San Diego Therapist Blog: Regina Huelsenbeck, PhD

This morning in my yoga practice, the teacher asked the students for any special requests. The responses often consist of requests to focus on the back, shoulders or hip area, commonly tight painful areas for many people. A woman at the back of the room hollered, "stress reduction". The teacher smiled and said, "we'll try to rush through some other stuff so we can get to stress reduction". We all laughed and then she quieted us down to begin formal practice.

As we were guided through breathing meditation, my instructor called our attention to the space at the end of the out breath. At the end of each breath cycle, there is a natural pause before the body moves into inhalation (take a minute to see for yourself, don't force it, just put your attention on your breath). Here she said, "you will find a natural space, the opportunity for stress reduction is innate to every breathing cycle. This calm space is there to be experienced at the end of every out breath, you just have to notice it".

There is indeed a natural pause at the end of each out breath, before the body naturally moves to the inhalation. At this pause, which often goes unnoticed, there is a space, a bit of nothingness, an instant of "mindlessness" if you will, to be experienced.

For the rest of the practice she would periodically call our attention to the out breath. We were in various poses, some more difficult than others, and she would continually remind us of this opportunity, this connection that is always there, regardless of the pose, state of mind or stress. The breath space was always there. 

I appreciated this gentle reminder to connect to the breath and experience the space within my practice. I have been mindful of this space today and have connected with it several times. I also appreciated my instructor's lesson for how it relates to mindfulness based therapy and mindful living. Life has such twisted predicaments, relationships and challenges, so often we are contorted, upside down and inside out, feeling lost, disappointed, stressed or hopeless.

But the calm space remains, untouched. 

The opportunity to experience it is up to us.

"To live with courage is the highest form of practice...It is interesting that both love and courage are said to reside in the heart. When we live by consciously choosing courage, we express life's spirit. Today express your courage by choosing something difficult to say or do. It need only be a small thing, but it will open your heart." 

The italicized excerpt was taken from "A year of living your yoga: daily practices to shape your life", by Judith Hanson Lasater, Ph.D., P.T.

When our lives are not going well, we may be more in touch with fear than with courage. Many people enter my office hoping to eliminate fear and find courage. Fear and courage however, are not mutually exclusive. You can feel both. Many people imagine that if they could stop feeling afraid, they could be change their lives.

But in reality, we can feel afraid and still practice courage. We can choose to stand up in courage and act courageously.

In yoga this morning, we were attempting a new trick, and my teacher gently reminded the class, "remember, yoga is a practice, not a perfect". Although I was feeling afraid, I decided to act with courage and try the new pose. It was indeed, not perfect, but I noticed I smiled a bit as I transitioned to the next asana. If you decide to practice courage today, do it with a gentle and compassionate attitude.

"...Today express your courage by choosing something difficult to say or do. It need only be a small thing, but it will open your heart." 

I am no longer afraid of mirrors where I see the sign of the amazon, the one who shoots arrows. There was a fine red line across my chest where a knife entered, but now a branch winds about the scar and travels from arm to heart.
Green leaves cover the branch, grapes hang there and a bird appears. What grows in me now is vital and does not cause me harm. I think the bird is singing.
I have relinquished some of the scars.
I have designed my chest with the care given to an illuminated manuscript.  I am no longer ashamed to make love. Love is a battle I can win.  I have the body of a warrior who does not kill or wound.
On the book of my body, I have permanently inscribed a tree.

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These are the words of cancer survivor and poet Deena Metzger...If you haven't read any of her books, I highly recommend them.

Healing is unique. Metzger's path to healing was intense, fierce and some might say radical, but it was Metzger's unique path. No one else could have dreamed it.

Every human being who traverses serious illness or trauma is tasked with finding a way through the darkness. It's beyond chemotherapy. I am talking about listening/seeing/experiencing and respecting the truth inside. It has been and continues to be the best guide through healing and transformation. Learn to listen...

How do you listen? The first session of  "The Integrative Oncology Lounge" is Tuesday March 30th from 4 to 5pm. We will learn mindfulness meditation attitudes/benefits and practice listening/seeing/experiencing.

