Originally written by Christian Swan on April 9, 2017 

"Would it be preposterous to you that, before we diagnose seasonal affective disorder, we have to rule out first starvation of the spirit, and that before we prescribe serotonin reuptake inhibitors or megalight, we first prescribe courses on Emerson and Thoreau and lessons in cross country skiing?" -Paul Fleischmann, M.D., delivered to the American Psychiatric Association, May 1993

During my undergraduate years in South Carolina, I participated in a sorority. When sorority "rush" occurred every January, we were asked to stay away from the Three Bs: No Bush (the president at the time), Bedroom, or Bible. For many, talk of politics, sex, or religion is viewed to be inappropriate or impolite. By mentioning them, you run the risk of making someone feel uncomfortable or marginalized. There are times in my life when I have understood people's desire to steer clear of these subjects. However, I have noticed a change in my personal life where I now notice an increased comfort around conversations related to politics or sexual themes. Talking confidently about politics can now be seen as a sign of increased education, while speaking of sexual matters demonstrates a confidence in one's self. And yet, even among circles where individuals share a common religion/spirituality, I sometimes experience tension when the topic comes up. Talk of spirituality can easily be perceived as a weakness, or something so intimate that it should not be shared with others.

As I've entered the therapy world, I have been surprised to learn that spirituality is still perceived as an uncomfortable subject. In my practice, I am passionate about including my clients' spiritual beliefs as they best see fit during our time together. After all, if we cannot experiment with topics that make us uncomfortable in the counseling setting, how are we ever going to be able to navigate them in our daily lives?

Before or during my first session with every client, I ask a variety of questions so that I can get a better understanding of who he/she is. Toward the end of my questions, I always ask about spirituality. Personal spiritual beliefs, practices, and past experiences immensely shape one's view the world. "But what if I believe in no deity and have no spiritual practice in my life?" You may wonder. Knowing this about my clients before we begin to do healing work is very helpful to me as a therapist, as it still makes a statement about how you view the world. 

There are times in which one's spirituality can be an asset in counseling. For example, consider an individual who professes to have few friends and is new to Denver. As a therapist, one might assume that this person has a limited support system and operate accordingly. But what if this same individual feels very connected to God and finds comfort in daily prayer and Scripture study? Knowing this about a client is very helpful in assessing the client's support system and also in using the client's perceived closeness with God as an asset in the therapeutic work. 

On the other hand, consider an individual who has recently experienced a trauma. While she felt connected spiritually before the event occurred, she now confidently proclaims that she doesn't believe in God and feels frustrated that she spent so much time investing in her spirituality in the past. It is important for me to know this information as a therapist in order to factor this individual's loss of a previous support system into her healing. 

After I ask about a client's spiritual background, I may ask follow-up questions. Specifically, are there ways that we can integrate your spirituality into our sessions to enhance your healing? It is important to me that we integrate your spiritual background to your comfort level in our time together. 

Does spirituality matter in the healing process? Yes. However, you get to be the one to decide the extent of its integration. 

Spirituality is a deeply personal and multifaceted aspect of human experience that encompasses a sense of connection to something greater than oneself. At its core, spirituality involves seeking meaning and purpose in life, often through practices that nurture the soul and foster a sense of inner peace. Unlike religion, which is typically organized around specific beliefs, rituals, and communal worship, spirituality is more individualized and can be practiced in various ways that resonate personally with an individual. Whether through meditation, prayer, nature walks, or acts of kindness, spirituality is about finding a path that aligns with one's innermost values and beliefs.

The journey of exploring spirituality often begins with introspection and self-awareness. It's about asking profound questions: "What gives my life meaning?" "What are my deepest values?" "How can I connect more deeply with myself and others?" These questions are not always easy to answer, but they serve as a starting point for discovering a deeper sense of purpose. Spirituality encourages us to look beyond the material aspects of life and consider our connection to the broader universe. This exploration can lead to profound personal growth, increased resilience, and a more compassionate worldview.

Compassion is a cornerstone of spirituality. It involves recognizing the shared humanity in all of us and acting with kindness and empathy towards others. Spiritual practices often emphasize the importance of compassion, not only towards others but also towards oneself. This self-compassion is crucial, as it allows us to acknowledge our imperfections and challenges with a gentle and understanding heart. By fostering compassion, spirituality can help reduce feelings of isolation and increase a sense of belonging and interconnectedness.

