Anxiety is one of the most common complaints that is seen in private practice, as well as a feeling that most everyone can relate to. Ranging from general (and normal!) nervous reactions to a specific stressor or life event, to free-floating generalized anxiety, to panic attacks, I think we can all agree that no matter what form of anxiety your body experiences, it can be one of the most uncomfortable and debilitating feelings to go through.
​

What is anxiety?
 
Your body’s warning system that something is wrong or a signal that something needs attention. In many cases, anxiety is quite normal and arises in response to natural stressors. It can even be a useful tool in determining areas that need change in your life.

• Bodily Symptoms of Anxiety: Shortness of breath, heart pounding, feeling like you can’t breathe, dizziness, tingling, sweaty, or nauseous.
• Emotional symptoms of Anxiety: Fearful, scared, nervous, or panicked. Feeling like you can’t relax or sit still.
• Cognitive Symptoms of Anxiety: Racing thoughts, thinking negatively or in a worst-case-scenario manner, ruminating thoughts (thinking over and over again about the same thing)

Although anxiety feels terrible in the moment, it is important to remember that in its most basic and natural form, anxiety does have a helpful and adaptive purpose: Anxiety lets us know that there something in our left needs attention, that there is danger, or that something needs to be dealt with. However, for many people, the anxiety feelings can rise beyond what would be considered a natural reaction to a trigger, and can exist in your body even in the absence of a stressor. When this happens, finding ways that work for you to quiet this anxiety in our body and return to a calmer state is crucial for your quality of life. The good news is that you have much more control over anxiety than you may realize. And you certainly have more control over it than you feel like you have in the moment that it is invading your body and mind. Anxiety a physiological process firing in your body, and there are many natural ways to reverse the anxiety response.
 
10 Strategies to Reduce Anxiety:

1.    Belly Breathing

So often we hear people say to “breathe, breathe, breathe…” Well, that is because it actually works! When we are anxious, many of us hold our breath or our breathing gets shallow and trapped in our upper body. Some people describe feeling as if they are choking. By taking long, slow, and deep breaths, you are changing the physiological response that anxiety has on your body, thereby sending calming messages to your body and brain.

Here’s how to make it work: Sit comfortably with your hands resting on your belly. Breathe in through your nose with your mouth closed. Send the air down to the lowest part of your belly, essentially feeling your belly push against your hands with the air. Slowly breathe out through your mouth. Repeat several times!

2.    Exercise
 
Exercise releases hormones and endorphins in your body that naturally reduce anxiety. Even mild exercise (such as walking for 30 minutes) can have a positive impact on your mood and quality of life. Doing this regularly, such as three to four times per week, can help keep these happy hormones and chemicals more consistently available in your body.
 
3.    Imagine your happy place
 
Every person is soothed by different things: For some people it is sitting at the beach listening to the ocean, for others is may be being in the arms of their spouse or in their childhood home. Closing your eyes, breathing, and imagining yourself in your safe space can have an immediate calming effect on your body.

4.    Avoid Substances, especially Caffeine, Nicotine, and Alcohol
 
Do you ever wonder why you feel anxious and irritable after that extra cup of coffee? Many substances—such as caffeine and nicotine—contain chemicals that act as a stimulant when you ingest them into your body. For many people, stimulants induce anxiety. In private practice, we often see clients who insist that these substances calm them down, or people who are not willing to cut back or eliminate these substances from their lifestyle—but yet, they can’t seem to turn down their anxiety. It may be that there is an initial calming sensation after ingesting the substance, but this is most often met with increased stimulation afterwards. Alcohol, on the other hand, is a depressant, but many people have anxiety reactions the following day as their body is coming back off of it.

Unfortunately, if you suffer from anxiety (or poor sleep), in general, it is really important that these substances are reduced or eliminated. An imagery technique that can help with this is visualizing the anxiety that you are ingesting into your body as you take that drink or puff.
 
5.    Get it out!
 
As we stated earlier, anxiety is often a warning sign in your body that something needs attention. Do you have an issue with a co-worker or your spouse? Are you feeling like there is a nagging issue in a relationship that needs to be addressed? Talking helps! By expressing your feelings, you are releasing tensions from your body. Not to mention, holding feelings in can lead to a host of other problems, such as anxiety, headaches, anger, physical ailments, and sadness.

6.    Take Action

Sometimes the anxiety or warning sign is related to a task that is being neglected. Do you have a have a deadline looming or a medical issue that needs to be checked by a doctor? Are you avoiding things that need to get done? Avoidance is one of the greatest ways to increase anxiety. Move your body, take action, and feel the peace that is your reward.
 
