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5 Mental Health Tips for Coping with the Coronavirus


1) Remember emotions are not good or bad. Each emotion serves a purpose to alert us to something important. Anxiety, in particular, can be helpful to help us “prepare” for a situation or perform during a stressful task. Ask yourself and label what emotion(s) you might be feeling. Labeling emotions in and of itself can be regulating to distress.

Siegel, D.J. & Bryson, T. D. (2012). The whole-brain child: 12 revolutionary strategies to nurture your child’s developing mind. Bantam Books.

2) If your emotions are doing more harm than good try Dialectical Behavior Therapy’s (DBT) skill – taking opposite action. Find actions that might feel the “opposite” to the overwhelming emotion you might be feeling. For example, if you are feeling down or depressed, maybe that means you engage in things that might make you laugh, smile, or feel happy. That could mean listening to music that makes you feel this way, watching a comedian on Netflix/Youtube, or looking at old photos that make you smile. 

Linehan, M. M. (1993). Skills training manual for treating Borderline Personality Disorder. The Guildford Press.

3) Schedule “worry/anxiety/panic” time. This Cognitive Behavioral Therapy (CBT) skill suggests you schedule 30 minutes daily let yourself worry, maybe read news, or talk to others about it etc., just letting these emotions and thoughts be. Then limit your exposure to things that might increase anxiety/panic (i.e news, social media etc.) other times of the day. By scheduling time to worry, you can help yourself refocus the rest of the day to carry on with what you might need to do, knowing you have your “worry time” set aside for later. 

McGowan, S., & Behar, E. (2012). A preliminary investigation of stimulus control training for worry: Effects on anxiety and insomnia. Behavior Modification, 7(1), pp. 90-112.

4) This Acceptance and Commitment Therapy (ACT) skill, suggests you decide how you would like to live out your valuesin this situation. By focusing on your values, you can align what is important to you with your actions, creating meaning and purpose (in spite of a sense of chaos). For example, maybe you value social justice, so you can focus on addressing the Xenophobia that has been present in the news/social media. Maybe you value knowledge, so you focus on obtaining the best evidenced-based research and facts, or maybe you value your religious faith, so you focus on religious scripture and/or rituals.

Harris, R. (2009). ACT made simple: An easy-to-read primer on Acceptance and Commitment Therapy. New Harbinger Publications, Inc.

5) Self-care. Engage in activities that will reduce stress (exercise, yoga, meditation, hot shower/bath), etc.) daily. You can Youtube yoga classes (if wanting low-cost free or to avoid people 😉 ) or try some meditation/mindfulness apps:

Meditation/Mindfulness Apps:

Insight Timer

Over 30,000 free guided meditations, imagery, and mindfulness. Covers topics of sleep, anxiety, stress, etc. Faith-based guided meditation included. Option for payment for additional features.

Headspace 

First 2 weeks free. Guided simplified meditation app. Subscription covers guided meditation and mindfulness exercises that are great for busy schedules.

Liberate

Free meditation app made by and for Black, Indigenous, and People of Color. Includes topics on gratitude, body, micro aggressions, sleep, race, etc.

Breathe2Relax 

Free made by the defense health agency. Practice and learn diaphragmatic breathing. Can pair with Apple Watch and Health Kit to measure heart rate.

Calm

Free 7 day trial app with mediation, breathing exercises, and music and video scenery for relaxation and stress relief. Also includes sleep stories, with new stories added every week.

Relax Melodies: Sleep Sounds

Free download includes sleep background noises. 7 day free trial includes guided meditations, stories, and guided gentle movements.

Eating Disorders 101


The term “eating disorders” refers to a group of disorders that are characterized by eating or eating-related behavior and significantly impairs someone’s physical health and/or psychosocial functioning. It is important to note that obesity is not considered to be an eating disorder, though it is associated with other mental disorders such as depression and binge-eating disorder. 

The main eating disorders outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). AN is characterized by restriction of energy intake, intense fear of weight gain or becoming fat, and disturbance in one’s experience of body weight or shape. BN is characterized by binge eating, inappropriate compensatory behaviors (e.g., vomiting), and self-evaluation that is influenced by body shape and weight. BED is primarily characterized by binge eating (without compensatory behaviors) as well as distress regarding the amount, frequency, and/or pace of eating. 

