Healthy Sleep

We all need to develop healthy sleep patterns.  When you are overwhelmed with work, school, family, or household responsibilities, do you cut back on your sleep?  Many people, believe that sleep is merely a “down time” when the brain shuts off and the body rests.  However, people need to re-think this view of sleep.

What Is Sleep?

In the past, sleep was considered just a block of time when you are not awake.  Thanks to sleep studies done over the past several decades, it is now known that sleep has distinctive stages that cycle throughout the night.  Your brain stays active throughout sleep, but different things happen during each stage.  For instance, certain stages of sleep are needed for us to feel well rested and energetic the next day, and other stages help us learn or make memories.

There are a number of vital tasks that are carried out during sleep which help maintain good health and enable people to function at their best.  Not getting enough sleep can be dangerous.  For example, you are more likely to be in a car crash if you drive when you are drowsy.

How Much Sleep Is Enough?

Sleep needs vary and they change throughout the life cycle.  Infants sleep between 16-18 hours a day.  Children in preschool sleep between 9-12 hours a day.  According to the Centers for Disease Control and Prevention, children ages 6-12 require 9- 12 hours of sleep and teens ages 13-18 need 8-10 hours of sleep per 24 hour period.  Most adults need approximately 7 – 8 hours of sleep.

Some people believe that adults need less sleep as they get older.  But there is no evidence to show that older people can get by with less sleep than younger people.

As people age; however, they often get less sleep or they tend to spend less time in the deep, restful stages of sleep.  Older people are also more easily awakened.

Why Sleep Is Good For You – And Skimping On It Isn’t

Does it really matter if you get enough sleep?  Absolutely!  Not only does the quantity of your sleep matter, but the quality of your sleep is important as well.  People whose sleep is interrupted a lot or is cut short might not get enough of certain stages of sleep.  In  other words, how well rested you are and how well your function the next day depend on your total sleep time and how much of the various stages of sleep you get each night.

Performance

We need sleep to think clearly, react quickly, and create memories.  In the article, Sleep Learning, and Memory, Dr. Robert Stickgold talks about how sleeps impacts memory before and after learning a new skill.  In fact, the pathways in the brain that help us learn and remember are very active when we sleep.  Studies show that people who are taught mentally challenging tasks do better after a good night’s sleep.  Other research suggests that sleep is needed for creative problem solving.

Skimping On Sleep Has A Price

Cutting back on even 1 hour can make it tough to focus the next day and can slow your response time.  Studies also find that when you lack sleep, your are more likely to make bad decisions and take more risks.  This can result in lower performance on the job or in school.

Mood

Sleep also affect mood.  Insufficient sleep can make you irritable and is linked to poor behavior and trouble with relationships, especially among children and teens.  People who chronically lack sleep are also more likely to become depressed.

Health

Sleep is also important for good health.  Studies show that not getting enough sleep or getting poor quality sleep on a regular basis increases the risk of having high blood pressure, heart disease, and other medical conditions.

In addition, during sleep, your body produces valuable hormones.  Deep sleep triggers more release of growth hormone, which fuels growth in children, and helps build muscle mass and repair cells and tissues in children and adults.  Another type of hormone that increases during sleep works to fight various infections.

This might explain why a good night’s sleep helps keep you from getting sick – and helps you recover when you do get sick.  Hormones released during sleep also affect how the body uses energy.  Studies find that the less people sleep, the more likely they are to be overweight or obese, to develop diabetes, and to prefer eating food that are high in calories and carbohydrates.

As you can see, there are numerous performance, mood, and health reasons to focus on sleep.  We all need to develop healthy sleeping patterns.

The information in this article is adapted and updated under license from Claire Communications.

Struggling With Relapse

Due to current stressors, many people are struggling with relapse.  The National Drug Institute reports that 40 to 60 percent of people who go through addiction treatment relapse at least once and some relapse multiple times.  The website TherapistAid.com provides an excellent free worksheet with Tips for Avoiding Relapse.  The following is a condensed version of the TherapistAid.com worksheet:

Tips for Avoiding Relapse

The most important moment before relapse isn’t the final decision to use a substance or act out.  It happens when you decide to expose yourself to triggers.  Examples of triggers are going to a party or walking through the liquor section at the store.  Before encountering triggers, you still have most of the control.  Not your craving.

If you are feeling the urge to use, try to wait it out.  If you distract yourself for even 30 minutes, it’s likely your craving will lessen in intensity.  It might not totally disappear, but it will become easier to resist.

Focus on replacing your past use with new positive activities.  If you used to go home after work and drink, you’ll need to make a new plan.  Going home and staring at a wall will eventually lead to staring at a wall with a drink in your hand.

