Mindfulness Based Cognitive Therapy does reduce stress, anxiety and depressive features! 2 tips to help you TODAY

Do you often feel STRESSED at work or at home?

Do you or someone you know suffer from DEPRESSION and/or ANXIETY? Do you often feel paralyzed and overwhelmed by intense emotions?

Do these feelings leave you with negative thoughts that may NOT even be accurate?

Learn two strategies to help you cope with these symptoms through Mindfulness Based Cognitive Therapy!

Mindfulness Based Cognitive Therapy (MBCT):

  • Helps people disengage from unproductive thought patterns and remain unengaged. Helps stop the downward spiral.
  • Helps people live in this moment, rather than worrying about the past or future; leading to more fulfilling lives and less suffering.

I use this MBCT technique with women struggling with depression and anxiety, especially Postpartum Depression, and Social Anxiety/Panic Attacks.

Learn more about MBCT from my interview below with Meredith McEver, LCSW of Arlington Virginia, a seasoned MBCT individual and group leader:

(Meredith G, LCSW): I work with many women who struggle with depression, anxiety and mood swings. Some have been suffering with these symptoms their whole life. Other women have experienced a trauma either small or large — that have left them in despair.

In therapy, I use a number of approaches to assist clients in easing and reducing these plaguing symptoms. I have incorporated mindfulness based cognitive therapy and have found that it really helps many of my patients.

Tell me more about this approach and how you use it in your individual and group work. For starters – – who is most appropriate to benefit from this type of intervention?

(Meredith McEver, LCSW) – Mindfulness Based Cognitive Therapy or MBCT helps people struggling with a wide range of issues. It was originally developed for people with recurrent depression, but has been used with people with other concerns such as generalized anxiety, Bipolar Disorder, and health anxiety. I even use it when I work with organizations to prevent burnout.

The research shows that MBCT helps people suffering from depression to recover. It’s considered to be the”gold standard” in the treatment of depression. Some people have more than one episode of depression. For the subset of people with 3 or more episodes of depression, MBCT has been shown to be 40-50 % more effective than individual CBT in preventing depression relapse. For those who recovered using antidepressants as part of their treatment, MBCT was found to be as effective, if not more effective, than continued antidepressants use in preventing depression relapse.

Its effectiveness has also been shown in increasing emotional regulation and psychosocial functioning for people with Bipolar Disorder and decreasing anxiety for anxious individuals. It has been incorporated in a program to prevent substance abuse relapse, which has been shown to be more effective in preventing relapse than treatment as usual.

Meredith G — Wow, I did not know MBCT was so effective and that it really helps in preventing relapse — which is one of the biggest fears among clients. Can you describe 2 techniques that you have found most helpful with those who have been in your groups or techniques that people can use as needed to ease work related stress that you spoke about.

(Meredith McEver, LCSW)

Taking a “BREATHING SPACE” has been very helpful to many of my clients. To do so, you

  • Bring your attention to the present moment;
  • Notice any body sensations that are present, doing your best not to comment on the body sensation or try to change it, just notice it;
  • Refocus your attention to your body and notice any emotions. Most people feel their emotions in their belly, chest, throat, corner of the mouth, eyes, or all over. Not trying to create emotions or push them away, just notice them with acceptance;
  • Refocus you attention to your thoughts. Sometimes when you focus on your thoughts, they go away, so noticing the lack of thoughts until a thought arises and then noticing that;
  • Refocus your attention to your breath for a few breaths. Then notice your facial expression, posture and your whole body.

It’s very simple and takes just a few minutes. Strange as it may seem, noticing and accepting your body sensations, emotions and thoughts just as they are and not trying to change them can lead to relaxation. Spending time denying that we’re in a bad mood is draining and prevents us from taking the action needed to feel better. This moment of noticing what’s going on gives you the space to calm down a little and allows your inner wisdom to emerge so you know what action to take rather than reacting reflexively.