Location: The Pacific Oncology and Hematology Associates 477 North El Camino Real, Suite D200 Encinitas, CA 

Cost: Free to all oncology patients (you do not have to be a "pacific oncology and hematology" patient). The group is supported by a grant from the Wings of Care program

Questions/RSVP/Comments: Regina@Ritualsofhealing.com or 858.880.0145

Many years ago, Integrative Medicine may have seemed "alternative". Today, it has gained acceptance in mainstream medicine because it works.

Integrative Oncology is a branch of integrative medicine (if you're into Andrew Weil his first book in the integrative medicine series is about Integrative Oncology). Integrative Oncology is a philosophy of healing which "focuses on the complex health of people with cancer and proposes an array of approaches to accompany the conventional therapies of surgery, chemotherapy, molecular therapeutics and radiotherapy to facilitate health".

On Tuesday March 23rd, Oncologist Dr. Steve Eisenberg and I will be discussing Integrative Oncology, engaging in treatment, healing, and your life. Expect to learn about Integrative Oncology and experience the benefits of mindfulness meditation. The talk is open to patients, family and loved ones.

This discussion will be held at Pacific Oncology and Hematology Associates in Encinitas. Tuesday March 23rd, 2010 3:30pm-4:30pm.

The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.

~ M. Scott Peck

It's quite possible that these uncomfortable and even terrifying experiences are the very times when we may grow the most, sprout wings and learn to fly.

Rebirth:  chronicles a woman's experience with Leukemia....through chemotherapy, a bone marrow transplant, heartbreak, loss, and also spiritual, emotional and physical rebirth.

"Rebirth" is Ludwig's year-long journal chronicling a story of love, sacrifice, heartache and discovery that culminated in her physical, emotional and spiritual rebirth. 

Cancer is such a dislocating experience. We feel alone, alienated and lost. Any sense of security is just gone. A personal story like Deborah's can really help us through our own experience. It can lessen our sense of anomie and isolation.

A portion of Rebirth's royalties will be donated to Leukemia and Lymphoma Society.

If you've recently been diagnosed, get a personal experience book like Ludwig's. You can also go to my coping resources page. I have other personal experience books listed here

Whatever you may be feeling internally is simply passing through at this moment. 

Breathe in and breathe out.

Your feeling state does not make you personally right, wrong, weak, strong, good or bad. Feeling states and thoughts float through us all day long. We are in a constant state of change. Nothing is permanent and nothing lasts forever. Thoughts, feelings, and even our basic biology is constantly in a state of change. Cells are changing every single minute. Some say we get cancer many times a day through flub-ups in cell DNA replication, but this does not always become a diagnosis of "cancer" per say, because we are constantly in a state of repair, replication and change. And the same is true for thought and feelings. They come and they go. Nothing is permanent. They float in and they float out.

It is only when something stops the stream, the flow, that things get out of whack. With thoughts, when we identify with the content of a thought, we get into trouble. For example, pretend the thought: "I can't do this" floats by. If I notice this thought for what it is: just a thought, then I can release it and the thought is free to continue floating by, and another thought will float through and so on and so on. However, if I get "hooked" or identify with the thought content by saying, "yes!, that is me, I can't do this... and...actually... in the past I could not do those other things...", then the spiral begins. The mind has gotten stuck in this content, hooked into the thought and a spiral has begun. This is one way depression or despair begins (which is anger turned inward)....through faulty thought identification.

To stop this spiral from happening you can pull out the hook. You can practice releasing thoughts. They are not really yours anyway. They are simply thoughts and feeling states. They come and they go. Getting hooked means identifying with or conversely fighting a thought or feeling (trying to push it down, deny it, or anesthetize). Either way, through identification or avoidance, you have engaged the thought/feeling state. It will usually stick around until you cut bait or gently release it. Try the fisherman's practice of Catch and Release.

Also note, there is usually a quality of rigidity and self-judgment to this downward spiraling. Add compassion and flexibility, to catch and release and see what happens.

A word on compassion from Pema Chodron:

Resource: Get out of your mind and into your life by Steven Hayes, PhD.  

....goes the Green Day song. This song is based on Billie Joe's (Green Day lead singer) experience of living through seemingly interminable grief after his father's death. He longs for the pain to end. The grief hangs on him, his constant companion.

"Here comes the rain again...drenched in my pain again" are poignant lyrics describing the experience of grief. As time goes on, you seem to feel alright for a moment here and there, but suddenly you are "drenched" again in the heaviness of it all, and you're completely and totally helpless. Like a sudden thunderstorm, grief pours from the heavens. The feeling washes over you like a wave, and you simply cannot shake it, you ride it.  

