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Archive for Coping Strategies

How to cope with grief and loss

How to cope with grief and loss

 

© 2014 Phoebe Hutchisonwww.areyoulistening.com.auGrief can be about anything: the loss of a relationship, job, financial status, house or loss of a friend, a family member, a spouse. Grief can also be related to loss of youth, beauty, strength or independence. A perceived loss can cause grief. Grief can prove to be more difficult if we have previously experienced unresolved grief in our lives, which compounds our losses.

What are the different types of grief?  

Normal Grief (the five stages of grief) denial, anger, bargaining, depression, acceptance (although not necessarily in this order), Unresolved Grief or Anticipatory Grief, Complicated Grief (absent, inhibited, delayed, conflicted, chronic, unanticipated and abbreviated).

How can we help the grief process?

What happens to your body and mind during grief? Why is it hard to sleep during grief? How do you help a person who has just lost someone? (Physical help) What NOT to do when supporting someone who is grieving? Why is talking/listening helpful for grieving person? (Mental/Emotional help, initially and then in coming months.)  What is the difference between depression and grief?

What are some helpful additional techniques for working through grief?

Use of symbols: Photos, videos, sharing thoughts about loved one. Writing: Write unspoken words to deceased. Write feelings/thoughts in journal.

Drawing: Draw pictures of how you are feeling (good technique for children).Cognitive restructuring: (With counsellor) Test irrational thoughts for accuracy.

Memory Book: Stories, events, memorabilia, to help integrate the loss.Directed Imagery: When working with a counsellor, the client sits opposite the empty chair and visualizes the loved one with eyes closed, and says what they need to say (It is a very powerful technique to talk to the loved one and not just about them).

The Five Stages of Grief by Phoebe Hutchison (Based on the Kubler- Ross Model by

Elisabeth Kübler-Ross & David Kessler)Denial, Anger, Bargaining, Depression and Acceptance The stages of Grief have evolved since their introduction and they have been very misunderstood over the past three decades. They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss as there is no typical loss. Our grief is as individual as we are. The five stages, denial, anger, bargaining, depression and acceptance are a part of the framework that makes up our learning to live with our loss. They are tools to help us frame and identify what we may be feeling. But they are not pit stops on a linear timeline in grief. Not everyone goes through all of them or in a prescribed order. Our hope is that with these stages comes the knowledge of grief’s terrain, making us better equipped to cope with life and loss. People often think of the stages of grief as lasting weeks or months. They forget that the stages are responses to feelings that can last for minutes or hours as we flip in and out of one and then another. We do not enter and leave each individual stage in a linear fashion as mentioned above. We may feel one, then another and back again to the first one.

Denial

This first stage of grieving helps us to survive the loss. In this stage, the world becomes meaningless and overwhelming. Life makes no sense. We are in a state of shock and denial. We go numb. We wonder how we can go on, if we can go on, why we should go on. We try to find a way to simply get through each day. Denial and shock help us to cope and make survival possible. Denial helps us to pace our feelings of grief. There is a grace in denial. It is nature’s way of letting in only as much as we can handle. As you accept the reality of the loss and start to ask yourself questions, you are knowingly beginning the healing process. You are becoming stronger, and the denial is beginning to fade. But as you proceed, all the feelings you were denying begin to surface.

Anger

Anger is a necessary stage of the healing

process. Be willing to feel your anger, even though it may seem endless. The

more you truly feel it, the more it will begin to dissipate and the more you

will heal. There are many other emotions under the anger and you will get to

them in time, but anger is the emotion we are most used to managing. The truth

is that anger has no limits. It can extend not only to your friends, the

doctors, your family, yourself and your loved one who died, but also to God.

You may ask, “Where is God in this?

Underneath anger is pain, your pain. It is natural to feel deserted and

abandoned, but we live in a society that fears anger. Anger is strength and it

can be an anchor; giving temporary structure to the nothingness of loss. At

first grief may feel like being lost at sea: no connection to anything. Then

you get angry at someone, maybe a person who didn’t attend the funeral, maybe a

person who isn’t around, maybe a person who is different now that your loved

one has died. Suddenly you have a structure – your anger toward them. The anger

becomes a bridge over the open sea, a connection from you to them. It is

something to hold onto; and a connection made from the strength of anger feels

better than nothing. We usually know more about suppressing anger than feeling

it. The anger is just another indication of the intensity of your love.Bargaining

Before a loss, it seems like you will do

anything if only your loved one would be spared. “Please God,” you bargain, “I

will never be angry at my wife again if you’ll just let her live”. After a

loss, bargaining may take the form of a temporary truce. “What if I devote the

rest of my life to helping others? Then can I wake up and realize this has all

been a bad dream?”We become lost in a maze of “If only…” or

“What if…” statements. We want life returned to what it was; we want our loved

one restored. We want to go back in time; find the tumor sooner, recognize the

illness more quickly, stop the accident from happening…if only, if only, if

only. Guilt is often bargaining’s companion. The “if onlys” cause us to find

fault in ourselves and what we “think” we could have done differently. We may

even bargain with the pain. We will do anything not to feel the pain of this

loss. We remain in the past, trying to negotiate our way out of the hurt.Depression

After bargaining, our attention moves

squarely into the present. Empty feelings present themselves, and grief enters

our lives on a deeper level, deeper than we ever imagined. This depressive

stage feels as though it will last forever. It’s important to understand that

this depression is not a sign of mental illness. It is the appropriate response

to a great loss. We withdraw from life, left in a fog of intense sadness,

wondering, perhaps, if there is any point in going on alone. Why go on at all?

Depression after a loss is too often seen as unnatural: a state to be fixed,

something to snap out of. The first question to ask yourself is whether or not

the situation you’re in is actually depressing. The loss of a loved one is a

very depressing situation, and depression is a normal and appropriate response.

