Blog

By: Eric Kruse

What is impulsiveness?
Impulsiveness is when you do something without any forethought, reflection, or consideration of the consequences. It can be unnecessarily risky and associated with undesirable, rather than desirable, outcomes. Examples of impulsive behavior are excessive spending, substance use, sex, fighting with others, and self-harm.

Emotional states are often the catalyst for impulsive behavior. For example, have you ever said something to someone that you regretted because you were in a bad mood? In that moment you were probably not considering how what you said may impact the other person or how it would impact you once you realized how it impacted the other person. If this is something you struggle with, the following are some steps you can learn to get your impulses under control.

Step 1: Understand how your impulsiveness functions
Everyone’s impulsive behavior is different, which is why it is important for you to understand how your impulsive behavior manifests. You need to uncover the early warning signs, identify the emotions that trigger your impulsive urges, and learn to identify the thoughts and feelings as they are happening in the moment. 

Focus on the thoughts, emotions, urges, and physiological sensations you are experiencing in your body and explore that. Name it in your mind. For instance, “I am noticing a hot sensation across my body, here is the anger that makes me want to criticize my partner” or “I am noticing my heart racing, here is the anxiety that makes me want to drink alcohol.” Writing in a journal and talking it through with a therapist is a great way to gain awareness into this process. Its not easy at first and you may not notice your impulsiveness until after you are impulsive. It’s an ongoing practice.

Step 2: Interrupt the Impulse
Sometimes you can setup conditions that make acting on the impulse harder or you can condition yourself to follow certain steps before you allow your self to act. The following are some examples of impulse interruption:

• If you notice your body is getting hot and that you are feeling angry, you can step away from the situation and write down your thoughts and feelings before you choose to return to the situation and respond.
• If you struggle with alcohol abuse, you can get rid of all the alcohol in your place of residence so that it is not readily available.
• If you struggle with spending impulsively, you can force yourself to wait 48 hours before you make any purchases and run your thoughts about the purchase by a loved one who has better spending habits than you.

Step 3: Challenge Negative thoughts and Take Action
Once you understand how your impulsiveness functions and you implement your impulse interrupters, its time to challenge your negative thoughts and take action. For example, let’s say you notice you are feeling anxious and have you the urge to drink alcohol to self-medicate your anxiety. You labeled the thoughts in your mind by saying, “I am noticing my heart racing, here is the anxiety that makes me want to drink alcohol.” You removed the alcohol from your place of residence, but now you are noticing that you are motivated to go out and buy more. You notice a negative inner dialogue about being a failure and how nothing matters so you should just drink.

It’s time to challenge those negative thoughts by saying, “I am not a failure. Things matter. This anxiety will pass. I am going to tolerate this feeling until it passes. Alcohol will make things worse in the long run, remember the negative consequences it has caused in the past. Temporary relief will be followed by an increase in future suffering.” After you challenge your negative thoughts, its time to take action. Go to an Alcoholics Anonymous meeting. Call a friend. Engage in physical exercise. Eat something healthy. Drink a relaxing tea. Take a hot shower or bath. Get creative. 

By: Ranjita Rao

I hear so many people tell me about their lack of quality sleep nowadays. Whether it be stress, anxiety, or too much time sitting in front of a computer screen, there are many different factors that contribute not only to your ability to fall asleep, but also to the quality of sleep that you actually get. Lack of sleep can increase your risk of obesity by 15%, your risk of cardiovascular disease, and your risk of mental health disorders such as anxiety and depression. Being awake for twenty hours or more has a comparable effect on your brain as being intoxicated. Here are some easy things you can start doing to not only get yourself to sleep, but also to improve the quality of sleep you’re getting!
 
Exercise. Getting exercise is one of the best ways to promote continuous sleep. If you find that getting to sleep is harder when you exercise later in the day, make sure you exercise before 3pm.
 