Grief and loss bring us to our knees. Very few things in life can provide suffering like losing someone close to us can. Grief is not only related to literal death. It also appears with other great losses, for example: the ending of a relationship (divorce) or the loss of one's innocence, youth, or agility (aging).

Grief can become heavy. We wish someone could "wake" us when it ends. But we cannot jump over grief, any more than we can skip the month of September. We have to walk through it. And September can feel like a very, very long month.

However, likewise, grief is also responsible for awakening, enlivening and individuating our persons. Individuation is a term clinicians often use to describe the process of becoming who we are, which is exactly what Billie Joe says in his song, "Drenched in my pain again, becoming who we are". In walking through grief, in being present to the whole experience of it, amazingly, bizarrely, you somehow are molded; somehow you expand from grief? Grief can actually heal you.

CLICK HERE for definition of "individuation" on wikipedia and read the Carl Jung explanation.

Sometimes we have to live through September. Surrender to September. The dawn will come. If this is where you are, you are exactly where you are supposed to be right now. Have faith and continue to be present through September. September will end; it always does, every year. 

Today, let's talk briefly about the Serenity Prayer...

God* grant us the serenity

to accept the things we cannot change,

The courage to change the things we can,

And the wisdom to know the difference.

Most of us are familiar with this prayer and have probably heard it or said it several times. The prayer is short, sweet and empowering.

But what does "Serenity" really mean?

Serenity is a state of mind. Serenity is the state or quality of being calm, or tranquil, having composure, calm, peacefulness, or peace. Serenity is having the presence of mind, or said another way, having the presence to your own mind, to your surroundings, and to your life.

The prayer is essentially saying, God grant me the "presence" of mind to see my circumstances, my mind, and my life clearly today. God grant me this presence, so that I may see the truth, and make choices from this clear and present state.

The prayer also asks for acceptance. Accepting one's current position or set of circumstances can be one of the most difficult things we must learn do. It is VERY HARD sometimes to accept exactly where you are at this moment. We often want to manipulate it, eat something, drink something or somehow change it. We want to jump over ourselves and get to where we are going. But first, we must accept. We must start from where we are. ONLY then can we begin to move with compassion and grace into changing or moving from this current position.

God* grant me presence to whatever my life holds for me in this moment. Allow me to be fully alive to my life, fully here for all of it. I wish you full, gentle, and complete presence in your life today.

 *Note to reader, please substitute whatever word for God which is meaningful for you.

In my work at the university, I see many trauma survivors; releasing guilt is a major focus in treatment. It's often imperative to release guilt to loosen the hold of PTSD symptoms (see below for general definition and description of PTSD symptoms).

Truly, many of us carry guilt about different things that have happened in our lives. We often believe that if we had just acted differently that things may have turned out better. "IF I had only taken his keys that night". "IF I had just been a nicer person or a better student, mom and dad would have stayed together". "I never should have gone out with her, I had a bad feeling and I should have trusted myself". 

3 basic ways we experience guilt:

1. We feel guilty that we did something that we should not have done, OR we feel guilty that we didn't do something that we should have done. (behaviors)

2. We feel guilty that we thought something that we shouldn't have thought or we feel guilty that we didn't think something that we "should" have thought of. (thoughts)

3. We feel guilty that we felt something we should not have felt or we feel guilty that we did not feel something that we should have felt.(feelings)

Kubany, a Posttraumatic Stress Disorder (PTSD) clinician and researcher has said that if he only had one hour to work with a trauma survivor (specifically he works with domestic violence trauma survivors) he would spend it on releasing her guilt. He went further and said that if he only had 10 minutes to spend with a victim of DV he would spend it on Hindsight Bias.

Hindsight Bias is basically blaming yourself now for decisions that you made before you knew what you know now. You cannot make a decision back then from the knowledge you hold today (knowing the outcome of the event). But we argue, "no, I had a feeling that something bad might happen". However, this is NOT the same thing as knowing the specific outcome of the traumatic event. You only attained that specific knowledge after the event, and not before. This is an important thing to keep in mind when we are blaming ourselves. We simply can't possibly know then what we know now. 

"A loving heart is the truest wisdom" ~ Charles Dickens 

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3 basic symptom categories of PTSD: