You Can Seek Help at Any Time: Rate Your Distress Scale

Use this distress scale to help you stay more aware of how you are doing. The scale is 0 to 10, where 0 is that you feel at peace and are completely calm, and 10 is distress that is so unbearable that you cannot function. Refer to the scale, as-needed. If you find yourself rated at 4, where negative thoughts begin to impact you, consider talking to a mental health professional because it is better to get help sooner than later. Don’t allow yourself to be in a distressful state for too long. When you feel change is needed, take action and contact someone.

Seek help from a mental health professional at any time, you do not need to be in distress to get help. A professional counselor can provide services for things such as managing stress and anxiety, examining thoughts and behaviors, support you in life transitions, and teach you how to strengthen your mind.

0: Peace and complete calm

1: No real distress, but a slight feeling of unpleasantness

2: A little bit sad or “off”

3: Worried or upset

4: Upset to the point that negative thoughts begin to impact you

5: Upset and uncomfortable

6: Discomfort to the point that you feel a change is needed

7: Discomfort dominates your thoughts and you struggle not to show it

8: Panic takes hold

9: Feeling desperate, helpless, and unable to handle it

10: Unbearably upset to the point that you cannot function and may be on the verge of a breakdown

Download this rate your distress scale below.

Red Rock Canyon, NV

Get In-Tune with Satiety & Hunger Cues: hunger scale tool and questions to consider

The hunger scale chart is one way to become more in-tune with your gut feelings and also, to have a better idea on whether or not you’re hungry and how much food to eat. Taking notes of how you feel will eventually lead to increasing your awareness and improving intuitive eating habits. The scale is 1-10. One, being that you’re feeling starving, weak, or dizzy and ten, is that you feel sick because you are so full.

When to Use

  • While deciding whether you should eat or not. Are you reaching for food because you’re hungry or because you’re feeling a particular emotion?
  • After eating a snack or a meal. Check-in with yourself to see where you are. Did you eat enough or did you eat too much?
  • Use this tool about twice per week, on a consistent basis, for about three to five months. This amount of time presents the opportunity to increase awareness and to settle into healthier habits.

How to Use

  • Pair this scale with practicing eating mindfully or intuitively.
  • Be non-judgmental of what number you are on the scale.
  • Feeling five or six after eating is appropriate. Seven is alright, every now and then, like during a holiday meal. The top goal is to feel comfortable.
  • Jot down in a journal or notebook your hunger scale number and a few other details, like what you ate, thoughts, and feelings.
  • Practice consistently, becoming more in-tune can take time. Practice being non-judgmental and patient with how long it might take you. It might take multiple changes and attempts, that’s alright.
  • Put the scale where you will see it and remember to use it. In a journal where you track habits, on the fridge, or on the dining room table. If you want to leave it on the dining room table, some people place it in a folder or a clear page sleeve.
  • Share what you’re working on with your dietician or mental health counselor.

Questions to Consider

An important point to mention is to notice thoughts and feelings while eating. A lot of times, we eat and are distracted by our phones, the television, or a conversation. Is this you? Are you feeling depressed or anxious while eating? Are you being judgmental or the food or yourself while you eat?

Another thing to notice is whether you are disassociated or non-present. Are you enjoying the food? Why or why not? Are you being mindful of the meal? Did you fly through the meal, eating fast? Did you eat at an abnormally slow pace? How big were your bites?

Be well.

Download the Hunger Scale below.

Mindful Breathing Exercise

When you feel stressed or anxious, have you been mindful of your breathing? Notice if you’re holding your breath, taking shallow breaths, or breathing too quickly.

Take control of your breathing by trying a short breathing exercise:

Lay, sit, or stand comfortably, with good posture to allow yourself to breathe easily.

If you’re laying or sitting, maybe you want to close your eyes to increase focus.

You may place your hands gently on your stomach to physically feel it move in and out as you breathe.

Take note of physical sensations and then focus on your breathe.

If you find yourself becoming distracted by anything, acknowledge the distraction (distractions occur naturally and are reminders to return to what we were working on), allow it to roll through your awareness, and then simply return your attention to your breathing.

Breathe in for 3 seconds: 1-2-3

Brief pause

Breathe out for 3 seconds: 1-2-3

Repeat 3 times

Notice any differences in how you physically or mentally feel.

Calmly return your focus to the environment around you.

You may want to play around with the time spent in the exercise, do what works for you.

*Tip for severe anxiety and panic: if you find yourself holding your breath for longer than the brief pause during this exercise, skip the pause all together and just focus on steady in-and-out breathes.*

Download this exercise below.

Somewhere in Pennsylvania

Being Productive & Calm, as a Busy Woman

To all of the busy women, here are some strategies that can help you be productive and calm.

Does this sound familiar to you? Personally, as a busy person (have a young daughter, maintaining relationships, keeping the house tidy, running my own mental health private practice, blogging (for two websites), and preparing for ultramarathons), I struggle with being calm while I go about my day.

Here’s how it usually goes.

I’m usually productive in some way because there is always something that needs done. I tend to feel like things need to be done in an overly particular way. Tasks get done, it’s just not always how well (quality) or in the order that I’d like it to be, so I need to be flexible.

When there’s anxiety present.

Anxiety couples this feeling that something needs to be a certain way or lack of having an amount of control. Anxiety is also provoked when I feel overwhelmed by the amount of things that I need to do. It’s difficult being calm. I want things to be completed in a timely manner and done right. Sometimes, I aim for perfection, but I know that that’s unrealistic. I put a lot of pressure on myself.

How do I remain calm while I’m in a state of being busy and usually anxious?

• I practice time management
• Prioritize tasks
• Ask others for help
• Tell someone “no” when they ask if I can do something when I truly don’t have the time
• Mindfulness
• Slow myself down, so I can think clearly
• Stay grounded
• Self-care. Sometimes taking a full day for it!
• Exercise or run
• I focus on my strengths and goals (and the reasons behind them)
• I think positive (in general)
• I reframe my distorted thinking
• I write down affirmations

There are probably some other tricks that I use that aren’t coming to mind. Whatever I do, I choose to act in a more helpful and healthy manner. I choose to react in a way that is more calm.

How do I know which strategy will help?

I don’t 100% of the time know which strategy will help, but I do know that I can try two or three and see if they work. Overtime, it is easier to know which strategies will work and for what. If a strategy doesn’t help, no big deal, pick another. There are instances where anxiety is stronger and it takes a handful of strategies to help. Also, no big deal.

The strategies from this list are additional “to do’s”, but they makes life better and adds peace. This work becomes more effortless the more that I practice it. You can do this, too.

How do you practice being productive, yet calm?

Overlooking a small town in PA

Calming Through Your Senses By Using Self-Soothe Skills

Self-soothe skills

Self-Soothe is about calming through the senses, and the goal is to engage your senses in behaviors that are relaxing.

As you practice self-soothe, allow judgements, stress, worries, and unhelpful thoughts to slide through your mind, and just be in the moment. This process will rejuvenate you and help regulate your body.

Commit to adding self-soothing strategies into your daily schedule.

Self-soothe skills (vision, hearing, smell, taste, touch)

Vision

What kind of things do you enjoy seeing? Seek out these visually pleasing things. Gaze at sunsets, nature, cityscape, aquarium, whatever is visually relaxing to you. You can also create your own artwork or take photos.

Take a few minutes to fully appreciate something, it can be as simple as leaves on a tree. Connect with it and take it in.

Hearing

Listen to soft music or go outside and soak up the sounds of nature.

Hear with your eyes closed and allow yourself to become immersed in the experience.

Smell

Choose household cleaners, perfumes, lotions, aromatherapy, essential oils, and candles that have pleasant smells.

Baking your favorite dish or dessert will fill your home with that smell.

Taste

A tip for taste is to eat a small amount of food one-mindfully, engaging all five senses.

Savor a piece of dark chocolate, a bite of a juicy apple, a spoonful of ice cream melting in your mouth, or the tanginess of a salsa.

Timing yourself to see how long you can draw out the experience is helpful for becoming immersed.

