Its narrow and inaccurate perception explains why many of us — women in particular — feel guilty about attending to our needs. It explains why many of us stumble around drained and depleted.

However, self-care offers a slew of benefits. And it feels good to nourish our needs.

Below, experts dispel seven of the most common myths surrounding self-care.

1. Myth: Self-care is all or nothing.

Fact: Many people believe that self-care means spending an entire day of pampering or “it’s not worth it,” said Anna Guest-Jelley, a body empowerment educator, yoga teacher and founder of Curvy Yoga. However, while pampering is a great way to nurture yourself, it doesn’t define self-care.

“I believe that self-care is really found in the small moments of life – when you choose to take a deep breath because you notice you’re feeling stressed, or when you give yourself three minutes before bed to sit quietly and reflect on your day.”

2. Myth: Self-care requires resources that you don’t have.

Fact: Self-care is often viewed as a luxury that many of us have neither the time nor the money to enjoy. “Self-care does not need to involve an expensive spa or tropical vacation, nor does it need to take hours of your day,” according to Joyce Marter, LCPC, a therapist and owner of the counseling practice Urban Balance.

For instance, self-care can be “10 minutes of mindfulness meditation a day or doing some stretching or taking an Epsom salt bath,” she said. These simple practices “can go a long way in rebooting your mind and body.”

3. Myth: Self-care is optional.

Fact: Running yourself ragged can lead to unhealthy habits, because our needs can’t go unmet for too long. “If you choose not to create room for self-nurture or rest, it will elbow its way in, often in forms that feel less than self-caring in the moment,” according to Ashley Eder, LPC, a psychotherapist in Boulder, Colo. These forms include compulsive behaviors such as overeating and even symptoms of depression, she said.

If you find yourself turning to these kinds of habits, explore the needs you’re meeting with them. And “offer yourself that choice directly instead of through these backdoor behaviors.”

4. Myth: Self-care is unfeminine.

Fact: The media perpetuates messages that femininity is “other-focused and self-denying,” Eder said. We typically see female protagonists focusing on everyone else’s needs, listening to others instead of speaking and playing a supporting role, she said. Care-taking is portrayed as a woman’s job.

“This only makes sense in real life if you want the star of the play to be a man. It does not work for a woman to play a supporting role in her own show.”

If you notice that your needs are going unmet, “try asking yourself who the main character in your life is right now, and whether you would like to stick with that or change it.”

5. Myth: Self-care is anything that soothes you.

Fact: Many people turn to alcohol, TV marathons, smart phone games and food to soothe their stress and unwind, Marter said. But these habits are the opposite of self-care. “Self-care practices need to support health and wellness and should not be addictive, compulsive or harmful to your mind, body or bank account,” she said.

6. Myth: We have to earn the right to practice self-care.

Fact: “Our lives are organized culturally with an emphasis in the first third of our lives on education, the second around career and family development, and the last third for leisure,” said Sarah McKelvey, MA, NCC, a psychotherapist with a private practice in Centennial, Colo.

This creates the notion that we can only take good care of ourselves after we’ve accomplished certain goals. Yet it is self-care that gives us the energy and nourishment we need to achieve great things.

7. Myth: Practicing self-care means making a choice between yourself and others.

Fact: “When we are not taking care of ourselves, we end up in a cycle of deprivation in which the activities of our day deplete our energetic and emotional reserves,” McKelvey said. We become frustrated, cranky and needy, she said. We look to others to nourish our needs and replenish those reserves.

“Ironically, all of our efforts of sacrifice make us vulnerable to actually ‘being selfish.’” Yet, when we’re meeting our needs, we have more energy to give to others. “There is nothing greater to offer the world than your inspired and well-nourished self.”

Self-care is an important part of our lives. It is the basis for our well-being.

Now, in addition to your original stressor, you’re under more pressure because you’re scrambling to find lost keys, dealing with hurt feelings or frantically reconstructing forgotten projects.

And on top of that, when stressed, our emotions are running rampant. That scramble for the keys is anything but calm and a remark from your mother about that missed phone call can send you deep into guilt.

It’s easy to attribute these lapses in memory and emotional intensity to simple overload. When we’re stressed it’s typically at least in part because we’ve got too much going on and we just don’t have the capacity to keep up with everything.

Scientists have known what common sense tells us — that stress has an impact on memory and emotion.  But it’s not just that we have a lot going on and aren’t paying attention. Stress actually has an impact on how the brain processes information and stores memories. And research over the last several decades has pinpointed changes in certain areas of the brain during times of stress.

Now new research, published in the Journal of Neuroscience builds on previous understanding of the brain. It suggests that dramatic changes that occur in the brain when under stress are linked to our emotions and scattered memory.

Chronic stress affects two important areas of the brain when it comes to memory: the hippocampus and the amygdala.

In this new research, electrical signals in the brain associated with the formation of factual memories weaken while areas in the brain associated with emotion strengthen.

So, according to these researchers, with increasing stress, our brains are wired to discount factual information and to rely heavily on emotional experiences.

“Our findings suggest that the growing dominance of amygdalar activity over the hippocampus during and even after chronic stress may contribute to the enhanced emotional symptoms, alongside impaired cognitive function, seen in stress-related psychiatric disorders,” the researchers suggest.

So when you’re under stress — like when you’ve forgotten that important work document and your boss makes a comment that causes you to turn to jelly inside — keep in mind that your brain is wired to highlight the emotional part of her message. The factual part of the message may be lost altogether, which can leave you both intensely emotional and failing to act on important facts.

“Between a shaky world economy, increasing unemployment, and related issues, many today are being forced to come to the edge of uncertainty. Just like the baby sparrows, they find themselves leaning into the mystery that change brings, because they have no choice: It’s fly or die.”

For persons struggling with depression and anxiety — and for those of us who are highly sensitive — uncertainty is especially difficult. Forget about learning to fly. The uncertainty itself feels like death and can cripple our efforts to do anything during a time of transition.

