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Holiday Coping

Friday, December 1st, 2017


Tis the season! The season for family and Christmas music and good food and… stress. During the holidays, we juggle busy schedules, celebrations, family dynamics, high expectations and complicated emotions. And this year, many of us are still recovering from the effects of Hurricane Harvey. That means that our “starting point” for stress may be higher this year than it has been in previous years. And therefore, ideally, it should also be the season for good coping skills. In case you feel a need to add to your coping repertoire or simply brush up on your existing skills, here are some practical ideas for you to try this holiday season.

1. Diaphragmatic breathing. This is the lynchpin of relaxation exercises that can and should be combined with anything else on this list. Often when we are feeling stressed, our breathing becomes shallow, causing our chest and shoulders to move. For diaphragmatic breathing, the goal is to fill your lungs so that your diaphragm is pushed downward, causing your stomach to pooch out. Your shoulders and chest should remain still. Don’t slow down your breathing to the point that you feel suffocated. If you can, simply try to linger a bit on the exhale.

2. Progressive muscle relaxation. This is exactly what it sounds like. You are simply walking through the muscles in your body, relaxing them as you go. One method for this is to imagine that your hands and feet are made of lead and so heavy that the rest of your muscles have to relax to accommodate them. Another alternative is to tense your muscles and then relax them one by one – starting with feet, moving up to legs, arms, core, shoulders, neck, face, scalp. Don’t forget to practice your diaphragmatic breathing while you do this!

3. Mindfulness. This is a state of mind where you intentionally notice. Notice what you see, hear, smell, and feel. Notice your thoughts, positive and negative. Notice tension in your muscles. The idea is to avoid judging. Your sensations and thoughts don’t need to be evaluated or “fixed.” You can simply notice them and then let them go. If you need help with this exercise, there are even mobile apps that you can use to help you practice mindfulness. A popular example is Headspace.

4. Exercise. This is a mood freebie, ya’ll! You don’t have to go to a Crossfit class. Just break a sweat regularly, even if it’s through a brisk walk. Your body will release endorphins, and you will feel better with minimal effort on your part.

5. Sunshine. Another freebie! Remember that walk – just take it outside in the sunshine. Without practicing any elaborate strategy, you will elevate your mood.

6. “Zone-out activities”. Sometimes you just need a mental and physical break. This is when sometimes people feel tempted to pour another glass of wine or binge on another show. It is a good idea to have an arsenal of mindless, distracting activities that are not addictive or destructive. Examples could be coloring, knitting, playing fetch with the dog or cleaning.

7. Journaling (or talking with a trusted friend). This is an excellent way to cope with strong emotions that may come up during the holidays, especially anger. In the past, the mental health community thought that anger could be dealt with by letting it out – by shouting, throwing something or punching a punching bag. Over time, however, research has shown that this sort of angry reaction actually causes the emotion to increase rather than decrease. In contrast, verbal expression of angry feelings caused the anger to begin to dissipate. So rather than punching the punching bag, try writing or talking when you feel your anger beginning to build.

8. Go easy on the alcohol! Stress plus availability of alcohol can be a tricky combo during the holidays. Set for yourself a number of drinks that you are allowed for the evening, and then be intentional about not going past your limit. If you feel that you “need” another drink to help with your stress, look back at the rest of this list and put one of the other strategies into practice instead.

9. Give yourself an out. Feeling stuck can be stressful under the best circumstances. If you feel stuck with difficult family, it can be downright panic-inducing. Give yourself permission to take breaks. Leave the house for your walk, coffee with a friend or a trip to the store.

May your holiday season be full of love and joy, even if those positive feelings live right alongside your stress!

Harvey Trauma Effects

Monday, September 4th, 2017


A traumatic event is anything that causes or threatens harm to us or our loved ones in which we are powerless to change the circumstances. In many instances, trauma happens on an individual level where one person or a small group is affected. In cases of natural disaster, whole populations can be exposed to trauma. Enter Hurricane Harvey. Houston has experienced a major trauma in the form of flooding and its resultant destruction. We, as a population, will spend the next days, weeks, and probably months recovering not only physically and financially, but also psychologically and emotionally from this experience.