Touch

Ask a loved one for a hug or to hold hands. Snuggle with your cat or dog. Give yourself a facial, neck, or hand massage. Wear your most comfortable clothes and fuzzy, thick socks or wrap up in a warm blanket. Take a mindful bubble bath or a longer shower.

Resource

Lane Pederson, Psy.D., LP, DBTC

Connoquenessing Valley Heritage Trail, PA

How to Get Through the Day When the World Seems to be Falling Apart

These 12 tips are specific to living through a pandemic (COVID-19) where there are multiple tragic events and crisis occurring at once on a worldwide scale.

A brief overview of the destruction that COVID-19 has caused

• People are ill and dying from a virus.

• People are socially isolated from family and friends.

• People are restricted in where they can go and what they can do.

• People have lost jobs and are financially unstable.

– Connected to all of this is the person’s identity because people identify themselves through going out and participating.

• Political issues, finger pointing and name calling are a big part of this pandemic.

• People wear face masks to reduce spread of the virus, but the mask also hides smiles.

• Anxiety, depression and suicide is on the rise.

• People are silently hurting.

The benefits of these tips are (but not limited to)

• Increased happiness

• Connection to others

• Raising awareness

• Fostering positivity

• Finding value and meaning in life

• Learning coping strategies

• Finding help

Keep in mind that this article isn’t telling you to ignore, dismiss, or minimize what’s going on around us. It is important to sit with the difficult emotions and thoughts, to process, and personally grow from what’s occurring in our lives. We can’t run, there needs to be a resolution to do something about it, but there needs to be a balance and healthy approach.

Let’s cover the tips on getting through

1) Limit your time on social media and watching the news. Be informed and have proper understanding about what’s going on around the world, but don’t allow the information to overwhelm and carry you away. The information on social media and the news shouldn’t occupy a good portion of your day.

2) Mute or unfollow people on social platforms such as Facebook, Twitter and Instagram if they are posting unhelpful information on the pandemic or are posting frequently on the pandemic. Always check the resource of what they post to make sure it is true and accurate. There is a lot of information being shared that is inaccurate or highly one-sided. Be your own researcher, fact-checker, and it is beneficial to try to see from both sides of an issue. Widening perspective allows us to have a more open mind and gives us a little more breathing room.

3) Use social media and technology to your advantage. Since we have to limit being around others or can’t be around people at all, use social media to connect and to lift up others. Post something kind or funny. Post a beautiful picture. Have an engaging conversation, but leave out the pandemic and political issues surrounding it. You can lift someone’s spirit and your own!

We use video platforms on almost a daily basis now, continue to use it to connect. Talk to a good friend who you haven’t seen in a while. Use video platforms to check-in with a person’s mental health, you don’t know who is suffering in silence.

Are you feeling unsure about how to check-in? This link will lead you to check-in questions:

https://finishstrongercounseling.com/2020/05/29/just-checking-in/

Do you have a favorite hobby or interest? Join and follow social media groups and pages to motivate and fuel your interests.

4) Virtual tours, adventures and visits. If you are looking for something new and interesting to do without leaving your house, take a virtual trip to a National Park, zoo, museum, etc. Think of somewhere that you’ve never been and would like to go. Read about it, look at pictures, watch videos, and take a virtual tour. This is fun activity to do with kids and it’s educational.

If you’re religious or spiritual, consider attending a virtual service or practice.

5) Teach someone about your hobby or trade. Write, blog, create social media content, and make a video to do so. Engage with people, answer their questions, and provide them with credible resources so they can learn more.

5) Increase your self-care. Do more of what you enjoy and try new things, even if you don’t feel like it. Take care of your body and mind. Try to keep to a normal schedule, this includes proper exercise, diet, and staying hydrated. If you’re overwhelmed with work, schedule in self-care. Slow down, read a book, take a bath, watch a movie, call someone you care about.

6) Make a vision board to stay focused on your long-term goals. Read how here:

https://finishstrongercounseling.com/2020/04/02/vision-board/

7) Journal. Read about journaling here if it interests you:

https://finishstrongercounseling.com/2020/04/10/the-benefits-of-keeping-a-journal-and-journal-prompts/

8) Practice mindfulness, breathing and or meditation. Find someone who provides these services online if you need help getting started. Create a YouTube playlist of relaxing music and sounds that you can practice to. Don’t give up if these exercises don’t immediately benefit you in an impactful way, it takes time to learn them. It’s a process.

