Health Tip – Mindfulness: Be Here Now!

Terri Speirs on March 13, 2017

Mark Minear 2012

Mark Minear, Ph.D., is a licensed psychologist at the Des Moines Pastoral Counseling Center

By Dr. Mark Minear, Psychologist at the Des Moines Pastoral Counseling Center  

“We never keep to the present… We anticipate the future as if we found it too slow in coming and were trying to hurry it up, or we recall the past as if to stay its too rapid flight.  We are so unwise that we wander about in times that do not belong to us, and do not think of the only one that does; so vain that we dream of times that are not and blindly flee the only one that is.” (Blaise Pascal, Pensees, 1659)

I know that it may sound simplistic, even trite, to suggest the importance of living in the present moment—but it is true.  The regrets of the past and the fears of the future are the primary culprits that take us from the gift of the present.   And—if you will allow me a little oversimplification, regrets and living in the past fuel depression and fears and living in the future fuel anxiety.  So… it does make intuitive sense that inhabiting the present moment is of great value to our wellbeing.  The challenge, which most of us don’t readily appreciate, is that if you want to improve your ability to attend to the here and now—then you will need to practice!

Jon Kabat-Zinn suggests that “mindfulness means paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.”  You can understand, then, how meditation is simply an optimal way to practice—paying attention with intention and lovingkindness to one’s breath, one’s thoughts, one’s body, sounds in the environment, a candle or a sunset, the taste of blueberries, the aroma of fresh baked bread, etc.… you get the idea.

It would be wise to take some time each day in a formal way—five to ten minutes is a good start (research has shown that consistency is more effective than lengthy times if they are sporadic); however, you can then augment your practice when you have a few minutes waiting for someone, two to three minutes at work for a mini-break, turning off the television and staying in your chair, etc…. you get the idea.

When you practice, you are more likely to know when you are not in the present moment so that you can gently return to the present moment—even under stressful conditions (when we are conditioned to return to the past or tempted to reach for the future).  So… in closing, here are a few nuggets to consider:

  • Be gentle with yourself: nonjudgmental = self-compassion.
  • When you catch yourself straining, know that you are not on the path of mindfulness.
  • Accept the things you cannot control, including your thoughts—but remember you can make choices (including the observation of and the response to your thoughts).
  • Explore the resources on mindfulness—great books, websites, YouTube, etc.
  • Experiment with your practice—investigate with curiosity for what is beneficial.
  • Integrate mindfulness meditation into your current spiritual practices.
  • Be grateful—always a way to be “in the moment”; consider developing a daily gratitude journal.

Two closing quotations:

“The best spiritual advice is the simplest—pay attention.”  (Alexander Green)

“You must live in the present, launch yourself on very wave, find your eternity in each moment.”  (Thoreau)

Register here for the Center’s upcoming Mindfulness Training class.

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In 2016 Dr. Mark Minear walked across the state of Iowa to raise awareness for men’s mental health. View his photo gallery and read his travel blog here. 

Health Tip – Valentine’s Day Special: Healthy Relationship Tips for Couples

Terri Speirs on February 14, 2017

Sarah McElhaney, L.M.F.T.

Sarah McElhaney, L.M.F.T.

By Sarah McElhaney, L.M.F.T., licensed marriage and family therapist at the Des Moines Pastoral Counseling Center

February 2017 – The relationship with your partner could be one of the most important in your life, yet it is too easy to forget how vital it is to nurture the relationship daily. In the season of hearts and roses as symbols of love, I’d like to offer the following practical tips on how couples may improve their relationship, and overall quality of life:

