In my practice, I frequently come across lessons that are highly applicable and useful to the larger community, whether you or  a loved one have been diagnosed with a condition or simply show a few symptoms related to the topic. These blogs come from my experience and passion.  They are not a replacement for therapy, but simply a source of information to improve understanding in certain areas and spark ideas and conversation. If you are concerned that any of the issues discussed here are impacting your life or the life of a loved one, please seek treatment to get the individualized care that you may need.

External Blogs:

Interviews and Articles:

Some of the articles below were originally published through Southeast Psych's Blog and have been reprinted here with their permission.

Hope you find these post enjoyable and educational!

Sincerely,
Andrea Umbach, PsyD

How Does Anxiety Impact Sleep?

posted Sep 12, 2014, 3:17 PM by Andrea Umbach Kettling   [ updated Sep 12, 2014, 3:30 PM by Andrea Umbach, Psy.D. ]

How Does Anxiety Impact Sleep?

When we worry, we become physiologically stimulated resulting in alertness and difficulty with sleep. Worry gives our brain a signal indicating there is a threat and our body instinctively prepares itself for action. So of course it is hard to sleep.

Tips to Improve Anxiety at Bedtime

Make Your Bedroom a Worry-Free Zone: Worrying may make you feel productive, but it is actually a very passive process. Instead, designate 20-30 minutes each day to focus on active problem solving. Do your problem solving outside of the bedroom, well before bedtime. Allow the rest of your day to be worry-free by postponing your worry until your designated problem solving time. You can also keep a notepad next to your bed to jot down quick notes to problem solve the next day if necessary.

Wind Down in the Evenings: Your body needs some time to prepare for sleep. It is very challenging to go quickly from high stimulation and action to restful sleep. Give yourself about an hour of down time before bed. You could take a warm shower or do relaxing activities like stretching or reading. Try to stay away from exciting television shows, planning for the next day, big decisions, and serious discussions. Also, make sure to create a comfortable and relaxing bedroom environment that welcomes relaxation.

Reduce Monitoring: Once sleep becomes difficult, we tend to increase our monitoring of internal body sensations, mood, and energy levels. Unfortunately, we often misinterpret these cues for sleep related threats. For example, one might notice how groggy they feel when they wake up in the morning and interpret that feeling as having a poor night’s sleep. However, it is perfectly normal to feel tired for 5-20 minutes when you transition from sleep to wakefulness even with a good night’s sleep. Therefore, our interpretations are not always accurate and usually result in more worry and hypervigilance.

Stop Watching the Clock: When worrying at night, we also start to become obsessed with the time. What time is it? How much time do I have left to sleep? How long did I sleep? While you might really want to track your sleep, looking at the clock only increases your arousal levels. Additionally, research has shown we tend to overestimate how long it takes us to fall asleep as well as underestimate our total sleep. This is mostly due to the fact that falling asleep is defined by the absence of memory, making our estimations of sleep very inaccurate. So turn your clocks around so you can’t see the time, because honestly knowing the time is actually making it worse.

Release Control: When we try to control our worry and our sleep, they paradoxically tend to get worse, not better. Trying to control or suppress our thoughts is not effective. Instead, we have to accept our thoughts, letting them come in and then eventually go out. It’s our interpretations of thoughts that give them importance. In the same way, we have to trust that our bodies will rest when they need to rest as well as trust our ability to function without perfect sleep.


A Better Alternative to New Year's Resolutions

posted Jan 9, 2014, 12:03 PM by Andrea Umbach Kettling   [ updated Jan 9, 2014, 1:31 PM ]

Have you ever wondered how New Year’s resolutions started in the first place? History shows us there were many religious traditions that focused on making promises to God for the upcoming year as well as reflecting on self-improvement. Although resolutions are not necessary religious these days, it is a time when people feel like they have a chance to start fresh and work on their goals.