I have been living in uncertainty, like many people, ever since December of 2008 when the economy plummeted and the creative fields — like architecture and publishing — took a hard blow, making it extremely difficult to feed a family. In that time, I think I have worked a total of 10 jobs — becoming everything from a defense contractor to a depression “expert.” I even thought about teaching high school morality. Now that’s desperate.

I don’t think I’ll ever be comfortable with uncertainty, but having lived in that terrain for almost five years now, I’m qualified to offer a few tips of how not to lose it when things are constantly changing.

1. Pay attention to your intention

I’m not a new-age guru. I don’t believe that you can visualize a check for $20,000 and find one in your mailbox the next day. Nor can you get on Oprah by believing you’ll be her next guest. (I tried both of those.) But I do recognize the wisdom in tuning into your intention because therein exists powerful energy that you can tap.

Awhile back I did Deepak Choprah’s exercise of recording my intentions and seeing how many of them actualized. I was surprised at the synchronicity between intention and events. Psychologist Elisha Goldstein writes in his book, The Now Effect: “Our intention is at the root of why we do anything and plays a fundamental role in helping us cultivate a life of happiness or unhappiness. If we set an intention for well-being and place it at the center of our life, we are more likely to be guided toward it.”

2. Tune into the body.

Psychologist Tamar Chansky, Ph.D. reminds us to listen to the body when we get anxious. If you understand why certain symptoms occur in the body – racing heart, dizziness, sweating, stomachaches – and repeat to yourself, “This is a false alarm,” you are less afraid, less panicked by the situation. Knowing that these symptoms are part of the sympathetic nervous system (SNS) trying to protect you from danger – part of the primitive regions of the brain mobilizing the “flight-or-fight” response –the reaction becomes less about the situation and more about talking to your body about why it’s freaking out so that you can use the parasympathetic nervous system (PNS) to restore the body to normalcy, which, in my case, is still pretty panicky.

3. Imagine the worst.

I’m not sure you will find a psychologist to agree with me on this exercise, but it has always worked for me every time I do it. I simply envision what it would look like if my worst nightmare happened. What if my husband and I could not get any architecture gigs or writing assignments? What if we can’t pay for health care insurance and my heart malfunctions (I have a heart disorder)? What if we both come to a bone fide professional dead end? Then I move to my actions. I think about selling our house, moving into a small apartment, and working as a waitress somewhere or maybe as a barista at Starbucks. (If you work more than 20 hours, you get health care insurance.) I research health care insurance options for persons who make minimum wage. Under ObamaCare, my kids, at least, would be covered. I invariably come to the conclusion that we will be okay. All is okay. A huge adjustment. Yes. But we are getting to be pros at that. This exercise makes me fret less about the things that I think I must have and get back to the essentials—literally a warm meal on the table, even if it’s one a day.

I am comforted by the words of Charles Caleb Colton: “Times of general calamity and confusion have ever been productive of the greatest minds. The purest ore is produced from the hottest fire.”

4. Describe, don’t judge.

In his book Get Out of Your Mind and Into Your Life, Steven Hayes, Ph.D. dedicates a few chapters to learning the language of your thoughts and feelings. Especially helpful to me is learning how to distinguish descriptions from evaluations.

Descriptions are “verbalizations linked to the directly observable aspects or features of objects or events.” Example: “I am feeling anxiety, and my heart is beating fast.” Descriptions are the primary attributes of an object or event. They don’t depend on a unique history. In other words, as Hayes, explain, they remain aspects of the event or object regardless of our interaction with them. Evaluations, on the other hand are secondary attributes that revolve around our interactions with objects, events, thoughts, feelings, and bodily sensations. They are our reactions to events or their aspects. Example: “This anxiety is unbearable.”

If we are feeling anxious about the uncertainty of our job, for example, we can tease apart the language of our thoughts and try to transform an evaluation, “I will be destroyed if I am fired,” to a description, “I am feeling anxious and my job is unstable.” By naming the emotion and the situation, we don’t necessarily have to assign an opinion. Without the opinion, we can process the object, event, etc. without hyperventilation.

5. Learn from fear.

Eleanor Roosevelt wrote, “You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face … You must do the thing you think you cannot do.” My body usually protests against that statement, but theoretically I concur with Eleanor. I sincerely believe the good stuff happens when we are afraid. If we go a lifetime without being scared, as Julia Sorel said, it means we aren’t taking enough chances.

Fear is rather benign in itself. It’s the emotions we attach to it that disable us. If we can confront our fear, or rather approach it as an important messenger, then we can benefit from its presence in our life. What is the fear saying to us? Why is it here? Did it bring roses or chocolate? According to Jones, this is an exercise of getting comfortable with being out of control, of learning to let go of the illusion of control — because we never really had it in the first place — and developing an inner knowing that everything will be okay.

When we function in a healthy manner, we don’t just experience joy and happiness, prancing around without a care in the world. We actually still experience a range of emotions, some of which can be very difficult to live with.

It’s absolutely healthy to feel anxiety, depression, anger, jealousy, envy, guilt, hurt or shame. But what makes experiencing these emotions healthy is that we don’t linger in them for longer than is good for us. We don’t demand that they ‘go away.’ We accept the appropriateness of how we feel, and do something about our situation.

Let me give you an example of how a person’s thinking can perpetuate depression.

Imagine that your favorite dog was very sick and you took her to the vet, who tells you she’s in a lot of pain and it’s best to euthanize her. How do you think you might feel? Very sad (most likely), guilty (perhaps), happy (to some degree if you know you can stop her suffering). So, do those emotions seem healthy and appropriate to you? Of course they do, and to experience them is human.

Given the choice, you may not have wanted to face that situation in the first place, but we can’t always pick and choose what happens to us in life. We can only choose how we deal with those situations when they arise.