To not experience depression after a loved one dies would be unusual. When a

loss fully settles in your soul, the realization that your loved one didn’t get

better this time and is not coming back is understandably depressing. If grief

is a process of healing, then depression is one of the many necessary steps

along the way.Acceptance

Acceptance is often confused with the

notion of being “all right” or “OK” with what has happened. This is not the

case. Most people don’t ever feel OK or all right about the loss of a loved

one. This stage is about accepting the reality that our loved one is physically

gone and recognizing that this new reality is the permanent reality. We will

never like this reality or make it OK, but eventually we accept it. We learn to

live with it. It is the new norm with which we must learn to live. We must try

to live now in a world where our loved one is missing. In resisting this new

norm, at first many people want to maintain life as it was before a loved one

died. In time, through bits and pieces of acceptance, however, we see that we

cannot maintain the past intact. It has been forever changed and we must

readjust. We must learn to reorganize roles, re-assign them to others or take

them on ourselves. Finding acceptance may be just having more good days than

bad ones. As we begin to live again and enjoy our life, we often feel that in

doing so, we are betraying our loved one. We can never replace what has been

lost, but we can make new connections, new meaningful relationships and

inter-dependencies. Instead of denying our feelings, we listen to our needs; we

move, we change, we grow, we evolve. We may start to reach out to others and

become involved in their lives. We invest in our friendships and in our

relationship with ourselves. We begin to live again, but we cannot do so until

we have given grief its time.Reference:

http://grief.com/the-five-stages-of-grief/Ultimately, we need to incorporate a loss into our lives, taking the time to heal and remember, and eventually move forward on this journey of life!

May your love for yourself, your life and your children, deepen daily.

Phoebe Hutchison (Author/Counsellor)

Dip. Prof. Couns. M.A.C.A.Maj. (Relationships & Conflict Resolution,Childhood Development & Effective Parenting, Grief & Loss)

Healthy Sleep

Tips for a healthy sleep

Set a regular bedtime: Get to bed at the same time each night. Choose a time when you would normally feel tired. Try not to break the routine on weekends when it is far more tempting to stay awake later. If you need to change your routine, let your body adjust by changing the time in small increments e.g. get up 15 minutes later or earlier.

Wake up at the same time every day:  If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock to wake up on time, you may need to set an earlier bedtime. As with your regular wake time even on weekends, try to maintain it.

Nap to make up for lost sleep:  If you need to nap do it early afternoon, do not stay in bed later in the day. It will allow you to continue your sleep schedule. While taking a nap can recharge the batteries, it can also worsen insomnia. If insomnia is the issue, it may be beneficial to eliminate napping or limit it to thirty minutes.

Fight after dinner sleepiness:  If you find yourself getting sleepy way before bed time, you need to get up and do something mildly stimulating to avoid falling asleep. If you do fall asleep this may mean that you wake up later in the night.

Make the bedroom more productive for sleep:  Indeed quality of sleep is hugely beneficial, if your routine is good and you are still not getting a good quality of sleep then the environmental conditions and disturbance need to be looked at.

Keep noise down – many people sleep better with the bedroom quiet. If you can’t avoid or eliminate sound, there are ways to mask the disturbance – electric fan, soothing sounds such as nature or white noise. Earplugs may also be beneficial. If you are missing the noise, try the more relaxing noise suggestions from above.
Also, if a pet regularly wakes you during the night, you may want to consider keeping it out of your bedroom.
Keep the room dark and cool – it is important to reiterate that even dim lights from TV, mobiles, and alarm clocks can confuse the body clock. Block the light out with heavy curtain and if necessary an eye mask .Temperature of the bedroom also affects sleep. Studies show room temperature of 18-19 degree Celsius with adequate ventilation is most productive for sleep. A bedroom that is too hot or cold can interfere with sleep.

Also important to look at the bed, is the bed big enough to accommodate you stretching. Mattresses have a shelf life of about 10 years; you may need to invest in a new mattress.
Your bed big enough? You should have enough room to stretch and turn comfortably. Make sure there is also enough room for your bedmate. Do your pillows adequately support your neck.

Bedtime Routine
Bedtime Routine is also vitally importing , it needs to be consistent , relaxing and designed to unwind for sleep .Relaxing before bed allows the brain the time to unwind and release the stresses of the day .Turning off the TV is also vital for falling asleep . TV stimulates the brain rather than helping it to relax and unwind .the light intensity from TV can interfere with your internal body clock, TV is also noisy which can actually disturb your sleep if you leave it on while asleep.

Relaxing things that can be used before bed:
Read a light magazine or book
Take a warm bath
Listen to some soft music or do a relaxation
Eat a light snack
Do some light exercise
Plan your day ahead.

Your bedroom needs to be kept for sleep only. You should not do any work in your room as this makes it more difficult to unwind. It is best to take work materials, computers and televisions out of the sleeping environment. If you associate a particular activity or item with anxiety about sleeping, omit it from your bedtime routine, this is where the sleep diary will prove hugely beneficial.

Eating and exercise:
Your daytime routine plays a vital role in sleep. It is really important that you are looking at what you are doing in the hours leading up to sleep.
Staying away from big meals in particular within two hours of sleep. Fatty food is much harder for the body to digest and should be avoided where possible. Avoid alcohol before bed; it is a myth that alcohol will help you sleep better. While you may fall asleep, alcohol reduces your sleep quality. Caffeine can also seriously hamper your sleep, where possible avoid and replace with decaffeinated or green tea. Remember that an apple is proven to awaken you in the morning far better than coffee. Fluids are important but try and illuminate them close to bedtime; this will reduce trips to the bathroom that can impact on your sleep. Quit the cigarettes, nicotine is a stimulant which can disturb sleep. Also many smokers, experience nicotine withdrawals that impact on their sleep and may also cause nightmares.
Eating a light snack before bedtime can help promote sleep. Particular foods e.g. peanut butter, granola bar, low fat yogurt, banana, turkey, chamomile can help the brain to relax and allow for a better sleep. It has been shown that adding a little calcium before bed can also help. Regular exercise 20-30 minutes during the day can really help with sleep. Exercise needs to be done morning or early afternoon in most cases for the desired effect; late afternoon or evening can stimulate the body and raise the temperature. Exercise stimulates the body to secrete the stress hormone cortisol . In the evening, some relaxation, yoga or other body practice can be beneficial.