Unfortunately, I am sure you are aware that many times these resolutions do not work out so well and are very short-lived. A study in 2007 by Richard Wiseman found only 12% of 3000 participants actually achieved their resolution. This very low number does not give much hope for resolutions.

So what is going on? Why is the success rate so low? There are actually several common mistakes people tend to make when they declare their resolutions on December 31st. Most resolutions are:

  • Too General
  • Unrealistic
  • Made with No Action Plan
  • Attempted with No Accountability

Additionally, we also make the false assumption that our new resolution will magically happen without any effort or change in our normal routines.

The good news is there is an alternative to these resolutions. There is a way to reach your goals and increase the likelihood of success. I call it putting Goals in Action. This includes:

  • Making SMART and measurable goals
  • Determining practical and specific steps toward your goals
  • Seeking support from others
  • Creating a consistent accountability plan
  • Using rewards for motivation
  • Tracking progress

Since people are much more successful when they have support and accountability from others, I developed the Goals in Action group for adults. This group will cover all the important elements listed above in a team atmosphere. You determine the goal and we will help you get there! Make this year’s resolution different!

Click for more details.

Research Supports the Positive Effect of Writing Our Thoughts and Feelings

posted Jan 9, 2014, 12:02 PM by Andrea Umbach Kettling   [ updated Jan 9, 2014, 1:30 PM ]

A few months ago I was watching PBS NOVA and came across a segment describing Sian Beilock’s research, a professor at the University of Chicago. In her personal life she had experienced a devastating blow when she “choked” under pressure in her athletic performance. She has now focused her career on researching the phenomenon of performing under pressure. She has found that pressure-filled situations amp up emotional centers of the brain like the amygdala which unfortunately prevents optimal functioning in the prefrontal cortex and working memory. Working memory is necessary to be successful in most performance tasks as it helps us to hold multiple pieces of information in our brains and manipulate the information.

So what can we do to perform even when in high pressure situations? Sian Beilock had students write about their deepest thoughts and feelings about the upcoming stressful task for 10 minutes before taking a high pressure test. It was found that this strategy boosted students’ scores by over half a grade point. She gives the metaphor that when we are stressed about an upcoming task it is like a computer having too many programs open and running at once. It can slow down the computer’s ability to process information or even crash. When writing about our thoughts and feelings, we are able to unload some of the programs and use other resources more effectively. So next time you are feeling the pressure, try writing for 10 minutes to help you unload before completing a task.

Increasing Flexibility in Kids

posted Jan 9, 2014, 12:01 PM by Andrea Umbach Kettling   [ updated Jan 9, 2014, 1:29 PM ]

As a follow up to my previous blog on “Becoming Less Rigid and More Flexible”, I wanted to add some important ideas for increasing this flexibility in your kids. It might be really hard to balance a child’s need for both structure and spontaneity. An important difference can also be made between being structured and being rigid. Structure allows for a framework, choices, and some flexibility, while rigidity means you better follow the rules or else. So think about how you can provide your child with structure, but also provide some fun, flexibility, and freedom. These are equally important skills.

One of the most important lessons children can learn is that when things do not go exactly as planned, it will be okay and they can problem solve and get through it. So next time your life gets turned upside down, remember that your children are learning from you about how to handle these types of situations. Do you melt down, fall apart, or rise to the challenge? How do you want them to handle these types of situations?

In order to build the skill of flexibility, it might also be helpful to change things up every once in a while. For example, some families will do breakfast for dinner or go see a movie instead of running errands. You can also build a fort to sleep in instead of their beds. These changes on your part allow them to see the importance of both structure and flexibility.

One of my favorite resources I frequently recommend to parents is “Wreck This Journal” by Keri Smith. She created a book that instructs children to do things they might never think to do. For example, crack the spine of the book, scribble in it, tear out pages, and drop it down stairs. Basically, she is trying to get kids to loosen up and think outside the box. They can learn that it is okay to do things differently and, most importantly, that not everything has to be perfect.

