stress management

What is mindfulness? How do you do it?

What is mindfulness? How do you do it?

What is mindfulness and how do you start practicing? Being aware of the here and now, using all your senses to be present in the moment without judgment. Easy mindfulness exercises to start practicing include noticing everything when you shower or wash dishes, that first drink or bite of food. 

Using the Mnemonic “Three Cs” with Children and Adolescents

Using the Mnemonic “Three Cs” with Children and Adolescents

Managing stress, anxiety and depression starts with managing your thoughts. 

How to Fall Asleep in Under a Minute

4, 7, 8: Can following asleep really be this simple? A few breaths and asleep within minutes? This technique has been used for years and has proven effective for many. Laura Wiley / Bit of News

Here is how you do the exercise:

  1. Place the tip of your tongue against the tissue ridge right above your upper front teeth. Keep it there for the remainder of the exercise.
  2. Exhale completely through your mouth, making a whooshsound as you do so.
  3. Close your mouth and inhale slowly through your nose while mentally counting to four.
  4. Hold your breath for a mental count of seven.
  5. Exhale completely through your mouth for a mental count of eight. Make the same whoosh sound from Step Two.
  6. This concludes the first cycle. Repeat the same process three more times for a total of four renditions.

In a nutshell: breathe in for four, hold for seven, and breathe out for eight. You must inhale through your nose and exhale through your mouth. The four-count inhale allows chronic under-breathers to take in more oxygen. The seven-count hold gives the oxygen more time to thoroughly permeate the bloodstream, and the eight-count exhale slows the heart rate and releases a greater amount of carbon dioxide from the lungs.

Link to full article

38 Health Benefits of Yoga

38 Health Benefits of Yoga

Still wondering if you should try out yoga? How is it really going to help you anyway? This article discussing 38 scientifically proven reasons why you should get up and strike a yoga pose.


If you’re a passionate yoga practitioner, you’ve probably noticed some yoga benefits—maybe you’re sleeping better or getting fewer colds or just feeling more relaxed and at ease. But if you’ve ever tried telling a newbie about the benefits of yoga, you might find that explanations like “It increases the flow of prana” or “It brings energy up your spine” fall on deaf or skeptical ears.

Why Crafting Is Great For Your Brain: A Neuroscientist Explains

What helps reduce your stress? New research is confirming what crafters have always known intuitively, that when they engage in a creative and repetitive act they go into a calming state. As a psychologist, I often recommend knitting, crocheting or other crafts as a stress reliever. This article discusses new research explaining why this is helpful. BY DR. SARAH MCKAY JUNE 24, 2014 4:39 AM EDT

Knit one. Purl one. Knit one. Purl one. Knit one. Purl one. The rhythmic and repetitive nature of knitting is calming, comforting and contemplative. It’s not a stretch for you to imagine knitting as a mindfulness practice, or perhaps a form of meditation.

I’m delighted to report that neuroscience is finally catching up on brain health aspects of the trend some have called "the new yoga."

Research shows that knitting and other forms of textile crafting such as sewing, weaving and crocheting have quite a lot in common with mindfulness and meditation — all are reported to have a positive impact on mind health and well-being.

How chronic stress is harming our DNA

We hear about how bad stress is for our health, but just how bad is it? This article sheds some important light on this issue. It is more important than ever to address your chronic stress through exercise, self care activities, social support and even therapy.

Elissa Epel is studying how personality, stress processes and environment affect our DNA — and how we might lessen damaging effects.

Food-Mood Connection: How You Eat Can Amp Up Or Tamp Down Stress

Food is comfort. It is no surprise that when we are upset we turn to food to soothe ourselves. Turns out that there is growing research supporting the idea that different foods can help you feel less stressed. Read below for more information.

How to make stress your friend-Ted talk

Can how we think about stress make us healthier and stronger? Can seeking social support extend our lifespan despite our stress level?  Watch this insightful Ted talk and find out.

Yoga Helps Ease Stress Related Medical and Psychological Conditions, Study Suggests

Yoga might increase GABA activity, low GABA (neurotransmitter) is linked to anxiety disorders, post-traumatic stress disorder, depression, epilepsy, and chronic pain. So practicing yoga might reduce distress from these disorders. Mar. 6, 2012 — An article by researchers from Boston University School of Medicine (BUSM), New York Medical College (NYMC), and the Columbia College of Physicians and Surgeons (CCPS) reviews evidence that yoga may be effective in treating patients with stress-related psychological and medical conditions such as depression, anxiety, high blood pressure and cardiac disease. Their theory, which currently appears online in Medical Hypotheses, could be used to develop specific mind-body practices for the prevention and treatment of these conditions in conjunction with standard treatments.

It is hypothesized that stress causes an imbalance in the autonomic nervous system (parasympathetic under-activity and sympathetic over-activity) as well as under-activity of the inhibitory neurotransmitter, gamma amino-butyric acid (GABA). Low GABA activity occurs in anxiety disorders, post-traumatic stress disorder, depression, epilepsy, and chronic pain. According to the researchers, the hypothesis advanced in this paper could explain why vagal nerve stimulation (VNS) works to decrease both seizure frequency and the symptoms of depression.

"Western and Eastern medicine complement one another. Yoga is known to improve stress-related nervous system imbalances," said Chris Streeter, MD, associate professor of psychiatry at BUSM and Boston Medical Center, who is the study's lead author. Streeter believes that "This paper provides a theory, based on neurophysiology and neuroanatomy, to understand how yoga helps patients feel better by relieving symptoms in many common disorders."

An earlier study by BUSM researchers comparing a walking group and a yoga group over a 12-week period found no increase in GABA levels in the walking group, whereas the yoga group showed increased GABA levels and decreased anxiety. In another 12-week BUSM study, patients with chronic low back pain responded to a yoga intervention with increased GABA levels and significant reduction in pain compared to a group receiving standard care alone.

In crafting this neurophysiological theory of how yoga affects the nervous system, Streeter collaborated with Patricia Gerbarg, MD, assistant clinical professor of psychiatry at NYMC, Domenic A. Ciraulo, MD, chairman of psychiatry at BUSM, Robert Saper, MD MPH, associate professor of family medicine at BUSM, and Richard P. Brown, MD, associate clinical professor of psychiatry at CCPS. They are beginning test these theories by incorporating mind-body therapies such as yoga in their clinical studies of a wide range of stress-related medical and psychological conditions.

Link to article

New Year, New Tips To Handle Work Stress

By Nerina Garcia-Arcement, Ph.D. Stress is on the rise in the United States. In a recent APA survey, Americans reported a 44% increase in their stress over the past five years. What are people worried about?  Money, relationships, work and the economy are at the top of the list.  Work is a popular concern. Not only are individuals worried about losing their jobs in this down economy but also about increased job responsibilities and difficult interpersonal relationships.  All this worry impacts your sleep, physical and mental health, and productivity. It also erodes your ability to be patient when dealing with others—all things that can make working more difficult and put your job at risk.

If this sounds familiar, you are not alone. The good news is you can change this. There are simple steps you can take that will help you manage your stress and improve your quality of life. Below are proven stress reduction suggestions you can use at work and at home.

While at work build into your day these three tips.

1. Walk away from what is stressing you and take regular breaks. Time-outs are not just for toddlers. They are an effective coping strategy that will allow you to clear your mind and refocus, as well as be more productive and creative.

2. Take deep breaths. Shallow breathing increases anxiety, while deep, slow breathing helps calm your mind and body.

3. Stretch your tense muscles. For example, progressive muscle relaxation sends your brain a message that you are safe and relaxed which helps reduce stress and anxiety.

While at home, try these habits regularly to decrease your stress.

1. Practice yoga. Even a few minutes will help calm your mind and relax your body.

2. Use imagery. Imagine yourself in a safe place, such as the beach or a cabin in the mountains. If imagining a peaceful place is difficult, you can use memories from a favorite vacation spot or familiar personal sanctuary (even if it’s just your favorite bench in Central Park).  Your memories will trigger positive feelings and distract you from your stress at the same time.

3. Speak to a trusted friend or family member. Share what is upsetting you, whether in person or over the phone. Social support is a great stress reducer and mood enhancer.

Preventing stress before you feel it is even better. Follow these suggestions to stop the stress before it hits.

1. Have open communication with your supervisors/bosses about what projects you are working on and their status.

2. Ask for help when you need it. We all require assistance at some point. Don't be afraid to ask for what you need.

3. Create a detailed list of work requirements and deadlines. This way you don't waste mental energy keeping track of what needs to get done and instead focus on how to accomplish those tasks.

If these tips are not enough, consider talking to a mental health provider that specializes in stress management.

Visit for more information about stress.

Mental Illness and Marriage

I was interviewed on how mental illness affects marriage and how to cope. Listen to the podcast.

What kind of impact does mental illness have on a marriage?

In today’s society, it’s becoming more and more common for individuals to be living with some sort of mental health condition or illness like anxiety or depression. And while there are many issues and conditions that present themselves in different, unique ways, oftentimes the effects on a marriage are very similar.

In addition to anxiety and depression, some people suffer from more extreme conditions like post-traumatic stress disorder and substance abuse problems. When these issues creep in without the proper treatment, their impact on a marriage and the individual can be fundamentally problematic. In some situations, the partner without the condition will have to pick up the slack for the other. And in many cases, couples will begin to suffer from tension and exhaustion within their marriage.

Our guest today is Dr. Nerina Garcia, a clinical psychologist with Williamsburg Therapy and Wellness in Brooklyn, NY. Nerina is here to give us some advice about how couples and individuals can learn to cope with mental illnesses within marriages while building a network of support.

To find out more about Nerina and her practice, visit her website or call (917) 816-4449.

Podcast: Play in new window | Download

Link to podcast

Bite, chew, savor

Mindfulness can help reduce anxiety and new research shows it can help with overeating. This article discusses the importance of mindfulness to gaining awareness of our eating habits and the role food plays in our emotions. 

Jean Kristeller reconnects people with their hunger and other inner experiences to curb overeating.

By Amy Novotney

November 2012, Vol 43, No. 10

Print version: page 42

Eat when you're hungry, stop when you're full. It sounds simple, yet for many Americans, it's anything but, says clinical psychologist Jean Kristeller, PhD. Barraged by advertisements for high-fat, high-salt and high-sugar foods, and confronted with restaurant portions fit for two or three people, it's all too easy these days to forget what the experiences of hunger and satiety feel like, she says.

"We eat when it's time to eat, when food is put in front of us or because we need to handle feelings of anger, anxiety, depression or simple boredom," says Kristeller, a psychology professor at Indiana State University and president and co-founder of The Center for Mindful Eating.

Kristeller has developed an intervention called Mindfulness-Based Eating Awareness Training (MB-EAT) that blends "mindful eating" exercises, such as being aware of hunger, chewing food slowly, tuning in to taste and noticing fullness, with mindfulness meditation practice to cultivate more general moment-to-moment awareness of self. Psychologists around the country are using it to help binge and compulsive eaters, diabetics, and people who are mildly and moderately obese to regulate their eating and avoid weight gain.

"Traditional techniques for tackling the obesity epidemic often don't take into account the strong drivers of eating: negative emotions, cravings and impulsivity, particularly in the face of highly palatable food," says University of California, San Francisco, psychology professor Elissa Epel, PhD, who has collaborated with Kristeller on several research studies using MB-EAT. "Mindfulness training gives us more control over these strong drives and makes us more aware of the triggers of overeating that come from outside of us."

Kristeller advocates no particular diet — and no foods are off-limits. She teaches students to savor their food while eating, rather than mindlessly eating while watching television, surfing the Internet or reading the paper.

