Michelle Goodwin

I have been watching the recovery of the Floridian building collapse with great sadness.  It reminds me so much of  April 1995 in Oklahoma City. I was in Oklahoma City during the time of the bombing of the Alfred P. Murrah building.  A friend of mine was a police officer and a first responder to the tragedy.  He told me of other first responders who continued to have a hard time with what they witnessed and were later diagnosed with Post Traumatic Stress Disorder.

     One of the first understanding of PTSD came out of World War One when soldiers were diagnosed with “shellshock” after experiencing on going anxiety reactions to the trauma of war.  The trauma would come back to the soldiers in the form of a nightmare of flash back.  The anxiety reactions interfered with relationship and work and the day to day of life.

   Humans react to life threatening experiences (i.e. surviving war combat, or a sexual assault) with fight, flight or freeze.  Scientist have discovered that severe experiences of trauma and or long-term exposure to trauma can change brain chemistry and this in turn can contribute to port-traumatic stress. People who have survived a traumatic event which has been outside of their control and are experiencing emotional problems could be experiencing PTSD.   

    We all react to trauma differently and everyone processes the events of trauma differently. If emotional reactions continue beyond a month, then it is important to look at the symptoms and see if they point to PTSD. Does the trauma keep coming back in the form of nightmares or flashbacks or images?  Are you easily startled or have a hard time sleeping? Are you feeling numb or detached? Are you having a hard time falling asleep or easily angered? Are you having problems with relationships and or work; functioning in daily life? The individual symptoms do not stand alone as indicators of PTSD but may be a sign it is time to talk with a mental health professional about how the trauma is still affecting you.

   PTSD can be treated with therapy and medication.  EMDR (Eye Movement Desensitization and Reprocessing) is a kind of psychotherapy that has been successful in treating PTSD.  Utilizing “bilateral stimulation” EMDR helps a person process the trauma instead of being stuck in reliving it.

   Recovery from PTSD can happen.  When clients can talk about the trauma with out feeling very up set or numb and are able to feel safe and are able to function better in day-to-day life, then the client is on the road of recovery.

When I was working with college students at a busy University, we were sponsoring a program for young people on leadership skills.  During the program one young man seemed to get agitated and then started having a panic attack.  His girlfriend got him outside the program area to the lobby. I met them there and took them to my office.  While his girlfriend went to look for a paper bag, I had the young man breathe with me and to listen to my voice and do what I ask him to do.  Just as his girlfriend came back with the paper bag, he was breathing in a regular rhythm, and his body was becoming to calm.  He and his girlfriend stayed for a while and we processed what had happened. 

   From this insistence, I began to appreciate how deep breathing can really help calm stress. The breath is linked to both the sympathetic and parasympathetic nervous systems. The breath reflects when we are in high stress and when we are calm and relaxed.  Our deep breathing can affect our heart rate.  There is something called the vagal nerve that wraps around your internal organs that can affect heart rate and digestive functioning.  The deep breathing activates the vagal nerve which then lowers the heart rate which in turns calms the body. Deep breathing is just one specific way to calm your body when stressed.

    I find clients with high anxiety often report their minds are racing.  These clients often report that they try the deep breathing but then the think about if they are doing it right or trying to check and see if it is working and end up getting agitated about trying the deep breathing.  With these clients I ask them to think of a word or phrase for the inhale and for the exhale, i.e. I breathe in peace and I exhale stress.  I ask the client to think the phrase for each inhale and exhale as they are doing it.  I might also ask the client to count a 3 or 4 breath, i.e., Inhale to count for count of three, hold for a count of three and   exhales to a count of three.  I find some clients need to engage and slow down their mind for deep breathing to work.

    Utilizing grounding exercise with deep breathing has helped some clients feels calmer before a test or before work.  I ask the clients to be seated in a chair with a back. I ask the client to put their feet flat on the ground, to feel the chair with their bask and to place their hands palms down on their thighs.  Then I ask the client to take four deep breaths.  I ask them to pay attention to the intake and exhale of the breath. While breathing in say, “I breathe in safety and peace.” and when breathing out to say, “I breath out anxiety.”

