Drawing on her own experiences and her observations of others, Schoen explains exactly what a “gentle self” is.  This type of narcissist puts others ahead of themselves because the narcissist feels that he or she is unworthy of love or respect.  I can definitely relate to the gentle self.  Schoen spends half the book comparing and contrasting the two types of narcissist.  You may be thinking, “How can someone who puts others first be a narcissist?  Isn’t that the exact opposite of what a narcissist is?”  Schoen addresses this very question.  She explains that a narcissist is anyone who is self-absorbed.  The gentle self is self-absorbed in the sense that they are constantly thinking about how they don’t feel like they belong, how they aren’t worthy of love, etc.

The second half of The Gentle Self is about how to overcome depression, anxiety, shyness, and low self-esteem.  Schoen offers such advice as, “If you feel strong anxiety or pain or even a nervous breakdown approaching, the first rule to remember is: leave yourself alone.”  She goes on to say, “We often tend to put more pressure on ourselves in the form of ‘I can’t possibly burst into tears right now,’ ‘what’s wrong with me,’ or ‘I hate myself,’” and suggests trying to “be your own friend” when others are being negative toward you.

In romantic relationships, Schoen recommends bringing the spontaneity that we crave into the relationship instead of waiting for our partners to do so.  If we sit around waiting for our partners to read our minds and do what we want them to do, our relationships will end in failure.  Affairs are a not uncommon problem in relationships with gentle narcissists.  In friendships, Schoen says that gentle narcissists should get out and meet people.  Since it’s human nature to crave connection, meeting strangers on the street can feel refreshing and give the gentle self the confidence he or she needs to feel good the rest of the day.

Some other practical methods that Schoen provides for dealing with personal issues are the typical options: psychotherapy, meditation, and growing up.  The phrase “growing up” means something different to everyone.  In the context of The Gentle Self, growing up can be explained with three ideas:

• Leave yourself alone.
• Stay involved with other people.
• Take care of somebody else such as a child, grandparent, or pet.

If you, or any other gentle self, can get your mind off of how you feel about yourself, you get out with friends or meet new people regularly, and you have someone you can pour your affection into, your life might just start to look a little bit brighter.

All in all, I’m not too sure how effective Schoen’s methods are.  I’ve tried meditation before with little success.  Though I do feel a little better when I’m interacting with people, when that interaction has ended, I’m back to feeling how I did before—worthless and unimportant.  There are a lot of things that I agree with in The Gentle Self.  As I read, I could see so many parallels with my life.  Everything from distant parents trying to live through me to my fear of intimacy in romantic relationships—Gerti Schoen covered it all.  I have yet to try psychotherapy, but it is something I’ve been looking into.  As for taking care of someone else, I don’t know what I would do without my pets.  The only way I can explain how I feel about my pets is how a parent feels for a child.  They mean everything to me and I would be lost without them.

On the whole, The Gentle Self was a slow read.  There are a few grammatical and spelling errors, but nothing that the average mind would notice unless it was looking for them.  Schoen offers sound advice.  Her methods work more often than not.  Ultimately, I would have to say that The Gentle Self is definitely a book I would recommend to anyone who suffers from major depression or bipolar disorder.  You may see yourself in the pages.

The Gentle Self: How to Overcome Your Difficulties with Depression, Anxiety, Shyness, and Low Self-Esteem
By Gerti Schoen
CreateSpace: August 25, 2011
Paperback, 136 pages
$7.20

Stress is not always harmful. Good stress allows you to stay alert and focused. For example, in a life-threatening situation, the stress response ultimately can have life-saving results. It can also help you in challenging situations, such as completing work tasks. However, there is also bad stress. Bad stress can cause damage to your overall well-being.

Many people often do not realize they are under stress until it has begun to consume them. It is important to recognize stress before it gets out of control. Stress can negatively affect your mental and emotional health and create interpersonal and relationship issues. It also can cause and exacerbate health issues such as: physical pain, skin rashes, digestive issues, sleep problems, depression/anxiety, heart problems, obesity, and autoimmune disorders.

How much stress is too much varies among individuals. Some people have a very high stress tolerance and may even enjoy stress to a certain extent; others may have a very low tolerance.

It is important to be able to recognize the causes of stress. If you are able to identify the causes, you can begin to find ways to successfully manage your stressors.

Causes of stress can be broken down into four main categories: general, life, work and internal.

General Stress

General stressors include fear and uncertainty. Fear, whether real or perceived, results in stress.

Uncertainty also produces stress. When we cannot predict an outcome we can feel a lack of control, which can produce stress.

Life Stress

Life stressors can include death of a family member or friend, injury, illness, new additions to the family, crime, abuse, familial changes such as marriage or divorce, sexual problems, interpersonal problems, physical changes, relocation, financial problems, environmental changes, or changes in responsibilities.

Work Stress

Work stressors include job demands, lack of support, relationships with co-workers and supervisors, poor communication, lack of feedback, criticism, lack of clarity, changes in organizational structure, promotion/demotion, long hours, or overall job dissatisfaction.

Internal Stress

Internal stressors are those we create. The way we perceive and view situations often can be the cause of stress. Some examples include negative self-talk, unrealistic expectations, wanting always to be in control, and seeking perfection.

Dealing with Your Stress

Once you have identified your sources of stress, you can work to begin to manage your stress effectively. Stress varies with the individual; effective ways to reduce it do also. Explore your options.

There are a variety of healthy ways to deal with stress. It often is helpful to look at each stressful situation independently and determine what can be changed — the situation or your attitude about it. Some individuals also choose healthy alternatives such as exercise, meditation, breathing techniques, and adopting an overall healthier lifestyle. Again, find what works for you.

If you are trying to cope with stress, or find yourself coping in unhealthy ways, you may benefit from talking with a close friend or family member. If your stress seems to be controlling you more than you are able to control it, you may want to seek out a therapist to guide you in the process. By identifying the source of stress in your life and identifying healthy ways to deal with it, you can control your stress. Find something that works for you and make it a part of your regular schedule. By doing so, you will be on the road to a life of less stress and overall wellbeing.

There are several medical options for dealing with stress. While medications can be helpful, many individuals want to avoid taking them every day or dealing with possible side effects.

There are several natural remedies to consider when dealing with stress.

Eating a Healthy Diet

Eating right is not only good for your body physically, but it is also good for emotional health. When we eat better, we feel better. Some suggest a natural body cleanse or detox to jumpstart this process. Avoiding excessive fats, carbs and processed foods will help you feel more energetic and may give you the energy to try other natural techniques. However, before making any changes to your regular diet, discuss options with your physician.

Exercise

Exercise releases endorphins – those “feel-good chemicals” that can improve your mood and leave you feeling good about yourself. It can help you cope with stress and ward off depression and anxiety. Studies also have shown that it can improve immune function, which is often compromised under high amounts of stress.

Having a Positive Attitude

Many individuals fail to recognize the results of a positive attitude. Making lemonade out of lemons can drastically improve one’s day. A positive attitude can leave you feeling more motivated to get things done, which can reduce stress. Having a positive attitude also can allow you to enjoy more success in all areas of your life.

Trying Herbal Remedies

Several herbal remedies can be used to reduce stress. Talk to your physician before beginning to use any, as some can interfere with other medications.