Avoid screen time. Make it a rule to avoid any screen time at least an hour before bedtime. Research shows that the blue light from phones, computers, and even TVs interferes with falling asleep and makes it harder to get into quality REM sleep.
 
Separate work and sleep areas. Avoid doing any work in bed. This even includes checking emails or making phone calls. Our brain makes associations between doing work and our environment, so reserve your bed for sleeping and relaxing.
 
Journal/Meditate. Journaling and meditating are great ways to unwind from your day and bring yourself into the “here and now”. While trying to fall asleep, your mind can be plagued with incessant thoughts. Getting these thoughts out of your mind through journaling, and following this up with some quiet reflection or meditation, is a great way to slow yourself down and help ease yourself into a restful night.

By: Eric Kruse

Legalization
Right now, 33 states have legalized medical marijuana, while 10 have legalized recreational marijuana. Advocates for legalization believe that legalizing the drug may reduce use and make its use safer. Critics argue that legalization will make marijuana more easily accessible, which will result in increased use, misuse, and abuse.

It’s too early to say whether legalization has resulted in increased marijuana use and research on the topic is inconsistent. The RAND corporation found a correlation between legalization, increased marijuana use, and increased dependence. However, Columbia University’s Mailman School of Public Health found increased use of marijuana, but lower rates of marijuana dependence.

Marijuana vs Alcohol
              Alcohol has been legal in all 50 states since the end of prohibition in 1933. Effects of alcohol on public health and safety are arguably more dangerous than marijuana. For example, liver damage, fatal care crashes, and anger outbursts that could lead to violent behaviors. Marijuana use is not harmless though. Daily marijuana abuse can increase depression and anxiety.

Marijuana and Depression
              Although marijuana is legal for medicinal purposes in 33 states, this system tends to get abused. Patients are prescribed marijuana for medical conditions that marijuana is not meant to treat, such as depression. Many patients claim that medical marijuana alleviates their depression and those who use it recreationally often use it for mood enhancement.

However, daily abuse of marijuana over time can increase depression. This is because your body builds a tolerance to any substance that you use daily. The stronger your tolerance gets, the less mood enhancement effect you will receive from the drug.

Furthermore, marijuana affects the processing of emotions. Researchers at Colorado State University conducted a 2-year study and found that marijuana users may have a reduced ability to implicitly identify emotions and to empathize on a deeper emotional level. Emotional connection and empathy play a vital role in cultivating meaningful relationships. Marijuana can impair these processes, which could result in increased social isolation. Furthermore, social isolation maintains depression and is a catalyst to increased depression.

Marijuana is a “Manageable” Addiction
              From a harm reduction standpoint, Marijuana is one of, if not the least harmful mind-altering substance one can be addicted to. Due to its less overtly harmful nature, it tends to be more “manageable” when compared to other addictions. For example, alcohol abusers will “blackout” and hurt themselves or others. Marijuana users eat too much food and go to bed. Unfortunately, it is still harmful in its own way. It distorts how we view ourselves, others, and the world around us. It can make us withdraw socially. It can make us feel apathetic, unmotivated, and depressed. Days turn into months, months turn into years, and we end up watching our life pass us by as we sit in a cloud of smoke.

Getting Help
              Marijuana addiction can be different to other substance addictions since it is lower on the totem pole for risky behaviors. Finding a recovery meeting tailored specifically to marijuana, such as Marijuana Anonymous can be beneficial for those who struggle with relating to harder drug addictions (meeting directory: https://www.marijuana-anonymous.org/find-a-meeting/).

             If one-to-one support is your method of preference, counseling is a good approach. A therapist can help guide you through the early stages of sobriety.  

By: Katrin Steinert

We have all said things to loved ones that have caused pain and suffering. It may even have blown up a relationship in a way that was not expected. To be in any active relationship, whether it is romantic or friendly requires constant nurturing and communication. What happens when a relationship becomes heated and a rupture occurs? How do all involved actively repair a damaged relationship? Here are 5 tools that can help on the journey of healing:

1. Self-soothe - Before engaging in a conversation, process what feelings are coming up and calm down any jittery, angry or anxious thoughts that may pop up.
   
