How to Fall Asleep When your Mind Just Won't Quit

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Have you ever laid in bed and your mind is racing, thinking about everything from that spreadsheet at work to a comprehensive list of your deepest regrets? Sleep deprivation affects your memory, mood, eating habits and your ability to function effectively. If you struggle to fall asleep or you wake up in the middle of the night and start planning and worrying, it can seem like nothing will get you to the sleep state you crave. And we all know that worrying about not being able to sleep is exactly what makes is impossible to fall asleep. Welcome to the sleep conundrum.

I am not a therapist, but a busy bee like you with a lot of practice tossing and turning at night. But because I struggle, I also want to share a compilation of methods I’ve tried that work for better sleep. I call it a lullaby for grown-ups. 

For better sleep, change habits first

• Don’t eat or drink alcohol close to bedtime. Have your last meal a few hours before bed.
  

• Put away your phone or devices while in bed. Electronics are making your mind overactive.
  

• Avoid caffeine and stimulants after a certain point in the day. For coffee drinkers, the cut-off for your last cup will depend on your sensitivity to caffeine. But if you struggle to fall asleep, consider finishing your last cup by 4pm, brewing it a bit weaker, or replacing it with herbal tea.
  

• Create a bedtime ritual. You don’t need to devote much time to it to feel the positive effects. Set aside 30 minutes for yourself before bed to decompress. Tuck the kids and put aside obligations, chores, and screens. Meditate, stretch, relax with tea or a hot toddy, listen to soothing music or all of the above!

Get comfortable

Being mindful of your surroundings at night can go a long way. At bedtime, you get to reward yourself with rest for getting through a hard day, and you want to feel good. Have you ever asked yourself if you’re actually comfortable? Before bed, eliminate any physical obstacles that you have control over:

• Body aches can keep us awake. Do what helps your body to reduce the pain - a cold or hot compress, or pain reducers if your body/doctor allows for that.
  

• If you’re too hot or too cold, itchy or scratchy, adjust blankets and sleepwear accordingly.
  

• Change your physical surroundings in ways that make you feel restful. If white noise is soothing to you, turn on a fan. If that sliver of light through the window bothers you, put up a light-blocking curtain.

Instead of counting sheep, count your inhales and exhales

Perhaps you’re lying in bed as alert as ever and considering just getting up and starting your day at 1 AM. Before you give up, try some of these tips.

• Bring your attention to each body part touching the bed. Notice how your stomach rises and falls. How each arm makes contact with the bed. Notice how your neck feels on the pillow, considering the weight of your head. As you notice each joint, muscle and bone, you might feel the sensation that you’re sinking into the bed. Your body might let go more..
  

• When thoughts start invading your mind and keeping you awake, redirect them and say “thanks mind.” Replace your thoughts with 5 second counts for each inhale and exhale. Breathe deeply, counting each breath in and out for a few minutes.

Thoughts will continue to come back, because the job of the mind is to generate thoughts. When that happens, “thank” your mind for doing its job and re-focus on your breathing and your body.

The wheels of our mind don’t always know when to quit. If your thoughts keeps creeping up on you, it’s time to reason with it.

Using logic to reason with your brain

Did you know the amygdala is the part of your brain responsible for emotional processing? In our hunting and gathering days, this region of our brain alerted us to predators and dangers. When our ancestors saw a mountain lion, they became hyper-alert, their heart would race, and breathing would speed up.

Today the amygdala continues to alert us to dangers that may not be real threats. Your brain doesn’t distinguish between the sight of a mountain lion and the deadline at work. The fear response is a residual protective mechanism to prepare you for fight or flight.

That said, here’s how to reason with your brain:  

• Thank your brain for its service, and remember that the anxiety you feel because of your thoughts present no real danger: you will survive that presentation, family function, or interview. If guilt or past pain are the culprits of your emotional state of mind, remember they serve no purpose right now. Forgive yourself and others, even if just in this moment.
  

• Ask yourself, “does thinking about this now solve any problems?” If not, your mind will find a way to deal with your source of worry during the day. Life will be there tomorrow. Thinking in terms of the best approach to solve problems, you can acknowledge that losing sleep won’t help anything. That said, don’t be too hard on yourself for having all these thoughts. Remember, they are natural. Your brain is just doing its job.
  

• If you absolutely must think about something at night that you don’t want to forget by the morning then keep a notepad by your bed and write it down. Don’t go looking for the Notes app on your phone; pen and paper work best here.

Once you’ve leveled with your brain, get back to breathing

Continue deep breathing and awareness of the sensations in your body.  Breathing with intention is a no-brainer solution to any stress, but it’s amazing how often we forget to do it (or sometimes how to do it). Focus on breathing deeply, and on how your physical body feels. When you feel heavier physically and a little groggier mentally, then you’re closer to being in a sleepier state.
                                                                         …

If sleeplessness is a recurring problem for you, consider talking to your doctor and addressing potential insomnia or other health concerns that can affect sleep. Melatonin can be helpful as an option before turning to pharmaceutical drugs.