7.    One day at a time… Stay in the present

Often anxiety can stem from free-floating thoughts that are focused on the past or future. Sometimes we think about past regrets or pains, or we may find ourselves lost in worries about the future. Not only can these thoughts create anxiety and sadness, but they also take us away from being connected to (and enjoying!) what is happening in our present life. A calm body and mind is one that is focused on the present. Yoga and guided meditation are great ways to train yourself to stay in the present.
 
8.    Basic Self-care

Our bodies do not function well if we are not keeping the gas tank full and the engine checked. Be sure to keep up with your basic self-care needs: healthy and consistent eating habits, proper sleep, regular exercise, avoiding substance abuse, and regular medical check-ups/medication use.

Check out my past blogs, The Formula for Success and Ten Tips for Better Sleep, for more guidance in this area!
 
9.    What is your purpose?
 
The human psyche craves meaning and purpose. What is yours? Have you met your personal goals and ambitions, whatever that may be? Maybe you want to be a college graduate, to be a mother, to own your own business, or to be a dedicated photographer. Each person has unique and personal journey, and only you know what fuels your soul. Whatever this may be, are you following it or taking steps to make it happen?

Along with this, as the old saying goes: helping others helps yourself. Do you give back to your community, help others, and volunteer your time?

10. Ok!! I have done all of these things and I am still anxious!!!
 
There are certainly people who dedicate themselves to relieving their anxiety (meaning: at least a few solid months of hard work to relieve your anxiety symptoms) and, unfortunately, their anxiety continues to be unrelenting. Typically there are two last things to consider in this situation:

• Some people have a chemical make up that is sending anxiety signals in their body no matter how well they take care of themself. If this is the case, you may need to consult with a psychiatrist or psychologist to find other ways to manage your anxiety.
• For other people, there is a major part of their life that needs to change, which is driving the continued anxiety. Ask yourself a few questions to see if this is you:  

1. Am I in a toxic relationship?
2. Am I completely neglecting one whole area of my life (such as having no friends or avoiding friends)?
3. Are you not meeting your personal goals? For example, have you been talking about going back to school for years but haven’t? Have you been single for years on end despite wanting to have a marriage and family someday, but aren’t getting out in the dating world?
4.  Do I absolutely hate my job but refuse to change my situation.
5. Am in major financial debt with no financial plan?
6. Am I living my life in a way that is not congruent with my values and goals?

If this is where you land, go back to #6 above and take action!!! Remember, this is your life: Embrace it, take charge, love it, and create your own reality!!





 
All the best to you and yours,

Sarah Ray, Psy.D.
 

How our bodies take the brunt of our stress and what we can learn from our aches and pains…

How many times have you ever answered the phone or turned on the news and became confronted with yet another story of hardship? Maybe it is a friend suffering from a family, health, or financial crisis, or maybe it is an instance of violence, crime, or needless societal tragedy. Problems with our children, cancer, death in the family, home foreclosure, combat trauma, marital distress, bodily injury, work stress—let’s face it, no one is immune from hardship. Unfortunately, stress and problems are a normal part of life for all of us.

The good news, as the adage goes, is that time does heal all wounds. No circumstance, stressor, or emotion is permanent. But, do you ever wonder how people (or maybe even yourself!) get through tough times? Luckily for us, the human body has amazing ways of protecting itself. Our body is naturally set up to help us survive the numerous stressors or tragedies that we all have to face at some point (or many points!) in our lives.
But here’s the deal: often times, we “deal” with stress, by actually not dealing with it at all. Have you ever noticed that during particularly tough times in your life, you find yourself catching a cold, getting a migraine, or having extreme fatigue? Maybe you have chronic unexplained pains, headaches, or stomach aches/diarrhea. Do you ever find that your body seems to fail you when you most need the strength?!?! For many people, we often think that we are “dealing” with our problems, but really we are just stuffing them away and letting our bodies take the toll.

So, what a depressing blog, right? I am sure you didn’t read this to be reminded that we all have problems, and that these problems are potentially wreaking havoc on your body. Here’s what am I really getting at… At the end of the day, we ALL have stress, and it is important—for our physical health, emotional health, and quality of life—that you know how to deal with your stress to truly manage it, not just tuck it away and wait for new problems to arise. And for so many of us, this is what we do, and our bodies are paying for it. So, what's the solution?
Often times, we turn to unhealthy coping skills to help manage our stress, because, let’s face it, it often feels faster, easier, and less painful in the moment. Earlier we discussed what I like to call “stuffing”—pushing our painful feelings or problems out of our awareness so that we don’t have to deal with them. This not only leads to bodily distress and physical symptoms, but it can also make our problems much worse since we are not actually acknowledging or dealing with them. Along with this, we often use unhealthy habits to help us keep the avoidance going, including using alcohol or drugs, sleeping too much, gambling/spending money, or over-eating, among other things. Unfortunately, eventually the problems will resurface, along with the emotions that it is creating, and we do have to face it.
 So, if you want to help heal from your stress and painful emotions, AND protect your body from carrying the brunt of the stress (which so many of us do!), we need to know how to tackle our stress.
 
