By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth Box Breathing for Stress
Stress is something we all experience to varying degrees, at various points in our day-to-day lives. When stress becomes unmanageable or our ‘fight or flight’ stress response is triggered, breathing techniques can help calm us, and help us make more rational and conscious decisions. Box breathing can work in high-stress situations by returning breathing to its normal rhythm. So, let’s learn how to use Box breathing for stress. Why practice breathing exercises? Practicing simple breathing exercises daily can help to not only manage your overall mood, stress levels and improve your focus – but this practice can help to prepare your body for higher stress situations so that you can preventatively cope in a more effective way. An added bonus is that breathing exercises are easy, can be done almost anywhere and don’t have to take more than five minutes. What is box breathing? Box breathing gets its name because there are four parts – like the 4 sides of a box. One full cycle through the 4 parts takes less than thirty seconds, but it’s recommended to practice for a minimum of three to five minutes. Why does box breathing work? And why is it important? Stress triggers our fight-or-flight response, and when this response is triggered, we tend to shallow breathe. But why is shallow breathing a problem? Shallow breathing can lead to a whole host of physiological symptoms – including, for example, changes in body temperature; lightheadedness or dizziness; or, feelings of derealization or depersonalization (where distance/perception can be altered). These symptoms can mimic anxiety – and so shallow breathing can inadvertently make subjective feelings of anxiety or stress worse. Box Breathing Technique – Here are the steps:
Then, repeat! You may at first find the practice challenging: don’t give up! Instead, reduce the count to three seconds and continue to practice. Once you’ve become more experienced with this practice you may be able to increase the count to six seconds or more, but start small. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth Why Practice Mindfulness – “I’m not good at it but I practice it anyway” Have you heard about mindfulness but are skeptical? Maybe you imagine mindfulness as meditation. You know the image we conjure, a person sitting cross-legged on the floor saying ‘ohm’, completely still and not thinking about anything. That’s not what mindfulness is! So, let’s talk about mindfulness, why I feel like I’m not very good at it but why I practice it anyway. What is mindfulness? Mindfulness is the practice of being present in the moment in order to prevent us from ruminating about the past or worrying about the future. It’s not an attempt to completely remove our thoughts but be aware of the things happening in the current moment. Think- being with ourselves and actually feeling our feelings. Why mindfulness is hard? One of the reasons I think mindfulness is hard is because we generally have an unrealistic expectation of what mindfulness is. Also, most people (myself included) don’t want to be bad at things and mindfulness is a skill you need to practice. I was first encouraged to engage in mindfulness practice when I started dialectic behavioural therapy (DBT). I’d heard of it before (at the time I was a psychology student in university) but I was skeptical about it being effective. The first exercise I was encouraged to do was a breathing exercise (which is very common with mindfulness practices, and I will talk a little bit more about later). The first handful of times I tried it, in many different variations, it was unsuccessful. Why? Because I was so fixated on being good at it that I missed the entire point of the practice. Rather than simply paying attention to my breath I was worried I was failing at it because I couldn’t breathe in or out for the total count they suggested. So, instead of being present I was focused on thoughts like ‘why am I so bad at this?’ and it actually made me feel more anxious. The first time I tried mindfulness was 2015, I believe, which is five years ago. I still practice mindfulness now and to be honest I don’t feel like I’m that much better at it. Why Practice Mindfulness Anxiety. I am an anxious person. I continually worry about things that’ve happened in the past, ruminating about small embarrassing moments and taking things people say out of context that convinces me they obviously hate me (they don’t!). On top of that, I spend an equal amount of time worrying about the things that could happen in the future. For me, something like simply test anxiety can turn into spirally thoughts. For example, that I’ll never graduate, or get a decent job, so I might as well quit now as my life is practically already over. Even though past evidence suggests this is untrue and will continue to be untrue. At the beginning of my time in therapy, I didn’t realize how much this prevented me from truly engaging with the present. Mindfulness works for anxiety. Despite all the research that says mindfulness works, I swore it didn’t for a very long time. Unfortunately, it just took a lot of practice and finding a way to engage with mindfulness in a way that made sense for me. (Not every way of practicing mindfulness is going to work for everyone). When we’re anxious, regardless of what we are anxious about, we get into our fight-flight-or-freeze response (our stress response). Mindfulness helps to break us out of that. One of the things we likely notice first when we start to feel anxious is our increased heart rate, engaging in a mindful practice helps to control our breathing which reduces our heart rate. What Mindfulness Practices Work for Me THE BASIC My go-to mindfulness practice is very basic. I use it when I notice myself getting fixated on particular thoughts or my thoughts are in an escalating feedback loop. I make sure to put away all distractions like my phone and my laptop. Sit in a comfortable position and close my eyes (I get too distracted by things in my environment but closing your eyes is not essential). Then pay attention to my breathing. I do not try to change my breathing, I just pay attention to it. While doing, it’s important to notice when thoughts enter your mind but let them go without judgement. For me, it’s helpful to say (or think) something like ‘this is just a thought I’m having’. When my fight or flight is engaged, and I am feeling less in control of my anxiety, I generally require a more focused mindfulness practice such as focused breathing or body scan. This gives my brain a little bit more to focus on which can sometimes help. FOCUSED BREATHING A focused breathing exercise requires a person to pay more attention to their breath as well as controlling it. One of the ways to do this is four stage breathing. The goal is to make each full breath last at least 10 seconds – 5 seconds on the inhale, and 5 seconds on the exhale. You do so by breaking each inhale and exhale into two parts: On the first inhale, fill up most of your lungs; on the second inhale, think about ‘topping up’ your lungs with air. On the first exhale, push out most of the air, and on the second exhale, think about fully emptying your lungs. This works better for me than some breathing techniques because there is less focus on counting which always throws me off and makes me feel like I’m failing. BODY SCAN I start in the same position as my basic mindfulness practice but ideally sitting on a comfortable chair with my feet on the floor. Then, while taking slow controlling breaths, I start at my feet and pay attention to all the sensations in each part of my body and then consciously think. For example, I think about how my feet feel inside my socks, how they feel pressed up against the floor and I may even wiggle them. Then move up my legs to my calves then my thighs, etc. Final Thoughts These are by no means the only ways to practice mindfulness, but they’re a decent place to start. Just remember that mindfulness works, but it takes practice. Don’t get discouraged; find something that works for you and try practicing it every day, not just when you’re feeling anxious. By Vanessa Rouzier, RCC We know the way we eat not only influences the way we feel physically, but also mentally. More specifically, our diet affects the production and transmission of serotonin and dopamine in our brain. These are commonly known as “happiness neurotransmitters” which have a significant impact on our mood. Our eating habits also influence cortisol levels in our brain, which is the stress hormone.
There is so much information out there about diet that it can be challenging to know where to start when it comes to eating healthy. If you made eating habits one of your new year’s resolutions, here are some strategies to help you begin. How to Make Changes Related to Diet 1 - Define your goal Target one specific behaviour you would like to change at a time. A smaller and more realistic goal is often better as it will be easier to reach. This will leave you with a sense of achievement and more motivation to continue. Your goal should also be in line with your vision of the future. Try to find the reason why you want to make that change. Is it to have more energy? To be healthier? More attractive? More productive? When you feel like giving in to a craving, connecting with that deeper motivation will help you stay strong and make healthier choices. 2 - Limit your sugar intake Sugar overconsumption has not only been shown to be one of the main contributors to weight gain, but it also has an impact on brain functioning. Research has linked sugar overconsumption to cognitive impairment, anxiety and depression. Academics have also shown that sugar is “tricking your brain” as it is increasing the impulsivity to feed. This means the more sugar you eat, the more you want to eat overall! 3 - Find strategies to manage your stress Emotional eating is very common. After eating high-fat or high-sugar food, the brain releases hormones that reduce the feelings of stress, which makes you want to have more. The “reward pathway” involved in your brain is similar to the one involved in addiction to drugs or alcohol. Find alternative ways to manage your stress. This will allow you to obtain a similar calming result, without the extra calories! Breathing exercises, mindfulness, meditation, yoga, aromatherapy, engaging with your favorite hobbies, and physical exercise are some good and healthy ways to cope with stress on a daily basis. 4 - Improve your sleep quality Research has shown sleep deprivation decreases the activity in the region of your brain responsible for assessing hunger, as well as in the region that controls cravings. Therefore, sleep loss boosts your appetite and drives you toward high-calorie food. As a result, a regular sleep schedule can help you regulate your sleep and therefore help you with your diet. Some other sleep strategies include avoiding screen time before bed and having a consistent bedtime routine. 