We’re all on this journey to make the most out of life but that requires giving our brains and bodies good rest. Wishing you sweet dreams. You can use some peace and a good night’s rest. 

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Running a small business is non-stop work, which means Ada’s blog sometimes gets pushed to the back burner. As the Executive Assistant here at People Bloom, I mentioned that I like to write, and Ada kindly offered for me to contribute blogs during busy times. I was thrilled! Now you know I like writing, but I also love to garden, cook, hike with my fiancé, and play on the pottery wheel.
I’m an office admin whiz - not a therapist. I write blog posts as a human navigating this world, a client sitting across from a therapist, much like you. Thank you for letting me share a part of myself. Maybe my journey will resonate with you, and we’ll get through this messy life together.
                                                                        - Karen Lenz

One Simple Thing You can do for Yourself that’s Kind and a No-Brainer

Source: Giulia Bertelli on Unsplash

So Valentine’s Day is over. All the hype about roses, chocolate and jewelry is behind us, for now. If you’ve been following my work, you know how I feel about Valentine’s Day. I wish that we’d remember to love everyday, to be less predictable in our gift giving and to send chocolates whenever. And, if you received a lot of love and attention on Feb 14th, I hope that tenderness continues throughout the year.

We often look to another person for care and for watching out for each other and extending mutual support. However, how much thought do we put into caring for ourselves? Like, the things you do for another or expect another to do for you - what would it be like if you did some of those for yourself?

Here’s what I mean by that.

I don’t even remember the context of this but I had to wake up really early one morning and the night before, I laid out a small thing for myself to help me get ready. The thing was so small I have a hard time recalling what the item was, but the impact was great. I’m not a morning person and when I woke up to this delightful surprise which I’d forgotten about from the night before, I was very grateful, to myself.

It was as if my husband anticipated a need and met it, except it wasn’t my husband; I was watching out for me. I still remember feeling warm inside, that someone loved me and cared for me. Aww, how incredibly thoughtful of you, I thought. That was so sweet. Thank you. I love you too. It was certainly a me, myself and I moment, passing the love around.

If this sounds a little foreign, it is.

In the way that you’d show appreciation to your partner if they did something nice for you, how is that different from when you show kindness to yourself? You want to make you happy; you want to tell yourself, “I love you and you matter to me. Of course I’ll help you prepare for the day, make coffee for you, drive you places, take you to do the things you love doing.” That’s a no brainer, except we don’t tend to think like that.

It’s a chore to do things for ourselves and sometimes, it’s a chore to do for others as well. We think we have to get through the day with these many to-do’s and we take for granted the privilege of being able to do for others, for ourselves.

The next time you find yourself grudgingly getting through the routine of the day, especially when doing the tasks that you’re doing for you, would you take a moment to do this: Instead of saying, “I have to...” say, “I get to...” and notice what that does. I get to lay out my clothes, for me. I get to do a load of laundry, for me. I get to cook a Blue Apron meal, for me.

Let me know how that feels different, if at all. I'll be here if you need more tangible help with self-compassion.

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. One of the most loving things she had done for herself lately was to buy herself some replacement socks. She has been wearing the same 5.5 pairs of cotton socks for many years, their colors fading and the wear and tear is evident. And, she has needed to do laundry quite frequently, or otherwise go fishing in her laundry basket at times. She’s very grateful for these new socks.

Ditch New Year's Resolutions. Set Intentions Instead.

Source: Pixabay

The hype with new beginnings

A new year marks a new beginning, a new you, a new future. Or so you hope. This is especially the case when last year was a disappointment. You make excuses for why things didn’t happen, both within and outside of your control. Now that 2017 is behind you, you dig your heels in and you vow that this year would be different.

Be disappointed, again

So, what did you promise yourself at the beginning of the year? Chances are, you would’ve already broken it. According to research out of the University of Scranton, only 8% of people achieve their New Year’s goals. The U.S. News also noted that approximately 80% of resolutions fail by the second week of February.  No worries, if you’re reading this blog when it was first posted, you have about another week.

Same old, same old

The thing is, why keep beating your head against the wall but in slightly different spots? This year you wanted to eat healthier. Last year you vowed to exercise more. The year before that you wanted to save more money to pay off debt. They are all noteworthy goals, but they are hard to sustain beyond the middle of February.

What to do instead

Set intentions. I don’t mean this in a wishy-washy kind of way. Oh, I intend to cut down on time spent on Pinterest, but there goes another three hours! Oh well… What I do mean is putting your best foot forward and being serious about why you’re wanting to achieve this goal. If you’re not responding to every notification, then what would you be doing instead? How would your life be different? Why would you want that life instead of the one you're currently living?

When you’ve figured out “why” you want to do something, then plan for “how” you’re going to get there.

Caution: The “how” could take 500 steps.

Change takes investment

We don’t tend to think about how much is at stake when we’re trying to make a new change in our lives. Going with our previous example, in order to spend less time on social media, your devices need to be less accessible. You’ll likely need replacement activities for those three hours. You’ll need to notice the urge to pick up your devices and redirect your attention. It’ll help to notice when you’re most vulnerable to doing your old habit and addressing those deeper issues:

“When I get tired or bored, I use social media to wake or pick me up.”