Step 1: Face the problem. We can’t fix something that we don’t acknowledge. Just because we ignore it, does not mean that it will go away.
I often see this in my practice with folks who are avoiding a difficult or painful decision. Let’s say you are faced with a conflict in your relationship that really needs to be addressed, or you are in an unhealthy relationship. Maybe the thought of working through the problem sounds exhausting (who has the time?!?), or the idea of ending the relationship is unbearable. Instead of problem-solving a new, healthier plan, it is often easier to just avoid it. However, the next thing you know, you have no appetite, you are crying for no reason, and that headache just will not go away! You hear yourself telling your friends (again) that you just don’t feel good, instead of speaking the truth: something needs attention in your life.

So, step 1, address the problem. And, more importantly, believe in yourself!! You are stronger than you think! Although it may be harder in the short term to face the problem, it is the first (and completely necessary) first step to move toward a happier, healthier, and more peaceful life.
 
Step 2: Self-care. Go back to the basics. Like I said earlier, your body is naturally equipped to deal with problems, but you have to take care of it. Eat well, get out of your pajamas, take a walk, get a good night’s sleep, avoid alcohol and substances, and turn off the TV and do something you enjoy. Try it, this will go much further than you think!

Step 3: Healthy Coping Skills. Please go back and read my April 2011 blog, The Formula for Success, which goes though ways to develop your own personal coping plan: http://sarahraypsyd.com/the-formula-for-success/

Step 4: Time = Healing. Practice makes perfect. Keep moving towards acknowledging your problems and using healthy coping skills to deal with them. No one is perfect, and you will have slip-ups. Habits are hard to change, but with time and practice, it is completely realistic and doable to form healthier patterns. Try your best everyday. Problems make come on quickly, but that doesn’t mean that they will go away as fast. It is hard enough to deal with stress and emotional pain in the first place, but our troubles will only get worse if we are hurting our bodies and creating physical problems in the process.

I wish you the best of luck and hope we can get your problems out of your body and help move you toward a healthier and happier life. Please feel free to email or call with any questions…
 

 All the best to you and your family…
 Dr. Sarah Ray  

​When I was growing up, our family had one major mantra instilled in us by our mother: "Peace and Love!" Whether my brother and I were bickering or we were struggling with teenage drama, this was what we were always told…
 
I thought about this when I recently read a New York Times article about Dr. Marsha Linehan, a woman who changed the course of psychological treatment for people suffering from some of the most treatment-resistant and severe mental health symptoms (see link below). She received her doctorate in Clinical Psychology in 1971, and since this time she has grown to become a pillar in the field of psychological research and treatment. She has dedicated her career to working with clients with the most severe emotional symptoms, those clients whom many clinicians feel helpless in trying to reduce their emotional pain and turmoil.

40 years later, a stunning discovery: Not only is she a renowned clinical psychologist, but she also suffered from a severe mental illness.
 
As the article explains, until June of 2011, it went unknown that Dr. Linehan suffered from severe mental illness as a youth and young adult. Depression, anxiety, low self-esteem, psychosis, cutting, burning, suicidal gestures, and hospitalizations were all a part of her emotional picture. Back then, the thought of her becoming a leader in psychological treatment would have been unfathomable. Today, she is a woman who you would never expect suffered with such extreme mental health symptoms.

Although this is an extreme example of how mental illness or mental health symptoms can afflict even the most unthought of people around us, the message shines through: Mental illness—or even just isolated mental health symptoms such as depression, anxiety, panic attacks, chronic pain, eating disorders, self-harm, or substance abuse or addiction—is often hidden. But the reality is, mental health struggles spans across all cultures. Throughout time, men and women of all races, sexualities, ages, and nationalities, including the rich and poor, young and old, educated or not have struggled with emotional pain. Mental illness doesn’t discriminate.
 
There are people around you who are likely suffering inside and you have no idea. Maybe it is your hairdresser, waitress, colleague, or even one of your closest friends or a family member… and maybe if you knew of their pain, you would take the few extra seconds (because that's all that it takes!) to be a little bit kinder, a little more patient, or a little less judgmental, because we never know what someone is going through on the inside. And, isn't that what we would want from those around us if we were hurting? Quid pro quo: You get what you give.
 