So how could a person drive themselves into depression after such an event? It’s easy. When a person feels sad about a loss or death, if they start taking far too much responsibility for what happened and judging themselves negatively, then depression will be only a short taxi ride away. The kind of thinking that perpetuates depression will be thoughts such as “I’m such a bad person for killing her,” “I should have done more to make her life happy,” “I should have taken her to the vet sooner and I would have saved her.”

None of those statements is wholly true, yet when you repeat them, you start to believe it and you feel depressed. You’ll even start acting depressed. Instead of going out for a walk, which you used to enjoy, you might stay at home watching TV, because ‘there’s no point in going out without your dog.’ You might even stop socializing with other dog walkers and so you’ll become more isolated, which perpetuates the problem.

So from a healthy sadness about the loss of a loved pet, with unhealthy thinking and behavior, your mood sinks into depression. And once there, it is a lot harder to get out of than when you’re healthily sad.

Anxiety, on the other hand, is depression’s opposite. Rather than dwelling on the past, people with anxiety tend to focus on the possible threat in the future, and employ defensive mechanisms against that perceived threat or problem. Let me give you another example.

Frank gives a presentation at work that doesn’t go down well with his boss. Frank gets shouted at and bawled out for not doing a good enough job. His boss also tells him that he must improve before the next presentation or else! How do you think you might feel? Disappointed (sure). Frustrated (maybe). Concerned (oh yeah).

So how does Frank perpetuate his anxiety? The first thing he does is to fly into the future and use ‘what if’ and ‘if…then’ type thinking. “If I deliver another bad presentation, then my boss will fire me.” “What if I can’t do it the way he wants?” “What if I’m terrible?”

These ‘what if’ thoughts are the precursors to the unhealthy demands that lead to anxiety: “I must know that the presentation will go well.” “I must not screw up the presentation or my boss will fire me.” “I must be perfect.”

The trouble with these irrational demands is that they lead to anxious behaviors: spending hours on the presentation; not sleeping; seeking others’ opinions; asking for reassurance; feeling nauseous beforehand; sweating; feeling ill at ease.

Clearly, Frank is not in a good state to be giving a presentation. He’ll most likely deliver a sub-par presentation. What do you think will happen next time he needs to give a presentation? He’ll feel worse.

To end these destructive cycles, we need to understand that emotions — even the difficult ones — are healthy. Emotions should be used as a guide to let us know that something is off-balance and might need changing. When we demand unreasonable things from ourselves, we’re destined to feel strong, unhealthy emotions.

It’s a thin line between healthy and unhealthy emotions, but by understanding how our thinking perpetuates our emotional disturbance, we can become a healthier version of ourselves.

Over time, pent-up anger and resentment causes tiny problems to become big ones. Anger can become displaced or is expressed in a way that becomes problematic. Many people feel more upset when they realize that they overreact or explode with anger, especially if it causes hurt for themselves or someone else. Thus, it creates the terrible cycle of struggling with anger.

But there is help for anger that doesn’t require you to dig up your past, explore your thoughts, or send letters to a dead loved one. It’s called biofeedback, and it offers individuals readily-learned techniques that are safe and effective (based upon decades’ worth of research).

Unhealthy, inappropriate anger looks like this: You get home from a bad day at work, where everything seems to be going wrong. The house is a mess, and the kids are running around screaming. Your spouse is yelling to you from the kitchen to help.

You explode with a nasty remark about how you were busy working all day, and you do not have time to help. You say something hurtful in regard to your spouse not being a good parent. The kids hear you yell, and your spouse yells back or begins to cry. You then kick one of the toys on the floor and leave the house to go to a bar for a drink to unwind, leaving your family in disarray.

On the other hand, people also can internalize anger and it will manifest in different ways. Internalized anger can cause migraines, stomach problems, high blood pressure, depression, anxiety, and so on. The body expresses anger in maladaptive ways when people do not express it constructively.

Biofeedback and neurofeedback techniques offer individuals skills in how to effectively manage anger.

People can monitor their physiological responses and thus learn how to gain control over them. Neurofeedback also helps create a stronger connection between the emotional and executive areas of the brain, allowing people to gain a proper “checking” system. Anger is then expressed in a rational, appropriate, and conducive manner. Communication becomes clearer, and others are more likely to respond to your needs.

Children also can internalize anger and carry it with them, or express it with aggressive and problematic behaviors. Biofeedback, with the use of a video game program, helps build a stronger connection between the midbrain (emotional center) and forebrain (executive control center).

Here’s how it works. The child has sensors placed on certain areas of the head to read brain waves such as delta, beta, and hibeta waves. The video game will not advance if he or she is not keeping active and focused (increasing beta waves). If he or she becomes anxious or distracted (hibeta waves), or begins to feel tired or daydream (delta waves), the game will stop.

The child then learns to find the medium where he or she feels a calm focus and is in control of his or her brain functioning. A study conducted at Boston Children’s Hospital showed that the children who received biofeedback therapy had better control over their reactions to daily frustrations than they had prior to receiving the treatment.

“The connections between the brain’s executive control centers and emotional centers are weak in people with severe anger problems,” explains Joseph Gonzalez-Heydrich, chief of psychopharmacology at Boston Children’s and senior investigator of a recent biofeedback study conducted there.

Building a strong connection and balance between the midbrain and forebrain allows a child or adult to gain better control over their emotional responses and behaviors. Aggression and anger are then diffused in a healthy and appropriate manner.

Biofeedback also teaches breathing correctly as a relaxation technique. Breathing deeply through the diaphragm and focusing on each inhale and exhale will clear the mind and allow the frontal brain to keep the midbrain and emotional centers in check. It gives the mind a chance to step back from the situation and view it objectively instead of impulsively reacting off of intense emotions.

Biofeedback is a time- and research-tested technique to help people learn to better control responses that many believe are automatic or uncontrollable. If you or someone you love is having trouble with anger, consider biofeedback as one potential treatment to help with this concern.

Reference

Boston Children’s Hospital. (2012, October 24). Video game with biofeedback teaches children to curb their anger. ScienceDaily. Retrieved from http://www.sciencedaily.com/releases/2012/10/121024164731.htm

In my 20 years living in the Boston area, I cheered on the runners on many occasions and now, even from far way, these events feel close to home.