Aromatherapy uses the medicinal properties of plant and herb essential oils to relieve tension and provide stress relief. Lavender, chamomile, rosewood, geranium and frankincense are just a few oils recognized for their calming effects. They also can be used as massage oils.

Some herbs can be taken orally. Again, consult your physician first.

Massage Therapy

A therapeutic massage can encourage relaxation and aid in relieving stress. It has been shown to lower the heart rate, lower blood pressure, relax muscles, and increase endorphins.

Finding the right massage therapist for you is important, so don’t be afraid to ask questions and do a little research. Check into costs and check your health care plan. You may be surprised to find your insurance may cover several sessions. If they are not covered by your healthcare provider, you may find it beneficial to work into your budget.

Massage is generally safe as long as it is done by a licensed therapist. However, they are not appropriate for everyone. Consult your physician first.

Relaxation Techniques

There are several types of relaxation techniques. Deep breathing, progressive muscle relaxation, visualization, and meditation are among the most popular.

Deep breathing involves slow and patterned breathing that has been proven to lower the heart rate, reduce muscle tension, and reduce anger and frustration.

Progressive muscle relaxation focuses on slowly tensing and relaxing each muscle group, allowing you to become more aware of physical sensations in the body.

Visualization includes forming mental images to take a visual journey to a calming place. During visualization it is advised to use as many of the five senses as possible.

Meditation is medically defined by the practice of concentrated focus upon a sound, object, visualization, the breath, movement, or attention itself in order to increase awareness of the present moment, reduce stress, promote relaxation, and enhance personal and spiritual growth. There are many types of meditation, so it is best to find the method that works best for you.

You will find that relaxation techniques take practice. The more you practice, the better you will become. Keep looking until you find the one that is right for you.

In fact, about 30 to 40 percent of people with ADHD have an anxiety disorder, which includes “obsessive-compulsive disorder, generalized anxiety disorder, phobias, social anxiety and panic disorder,” according to Roberto Olivardia, Ph.D, a clinical psychologist and clinical instructor at Harvard Medical School. The Anxiety Disorders Association of America even estimates the figure to be almost 50 percent.

Here’s why ADHD and anxiety co-occur (occur together), how this affects treatment and several strategies for coping with anxiety.

Why ADHD & Anxiety Co-occur

ADHD symptoms can be very intrusive and make life a lot more stressful. For instance, you might miss a critical deadline at work and get fired, forget about your math final and fail the exam or act impulsively and put yourself in danger. Even the fear that you might forget something can keep people continuously worried and anxious.

In other words, “People with ADHD, especially when untreated, are more likely to feel overwhelmed and to have more things fall through the cracks which evokes more frequent negative situations—others are angry with them, they feel disappointed in themselves,” said Ari Tuckman, PsyD, a clinical psychologist and author of More Attention, Less Deficit: Successful Strategies for Adults with ADHD.

People with ADHD tend to be sensitive, which can leave them especially “vulnerable to feeling things more deeply and being more affected by situations and emotions,” Olivardia said.

Genetics also may explain why ADHD and anxiety co-occur. According to Olivardia, there’s good evidence to show that ADHD and OCD have genetic underpinnings. (Here’s one study.) Studies from Massachusetts General Hospital suggest that 30 percent of people with OCD have ADHD.

How Anxiety Affects Treatment

“Anxiety adds another element to ADHD treatment, because you are both developing strategies for the ADHD symptoms and working with the resulting anxiety simultaneously,” Olivardia said.

It also potentially complicates treatment because anxiety can paralyze and leave people stuck in their old ways. As Tuckman said, “People who are anxious are less likely to try new things for fear of them not working out—this includes new strategies to help them get on top of their ADHD.”

Anxiety has another side effect. “We don’t think as clearly when we feel anxious or preoccupied which can add to the ADHD-based distractibility and forgetfulness,” Tuckman said. This can happen particularly with more complex problems, he added.

Anxiety & Stimulants

Stimulant medications are highly effective in treating ADHD. But stimulants “can sometimes exacerbate anxiety symptoms,” Olivardia said. Still, symptoms should subside after several days or weeks, Tuckman said.

Also, these symptoms actually might be responses to the medication. According to Tuckman, “the physical sensations of faster heartbeat, dry mouth, etc. are just normal reactions to the medication, just as we would expect that our heart rate would increase after running up a flight of stairs.”

If people can’t tolerate stimulants, psychiatrists may prescribe a non-stimulant along with a selective serotonin reuptake inhibitor (SSRI), which has anxiety-reducing effects. (Tuckman noted that non-stimulants may be less effective than stimulants.)

However, if a person doesn’t want to take several medications, they might decide to medicate one of the disorders and cope with the other behaviorally, Olivardia said.

Also, therapy is very effective for anxiety, said Tuckman, who typically “prefer[s] to address the ADHD first and then see how much of the anxiety shakes out on its own…”

Anxiety-Alleviating Strategies

• Understand how your anxiety and ADHD work. Determining how your anxiety functions will help to “inform your treatment,” Olivardia said. “For example, if you found that most of your anxiety was coming from consequences of your ADHD, then the focus of treatment should be the ADHD. If you find they are independent of each other, although are affecting each other, then you want to make sure you are adequately giving each the clinical attention it deserves,” he said.

• Minimize worry. Anxious people worry excessively, and these negative thoughts can run your life if you let them. Instead, “Try to come up with alternate explanations or predictions,” Tuckman said. Let’s say your boss was short with you. Instead of thinking that you did something wrong, consider that she’s stressed because of personal reasons, he said. Unless you have a specific reason or actual proof, worrying is needless (and only makes things worse).
• Don’t believe everything you think. Again, worry thoughts energize anxiety. But you don’t have to listen to them. “Notice your anxious thoughts without believing everything your imagination comes up with nor feeling compelled to act on it,” Tuckman said.

  He explained that anxiety acts as an alarm that “warns us of danger.” For some people, this alarm is super sensitive. He compared it to a “fire alarm that goes off every time someone burns the toast. It’s bothersome to listen to that alarm go off, but we don’t go running from the building. We check out the situation, see there is nothing to worry about, then go about our business.”

• Engage in healthy habits and good self-care. Poor nutrition, lack of sleep and little exercise also fuel anxiety, and ensure you have a shorter fuse when it comes to stress. It’s tremendously helpful to eat nutritious foods, participate in enjoyable physical activities and get enough sleep.
• Minimize stress. Olivardia suggested that readers “lower [the] stress in their lives and introduc[e] activities that they enjoy and feel soothed by.”
• Surround yourself with supportive people. Negative people only add to your stress. Instead, fill your life with “positive, affirming people,” Olivardia said.
• Practice relaxation techniques. “Engaging in relaxation training and deep breathing can help [alleviate anxiety],” according to Olivardia. Learn more about relaxation and meditation methods and deep breathing.

Both anxiety and ADHD are very treatable with medication and psychotherapy, and there are many effective strategies to manage symptoms and lead a more enjoyable life.

Anxiety can be triggered by events or situations; however, it can also strike without cause. Symptoms vary for each individual and often with each attack. Anxiety can cause feelings of tightness in the chest, breathlessness, dizziness, confusion, racing heartbeat, upset stomach, and that feeling of just wanting to escape. It’s no wonder anxiety is so frightening and becomes debilitating to individuals.

It’s important to know that finding and understanding the root cause of anxiety often makes it easier to handle. Many therapists agree that this is essential for moving forward. In my experience, asking individuals to identify the thought or feeling that preceded the anxiety is often a great place to start. It may also be beneficial to think about what the environment was like.