“I just got into an argument with my partner and I went online to get some validation.”

“I felt lonely and Facebook provided some sense of community. Well, kinda, sorta.”

If the above were true, you’ll probably need to catch some snooze, fill your life with other meaningful activities, work things out with your partner and be in good company. Unless those things happen, your devices will be an easy go-to.

Ditch New Year’s resolutions

Given the complexities involved in setting and meeting a goal, it helps to ditch the expectation-filled New Year’s resolutions and set intentions instead. After all, if you haven’t gotten around to meeting and sustaining gains last year, what makes a new year any different? And, New Year’s resolutions sound like they can only happen at the beginning of the year. If you’ve lost momentum by now, does that mean you have to wait until 2019 to make new goals because the rest of the year is a lost cause? That hardly sounds rational. Finally, New Year’s resolutions sound like you have either kept them or failed them, which can feel very rigid.

Setting intentions, on the other hand, is quite the opposite.

What intentions do for us

Setting intentions is about putting forth your best for that moment, that day, and choosing to be one step closer to living the life you want. It implies that you’re a fluid individual with good days and not-so-good days and your best can really vary depending on what happened. However, you’re kinder to yourself when you deviated from your goal and you’re cognizant of what detoured you. The next moment you have, be it on February 6th or September 17th, you get back on track and you keep going.

Setting intentions is not about succeeding or failing. It’s about separating your last moment from the moment you’re about to have. What would you want to do with the things you can control?

May your year be filled with intentions that become nourishing habits over time. And if you need more help living fully each day, you know where to find me. 

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. One of her intentions for 2018 is to be early or on time to things. Tracing her 500 steps, this goal involves engaging in meaningful activities during the day and getting enough sleep. She succeeds some moments and not others and will keep at it again and again.

3 Healthy Eating Tips to Savor the Holidays

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Bye Bye Thanksgiving

We’re in between two major holidays right now. Thanksgiving has come and gone. It’s amazing how quickly time passes! For our Fakesgiving two weeks prior, my Mother-in-law managed to pre-order a turkey. We also had salad, chips and dips, carrots, asparagus and mushroom stir-fry, Korean noodles, sweet potatoes, mashed potatoes, stuffings, rolls, jello, and two pumpkin pies and a berry pie! That was an enormous amount of food!

When there’re that much goodies on the table, it’s hard to resist. I wore pants with elastic bands and I went back for seconds and thirds. Most everyone left the table and came back with more food. On a normal day, we would’ve stopped eating sooner, but we just kept on grazing.

Now that’s just the beginning...

Hello Christmas (and everything else)

There’s holiday edition craft beer and baked goods and sweets, company and non-company holiday parties, year end get-togethers, Christmas and finally New Year’s! That can translate to A LOT of eating. Now that I think about it, it can seem like eating at The Capitol in The Hunger Games.

When there are so many meals to savor, it’s easy to remember the first bite and not the rest. Or, remember that it was good food and not what it tasted like. With the hustle and bustle of the holidays, how would you like to take a moment with your food, like really savor it and see how it sits with your body?

Take it easy

Before I introduce three healthy eating tips that can be generalized to all meals, let me say that you don’t have to do this at every meal for the duration of the meal. That will take you forever to eat and you will miss out on great company! Rather, implement this in the first 5-10 minutes of every meal and your body might just thank you.

Healthy eating tips

1. Eat with your non-dominant hand

We’re creatures of habit. When we habitually eat with our usual hand, we don’t pay attention to the gesture of lifting a fork, aiming and poking at food, raising the food to our mouths, the opening of our mouths, our mouths salivating, our mouths closing, our hand lowering the fork, our teeth chumping down the food, our tongue pushing the food around, the food breaking into smaller pieces, and finally our swallowing.

Okay, perhaps that’s a lot to ask but imagine if you paid attention, what would you notice? A hidden ingredient? The color? A crunch? Could that help you appreciate and savor your food more?

2. One bite at a time

I don’t know about you but I tend to reach for my next bite of food while I’m still chewing. I seldom put down my fork because I’m still eating! Similar idea, if you took your time with each bite, you’re more likely to notice your food, pace your eating and feel the food in your body more. That peanut butter chocolate cookie did not sit well with you? You had WAY too much meat? Eating slower can help you know that sooner and change your course of action, if you want.

It’s okay to notice your tendency to pick up the fork while you’re still chewing. You can always put it down again. The fork is not going anywhere.

3. Feed and be fed

Yes, you heard me. It’s not just for babies or during wedding cake cutting. It’s also not the same as getting pied in the face. Here I’m encouraging you to intentionally feed each other with care. If you consider feeding to be a very nurturing gesture, what if you took a few moments to feed your partner, your family member, a friend? It takes care and attention to know how much food to scoop up per bite and where to aim the forkful so nobody gets hurt.