Experiencing trauma can have a dramatic effect on our bodies and our minds.  And although it’s a different experience to witness a trauma on television, it still can affect us.

When you perceive a threat, the body activates the stress response. The stress response occurs in both your body and brain.

The body’s response to acute stress is a preparation for emergency.  Adrenaline and other hormones are released.  The body shuts down processes associated with long-term care.  When under immediate threat, digestion, reproduction, cell repair and other body tasks related to long-term functioning are unimportant.

Of immediate importance is survival.  Increased blood sugar can provide extra energy for muscles. Increases in cortisol counter pain and inflammation. Blood pressure increases. Blood is diverted from our extremities to our major muscles to provide us with extra strength. Increased endorphins can help us ignore physical pain.

You can see the effects of these changes to the body in many of the symptoms of stress, such as racing heart, dizziness, nausea, shortness of breath, shaking, feeling hot and flushed, and sweating.

But it is the impact of trauma on the mind that is often the most disturbing.  Traumatic events can leave us feeling unsafe.  They can disrupt our beliefs and assumptions about the world. Your sense of your ability to control your life may be shattered. You may question how much influence you have over your life and your life choices.

A trauma, such as the one the occurred at the Boston Marathon, can leave us distrustful of other people.  You may question your basic trust of other people in the world.  Trauma can affect your ability to be intimate with others and may impact your feelings of self-worth.  Those who survive the trauma often feel guilt and wonder why they lived when others were less fortunate.

As we grow, change and have varied experiences throughout life, our beliefs and assumptions typically evolve over time.  With trauma, those beliefs and assumptions that we use to make sense of the world around us change nearly instantaneously.

It’s common to experience a wide range of psychological symptoms, including intrusive thoughts, worry, difficulty sleeping, trouble focusing, bouts of crying, blame or self-judgment and lack of satisfaction.

The effects of trauma also can cause intense emotion, including extreme emotional fluctuations, unhappiness, anxiety, loneliness, anger, and irritability.

Multiple traumas or repeatedly being exposed to life-threatening events can have a further impact on your body and mind. Parts of the brain can become sensitized, causing you to be on high alert and to perceive threats all around, leaving you jumpy and anxious.

Other parts of the brain associated with memory can actually shrink, making it difficult to consolidate and form new memories.  Prolonged stress can effect the development of a number of health issues, including diabetes, obesity and hypertension. And repetitive stress affects our moods, brings on anxiety disorders, and affects our experience of chronic pain and our ability to control food intake.

But when horrible events occur, such as those that occurred at the 2013 Boston Marathon, we also see the generosity and caring that is a large part of human nature.

Countless individuals ran to help without a second thought.  First responders, medics, EMTs and even bystanders jumped into action to do what they could to save lives.  Runners crossed the finish line and kept on running straight to give blood.

As we deal with the impact of violence, we can also keep in our minds the heroes and the strength of the human spirit that brings us together when we are faced with senseless tragedy.

Image: Wikimedia Commons: Aaron “tango” Tang

She gives several powerful examples: We vote a certain way because our parents do. We work a numbing number of hours because we’re taught this makes us good providers. We sabotage our successes because we’re taught that wanting money is akin to greed.

In the midst of clinging to these old concepts, we forget the most important idea of all: living from our authentic values.

When we lead lives based on what matters to us most, we’re happier and more fulfilled. However, when we lead lives based on ideas that don’t fit anymore, we use random things to fill us up and typically end up feeling empty anyway.

Campbell references things like reality TV, shopping sprees, toxic relationships and alcohol.  “These things provide quick bursts of happiness or relief, but always leave you feeling a bit hungry, a bit empty. It’s kind of like spiritual junk food: it tastes good going in, but it isn’t enough to sustain you.”

In her book, Campbell features a powerful exercise to help us rediscover our values, because, as she writes, “Understanding your values and desires will create the infrastructure for your life.” She suggests spending at least 30 minutes on this exercise and doing it every year. Here are the details:

• Ask yourself, “What matters to me now?”
• Jot down your responses — without judging yourself. The key is to discover your authentic values.
• Rank your responses. So put the number 1 by what you value most. Campbell explains that our core values will likely remain the same but their rankings might change. For instance, your career might top your list, but after you have kids, it slides into second.
• Next, grade yourself. If you’re taking daily action toward your top 5 values, give yourself an A, Campbell writes.  Again, be honest. “Where are you soaring? Where are you falling short?”
• For the values you assigned a B and below, consider if each one still resonates with you. Is it outdated? If it’s not and it’s still very important to you, “look then at the ways you’ve separated from it and figure out a few things you can do to get back on track.”
• List several things you can do today to honor your top values. If you value spiritual growth, Campbell writes, you might start meditating for 10 minutes a day. Engage daily in the activities that align with your values. Put them on your to-do list.

According to Campbell, “When you’re willing to discover and live from your deepest values, life not only becomes a more fulfilling and passionate adventure, but it also becomes easier.” Decisions suddenly seem clearer, and we stop second-guessing ourselves so much. Instead, we focus on “creating a life that supports the things that drive it. [We] live with personal integrity.”

Other countries have long had to deal with seemingly random bombings in urban areas; the U.S. is relatively late to this particular brand of horror. I’m not sure how one ever gets used to the idea that by just going shopping or watching a parade or sporting event, something really bad could happen.

But life carries on — we cannot stop living out of fear.

With the prevalence of always-on media, it’s tempting to keep updated when tragedies like this strike by monitoring the news 24/7. But that would be a mistake, as we become overwhelmed with the sheer magnitude of information (at first), and then the agonizingly slow trickle of new information (later on).

But there are some things you can do to help yourself — and others.