Anxiety and Stress
Stress and anxiety can make it difficult to sleep soundly. One technique is to look at recurring themes that are hampering your sleep. If you are always worrying about things outside your control, you need to look at ways of getting this worry under control. If personal stressors such as family, friends, work or education are keeping you awake – you need to look at getting support with stress management. By managing your time, stress can be handled and utilized in a more productive way .Relaxation techniques: They are a great way to wind down, calm the mind and settle for sleep.

Pain and Medication:
Is there an underlying medical complaint that is causing pain or discomfort? Some children and adults with disability cannot reposition themselves by night which in turn could cause sleeplessness.
Is their medication that could be hampering your sleep, it is vital to discuss this with your doctor or chemist?

Ways to return to sleep:
It is very normal to wake well during the night; a good sleeper probably will not even remember waking. If you are waking up during the night , stay out of your head – remain relaxed , try not to stress over waking up and an inability to fall back to sleep again . As difficult as it is, try a relaxation exercise and focus on relaxation over sleep .If necessary do a quiet non stimulating activity like read a light hearted magazine. Do not turn on TV, laptops etc. A light snack or decaffeinated tea may help sooth you. Brainstorming should not be done at this stage as it allows for anxiety to creep in. If you need to write a very brief note for you to look at the next day. Staring at a clock in your bedroom, either when you are trying to fall asleep or when you wake in the middle of the night, can actually increase stress, making it harder to fall asleep. Turn your clock’s face away from you.

Medical Intervention:
It is so vital to seek professional treatment if your sleep problems are consistent. Consider a visit to your doctor to look at underlying causes. It is vital to keep a sleep diary as well to look at your sleep patterns, there may be a cause or trigger in this that would otherwise be missed. Your doctor may need to treat your sleep problem.
Some of these tips will be easier to include in your daily and nightly routine than others. However, if you stick with them, your chances of achieving restful sleep will improve. That said, not all sleep problems are so easily treated and could signify the presence of a sleep disorder such as apnea, restless legs syndrome, narcolepsy, or another clinical sleep problem. If your sleep difficulties don’t improve through good sleep hygiene, you may want to consult your physician or a sleep specialist.

Anger Management

ANGER MANAGEMENT TECHNIQUES

While anger management tips can help you keep from blowing up, the best anger management strategy is to begin anger management when you're not inflated!
Most experts agree that in order to learn long-term anger management techniques, you first need to recognize the "triggers" that set off your anger. But, what do you do if you're angry most of the time?
An excellent beginning anger management strategy is a small change in your environment. Even a 15-20 minutes environment change, can make a big change in your perspective.
Anger Management Strategy #1: Changing Your Environment
1. If you usually spend your day indoors, make a point to spend some personal time outdoors. Putter in your yard or take a walk. The fresh air will do you good, both physically and mentally.
If you work mostly outdoors, spend some personal, private time indoors. Go home, put your feet up and and relax.

2. If you spend the day in physical labor, give yourself a "quiet time". Sit on a park bench and watch the world go by or sit in your favorite chair and let your tired muscles relax.
If you spend most of your day ina sit-down job, get those lethargic muscles moving! After work, take some time to walk, run, exercise to feel a surge of renewed energy in both mind and body!

3. If you spend your day in noise, make sure your "quiet time" is quiet. Give yourself a chance to calm down and clear the chaos from your thoughts.
If you spend your day where the silence is deafening, go home and pump up the volume! Listen to the radio, play a CD, watch an half-hour of television. Get your mind off your problems!
Anger Management Strategy #2: Learn to Recognize Your Anger Activators
When you're reasonably calm, take a few minutes to examine recent times when your anger flared. Jot them down. Don't relive each; just look for what triggered your anger - your anger activators. What started you simmering and when did you boil over? What effect did your temper flares have on those around you and most importantly, you? What resulted from your anger? Let this be the beginning of your anger log or anger diary.
Each day, "log" occurrences of your anger and their triggers. You'll likely find that many of the same things are making you see red everyday.
For instance, a lot of folks start each day confronted by the harsh, irritating beeping of an alarm clock. If you're one of them, consider changing its tune. Set a clock radio to music instead of alarm or purchase an alarm that starts with a quiet pulse and slowly increases in intensity.

Anger Management Strategy #3: The Serenity Prayer
You may have heard the platitude, "You're either part of the problem or part of the solution." However, to paraphrase Abe Lincoln:
"You can solve all of the problems some of the time and some of the problems all of the time, but you can't solve all of the problems all of the time."
For instance, when you experience the loss of a family member, the anger you may feel is a natural part of grieving. No matter what you do, you can't solve the problem, but you can learn to control and resolve your anger.
"God grant me the Serenity to accept the things I cannot change,
The Courage to change the things we can,
And the Wisdom to know the difference."
For decades, Alcoholics Anonymous and other 12-step programs have used the Serenity Prayer to help their members cope with their problems. Even if you don't believe in a higher power, you can still use this simple message as an anger management strategy to help control your anger.
If anger is affecting your relationships, your work, or your health, consider seeking help. An anger management group, class or private counseling may be your best anger management strategy. Any of these can help you develop an anger management program based on proven anger management techniques.

Anger Management Techniques
One of the greatest detriments of anger is that it makes us feel helpless and out of control. Anger management techniques aren't meant to eliminate your anger. Anger management techniques put you in charge of the situation and teach you how to make your anger work for you.
When we take the attitude that "there's no time like the present" to vent our anger and "let it rip", anger often tears huge holes in the fabric of our lives, dropping us down the rabbit hole with no way up! Anger management techniques help you learn to express your anger in constructive ways and sew up your problems before you find yourself trying to mend fences instead.
Silly mental pictures can help diffuse anger in many situations.
Anger Management Technique #1: Accentuate the positive.
Your partner or spouse is late again and it's making you mad as a hatter. Picture yourself at the "Mad Hatter's tea party", the White Rabbit making his entrance "I'm late - I'm always late". Surely, the Cheshire cat's smile is growing in the background as the angry dormouse shrinks back into the teapot! Why? Because your partner's tardiness just bought you some extra time!