Wreck This Journal

Becoming Less Rigid and More Flexible

posted Jan 9, 2014, 11:59 AM by Andrea Umbach Kettling

Although structure, organization, and consistency are highly encouraged, there can come a point where we go a little overboard and become rigid and inflexible. You may have heard the words “control freak” or “uptight” used to describe this phenomenon. Unfortunately, people that have a controlling and inflexible nature often find themselves frustrated and let down. The reason this happens is because everyone else is not living by your rules. For example, just because you want all the food lined up in the refrigerator, does not necessary mean that the rest of your family wants it that way. Basically, we are setting ourselves up for disappointment because the world is not able to meet all of your expectations.

So how do we find balance? The best thing you can do is to maintain structure and organization, but at the same time allow for some flexibility, spontaneity, and differences of opinions. The following are some ways to practice increasing your flexibility.

  1. Try new things. Try anything that you have not tried before. It can be a new food, sport, type of movie, deodorant, anything! The point is to get your brain used to doing things that are different. This will also help you to tackle the unexpected and probably open up some new fun experiences in your life.
  2. Mix it up. Look at what you do exactly the same every single time. Do you do it this way for a reason, or is it just habit? Practice doing things a little different. For example, drive a different way to work and check out the new scenery, do laundry on Tuesday instead of Friday, or skip yoga and do a spinning class instead. Show yourself that you can do things differently and nothing disastrous will happen.
  3. Go with the flow. This one might be a bigger challenge, but allow others to do the planning. For example, if you are the one that plans nights out or dictates the way things need to be done around the house, try to give your partner a turn. For example, have a day where your partner gets to plan everything for the day without your opinion. It is also a great way to see how it feels to be on the other side.
  4. Catch yourself. Monitor what you think and say while looking for specific words such as “can’t,” “shouldn’t,” or “not right.” These words are red flags that you are moving into rigid territory. Practice using some new vocabulary like “let’s see,” “let’s find out,” “I’m not sure,” or “what do you think?” This allows for exploration and openness rather than rigidness.
  5. Practice. Just like you have to practice stretching your muscles to become more physically flexible, we need to do the same thing to become mentally flexible. The more you can challenge yourself to be spontaneous and allow for some new experiences, the easier it will be to integrate into your everyday life!
Flexible

Organizing Your Filing System

posted Jan 9, 2014, 11:58 AM by Andrea Umbach Kettling

Out of all the things we have to organize in our lives, paperwork is one area that most people struggle with or just hate to deal with altogether. There are several factors that might contribute to this difficulty. First, you have to create a system for your papers. If you do not have a system in place, you will have papers disorganized and likely all over the place. To create a system, you first need to set up your categories. Think about what types of paper you come across. Then begin to label file folders with these categories. My personal home filing system includes the following categories:
  • Residence (lease, renters insurance)Filing system
  • Paid bills
  • Bank information/statements
  • Credit cards (agreements, statements)
  • Work financial (pay stubs, reimbursements)
  • Medical (insurance, receipts, bills)
  • Life insurance
  • Car
  • School loans
  • Computer
  • Donations
  • Pets
  • Manuals/warranties
  • Important documents (copy of birth certificate, marriage license)
  • Previous tax returns
  • Contact information
  • Art and decorating ideas
  • Interests and activities
  • Gift ideas
  • Restaurant menus

These folders can be put in order of importance or alphabetical order when they are in your filing cabinet. You might also have to file some items in places other than a filing cabinet. For example, I have a box where I put more sentimental materials such as cards and letters and a box for photos. I always suggest that people should have a memory box where these items that you may not need immediate access to can be stored together safely. You will also want to have a place on your desk or counter for current “to dos.” Have a designated location for bills that need to be paid or paperwork that needs to be acted on.

Another area to consider is how long paper needs to be kept. If we keep all paper, sooner or later your filing cabinet will be stuffed. This means every 3-4 months you should go through your files and purge what you no longer need. Since so many things are tracked electronically now, we can get rid of a lot of paper once we check for accuracy. This means we can throw away credit card statements and receipts for minor purchases on a regular basis.

