Rumination: Why Do We Get Stuck?

We’ve all experienced it. An embarrassing social interaction. A stinging critique from your boss. A Freudian slip during an all staff presentation. A brief moment, no big deal. Until your mind starts replaying it over and over and over and over and over and over and…

This delightful habit is rumination. Most of us can think of a time or two that we’ve been stuck in a negative thought cycle. But if you engage in ruminating or repetitive thoughts on a regular basis, it will have negative effects on your mental health and well being.

It may take a long time to recognize rumination as a problematic behavior because, at it’s core, it is an attempt to problem solve. Problem solving is good! However, it slips out of the realm of healthy problem solving and into rumination if any of the following are true:

• You are thinking about it repeatedly for a long period of time that seems disproportionate to the problem

• You aren’t identifying solutions, just continuing to replay the problem

• It is a situation that doesn’t actually have a solution (i.e. an awkward social exchange - you can’t change the past!)

• It is negatively impacting your ability to participate in and enjoy daily life

Research on rumination shows that this behavior increases the likelihood of experiencing depression and anxiety. But research aside, think about this way. You have a problem, with all the emotion that is tied to that problem. Then the problem ends. But you continue to think about it, and feel about it, over and over again.

Rumination extends the emotional lifespan of temporary problems for however long you allow it to.

The good news: this is a learned and therefore able-to-be-unlearned behavior! Just like most things I write about here, with some practice, and some mindfulness, you can train your brain to decrease rumination. If you’re a ruminator, here’s a quick list of strategies to try:

• Distract yourself. This must be with an activity that you enjoy, so that your mind is actively engaged with the activity and therefore less likely to wander back to the problem.

• Talk with friends or loved ones – about anything but the problem.

• Use humor! Sometimes the ability to laugh at ourselves can be exactly what we need to break a negative cycle. Ever notice how many funny memes there are about social awkwardness and mental health? Because it’s hilarious - and we all experience it.

• Schedule time for ruminating. This might seem counter intuitive, but for many people, it is helpful to say to yourself, “I am allowed to think about this for 30 minutes at 3:00”. Think of it like compartmentalizing. If your mind knows it will get its chance to ruminate, it will be less likely to wander over to those thoughts while you’re taking care of business the rest of the day.

• Meditate. Meditate. Meditate. The practice of meditation is a natural solution to overthinking. Bring mindful awareness to your physical self and to your thoughts, allowing them to pass by, rather than to linger.

If you’re someone who ruminates, rehashes, or overthinks, and want some support in learning how to change that behavior, consider seeing a therapist for help with making that change!

Kathleen is a mental health professional in St. Louis, MO.  She specializes in the treatment of depression and anxiety in adults, college students, and high school students.  You can contact her office by phone: 314-499-2994, or email: kathleen@newleafstl.com.

The trouble with "Good Vibes Only"

Every day I see this on IG and on notebooks and t shirts that my students wear around the high school: “Good Vibes Only.” It’s an upbeat, passing thought, and I’m sure I’ve posted things similar, if not this exact phrase.

The sentiment here is innocent and cheerful with a hint of power (i.e. the implication that you have the power to control every vibe that comes your way - which *spoiler alert* nobody does).

But lately when I see it I can’t help but think: would I ever say this - With sincerity - to a distressed client or friend? What about those days when we just don’t feel good or positive? 

At best, this is a simple mantra and in the right setting could give someone a mental boost. But at worst – on those not-so-good days - it’s potentially isolating and invalidating to those who just aren’t feeling all light and positive right now.

Think about this in action. If your best friend loses a loved one, and comes to you distraught, lost, tearful, seeking connection and solace – would you say to them “ooooh, sorry, but good vibes only,” and shut down that interaction? My guess is no! Because what comfort does it bring to someone who is experiencing emotional pain to say only the fluffy, positive stuff is allowed?

And that’s why this phrase doesn’t work for me. The absoluteness of ONLY. The human experience isn’t ONLY anything. It’s not good vibes only, or bad vibes only. It’s both of these, as well as the whole range of emotion in between and around those two. 

Validation of emotions – all of our emotions – is an intensely important ingredient in human connection. Connection to self, and to others. 