• Use the time to file your nails, read that magazine article you don't have time to read, file your nails, check your e-mail...
Anger Management Technique #2: Put your anger on hold.
Your partner arrives an hour late and full of excuses. You've managed to stay reasonably calm, but you can see your anger rearing its head. Say, "I know White Rabbit. Let's talk about it later and smile! You are still in control of your emotions and the situation; that's what's important. Timing is often critical to keeping anger at bay. Don't discuss issues when you're tired, or the situation has already made you irritable. Do choose a time to find solutions to problems; just make it when you can talk rationally and comfortably - when you can stay in control.
Anger Management Technique #3: Let humor calm you down.
• Ex: Another driver "cuts you off" in traffic. Break it down to the ridiculous. Lean back in your seat and take a deep breath. Breathe a sigh of relief that you at least still have your legs! Picture how silly you must look to other drivers, tooling down the road in your "cut off" vehicle. Parallel parking will sure be a breeze now, won't it?

Anger Management Technique #4: Don't react to anger - respond.
A major anger management technique is in changing the way you think and learning to respond to anger instead of reacting to it. Reacting to anger is a learned, impulsive behavior that becomes instinctive. Responding to anger allows you to examine various solutions and gives you the opportunity to choose the one that works the best for you.

Anger Management Technique #5: Take care of you.
• Make personal time each day to reflect on issues and consider solutions to problems.
• Work for balance in your life. Try to leave work problems at work and personal problems at home.
• Although we tend to often separate mind and body, they work together to make each of us into one unique being. Regular exercise, healthy eating, and adequate sleep are as essential to your emotional health as they are to your physical well-being.
Anger Management Technique #6: Don't look back, move forward.
Yelling, "This blasted machine never works!" doesn't make the machine work. "You're always late!" doesn't change what happened in the past and makes no plans for change in the future, except maybe for a destroyed friendship. When you put the lid on past problems, you free up time now to find solutions for current and future problems - anger management techniques to secure the lid on that grumpy dormouse!

Relaxations and Visualisations

Guided imagery for stress relief

Visualization, or guided imagery, is a variation on traditional meditation that can help relieve stress. When used as a relaxation technique, guided imagery involves imagining a scene in which you feel at peace, free to let go of all tension and anxiety. Choose whatever setting is most calming to you, whether a tropical beach, a favorite childhood spot, or a quiet wooded glen. You can do this visualization exercise on your own, with a therapist’s help, or using an audio recording.

Close your eyes and let your worries drift away. Imagine your restful place. Picture it as vividly as you can—everything you can see, hear, smell, and feel. Guided imagery works best if you incorporate as many sensory details as possible. For example, if you are thinking about a dock on a quiet lake:

See the sun setting over the water
Hear the birds singing
Smell the pine trees
Feel the cool water on your bare feet
Taste the fresh, clean air

Relaxation:

Loosen your clothing, take off your shoes, and get comfortable.
Take a few minutes to relax, breathing in and out in slow, deep breaths.
When you’re relaxed and ready to start, shift your attention to your right foot. Take a moment to focus on the way it feels.
Slowly tense the muscles in your right foot, squeezing as tightly as you can. Hold for a count of 10.
Relax your right foot. Focus on the tension flowing away and the way your foot feels as it becomes limp and loose.
Stay in this relaxed state for a moment, breathing deeply and slowly.
When you’re ready, shift your attention to your left foot. Follow the same sequence of muscle tension and release.
Move slowly up through your body — legs, abdomen, back, neck, face — contracting and relaxing the muscle groups as you go.Right foot
Left foot
Right calf
Left calf
Right thigh
Left thigh
Hips and buttocks
Stomach
Chest
Back
Right arm and hand
Left arm and hand
Neck and shoulders
Face

Step-by-step meditation guide

The following simple exercise is recommended by Dr Jon Kabat-Zinn, founder and director of the Stress Reduction Clinic at the University of Massachusetts Medical Center, as an effective method for achieving this state.

Find a quiet place where you won't be disturbed and practise the following exercise for several minutes each day:

  • Assume a comfortable posture lying on your back or sitting.
  • If you're sitting, keep the spine straight and let your shoulders drop.
  • Close your eyes if it feels comfortable.
  • Focus your attention on your belly, feeling it rise or expand gently as you inhale and fall or recede as you exhale.
  • Concentrate on your breathing, 'being with' each breath.
  • Every time you notice your mind has wandered off the breath, notice what it was that took you away and then gently bring your attention back to your belly and the feeling of the breath coming in and out.
  • If your mind wanders away from the breath, then your job is simply to bring it back to the breath every time, no matter what it has become preoccupied with.
  • Practise this exercise for 15 minutes at a convenient time every day, whether you feel like it or not, for one week - and see how it feels to incorporate a disciplined meditation practice into your life.
  • Be aware of how it feels to spend time each day just being with your breath, being 'in the moment' without having to do anything.


Learning how to relax

Planned relaxation calms anxiety and helps your body and mind recover from everyday rush and stress. Music, a long soak in the bath, or a walk in the park do the trick for some people, but for others it's not so easy. If you feel you need help with learning to relax, try a relaxation or meditation class. Your GP and local library will have information about these.

  • Choose a quiet place where you won't be interrupted.
  • Before you start, do a few gentle stretching exercises to relieve muscular tension.
  • Make yourself comfortable, either sitting or lying down.
  • Start to breathe slowly and deeply, in a calm and effortless way.
  • Gently tense, then relax, each part of your body, starting with your feet and working your way up to your face and head.
  • As you focus on each area, think of warmth, heaviness and relaxation.
  • Push any distracting thoughts to the back of your mind; imagine them floating away.
  • Don't try to relax; simply let go of the tension in your muscles and allow them to become relaxed.
  • Let your mind go empty. Some people find it helpful to visualise a calm, beautiful place such as a garden or meadow.
  • Stay like this for about 20 minutes, then take some deep breaths and open your eyes, but stay sitting or lying for a few moments before you get up.

Practising a regular relaxation routine

It's important that you make time to practise a thorough routine on a regular basis. There are plenty of resources out there to help you do this - the anxiety section lists just a few.

Relaxation is one of the most effective self-help activities for mental health. It can be a useful addition to any other form of treatment as well as being an effective measure to prevent the development of stress and anxiety, and at the end of the day to help you sleep.

