Mindfulness Challenge: Day 4

Touch

Today’s exercise utilizes our sense of touch. Mindfulness – non-judgmental observation – often comes readily when we focus on tactile sensations. Anxiety, stress, and heightened emotion can take our mental presence outside of our physical space. To return to where we actually are, it can be grounding to recognize and connect with our physical surroundings. 

This exercise can take a matter of moments; no set amount of minutes. More than time, the measure of completion will be the number of items you mindfully touch. Sit comfortably and count five deep inhaled and exhaled breaths. Scan your surroundings for three different objects that you can touch without having to move from your seated position. These could include items of clothing, jewelry, your body parts, furniture. Place your open hands on the first item – say, your shirt. Feel its texture between your fingers. Describe it to yourself objectively / without judgment (“The cotton is crisp.”, “This sleeve is rolled up.”) versus “This shirt has always been too tight.”). Allow your fingers to roam while your mind stays still. Once you’re done with this item, again place your open hands on it for the length of one deep inhaled/exhaled breath. Select the next item. Repeat the directions above: feel the item with both of your open hands, then use your fingers to touch and observe it mindfully, then close your experience of that item with a deep breath and open hands. Move on to the third item. Take that final inhale/exhale, and thank yourself for allowing this experience to be a part of your day.

Sara

Mindfulness Challenge: Day 3

Fresh Lens

Find a part of your daily routine when you can take a moment to incorporate mindfulness. Perhaps even challenge yourself by identifying a part of your day that’s not your favorite.

For me, commuting is a necessary evil, providing an ideal opportunity for regular mindfulness practice. Nearly daily, and especially during the winter, I pick a part of my commute during which to be more present. When I first began this practice, I imagined that I was visiting from a foreign country and had limited time to explore my surroundings. This new lens enabled me to soak in aspects of my daily commute with a fresh perspective. I began to notice details of buildings and entryways, as well as unique sounds, both man-made and natural. Instead of walking with my head down, in my own mind about all the things I have yet to do and feeling miserably cold, damp and tense, with a small shift and simple mindfulness practice, I was able to seemingly escape and became grateful for a part of my day that I’d previously found tiresome. Nothing about my commute had changed, but my presence, perspective and willingness to be more present.

Today I encourage you to view a part of your day through a fresh lens, as though you’re visiting a place or having an experience for the first time. Notice, even if just for a brief minute or two, what you see, hear, smell, and feel.

Katie Hibey


Additional Resources

For more ideas on how to be mindful every day, check out this brief Psych Central article 

Mindfulness Challenge: Day 2

Just Listen

Today’s mindfulness challenge is beautiful in its simplicity. How often do we find ourselves multitasking, leaving on music or TV for company or distraction, or somehow avoiding being alone with ourselves? This exercise is meant to be different from our usual ways of being, without too many detailed instructions.

To start, set a timer for 5 minutes (or longer if you’re up for it). Trust this timer to let you know when to stop. Find a comfortable, supported seated position and allow your eyes to gently close. Until the timer goes off, simply listen. Listen to the ambient noises of the space you are in. Listen for louder sounds as well as softer, subtler sounds you might not have noticed right away. When your mind drifts, as minds tend to do, notice that it has drifted and gently, compassionately guide your mind back to listening. Listen without judgment. Your sole task for these 5 minutes is to just listen. When the timer goes off, listen to that sound for a moment too before opening your eyes. Remember the point is not to feel relaxed but to engage with the world differently and to pay attention. You are invited to open up to what you might discover by simply listening.

This is often one of my go-to mindfulness exercises. It proves that we don’t need a whole lot of complexity to practice paying attention - we have everything we need in the simple sounds around us. I will often amend this to suit short moments: when I need to collect myself in 30 seconds or less I can always close my eyes and listen with my whole attention for a brief moment before proceeding with a clearer headspace. I hope you find this useful in your practice!

