For some people, going to bed in the evening is a pleasant and natural part of their day. They curl up under blankets and drift peacefully off into dreams as soon as they close their eyes. However, many find the process of getting to bed to be a nightly challenge that results in hours of tossing and turning before managing to capture a few hours of quiet slumber. If you are in the later category there may be a few simple things that you can do to start the process of getting a better night of rest.
- Set a consistent time to wake up every morning. Although it can be tempting to sleep in on the weekends, or to catch up on sleep after a short night, an inconsistent sleep schedule can confuse your body and lead you to feel awake when you wish to be going to sleep, and sleepy when you are intending to wake up.
- Don’t watch your clock. In fact, you should probably turn it around so it does not face you. Watching minutes or hours pass by while you lie awake in bed will just increase anxiety, which makes it more difficult to fall asleep.
- Get out of bed if you are too alert. If you find yourself lying in bed for more than 20 minutes (your estimate not based on the clock) without falling asleep, it is best to get out of bed and do a calming activity (like reading or writing, not something activating like browsing the internet) somewhere else. The goal is to avoid associating being in bed with being alert or anxious. Therefore, you should only return to bed when feeling calm and sleepy.
- Your bed is only for sleep and romance. Again, you want to avoid associating your bed with eating, doing work, fighting, or anything else that might be stressful or activating.
- Avoid napping. It is natural to want to doze if you are feeling exhausted, but if you are someone who has difficulty falling asleep at night, napping is a bad idea. People need to accumulate a certain amount of “sleep debt” to feel tired at night and napping can disrupt this. If you absolutely must nap, try to do it early in the day and for no more than 30 minutes.
- Limit your caffeine intake. While some people can drink cups of coffee before bed and still sleep soundly, if you are someone who has difficulty sleeping you may want to try cutting out caffeine altogether, but definitely after noon.
- No “night caps.” While alcohol can induce drowsiness, as it wears off it interferes with sleep cycles making the hours you do get to sleep less refreshing. It can often cause early morning awakening as well.
- Put anxious thinking on hold. If you feel your thoughts starts running as soon as you get into bed, you may want to try a few tricks to try to calm yourself and empty your mind. You can try keeping a notepad and writing down topics that come into your mind. Once they are on paper, tell yourself you can let go of them and can come back to them tomorrow. You can also try relaxation exercises like progressive muscle relaxation (find an MP3 to guide you through an exercises here) or can count down from 100 while visualizing walking down stairs.
- Avoid eating or exercising close to bedtime. Exercise is physiologically arousing which interferes with sleep, and digestion slows when sleeping which can lead to discomfort.
- Try to control light and sound. Some people find it helpful to have earplugs or a fan for “white noise” when they sleep and others benefit from an eye-mask.
If you have tried out all of these tips and still find sleep to be out of your grasp, it may be helpful to work with a psychologist who can help to apply some additional behavioral skills such as “sleep restriction.” This can help a person facing insomnia to reset their bodies in a way to enable them to sleep more easily.
It can be very difficult to seek help, especially when many people fear that they will be judged negatively, or that asking for help means they are not strong enough to do something on their own. I have heard many people say that they think of themselves as strong and that they never thought they would be so weak as to need to go to therapy. I offer an alternative perspective – that it takes great strength to face challenges head on and to recognize that you could benefit from this kind of support. Gaining support may help a person to move through challenge without damaging other areas of their life such as job or academic performance and relationships. By learning skills to manage stressful situations, you also may be able to prevent future difficulty and move through future challenges more easily on your own. Wanting to feel connected and supported when facing hardship is also a very normal human desire and having support can at times protect a person from more severe emotional or physical health problems developing. These factors seem to make seeking therapeutic help a smart idea, rather than a sign of weakness.
It is easier to avoid looking at things that are uncomfortable, painful, or require reflection on your own areas for growth. If it doesn’t feel good, many people just choose not to do it. However, ignoring the challenges in your life often lead to a lack of change. Without understanding distressing patterns and developing new ways of coping with or addressing them, you are more likely to stay stuck in the same place. It takes a strong will to look at such things and to create change in your life – to me, that is far from being weak.
The buzz of a text message pulls you away from the conversation at hand and you stop to respond to a message that feels urgent. An hour passes as you browse on Facebook the seemingly exciting lives of your friends and acquaintances – travels to exotic places, happy announcements of engagements/weddings/births, and images of them looking happy and at their best. As you wait for a friend to go to the bathroom, you pull out your phone to check email or play Angry Birds. While adults converse at a table, the kids are entertained by video on cell phones, texting with peers, or a variety of games.
