Pride London and LGBT Mental Health

This will not be a long post, because I cannot claim to be an expert on issues affecting a community I am not part of.  However, I would like to take a moment to acknowledge London Pride and to wish all who celebrate it a wonderful day.

Pride is a celebration of equality and diversity, but a huge number of people in the LGBTQIA+ community suffer with poor mental health, much of which can be attributed to social factors such as homophobia/transphobia, discrimination, and isolation or rejection from families or peers.  Some recent statistics suggest young people in the LGBTQIA+ community are more than twice as likely to have self-harmed at some point in their lives, and at much higher risk of suicide, with 44% having contemplated this compared to 26% of non-trans, heterosexual people.  This risk increases further if you are from an ethnic minority, or have a physical disability.  Back in 2012, the Trans Mental Health Study also found that a shocking 33% of trans people had attempted suicide more than once in their lifetime.

Living in a heteronormative society can be excluding and rejecting, and leave people feeling alone, defective, or confused, so turning to alcohol, substances, self-harm, or suicide might well feel like the only solution.  As with so many mental health problems, therapy can help the individual cope, but wider societal changes are needed to reduce the likelihood of LGBTQIA+ people struggling to accept themselves and live happy fulfilling lives.

If you or someone you know is struggling with poor mental health and this feels linked to their gender or sexuality, the good news is that (aside from mainstream services, including the NHS) there are services out there to help with just this.

I have pinched a few links from other sites and will post these below; however, today, the day of Pride London, I encourage everyone to appreciate diversity and respect everyone's rights to be who they want to be and love who they want to want to love.

Happy Pride, all!

The Bear xXx


Providing support to the LGBTQIA+ community: https://www.stonewall.org.uk/help-and-advice
Offers a directory of therapists specialising in work with the LGBTQIA+ community: http://www.pinktherapy.com/

Information on issues affecting LGBTQIA+ people: https://www.mind.org.uk/information-support/guides-to-support-and-services/lgbtq-mental-health/#.W0DcYdJKiUl

For people in London: http://londonfriend.org.uk/get-support/#.W0DeC9JKiUk

For LGBT Muslims: https://imaanlondon.wordpress.com/

Self-Soothing with Smells

And so we have reached "smell", the last of our five senses for self-soothing!  Since smells can be powerfully linked to memories, it is important to think carefully about which fragrances and aromas are soothing for you as an individual, and which can be triggering and remind you of sad or difficult times.  You may choose to use smells that remind you of happy times, good people, or lovely places, or just fragrances you find pleasing.

Here are some more ideas.

Now you have self-soothing ideas for all of the senses you can pick and choose which work best in which situations or for specific moods for you.  You may find the most effective self-soothing activities combine senses, for example, taking a scented bubble bath, or lying on the grass in the park where you can watch the clouds, feel the sun on your skin, and listen to the birds.

What works best for you?

I hope to see you again soon.

The Bear 

xXx

Self-Soothing with Vision

One of the many ways we can make ourselves feel better when things are tough is by looking at or watching something which is either soothing or enjoyable.  For some people, this might be watching the clouds drift by, and for others it might be watching a dance performance or a favourite television show.  There are many ways to self-soothe using vision.

Here are some more ideas.

You can also self-soothe with touch, sounds, taste, and smell.

Why not make a list of the most effective techniques for you?

I hope to see you again soon.

The Bear 

xXx

Self-soothing with Touch

Today's post continues the topic of self-soothing with the senses, and focuses on touch.  How much we like to be touched by other people can be variable, with some people being very tactile and affectionate, and others quite reserved with a need for a lot of personal space.  We might also enjoy physical contact when we are in some moods but not others.

Fortunately, self-soothing with touch does not necessarily involve physical contact with others.  It may be more about sensations on our skin from nature (e.g. the sun or rain) or from caring for ourselves (e.g. by applying moisturiser or having a shower).

Here are some other ways to self-soothe with touch.

Why not check out how to self-soothe with taste or sound?

Check back for more posts on self-soothing with the senses.

The Bear 

xXx

Self-Soothing with Sound

Self-soothing involves applying techniques we have learned to help us feel better when we are distressed, depressed, anxious, or angry.  Some of us are already very good at self-soothing, but others have not yet found helpful ways to feel better or struggle to give themselves permission to do so.

Self-soothing using our senses can be very effective.  Check here for ways to self-soothe with taste and check back for future posts to find ways to self-soothe with other senses.

Today's brief post focuses on sound.

Here is a brief list of ways you can self-soothe with sound.