Elvira G. Aletta, Ph.D., for instance, had these helpful suggestions after the Newtown, CT shootings:

• Share in our humanity. Highly sensitive people (and who among us is not?) feel empathy profoundly. Just because it has not happened to us directly does not mean we do not grieve. Even from a great distance we are sensitive to the depth of loss. Cry, be sad. Allow grief to happen. Then wash your face, breathe deeply and allow life to happen, too.

• Turn off the radio, television, step away from the computer and put down the newspaper. Allow yourself the space to adjust to the news at your pace, not theirs.
• Do good. I do not mean make a donation or give blood. Although all that is good, there is more we can do. I mean what Chris said in a comment he left on my blog the day of the shooting, let us out-grace one another. Let us look for opportunities to act with kindness. Pay forward the kindness received from others. Let us breathe in the healing love and goodness in the universe and breathe out the poison.
• Stop the hate. Now that I’ve breathed out the hate I am hopeful I can let it go.

These are still helpful suggestions today. I would also add:

• Talk about it. Get together, face-to-face, with some friends or family members to share in your grief, or just the need to talk. Spending more time with others helps reinforce those emotional and social bonds that help us feel safe and secure.

• Engage in self-care. Now is not the time to challenge yourself to start a new diet, or challenge some habit or behavior you’ve been meaning to change. Instead, ensure you are getting your emotional needs met — ask for a hug, give a hug. Let others know what you need, and take the time you need to keep yourself together.
• Volunteer. While the Red Cross in Boston isn’t in need of blood donations right now, they will again in a few weeks. Commit to helping by giving blood, or donating in some other way that can help the victims of this tragedy (or even a recent tragedy closer to your own home or local community).

Our hearts and prayers go out to those who were injured or lost a loved one in the Boston Marathon bombings.

Although I can’t stand spicy food, I dribbled Tabasco sauce over my fajitas and took a bite, eyes immediately watering, mouth burning. I have good reasons to be uptight, I thought, shoveling the spicy food into my mouth.

The past few weeks, life had seemed to be a constant stream of stresses, and I hadn’t handled them well. A new job was giving me a steep learning curve. Rush hour had been brutal. I wasn’t sleeping well. Freelance projects on the side took up all my spare time.

All this had contributed to irritation in my interactions with family and friends, frustration at things I couldn’t change, and super-sensitivity to any perceived failures at work or at home.

Suddenly, the awareness of my super-stress hit me like a mouthful of hot jalapeños. I realized how ridiculous I must sound to my mom. Twenty-two should be a fiesta, a time of exploration and growth. But the stressors I was encountering — typical stressors for adults of any age — were sabotaging my youth, health, and everyday happiness.

April is National Stress Awareness Month. Considering that it’s tax season, we’re a ways off from another calendar holiday, and winter storms where I live have kept our spring season gloomy, it seems fitting.

It’s no news that unceasing high stress has a negative effect upon health. According to WebMD, 40 percent of all adults suffer adverse health effects from stress. As health care professionals promote public awareness about the common causes and symptoms of stress this month, we’d do well to consider the long-term medical effects, too.

Two recent studies agree that negative responses to everyday stress can have a negative effect on your long-term health.

A longitudinal study conducted by researchers at the University of California, Irvine found that reacting negatively to stress from even small events increased the risk of psychological distress and mood disorders among the 700 adults they studied.

Penn State’s study of the effects of stress was even more fascinating. Researchers spoke on the phone with over 2,000 adults for eight nights in a row, asking simple questions about the events of their day and their mood. In both projects, researchers found that people who handled stress badly on a day-to-day basis were more susceptible to ill mental health and chronic diseases later in life.

It seems that the research supports the age-old quip “attitude is everything.” The idea that our long-term health because of our present choices is not new, but it should be a wake-up call to those of us who do not pay attention to how we are reacting to our stress.

Beyond being aware of our stress this month, let’s take one step further and make a plan to react better to it.

Some Tips for De-Stressing Your Life

In honor of National Stress Awareness Month, I’m focusing on changing the things I can and reacting more positively to the things I can’t. Here’s what this will look like in my daily life:

• Stop fueling frustration. When I feel a burst of work-related or personal frustration, I’m not going to waste emotional energy fuming about it. My goal is to think of one thing I can do right now to make the situation better, and do it. Fueling the fire of my irritation will only tie my hands to solve whatever problem I’m facing. This positive, action-oriented reaction will help me keep stress at bay.
• Keep things in perspective by writing them down. Lots of our problems aren’t even worth our stress and can seem especially silly when you actually articulate them. This month I will name my stressors on paper and gauge how worthy they are of distress. I’m willing to bet most of them aren’t worth worrying over.
• Spend time with positive people. I heard on the radio recently that if you are easily prone to stress and discouragement, you should intentionally surround yourself with people who are opposite. I’m going to make time in my busy schedule for quality time with the sunny souls in my life and soak in their positive reactions.

Writer and theologian Charles Swindoll has said “Life is 10 percent what happens to you and 90 percent how you react to it.” With recent psychological studies showing the importance of how we react, it’s extremely important to be aware of our reactions and work on reacting more positively.

Then, I walk into the lab next door for a blood test and the line I hear is: “Oh, your blood pressure was high, let me see if I can draw your blood now.”

Wait, what? Do they actually think that these comments will make me feel more relaxed?

I’ve also experienced more direct unpleasantries from doctors who project an icy, or even a rude demeanor. A poor bedside manner does affect a patient’s emotional disposition; it does heighten any anxiety, and it certainly ensures difficulty in forming a positive bond with a professional who’s in a field that’s supposed to alleviate illness.

“A bedside manner refers most often to the way a medical professional interacts and communicates with patients,” a 2012 post on Wisegeek stated. The post stresses that a doctor with a good bedside manner demonstrates empathy,¹ and emits an aura of ease for the patients, while also involving them in health decisions. On the flip side, poor bedside manners reflect rudeness, cold attitudes, inadequate listening skills, and a complete disregard for the patient’s fears.

Why are such mannerisms prominent in the medical field?