Instead of brushing aside the “bad vibes”, try mindfully sitting with them, possibly with the support of a therapist or trusted person. Feel the heat of anger in your belly. Marvel at the vast depths that sadness can reach. Note the physical responses in your body to frustration or anxiety or embarrassment. Even right now, you might notice your shoulders raised to your ears, or your jaw clenched. Observe how grief and loss can roll over you like waves, sometimes crashing frequently, other times calm and receding. And note that all of these can occur simultaneously with other emotions - including the "good" ones.

And as you do this remember:

Your. Emotions. Are. valid.

In all their complexity and intensity, they are valid, and they are yours. And it’s OK to experience them - ALL of them. 

So … good vibes? Definitely!

But not good vibes only.

Kathleen is a mental health professional in St. Louis, MO.  She specializes in the treatment of depression and anxiety in adults, college students, and high school students.  You can contact her office by phone: 314-499-2994, or email: kathleen@newleafstl.com.

What to say to an anxious friend

Providing support for someone with anxiety is not always intuitive. You might find yourself tongue-tied trying to find just the right thing to say to your anxious friend, or stumble onto phrases that inadvertently make them feel even more anxious or isolated. 

Things that might feel like a pep talk for you, could actually have the reverse effect. “Come on, it’s not that bad!” or “It will be over in just a few minutes” or my personal least favorite…”JUST RELAX/CALM DOWN” appeal to the idea that their heightened emotional state is not a rational response to the stimulus. And that’s the thing…

Most of us anxious folks are fully…sometimes hyper-aware that what we are feeling is irrational. That knowledge does not change our experience.

So if you have a loved one dealing with anxiety, and you want to be a supportive person, what can you say?

Well before you say anything at all, remember to approach them with compassion, patience, and nonjudgment. Then evaluate how they're doing. 

If your friend is feeling anxious, but is calm enough to have a conversation, (or maybe after a panic attack has subsided) you could ask:

• Is there anything specific I can do for you right now? (This may be getting them a glass of water, or just listening, or nothing at all)
• Do you want to tell me more about that experience?

The key here is to show you are curious and caring, rather than judgmental, about their experience. Validating them can help create a safe and supportive environment.

If they don’t want to chat, you can simply express empathy through phrases like:

• This must be so hard for you.
• I am so sorry you are dealing with that.

Always be authentic. If these phrases don't work for you, find the words that do. There's no one-size response, as long as you approach with compassion!

If your friend is fully panicking, first remember not to contribute to their heightened state by also panicking. Instead, calmly try the following:

• I am here for you. You are safe.
• Can I walk with you to a different space (if the space they are in is triggering or vulnerable)?
• Depending on your comfort level and familiarity with their coping skills, offer to do a breathing exercise with them or offer them a glass of ice water (actually dunking your face in cold water helps too, but leave that up to them!)

Remind yourself that while a panic attack can be frightening – it will pass. And sometimes you can be supportive by just being present, possibly in silence, while they ride it out.

If you are struggling with anxiety, or want to learn how to support a loved one who is struggling with anxiety, booking an appointment with a therapist is a great place to start.

Kathleen is a mental health professional in St. Louis, MO.  She specializes in the treatment of depression and anxiety in adults, college students, and high school students.  You can contact her office by phone: 314-499-2994, or email: kathleen@newleafstl.com.

What you say to yourself matters (2 of 2)

Now that you’ve spent some time identifying your negative thoughts from that nagging inner-critic, what are you gonna do about it? 

When we feel unhappy, overwhelmed, depressed, or anxious, the feeling is a product of the thoughts we have about our situation, not the situation itself.

And this is good news! Because while you can’t always control your environment, you can exercise some control over these thoughts.  Small shifts in perception and mindset can help to turn things around.  Here are some strategies to try the next time your inner critic is on a rampage.

Observe them

If you read last week’s post, you’ve already done this! Simply identify your thoughts that are negative, and give them the space to exist without judgment. Just observe them. 

You might also try sitting with the thoughts and observing the feelings that arise - emotionally and physically. A brief body scan pairs well with this observant activity.

Challenge them

This is less passive then the first strategy.  Look at the content of the thought and ask, is this really true? Could I be overthinking/assuming/exaggerating? 

And also is it permanent? Will I feel differently about this in one hour? One week? One year?

Spin them

Try to shift perspectives and see, is there any other way to look at this situation that would be less upsetting? Is there anything positive here?

Box them up

If you find you can’t spin the thought, feel free to box it up for later in order to get on with your day.

You could do this by thought-stopping (actively telling your inner-critic “stop!”) or for some, it helps to actually visualize placing the issue in a box and putting it away for later. Just remember to come back and unbox it when you are feeling up to the challenge.

Crowd them out

There's a reason the phrase “Go to your happy place” is a cliche in mental health care. It might elicit an eye roll, but shifting your mental focus away from the negative thoughts does help.

You can internally crowd out the thoughts by thinking of happy memories, or just lighter, even humorous topics. Externally, you distract yourself by engaging in an activity that releases your feel-good chemicals, whether that's having a cup of tea, going for a run, meeting up with a friend, etc. 

As always – treat yourself with kindness.

When you catch that inner-critic harassing you, counteract that with compassion and care. If you're having a hard time telling yourself kind things, try a self-love meditation like this one.

Remind yourself that you are enough, that you are trying, that you are human and you are worthy of love and kindness. 

Do you feel like your negative thoughts are preventing you from living your best life? Do you find yourself in thought spirals of self-criticism? Working with a therapist is a great way to start taming that inner-critic in a safe, judgement free space. 

Kathleen is a mental health professional in St. Louis, MO.  She specializes in the treatment of depression and anxiety in adults, college students, and high school students.  You can contact her office by phone: 314-499-2994, or email: kathleen@newleafstl.com.

Say 'yes' to YOU (3 of 3)

"When you say 'yes' to others, make sure you are not saying 'no' to yourself." - Paulo Coelho

Now that you’re a pro at gracefully declining at work, let’s talk about the tricky topic of saying no to friends and family. I say tricky because while clear boundaries are an expectation of professionalism, personal relationships are much more nuanced.

The task of developing this skill in our personal life doubles as a reflection on the health of our relationships. Sometimes, we avoid looking at this, because it could lead to tough decisions about who we are spending our time with.

I’ll put a pin in the larger topic for another day, but keep in mind that as you begin prioritizing yourself, and truly putting your needs first, some of your relationships will inevitably change.

Take a moment. Think through various personal relationships. Identify a person or people who you have a hard time saying no to, even when it’s bad for you to say yes. Ask yourself what makes it difficult to say no to this person.  Is it a fear of letting them down?  Are you afraid that if you say “no,” they will like you less?  Do you worry they won’t invite you the next time?  Is it something else entirely?

Always saying yes for these reasons is damaging in at least two ways:

• When you say yes because of fear or anxiety about losing the friendship, you are compromising yourself. The more damage we do to our sense of self, the more likely we are to continue in cycles of unhealthy friendship based on a false sense of obligation.
• When you say yes indiscriminately because of FOMO, you will overextend, and end up regularly bailing. This hurts friendships across the board. You become that unreliable friend who’s “Yes” is actually “Maybe.”

I’m guessing that you don’t want either of those outcomes for yourself.  And even if you already recognize those things in your life, it’s never too late to strengthen your sense of self, and to become a reliable friend with healthy boundaries. 

When you are struggling to say no, remind yourself of the following:

• Your time is yours and no one else’s.  
• You have personal goals and priorities, and if what is being asked of you does not align, you get to say no.
• "Maybe’s" are wishy-washy – people would rather know up front than be left in limbo.
• If you’re unsure, you can delay a response, but only temporarily.  Always give a firm yes or no.
• You can explain why you are declining, but you are not obligated to do so.
• If a friendship can’t survive a declined invitation, it may not have been a healthy friendship.
• When you say “no” to something that doesn’t align with your wants and needs, it frees up time for you to say “yes” to things that enrich your life.
• The more you practice this skill assertively, the easier it gets.  People respect clear boundaries. They are fundamental to healthy relationships.   

Do you have a hard time saying NO to friends and family, even when it's in your own best interest to decline? Meeting with a counselor is a great place to start developing this and other assertive communication skills.

Kathleen is a mental health professional in St. Louis, MO.  She specializes in the treatment of depression and anxiety in adults, college students, and high school students.  You can contact her office by phone: 314-499-2994, or email: kathleen@newleafstl.com.

Saying no like a pro (2 of 3)

Last week we started looking at NO and why it's tough. Saying NO in a professional setting can be particularly delicate. But it is a critical skill. Otherwise, you’ll find yourself with an overloaded plate and stress through the roof.  

