If you’re someone who struggles with anxiety, the process of finding a therapist can feel overwhelming. Since therapists often specialize in treatment methods, finding the right type of therapy for you is the best way to get started. Cognitive Behavioral Therapy (CBT) is a popular and proven technique to treat anxiety disorders such as generalized anxiety and social anxiety. CBT is a short-term treatment aimed at developing skills to help you alter emotional responses that are harmful to your wellbeing. Your therapist will help you change the thoughts and behaviors that trigger or worsen your anxiety. Because thoughts come before feelings, and feelings lead to actions, changing your thoughts can reduce or eliminate your negative emotions and unhealthy behaviors. In other words: thought → feeling → behavior. If you can change your thinking, your feelings and actions will change as well. CBT does this by using a three-step process.

For an example of how the CBT process works, let’s use a thought someone with social anxiety might have: “I feel so awkward at parties. Everyone must think I’m a loser.” This thought may lead to feelings of sadness, shame, and fear. You’re ashamed of how you act at parties, sad that people think you’re a loser, and feel anxious at the thought of attending a party. These feelings then lead to behaviors like isolation and avoidance, which make you feel worse.

In CBT, a thought like that is called emotional reasoning: “I feel it so it must be true.” But feelings are not facts. Just because you feel awkward at parties doesn’t mean other people think you’re awkward.
Emotional reasoning is an example of a cognitive distortion. Cognitive distortions are irrational thought patterns that lead to an inaccurate perception of reality. It’s your mind convincing you that something is real when it isn’t. CBT is designed to treat the most commonly occurring cognitive distortions, including emotional reasoning.

A CBT-trained therapist will take you through three steps to reduce or eliminate the distortion:
Step 1: Identify the negative thought
In this case, the thought is, “I feel so awkward at parties. Everyone must think I’m a loser.” In a CBT session, it may take some time to uncover this thought. At first, you might talk to your therapist about your feelings toward going to parties, and how you feel when you attend one. Together, you’ll find the root thoughts behind your anxiety and tackle each one separately.

Step 2: Challenge the negative thought
Your therapist will help you question the evidence for your thought, analyze the belief behind it, and reality test it. For example, you might talk about the time in middle school someone called you a loser and how it has shaped your self-esteem. Then you’ll discuss why you feel awkward at parties. Finally, you’ll test your negative thought by separating your thoughts and feelings from reality. You may feel uncomfortable at parties and assume people dislike you, but they wouldn’t invite you if they thought you were a loser, and you get invites all the time! Your thoughts and feelings aren’t based on facts.

Step 3: Replace the negative thought with a realistic one
If you try to change your negative thought into its opposite extreme, the new thought won’t stick in your mind for long. “Everyone thinks I’m the coolest person in the world” also fails the reality test. It will quickly fall apart, which will send you hurtling back to the negative thought. Instead, you want to find a realistic thought that passes the reality test. For example: “Just because I feel awkward doesn’t mean other people see me that way.”

In CBT treatment, you’ll learn about more cognitive distortions and repeat this three-step exercise for other negative thoughts you have. When you practice challenging your negative thoughts and replacing them with realistic ones, it’ll become easier to identify distortions before they hurt you. With CBT, practice makes perfect and perfect is a life without debilitating anxiety. Finding a therapist who is familiar with CBT is a good place to start when looking for help with your anxiety.

​https://www.psychologytoday.com/us/blog/mindful-anger/201906/3-steps-treat-your-anxiety-using-cbt

By Terry Gaspard, MSW, LICSW
​From: https://www.gottman.com/blog/what-to-do-if-you-dont-trust-each-other/

​Maura, 47, and Kevin, 49, sit on opposite ends of the couch during their first couples counseling session. When I ask them about some of the challenges they’ve faced in their four-year marriage, Maura opens up about why she requested to meet with me. 
Kevin’s been giving me the cold shoulder and I feel his anger. He just can’t seem to get over his resentment toward me since he found out that I charged over $5,000 on credit cards over the last year. At times, I told him about my purchases for my new business. Other times, I worried that he’d think I was being frivolous. I guess I never saw myself as being dishonest until Kevin saw my Visa bill and got very upset.
Like Maura and Kevin, many of the couples that I work with in my practice have feelings of mistrust when it comes to facing day-to-day challenges. In The Science of Trust, Dr. John Gottman explores the milestones that all relationships have, particularly in the early stages. He writes, “As we shall see, most of these issues have to do with trust.”
Trust is an essential aspect of intimacyMaura knows that her emotional sensitivities make it difficult for her to open up to Kevin and increase her fear of being hurt or left by him. She strives to be transparent with Kevin about finances but struggles to do so because she doesn’t feel secure in her relationship with him. After enduring a difficult divorce, Maura has trust issues and describes how she “walks on eggshells,” fearing she will lose Kevin.
In Hold Me Tight, Dr. Sue Johnson explains that by being vulnerable, you can create a level of emotional safety with your partner. It’s the primary way to strengthen a marital bond and keep love alive. Through vulnerability, you’ll be able to re-establish a secure emotional attachment and preserve intimacy in your marriage. Brené Brown also champions this idea in her popular TED talk, The power of vulnerability. 
Even though Maura doesn’t believe she was overspending on her new business, she also realizes that withholding financial information is creating mistrust and damaging her marriage. 
Johnson explains that you can tell when one of your “raw spots” has been hit because there is a sudden shift in the emotional tone of the conversation. She writes, “You and your love were joking just a moment ago, but now one of you is upset or enraged, or, conversely, aloof or chilly. You are thrown off balance. It is as if the game changed and no one told you. The hurt partner is sending out new signals and the other tries to make sense of the change.” 
Kevin reflects.  
I don’t always like to talk things through, but that doesn’t mean I don’t love Maura. She’s insecure and wants me to reassure her all the time that I’m there for her and she needs to realize that I am not going to leave her like her ex did. When she gets mistrustful, her voice changes and she often threatens to leave me.
Maura responds thoughtfully. 
Things don’t always go smoothly when we disagree. When we have conflict, Kevin doesn’t usually want to talk about it. And I have a problem because my ex also gave me the silent treatment and then left after sending me a text that he wanted a divorce. I feel rejected when Kevin goes into his shell, but I’m learning to let go of my old baggage and give him space.
So where do they go from here?
Learning to trust each otherOne of the hardest things about trusting someone is learning to have confidence in your own judgment. Trust is about much more than finding signs that your partner has been unfaithful. It’s about believing that they have your best interests at heart. 
Every person is born with the propensity to trust others but through life experiences, you may have become less trusting as a form of self-protection. Falling in love and getting married can be invigorating and scary all at once. An inability to trust a new partner may take several forms, from feeling they’re dishonest or secretive, to doubting they’re going to keep their promises or be dependable. 
Take a moment to consider this: Your partner is not solely responsible for creating mistrustful feelings. In most cases, you must take equal responsibility for creating an atmosphere of safety and security in your relationship. In order to begin the process of overcoming mistrust, ask yourself:

• What is the story I’m telling myself?
• Does my fear of loss and abandonment cloud my perspective and cause me to overreact to my partner’s actions?
• Is my mistrust coming from something that is actually happening in the present, or is it related to my past?
• Do I feel comfortable asking for what I need and allowing myself to be vulnerable?
• Do I bring my best self to my interactions with my partner?
• Do I possess self-love and allow myself to be loved and respected?

Many relationships are sabotaged by self-fulfilling prophecies. If you believe your partner will hurt you, you can unconsciously encourage hurts to emerge in your relationship. But day by day, if you learn to operate from a viewpoint that your partner loves you and wants the best for you, you can enjoy trust in your marriage.
Here are seven ways to proactively build trust in your relationship. 
Acknowledge your feelings and practice being vulnerablein small steps Build confidence in being more open with your partner. Discussing minor issues (schedules or meals) is a great place to start before tackling bigger matters like disciplining kids or finances.
Be honest and communicate about key issues in your relationship
Be sure to be forthcoming about finances, your past, and concerns with a family member, co-workers, or children. Don’t sweep important issues under the rug because this can lead to resentment.
Challenge mistrustful thoughts
Ask yourself: is my lack of trust due to my partner’s actions, my own insecurities, or both? Be aware of unresolved issues from your past relationships that may be triggering mistrust in the present.
Trust your intuition and instincts
Have confidence in your own perceptions and pay attention to red flags. Be vulnerable and ask for reassurance if you feel mistrustful.
Assume your partner has good intentions
If he or she lets you down, it may just be a failure in competence–sometimes people simply make a mistake.
Listen to your partner’s side of the story
Believe that there are honest people in the world. Unless you have a strong reason to mistrust him or her, have faith in your partner.
Practice having a recovery conversation after an argument
Take a short break if you feel overwhelmed or flooded and set a time to process what happened. This will give you both time to calm down and collect your thoughts so you can have a more meaningful dialogue with your partner.
According to Dan Wile, author of After the Fight, after a disagreement your focus needs to be on listening to your partner’s perspective, collaborating, building intimacy, and restoring safety and good will.
In The Science of Trust, John Gottman explains that practicing emotional attunement while relaxing together can help you stay connected in spite of your differences. This means turning toward one another by showing empathy, responding appropriately to bids for connection, and not being defensive. 
Asking your partner open-ended questions is also a great way to increase emotional closeness and build trust. If you ask questions that require a yes or no answer, you’re closing the door to intimate dialogue. In other words, take your time and make love to your partner with words. 
For a relationship to succeed in the long run, you must be able to trust each other. Building trust with a partner is really about the small moments of connection that allow you to feel safe and to truly believe that your partner will show up for you. It’s the bedrock of a happy, long term partnership. 
How to rebuild trust when it’s been brokenIn their new book Eight Dates: Essential Conversations for a Lifetime of Love, John and Julie Gottman suggest that if you break any agreements about trust with your partner, there are steps to fix what’s been broken. These steps include setting a time to talk, naming the feelings you experienced due to the breach of trust without blame or criticism, listening to your partner without judgment, and each partner describing their perspective and discussing any feelings that were triggered by the incident. 
The final three steps essential for rebuilding trust, according to the Gottmans in Eight Dates, are both partners assessing how they contributed to the incident and holding themselves accountable, each person apologizing and accepting an apology, and developing a plan to prevent further breaches of trust from occurring.
An important part of my work with Maura and Kevin focused on facilitating conversations between them that helped to rebuild trust and affirm their commitment to one another over time. Specifically, they worked through the steps in Eight Dates and were eventually able to apologize to each other for their part in the issues they were struggling with.
For instance, Kevin was able to be vulnerable and apologize for giving Maura the silent treatment, which triggered her feelings of mistrust and insecurity. Instead of telling her she was  “too needy,” he began responding to her bids for connection more often. Fortunately, Maura gave Kevin a sincere apology for her financial infidelity related to expenditures for her new business, and she promised to practice full disclosure in the future.
Maura put it like this.
It was unexpected when Kevin was willing to listen to my side of the story and not dish out blame. I made a mistake and was willing to accept responsibility for my actions but he didn’t rub it in or make me feel worse than I already did. It feels like we can start fresh now that I’ve apologized and made a promise to be more open with Kevin. I know that I’m lucky he forgave me.
You have the power to break free from the hold that mistrust has on your relationship and create the kind of intimacy you deserve. 

Most of us have had experiences where we can't stop thinking about something, no matter how hard we try. We pick apart the situation to see what we could have done differently or try to analyze the minutiae of the incident to figure out what it all means. Clinical psychologist Dr. Susan Nolen-Hoeksema referred to this process as rumination and defined it as "a method of coping with negative mood that involves self-focused attention" and "repetitive and passive focus on one’s negative emotions."


