Dr. Megan Johnson

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Building Psychological Resilience

You can’t avoid the difficult aspects of life, but you can learn to adapt and cope with them. In the psych world, we like to build resilience to the painful or confusing life experiences we all have. Resilience is our ability to cope with and tolerate challenges.

So what makes a person resilient? The research shows that having a supportive group behind you actually contributes most to our resiliency. You can read more about that here. So get yourself a support network around that can build you up, love on you, provide reassurance and encouragement, and offer examples of how to navigate the ups and downs of life.

How to build psychological resilience:

Embrace change. Accept that situations and people can and will change. This is a great opportunity to focus your energy on things that you can change. Resilience means being flexible and allowing for change to motivate, rather than discourage or derail.

Make connections. Build healthy relationships BEFORE you encounter a crisis so you have people there when the hard times inevitably hit. We have a great blog post on creating healthy and meaningful relationships here. The best place to start is by reaching out to friends and family. If that is not possible, you might seek out new social networks through community associations, support groups, or religious organizations.

Get creative. Sometimes the solution to your predicament isn’t obvious or immediate. Sit with your problems for a while. Observe your emotional responses and learn more about your triggers. Run them by other people. See what comes up. Feel the freedom to try something new like journaling, seeking out professional help, or spending more time in self reflection.

Goal Setting. Set realistic and attainable goals. Then break them down into smaller actionable items and take conscious, decisive steps toward them every day. Make a conscious effort to put one small change in place at a time, so you can start to learn to trust yourself. Trusting yourself and self-esteem go hand-in-hand. Read more about healing self-esteem here. When you have unshakable self trust, then crises won’t throw you off kilter as much.

Gain Perspective. View challenges and obstacles through a hopeful and optimistic lens. When you run into difficulties, avoid looking at them in a fatalistic manner and ask yourself what you could learn or how you could grow in this situation.

Cultivate a practice of prayer/meditation. Most of the things we worry about are things that happened in the past or will happen in the future. While worrying takes us out of the present moment, prayer and meditation keep us in the here and now.  These practices also help us deliberately confront and engage our emotions when they arise, rather than stuffing them down or numbing them out.

So what now?

Keep these ideas in a place where you can easily refer to them and find one small way to make a change today. Resilience in a practice. You’ve got to show up for yourself daily in order to create a stronger muscle response to pain, uncertainty and crisis. If you are needing help creating psychological resilience, we can help. Reach out and schedule a free consultation.

Written by: Megan Johnson, PhD

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What To Do With “Negative” Emotions

Are you feeling plagued by chronic uncomfortable feelings? Does your anxious mind keep you up at night? Do you often wonder what you can do to make these feelings stop? Perhaps you have tried making every change you can think of, yet you still experience a depressed mood most of the time. Sometimes our emotions can lead us to feel overwhelmed and defeated. Or our feelings can cause to do and say things we are not proud of. But you don’t have to live like this day in and day out! There is hope – and you don’t have to keep existing in this uncomfortable space. Below are 6 strategies that can help you disembark from the emotional roller coaster you are on and being to feel calm and pleasant in your current circumstances.

Reassess.

First and foremost, we must understand that emotions are neither good or bad. They are not right or wrong. They just are. Whether it is anger, sadness, guilt, frustration, or anxiety – having an emotion simply means that you are human. Begin to accept your emotions as part of your humanity and refrain from judging the emotions that come up for you. Rather than assigning a label of “good” or “bad” to your emotions, it can be more helpful to think of them as pleasant or unpleasant. Take the feeling of grief, for example. Most people would say that grief is an unpleasant emotion. But it is not a bad emotion. In fact, it would be abnormal if you didn’t feel grief in particularly sad situations. Similarly, grief is not a wrong emotion. It simply means that you cared deeply about something or someone that that is now lost.

Listen.

Once we stop judging our emotions as good or bad, the next task is to begin listening to what those emotions are trying to tell us. Emotions are subjective, internal states that represent a response to our internal and/or external experiences.1 Emotions are the body’s way of communicating something to us. For example, if you are experiencing anxiety, that is your body telling you that there is potential danger ahead. If you are about to jump off a cliff, you will feel anxious because your body is sending warning signals that this activity could hurt you. However, when we feel anxiety in our everyday lives, the danger is rarely physical. Sometimes we feel anxious in relationships because we perceive the possibility of being rejected or disappointed. We may feel anxiety at work or school in response to our awareness of the potential for failure or negative evaluation. While most humans feel a similar range of emotions2, we all feel them in response to different triggers, so it is important to listen to the messages that your emotions might be telling you. Emotions are our guide to ourselves, and if we use them to our advantage, they can help us make sense of our experiences.

Own your experience.

Along the same lines of listening to rather than judging our emotions, we must also own the feelings we have. Oftentimes when people experience unpleasant emotions, the knee-jerk reaction is to stifle them in some way. This can come in the form or ignoring, suppressing, or numbing out emotions. Common ways in which people attempt to avoid their emotions include masking them with humor, distracting themselves with shopping, TV, or hobbies, isolating from others, or consuming excessive amounts of alcohol. But when we silence our emotions, we are not being authentic and honest, and we run the risk of missing out on the message our emotions are trying to communicate to us. It is essential that you own your emotions by labeling and accepting whatever it is you are experiencing. One way to acknowledge your emotions is to keep a journal. Your journal does not have to contain lengthy or profound entries, but it may be something as simple as identifying your emotion and describing what it feels like in your body. If you find that you are lacking words to describe your emotions, check out Dr. Gloria Wilcox’s Feeling Wheel.3 Identifying and tracking your emotions can also help you to listen to what they might be telling  you as you begin to notice patterns emerging over the weeks and months.

Soothe.

Although it is psychologically health to accept and listen to our emotions, the things we feel internally can often cause us to behave in unkind ways. For example, it is reasonable that you feel angry during an argument with your partner and it is important to understand what your emotional arousal is telling you about your relationship with him or her. But, if these feelings cause you to lash out, an intervention to regulate your response should be used.  Some practical tips for regulating your response to unpleasant emotions include:

Mindful Breathing: Research has shown that mindfulness practices and the breathing exercises they contain can actually have a physiological effect on your body that calms you down.4 There are many patterns of breathing that have been suggested to help calm the mind, but the easiest way to engage in mindful breathing is to take 10 slow, deep breaths in which your out-breath is longer than your in-breath.

Don’t respond right away: No feeling is permanent and whatever intense emotion you are experiencing will eventually subside. Make the conscious decision not write that email or send that text or say those words until your emotional experience has settled down.

Find outlets to help you cope: Increasing your pleasant emotions can help you you’re your more unpleasant emotions at bay. If you are felling particularly emotional, try out various coping mechanisms. This may include exercise, meditation, or proper nutrition; but it can also include life’s integrating more simple pleasures such as listening to your favorite song or podcast, picking up your favorite coffee drink on your way to work, going for a walk outside on your lunch break, putting on your most comfortable pair of yoga pants, or treating yourself to your favorite meal or TV show after work.

Therapy: When your emotions begin to get in the way of you living the life you desire, it may be time to reach out to a therapist. If you find that your unpleasant emotions are too overwhelming to cope with on your own or you need help making sense of the messages your emotions could be trying to communicate, therapy can help you.

References [1] Tang, Y.Y., Holze, B.K., and Posner, M.I. (2015). The neuroscience of mindfulness meditation. Nature Reviews. Neuroscience. 16(4) 213-225. [2] Ekman, Paul. (1992). “Are there basic emotions?” Psychological Review, 99:550 –553 [3] Wilcox, G. The Feeling Wheel. Accessed at: https://www.thinglink.com/scene/503651459225616386 [4] Gross, J. J., Richards, J. M., & John, O. P. (2006). Emotion Regulation in Everyday Life. In D. K. Snyder, J. Simpson, J. N. Hughes(Eds.) Emotion regulation in couples and families: Pathways to dysfunction and health (pp. 13-35). Washington, DC, US: American Psychological Association. doi:10.1037/11468-001

Written by Megan Johnson, PhD

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What is psychological assessment and how can it help me?

Psychological assessment, or testing, is a formal way of capturing a picture of what is going on with a person psychologically. Assessment can help clinicians clarify diagnoses and get to the root of a client’s problem. Psychologists are trained to translate your symptoms into diagnoses. But this tells you little about the underlying causes of what your are experiencing or how to address it. Assessments can be used to fill in these gaps and answer these questions. Unlike other medical professionals, psychologists are not able to run lab tests such as drawing blood or taking x-rays to examine the underlying causes of symptoms. Therefore, they use assessments to better understand what is going on internally with a person.

It can be helpful to think assessment results as a map of your psychological functioning. Therapy is an investment, so it’s helpful to have a roadmap before you start your journey.

Oftentimes, assessment is conducted at the outset of treatment in order to get a clear picture of a client’s diagnosis, strengths, and goals. It can inform the treatment and help provide clarity for both the clinician and client. Assessments are also sometimes conducted during the course of treatment either to monitor progress or better understand roadblocks to progression. In addition to clarifying a diagnosis and establishing a treatment plan, assessments also highlight your strengths so that they can be used to your advantage.

How do I know if and when I need an assessment?

We recommend completing an assessment before beginning therapy. An assessment will provide diagnostic clarity and reveal what may the underlying causes of your complaints. Additionally, your assessment will identify your relative strengths, which will be beneficial in treatment planning. Other times assessments may be recommended are:

Around major life transitions such as marriage, divorce, starting a family, medical procedures, etc.

You are considering making a career change

You are interested in going to college or graduate school

You are feeling stuck in therapy

You have tried many things and are still struggling

You feel stagnant in your career

You cannot keep up in work or school

You are interested in receiving accommodations at work or school

You are considering going to rehab or getting sober from drugs and/or alcohol

You have heard several diagnoses from different doctors over the years

Your functioning in some domain has noticeably declined

You find yourself repeating similar patterns in interpersonal relationships

You or your health care providers suspect you have a cognitive or neurological disorder (i.e., ADHD, learning disability, concussion/traumatic brain injury, dementia, etc.)

What should I do to prepare for my testing session?

All assessments will include a formal informational interview where the clinician will gather background information. Most assessments come in the form of paper and pencil tests. You will be asked to answer questions about your feelings and preferences. You may also be asked to respond to various questions in which your performance will be evaluated, such as with cognitive testing that can answer questions about job performance or neurological functioning. Some assessments are very short and consist of a series of questions that can be answered in a couple of minutes. Other assessments will take a few hours to complete. Your clinician will choose the appropriate tests for answering the question that you and your other healthcare providers are asking.

Prior to your testing session, your clinician will let you know how long you can expect the testing to take. There will be frequent breaks in order to stretch, eat, drink water, and use the restroom. It is essential that you get a good night’s sleep the night prior to your assessment session so your clinician can get the most accurate picture of your current functioning. If you are feeling nervous about your assessment, please be assured there is nothing to fear. During the interview and when answering test questions, there are no right or wrong answers. Psychological assessments are not like tests in school in which you can pass or fail, but instead they seek to describe your current functioning.

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Overcoming Your Fears About Going to Therapy

Are you considering therapy but feel nervous about taking the plunge? Maybe you don’t know what to expect from therapy, or you are wondering if therapy can help you with whatever it is you are dealing with. Or maybe calling a stranger or meeting new people makes you shake in your boots. Whatever it is that causing you to take pause before starting therapy, know that your feelings are normal – of course you feel some anxiety about telling your innermost thoughts and feelings to a stranger! Here are some common fears that keep people from seeking  therapy and what you can do to ease your fears about starting therapy.

“I don’t know what to expect.” The relationship between therapist and client is unique and unlike other relationships in our lives. We have different a framework in this relationship than we do in our families, friendships, romantic relationships, and business partnerships. If you have never been to therapy before, or if you have had an unpleasant experience in therapy previously, you may be wondering what to expect. A lot of anxiety is rooted in fear of the unknown so by increasing your knowledge, you will feel more at ease. The best place to start is to read the “what to expect” portion on my page. But maybe you have more specific questions such as, “What time do you offer appointments?” or “How much do you charge?” or “Where do I park?” Those are all great questions and can be answered during the free 15-minute phone consultations I offer. There is no such thing as a stupid question, so ask away!

“My therapist won’t understand me.” Many people worry that because their therapist is not in their shoes, they won’t be able to relate or help. For example, I once had a client tell me, “You don’t have children, so you cannot possibly help me work through my parenting anxiety.” She was partially right – I am not a mom. But I don’t help my clients based on my experience. I offer help to my clients based on my training and understanding of psychological principles that apply to all humans. Furthermore, therapy is more about the relationship that we create together in the room and less about my particular gender, age, marital status, ethnicity, religion, or any other feature that makes up my identity. Yes, those things are important and do influence who I am and how I interact with the world. But they are not the focus of your treatment. No matter who you select as your therapist, you will be different from them in some way because you are a unique individual. Embrace those differences and discuss them in order to develop a better understanding of who you are and how you view life. The best part about therapy is there is no topic that is off limits, so if you are concerned your therapist won’t understand some aspect of your identity, bring it up during your session.

“I’m worried my therapist will judge me.” Attending therapy and sharing your most intimate thoughts and feelings is a very vulnerable action, so it is only natural that you would have some hesitation about your therapist’s response. But know that your therapist is there to help you and support you. Day in and day out, your therapist works with people who have concerns and struggles, just like you. They know that you are human and don’t expect you to be perfect or having it all together. Your therapist has spent many years in school and clinical training learning about people and what makes them tick, so they are well acquainted with the fact that no one is perfect. In fact, they have probably previously sought or are currently in therapy themselves. All of these things mean that they get it. It may even be helpful to share with your therapist why you are nervous, so these issues can be addressed head on from the get-go.

