The Art of Self-Nurturing

Feeling tense? Running on empty? Maybe work, finances, relationships, changes in routine, or daily life have you feeling overwhelmed. Warning signs include feeling anxious, irritable, fatigued, and having repeated intrusive thoughts about a stressful situation. Extreme stress can make you feel like there is nothing you can do. The key to regaining control is a radical return to self-nurturing, to recharge your emotional and physical batteries. Here are some strategies to foster the Art of Self-Nurturing.


Admit your stress. Admit when circumstances have got you down and change is needed. Admitting this creates a moment of calm and stillness, a space to breathe, and a space for observation and awareness. Moving forward is difficult unless you recognize the situation and make a commitment to help yourself through it.

Identify Your Hot Buttons. Figure out what is causing the stress–a relationship to a co-worker or loved one, work demands, a financial commitment, uncertainty about the future?  Write this down.

Acceptance. Take a look at your list of stressors and identify the things that can be changed as well as the things that can’t. Accept that some things are always going to be stressful. Then, attention can be focused on the things that can be changed instead. Try focusing on action steps to make the future less uncertain, such as acquiring skills, making friends and setting goals.  This also means not sweating the small stuff - pick your battles and invest your energy wisely.

Notice how you talk to yourself about yourself and others. Observe the language you use to create your reality, to define and judge yourself and others.  For example, you may say to yourself, "Here I go again, stressing out", when a more effective, self-compassionate statement would be, "Stress is part of life and I'm learning to address it effectively by taking it one day at a time."

Get Outside. Taking in natural beauty, along with physical exercise, can reduce stress and improve physical health. The color green has been shown to have soothing effects on body and mind.  Nature can provide a peaceful soundtrack, beautiful scenery and fresh air to help soothe the soul. Try hugging a tree or walking barefoot in the grass.

Let It Out. Bottling up emotions can increase stress through accumulated feelings of loneliness and helplessness. Communication, both with yourself and others, is key in addressing problems quickly and honestly.  If you need help identifying what's causing your stress, and how to effectively address it, talk to a trusted person or mental health professional.

Help! I Have Intense Emotions!

Feelings are like children:  You don't want them driving the car, but you don't want to stuff them in the trunk either. (Quote from the movie "Thanks for Sharing")

Most of us have been conditioned by our environment that having positive emotions means success, and having negative emotions means failure.  However, both positive and negative emotions are a normal and desirable part of life.  Like children, they can be unpredictable.  Just the same, they can be brutally honest and teach us about ourselves.  Unlike rational thought, the experience of feelings is often non-linear, it can feel like a spiral or circle, or an endless loop.  This can be a challenging experience.

Some emotions can create an intense experience.  Feelings such as anger and fear can leave us with the perceived notion of feeling overwhelmed or out of control. When faced with such intense feelings, we may often feel compelled to stuff them away and supress them. We may have been taught not to listen to, show, or express our feelings.  Most of us believe we shouldn't have negative or challenging emotions or that if we allow ourselves to have them, we may lose control and something "terrible" might happen.  So when we are faced with a difficult situation in our life, we may feel upset or angry, and tell ourselves that we shouldn't be feeling this way.  Our habitual response may be to stuff those emotions in the trunk of our car.  But what happens? The stuffed away emotions start knocking, screaming, and expressing their discontent at being in the trunk.  So we try to block out the noise.  In real life, this manifests as numbing out: by staying busy and filling our lives with escapes, pursuing addictions and distractions such as overworking, substances, food, shopping, sex, getting in and out of relationships, or other impulsive behaviors.  This can give us the false illusion that the emotion has gone away.  This may work...temporarily.

What's the true "fix" for intense emotions?  Some musings and food for thought:

• There is no need for a "fix".  Emotions are merely experiences that are temporary.  Usually they can teach us some important insight about ourselves.  
• It's important to accept there is nothing wrong with having emotions: being afraid, angry, upset, surprised, disgusted, being happy, being excited.
• Try not to get caught up in what your emotions mean about other people, but rather what they mean about yourself.
• If you have a tendency to stuff your emotions in the trunk of your car, play with the notion of putting them in the back seat instead.  Check on them in the rearview mirror - acknowledge that they're there, talk to them every once in a while.  Maybe listen to what they have to say.
• Letting go of the success/failure duality of emotions opens up amazing freedom.  Emotions just "are", without being good or bad, until we tell ourselves a story about what they mean, could be, or should be.
• Don't be scared of emotions, just ride the wave.  They are temporary.