  • Know your partner’s inner world. Regularly make time with your partner to tune into one another exploring and learning more about each other – from the big stuff like their hopes, dreams, and current goals to the details that make them unique – like their likes and dislikes. Make time, get generally curious, and ask open-ended questions.
  • Promote a positive relationship culture. Good relationships have a ratio of 5:1 positive to negative interactions (contrasted with almost 1:1 in struggling relationships). Point out what your partner is doing right and focus on expressing appreciation, fondness, affection, and respect regularly and in small, everyday moments.
  • Be available and responsive. Being consistently available and responsive to one another and each other’s needs creates a sense trust and an emotional safety net that can be helpful when weathering times of stress. It answers our most basic underlying needs for connection, “Are you there for me? Do I matter?”
  • valentines dayManage conflict calmly and effectively. Conflict is inevitable in relationships. And in couple relationships, 69 percent of problems are “perpetual” problems that are often “unsolvable.” Couples that do well at managing conflict address these areas calmly, have conversations about them that often does not focus on “solving the problem” but rather accepting each other’s influence and positions.
  • Recognize the early signs of relationship distress and seek guidance early. The research is clear — couples generally tend to wait too long before seeking couples therapy (on average an entire six years from when they first began noticing problems), but two of the most important factors for couples doing well in therapy is their motivation level and timing.

The Des Moines Pastoral Counseling Center offers couples therapy along with a broad range of mental health services for children, adolescents, adults, couples and families through 26 licensed clinicians. For more information, please visit our website: dmpcc.org. To schedule an appointment, call 515-274-4006 or email [email protected]

(Tips are adapted by the research and practice from Gottman Method Couples Therapy and Emotionally Focused Couples Therapy, both research and evidenced-based models for couple’s therapy)

 

Health Tip – Treating depression after a cardiac event or diagnosis

Terri Speirs on December 30, 2016

Psychiatry team at Des Moines Pastoral Counseling Center

Psychiatry team at Des Moines Pastoral Counseling Center

by Dr. Geoffrey Hills, D.O., psychiatrist, and Susan Koehler, P.A.-C. (psychiatry physician assistant) at the Des Moines Pastoral Counseling Center

June 2016 – Did you know cardiovascular disease may trigger depression? Counseling and medication can help. When someone has a heart attack, heart surgery or stroke, the immediate concern is addressing his or her physical health. Once down the road to physical recovery, it’s also important to monitor mental health. If you or a loved one have experienced a cardiac event or diagnosis, and are having difficulty regaining the zest for previous life interests (such as hobbies or relationships,) you may wish to ask your doctor for a referral to a qualified mental health professional.

The Des Moines Pastoral Counseling Center’s in-house psychiatry team can work with your doctor to treat your cardiac-related depression. For more information on the Center’s psychiatry services, visit dmpcc.org/psychiatry, call 515-274-4006 or email [email protected]. The Des Moines Pastoral Counseling Center provides quality mental health counseling for children, adolescents, adults, couples and families through 26 licensed clinicians.

 

Health Tip – Exercise Gratitude

Terri Speirs on December 30, 2016

by Jim Hayes, Executive Director, Des Moines Pastoral Counseling Center

January 2017 – The turning of the year provides an opportunity to look back with gratitude for all that has given us life in the past year, and to direct that positive energy into our communal and individual resolution to make 2017 an even better year.

I’m a big believer in the nurturing of habits and virtues. Through the habitual exercise of virtues we value, we can make them a more integral part of who we are. Gratitude is certainly one of those virtues for me. If we take one minute each day to ask the question: “What was I grateful for today?”, we nourish our ability to face future challenges.

If you’re a visual learner, search YouTube for the video of Shawn Achor entitled the “Happiness Challenge.” Here’s a link:

Achor’s thesis is that grateful folks are happier in the long run and often engage others more deeply as a result of the insight that each moment is a precious opportunity to make a difference in the lives of others. Here’s a summary of his 21 day happiness challenge:

  1. Reflect on three things you’re grateful for each day.
  2. Journal on one thing for which you’re grateful.
  3. Exercise (even a five minute walk will do it).
  4. Meditation/mindfulness (even two minutes of sitting quietly helps).
  5. Perform a random act of kindness. I find a quick note to someone for whom you’rE grateful is a great exercise of this.

I am grateful to begin my tenure at the Des Moines Pastoral Counseling Center and to be working with such a great group of people. May your 2017 be filled with abundant experiences and people that will provide you with a grateful heart.