Since eating is a basic survival need and we do this independently, it also takes a lot of vulnerability to be fed. In feeding and being fed, what might show up for you and how might you notice the food differently?! You can always start with just a cookie.

Okay it’s not easy

“Can we go back to eating normally now?!” says my husband. We’ve fed each other twice now and while I’m having a lot of fun, he was feeling frustrated. Yes, this is strange and foreign and that’s exactly the point. Rather than breezing through your next holiday meal, let’s make what is familiar unfamiliar. Take the time to savor the deliciousness. Allow your body to take in everything this bite of food has to offer you: nutrition, energy, even love.

This is not easy. If anything, it’ll be hard. And, “Yes husband, we can stop.” The rest of our meal was still amazing but something else about it was memorable, for me.

Let me know if you need help slowing down not just with food, but life in general during this hectic holiday season. I'll be here!

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories.  Her favorite food across seasons is sushi and if attempting to eat that with her left hand, she’d need to trade in her chopsticks for a fork. As 2017 comes to an end, may you and yours savor much goodness this holiday season.

Sadness: a Normal Part of Life

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In my last post, I wrote about managing Seasonal Affective Disorder (SAD). Sitting at a cafe by the window, the mood lighting inside is definitely brighter than the grey skies outside. The drizzle is constant and the puddles invaded by rain droplets. You can interpret this as being nice and cozy or a real dread. The thing is, if you’re affected by the rainy Seattle weather, chances are, looking outside will not give you the energy boost. It might do the opposite of inducing sadness and low energy.

We don’t like to feel sad, do we?

Ever wonder what good is sadness? Like, why bother? After all, we all want to feel good. We chase after and try to create happy moments like eat at our favorite restaurants, go on vacations and hang out with people who matter to us. On the flip side, we stay away from negative experiences like heart breaks, bad news and surgeries. We’re good at celebrating wins but as a society, we don’t do as well being with sadness.

If you look at a baby who came into the world happy all the time, it’s hard to imagine that we’re not meant to be happy, like all the time.

Sadness is a normal part of life

The thing is, with time, we become acquainted with the pains of life. From abuse to social isolation, job loss to still births, accidents to illness, could sadness and other unpleasant feelings be, sadly, a normal part of the human condition? What if we’re not meant to be happy all the time; rather, it’s about living a full and meaningful life despite our circumstances?! If sh*t will hit the fan and it’s just a matter of when, could a feeling like sadness help us navigate through life’s complexities?

You might beg to differ but Inside Out has something to say about that:

Being with sadness

Here, Joy is trying to cheer up Bing Bong, the imaginary friend who is grieving the changing relationship with coming-of-age Riley. Joy tries hard to get Bing Bong out of his sadness with quick reassurances, tickles, jokes and distractions. She doesn’t get it and thinks if Bing Bong were to feel his grief, things will only get worse.

Sadness, on the other hand, understands his loss. She sits next to Bing Bong, tells him it makes sense for him to feel this way and lets him cry on her shoulder. While in real life, the turn around is often less drastic, Bing Bong feels better after balling candies and was more ready to move on with their journey. For the first time, Joy saw that Sadness made something better.

Sadness has a place in our hearts

Sadness helps us know when something isn’t right. It validates that it’s hard to be where we are but that it also makes sense to feel what we feel where we are. Our situation may stay the same, but we can feel our way through it. And because we’ve been there or can imagine what it’s like to be there, we can empathize with others and share in their pain. We don’t have to be alone in our sorrows.

The next time you feel any degree of sadness, know that it makes sense. You don’t have to hurry up and get over it; nor do you have to be paralyzed by it. Cry your eyes out if you need to. Surround yourself with people who understand. Then still ask yourself, “What would make this moment full and meaningful?” and go do that.

If you're having trouble being with sadness or other difficult feelings and could use some help, let me know.

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. Here at the cafe, it went from raining to pouring outside and the puddles have turned into little streams. She must go now, knowing that hiking 1.5 blocks back to the car is a part of getting back to the car.

5 Tips for Managing Seasonal Affective Disorder

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'Tis the season to be sad

While I don’t wish this upon you, Seasonal Affective Disorder (SAD) is a thing around here. Especially with the end of daylight saving time, we’re feeling the effects of brighter mornings and less evening light. Given how much we love our Seattle summers, the shift into chilly, rainy weather, bare trees and gloomy skies is enough to make many of us want to crawl into bed and stay there.

If you are already struggling with depression, you might feel the effects of it more. If your mood is often weather-dependent or you’re a transplant from a sunnier climate, chances are it’ll affect you too. While winter solstice is less than seven weeks away, let’s help you figure out how to get through this long stretch of fall and winter months.

Before we talk about what to do, let’s address the symptoms of Seasonal Affective Disorder (SAD).

