Strategies to Manage Stress

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We all experience difficult times when stress and anxiety. Although it is normal to feel stress and concern, stress reduces serotonin, an important neurotransmitter for maintaining good mood. The practices listed below can all help reduce stress and anxiety and improve your overall mental health.

1) Breath

Your autonomic nervous system, which is responsible for the control body functions such as breathing, heart and digestion, is in part comprised of the sympathetic nervous system (SNS) which control the “fight or flight” response, and the parasympathetic nervous system (PNS), which is the “rest and digest” system. It is the PNS that is key to reducing stress – both physically and mentally. A recent research paper from Stanford confirmed that the best breath pattern to engage the PNS and relieve anxiety is to hold the exhale a little bit longer than the inhale. There is also a hold period at the “top” between the inhale and exhale. For example, breath in for 4 (count 1, 2, 3, 4) hold for 2 (count 1, 2) out for 6 (count 1, 2, 3, 4, 5, 6) and repeat. You can feel the inhale energize your SNS while at the same time, the exhale activates the PNS and it relaxes you. If you like, try to slowly look up to the sky on the inbreath, hold and then as you exhale, slowly look down to the ground. Here are some other breathing exercises as suggested in Health Link BC.

2) Affirmations

In times of difficulty it’s easy to lose sight of your hardiness and resilience and it’s helpful to remind yourself of how safe, secure, capable and worthy you are. Stating affirmations or simple truths about your “self” will help reinforce these strengths which can help to calm your anxiety and relieve stress. A simple google search on “affirmations” can help you choose those that resonate the best.

3) Walk in Nature

Researchers have found a positive link between walking in nature (ecotherapy) and mood. Research has cited that the prefrontal cortex (where our inner critic lives) has lower activity after a walk. When the body connects with nature it grounds us, so go for a walk along the water or hike a trail in the woods which the Japanese call “shinrin-yoku” or “forest bathing”. Our mental health benefits from our interaction with nature. As Joseph Campbell said, “the head was made for the city but the body craves the nature of the country.”

4) Visualization / Creative Imagery

Put whatever problem is causing you anxiety into a “container”, which includes any negative thoughts about yourself. Once the worries are in the box and sealed away, visualize a calm beautiful place where you are calm and at ease… a forest, mountains, nature resort or walking along a beach with your feet in the sand and feel the stress fall away with this mindful meditation. If you know it, use the “Butterfly Hug” which is a simple exercise of crossing your arms over your chest and tapping lightly on each shoulder. If you are unfamiliar, here is a Youtube video for you or just let me know and I can show you the wonderful little grounding exercise.

5) Meditation

Meditation is a still point or a refuge and has proven psychological and physical benefits – for instance, it increases the gray matter in the insula, which manufactures oxytocin for improved mood (Holzel et al. 2008), which can potentially help reduce dementia. Meditating also reduces stress related cortisol and strengthens the immune system (Davidson, et al. 2003). A wonderful yet simple mindful meditation is Vipassana which on your breath moving in through past your nostrils and back out through your nose and you will notice that you feel the cool air enter the nose but that you can’t feel the air pass out through your nose because it’s at body temperature. Just notice this breath in and out and just accept any thoughts (positive, negative or neutral) pass and then go back to the breath in and out to centre yourself. A good overview of Vipassana meditation can be found here. In addition, there are a number of popular meditation apps such as Headspace and Calm.

6) Exercise

Exercise releases chemicals like serotonin and endorphins which help improve your mood. Even gentle exercise can centre the mind and make you feel balanced and research has shown that depression and anxiety both decrease. So go for a workout, have a swim, a good walk or ride a bike and feel the stress melt away and your mood improve.

7) Sleep

What beats a good night’s sleep? Make sure you practice good sleep hygiene because it helps to replenish our physical and mental resources and fortify our resilience. Here is a good YouTube video “How to Fall Asleep in Two Minutes” and an article on sleep hygiene.

 

8) Relationships

The need to connect is part of our DNA and accordingly feeling isolated can exacerbate our negative and/or anxious mood. Reach out to a friend or family member for company. If that’s not possible for reasons of health or location, pick up the phone, email, text or video chat. We are bonding mammals and what connects people is not how perfect someone is but their imperfections and their authenticity. Here’s a great article on the importance of connection.

9) Mindfulness

Mindfulness is “a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations.” Joseph Campbell believed that more than meaning in life, people thirsted for the experience of life. After all he said, there is only the experience of a flower. Try this link and enjoy the beauty of mindfulness and how it can enhance your experience of life while reducing anxiety. Another exercise is the “54321”. Find 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste. But do it slowly and mindfully!

10) Tapping

Bessel Van der Kolk “The Body Keeps the Score” extolls the benefits of Tapping, which, by tapping on various acupressure points in the body, can reduce the stress in the body and as a result, have a positive psychological effect on mood (including anxiety). It is also known as Emotional Freedom Tapping (EFT) and here is a video that demonstrates the technique.

Psychedelic Therapy Research

References and Clinical Research Papers:

There have been several notable clinical studies that indicate the therapeutic benefits of psilocybin and MDMA. Here are some key studies for both substances:

  1. Johns Hopkins University Study on Depression and Anxiety (2016):
  • Study: Psilocybin-assisted therapy for depression and anxiety in patients with life-threatening cancer.
  • Findings: The study showed that a single high dose of psilocybin produced substantial and sustained decreases in depression and anxiety in 51 patients. Six months after the treatment, approximately 80% of participants showed clinically significant reductions in depression and anxiety.
  • Source: Griffiths, R. R., et al. (2016). “Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial.” Journal of Psychopharmacology, 30(12), 1181–1197.

  1. Psilocybin for Treatment-Resistant Depression (2016, Imperial College London):
  • Study: This study focused on treatment-resistant depression, administering psilocybin to 12 patients.
  • Findings: All patients showed improvement after just two sessions, and five were in remission after three months. The study showed significant potential for psilocybin to help individuals who have not responded to traditional treatments for depression.
  • Source: Carhart-Harris, R. L., et al. (2016). “Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study.” The Lancet Psychiatry, 3(7), 619–627.

  1. Psilocybin and Long-Term Depression Relief (2020, Johns Hopkins):
  • Study: Examined the long-term effects of psilocybin on patients with depression.
  • Findings: After two psilocybin sessions, 71% of the participants showed a clinically significant response after four weeks. Around 54% met the criteria for remission of depression.
  • Source: Davis, A. K., et al. (2020). “Effects of psilocybin-assisted therapy on major depressive disorder: A randomized clinical trial.” JAMA Psychiatry, 78(5), 481-489.

  1. MAPS Phase 3 Clinical Trial for PTSD (2021):
  • Study: The Multidisciplinary Association for Psychedelic Studies (MAPS) conducted a phase 3 clinical trial for MDMA-assisted psychotherapy for PTSD.
  • Findings: After three MDMA-assisted therapy sessions, 67% of participants no longer met the criteria for PTSD, compared to 32% of those receiving a placebo with therapy. The study is significant because it shows the potential for MDMA to treat PTSD where traditional therapies have failed.
  • Source: Mitchell, J. M., et al. (2021). “MDMA-assisted therapy for severe PTSD: A randomized, double-blind, placebo-controlled phase 3 study.” Nature Medicine, 27, 1025-1033.

  1. MDMA and Social Anxiety in Autistic Adults (2018):
  • Study: MDMA-assisted therapy for social anxiety in adults with autism.
  • Findings: This small pilot study found that MDMA significantly reduced social anxiety in autistic adults after two sessions, with participants reporting long-lasting improvements in social interactions and a reduction in avoidance behavior.
  • Source: Danforth, A. L., et al. (2018). “Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: A randomized, double-blind, placebo-controlled pilot study.” Psychopharmacology, 235, 3137–3148.

  1. MDMA for Alcohol Use Disorder (2020, Imperial College London):
  • Study: MDMA-assisted therapy for the treatment of alcohol use disorder.
  • Findings: Early results from a small study suggested that participants experienced significant reductions in alcohol consumption following MDMA-assisted therapy sessions. Participants reported that MDMA allowed them to address underlying trauma contributing to their addiction.
  • Source: Sessa, B., et al. (2020). “MDMA-assisted psychotherapy for alcohol use disorder: Open-label pilot study.” Journal of Psychopharmacology, 34(3), 285–295.

  1. Griffiths, R. R., et al. (2016).

“Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial.”

Journal of Psychopharmacology, 30(12), 1181–1197.

  • This study demonstrated the efficacy of psilocybin in reducing depression and anxiety in individuals with life-threatening cancer.

  1. Carhart-Harris, R. L., et al. (2016).

“Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study.”

The Lancet Psychiatry, 3(7), 619–627.

  • This open-label study showed psilocybin’s potential in treating treatment-resistant depression.

  1. Davis, A. K., et al. (2020).

“Effects of psilocybin-assisted therapy on major depressive disorder: A randomized clinical trial.”

JAMA Psychiatry, 78(5), 481-489.

  • A clinical trial that showed psilocybin-assisted therapy significantly reduced depression in patients with major depressive disorder.

  1. Mitchell, J. M., et al. (2021).

“MDMA-assisted therapy for severe PTSD: A randomized, double-blind, placebo-controlled phase 3 study.”

Nature Medicine, 27, 1025-1033.

  • This pivotal phase 3 trial showed that MDMA-assisted therapy led to a significant reduction in PTSD symptoms, with 67% of participants no longer meeting the criteria for PTSD.

  1. Danforth, A. L., et al. (2018).

“Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: A randomized, double-blind, placebo-controlled pilot study.”

Psychopharmacology, 235, 3137–3148.

  • This pilot study investigated the effects of MDMA-assisted therapy on social anxiety in autistic adults, showing significant improvements.

  1. Sessa, B., et al. (2020).

“MDMA-assisted psychotherapy for alcohol use disorder: Open-label pilot study.”

Journal of Psychopharmacology, 34(3), 285–295.

  • A study investigating the potential of MDMA in reducing alcohol dependence by addressing the emotional roots of addiction.

  1. Carhart-Harris, R. L., et al. (2014).

“The effects of psilocybin on brain activity and brain connectivity.”

Journal of Neuroscience, 34(46), 15112–15119.

  • A study showing that psilocybin alters brain connectivity, leading to changes in how different brain regions communicate and process emotions.

  1. Nichols, D. E. (2016).

“Psychedelics.”

Pharmacological Reviews, 68(2), 264–355.

  • A comprehensive review on the pharmacology of psychedelics, including psilocybin, LSD, and MDMA, and their effects on the brain’s serotonin receptors.

  1. Pollan, M. (2018).

How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence.

  • A popular book that explores the history, neuroscience, and therapeutic potential of psychedelics.

Hillary Clinton: The Emotional Meaning Job Loss and Reclaiming Self-Esteem

“Everybody knows the war is over, everybody knows the good guys lost.” Donald J. Trump is now President, but the majority of America’s voting electorate believe Leonard Cohen’s lyrics were written for Hillary Clinton and her lost election. There she stood giving her concession speech surrounded by family and supporters who gave so much of themselves to her campaign. During Hillary’s concession speech, you could hear the pain in her voice and see the hurt in her eyes made all the more real by her grace, bravery and eloquence. Even her most fervent adversaries couldn’t help but connect to the emotional despair and empathize with her political and emotional loss.

Trauma

The Greek word for wound is trauma and emotional trauma is any distressing experience resulting a lasting psychological impact. Losing your job can be so traumatic, researchers have compared it to a “living death.” In the corporate world, one is “terminated” from their employment, which conjures up a vision of death.

Job loss is more than a lost paycheck, although that in itself can create anxiety. Job loss also means the loss of life structure, a community of friends and often ambitions, meaning and identity. The degree to which trauma is felt is in part related to the attachment one feels to their work and to their underlying level of self-esteem.

Curiously Hillary didn’t have the job as President, so why was it so painful? Because for Hillary, it was the loss of a “non-event,” like being jilted at the altar, because even though she didn’t have it, the loss was just as real and just as painful. She was so close to breaking that glass ceiling and yet her dream now lies in tatters.

Grief and Pain

Like almost everyone who experiences job loss, Hillary will follow the path of grief Kubler-Ross so beautifully articulates in her seminal work, “On Death and Dying.” First is the shock of the loss and the denial hoisted as a shield, but this gracious and most welcome coping mechanism eventually gives way to reality and pain. Anger follows in its various forms, including frustration and resentment. While anger is an emotional tool we can use for self-reflection, self-revelation and growth, at its worst, anger is a poison pill we swallow believing it will hurt the person or thing that has wronged or trespassed against us. You can almost hear her wrath, “How can this man, who exploits racism, belittles women, leverages religious bigotries and spouts mistruths, win an election over me? I can’t believe it.”

Denial and anger give way to the bargaining stage as she desperately tries to make sense of and understand the loss in order to deal with the pain. You can almost hear her thoughts, “If I had spent more time in Wisconsin and Michigan…” or “if the FBI had not launched investigations without merit into the Clinton Foundation, Benghazi and twice into my private email server which resulted in zero charges of wrong doing” and “Yes, I regret calling half of Trump’s supporters ‘deplorables,’ but why is it that women and men in America are compared with different behavioral norms… that men need only to be respected but women have to be liked and respected.” In the end, it is what it is, and fairness doesn’t matter because to the victor go the spoils and Hillary lost the job she wanted most and had worked for her whole life.

Hillary valiantly admitted her pain in the concession speech and although she was stoic, sadness in emotional loss is unavoidable. Tears work to wash away the pain of the loss. Some reporters claimed with mildly sexist disdain that Hillary cried all night and that this was the reason she waited until the next day for her concession. Any insinuation that tears are weak is gender-based hypocrisy because where is the correlation between tears, emotional hardiness and strength of character? Listening to Hillary’s words and watching her display the resilience of a hundred, I wonder if Donald Trump have responded with the same dignity.

Tears are a necessary part of the grieving process and to stifle them is to prevent oneself from acknowledging the sorrow so necessary to move on. It is when sadness is not honored that one can become stuck and the trauma of job loss becomes a fertile ground for major depression. Men who have a stoic pre-occupation with emotional control as a mandatory behavioral norm can be more susceptible to depression, because they can’t embrace their emotions as a path to self-awareness and a means to acceptance.

What complicates matters is that it is not just one straight line from loss to the final acceptance stage. Rather than a linear process, it goes up and down and back and forth like an emotional roller coaster. Just when you think the sadness has passed, your mind turns back to the what-if scenarios of bargaining… “If only I had done this or that” and then to anger, etc. It helps to understand this, but it still hurts.

Stigma & Shame

Society often and wrongly attaches a stigma to job loss as if there is something inherently wrong or missing in the value and make-up of the “loser” or the one terminated from their job. Does Hillary have less value than Donald Trump? As a society, are we so obsessed with winning that it gives the victor license to do and say what they will simply because they won? Indeed, we should re-assess the stigma of “without cause” job loss for being the fallacy that it is.

Along with the public stigma comes its twin brothers guilt and shame with the latter even more devastating. Feeling guilt over a regretted action is difficult enough to reconcile emotionally, but shame is an emotional swamp signifying not the guilt over making a mistake but instead the feeling that I am the mistake. That belief is like quicksand for self-esteem – which is simply your own internal opinion of your value and self-worth. I hope that Hillary has the emotional fortitude necessary to vaporize the feelings of guilt and especially shame, which is a very private hell. The best remedy for shame is the power of bearing witness: bringing it out in the open where someone is able to see that what somebody did or happened to them does not translate into who they are as a person of value. Most people understandably need help processing the loss and how they see themselves, but for Hillary the loss was so public and the support so strong and heartfelt that I hope shame is a non-issue.

The Echo Effect

Otherwise known as the “systems effect,” this is the repercussion or impact on those around the one who suffers most directly… in this case, Hillary. Watching the concession speech, one could see the emotional loss in the eyes and demeanor of everyone around her in the room. Her husband looked angry and her running mate Tim Kaine looked sad and the audience looked at times confused in their denial of what had happened. Indeed, it seemed as though half of the voting public was in shock and mourning as evidenced a week later when I witnessed tears and anger from a stranger at a conference. This is a double-edged sword for Hillary, because on the one side, she bears the weight and burden of all their emotional loss and you could hear it in the contrite tone of her speech and the apologetic words she used. On the positive side, however, with the support of so many, perhaps “a burden shared is a burden halved.”

The Path to Acceptance

There must be time to heal and a path to acceptance. The first step for Hillary, or anyone who has lost their job, is to understand that the loss does not define their worth. As she said, the election loss “This is painful, and it will be for a long time” but it does not diminish who she is, all that she has accomplished and her value. This self-understanding of self-worth is the existential turn necessary for healing and acceptance.

Structure needs to be re-established in her life. It may not be the whirlwind of activity that occupied her before, but having structure will allow for her productivity and contribution to life to grow and flourish. In addition, having a positive vision and intention for the future will help propel her forward. Seeing the possibilities for herself and believing she can continue to make a real contribution in the future will fuel her continued the life long journey called career. This future-mindedness will help her take control of her life, search for the truth of what transpired and why, ultimately to find closure and move on to a full life.

Transfer of Meaning

Hillary derived so much of her meaning and identity from her public service and her decade-long pursuit of the Presidency. It was more than just the meaning derived from work: there were elements of community service and family embedded in her quest. Time may not heal all and I acknowledge that for some, and maybe for Hillary, there may always be a painful loss of meaning and purpose for what could have been, and for her supporters, what should have been. But what is of paramount importance is that Hillary brings other things of meaning into her life that give her real continued purpose, accomplishment and identity. This meaning may not only be found in work, but, as Viktor Frankl told us, may also be found in many forms including family, creativity and spirituality.

Hillary’s drive has always been to make a difference in the world. I am not criticizing Donald Trump’s ambitions to build his own personal brand into millions of dollars and win the Presidency, but Hillary has mostly dedicated her life to the public good, and she can continue to accomplish and flourish, and with that, better accept the results of the election and turn her emotional loss into a reincarnation of an even better and deeper self. Perhaps that is trauma’s silver lining.

We know life isn’t always fair, but with a fortitude and resilience so often demonstrated in her career, irrespective of the cards dealt on November 8, 2016, Hillary can and I believe will do great things, as she has done before. Because in the end, we each have the ability to bring meaning and purpose into our life from the work that we do and the contribution that we make—that is Hillary’s and our own individual and existential responsibility.