9) Use online presence to raise awareness or funds for a cause that you’re passionate about. Help people learn more, support people who need it the most, connect to others who care about the same thing as you. Feel good!

10) Use positive affirmations and practice them regularly. Read more and find examples here:

https://finishstrongercounseling.com/2020/05/05/positive-affirmations-to-get-through-a-crisis-or-difficult-time/

11) Have a safety plan and an emergency plan. For the safety plan:

• Write down what triggers maladaptive behaviors.

• Write coping strategies for each trigger that you can participate in right away.

• Write down three positive affirmations or favorite quotes.

• List three people whom you can trust to call and talk to and receive support from (Do ahead of time: make sure that they know they are on your safety plan list and tell them how they can best support you if you contact them.) (Ideas on how they can help: this can range from a phone call to recall favorite memories or to meet up for coffee.).

• If your situation turns into an emergency, call 911 or the National Suicide Prevention Lifeline 1-800-273-8255 or your local mental health crisis lifeline. Add these emergency phone numbers to your safety plan.

Here’s a simple example of a safety plan:

https://finishstrongercounseling.com/2020/02/11/safety-plan-on-an-index-card/

12) Speak with a professional counselor. They can teach you several coping strategies and powerful tools like cognitive reframing. They are someone who will be present with you, be non-judgmental, listen, and provide feedback. They will support you and give you space for you to process your strongest emotions and thoughts.

Check out these other benefits to seeing a counselor:

https://finishstrongercounseling.com/2020/07/27/the-value-of-seeing-a-therapist-what-does-your-therapist-do-when-theyre-not-in-session/

Give teletherapy a try, it is convenient and you receive the same mental health benefits as you would during an in-office session.

If you’re not sure where to find a counselor, use a directory like Psychology Today or TherapyDen. There are several other counselor directories out there.

These are only a dozen tips on getting through a pandemic and crisis. Share your ideas and tips below. Please share this article to reach others.

Be well!

Baker Trail, Cook Forest State Park, PA

IMPROVE Skill (Distress Tolerance from DBT)

IMPROVE

IMPROVE the Moment is the next skill. The acronym IMPROVE makes life a little bit better when it is not going so well.

During a crisis, you have two options. You can sink into the distress or invest in behaviors that might improve how you feel in the moment.

The acronym

I: Imagery
M: Meaning
P: Prayer
R: Relaxation
O: One thing (or moment) at a time
V: Vacation
E: Encouragement

Imagery

Imagery is powerful because your mind can convince your body that you are elsewhere. A good example is being at the beach. When you’re actually sitting on the beach, your muscles are relaxed. When you imagine yourself at the beach (and you’re elsewhere), you can still get your muscles to relax, you convince your body that you are sitting there.

Ideas for imagery

Use an app or purchase a recorded guided imagery. You can also just use your own mind and create a guided imagery.

• Forest path
• Walk on the beach
• Favorite place
• Safe place
• Sunflower field
• Stroll by a stream
• Waterfall
• Garden of butterflies
• Sunset
• Star gazing
• Mountain summit hike
• Sitting by a campfire

Practice and enjoy the benefits! Also, imagine yourself doing well and practicing your skills.

Meaning

Viktor Frankl (1905-1997), one of the founders of existential therapy, once said “If there is a why, then a person can figure out the how.” [Look him up, his life was remarkable. He wrote the book “A Man’s Search for Meaning,” which is about being a psychologist in a concentration camp. He is well-known for this book, but he has several other accomplishments.]

List and contemplate your “whys” for working on any problem.

Examples: Why stay safe?; why practice your skills?; why improve your self-care?

Having meaning motivates you; your whys will motivate you to act.

Prayer

Prayer is a calming ritual, it also provides connection, guidance, and peace.

Pray where you are at, or go to your place of connectedness or worship. This skill is useful anywhere and at anytime. Connect to your spirituality.