In his 2011 book, Flourish, Dr. Martin Seligman points to the value of kindness towards others. His research in Positive Psychology shows that helping others increases our own self-esteem, decreases depression, and enhances our overall satisfaction in life.  So, next time you meet someone new, are frustrated with a co-worker, or are with your family, let’s try to show a little more love and EMPATHY for those around you. You never know where mental illness or mental health symptoms are weighing on someone’s heart, thoughts, or behaviors, and nothing heals like compassion.
 
Imagine how much more gentle and enjoyable this world would be if we all just showed a little more peace and love… Pay it forward!


 
All the best,
 
 
Dr. Sarah Ray
 
 

• Do people often become defensive or shut down when you try to express your point?

• When you try to communicate your feelings or needs, do things end up getting even more stressful, painful, complicated, or conflicted?

• Do people tell you that you are being more aggressive than you feel that you are?

If so, you are not alone. Many people struggle to communicate with others because they are overly aggressive in their communication style, even when they don’t mean to be. Many people don’t even realize when they are aggressive! Aggression makes it difficult to have mutual respect with others, complicates finding solutions to problems, and encourages others to be opposing or resentful. Some common factors of aggression include:

• Using loud or hostile tones
• Swearing, name calling, or using demeaning language
• Demanding attention to your view without listening to others’ opinions
• Bullying to get your point across
• Having threatening body language, such as having clenched fists, glaring eyes, or invading others’ personal space
• Interrupting or talking over others
• Being humiliating or condescending with your words or actions
• Using violent words, gestures, or actions

What we really want to strive for is assertiveness. Assertiveness means that you are capable of standing up for yourself and expressing your feelings or needs in a way that communicates your point of view without disrespecting others.  You are able to have an open and honest conversation about how you feel without becoming intimidating, threatening, or escalating the situation. In addition, communicating in an assertive way strives to be open to strategies that will help resolve the issue and breeds trust and respect with others.

 
Benefits of practicing assertiveness over aggression:

• Healthier, more effective relationships
• Better communication skills
• More respect from those around you
• Increased ability to get your needs met
• Decreased stress, interpersonal conflicts, guilt, anxiety, depression, or other problems that occur after you become aggressive.
• Increased self-esteem
• Resolution to conflicts so that you can move forward from problems
• Increased intimacy, trust, and safety with others
• Overall, people will have a greater desire to be around you and you will have closer and more meaningful relationships!

 
6 ways to reduce aggression and increase effective self-assertion:
 

1. Modulate your Tone – A calm and even tone that is not overly loud, shrill, or harsh will help the other person be better able to hear your point and work towards a resolution.  

 

1. Be Aware of your Body Language – Avoid clenched teeth or fists, crossed arms, glaring eyes, a posturing demeanor, or crossing others’ personal boundaries. Try instead to keep your body relaxed and open, take deep breaths, and take a time-out if needed.

 

1. Choose your words carefully – Avoid swearing, name-calling, blaming, ultimatums, being condescending, or using other words that will be upsetting or disrespectful to the person that you are talking with.

 

1. I Statements: “I Statements” are an effective and simple communication strategy that can greatly contribute to more effective conversations. Using “I statements” helps the people that we are talking to be better able to hear the feedback we are saying, without eliciting defensiveness from them. It also allows us to express our feelings without blaming.

• Non-I Statement: You never help around the house! You make me so mad!!

• I Statement: I feel frustrated when I have to clean the house on my own. It makes me feel overwhelmed. I wish that you would be more helpful with the chores.

  The main goal of “I statements” is using “I” to communicate how you feel, instead of “You” which comes across as blaming.
 

1. Happy Sandwich: This is *by far* my favorite communication strategy. When we are upset, or dealing with something difficult, it is quite easy to hurt someone’s feelings (or get ours hurt!) while trying to communicate. As we communicate, we often create a greater conflict with even more layers by being overly aggressive or blaming. The “happy sandwich” is a way that we can communicate feedback in a non-hurtful way so that it promotes positive changes in a relationship instead of increasing problems!

 
Often when we are angry with people, we lose empathy for them or become disconnected from the things that we appreciate in them. The “happy sandwich” is an easy 3-step process that will not only help others take in what we are saying, but will also help maintain empathy, decrease frustration, and stay connected with the greater purpose—resolving the conflict!
 
          1.      Begin by saying a positive statement or something that you appreciate in the person.
 
          2.      Using an “I statement,” express your feelings or needs.
 
        3.   Complete your statement by going back to another positive statement, such as reminding the person that you care or telling the something that you appreciate in them.

Using the example above, it may look like this: “I think it is great that you cleaned out the garage for us yesterday. However, I am feeling really overwhelmed with the house, and wonder if you can help with the kitchen today? I love you and want us to be able to relax and enjoy our weekend together.”