It's this everyday applicability that makes Kristeller's approach so valuable, says social psychologist Ronna Kabatznick, PhD, a former consultant to Weight Watchers International. "It's one thing to have these strategies in textbooks, but she's embodied them by teaching people very specific skills such as how to enjoy a buffet or restaurant meal," Kabatznick says. "She's simplified mindful eating for everyday living."

Saying goodbye to super-size

Kristeller's MB-EAT 10-week course teaches people that, once they pay attention to their body's signals, brownies and chocolate cake are best experienced and savored in just a few bites.

"Our taste buds are chemical sensors that tire quickly," she says. "The first few bites of a food taste better than the next few bites, and after a large amount, we may have very little taste experience left at all."

Mindfulness-Based Eating Awareness TrainingParticipants in her training programs — those who struggle with food and weight issues and health-care professionals interested in helping them — focus on three mindfulness practices: awareness of hunger and what it feels like in the body, awareness of what it feels like to be full, and the practice of savoring — slowing down to truly taste food and be mindful of the various flavors and sensory experiences associated with each bite. A variety of foods — including chocolate — are used in the program, and Kristeller even assigns participants increasingly challenging homework assignments, such as going to a buffet. She teaches them that by attending to how much they are enjoying the food and recognizing the point at which it stops being as enjoyable, they can eat much smaller amounts, leave food on their plates and return for seconds if they still want more.

"It's about finding satisfaction in quality, not quantity," Kristeller says. She also teaches people not to beat themselves up if they overeat, but to see this as a learning experience.

With funding from the National Center for Complementary and Alternative Medicine at the National Institutes of Health, Kristeller has proven the program's effectiveness. She's completed two studies — one at Indiana State University, another with Ruth Wolever, PhD, at Duke University — with more than 100 binge eaters and obese non-bingers. She's found that binge eaters who take her MB-EAT program reduce their bingeing from four times per week, on average, to about once a week. When they do binge, she says, they report that the binges are much smaller and feel less out of control. Participants also report that their depression decreased (Journal of Health Psychology, 1999Eating Disorders: The Journal of Treatment & Prevention, 2011). Both bingers and non-bingers also improve significantly on other indicators of more balanced eating and emotional regulation. Furthermore, these effects are proportional to the amount of mindfulness meditation practice that is reported.

Other researchers are testing her program as a treatment for obesity. Gayle Timmerman, PhD, RN, at the University of Texas at Austin, has successfully adapted it for use with eating restaurant meals, showing a significant impact on weight and dietary intake. Epel and her associate, Jennifer Daubenmier, PhD, recently paired MB-EAT with stress reduction exercises in an intervention with obese women. They found that the more mindfulness the women practiced, the more their anxiety, chronic stress and deep belly fat decreased. Obese participants in the mindfulness program also maintained their body weight while those in the control group increased their weight over the same period of time (Journal of Obesity, 2011). And in an ongoing study with overweight pregnant women, Kristeller, Epel, Daubenmier and Cassandra Vieten, PhD, director of research at the Institute of Noetic Sciences, are teaching participants similar mindful-eating techniques in an effort to help these mothers-to-be avoid excessive weight gain.

"One lesson we've learned is that with the effort and attention to eating taught in the MB-EAT program, people can change their relationship with food very quickly, and within a few sessions, they're often starting to eat differently," Epel says.

The three-minute raisin

Kristeller's interest in meditation began as an undergraduate at Swarthmore College, where she read about research on how meditation can help lower blood pressure and heart rate and reduce ruminative thinking. Kristeller began meditating to reduce the stress of college and immediately found that it calmed her "chattering mind," she says. Later, as a doctoral student at Yale studying food intake regulation with Judith Rodin, PhD, and self-regulation theory with Gary Schwartz, PhD, Kristeller began using meditation to treat eating disorders.

"Judy was identifying how a lot of the disregulation in eating behavior was from people's lack of tuning in to their hunger signals," Kristeller says. "I thought you could help people tune back into those experiences."

