​Now that you’ve read about some of the basics, here are some ways to help or get involved. If you are worried that someone you know might be experiencing suicidal thoughts, there are some things you can look out for. The following list, taken from Suicide Awareness Voices of Education, can be warning signs of suicide: 

• Talking about wanting to die or to kill oneself;
• Looking for a way to kill oneself;
• Talking about feeling hopeless or having no purpose;
• Talking about feeling trapped or being in unbearable pain;
• Talking about being a burden to others;
• Increasing the use of alcohol or drugs;
• Acting anxious, agitated, or reckless;
• Sleeping too little or too much;
• Withdrawing or feeling isolated;
• Showing rage or talking about seeking revenge; and
• Displaying extreme mood swings.

If you notice someone you love showing some of those warning signs, you might become worried and wonder what to do. The Suicide Prevention Lifeline has some suggestions to help. Let’s talk about these:

• Ask: Start by asking if they are experiencing any suicidal thoughts or desires. There is a common misconception that if we talk about suicide, that will put the idea in someone’s head and then they will be more likely to hurt themselves. Research tells us that this is not the case! When you are able to acknowledge directly that someone is in pain, there is often a sense of relief in that person that someone cares enough to ask. 
  
  Yes, this is a challenging topic, and when we are uncomfortable, we tend to shy away from words like ““suicide,” “killing yourself,” and “self-harm.” When we are visibly uncomfortable with those things, it sends a signal to the person that is experiencing suicidality that those aren’t okay topics to discuss, which leads them to close off and fear reaching out for help.
  
  When asking someone about their suicidal thoughts, it is best to be as direct as possible and to seek specific answers. Asking questions such as “Have you been experiencing thoughts of suicide recently? To what extent? Do you have a plan?” etc. can be much more helpful than a generic “How have you been doing?” which can easily be brushed off with a “fine” or “okay.” The direct questions signal to someone that you are a safe person to talk to about these things, you won’t freak out if they mention those words, and are more difficult to avoid answering directly.
  
  
  
• Be there: Once you ask someone if they are experiencing suicidal thoughts, and they say yes, this is the time for you to step up. 
  
  There are many ways to “be there” for someone. It can be helpful to ask, “Is there anything I can do for you?”, but sometimes, a suicidal individual does not have the mental or emotional energy to figure out what might be helpful. Instead, provide suggestions and see if any of them stick. For example, you might say something like: “Thank you for sharing that with me, I know it’s not easy to talk about. I would like to do something to support you while you’re dealing with this. Would you like it if I sat with you for a little bit, or spent the night so you aren’t alone? Or maybe I can make a point to call you every night this week just to check in. I can also pick up some dinner for you on the way home from work tomorrow and we can eat together or I can just drop it off so you can have some alone time. Do any of those sound like they would be helpful?”
  
  Often, people who are experiencing suicidal thoughts believe that they are a burden to everyone in their lives and that their loved ones would be better off without them. When you are expressing your desire to support them, make sure you emphasize that you don’t think they are a burden, that they are important to you, and that you actually want to help them, not that you feel you have to.
  
  
  
• Keep them safe: When you ask someone if they are experiencing suicidal thoughts and they say yes, there are some important follow up questions you can ask. One, you can ask them if they have a plan. If they say yes, ask what it is. Then, you can determine whether they have access to that plan. For example, if your friend tells you that they have a plan and they are going to take their roommate’s pain pills, you can now work with the roommate to find a safe hiding place for their pills so that your friend no longer has access to those pills. As expressed on the Suicide Prevention Lifeline Website, “A number of studies have indicated that when lethal means are made less available or less deadly, suicide rates by that method decline, and frequently suicide rates overall decline.”

If someone expresses that they are actively suicidal (meaning that they tell you they have a plan, they have access to the means to carry out that plan, and they have the intent to carry out that plan), it might be time to seek professional help. Offer to sit with them while calling the National Suicide Prevention Hotline at 1-800-273-8255 or in the state of Georgia, you can call the Georgia Crisis and Access Line at 1-800-715-4225. If more immediate assistance is needed, call Emergency Medical Services and stay with the individual until help arrives. 