If anxiety seems to strike frequently or there seems to be no identifiable cause, keep an anxiety journal. Chart when the anxiety takes place, write down as much information as possible, and rate the anxiety on a scale of 1-10. Charting the anxiety may provide information about the cause and may show a distinct pattern.

Once the cause is identified, try challenging the thought. If it is a fear of danger, stop and ask if you are in real danger. It should be noted that understanding the root cause may make anxiety easier to deal with, but it does not necessarily make it go away. If you or someone you know is struggling with anxiety, don’t be ashamed to seek help.

For many individuals, finding treatment for anxiety is important. There are several options for treating anxiety – herbal or naturopathic remedies, medication, therapy, or combinations of those. A skilled doctor or therapist can guide an individual in finding the best treatment. Treatment enables to individual to make the necessary lifestyle changes to better deal with anxiety.

In addition to treatment options there are also ways to help yourself. Anxiety is often triggered by perception. Perception can be altered by retraining the brain and challenging negative thoughts. This can be done in two ways: replacing the negative thought with a positive one or questioning the negative thought.

For example, if the negative, anxiety-producing thought is “I’m going to perform horribly on my test tomorrow,” immediately replace that thought with “I will excel on my test tomorrow.” If done consistently, it will become second nature and often curb the anxiety before it gets out of control.

Questioning the negative thought forces you to challenge your thoughts and change your perspective. Examples of these types of questions are:

• Is there a better way to look at this situation?
• Is this something that can actually happen?
• Will worrying about this help me in any way?

You can also take yourself out of the role of the worrier, and imagine how you would advise someone else in the same situation. Would you tell them to worry? Would you tell them that they have no reason to be concerned? How would you help them to have a more positive perspective?

You also can help yourself by acknowledging that your anxiety does exist. Don’t try to ignore the anxious thoughts and feelings; this often makes it worse. Embrace them for what they are – thoughts and feelings. Try to remember to react rationally and think of ways to deal calmly with the situation. Stay in the present. It is easy to say to yourself “oh no, it’s happening again and it will be awful.” It is also easy to get stuck on a negative thought. Be mindful of where you are in that moment. Find a focal point and breathe. Imagine your body calming down and the negative feeling going away.

These are not particularly easy tasks. They take practice. Explore your options and find what works best for you. It may be a matter of trial and error. This change is unlikely to occur overnight, but if you are consistent you will see some benefits.

It should be noted that many symptoms of anxiety can be caused by a serious medical condition, improper diet, or medication side effects. If you are experiencing physical symptoms, it is best to see a doctor as soon as possible. It is better to be safe than sorry. A doctor can rule out possible physical problems, and if you are truly experiencing anxiety, you can begin the journey to overcome it.

Harris is a physician and therapist who’s worked with many clients — thousands, he says — who hadn’t pursued their dreams because of little self-confidence and a whole lot of self-doubt. He’s also been there. For many years, Harris was drowning in insecurities and self-destruction. As an anxious young man terrified of failure and social situations, Harris used alcohol to cope with his crushing self-doubt. He drank his way through medical school, rarely had any meaningful relationships, and was even hospitalized for alcohol poisoning his third year. When it came to studying, his self-doubt was so powerful that he actually avoided it altogether and failed every exam his first two years of school.

As a junior doctor, his self-doubt and anxiety peaked — so much so that he developed red blisters on his fingers because his sweat-soaked hands would rub against his surgical gloves. Eventually, he got better and has been able to pursue his own passions, including writing books and regularly speaking to large audiences, with confidence.

The Confidence Gap is easy to read, encouraging and relatable. In addition to sharing his personal experiences, Harris features various anecdotes, including the stories of Nelson Mandela and Joe Simpson, climber and author of Touching the Void, along with a variety of techniques to help readers build up their confidence. These tools and tips are based in Acceptance and Commitment Therapy (ACT). Developed by psychologist Steven Hayes, ACT is a form of cognitive-behavioral therapy that was originally created to treat depression. But it’s been successfully adapted to many different fields.

One of the keys of ACT is mindfulness—a mental state of being fully aware and focused. Mindfulness helps people deal with self-defeating thoughts and painful emotions (such as anxiety and anger) and focus on fully engaging in life. Throughout the book, Harris provides readers with advice on cultivating mindfulness. Another part of ACT involves identifying your core values and letting those values guide your life.

According to Harris, ACT represents the following:

A—Accept our thoughts and feelings
C—Choose a valued direction
T—Take action mindfully

The book is divided into five parts. In the first part, “Warming Up,” Harris debunks common myths about confidence and explains why we lack self-confidence. In “The Double-Edged Sword,” readers learn what to do with negative thoughts. Unlike other approaches, ACT doesn’t try to change negative thoughts or use positive affirmations; instead you learn that “negative thoughts are not inherently problematic.” It’s when we get caught up in these unhelpful thoughts and let them prevent us from reaching our goals that they become a concern. Here, Harris also shows readers how to handle these thoughts and be fully present using all our senses.

In “What Gets You Going?” Harris helps readers identify their values, which he says “play a major role in developing confidence and enhancing performance.” Knowing your values is the best way to achieve your goals. According to Harris, values provide the inspiration and motivation to follow through even when things get tough; values provide a sense of direction (akin to a compass); and they make life fulfilling.

In “Taming Your Fear” Harris explains how fear works and teaches readers to accept it and use fear to their advantage. Throughout the book, he lists a variety of confidence “rules.” In this section, he writes: “Don’t fight your fear; allow it, befriend it, and channel it.”

The final chapter, “Playing the Game,” puts it all together and underscores the importance of acting with confidence. (“The actions of confidence come first; the feelings of confidence come later.”) Harris also shows readers how to get unstuck, get motivated (it’s not what you think), rebound from failure and reach peak performance.

At times, Harris’s tone is preachy, and there are plenty of cliché statements. He also includes many breaks in the text to encourage readers to pause and pay attention to their thoughts and reactions to the material. Some readers will love these brief breaks because they offer another lesson in mindfulness; help you become more aware of your thoughts and how they affect you; and may be comforting and reassuring. Others may find them annoying and distracting. But, of course, you can easily just skip over those sections. Here’s an example:

Now, before we go on, I’d like you to pause for ten seconds and notice what your mind is doing. Just quietly listen in to that voice in your head and notice what it is telling you.

Is your mind getting annoyed or frustrated: “Oh, please, don’t tell me he’s going to go down that old ‘fake it till you make it’ path. I’ve heard that one before!”? Or is it predicting the worst: “Oh no. He’s going to tell me I just have to put up with these feelings of anxiety, grit my teeth, and force myself to do it!”?

If your mind is telling you something like the above, that’s perfectly normal and only to be expected; as we shall see later, the human mind has a natural tendency to predict the worst. So let’s take this opportunity to clarify something: I am not ever going to ask you to “fake” anything or to “put up” with unwanted feelings. Quite the opposite, in fact. Two important themes in this book are being true to yourself (as opposed to being “fake”) and handling fear in effective, life-enhancing ways (as opposed to “putting up with it”).

And The Confidence Gap does just that. It’s packed with valuable insights and activities and inspiring anecdotes that’ll help both readers who need a little lift in their confidence and those who need a big boost. If you’re willing to put in the work to do the activities and practice the new skills, The Confidence Gap will help you create and live a more fulfilling life.