There are many factors that can contribute to developing an eating disorder. These include genetic, biological, psychological, and sociocultural factors. Treatment of eating disorders must therefore address the factors that contribute to or help maintain symptomatology. Treatment modalities include individual, group, and/or family therapy. There are also various levels of care based on severity of symptoms. Inpatient treatment tends to be effective for medically and psychiatrically unstable individuals. Residential is suitable for individuals who are medically stable but psychiatrically impaired. Partial hospitalization is helpful for individuals who are medically stable but need daily assessment of their physiological status as well as those who are psychiatrically stable but are engaging in disordered eating behaviors (e.g., restricted eating). Lastly, outpatient or intensive outpatient is an option for individuals who are stable and do not need daily monitoring. It is also effective for those who are psychiatrically stable and can function in day-to-day situations.

Lexapro is my first medication when I was depressed and had various anxiety disorders. it only helped a little but since I was undergoing intensive therapy it was not enough in my opinion. Check out more info about Lexapro medication.

With regard to treatment options and theoretical orientations, clinicians, therapists, etc. have used the spectrum of options, from acceptance and commitment therapy (ACT) to psychodynamic therapy. There are some, however, that are shown to be particularly beneficial for individuals with specific symptomatology. For example, eye movement desensitization and reprocessing (EMDR) has been effective for individuals with a trauma history. Cognitive remediation therapy targets rigid thinking processes usually associated with individuals with AN.If you or someone you know is engaging in disordered eating behaviors or meets full criteria for one of the specific eating disorders in the DSM-5, it is beneficial to meet with a qualified health professional to address symptoms. Please feel free to contact us at 312-573-8860 to meet with one of our therapists or to receive additional resources for treatment.

Come As You Are: Examining Our Own Narratives Around Food, Health, and Body Image


Common assumptions around eating disorders often narrowly focus on an individual’s food intake and exercise. It’s time to examine how cultural norms directly impact all of us. A leading factor in the development of disordered eating is a cultural emphasis on being thin (Culbert, Racine, & Klump, 2015). When thinness is celebrated and equated with health, anyone outside of thinness is subjected to weight stigma and bias. One’s “discipline” and even morality is questioned. Weight stigma is a subsequent threat in and of itself as a risk factor for depression and anxiety (Andreyeva, Puhl, & Brownell, 2008). Rather than investing our time, money, and energy into a narrow and often impossible standard, what if our focus is to work against weight stigma and the idealization of thinness? 

This work begins with ourselves, in identifying the ways we have internalized messages of shame for our bodies, or perhaps in how we have pursued and been devoted to this standard of thinness. For parents and caregivers there is a compelling obligation to consider one’s own beliefs and actions around health, wellness, and eating patterns for the sake of their children. All children are currently composing their own narrative of what it means to “be healthy” and are modeling behaviors from those around them, for better or for worse. (Andreyeva, Puhl, & Brownell, 2008). 

This work is individual and collective. National Eating Disorders Awareness Week is from February 24th-March 1st. The National Eating Disorders Association (NEDA) theme for this year is “Come As You Are, Hindsight is 2020.” Let us take time, be it in conversations, prayer, or in counseling to reflect about our own narratives around food, health, and body image. Let us work toward a culture in our families and communities that speaks to each and every one: “Come as you are.”

References

Andreyeva, T., Puhl, R. M. and Brownell, K. D. (2008), Changes in Perceived Weight Discrimination Among Americans, 1995–1996 Through 2004–2006. Obesity, 16: 1129–1134. doi:10.1038/oby.2008.35

Culbert, K. M., Racine, S. E., & Klump, K. L. (2015). Research Review: What we have learned about the causes of eating disorders – a synthesis of sociocultural, psychological, and biological research. J Child Psychol Psychiatry, 56(11), 1141-1164. 

On the Epidemic of Fatherlessness in the Black Community


In 1965, the Assistant Secretary of Labor, Daniel Patrick Moynihan, commissioned a report on the state of the African-American family. The report was titled, The Negro Family: The Case for National Action. This famed report, which was later commonly referred to as “The Moynihan Report,” resulted in a great deal of controversy, but it unequivocally illustrated the glaring familial disparities that have existed between white and black families. One of the most striking findings of the report was that in 1960, approximately 30 % of black children were being raised within a single parent household, which was a far cry from the 10 % of white children being raised within a single parent household (United States & Moynihan, 1965). Unfortunately, these statistics have continued to rise, and the most recent statistics indicate that roughly 65 % of black children are being raised within a single parent household, whereas approximately 25 % of white children are being raised by single parents (Livingston, 2018). Often times when the nuclear family structure dissolves, it is the mother that serves as the custodial parent, although it should be noted that there are indeed exceptional cases where the father is the primary caretaker. However, the unfortunate reality is that on the whole, fatherlessness is plaguing our society, and this epidemic has had the most pernicious effect on black children.