See the end of this post for a more detailed list of suicide crisis lines.

• Help them connect: As mentioned earlier, one of the warning signs of suicidality is withdrawing and self-isolation. This can be an effect of not having enough social energy or because one feels their friends don’t actually want to spend time with them. By coming to them, you can ease the amount of energy the individual has to expend, but you also are letting them know you want to spend time with them. Help connect the individual to their support system, and if they don’t have one, assist them in building it. Bring them out with you, help them get involved in local religious organizations, connect with co-workers, or even offer to take them to a therapist.
•  
• Follow up: Don’t let your care end when the crisis ends. Continue to reach out to the individual who shared their suicidal thoughts with you. Your continued effort and connection can make a huge difference for someone who can easily get trapped within their depression. By setting up a habit of checking in, you are continuing to show your love for that person and can help them get support again if they need it, before they reach the same level of crisis as before. 

As you are working to care for someone in such deep pain, make sure that you are also being taken care of. Crises are challenging for both those experiencing the crisis as well as those supporting the individual experiencing the crisis. By taking care of yourself, you are able to have the time and energy to devote to your loved ones to show them you care and want them around.

Below is a more comprehensive list of national suicide crisis lines (taken from this Wikipedia page):

• 911 is the national emergency number in the United States.
• The National Suicide Prevention Lifeline         (http://suicidepreventionlifeline.org/) is a 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress.[42][43] It provides Spanish-speaking counselors, as well as options for deaf and hard of hearing individuals. It is only available in the United States.[44] A 24-hour an Online Chat in partnership with Contact USA[45] is also available.
  • The National Suicide Prevention Lifeline can be reached at 1-800-273-8255, and in 2019, the use of 988 was approved.[46][47]
  • The National Suicide Prevention Lifeline (ESP) can be reached at 1-888-628-9454
  • The National Suicide Prevention Lifeline (Deaf & Hard of Hearing Options) can be reached at 1-800-799-4889
• The Veterans Crisis Line (https://www.veteranscrisisline.net/) is a 24-hour, toll-free hotline that provides phone, webchat, and text options available to military veterans and their families. It provides options for deaf and hard of hearing individuals.
  • The Veterans Crisis Line can be reached at 1-800-273-8255, followed by Pressing 1.
• IMAlive Crisis Chatine (www.imalive.org) is a non-profit, worldwide 24/7, anonymous chatline to help anyone in crisis via instant messaging.
• The Crisis Text Line (crisistextline.org) is the only 24/7, nationwide crisis-intervention text-message hotline.[48]
  • The Crisis Text Line can be reached by texting HOME to 741-741.
• Samaritans USA (http://www.samaritansusa.org/) is a registered charity aimed at providing emotional support to anyone in distress or at risk of suicide throughout the United States.[9]
• The Trevor Project (http://www.thetrevorproject.org/) is a nationwide organization that provides a 24-hour phone hotline, as well as limited-hour webchat and text options, for lesbian, gay, bisexual, transgender and questioning youth.[49]
  • The TrevorLifeline can be reached at 1-866-488-7386.
  • TrevorChat can be found at https://www.thetrevorproject.org/get-help-now/ (available 7 days a week from 3PM to 10PM ET).
  • TrevorText can be reached by texting TREVOR to 1-202-304-1200 (available M-F from 3PM to 10PM ET).
• The Trans Lifeline (https://www.translifeline.org/) is a nonprofit organization that is created by and for the transgender community, providing crisis intervention hotlines, staffed by transgender individuals, available in the United States and Canada.
  • The Trans Lifeline can be reached at 1-877-565-8860.[21]

To sum this up - at Bethel Haven we look at our clients through a holistic lens. We believe (along with many in the mental health profession) that mental health cannot be separated from other parts of an individual. The biological, social, psychological, and spiritual parts of us are all interconnected and therefore they impact one another. We believe that ignoring this important concept would be a disservice to our clients! 
​

So what do we mean when we say that we consider all of these factors when working with clients? Well, from the very beginning of therapy, we like to assess functioning in each of these areas. Our therapists ask questions like:

Is there a history of mental illness in your family? (Biological)
How would you describe your friendships? (Social)
What are your strengths? Your weaknesses? (Psychological)
Do you have spiritual and/or religious beliefs? If so, what does this look like in your life? (Spiritual)
Describe your marriage. (Social)
Do you have any medical problems? (Biological)
How would you describe yourself? (Psychological)

​
Looking at each of these parts of our clients helps us see our clients concerns in a more comprehensive way and aids us in planning treatment. We want to serve every client well and this approach helps us ensure we are giving our community the highest level of care. Have you been considering therapy? Give us a call to see if Bethel Haven is a good fit for you!
 

It’s well known that emotional intelligence is key to thriving in today’s society, with self-regulation being one of its vital components. The ability to regulate ourselves amidst chaotic or difficult circumstances is an invaluable skill that can help us thrive no matter what we face. When we talk about self-regulation, it’s important to define what it means to be dysregulated. When we are dysregulated, our emotions (often emotions such as anger, fear, sadness) are out of control and we feel unable to calm down - or regulate - ourselves back to a calm state. 

When you’re dysregulated, your sympathetic nervous system (what you may recall as “fight, flight, or freeze”) is in charge. When your body is in this response mode, the part of your brain that helps you reason, focus, and interact well with others has diminished functioning. You also find yourself more irritable, reactive, and overwhelmed rather than calm and centered. Now, your sympathetic nervous system is important and vital to survival, but it’s not meant to be in charge all the time. Your parasympathetic nervous system (known as “rest and digest”) is built to be in control. When it’s activated, your body is calm and you are able to reason and think clearly.

If you’re tracking so far, you’ve probably concluded that self-regulation is how we return to parasympathetic-dominance from sympathetic-dominance. In other words, self-regulation is the process in which we return to a calm state when we are feeling out of control. So, how does this happen? Over the years, researchers have proposed and developed methods of what they call “bottom-up” regulation. I won’t get too scientific, but essentially bottom-up regulation is being aware of your body and its sensations (whether that’s tightness, pain, tension, heart rate, the breath) and using that awareness  to  return to a state of calm. 

Returning to calm, to parasympathetic-dominance, allows us to be more intentional, less reactive, and better connected. It gives us space in between what happens to us and how we react - space to think and choose rather than act on impulse. Next week on the blog, we’ll discuss specific strategies for bottom-up self regulation that you can put into practice right away, so stay tuned!

​

Empathy. You’ve heard the word, but do you really know what it means? Counselors are deeply familiar with this word, however, it’s a concept that’s misunderstood by so many (myself included in my pre-graduate school days). Why is this? Well, we often think that empathy is synonymous with sympathy, however there is very important distinction between the two - a distinction that can be the difference in whether or not we connect or disconnect from each other.

Renowned author Brene Brown states that “empathy fuels connection, sympathy drives disconnection”. But wait! I thought sympathy was a good thing! Let’s dig a little deeper into the semantics of these two words and you’ll see what I’m talking about. Empathy involves identifying with another’s emotional pain, placing oneself in another’s position to gain understanding, and the willingness to “just be” with another. Mirriam-Webser defines empathy as “the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another”. 

So, how is this different from sympathy? Sympathy is feeling sorry for another without attempting to understand or identify with another’s pain. It can also look like trying to "lighten the mood" or "find the silver lining", which comes across as dismissing another’s pain rather than listening and acknowledging it. 

Theresa Wiseman, a nursing scholar, proposed four attributes of empathy that can give us more clarity as to what empathy looks and sounds like:

1. The ability to lay aside our own views and to see the world as another sees it.
2. The ability to refrain from judgement.
3. The ability to understand another’s feelings.
4. The ability to communicate your understanding of another’s feelings.