Simple Tools for Stress Management

Stress is part of everyday life, yet it is also a complex concept. Psychological stress occurs when a person perceives that the demands placed on them exceed their personal and social resources to help them cope.  This means someone can feel little stress when they have the time, experience, and resources to manage a potentially stressful situation. In other words, stress is not an inevitable consequence of an event - it depends on your perceptions of a situation and your ability to cope with it.  

Let's take the common everyday stressor of traffic.  If we perceive it as defeating and frustrating, and that we are helpless against it, we become di-stressed and sit in the car fuming.  If we accept it as just a fact of life, and that it's an opportunity to sit and meditate, catch up with a friend on the phone, or listen to an entertaining program, we create positive emotions for ourselves instead.  The prerequisite of this happening of course means that we have a phone or program available, and that we feel confident that these strategies will help us feel better.

Causes of Stress
To understand stress better, it may be helpful to think it terms of what usually causes people stress.  Here are four main categories that are common stressors in our society.

• Life Transitions (for example, moving, job loss/change, diagnosis of illness, marriage, divorce, pregnancy/childbirth, death of a loved one)
• Work- or school-related (for example, high demand job environment, boredom, team conflict, lack of support)
• Problematic relationships (eg, unreasonable demands, high conflict, persistent sense of being taken advantage of, lack of supportive relationships)
• Your environment (eg, housing problems, transportation problems, chronic traffic problems, noisy neighborhood, living in poverty, living and working in an environment that's not conducive to relaxation and recreation, dangerous living or working environment)

However, it's important to recognize that an accumulation of smaller, minor stressors can be at least as, if not more, detrimental to one's physical and mental health as one or two major life stressors.  Car trouble, an argument with your spouse, an important work deadline, and trying to plan a big family party all in one week can certainly add up.

Signs of Stress
The first step to effective stress management is understanding your own personal stress signals.  Stress can get expressed in many subtle ways.  Here are some examples - see if you recognize yourself in some:

• Feelings: Anxiety, irritability, fear, moodiness, embarrassment, frustration, and anger 
• Thoughts: Self-criticism, difficulty concentrating and making decisions, forgetfulness, preoccupation with the future, repetitive thoughts, fear of failure 
• Behaviors: Crying, being disorganized, sense of time pressure, “snapping” at love ones, acting impulsively, alcohol or other drug use, teeth grinding or jaw clenching, stuttering or speech difficulties, having more accidents 
• Physical: Sleep Disturbance, changes in appetite, tight muscles, headaches, fatigues, cold or sweaty hands, back/neck problems, stomach problems, getting sick more often, rapid breathing, pounding heart, trembling, dry mouth

Think Stress Away
One of the most important ways to bust stress is to practice positive thinking and keeping things in perspective.  Remember, how we perceive an event is a major contributor to stress.  If we can neutralize our initially negative perception of a stressor, we have more control over the impact it has on us.  In other words, re-think how you think about stress.

Here is a simple guideline:
1. Recognize your negative thoughts
2. Stop, breathe
3. Reflect: Is this thought really true? Did I jump to a conclusion? What evidence do I actually have? Am I letting negative thoughts balloon? What’s the worst that could happen? Does it help me to think this way?
4. Choose: Decide how to deal with the source of your stress. Create and write down an action plan. Recognize negative thoughts and let them go.

Here are some simple examples of negative thought patterns during stressful situations, and their more neutral alternative thoughts.

1. Should statements:
•I should be able to deal with stressful situations better.
•Better: I know how to deal with stress and I am having a hard time right now.

2. Disqualifying the positive:
•I hate my life, it always is so difficult.
•Better: There are some things going on right now that are difficult and also some things that are actually going right.