Trauma does a number on our nervous systems. Because we feel threatened (or that someone we love is threatened), our sympathetic nervous systems are activated. Now this is not a strange thing. Our sympathetic nervous systems play a valuable role in escaping danger. This is the biological system that tells the body to release adrenalin and cortisol, increase heart rate, breathing rate, and perspiration, send blood away from the brain into the arms and legs, and generally prepare us to escape from the threat. You may have heard this described as the “fight or flight” response. That’s helpful stuff. But problems arise when this reaction continues for a long period of time.

In cases of trauma, when we can’t escape from the danger, our sympathetic nervous system just keeps doing it’s thing. The result? We eventually find ourselves exhausted, depleted, possibly struggling to sleep and eat, possibly developing physical ailments like stomach aches or headaches. And here’s the rub – these symptoms can affect those that were impacted directly by the flooding as well as those who stayed dry but heard from friends, family, or simply watched the news. We have ALL been affected. And that means that we all need to take care of ourselves.

Please take a look at these self-care suggestions and put some of these into practice to begin calming down your sympathetic nervous system. If you need additional help in this process, we at Anthology are ready to support you. Please don’t hesitate to reach out for assistance!

Winter & Spring: The Parable of the Seasons

Wednesday, April 5th, 2017
by Sarah Burkhart – MA, LPC

Several years ago, I moved to St. Louis for a three-year grad program. Having lived my whole life in the great state of Texas, I had been exposed to only two types of weather up to that point: warm and blazingly hot. In St. Louis, I gained my first experience with that mythical season that I had read about in books and seen in movies – winter. At first, my emergence out of my weather comfort zone was full of fun and novelty. I enjoyed watching the leaves turn orange and red and yellow and shopping for scarves. Then slowly I realized that I had to be very careful with my wardrobe choices before a long hike or jog because otherwise my fingers and ears would ache and throb until they eventually went numb. That was just before I recognized the shortcomings of my “warm” winter coat, which had always been more than cozy in Texas but was now sadly insufficient since it covered no part of my legs. And all of these realizations came before the first snow fall, at which point my eyes were opened to my need for good boots with traction, an ice scraper, WARM hats and gloves (cuteness in my wardrobe choices was being swiftly replaced by functionality) and lots of patience for being stuck inside. By mid-January, the novelty of winter was long gone.

I’m not going to lie, that first winter was hard. I tried to make the best of it but the gray days, the leafless trees, and the COLD began to get under my skin and grate on me. And, what was worse, I was powerless to change the weather. The truth of the matter (my academic brain told me) is that the earth is tilted on its axis and when it is tilted away from the sun, it is going to be cold. I found myself in an uncomfortable state that I was totally powerless to change.

And then late March came. And I saw this:

I actually posted this picture on Facebook with the caption “Praise God, it’s Spring!” I remember the feeling that I had seeing the trees and flowers in all their springtime glory that year. It was a beauty and a brightness almost too lavish to be believed. Not only is spring in St. Louis a bit more, shall we say, “showy” than Texas spring, it is also appearing to people beaten down by the long winter they have just endured. The stark contrast between the seasons dazzled my unaccustomed eyes. Not only did I see nature returning to life all around me, I felt my own spirit revive with it. And, perhaps even more powerfully, I discovered through multiple years in St. Louis that this phenomenon happens EVERY YEAR. Because, as I gloomily surmised during that first winter, the earth is tilted on its axis and therefore a season of cold is inevitably followed by a thaw. Without fail. I could not, try though I might, shorten the winter months. But powers greater than me, which proved to be consistent and reliable, brought spring each year without my help.

There is a point to this. We’ve probably all heard someone say that life is made up of seasons. This word carries implications that I, the native Texan, really never considered before my time in St. Louis.