So let’s say you’re talking to a friend about his job, and he comments that he is very frustrated with a coworker. Empathy might sound like saying, “Wow, that sounds tough. I can see why you feel that way. That must be so hard for you. I’m not sure what to say, but I’m here to listen.” Sympathy would say, “Well, at least you have a job. I know lots of people who don’t have jobs. You can’t get along with everyone!” Sympathy tries to “fix” the situation rather than listen and support. 

Am I saying that we should never give feedback or speak truth to our loved ones? By no means. However, the moment when your friend is sharing their raw emotions and struggles with you is often not the best time for giving advice. Rather, these are the moments that they just need to feel heard, connected, and acknowledged. 

There are many hurting people in our world, and now more than ever do we need to grow in empathy. Notice I said grow in empathy. Although empathy may come more naturally to some, empathy is a skill that can be practiced and developed. What does this look like? Brene Brown suggests: 

• “Be kind.
• Be curious.
• You don’t need to fix it or make people feel better. Connecting and listening is powerful.
• Try to understand how the person is feeling (not how you might feel in the same situation).
• Help people know that they are not alone in their feelings. Even if you’ve never had that experience, you might know the feeling.
• Let people know that you are grateful they shared with you.”

Empathy matters, because it increases our understanding of and connection to others, even if we disagree with them. It helps us bridge divides, heal wounds, and create the connection that our hearts need.

​

“I’m so stressed”
“My anxiety is really bad right now”
“This is really stressing me out”
“I can’t control my anxiety”
“I have so much stress in my life”

​These are phrases we hear as counselors all the time, and I assume you hear and/or say these phrases often in your own life. We often hear the words “stress” and “anxiety” used interchangeably, but have you ever stopped to think about what these words actually mean? They sound similar -- and they are to a degree -- but the clinical definitions of them show them to be two different experiences.

​Let’s start with some definitions:

• Stressor: any event or experience that can trigger stress response 
• Stress: occurs when the body and mind detect an external threat/stressor, usually short term and has an identifiable trigger
• Stress response: an activation of the Sympathetic Nervous System (SNS), physiological changes that occur when a threat is detected -- also known as “fight, flight, or freeze”
• Anxiety: “persistent, excessive worries that don’t go away even in the absence of a stressor” , 

These definitions teach us an important and often overlooked fact - stress is not what happens to us, but rather how we react to what is happening to us. Undergoing stress most often results from external events/stressors rather than internal experiences. So for example, the sweaty palms, shaky hands, fast heartbeat, stomach discomfort, and anxious thoughts that come and go in relation to what’s going on in your life are probably related to your experience of stress rather than chronic anxiety.

On the other hand, if you are regularly experiencing these symptoms and can’t always identify an external trigger, then perhaps there is something more going on than just stress. While stress is typically a short term experience that dissipates when the stressor has been removed, anxiety is internal and ongoing.

So…

Now that we’ve defined what stress and anxiety are, maybe you’re thinking, 
“Yep, that sounds like me” or
“Now, I’m stressed that I might have anxiety!” 

Here’s the thing -- stress is normal. It’s a process designed by God to help us be productive and stay safe. Many scholars even say that a little bit of stress is good for you! Think about it -- let’s say a bear is chasing you, and you need to escape. It’s an AMAZING thing that the appropriate hormones are released so that you can all of a sudden be faster and stronger to run away!

But, let’s be real. Most of us aren’t needing all of that adrenaline and cortisol so that we can escape from a hungry bear on a daily basis. In modern society, we are faced with stressors like an upcoming job interview or caring for a sick loved one. Stressors in our fast-paced world seem to come without end, and we usually face not one but many stressors at a time. The result is that we go about our days in a chronic state of stress response, which ends up harming us more than it helps us.

