Mind Your Triggers

As a medical student, I was often in the scary situation of doing something for the first time.  One day, the resident told me I would be doing a blood draw on the next patient.  We entered his room and explained this to him.  He took one look at me, and flatly refused.  I quickly left the room, near tears, and went back to the other students to rant and rave about this man who wouldn’t let me poke him with a needle.  Looking back on the incident, I think I overreacted, right?  This man was very ill and had a right to decide who would be drawing his blood.  But I felt like he was judging me, and had decided that I came up short.  This situation caused a strong reaction, not because of the incident itself, but because it hit one of my emotional triggers: being thought of as incompetent.

Emotional triggers are people or situations that create a strong emotional response within us.  When triggered, we might feel angry, defensive, resentful or afraid.  We may react strongly, in a way that feels almost beyond our control, and certainly out of proportion to what’s really happening.  Chances are, most of us have a trigger or two.  Common ones include being ignored or abandoned, being judged or dismissed, or being powerless.  It may become obvious over time that our reaction is always the same when our trigger is hit.  What isn’t always so obvious is that our responses can be controlled.  While I may always feel defensive when I think my competency is being questioned, I don’t have to respond in an angry or unprofessional way.

The key to managing triggers is awareness.  I need to know the potential dangers before they strike, or I can’t expect to change powerfully ingrained responses.  Meditation will absolutely increase self-awareness over time, so a regular sitting practice will help with responses to triggers.  A more direct approach utilizes a technique similar to thought records of cognitive behavioral therapy.  You will need a pen and something to write on.  Divide the sheet into three columns.  In the first column, write down situations that caused an intense emotional reaction.  In the second column, identify the emotions you experienced, and in the third column, write how you responded.  Try to come up with multiple scenarios from your life, and add any new situations that arise over the next week. Then, the investigation begins.  What do these situations have in common? Try to look at them objectively, and identify the trigger in each one.  You can explore the origins and reasons behind them through journaling, or with the support of a good therapist.

Once you have a handle on your triggers, the real work begins. Now we have to identify triggers in real time, and be conscious enough to alter our ingrained responses. This means being alert to emotions and recognizing when a strong one is occurring. Next, we have to slow down. Instead of reacting, take a deep breath and look inside at what’s happening. Could this be a trigger? If so, proceed with caution. Bring out your objective observer and respond only to what’s real, not the automatic conclusions of your triggered mind. Over time, the awareness gets stronger and we can quickly assess any situation- trigger, or real reason to flip out?

Being conscious of triggers not only increases self-awareness, it also helps prevent conflict and improves communication. As we get to know ourselves, we can truly be open to others. Imagine if I had been more self-aware as a 24 year old medical student.  I would have sensed the feeling of resentment and anger, and looked for signs of old patterns. Then, I could have taken a deep breath and responded to the real person in front of me. I could have explained my role in his treatment team and calmly asked about his concerns. Then I would have answer truthfully, not emotionally, and asked permission to draw his blood. Maybe the outcome would have been different?

Sleep Easy

Insomnia is one of the most common problems I see, which makes sense because it is a symptom of stress as well as many psychiatric conditions.  As many as 20-40% of adults suffer from insomnia in any given year, and 55% of adults have problems falling asleep during their lifetime.  I’m willing to bet that every adult has had at least a few sleepless nights!  I’m no stranger to insomnia myself.  It’s not unusual for me to lie in bed with my mental wheels spinning furiously.  I may replay the day, plan for tomorrow or just worry.  This was an almost nightly occurrence for me until I started doing yoga.  The combination of physical exercise and deep relaxation led me to fall asleep more easily.  Since then I’ve found a number of techniques to enhance sleep, including restorative yoga and breathing practices.  Sometimes my mind needs more distraction to let go of thinking.  So, I have a repertoire of ways to gently steer my mind away from thought and into a state of relaxation.  Keep in mind that these techniques may help mild to moderate insomnia, but more severe symptoms or reduced need for sleep can indicate a serious condition.  Please consult your doctor if your sleep issues are chronic or severe.