Though most of us ruminate from time to time, some people ruminate frequently, and people who do this are at higher risk for depression, disordered eating, and other mental health issues. Below are nine strategies that Dr. Nolen-Hoeksema and others have recommended for coping with overthinking.


1. Recognize that rumination is different than problem-solving or planning. Problem-solving and planning are active coping strategies, while rumination involves rethinking situations, analyzing them, and replaying them without forming an action plan or feeling a sense of resolution. Sometimes simply recognizing that you're ruminating can be a helpful step toward decreasing it and getting on a different track.


2. Research suggests that distraction may help. Because the pull of rumination can be strong, Dr. Edward Selby suggests specifically selecting activities that are highly engaging and positive, so that they effectively shift your attention from overthinking. Examples may include vigorous exercise, taking a hot shower, doing a crossword puzzle, holding an ice cube in your hand (a suggestion from dialectical behavior therapy), watching an engrossing movie, playing a game, or any other type of healthy activity that you find helpful.


3. Stop fighting with your thoughts. This might seem counterintuitive, but acceptance and commitment therapy suggests that efforts to stop certain thoughts can have a paradoxical effect. If you observe your thoughts in non-judgmental wonder (e.g., thinking it’s interesting your mind is repeating something, rather than getting frustrated with yourself for not being able to stop it), they might decrease in frequency or intensity. The example that is often used is trying not think about a white bear and being unable to think of anything else. If you instead allow yourself to think of the white bear, you may actually think of it less or at least not feel as distressed by it. More details about this approach, including useful metaphors, are available here.


4. Challenge perfectionistic standards with cognitive-behavioral therapy techniques. Are you judging your behavior against an unrealistic vision of how a person would ideally act in a situation? Are you overly focused on any minor missteps or negative aspects while discounting the positive aspects? One strategy that might help is thinking about what you would tell a friend who felt the way that you do.


5. Plan dedicated daily rumination time. Dr. Nolen-Hoeksema recommended scheduling a dedicated time (e.g., 30 minutes) in the day when you plan to ruminate, an exercise similar to one developed by Dr. Thomas Borkovec for worry. This might sound strange, but the idea is that if you start ruminating or worrying at any other time during the day, it is easier to change course if you think to yourself, "I don't need to think about this now. I will save it for my designated time later." In my experience, when people devote time to ruminating in a focused way, they often find that they can't fill the full time, or they find some resolution at the end of it. This is in contrast to a common pattern of ruminating, which involves going in and out of it in a shallow way of thinking throughout the day while completing other tasks.


6. Try relating to your thoughts differently via mindfulness or prayer. Dr. Nolen-Hoeksema conducted community interviews and reported that some people turn their concerns over to a higher power when ruminating, and that this seems to help them gain acceptance and peace about a situation. In particular, some clients that I have worked with find the serenity prayer to be helpful. For people who are not religious or who are just looking for an additional healthy coping strategy, she suggested trying meditation and/or mindfulness exercises.


7. Write thoughts out instead of letting them circle around in your head. The key is to make sure that the writing is leading to a sense of resolve and relief rather than adding a new place for ruminating. If you find that it makes things worse, then it is best to try some of the other strategies.

8. Talk to someone about the problem and gain a new perspective. Just beware of co-rumination ("extensively discussing and revisiting problems, speculating about problems, and focusing on negative feelings"), which can exacerbate the problem.


9. Create positive emotions. It might seem like this is particularly hard to do when stuck in a rumination cycle. However, if you can find a way to add some positive emotions (reading or watching something funny, listening to an upbeat song), even briefly, it might help you to look at your problem differently or in a more lighthearted way.


I hope that you find these recommendations helpful for reducing overthinking. However, if you feel that you are stuck or that your rumination is leading to significant distress or impairment in your life (e.g., negatively affecting relationships, work, or school), please seek help from a mental health professional. In addition, sometimes thoughts and memories can keep returning to people's minds because of the experience of a traumatic event. This can be quite different than rumination, and you should seek professional help specifically for trauma if that is what you are experiencing.

​https://www.psychologytoday.com/us/blog/out-the-ivory-tower/201905/9-strategies-overcoming-overthinking

By Zawn Villines

In her seminal book, On Death and Dying, psychiatrist Elisabeth Kübler-Ross identified five distinct stages of grief. Kübler-Ross worked with dying people and designed her model to describe the distinct grief of dying.
In On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss, a book co-authored with David Kessler, Kübler-Ross expanded her model to include many other types of grief. A modified version of Kübler-Ross’s model adds two new stages, shock and testing. This seven-stage model of grief is familiar to many people who have grieved a loss, yet little research supports the model.
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THE SEVEN STAGES OF GRIEFAccording to Kübler-Ross, and later to her co-author David Kessler, there are five stages of grief: denial, anger, depression, bargaining, and acceptance.
Some grief experts suggest this model might leave out two additional stages. This is sometimes called the Extended Kübler-Ross Model. According to that seven-stage model, the stages of grief are as follows:

1. Shock: This is a person’s initial sense of paralysis and shock following bad news.
2. Denial: Denial is an attempt to avoid the pain of the loss. Sometimes people distract themselves with other pursuits.
3. Anger: Anger is a reaction to the loss of control that often accompanies a loss. A person may experience overwhelming feelings of frustration or target their anger to a specific source, such as God, a doctor, or the person who shared the bad news.
4. Bargaining: Bargaining is an attempt to regain control. During this stage, a person tries to find a way to escape the pain. For example, a person dying of cancer might adopt a very healthy lifestyle, or a parent whose child is dying might spend lots of time praying.
5. Depression: When bargaining fails and a person realizes they cannot control the loss, they may enter a state of intense depression.
6. Testing: During this stage, a person experiments with ways to better manage and cope with the loss.
7. Acceptance: During acceptance, a person integrates and understands the loss. This does not mean they are “over” it, but they are able to move forward. The degree to which a person is able to accept the loss and move forward depends on the specific loss, personal psychological factors, a supportive environment, and more.