The most difficult part for most people is to maintain the system. Basically every time paper enters your house, it should go to its designated file folder, long-term storage box, or desktop. Then the most important information will be right on your desk ready for you to handle and all other information will be easy to find when you need it. The problem comes when the filing system is not used on a regular basis and the piles get higher and higher, making it very hard to find what we need to find. Again, we also have to do some clean-outs in order to get rid of the stuff that is outdated and no longer needed.

Five Ways to Challenge Anxious Thoughts

posted Jan 9, 2014, 11:56 AM by Andrea Umbach Kettling

Since our thoughts, feelings, and behaviors are all connected, one way to reduce anxious symptoms is to work on challenging anxious thoughts. Challenging means to slowly chip away at potentially years and years of anxious thinking. When faced with anxiety-provoking situations, your brain will automatically go a certain direction potentially without you even realizing. What challenging will do is to slow down the process and give your brain the chance to go in another direction. The following are some strategies you can use to challenge your anxious thoughts. The idea is to keep an open mind and be willing to consider alternative thinking paths.

1. Examine the Costs and Benefits of Your Thoughts

  • How does this thought help you or hurt you?
  • Does this thought motivate you or hold you back?
  • How would the quality of your life improve if you didn’t have the thought?

2. Examine the Evidence For and Against Your Thoughts

  • What are the facts? What are my assumptions/predictions?
  • How do I know for sure that my prediction will come true?
  • What does my past experience tell me about the likelihood of my thoughts coming true?

3. Shift Your Perspective

  • What might you say to a close friend/relative who was having the same thoughts as you?
  • How might you view someone else who was exhibiting the same behavior as you?

4. Challenge Catastrophic Thinking

  • How can you cope with… if it were to occur?
  • Would…really be as terrible as you think?
  • Does this really matter in the big scheme of things?
  • Will you care about this a month from now?

5. Use Rational Coping Statements (short, neutral/positive, realistic/rational)

  • Anxiety is uncomfortable but not dangerous.
  • People don’t seem to notice my anxiety symptoms.
  • It would be manageable if…
  • Blushing ≠ Looking stupid
  • One “C” on a test ≠ Being a total failure
  • It will probably go okay (rather than…it probably won’t be a total disaster)
  • The worst that can happen is….and I can live with that.
  • The worst that can happen is…but that is unlikely.

When Reassurance Becomes a Crutch

posted Jan 9, 2014, 11:55 AM by Andrea Umbach Kettling

In order to be supportive we often feel that we should give empathy, encouragement, and reassurance to others. While empathy and encouragement are highly recommended, there are times when reassurance may do the opposite of what we intend. For some people, reassurance becomes a crutch. People feel like they need someone to tell them everything is going to be okay in order to complete a task or face a difficult situation. A little reassurance here and there is harmless, but when it is absolutely necessary for someone to be able to function this is a red flag.

CrutchesFor example, if a family member is not willing to go to a party unless you go with them or remind them everything is going to be okay the whole time you are there, they are likely over-reliant on you as a safety person. Reassurance may get them through the moment, but it ends up maintaining their anxiety in the long run. It becomes difficult for the person to rely on themselves and function on their own. And children especially need to learn to cope on their own because we cannot always be there.

Examples of reassurance statements:

  • I promise (or know) nothing bad will happen
  • I am here and will protect you
  • This will not hurt or will not be scary

Basically, we do not want to make promises we can’t keep or pretend that we can control situations that we cannot. I can never make the promise that nothing bad is going to happen or that everything is going to be okay. Although this might be the highly probable in the situation, I cannot guarantee it. There is a chance that something could go wrong. A really hard concept for many people to grasp is that life does not have guarantees, but we do things and take appropriate risks anyway. And we live with ambiguity and uncertainty all the time. Additionally, we do not want to indicate that there is something wrong with feeling scared and that this feeling means we have to be rescued or retreat.