3. Emotional reasoning:
•I don't feel good right now so I can't handle anything.
•Better: I feel like I can't handle things right now and I know that I can.

4. Catastrophizing
•If I don’t do well on this presentation (insert other important task), I will be judged poorly.  I may become jobless and homeless.
•Better: Nobody’s perfect. I’ll do my best on the presentation and know that it’s not the end of the world if I don't do perfectly.

Relax Stress Away
A relaxing activity that provides relief from a stressful activity by reducing physiological activation.  Incorporating relaxation in your daily routine is paramount, as the physical effects of chronic stress can lead to many health problems, such as cardiovascular disease, cancer, and a susceptible immune system.
Healthy examples for relaxation:

• physical exercise
• a hobby
• spending time with friends and family
• a warm bath or shower
• prayer or meditation - here are some great meditation apps
• Guided Imagery/Relaxation - there are many great resources online; here's one example

Finally, talking to a mental health professional about your stress can help you organize your thoughts, determine where to invest your energy, and learn skills in managing stressful situations and people in your life.

Job Burnout - Are You At Risk?

"Without work, all life goes rotten, 
But when work is soulless, life stifles and dies." - Albert Camus


Feeling stressed at work and unfulfilled by one's job is a familiar topic to most people.  But there is a difference between having a difficult set of days or weeks and actual job burnout.  Burnout is not an all or nothing phenomenon.  Fluctuations in motivation and enthusiasm are normal.  Job burnout occurs when enthusiasm and motivation have completely dried up while your job skills and knowledge remain intact - a very frustrating feeling.  Those hardest hit by job burnout are people in the helping and medical professions, those who make high stakes or life and death decisions, and those whose work is very detail oriented.


Burnout is a cumulative process and it is important to be in in tune with early warning signals:
- Loss of interest in work
- Emotional fatigue
- Increased moodiness and irritability in both personal and professional situations
- Increasing frustration with everyday responsibilities at work
- Inability to re-charge your internal batteries while not working
- Interpersonal problems marked by decreased tolerance and patience
- Social withdrawal - becoming aloof and inaccessible
- Indifference towards people and dehumanization of those you work with (eg, thinking of clients as objects not people)
- Health problems as a result of chronic tension or stress
- Substance abuse as a way to cope with difficult feelings
- Declining performance at work
- Being emotionally or physically absent from work
- Ceasing to find meaning in your work

Most people suffering from burnout share an experience of powerlessness, hopelessness, and helplessness.  They lose a sense of being able to control their work and self-confidence takes a major dwindling hit.  Re-establishing a sense of empowerment and confidence is key to addressing job burnout.  Before deciding whether or not to quit a job, it is important that you get yourself to a replenished and rational place first.


Here are some tips to help you reclaim a sense of personal control:
- Learn better ways to manage stress.  Healthy coping is key to replenish those dead batteries and get you to a place where you can clearly assess and evaluate what to do next about your job situation.
- Seek social support.  Even though the first instinct during burnout may be to withdraw from others, it is important to counteract this instinct.  Build a solid network made up of friends, family, and coworkers.
- Increase your knowledge base.  By continuing to build your marketable job skills set, you increase your personal and professional sense of empowerment.
- Manage negative thoughts.  See previous blog entry on Talking Back to Your Internal Chatterbox to learn how to manage types of thinking that can take control of your emotions.
- Develop detached concern.  This means learning to let go of attachment to how things could or ought to be - a skill that becomes immeasurable especially when you are working with serious or impossible situations.
- If all else fails, consider changing jobs.  However, it is paramount that you analyze the source of your job dissatisfaction first and explore what is needed to improve the situation.


Talking to a mental health professional who specializes in job burnout can be a powerful tool to regain a sense of control.  It can help to have a neutral person to process the above topic with.  I am a Houston psychologist and enjoy working with job burnout concerns.  Visit my webpage at DrGortner.com for more information.

Negativity: Talking Back To Your Internal Chatterbox

Thousands of thoughts run through our head every day.  Just consider your own internal dialogues all day long – about your own actions, about others’ behaviors, about the world as a whole, about what has happened in the past, about what is yet to happen.  The way we talk to ourselves can be positive, negative, or neutral.  Or even a mix of all of those.  Self-talk is often a mostly automatic and even unconscious process.  These dialogues can turn very unpleasant – such as beating yourself up in the face of perceived “failure”.  