A last technique is learning that ”Thoughts are NOT facts”has also been very helpful. And while everyone intellectually knows that thoughts aren’t facts, we sometimes react as though our thoughts are true. For example, a friend doesn’t respond to an email and we think that they’re mad at us.

  • Thinking it is one thing, but automatically believing it can lead us to feel depressed or angry and behave in a way different than we would if we believed that the email got lost.
  • Experiment with it yourself and notice what some of your automatic thoughts are and what emotions they lead to.

So we teach people in MBCT how to be mindful of thoughts, which is being aware of thoughts when they occur without judging the thought or yourself. This moment of mindfulness, being aware of what is happening in this moment without judgment, gives us an opportunity to decide how to respond to the thought rather than jumping to our conditioned, automatic response. You have an opportunity to realize that there are a myriad of reasons why that person didn’t respond to your email and you really don’t know what their reason is.

Squashing the Worry Bug

Do you have a child that worries? Does the anxiety get in the way of having fun, participating in activities, with friendships? Does your child have the following traits?

  • DemonstrateS excessive distress with crying, physical symptoms, sadness, anger etc.
  • Easily agitated or angry in stressful situations accompanied by stomach aches or headaches.
  • Needs repetitive reassurance to ”what if” concerns

These are just a few symptoms of children who worry excessively. There are few ways to combat anxiety and, at the same time, give your child the confidence to manage it. Tamar Chansky, PhD, author of ”Freeing your Child from Anxiety” has identified 5 steps in creating this management plan.

Empathize with your child what you are feeling:

  • Acknowledge what is going on with her. Don’t tell her not to worry, but reflect her feelings by saying: ”this seems so hard, so unfair”, ”this is making you so upset”…
  • Relabel the problem ’ give it a name.
  • This allows the child to determine what thoughts are from her worry voice and what she really THINKS.
  • Give it a name like ”worry bug”, make a puppet to remind her, or even draw pictures of it.

Rewire and Resist

  • Help her find the truth and not let the powerful feelings get in the way
  • Teach her to say things like ”my parents would never let me be in danger — I am not listening to you worry bug!”

Get the body on board

  • Slow the body down by counting, deep breaths, thinking of something that makes her happy and calm.
  • Remind your child that anxiety always passes

Refocus on what you want to do

  • Ask your child what she would be doing if she was not worrying? Then get into the activity ’ or something like it — the brain will follow but not the worry bug!

Reinforce your child’s efforts at fighting her worries!

  • Reward any behavior that demonstrates any coping, effort at beating this worry bug!
  • Change the reward after a partial goal is met

You can use these steps with children and adults at all ages, just adapt to their age and maturity level. Chansky and others believe that it takes about 2-3 weeks for a new behavior to really be established, so practice and reward consistently! For more information regarding anxiety in adolescent girls and women visit the blog section of my website at www.mgelman.com

Time Outs for Everyone

As a parent of three young children, the days of time outs are not far behind me. What I find interesting is how this behavioral tactic is so useful for children and adults of all ages. When Time Outs are used with self-soothing techniques (ways to calm yourself down), the road to compromise with your offending partner is not so bumpy! But how do you know when to take a Time Out during a disagreement?

John Gottman talks about this important break in his book ”And Baby Makes Three”. The first important step is identifying what you are feeling and if you are becoming flooded. Yes – just like your basement flooding or sadly the Titanic, but it happens more quickly and is felt differently across gender lines.

For some people they may feel:

  • Knots in their stomachs
  • Jaw tightening
  • Changes in their breathing patterns
  • Freezing/or difficulty moving

Gottman describes this as a tidal wave of physiological sensations: called Diffuse Physiological Arousal: DPA. When we are in this state, our reasoning, hearing, and rational self are altered. Thus the fight or flight sensation is activated. According to Gottman, we must then know to take a break and calm down in order to effectively navigate (and compromise) within the argument. If not, we end of saying and doing things that we often regret later. Sound familiar?

Gottman believes that we need to first understand and recognize the signs of DPA so that it does not suck us into a vortex of an alarmist state ’ ready and mobilized for action! Taking this break has to happen before the flooding. It is also important to indicate when you will resume talking about the issue at hand. It is recommended at least a half an hour, but not more than one day.