Part of the problem is just semantics. When we hear “NO” we connect big meaning to a tiny word. We tie it to rejection, to disinterest, to negativity, to not being competent or able to do the job. And we worry we'll tie ourselves to these things if we dare utter those two letters.

Imagine your boss emails you and asks you to take on a new task. Imagine clicking reply, typing just “No”, then hitting send. What does that communicate? How would you feel sending off that email? How would your boss take it?

Of course you wouldn’t do that, because of things like respect and professionalism. So the skill isn’t just running around saying NO to everything and everyone. The skill is gracefully declining invitations and requests. 

Develop a general script or list of phrases for these types of emails or phone calls, and keep in mind the following:

• Be brief – offer an explanation for declining, but don’t share your whole life story. Your boss doesn't have time for that. 
   
• Be kind – express gratitude for the opportunity, and remember this isn’t the forum to gripe about how stressed you already are. (That's what us therapists are here for!)
   
• Be honest – avoid that familiar urge we “yes people” have to make up an excuse.  No one wants to hear your excuse. They just want to know if you’re gonna do this thing or not.

You can further soften the blow of NO by offering alternatives. Just be sure that whatever you offer is something you can follow through on.  For example, “I’m unable to (x,y,z) at this time, but my schedule will open up next month when I finish (x,y,z)” or “I can’t at this time but (name of colleague) expressed interest in this. If you’d like, I can connect you.” And then, ya know...follow through. 

Like any skill, this gets easier with practice, and can contribute to a healthier, more balanced professional life. Next week we'll talk about saying no to friends and family...a whole different story, but equally important.  

Do you have a hard time saying NO even when you know you're over-extended?  Meeting with a counselor is a great place to start developing this and other assertive communication skills!

Kathleen is a mental health professional in St. Louis, MO.  She specializes in the treatment of depression and anxiety in adults, college students, and high school students.  You can contact her office by phone: 314-499-2994, or email: kathleen@newleafstl.com.

"No is a complete sentence." (1 of 3)

If you’re like me, saying “no” is a skill not easily acquired. You also know that jaw clenching anxiety that creeps in when someone asks for something that you can’t or just don’t want to do.

If you know what I'm talking about, you might be a people pleaser, and your knee-jerk reaction to any request or invitation is “yes!” But indiscriminately responding with the positive ultimately leads to lots of unintended negatives.  Practicing the skill of “no” can be one of the best things you do for your own mental health, and the health of your relationships. 

When you say yes to every task run by you at work, even when your plate is full, you risk the integrity of your work, and your work-life balance. When you say yes to every social or family invitation, you risk double-booking, de-prioritizing time for yourself, and becoming that friend that consistently bails because she’s over-extended. 

We don’t want to be that person who half-asses her work and flakes on friends and family. So why is it so hard to say no? 

I’ve talked about this in previous posts, and I’ll go ahead and drop it in here too: FOMO.  The fear that any time we say no, we’re missing out on something. The desire to be included and part of the group is real, and it’s not always in our best interest.

Sometimes it’s hard because of who we’re saying no to. Think about it.  Who’s that one person that gets it, and you can say no without having to explain yourself? And who’s that person whose invitations are more like obligations? Learning to say no is part of boundary setting, and with practice, you can get good at it no matter who is on the receiving end. 

And sometimes, we don’t say no because we think saying yes will make us more agreeable, and therefore more lovable. And who doesn’t want to be loved?

All that being said, you probably shouldn't just start saying no no no to every single thing.  There are some intentional and thoughtful ways to do it. If you've been a yes person for a long time, it might take some time for you and your people to get used to your new skill. And that's ok!  In next week's post, I'll get into the art of saying no, and how to do it without damaging relationships.  

Do you have a hard time saying NO even when you know you're over-extended?  Meeting with a counselor is a great place to start practicing this skill, and other assertive communication skills!

Kathleen is a mental health professional in St. Louis, MO.  She specializes in the treatment of depression and anxiety in adults, college students, and high school students.  You can contact her office by phone: 314-499-2994, or email: kathleen@newleafstl.com.

Is mindfulness just a buzzword? (1 of 2)

Well…yeah. It’s a word. And there’s buzz about it. You see it on magazine covers, talking about the mindfulness revolution, mindfulness in the workplace, mindfulness in school. There are books ranging from using mindfulness to deal with depression and anxiety, to being mindful while eating.  It seems like anything can be done mindfully. But does this mean the practice is something to be brushed off as “just another buzzword?” I don’t think so. 