Needless to say, the way we talk to ourselves can give rise to many different emotions. For example, if you tell yourself that if you don’t do well on tomorrow’s presentation at work, then you’ll never get promoted.  Or if you feel like a conversation with a friend felt awkward and you find yourself wondering if they now think less of you.  Both of these examples of self-talk can result in feelings of anxiety or hopelessness.  The key about making self-talk more constructive is learning to be more gentle and compassionate in the ways we talk to ourselves.
 
Cognitive and cognitive-behavioral therapists work with their clients to change negative self-talk into more rational responses.  The goal is that if we can start recognizing our own automatic negative thoughts and then turn them around, we can feel better about ourselves and the world around us.  Much research has been done to back this up as an effective form of therapy, especially for anxiety and depressive disorders. 
 
There are different categories of negative self-talk, and if you work with a cognitive or cognitive-behavioral therapist, you will get to know them intimately.  Below are some examples of negative self-talk (also called “cognitive distortions”) and more gentle alternatives.  Note that these are simple examples for illustrative purposes. 
  
1. Should statements:

• Negative Self-Talk:  I should be able to deal with stressful situations better.
• Better:  I know how to deal with stress and I am having a hard time right now.

2 .  Disqualifying the positive:

• Negative Self-Talk:  I hate my life, it always is so difficult.
• Better:  There are some things going on right now that are difficult and also some things that are actually going right.

3. Emotional reasoning:

• Negative Self-Talk:  I don't feel good right now, so it feels like I can't handle anything.
• Better:  I feel like I can't handle things right now and I know I can.

4.  Catastrophizing: 

• Negative Self-Talk:  If I don't do well on this work presentation, my boss will think poorly of me, I'll never get that promotion, and eventually I'll be jobless and homeless.
• Better:  Nobody's perfect.  I'll do my best on the presentation and know that less than perfect is not the end of the world.

If negative self-talk is ingrained in the way you think, and is regularly impacting your mood and relationships, you might consider working with a psychologist or other licensed mental health professional.  Also look for a future installment on this blog about how to foster more self-compassion.  I am a Houston psychologist – to learn more about my services, visit DrGortner.com. 

What To Do About This Pesky Anger...

Anger is an interesting and powerful emotion.  We have all felt it – perhaps as a fleeting annoyance or even as full-fledged, out-of-control rage.  Anger is a normal human emotion designed as a “red flag” to let us know something is causing us stress.  But when anger takes a hold of our life, it can lead to problems at work and in relationships.

Some experts consider anger a “secondary” emotion – meaning it is formed as a reaction to and cover-up for more primary emotions, such as sadness or fear.  It may feel easier or more acceptable to express anger rather than sadness or fear. It is therefore important to first understand triggers for our anger – what in our lives is causing us this emotion.  Is it irritability with rush hour traffic, or is it flying off the handle unexpectedly after the death of a loved one?  Both involve anger but the causes are very different.  It is often helpful to determine the true cause of anger and address it directly.

Here are some thoughts about anger, meant to help guide you in the right direction of addressing it:

• Do you bottle up your feelings rather than expressing them?  Your anger may be an issue of learning effective and assertive communication to express feelings in an appropriate and timely manner.
• Simple relaxation tools, such as deep breathing and relaxing imagery, can help calm down angry feelings.  An example would be breathing in for 4 counts, holding your breath for 4 counts, and exhaling for 8 counts.  As you exhale, tell yourself a relaxing word, such as “peace”, “relax”, or “let go”.  Do this at least 3 times.
• Rigorous exercise can help address anger – this is especially effective if the underlying cause is anxiety.
• Changing your environment may be the key to address angry triggers.  This may become an “If all else fails” strategy.  For example – if it becomes increasingly difficult to control your road rage, consider public transportation.  If anger is a reaction to a toxic person in your life that drains your resources, it may be time to learn to set concrete boundaries.
• Pick your battles.  One powerful tool to address anger is learning to distinguish between what we can and cannot change.  Then invest your energy into those aspects of your life that are worth the effort.  This may be particularly helpful if your anger is accompanied with a sense of helplessness or powerlessness.