Relaxation exercises can be divided into two broad categories: those for the body and those for the mind. Body-centred exercises also have an effect on the mind. Having a relaxed body may not prevent a constant flow of anxiety-inducing thoughts but it's a good basis for getting some control of them. So for best results try to combine the two techniques.

How to practice deep breathing

The key to deep breathing is to breathe deeply from the abdomen, getting as much fresh air as possible in your lungs. When you take deep breaths from the abdomen, rather than shallow breaths from your upper chest, you inhale more oxygen. The more oxygen you get, the less tense, short of breath, and anxious you feel. So the next time you feel stressed, take a minute to slow down and breathe deeply:

Sit comfortably with your back straight. Put one hand on your chest and the other on your stomach.
Breathe in through your nose. The hand on your stomach should rise. The hand on your chest should move very little.
Exhale through your mouth, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little.
Continue to breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count slowly as you exhale.
If you have a hard time breathing from your abdomen while sitting up, try lying on the floor. Put a small book on your stomach, and try to breathe so that the book rises as you inhale and falls as you exhale.

Caring for a family member friend who is unwell and Self-care for the carer

1. What and who are Caregivers / Carers

 

A caregiver (Canada and United States (U.S) or carer (Australia, Ireland, New Zealand (NZ) and the United Kingdom (UK)) is anyone who takes care of a family member, partner, friend, or neighbour who is aged, injured or have a mentally or physically disability. In the UK 12.5 % of the adult population are carers, in Ireland 4%, in Australia 11%, in NZ 10%, in Canada 13%, in the U.S 29%  and within the EU rates vary from m 15.8% (in Spain) to 43.6% (in Latvia). For some caregiving is brought on by changes in life circumstances be it accident, illness or birth for others they are born into a family where an existing member of the family is in need of care and are brought up involved in this role. The keys to providing the best care are outlined below being to self-care to ensure that you remain in good psychological and physical health, have knowledge to enable you to plan and prepare and have access to supports.

 

2.  What can a caregiver do to support a person?

a) Identifying the illness and role can help both yours and the dependant’s needs to be met.

  • To identify / accept yourself as a caregiver helps you to gain access to support and information which increase your confidence.

 

  • Gain an understanding and knowledge of your role with the person you are caring for. We are all individuals and the support a person may want can differ even among those suffering from the same condition. Find out from the person who depends on you what are their specific physical and emotional needs. People may require help with managing medication, attending appointments, communicating with professionals, self-care tasks, looking after essential paperwork, emotional support and encouragement to socialise, find peer support and work. Once you have an idea of the persons support needs prioritize, make lists and establish a daily routine to remain organized as this can help ensure both parties’ needs are met. For example, it might be that you are not always wanting to accompany someone to a shop but if there is that need planning and arranging that visit prevents a dispute.
  • What are the symptoms, course, treatment, cause and consequences of the condition or injury that the person you care for suffers from? This enables you to gain a representation of the illness / injury enabling you to be prepared and informed. Along with the person you are caring for you can plan to deal with the consequences and learn about and various treatment and support options.  For example, in making efforts to help a person engage in social activities consider the symptoms of their illness as to what they night enjoy. A trip to the cinema for a depressed person may not help if their concentration is not good and a trip for lunch ensuring a healthy meal might be a better choice.
  • Obtain any information on mental health acts or laws relating to disability and illness to ensure both yours and the person you care for rights are being upheld.

B) Understanding the relationship between the carer / caregiver and dependant

  • Feeling a burden: Often dependents feel a burden on their caregiver however research has shown that the majority of caregivers find the experience rewarding. Caring can also help to form a stronger bond and better quality of relationship with the person. One way the relationship us improved is that the caregiver tends to spend more time socialising with the dependent so a good way to maintain a healthy relationship is to find mutual interest which you can both enjoy together. Surprisingly caregivers also enjoy many of the tasks involved with caregiving perhaps the tasks least enjoyed can be discussed and any alternatives found. If a dependent tells you they feel like a burden perhaps reflect back if a family member or friend of your need care would you feel it was a burden to them?
  • Empowerment:  Ensuring your dependent has knowledge of and access to resources and supports will ensure they remain in control and maintain self-esteem. This can be as simple as a list of helplines, support groups and a coping plan for times of distress.  By asking what does the person not need help with ensures that they are only supported were need so as not to bring about unnecessary frustration or feelings of helplessness.
  • Frustration: Being dependant on another person to meet our needs whether it be to look after our medication, to accompany us out, can be frustrating and one may feel watched, inferior or even controlled. Be mindful of your actions and remember a person would all rather be independent on not have to wait for another to be ready to take them out.

For the carer the dependent person can encourage and support the person in asking for and accepting any outside help from support groups. If there are other immediate or extended family around maybe find ways of sharing responsibilities around as no one person can meet all the person’s needs.

 

c) Mental health

Many illness are subject to stigma. Following any diagnosis be it physical or mental both the patient and family friends embark on a journey through the unknown. There are many campaigns and organisations including O la go la whose work acts in part to reduce stigma and educate people about mental ill health. The stigma of being mentally ill or caring for someone who is can lead to social isolation for both carer and dependent so wait until you feel comfortable with people or are in a setting where you feel comfortable sharing. It is important that people recognize that having a mental illness does not make you more fragile or incapable by educating people about the illness such stigma can change. We are all equal and people with mental health problems have the same potential and talents as those without. More and more people in high positions and celebrities are revealing their own struggles with mental ill health

3. Self-care and Support for the Carer or Caregiver

  1.  

    Professional support

Your family doctor or General Practitioner can help provide support to you and your family or friend. If you need help in managing the stress of being a carer please reach out for the support that you deserve. The GP might arrange treatment for yourself, resources explain the illness and availability of support or check that the person you care for is being managed as best as possible. .

 b) Self-care

Whilst acting as a carer it is important to look after our physical, mental and social health. In your community there may be support group or resources for careers and try where you can to stay in touch with friends and family. For your physical health try to exercise, eat well, sleep and go for regular dental and medical checkups. Develop a self-awareness being alert to the emotional and physical toll, due to the psychological distress of seeing a loved one unwell be unable to function or place themselves at risk. Being a carer should not preclude you from working or having healthy relationships by being informed, communicating and maintaining you’re physical, mental and social health a full life is possible. Remember a persons’ recovery and health is up to them, you are not responsible for how they feel.

