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A Comprehensive Checklist of Sleep Hygiene Tips
I’ve worked with lots of clients on sleep. It is estimate that about 40% of Americans are sleep deprived (let that number sink in). Impaired sleep is one of those things that can be a symptom of mental health problems, but it is also a potential cause all by itself. For example,
I’ve worked with lots of clients on sleep. It is estimate that about 40% of Americans are sleep deprived (let that number sink in). Impaired sleep is one of those things that can be a symptom of mental health problems, but it is also a potential cause all by itself. For example, being awake for 20 hours straight produces the same impairment as drunk driving. And those who have slept only 4-5 hours instead of the recommended 7 are shown to pose the same driving risk as drunk drivers. Additionally, most experts agree that it is useless at best to workout if one is cutting out sleep to find time because the body isn’t really capable of losing weight or building muscle if sleep deprived and you are at increased risk of injury while impaired.
So, if you are motivated to make a change of some kind, here’s a compilation of all of the best sleep hygiene tips I’ve come across. This article is not a substitute for medical advice so any changes you make should be in coordination with your doctor. All tips are descriptions of ideals, so remember that any change is likely better than none, so consider the principles of change when attempting improvements. Achieving “successive approximations to the target behavior” may look like a goal of going to bed at the same time daily and one step in the right direction may be to shoot for waking up between 7 and 9am daily instead of what a person is currently doing, which is waking between 6 and 11am daily.
Find a new place for Fido- sleeping with your pets, while it may seem nice- is actually one of the WORST things you can do for your sleep. Pets often hog the bed or move around at some point during the night. Even if your pet sleeps like a log, if you are anything like me, you wake yourself on accident trying not to squish your pet as you turn over. Alternatives can be as simple as moving your pet to an animal bed next to your bed. If you are hesitant to make this shift, ask yourself why and begin to problem solve. For example, many sleep with their pets for a sense of security and comfort. One may ask “what are the costs of sleeping with my pet?” compared to “are there other ways to love my pet when I’m awake?” and “are there other ways to experience comfort while I’m in bed?”
Emergency contacts- If you are not the emergency contact of anyone living outside your home, you can simply put your phone on airplane mode before you go to sleep. Otherwise, you can put your iPhone on do-not-disturb and either add favorites or turn on the function that allows calls to come through if the same number calls you more than once within a 5 minute span.
Pick a time to sleep and stick with it- our bodies operate on a circadian rhythm, which is a natural oscillation that repeats about every 24 hours. Ideally, a person will initiate and wake about the same time every day. One’s rhythm won’t be disturbed if there is a change of about 30 minutes - 1 hour. Added tip: create a 5-10 minute routine in the morning that helps you get up- read through inspirational quotes, check your schedule for the upcoming day, pray, breath, stretch, etc.
Don’t pressure yourself- remember that you can’t force your body to sleep, so that is not the goal. Setting your body up to be able to sleep is the goal. Therefore, keep in mind to control what you can and don’t sweat what you can’t. Feeling pressured to fall asleep is anxiety or anger producing, both of which amp up your nervous system rather than calming it down to produce the internal state necessary to sleep.
Don’t watch the clock- doing this while trying to fall asleep can have the opposite effect you desire.
Allow for wind down time- your body can’t go from high energy activity to sleep immediately, unless you are exhausted. Make a list of wind down activities that are low-stimulation and save those activities for the 2 hours before bed.
Light- Doing things like turning off artificial light 90-120 minutes before bed can help your body realize it is time to produce melatonin and therefore get drowsy. One easy way to do this is to buy color changing light bulbs or red colored light bulbs and use those during your wind down time. This is because your sense of “daylight” is related to the eyes registering blue light, not red light (different wavelengths of light). And, if you’ve been keeping up with technology lately, you may be aware that our gadgets typically produce blue light. Thus, you can wear blue blocking glasses or turn your phone on “night mode” to reduce the negative impacts of screens. You may also use a Kindle Paper White or another device that is not backlit. There is also a setting on iPhones which allows you to manually turn the brightness down further than normal (settings > accessibility > display and text size > toggle “reduce white point” on. Don’t forget to turn it back off when you wake so you can see your phone screen during the day.) If you choose to use these tips for light, just remember that electronics will still impair your sleep if you do high-stem activities on them so light is not the only reason why screens are discouraged during your wind down time.
One of my favorite wind down activities is a bath because not only is it low-stim, but it also warms me up and then after I get out, my body is actually cooling off (without my toes feeling cold), which induces drowsiness because drops in internal temperature support sleep initiation.
Sleep when sleepy- rather than staying in bed while you are not drowsy, get out of bed after you’ve tried to sleep for about 15 minutes and do a low stimulation activity in low or red light. If you find yourself waking too early, let’s say 4am, go ahead and get up and require yourself to stay up until bed time. While you may be exhausted for a day or a few, your body will begin to learn that it has to get up when it wakes or at a certain time (when your alarm goes off), and therefore, can’t afford to stay up at night.