If you feel that your anger is out of your control, impacting your relationships and important parts of your life, you might consider counseling to learn how to handle it better. A psychologist or other licensed mental health professional can work with you in developing a range of techniques for addressing and managing anger.  I am a Houston psychologist – to learn more about my services, visit DrGortner.com. 

Great Expectations and What's Love Got To Do With It

Romantic relationships are one of the most frequently discussed concerns in counseling.  Lots of people would agree that it is at least as hard to maintain a relationship as it is finding that special someone. 

What constitutes a healthy relationship?  Mutual respect, trust, and support are basic building blocks.  Honesty and safety, both physical and emotional, must be a given, not a privilege to be earned.  Open communication and willingness to negotiate keep relationships steady.  In addition, we all deserve to be respected by our partner as a unique individual, while acknowledging that we can make conscious choices to mutually make positive changes in our behaviors and attitudes towards our partner.

There are clear warning signs that a relationship is in trouble and that something fundamental needs to change.  Possessiveness and controlling behaviors, as well as threats or use of violence are obviously huge red flags.  Less easy to detect are unfair and unrealistic expectations that may slowly seep into a relationship once the initial romance wears off.  These expectations can be of your partner, yourself, or the relationship as a whole.  Some examples of common unrealistic expectations in relationships are:

• Expecting that he/she will change.
• Hoping that he/she will never change.
• Assuming that your partner thinks and reacts as you do.
• Assuming that your partner knows your wants and needs.
• Expecting that he/she has the same priorities, goals, and interests as you.
• Believing that the relationship will fulfill all of your social, intellectual, and personal needs.
• Giving up other interests, activities, and friends.
• Seeking improved self-esteem through the relationship.
• Feeling incomplete without a relationship.
• Expecting that each new relationship is "the one."
• Expecting that he/she will never make mistakes.
• Viewing conflict as a threat to the relationship and to be avoided at all costs.
• Working hard to get the relationship started, but exerting little effort to keep it going.
• Trying to be what he/she wants, rather than being yourself.
• Not understanding that feelings of love and passion change with time, as do your priorities and expectations.

Most people recognize themselves somewhere in these expectations.  Individuals who succeed in relationships are able to recognize and work on unrealistic expectations of oneself and others.

Finally - what many forget is that within a relationship, you also have to be accountable to yourself.  This means that being part of a healthy relationship is taking care of yourself.  This can be deduced from several of the above bullet points.  By being yourself – from the beginning, keeping your own life balanced, and not losing yourself in the relationship, you plant seeds of stability and health within a healthy partnership. 

If you are struggling with finding or maintaining a healthy relationship, talking to a psychologist or other licensed mental health professional can help. I am a Houston psychologist and I work with both couples and individuals.  Call me for a free consultation at 713-364-8328 or visit DrGortner.com for more information on my services. 

Hot Summer Days Got You Down?

 We are in the midst of another heat wave in Houston as we are braving another hot summer.  For many, being outside during this time can be torture – not just physical, but also mental.  The common expectation is to be happy and outdoorsy in the summer, attending barbeques and other outdoor events.  However, you may find yourself feeling actually more depressed and irritable these days.

You may have heard of Seasonal Affective Disorder (SAD), a form of depression that affects people in colder climates during winter months when days get shorter and colder.  It is connected with less exposure to sunlight.  What few people know is that there is a summer version of SAD. It is actually more common in the Southern United States and in countries near the equator. Like winter SAD, summer SAD affects primarily women in their 20s to 40s.

Summer SAD is thought to be related to increases in temperature and light, along with decreases in the brain’s production of melatonin, a hormone associated with sleep. Other hypothetical causes include fluctuations in barometric pressure and physical difficulty with regulating body temperature.  Individuals who are naturally sensitive to light and heat may be more vulnerable.