Make a list of your own ideas and favourites and put it somewhere you'll notice it when you're having a hard time so you can give self-soothing with sound a try.

I hope this has been helpful.

Check back for self-soothing with vision.

The Bear 

xXx

Self-Soothing with Taste

Self-soothing is all about comforting, nurturing, and being kind to yourself when you are distressed, anxious, overwhelmed, or feeling vulnerable.  It is about telling yourself it's okay to have your feelings, but also helping you to survive them and feel better.  For me, self-soothing is a lot about comfort.  It is the equivalent of someone looking after you when you are ill, bringing chicken soup, tucking you up in bed, and being generally kind and caring towards you.

Self-soothing can include any or all of the five senses.  This short post focuses on taste.  Good food and drink can be a great way to self-soothe, but please remember it may be less useful if you have an eating disorder or use food to avoid your feelings.

Some ways to self-soothe with taste include:

- Drinking your favourite hot drink.

- Treating yourself to a dessert.

- Sampling flavours at an ice cream shop.

- Enjoying some seasonal fruit.

- Chewing gum or sucking boiled sweets.

- Having your favourite meal.

- Eating your food mindfully, focusing on taste.

- Treating yourself to a freshly squeezed juice or smoothie.

- Having a soothing peppermint tea.

- Combining touch and taste by having something cold, like an ice lolly.

- Having something hearty and comforting to eat, like a stew.

Do you have any other ideas for self-soothing with taste?

Check back for my next post on self-soothing with sound.  

Thanks for popping by.

The Bear xXx

Self-Care & How to Survive Stress with the PLEASE Skill (DBT)

Last week was Mental Health Awareness week and the theme was Stress.  I chose to share the PLEASE skill as a way of surviving stress, but it is so much more than that!  The PLEASE skill is a DBT skill which focuses on self-care, and this is incredibly important, because we so often forget or overlook the importance of this.  In many ways, we often mistake self-care for indulgence and start to feel like our needs are unimportant as long as everyone else is okay.  This is where the masks on an aeroplane analogy comes in; putting your mask on first keeps you fit to help everyone else, if this is what matters to you.

So here is the PLEASE skill, which focuses on ways of keeping yourself physically and emotionally well.  If you or someone you care about is having a really bad time or is in crisis, these are the basics.

PL - Treat Physical Illness

We are all guilty of ignoring illness or letting ourselves get run down.  Maybe we think we've had too many sick days recently.  Maybe we think it's just a sniffle and it'll pass.  Maybe we have too much to do to be ill, or just can't face the faff of a long wait at the doctor's, if we can even get an appointment to begin with.  Being physically unwell has an influence on our mental health, leaving us feeling tired, run-down, and more vulnerable to emotions.  Moreover, if we ignore our body's protests we can end up more ill or injured.  It is important that we take time to let ourselves recover, seek medical attention if it is needed, and finish that course of antibiotics as prescribed to give ourselves the best shot.

E - Exercise

Some of us love exercise, and can't beat the high we get from achieving a personal best when running, learning a new yoga position, or scoring the winning goal in a football match.  Others can think of nothing worse.  Exercise might not be one of your hobbies, but it is important, so start small if need be.  Get off of the bus a few stops early and walk the rest of the way.  Climb the stairs instead of getting in the lift.  Ride your bike at the weekend.  Follow a Youtube video in the privacy of your own living room, or head to the gym with a friend to try a class.  Try to do around 20 minutes of exercise per day, and over time, see if you can increase to 30 minutes of exercise that increases your heart rate, five times per week. Feeling stronger and fitter can also boost your confidence which can do wonders for your mental health.  

***As always, this might be one to avoid if exercise is associated with an Eating Disorder or unhealthy coping behaviour for you.***

A - Avoid Mood-Altering Drugs

This might not be the most popular form of self-care, but alcohol and illicit substances are unlikely to be helpful when you are not feeling your best.  Alcohol is a depressant, and is unlikely to improve your mood in the long-term, whilst regulating your mood is more difficult when intoxicated.  We can also easily become dependent on substances to help us avoid our feelings, which will ultimately prevent us from changing our circumstances and overcoming our difficulties.  Self-care might involve facing our emotions and difficulties face on rather than numbing ourselves to them.



S - Balance Sleep

Sleep is incredibly important to our emotional and physical health.  Adequate rest will allow our bodies to recover from physical injuries and illness, and optimise our ability to think and focus.  Being tired can severely impact our motivation and leave us feeling overwhelmed or unable to cope.  Try to set yourself a regular bedtime and develop a routine.  Don't watch television in bed, avoid using your phone, and aim for 7-8 hours of sleep per night.