Relaxation

Everyone needs relaxation. What do you do to relax? What do you think could be relaxing that you would like to try?

Schedule in some of those relaxing behaviors every day. Keep in mind that relaxing also takes practice.

Tips for practice: Be mindful of your breathing; be mindful of tense muscles and release the tension; sit in a quiet place.

One thing (or moment) at a time

Take on only one thing in the moment. When we try to juggle or do too many things at once, we become overwhelmed and or shut down completely.

Example: You don’t know how to make it through your day, but you know that you can make it through the next hour, or through the next 5 minutes. Focus on what is manageable.

Vacation

Take a break from your stressors or crisis. These breaks need to be planned, like scheduling a walk in the park in the evening, or watching your favorite movie before bedtime. Taking quiet time to reflect, meditate, or do deep breathing exercises are also good ideas.

Allow yourself to take a break when you feel that you need it.

Encouragement

You need encouragement during those tough times. The things that you say to yourself matter, they influence how you feel.

During your self-talk, say affirmations, coach, and cheer for yourself.

Write down 10 affirmations you can repeat to yourself throughout difficult times.

• This crisis will pass.
• I can do this!
• I have everything that I need to get through this.

Download affirmations to help get through a crisis here

https://finishstrongercounseling.com/2020/05/05/positive-affirmations-to-get-through-a-crisis-or-difficult-time/

Connoquenessing Valley Heritage Trail, PA

Distress Tolerance (DBT)

Distress Tolerance (Dialectical Behavior Therapy)

When people “cope” with stress and crisis, they find out ways (behaviors) that relieve stress, however, some of these ways come with heavy consequences. Examples of ineffective behaviors are drug and alcohol use, self-injury, gambling, spending money, and overeating.

We can learn distress tolerance skills to effectively manage the stress and crisis. These skills are more helpful than dealing with the consequences of the ineffective behaviors that make life worse.

Try it out

Make two lists, one is your ineffective coping behaviors, and the second is your healthy coping behaviors. If you’re struggling coming up with the healthy ones, keep thinking, because everyone has at least a few.

The goal is to work on eliminating the ineffective coping behaviors on the first list while developing the behaviors on the second.

This process is “doing more of what works”, replacing the ineffective with the healthy and effective.

Guidelines to improve distress tolerance skills

1. Practice the skills daily, even when you’re not feeling distressed. The skills tend to be enjoyable, so practicing shouldn’t feel like work.

2. Diversify the skills, try new ones, and practice every skill more than once because you don’t know which ones will “click” for you.

3. Organize a distress tolerance plan for when you’re in crisis and choose to follow the plan. It will keep you focused. Write down your organized plan on an index card. This would be your coping behaviors and any people who can provide support. Keep this card with you.

This index card plan works well for children while they’re away from home. Example: at school.

Distress tolerance skills to learn

• Wise Mind: ACCEPTS acronym
• IMPROVE acronym
• Self-Soothe skills: vision, hearing, smell, taste, and touch.
• Radical Acceptance
• Everyday Acceptance
• Willingness
• Bridge-Burning
• Ride the Wave: Urge-Surfing
• Grounding
• Pros and Cons

This is general information on distress tolerance and the skills to learn to better cope with stress and crisis, the next step is to learn the skills themselves, practice applying them, watch for improvements, and make necessary adjustments.

Wise Mind: ACCEPTS

https://finishstrongercounseling.com/2020/08/12/wise-mind-accepts-skill-distress-tolerance-from-dbt/

Resource

Lane Pederson, PsyD, LP, DBTC

Connequenessing Valley Heritage Trail, PA

MINDFULNESS 5, 4, 3, 2, 1 GROUNDING TECHNIQUE

This is a popular grounding technique, and it is for everyone.

This technique engages all 5 senses, which reminds you of the present moment, and builds awareness. This is a calming technique that can help you get through tough or stressful situations. Taking a deep belly breath at the beginning and end of this activity can feel calming and will help prepare you for the next thing that occurs. As you do this activity, saying the things that you sense out loud will reinforce your present state of being and awareness because you are hearing in your own voice what your brain is telling you and what your body is actually experiencing.