Remember, one of the goals here is to decrease conflict. By using this strategy, we are encouraging the conflict to be resolved, instead of feeding the anger, blame, or problem at hand.
 

1. Decrease Reactivity: Think before you speak!! Count to 10, take a time out, or try another strategy to increase the amount of time before saying something that you will regret later!!

For many people, effective communication and managing aggression is very challenging, and is an ongoing source of frustration. The age-old saying that “Practice makes perfect” is a necessary mindset when it comes to this topic. Every time you face an issue, you have an opportunity to practice being more assertive and less aggressive. Also, remember that these strategies can be used in any type of relationship: With your partner, children, family, colleagues, or anyone else that you interact with. By increasing your self-assertion, and thereby decreasing aggression, you can create a climate in your life that promotes happiness, love, peace, and connection with others—instead of anger, stress, conflict, guilt, and isolation.  Which do you choose?


All the best,

Dr. Sarah Ray
​

Many people experience trouble sleeping from time to time. Some people have trouble falling asleep, while others cannot stay asleep. Some people wake up in the early morning. Sleep problems may vary from restless or disturbed sleep, to a reduction in the usual time spent sleeping, or, in the extreme, complete wakefulness. Requirements for sleep vary widely from person to person. Most adults need the traditional seven or eight hours of sleep a night, but some adults do well on much less. Many people overestimate the amount of sleep they need. In addition, people who have trouble sleeping often actually get more sleep during a restless night than they realize. Because episodes of sleep disturbance are so common, generally there is no need for concern. However, when it becomes an ingrained pattern or it impairs your ability to function well during the day, improving your sleep may be quite important for your overall quality of life.

Sleep can become disturbed for a variety of reasons. Some people are kept awake by painful physical conditions such as arthritis or chronic pain. In addition, some medical factors such as menopause or hyperthyroidism, as well as some medications, can also disrupt sleep. Other common causes of sleep disruption include lifestyle choices, such as caffeine consumption, a heavy meal before bed, alcohol use, drug use, or taking naps—all of which interfere with sleep quality. In the majority of cases, however, the core problem interfering with sleep is emotional. Many people are kept awake by anxiety, worries, depression, or anger. For some people, situational life stressors may be interfering with their ability to relax and get rest; family problems, work stress, lifestyle changes, or unresolved conflicts can all disrupt healthy sleep patterns. Treatment of any underlying emotional problem, or adapting your lifestyle to promote healthy sleep, are both necessary if they are contributing to your sleep troubles. Take a few minutes to review what may possibly be related to the difficulty that you are experiencing with your sleep.

Whatever the reason may be, for many people, sleep is one of the first things to become disrupted when they are facing challenges in life. Many times, it is our body’s way of raising a red flag and telling us that something in our life needs attention or improvement. For many people, when they handle the stressor that they are faced with, their sleep patterns naturally improve. This is often the first step toward sleep improvement. However, there are also other strategies that can help assist with the process of getting back to quality sleep. And, as anyone who has suffered from poor sleep knows, when we don’t get a good night of sleep, it can be very challenging to have a good day. A poor night of sleep can cause irritability, fatigue, poor coping abilities, sadness, and feeling overwhelmed by daily tasks. But, the good news is that the opposite is also true: Improving your sleep can cause a drastic positive impact on your quality of mood, concentration, patience, energy level, and ability to manage stress. Further, daily improvements in these areas can have a larger impact on your overall quality of life by helping support healthier relationships, job functioning, and improved self-esteem. We can see why sleep is so important!



TEN TIPS FOR BETTER SLEEP
 

1. Establish a regular time for going to bed and getting up in the morning. This helps tocue your brain that it is time for sleep. Going to sleep at the same time and awakening at the same time daily helps stabilize your internal clock. Having a different sleep-wake schedule on the weekends can throw you off. For the best results be consistent.

1. Do not go to bed too early. Try not be tempted to go to bed earlier than you would normally need to. When people go to bed too early it may contribute to the problem of fragmented sleep. Your body normally lets you sleep only the number of hours it need. If you go to bed too early, you might also awaken too early. Only go to bed when you are feeling tired and sleepy.

 

1. Determine how many hours of sleep you need for optimal functioning and feeling rested. Consider the following to determine the natural length of your sleep cycle.

·         Before you began to experience sleep difficulty how many hours of sleep per night did you sleep on the average?
·         How many hours of sleep do you need in order to not feel sleepy or tired during the day?
 

1. Develop rituals that signal the end of the day. Rituals that signal closure for the day are targeted for shifting your thinking from the daily life and stressors to the idea that the day is over and it is time for rest. The rituals may include tucking in your kids, taking the dog out, closing up the house for the night, watching the news, or reading a book. Or, you may try to do something relaxing before going to bed, such as having a cup of calming herbal tea, taking a warm bath, meditating, or doing deep breathing exercises.