It is an unfortunate fact that if one is raised without a father, he or she is more likely to be rendered absent of sufficient guidance and discipline. This is in part because traditionally, fathers provide discipline, whereas mothers furnish nurturance and compassion. Of course, these are not strict rules, as it is certainly more advantageous for children when both of their parents properly exercise their capacities for discipline and compassion. However, generally speaking, the traditional paternal ethos is characterized by discipline, whereas the traditional maternal spirit is more tilted towards nurturance and compassion.

Being raised without a father is especially a problem for boys, as fathers play a major role in regulating the aggression of boys and teaching them how to properly harness their aggression. If one respects their father, who generally stands as a proxy for authority, this respect is likely to generalize to other purveyors of authority in the non-domestic sphere (e.g., school teachers, employers, law enforcement officers). In order for boys to develop into socially sophisticated, disciplined, academically astute, responsible, and professionally accomplished men that contribute to the welfare of society, they need their fathers to be a regular presence in their lives.

As for girls, they need their fathers to serve as proxies for authority and discipline too, but they also need them to affirm their value and to teach them what they ought to expect from men. Unfortunately, if such a paternal presence isn’t there, there’s a high probability that the girl may grow up with low self-esteem and accept untoward treatment from men, because even untoward treatment is preferred over not being shown any attention at all. As a general rule, attention is the preferred currency of children, and if a girl grows up without the regular attention of her father, she may settle for adverse attention from other men because her barometer for positive attention was never properly set.

There are many historical and contemporary factors which have contributed to the epidemic of fatherlessness with our society, especially within the black community. However, surveying all of these factors is outside of the scope of this article. Nonetheless, what is undeniably true, is that one of the antidotes to many of the societal ills that plague the black community, is present fathers. Surely, people can co-parent well without being married or romantically involved, but generally speaking, marriage increases the likelihood that fathers will remain tethered to their family and their children. Marriage certainly does not guarantee that one will exercise their paternal responsibilities wisely, but on the whole, it increases the likelihood that it will be the case. Fathers, or husbands for that matter, have been charged with the responsibility to be emotionally attuned to their wives, exhibit reliability, show genuine curiosity in the interests of their children, and to endow their children with guidance, discipline, and wisdom. If we desire a better future for our nation’s children, then society must promote the necessity for fathers and contribute to this endeavor by supporting and fortifying marriages.

References

Livingston, G. (2018). About one-third of U.S. children are living with an unmarried parent. Retrieved from https://www.pewresearch.org/fact-tank/2018/04/27/about-one-third-of-u-s-children-are-living-with-an-unmarried-parent/

United States & Moynihan, D. P. (1965). The Negro family. The case for national action. Washington, DC. 

How Do I Know When I Have Actually Forgiven?


In my work with clients, it is not unusual for me to bear witness to confusion about forgiveness. One specific area of confusion arises in a client’s uncertainty about whether or not forgiveness has actually taken place. Examples of some of the comments I hear include, “I thought I forgave her for the betrayal years ago, so why does it still hurt?” “I told him I forgave him for mismanaging our finances and I thought I really meant it, but now I’m questioning whether I forgave him at all.” “If I forgive him, why do still feel triggered?” These statements are touching on the delicate, sensitive process that we go through when we bravely enter into the forgiveness process. 

One image I find that is helpful is imagining forgiveness as a mountain with a path circling it like a spiral from top to bottom. The closer and closer you get to the summit, the tighter the spirals. As you move up the mountain, you grow, develop insight, integrate old experiences with new ones, and generally tend to make meaning out of your life as time moves along. Somewhere along the way, someone hurt you. Let’s call that “Spot A” on your mountain. You continue on up your mountain and at some point later decide to forgive that person. Let’s call that “Spot B” on your mountain. Life continues and you move up your mountain along your forgiveness path and are surprised a while later on when you find yourself standing directly above Spot A, and find yourself confused by an onslaught of troubling emotions that might make you question what happened down there at both Spot A and Spot B. These emotions might sound like, “Wait, didn’t I forgive him?” “I thought I took care of this back at Spot B!” “Why does this hurt so much all over again?”