  • Seasons are not short. They require patience and endurance if we are to make it through to the next.
  • Seasons are not under our control. Sometimes we can take practical steps to make them more bearable (think hats, gloves, pot roast), but we cannot wish or work them away.
  • Seasons are not permanent. Summer turns to fall turns to winter turns to spring. We may love some of them and hate some of them but we are not stuck in any of them.
  • Seasons teach us… about ourselves and about God.

On the Christian calendar, we are currently in the middle of the season of Lent. Lent, historically, has been observed as a period of focus on God through fasting – not necessarily fasting from food but fasting (or refraining) from something that we would normally lean on for comfort or pleasure. In seasonal terms, Lent is winter. Lent is a desert. We may, in our best moments, be able to pick out a stark beauty during this season. But certainly we will also have our moments when we really just wish we could make it end a bit faster. The idea is to feel some amount of discomfort for a season – not because there is virtue in discomfort itself but because such is life. And there is certainly potential virtue in our reactions to our discomfort. But there is another point to Lent that I find much more important. It culminates in the celebration of Easter – the day that Jesus rose from the dead after being put to death. The day he redeemed us and made us new. Easter is springtime. And after a long winter, such a springtime should dazzle us to the core. In whatever season you find yourself now, may this reality bring you courage – the turning of the seasons may be out of our control but it is coming nevertheless. Spring is on its way and even the harshest winter cannot impede its approach.

Fantasy vs. Reality: Can You Handle the Truth?

Tuesday, September 6th, 2016
Sarah Burkhart Headshot Verticalby Sarah Burkhart, MA, LPC

A wise pastor by the name of Chuck Swindoll once said, “Life is 10% what happens to you and 90% how you react to it”. I would like to take a step back from that statement and add (completely without Mr. Swindoll’s permission), “How you react to life has a whole lot to do with your expectations.” Let’s think about a kid on Christmas morning. This kid receives a pair of fancy new headphones. How does he react? Well it really depends on whether he was expecting a pony or a pair of socks. The kid who was expecting a pony is pretty bummed out about his headphones. Even if they’re cool, they’re nowhere near pony status. But the kid who was expecting a pair of socks? That kid is ecstatic. He hit the Christmas jackpot and cannot wait to try out his headphones. Same gift, very different reactions. And, by extension, very different Christmas experiences.

I’ve said it before and I’ll say it again – Life is hard. But here’s the problem. We are in a period of US history where it is possible– or at least it seems possible – to pretend that life isn’t actually hard at all. Those of us who are in the Gen Y or Millenial cohort (I’m right on the edge but will include myself for the sake of humility) grew up insulated from catastrophic world events. Our grandparents were part of the Greatest Generation, who weathered the Depression and World War II. Our parents, raised by those Greatest Generation folks, were taught (perhaps to the extreme) that life is hard and requires hard work. As a result, the Baby Boomer generation is known for their group work ethic and willingness to invest time, money, and energy for the delayed gratification of financial and social stability. Enter: Gen Y and Millenials. World War II is now two generations removed from our collective memory. Our parents did pretty well and managed to give us comfortable childhoods and to instill a sense of optimism about the future. We’ve been told that we can do anything that we put our minds to. If we return to the Christmas morning image, we have been raised to expect that life will shower us with ponies. We want to do something special, be something special, follow our passions, and live life to the fullest.

Here’s the problem: we will often find ourselves living rather mundane lives, low on the passion scale. And that does not mean that we are doing something wrong. It doesn’t mean that we need to work harder for self actualization. It just means that we have moved from the realm of fantasy into reality. And the harsh truth is: we are not that special.