2. Active listening - To engage in active listening one must be able to process what is being said without willfully wanting to get their agenda heard.
   
3. Clarify - Ask questions and be curious about the other persons experience and perspective. Starting conversations with “I wonder if you felt…” can be helpful to make the other person feel understood.
   
4. Validate - Validate the others persons experience and let go of who is right or wrong. To validate does not mean to agree with but rather make the other person feel as though you understand their perspective.
   
5. Compromise - Find the middle path. Figure out what each person’s priorities are in the argument and see if there is a way to find meaning in the middle.
   

By: Ranjita Rao

While stress can be a normal part of life, too much of it can be unhealthy and take a toll on your body. Getting sick often, or feeling sluggish, overwhelmed, dysregulated, can all be signs that you might be stressed out. Start using these easy techniques in your daily routine to stay ahead of your stress!
 
Be present. Check in with yourself and your body. It’s not uncommon to be running on autopilot. Close your eyes a focus on what your body needs. Being mindful can help slow you down and help focus on the ‘here and now’.  
 
Make time for yourself. The days where you think you have no time for yourself are the days you need it the most. Whether it be ten minutes or an hour, make time to do something for yourself every day.
 
Get moving. Physical exercise can be one of the best ways to relieve stress. Figure out what you like to do, whether that be to run, hike, dance, or swim, and get out there and do it. If you can get outdoors—especially in nature, even better!
 
Meditate. Take some time every day to meditate. There are many different apps (Headspace, Calm.com) that can provide different genres of meditations. You do not need to spend an entire half hour meditating—it can actually even be done just a few minutes every day!
 
Remember, even a few minutes of any of these activities can work wonders on your stress level, and the way that you feel.  Take a minute to close your eyes and listen to your favorite song, step out of the office and take a brisk walk outside, do a 5- minute meditation.  When it comes to self-care, any amount is better than none.  Your body and mind will thank you!

By: Eric Kruse

“We are addicted to our thoughts. We cannot change anything if we cannot change our thinking” – Santosh Kalwar

What is a Cross Addiction

        Cross addiction is when an individual replaces one addiction with another. This is typical occurrence in drug and alcohol treatment. When an addict first gets sober, they need to find new ways to pass time. The goal is to accrue more time sober to restore one’s physical and mental health. The best way to amass sober time is to stimulate oneself without the use of drugs and alcohol. This can be through exercise, eating, social interaction, reading, watching movies, playing games, etc. Although the substance can be removed, the individuals addicted thinking pattern remains intact. Addicts tend to feel empty inside, like something is missing in their life. They chase anything to fill the empty void. Drugs used to fill the void, but now that one has made the choice to get sober, there is a high probability that they will find a new obsession to fill the void. That is the cross addiction. From a harm reduction standpoint, it is still an improvement, especially in the early stages of recovery, but balance is the long-term goal.

How to prevent cross addictions?

• Find multiple activities that stimulate you, not just one. You are less likely to overdo a single activity if you have multiple ways to keep yourself occupied. Anything in excess can be harmful, even exercise. Overexercise can lead to injury, fatigue, mood swings, and depression. If you are the type of person who hates working out, don’t worry, you are probably not overexercising.
• Make a schedule with different activities throughout your day and follow the schedule. If you scheduled 3 hours to watch Netflix at night, don’t binge watch for 8 hours, sleep in, cancel going to the gym in the morning, and then start binge watching more Netflix. This goes for work too. If you are employed and you find that you are overworking, set a cut off time in your day when you stop working and engage in a different activity. Yes, you can get addicted to your job. Once again, better to be addicted to your job than to drugs and alcohol, but that can take its toll over time as well.
• Avoid as many harmful cross addictions as possible. Examples include overeating, sex, and gambling. These cross additions are harmful to your recovery. Many individuals will binge on sugar during the early stages of their recovery. Although not terrible in the 1st 30 days of sobriety, it will catch up with you quickly.
• Force yourself to try new things, especially if you notice resistance. Remember, part of addicted thinking is its influence in poor decision making. It tells us that we want things that are bad for us. Sometimes we must push ourselves to try healthy activities that we don’t want to do. You may be surprised to learn that you enjoy it.