Lorianna De Giorgio’s 2012 article in the Toronto Star discusses why positive relationships between patients and doctors may be lacking in the profession.

Adam Waytz, assistant professor of management and organizations at Northwestern University, explained that a process of “dehumanization” lies behind an unfortunate patient-doctor rapport. Dehumanization may occur due to psychological demands placed on practitioners, and from ongoing advances in technology as well. Waytz determined that a bulk of medical decision-making gives way to a very mechanical method of thinking; problems are often solved and issues are fixed without recognizing the patient’s feelings.

While many individuals enter the medical field for humane reasons, “they get into the system, and the system is so stressful that sometimes the humanity is just beaten out of them,” notes Marjorie Stanzler, senior director of programs at the Schwartz Center for Compassionate Healthcare.

Waytz and Stanzler advocate that a proper bedside manner would result in improved psychological and physical outcomes for the patients in treatment.

A 2008 blog post entitled What Bad Bedside Manners Really Mean reviews the negative impact and consequences of these adverse behaviors:

“Doctors are supposed to be in the line of work of helping people. With this profession comes a lot of responsibility. The medical field is not supposed to be simply diagnosing a problem, handing out a few pills, and moving onto the next patient. It means much more. It means being a physician, and a physician means being a healer.”

I could not agree more. Patients may feel naturally anxious, waiting on an impending prognosis (especially if the condition has the potential to be serious). Do they really need aloofness on top of that?

“If the doctor seems disinterested in what you are telling him, there are greater chances of him missing something that you said,” the post stated. “If he seems put-out or preoccupied, the patient might be more likely to leave out pertinent information.” Furthermore, if the doctor is disrespectful, it may discourage patients from seeking medical assistance altogether.

Due to a distressing environment and technological developments, I can understand why medical practitioners may harbor some poor bedside manners, but that doesn’t make their etiquette right or beneficial.

I think it’s important for them to remember why they’ve entered the field in the first place; if it’s because they sincerely want to help people, it’s crucial to know how to relate to patients on an emotional level.

1. l personally think medical schools should have official courses on being more empathetic

Chen can only move her big toe. She writes emails and communicates with others using special technology. Composing an email with five short sentences takes her 20 minutes. But she continues to email with her family, friends and other ALS patients. She also visits patients in person with the help of her caregivers and relatives.

Chen’s remarkable story is featured in Richard Cheu’s empowering book Living Well With Chronic Illness: A Practical and Spiritual Guide. Cheu provides pastoral counseling to patients in New York City medical and hospice centers. He helps patients find peace with their illness and live their lives to the fullest.

Getting diagnosed with a chronic illness is overwhelming. It can unleash a range of reactions, from shock to fear to grief, said Cheu, also a stress management consultant, Catholic deacon and a caregiver himself. The diagnosis can shatter your self-image, he said. It’s as though you draw a line in the sand, one side representing you before the diagnosis, the other side representing you after.

While chronic illness changes your life, it doesn’t have to stop you from enjoying it. Chen is just one example of many individuals who’ve carved out meaningful, satisfying lives with a debilitating disease.

When she was first diagnosed with ALS, Chen was heartbroken and depressed. She isolated herself from her loved ones. But talking with another ALS patient at her monthly support group helped Chen start accepting her diagnosis and reach out for help.

Accepting your condition and asking your physicians about your options opens up a world of resources and support, Cheu said.

Taking Charge of Your Health Care

Cheu stressed the importance of taking charge of your health care with these three steps: Stop, look and listen. When you’re first diagnosed, stop, “and just sit down, and take some deep breaths.”

“Look at your disease, and learn everything you can about it, [such as] how it can affect you.” Think of it as learning a new language. If you were traveling to France, and wanted to make the most of your trip, you’d learn some French, he said.

Finally, “listen to your advisors,” or your health care team. Your doctors advise you on what to do, but you ultimately make your own decision on how to proceed, he said.

Taking charge of your health also includes: engaging in healthy behaviors, coping with your emotions and creating calm every day. For instance, you can meditate, journal or spend time with loved ones.

Focusing on Today

“Every person is unique, and has unique concerns that day in that moment,” Cheu said. That’s why he asks his patients to focus on today and consider: “What do you think is the most important thing to achieve today?”

Having a Hero

In addition to Ein-shei Chen, Cheu features other chronically ill individuals in Living Well With Chronic Illness. “Everyone needs a hero,” he said. Pick a hero who inspires you to keep going, someone who’s overcome major hurdles but is living life to the fullest.

Overcoming Loneliness

Loneliness is a common issue for chronically ill patients, Cheu said. After you’re diagnosed, the people in your life might stop calling and inviting you to social events. You also might distance yourself from others. The first step in overcoming loneliness is to recognize that it’s part of chronic illness, he said.

Next, in his book, Cheu encourages readers to “create peaceful and meaningful solitude.” As he explains, “Happiness starts within, and the best relationships happen when you are at peace with yourself regardless of your present condition or circumstances.” Choose activities you find restorative and that bring you joy, such as praying, spending time outdoors, reading or playing music.

Cheu also suggests considering how you’d like to improve your relationships. Would you like to enhance your current connections or make new friends? Would you like to hang out with people who share your religious beliefs or individuals who have the same illness? Then make a list of specific ways you’ll approach these relationships. Cheu also underscored volunteering and having face-to-face interactions.

Cultivating Spirituality

In his book, Cheu defines spirituality as “a way of thinking and living that uses the positive aspects of human thinking, feelings, and behavior to achieve meaning and purpose in life.” He suggests exploring your personal values and making a commitment to live them. Consider how you’re “going to live out this life, today and every day.”

Cultivating spirituality also includes regularly checking in with yourself and asking whether your current life reflects your values, Cheu writes. He also notes the importance of gratitude, and showing your appreciation for your caregivers.

Having a chronic illness can be devastating and make you feel incredibly helpless. While you have little control over your diagnosis, you can take charge of your responses and reactions. A chronic illness doesn’t have to stop you from leading a fulfilling life.