Jim

Heath Tip – When trauma and the holidays collide – how to cope

Terri Speirs on December 4, 2016

Dr. Christine Dietz

Dr. Christine Dietz

by Christine Dietz, Ph.D., L.I.S.W., therapist and spiritual director at the Des Moines Pastoral Counseling Center, and the Center’s Director of Clinical Training

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December 2016 – The holiday season is often stressful, especially for people who suffer from physical or emotional distress. The idealistic pictures of happy families offered by the media may be out of sync with the truth of our lives. Due to recent events that disconnect may feel even greater.

Our mission at the Des Moines Pastoral Counseling Center is to offer hope and healing to adults and children through attention to mind, body and spirit. There has never been a time when hope and healing were more needed, in our communities, our nation and the world. Conflicts over immigration policy, race, violence, gun control, health care, foreign policy, LGBT rights and gender inequality have intensified. Bragging about sexual harassment and threats to people of color and immigrants became acceptable. And gun violence seems to increase daily. Many of us are feeling weary and discouraged, fearful of what may happen. But for the most vulnerable among us, those fears are all too real. For survivors of sexual assault, racism, and bullying as well as those who came to America seeking refuge from terrorism, these events evoke memories of what has already happened and fears that it will happen again.

According to Bessel van der Kolk*, a neuropsychiatrist specializing in psychological trauma, “we now know that more than half of the people who seek psychiatric care have been assaulted, abandoned, neglected, or even raped as children, or have witnessed violence in their families” (Van Der Kolk, 2014, p.24). These numbers hold true for the Center’s clients as well. Experiences such as these lead to overwhelming feelings of anxiety, depression, despair, and fears for safety. They cause physical illnesses as well as emotional distress.

How do therapists help? First, we acknowledge that these experiences are real – we don’t offer false reassurances or dispute the survivors’ experiences. Survivors are not crazy; they are experiencing the mind and body’s normal response to intolerable stress. We listen, validate, and support people in learning how to deal with the aftereffects of trauma. We help them find ways to feel as safe as they can and to handle the emotions and memories that torment them. We encourage them to reach out to supportive people and communities.

This work will be more difficult now. Already our clients report feeling increasingly unsafe and vulnerable. Survivors of sexual assault report feeling unsafe and experiencing flashbacks. Children of immigrants worry about coming home from school and finding their parents gone. LGBT clients and people of color feel targeted and unsafe. There are reports of increased bullying, racist and anti-Semitic graffiti and hate speech.

What can the rest of us do? Here are six things you can take to make the world safer for the most vulnerable among us at this holiday season:

  1. Listen – to those who are afraid, and to those with whom you disagree. It can be difficult to sit with people’s fears and discomfort without trying to offer rational explanations, but it is most helpful to acknowledge the feelings without trying to change them. Acknowledge that the feelings and fears are real, whether or not you share them.
  2. Ask how you can help. Often people just need to know that others believe them and want to support them. Ask if there are concrete actions you can take, and do them.
  3. Children may be feeling particularly confused, frightened and unsafe. They may not know who to trust. Listen and validate their feelings, and offer realistic support. Let them know that you will do everything you can to protect them and make the world a safe place for them. Do not offer reassurances that you can’t deliver. Do reassure them that it is ok to talk to you, draw pictures and express their feelings in other ways. They need your help to make sense of what is happening.
  4. Take action. We all feel more anxious when circumstances seem out of control. Identify what you can do – join a group, call your legislator, contact organizations that are trying to make the world a better place and ask what they need. Convene a group of friends and plan actions that you can take together. Donate to organizations whose goals you support.
  5. Take care of your physical health and that of family members. Fears and uncertainties stress the body as well as the mind. Exercise, relaxation and meditation practices help restore a sense of calm to the body and mind.
  6. Celebrate the holiday season. Research tells us that connecting to a sense of meaning and purpose helps manage stress. Focus on what you have to be grateful for and what you value.