After graduating from Yale in 1983, she joined the faculty at the University of Massachusetts Medical School, where she met Jon Kabat-Zinn, PhD, and took part in his eight-week Mindfulness-Based Stress Reduction (MBSR) program. Kabat-Zinn introduced her to an exercise where participants slowly eat three raisins as a way to begin to cultivate mindful awareness.

"A light bulb, so to speak, went off for me during this exercise," Kristeller says. "I saw it as another way to help ground people in their experience of eating, and began thinking about how to do this more systematically, particularly around the kinds of foods that people eat that get them in trouble — the high-sweet, high-fat foods. I wondered what would happen if people started engaging with those foods this way." Now, thanks to her research and her clients' enthusiastic feedback, she knows.

Link to article

20 Ways Shrinks Stay Sane

Here I am quoted on coping strategies to reduce stress. By   |

It’s mental health month! Like many of you, I’ve been actively sharing mental health information as a way to increase education and reduce stigma surrounding mental illness. While it’s an honor to be in a profession that focuses on supporting the mental health of others, being a therapist often requires regularly going to “dark” places with clients, and that can take a toll on our ownmental health.

After nearly 20 years in the field, I’ve noticed that a lot of therapists (myself included) tend to be caretakers, people-pleasers, and self-sacrificers, making us particularly vulnerable to neglecting our own mental health in the name of caring for others. I have learned to become fiercely dedicated to self-care, self- awareness and to maintaining my own relationships in order to protect and nurture my own mental health.

I wanted to reach out beyond my own experience to therapists around the world to see how they nurture their own mental health in a profession that can be emotionally and mentally exhausting. Here’s what they had to say.

1. Live in the present

“I make myself more present by asking ‘Where am I in space right now? What do i hear? What do I feel? What do I taste and smell? What do I see?’ ” Natalie Robinson Garfield.

“I find 20 minutes a day to escape from the world and enjoy the peace and quiet.” Deborah Serani, Ph.D.


“I meditate regularly and journal about my dreams.”  Dr. Will Courtenay

2. Surround yourself with positive people

“I rid myself of toxic relationships and situations immediately and I engage in religious activities, especially prayer,” says Leticia R. Reed, LCSW.

Surrounding yourself with positive people also includes you. Kim Olver, LCPC checks the stories she tells herself about her own life. “If they serve me great, if they don’t I’ll change them. I’m the one who makes them up after all,” says Olver.

3. Go to your own therapy

“I go to my own therapy on a regular basis.” Dr. Will Courtenay

“I take care of my mental health by checking in with my own counselor when I need someone objective to bounce things off of and get centered or grounded.” Xiomara A. Sosa

“I have entered therapy 3 times since my core training. 3 different styles to suit the issues I was experiencing. I also do workshops and retreats throughout the year for personal/spiritual development.” Jodie Gale

4. Get moving

“I have two Labrador retrievers who demand a lot of attention. I find a great escape just going out into the backyard and throwing the Frisbee for an hour.” Regina Bright, LMHC

“I salsa dance! I rely on the nonverbal connection with my partner and happy music to get through some challenging weeks.” Dr. Amy E. Keller

“Every day I take time to meditate or participate in Pilates or yoga.” Diane Petrella, MSW

5. Nurture a sense of humor 

“I try to maintain a good sense of humor and find ways to laugh during life’s challenges.” Ashley Bretting, LMFT

“My spouse and I attend a comedy show every week.”  Stacey Kinney, LMFT

6. Maintain friendships

“I make sure to have tea or lunch at least once a week with a friend that is supportive and makes me laugh.” Nerina Garcia-Arcement, Ph.D.

“I find that participating through friendship in the life of someone outside the field is even more refreshing and grounding than the peer consultation we used to do.” Mark E. Sharp, Ph.D.

7. Take a break

“I love vacationing to Costa Rica.”Dr. Amy E. Keller

“I enjoy watching funny and/or inspirational YouTube videos.” Hugh A Forde, PhD

“Hiking is a great activity that helps reduce my stress levels.” Dr. Karen Sherman

8. Catch some zzzz’s regularly

This one is an important one for me. I try to take a long naps every Sunday afternoon.