So how can we be supportive without providing reassurance?

1. Validate Feelings: It is important not to sugar coat situations. The best thing we can do is recognize and validate what is going on in the present moment. This is especially important when we are facing uncomfortable or scary situations. For example, recognizing that the situation is scary, that it might hurt, or that we might feel like we want to flee are all important feelings to express and validate.

2. Use Coping Statements: Rather than using language that takes away from thoughts and feelings in the moment, use language that promotes one’s ability to get through the situation, even when it might be really hard. For example:

  • You are strong and you can do this
  • You can get through this
  • Your feelings (or the situation) are temporary
  • You always feel better when you stick with it
  • You have to stay in order for your fear to ultimately decrease

Movie Recommendation: "The Way"

posted Jan 9, 2014, 11:01 AM by Andrea Umbach Kettling   [ updated Jun 15, 2016, 3:03 PM ]

Although I am not as big of a movie buff as Dave Verhaagen (www.shrinktank.com), I was recently impressed by the movie “The Way.” Written and directed by Emilio Estevez and starring his real life dad Martin Sheen, we are taken on an 800 kilometer journey along the Camino de Santiago. Since the official movie website (www.theway-themovie.com) can summarize the movie better than I can, here is a quick synopsis:

    “The Way” is a powerful and inspirational story about family, friends and the challenges we face while navigating this ever-changing and complicated world. Martin Sheen plays Tom, an irascible             American doctor who comes to France to deal with the tragic loss of his son (played by Emilio Estevez). Rather than return home, Tom decides to embark on the historical pilgrimage “The Way of St.      James” to honor his son’s desire to finish the journey. What Tom doesn’t plan on is the profound impact this trip will have on him. Through Tom’s unresolved relationship with his son and unexpected      and oftentimes amusing experiences along “The Way,” he discovers the difference between “the life we live and the life we choose.”

Although there were many opportunities to find meaning in this movie, there was one subtle comment that struck the most for me. At one point, Tom explained that his deceased son frustrated the heck out of him, indicating that their relationship was not always smooth. Pairing this comment with the symbolic gesture of love he was making for his son by taking this journey, displayed how we can often having highly contradictory feelings about people. We can get frustrated, angry, and annoyed, but at the same time love and respect the person just the same. Even though we may have arguments or disagree, this does not necessarily mean the love goes away. This may just indicate a need for improved empathy, understanding, and communication. Ultimately, it reinforced that we can be very different people, with very different opinions and lifestyles, and still feel connected in the deepest of ways.

Keeping the Love Alive

posted Jan 9, 2014, 10:27 AM by Andrea Umbach Kettling

Valentine’s Day is such a wonderful opportunity to set aside time and share our love with our spouse or significant other. But sometimes it is hard to figure out what to do year after year to show how much we love and care about them. And between holidays it is hard to keep that special spark alive. So what do we do?

Dr. Gary Chapman suggested in his book, The 5 Love Languages, that each individual has an emotional love language. This language is likely different from your spouse’s language. Therefore, in order to keep love alive, we really need to identify and understand our own love language as well as learn to speak our spouse’s love language.

Dr. Chapman’s 5 love languages include:

  • Words of Affection
  • Quality Time
  • Receiving Gifts
  • Acts of Service
  • Physical Touch

In order to identify your own love language, ask yourself several questions:

  • What makes me feel the most loved?
  • What do I desire above all else?
  • What have I most requested?
  • In what way do I regularly express love to my spouse?

By making it a priority to learn more about your spouse’s love language (and it may surprise you what it is) and express love in a way your spouse will most appreciate, it is more likely that their love tank will be full. And when love tanks are full we feel better and act better. So in a nutshell, love generates more love. For that reason, make love the focus of each day, not just Valentine’s Day, and explore how speaking your spouse’s love language can benefit your marriage for a lifetime.

For more information, visit www.fivelovelanguages.com

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