One important thing to keep in mind is how much and what support do you think you could realistically give to the person.  It is best to put our own needs as regards our health first and it might be helpful to be honest and open with the person about how much you can be there for them. Just like you didn’t ask to be a carer the person you are caring for did not ask for their illness or disability. Even if the help you can provide to a person is limited or restricted it is appreciated no matter how small the help provided.

c) Links

Australia: http://www.caregiver.com/regionalresources/intl/support/australia.htm

Canadian Caregivers Association http://www.ccc-ccan.ca/

European Union: www.eurocarers.org

Ireland: http://www.carersireland.com/

New Zealand: http://www.msd.govt.nz/what-we-can-do/seniorcitizens/care-and-support/caregiver.html

United Kingdom (UK) http://www.carersuk.org/

United States: http://www.caregiving.org/

ASSERTIVENESS

I. What is Assertiveness?

Assertiveness is the ability to honestly express your opinions, feelings, attitudes, and rights, without undue anxiety, in a way that doesn't infringe on the rights of others.

It's dependent on a feeling of self-efficacy, a sense that if you behave in a certain way, something predictable will occur.

Where does non-assertive behavior come from? Many of us are taught that we should always please and/or defer to others, that it is not nice to consider our own needs above those of others, or that we shouldn't "make waves", that if someone says or does something that we don't like, we should just be quiet and try to stay away from that person in the future

 

II. Why is Assertiveness Important?

If you don't know how to be assertive, you might experience ---

Depression. From anger turned inward, a sense of being helpless, hopeless, with no control over your life.

Resentment. Anger at others for manipulating or taking advantage of me.

Frustration. How could I be such a wimp? Why did I let someone victimize me?

Temper/violence. If you can't express anger appropriately, it builds up until it blows

Anxiety, which leads to avoidance. If you begin to avoid situations or people that you know will make you uncomfortable, you may miss out on fun activities, job opportunities, relationships, and lots of other good stuff.

Poor relationships of all kinds. Non-assertive people are often unable to express emotions of any kind, negative OR positive

 

III  Learning to be more assertive

People develop different styles of communication based on their life experiences. Your style may be so ingrained that you're not even aware of what it is. People tend to stick to the same communication style over time. But if you want to change your communication style, you can learn to communicate in healthier and more effective ways.

Here are some tips to help you become more assertive:

 

  • Assess your style. Do you voice your opinions or remain silent? Do you say yes to additional work even when your plate is full? Are you quick to judge or blame? Do people seem to dread or fear talking to you? Understand your style before you begin making changes.
  • Use 'I' statements. Using "I" statements lets others know what you're thinking without sounding accusatory. For instance, say, "I disagree," rather than, "You're wrong."
  • Practice saying no. If you have a hard time turning down requests, try saying, "No, I can't do that now." Don't beat around the bush — be direct. If an explanation is appropriate, keep it brief.
  • Rehearse what you want to say. If it's challenging to say what you want or think, practice typical scenarios you encounter. Say what you want to say out loud. It may help to write it out first, too, so you can practice from a script. Consider role playing with a friend or colleague and ask for blunt feedback.
  • Use body language. Communication isn't just verbal. Act confident even if you aren't feeling it. Keep an upright posture, but lean forward a bit. Make regular eye contact. Maintain a neutral or positive facial expression. Don't wring your hands or use dramatic gestures. Practice assertive body language in front of a mirror or with a friend or colleague.
  • Keep emotions in check. Conflict is hard for most people. Maybe you get angry or frustrated, or maybe you feel like crying. Although these feelings are normal, they can get in the way of resolving conflict. If you feel too emotional going into a situation, wait a bit if possible. Then work on remaining calm. Breathe slowly. Keep your voice even and firm.
  • Start small. At first, practice your new skills in situations that are low risk. For instance, try out your assertiveness on a partner or friend before tackling a difficult situation at work. Evaluate yourself afterward and tweak your approach as necessary.

Toolbox for mental wellbeing every day

Toolbox for mental wellbeing everyday

What is mental well-being?

There are many different definitions of mental well-being but a common overlap is functioning well and feeling good in your day to day life. Consequently there are some tools available to help improve your mental well-being which will be discussed below.

Talking

Talking allows you to express and release emotions which can sometimes feel are building up inside of you. Therefore talking is a self-help mechanism which can help improve your well-being by allowing you to find tip son how you can feel better about a scenario and feel listened to. Choose someone who you would feel comfortable to talk to and perhaps you have previously spoken about your feelings to so the conversation doesn't feel awkward. If you feel you don’t have someone to talk to there are helplines and communities both online and offline who you could talk to. Sometimes it can feel hard to talk about how you are feeling, perhaps try to talk about a smaller thing on your mind and gradually open up as the conversation flows.

Accepting and liking yourself

A good self-esteem involves appreciating and valuing yourself, this can help your well-being by increasing your confidence and helps improve your mood. Instead of comparing and wishing you were like someone else,try and think of the things you are particularly good at and see yourself as a unique individual. For example, you could be good at cooking, making people laugh or a type of sport. How you feel about yourself affects your daily life so if you don’t feel good about yourself, try changing this. For example, you could start learning a new skill/hobby, enroll in a course or volunteer.

Enjoy yourself

Find something you enjoy doing, this could be playing an instrument, watching a film or dancing. Think about things you enjoy now and you have previously enjoyed in the past, or try something new. Doing an activity you enjoy can help you distract yourself and forget the negative emotions you were feeling. It can also make you feel happy and reduce stress levels which thus help improve your well-being. Furthermore it can help yo umeet people who enjoy doing similar things to you or allow you to be yourself.

Eat well

It has been shown in research that a good healthy balance diet can have a positive impact on how we feel. To eat well you should have  3 good proportion sized meals a day and drink lots of water. Certain food types are associated with a better well-being such as fruit and vegetables. However your diet may change depending on different circumstances such as a physical problem may impact on the dietary requirements your doctor or health professional has given you.