1. Keep the bed for sleeping and sex only. If you use your bed as a workspace for other activities, your mind will associate the bed with those activities, which is not conducive to sleep. Do not eat in bed, watch TV in bed, work in bed, read in bed, worry in bed, or study in bed, etc.

1. Avoid physical and mental stimulation just before sleep time. Exercising, working on projects, house cleaning, or watching something exciting on television just prior to going to bed can energize you instead of helping you to have closure at the end of the day.

1. Be careful of naps. Some people are able to take naps and feel rejuvenated by them without interfering with their sleep-wake cycle. However, for many people, naps sabotage nighttime sleep.

1. Get regular exercise. Regular aerobic exercise like walking can decrease body tension, alleviate stress, alleviate depressive symptoms, and contribute to an overall feeling of wellbeing. Less stress equals better sleep.

1. Avoid caffeine, nicotine, alcohol, and large meals in the evening. Your daily lifestyle choices can greatly impact your sleep quality. Are you living in a way that promotes good sleep?

 

1. Release your worries. Keep a journal by your bedside to write down your to-do list for the next day, make an action plan for a problem that you are faced with, or document anything that is bothering you so that it is out of your mind before falling asleep. Harbored worries or frustrations can awaken us during the night.

 
On a final note, be careful not to obsess about sleep. When someone is experiencing sleep disturbance, they can become so focused on the issue of sleep, or trying to fall asleep, that they increase their anxiety at the end of the day, which induces stress, negativity, and tension instead of the relaxation that is necessary for the natural sleep rhythms to be initiated. Instead, try to relax and think about something soothing or pleasant. If after 15 minutes you have not yet fallen asleep, get out of bed! Lying in bed not sleeping can create more negative sleep associations. So, if you cannot sleep, get up and go to another room to meditate or engage in some other ritual that you find helpful to inducing feelings of drowsiness so that you can sleep.
 
If your sleep problems persist, a doctor should be consulted.
 

Wishing you a wonderful night of sleep!

 
All the best,
  
Dr. Sarah Ray

​Let’s face it, humans are complex.

Each of us is a complicated and unique combination of hormones, chemicals, emotions, thoughts, physical changes, and stressors…not to mention our personal upbringing, past relationships, and distinct life experiences. Often times, these complexities make it particularly difficult to truly enjoy our life. We may feel that every time we turn around, we have something new to contend with: Mood changes, family stress, work issues, medical issues, hormonal shifts, or unexpected stressors. We may look at other people and think that they have it easier. It is natural to assume that others lead a better, a happier, or a less complicated life. But, the reality is, we ALL have to deal with these constant and sometimes unexpected shifts in our bodies and in our lives. The trick is, how do we maintain quality in our life when our bodies—and the situations around us—make it continually challenging?

When I work with clients, I like to help people learn how to maintain quality in their life as much as possible. The goal is not to stop having problems, stressors, or challenging emotions, but to learn how to deal with these normal occurrences more effectively. I strive to help my clients maximize the peace, happiness, and stability in their lives, while also helping them minimize or protect themselves from letting the normal shifts and struggles cause too much chaos in themselves or in their environment.

One of the most basic elements of having consistency and quality within our bodies and in our immediate environments is to have structure. In my opinion, each adult is responsible for knowing his or her own formula for success. What is it that you need to be as healthy and happy as possible? Here are some common areas that people need to tend to on a regular basis to feel the best that they can, and to be able to flow with the normal stressors of life:

• Exercise – We ALL need it. Period. It might be as simple as a 30 minute walk a few times per week, but it will make a difference in your body, mood, and overall stability.

•  Diet – Do you eat on a regular and consistent basis? Are you over-eating or under-eating? Are you consuming the things that your body needs to thrive on?

• Sleep – Are getting enough sleep? Or maybe too much? Are you going to bed and awaking around the same time each day?

• Alone Time – How much do you need? Do you take enough time for yourself? Do you isolate?

• Social Time – Connecting with others is a basic human need. We often tend to neglect this during times of stress, but even a quick lunch with a friend can be recharging.

• Spirituality/Personal Values and Beliefs – Are you following your personal core sense of right vs. wrong, the things that you believe in? Are you allowing time to nurture your spiritual beliefs?

• Personal Growth – Are you tending to the areas of yourself that need a little work? We all have them. Avoiding them will often make them even more powerful and problematic.

• Productivity – Are you engaging in work, volunteering, care taking, or something else that makes you feel useful? Humans thrive on a sense of accomplishment and production.