And it’s not surprising. According to Ashley Eder, LPC, a psychotherapist in Boulder, Colo., “We are surrounded by overt and covert messages that encourage us to minimize our own needs and feel guilty when we engage in self-care.”

Food and relaxation are prime examples. “Think how many times a day you see some kind of reference to a woman ‘indulging,’ ‘splurging,’ or ‘sinning’ because she meets a basic need like eating food she enjoys or taking time to relax.”

There’s also the belief that taking care of yourself leaves less time and energy for others. But, as Rachel W. Cole, a life coach and retreat leader, said, “self-care is other care.” In other words, practicing self-care helps us help others more effectively. Below, Cole and Eder share other powerful ideas to consider if the palpable guilt appears.

Being Self-Centered

“We can move through self-care guilt by deciding that a big part of our service to the world is being exquisitely self-centered,” Cole said. But this has nothing to do with being selfish or narcissistic. Cole defines self-centered as someone who is “centered deeply within themselves,” as she writes in this post. She further explains:

Self-centered women are not easily blown over by the gusts of other people’s opinions, agendas, or problems coming their way. Their strong center keeps them steady. [...]

Self-centered women don’t put others before themselves to the point that they have nothing left. In turn, they have more to give to everyone. [...]

Self-centered women are their own compass. Their own north-stars. They navigate these choppy waters as an eye in the storm. This is why we so often take refuge in their work, words, and presence.

They are lighthouses for the rest of us because they are lighthouses for themselves.

Self-Care as Finite

“Think of care as a finite resource, like money in the bank,” Eder said. “You can’t give more than you have without bankrupting yourself. You also can’t invest your money in making more money if you give it all away. Having the resources to share with others depends on conservation and renewal of your own supply.”

Avoiding Resentment

When you’re tempted to do or give too much because of guilt, Eder said, remind yourself of the risks of resentment. Think about what it feels like to be on the receiving end of a resentful giver, she said. This person “generously helps you out… and then reminds you of it with loud sighs and indirect comments about how much they sacrificed.” And this never feels good — for either person.

But when we over-do or over-give, bitter sentiments are a natural result. “Giving more than you can spare ultimately leaves you resentful and spent,” Eder said.

Self-care actually turns out to be a powerful way to care for others. According to Eder, “One of the most loving things you can do for people in your life — your kids, partner, friends, colleagues — is not put them in a place of future resentment.” This kind of care nurtures both you and your relationships, she said.

Ultimately, remember that self-care is essential and non-negotiable. It’s not the same as pampering. (But, on some days, it could be.) When we confound the two, we make self-care into an indulgence or a someday activity. It’s neither.

As I wrote in this post on Weightless, “Self-care is everything from getting enough sleep to being honest with your spouse. It’s giving yourself what you need and asking what you need from others.”

Self-care is a fundamental piece of our lives. As Cole said, “we’re part of the fabric of life and we, ourselves, are our little patch to take care of.”

One strategy particularly struck me. He suggested that if you’re feeling a negative emotion, you can work to reduce it simply by labeling it in one or two words.

Note, however, that thinking or talking at length about the emotional state tends to intensify it, while simply observing and labeling it helps to quell it.

I do this myself, instinctively. I find myself thinking, “I’m overwhelmed” or “I’m frazzled” or “I’m feeling defensive” — and it’s odd how calming it is. Just putting a label on a feeling helps me to master it.

For those who enjoy reading about what’s happening in their right ventrolateral prefrontal cortex and elsewhere, Rock explains how brain function accounts for this phenomenon.

How about you?
Have you ever tried a strategy like this — and did it work?

Lots of great material on Positive Prescription — I especially enjoy the category Visual Prozac — “because looking at beautiful things increases happiness.” Indeed.

I got a big kick from seeing The Happiness Project make an appearance in Dan Zevin’s hilarious piece in the New York Times Sunday Review, on The Dow Jones Emotional Average.  “The Dow feels better about itself today after it stayed up all night reading ‘The Happiness Project.’”

It’s especially helpful if you’re raising a child who’s under 5. As Neff writes, “Raising infants and toddlers, with their constant need for supervision, picky food habits, tantrums, not to mention dirty diapers, has to be one of the most challenging jobs around.”

In Self-Compassion, Neff shares the work of Australian psychologist Rebecca Coleman, Ph.D. Coleman has developed a parenting program called Mindful Awareness Parenting (MAP). It teaches parents mindfulness and self-compassion skills and helps them make good decisions in tough situations.

Neff explains that MAP also teaches parents to empathize with their kids, and help them nurture their kids’ needs.

Specifically, in order to respond to your child’s needs, it’s important to be fully present — body and mind. This helps you build a secure attachment, the best kind of connection you can have with your child. According to Coleman on her website:

“Children learn about themselves by the way we communicate with them. For children between birth and five years this is mostly non-verbal, so they need to see our eyes & face which mirror that they are worthy of our kind attention, love & delight. Our loving presence enables our children to experience being protected and understood which builds their confidence and trust in life. Fifty years of research supports the long-term benefits of having a secure attachment relationship with Parents and Caregivers. Secure attachment is formed when we sensitively and consistently respond to our child’s relationship needs with strength and kindness (‘tuned in’ or ‘attuned’). When we are preoccupied with the past or worried about the future (in ‘automatic pilot’), we are physically present with our children but are mentally absent. Children do not need us to be fully available all the time, but they do need our presence during connecting interactions. This includes needing to be welcomed by us when frightened or supported to explore their environment when curious (attachment & exploration needs).”