Whitney

Mindfulness Challenge: Day 1

Welcome to Wildflower's 10-Day Mindfulness Challenge! Our team has made a commitment to completing at least one mindfulness exercise per day over the next ten days and sharing our experiences in the comments section of this blog. We invite our colleagues, clients and friends to join us in this endeavor! Every day you will see a new post that introduces a particular mindfulness exercise. Feel free to engage in the suggested practice, or complete your own and contribute to the conversation in the comments section.

To learn more about mindfulness, you can read one of our articles here.

Mindfulness exercise: Follow your breath

Focusing on the breath is a foundational mindfulness practice and a powerful means of anchoring ourselves in the here and now. Your breath is always with you, wherever you are. Many of us take the breath for granted, barely noticing it as we go about our everyday lives. Its life-sustaining force, not to mention the power to influence our mood and thoughts, may not be acknowledged unless we are perhaps having a panic attack or otherwise experiencing difficulty breathing. In this exercise, we will cultivate a gentle sense of curiosity about each in-breath and out-breath, without trying to control our breathing in any way. We will simply pay attention to the experience itself, notice when we become distracted or caught up in thoughts, and bring the attention back to breathing. You may find that you are having to return attention to your breath several times during this exercise. Make an effort to practice for at least 3-5 minutes. It may be helpful to set a timer.

Begin by sitting down on a chair, floor or wherever you can be comfortable while maintaining an erect and dignified posture. Place your feet on the floor; make sure your legs are uncrossed. Gently close your eyes. Start by focusing your attention on breathing in. As you breathe in, say quietly in your mind the word "inhale" and as you breathe out, say "exhale." Repeat again and again, noticing the rising and falling of your chest, the air coming in and out of your nostrils, the sensation of air traveling through your body and making its way into your lungs and out again, the pause in between. If your mind wanders, as it naturally will, gently and without any judgment bring it back to your breath and to the words “inhale” and “exhale.”

We would love to hear about your experience with this exercise or any other mindfulness exercise you have chosen to practice today! 

Thank you!

Wishing you a day full of wonder,

Aga


Additional Resources

 

10 essential facts about postpartum depression

by Aga Grabowski

1. Postpartum depression represents only one of a number of disorders experienced by women in pregnancy and postpartum.

They are collectively known as perinatal mood and anxiety disorders (PMADs).  Not knowing that mental health disturbances in the postpartum can encompass symptoms such as agitation, anger, anxiety, obsessive thoughts and others, new moms who call our practice frequently report being confused about what they are experiencing.  “I am not depressed,” we hear from them, “but something feels wrong.”  

Anxiety is particularly common in the postpartum. Women report feeling irritable, overwhelmed, even angry.  They may worry and ruminate and have panic attacks. Insomnia – not being able to fall asleep or remain asleep even when baby is sleeping – is another common symptom. Women may develop scary, obsessive thoughts of harm coming to their baby or of causing harm to the baby. Some new moms who have experienced their childbirth as traumatic go on to develop symptoms of PTSD.  

In other words, sadness and lack of energy are just a few of many symptoms that can develop in the first postpartum year.  What is important to remember is that postpartum depression itself rarely conforms to our stereotypical notion of depression as characterized by a flat, persistently low mood. Depression in the postpartum tends to be more agitated and feel like an up and down rollercoaster of emotions.

2. Every new mother will at times (read: frequently!) feel overwhelmed by demands of new motherhood, but there is a clear distinction between very normal negative emotions and thoughts that accompany this transition and symptoms that require professional help.

Frequently, the reason why women wait to get help or don’t get help at all has to do with the erroneous belief that their symptoms are a normal facet of their new reality. Admittedly, it can be very difficult to figure out whether the emotional rollercoaster of new motherhood represents normal adjustment or if something more serious is taking place. Severity and duration of negative emotional experience are two important factors we take into account as mental health professionals when making this determination. If a woman reports to us “I am not myself”, which is a frequent statement we hear from women suffering from PMADs, this alerts us to the possibility that her negative emotions are impairing her functioning and constraining her ability to enjoy her life and baby.  If negative emotional experiences are fleeting, do not persist and upon resolving allow a woman to tap into a sense of calm and enjoyment, likely what she is experiencing is normative and does not require professional attention.