Do not try to do this alone.  Sharing your goals for sobriety with a friend makes all the difference.  They can hold you accountable when you are making questionable decisions.  They can also offer support when you are struggling.

Remind yourself that cravings will pass.  Have you ever had that experience when you are sick where you can not remember what it feels like to not be sick?  The same thing happens with cravings.  Give it time, and believe it or not, the feelings will go away.

You will have to make sacrifices beyond giving up the drug.  If you previously used drug specific activities (watching a game on TV or going to concerts), you may need to make changes.  This might mean not watching the game or making new friends who are sober.  This can be really hard, but that’s what makes it a sacrifice.

Have a plan for when things get bad, because at some point, they will.  People get fired, hearts get broken, and sometimes people leave us forever.  Develop a plan to get through these major life challenges- without the use of drugs-before they happen.

Do not become complacent with your sobriety.  If you someday consider having “just a glass of wine”, don’t make the decision lightly.  If you have struggled with addiction in the past, you are much more likely to develop an addiction again.

If you do relapse, don’t give up.  A lot of people find it helpful to keep track of how long they’ve been sober, but don’t confuse this count with the true goal of leading a good life.  If you are at day 100 of sobriety, that’s great.  However, if you make a mistake and end up back at day 0, know that you are not starting over (you gained knowledge, experience, and confidence).  In other words:  Slipping is not a license to go on a binge.

Come up with new rituals.  How do you celebrate holidays, special events, or any other happy occasion?  If your answer includes any sort of drug or acting out, you will want to get creative and figure out something new.  Go wild with a hobby for the day, treat yourself to a nice dinner, or take a trip.  Make sure it is something you get excited about.

During this stressful time, many people are struggling with relapse.  When relapse occurs, people may have feelings of shame or regret.  They might feel like giving up.  These are normal reactions to relapse.  The sooner a person recognizes relapse, the easier it will be to get back on track.

Using the Just for Today Meditation to Manage Change

Self Help addiction groups such as Alcoholics Anonymous, Narcotics Anonymous, and Sex Addictions Anonymous, often use daily meditations to help remind members to stay focused on sobriety.  The “Just for Today” meditation is one of these popular meditations.  It reminds people that we have choices.  We cannot control changes that occur in our lives, but we can choose how to respond to changes.  During stressful times, it may be helpful to remind ourselves of these principles.  The following is a version of this mediation:

Just for Today

Just for Today I will try to live through this day only, not tackling my whole life problems at once.  I can do something at this moment that would bother me if I felt that I had to keep it up for a lifetime.

Just for Today I will try to be happy realizing that my happiness does not depend on what others do or say, or what happens around me.  Happiness is a result of being at peace with myself.

Just for Today I will try to adjust myself to what is and not force everything to adjust to my own desires.  I will accept my family, friends, my business, my circumstances as they come.

Just for Today I will take care of my physical, intellectual, and spiritual health.

Just for Today I will do an act of service for someone else without being found out.  If anyone finds out about it, it will not count.  I will do at least one thing I do not want to do, and I will perform an act of love for my neighbor.

Just for Today I will try to go out of my way to be kind to someone I meet; I will be friendly and act appropriately, I will dress becomingly, talk low, be courteous and not critical, I will not try to control situations or other people.

Just for Today I will have a program.  I may not follow it perfectly, but I will have it.

Just for Today I will stop saying, “if I had time”.  I will never “find time” for anything.  I will have to take time.

Just for Today I will make time to meditate and seek serenity, truth, and acceptance of myself and others.

Just for Today I shall be unafraid.  Particularly, I shall be unafraid to be happy, to enjoy what is beautiful, and what is lovely in life.

Just for Today I will accept myself and live to the best of my ability.

Just for Today I choose to believe that I can live this one day.

When people are struggling with stress and change, they can lose sight of recovery.  It is important to renew ourselves physically, intellectually, and spiritually often.  Considering the Just for Today meditation can help with this endeavor.

Focus on the Five Love Languages

This month I want to focus on Dr. Gary Chapman’s book, The Five Love Languages.  Dr. Chapman says every person has an “emotional tank” waiting to be filled with love.  He indicates there are five ways that people speak and understand emotional love.  The following is a list of the five love languages.  Dr. Chapman indicates that each person may have more than one love language and within each of the love languages there are many dialects.