Mindfulness and self-compassion also help to repair your relationship when you inevitably make mistakes. Coleman writes:

“Being a Mindful Parent means having intention in our actions so we can purposefully choose our behaviour with our child’s emotional & social well-being in mind. Parental self-compassion helps our children to learn that perfection is not the goal and rewards are not just for perfect jobs. Repairing relationship disconnections is the key to being a ‘Good Enough’ Parent, which basically means making mistakes with our children and knowing how to fix them. With mindfulness & self-compassion we can repair relationship disconnections with our children, which is a crucial aspect of developing secure attachment relationships with our children.
”

Helping Your Child Express His or Her Feelings

When their kids have an outburst, many parents give them a “time-out.” Neff, however, suggests giving your kids a “time-in.” In her book she includes a helpful exercise based on Coleman’s MAP protocol. It aims to help your child process “big feelings,” such as a tantrum or crying.

When kids misbehave, sometimes it’s because they’re seeking support and connection, Neff explains. This exercise helps you connect to your child and teaches them to express their emotions healthfully.

According to Neff, this exercise “allows your child’s feelings to ‘be felt’ and accepted. It shows your child that you are willing to help him and that your love means you will be welcoming and accepting of his emotions – even difficult ones.”

Neff gives the following suggestions for creating a “time-in”:

• First, make sure you’re calm yourself. This way, you can truly tend to your child’s needs. If you’re not, tell your child that you’ll need 10 seconds to calm down.
• Have a specific spot for “time-in,” like a chair or cushion you can move throughout the house. Both you and your child will sit there.
• Invite your child to come to this spot. “If he is emotionally out of control and presents a danger to others, he may need help getting there.”
• Keep your tone “firm, reassuring and kind.” Be sensitive and sympathetic. Try to be present, in the moment.
• Observe your child closely and try to figure out the feelings and meaning beneath their behavior.
• Help your child describe their feelings when they’re finally relatively calm. Neff suggests saying something like: “You look like you’re struggling with this …” or “This looks hard for you; are you angry/afraid/sad?”
• Wait for your answer, and listen intently. “Acknowledge and accept the answer (or lack thereof).”
• Share your own feelings, using sentences such as “When you did _______, I felt _______ (emotion) arising in me.” Try to convey your feelings in a straightforward but non-blaming way.
• When your child is calm, help them find another activity to do, or continue with your plans, such as eating dinner or going to bed.

Learn more about Kristin Neff and her work here. Also, for information on parenting and mindfulness, check out our popular Psych Central blog Mindful Parenting.

However, according to Dana Becker, Ph.D, author of the thought-provoking book One Nation Under Stress: The Trouble with Stress As An Idea, by focusing on how each person can manage stress, we’re obscuring the bigger picture and issues: the social, political and economic problems that spark and perpetuate our stress in the first place.

Today’s articles and rhetoric on stress imply that if we fix ourselves, we’ll fix everything. Instead of stress-reducing tips empowering us, according to Becker, “we’re being sold a bill of goods.” We’re buying into an illusion that “blames the victim.”

“The advice is targeted to help us achieve a sense of control in situations that aren’t really controllable except through some kind of economic, political or social level.” In other words, “having control over how well we eat isn’t the same as changing workplace policies.”

Instead of talking about poor workplace policies, spotty daycare and other hurdles for single parents or dual-career households, we’re talking about stress, said Becker, a psychotherapist and professor of social work at Bryn Mawr College. Instead of fixing the problem of a single parent with three kids having to work ‘til 8:30 p.m. every night, we’re talking about taking a bubble bath, she said.

Becker doesn’t dismiss the importance of self-care or healthy habits. She views this as a “both and.” “Nobody is saying that it’s a bad thing to take care of ourselves. [But] a lot of these problems won’t be solved unless we engage in a national discussion.”

History of Stress

So how did the concept of stress come to be? The term “stress” was used as early as 1914 by Harvard physiologist Walter Cannon. But his concept was different than ours today. As Becker notes in One Nation Under Stress, “Cannon described stress in terms of heat, hunger, oxygen deprivation and other phenomena that can cause predictable physiological responses.”

He concluded that in response to fear and fury, our bodies released adrenalin and our heartbeat and blood sugar increased. But our bodies would always return to “homeostasis,” or keep “on an even course.”  Remnants of this theory do live on today. According to Becker in her book:

“…it is generally agreed that, after Cannon, all stress theories were based at least in part on his ideas about homeostasis. Cannon’s work lives on in the popular idea that there is an ongoing battle between our out-of-date physiology and the demands of modern life. We make biological ‘adjustments’ that are no longer functional: we react to an angry boss the way our Stone Age counterparts reacted to a saber-tooth tiger, but we can’t run away…”

It was Czech-born endocrinologist Hans Selye who popularized the concept of stress. At first, Selye used the term “stress” much like Cannon did. But by 1950, Becker writes, “he was describing stress as a ‘response to a condition evoked by stressors.’” In his book The Stress of Life, which Selye penned for the public, he refers to stress as “the rate of wear and tear caused by life.” He also made the connection between stress and disease.

Selye was a master marketer of stress. According to Becker in her book, “A tireless promoter of the stress concept, Selye sold and resold it over the years in popular and professional venues – in his best-selling books The Story of the Adaptation Syndrome and The Stress of Life, in talks to doctors’ groups in Canada and the United States, and at meetings of the American Psychological Association.

But Selye was so good that while the public accepted stress as a prominent concept, his specific theories got lost. In fact, “…the ‘truth’ of the stress concept and the American embrace of it did not come about through scientific agreement or through medical cures for ‘stress-related’ diseases. It was stress’s popularity that made it ‘true,’” Becker writes.

Collective Movements

While it’s the American way to believe we can fix anything on our own, some problems require collective action, Becker said. Take discrimination, for instance. The only reason the brave behavior of Rosa Parks “worked is because there was a movement already afoot,” Becker said.  If a movement didn’t exist, her individual protest would’ve likely been an isolated one.

Today, there are many collective movements that aim to effect change. Becker mentioned a website called MomsRising, a place where moms can connect and pressure their representatives to make changes at the policy level.

Ultimately, Becker believes we’re asking the wrong questions about “stress.” Rather than solely asking how we can alleviate or reduce our own stress, we should be asking how our society – at the policy level – can address the bigger picture. The problems at the root of our stress are rarely individual issues; they’re social ones.