Certain signs make the need to seek help very clear. These are: sleeping disturbances unrelated to the need to care for the baby (not being able to sleep when the baby sleeps); persistent anxiety (worry, rumination, obsessive thoughts) and/or sadness, persistent guilt, hopelessness, thoughts of escaping; feeling disconnected from the baby; changes in appetite; lack of enjoyment and motivation; thoughts of self-harm, suicide or death.

3. With the right treatment, women get better.

Mental health treatment for PMADs works! Part of the reason why we love working with women who are pregnant or postpartum is that it is such a joy and privilege to see them become themselves again, find happiness in their lives and families. In cases where symptoms are mild to moderate, psychotherapy tends to be sufficient. In more severe cases, pharmacological treatment may need to be considered in addition to psychotherapy.  Both pharmacological and psychotherapeutic treatment require that women be seen by specialists in women’s reproductive mental health who stay abreast of the latest research and utilize evidence-based approaches that have the highest potential to help women quickly. The bottom line is that treatment is the best gift a suffering woman can give herself and her family.

4. Postpartum blues does not last longer than 2 weeks.  Not all emotional reactions experienced in the first two weeks after childbirth can be ascribed to postpartum blues.

Often women and their medical providers incorrectly ascribe serious postpartum mood disturbances to postpartum blues. Postpartum blues is a normal experience reported by the vast majority of new mothers in the first two weeks following childbirth. It is thought to stem from rapid hormonal changes as well as the stress of birthing and the overall psychological and physical demands of the transition to parenthood. What is critical to remember is that a woman experiencing the blues is more irritable, tearful, and vulnerable to mood swings, but she is also happy or at peace most of the time. Her ability to function is not impaired. Blues tends to peak at 3-5 days postpartum and lessen over time, going away within two weeks of delivery. If a woman had a baby a few days ago and feels persistently and severely sad or anxious, this likely is not postpartum blues but something more serious. Again, the key distinction is that women with the blues have moments of irritability, tearfulness and feel overall more reactive, but are able to return to a happy, contented baseline and function is unimpaired. When in doubt, it is best to reach out to a professional who can provide further assessment.     

5. Screening positively on a mood questionnaire such as the Edinburgh Postpartum Depression Scale does not automatically mean that a woman is depressed.

In Illinois, obstetricians and pediatricians are required to invite pregnant and postpartum women to complete a mood questionnaire such as the Edinburgh Postpartum Depression Scale or the Patient Health Questionnaire. This screening is meant to yield information about a woman’s mental health but not provide a mental health diagnosis. A woman who scores highly on it does not necessarily have depression. High scores simply mean that further assessment is needed and that the woman should possibly be referred to a mental health specialist. It is critical that women answer the screening questions truthfully – if they need professional treatment, obtaining it as soon as possible usually leads to a quicker and easier recovery. 

6.  Symptoms of depression and/or anxiety frequently begin in pregnancy.

PMADs are common in pregnancy and not just the first postpartum year. Postpartum depression is a misleading term since it not only does not capture the range of symptoms women experience but also suggests that mental health issues develop only AFTER the baby is born. Yet up to 20% of pregnant women are affected by PMADs. Being anxious and/or depressed in pregnancy significantly increases the risk of developing postpartum mood disturbances. At Wildflower, we find that women who are struggling in pregnancy and seek out psychotherapy tend to fare better in the postpartum than women who come to us once the baby was born and report that they struggled in pregnancy as well. While we cannot promise that psychotherapy in pregnancy will prevent symptoms in the postpartum, women who do see a psychotherapist in pregnancy feel more prepared and able to cope with challenges of the transition to parenthood when they have learned effective coping techniques, increased their social support networks, and created solid self-care routines prior to baby’s arrival.