Take a deep belly breath to begin.

5 – LOOK: Look around for 5 things that you can see and say them out loud.

Example: “I see a dog, a chair, a lamp, a window, and a cup.”

4 – FEEL: Pay attention to your body and think of 4 things that you can feel. Say them out loud.

Example: “I feel the dog, the cushion that I’m sitting on, the sun coming in through the window on my skin, and the carpet beneath my feet.”

3 – LISTEN: Listen for 3 sounds and say them out loud.

Example: “I hear the dog snoring, the air conditioner running, and the birds outside singing.”

2 – SMELL: Say 2 things that you can smell. If you can’t smell anything from where you are, you may move to go smell something or say your favorite scent.

Example: “I smell the candle burning and the fabric softener on the chair throw.”

1 – TASTE: Say 1 thing that you can taste. If you can’t taste anything, then you can say your favorite thing to taste.

Example: “I taste the toothpaste mint from when I brushed my teeth.”

Take another deep belly breath to end and notice how you feel.

Download this technique below to store on your device or to print it out and share!

Great Falls Park, McLean, Virginia

Mindfulness (DBT)

What is mindfulness?

Mindfulness is choosing to be aware of the present moment, on purpose, and in a non-judgmental way. When being mindful, our attention and focus is on whatever we choose to observe or do.In this moment, choose to focus your mind wherever you’d like it to be.

Practice

Maybe you focus on your emotions, thoughts and physical sensations as you experience the environment around you.

Hold your attention there, focusing on being in the moment.

States of mind

We have three states of mind:

• Emotion Mind
• Reason Mind
• Wise Mind

Wise Mind

Wise Mind is the balance between emotion and reason. We acknowledge and validate our feelings and use reason to problem-solve, think about consequences, and choose effective behaviors.

In Wise Mind, we act in ways that reflect our goals, values, and who we want to be.

Ask yourself, in any moment, “What is my Wise Mind telling me?” Then act.

Getting into Wise Mind, Step One

• Observe and describe what and how you behave, think, feel, and your surroundings in a non-judgmental way. Stay focused one-mindfully.

To observe means just noticing how things are, without adding or taking away.

To describe means to put words to your observations.

Step Two

• What you do is participate and how you do that is effectively.

• Take what you observed (step one) and choose what you want to participate in. Participate in it fully, immerse yourself in the experience.

• How to choose what to participate in: base it off of what will work or be effective.

Once you are participating effectively, you’re in Wise Mind. Notice what this feels like.

Let Go of Judgments

We all have judgments. Whenever you notice yourself judging, let the judgment pass through and drift off, don’t allow it to stick around. Judgments should come and go like clouds and ocean waves.

Practicing Mindfulness in the Moment

Be present in the “small moments.”

Example

Take 10 minutes and clean part of your home, fully immersing yourself in the process.

When you find yourself distracted, this could be a judgmental thought, refocus on what you’re doing. Full focus and attention, non-judgmentally.

Meditation

A thought on meditation. Meditation can be considered anything if you are present, being non-judgmental, and have an open heart.

Practice

Meditate on your life experiences, starting with the moment you are currently in. Stay present for some time, connecting to the moment, then, when you’re ready, shift your focus to another moment.

Teflon Mind

Let potentially stressful situations, criticisms, or anything else that might “stick” to you, causing needless suffering, roll off your mind. Allow these experiences to slide through your awareness.

Distractions, distractions, distractions

Distractions don’t go away, they are a part of this world. Do not get frustrated with distractions, they are reminders to go back to what you’re working on. They’re natural.

When you become distracted, bring yourself back to the present moment. Do this over, and over, and over again, if you need to.

Taking hold of your mind


Direct your mind where you want it. There are many thoughts, emotions, and physical sensations to direct your attention towards. Choose one of those, opening up your mind to it and closing your attention off from the other options.

If your mind drifts towards a closed off option, gently re-close it and return to the option of choice.

Resources

Lane Pederson, Psy.D., LP, DBTC

Anza-Borrego Desert State Park, CA