In his book Finding Meaning: The Sixth Stage of Grief, David Kessler argues that the quest for meaning might be the final stage of grief before acceptance.
While the original model was presented as sequential, most grief experts now argue that a person can go through the stages in any order. They may also repeat or revisit stages, especially during times of intense emotional distress. For example, a person grieving the loss of their father might become angry over his loss when he is not present at their wedding, even if they already experienced the anger stage years before.
While the original model was presented as sequential, most grief experts now argue that a person can go through the stages in any order.
SHOCK: THE FIRST STAGE OF GRIEFGrief often begins with bad news—a stunning diagnosis, a phone call announcing a loved one’s death, or an ultrasound that reveals a baby is not developing normally. This can feel like a massive blow, sending a person into a state of emotional shock. During this earliest stage of grief, a person may feel unable to process the meaning of the news.
Shock can last just a few moments or for many days. For some people, shock reappears as the grieving process unfolds. A person grieving the death of a relative may feel another wave of shock settle in at the funeral or burial, for instance.
Some hallmarks of shock include:

• Difficulty expressing emotions
• Trouble processing the meaning or effect of the news. A family member might be unable to plan a funeral, while a newly diagnosed patient may feel ill-equipped to make treatment decisions.
• Feeling numb, paralyzed, or overwhelmed
• Feeling overstimulated and in need of a break from the weight of the grief

TESTING: AN OFTEN OVERLOOKED STAGE OF GRIEFAs a person meanders through the stages of grief, they may arrive at a period of testing. This stage of grief is similar to bargaining, but typically occurs later. During testing, a person experiments with different ways to manage their grief. For example, a person going through a divorce might contemplate joining a support group, weigh the benefits of a new hobby, or consider dating.
Testing differs from bargaining in that testing is about finding sustainable strategies for living with bad news. Bargaining is about escaping the bad news and regaining control.
A person in the testing stage may:

• Be interested in learning about grief or their specific loss
• Try new strategies for coping
• Reach out to loved ones for support
• “Try on” different philosophies or spiritual traditions

HOW HELPFUL ARE THE STAGES OF GRIEF?While many grieving people report experiencing at least a few of the stages of grief, most research does not support a stage-based model of grief. A 2007 study found people grieving a death experience denial, anger, depression, and acceptance in a similar sequence to that identified by Kubler-Ross. That study, however, found no support for bargaining and found the most prevalent grief-related emotion was yearning for a lost loved one.
Factors such as a person’s social environment, how supported they feel, and the nature of the loss may also change how a person grieves.
Factors such as a person’s social environment, how supported they feel, and the nature of the loss may also change how a person grieves.
Some studies have found a person’s grief may depend on the loss. A 2016 study, for example, argues that people caring for a loved one with dementia face a unique grieving process. This is because they “lose” the person before they die but then experience another loss at death. The study proposes a dementia-specific model of grieving and argues that ambiguity is a core component of each stage of dementia grief.
The extent to which a stage-based model of grief helps people is unclear. People who experience one of the traditional stages may feel less alone when they learn their feelings are common. People who do not go through the stages of grief, however, may feel alone or stigmatized. They may even feel pressured to manifest outward signs of internal grief stages they do not actually feel.
There is no right or wrong way to grieve. Grief is the natural reaction to a loss. Cultural norms, personal factors, social support, health, religious and social values, and myriad other factors may affect how a person experiences grief. Therapy can help people manage their grief and find a way forward. The right therapist may even help a person find meaning in a loss, or a sense of purpose in persisting despite the loss.
“These models can…help people understand and explain their experience. However, grief is not predictable, linear, stable, or neat. It is an experience marked by its ferocious aliveness and proclivity for shape shifting. Models run the risk of being too prescriptive…and can render people feeling like they have a map of mere country borders and seashores, not the detail or scope to actually navigate one’s way around with any seriousness. Use the seven stages as a basic introduction to the language of grief, but when one becomes fluent in their own personal grief experience, they will realize it’s a language entirely unto its own. Therapy and other therapeutic work help hold and develop the latter,” says Jade Wood, MA, LMFT, MHSA, a Washington, D.C. therapist who specializes in managing grief.
To begin your search for a compassionate grief therapist, click here.
References:

1. Additional stages of grief. (n.d.). Retrieved from http://www.econdolence.com/learn/articles/additional-stages-of-grief
2. Blandin, K., & Pepin, R. (2016, October 15). Dementia grief: A theoretical model of a unique grief experience. Dementia (London), 16(1), 67-78. doi: 10.1177/1471301215581081
3. Kübler-Ross, E. (2009). On death and dying. Abingdon: Routledge.
4. Maciejewski, P. K., Zhang, B., Block, S. D., & Prigerson, H. G. (2007, February 21). An empirical examination of the stage theory of grief. JAMA, 297(7), 716. doi: 10.1001/jama.297.7.716
5. Testing stage. (n.d.). Retrieved from http://changingminds.org/disciplines/change_management/kubler_ross/testing_stage.htm
6. The Kübler-Ross Grief Cycle. (n.d.). Retrieved from http://changingminds.org/disciplines/change_management/kubler_ross/kubler_ross.htm

© Copyright 2019 GoodTherapy.org. All rights reserved.

Original article: https://www.goodtherapy.org/blog/shock-testing-two-more-twists-on-road-to-grief-recovery-0314197

Recently I was contacted by a local TV station asking about the use of weighted blankets to help people with insomnia. Typically, when people ask about which pillows and mattresses are best for sleep, I have to explain that there really isn’t much in the way of research to guide decision making about what to use. In general, I would say the best mattress or pillow is the one that you are comfortable with. Whether you need to be on a stack of feather beds to drift off or you enjoy sleeping out under the stars with a rock for a pillow, it's fine if it works for you. That being said, if you are interested in quality and pricing ratings on items such as pillows, sheets, and mattresses, you could check out the March 2019 issue of Consumer Reports. It provides some guidance for people looking to purchase these items for the highest quality at the best price.