7. In the postpartum, symptoms do not necessarily develop soon after birth. They can develop in the months that follow.

Symptoms of a postpartum disorder may begin right after birth but may also not start until several months later. Symptoms tend to peak between three to six months postpartum. There are varied reasons for delay in symptom onset, such as significant, unexpected stressors, sudden weaning or resumption of periods, and illness.

8. Untreated, PMADs often become chronic. The consequences can be serious.

It is never a good idea to “power through” PMADs and not seek treatment. Untreated, PMADs can become chronic. These disorders not only impair a mom’s ability to function in everyday life and enjoy this time, but the longer they last, the higher the risk of aversive outcomes for the mother, her partner, and child(ren).  

PMADs can have negative implications for the mother’s ability to parent sensitively, effectively, and bond well with her baby. Children of depressed/anxious mothers are at a higher risk of developing problems in cognitive, social, and emotional development. Untreated symptoms in pregnancy can lead to pre-term delivery and baby’s lower birth weight.  The risk for infanticide and/or suicide is increased with PMADs. Suicide is a leading cause of maternal mortality.  Lastly, partners of afflicted women are also at a higher risk of developing mental illness.  The bottom line is that it is critical to seek treatment as all these risks can be greatly mitigated.

9. Women who are suffering often don’t look like they are.

Pregnant and postpartum women who are struggling with PMADs often go to great lengths to mask their symptoms. Just because a woman has done her hair and has make up on does not mean that she is doing well. We need to not make assumptions about women’s wellbeing based on their appearance but sensitively and genuinely inquire about how they are feeling. At Wildflower, we remind all women and their partners that they are not to be blamed for their symptoms. PMADs can happen to anyone, regardless of whether they have a history of mental illness or not.   

10. New dads are at risk of developing symptoms as well.

Although fathers do not experience the same hormonal shifts that are thought to play a role in perinatal mood and anxiety disorders, they too are susceptible to mental illness in the transition to parenthood. About 10% of new dads have depression, mood, or anxiety problems. The risk is increased for fathers whose partners are suffering from PMADs. At Wildflower, we are glad to see that dads are increasingly willing to seek support in this challenging time. Often they report that the initial step of reaching out is the most challenging part of starting psychotherapy due to stigma as well as internalized expectation that they be “strong” and not show emotion.    

 

Three things to keep in mind as you decide whether to reach out to a psychotherapist (and to remember if you’re already seeing one!)

by Aga Grabowski

Starting psychotherapy feels daunting to most, if not all, people.  The majority of clients we work with attest to the fact that reaching out to schedule an appointment and coming for the first session was the single most challenging part of the entire process.  There are multiple, valid reasons for feeling uneasy. Not knowing what to expect, not being sure if the psychotherapist is the right fit, fear of not being understood or (worse!) being judged, negative experience with psychotherapy in the past – the list could go on. One source of unease that is singularly powerful  – so much so that when present it often causes people to decide against reaching out – is believing that wanting/needing psychotherapy means something bad about you.   

In this post, I would like to set the record straight about what reaching out to a psychotherapist says about you.

 1.       Decision to seek psychotherapy is a sign of strength, not weakness.

In our society, we tend to place enormous emphasis on independence and self-sufficiency. This becomes problematic when this cultural value is not tempered by recognition of our basic, inherent need for connection and community. 

We are social beings – as such, we thrive and heal in context of relationships, not outside of them.

If we embrace only the drive toward independence and self-sufficiency, we quickly become lonely and isolated. At the same time, if we seek connection and support indiscriminately, in all matters and at all times, we would likely become helpless, passive and lose our sense of self.  To be resilient means to walk the middle path between autonomy and relatedness, to know when we need to reach out to others and to act on that knowledge without shame or judgment. 

The decision to come to psychotherapy demonstrates resilienceOf course, this does not mean we feel particularly resilient when reaching out (more about that in #2).