Exercise

Exercise has been shown to help make you feel better due to more chemicals being released in the brain and improve self-esteem. Exercise can also be an enjoyable and a fun activity. Check what classes your gym does,find ways you can exercise at home such as an aerobic DVD, use the environment around you to exercise such as running through a beautiful park or find hobbies you enjoy and turn that into an exercise such as dancing. However too little or too much exercise could have a negative impact on your mental well-being, so take into consideration how much exercise is healthy and suitable for you.

Sleep

Poor sleep has been linked to physical and mental health problems which can cause a low mental well-being and mood. If you struggle to sleep try and find podcasts that are designed to help someone fall asleep, do something relaxing before you go to bed or try and clear the mind using calming techniques. Also try and respond to what your body wants, perhaps you need a small nap in the day if you become very tired. Sometimes changing small things to do with your environment can help you sleep such as changing the light,temperature and noise.

Take breaks

Taking a break from a scenario that is causing you stress or other negative emotions can be beneficial as it would allow you to feel calm and stable again. For example, teachers encourage their students to take frequent breaks from revision during the exam period. This helps the student regain energy and also help them not become too stressed. Taking a break can range from a very active activity to not doing much. Popular ways to take breaks can be yoga and meditation but think about what you would find as ade-stressing break.

Care for others

Supporting someone else can provide a rewarding and uplifting sensation. It also can raise your self-esteem and help understand howto help yourself with the advice you give to others. Caring for others can range from your friend to volunteering to caring for your pet. Furthermore it helps keep people close to you as everyone eventually needs support and help with a wide range of scenarios. But it is a good idea to remember that sometimes its ok to focus more on yourself when you are in a bad way and need more self-care.

Connect and socialise

Sometimes it is nice to have time to yourself and do the things that you want to do. But it is also good to connect and socialise with  those around you, whether it’s face to face or over the phone. Organise to do things with your friends and family whether its meeting at a restaurant or participating in a hobby you both like. Even if you see someone for 5 minutes,it can help you complete some of the points discussed above such as taking breaks and enjoying yourself. It is also good for your well-being as you can talk about things that could be building up, help give a change of scenery and help you remember how many people enjoy your company. However if you find a relationship is bad for your mental health, it may be best to end it or take a break from it.

When making decisions think about what is best for your mental well-being, don’t be afraid to say no to things you think will make you feel worse and also don’t be afraid to try something new.

Mood diaries

What is a mood diary?

The idea of a mood diary is very similar to an ordinary diary where you write about your experiences, thoughts and behaviors each day. However a mood diary is more specific as you write about your mood changes, how the scenarios around you affect your mood and how you cope with these mood changes.

 

Who is it suitable for?
Anyone who feels that their mood has a great impact on their daily well-being. It has been seen to be useful for people who have mood disorders such as depression or bipolar.

How is it useful?

·        A mood diary is a self-help technique where you can increase the understanding of your disorder and yourself which can provide a sense of control within your recovery.

·        It can allow you to reflect on what causes/triggers your biggest negative mood changes and also what makes you feel better. Consequently this could allow you to build and plan coping mechanisms and techniques that are most suitable for you in order to reduce negative moods. For example, does your mood diary show that stressful situations have a big impact on your depressive symptoms? If so perhaps you need to practice calming strategies and take time out when stressful situations occur.

·        Mood diaries can be useful if you would like to show your doctor or another health professional an insight into how your mood has been over a length of time. This can be especially useful if you find it hard to convey your thoughts and feelings.

·        Also it can allow you to reflect on how far you have come. Therefore a mood diary can be a rewarding task as you can see how you have improved over a certain amount of time.

 

If you wish to start a mood diary there are templates available on the internet or you can set it out how you want. For example you may want to use scales to illustrate how much a certain emotion is felt in a certain situation or how you are mainly feeling that day. You may also want to draw or use pictures to convey your meaning and describe emotional sensations.Or you may wish to write down all of your thoughts and feelings.

Exercise and diet for improvement of better well being

N.B. Nothing should be substituted for medical advice. If you are to make drastic changes to your diet and exercise plan, please consult your GP first.
What is well-being?

Well being is a contented state of existence characterized by being mentally and physically healthy.

Well being is very important in being able to live a fulfilling life. With this we are able to make the most our potential, cope with life stresses, build long meaningful relationships with others and much more.

Exercise and diet are the two largest factors that affect our mental and physical well being.

Sometimes, we don’t always feel happy or physically well for different reasons.Therefore in order to improve and maintain our well being, we must exercise regularly and maintain a healthy diet.

How does exercise and diet improve well being?

Exercise
Physical activity is good for our physical health. Research shows that it can:

·       Boost our energy levels

·       Strengthen your heart

·       Improves muscle and bone strength

·       Increase a healthy appetite

·       Lower the risk of chronic diseases (e.g. heart disease, type 2 diabetes)
Physical activity is also good for our mental well being. Research shows thatit can:

·       Improve mood

·       Improve self-esteem  and learn to value yourself

·       Improve sleep quality

·       Improve social life

·       Reduce stress and mental fatigue

·       Ward off anxiety and feelings of depression

·       Provide a sense of achievement and purpose in life

·       Reduce anger or frustration

It is also linked to reducing the risk of depression, dementia and Alzheimer’s disease. Despite its effectiveness, it is often under used as an additional treatment method.

How?

     When we exercise, chemicals responsible for making us feel good are released within our brain. These are often referred to as endorphin's.

·      Physical activities are a great way of meeting people. This can help building that social support in your life and bring great emotional comfort, knowing that others are supportive of you.

·      It can break up your normal life routine. This is a great way to step away from the stress and responsibilities in your life and give yourself a well deserved time out.

·      Exercise and physical activity can provide something worthwhile in your life. Something that you really enjoy, that gives you a goal to aim for and a sense of purpose.

Diet (You are what are eat):

·      There are strong links between what we eat and how we feel. For example caffeine and sugar can make us more alert, while food allergies/intolerance can cause you to feel tired and lethargic.

·      However food plays a vital part in the functioning of our body and brain. The brain and body require a well balanced mix of nutrients to stay healthy and function well. This is why a well balanced die tcan provide benefits to our physical and mental health.

Tips for exercise:

There are lots of ways you can be active. To obtain the health benefits from exercise, you should aim for activities that increase your heart rate, breathing and temperature.