The Confidence Gap: A Guide to Overcoming Fear and Self-Doubt
By Russ Harris, MD
Trumpeter: September 13, 2011
Paperback, 240 pages
$15.95

These consuming and crazy-making fights are generally fueled by unspoken and unnamed fears. Because most of us do not like feeling scared, we have spent years developing strategies to try to control our fear by squashing it or avoiding it. The problem is, fear does not like being forced out of town. It may ride away for a while, but it will come back, with its posse, armed and ready to force us to hear it and take it seriously.

It is often in a marriage or committed intimate relationship that our fear comes riding back into town, ready to avenge us for casting it out. We have treated fear as the enemy, so it has gone into fighting mode. In fighting mode, fear is ruthless.

In fighting mode, fear attacks by pulling us into a dark and catastrophic drama where we become so panicked and terrified that we can’t ignore the fear any longer. For example, perhaps a woman has a deep fear about being isolated and lonely. When this fear hits her periodically, she keeps it inside, trying to push it away. Eventually, the fear fights back, spinning a tragic story that features her husband as the ‘losing interest’ spouse who will eventually leave. Her mind, now controlled by fear, gathers bits and pieces of information that confirm and support this story.

Now, perhaps the relationship does need some work. Perhaps her husband has been distracted and has not been attending to the relationship. Perhaps her husband’s energy is unavailable because he is being attacked by his own fears. As in any relationship, these thorny issues of ‘give and take’ must continually be addressed and worked out.

Once fear has gone into attack mode, however, and the tragic story has been spun, there is no way to deal with these issues in a productive manner. Instead of a respectful and solution-focused conversation, the husband is now locked into the bad guy role. As a result, he may feel so trapped, frustrated and misunderstood that he is likely to lash out or run away from any discussion. This just confirms that he is the villain.

To further intensify the drama, perhaps the woman is now the villain in the partner’s fear-driven storyline. He is now seeing the woman as the demanding and ‘never satisfied’ demon in the story that was created by his underlying fear of ‘not being good enough.’ Now stuck in the demon role, the woman feels so trapped, misunderstood, and frustrated that her own story reaches a fevered pitch of terror. The relationship hangs on the edge of a cliff, with imminent doom and total destruction.

Coping with Fear in Your Relationship

It doesn’t have to be this way. There is another way to deal with fear:

1. Name the underlying fear. Some examples are: Fear of falling apart, fear of rejection, fear of not being understood, fear of being judged, fear of being alone, fear of loss, fear of change, fear of aging, fear of being overwhelmed, fear of your needs being ignored, fear of boredom, fear of lack of control, fear of failure, and fear of helplessness.

2. Tell your partner that you have some fear arising inside of you, and share those fears. Own your fears instead of blaming your partner. For example, say ‘I am feeling afraid of a loss of control of our finances’ instead of ‘You always have to be the boss with our money.’

3. Listen to your partner’s fears. Do not try to minimize, negate or ‘fix’ the fears. Do not try to bully your partner’s fear into submission. Do not belittle, humiliate, shame, and threaten the fear. Do not make snide remarks such as ‘Oh, you are always afraid of something,’ or ‘Why can’t you just relax and be happy for once?’ By trying to run the fear out of town, this technique to try to avoid a difficult conversation will backfire and leave you with a bigger mess.

4. Recognize that your partner’s fears are likely to trigger your own fears. For example, if your partner voices a fear of boredom, you may interpret this to mean that he or she is judging you as not being interesting enough, and you may feel a deep fear of rejection. It is important that you do not take over the whole discussion with your reaction-fear, and leave no space for your partner’s fear. On the other hand, it is also important that you make some room for your own fear, letting your partner know how you feel.

5. Focus on the fear and do not get detoured into specific details of the relationship. For example, don’t let ‘I feel fear of loss of control of our finances’ turn into ‘Why can’t you stop spending money on golf?’ Plan to discuss concrete and practical relationship issues at another time, when fear is not running the show. (And then stick to that plan!)

6. Contain the fears within boundaries. Recognize that these ‘fear’ talks will occur regularly throughout the course of the relationship, but keep each discussion within a reasonable time limit, such as 10 to 20 minutes. Kindly support each other to move on and enjoy life once the fears have been named and heard. Don’t set the boundary with anger and bullying by saying things like ‘Aren’t we done with this yet? Can’t you just let it go already?’ If one person is not done processing, gently but firmly plan for another time to talk the next day.

No one is very good at this. It goes against our lifelong patterns that have been set up to push fear away. Even if we move slowly in this direction, however, it can lead to a triumph of love over the destructive potential of fear, and make the difference between a relationship living or dying. That is not to say that love and acceptance transforms fear into rainbows and butterflies. Even within the arms of love, fear is still raw, painful, and deeply unsettling. But when fear becomes an accepted ‘citizen’ in the relationship, it is no longer the enemy. It’s just the colicky baby that needs your time and attention once in a while.

“Think for a moment,” Dr. Forbes says in her introduction, “how many times have you known what your issues are, yet not been able to change them?” She argues that traditional psychotherapy sessions that dwell on talking are not the only way to change. She believes that “Conceptual insight is not required for change; in some cases it actually interferes with it.” and states that “. . . working in a body-based realm we can bypass this mental interference. We can feel rather than think the emotional experiences that heal us.”

She spends a significant amount of time explaining the relationship between the mind, nervous system, and body. Dr. Forbes largely appeals to our own experience to validate her claims. When speaking about anxiety, for instance, she says “Your mind provides the sped-up, worried thoughts. Your nervous system builds on that foundation by elevating heart rate and blood pressure and producing a host of other mind-body effects. Your body chimes in with rapid physical movements, or fidgeting.” Although this line of reasoning is compelling because even those of us who don’t suffer from clinical depression or anxiety can still identify with this description of mental and physical symptoms, she fails to mention research that supports her claims that mental conditions can be treated through body work.

Dr. Forbes also combats what she calls “the myth of instant healing.”  This recurring theme, which is perhaps one of the most valuable parts of the book, stresses that since our patterns of depression and anxiety develop over time, any treatment must also be given time to be effective. On this topic she supports her claims by citing  research about neuroplasticity. In the section called “Our Capacity for Change,” Dr. Forbes says, “Neuroplasticity refers to the brain’s extraordinary capacity to transform with experience.  When we commit over time to a pursuit such as yoga, our brains forge new connections, grow new cells, increase cell size, or enhance cell activity.  She states that “[the brain] also builds patterns through yoga’s therapeutic tools: in particular, breath, relaxation, meditation, and postures.”

The cornerstone of Forbes’s system of treatment is her “five building blocks for lasting healing.” The building blocks are balancing the nervous system, regulating the breath, cultivating direct experience, quieting the mind, and changing our personal narratives. Her simple yoga poses address the first two through physical means, facilitating the final three through “going inward,” or introspection and nonjudgmental awareness of what arises in our psyche.  In many ways these three aspects are reminiscent of other Eastern philosophy-inspired methods of self-analysis, such as Buddhist Zen meditation, as well as with more modern incarnations, such as Don Joseph Goewey’s Mystic Cool.

The second section of the book is a diagnostic to help the reader determine his or her  emotional type in order to determine which type of Restorative Yoga practice is best suited.  The four emotional types are given as  “anxious body/anxious mind, depressed body/depressed mind, depressed body/anxious mind, and anxious body/depressed mind.”  When readers determine which emotional type they have, they can move on to the final section of the book, a series of yoga poses designed for their specific needs.