When we decide to seek psychotherapy, it is at least partly because we have come to realize that a new way of approaching our challenges needs to be found. Coming to psychotherapy is a statement of recognition that the coping that has been attempted thus far, whether alone or with the aid of friends and family, is not sufficient to overcome symptoms or other problems.

By reaching out, know that you are demonstrating several characteristics of resilient individuals: resourcefulness, self-awareness, acknowledgement of limitations, desire to learn and grow.

2.       Decision to seek psychotherapy is an exercise in vulnerability - and that is a good thing.

Vulnerability is a charged word that provokes some pretty powerful, conflicted feelings. The dictionary definition of the word vulnerable is: “capable of being physically or emotionally wounded; open to attack or damage.” It is safe to say that we do not like to feel vulnerable much of the time. It implies feeling unsteady, uncertain, exposed in a way we may not wish to be.  I do not need to dig too deeply in my mind to excavate memories of unwelcome vulnerability.  The time I was overtaken by performance anxiety and forgot what I meant to say to my audience and just stood there, frozen. The time I decided to share a painful secret with a friend and was met with a dismissive “That’s it? Don’t worry about it.” Examples abound.

It is impossible to come to psychotherapy and not feel vulnerable in the process.  Why would we want to subject ourselves to the discomfort that this may create in us or to the potential for being hurt (misunderstood, judged, etc.) that comes along with it? Because without vulnerability, there can be no real connection, no love, no deeper meaning.  Brene Brown, renowned research professor at University of Houston Graduate College of Social Work, explains this brilliantly in her famous 2010 Ted Talk “The Power of Vulnerability.” She defines vulnerability as: “uncertainty, risk, and emotional exposure.” Unless we take the risk inherent in being honest about who we are, how we feel, and what we need and want to thrive, we are not going to feel a real sense of connection and belonging. By pushing vulnerability away, we inevitably reject much of ourselves and make deep, satisfying relationships impossible. As Brene Brown notes, to feel is to be vulnerable.

 

"There is a crack, a crack in everything                             That is how the light gets in" 

Leonard Cohen       

Coming to psychotherapy is an exercise in embracing vulnerability. It is an experience that nurtures our ability to be real, authentic, and, hopefully, self-compassionate. It takes courage to engage in this process. 

If you decide to reach out to a psychotherapist, try to greet the feeling of vulnerability with acceptance. It is not a weakness!  Remember that, as Brene Brown so aptly put it, “Vulnerability is the birthplace of love, belonging, joy, courage, and creativity. It is the source of hope, empathy, accountability and authenticity. If we want greater clarity in our purpose or deeper or more meaningful spiritual lives, vulnerability is the path. “

3.       You are the expert on your life and coming to psychotherapy does not diminish that. To the contrary!

The relationship between a psychotherapist and a client is a collaborative alliance between two equals who enter into it willingly and with a sense of agreement about its goals and outcomes. In this process, two sources of wisdom and perspective come together:  that of the client and that of the therapist. Neither source is “better” than the other:  they are simply different. Contrary to what is sometimes believed, the therapist is not someone who has figured everything out, who has it all together and will now impart his/her knowledge to the client. The essence of the therapeutic relationship is nicely captured by a metaphor derived from Acceptance and Commitment Therapy, paraphrased here:

Imagine that you (the client) are climbing a big, steep mountain that is full of all sorts of potentially treacherous, slippery spots. My role as a therapist is to watch out for you and help you see them. How could I best do that? If I am standing on the top of the mountain and looking down at you, it will not be possible. If I am walking right next to you, we share the same view and that will not helpful either.  Instead, I am climbing my own mountain, just across the valley. From there, I have a good view of your path. I can see certain things that you cannot, such as that an avalanche is likely, or there is an impassable further up on your trail, etc. At the same time, only you know exactly what it feels like to be on your mountain and what is in front of you – in other words, you are the expert on your mountain. I can, however, offer a different perspective. Together we can figure out how to go about climbing this mountain.

I hope that these perspectives help you feel more empowered and at ease as you navigate the process of starting psychotherapy. Thank you for reading!