5 - Seek professional help if you are feeling depressed or if you have experienced trauma Research shows that the relationship between mental health and diet is bidirectional. This means the way you eat affects how you’re feeling as much as your mental state affects your eating habits. For example, depression can increase or decrease your appetite, lower your motivation to cook or move and be associated with more cravings. As for trauma, it can lead to a state of “hypervigilance” or to a sense of “numbness”, both affecting hunger signals, which in turn can lead to poor eating habits. If you’re experiencing mental health challenges, it can be helpful to have the guidance of a mental health worker to approach the changes you want to make from a more global perspective. Reach out to the Psychological Health and Safety Clinic today to speak with a clinic counsellor. Final Thoughts on Diet and Mental Health A lot of us are struggling as a result of the stresses we’ve experienced over our lives. So, it’s important to remember to be gentle with ourselves and our bodies as we move into the new year. Yes, our diet is connected to our mental health and wellness, so we can set good intentions about eating healthy and moving our bodies in a way that feels good without focusing on weight loss. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth Loving-Kindness Meditation – Meditation for Self-Compassion
Meditation practices can seem intimidating but they don’t have to be. While many of us may think the point of meditation is complete stillness and thoughtlessness, that’s not the case. The goal of this meditation practice is self-compassion (learn more about self-compassion here), it’s a guided practice that focuses on the ways we can include ourselves in our circle of kindness. But before we get into the practice, let’s talk about what meditation is. What is meditation? There are countless definitions, approaches, techniques and schools of practice relating to meditation. However, at its core, meditation is a mental exercise that involves quieting the mind with simultaneous concentrated focus (typically on the breath or a mantra) for the purpose of attaining an enhanced state of inner awareness. What’s the difference between mindfulness and meditation? Counsellors and psychologists often speak about mindfulness, and others use these two terms interchangeably. Mindfulness and meditation are related but they aren’t the same thing. Mindfulness is about being aware, and psychologically present, in the moment. It focuses on paying attention to your present thoughts, feelings, urges and behaviours. Mindfulness can be practiced informally at any time and is often paired with simple breathing exercises. Mindfulness can be used in conjunction with meditation practices and can certainly help those new to meditation begin the process. How to Practice Loving-Kindness Meditation for Self-Compassion The goal of this meditation practice is to bring your awareness to the value of kindness and the importance of bringing yourself into your circle of kindness. Get into a comfortable position as you would with any mindfulness or meditation practice. Close your eyes full or partially and take a few deep breaths to settle in your body and into the present moment. Then put your hands over your heart to remind yourself you’re bringing not only your attention, but loving attention, to your experience. Feel the warmth of your hands, the gentle pressure of your hands, and feel how your chest rises and falls beneath your hands with every breath. Then bring your mind to a person or other living thing that makes you smile. This could be a child, your grandmother, your cat or dog – whomever naturally brings you happiness. Perhaps it’s even the bird outside your window. Let yourself feel what it’s like to be in the presence of that being. Allow yourself to enjoy the good company. Then, recognize how vulnerable this loved one is – just like you, subject to sickness, aging, and death. Also, this being wishes to be happy and free from suffering, just like you and every other living being. Repeat softly and gently, feeling the importance of your words; May you be safe. May you be peaceful. May you be healthy. May you live with ease. Remember that if you notice your mind wandering, slowly bring your attention back to the words and the image of the loved one you have in mind. Savour any warm feelings that may arise. If you have the time, go slowly. Then, add yourself to your circle of goodwill. Put your hand over your heart and feel the warmth and gentle pressure of your hand, saying: May you and I be safe. May you and I be peaceful. May you and I be healthy. May you and I live with ease. Visualize your whole body in your mind, notice any stress or uneasiness that may be lingering within you, and offer kindness to yourself. May I be safe. May I be peaceful. May I be healthy. May I live with ease. Then take a few breaths to just rest and sit quietly in your own body, savouring the goodwill and compassion you’ve found. Know that you can return to these phrases anytime you wish. Gently return back to the room, open your eyes if you closed them and enjoy the rest of your day. If you can, take the time to reflect on how this meditation practice impacted self-compassion. Did it feel weird to include yourself in your circle of kindness? Did you experience some resistance? If you were able to get past that, how did it feel? What were the impacts of providing yourself with self-compassion? Final Thoughts on Meditation for Self-Compassion Although meditation is a great way to practice self-compassion, it isn’t the only way. If you’re struggling with meditation, first we recommend being gentle with yourself and continuing to practice. Learning these skills that’s time and patience – remember that it’s okay for your mind to wander, if this happens simply notice and gently bring it back. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth As humans, virtually all of our traits – even the ones we value – can cause difficulties in particular situations. For example, being sensitive and having strong emotional reactions is not in and of itself problematic – these traits also lead us to be high empathy and experience joyfulness and happiness.