SAD defined

SAD mirrors symptoms of Major Depressive Disorder, also commonly known as Depression. You might have SAD if you:

• feel depressed
• don’t want to do the things you used to enjoy
• have low energy
• have trouble sleeping, often times oversleeping
• experience changes in your appetite, often times crave unhealthy comfort foods and experience subsequent weight gain
• feel agitated or sluggish
• have difficulty concentrating
• feel hopeless, worthless or guilty
• have frequent thoughts of death or suicide

If you have thoughts of wanting to hurt or kill yourself, you need to stop reading this and call the National Suicide Prevention Hotline at (800) 273­-TALK (8255). If you have a milder form of SAD but you’re feeling down, struggling to get out of bed, overeating, gaining weight and saying no to social engagements, then here are some recommendations for you.

5 ways to move through SAD

1. Light therapy

You know that it’s a common purchase when they sell it at Costco. Therapy lamps provide bright, artificial white light during months of diminished sunshine. Keep it in a well-trafficked area and follow instructions for use between 20-60 min. Depending on your circadian rhythm, you might find the light exposure helpful in the morning or the evening. Remember to choose a light box that emits 10,000 lux, which is equivalent to 20x that of usual indoor lighting. With lesser lux units, you might need to use the lamp for longer to get the same effect.

2. Physical activities

I don’t mean exercise. The gym is not for everybody. Rather, there are a lot of fall and winter activities that can get your heart pumping and your brain releasing happy hormones. It can be indoor climbing, yoga, laps in the pool, racquet ball, even housework. Outdoors you have a walk around your office or neighborhood, winter hikes, and snow sports.

Now I understand the fact that you feel SAD means you don’t want to move very much. However, if you wait until you want to do something before you do it, you might never do it! Instead, act the way you want to feel. That said…

3. Positive activities

What activities used to bring you alive? What did you use to enjoy? Or, what is something new you’d like to try? It can be a physical activity listed above or it can be art walks, concerts, a meetup, a good novel, a weekend away. You can be with strangers, close friends or be by yourself. Given the tendency to socially withdraw, I’d recommend doing some activities with others and developing accountability to increase follow-throughs. While there’s no guarantee that you’d feel better afterwards, it’d help you in the long run to stay active and engaged in life.

4. Medication

I don’t know how you feel about taking meds, but sometimes an anti-depressant is necessary to get you past this hump. It doesn’t mean you have to stay on this medication forever; only until you have more tools under your belt to be without it. Also, if you’re currently on an anti-depressant and you’re questioning whether it’s working properly, it’s probably time to visit your prescriber again. Remember that it can take up to 6-8 weeks for the medication’s benefits to kick in, while you might feel the side effects more immediately.

5. Take it in

While this is not the most exciting time of the year for you, can there be any beauty in taking in the vibrant colors of the leaves, the rustling of leaves against the wind, or the crunching of leaves under your feet? What about the beating of rain on pavement, the dancing flame from a crackling fireplace, and the warmth of peppermint tea against your lips?

This will pass

This season is here and it will pass. Since there’s no ushering it away, I hope there’s a part of you that can find it a friend, rather than a foe.

And if you need a therapist to help you ride out this season, I'll be here!

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. This fall, she noticed the changing colors of the leaves more. Her favorite food group this season is all things squash and her favorite activity is baking.

How to Overcome Barriers by Cultivating 1:1 Relationships

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My new pet peeve

So I go to yoga about two times a week, preferably three. I love the studio; love the teachers. It’s a great community there. It’s like 83 degrees inside and people sweat bullets, or more like puddles. I’m fine with feeling my own sweat and wiping it but I discovered a new pet peeve: I don’t like stepping on other people’s sweat. There’s something about my bare feet touching someone else’s bodily fluids that makes me cringe. The mood lighting does not help as I navigate my way around the studio after class. 

How I’ve coped

As with most pet peeves, we find a way to cope with them or to otherwise avoid them. I’d scoot around the studio after class, using what little lighting there is to side-step shiny liquid reflections. If I’ve landed on a puddle, my towel is just a reach away. This was my coping strategy, until one day, my world was turned around. 

Sweat has a name

It was a usual Wednesday evening class with teacher Aaron and he asked us to do something out of the ordinary. After some power vinyasa routine where we were dripping wet, he asked us to find a partner to do this strap exercise. It looks difficult enough: you’re doing some backbend with your leg behind you strapped to your hands overhead. Your partner is spotting you. “Bob” and I were the only ones without partners and I jumped to my feet to join him.

We met in the middle of a matless area and started doing the pose with me spotting him. He talked about not being very flexible and fell over. Fa-thud! I’m not a very good spotter, am I?! Someone then recommended that we do it on a mat and we walked over to his mat. He had a towel spread over it and it was soaking wet. “Bob” was noticeably embarrassed. He started wiping the outskirts of the mat where his sweat puddles formed. He might have apologized for how damp his towel was, but I don’t remember.

None of that mattered. I was about to spot him again so he could do his backbend, hopefully without falling. And I had a few turns and realized the pose was easier than it looked. We chit chatted for a bit while waiting for Aaron to gather us in. We shook hands, shared our names and I eventually went back to my mat. 

Why wasn’t I bothered?

My feet were damp and I wiped them off but I didn’t feel the usual disgust. Why? It could be that I was distracted by the pose or engaged with “Bob.” In retrospect, I think it had more to do with the fact that sweat has a name and it belonged to “Bob” and he was kind and personable. “Bob’s sweat” didn’t bother me because “Bob” is a human being I have come to know, for all of ten-minutes. It’s no longer a nameless sweaty pile on the floor that I tip toe around. 

Perhaps it is a bit of a stretch to say that “Bob” and I have formed a friendship, but he sure is no stranger. He wasn’t in class this past week; otherwise I would’ve waved. The human-to-human connection changed the way I feel about something I used to dread. While I can’t say I’m now free to glide through the yoga studio in the dark without holding back, I am a step closer to that direction because of “Bob”. 

So why am I telling you this story? 

Relationships break barriers

When I think about my experience, that human touch made a difference for me. It’s after all easier to stay on our “mats” or “pair up” with people we already know and feel comfortable with. But we then miss out on opportunities to get to know an “other,” someone different than you; someone different than me. When we do take that time, what might happen? What beliefs might be challenged? What relationship might come of that? 

At the core of who we are, we’re human beings who breathe, sleep, eat, pee, poop and yes, sweat. We all feel glad, sad, mad, fear, disgust, shame/guilt, surprise, and interest. We are all a brother, a sister, a daughter, a son, a friend to someone, somewhere. Our humanity is our common denominator. And, we can be each other’s guide through the discomforts of life if we allow each other in. 

If you ever need help leaving your “mat,” you know where to find me. 

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She mostly helps unhappy couples and breast cancer patients. At the heart of what she does, she’s about helping people flourish and live compassionate and vital lives. She can be found at PeopleBloomCounseling.com.

Two Approaches to Dealing with your Fears

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I was born a little skittish. I get startled easily when I see and hear something I don’t expect. I had to tell my husband early on in our marriage to make noises as he enters the room. Otherwise, I’d scream bloody murder, which would freak him out. Oh, and I don’t like scary movies. Husband got into a kick recently and watched the three original Alien movies while I was out-of-town. Good, cuz it ain’t happening when I’m home.

The thing is, we’re all wired a certain way, along the continuum of higher versus lower threshold for fear. It’s not a right or wrong, good or bad. It just is. But, what’s the point of fear? Is it even necessary? Ever wondered where fear came from?

The origin of fear

Too many million years ago during the age of saber-tooth tigers, wonderful men hunted and awesome women gathered. Whether they were out in the fields or back at the shelter, they had to be on hyper alert for wildlife. They were either going to have lunch or be lunch. With that hard-wired alert for danger, those who were careful and watchful procreated and lived on. Those who had a low radar for fear and lived a carefree life did not.

What does this mean for us in 2017?

Real threats

Though we’re no longer living amongst saber-tooth tigers, some threats in our lives are very real. It could be a life threatening illness, an accident, any other traumatic events or threats to our dignity as people. During these moments, our fears make sense and fit the facts of the situation. These threats ought to make us have the automatic reactions of fight, flight or freeze. When our fears are justified, we should take action to effect change where we can. This is for our survival and the survival of people we care deeply about.

Perceived threats

There are real threats and then there are perceived threats. Perceived threats are when you’re no longer in the car accident, in the abusive relationship, in the situation that made you feel so threatened and yet, you live as though you’re still in that life-threatening event. Or, your fears are not tied to something that has happened, but a fear that something might happen. You then avoid places, people and activities that might remind you of your fears, examples being you do less because you fear failing or embarrassing yourself in public. When checking the facts of the situation, you realize the probability of something bad happening is very low, or your fears may be unpleasant, but they’re not life-threatening. What are you to do?

Facing perceived threats one of two ways

When your fears are not justified, it is important that you learn to face your fears. I share two approaches here:

1. Whatever you’re afraid of doing, do it over and over again.* Not kidding you. When there is little evidence for why you should be afraid of something that has occurred in the past or might occur in the future, the way to overcome that fear is to face it head on. Do the very things you want to avoid with consistency. Is it public speaking? Getting behind the steering wheel? Watching certain shows that might be triggering? Take baby steps to overcome your fears by approaching, rather than withdrawing. Overtime, you’ll feel more in control over your fears.
2. Harry Potter shows us another way to face our fears during a boggart lesson:

We can have a different relationship with our fears.** Put in its original context, Ron’s afraid of spiders, Harry Dementors, and Professor Lupin a full moon. When they cast the spell Riddikulus and envision something humorous, the shape-shifting boggart assumes a comical form. Followed by outright laughter, they had the power to make the boggart disappear!

While we don’t have this power at our disposal during current times, Professor Lupin’s lesson is for all of us. Can we see our fears differently, and therefore, relate with them differently? What if a natural disaster turned into a ribbon twirling performance, social humiliation took the form of people high fiving you, and the car accident transformed into a scene from Fantasia?

Facing your fears together

Don’t let the fears of your fears hold you back! If you need help facing your fears or otherwise make them ridiculous, well, you know where to find me.