“I can’t afford therapy.” Therapy is an investment in your well-being and your future, both of which are priceless. Many mental health issues and daily worries can cause long-term damage to our relationships, our physical health, and our emotional well-being. I like to think of therapy like preventative maintenance on a car. When you notice that check engine light go on, you take your car to the shop to see what is wrong and fix the problem. If you don’t, your car will keep running for the time being, but it could cause further and more expensive damage to your car down the road. Therapy is similar. If something is nagging at you or you have tried on your own to fix things and you still feel like your emotional check engine light is on, it might be time to seek therapy from a trained professional. And although therapy is not free, it does not have to be extremely expensive. My colleagues and I provide our clients a Super Bill at the end of each month, which can be submitted to your insurance for reimbursement. In the past, clients have had a lot of success in getting their therapy covered by their insurance using this method. Your employer may also offer means for covering the cost of your treatment. These concerns can certainly be discussed during our free 15-minute consultation prior to starting therapy.

Written by: Megan Johnson, PhD

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5 Things to Know Before Beginning Trauma Therapy

Beginning trauma therapy can be overwhelming and intimidating.  In fact, those who have experienced trauma might have the most difficult time beginning therapy because their experiences have been so confusing and overwhelming. Here are a few ideas before you begin the journey of overcoming trauma:

1. Your experience matters more than the details of the event(s)

Many people think of Posttramatic Stress Disorder (PTSD) and its symptoms when they think of combat veterans and victims of violence. But trauma responses can occur following any upsetting or life-altering event or events. The Diagnostic and Statistical Manual (5th edition), which mental health professionals use to diagnose, defines events that might lead to post-traumatic symptoms as any circumstance in which you are exposed to “actual or threatened death, serious injury, or sexual violence” as well as witnessing or hearing about such events [1]. Research also shows that even watching coverage of traumatic events on TV can result in increased stress response, particularly in children and adolescents [2, 3]. What happened is not as important as your reaction to what happened. If you feel distress following an event, it is helpful to seek therapy to talk about your experience.

2. Your feelings are not weird

There is no right or wrong response to trauma. Many of your struggles following trauma may feel foreign and unpleasant, but this does not mean you or your feelings aren’t normal. In fact, your trauma response is a normal reaction to an abnormal situation. Following a trauma, you may have nightmares, intrusive memories, anxiety, headaches, irritability, anger, insomnia, or feelings of confusion. It is also normal to feel shame, numbness, depression, dissociation, or isolation. Trauma responses can manifest in a variety of ways, and whatever your feelings are – they are normal, but they don’t have to be permanent. Therapy can help.

3. PTSD symptoms can also manifest physically

Some people respond to trauma with physical symptoms such as feeling faint, not being able to sleep, difficulty breathing, digestive problems, and muscle tension. Others may experience a sensitivity to some sights, sounds, or smells. It is important to look at what these bodily cues are telling you so that you can begin to feel physical and mental peace. Therapy is a safe place to make sense of these reactions.

4. Drinking and substance use can hinder your healing

When feeling overwhelming stress following a trauma, it can be tempting to reach for a soothing drink or take medication that puts you to sleep. While this may offer short-term relief, it will actually make your trauma symptoms worse in the long run. Trauma therapy is focused on working through your troubling feelings. Excessive alcohol or drug use can get in the way of that work by numbing your feelings. If you are currently coping with your trauma by drinking or using recreational drugs, therapy focuses on finding more effective and longer-lasting coping mechanisms.

5. Therapy is the gold standard treatment for trauma

There is no medication currently available that cures PTSD or other trauma-related disorders. While some medications might reduce the physical symptoms of PTSD, research has shown that therapy is more effective in treating the condition in both the short and long term [4]. Trauma shifts your world-view and can threaten a prior sense of safety, security, and well-being. Such issues are discussed and explored in  therapy, which is focused on helping a person cope with and make sense of the trauma and other feelings.

Written by: Megan Johnson, PhD

Resources:

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.

Pfefferbaum, B., Nixon, S. J., Tivis, R. D., Doughty, D. E., Pynoos, R. S., Gurwitch, R. H., & Foy, D. W. (2001). Television exposure in children after a terrorist incident. Psychiatry: Interpersonal And Biological Processes, 64(3), 202-211. doi:10.1521/psyc.64.3.202.18462

Slone, M. (2000). Responses to media coverage of terrorism. Journal Of Conflict Resolution, 44(4), 508-522. doi:10.1177/0022002700044004005

Lee, D. J., Schnitzlein, C. W., Wolf, J. P., Vythilingam, M., Rasmusson, A. M., & Hoge, C. W. (2016). Psychotherapy versus pharmacotherapy for posttraumatic stress disorder: Systematic review and meta-analyses to determine first-line treatments. Depression and Anxiety, 33, 792-806. doi:10.1002/da.22511