  The self-calming techniques can really help when you feel stressed out.  As the song goes, “Breathe…just breathe.”

• Michelle Goodwin, LPC

It has been a year like no other.  It does not seem possible that it has been a year March that we heard from the school districts that we would be taking two weeks for Spring Break and then everyone would be back at school, but it did not happen quite that way.  It seemed every month we were told something different.  We had all-in-shelter and masks and social distancing and for many of us working from home.  Then in the state of Texas, we had “SNOVID” where there was no electricity and/or water in sub degree temperature.  Netflix seemed to flourish but many of us did not.    

   May is Mental Health Awareness month and as we hopefully turn a corner on COVID-19 maybe it is time to really look at the personal toll from these past months.  Many of us were isolated without touching or being with loved ones for an entire year.  Some of us have been feeling really anxious about socializing or being in public.  For some of us the family dynamic shifted in a negative way.   One of the ways to honor mental health awareness is to look at ourselves and see where we are.

5 reasons it might be a good idea to go talk to someone.

1. If you are going through life changes such as an isolating move, divorce or death of family member.  You may need someone who isn’t family to talk through these difficulties and share your grief.
2. If you can not sleep and you cannot quiet your mind.  Your thoughts are racing and there is a sense of unease and anxiety about most things.  You have tried several different things, and nothing seems to work.
3.     If you have had a hard time getting out of bed and feel just exhausted with little or no motivation to do anything.
4. If you find you and your significant other did not grow closer during this time but old issues became even more apparent and the gulf between the two of you has grown larger.
5. If you feel you are at the end of your capacity to handle things, even the small things seem big.

    If you are feeling any of these things then maybe it is time to seek counseling.  You do not need to be in mental distress or emotional pain.  Just as slowly many of us are going back to our doctors for check-ups and are addressing health issues we haven’t in a while maybe it is time to address emotional needs too. Maybe this is the month to be aware of your own mental health.

Written by: Michelle Goodwin, LPC – Therapist- San Marcos location

Continuing with the theme of A day at the Beach, this blog focusses on the activities that can be done outside. These activities are designed to keep kids active and everyone in the family can participate. There will be some preparation for activities to happen. Better to decide what activities you can do and then do the preparation for each activity before you tell the kids what you are doing. You may need time to figure out how to adapt to your space. For these activities it will be fun to dress for the beach.

In general:

What to wear: Bathing suits or shorts and loose-fitting tops; sunglasses and hats.

What to have handy: Sunscreen and Beach towels

Activity 1 – Outside Swim Activities (Teenagers can help set up space and participate. After smaller kids participate, have adults compete and or compete against teenagers)

A) Swim relays – You will have to figure out how to set up backyard.

1) Have children line up. Adult says, “On your mark, get set, go!” The kids race moving arms like they are swimming arms while walking really fast.

2) Have children line up. Adult says, “On your mark, get set, go!” The kids move arms like they are swimming arms while hopping.

3) Have children line up. Adult says, “On your mark, get set, go!” The kids move arms like they are swimming arms while running.

4) Have children line up backwards. Adults says, “On your mark, get set, go! The swimmer has to go backwards move arms like they are swimming arms (back stroke) while walking.

B) Surfs Up – Put two beach towels side by side on ground (Old towels you don’t care about)

One kid each (or an adult and kid) on a towel and the adult will say “Surfs up!” and kids pretend to surf and then the adult yells “Wipe out!” and the participants must fall down and have to swim (run) length of yard before getting back on surfboard towels. (repeat as many times as fun)

C) Pool Noodle Race – If you have pool noodles, you can do relays with one person holding the pool noodle or two people holding the same noodle and racing. If you can do the relays with two people holding the noodle, one at each end. Do one race skipping one race walking fast and one race running. If one person is racing against another one person then each must hold the noodle on one shoulder with one hand.

(Relays can be done with beach pails filled with water or inflated beach balls if you have enough.)

Activity 3 – Water activities -Inflatable pools, water guns, water balloons, water balloon volleyball, sprinklers. Kids love participating in all these things. Choose one to do. I know these are generally summer activities, but the weather has been warm, and it is time to play.