According to the NHS, the recommended physical activity levels are:

-         180 minutes every day (Children under 5)

-         60 minutes every day (Young people,5-18)

-        150 minutes every week (Adults)

Examples of moderate exercise include:

-        Walking fast

-        Exercise classes e.g. aerobics

-        Gym

-        Bike riding

-        Sport (tennis, swimming etc)

-        Dancing (alone or with others)

-        Taking the stairs instead of the lift

Tips for healthy diet:

A healthy balanced diet includes:

·      Lots of different types of fruit and vegetables

·      Wholegrain cereals or bread – so that energy is released over a longer period of time.

·      Nuts and seeds

·      Dairy products

·      Oily fish

·      Plenty of water

·      Eat at least 3 meals each day.

·      Try to limit how many high-caffeine or sugary drinks you have, and avoid too much alcohol – these can cause fluctuations in mood.

Perhaps use this active interest in your diet as an excuse to practice your culinary skills.

NB: The advice on this page may not apply if your doctor or dietician have given you specific dietary advice, e.g. if you are a kidney patient or a diabetic.

OVERCOMING BARRIERS:

Making changes in your life may mean overcoming some obstacles:

Fear of failure – start slowly with a beginner’s class or jog for ashort period of time that suits you and then gradually increase. Set realisticaims where you can feel a sense of satisfaction and reward.

Money – Exercise doesn't need to cost a thing. There are lots of free activities such as jogging or walking fast in your local park.

Social anxiety – Ask a friend to go along with you or just go for it. You won’t know until you try it.

Stress - This is a normal and keeping active can help you deal with excess levels.

Feeling low and low energy - When you feel down it can be difficultto motivate yourself. But exercise can help left your low mood and give you a positive outlook on life. But know when to say stop and listen to your body.

Seasons – For cold winter evenings, perhaps try an indoor activity where it’s warm and dry.

Injury or illness – Take advice from your GP if you need to. If an injury is going to be an on-going problem, perhaps consider a more suitable activity.

What to do if panic attacks?

When you have a panic attack your heart rate will go up. You will start to breathe faster and this elevates the level of oxygen in your blood. Not a great thing. When you have too much oxygen in your blood you will be tricked into thinking you are short of breathe but in actual fact you have too much breathe! Breathing fast causes your body to hold on to too much oxygen and not enough carbon dioxide and as such you start to feel dizzy and short of breath.

 

1. Go outside into the open

After my first panic attack I was left feeling terrified and vulnerable. I had heard about panic attacks but I had never realized how bad they could be. One of the scariest things about the panic attack was that I felt completely confined and unable to escape the situation.

So the next time I felt a panic attack coming on I raced outside and down the road to the local park. This park near my house has a great big creek running through it and lots of trees and birds. It is very relaxing. I soon started to feel more open and spacious and no longer felt trapped by the panic.

Getting outside in the open is surprisingly effective. Often when we are having a panic attack we are indoors and alone. Going outside might seem like the last thing you want to do but I am certain that it helps.

2. Take a shower

As I mentioned, sometimes during a panic attack you can feel dizzy, sick and very panicked. I found that taking a nice hot shower really helped to calm me down.

Now this tip is not going to be for everyone. Some people like showers, other people don’t. If you are feeling the symptoms of an attack it might be a good idea to strip off and jump in the shower. The hot water, the repetitiveness of the water drops and the steam are all really good ways to slow down. When I had my panic attacks I used to sometimes sit down in the shower for five minutes while my mind settled.

Showering is nice because it is something physical. You get the bodily sensations as well as the mind relaxing. This body/mind combination can be really powerful – especially if you combine it with some slow breathing.

3. Practice some breathing meditation

The last thing you will feel like doing during a panic attack is sitting down and having a formal meditation session. However, I found that a simple breathing meditation really helped to calm me down.

The first thing I would do is remind myself that this panic attack was a good opportunity to learn to master my mind. If I could meditate during a panic attack surely I would be able to deal with anger, pride, attachment, etc. during normal life. This put me in good stead as I saw the panic attack as an opportunity instead of a negative event.

4. Call a friend

Sometimes the best thing during a panic attack is to hear somebody’s voice. They reassure you that everything is going to be okay and they remind you that there is some perspective. Calling a friend can be a wonderful help.

However, there is a downside to relying on a friend. If your panic attacks become re-occurring events it might become tempting to call that person every time. You might make the mistake of thinking that you cannot get through the ordeal without them. This is a very bad thing. You do not want to becomedependent on anyone else for your own happiness. It is important that you become strong on the inside.

Relying on a friend is fine if you need that support. Do not feel guilty about calling a friend – they will not mind – that is what they are there for. But do be careful about developing any unhealthy habits. This won’t help anyone.

5. Realise that you are going to be okay

One of the most important things to do during a panic attack is realize that you are going to be okay. Panic attacks do not last forever. You are not going crazy. You will be okay in a few minutes.

Panic attacks are thought to be caused by the part of the brain that governs our fight or flight reaction. If it feels threatened it will pump chemicals into the body that cause you to panic so you will get out of the harmful situation. This is all well and good if there were a threatening situation but most of the time panic attacks seem to come out of the blue or after a not so threatening situation.

Seeing as the panic attack is caused by a chemical reaction it is going to take some time for your symptoms to ease. Your body has just been flooded with hormones and you will not feel better immediately – even if your mind has calmed down a bit. Give yourself time and remind yourself that it will all be over soon. This goes a long way to reducing the severity of the situation.

6. Listen to some slow, rhythmic music

Music is a very powerful tool. It has the ability to change our moods in an instant. I found music to be a particularly useful tool when I was trying to deal with a panic attack.

The best music to listen to during a panic attack is something that is graceful, slow, melodic and rhythmic. I really like to turn on some Vivaldi or Mozart and listen to the happy and joyful songs of the violin and piano. Hip hop and other tracks with a bouncy and catchy baseline can also be beneficial.

See what works for you. Spend a few weeks listening to some new music and see what calms you down. Play that music during the times that you are feeling happy and relaxed (like in the bath) and then when you have an attack you can turn the music on and go back to that place.