These are common ways technology has woven itself into many of our daily lives. It is easy to feel connected to a vast social network at the tip of your fingers and to keep yourself entertained by games or information that provide immediate pleasure or interesting information. However, many people are starting to wonder whether there are dangers to the way in which we have allowed technology to integrate itself so fully into our lives. Sherry Turkle, a psychologist and sociologist, explores some of these concerns in a TED talk that can be found here. She questions whether we are becoming used to the illusion of companionship that we find through social media while we are losing our ability to engage in conversation, tolerate being alone without some form of entertainment, and make time for genuine engagement with each other. She argues not that we should stop using technology, but rather that we should be more mindful about the way it affects our lives and make thoughtful decisions about how to use it and how not to use it.
Another potential danger lies in the type of content that is presented in social networks. Most people tend to present the positive events that are occurring in their life – the fun events, exciting accomplishments, and happy news that they want to share with the world around them. Unfortunately, if things in your own life are not going in the direction you would hope, comparing yourself to your network of friends may increase painful or negative feelings about yourself. In reality, other people’s lives may not be as wonderful as their projected internet identity, but that is not possible for you to know based upon what is posted on your newsfeed. Comparing one’s self on life events and successes is only one form of comparison that people engage in when browsing their social networks. SELF Magazine took a look at another way that social networking can affect self perception in its article “Is Facebook Bad for Your Body?” that can be found here. This article discusses the finding of a study, conducted by the Center for Eating Disorders at Sheppard Pratt, that found in its sample of 600 respondents that 51% reported feeling more conscious of their body and weight when seeing photos of themselves and others on Facebook with 32% saying that comparing their pictures makes them feel sad. It also discusses some ways to set guidelines for yourself to help maintain a healthier relationship with your body and Facebook.
Neither Sherry Turkle, nor the SELF Magazine article recommend removing technology from your life, but both seem to be asking us to think more carefully about how we use it. You may want to ask yourself how your use of technology has changed you or the way you interact with others. Is it easier for you to converse with people via technology than in person? Would it be useful to set specific limits on the amount of time, or the circumstances in which you use technology? Could it be healthy for you to set a time of day where you turn off computers and phones for some period? The amount of technology that is appropriate to use in one’s life may be different for every person, but the act of being purposeful in determining what is right for you may keep your relationship with technology healthy.
If you have scheduled a first session with a psychologist, you have already had to jump over a number of hurdles – acknowledging that support could be helpful, calling a stranger and telling them about yourself, finding time in your schedule to come in, and deciding to spend money on working on your well being.
Now here you are, ready to go to the appointment but feeling a bit anxious as you wonder about what the next hour will look like. Here is some information about what to expect in that first session. It tends to look different from those that follow, as it is more focused on information gathering and less on being therapeutic. Unfortunately you aren’t likely to find solutions to what bring you in on the first day, but it is a way for you and the therapist to understand your concerns more fully. Every therapist may handle this a bit differently, but most first sessions will include these components.
- Paperwork, Forms, and Signatures. You may receive these by mail or email prior to a session, in a waiting room before the session starts, or at some point during the session, but most therapists will want you to fill out some paperwork. Often there is some sort of information sheet that includes basic information about you (address, phone numbers, emergency contact, etc) and may ask you some questions about what brings you in or what you are experiencing. In addition you will usually be given a HIPAA privacy notice, and some sort of consent to services. Some therapists will have additional measures they wish you to fill out too.
- Payment, Cancellation and other Policies: Often payment and office policies are discussed prior to the first session when scheduling or in the consent to services that the therapist provides you in writing. One way or another, these things will typically be touched upon by the end of the first session.
- What is private? At the start of the session, the therapist will explain what you can expect in terms of privacy. They will also let you know what situations they are legally required to report information about (see my FAQ page for what information has to be reported). They may also tell you a bit about the type of treatment they provide or what you can expect from the session.
- What brings you in? Therapists will typically start by asking you a bit about why you are interested in counseling and what brought you in at this point in time. They may ask lots of questions to try to fully understand what you are experiencing, how long it has been going on for, how it affects other areas of your life, and how you have been coping with it.
- Let’s take a look at your history? To truly try to understand what you are experiencing now, the therapist will ask you questions about your past. They will likely ask you about your family, romantic partners, and friendships. They may want to know what school was like for you growing up or how you feel about and interact in your work environment. They may ask you about how much you drink or use other substances, and whether you have had any medical problems or surgeries. They may ask you questions that seem like they have nothing to do with what brought you in, but this is all part of trying to get as thorough an understanding of you as possible.
- Goals. Often a therapist will ask you about whether you have a clear sense of what you wish to accomplish in counseling, but you don’t have to have the full answer. A lot of the time goals become more clear as you go.