• Pleasurable Experiences – What brings you joy? Hobbies, art, movies, music. We all need to stay connected to the things that fulfill us.

• Medical Health – Are you consistently attending to your physical health? It is important that we have regular medication use, check-ups, and that we give the appropriate attention to your medical needs.

 
When we raise children, we often do so with some level of organization. We give children structure to help them thrive—rules, bedtimes, meals, snacks, family values, and opportunities for learning, socialization, and growth. Well, here is the beauty: Just like children need structure, so do adults. And, if we can implement consistent attention in our lives to the areas above, we can have a much greater feeling of order, stability, peace, and happiness both within ourselves and in the things and people that we invest in.


Do you know your formula?
 

All the best to you and yours,

Dr. Sarah Ray
 

We all have those days where we need a little pick-me-up…

I like to read (and re-read) inspirational quotes to help keep me on the positive side of life when I am having a trying day (and yes, we ALL have them!)  
 
Here are a few of my favorites:

"Resolve to be tender with the young, compassionate with the aged,
sympathetic with the striving, and tolerant with the weak and the wrong.
Sometime in your life you will have been all of these." 
– Robert H. Goddard


"I've learned that people will forget what you said,
people will forget what you did,
but people will never forget how you made them feel." 
– Maya Angelou


"Happiness is not the absence of problems,
but the ability to deal with them" 
– Abe Lincoln


"The secret of health for both mind and body is not to mourn for the past,
worry about the future, or anticipate troubles,
but to live in the present moment wisely and earnestly" 
– Buddha


"If you think about what you ought to do for other people,
your character will take care of itself." 
– Woodrow Wilson


"For attractive lips, speak words of kindness. 
For lovely eyes, seek out the good in people. 
For a slim figure, share your food with the hungry. 
For beautiful hair, let a child run his/her fingers through it once a day. 
For poise, walk with the knowledge that you never walk alone.
People, even more than things, have to be restored, 
renewed, revived, reclaimed, and redeemed; never throw out anyone. 
Remember, if you ever need a helping hand, 
you will find one at the end of each of your arms. 
As you grow older, you will discover that you have two hands; one for helping yourself and the other for helping others." 
– Audrey Hepburn


‎"Man must evolve for all human conflict a method which rejects revenge, aggression and retaliation.
The foundation of such a method is love."
– Martin Luther King, Jr.


"It's a troublesome world.
All the people who're in it are troubled with troubles almost every minute.
You ought to be thankful, a whole heaping lot,
for the places and people you're lucky you're not."
– Dr. Seuss
 
All the best to you and yours,
Dr. Sarah Ray

For many people, the decision to enter into psychotherapy can be challenging. Some people seek therapy because they are in crisis, some people are struggling to manage their feelings and behaviors on their own, and others just want to learn a little more about themselves or improve their quality of life.

No matter what your personal situation is, for many people, the investment of time, energy, and finances of therapy can seem overwhelming. And for some, the thought of facing and exploring feelings and issues that are painful or challenging for them is difficult to face. However, one of the many wonderful things about therapy is that your treatment is personally tailored to meet your needs. Some people choose to participate in brief psychotherapy, as little as a handful of sessions, while others invest in long term self exploration; Most people choose something in between. In addition, some people choose to focus on a specific problem or issue, while others prefer to come in and see what arises from session to session, and others want to explore and heal from past pain or trauma. Amongst all of the differences and uniqueness of why people seek therapy and how they choose to participate in it, there is one main thing that is shared: Talking helps. This simple lesson was introduced to us by the founder of Existential Therapy, and a personal favorite psychotherapist of mine, Mr. Irvin Yalom. This simple philosophy has led countless people to greater health, happiness, and peace in their lives. Here are a few of the many ways that talk therapy may be able to help you…

• Improving your relationships, including reducing conflict, having better boundaries with others, picking healthier friends and companions, and improving communication techniques.

• Making healthier decisions.

• Obtaining a solution to a specific problem or dilemma that you are faced with.

• Being able to understand yourself and your personal values and goals better.

• Managing specific problems or feelings, such as past trauma, a phobia, an eating disorder, low self-esteem, anger, depression, anxiety, or other feelings and behaviors that you are struggling with.

• Obtaining greater awareness and understanding of your family dynamics. Relating to your spouse, children, or family in a more productive and health way.

• Improving personal habits, such as sleeping, eating, and self-care.

• Managing chronic health conditions or chronic pain.

• Healing childhood trauma and lessening their impact on your adult life.

• Reducing or stopping unhealthy habits or patterns.

• Improving your personal situation, such as your employment, finances, or hobbies.

• Obtaining greater self love and understanding.

• Feeling happier, more peaceful, and improving your quality of life.