Work with your body to find out how much sleep you need- most adults need 7-9 hours of sleep per night but ranges can vary over the life span and person to person. It can be helpful to note that you may feel drowsy during the day if you aren’t sleeping enough, but also if you sleep too much. Sleepfoundation.org makes it simple by describing what getting enough sleep looks like: “you fall asleep soon after getting into bed, within 30 minutes or less, you typically sleep straight through the night, waking up no more than once per night, you’re able to sleep the recommended amount of hours for your age group, you fall back asleep within 20 minutes if you do wake, you feel rested, restored and energized upon waking in the morning.” I know when I am getting the perfect amount of sleep when I become conscious right before my alarm goes off. It is also nice because then my alarm is not shocking me out of a dead sleep. If your alarm goes off and you are still having trouble feeling sleepy after 15 minutes out of bed and active (such as getting ready for work or school), you might be sleeping too little. Adjust your routine in 15 minute increments about every 3-5 days for best results.
Your bed is for sleeping (and sex) only. If you stay out of bed for other activities, you will condition your body to understand that bed = sleep.
Avoid stimulants like caffeine and nicotine after at least 4-6 hours before bed. Avoid intake of these at least 90-120 minutes after waking because they interfere with your body’s natural release of cortisol (which helps you feel awake) soon after waking. Studies indicate that the best time to drink your morning caffeine is likely between about 9:30 and 11:30am, but not before because the body’s natural cortisol spike is already happening at about 8:30 on average. Those who drink their caffeine too early may notice more afternoon drowsiness. So morning caffeine too early is likely redundant at best, inhibitory at worst. If you are using stimulants in order to get up in the morning, you might consider other things in this article as ways to problem solve.
Avoid using depressants like alcohol to help you fall asleep. They only help you feel drowsy, while simultaneously wrecking the quality of your sleep (there is a difference between sleep and restorative sleep) and make it harder for your to learn how to fall asleep without sedative help.
Some supplements such as Magnesium and the combination of Calcium and vitamin D (taken in the evening since magnesium induces a feeling of relaxation and calcium induces a feeling of drowsiness) have been proven to aid with sleep without any adverse side effects. St. John's Wort has also been proven to aid with sleep, but some researchers question if there might be adverse side effects. Zinc is the natural building block for your body to make Melatonin so some have suggested taking it in the morning will support a natural release of Melatonin at night.
Exercise 30 minutes per day- but know that as little as 10 minutes of aerobic (high heart rate) exercise has been proven to improve sleep quality. Important note: avoid doing this right before bed. Workout at least 3 hours before you go to sleep for best results.
Stretch- This is proven to aid in relaxation and blood flow, both of which will help you drift off. You can YouTube or internet search specific yoga or stretching positions that are helpful to use in bed as you fall asleep.
Eat (and avoid) the right foods before bed- avoid foods that are rich, fatty, fried, spicy, citrus, or carbonated before bed… these are difficult for many to digest while sleeping. However, if you get hungry before bed, feel free to eat a snack of healthy fat (your brain eats ONLY healthy fats- did you know that?) with a little protein (especially proteins that are easier to digest), which can help your body have the fuel for REM sleep. Think avocado, nuts, eggs, fish, tofu, lean chicken, turkey, or beef, chia seeds, or full fat yogurt or milk. If you have special dietary concerns, like diabetes, consult with your doctor about how to manage your PM diet.
Control your physical environment.
The average person gets the best quality of sleep in a room between 60 and 68 degrees, with sheets and blankets to adjust the temperature.
Consider your pillow and mattress- if you wake up sore, this is a sign that your body is asking for a different setting.
Ensure that you are sleeping in darkness (you may use blackout curtains or a sleep mask to help with this) and waking up to adequate natural light- the human body relies on natural light to signal the natural release of melatonin at night as well as the cessation of this in the morning. Sunlight viewing in the morning can also help with waking (https://www.hubermanlab.com/newsletter/using-light-for-health).
Find your preferred noise level- some like to sleep in complete silence- earplugs can help with this if you need help, and there are specific ones made for sleep (an internet search can help with this). Others like a low level of noise- a white noise machine, a fan, or other calming sounds.
Daytime naps: 20-45 minutes max. Most scientists agree it’s best if you don’t take naps but this time limit will allow the nap to energize you without you falling into deep sleep and making you feel sleepy upon waking. Limit naps to before 4pm.
Personalize your alarm- there are tons of options- some that require solving a math problem, some that require you to get up and chase it around to turn it off, some that wake you up using increasing volume or increasing soft/natural light. You can also make it impossible to reach your alarm while you are still in bed- simply plug it in across the room or in a different room. Most experts recommend that you avoid using your phone for your alarm to avoid receiving phone calls, texts, alerts, etc., and also to prevent using your phone to read the news right before you go to sleep or right after you wake up (there are other choices of wake up routines that are MUCH better for your mental health!) DO NOT use snooze to get 15 more minutes of sleep- it will only make you more sleepy. The only helpful way to use the snooze function is to press snooze upon waking and only turn your alarm completely off when you are physically out of bed. This can help prevent any accidental falling back asleep.