- Questions. Feel free to ask the therapist questions you have about how therapy works, concerns you have about policies, etc.
Sometimes these tasks can take more than one session and they may look a little different depending upon your therapist’s style, but hopefully this gives you a general sense of what you might expect when walking into a therapist’s office for the first time.
People often wonder whether what they are experiencing is severe enough to warrant professional attention. I would urge them to keep in mind that once a situation gets very severe, it is much more difficult to work on. If instead you are able to get help when you are having milder symptoms, you are more likely to be able to utilize therapy and the skills you learn to improve more quickly and prevent a crisis.
Similarly, people often think that they are capable of getting through something difficult on their own. They wonder why they should bother with getting help, when they may eventually feel better without it. It is possible that it is just an issue of time passing and a wound healing or a stressful circumstance resolving itself. However, a supportive therapist can often help lighten the load. You may need an outlet to think about and express what you are experiencing. Or perhaps there are some useful skills that a counselor can provide you to help work through the problem. By getting support with something difficult sooner you may learn things about yourself and tools you can utilize in the future when facing challenges.
Often people come into therapy later in life and learn a way of dealing with a problem they have faced for many years. Maybe they have battled sleep problems that have caused them to live in a haze of exhaustion, only to find that with some adjustments to their bedtime routine and the application of certain behavioral techniques that have been shown to help with overcoming insomnia, they are able to sleep soundly for the first time. Others may find that by putting off getting help the situation has become unresolvable. On average, couples tend to come in to counseling 7 years after a problem has begun. By this time, in addition to the original problem, there are many layers of pain and frustration that are exacerbating the problem and in some cases it can be too late to save the relationship. In either situation, people often wish they had not waited so long to address the problems at hand.
It can be very difficult to take the steps towards getting help, and much easier to put it off or hope that things improve on their own. However, getting help sooner may save you later pain and provide you with healthy skills for the rest of your life.
Check out this interesting article by Diane Ackerman in the New York Times entitled, “The Brain on Love” (find it here). It discusses the way that loving relationships can affect the brain’s wiring, and what the brain’s response to love looks like. It takes a look at the way that love can ease stress, reduce the experience of pain, and lower blood pressure while also noting that interpersonal loss or rejection stimulates the same parts of the brain associated with physical pain.
For a fun look at what people’s brain’s do when they are experiencing love, check out “The Love Competition.” A video made at the Stanford Center for Cognitive and Neurobiological Imaging where participants were interviewed about people in their life that they love and then given five minutes in an fMRI to “love as hard as they can.” Participants were then compared on whose brains showed the most activity in areas associated with loving feelings. The video does not go into detail about the neuroscience associated with love, but does provide an overview of the brain pathways involved and includes some touching stories from participants on how they have experienced love in their lives. Can you guess who will win the love competition?
Talking to friends and family in times of difficulty can be incredibly helpful. Often they can provide support to help you through hard times. People are often worried about being a burden to others. However, in most cases, people enjoy being able to support their friends when they are in need.
As good as it can be to get support from people in your life, talking to a psychologist can provide a different kind of support. A psychologist is trained to help you find patterns in your life, identify helpful skills to cope, help you gain new perspectives, and perhaps most importantly, provide impartial non-judgmental support. Some friends and family members are better at providing support than others. If yours are not as skilled at being supportive it can be frustrating to feel that when you do reach out you come back disappointed. Psychologists, on the other hand, have gone through extensive training on how to provide support and tend to be fairly good at it.
Sometimes when you share things with friends or family they give you an opinion based upon what they want for you. For instance, maybe a family member does not want you to move far away so they are biased when you talk to them about the job prospects you are considering. Because a psychologist does not know you personally, they don’t have a stake in what you choose. Their only goal is to help you to do what is going to be best and healthiest for you.
Many people feel they have to censor themselves when talking with friends because they are embarrassed about certain topics or worry what they say will be repeated to others. When you talk to a psychologist, it is judgement free and confidential. Psychologists are used to talking about topics that are typically considered taboo or uncomfortable, and they don’t judge you for thoughts and feelings you may not want to admit to other people. Unless a psychologist is concerned about an immediate safety issue, they are also legally bound to keep what you share private. This means you can talk freely to them without being concerned that someone might hear about the intimate details of your life.
Reaching out for support from the people in your life is a very important skill to learn, and a psychologist can provide forms of support that friends and family often don’t have the expertise or impartiality to provide. Both peer support and professional support can be important at times, and having one does not necessarily mean you wouldn’t benefit from the other.
In January, the American Psychological Association released a report on “Stress in America.” They have been conducting annual surveys to examine levels, causes, and perceptions of stress over time. The good news is that average levels of stress dipped slightly from the previous year. Unfortunately, average stress levels still remain higher than what people consider to be healthy.