Written in a very readable, almost personal style, Yoga for Emotional Balance is a compelling read for anyone interested in yoga or psychology, and not necessarily just for those suffering from anxiety or depression. Although the use of so many case studies becomes formulaic and predictable, they also help to illuminate the author’s point and make some academic or philosophical points seem more tangible.

It’s difficult to attest to the efficacy of the treatment plan as I do not suffer from the conditions described in the book, and I have not implemented the practices for a significant amount of time.  However, what I have experienced so far does match the book’s claims. For instance, the breathing technique called “1:2 breathing,” where, while breathing through your nose, you lengthen the exhale until it is twice as long as the inhale, did indeed lower my heart rate as the book claimed. My thoughts also slowed while I practiced this technique, which the book also predicted. If the other claims made in the book are as accurate as these, then I could see how the practice could be a powerful tool for positive change.

Yoga for Emotional Balance: Simple Practices to Help Relieve Anxiety and Depression
By Bo Forbes, PsyD
Shambhala: March 8, 2011
Paperback, 256 pages
$19.95

Jason Eric Schiffman, MD, MA, MBA, a psychiatrist at the UCLA Anxiety Disorders programs and editor of Anxiety.org says it’s one of the paradoxes of anxiety disorders. The severity of the disorder, the fear of being stigmatized, and general mistrust of conventional treatment may create obstacles to seeking help.

What Makes Complementary and Alternative Treatments Attractive Options?

The fear of conventional therapy could explain why complementary and alternative therapies (CAT) — such as vitamin supplements and yoga and meditation — are becoming increasingly popular. There was a time not long ago when we trusted Western medicine more than alternative treatments, but today the opposite is said to be true.

What accounts for this shift? Schiffman identifies four reasons why patients may be leaning toward complementary and alternative techniques to relieve their anxiety.

1. General mistrust of pharmaceutical companies.

The 2010 movie Love and Other Drugs does a good job of explaining patients’ growing mistrust of pharmaceutical companies. In a sentence, the relationship between pharmaceutical companies and physicians has become blurred. While Hollywood exaggerates the issue, the movie raises a legitimate concern: How much influence do pharmaceutical companies have on a doctor’s decision to prescribe certain medications? “The pharmaceutical companies are, by and large, publicly traded health companies, which means they have a fiduciary responsibility to their stockholders to maximize profit and that does not always align with the goal of doing what’s best for the greatest number of people,” says Schiffman. Although there have been recent efforts to prevent bias by limiting the way physicians and pharmaceutical companies interact, the general mistrust has stayed.

2. Side effects from commonly used SSRIs.

Schiffman says there is a correlation between the “amount of desired effects that a medication has and the amount of undesired side effects.” In other words, pharmaceutical treatments used are more effective than nonconventional treatments, but they tend to come with more side effects. In the case of selective serotonin reuptake inhibitors (SSRIs), a class of medications commonly used to treat anxiety disorders, sexual side effects can be perceived as intolerable. A previous post written by Psych Central founder and editor-in-chief John Grohol on Managing the Painful Side Effects of Antidepressants lists several of these common side effects. These reasons may be enough to pique patients’ interest in seeking alternative treatments.

3. No relief from SSRIs or difficulty in treating certain anxiety disorders.

According to Schiffman, “Only somewhere between 30-40% of people respond to their first treatment with SSRI’s.” And for some anxiety disorders, such as severe obsessive compulsive disorder (OCD), conventional treatment approaches may not always work. In fact, he says some patients in a “heroic effort to get relief” have even tried neurosurgery. The truth is that in comparison to Generalized Anxiety Disorder (GAD), OCD patients will require a higher dosage of medication. “If people have tried conventional approaches and are still suffering, it makes sense that they would then be willing to try complementary and alternative approaches.”

4. It’s human nature to believe natural products are better than synthetic.

When you hear the words “all natural” do you immediately associate it with low- or no-risk products? Equating natural products with safety and trust is a common and prevailing misconception with CAT. In fact, Schiffman says, “Natural products can be just as dangerous as synthetic products. Just because something is marketed as a natural supplement doesn’t mean that it is without risks.” In March 2002, the U.S. Food and Drug Administration (FDA) issued a warning about kava kava, a supplement used to treat anxiety, because of its potential negative side effects such as severe liver damage.

Yet, people who take supplements are more likely to trust companies and individuals promoting alternative treatments and supplements than pharmaceutical companies and the FDA. Instead Schiffman says, “the FDA and pharmaceutical companies and the marketers of supplements deserve the same degree of healthy skepticism.”

The Challenge with Seeking Alternative Treatments

It is understandable that individuals suffering from anxiety disorders want to seek alternative therapies — even more so because they can find information about them via the Internet in the comfort of their own homes. But because what’s out there on the World Wide Web isn’t regulated, patients may get misinformation that could have costly consequences.

Another problem is that many psychiatrists are not up to date with the latest research and information on alternative therapies. And if they are, Schiffman says they may be reluctant to comment on them either way. “One of the problems is that these medications have not been evaluated by the FDA [and] they’re fearful of the liability associated with recommending treatment that hasn’t been thoroughly evaluated or approved by the FDA.” As a result, people who are most qualified in terms of training and experience (such as psychiatrists) are less likely to evaluate potential treatments than people who aren’t trained because of the fear of liability issues.

What to Do if You’re Interested in Seeking Complementary and Alternative Therapies

If you think you are experiencing an anxiety disorder, you should always seek treatment from a mental health provider. If you are working with a therapist and are interested in pursuing an alternative route, consider asking them about potential treatments. In addition, a pharmacist or physician may also be able to answer your questions on supplements and provide information on any potential negative interactions with medications you are taking.

And while Schiffman has seen the positive effects of behavioral interventions such as yoga, meditation and deep breathing on anxiety patients, he advises individuals to avoid making decisions based on anecdotal evidence. Sites such as PubMed that publish current and evidence-based research are the best route for obtaining information via the Internet.

If you are suffering from a less severe anxiety disorder such as General Anxiety Disorder, Schiffman suggests “non-pharmalogical approaches first whether those approaches are complementary or alternative approaches like yoga or meditation or conventional approaches like cognitive behavioral therapy.” This is because there is less risk involved and fewer physiological side effects. However, it is important to note that if you are experiencing more severe symptoms or in the moment anxiety as in the case of phobias or panic attacks, CAT may be less effective. Cognitive Behavioral Therapy (CBT) alongside complementary and alternative techniques might work best in those situations.

Knowing all the work and research involved, is it worth seeking complementary and alternative therapies?

Schiffman wholeheartedly says yes. “When someone gets better from anxiety through a practice such as yoga, meditation or through therapy, they get better because they’ve learned something rather than getting better because a pill has made a change or caused a change to their neurochemistry.” Making an effort to change your lifestyle by learning ways to reduce stress and anxiety not only empowers individuals, but creates change that is “much more profound and long-lasting.”

The choice ultimately is yours. But Schiffman leaves us with this final thought to mull over: “If the goal is to increase the quality of life of the person who’s suffering from anxiety, it doesn’t make sense to limit one’s self to either conventional or non-conventional treatment.”

The stigma and prejudice toward mental health issues in Black communities is especially thick, making it very difficult for persons suffering from depression or anxiety (or any mood disorder) to acknowledge it, let alone seek treatment. When I participated in a six-week outpatient program at Laurel Hospital, half the group was African American. The stories horrified me. Most of the African Americans could not reveal to any member in their family what they were doing (the outpatient program) because the stigma was so deep and tall and wide.

Awhile back I interviewed professor and blogger writer Monica Coleman, Ph.D., on Beyond Blue. She described the stigma in this way:

In many ways, I do think that there is a greater stigma among African American culture than among white cultures. I live in southern California, and many white people will freely reference “seeing a therapist” in normal conversation. Black people don’t do that. Seeing a therapist is generally seen as a sign of weakness or a lack of faith. There is still an active mythos of “the strong black woman,” who is supposed to be strong and present and capable for everyone in her family – and neglects her own needs. In the midst of a depressive episode, I had a friend say to me, “We are the descendants of those who survived the Middle Passage and slavery. Whatever you’re going through cannot be that bad.” I was so hurt and angry by that statement. No, depression isn’t human trafficking, genocide or slavery, but it is real death-threatening pain to me. And of course, there are those who did not survive those travesties. But that comment just made me feel small and selfish and far worse than before. It made me wish I had never said anything at all.

So without support from the community, or at least family and friends, how does a person begin to recover?

Monica has found strength and healing and affirmation through speaking and writing candidly about her own depression — her attempts to penetrate the stigma for others. She says:

I am just now learning that vulnerability is strength. I am learning to speak and write boldly about the reality of living with a depressive condition. Even when it’s hard and I don’t have it all figured out and it’s actively kicking my butt. It’s the most terrifying thing I’ve ever done. It feels like running naked across the front lawn.

But I also feel a lot of affirmation when people respond — especially other black women — and let me know that their processes and challenges are made lighter by hearing their experience reflected from a pulpit, leadership, the classroom, or wherever I am. That confirms what I’ve felt is a calling from God. It encourages me, and helps my health.

A few other African-American voices have joined her in coming forward with their stories, in becoming vulnerable so to free others from a different kind of oppression that Blacks have experienced in the past, but an oppression just as real. Among them is Terri Williams, who participated in a panel discussion at the Mental Health America conference last year. She gave me a copy of her provocative and insightful book, “Black Pain: It Just Looks Like We’re Not Hurting.” In it, she writes:

For much of my career I have spoken to diverse groups of thousands of people around the country about achieving success in business and in the field of public relations. In the last two years, I’ve begun dealing with major depression in my life, and when I give talks now, they’re less about business than they are about this misunderstood disease. First I talk about how depression almost killed me; in other words, I stand in front of audiences of hundreds of people, naked and transparent, with my arms flung open. Then I talk about depression and Black people–how it is crushing our youth and destroying lives–those who suffer from depression along with those who care about them. It is then that I think of Queen Esther, because she was called upon to reveal herself to save the lives of her people, AND SHE WAS SCARED TO DO IT, but she couldn’t stand to watch her people be destroyed–she had to save them. I think of Queen Esther because depression is killing Black people by the thousands, and I have to talk about it no matter how much it scares me.

As more voices join the chorus, may there be more dialogue in African-American communities about mental illness so that those inflicted with mood disorders have a chance to recover.

But always being in the know has a downside. In fact, the combination of safety-compromising events — 9/11, its upcoming 10th anniversary, terrorism, tsunamis, tornadoes, earthquakes, unemployment, dwindling economy — and 24/7 access can cause a kind of collective anxiety and helplessness, he said. (Interestingly, he’s noticed more people coming in with anxiety issues to his private practice and other facilities where he works.)

If you’re worried about the state of the world — or you’re struggling with anxiety in general — there are steps you can take. Tsilimparis discusses what fuels anxiety and how to overcome it.

Anxiety-Fueling Factors

For many people, anxiety comes from clinging to the illusion of control, Tsilimparis said. People think that they can control what happens in their country and with other people. They search for ways to control their environment to ensure safety and curtail anxiety. But the tighter you cling to the idea of controlling uncontrollable events, the greater your anxiety — because you inevitably fail.

Dualistic thinking — black-or-white, all-or-nothing thinking — also fuels anxiety: America is either safe or it isn’t; the economy is either swelling or sinking. There are no shades of gray, even though, as Tsilimparis said, few absolutes exist in life.

People with elevated anxiety also hold certain rigid beliefs about how they should live their lives, known as adhering to a “consensus reality,” or one-way thinking, he said. For instance, you might believe that by the time you’re 28, you should be married and have children. Or you might define happiness as owning your own home or success as making a six-figure salary.

What also drives anxiety is perfectionism — “you either succeed at 100 percent or fail at 97 percent” — and relying on others’ approval, Tsilimparis said. Looking for outside validation inevitably leaves people walking on eggshells and panicked over whether they’ve said the right thing or have done the right thing.

Solutions for Anxiety

First, it’s important to separate out the things you can control from the things you can’t. In other words, the motto your parents probably taught you is all too true: The only thing you have control over is yourself, Tsilimparis said. He admits that the statement is “trite and simplistic” but no doubt accurate.

If you can focus on the stressors in your life that you can control, you’ll end up feeling better about everything else. For instance, when clients come into Tsilimparis’s office with a freeway phobia (remember, he practices in L.A.), the last thing he treats is the actual phobia.

Instead, he helps them address “the little things in their lives they do have control over.” Why? Because anxiety is a shape-shifter. It doesn’t just make you fear freeways; it permeates other areas of your life. In other words, there are parallels between one’s freeway fears and how they lead their life in general.

Take the case of one of Tsilimparis’s clients. The client had been a caretaker his entire life, caring for his grandmother, who’d been in the Holocaust, and his mother who’d suffered abuse. He was terrified of driving on the freeway. He’d constantly focus on the other cars — and rarely on this own lane. The parallel? He also rarely focused on himself, a byproduct of being brought up in a family where his sole job was as caretaker. Tsilimparis worked with him on addressing his own needs and alleviating the stressors in his life that he could control.

The irony is that once you let go of wanting to control everything and focus on yourself, you gain control and your anxiety decreases. What also helps is acknowledging your belief system, which may be distorted. Tsilimparis suggested thinking of yourself as a movie director. Anxiety acts like tunnel vision, so you end up focusing on one thing. Instead, pull back the camera so you can see the whole picture. Adjusting your lens helps you “gain some perspective.”

It’s tremendously valuable for people with anxiety to notice their belief systems and then challenge them. Tsilimparis asks his clients to pay close attention to whether they’re seeking perfection, control or approval during the day.

The key is to “be reflective, not reactive,” Tsilimparis said. Reactivity breeds anxiety. If an anxiety-producing thought pops up, you might say, “There I go again, I’m about to go into illusion-of-control thinking, and I refuse to go there. I’m going to think differently.”

By disputing your beliefs, you can develop “new eyes.” Think of it as a swimming pool, Tsilimparis said. When you first jump into a pool, the water is freezing. The longer you stay in, the warmer it feels. But the water temperature, of course, never changed; just your perception did.

Here’s another example: The thought “I’m never going to be safe because terrorism is a real threat” might cause a surge in anxiety. Tsilimparis believes that no thought should go unchallenged. So a rational way to challenge this thought is by saying to yourself: I’m focusing on something that I have zero control over. This is the government’s job. So I’ll focus my energy and efforts on what I can control in my life, including my own job and being a good husband and father.”

There’s also nothing wrong with taking a break from the news, which Tsilimparis has suggested to some clients. Simply switch the channel or go TV-free for a few days.

• Strategies to Reduce Anxiety and Stress
• Taking on Anxiety and the Irrational Fears in Your Life

The book Transcendence: Healing and Transformation Through Transcendental Meditation was on my decline stack until I read the short bio on Norman Rosenthal, M.D. and became intrigued. He’s a clinical professor of psychiatry at Georgetown Medical School. He conducted research at the National Institute of Mental Health. And he was the one who first described and diagnosed seasonal affective disorder (SAD). Ironically, I knew of him through my good friend Michelle, who had been one of the case studies for him on SAD.

So, with those credentials I opened the book and began to read stories that inspired me and gave me hope that one day I might be a meditator too.

Rosenthal won my trust in that he clearly states in the introduction that Transcendental Meditation is not a stand-alone treatment for emotional disorders, especially when effective treatments are available and work (if not full proof). He writes, “The fact is that no single treatment works every time for any given set of symptoms. We often have to try several different medications or treatment approaches before we find the right mix. I am suggesting that TM should be part of that mix, especially when conventional approaches prove unsatisfactory.” Rosenthal would in no way advise a person to go off his meds and try this type of meditation. However, he believes that practicing it can be the difference between a life of coping and a life of living.

Before reading Rosenthal’s book, I was unaware of the ways different kinds of meditations activate neurons in distinct regions of the brain. For example, Mindful Meditation increases the activity of neurons not only in certain emotional areas of the brain, but also in frontal regions, which are responsible for decision making and other functions. In Transcendental Meditation, there is a more global effect. Characteristic brain wave patterns are seen in many different parts of the brain, so the meditator has a better chance of experiencing the effects of meditation long past the meditation session.

What, exactly, is this Transcendental Meditation? Rosenthal writes:

Transcendental Meditation is always taught one-on-one, at least initially, by a teacher who is a longtime meditator trained not only to instruct new students and provide follow-up, but also to customize the approach for each student. Initial instruction has seven steps: two lectures and a personal interview with a certified teacher, then four teaching sessions on four consecutive days. Each session lasts about ninety minutes. Ideally, the fledgling meditator then follows up with the teacher, perhaps weekly for the first month and monthly thereafter. These thirty-minute “checking” sessions give students a chance to ask questions and make sure their technique is still on track, so they will derive the maximum benefit.

Basically, TM is a nonreligious practice that involves sitting comfortably for twenty minutes twice a day, while using a silent mantra, or nonverbal sound, to attain a profound state of aware relaxation. And just like yoga or martial arts, says Rosenthal, in order to learn it correctly, you need ongoing guidance with a teacher.

A profound gift of TM is that regular practice increases brain wave coherence, meaning that the frequencies of brain waves in different parts of the brain work together as a result of TM. In seasoned meditators, brain wave coherence can be found throughout the day, not only during meditation. Electroencephalograms (EEG) indicate that TM calms the brain while organizing the prefrontal brain regions so that meditators can improve their focus, decision-making, and job performance.

Especially enlightening to me were Rosenthal’s chapters on how TM can help treat acute anxiety, major depression, and bipolar disorder. This psychiatrist and some of his colleagues obtained a grant to study TM in a group of bipolar patients. In the study, eleven people received immediate TM training, while fourteen people were placed on a wait list. Both groups continued with their previous medical treatments. A few from the TM group reported a drop in manic symptoms, however, depressive symptoms were especially relieved, as stated in the patient reports but also upon inspecting the results of TM by Rosenthal and his team. Explains Rosenthal:

Several patients reported increased calmness, improved focus, and improved ability to stay organized and set priorities–no surprise, given TM’s known effects on the prefrontal cortex. TM helped bipolar patients improve their executive function, just as it did for people with anxiety disorders and ADHD… All in all … our study study suggests that TM might be very helpful for bipolar patients. In fact, all the clinicians who worked on the study are now referring certain of their bipolar patients, particularly those with residual depression, for TM training–along with their other treatments.

Check out Rosenthal’s book, Transcendence, for more information on the science and benefits of Transcendental Meditation.

The book begins with a preface detailing the premise of the following chapters: that while some fear is useful, most is a relic of humanity’s primitive days and does not serve us well.  Following this theory, we can then be set free from this useless fear through a love of God and the practice of our “God-given” spiritual instincts.  Chapter 1 furthers these aims, describing more fully the “power and peculiarity of fear,” namely that fear is often inextricably entwined with love, is felt and expressed differently by different people, tends to be “managed” rather than set free, and finally that tension arises when religion is the source of fear—as in, the “fear of God.”  He also categorizes fear based on the three varieties with which people have approached him for guidance:

“1) ‘My world is falling apart’;
2) ‘The world is pressing upon me,’ the widely known ‘panic attack’;
3) ‘falling into the abyss,’ the so-called bottomless pit, which is the worst of the three.” p.17

Chapter 2 continues to examine fear through the author’s five insights:

“…the only power that fear has is the power that we give to it.”

“The freedom we want the most is found beyond the fear that we avoid the most…”

“…we must strengthen our Spirit…cultivating the very spiritual instincts that our fear would have us neglect or ignore.”

“One fear contains the power of every fear within it.”

“’How can we move through fear?’ and ‘How can we become who we are meant to be?’ are…one and the same.”  p. 34, 40, 46, 49, 52

The following seven chapters describe the spiritual instincts of Moving Through Fear’s title, one per chapter, and all conclude with a Spiritual Practice comprising suggestions for using each instinct in practical ways.  Chapter 3 starts off with “Awe,” defined here as “sensitivity to God’s presence,” be it in church or witnessing a sunset.  Awe has the power to “release the grip that fear has on us” through amazement of the vast, uncontrollable world around us (p.58).  Chapter 4, “Love,” has a similar message that when we release the need to control, the capacity for love increases.

Chapters 5 and 6, “Intent” and “Conscience,” relate to the part of fear that is within our conscious awareness.  Intent gives us the choice to be present in the moment of fear and so recognize when it has overtaken us (this concept is also referred to as “mindfulness” in many comparative works).  Conscience, our moral compass, tells us the right thing to do, the absence of which creates a vacuum for selfishness and fear.  “Community” and “Rest,” Chapters 7 and 8, suggest different ways through fear.  Relationships and recognition that humanity is in a “life together” combats the fear that results from loneliness; and freedom from the fear of doing nothing, noted here as “resting in God,” allows us the stillness that infuses peace (p. 189, 213).

Chapter 9, “Faith,” describes this final instinct as the most important, to be emphasized over all others:

“Faith is our God-given capacity to leap into the unknown.  To make this leap, we can no longer put our faith in the service of fear, or use faith to conceal our fear.” p. 235

The author also connects faith in the chapter-ending Spiritual Practice with all the other instincts to show how they are interrelated and circle back to the overarching importance of faith.

The book closes with an epilogue, “In Defense of Joy,” that wraps up the examination of fear with a description of what a joyous life can be, when fear is not allowed to rule.

When evaluating Moving Through Fear, there are two overall facets of it that must be addressed.  First, it is an inherently Christian book, even as it is described as “spiritual,” and second, it is also very personal.  To the former point, Bible references dot the text and are used both as background and examples.  The assumption has been made that the stories of St. Francis, Jericho, etc. are well-known and that they are accepted as matters of faith.  This is not to say that the book is wrong in doing so, just that it becomes gradually clearer that the intended audience should be of the Christian faith in order to get the most out of it.

To the latter point, the author has peppered the book with personal anecdotes and experiences, using the “I” voice almost exclusively.  This is not done unwittingly, and in fact is quite purposeful: “…I realize that anyone reading this book deserves to know a great deal about me as a person” (p. 14).  It does, however, make it harder to relate to than, say, Eckhart Tolle’s works on spiritual matters, in which he uses general fables and naturalistic examples that are more widely understood and easier to relate to.

Keeping those overall impressions in mind, then, Moving Through Fear is still a very insightful work, full of apt observations of the nature and effects of fear on the unaware person:

“Fear also has superb skills in the art of misdirection and distraction.  It will do anything and everything to turn our attention toward itself (that is to say, toward its power), and with equal cunning, away from itself, when denial serves its purpose.” p. 30

The author also uses a broad variety of settings and examples to combat the personal nature of his writing, with a modicum of success.  Bringing in NASCAR, Robert Oppenheimer, chicken farming in the South, and the Oracle of Delphi (to name a few) into one book is impressive.  It shows this reader what the author’s experience as a cultural anthropologist has brought to the table.  He rounds out a practical element of the work, too, by ending each chapter with useful and valuable suggestions on how to use that particular spiritual instinct as well as supplying a list of references and further reading to finish the book.

To conclude, while Moving Through Fear has a specific way of addressing its intended Christian audience, its central message is one from which we all can benefit:

“…we do not reach a point in our lives when we become completely free from fear, nor should we ever believe we can.  The issue is not whether we have fears, but whether we’re willing to find it within ourselves to move through them…” p. 164

While reading this book I was saddened by the lack of understanding that is often surrounding these problems but also hopeful that with reading materials like this, things will get better because they will be better understood. We now know that there is what is called simply the “baby blues,” which is not one of these disorders but simply a mild depression brought on mostly by physical changes in the new mother’s body. Although it should be treated and understood, it should not be mistaken for the more serious disorders that “Beyond the Blues” discusses.

This book set out to help caretakers of new mothers diagnose such problems as well as give several types of solutions for the various types of PPD. It also was written in such a way that the average person can understand what this terrible disease really is and how we might better help our families and friends through these hard times. It does a good job of removing the stigma and shame that has surrounded such problems. Hopefully, this will give pregnant women the courage to let their doctors know what’s going on even if it might feel embarrassing or confusing to the patient herself.

I especially enjoy the fact that the authors wrote several pages of questions the patients might have with answers that would make anyone feel more “normal” rather than the lepers they’ve been made to feel like in the past. One question is “Won’t medication be a crutch?” and the answer is, “A crutch is a temporary tool that you use until you no longer need it. If you broke your foot you wouldn’t think twice about using crutches to support you while your foot heals. Medication restores your brain chemistry to a normal state, allowing you to get back to feeling yourself and back to your life. As you become well, you and your doctor will develop a plan to wean you off the medication.”

Now, this might seem like a “no big deal” conversation, given the topic. However, I felt as though this was one of the ways that the authors legitimately make the once hidden topic seem as normal as breaking a foot.

Since giving birth and raising healthy, well-adjusted children is probably one of the most important jobs there is, it behooves us all to help keep mothers well-adjusted too. I believe in the fact that it “takes a village” so in that sense it takes a village to watch for problems with the mother, who is the main caregiver for the children in this world. We’ve seen and heard some horrific stories, which certainly aren’t the norm for mothers with PPD but the possibilities of tough and difficult to horrific are not possibilities that a new mother needs. If all of us read this book and understand more than we’ve understood in the past about this problem then maybe we can make it as easy to talk about as the “broken foot” scenario. That’s a nice thought when you consider we’re really on the fast track from hiding something in the basement to bringing it to the light of day.

I’m a 63-year-old woman who was lucky enough not to suffer from any of these problems when I had my two children. However, I was having my babies during the time when everything was simply called the “baby blues” and the mother was patted on the head and probably given the old standby in that day, valium, otherwise known as Mother’s Little Helper — which helped very little in most cases! I had several friends who suffered from what I now believe was PPD but were never diagnosed because they were ashamed or they were told by their doctors to “get over it.” Only through friends and families did some of them make it through without dire consequences and it’s good to know that this problem is now being brought to light.

This book, in my opinion, is something that should be in caregivers’ offices and even offered in whole or in part to women to take home and offer this information to the father, family and friends. If the mother never suffers from any form of PPD then she’ll be lucky but have also learned something she can pass on to someone else who might one day need it.

Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression & Anxiety

By Shoshana Bennett, Ph.D. and Pec Indman, Ed.D., MFT

Paperback, 157 pages

Publisher: Moodswings Press; 2011 updated edition (Nov. 1, 2010)

To the contrary, “many people get fearful in smaller situations,” with as little as five people or less, Esposito said. A person might get nervous at a meeting when co-workers are going around the room and updating others on their work. Or they might get anxious when introducing themselves to new colleagues.

I can relate. When I did my thesis defense, the entire time my knees were sweating — who knew it was possible to sweat profusely from your knees! — and this was just in front of my advisor and two committee members, who couldn’t have been more supportive or kind. Regardless, inside, particularly in the beginning, I was screaming “get me out of here.” Or some version of this phrase.

“People can also get anxious in situations in the community,” she said. She sees many clients who get anxious in church when asked to do a reading or a eulogy; or even when giving a toast. Anxiety can spike if an individual is speaking with someone of authority. Even teleclasses or teleconferences can trigger speaking anxiety. So can a regular conference when a person wants to ask a question.

What people fear most about public speaking is their own physical reaction and that others will notice the symptoms, Esposito said. Symptoms can include a shaking voice, profuse sweating, trembling, blushing and flushing, difficulty catching your breath, dizziness, nausea and gastrointestinal problems.

In addition to a surge in physical anxiety, people’s minds get flooded with fearful thoughts, she said. These automatic negative thoughts (such as “Other people will think I’m stupid because I’m stuttering or shaking” or “How am I going to get out of this?”) make individuals doubt that they can handle these situations, kick-starting a vicious mind/body cycle. “The more bodily symptoms, the more the mind gets really scared; the more the mind gets scared, the more the body amplifies these symptoms.”

As a result, many people try their best to avoid public speaking. But while avoidance provides immediate relief, it’s temporary and even backfires. It “makes [the fear] bigger and bigger in your mind,” Esposito said.

Fortunately, there are many healthy ways that you can take action and push through your public speaking panic. Below, Esposito explains her holistic approach, which takes into account the body, mind and spirit.

Your Body and Anxiety

Because people are usually “so concerned about what’s going on their body,” it’s important to practice strategies that calm the physical symptoms. The first step is to stop fearing the physical reactions, because this fear only magnifies symptoms. Observe these sensations without getting worked up, accept the symptoms and “ride the wave of anxiety.” Also, “remind yourself that even though the symptoms are unpleasant, they’re not going to harm you,” and your feelings will pass.

Breathing is another issue. “Many people either hold their breath or breathe very fast, choppy, shallow and erratically,” Esposito said. This tells your body that there’s an emergency. Instead you want to slow down and deepen your breath, she said.