However, being high in interpersonal sensitivity can make us more sensitive in our reactions to benign joking or teasing. This can directly impact our self-esteem and our relationships with others (like those doing the joking, for example). While we may not be able – or even want – to completely change these traits, we are often able to make conscious decisions that help us deal with these situations better. Where does sensitivity come from? Any personality trait or attribute exists along a continuum, and we all tend to have a set-point range where we fall along that continuum. The contributing factors are multiple, and ultimately a combination of nature and nurture:
Being sensitive is neither bad nor good, it just is There are great things that come along with being sensitive – sensitive people are more likely to experience intense positive emotions, tend to connect with others’ emotional experiences on a deeper level, are more attuned to changes in others’ moods, and have a strong ability to empathize with others. However, there are also downsides to being highly sensitive and emotional. Sensitive people are more likely to personalize things, interpret things with negative intent when it may not exist, and overreact negatively to what may be a perceived insult. They are also likely to ruminate over things that have been said or done by others, have a hard time letting go of the past, and experience deeper hurt when it comes to conflict in interpersonal relationships. Our thoughts shape our reactions When it comes to our emotional reactions, the single most important factor that shapes how we react is our thoughts and interpretations about the situation. If you are walking down the street, wave to an acquaintance you recently met at a party who ignores you, and think “I must have said something she didn’t like when we met” you are likely going to react negatively. If instead, you think (as people who are high in emotional resilience would) “she didn’t recognize me, seeing me here is out of context” or “she looked preoccupied with a phone call she was on” you will probably have little to no emotional reaction. So, how can we have better control over our emotional reactions, particularly as they relate to emotional sensitivity? 1. Identify the automatic thoughts and interpretations that come up for you in a particular trigger situation. What are you thinking, perceiving and believing? Be as specific as possible. 2. Ask yourself a few key questions:
3. Actively work on replacing the automatic negative/personalized thoughts with thoughts that are more accurate to the situation, based on a review of all of the evidence. A core part of our life’s work is to continue to build awareness of who we are, recognize the patterns and behaviours we engage in that may be negatively impacting us or those around us, and work to continually improve areas of weakness. The goal is not to do away with fundamental elements that make you who you are, but rather to embrace those attributes in a way that the positives are maximized and the negatives are minimized so that you are living an overall happier life. Editor’s Note: This post was originally published as part of a Globe and Mail “Ask the Psychologist” column authored by Dr. Samra, and has been edited and updated. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth Breathing Exercises to Manage Stress
Breathing exercises can be very helpful tools for managing symptoms when our “fight-flight-freeze” stress response is triggered. And the great thing about breathing techniques is they’re easy – once we master the steps. One of my go-to breathing exercises, which we teach to many clients in our clinical practice group, is “four stage breathing”. This is a variant of the more common box breathing approach. Both can be equally effective approaches – it’s just about finding a style that works for you! What is Four Stage Breathing? Four stage breathing is a type of breathing technique that slows down our breathing actively and intentionally. It’s called four stage breathing as there are – surprise! – four stages to each full breath: two parts to the inhale, and two parts to the exhale. Why do breathing exercises work? And why is it important? Stress triggers our “fight-flight-freeze” response and when this response is triggered, we tend to shallow breathe. So why is shallow breathing a problem? Shallow breathing can lead to a whole host of physiological symptoms – including for example, changes in body temperature, lightheadedness or dizziness, or feelings of derealization or depersonalization (where distance/perception can be altered). These symptoms can mimic anxiety – and so shallow breathing can inadvertently make subjective feelings of anxiety or stress worse. Four stage breathing helps anxiety by providing control over the physiological symptoms – and this, in turn, helps calm the emotional symptoms. The Technique: How to do Four Stage Breathing First, ensure you are breathing in through your nose and out through your mouth. This naturally slows down the pace of our breathing. Second, make each full breath last at least 10 seconds – 5 seconds on the inhale, and 5 seconds on the exhale. Break each inhale and exhale into two parts: On the first inhale, fill up most of your lungs; on the second inhale, think about ‘topping up’ your lungs with air. On the first exhale, push out most of the air, and on the second exhale think about fully emptying your lungs. This helps to maximize our lung capacity. Repeat this cycle for 3-5 minutes. When you are first learning four stage breathing, it’s important to practice when you are already relatively calm or feeling low stress – this can help build mastery. Then, over time, use it as a tool when you feel your stress or anxiety increasing. How I incorporate Four Stage Breathing into my life
There is a very strong evidence-base on the benefits of breathing to reduce the frequency and intensity of the physiological symptoms associated with stress and anxiety-related. I encourage you to try four stage breathing regularly for a week – just a handful of times a day, for just a handful of minutes at a time and see how you feel. Remember: when we are experiencing stress, the best thing we can do is focus on the things within our domain of control and breathing is one of them. |
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