Sometimes the simplest things are overlooked when it comes to creating a good atmosphere for sleep.  I can’t tell you the number of people who disregard the “Sleep Hygiene” rules, and don’t recognize how their habits affect their sleep.  So the basics include a room that is a comfortable temperature, dark enough and quiet.  If you are a light sleeper like me, you may want to use a white noise machine or relaxation track to disguise other sounds.  It’s also important to minimize disruptions, so turn off phone notifications or, better yet, leave your smart phone outside the room.  The same goes for any bed-hogging pets!  Also, bright light signals wake time to the brain, so if you wake during the night, leave the lights off.  Even LCD alarm clocks can disrupt the normal release of melatonin, so turn the clock away from you, or place it across the room.  This also prevents clock watching, which leads to the endless calculations of “how much sleep can I still get if I fall asleep right now?” Or maybe that’s just me.

There are many habits that promote good sleep.  Get regular exercise, avoid caffeine after noon and keep a fairly rigid sleep schedule.  That means go to sleep at about the same time every night, and wake at about the same time every morning.  Even on weekends.  I know, I don’t want to do it either, but it really does help.  Other simple changes include turning off the TV and back-lit electronics at least an hour before bedtime, and choosing a relaxing activity instead, like reading or meditation.  This can be incorporated into a nightly routine that sends a signal to start to wind down.  I also like to journal before bed, to allow myself to write down any thoughts or worries.  Then I can tuck them away for the night.

Even if I follow all these rules, it’s pretty normal to still get an occasional bout of insomnia.  Then I like to use my favorite relaxation techniques to quiet the mind and the body.

1. A yoga practice that coordinates breath and movement is a good way to release tension.  Try this simple flowing yoga sequence, demonstrated by yoga and meditation expert Tanya Penny: http://yogahealingpro.com/transformation-tuesday/yoga-for-insomnia

2. Meditation is the ultimate expression of a quiet mind.  Practice before bed, or consider listening to a guided healing meditation designed especially for insomnia, like this one, also by Tanya Penny: http://yogahealingpro.com/store/cds/easing-into-sleep

3.  Try deep breathing.  We can easily induce the relaxation response by lengthening the exhalation of each breath.  I like to count the length of my inhale, then try to make the exhale 1 or 2 counts longer.  This has the added benefit of giving my mind something to focus on.  If I get distracted, I simply return to counting at one with my next in-breath.

4. Progressive muscle relaxation is another tried and true way to ease into sleep.  This involves sequentially focusing on muscle groups in the body and deliberately allowing them to relax.  I like to start at my feet and move upwards, breathing deeply between each section.  I notice the sensation in my toes, and relax any tension I feel there.  Then I bring awareness to my feet and release any last feelings of tightness, and so on.  The combination of the breath, body focus and a structured format allow me to release thinking for feeling as I relax deeply.  I’ve had several patients tell me they never get through their entire body with this exercise, sleep comes well before they reach the torso!

5. There are also many natural herbs and supplements that promote sleep. Lavender oil is safe and surprisingly effective when sprayed on your linens or in the air, and chamomile tea is very soothing as party of a bedtime ritual.  Your doctor or natural health provider can offer suggestions specific for you.

Often, one or a combination of several of these techniques can restore healthy sleep.  Remember that a good night’s sleep is an important part of self-care and good health.  Many things may seem more important than a bedtime routine, or a full 8 hours of rest, but the next day will look a lot brighter if we’ve allowed sleep to restore our body and mind.

Driven to Distraction

Lack of concentration is a symptom of many psychiatric illnesses, from depression and anxiety to adult ADHD.  But before jumping to any conclusions, remember that it’s also a symptom of stress and the chaotic nature of a busy lifestyle.  We live in a world filled with distractions, where everything seems to be urgent, and we are always on call and available.  Every text message has become so important that it can’t wait until the car is parked (yikes!), and the computer can’t be turned off for a 20 minute lunch break.  We are trying to do more in less time, using technology to make us more efficient.  Yet somehow we feel less focused than before the invention of the smart phone.