In times of difficulty, spirituality can offer hope and solace. It provides a framework for understanding and coping with life's challenges, offering comfort through the belief in a higher power or a greater purpose. Spiritual practices such as prayer, meditation, or mindfulness can be powerful tools for managing stress and anxiety, promoting mental well-being, and enhancing emotional resilience. They help us stay grounded in the present moment, cultivate gratitude, and maintain a positive outlook even during tough times.

Ultimately, spirituality is a journey unique to each individual. It evolves over time, reflecting our changing experiences, beliefs, and needs. Embracing spirituality means embracing the journey of self-discovery, growth, and connection. It's a path filled with hope, compassion, and the search for deeper meaning. By nurturing our spiritual well-being, we open ourselves up to a richer, more fulfilling life, grounded in a profound sense of purpose and interconnectedness with the world around us.

Originally written by Christian Swan on March 23, 2017

A couple of weeks ago, I had the privilege of meeting at Whole Foods with my dear friend Debbie Johnson. I learned about her new book, A Pocketful of Seeds, and we exchanged ideas about ways that we wanted to create positive change in our communities. 

Because I was already at Whole Foods, I decided to buy some groceries following our meeting. As I was checking out, the cashier asked, "is there anything new happening in your life?" Intrigued by his question, I explained that I had just had an encouraging meeting and that I was looking forward to growing my private counseling practice. Curious about his life, I returned the question to him. "Nothing new here," he said, "every day just starts to feel like Groundhog Day." He went on to explain to me that he had met another individual who had also described her life as "Groundhog Day" that morning. 

Nearly two weeks have passed since this exchange occurred, and I have struggled to stop thinking about it. I have felt saddened by this individual's description of his life as the "same thing every day," and yet remember times in my life when I felt I would never break out of my dissatisfying routines and habits. 

Before I continue, I want to add that I do not think having a life structured around routine is necessarily bad. I eat two eggs and an apple every morning for breakfast. It's simple and reliable and makes me happy. What would be very unsettling is if I felt trapped by this routine. We've all been there, right? I'm talking about that feeling that you have no control over the trajectory of your life...the feeling that makes even your best efforts seem without purpose...the feeling that no matter what you do, you will be in the same unhealthy relationship or job or stuck with the same unhealthy habit forever. 

We've seen the movie (or maybe the most recent episode of Mindy Project?--anyone?) where the individual relives the same day every day until some conflict is resolved. The lead character doesn't have any control over when his/her life will resume and begins to lose hope until finally--tomorrow comes. While these scenes are certainly entertaining, they possess a quality that our real life does not--powerlessness. These characters have no power over when "tomorrow" will come. 

I WANT YOU TO KNOW THAT RIGHT NOW, IN THIS MOMENT, YOU HAVE THE POWER TO CHANGE YOUR FUTURE. 

What sort of change are you seeking in your life? Is it something small like waking up fifteen minutes earlier every morning? Or maybe it's something larger like a job or relationship that takes joy out of life. Sometimes change can feel so overwhelming that we don't know where to start. 

When considering change in your life, start at the finish line. When you picture a "changed" life for yourself, what do you envision? Take some time to write it down and imagine all of the details of this changed life. Next, begin to think about the first small step that would help you get to this goal. And if that step seems too great, think about the smaller step that would help you get there! If creating change still seems too overwhelming, consider speaking with a professional counselor or coach. Working with an objective individual can help you to figure out what is keeping you back from creating effective change in your life. But regardless of how you get there, remember that change IS possible, and that YOU already have what it takes to make it happen. 

Written by Christian Swan, originally published on June 1, 2017

I mentioned the concept of self-care to a new mother a few weeks ago, and she just started laughing at me. Her eyes, darkened by lack of sleep, seemed to shine as she laughed and I couldn't tell if she was going to start crying or laughing louder. Does this woman sound familiar to you? Perhaps you have met this woman before, or she may even be the woman who stares at you in the mirror every morning. In the early days of motherhood, it can be difficult to separate the concept of caring for yourself versus your baby. Comparison, the thief of joy, may also sneak into your thoughts as you begin to see other mothers to "have it together" or have babies with easier temperaments. Self-care must be for those moms. Or maybe, as you compare, you begin to think that self-care is something only selfish people do. Don't these other mothers recognize that they have a child to take care of? Perhaps that should be taking priority over the self. 