Now please don’t hear what I’m not saying. I believe that people were made in the image of the Almighty God and are therefore, in many ways, unbelievably special. But we Millenials need to rethink our definition of that word. Special does not necessarily mean rich, famous, and vocationally successful. It certainly doesn’t mean happy and fulfilled at all times. It does mean that each of us has particular talents and gifts that can be used for particular purposes. But here’s the thing: I would contend that those purposes are wrapped up in something much bigger than self-actualization. Let’s think about some of the people who have become household names because of their life accomplishments – Gandhi, Mother Theresa, Martin Luther King, Dietrich Bonhoeffer. Would we say that any of those legendary figures lived incredible lives of self-actualization? On the contrary, each of these lives is marked by a willingness to live sacrificially for the good of others. Let’s take a more mundane example. If you’ve ever seen the movie “It’s a Wonderful Life,” you know the story of George Bailey. George dreamed of self-actualizing adventure. He wanted to travel and see the world, break out of the small town where he had been born and raised. And yet, through circumstances outside his control, he finds himself again and again held back from his dreams and pouring his lifeblood into that very town he so desperately wished to escape. Eventually George becomes so disillusioned with the difficulties of this oh-so-real life of his that he considers suicide. And in that moment of despair and hopelessness, he is shown the truth: that his life of service touched, in beautiful and loving ways, the lives of everyone else in that town. George lived a life of love and, in the end, he decided that that was a life well worth living.

I would add that a hefty amount of self-actualization also took place in George Bailey by accident – perhaps more than would have happened if he had managed to become a world traveler. Because self-actualization really has nothing to do with fame, success, or even happiness. On a literal level, self-actualization means that we are learning the truth about ourselves. Unfortunately, the Millenial methods of self-actualization are often counterproductive – they hide the truth rather than reveal it. If we are intent on living lives full of novelty, social stimulation, peer recognition, adrenalin, or whatever else we equate with that wispy notion of passion, we will fail to know and befriend huge parts of ourselves: the parts of us that can only be known in the context of deep interpersonal relationship or in long-term monotonous commitment to a goal or in the process of persevering through suffering. Those are the parts that George Bailey figured out without intending to. He learned what he was really made of in the trenches of life.

My purpose in writing this post is not to be a Debbie Downer to all you optimistic Millenials out there. Rather, I hope these words are an encouragement to anyone who has experienced a reality that looks very different from the fantasy. There are lots of real-life examples of expecting a pony and receiving headphones. Or, let’s be real, expecting a pony and receiving nothing at all. But by persevering through the harsh realities of life, building meaningful relationships, and acting out of love, we will begin to see what we are really made of. We will receive solid truth in place of wispy passion. And I will take the marred beauty of a solid truth over an ethereal mirage any day. Millenials, let’s start looking for actual self-actualization, shall we? We can handle the truth.

Treating the Effects of Trauma with EMDR

Wednesday, August 3rd, 2016

Introducing Eye Movement Desensitization and Reprocessing (EMDR)

by Sarah Burkhart, MA, LPC

The news lately has been full of horrors: mass shootings, international terrorism, police brutality, brutalizing of police. The reality of trauma in our world has been impossible to escape in recent months. But when it affects you personally in some way, you are stuck trying to figure out how to deal with trauma – how to work through it and move on. And it helps to know of tools that are at your disposal.

To start, we need a working definition of trauma: any experience that makes us feel both threatened and out of control of our own safety. So, for instance, the experience of a car accident where you are fearful for your life and simultaneously helpless to protect yourself would certainly fall under the trauma heading. Likewise, suffering from a debilitating illness, abuse by a parent or partner, or loss of a loved one could all constitute life traumas.

Ultimately, however, it is not the nature of the experience itself, but our emotional reaction that allows us to use the trauma label for a given experience. Two people may be in the same car accident and come away with very different reactions. One may experience no long-term debilitating effects while the other feels a heightened sense of stress, or hypervigilance, has terrible nightmares about the crash, and periodically feels vividly as if he was reliving the crash all over again. If these symptoms persist, we would say that the second person is probably suffering from post-traumatic stress disorder or PTSD.