The primary symptoms of summer SAD are the following:

• Poor or increased appetite
• Insomnia
• Increased anxiety
• Increased irritability and/or agitation
• Weight gain or loss
• Increased or decreased sex drive
• Loss of interest in your usual activities
• Hopelessness
• Feelings of Depression
• Suicidal thoughts

If you think you might suffer from summer seasonal affective disorder, here are some recommendations.

Limit your exposure to heat. Stay indoors in air conditioning.  Plan some indoor social activities (for example, game night).  Some people with extreme forms of summer SAD prefer windowless rooms and using ice packs to cool down their body, especially at night.

Get enough sleep. Make sure your sleeping quarters have a consistent cool temperature.

Eat light meals and keep a regular exercise schedule.  Stick to indoor exercise during extreme heat.

Plan your vacation in a cooler climate, if possible. 

Wear Polarized Sunglasses.  This is important for everyone, but especially light skinned and blue-eyed people.  For some, wearing these types of glasses already translates to mild to moderate mood boost.

Recognize you are not alone! The difference between what we think we “should” feel in the summer (energetic, happy, carefree) and what we may actually feel (anxious, bored, uncomfortable) can alone lead to feelings of irritability and depression. Remember, even though it may seem as if everyone else is having a wonderful time frolicking in the sun, many people are not and are coping with some of the same concerns as you!  

Recognize there is help.  If you are having suicidal thoughts or have been struggling for more than two weeks with the symptoms listed above, get help from a psychologist or other licensed mental health professional.

I am a Houston psychologist specializing in depressive disorders such as SAD.  Call me for a free consultation at 713-364-8328 or visit DrGortner.com for more information on my services. 

Finding Yourself High and Dry? Navigating Stress During a Financial Crisis

The financial crisis is back on everybody’s mind as we have been watching the news.  Money worry is familiar to most of us.  And it doesn’t help to see this issue illuminated from all angles on our news networks.  No matter what your employment status or how far away you are from retirement.

People deal with financial stress in different ways.  Some take the “head in the sand” (aka ostrich) approach by avoiding thinking or talking about the topic.  This can often backfire – the more we suppress certain thoughts, the more likely they are to pop back up in sneaky ways in our minds (research backs this up).  This approach can also leave us in the dark when we may need to make important decisions. 

Other people become obsessed with the topic and find themselves glued to the TV screen, analyzing each minute detail.  This too can be unhealthy, as it takes away important mental resources from our daily lives and may not help us solve the problem. 

In this, as with many other issues, balance is key when we try to cope.   Here are some things to keep in mind:

Be News Savvy.  While it’s important to stay in the know, don’t get caught up in the media hype prophesizing doom and gloom.  Try to limit your news intake to a certain amount of time per day - for example 15-20 minutes from a trusted news source.  Avoid these news first thing in the morning or right before bedtime.

Take Inventory.  It is important to assess what in life we are in control of, as opposed to what we are not.  All too often we grip onto and waste our energy on things that will run their course.  If you are immediately affected and/or have lost your job, create a written outline on how you and your family can manage expenses and finances differently and more efficiently.  Reaching out to credit counseling services and financial planners can help alleviate anxiety.  Talk to your bank, utility companies, and credit card companies about payment options.  Research options for continuing education to make yourself more marketable.

Notice How You Deal With Stress.  Stress can be sneaky – before we know it, we can turn to food, inactivity, smoking, alcohol, or other substances to somehow manage it.   We may withdraw from family and friends and lose sight of what’s important.

Identify Healthy Choices.  Take a walk with a loved one, try a new recipe at home, call a friend.  Be proactive while taking care of yourself.  Reach out for support.  Make sure to eat right and make some room for exercise and socializing – again, things you can control. 

Be Patient.  Uncertain times leave us with more questions than answers.  It takes courage and tenacity to weather these types of storms.  Having question marks in our lives can help us reflect on what’s important.  And this can leave us richer in the long run.

If you continue to be overwhelmed by the stress, it can be useful to seek professional support.  A career counselor can help you create a concrete vision and goals if you are in a job transition.  A psychologist can help you address the emotions and meanings behind your worries and teach new skills to manage stress.  I am a Houston psychologist – to learn more about my services, visit DrGortner.com.