By: Katrin Steinert

Dialectical Behavior Therapy or DBT is an evidence-based treatment that was created by Marsha Linehan in the 1980s. DBT was originally created to treat highly acute borderline personality disorder. Linehan based DBT after having worked as a CBT therapist but realized that CBT was missing one key component; acceptance.

Dialect
The D in DBT stands for dialectical. The definition of a dialect is two seemingly opposite truths that exist at the same time. A good example of a dialect is I love you and I hate you. The world is full of dialects and DBT encourages the acceptance of living in the dialectic. 

Mindfulness
The cornerstone of DBT is mindfulness. According to Linehan, without the practice of mindfulness it would be nearly impossible to recognize and describe emotions that are coming up when high stress situations occur. Being mindful can be done in many ways including mindful walking, mindful driving or mindful eating. These are daily activities that most people engage in and by practicing them mindfully will create more insight into feelings and experiences that are coming up in the body.

By: Eric Kruse

If your family dinners are anything like mine, then you are probably used to individuals speaking over one another. You must fight to have your voice heard and there is no space to reflect before responding or else your voice will be lost. The result is that conversation is watered down and less meaningful than it could be if people slowed down, reflected, and took time to process how to respond. The following are different approaches you can use to respond in your next conversation. Make it meaningful, there is nothing wrong with a long pause as you process how to respond. As Buddha said, “If you propose to speak always ask yourself, is it true, is it necessary, is it kind.”  

Ways to Respond in Conversation
Advice (fix it)
Advice is when you give guidance on how someone should proceed in a situation or how you may proceed if you were in the same situation. You offer solutions to a problem by going into fix it mode. This is the probably the most common type of response that individuals offer in Western society. There is a time and place for advice, but often it is not the best way to build connection. There are more effective ways to show someone that you care about what they are saying.

Challenge (new perspective) –
When we listen to others speak, we often consider different perspectives that the speaker has not considered. This is when we challenge them to consider an alternative view. Challenging someone or being challenged by someone is how we grow and change. However, it is also not the most effective tool to build connection. Sometimes people want to be listened to and heard, and not challenged.  

Validate
Validation is when you demonstrate support for someone’s view or feeling. You say, “I understand what you are saying” or “It’s understandable that you feel that way.” It normalizes their experience and demonstrates that you are listening.

Empathize
Empathy is the strongest tool for emotional connection. Empathy is about putting yourself into someone else’s shoes and feeling the emotions they are feeling in that moment. Examples of empathic statements are “that sounds like it must have been very difficult for you” or “I don’t know what to say right now, but I am glad that you told me, and I am glad that we are talking about it.” Empathy is an advanced form of emotional connection and if you are not accustomed to using it, it will take some practice. A great prompt for empathizing is: “The part of your story that felt like it was happening to me was [Fill in a part of their story that was impactful to you, using their words, don’t talk about yourself].”

Ask the Speaker what they Need
Next time you have a conversation with someone, I encourage you to take a moment to slow down. Ask the speaker what type of response they need from you. Ask them if they are looking for advice, validation, empathy, or if they are looking for a new perspective (challenge). Many misunderstandings stem from the listener responding in way that the speaker was not looking for when they decided to share part of themselves with you. Ask them what they need and take a moment to reflect before you respond.   