“My goal is to get at least eight hours of sleep every night.” Stephanie Moulton Sarkis PhD

9. Uplifting media

“I like to read books, listen to music, and subscribe to inspirational Facebook pages.” Dr. Matthew Clark

10. Reach out to those in need

“I do volunteer work with Mission Outreach, a non-profit group that collects unused medical supplies in the United States and sends them to third world countries. Being able to help others in such a simple, easy way does wonders for one’s outlook on life.” Sujatha Ramakrishna, M.D.

11. Create fun each day

“I ask myself, ‘Have I had fun today?’ If the answer is no, then make it happen before the night is over!” Natalie Robinson Garfield

“I pursue my hobbies of photography, painting, and jewelry making.” Stacey Brown 

12. Say no

“I have found that out is easier to say “no” when I realize that if you say “no” to one thing, you are always saying “yes” to something else. If I say “no” to a new client, I am saying “yes” to time with family and a less busy mind.” Joseph R. Sanok, LPC

“I hold stringently to my practice days and hours—keeping mornings for myself to exercise and write, using afternoon to early evening for clients, and taking off Fridays for whatever I want to do.” Karen R. Koenig, LCSW, M.Ed.

13. Celebrate nature

“I love to spend time in nature by walking through the woods or listening to the birds chirp.” Sujatha Ramakrishna, M.D.

“I work in a professional office setting and need to be reminded that I am an animal. Getting out to a park or the beach or a hike in the mountain, or even a drive up the coast with the top down are instant healing techniques.” Nancy B. Irwin Psy.D

14) Express yourself creatively

“I nurture my own mental health through my other profession which is as a comic/writer….in writing my own material I get to see the humor in almost every situation and in performing it, I get to bring laughter…one of the greatest stress reducers of life….to others.” Jane Stroll

“I write in a journal often.” Xiomara A. Sosa

“I take a writing class, so that I can stay creative and do something that’s just for me!” Janet Zinn, LCSW

15. Get pampered

My personal favorites are a message and a pedicure. I try to do at least two pampering activities a month to help me relax and to nurture myself.  Ashley Bretting, MFT gets pampered by having her hair washed by someone else. Whether it’s a hot bubble bath or a leisurely walk, do something that feels nurturing on a regular basis.

16. Be a kid

Ashley Bretting “I bring out her inner child by coloring with crayons or paints!”

“I spend time with animals and children. The unconditional, pure love and affection from these creatures soothes the soul.” Nancy B. Irwin Psy.D

17. Get out of your head

“I bike to work as much as I can — this is a 30 minute commute by bike, 20 minutes by car.  In doing this, I ensure that I arrive at work very relaxed & calm (having just spent time close to nature — hearing the birds chirp and the wind blow and seeing green around).  When I leave the office at the end of the day, all of my worries get worked out by the time I get home.  So, I arrive at home very relaxed also!” Sally Palaian, PhD

18. Process your feelings regularly

Karen Hylen, Ph.D, of Summit Malibu Treatment Center suggest regularly sharing  your feelings with a friend or a loved one to avoid emotional explosions. Hylen shares this analogy:

When you bottle up your emotions, you are figuratively assembling a bomb in your head. Each feeling you bury in your head is you  putting together another piece of the bomb. Keep enough of your feelings to yourself and before you know it you’ll have an emotional explosion.

19. Focus on family

I enjoy spending time with my family. Going to the beach and reading or walking is especially refreshing. I take two trips a year with the family and then one with just my husband. Regina Bright, LMHC

“I make sure I make time for my loved ones. It is an anchoring force,” shares Dr. Anandhi Narasimhan.

20. Consult regularly on difficult situations

When I first went into independent practice I set up to have lunch or breakfast with a colleague also in independent practice every couple of weeks. It allowed us to bounce ideas off of each other and not feel so isolated in our work. Mark Sharp, Ph.D

Link to article