* Borrowed from Cognitive Behavioral Therapy and Dialectical Behavior Therapy
** Borrowed from Acceptance Commitment Therapy

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Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She mostly helps unhappy couples and breast cancer patients. She also loves helping people address fears that hold them back in life. Her favorite Harry Potter films are the Order of the Phoenix and the Deathly Hallows: Part 2. Her worse fears are, well, she can identify with Ron. 

The Guide to Surviving Breast Cancer Screening and Diagnostic MRI

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Last month, I wrote about the guide to surviving mammograms. When your breasts* are temporarily smashed, to the point where you didn’t think they could be flattened any further, there is nothing fun about that. Breast cancer patients tend to talk about surviving cancer and not about getting through these imaging appointments. Today, I’d like to touch on ways to survive a diagnostic breast MRI, which is sometimes used in breast screening to supplement a mammogram.

Breast Magnetic Resonance Imaging (MRI)

Breast MRI uses powerful magnets to generate detailed pictures of your boobies. You’re to lie tummy down, hands over your head on a moveable flat table, with your boobs hanging into an opening. After you’ve been situated as comfortably as possible on this hard, narrow table, you, along with the table, will slide into a large cylinder-shaped tube. This procedure will last approximately 18 minutes, during which you’ll hear a constant sound of jack hammer, with some breaks in between. You’re to hold completely still to insure accuracy. Once inside the tube, you’ll feel alone in a tight space.

You might be given the choice of music to occupy your mind, but the music would have to be really loud to drown out the construction noise. Near the beginning of the scan, a contrast material will be injected into your arm through an IV to help outline breast tissue details. The technologist will speak to you through a speaker if any communication is to be had. These 18 minutes can feel like forever. How can you survive it?

Do’s and don’ts during a breast MRI

DO ask a friend or family member to come along. Even just knowing that your loved one is near can be comforting.

DON’T be afraid to ask questions or interrupt the process if something is really bothering you. The technologist can help you adjust your position or let you take a break as needed.

DO focus on your breathing. Notice the natural rising and falling of your body as you lay there. Come back to your breath over and over again.

DON’T scratch an itch or move around. If you pay close enough attention, you will feel some level of discomfort. Unless you're in pain or you're super uncomfortable, know that these feelings will pass.

DO close your eyes if it can help forget that you’re in a tube. Instead, imagine you’re in open space.

DON’T tense up your muscles. Notice when you feel tension in your body, from your face, arms, shoulders, torso, gluts to your legs. Invite relaxation into those muscles and let your body fall heavy on the table.

DO hum or speak softly to yourself. You can hardly hear yourself but you can feel what you’re saying. Soothe yourself with your own voice.

DON’T say to yourself, “I can’t wait for this to be over!” This will likely lead to further impatience and frustration. Your scan will take as long as it takes.

D0 think about what you plan to do to reward yourself after you leave the clinic. Perhaps it is a, “Jenny, you did it!” or a mocha waiting for you down the street.

DON’T try to calculate how long it has been. Chances are, it hasn’t been as long as you think.

Bonus tip on surviving a breast MRI: self-touch

No, I’m not asking you to think kinky thoughts as you lay inside an enclosed tube. Rather, remember your arms overhead? Your hands could be touching each other. In fact, before the machine starts, bring your hands to touch, one on top of the other. Feel the warmth of your hand, the texture of your skin. Notice what it is like to be touched, to be cared for, to be comforted, by you. Much like the touch of a loved one can help lower your cortisol level, so here you are, lowering your own stress level because you’re loving you.

Loving yourself through cancer

It’s hard enough going through cancer, your body does NOT need another, “Hurry up and get this over with!” moment. Instead, consider how you can love yourself through it all. If you need help getting through cancer care and life thereafter, let me know!

*Breasts are used in plural form with full awareness and respect that this might not be true for everyone

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps distressed couples and breast cancer patients. That can also mean couples distressed by a partner’s cancer diagnosis, or couples wishing to use their marriage as a resource during their cancer journey. When she’s not thinking about couples and cancer, she has found yoga to be a wonderful practice to nurture present moment, self-love and self-compassion. She has grown pretty fond of her toes recently. She says hi to them every time she passes them by.  

The Guide to Surviving Breast Cancer Screening and Diagnostic Mammograms

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Surviving cancer

Let’s face it. When breast cancer patients are in the thick of their cancer diagnosis and treatment, they’re just trying to get by. Surgery, radiation and/or chemotherapy all require recovery periods. The side effects of treatment are very real and some of them lasting. Many breast cancer patients are simply taking it a day at a time, trying to survive.

Having survived cancer, it is then interesting to note that some of the patients I have spoken to have a hard time with the screening and diagnostic tools such as mammogram and breast MRI. While they might be grateful for the accessibility of screening and early detection of cancer recurrences, they dread going to those appointments. Since regular mammograms and in some cases MRI might be recommended as routine care, is there value in talking about how to survive not just the cancer, but also follow-up care?

Whether you’re walking into your second mammogram or your 20th, I present to you a two-part series on how to survive these screening and diagnostic imaging appointments. Please note I’ll be using breasts in the plural form; I understand we do not all have two breasts and I’m cognizant of that.