Five Love Languages

1. Words of Affirmation – this includes encouraging words, compliments, kind tone of voice, making requests rather than demands, and expressing appreciation.
2. Quality Time – this language consists of quality conversations (using listening skills), sympathetic listening, giving undivided attention, quality activities like going for a walk, listening to music, picnicking, gardening, shopping, or taking a vacation together.
3. Receiving Gifts – encompasses gifts of money (the gifts do not necessarily need to be expensive) or of self (being there when your partner needs you).
4. Acts of Service – Doing things you know your partner would like you to do (e.g. walk the dog, wash the dishes, clean the car, rake leaves). With this language, you seek to please your partner.
5. Physical Touch – holding hands, kissing, embracing, massage, sexual intercourse are all ways of communicating emotional love to one’s partner.

Note:  Dr. Chapman believes that physical touch can make or break a relationship.  It can communicate love or hate.  To the person whose primary love language is physical touch, the message projected through touch will be far louder than the words “I hate you” or “I love you.”

Dr. Chapman says that relationships develop better when we understand each other.  He believes that focusing on the five love languages give us important insights into the ways we all express and experience the emotion of love.

The Change Curve can help people navigate through difficult times.  People are currently struggling with many challenges and changes.  We are all wondering about the coronavirus and how it will impact us individually and collectively.  At this point, we do not know exactly what the future holds.  However, there is a high probability that we will all have to adjustment to a “new normal” due to the pandemic.

As a result of all the challenges, I thought it would be helpful to review the Change Curve.  The Change Curve is a model that professionals use to understand the stages of personal and organizational change. The model helps us identify the ways people react to change, make transitions, eventually accept, and adapt to change.  The model also helps us recognizes spots where additional support may be needed.

Stage 1:

When change occurs, people may initially experience shock or denial.  They react to a change in the current situation or status quo.

Stage 2:

In stage 2, people tend to react negatively.  They are often fearful and angry about having to make changes.  They often correctly identify real threats to their situation or position.  Overall, this is an unpleasant stage where people will stay stuck if they resist change.

Stage 3:

In stage 3, people start to accept the idea of change and begin exploring new options.  They become more optimistic about the future and new possibilities.

Stage 4:

People move past acceptance and start embracing the change.  They are generally more positive, develop new ways of doing things, and able to see the benefits of their efforts.

People can get stuck at any of the stages.  They may need help breaking through denial or confronting fears about change.  Fear of the future is always a challenge.  They often need help developing new ideas on how to move forward.

Understanding the Change Curve can help us get through this difficult process.  We all experience things that require us to adjust and adapt.  Common responses are to resist, dig in and try to avoid change.  However, if we make changes, we can benefit from the positive aspects of doing things in new and different ways.

Please see the Edinburgh Napier University website for additional information –

https://staff.napier.ac.uk/services/hr/workingattheUniversity/LandD/organisational-change/support/building-your-resilience/Pages/The-Change-Curve.aspx

When I work with a client, I encourage them to start meditating.  Meditation is important for our overall physical and emotional health.

In the article, “Harnessing Neuroplasticity:  9 Key Brain Regions Upgraded Through Meditation,” the EOC Institute talks about enhancing regions of the brain through meditation.  The article says that the parietal lobe is one area of the brain that can be enhanced through mediation.  The parietal lobe is located at the top of our head above our ears.  It is responsible for sensory perception and integration.  We take care of the parietal lobe physically by getting enough sleep, eating nutritious food and exercising.  We take care of the parietal lobe emotionally when we make connections with others.  The parietal lobe regulates our emotional well-being by making neuronal connections.   Research has found that there are many health benefits to feeling connected to others such as improved immunity, decreased depression and improved self-esteem.

When the brain becomes overheated with obsessive thoughts about the past or worry about the future, the parietal lobe can act like a radiator to cool things down.  The parietal lobe can help us focus on the present in order to regulate our thoughts and emotions.  Meditation and mindfulness help the parietal lobe develop much needed regulation skills.

Mindful.org lists 5 reasons why everyone should meditate –

1. Understand Pain:  Mental pain and anxiety are background noise that can underlie the things we do.  Meditation helps us break through the noise and see what is causing the pain.
2. Lower Stress: There is evidence that excess stress causes illnesses and makes other illnesses worse.  Mindfulness decreases stress.
3. Connect Better: Ever find yourself zoning out during a conversation?  Mindfulness helps you give others your full attention.
4. Improve Focus: It can be frustrating when our mind wanders off from what we are doing.  Meditation helps develop our ability to focus.
5. Reduce Brain Chatter: The background noise of our brain chatter never seems to stop.  Meditation helps us to quiet this chatter.

It takes time and effort to develop meditation skills.  Here are a few exercises that can help.

Meditation Exercises

Diaphragmatic Breathing – is also called the natural relaxation response.  Deep breathing that is done by contracting the diaphragm.  It helps you relax, lowers heart rate, blood pressure and the stress hormone cortisol.