Figure out how to coax yourself out of bed- A few months ago, I had trouble getting out of bed for three days in a row. It was winter and I didn’t want to get out of my warm bed. So, I decided to lay out my clothes for the next day right beside my bed. The next morning, I literally got dressed under my covers while my husband laughed at my ridiculous strategy for helping myself get out of bed. It totally worked by the way. I’ve known others who put their breakfast by their bed (think electric hot water pot and oatmeal, or fruit, or a protein bar, or even milk in a thermos and cereal), or threw their covers off their bed when their alarm went off- whatever worked for them to get up and out of bed.
Practice relaxation! Guided meditations and other forms of meditation can help you learn to focus your attention or calm down your mind, which is necessary for falling asleep.
Keep a notepad on your nightstand. When my mind is still running at night, two questions help me calm my mind down- “Is it true?” “Is it necessary to think about now?” Almost always, I answer at least one question “no” and can then think about it later. However, when I remember something important that I don’t want to forget, I write it on my notepad to see tomorrow morning and can then let it go from my mind.
Set aside a specific “worry time” (including a start and end time) to think about all of the things that keep your mind racing as you are trying to fall asleep. If you schedule time to think about the things that are on your mind during the day, they won't be so intrusive at night. And, you can always remind yourself that you can think about whatever it is during your next worry session.
If you have come to the end of this list and implemented everything on the list for 2- 4 weeks, it is time to schedule an appointment with a primary care physician and/or a counselor. You may be suffering from medical conditions, such as sleep apnea, that may be discovered by a sleep study. You may also have some mental health challenges that will remain despite your good sleep hygiene until you address them. Kaley Chiles at Deeper Stories is trained in cognitive behavior therapy for insomnia which might interest you wherever you are at in your sleep journey if insomnia might be an issue.
What is Trauma?
Many people look at their story and think that nothing traumatic has ever happened because our understanding of trauma is often so extreme. We think if we haven’t experienced sexual abuse, combat zones, or physical injury, then we haven’t experienced any significant amount of trauma. But this unfortunate understanding keeps us from recognizing and dealing with the trauma in our own lives.
What is trauma?
Trauma is a word we throw around a lot, but often struggle to understand. It is a very real experience that, if unexamined, can lead to ever-increasing pain and confusion as we attempt navigate our stories. If you remember nothing else from this article, remember that trauma not as much about what happened to you, as it’s about how an experience landed with you.
Through examples, and a quick look at nuero-science, we will unpack the concept of trauma so and deepen our understanding of it. By digging deeper, we will cultivate the capacity to recognize the impact of trauma by identifying its those experiences and their resultant patterns in our lives. Engaging the trauma’s in our story will help us understand our stories and the deeper meaning behind them.
Understanding trauma
Trauma comes from a Greek word that literally means “wound.” In the mental health context, we understand trauma as an event (or series of events) that results in emotional or psychological wounding. Because it’s inherently painful, our tendency is to manage the pain and move away from it as quickly as possible. Often, in our scramble to dull the pain from a traumatic experience, we move on from that experience without taking the time to figure out why it was painful or what it means for our story. But doing this leaves us raw and exposed, making the wound vulnerable to unintentional irritation through otherwise perfectly normal actions.
For example, if a soldier is wounded on the battlefield, there often isn’t space to properly dress and treat the injury. A tourniquet, a compression bandage, and vitals verification is often all there is time for in the heat of a battle, and rightfully so. But in the wake of the battle, if the wound isn’t properly treated, it can lead to a faux restoration. As a result, a friendly pat on the effected shoulder can result in blinding pain, placing the wounded individual back in the traumatic experience.
In the same way, untended traumas can leave us vulnerable to people who don’t mean to harm, but who may inadvertently ‘bump’ up against an unhealed wound. When this happens we can find ourselves ‘triggered’, or having an unexpected or disproportionate reaction to an otherwise innocuous event; but one that relates to a trauma in our story.
This is why it is so important to address trauma in our lives. It is not enough to quickly dress the wound and try to move on or forget the wounding experience ever happened; instead, we must summon the courage required to face our trauma and work towards healing.
Responding to Trauma
Our response to trauma takes us out of our normal, everyday functional cognitive capacities, making us respond in one or more different ‘triggered’ modes: fight, flight, freeze, submit or tend-and-befriend. In our triggered state, our brain registers that we are in distress and immediately responds by slowing or stopping certain autonomic processes normally associated with rest and restoration. Simultaneously, the mind and body reallocate resources to muscles (so we can either fight or run), and to more primal parts of the brain that are responsible for threat mitigation (like the amygdala, hippocampus, and medial-prefrontal cortex). This means that other lower priority signals and processes aren’t tended to in the moment. When this state of hyper-arousal is persistently maintained it can result in chronic fatigue, high blood pressure, and a host of other significant health concerns.