Multi-tasking is valued in many areas of life.  It is a good skill to have when I’m trying to make dinner, finish the laundry and help my kids do homework.  Everything gets accomplished, but sometimes things get forgotten.  I can’t tell you how many times I’ve filled the washer and walked away without pushing start.  Or walked into the pantry only to walk back out having no idea why I went there in the first place.  This morning, I found the ice cream in the refrigerator.  Am I losing my mind? No, but I am too distracted to give my full attention to any single task.  The division of focus means things will fall through the cracks.  Let’s face it, a human brain simply can’t do several things at once.  At least, it can’t do them all well.

So what is the antidote to an overly multi-tasked life?  I often suggest a radical idea to stressed out people complaining of memory and concentration problems: Slow down and do just one thing at a time.  I think I once saw a busy mom’s head actually explode at the idea, and I understand why.  It’s not what we’ve been trained to do.  But hear me out.  If I give my full attention to just one task, I am focused, efficient, and can see it to completion in a shorter period of time.  Then I can turn my attention to the next thing with the same devotion.  I propose this method will take only slightly longer than the old way, and fewer mistakes will be made.

I also believe we lose a lot of the richness of life when we are distracted.  Meals get ingested, but not savored. when eaten in front of a computer.  Conversations with friends have no give and take if we are all busy checking our messages.  So why not try single-tasking for a change?  Consciously turn off the computer when on the phone, disable email and text alerts, and put your focus on what’s going on right now.  This is living mindfully.  Every task has its moment, and we can enjoy each of life’s experiences in their own time.

What’s Your Motivation?

One of the biggest complaints I hear from people is “I have no motivation.”  This can be a symptom of depression, but I see it as a more universal issue.  Especially since I noticed the slump in my home practice of yoga.  I had a busy couple of weeks, and wasn’t able to go to my regular yoga classes.  Apparently, they have been keeping my practice afloat, because when I couldn’t get there, I was barely rolling out my mat at all!  Once upon a time, I did yoga daily, no matter what.  At home with a web class, my own sequence, studio class, it didn’t matter, I did it.  But lately I’ve counted a few stretches after walking the dog as my practice.  Well, today I rolled out my mat and did some serious yoga, and I feel so much better!  So why aren’t I motivated to do it every day anymore?  I decided to take a look at motivation, and what promotes it or detracts from it.

I think one of the big downfalls of motivation is lack of direction.  It’s much easier to make a plan of action if my goal is to exercise than if it’s to “get healthy.”  So, I need to set a specific goal that allows me to focus my attention.  Then I can create concrete steps to achieve it.  Motivation comes from having a direction and knowing how to get started.  Then I can tell someone about my goal, because accountability promotes good motivation.  It’s best to choose someone who will cheer success as well as give a gentle nudge when needed.  Or, I can set up a buddy system with someone who shares my goal.  I increase accountability, but I have also added a partner to keep myself going.  I know I’m more likely to get up for morning yoga if I’ve planned to meet a friend in class.

Now I’ve set my goal and created accountability, next I have to actually begin my plan.  This part can be tricky, because I have decided to make a change, and I want to do it all right now!  My tendency would be to plan a home yoga practice every day I can’t attend class from here on out.  Obviously over-ambitious.  The first time I don’t meet my goal, I’ve set myself up for that classic all-or-nothing thinking that can derail the best plans.  Instead, I should start small, with a realistic schedule.  I can successfully do yoga at home 2 days a week.  Once I meet my goal, I can always add more.  But right now, that’s enough.

Now that I’ve started my return to regular home yoga, I have to keep doing it.  Obviously, right?  What I mean is, I have to create a habit.  Routine is a powerful motivator.  I have realized that I used to do yoga at home all the time because I used to do yoga at home all the time.  It’s just what I did.  Somewhere along the line I got out of practice, and now I have to rebuild.  It takes about a month to create a new habit, and that month carries a lot of potential to give up.  But, if I follow my own advice to stay motivated and keep rolling out my mat, eventually it will become routine again.  In the meantime, I will focus on the positive aspects of reaching my goal, like increased energy, a calmer mind and stronger body.  I know those things are the ultimate goal, not the daily practice.  Keep your eye on what’s good about your goals, and it will keep you going!