Body Scan – these exercises allow you to tune out distractions and focus on various areas of the body.

Progressive Muscle Relaxation – you focus on a group of muscles (e.g. neck, shoulders and arms).  You tense the various muscle groups as you breathe in and relax them as you breathe out.

Yoga – breath control with body positions or postures used for health and relaxation

Mediation is an important and productive way to care for our physical and mental health.  Try to find a few minutes every day to practice some type of meditation exercise.  Meditation will help you focus on the present.  It will enable you to be more aware of what is happening in your body and in the environment.  It will enable you to calm both your mind and body.  Overall, it can reduce our stress and help us feel less isolated.

*If you would like more information about how meditation helps our brain functioning, please see the article, “Harnessing Neuroplasticity:  9 Key Brain Regions Upgraded Through Meditation.”

Since people are currently quarantined and spending more time with each other, I thought it would be appropriate to consider how couples build lasting relationships.

Here is a summary of theories and concepts taught by Dr. John Gottman from The Gottman Institute( https://www.gottman.com/blog/build-love-maps/ ) Dr. Gottman indicates that marital friendship is the foundation of what he calls the Sound Relationship House. Friendship is the thing that keeps the relationship going. He says that couples who have been together for a long time don’t stay married because of luck or the absence of conflict. They stay married because they know and like each other.

Dr. Gottman believes the primary task of new couples is to get to know each other.  He thinks there will always be more that you don’t know about your partner than you do.  He indicates that you need to make it a priority to get to know your partner over the lifetime of your relationship.

Dr. Gottman stresses the importance of getting to know your partner’s world through a process he calls Building Love Maps.  He describes building love maps in the following way:  When you choose to spend your life with someone, you hand them a map to your inner world. Your inner world is complex including the memories of your past, the details of your present, your hopes for the future. It includes your deepest fears and your grandest dreams. But the map you hand your partner is a pencil sketch.

Couples need to constantly be adding details to the love map.  The map needs things like color, texture, scale, landmarks, direction, and legend.  A love map that is well developed can bring perspective to the challenges that a marriage will encounter.  Dr. Gottman stresses the importance of starting this early in a marriage.  He says, “if you don’t start off with a deep knowledge of each other, it’s easy for your marriage to lose its way when your lives shift so suddenly and dramatically.”

Here is a Love Map Questions Game Adapted from John Gottman, The Seven Principles for Making Marriage Work.  Dr. Gottman suggests playing this game frequently with a spirit of gentle fun.  He developed this game to help people strengthen their relationships.  Here are 10 questions from the game.  Please see his book for additional questions.

Name my two closest friends.

What was I wearing when we first met?

Name one of my hobbies.

What stresses am I facing right now?

Describe in detail what I did today or yesterday?

What is my fondest unrealized dream?

What is one of my greatest fears or disaster scenarios?

What is my favorite way to spend an evening?

What is one of my favorite ways to be soothed?

What is my favorite getaway place?

Note:  The Gottman Institute has created another tool to help with Love Map development.   They have a deck of cards called 52 Questions Before Marriage or Moving In which can also be helpful.

Hopefully this information can help us be more mindful about the importance of really getting to know our partner in order to help build lasting relationships.

Achieving Goals

Most people have some type of goal they would like to achieve. They may want to improve their health, make more money, have better relationships or develop a skill. They start working on a goal and make some progress. However, they find it difficult to maintain the improvement. Others want to make changes, but they just get frustrated and quit. As a therapist, I am interested in helping people make changes and maintain them.

The American Psychological Association has developed a willpower-fact-sheet that can help people achieve goals.   Here are a few strategies that they suggest.

Researchers indicate that it is most effective to focus on a single clear goal rather than taking on a list of goals at the same time. After completing one goal, then we can focus on the next goal.   An example of this approach can be seen in doing household chores. Things like doing dishes, vacuuming, and laundry. If you try to do all these tasks at the same time, you might have difficulty completing them and feel very overwhelmed. People do better with one thing at a time, like doing the dishes and then moving on to the laundry, etc. They get the satisfaction of completing a task and then can move on to the next level or goal.

Avoiding distractions is another tactic for achieving goals. It can be helpful to keep tempting items out of sight. For example, it is important to have a study space that is conducive to work with minimal distractions. You might improve concentration by removing cellphone, iPad, internet or television access.

Having a plan in place helps people resist temptation.   For example, if you are on a diet and are invited to a birthday party. Chances are pretty good that sweets will be served at the gathering. You may want to say you are trying to eat healthier and avoid sugar. Another option would be to ask for a small piece of cake with no ice cream or say you aren’t hungry after eating dinner. Having a plan in place ahead of time allows people to make better decisions in the moment.