The freeze response is similarly taxing. It’s an autonomically-initiated dissociative state of varying intensity designed to preserve and protect a person’s core identity from the wounds that are being inflicted on the body or self. This hypo-active response is typically initiated when the fight or flight responses are judged to be ineffective. A remaining option in this event is to posture in such a way as to freeze and endure the travail as opposed to combating or escaping it.
The submit response is an effort to move with, rather than against, whatever is perpetrating the trauma. This can often look like appeasement. The victim attempts to mitigate the damage by going along with the harmful components of a person, system, or community.
According to Teresa B. Pasquale, in her book Sacred Wounds (2012), a more recently identified defense mechanism is to tend-and-befriend. In this case, in an effort to mitigate victimization, a person will experience a powerful bonding dynamic with the perpetrator(s) creating an unhealthy alliance. The “restoration” that happens in this space is generally shallow and duplicitous, leaving the victim vulnerable to repeated perpetration in the future. This response is empowered by the natural bonding system that keeps people together in difficult times. In its more severe iterations it can present as something like Stockholm Syndrome, where a hostage identifies and aligns with their captors.
Brain Response
This is a SPECT scan of an individual’s brain recalling a traumatic event. Blood flow (depicted in red) is substantial to multiple areas of the brain. When the trauma has been addressed and resolved the same memory results in a substantially more peaceful neurological picture.
As we think about how our body naturally responds to trauma, let’s consider the brain as something akin to a distribution center, and our senses are the trucks that deliver the data to the appropriate docking bays (or cortices of the brain). Our senses like sight, smell, touch, etc., bring information about every single life experience for our brain to process. High-level cognitive processes get slowed and stopped so that the docking bay in your brain has to hold all of the information instead of processing it and moving it somewhere else for storage. That docking bay is suspended in time, but a memory, when mal-adaptively encoded, will be temporally bracketed. When you go to the “docking bay” to look at a memory that’s stored there, it feels like it’s happening in the present moment because it was never processed and stored. As a result, even if the memory is decades old, the experience of recall can make the event feel as if it is happening again.
When we recall an unprocessed traumatic memory, multiple areas of the brain are inundated with blood flow and the subject is typically overwhelmed and triggered. However, if treated effective trauma interventions, the memory is adaptively encoded and the subject can recall the traumatic event without significant distress. Understanding how the brain responds to trauma reveals another important aspect of trauma: because it has to do with how your brain stores the memory, it’s a primarily subjective experience issue, not an objective experience issue.
That’s why two people can experience the same event but only one registers it as trauma. Children can grow up in the same home and be part of the same events, but one may register negative experiences as trauma and the other won’t. One isn’t right and the other wrong, that’s just the nature of trauma. It’s all about how we as individuals receive and then process the experiences in question.
Recognizing Trauma in your Story
So how do we approach trauma in our lives? If the initial trauma is subjective to each person’s experience, how can we begin to recognize when we’ve experienced trauma and learn to recognize when that trauma is impacting us down the road?
We can begin by identifying triggers. Triggers are anything that induce some variation of the aforementioned trauma responses. They can be related to feelings, fear, or energy you experienced at the initial time of the trauma.
Perhaps, for example, your last relationship ended badly after a subtle energy shift which resulted in your fiancé leaving you. You may not have connected it at the time, but that little shift stayed with you.
Now, in your current relationship, this old trauma may play out as you noticing a similarly subtle shift in the energy of your partner. As a result of your trauma, you may find yourself hyper-aware of this shift, but may struggle to give it language. The presence of the shift increases your anxiety (triggers you) and you become hyper-vigilant to notice any relational nuance. As a result, you pull away, or hover in an effort to avoid or address the conflict. What’s really happening is you’re being triggered and probably don’t realize that it’s related to a past trauma. If left untended, this dynamic often decays into a self-fulfilling prophecy; in our effort to avoid our worst fear, we actually re-enact it.
Trauma and triggers can be very nuanced, and if you aren’t attentive to them you can find yourself in these maladaptive patterns that not only hurt you, but the people you love as well.
Many people look at their story and think that nothing traumatic has ever happened because our understanding of trauma is often so extreme. We think if we haven’t experienced sexual abuse, combat zones, or physical injury, then we haven’t experienced any significant amount of trauma. But this unfortunate understanding keeps us from recognizing and dealing with the trauma in our own lives. Remember that trauma means “wound”, so any kind of wounding we experience carries with it the possibility of resultant trauma.
When we experience trauma as children, our natural response - because we don’t have the maturity to know how to address it - is to normalize it. That is, we assume that this is typical life; that everyone experiences something like this in their upbringing. This response serves us well as children because it allows us to live with innocence and minimize pain when we aren’t equipped to handle it. But in our adult world this avoidant tactic is neither helpful nor productive. It serves to stunt our emotional growth and our ability to live in healthy and integrated relationship with others by undermining and devaluing our emotional and relational experiences.
To respond to trauma as adults requires courage and curiosity. Allow yourself to be curious about your triggers without jumping to the “why” question. “Why?” is often a question laced with contempt and accusation resulting in a defensiveness that shuts down further exploration. Instead of asking why, be willing to step back into your story where a trauma may have occurred and see what really happened. Ask how it impacted you and how you experienced it. Explore what you felt and what was going on, and notice how you feel as you enter into the memory.