I've heard some people refer to the early days of motherhood as "survival mode." As long as you survive that first year of motherhood, you are thriving. But what if I told you that self-care is actually an integral part of that survival? In fact, developing a good self-care practice may actually lead to true thriving instead of the feigned, half-crying, half-laughing insistence that you are doing okay.

A Blow to your Expectations  
Before I became a mother, I would wake up every morning and have a two hour self-care ritual. I exercised for 30 minutes to an hour, cooked breakfast, made hot tea, and sat alone at the table while I enjoyed it. Pre-baby, this is how I would have defined self-care, because it was what nourished me best at the time. Becoming a mother required a shift in my expectations of what self-care would look like. There was absolutely no way this was going to happen after my baby was born (nor has it happened since), as my child seldom left my chest for the first several months of her life. The first step to creating a good self-care ritual postpartum is acknowledgement that self-care will not look the same. This may also involve a period of grief, where you take time to mourn the loss of self-care practices that worked well for you for so long. 

Creating New Rituals 
After you have taken time to grieve (and given yourself grace if this grief took longer than expected), one can begin to redefine self-care as it applies to postpartum life. Are there really ways that you can care for yourself in the first few weeks of motherhood? Yes! While self-care may not be a 2 hour morning routine, or an hour long run, or even a long evening out with girl friends, it is still possible to create meaningful rituals around self-care. Sometimes, self-care may look like mindfulness and self-compassion. As you nourish your baby, can you take time to notice the sensations in your body?  Or, can you practice having compassion for yourself in the middle of the night when you feel too tired to move and the baby is crying again? Can you remind yourself that you are still a good mother if you are wishing you did not have to wake up every 2-3 hours? In my early days of motherhood, I developed my self-care rituals around our nursing schedule. Before nursing, I would notice if I had any needs first. Did I need another pillow behind my back? Did I need to have food in front of me? By creating comfort for myself before nursing, I was able to nurse my child more joyfully instead of focusing on my back pain/hunger/etc. 

It's possible that these recommended rituals don't resonate with you at all, but I invite you to take time today to think about what might be nourishing for you instead. You know yourself and your needs best, and I encourage you to listen to them. 

Remember Why Self-Care Matters
It's very possible that you have read this and still do not believe self-care is necessary--that perhaps it is a luxury only afforded to some mothers. However, my hope is that all mothers will recognize how valuable self-care is, not only for your own mental health, but for your child as well! 

Do you remember hearing a flight attendant talk about putting an oxygen mask onto yourself before putting it on to your child? When I first heard this, I remember thinking that I would always put it on my child first. However, you can't care for your child if you are not breathing! The same concept applies regarding self-care. It is more difficult to give your child the best care he/she needs if you are not creating rituals that will help you thrive during the day. By taking time out of your day to care for yourself, you are setting yourself up for more success as an individual and as a parent. 

What are some ways that you can meaningfully take care of yourself during this new stage of life? If you find yourself feeling overwhelmed regarding the topic of self-care, it could be helpful to reach out to a trusted friend or a mental health professional who is trained in postpartum care. In this new and exhausting stage of life, you and your mental health do truly matter! 

​In the journey of healing from trauma, fostering self-compassion is not only crucial but also deeply transformative. Here, we delve into practical steps individuals can take to cultivate self-compassion as they navigate the complexities of trauma recovery.