Weighted blankets, however, are different in that there has been some research looking into their effectiveness. I had not appreciated the degree to which weighted blankets had become a “thing” until I heard from the reporter. Weighted blankets have become very popular and sold like hotcakes during the last holiday season. People I know who watch a good deal more TV than I do explained that they had seen quite a few ads for weighted blankets and a number of them had strongly considered getting one. It turns out that one of the most popular of these blankets is known as the gravity blanket and got started as a Kickstarter campaign. It has earned millions in sales. 


Because my wife worked in autism research at the Yale Child Study Center for many years, I had become aware that weighted blankets have been used to help some people with autism feel calmer and more comfortable. It is easy to imagine that people would probably find the feeling of a weighted blanket to be comforting, something like being in a safe cocoon. Occupational therapists have utilized weighted blankets for years for grounding patients, increasing reality orientation, helping them to relax, and helping them to self-sooth, among other uses.

These blankets provide tactile sensations including warmth, pressure, and a feeling of being held. Because anything that allows you to be comfortable and relax is likely to help you fall asleep, at least in theory, a weighted blanket could be helpful to those with insomnia. 


A study by Ackerley, Badre, & Olausson (2015) was conducted in Sweden and specifically explored whether weighted blanket can decrease symptoms of insomnia. The research was undertaken in an effort to find simple and easy methods to reduce insomnia without the need for medications, supplements, or extensive therapeutic interventions. This is a worthy goal as insomnia is a disorder that significantly and negatively affects quality of life and can be challenging and expensive to treat.


They used blankets that were commercially available and had previously been used with elderly individuals living in nursing homes and with patients who had autism spectrum disorders. The blankets were weighted by a metal chain that was evenly distributed throughout the blanket. This allowed for application of constant pressure and sensation across the body. These blankets had two sides and participants could choose to have the padded side or the chain side next to them. The weighted blankets could be used with another quilt either over or under them.

Unlike some weighted blankets that can be purchased today, the study blankets were not thick and did not provide much additional warmth. The blankets were tested in three different weights: 6 kg (13.2 lb.), 8 kg (17.6 lb.), or 10 kg (22 lb.). Participants were allowed to choose their preferred weight and the most commonly chosen was the 8 kg version.


Participants had to have an existing complaint of chronic insomnia. If they were taking a sleep medication immediately prior to the study they could keep taking it throughout. People with recent onset insomnia, sleep apnea, untreated metabolic disorders, and high blood pressure were excluded. There were 31 participants, inclduing 20 women and 11 men. The study was conducted with participants sleeping in their usual setting. There was a week-long pre-test baseline period, a two-week period of nightly use of the weighted blanket, and then a one-week post-test period in their normal setting but without use of the weighted blanket.


A number of measures were used. Questionnaires were used to assess patients’ level of insomnia (they had moderate difficulty falling and staying asleep) and sleepiness (they had some excessive daytime sleepiness). Objective measures of sleep were utilized including actigraphy (used to analyze patterns of movement to show likely periods of wakefulness and sleep) and polysomnography (that uses brain waves to specifically score the presence of sleep). Subjective measures were also used including sleep diaries, ratings of quality of sleep, and feelings about the weighted blankets. 


The results were quite interesting in that, on average, length of sleep was significantly increased by the use of the weighted blanket. Additionally, movement during the night was reduced with the blanket. For participants already using sleeping medication, the time to fall asleep and time spent in bed were reduced when using the blanket.

Sleep time was reduced and activity level was increased during the post-test period when the blankets were no longer used. For the 20 participants who liked using the blanket, wakefulness during the night was reduced and total sleep time was increased. Quality of sleep was judged to be better when using the weighted blanket. By far, participants (63%) preferred the padded side of the blanket to the chain side. Most (63%) just used the weighted blanket without an additional quilt but when the additional quilt was used most preferred to have it under rather than over the blanket. In general, the blankets had a positive effect on sleep for participants with chronic insomnia, especially when they enjoyed using the blanket and if they were already taking sleeping medication. 


The authors concluded that weighted blankets were effective in improving quality and quantity of sleep for participants with mild to moderate insomnia who had some excessive daytime sleepiness. Thus, these blankets could be beneficial for use by patients with general insomnia and mild sleep problems. Physiological arousal may be reduced by the sensation of deep pressure and consistent sensory input, as provided by the weighted blanket, and this can facilitate relaxation into sleep. This was seen in the decreased nocturnal movement of participants while using the blankets. Not everyone liked using the blankets, the mid-weight blanket was most often chosen by participants, and the positive effects only occurred while the blankets were used and did not persist after use was stopped. Weighted blankets may indeed be an effective, complementary, non-pharmacological intervention for patients with chronic insomnia.


So, should you purchase a weighted blanket? It could be a good choice, if you struggle with the sleep problems above. I would be aware of cost considerations and the types of materials used. Also, it would be important to be sure that there is a good return policy before you give it a try—no sense in losing sleep over a bad investment!

​https://www.psychologytoday.com/us/blog/sleepless-in-america/201903/weighted-blankets-can-help-insomnia

By Shelbie Fowler  //  July 13, 2018
From https://www.gottman.com/blog/distracted-while-parenting-be-more-attentive/

Parenting is often described as one of the best and most stressful jobs that a person can take on. Becoming a parent is an incredible responsibility that comes with a new set of rules, and the need to constantly be “on.” So what happens when parents go from being “on” top of things to being distracted and “on” their phone maybe a little too often?
The term for this phenomenon is distracted parenting. You may not have heard this term before, but you’ve likely seen it in action. Here are some examples of distracted parenting:

• An entire family on their phones at a restaurant, not even making eye contact.
• At a playground, a child is misbehaving and would likely be corrected if their parent was not texting.
• At an event and one kid is running out of the door with no adult present and you think, “Where is the adult?”