Shifting your attention from fear and anger to what you can do, for yourself, your family and your community, is the only way the world becomes better. As Gandhi said, “be the change you want to see in the world.”

*Bessel Van Der Kolk, The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma. New York: Penguin Books. 2014.

An abbreviated version of this post appeared in the Urbandale Chamber Newsletter in December 2016

Health Tip – When Holidays and Trauma Collide – What to do?

Christine Dietz on November 25, 2016

Christine

Dr. Christine Dietz, Ph.D., L.I.S.W.

A more comprehensive version of this post can be found here.

By Dr. Christine Dietz, Ph.D., L.I.S.W., Director of Clinical Training, Des Moines Pastoral Counseling Center

December 2016 – The holiday season may be stressful for all of us. The idealistic pictures of happy families offered by the media might be out of sync with the truth of our lives. Recent events have made many of us, especially those who have suffered from violence and trauma, feel angry, unsafe and vulnerable. According to Dr. Bessel van der Kolk*, “we now know that more than half of the people who seek psychiatric care have been assaulted, abandoned, neglected, or even raped as children, or have witnessed violence in their families” (Van Der Kolk, 2014, p.24). They may have experienced war, terrorism or violence. These experiences can lead to overwhelming feelings of anxiety, depression, despair, fears for safety, and physical illnesses.

There are many ways all of us can support survivors of trauma during these difficult times. Here are a few suggestions:

Professional counselors listen, validate, and support people in learning how to deal with the aftereffects of trauma. Counselors help trauma survivors find ways to feel as safe as they can and to handle the emotions and memories that torment them. Counselors encourage them to reach out to supportive people and communities. Professional counselors acknowledge that trauma is real – and do not offer false reassurances or dispute survivors’ experiences. They are not crazy; they are experiencing the mind and body’s normal response to intolerable stress.

Many of our neighbors feel unsafe. What can the rest of us do? Here are six ideas:

  1. Listen and support those who are afraid.
  2. Ask how you can help.
  3. Reassure the children.
  4. Support groups taking positive action to make our communities safer.
  5. Take care of your physical health.
  6. Connect with a sense of meaning this holiday season.

Shifting your attention from fear and anger to positive actions is the only way forward. As Gandhi said, “be the change you want to see in the world.”

The Des Moines Pastoral Counseling Center offers professional counseling, psychiatry and a broad range of mental health services for children, adolescents, adults, couples and families through 26 licensed clinicians. For more information, please visit our website: dmpcc.org. To schedule an appointment, call 515-274-4006 or email [email protected].

*Bessel Van Der Kolk, The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma. New York: Penguin Books. 2014.

A more comprehensive version of this post can be found here.

Health Tip — Need Sleep? Five Ways to Rest Well 

Terri Speirs on November 8, 2016

Susan Koehler, P.A.-C. (Psychiatry Physician Assistant)

Susan Koehler, P.A.-C. (Psychiatry Physician Assistant)

By Susan Koehler, P.A.-C., Psychiatry Physician Assistant, Des Moines Pastoral Counseling Center

Sleep is essential for a person’s health and well-being, yet millions of people do not get enough sleep on a regular basis. Surveys conducted by the National Sleep Foundation reveal that at least 40 million Americans suffer from over 70 different sleep disorders. Helping my patients establish healthy sleep hygiene is a foundational part of my treatment approach because good sleep is vital for overall quality of life. Here are the top five sleep tips I share with my patients, simple steps one can make to create a better sleep hygiene:

  1. Establish and maintain a regular bedtime and a regular arising time. Try to maintain a regular arising time, even if you have had trouble sleeping the night before.
  2. Have a regular bedtime routine – a warm bath or shower can be relaxing and help you drift off to sleep.
  3. Avoid naps during the day or evening.
  4. Alcohol and caffeine can interfere with sleep. Avoid both after dinner.
  5. Regular physical activity helps sleep and well-being.

The Des Moines Pastoral Counseling Center offers psychiatry and a broad range of mental health services for children, adolescents, adults, couples and families through 26 licensed clinicians. For more information, please visit our website: dmpcc.org. To schedule an appointment, call 515-274-4006 or email [email protected].