Mammogram

Mammo: I recently heard this term and I consider it a euphemism for mammogram. Call it whatever you want, but it is not pleasant. A technician cues you to stand against a large machine as she operates slides and squishes your boobies into pancakes from various angles. X-ray images are taken of your flattened boobies and checked for abnormalities. If you’re going in for a diagnostic mammogram, more images will be taken and magnified for accuracy. In other words, more pancakes.  

While cancer patients tell me they’ve been instructed with all kinds of creative things to do as they bare their boobs against the mammography machine, you don’t hear this one very much: “Lean in(to the machine) like you love it!” That would be quite difficult to do considering the circumstances. However, there are ways to get through that moment of pain and discomfort. Let’s call it mindfulness, distress tolerance and self-compassion.

The mindful way through a mammogram

Mindfulness is about making space for the experience you’re about to enter into, paying attention to it, moment-by-moment. Usually when the experience is pleasant, we have no problem jumping in. However, when you’re about to get your chest temporarily flattened, it’s harder to accept the experience without resisting it and being with it as it is. Here are some ways you can practice staying present during a mammogram.

Feel the Robe

First of all, let’s backup and see if you can ask for a warm robe. Whether you’re getting a mammogram in the middle winter or the heat of the summer, a warm robe feels nice. We often associate warmth with comfort. Why not take a moment and feel into that warmth? The robe is there to keep you from the cold air in the room. Let’s take a moment to acknowledge what it’s doing for you.

Experience your breath

As the technician is setting up the machine and pulling up your record, take the time to ground yourself by focusing on your breath. Your breath is your anchor. Feel the rising and the falling of your chest. Perhaps notice the cold air coming into your nostrils and the warm air as it leaves you. No one breath is the same. Take some time with your breath. You’re alive because of it.

Sense your pain

This may seem contrary but as your breasts are being flattened, feel into those sensations. Your body is experiencing pain for good reasons and it’s sending you signals. The technician will often use a dial to tighten the slides together and you will experience an increase in pain with every turn. See if you can notice where you’re feeling the pain. Take it all in. Feel the tension, then feel the release when the slides separate again. Notice how when you enter into your pain rather than avoid it, it still hurts, but you learn to not be afraid of it. You are co-existing with it and watching the sensations come and go, come and go.

Tolerating the distress of a mammogram

Borrowing from Dialectical Behavior Therapy (DBT) tradition, when you cannot change difficult circumstances, it’s about getting through it without making things worse. After all, you wouldn’t want to have to reschedule your mammogram or have additional images taken because you couldn’t hold still. Within DBT there’s a set of skills designed specifically to help you tolerate your distress and survive the moment.

Here are some additional ways to get through a mammogram:

• Think of a comforting, safe image - some mammo technicians suggests your kids, grandkids or pets. Others mention butterflies and unicorns. Whatever floats your boat.
• Conjure up soothing sounds and play them in your head
• Say a prayer to your Higher Power
• Count to 10 and back – if this is too easy, count by 3’s. That should grab your attention
• Focus on touch – as you hug the machine, notice the texture, color, shape, etc.
• Notice what you hear – be curious and name the different sounds you hear. Can you notice a new sound every time the machine moves?
• Remind yourself this will soon be over - “Beth, you’re doing it. You’re here and this will pass.”
• Be grateful for medical access - “Beth, this hurts like heck but I’m glad you can access this kind of care.”
• Affirm yourself – “Beth, you’ve been through harder things and I’m with you and I love you.”

If the latter sounds a lot like self-compassion, that’s where we’re heading.

Extending compassion to yourself

Kristin Neff is a guru when it comes to all things self-compassion. Unlike mindfulness where you enter into the experience of pain without escaping, self-compassion is about seeing yourself in pain and wishing it wasn’t so. While compassion does not make the pain go away, it does ask the questions, “What do I need right now? Can I give that to myself? What can I do to hold myself with more tenderness?”

Self-reassurance and self-advocacy

Would it reassure you to tell yourself you’re well loved and cared for? Would you want to close your eyes and focus inward? Would it soothe you to think about your partner? If the technician is turning the dial too tight, would you love yourself enough to say something about it? I ask that because I once had a patient tell me her breasts were bruised for two weeks after her mammogram. She said the technician made the slides too tight and she didn’t want to speak up. You’re important to speak up for. Would you do that for yourself?

Life after cancer

While you may no longer be in cancer survival mode, follow-up appointments and regular diagnostic images are and will be a part of your life. You don’t have to white knuckle through these tests “just to get them over with”! You also don’t have to wish your cancer experience away. Let me know if you can use some help staying present, tolerating distress and loving yourself as you are. I’m here!

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Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps distressed couples and breast cancer patients. That can also mean couples distressed by a partner’s cancer diagnosis, or couples wishing to use their marriage as a resource during their cancer journey. When she’s not thinking about couples and cancer, she has found yoga to be a wonderful practice to nurture mindfulness, distress tolerance and self-compassion. She has grown pretty fond of her toes recently. She says hi to them every time she passes them by.