You may be wondering why being stressed out is such a big deal. The survey also shows that many people are not particularly concerned about their stress and do not prioritize addressing it. Unfortunately, stress can contribute to the development of a number of health problems including heart disease and high blood pressure. It can also damage the functioning of your immune system making you more susceptible to infections and illnesses. By not addressing stress early on, we may be increasing the likelihood of health problems that will be costly in the future. The concern is that if we do not shift the way we view stress, we will continue to play catch up – treating health problems after they occur rather than preventing them.
When you are stressed, you may feel too overwhelmed to take care of yourself. Among the many things that you are juggling, it may seem that taking steps to manage your stress would just be another task to add to a load that already feels like too much. Despite these feelings, I urge you to prioritize finding healthy ways to care for yourself. You may find that once you explore ways of coping (such as eating healthy, relaxation exercises, exercise, talking to someone, etc), that it is easier than expected to reduce stress in your life, leaving you free to address the challenges before you with greater energy and good health.
To read a summary of the findings of the APA Stress in America Survey, click here.
Do you tend to focus on and notice the things that go wrong during your day? Many people find that it is the frustrations, disappointments, and challenges that they face during their daily life that dominate their thoughts. Especially when we are facing particularly challenging life circumstances, it is easy to feel that there is a pervasive darkness in our life, with few rays of light.
Some people find the following exercise helpful in creating greater balance and finding moments of joy even when things are very difficult. Those who are not currently feeling distress, may find it helpful in increasing their positive outlook and finding meaning in various places within their lives.
- Each evening before bed, pull out a notebook and a pen.
- Add a new item each day to a gratitude list. This can be difficult at first. If you do not normally notice these kinds of things in your life, you may feel like you cannot think of anything. Keep trying. It can be a brief moment or a major event. Maybe the sun was out and you were grateful for the warmth on your skin. Maybe you had a cold drink on a hot day and were grateful for your refrigerator. Maybe a stranger picked up something you dropped and you were grateful for their kindness. Maybe you are grateful for chocolate!
- Do not repeat any items. Each night you must come up with something new you are grateful for. You may have to start looking for these things during your day so that you have something to write down in the evening.
- Challenge yourself to see how long you can keep this going!
The aim is to fight back against the part of us that tends to focus on the negative, and to make an effort to notice the positive things in our lives as well. I want to emphasize the fact that it is normal to pay more attention to what goes wrong than what goes right, and there is nothing wrong with you if this is what you find yourself doing . I also do not want to ignore the fact that those things that go wrong are important and worthy of your attention. This exercise is merely about noticing what might otherwise go unnoticed, not ignoring the bad.
Here’s to getting grateful!
“So, you are a psychologist, huh? What do you really do? What kind of people do you work with?”
“ Are you analyzing me right now?”
“If you are a psychologist, can you read my mind?”
These kinds of questions are regularly asked of psychologists. It seems to be a profession shrouded in mystery. Much of what people know about psychology is based upon media representations, which tend to give inaccurate pictures of the field.
My hope for this blog is that it will address some of the common questions that people have about the field of clinical psychology, and will provide information about common reasons people seek psychological help. I hope to demystify the field a bit while providing some helpful information about common challenges people face, skills for addressing them, and what new research is showing. Expect to find information, exercises, skills/tips, and links to articles that you may find interesting.
Who is this blog written for? It is my belief that all of us can benefit from the kind of information I will include here. Much of what I do as a psychologist is work with people who are facing the kinds of challenges that we all face in our lives. Dealing with transitions, losses, stressful events, relationship conflicts, and life stress is something that most of us can continue to grow and improve upon. Many have also experienced periods of depression, anxiety, shyness in social or performance settings, difficulty sleeping, and other types of challenges that can benefit from basic skills and psychological knowledge. Additionally, this blog hopes to address ways to increase positive experiences in your life and grow happiness and wellness.
Of course, what I include here can only be basic information, and if you are truly struggling with a challenge in your life, I would recommend meeting with a psychologist or other mental health practitioner for information and support tailored specifically to you. Hopefully this information will get the ball rolling and help you decide whether meeting with someone for further support would be useful.
So…no, when you meet a psychologist at a social gathering, they are probably not analyzing you (at least not in a way that is different from what anyone does when they meet a new person – we all try to get a sense of who the person is). We also can’t read your mind (as helpful as that might be!). But, if you are in distress and you come to our office, most of us will do our very best to help you. It may look very different depending on the psychologist you meet with and what you are there to work on, but hopefully I can start to paint a clearer picture of what it can look like with the words that will follow here in this blog.
Thanks for reading,
Lindsay Shortliffe, Psy.D.