What you are experiencing may be the difference between decisional and emotional forgiveness. According to forgiveness researcher Everett Worthington, these two things are crucial, but separate processes within the larger experience of offering forgiveness to an offender. Deciding to forgive means choosing to offer forgiveness to someone who has wronged you. Emotional forgiveness means replacing the negative feelings you had toward that person or event with positive feelings such as compassion or empathy. Each type of forgiveness has different functions in our lives. Worthington’s research has found that emotional forgiveness is what helps us most to release those negative or painful emotions, while decisional forgiveness may promote repair in relationships[i]. As you progress through your own life experience on your forgiveness journey, let me encourage you to consider both the decision to forgive and the process of replacing the negative emotions with positive ones as parts of your own unique forgiveness process. Each are worthy of your attention and energy as you continue forward. Perhaps as you circle closer and closer to the summit of your own mountain, you will release more and more negative emotions and replace them with neutral or even positive emotions. Regardless of where you stand decisionally or emotionally in your forgiveness journey, perhaps instead of asking, “how do I know I’ve forgiven,” consider asking yourself, “Where am I in my forgiveness process?” 


[i]Worthington, E. (2004). Forgiveness and reconciliation: Theory and application. New York: Taylor and Francis Group.

Strategies to Reduce Depression During the Holiday


For your physical health:

Be deliberate about what activities you choose to attend. Decide ahead of time what would benefit you the most and what is in line with your needs.

Ask for help from others. We tend to think we have to do everything, when a team effort can be more fun.

Make time to rest and rejuvenate even amidst the pressure of getting things done. This will give you more energy.

Pay attention to your eating and drinking.

 

For your emotional health:

Express your feelings in an assertive and respectful way. Say “yes” because you want to, not out of obligation or to please others.

Surrender to those things that we cannot change. Surrendering is accepting things that we cannot control which allow us not to struggle and feel more at ease.

Don’t isolate. Reach out to others if you feel lonely. If you don’t have someone to be with, volunteer to help those in need. It can be very uplifting and gratifying. Spend time with supportive people.

Spend time to reflect and grieve, if necessary. Let yourself feel. Then do something nice for yourself and socialize.

Practice mindfulness. Try to observe your internal experience, just as it is, without judgment.

 

For your spiritual health: 

Don’t compare yourself to others. You are perfect just as you are today.

Extend forgiveness.

Let go of the past. Life brings changes and each holiday season is different and can be enjoyed in its own way. Look forward.

Each week, call or email a family member or friend that you have not connected with in some time.

Make a new friend and invite them for coffee.

Find time to be with God. Pray!

When to be worried: A growing child and drugs and alcohol


Finally spring is here and before we know it summer will arrive, something many Chicagoans look forward too. We get to enjoy the city at last, the beaches, festivals, block parties, and music fests. With these events and activities comes the prevalent drink of choice: alcohol.  As any Chicagoan is aware of, there is always a preponderance of underage drinking at these events. It almost seems that this is a common practice and accepted by many. Not only is alcohol common in summer celebrations but also drug use as well. What should a parent do? While marijuana becomes more and more accepted in the mainstream, parents are still concerned with the health and safety of their children. How should a parent address this with their children? At what point is there “a problem”?

Perhaps the most important thing to do as a parent is to communicate with your child. Communication, like in any relationship, is fundamental to a healthy partnership. Have you discussed drug use and drinking with your child? Have you been clear on your own views of drinking and drug use? Have you set clear rules for them? Also, importantly, do you feel you have created a space for your child to discuss this with you as well? In discussing drug use with your child I often describe it as a balancing act. On one hand you want to be able to establish clear rules and consequences, on the other you don’t want your child to fear having a conversation about it. Creating a safe place for your child to openly discuss the topic of drugs and alcohol with you is paramount; otherwise your child will find answers elsewhere.

While no one person can perfectly predict substance abuse, as parents there are always things to look for. Declining grades, dramatic shift in peer groups, isolation, and emotional turbulence are a few key factors to note. And of course, while these may be classic “teens being teens” actions, the extreme prevalence of all these factors could be a cause for concern.  Substance use in adolescents is detrimental to their health in both physical and psychological ways. The developmental time period for teens is at a critical point in developing into healthy adult. This is why it may be necessary that if you do see these warning signs, to discuss it even further with your child. Along with more open and honest conversation, treatment may be necessary.

