note were greatly valued,. Messages that bring to mind shared moments, explanations about the significance of the gift, and the connection between the gifter and the giftee are a gift in themselves.

Also see the Mental Health Benefits of Random Acts of Kindness.

Is simplicity significant?

Whether or not you call it minimalism, neuropsychological research indicates there are certainly mental health benefits to this type of lifestyle. Primarily, following a minimalist lifestyle emphasizes saving time, energy, and money, areas that are integral to mental health. Based on research from clinical psychology, minimalism has cognitive, social, and emotional benefits.

Allows you to self reflect
Overcommitment creates a frenetic pace. Time to sit and think is rare. Making time for meditation, prayer, and breath work/pranayama forces our brains to slow down in a way that is often not possible during the rest of our busy lives.

Encourages solitary time
Neuropsychological research shows that solitude has a number of benefits including increased feelings of creativity, introspection, agency, and even spirituality. Decreasing our social commitments and social media time is often difficult but actually provides a brain boost.

Reduces decision fatigue
Over 35,000 times. That’s the current cognitive research estimate on how many decisions we are required to make each day. And, if true, that comes out to 2000 decisions per hour or one decision to be made every two seconds. Overthinking is not just a phrase, it’s reality.

Supports executive brain functioning(such as organizing, planning, prioritizing, and self monitoring).
Simplifying life can help assist with productivity. Everything from meal prep, giving away items that are not used, going through your closet, not scrolling endlessly, and removing unnecessary events and tasks from your calendar all support your frontal lobe abilities.

Also see my post on simplified daily rituals that matter.


On Neuropsychology and Respect: the complicated history of sage

Burning sage, also known as smudging or cleansing, is an ancient indigenous North American spiritual ritual.

Scientifically, it has been established that white sage (Salvia apiana) is rich in compounds that activate certain receptors in the brain. These receptors are responsible for elevating mood levels, reducing stress, and even alleviating pain. In addition to dissipating negative energy, improving mood, and strengthening meditative practice, burning sage may improve memory, attention, and focus. A 2016 literature review of neuropsychological studies noted that evidence for Salvia’s cognitive-enhancing benefits are promising, and perhaps a means to help battle dementia and Alzheimer’s disease. Last but not least, burning sage has antimicrobial properties. It truly cleanses.
Smudging has been well established as a Native American cultural or tribal practice (see the American Psychological Association sources on indigenous mental health).

As non-native individuals and mental health practitioners, it is our responsibility to be informed and respectful. For example, if non-native people “cleanse their space of negativity” through the use of smudge medicine (burning sage, sweetgrass, palo santo, etc.), it is crucial to understand its cultural significance and history. It was illegal for Native Americans to practice their religion until 1978 in the U.S., and many were jailed and killed just for keeping indigenous practices and traditions alive. Smudging sage was part of those banned religious practices. It was literally a crime.

Because of all that complicated history of sage burning, when non-Native people use white sage to “smudge” their homes or other spaces, it can infringe upon the cultural importance and authenticity of the ritual and its historical spirituality. The practice of smudging, therefore, should not be taken lightly, according to Dr. Adrienne Keene, an assistant professor of American Studies, Psychology, and Ethnic Studies at Brown University, author of the blog Native Appropriations, and citizen of the Cherokee Nation

It is possible to practice and appreciate indigenous cultural, medical, and spiritual practices without disrespecting them. Do research, be mindful, have gratitude, and strive to celebrate Indigenous people and traditions in a way that is culturally conscious. It is a gift, not a right.

Hurts so good: Neuropsychology and Chili Peppers

Ghost peppers
The world’s hottest peppers, originally grown in Assam Province, Northeast India, epitomize the lure of pain and pleasure. Also known as raja mircha (king chili), ghost peppers or bhut jolokia originated in a region of the country where the cooler temperatures, heavy rains/monsoons, and soil quality made them grow naturally.