These situations are too commonplace and have caused concern among pediatricians. The American Pediatrics Association recently revealed that more children are being treated for more severe injuries from playground accidents than in the past. Parents were observed at playgrounds where they looked at their phones, talked to each other, and did other things more often than they looked at their kids.
The dangers of distracted parentingThese distracted parents gave their children the perfect opportunity to take risks that could otherwise be prevented such as throwing sand, climbing up the slide, or jumping from large heights. Over 200,000 children under 14 years of age are treated in emergency rooms for playground-related injuries each year, and children will take risks regardless. While none of the children in this study were seriously injured, researchers noted that children are more likely to take those risks when their parent is distracted.
Not only is there a potential for physical harm when distracted parenting happens, it can also be emotionally damaging if a child or teen feels that their parent is too busy to be attentive or connected to them at the moment. Children may even engage in risky behavior just to attract the attention of distracted parents, and distracted parents are not as responsive to their kids, or as sensitive to their needs.
Parents, instead, might share that perfect Instagram pic of their kid going down the slide rather than going down with them. Parents may be more interested in posting about their family dinner rather than participating in a conversation at the table. These actions in place of making eye contact, engaging in conversation, and actively participating in play can leave a child wondering what they need to do to regain the attention of their parent(s).
Distractions are a part of life, but they can be managedAn article on Psychology Today notes that being distracted as a parent is expected to a degree, especially with multiple children in the home and/or with parents working. It’s part of family life when you have to balance chores, meals, jobs, and a budget.
However, it is the level to which the distraction occurs that matters. Children and teens are aware when the important people in their lives, like their parents, are not paying attention to their needs physically or emotionally. In those moments when a child feels a disconnect from their caregiver, they will test what they can get away with, whether it’s jumping from the highest point of a jungle gym, sneaking out at night, or skipping school, among other risky behaviors in the hopes that someone will notice them.
Make efforts to be intentionally attentiveIf you think you may struggle with being a distracted parent, leader, teacher, or caregiver, think about your habits and ask yourself these questions:

• When was the last time you played with your child or teenager?
• What was the last conversation you shared as a family?
• Ask your kids if they feel you are distracted. Honesty can go a long way in opening up communication, just avoid responding defensively and ask more about what they need from you.
• Think about the last conversation you had with an adult: Were they on their phone? Did you make eye contact? Did you feel heard?
• What makes you feel heard? The same probably applies to the children and teens in your life. Have an open conversation about what listening looks like in different settings.

There will always be distractions in our lives. We will all have a “parenting fail” moment at some point, but those should be our moments that cause changes in our behavior. We can all learn to become less distracted and more active in the lives of our families. We can be better about putting the phone down, closing the laptops, and turning off the TV in order to engage our children in conversation, make eye contact across the table, and have time to play.
These acts, like The Gottman Institute’s motto of “Small Things Often,” may seem small in nature but they will have long-lasting positive effects on the emotional health of families. To do that, we can focus on creating undistracted time in order to fully engage with the people that we interact with on a daily basis. Try setting aside an hour at home, with your kids, where no phones or screens are allowed, and do something fun with them. Try putting your phone away more often when you’re engaged in conversation with others. Your children, teens, friends, and other family members will notice when you make the effort to give them your attention on a regular basis.

Failure: you can’t grow through adolescence without experiencing it. 
Frustrating at best, often disheartening, at worst it can cause a sense of worthlessness that is serious indeed when a painful incident is turned into a personal descriptor: “I’m such a failure!”
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Now you have a wipe-out of self-esteem.
So, parents need to monitor experiences of failure in their teenager’s life to make sure the young person is getting through the unhappy experience without significant injury. They don't want the experience of failure to  drive the young person emotionally further down into significant despondency.

Of course, parents should NEVER (in disappointment, frustration, or anger) call their adolescent a “failure.” Such a painful criticism from such high family authority can severely wound adolescent self-worth, like being called a “loser” who will never measure up and “win” their approval. Never forget: adolescents partly see themselves through their parents' eyes.

Adolescence is littered with experiences of failure because growth challenges must be continually surmounted, every kind of failure raising its own powerful psychological issues. Consider just a few.

• ·     Failure to fulfill a dream (ambition),
• ·     Failure to follow rules (obedience),
• ·     Failure to be accepted (rejection),
• ·     Failure to try (motivation),
• ·     Failure to pay attention (concentration),
• ·     Failure to fit in (conformity),
• ·     Failure to reach a goal (success),
• ·     Failure to please (approval),
• ·     Failure to finish (completion),
• ·     Failure to get along (cooperation),
• ·     Failure to win (competition),
• ·     Failure to stay positive (hope),
• ·     Failure to be included (belonging),
• ·     Failure to look okay (appearance),
•       Failure to meet expectations (disappointment.)

Any of these failures and many others can be emotionally costly and no teenager can escape encountering some of them along the way. Like missing younger dependencies and fearing older demands, they’re simply part of the discomforting price that must be paid for growing up. Every effort carries with it a risk of failure, so failure is not a problem; it is a fact of life.

Worth noticing is how failure often comes bearing unexpected gifts. Consider a few of the following questions a parent might helpfully ask.

"If you succeed in giving your all but don't get what you strived for, is that only a failure?"

"If you don't get what you want but grow wiser in the process, is that only a failure?"

"If you give up a futile effort only to find a better objective, is that only a failure?"

"If you dared to follow a dream and came up wanting, is that only a failure?"

"If you can say to yourself, 'well at least I tried,' is that only a failure?"

Or maybe all that is required is empathizing with the hurt, providing some emotional support, and encouraging the wounded young person to move forward in a healing way. 

Whenever I think about how a parent can help an adolescent process failure, I recall the father consoling his downcast teenager who was hunched  over in disappointment, entrapped in self-blame for “failing again!”

“Son,” the older man said, “as far as I’m concerned, the only real failure in life is the failure to try. If a person isn’t failing sometimes that just means they’re not trying hard enough. I admire how you keep after it!”