These types of questions - “What happened?” “How did it make me feel?” “What did I believe about myself in that moment?” “What triggers that trauma today?” will help provide context for your current story allowing you to move forward in health … for yourself, and those that matter most.
How to Pick a Therapist
When it comes to navigating the bevy of credentials, certifications, specializations, and licenses, finding a good counselor or therapist can be daunting. Even with all the degrees and letters aside, there are many practical, ideological, and relational dynamics that may help you narrow your search.
How to Pick a Therapist
There are several excellent reasons to see a therapist. When beginning the search, most people will ask their friend 'Google' who the best counselors are in their area. While the internet can be a great resource, your real-life friends will typically be able to connect you more effectively. Even so, if you're stuck with the internet, www.psychologytoday.com is a great place to start. Like most things, the idea of doing something is often more straightforward than actually doing it. When it comes to navigating the bevy of credentials, certifications, specializations, and licenses, finding a good counselor or therapist can be daunting. Even with all the degrees and letters aside, there are many practical, ideological, and relational dynamics that may help you narrow your search.
Why consider all of these issues? According to the Family Institute, the quality of the therapeutic relationship is one of the most reliable indicators of success in therapy. Therefore, putting in the effort to make a good therapy choice in the beginning, can pay significant dividends in the end.
Practical Questions
What can you afford?
Maybe the first and most basic question is price. What can you afford? Going into debt or taking on financial burdens will only increase the stress in your life, so it's wise to keep affordability in mind when looking for the right therapist. As a point of reference, Licensed Professional Counselors (LPC) in Colorado Springs generally charge around $125/hour.
Do you want to use insurance? If so, are they paneled with your insurance company?
You may be able to use your insurance, and if you're in crisis, don't hesitate to do so. That said, if you go the insurance route, it can introduce some limitations. Before you try to use your insurance talk to your insurance company about what kind of mental health benefits you have. You may be able to see people out of network and get reimbursed. Or an in-network provider can bill your insurance company directly and collect a copay at the point of service. If you use insurance, the therapist you work with will have to issue a diagnosis based on the information you provide. That diagnosis will then be part of your permanent medical record. If you don't meet the criteria for a diagnostic condition, later the insurance company may not pay your claim. Of course, there will be a limited number of therapists that take your insurance, thereby reducing the number of therapists to consider.
Do they offer a free consultation?
Try them out! Not every therapist is for every person; if it's not a good fit, try a different therapist. Not even a counselor will connect well with every person they see. A free consultation allows you to get a feel for the energy and approach of your prospective therapist (and occasionally a good cup of coffee). Getting a feel for different clinical methods will give you more of the information you need to find the right therapist for you in your current situation.
Can they work with your schedule, or can you work with theirs?
How soon do you want to see a therapist? The more flexible your schedule, the more choices you'll have. If you've found the therapist that you want to work with, but are struggling to find a workable time, consider taking an extended lunch break? Can you come in an hour early or leave an hour late to facilitate your meeting with a therapist during their counseling hours? We all make time for what we value, including time for our personal and emotional wellbeing . Work with your prospective therapist to find a time to connect, and if they are unavailable, wait for the time slot you'd like to open up or ask to be added to their waitlist. If the challenges abound as for anyone they would recommend that may be able to work with you within your time constraints.
These practical questions are worth considering and may limit the field considerably, making the choice more straight-forward. Many therapists will work with you to figure out timing, affordability, and other considerations, so don’t be afraid to ask.
Ideological Considerations
Are they in alignment with your values? Does that matter to you?
Values have to do with faith, worldview, politics, drugs and alcohol, sexuality, and morality. These values aren't equally relevant or prominent for everyone, and that's okay. Sometimes people are just looking for a safe place to explore their the story they find themselves in. They don't put a high premium on their therapist completely aligning with their values. After all, an ethical counselor will work diligently to avoid imposing their values on their client. For others, that question is at the top of the list. Take time to figure out how important your values are to you and use this awareness to help you narrow your options to the therapists that will be best for you. Feel free to ask your prospective therapist(s) what their orientation is regarding the values most important to you.
If having your therapist align with your values is important to you, there are other questions to consider along those lines. Will they support your faith system, for example, while also calling out its failures or harm? Will the therapist be affirming of your sexuality? Will they help you navigate the complex spaces that have emerged between sexuality and faith. A good therapist is there to help you, so be honest and transparent regarding your values and goals. This posture will bring clarity and direction to the work you embark on together.
What's their specialty?
Some therapists are trained specially to work with people that have specific issues or challenges. Some counselors specialize in trauma, sexuality, faith, addiction, couples, testing and assessments, and medication. If you're navigating a specific kind of challenge, there are certainly therapists that have dedicated their practice and career to someone like you. If you're having a hard time finding the right practitioner, tap into your network. You'd be surprised by how many of your friends and acquaintances know someone who may be well suited to your needs and preference. Some people want to journey with people who have been there. Despite their experiences, some therapists can still help get to the root issues you wish to address without having similar experiences as you. Do that free consult, or sit with a potential therapist for a few sessions to see where it goes. Again, the quality of the therapeutic relationship is one of the most reliable indicators of success, so if the chemistry is there, you may not need the specialty.