Fortunately, stress can be managed with the right strategies and a little bit of work. Here are a few research-based practices that can help you take on the stressors in your life with confidence:

• Controlled, deep breathing. Focusing on your breath is a great way to manage stress, because it turns off the stress response in your body and activates the parasympathetic nervous system (PNS). The PNS helps your body return to a calm state.
• Progressive muscle relaxation (PMR). There are many variations of this exercise, but essentially it involves focused contraction and relaxation of each muscle group in the body. One easy way to use PMR is start with your feet and work your way up to your head, squeezing then relaxing your muscles until you’ve relaxed your whole body.
• Mindfulness meditation. During a mindfulness meditation, your goal is to relax your body, control your breathing, and focus on the current moment that you are in rather than the things that are causing you stress. There are many great apps and websites that offer free guided mindfulness meditations.
• Exercise. Exercise is one the THE best ways to alleviate stress! Whatever you like to do to get your heart rate up, do it! There’s so much empirical evidence that supports exercise as stress relief.

As for anxiety, it can also be managed and treated with the right kind of help. The stress management strategies listed above can be very effective in coping with anxiety, however seeking professional help is always the best option. Anxiety disorders have different roots, and it’s important for a licensed clinician to perform assessments to help determine appropriate treatment. Everyone’s experience of anxiety is different, and meeting with a trained therapist can open the door to finding the best treatment plan for you. 

At Bethel Haven, we are primarily offering TeleMental Health services during the COVID-19 pandemic in order to promote the safety of our staff as well as our clients. Even though sessions are not taking place in the office, we are still taking new clients at this time and would love to support you as you combat stress and anxiety and work to stay well mentally, emotionally, and spiritually! If you feel that the time is right for you to start seeing a therapist, give us a call!

​

Like anyone else with a social media account, I have been seeing a lot of people sharing the things they have been doing during the pandemic. Some have been learning new things, others have been taking up new hobbies, and some people have been reaching out to someone different every day. It’s kind of exhausting to think about.​​​

​When we post on social media, we like to share the pretty side of things. With my work with my clients, I have seen something else. We are all feeling pressure to be productive, even while we are feeling like we have less energy than ever before, and we’re being hard on ourselves for not using this time the way we feel we “should” be. 


Do you find yourself wondering why you’ve been feeling unmotivated even though you have more time on your hands? You’re stressed. Whether you’re still working or not, whether you’re caring for a family or not, and whether you’ve been personally affected by Coronavirus or not, you’re stressed. 


I know you’ve heard it already, but we are experiencing “unprecedented times.” What this means for our brains is that they are working overtime to try and understand what’s going on and how we are going to adjust. Every day the news says something different, we hear new numbers, and we have to make changes to our expectations about what life is going to look like for the foreseeable future. This takes a lot of mental effort and energy that we might otherwise have devoted to other tasks.


During this pandemic, a lot of us have been experiencing a constant state of fight or flight. We know there is a threat to our livelihood and we don’t know what to do about it. So we remain in this limbo stage as we wait to see what is going to happen next.


When we are this stressed for such an extended period of time, it takes a real toll on our brains and bodies. When we are anxious, upset, or worried about something, our bodies release a stress hormone called Cortisol. Usually, this is a short-lived experience, and the cortisol helps us know that there is a threat so we can solve the problem quickly. What looks different right now is that we’ve been stressed out for almost 2 months. When we are exposed to cortisol at such levels for such a lengthy amount of time, it can result in symptoms like anxiety, depression, headaches, sleep problems, and memory and concentration impairment, as shared in this article by the Mayo Clinic.


Do you feel drained? Do you feel less motivated? Are you having trouble paying attention to things? Are you feeling anxious or trying to numb certain feelings by zoning out, spending all your free time watching Netflix? Are you having trouble sleeping or getting more headaches? These are symptoms of extended stress.


The bottom line here is that your body is doing what it knows to do in order to cope with all the uncertainty we're experiencing. Being upset with yourself for not being as productive as you used to be is going to feed the cycle. So I’m going to invite you to try something else.


Give yourself some compassion. Cut yourself some slack. Treat yourself with grace. You’re going through something tough and that last thing you need is to beat yourself up for how you’re handling it. The next time you catch yourself thinking negatively about your response to this crisis, try to pause and thank your body for taking care of you.


It’s doing its best. 
So are you.
​