At that, the young man looked up, straightened up, and smiled: “Thanks, Dad. Just what I needed to hear!” 

https://www.psychologytoday.com/us/blog/surviving-your-childs-adolescence/201902/talking-about-failure-your-adolescent

By Drs. John & Julie Gottman
https://www.gottman.com/blog/if-youre-too-busy-for-date-night-youre-too-busy/​

The plain and simple truth is date nights make relationships. 
You’re probably thinking, that sounds great and in a perfect world date nights are doable, but who has the time, the money, or the childcare (if applicable) to go on dates?
As we explain in our new book, Eight Dates: Essential Conversations for a Lifetime of Love, date nights are always doable, even if it means getting a little creative in carving your time out together. 
It also helps to define what a date night is and what a date night isn’t. Watching Netflix on the couch together while scrolling through your Instagram feed is not a date night. 
A date night (or date afternoon or morning) is a pre-planned time where the two of you leave your work life and work-in-the-home life, and spend a set amount of time focusing on each other, and really talking and listening to each other. 
Here are the most common date night obstacles and how to overcome them. 
Time
Life can feel so incredibly busy that the thought of finding time for yet one more obligation feels overwhelming. But a date night is more than an obligation—it’s a commitment to your relationship. It helps to carve out a specific and regular time each week and make this “appointment” a priority. 
Unless someone is in the emergency room, make date night a “no matter what” event. Set aside time like you would for a birthday, or church, or an anniversary, or any other special event you celebrate in your life together. 
Date nights should be sacred times to honor your relationship. Think of them as such, schedule them in your calendars for as much time as possible—even if it’s just for an hour, show up no matter what. 
Money
Dates don’t have to be expensive. In fact, they don’t have to cost anything at all. Pack a picnic, go for a walk, sit in a park. There are endless ways to spend time together without breaking the bank. In each of the Eight Dates, we make suggestions about where best to go on your date depending on the topic of conversation. These are only suggestions. 
We used to have a cheap date by getting dressed up and going to the beautiful Hotel Sorrento in Seattle, and pretending that we were hotel guests. We would sit in the beautiful lobby in front of a fire and nurse one drink all evening. We would answer each other’s open-ended questions for hours. 
Childcare
Childcare is often the stickler for couples who want to go on date nights but have young children at home. Childcare does not have to be expensive or stressful. At times, we would trade childcare with other couples, so both couples could enjoy date nights. If that’s not possible, see if a trusted family member or close friend will help you in your quest to spend sacred time together. 
Look for inexpensive babysitters in your neighborhood, or ask friends for recommendations. Some parents worry about leaving their children with other people, but if you find a safe and reliable person to watch your children, you’re helping them learn that other people, besides their parents, are trustworthy and reliable. 
Children are incredibly resilient, and by showing your commitment to your relationship with your partner, you’re nurturing your children by ensuring that they will be raised by parents in a healthy and stable relationship. 
Too often, especially after couples have children, date night becomes a random, freak act of nature. Don’t let it. If you’re too busy for date night, you’re too busy.

by Robert Enright Ph.D.

When I discuss the theme of forgiving people who acted unfairly, I sometimes get this response:
     What you are proposing is dangerous. It makes no sense to forgive. Forgiveness lets my guard down. I then am vulnerable to the abuses which I suffered before. No, I will not forgive until the other person: 1) knows that wrong was done; 2) feels an inner sorrow for doing it; 3) apologizes to me; 4) and makes amends. Then I know it is safe to forgive and enter back into the relationship.
The above statement, which is quite common, confuses what forgiveness is and what reconciliation is. Forgiveness is a moral virtue in which the offended person tries, over time, to get rid of toxic anger or resentment and to offer goodness of some kind to the offending person. Reconciliation is not a moral virtue, but instead is a negotiation strategy in which two or more people come together again in mutual trust.
All moral virtues concern the inner quality of goodness and the possible outward manifestation of it. For example, the moral virtue of justice has the inner quality of knowing what it means to give people what they deserve and the outward manifestation of being fair. If you contract with a bricklayer to pay $1,000 for a new wall to be built, you first have the inner intention to pay for the work. You then follow through outwardly when you exercise the virtue by paying the bricklayer once the work is done. If the bricklayer, for some unexplained reason, leaves the United States never to return, and gives no forwarding address, you do not then exercise the outward manifestation of justice. You do not pay the $1,000. Yet, you have exercised the moral virtue of justice because you have the inner quality of fairness and the intention to pay.
It is the same with forgiveness. You start with the inner quality of a motivation to rid yourself of resentment and the inner intention to be good, within reason, toward an offending person. If that person has no inner sorrow, never intends to apologize or to make amends, then you do not exercise the outward quality of forgiveness directly to that person. Yet, you still can have the intention to reconcile if the person substantially changes and the interactions become safe. You even can show an outward quality of forgiveness, for example, by not talking disparagingly about the offending one to other people.
In forgiveness, if a person continually verbally abuses you, you can have the inner quality of struggling to rid yourself of resentment as well as the inner quality of intending to be good to the other if that other substantially changes. Yet, if that person shows you by continued verbal abuse that there will be no apology, no making amends, then you do not exercise the outward quality of forgiving, at least not toward the person directly.
As you forgive in the above circumstance, you do not reconcile.
Suppose now that you decide to make the following rule for your life: I will not forgive if I cannot reconcile. What, then, are the implications for your own inner world, for your own psychological health? In a recent blog here ("8 Reasons to Forgive," April 16, 2018) I argued that one of the reasons to forgive is “to become emotionally healthier. Forgiving can reduce unhealthy anger.” A growing body of research shows that as people forgive by exercising the moral virtue of forgiveness by trying to be good, within reason, toward an offending person, then the forgiver can reduce not only in anger but also in anxiety and depression and improve in self-esteem and hope (Enright & Fitzgibbons, 2015). There are more reasons to forgive than this one, but this one can make a substantial difference to the forgiver’s health.
Why would you not want to become healthier? If you reject forgiving because you conflate it with reconciliation, you may be inadvertently depriving yourself of a second chance at a healthy psychological life and even at a healthy relational life with others (not necessarily with the offending person). Deep anger from injustices can lead to a lack of trust in general, thwarting potentially uplifting relationships.
The offer of forgiveness can be **unconditional,** not at all dependent on the other's response of any kind, including an apology. Reconciliation, when at least one party is deeply and unfairly hurt, is **conditional,** dependent on how the offending party or parties understand their hurtful ways, change, and even apologize.
How we think about forgiveness matters a great deal. If we make the philosophical error of equating forgiving and reconciling, then we are allowing the effects from an offending person to live within us for a long time, perhaps even for a lifetime if the psychological wounds are deep enough.
Forgiving and reconciling are not the same. You are free to forgive, if you so choose, even if the other refuses to apologize.
References
Enright, R.D. & Fitzgibbons, R.P. (2015). Forgiveness therapy. Washington, DC: American Psychological Association.