Relational Questions
Does gender matter?
The vast majority of the mental health field is female, so if you’re looking for a female therapist you’re in luck. However, it is important to be openminded; different genders can help you work through distinctive parts of your story. If you’re not sure, taking therapists up on their offer of a free consultation can be valuable. Also, take into consideration the critical parts of your story. If you're often triggered by one gender more than the other, that can inform the therapist you choose. If you're new to therapy, it may be wise to work with whichever gender you find safest. If you've done some work, and you're looking to venture into uncharted territory, it may be time to work with a more challenging therapist.
How do you receive feedback?
Regardless of who you choose to work with, know that a good therapist will give honest and insightful feedback. If you are struggling to find the right therapist, you may want to consider if you are willing to contend with the issues that therapy is exposing in your story. If you've struggled to connect with several therapists, it may be that something continually resurfaces that you're unwilling to address. Take note of this; it may be your invitation to go deeper into your personal narrative.
Navigating Credentials
One of the most overt considerations, even if it's not the most important, is to evaluate your prospective therapists' qualifications. Different licenses allow therapists to do different things and knowing this can help you choose the right one. Keep in mind, if a therapist has more education, experience, and demand, it is likely they will have a higher price-point. Here is a list of the various types for reference:
RP – A Registered Psychotherapist is unique to the state of Colorado. This practitioner is not required to have any additional training or credentials and only needs to pass a state test to earn their title and practice.
LPC – A Licensed Professional Counselor (LPC) has a masters degree (but can have a doctorate as well), has passed the Colorado Jurisprudence Exam, logged 2,000 hours of post-degree of supervised experience, and can specialize in a variety of arenas.
CAC I, II, III – A Certified Addictions Counselor (Level I, II, or III) is a title that identifies clinicians specially certified to work with substance abuse and addiction.
LAC – A Licensed Addiction Counselor has completed all the training of the CAC and has received sufficient addictions-specific supervision to carry an Addictions License with the state.
LCSW – A Licensed Clinical Social Worker (LCSW) typically has a masters degree and usually works at providing and identifying relevant community resources. In a more clinical setting; their focus is often, though not exclusively, related to resourcing clients with various community-based interventions and programs.
LMFT – A Licensed Marriage and Family Therapist has a masters degree and two years of post-masters supervised practice. As their title indicates, they specialize in marriage and family dynamics. If you're interested in couple therapy, or if you're dealing with a difficult family situation, the LMFT could be the right pick for you.
A Psychologist holds a non-medical degree and cannot prescribe medication. In the state of Colorado, they have at least one year of supervised post-doctoral work. Psychologists can offer high-level assessments and then interpret and deliver the results. They are often trained in research and have deeply specialized experience in their given areas of clinical practice. They are frequently on the leading edge of new clinical explorations.
A Psychiatrist holds a medical doctoral (MD) degree with specializations in psychiatry and psychiatric medicine; this means they can prescribe medication. They're required to practice for four years under supervision, typically in a residency program. They often, though not exclusively, do a lot of work with medication management. In other words, you're likely to get an initial consultation, followed by appointments every few months to ensure that your medication levels are adequate and effective. It is not unusual to see Psychiatric Nurse Practitioners functioning in the similar spaces as psychiatrists.
Finally, there are community mental health centers. I've saved this for last because you will likely find all of the above categories in these organizations. They can be useful, but often practitioners are overworked, seeing as many as 40 clients a week. If you're on Medicaid* or other government-mandated or managed care, this can be a great place to start, though many clinicians in private practice also accept Medicaid..
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*Medicaid recipients may not pay out-of-pocket for covered services. Charging a Medicaid client for such services is considered fraud.
Even if your search for the right therapist takes time, keep your long-term goal in mind: emotional and relational wellbeing. The value of exploring your story is staggering; it's worth it to take the time to find the right person to help you get there.
Three Reasons to See a Counselor
Though the idea of going to therapy is starting to be more acceptable, questions about the details of seeing a therapist remain. When should you see one? How should you choose one? How will you know what to talk about, and will you just be sitting there awkwardly trying to figure it out?
Therapy. Perhaps no other health field is viewed with as many polarizing and opposite emotions as this one. Admitting “I’m seeing a therapist” can elicit reactions of shock and judgment from certain people. Or it can indicate that you’re seeking health and balance in your life.
While some people today still view therapy negatively, I’m starting to see encouraging trends regarding mental health in Colorado Springs and beyond. Pop culture and our society are beginning to normalize mental health in a variety of ways. For example, it’s not uncommon to see a character in a sitcom, TV show, or a movie visit a therapist to discuss whatever issues they seem to be facing. Likewise, people in coffee shops and restaurants often share with each other about a therapist they know or work with.
