6. Exercise
The physical benefits of exercise are so numerous. These can include losing or maintaining weight, reduced cardiovascular risk, reduced risk of diabetes, reduced risks of some cancers, improved bone strength, improved balance, and increased chances of longevity (Center for Disease Control, 2018).3 Most of us know of these benefits, and though it may not be laid out in black-and-white, we all know exercise is good.
What you might not know about is the mental health benefits of exercise. If you have ever started working out consistently, you begin to feel better about yourself. Maybe your clothes fit better, or you’re getting compliments at the office, or you just feel better. This feeling is separate from the obvious physical benefits, but it is this feeling that keeps people going, at least initially. But if this isn’t enough, let’s look at some of the research on exercise and mental health.
Recall the GAS response described in Chapter One, where your stress response gets stuck in the “on” position. Even moderate exercise (moderate exertion for ten to fifteen minutes) reduces physiological reactivity to stress.4 Exercise has also been shown to reduce anxiety, depression, and negative mood, in part by improving self-esteem.5 Many studies suggest that exercise is as effective in treating depression as medication and psychotherapy.6 Exercise can also help with fatigue and insomnia. Exercising regularly is known to increase energy during the day. And when it is time to go to sleep, you fall asleep faster and sleep better.7 Though I would not suggest exercise as a replacement for therapy, I can say confidently that exercise does help people manage negative feelings, and it does so without the potential complications of psychiatric medication.
7. Volunteering
Want to feel better about yourself and help others? Try volunteering. Through volunteering you give something that is truly limited and extremely valuable: your time. Sure, you can donate money. But if you want to make your gift a very real and visceral experience, volunteer your time. I was forced (although I’m thankful that I was now) to volunteer at a homeless shelter as a young boy. I remember complaining about all the things my friends had that I didn’t, then I had to go to the local homeless shelter and help serve meals to people who didn’t have shoes on their feet. Talk about a wake-up call—it was one that a thirteen-year-old teenager needed. That experience was eye-opening to me and helped me be grateful for the things that I had and less envious of the things that I didn’t.
There are volunteer opportunities everywhere. Go to nearly any hospital, animal shelter, library, nursing home, or church and ask. The best thing about volunteering is that you get to help others in need, and to me, that is the greatest gift you can give, and one you can feel good about.
8. Mindfulness
Mindfulness has become extremely popular recently. Mindfulness is derived from Buddhist meditation8, which emphasizes reaching enlightenment and peace of mind. Mindfulness has been shown to be a helpful technique for depression, anxiety, OCD, addiction, and borderline personality disorder.9 Why does it work? To put it simply, it is common in our society to slip into autopilot. Watching TV and scrolling through social media are common examples of mindless activities. While on autopilot, you may slip into worry about the future (anxiety) or into regret about the past (depression). As a result, the moment gets lost.
Mindfulness focuses on living in the moment, fully aware and without judgment. During mindfulness meditation, you are called on to be mindful of when your mind leaves the present moment and then gently return to the present. The present contains physical sensations (what you feel, hear, see, touch, and taste) as well as your thoughts and feelings. Imagine that you are on the ground and that your thoughts are in the sky. You are not reacting to the clouds, merely observing them.
Mindfulness is an especially helpful technique for specific difficulties, such as worry or obsessive thinking (rumination), cravings, and sleep problems. When you ruminate, you are typically thinking about the future. Mindfulness brings you back to the present moment and reduces the anxiety associated with worry. Mindfulness can be helpful in coping with cravings or triggers for addiction. Anyone who’s tried to stop smoking has thought, “I need a cigarette right now.” Mindfulness reminds us that cravings are merely thoughts that can be observed rather than compelling us to react. The final example is sleep. As soon as you put your head down, you start worrying about tomorrow. Focusing on the moment and what you feel (sheets, pillows) or hear (breathing, AC turning on, ceiling fan) can help bring your mind back to the moment.
There are many mindfulness resources online. Dr. Kabat-Zinn founded the Mindfulness-Based Stress Reduction program at the University of Massachusetts. His book Wherever You Go, There You Are: Mindfulness Meditation In Everyday Life is superb.10 There are also several videos of Dr. Kabat-Zinn on YouTube where you can hear it from the man himself.
9. Get your social black belt.
A book I would recommend to anyone who needs help is Your Mind, An Owner’s Manual for a Better Life11 by Drs. Chris Cortman and Harold Shinitzky. The book reviews ten psychological truths which are backed by research and have held true over the course of millennia (and can be seen in biblical texts). The book is also the basis for a social and emotional learning program called the Social Black Belt that is being worked into school districts around the nation.
So what is the point of this book? It helps you prepare for the challenges of everyday living. These truths are universal and are relevant throughout one’s lifespan, and if you can live them and understand them, it is extremely beneficial. I (Dr. Walden) frequently cite the ten truths in my therapy sessions because they are easy to digest and help clients understand their own behaviors and others’ behaviors.
I’ll list what the ten truths are and briefly touch on the significance behind each. The book is available online through Amazon or Barnes and Noble.
Truth #1: Emotions are not mysterious visitors; they can be identified and understood.
People have difficulty understanding their emotions. They have even more difficulty communicating their emotions effectively. Well, I’m here to tell you that emotions have a purpose and are significant. Our emotions are statements about ourselves and are likely the result of our thoughts, attitudes, and beliefs. We are most emotional about the things in which we are most invested. For example, most parents are very invested in their child’s health, and if your child hurts, you hurt with them. If you can understand why you feel a certain way, communicating that to another human becomes easier.
Truth #2: You can change your compulsive behaviors if you change your thoughts and address your feelings.
Compulsive behaviors (i.e. denial, avoidance, and substance abuse) are intended to alter how we feel and are usually (temporarily) effective. Compulsive behaviors also tend to continue despite negative consequences, because we all have patterns of behavior. But we can change these harmful behaviors and break the cycle by changing our thoughts about the bad behavior. The bad behavior is an attempt to relieve a negative feeling, but addressing these feelings in a healthier way is a better option.
Truth #3: Every behavior has an underlying purpose, and it’s not always what we think.
This truth states that we do everything for a reason, and of course, sometimes that reason is not clear or obvious to us. Mr. Avoidance, a pattern we spoke about earlier in this book, is an example of purposeful behavior that might not be obvious to the person. Avoiding talking about a sexual assault that you experienced denies the fact that this terrible thing did happen. The purpose of not talking about it, then, is allowing the individual to pretend that it didn’t happen to them. Determining the purpose of the behavior can be extremely helpful in understanding if the behavior is helpful or not.
Truth #4: We all sabotage ourselves unless we confront out internal saboteur.
We have an internal monologue that can be our best friend or our worst enemy. I think the expression, “I’m my own worst cr
itic” speaks to this “internal saboteur.” If you’ve ever thought “I’m my own worst critic,” this truth is for you. While the inner saboteur may seem like a friend protecting us from fearful things like rejection, failure, and disappointment, more often than not it prevents us from reaching our potential.
Truth #5: All behavior requires permission, so we must learn what we’re permitting ourselves to do.
This truth is related to the concept that you are the only one who gives yourself permission to engage in any behavior. For example, speeding while you’re driving doesn’t just happen, it occurs because you give yourself permission to drive above the speed limit. We grant ourselves permission to engage in all behavior, good or bad. And if that behavior is unhealthy, removing the permission for the behavior to occur will likely benefit you.
Truth #6: Emotional energy is finite and needs to be invested, rather than wasted on wishing, worrying, and whining.
Everyone wakes up every day with a limited amount of “emotional energy.” It’s helpful to think about your emotional energy as if it were money. Let’s say you wake up every day with $100 worth of energy that you can spend any way you see fit. Let’s say you spend $35 on worry, $20 on resentment, and $10 on anger. That leaves you with only $35 left for work, your two kids, your husband, and yourself—not much of a budget. Managing your budget and allotting “money” (emotional energy) for things that will yield a return (such as exercising, date night, or self-care) is the best way to manage your money.
Truth #7: Our relationships depend on self-empowerment and not on enabling others.
Paying bills for your adult child who has careless spending habits is enabling. Picking up a six-pack for your alcoholic mother on your way to her house is enabling. And while this may be easier than arguing with that person, it doesn’t make you feel very good. Setting boundaries with others and using assertive communication is a healthier approach.
Truth #8: Ego boundaries protect us from rejection, insult, and intimidation.
An “ego boundary” is the line that separates where you begin and where another person begins. People benefit from being critically aware that they are not responsible for what others say and do. Too often people fall into the trap of thinking, “What did I do wrong?” Having healthy ego boundaries can help prevent rejection, insults, or intimidation.
Truth #9: You can trust people to be who they are, not who you want them to be.
People fall into patterns of behavior, for better or worse. We all have at least one friend who is always late. Let’s say we invite that person to our birthday party. If we expect that they will show up on time, we’d likely be greatly disappointed. However, knowing that you can trust people to be who they are can help manage our expectations, resulting in improved emotional well-being.
Truth #10: Time doesn’t heal pain; we heal ourselves by learning how to let go.
This should sound familiar, and if it doesn’t, please refer to the book you’re holding. This book is actually an elaboration on the tenth truth. Time passing isn’t sufficient to heal from traumatic experiences. But by completing the Fritz, you can heal.
Again, the above is by no means a comprehensive representation of the Social Black Belt, but it is a beginning. These ten truths are relevant to almost every single human interaction that you have ever had and will ever have. And knowing these, I think, provides an extremely helpful set of coping skills.
10. Find your own therapist
Finding a good therapist isn’t easy, but I’ll try to give you information to expedite the process. Also, I’ll go through some of the common questions I hear when people try to find a new therapist as well as how to know if you might benefit from therapy.
When do I need to start therapy, or would I even benefit from psychotherapy? Broadly speaking, everyone could benefit from therapy. The content of this book focuses on very heavy material, but even those without trauma may benefit from therapy. Difficulties with your spouse or children, transitions in life (new job, retirement, moving, etc.), insomnia, or addictions are all common reasons to seek therapy. The positive psychology movement has taught us that normal functioning is not necessarily optimal functioning. Everyone deserves to make the most of their life.
When to start? In an ideal world, people would come to therapy before the stage of full-blown depression and suicidality or before full-blown addiction. But often, psychotherapy is a last-ditch option. This is fairly normal, and new clients are frequently in crisis mode. Ideally, however, people come in before they reach rock bottom. If you have ever thought, “Maybe I need to talk to someone about this,” then you’re probably right. If you feel like you’ve tried everything, asked friends and family for help, done some internet research on “how to cope with _____,” tried medications, and you still remain unhappy, maybe therapy is the answer. In other words, use your emotional well-being (or rather, lack of well-being) as your guide for when to start therapy.
Where to start therapy? The answer depends on your circumstances. First, let’s assume you have insurance that covers mental health services. Take out your insurance card. Call your insurer and ask for local, in-network mental health providers. Or try finding a list of local in-network providers on your insurance company’s website. This is a kind of a “top-down” approach, in that your insurance company dictates your options for therapists in the area.
The “bottom up” approach is to search Google.com for psychologists in your county. You can call these offices directly and give them your insurance information, and they will determine your cost, co-pay, and whether the therapist is in-network as regards your insurance. PsychologyToday.com allows you to search by city or zip code. After this search, you can refine your results with more filter options, including insurance providers accepted, gender, languages spoken, type of issues, and so on. These can help narrow the search for someone with whom you’ll feel comfortable. If you click on a therapist link, there’s usually a photo and a brief description, along with credentials, areas of expertise, and contact information.
Who should you pick? I often hear, “I only want to see a PhD” and, “Are mental health counselors good enough?” There are some excellent masters-level counselors out there, and some really horrible doctors. Consider experience with specific issues. Someone with a master’s degree who has worked with children for fifteen years is going to do better with children than a psychologist who has specialized in addictions. Training and experience trump credentials.
Another question I hear often is, “Should I work with a male or female therapist?” Success in therapy depends heavily on the relationship with your therapist, so choose someone you’re likely to be most comfortable opening up to emotionally. Here’s something else to think about, though: to use an example, being a male psychologist working with females who have been traumatized by men provides certain challenges and benefits. Of course, after learning a female client of mine has been victimized in some way by a man, my job is to help her feel safe and trust me in the early sessions. Having this experience can in and of itself be therapeutic. Learning to feel safe and trust someone who resembles the individual(s) who created your issues is probably helpful.
Regardless of who you pick, you should feel confident in this person’s abilities, feel better, feel more hopeful, and look forward to working together. If you don’t feel this way within the first two sessions, find another therapist. I’ve heard stories of people staying in therapy with someone for months, or sometimes years, with someone with whom they don’t feel comfortable or who is not benefiting them. This is very frustrating indeed. If you are sitting there and have questions, comments, or concerns, share these with your therapist. It’s called talk therapy for a reason. If you’re not sure about the direction of therapy, ask them. Communication is the foundation on which a strong therapeutic relationship is built, so communicate openly and freely. The therapeutic relationship is unique and different from
any other relationship, so if you don’t feel helped quickly, don’t wait around for it to improve. If you’re at a private practice where there are other counselors, ask to see a different counselor, or if you must, find a new office altogether. Hopefully, you won’t have to do this too many times before you find someone who you believe you can work with.
I want therapy, but I don’t have insurance and can’t afford it. Many Americans don’t have insurance, but still want help. Most offices have a self-pay rate offered to people who don’t have insurance or who don’t want to use their insurance. Call different offices and find out what these rates are and determine if you can afford them. Most offices also have a sliding scale rate which considers your income and adjusts the self-pay rate accordingly. Again, you must call and ask. Also note that the average Master’s-level counselor charges less than the average psychologist., and there are excellent Master’s-level therapists out there. Some offices have students in training who are close to completing their graduate degree and can still provide excellent therapy.
If you find a therapist you really think will be perfect for you, but their rate for a session is steep, try seeing that person at a reduced frequency. Typically, with insurance companies, seeing a therapist once a week is standard, however if you’re paying out of pocket, attending treatment every other week, or even once a month, may be cost-effective.
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