The practice of mindfulness has been around for centuries and is rooted in Buddhist tradition, though the word itself is newer. There are countless definitions for what it is, with common themes of awareness and attention to the present moment, observation of our physical, mental and emotional experiences in our environment, and compassion or nonjudgment of these observations.  Simple!  But maybe not easy. 

The rise of mindfulness in the mainstream seems to coincide with a world that is increasingly distracting and inattentive.

With our smartphones and social media, our world is quick, connected, and largely concerned with social capital and public perception.  Slowing down and disconnecting, even for a short period, seems impossible to so many people.  We even have a word for it now – FOMO anyone!? And this is exactly why we can't brush it off.  We need it. 

Mindfulness is the human response to a loss of attentiveness and care for ourselves that we’ve been experiencing for years.

Its popularity says to me that there is a desire to bring balance and wellness back into our lives.  It’s helping us realize that it’s OK to unplug for a minute, to stop focusing outward, and to turn that attention and compassion inward. It wants us to come back to ourselves, in this very moment. To recenter, refocus, relax.  

All of this is why it's not always easy.  It is a practice, that we can get better at.  In part two of this topic, I’ll get into some of the ways mindfulness benefits us, and some tips on how  you can start practicing mindfulness as part of your daily life.

Do you have a hard time hitting pause and want some guidance on developing your mindfulness skills? Your counselor's office is a great place to unplug and focus inward.  

Kathleen is a mental health professional in St. Louis, MO.  She specializes in the treatment of depression and anxiety in adults, college students, and high school students.  You can contact her office by phone: 314-499-2994, or email: kathleen@newleafstl.com.

#selfcare

It's trending...and why wouldn't it be? Spending time outdoors, eating food (sometimes healthy, sometimes pizza), drinking wine, yoga, meditation, spa days, time with loved ones, time with pets, time alone. Sounds perfect! But this isn’t all there is to caring for yourself. 

This is #selfcare. We see it all over our Instagram feeds. It sometimes seems indulgent; it emphasizes slowing down and enjoying ourselves. It is setting aside time for specific, self-motivated activities that recharge us. And it IS beneficial. Taking a yoga class, downloading a meditation app (and actually using it), getting outside to soak up some sun, enjoying time with a friend, being present in an activity you love like painting or reading. All these things can help decrease stress levels and recharge us emotionally.

Why, then, do we so often feel stress roll right back in as soon as we leave the yoga studio? If this feels familiar, it could be because you are using #selfcare as an escape from a stress-filled life, rather than as a counterpart to true Self-care in a balanced life.

Self-care includes the less Instagram-worthy activities that contribute to our long-term wellness. Things like evaluating personal relationships, nurturing positive ties and cutting unhealthy ones; self-advocating in the workplace when you deserve a raise or are unhappy with a policy; sitting down with your finances and creating a budget; keeping up with things like homework, laundry, oil-changes, doctor’s appointments; engaging in physical exercise and healthy eating depending on individual ability and needs; keeping your environment clean so that you can relax at home. While these things aren't as glamorous or fun, staying on top of activities like these creates a foundation for long-term wellness and balance. When you put them off, they grow larger, and more daunting. But when they are attended to, it allows #selfcare to become part of the wellness picture, rather than an indulgence or escape plan. 

So how do you start truly caring for yourself? 

Start by sitting down and writing out the things in your life that need some attention – maybe things you’ve been avoiding – and ask yourself: 

What items on my list would take just a couple of minutes to complete? 

What items need more in-depth attention? 

What items might I need help with? 

See it on paper. Break it down into manageable tasks. Start checking these off, one task or sub-task at a time. Ask for support. Incorporate your favorite #selfcare activities to stay energized as you start to manage your list. And of course, be compassionate and patient with yourself. Care about yourself enough to get it done, because you know it will benefit you. And enjoy a balanced life where a good book and a glass of wine is an enhancement, not an escape.

Do you feel like you can’t get ahead of life’s to-do list?  Do you engage in #selfcare to avoid or escape?  If you feel you can’t even begin making this list, meeting with a counselor is a good place to start.  You don’t have to do it alone!

Kathleen is a mental health professional in St. Louis, MO.  She specializes in the treatment of depression and anxiety in adults, college students, and high school students.  You can contact her office by phone: 314-499-2994, or email: kathleen@newleafstl.com.