Over time, scientists have learned that trauma affects the brain in particular ways. In his book, The Body Keeps the Score, Bessel Van Der Kolk lays out the results of brain scans performed on PTSD-diagnosed patients while they were re-experiencing a traumatic event. He found, unsurprisingly, that the amygdala (which is the brain’s fear center, regulating the fight or flight response to danger) was active during this re-experiencing. Even more interesting, he found that a region called Broca’s area was deactivated. Broca’s area is one of the brain’s speech centers, which allows us to translate thoughts and feelings into words. With a temporarily malfunctioning Broca’s area, trauma survivors are unable to articulate the horror of their experience. What’s more, Van Der Kolk found that the whole left side of the brain slowed down during this traumatic re-experiencing. The left hemisphere is the center for logic, sequencing, and organization. So not only do traumatic experiences leave people literally speechless, but they are also left feeling scattered and disorganized, divorced from the logic of cause-and-effect sequencing that the left hemisphere would normally provide.

Counselors and mental health practitioners, then, have a unique challenge in treating PTSD. I, for one, regularly describe my job as “talk therapy”. But how do you offer helpful talk therapy to a person whose experience falls outside the realm of language? How do you use logic and reason to talk through a period of time that has never been successfully organized into a logical sequence of events? As we learn more about the nature of trauma and the brain’s responses, the mental health community is building an arsenal of effective treatments. I cannot give an exhaustive account here of all the treatment options that are out there, which is good news – there are just too many of them. I, however, have chosen to become trained Eye Movement Desensitization and Reprocessing, a technique that has been shown to be effective through almost thirty years of research.

The creator of EMDR therapy, Francine Shapiro, stumbled across this technique during a walk in the park when she noticed that her emotional response to a distressing memory was lessened as she moved her eyes back and forth. Since that initial experience, she has streamlined EMDR into a treatment protocol that has been shown to successfully treat PTSD symptoms in multiple controlled studies. The protocol involves very little talking. Instead, the client is asked to focus on a traumatic memory while moving her eyes back and forth, following either a light or the therapist’s fingers. Shapiro theorizes that EMDR accesses the brain’s natural healing process, allowing traumatic memories to be reprocessed into what Shapiro calls an “adaptive resolution”. We can compare this process to the skin’s natural ability to heal itself. If the wound is small and manageable (not traumatic), the skin will heal itself spontaneously much like the mind is able to process and manage low-level (not traumatic) stressors. However, if the would is large (traumatic), there may be some outside interventions required to help with the same natural healing process. Stitches or steri strips give the skin a “boost” in the direction of healing so that it can take over with the same natural processes that worked so well in the non-traumatic example. We can think of EMDR as mental stitches. It gives the brain the same sort of boost in the direction of healing, allowing natural processes to then take over.

EMDR has been shown to be effective not only for PTSD but also for phobias, panic disorders, sexual dysfunction, chemical dependency, performance anxiety, and chronic pain. Research results, in many instances, have been quite dramatic. In a 1997 study of female rape victims, 90% of subjects were found to no longer meet the full PTSD criteria after only three EMDR sessions (compared with 12% in the control group) (Rothbaum, 1997). EMDR has been found to be particularly effective for those who have suffered a single-event trauma, such as a car accident or sexual assault. In another 1997 study, 100% of single-trauma victims were found to no longer meet the PTSD criteria after an average of 6.5 EMDR sessions (Marcus, Marquis, and Sakai, 1997).

If you would like to learn more about EMDR or would like to discuss whether this could be an effective treatment option for you, I encourage you to contact me. I will be more than happy to chat, brainstorm, answer questions and ask them right back. I am excited to be able to offer this tool to those suffering from the effects of trauma. And I am thrilled to have the opportunity to see firsthand the healing effect it can have on clients’ lives.

About Anthology

We are a group of professionals dedicated to promoting health and healing in the whole person – body, mind, and spirit. We believe that healing occurs more effectively and more efficiently when each facet of a person is addressed.