One of my favorite quotations is from Abraham Lincoln. He said, "Happiness is not the absence of problems, but the ability to deal with them." If this is your time to make positive changes in your life, we would be honored to help you on your journey…

All the best to you and yours,

Dr. Sarah Ray
​

Living in Southern California, we are lucky to have amazingly stable weather all year round. In fact, as I write this blog, I am looking out of my office window and into the sunshine. However, as a Michigan native, I am all too familiar with brutally cold and snowy winters. Even more, I have seen first-hand how these weather patterns can severely impact people's moods and quality of life.
 
Seasonal Affective Disorder, or SAD, is a mood disorder characterized by symptoms of depression during the winter months, despite experiencing primarily normal mental health throughout the other seasons. While many people can recognize “depression” when they are feeling sad or blue, for many people, symptoms of depression often go beyond just sadness. Other indicators that you may be experiencing depression include: Irritability, fatigue, poor sleeping (over sleeping or disturbed sleep), lack of pleasure in previously enjoyable activities, social withdrawal, poor concentration, negative thoughts, worries, change in eating habits, and increased bodily complaints (such as headaches, stomach distress, and body pain). Does any of this sound familiar to you?

For those of you who suffer with SAD, or are just merely feeling “off” during the winter months, there are many things that can be done to make this time of year much less stressful, and even ENJOYABLE! Wintertime makes up approximately 3 months of the year (and in some areas, quite a bit longer!). That is, at minimum, 25% of your year—and your life! In my opinion, this is far too much time in your life to spend feeling blue…especially when there are ways to make it better!

But the reality is, many people experience these types of emotional reactions in the winter, and the good news is that there are specific strategies to help manage these feelings. Whether you have these feelings in the winter, or all year round, here are three simple ways to help reduce depression:

1)     Increase Socialization with Friends and Family
 
2)     Increase Exercise
 
3)     Increase Pleasurable Activities

Many people who experience mood changes during the winter are going through this, in part, because they feel disconnected from their regular routine and are cooped up inside of the house. And many people who are depressed in general, tend to isolate and stop doing things that they once enjoyed. A common struggle is how to give your body and mind the same outlets that you may get during the other months when the weather is not so constricting. Oftentimes, when people are stuck inside of the house, they spend a lot more time worrying or thinking of things that are not going well. And frequently, these negative thoughts are dancing around in your head even when you do not realize it! One of the best solutions to help yourself disconnect from these negative, and ultimately unhelpful, thoughts, is to distract yourself. Doing something that you enjoy, on a regular basis, is a natural protection against depression. However, it is often more difficult to come up with ideas of what to do when you are stuck inside or already down in the dumps, so here are some ideas:

• Take a long bath                                
• Write/Journal
• Call a friend
• Watch a movie
• Read a book
• Do a crossword puzzle
• Draw, color, paint
• Clean
• Cook a new recipe
• Volunteer
• Fix something around the house
• Organize old pictures
• Jigsaw Puzzle
• Arts & crafts
• Read a magazine or the newspaper
• Look up a subject you’ve always wanted to learn about
• Take a class
• Play/learn an instrument
• Organize a room in your house
• Donate old clothes
• Go to lunch with a friend
• Write your autobiography or a story
• Go to church
• Go to yoga
• Sing a song
• Play a game
• Write a poem or song
• Make a to-do list & tackle it
• Go to an exercise class
• Be there for someone else
• Take special care of your pets
• Take an art class
• Write your beliefs
• Send cards to loved ones
• Clean out drawers and cabinets
• Dance
• Go to a new restaurant
• Go to the gym
• Visit with family or friends
• Go to a coffee shop
• Color
• Make a magazine collage
• Change your photo frames
• Plan a party
• Make a list of short and long term goals and steps to meet them
• Do something nice for someone
• Laugh out loud
• Play solitaire
• Search the internet
• Go to a sporting event
• Redecorate a room
• Count your blessings – Make a list of everything that’s going well

Although this list may seem very simple, I encourage you to pick a few and give them a try on a consistent basis. Often when we struggle with negative thoughts and feelings, we don’t feel like doing anything. This is the depression taking charge. Practicing something pleasurable over and over again is an important way to start changing how you feel. Remember, feelings follow behaviors, so a great way to start feeling upbeat again, is to do something—put your body in motion and distract your mind from negativity.

Aside from these three ways to combat your depression, it is also important that you seek professional help if your symptoms persist or become more severe. Talk therapy, even just in the winter months, can be an excellent way to help manage your feelings during these times. In addition, some people decide to use medications to help mange their moods during this time. If you’re interested in this, consult your doctor or a psychiatrist.

Is it Spring yet? 
 
 

All the best to you and yours,

Dr. Sarah Ray
​