Health Tip – How couples can manage conflict

Terri Speirs on October 11, 2016

Julie McClatchey, M.S.W.

Julie McClatchey, M.S.W.

By Julie McClatchey, M.S.W., Des Moines Pastoral Counseling Center

Conflict is a normal and expected part of marriage or other intimate partnership. Our goal isn’t to avoid conflict but to resolve it in ways that lead to a better understanding of each other and, ultimately, to strengthen our relationships.

Tips for effective conflict resolution include:

  • Set your goal as problem resolution that is a “win-win.” If you seek to prove you are right or to win an argument, the relationship loses.
  • Stop what you are doing and put your focus on your partner when there is an issue to discuss. Through eye contact, setting down your laptop and giving your full attention, you show respect and interest in your partner and set the stage for greater success at resolution.
  • Talk to each other with respect. Shouting, name-calling, criticizing, accusing, and other adversarial behavior will intensify the conflict, lead to hurt and anger, and, over time, damage your relationship.
  • Discuss one issue at a time, avoiding bombarding each other with multiple issues. Success in resolving one issue will help you to make progress in others.
  • If tensions or tempers are rising, take a “time out.” Agree to end the discussion and commit to a time to come back to the discussion when both of you feel calmer and ready to try again.
  • Focus on addressing behaviors vs. attacking the person. For example, replace statements like “You are always so selfish” with “I feel hurt when you don’t spend more time with me.”
  • Reflect back what you hear your partner say such as “I hear you saying you want more time together. Is that right?” This helps you to reach mutual understanding.
  • Listen, listen, listen! Feeling heard by your partner helps with resolving conflict and also goes a long way toward strengthening trust, respect, and intimacy.

The Des Moines Pastoral Counseling Center offers mental health counseling for couples, as well as children, adolescents, adults and families through 26 licensed clinicians. For more information, please visit our website: dmpcc.org. To schedule an appointment, call 515-274-4006 or email [email protected].

COOL – Children Overcoming the Obstacles of Life

Terri Speirs on June 15, 2016

We are pleased to reprint this classic piece by Grace Percival, co-founder of the Center’s COOL practice (Children Overcoming the Obstacles of Life).

Beauty Teenage Girl In Hat OutdoorsChildren are born with varying degrees of potential for growth – physically, cognitively, emotionally, and relationally. They rely on and look to the adults in their environment to not only keep them safe, but to help in the monumental and awesome task of realizing their potential to understand and integrate the world around them.

They are eager to connect and to please. They are eager to develop relationship. It is what they are born to do.

I am on the floor in the children’s waiting room at the Center picking up some toys and I notice an eight-year-old boy several feet away intently building with Lego blocks. His mother sits in the rocker close by slowly rocking, her face set in tired lines. The boy completes his masterpiece and raises his face to his mother. His eyes are shining as he exclaims, “Mom! Look at what I built!” Just then his therapist enters the room and greets the boy and his mother. His mother never looks at the boy or his masterpiece. She says hello to the therapist and says sharply to the boy, “Pick up that mess. Hurry up. You have to go.” The boy’s face falls, his body slumps. He knocks down his masterpiece.

Portrait of a boy teen outdoorsWe are much concerned in society today with providing safe physical environments for our children. This can be tricky while trying at the same time to nurture the child’s natural curiosity and sense of independence. If environments are too physically safe, children do not learn their limits very well nor do they learn to trust their bodies or their developing “self.”

Climbing, jumping, balancing result in a child’s feeling grounded and at one with the earth, which increases feelings of “I can-ness,” mastery and self-power. When a toddler begins to climb onto something and checks back with an adult, an encouraging, rather than fearful, response can convey not only a message of support but also of trust, e.g., “I trust that you can manage this.”