While the idea of going to therapy is starting to be more acceptable, questions about the details of seeing a therapist remain. When should you see one? How should you choose one? How will you know what to talk about, and will you just be sitting there awkwardly trying to figure it out?
I’ll be addressing these questions and more in a blog soon, but for today, I want to focus on that first question: When should you see a therapist? I propose three main times.
1. When you’re stuck
To various degrees and in different seasons, we all experience the frustration and anguish of feeling stuck. Your relationship may be in crisis. You may find yourself addicted. Perhaps you’re living with crippling anxiety or depression. Or perhaps you’re losing momentum at a critical point in your life or career. In any of these instances, feeling stuck is real and can cast a shadow over everything in your life. Without the right tools to navigate these seasons, even the most mundane tasks can feel overwhelming.
Feeling stuck is a really good time to see a therapist. Therapists are trained to help you get to the root of why you’re stuck and give you tools for moving forward. If the people closest to you keep bringing up therapy, that could be another indication that this would be a good step for you to take. As an aside, if you’re finding everyone else is to blame for the problems in your life, you’re likely the one in the group who would most benefit from therapy.
2. When you’re in a major life transition
Transition, even when it’s healthy or positive, can be hard. The stress of a move, a new job, or a different life phase can lead to a confusing cacophony of emotions that threaten to break out of you at any time and without warning. Whether anticipated or not, events like death, divorce, a miscarriage, or your last child moving out of your home can throw your life into disarray. The intense joy of marriage, a new baby, graduation, or a job promotion can be exciting, while seismically shifting the landscape.
Any of these events will force you into a substantial role transformation that often creates pressure and stress, pushing you into the uncharted territory. These resultant emotions are often raw and exposed, and can be challenging to navigate on your own. If you’re in a season of change, a therapist can walk with you in compassion and care, helping you understand the dynamics of your story and how the transition you’re navigating impacts your journey.
3. When everything is going great
The best time to see a therapist is when everything in your life is going great. While this may seem counter-intuitive, let me ask you a question: Do you only visit your medical doctor when you’re sick? Hopefully not. Receiving regular check-ups ensures you’re healthy and your body is functioning as it should. Additionally, it also provides an opportunity to catch more potential severe health complications early on.
Seeing a therapist when everything is going well can help you prepare for the inevitable changes you will experience down the road. A counselor can help you trace the patterns and themes in your life story; helping you draw connections and meaning that you may be too close to see. Cultivating this awareness allows you to process the trauma and gifts of your past that are influencing your style of relating and ways of doing life. These patterns weave together like threads in a tapestry. Taking the time and space to explore them when all is well will more clearly reveal both the beauty and tragedy of your journey. With that knowledge, you will be equipped to engage your story with more compassion, curiosity, and courage.
Here are a few more reasons the good times are the best times to start a relationship with a therapist:
You have the margin and resources to do your research and find the perfect therapist for you. Do you mesh with this person? Do they share your values? Are they able to work with your schedule? Can you afford the therapist you want, and make room in your budget for therapy? These are all questions you may not have the luxury of considering if you wait until you’re in a crisis.
Seeing a therapist when everything is going well allows you to establish a therapeutic relationship with someone who understands your story when you inevitably experience crisis or change. Trying to create that relationship when your life is chaotic is much harder than when you feel stable and healthy.
Meeting with a therapist can help develop a language to know how to understand your story and emotions. If you do this while you’re in a season of comparative health, it will benefit you tremendously when you go through more difficult seasons. Cultivating an awareness of your emotional and relational life will provide a framework that will reinforce your heart and relationships as you navigate your story.
Accessing and understanding your emotions is easier when you aren’t in crisis. A therapist will help you interpret the unique data your emotions provide so you can walk integrated with your feelings, rather than at war with them. When we disconnect from our hearts, it’s much harder for us to ask for help when we need it.
Counselors like me exist to help people understand their stories, their emotions, and their histories so they can live in health and abundance. Fundamentally, the best time to see one is when things are going great. However, at any stage, seeking help requires courage, an understanding of your story, your purpose, and your emotions ... both for you, and for those you love.
If you’re ready to start the journey, reach out to me and schedule a free consult. If I’m not a good fit for you, I’ll do my best to set you on the right path.
Coffee
Don't settle for coffee to merely get you going in the morning, instead let your heart revel in the beauty of your coffee's brewed goodness. Enjoy the artful flavors and precision of a single, glorious cup of pure delight, crafted by your own hands, in a ritual inviting your body and your mind to experience the joy of one of God's greatest gifts: Coffee.
Good therapy, like good coffee, is handcrafted.
One of the things that I love most about my job as a counselor here in Colorado Springs is that for any client that wants it, I make a custom cup of third-wave coffee (Click that link if you're wondering what third-wave coffee is). The coffee I make is roasted here in town, never more than a few weeks old, ground on the spot, and brewed expressly for the person(s) in my office. I am proud to work with a local roaster and have been privileged to learn more each time I order from Sean and his team at Building Three Coffee.