Original Article: https://www.psychologytoday.com/us/blog/the-forgiving-life/201804/why-forgiving-does-not-require-apology

​You long for sleep. You may even feel tired before going to bed. But as soon as your head hits the pillow, it happens again. You're wide awake. You can't stop thinking. It's the worst.

I regularly speak to groups about the necessity of sleep for prevention of burnout, management of stress, improvement of mood and a host of other benefits. Almost every time I do, someone comes up to me and says:
“I know I need more sleep. But what do I do if I can’t fall asleep? I get into bed early enough to get eight hours, but then I just lie there with my mind racing.”
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I also frequently hear this from coaching clients and patients. When I do, I start asking questions. And usually find the answer.
Here are the questions, for you to ask yourself:
1)    Do you take your phone to bed?
First of all, the light from the phone is stimulating to the brain and can suppress melatonin release (melatonin helps you sleep). The best solution is to not look at your phone after 9 pm (or an hour or two before bed), but lots of people aren’t ready to give up that habit. If that’s you, use a blue light blocking mode like “Night Shift” on iPhones and turn your screen brightness down as far as it can go.

2)    What are you reading or doing in bed, before you go to sleep?
This is my second point about the phone. I once heard a sleep expert at Harvard say that texting at bedtime is a bad idea. The thought processes that you use are too stimulating to your brain. Obviously, checking work emails (or any email) at bedtime is a really bad idea, especially if you come across something stressful. You may not even want to read the news, in case there’s a headline that stimulates thoughts or concerns.
If you like to read to wind down, choose a book (the printed kind). Ideally, that book should not be too thought-provoking or stimulating. It shouldn’t be disturbing. It also probably shouldn’t be so incredibly captivating that you can’t put it down…

3)    What do you do with your evenings?
If you have trouble winding down to sleep, take care not to wind yourself up over the course of the evening. Good rules of thumb:

• Avoid challenging conversations with your spouse in the evenings if possible. Definitely avoid starting a difficult conversation close to bedtime.
• If you must work in the evening (i.e. answering emails), try to do so earlier vs. later, so you have time to wind down your mind before bed.
• Working out in the evening makes it harder to wind down and fall asleep. Do it earlier in the day.
• If you go out on a work night, plan to get home at a reasonable hour so you have time to wind down and still get into bed on time.

4)    What lighting do you use at night?
This is another key to winding down. People used to sleep an average of nine hours a night, before the advent of widespread electricity. The lights we have on at night in our homes are stimulating and can also suppress melatonin secretion.
Feel the difference between two late evening scenarios:
A)    All the lights are on. The TV is blaring. You’re sitting at a table catching up on emails while simultaneously conducting a logistical discussion with your spouse. You feel stressed and don’t even want to go to bed. You’ll need at least an hour of Netflix to wind down from this (not a good idea, because of the screen involved and also if it’s a really well-written show it will be hard to turn off in time for bed).
B)    All the lights are off, except a warm yellow lamp in the corner of the room. Soft music is playing. You and your spouse are quietly reading. As you read, the inevitable happens. Your eyelids start to droop. Your head bobs as you fall asleep for a split second. Even though it’s earlier than you’d planned, you get up and head over to the bathroom to start getting ready for bed.

5)    Is there something specific you're worried about?
article continues after advertisementPerhaps there’s a stressful situation you can’t stop worrying about, keeping you awake. In this case, I’d recommend a variety of approaches:

• If it’s serious, get professional counseling support to help you problem-solve the situation and/or your response to it.
• Journal before going to bed, to get your worries out of your head and onto the page.
• Learn a relaxation practice, such as a simple relaxation breathing meditation, to quiet your mind and body before bed. If I can't fall asleep, I focus on a three-line scripture about peace as I breathe slowly in and out, it almost always works.  One of my coaching clients, a former figure skater, skates in her mind until she falls asleep.

6)    How are you using your bed?
Leverage the strategy of “stimulus control.” If you do lots of different things in bed (watch movies, answer emails, take phone calls etc.), your body and mind get confused about the purpose of bed. If you have insomnia, it’s best to only use your bed for sleep. For the same reason, if you can’t fall asleep, get out of bed and go do something quiet and relaxing until you start to feel sleepy and then head back to bed.

7)    How much caffeine are you drinking?
The sleep expert I mentioned earlier also said that if you struggle with insomnia, you should eliminate caffeine (and any other stimulants) completely and see if that helps. If that feels impossible, start by eliminating caffeine in the late afternoon or evening. Sources of caffeine include coffee, non-herbal teas, chocolate and some supplements.

Note: some people who can’t sleep have a bigger issue, such as Generalized Anxiety, Bipolar Disorder or other medical concerns. If your sleeplessness is extreme or doesn’t respond to simple interventions, it’s important to talk to your doctor about it.

https://www.psychologytoday.com/us/blog/prescriptions-life/201901/how-calm-your-racing-mind-so-you-can-sleep​