Experimentation as a teenager is typically normal, finding new friend groups, venturing into new hobbies, finding new passions; drug use does not have to be one of them. Teens will always be curious about the unknown and the prohibited, it is their nature. However it does not have to necessarily venture in to illegal use. Therefore, communication and discussion is so necessary. This summer while your kids are outside living their lives make sure to talk with them about drugs and alcohol. Don’t be afraid to openly bring up this topic.  Make your rules clear, but also be open to hearing the questions and accept their most likely push back on the subject.   Remember there are resources available nearly everywhere online, and if you really are concerned, feel free to give your local treatment provider a call, just make sure they are trained in addiction treatment.

Self-Care Tips to Get You Through the Holidays


While the holiday season can be a time of connection and cheer for many, for others it can bring about additional stress and isolation. During the season of giving we often devote so much time to others that we forget to take care of ourselves. Reclaiming and incorporating time for yourself is an essential part of maintaining a healthy and balanced holiday season. Below are a few ways in which you can give to yourself this season:

  • Reflect: Throughout the year reflection is a key aspect of self-care, but moving it to the forefront is especially important during the holidays. Reflection can bring about renewal and change as you enter the new year, and for some can even bring closure. Meditation and journaling are ways in which you can reflect on what it most important during these times. Both provide emotional and physical benefits that aid in the mitigation of undesirable symptoms.
  • Rest: Another important aspect of everyday life, that is especially important during this busy time, is rest. By maintaining a routine, you allow yourself to remain recharged and refreshed during this season of rush.
  • Prioritize: In an effort to match the pace of the season, many people often find themselves playing catch up once the holidays have ended. Allow yourself time to create and stick to realistic goals, which can include scheduling and budgeting. This eliminates the burden of overspending and overexerting yourself.
  • Create: Instead of focusing on the hustle of the season, take advantage of the magic of the season by creating traditions that will last for many seasons to come.
  • Redefine: Many assume that giving requires spending. During the coming days, take time to reflect on the meaning of the holidays by redefining what it means to give. Giving your time to be in service of others is an easy and inexpensive way to lift spirits.

In keeping with the holiday season, it is important to remember that self-care is key to achieving greater health, happiness, and prosperity. As stated by Calving Coolidge, “Holidays are not a time nor a season, but a state of mind. To cherish peace and goodwill, to be plenteous in mercy, is to have the real spirit of the Holidays.”

What is your parenting style?


Authoritarian Parenting

In this style of parenting, children are expected to follow the strict rules established by the parents. Failure to follow such rules usually results in punishment. Authoritarian parents fail to explain the reasoning behind these rules. If asked to explain, the parent might simply reply, “Because I said so.”

 

Authoritative Parenting

Like authoritarian parents, those with an authoritative parenting style establish rules and guidelines that their children are expected to follow. However, this parenting style is much more democratic. Authoritative parents are responsive to their children and willing to listen to questions. When children fail to meet the expectations, these parents are more nurturing and forgiving rather than punishing. Baumrind suggests that these parents “monitor and impart clear standards for their children’s conduct. They are assertive, but not intrusive and restrictive. Their disciplinary methods are supportive, rather than punitive. They want their children to be assertive as well as socially responsible, and self-regulated as well as cooperative.”

 

Indulgent Parenting

Permissive parents, sometimes referred to as indulgent parents, have very few demands to make of their children. These parents rarely discipline their children because they have relatively low expectations of maturity and self-control. According to Baumrind, permissive parents “are more responsive than they are demanding. They are usually nontraditional and lenient. Permissive parents are generally nurturing and communicative with their children. This style of parenting should be careful not to take on the status of a friend more than a parent.

 

Uninvolved Parenting

An uninvolved parenting style if characterized by few demands, low responsiveness and little communication. While these parents fulfill the child’s basic needs, they are generally detached from their child’s life. In extreme cases, these parents may even reject or neglect the needs of their children.

 

The Impact of Parenting Styles

What effect do these parenting styles have on child development outcomes?

  • Authoritarian parenting styles generally lead to children who are obedient and proficient, but they rank lower in happiness, social competence and self-esteem.
  • Authoritative parenting styles tend to result in children who are happy, capable and successful.
  • Permissive parenting often results in children who rank low in happiness and self-regulation. These children are more likely to experience problems with authority and trend to perform poorly in school.
  • Uninvolved parenting styles rank lowest across all life domains. These children tend to lack self-control, have low self-esteem and are less competent than their peers.

Baumrind, D. (1989). Rearing competent children. In W. Damon (Ed.), Child development today and tomorrow (pp. 349-378). San Francisco: Jossey-Bass.

Baumrind, D. (1991). The influence of parenting style on adolescent competence and substance use. Journal of Early Adolescence, 11(1), 56-95.

Cornerstone Counseling Center of Chicago