E - Balance Eating

Last, but by no means least, eat adequately.  Avoid under-eating, as under-fuelled bodies and brains are far from effective.  Try to eat a balanced diet with plenty of fruit and vegetables, but also fats and carbohydrates.  Everything in moderation.  Notice whether you are using food as a way of coping with your emotions, and if so, which feelings you are trying to suppress or escape from.  Try eating mindfully, focusing on tastes, smells, and textures as you eat, looking at what is on your plate, and noticing any sounds (if you can bear to!).

The PLEASE skill is the foundation on which you can build other things.  It is putting your mask on first and ensuring you are fit to care for others, as well as acknowledging that you deserve care and nurturing (YOU DO.).

Take good care of yourself.

The Bear xXx

How to Calm Down Fast.

When I was little I would sometimes get myself into a big state about something, crying and crying and unable to calm down.  After this had gone on for quite some while, my dad would generally try to resolve it by bringing me a hot flannel to put on my face and neck, at least partly to calm me down (though probably also to reduce the attractive post-cry puffiness).  I suppose in doing so he was using some variant of the TIP skill.

The TIP skill is a good choice for people who become intolerably overwhelmed, have found themselves in a state whereby they cannot think clearly or even conceive of calming down, or have the urge to harm themselves in some way.  It is another Distress Tolerance Skill from DBT (Dialectical Behavior Therapy) and is designed to quicky reduce emotional arousal by changing our physiological state.

This skill has four parts:

Temperature
Intense Exercise
Paced Breathing and Paired Muscle Relaxation

The two Ps count as one in the acronym but are two distinct skills.  Don't ask why; I'm not sure beyond it ruining the acronym otherwise!

T is for Temperature.
This skill is not recommended for people with a history of heart difficulties or an allergy to the cold (e.g. cold urticaria).  Otherwise, it can be a really very effective way of calming down quickly!

To use this skill, hold your breath, and place your face in cold water.  Your eyes, nose, and mouth should all be submerged.  Keep your face in the water for between 30 and 60 seconds, depending on your lung capacity and how uncomfortable this is for you.

Doing this tricks your brain into thinking you have dived into cold water.  For this reason, this skill is often called the "Dive Skill" or "Dive Reflex Skill".  The dive reflex is a mammalian reflex in which the body responds to being immersed in cold water without oxygen by slowing the heart right down to below the normal resting rate.  The parasympathetic nervous system kicks in to decrease arousal, which is handy as it was under-active whilst you were distressed!

The easiest way to use this skill is to fill the sink or a bowl and to dunk your face, but you can also use a cold compress or an ice-pack (wrapped in a towel to avoid freezer burn!).  The water in a bowl or sink shouldn't really be below 10C (50F) as this is likely to cause pain, and that really isn't the point here, so don't add ice to this.  If submerging your face is not an option, splashing it with cold water whilst holding your breath is an alternative, though this is unlikely to be as effective.

The Dive Skill is probably most useful when you are feeling completely overwhelmed and finding it hard to calm down; however, it can also be helpful to ground you if you are dissociating.

This skill is generally very effective in decreasing arousal; however, if you return to the stressful situation immediately afterwards, the agitation may quickly return, so it is important to consider combining this with another skill.


I is for Intense Exercise.
This skill involves doing at least 20 minutes of aerobic/cardio exercise.  This might include spinning, running, walking, swimming, dancing, kickboxing, or hiking.  The aim is to decrease negative mood and increase positive affect.  Research has shown significant increases in positive emotions for those who manage to get their heart rate up to 70% of the maximum heart rate for their age. 

Part of the rationale for using intense exercise comes from what we know about the body's reaction to intense emotions.  As animals, our emotions tend to evoke actions in a bid to help us survive.  Anger prepares us to fight whilst fear prepares us to run.  Completing a burst of action might therefore re-regulate our emotions by releasing the physical energy and tension.

Exercise is a good choice when you are feeling angry or so anxious that you feel sick or have an upset stomach.  It should probably be avoided if your relationship with exercise is potentially harmful, for example,  if it is involved in an eating disorder.


P is for Paced Breathing.
Paced breathing involves slowing your breathing right down to five or six breaths per minute, and ensuring those breaths are coming from your belly (low abdomen).  If you are breathing in for four seconds, you should generally be aiming to breathe out for about eight.

The heart is generally slower during out-breaths than in-breaths, so breathing in this way can help reduce your heart rate when you are agitated.  This can have a similar effect to the Dive Reflex.


P is also for Paired Muscle Relaxation
Paired Muscle Relaxation combines paced breathing with progressive muscle relaxation.  The general idea is that when you are feeling stressed, overwhelmed, angry, or anxious, you are probably very tense, and there is a good chance you are not even aware of where you are holding the tension.  By deliberately tensing and relaxing your muscles, a zone at a time, you will release any tension you were inadvertently holding before.  This will increase awareness of the tension you had as well as heightening the sense of relaxation.  Noticing this can be quite mindful, and as mindfulness is also a very useful skill for people struggling with emotional intensity, this is a bonus.  If you fancy it, you can also say "relax" to yourself in your mind as you exhale and release the tension.

To try progressive muscle relaxation do the following:

Find a quiet place with minimal distractions.  Sit or lie down.  As you tighten each set of muscles, breathe in.  As you release, breathe out, and try thinking "relax".  Hold the tension for 5-10 seconds each time.  Being tense should be very still and tight, whilst the relaxed state should feel more like being a ragdoll.  It may take practice to achieve this.

Try each group, one at a time.

1) Make fists with both hands and pull fists up on your wrists, towards your body.
2) Make fists and bend your arms so your fists touch your shoulders.
3) Pull your shoulders up to touch your ears in a shrug.
4) Try to pull your eyebrows together, wrinkling your forehead.
5) Shut your eyes tightly.
6) Scrunch up your nose and bring your lips and cheeks up towards your eyes.
7) Press your lips together and stretch the edges of your lips back towards your ears in a closed smile.
8) Press your teeth together and push your tongue against the roof of your mouth.
9) Push your head back against your back, or forward so your chin is on your chest.
10) Take a deep breath and hold it.
11) Hold your stomach in tightly.
12) Squeeze your buttocks together.
13) Put your legs out and tense your thighs.
14) Put your legs out and point your toes down.
15) Put your legs out, point your toes together with your heels out, and curl your toes under.


Next time you are feeling overwhelmed and need to calm down fast, give these a try and let me know how you get on.  I hope to see you again soon.

The Bear xXx

Coping with Overwhelming Emotions

So it's been a while, but I'm back!  In my absence I have been working on my doodles and thinking about how best to create useful content.

This week I have been immensely frustrated by a courier returning a parcel I desperately needed to the sender after just one attempt to deliver.  Since my special interest is working with people who struggle to manage their emotions when such things happen, I decided to take inspiration from my anger and write a brief post about a Dialectical Behavior Therapy (DBT) skill which might help in such circumstances.

DBT aims to equip people with a range of skills to help them manage emotions and relationships.  This skill is a Distress Tolerance skill, and is therefore used to help survive potential crisis situations without making them worse or getting stuck on the injustice or painful feelings in a way that adds more suffering to the natural angst generated by the situation.

THE "STOP" SKILL

Marsha Linehan, the creator of DBT is rather fond of an acronym (even if they are sometimes a bit of  stretch).  In this case, STOP stands for Stop, Take a step back, Observe, and Proceed Mindfully.  Here's how.

Let's break it down a bit.

First up, we STOP.  Freeze.  Do not move a muscle.  When you are in a highly emotional state (e.g. furious!) you may be driven to act on your emotions.  It may be extremely difficult to think clearly, and as a result, the action you take may not be in your best interests.  Stop to enable yourself to regain control.

Next up, we Take a step back.  Take a break.  Step away from the situation and take deep breaths.  Try to let go of the thoughts and feelings and get yourself back towards that calm baseline as best you can.  Do not let your feelings make you behave impulsively; you may regret it later.

Now we Observe what is going on inside and outside of us.  What is the situation?  What are you thinking and feeling?  What are other people saying or doing?  What are the facts of the situation?

 

The final stage of this skill is to Proceed Mindfully.  Your job now is to act with awareness of the facts, your thoughts and feelings, and other people's thoughts, feelings, and actions.  Keep in mind what your goals are (longer-term).  Will the action you take get you closer to or further away from your goals?  If it will make things harder, is there a better option? 

It really is important at this point to remember that you may need to repeat these stages.  If you have taken a step back and the other person or situation has wound you back up immediately, start again from the beginning.  You cannot proceed mindfully until you are able to think again, and you cannot think when you are too distressed and in "survival" or "fight/flight/freeze" mode.

I hope this brief post has been helpful!

Thanks for reading =)

The Bear xXx