By: Ranjita Rao

It is so easy to look back at the end of a day and be critical over the way you looked, the things you didn’t get accomplished, and things you wish you had done better. But how often do you look back and think about all the positive things, or give yourself a little pat on the back? My guess is not nearly as often. What if I told you that making some small changes every day could have a profound effect on not only your mental health, but your physical health as well?
 
Practicing self- gratitude can not only boost self-esteem and confidence levels, but can also improve symptoms of anxiety and depression, your relationships, and even your immune system. Let’s take a look at some easy changes to start implementing today so that you can start practicing self- gratitude and take advantage of these benefits!
 
Compliment yourself. Find a couple times a day where you can give yourself a compliment. If you’re in front of a mirror, tell yourself something that you like about your appearance. If you’ve just gotten out of a meeting, take a minute to recognize something you’ve done.
 
Practice self-care. It may be challenging to find the energy to compliment yourself when you don’t allow yourself the time to do what you love. Find time every day (even if it’s only twenty minutes) to do something for yourself!
 
Learn to take compliments. Ever felt uncomfortable when someone gives you a compliment? Accepting a compliment can be challenging in the beginning, but practice saying “thank you” and sitting with that compliment, and acknowledging the feeling that it brings – you may soon realize that you enjoy it!
 
Keep a Gratitude Journal/ Gratitude Jar. Take time every day, maybe at night before going to sleep, to write down some positive affirmations about yourself either in a journal or on some piece of paper that you can save and look at.  Linking behavior change to something tangible is the best way to hold yourself accountable and make it stick.  Lasting change will happen before you know it as you begin to experience the benefits of self-gratitude.

By: Eric Kruse

“Deciding whether or not to trust a person is like deciding whether or not to climb a tree, because you might get a wonderful view from the highest branch, or you might simply get covered in sap, and for this reason many people choose to spend their time alone and indoors, where it is harder to get a splinter.”        
Lemony Snicket

Lately I have heard many people talk about betrayal and how they are making the choice to never trust again. I understand where they are coming from. They have been hurt in the past and they are choosing self-preservation at the cost of cultivating deeper relationships. As the age old saying goes, fool me once… However, this is sad to me because I believe that those who choose not to trust are missing out on the opportunity to have something beautiful in their lives. The following are my thoughts about how to build trust.

Trust People to be Themselves
If you have been hurt in a relationship before, you probably are wary about opening yourself up again. You may be one of those individuals who says, “I tired building trust with others and then I got cheated on so…” or “trust isn’t worth giving to anyone honestly.” I would challenge these people to consider the ways they trust others in small ways in their life every day. For example, you trust your doctor/hair stylist/dentist/ will be in when you show up for your appointment. You trust that your parents will be annoying at thanksgiving. You trust that your teacher will administer an exam when its scheduled. You trust that your friend who forgets to shower may smell when you hang out. If you are starting to see a theme in the examples here, then you may begin to understand my point. People do as they do. There are patterns in their behavior that are consistent so you place faith in the probability that it will continue (with exceptions of course). Sometimes people try to change bad behaviors and if they fail at it, don’t take it personally. You can trust that quitting bad habits is a hard thing to do and that people falter at it along thee way.  

Surround Yourself with People who have Similar Values
Since people do as they do and you can trust them to do as they do, then pick someone with similar values to your own. For example, if you value honesty, integrity, and monogamy, then find someone who also values it. Talk about your values with this person and see if they also feel strongly about it. You may start to get a sense of whether you can place trust in this individual. If they live by their principals in the same way that you do, then you are less likely to get hurt. Unfortunately, there are deceptive people out there (The Betrayers) who can fool you. If you place your trust in someone and they betray you, then you have been “covered in sap” on your way up the tree in pursuit of the “wonderful view,” but that does not mean you should “spend your time alone and indoors, where it is harder to get a splinter” (see quote at the top). Furthermore, sometimes people who are trust worthy make a terrible mistake and it’s worth trying to rebuild that trust with them. This is where therapy can help.