It is important to realize that “safety” involves not only management of the physical environment, but also involves psychological and emotional safety. This bigger picture of safety calls upon adults to provide:

  • encouragement rather than limits,
  • praise rather than criticism,
  • patience rather than sarcasm,
  • negotiation rather than issuing edicts.

child paint handsThis bigger picture of safety also involves understanding that children do not possess the communication skills or experience to always adequately convey motivations or explanations. It means that adults recognize that children, of every age, are easily frightened and psychologically wounded.

At the Center, we see the consequences when children are not provided this kind of psychological and emotional safety. We see children who carry their bodies stiffly and shy away from touch. We also see children who are afraid to make a choice of a game for fear of displeasing the adult or who will not try something new because they might get hurt or fail. We see what happens when the very things intended to protect become obstacles to growth. So, providing a safe environment also means providing time and space for kids to be who they are without fear of judgment, criticism, or too many limits. It means providing environments that are rich and ripe for exploration without fear of getting in trouble for getting dirty or hurt.

It seems that adults are so often concerned with “teaching a lesson” and/or discipline that they forget how it is that kids learn best:

  • by exploring,
  • by making mistakes, and
  • by being in caring, non-punitive relationships.

Kids learn through their relationships with other people and through physical interaction with the environment. Indeed, infants are neurologically “wired” to attunement with other people. They pick up on and respond to the emotional tones around them, as well as other sensory input. A harsh tone, a turning away from, a lack of acknowledgement of the infant or child – all have profound effects on the developing child throughout his/her life.

For example, the child who learns that people cannot be relied upon to provide for basic needs may grow into an adult who has trouble with intimacy. There is also the misbegotten idea that if a child misbehaves, punishment in the form of reprimand or time out or removal of privilege is required or the child will not “learn the lesson.”

IMG_1034The problems with the use of punishment are that:

  • the effects are usually temporary,
  • a whole host of emotional and physiological reactions are engendered that actually interfere with learning, and
  • relationships are damaged.

This last issue – damage to relationships – has profound ramifications for future learning. If a child learns to not trust a significant adult, chances are the child is not going to learn from that adult anything other than how power impacts the relationship. For example, a child learns that bigger people have power and can use force; little people are not listened to; there are right ways of doing things and wrong ways and nothing in between; what the adult says goes and it does not matter what the child thinks or feels.

Most people reading this may think, “Well, I never act like that.” However, think about the last time you were playing a board game with a kid and the kid changed the rules in the middle of the game; or when the three-year-old decided to climb onto the counter to get something out of the cupboard; or the 12-year-old tried to recreate a science experiment with a plastic pop bottle, tin foil, and matches; or the 16-year-old stayed out past curfew. What was your response? Were you reactive out of fear or anger or were you responsive, pointing out consequences of their behavior?

IMG_1035Children require physical, social, and emotional environments that trust their innate capacity for growing, learning, and relating. Our job as adults in relationship with children is to nurture these bright young spirited beings through the obstacles that life throws at them. Our role is about being a guide on the side, rather than a sage on the stage. It’s about taking the back seat and relinquishing the spotlight. It’s about giving and it’s about giving up – sleep, that new thing, my time, my fears….

I am standing on a stool in the kitchen full of all my four-year old know-how, trying to separate an egg. My mother’s hands are on either side of the bowl; she must have been standing behind me. Her words in my ear encouraged me to pour the egg from one shell to the other. Her hands never touched mine. She was present but she let me separate the egg, with yoke splitting, yellow mixing with white, and flecks of shell falling.

Grace Percival, M.A. / Grace is a licensed pediatric psychologist, formerly on staff with the Des Moines Pastoral Counseling Center

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The Center’s COOL practice (Children Overcoming the Obstacles of Life) is an experiential approach to counseling that integrates art, play and physical movement to help young people communicate their inner life.

Resources

  • Holt, John (1995, revised ed). How Children Learn. NY: Perseus Publishing.
  • Karen, Robert (1994). Becoming Attached: First Relationships and How They Shape Our Capacity to Love. NY: Oxford University Press.
  • Standing, E.M. (1998, New Ed). Maria Montessori: Her Life and Work. NY: Plume Publishing.