Record your behavior. Research indicates that recording behavior makes people more aware and helps to change that behavior. Make a reasonable plan with small steps toward meeting your goal. For example, if you want to lose 20 pounds, then weighing yourself once a week and recording the results can be helpful.

Reward yourself. When you reach a goal, reward yourself for a job well done. The reward should not interfere with the change you are trying to make, like having a beer because you haven’t taken a drink in a month. Reward yourself with another healthy alternative.

Sleep deprivation can negatively impact performance.  When people don’t get enough sleep, their willpower is more likely to fail. Just one night of good sleep can increase self-control.

Research shows that having a support system can help people reach their goals. Surround yourself with people who will help you succeed.

If you are trying to achieve goals, a mental health professional can help.  A therapist can help a client identify their strengths and challenges.  They can help the person develop a reasonable plan.  They can also provide clients with much needed encouragement and support to help them with achieving goals.

American Psychological Association Harnessing Willpower To Meet Your Goals –

http://www.apa.org/helpcenter/willpower-fact-sheet

Fresh Start

Hello Dr. Chen,

It has been awhile since I have spoken to you. I wanted to let you know what has been happening and that I am making a fresh start.  My husband filed for divorce last spring. I have been staying home and caring for my family and animals.

Before I completed treatment, you met with both of us. After meeting him, you said he struggled with sexual addiction. I have had time to think about this comment and believe that you are right. I have been trying to figure out how you knew. His addictive behavior went on right in front of me for years. It has truly taken me a very long time to put all the pieces together.

When I figured out that I hated having sex with him, is when everything started to make sense. It wasn’t that I disliked sex, but I didn’t like the uncomfortable lack of communication and connection with him. He was so preoccupied with himself that he couldn’t be available for me.

I want to let you know that you really have helped me cope with my life and this crazy situation. I have been trying to move on and am preparing for one more big change. I am moving to a new community for a fresh start.

Thank you for being there when I needed you!

Cathy

Attitude of Gratitude

In my office I have a sign that says “An Attitude of Gratitude, brings blessings.”  In our busy lives it’s easy to get caught up in work, family, social media, and attending events.  All these activities can lead to feeling stressed and overwhelmed.  During the month of November, we celebrate Thanksgiving and gratitude.  I hope each of us can take a step back and focus on the positive, pleasant parts of life.

Several years ago, I had a client who visited her father on Thanksgiving. They had a wonderful day together having a home-cooked meal, sharing stories, and enjoying being together.  That night her father had a heart attack and passed away.  My client had mixed feelings about feelings of gratitude and giving thanks. On the one hand, she and her father had a wonderful day together. On the other hand, she was grief stricken and angry about the loss of her father. The holiday ended up being very bitter-sweet.

Over time, she came to terms with the irony of this event. She worked to “let go” of her anger and accept what happened.  Eventually she was able to focus her attention on feelings of appreciation.  She concluded that bitterness made her grief worse and focusing on positive thoughts and memories made her feel better.

An article titled 14 Health Benefits of Practicing Gratitude According to Science, by Kori Miller, describes many benefits to focusing on gratitude. One of the most important benefits is the release of dopamine in the brain. The dopamine creates a connection between the behavior and feeling good. The more a person focuses on gratitude, the more dopamine is released.

The article provides a list of ways each person can benefit:

Health Benefits

• Increased happiness and positive mood
• More life satisfaction
• Less materialistic
• Less burnout
• Improved physical health
• More energy
• Lower levels of inflammation
• More resiliency
• Encourages the development of positive qualities such as patience, humility, and wisdom

Developing An Attitude Of Gratitude

In the article, Gratitude and Wellbeing; The Benefits of Appreciation, by Sansone & Sansone write about psychological strategies that may enhance feelings of gratitude. They suggest that the following interventions are easy and reasonably effective.

• Journaling about things for which you are grateful
• Thinking about someone for whom you are grateful
• Writing a letter to someone for whom you are grateful
• Meditating on gratitude
• Count Your Blessings – at the end of the week, write down three things for which you were grateful
• Practicing saying “thank you” in a sincere way
• Writing thank you notes
• If religious, praying about your gratitude

Most of us have struggles in life; however, we have a choice regarding where to focus our attention.  We can concentrate on positive or negative thoughts and experiences.  There are definite health benefits to focusing on gratitude.  The strategies and skills to develop gratitude are relatively simple and effective.

Wishing you and your family all the best this holiday season,

Steven J. Chen, Ph.D.