Currently, they are served most delectably as a condiment with mounds of rice ladled with curry, lentils, salad, and vegetables. They also pack a punch served with Maggi noodles, a South Asian comfort food, leaving you with a runny nose, sweating face, and a slow burn of volcanic heat.

The neural science
Brain pain receptors are proteins that have a certain shape that only fit specific molecules. Some pain receptors have the correct shape for capsaicin, the heat component of all peppers to fit into, like a lock and a key. When a capsaicin molecule binds to one of these pain receptors, there is a release of neurotransmitters that send a message to the brain. All neurotransmitters are chemicals that are transmitted from one neuron to the next, instant messaging, saying this is HOT. There is a quick burst of endorphins, the pain alleviating neurochemicals. Capsaicin also stimulates the thermo receptors that perceive heat, stimulating sweating and flushing. This actually has a cooling down effect, crucial in hotter climates. Not surprisingly, many countries with extremely hot menus are found in Africa, South Asia, the Caribbean (the Trini Scorpion chili pepper will make you gasp), and South America, where the temperatures are often steamy.

Why yearn for the burn? A sample of the research.
-Longevity: All chili peppers have anti-inflammatory, antioxidant, anticancer (free radical), and blood-glucose regulating effects. Many of the health benefits have specifically been attributed to capsaicin molecules. Additional benefits include lower levels of bad cholesterol, increased metabolism, better gut health, analgesia (increased pain tolerance), and a general boost in immunity.

-Personality: A number of studies have found that more adventurous people are drawn to spicier and more stimulating foods. Chili 🌶 lovers are eager to try new things; willing to take risks; have a higher level of mental flexibility; and may be hungry for a variety of strong emotions, visceral experience, and adventures. This means they have a high degree of curiosity; or in other terms, they may be easily bored.

-Mood: Spicy foods create a safe high. The burst of endorphins produced by biting into a searingly hot pepper creates a burning sensation and then a sense of euphoria.

-Social Interaction:  Sharing hot food creates a sense of connection or similarity. Couples and family research shows that arguing over ‘what to eat for dinner’ is a common source of potential conflict or compromise.  “Because what I eat, what I drink, is in itself the ‘second self’ of my being,” wrote the philosopher Ludwig Feuerbach. Figuring out what each person would like to eat, or not, is part of relational negotiation: do we fit together?

Also see: On nutraceuticals and mental health – Turmeric and Mental Health.

The power of social activism + neural science.

Dr. Anne Beaumanoir was a human rights activist and clinical neuropsychologist/neurologist in France during World War II. Her parents were activists who appreciated education, science, and research as tools to help improve daily lives. Her mother, the milkmaid daughter of an organic farmer, and her father who owned a bicycle shop, were both shunned by their families for their marriage. Together, they opened a popular bistro where they served local food and libations. The bistro was known as a gathering place for intellectuals and the bookish.

Dr. Beaumanoir spent many hours in the family restaurant where she had the opportunity to interact with her neighborhood and community. She helped Jews in her town evade Nazis, once saving two teenage neighbors by arriving at their home just before the Gestapo came to their door, to spirit them away to her parents’ restaurant. Later, she moved to Algeria which was a colony of France in North Africa, and worked with the Algerian resistance movement, doing everything from working as a chauffeur to hotel bellhop.

She completed medical school in France and fell in love with EEG technology. She is one of the first advocates of using EEGs to diagnose different types of seizure activity. Throughout her lengthy career, she emphasized the importance of using medical research to help the less advantaged and was especially interested in cerebrovascular disease and childhood epilepsy. She died in March 2022 at the age of 98, in Quimper, France.  Learn more:  Anne Beaumanoir, Activist and Clinical Neurologist, Dies at 98

Diabetes and Mental Health

37.3 million Americans—about 1 in 10—have diabetes.

About 1 in 5 people with diabetes don’t know they have it.

96 million American adults—more than 1 in 3—have prediabetes.

More than 8 in 10 adults with prediabetes don’t know they have it.

For the past three years, approximately 1.5 million new cases of diabetes were diagnosed each year. Many more go undiagnosed.

For people aged 10 to 20 years, new cases of type 2 diabetes increased for ALL racial and ethnic minority groups, especially Black teens.

This past week, the House of Representatives passed a bill capping the cost of insulin on Thursday night with unanimous Democratic support, a mere 12 Republicans voted for the legislation, with 193 voting against it (five didn‘t vote at all). The House (Democrats) voted to cap the price of insulin at $35. (The bill will go to the Senate after Easter).

FACT: The cost of insulin for patients WITH insurance ranges from $334 to $1,000 a month.
FACT: The manufacturing cost for a vial of insulin is approximately $10.
FACT: Many diabetes patients ration their medicines or discontinue them because of the cost.


  • uncontrolled diabetes is implicated in a threefold increase in vascular dementia
  • uncontrolled diabetes drastically increases the chance of stroke, which also brings an entire set of cognitive and physical consequences
  • untreated diabetes and prediabetes results in impaired attention and concentration, brain fog, fatigue, headaches, learning problems, and lethargy
  • diabetics have a much higher level of clinical depression and anxiety, medical related worries, financial hardship, and overall stress
  • diabetics are at higher risk for secondary events, such as car accidents, work disability, and falls
  • people with prediabetes are at far greater risk for long-term cognitive decline and memory problems because they most often walk around without any diagnosis or treatment
  • most people will have/will have a loved one, family member, colleague, or friend who suffers from diabetes and related sequela in their lives. As such, diabetes affects everyone
  • BIPOC individuals have a significantly higher rate of diabetes, with the highest group being Black men, women, and children
  • diabetic medical consequences that affect daily life include vision problems, neuropathy, chronic pain, kidney problems and possible renal failure, memory weakness, increased risk of hypertension, sexual dysfunction, tooth/gum problems, and foot/mobility problems
  • individuals with diabetes have a much higher chance of long-term consequences from COVID-19
  • the consequences of untreated or undertreated diabetes will create an added strain on the medical and mental health system, which is already under severe pressure. This, in turn, has a trickle-down effect on treatment of other conditions
  • as a psychologist, management of diabetes, medication regimen, diabetic self-care, nutrition, and related stressors are often a focus of treatment

(Data sources: Kaiser Health, WebMd 4/22, CDC, 1/22)

The Psychology of Pranking

Psychologists have studied pranks for years. Humor, in general, is good for us. Neuropsychology research has shown that laughing improves well-being.

Humor and laughter release endorphins and oxytocin, neurochemicals that are associated with happiness and social bonding. But why are practical jokes or pranks even funny in the first place?

From clinical psychology, a summary of research on pranks:
*Practical jokes are a subtle form of “play-fighting.” Jokes imply a sense of closeness or insider group feelings in the relationship. That is, you tend to prank those you believe you’re close with or can handle the joke.

* A good prank satirizes human fears or vulnerabilities, and is found in a wide variety of international initiation rites and coming-of-age rituals. The Daribi of New Guinea, for example, have children make a small box and bury it in the ground, telling them that after a while a treasure will appear inside but they must not peek. Invariably the youngsters succumb to curiosity, only to find a box of animal feces (research cited from the University of Virginia, department of psychological anthropology).

* The prank releases inhibition, liberating us for a moment from having to act “properly”.

* In psychoanalysis, motivations for the impulse to prank one’s own family or friends has been described as a subtle form of the desire to do bad things to the very people one claims to care for. It may be one of the modalities through which everyday sadism can manifest (i.e., potentially obtaining pleasure from hostile forms of humor, sarcasm, and practical jokes).

When NOT to Prank:
Has the target of the prank stated they want this behavior to stop, or have they shown previous distress with any pranks?

Is the target of the prank a vulnerable person, such as a child, an individual with a mental disorder, or person with disabilities?

Could this prank in any way cause harm to a person, either psychologically, physically, or both?

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.

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…
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.