During that time, our systems have calmed down and we will be better able to compromise with our partner, child, and co ’worker. The details of the time out (the identified mutually agreed upon sign that a break is needed, for how long and can we commit to this ritual) with a partner / child can be discussed during calm times before a heated discussion.

With outside people, one can simply say ”it seems as though we don’t agree, why don’t we talk about this situation later when we can have some time to think about it?” .

Don’t forget to calm yourself down when the time out is happening. Some clients of mine write, other listen to music, exercise, and take deep breathes. This part of the ritual must happen or you won’t be ready or able to do the next big step: compromise!

Try this method out! You will be surprised how well it works.

Best Way to Communicate Issues

Dr. John Gottman’s describes one way to communicate difficult feelings within a couple is by utilizing what he calls the slow start up. I have found the process also helpful within families, with children, in the workplace, and amongst friends. Gottman believes it is all about the way we begin verbalizing our feelings and needs.

Now we all have found ourselves in situations where we approach our partners “guns” firing in all directions. Usually the person responds defensively with criticism, real contempt, defensiveness or they stonewall us. I think we can all recall where we have been on both sides of this type of argument.

I support Gottmans’s belief that if you begin communicating your needs in a “soft” way the message is better received. Describe the situation neutrally, using “I” statements and state what we need — not what we are NOT getting. That is like stab in the heart.

So: Say what you are feeling

Describe the problem neutrally — but don’t blame the other person

Say what you need

Ready to try it out?

Social Anxiety in Adolescent Girl

”I just wanted to order a hamburger, but I was too scared to even tell the waitress my order. My eyes began to water, my heart was racing, my face was beet red, and my throat was closing up. I just shook my head no ’meaning nothing for me today.”

That was one moment in the day of a life of a 15 year old girl struggling with a form of a phobia called social phobia or social anxiety. Often adolescents, who suffer from this type of anxiety, experience the above difficulty, as well as the fear of raising their hand in class, making spontaneous conversations with peers or new friends, making presentations in school, joining a new sport or social clubs, and more. Sometimes their physical symptoms can even lead to panic attacks.

According to the ADAA (Anxiety Disorder Association of America)

  • About 15 million American adults have social anxiety disorder
  • Typical age of onset: 13 years old
  • 36 percent of people with social anxiety disorder report symptoms for 10 or more years before seeking help

When asking about beginning a conversation with someone, socially anxious adolescent girls state they worry they won’t know what to say and then they will embarrass themselves.

It sounds trivial but it is not for those experiencing this type of anxiety. This fear and anxiety is so overwhelming that they resort to retreating, having few friends, and limited social experiences. The small number of social experiences they do participate in are ONLY with those who they know very well.

There are many ways to approach coping with social anxiety. I often begin with encouraging an increase in awareness of the different types of feelings one is experiencing at that time of their flooding worries.

Where in their body are they feeling these overwhelming physical sensations?

What is exactly happening?

How long is this occurring?

What situations are you most triggered?

Having this awareness of the different sensations and feelings that are occurring, when, and the duration, often allows individuals some control and allows us to begin to create achievable goals.

After one can understand and name what is happening, it is time to develop coping strategies to handle these intense feelings and transition back into the social world. I often use a combination of Cognitive Behavioral Techniques (CBT) and Exposure Therapy as a way to nurture this new skill set in adolescents.

CBT focuses on identifying, understanding, and changing thinking and behavior patterns. Exposure therapy is where a person is gradually exposed to a feared situation or object, learning to become less fearful over time.

I also teach girls to employ other ways to cope with the uncomfortable, scary feelings (either through ways of relaxing, visualization, or the introduction of grounding objects). These techniques distract the brain and prevent the flooding of too many intense feelings.

Small exposures over time combined with awareness and challenging negative thoughts help lessen this type of anxiety. If you or someone you know is struggling with social anxiety, contact a mental health professional today to gain more information and insight on ways cope.