This post is specifically about how to make a great cup of pour-over coffee. Why should a counselor write about this you ask? Because I absolutely love coffee, and I'm happy to share that passion with you all!
Equipment
Scale and Timer (grams)
Conical Burr Grinder
V60 Pour Over System (Ideally Ceramic)
Goose Neck Kettle with temperature settings
Beans
First, I recommend you find a good roaster or coffee shop somewhere. It absolutely matters the roast and variety you get for your coffee. However, your local roaster will be able to guide you in your coffee selections. As a general rule, lighter roasts will have brighter flavors and will be higher in antioxidants; they will also have a bit more caffeine.
On the other hand, darker roasts will generally have a more bold flavor, may be lower in some of the natural health benefits, and will have noticeably less caffeine. As a general rule, I always recommend that you buy whole bean coffee. Whole-bean coffee preserves the flavor and freshness of the coffee in a significant way.
Measuring & Grinding
After you've selected your bean, the first thing that you'll want to do is weigh out about 22 grams of coffee (the scale will be vital if you're going to keep your ratios correct). For this measurement, I will actually use a small container and, zeroing the scale with the container on it, adding whole beans until I reach about 22.3-22.7 grams (this is way more precise than necessary, but its fun). Then I'll throw the beans into the grinder.
How fine or coarse you grind your beans is one of the more significant variables, and it will likely take a few cups to dial in the specific bean you have (yes, each bean and roast is unique and will require some optimization). We'll talk more about the grind as we go. To start with, grind somewhere between drip coffee (a middling coarseness) and French press (very coarse).
Brewing
While your coffee is grinding, heat your water to just under boiling. I'm a counselor in Colorado Springs, CO, and our altitude is a little bit over 6000 feet. As such, our boiling point is technically about 202 degrees Fahrenheit. If you bring your water to a few degrees below boiling, that's ideal (I hold my water at about 200 degrees). The closer to sea level you are, the closer you'll be to the typical 212 degree boiling point. Place your filter (V60 Size 2) into the ceramic V60 pour over thingy, and then wet the filter with your hot water. Soaking the filter reduces the paper taste that you can get from dry filter paper.
A note about water
The water you use can be a very significant variable. Well-water, laden with lots of minerals and other stragglers, can significantly impact the taste of your coffee. Likewise, filtered water can also have an impact on the palate. If you really are intent on hardcore nerding out on your water choice, you can actually purchase mineral additives (which you add like sugar to the water) to optimize your coffee's flavor profile. For my purposes, I use filtered artesian well-water.
The Pour Over
When your coffee is ground, place the cup, the V60 and the wet filter on the scale and turn it on. The scale should automatically zero (tare) itself. Add the ground coffee to your filter and verify that you have about 22 grams of coffee (sometimes you can lose a bean or two during the grind, so tapping the grinder firmly as it finishes can dislodge any residual coffee into the hopper).
After verifying you have all your coffee, tare the scale again, start the timer and add 20-30 grams of water (trying to wet all the coffee grounds) for a stage called the bloom. During this first 30 seconds, the coffee grounds are bleeding off excess gasses. After the first 30 seconds, start slowly pouring more hot water (still about 200ish degrees Fahrenheit), beginning in the middle of the grounds and working your way out to the edges of the filter. Try to get as close to the paper filter as you can while still pouring the water on the grounds. Pour slowly and consistently; ideally, you will reach 300 grams of water at about 1:15 on the timer.
At this point, you're merely waiting for the water to finish draining. The cup should be ready between 2:30 and 2:45. You can stretch it to 3:00, but you'll want to pull your grounds at this point no matter how much water you have left in the filter.
This stage of the process is where you can verify the coarseness of your grind. If the water drains from your filter before 2:30, this means your grind is too coarse, and you're likely under-extracting the coffee. You can verify this by tasting the coffee; if it's watery, adjust the grind and try again. If you still have substantial water in the filter by 3:00, your grind is likely too fine, and you're going to over-extract the coffee. Over-extracted coffee will result in a more bitter taste. Again, adjust the grind and try to find the sweet spot between 2:30 and 2:45.
I recommend drinking your coffee out of a mug or cup that is open at the top. Travel cups, with their lids, don't allow you to enjoy all the aromas that enhance the taste of the brewed coffee. However, the coffee will cool faster (which will also impact the flavor profile). If you're like me, quickly cooling coffee can increase the rate at which you drink and can have an impact on how much you drink (especially, if you have access to this kind of coffee glory all day long).
So slow down, choose to enjoy the nuances of your coffee as you imbibe. Pay attention to the different tasting notes and unique aromas. Don't settle for coffee to merely get you going in the morning, instead let your heart revel in the beauty of your coffee's brewed goodness. Enjoy the artful flavors and precision of a single, glorious cup of pure delight, crafted by your own hands, in a ritual inviting your body and your mind to experience the joy of one of God's greatest gifts: Coffee.
P.S. Thanks to Taylor, from Good Neighbors Meeting House in Colorado Springs, for teaching me how to make amazing coffee!