Activity 4 – Listen to the surf – Good calming activity when kids start to quiet down. Have each kid lie on a towel or chaise lounge. Have them breathe in slowly through the nose and breath out slowly through the opened mouth. Have kids do in unison (if possible) and tell them that is the sound the sea makes when the tide come in at the beach.*

Part of mental health is having balance in our lives. The nice thing about these activities is you can do just one activity or do one each day or do a Saturday morning of fun! The other thing that is great is once we are not quarantined from each other, you can invite friends and family to do some of these things again. It is important to take some time out of the seriousness of this virus and have some fun. Happy Beach Day!

*Ocean Breath taken from (Therapist Aid, 2015)

Written by: Michelle Goodwin, LPC – Therapist – San Marcos location

The days are getting warmer and we are still in lock down. Why not plan a day at the beach…COVID-19 style? There are inside and outside activities. The weather has been in the 80’s so it may be just the time for out-door water activities. There will be some preparation for activities to happen. Better to decide what activities you can do and then do the preparation for each activity before you tell the kids what you are doing. You may need time to figure out how to adapt to your space. Part one of the blog is to do the inside activity for day at the beach

Activity 1: Collect Seashells –

Collect seashells is a two-part activity: 1st part is coloring shell shells from printable coloring sheets or drawing them freehand and then 2nd part is a collecting shells.

Creating Seashells:

Materials needed printable coloring sheets of seashells from internet. (Free printable coloring sheets: (Pinterest – Coloring Home or Color Pages for Mom) ; 1 sheet with several shells printed on the paper (any where from 6-12 )for each child; crayons; construction paper; scissors and glue sticks.

If kids are young or not crafty, you can have them color and you cut out the shells on the paper and have them glue on construction paper (after coloring) or you can glue it.

Collecting Seashells: There are several ways to do this depending on age and number of kids; space and time.

A) You can collect shells by scotch taping paper shells to one section of a window. Parent provides the tape and each child gets to tape up one shell at a time until a section of the windowpane is covered. Have kids count how many shells they collected together. Have them stand around the window, take picture and post it.

Alternative: If you’d rather not have sticky stuff on window, you can take construction paper and staple together to make a good display sheet and do the activity, or if you have a poster board use that. Another way to display is to cut construction paper to fit on the side of a bookshelf. You can tape the panels on the bookshelf when done. This is especially good if you only have one child or two. Once again have kids count and gather round the shells, take pictures and post.

B) Scavenger hunt – If you have a lot of real seashells at home, one parent or adult could be hiding seashells in other rooms or outside while the coloring is going on in a different room. When they are done with the craft each child gets a plastic bowl (small Tupperware) and searches for seashells. At the end gather kids and take pictures.

At the end of the activity, treats for all. (ice cream, popsicles or whatever you can get in the store.)

Sunday morning, since church was canceled for gathered worship, I decided to go to the grocery store and pick up groceries for the week.  HEB had changed their hours so that they could restock their shelves for the demand of items.  Originally the grocery store is opened at 6:00 am but this Sunday the hours were revised from 6:00 am to being open from 8:00 am.

I arrived at the HEB parking lot at 7:30 am and a line had already formed. I got my basket and stood in line outside the store as a light rain began to fall.  There were in fact 80 people in front of me ( I only know the exact number because they counted us off as we went in the store). By time the line began to move at 8:00 am the HEB staff had informed us they were only letting in 40 customers in at a time and that there were restrictions on water, and toilet paper and they were out of eggs and milk.  By the time my set of forty reached the front entrance, the line of people reached all the way down the end of the row of shops the length of at least 2 city blocks.  The entire experience from the time I arrived at the grocery store until I got in my car took 2 hours.  I was able to get what I needed, and I was grateful.

This grocery shopping experience capped a week in which universities across Texas had decided to extend Spring Break by another week and do tele-learning for a month or in some cases until the end of the semester; nursing homes in our area were put on lock down and two friends couldn’t see love ones face to face and our office among many was trying to determine how to serve clients in safety.  How do you stay calm during such times when so much is unknown, and the news is swift often misleading, and the consequences can be dire?

In times of extreme circumstances, it is difficult not to feel the stress and worry of everything. I think it can be helpful to acknowledge what we can do in these circumstances and face what we cannot and take comfort from those who faced hard times before us.  When I work with anxiety clients, I say let’s look at the situation in small pieces and deal with each individually. I think that may be helpful now.

What we can do:

• Prepare not panic – Some of this comes down to the questions we ask ourselves. What does my family need in the next week or few weeks?  Have my circumstances changed? Will I be working from home and are my kids home? Even in line at the grocery store line this morning a discussion ensued whether it was the media’s or government’s fault for all of this. The truth is in the here and now of our lives what matters is how we react to the situation.  Not that we don’t need to hold government and media accountable, but we must look at is what we can control.  We can control our reactions and actions in the next few days.
• Try to keep family rituals and schedules the same. This helps kids keep a sense of normalcy in the days and weeks ahead.

• During the call for social distancing keep making connections. Big social, entertainment and sporting activities have been canceled and people have been encouraged to stay at home which seem to be essential for the common good.  That means each of us has to work hard not to feel so isolated in the midst of all of this.  Looking online and seeing the people in Italy sing from their balconies to fill the neighborhoods with song is a reminder that we can each find a way to reach out to each other.  It would be good to reach out to relatives and loved ones and see how they are faring through all of this.  Make an extra effort for the elderly and those who are pregnant or hurting in your neighborhood or apartment complex and remember those who live alone.  Call and text more often.  With small children if events have been canceled share their solo or song with family through skype and zoom.  Send cards or jokes or stories via mail and e-mail.  When you start to feel alone, reach out and remind yourself you are not alone.  The entire world is facing this together.  All of us together.

• Remember the medical community. The front-line responders on this are our neighbors and family members who are doing their best in extraordinary times to help everyone else. When you are picking up subscriptions at your drug store why not drop off a thank you note.  Send thoughts prayers and good wishes to the pharmacist and nurses and doctors and emergency personnel who are working the front line for our safety and good health.

• Remember yourself. Do self- care. These are times that none of us have ever faced before.  It is important to share feelings with trusted friend and family and trusted professionals.  Remember deep breathing and meditating and prayer and taking time to do what you need to do to stay centered and calm. Get good sleep.  Eat nutritionally and exercise. Some people not watching the news for a cycle is helpful. Keeping yourself calm and centered is the best way to prepare for the uncertainties that are present and before us.

  Face what we cannot do:

• We cannot tell the future. It is important as we heed medical professional’s directives and take cautionary steps for our own health and that of our families that we do not catastrophize. Catastrophizing is a term that describes seeing the worst-case scenario in each situation.  It leads to sleepless nights and panic and doesn’t solve or make present situations any better.  What can you do?  When doing grounding exercises with PTSD or high anxiety clients it is important to engage the mind, center the body and sooth the sympathetic nervous system.  We ask anxiety clients to take deep breaths but to count the breaths as they go. That way their mind can’t race while doing deep breathing. For PTSD client we ask them to name the colors in the room and to feel the back of the chair so that they can orient themselves to here and now.  We ask client to tense different muscle blocks in their body and release them.  All of these exercises are to help orient to the here and now and deal with what is right in front of the client; to calm the breathing which will lower the vitals of a client and engage the mind so that thoughts don’t escalate emotions.
• Live continually in despair, fear and panic. Things are happening very fast and we are facing an uncertain future. A lot of the solutions may be out of our control.  That is why I started with what we can do and how we can each of us in small ways can move forward. You may feel really really down and hopeless and that is understandable.  If despair descends on you, treat it as a visitation, and not a place to live. Seek help find others to join you and don’t stop until you get the help you need.

Take comfort with those who have faced hard times before us.  The title of this blog is “Keep Calm and Carry On,” which is taken from a slogan that the British adopted during World War II.  Great Britain was among the last countries standing against the invading armies of Germany.  By many accounts they were doomed to fail.  It took military and historical alliances of course to make a difference but the people also in their own way contributed.  As a people, they made it through to the other side and so will we.

Keep calm and carry on.

 

By Michelle Goodwin, LPC, Therapist, San Marcos location