1.    Mindfulness Practices: Begin by cultivating awareness of your thoughts, emotions, and bodily sensations without judgment. Mindfulness allows you to observe your inner experience with curiosity and kindness, rather than getting caught up in self-criticism or rumination. Practices such as mindfulness meditation, body scans, and mindful breathing can help anchor you in the present moment and cultivate a compassionate attitude toward yourself.
2.    Self-Kindness vs. Self-Criticism: Notice the ways in which you speak to yourself and challenge the inner critic with self-kindness. When faced with self-critical thoughts, imagine what you would say to a close friend experiencing similar struggles. Offer yourself words of encouragement, validation, and support, acknowledging that you are doing the best you can in challenging circumstances.
3.    Self-Compassionate Self-Talk: Develop a repertoire of compassionate phrases or mantras to soothe and reassure yourself in times of distress. Repeat these phrases regularly, especially when facing triggers or difficult emotions. Examples include, "May I be kind to myself in this moment," "I am worthy of love and understanding," and "I am not alone in my struggles."
4.    Cultivate a Supportive Inner Dialogue: Engage in a compassionate inner dialogue, acknowledging your experiences with empathy and understanding. Reflect on the ways in which you have shown resilience and strength in the face of adversity. Celebrate your progress, no matter how small, and recognize that healing is a journey that unfolds gradually over time.
5.    Practice Self-Care: Prioritize activities and practices that nourish your body, mind, and spirit. Engage in activities that bring you joy, relaxation, and a sense of fulfillment. Whether it's spending time in nature, practicing yoga, or connecting with loved ones, self-care is an essential aspect of self-compassion and healing.
6.    Seek Support: Reach out for support from trusted friends, family members, or mental health professionals who can offer validation, empathy, and guidance on your healing journey. Surround yourself with individuals who uplift and support you, and don't hesitate to ask for help when needed.

By incorporating these practices into your daily life, you can cultivate a compassionate relationship with yourself that serves as a cornerstone of your healing journey. Remember, self-compassion is not about denying your pain or minimizing your experiences but rather embracing yourself with kindness, understanding, and acceptance as you navigate the path toward healing and wholeness.

In the wake of trauma, amidst the pain and challenges, there exists a profound opportunity for growth and resilience known as post-traumatic growth (PTG). This transformative process involves finding meaning, cultivating resilience, and experiencing personal growth in the aftermath of adversity. When healing from trauma, it is essential to understand PTG and how it intertwines with the healing of the nervous system.

Post-traumatic growth is not about minimizing the impact of trauma or dismissing the pain it causes. Instead, it acknowledges that trauma can catalyze profound inner change and transformation. Through PTG, individuals may develop a deeper appreciation for life, experience increased personal strength, forge deeper connections with others, and discover new possibilities for growth and fulfillment.

Central to the process of post-traumatic growth is the healing of the nervous system. Trauma can dysregulate the autonomic nervous system, leaving individuals in a state of chronic stress, hypervigilance, or dissociation. However, through interventions such as trauma-informed therapy, mindfulness practices, and somatic experiencing, it's possible to restore balance and resilience to the nervous system. These approaches help individuals regulate their stress responses, release stored trauma from the body, and cultivate a greater sense of safety and well-being.

Fostering post-traumatic growth requires a safe and supportive therapeutic environment where individuals feel empowered to explore their experiences and emotions. By validating their struggles and offering tools for healing, therapists can guide clients on a journey of self-discovery and transformation. Through compassionate listening, empathy, and unconditional positive regard, therapists can help individuals navigate the complexities of trauma and embrace the potential for growth and resilience.

While the path to post-traumatic growth may be challenging, it offers hope and possibility for those who have experienced trauma. By embracing the journey of healing, individuals can cultivate resilience, find meaning in their experiences, and ultimately thrive in the face of adversity. For us therapists, it is a privilege to witness the resilience and strength of individuals as they embark on this transformative journey toward post-traumatic growth.

In conclusion, post-traumatic growth is a testament to the human spirit's capacity for resilience and transformation. By understanding the role of the nervous system in trauma healing and creating a supportive therapeutic environment, trauma specialists can facilitate this process of growth and empowerment. Together, we can honor the courage and resilience of trauma survivors as they navigate the path toward healing, growth, and a renewed sense of purpose.

When discussing Post-Traumatic Stress Disorder (PTSD) with clients in the aftermath of their traumatic experience, we have noticed a recurring experience. Many times, clients who meet criteria for the diagnosis of PTSD understand this to mean that they will always suffer from the effects of their trauma. All too often, we see a shadow sweep over our client’s faces as shame and fear rise in their bodies. We want to help clarify this particular diagnosis with a message of hope. PTSD is not a lifelong chronic condition, rather a description of how our bodies work to restore safety after trauma. Let’s talk about Post Traumatic Stress and how we can use this information to work toward healing.

Post-traumatic stress (PTS) is a natural response to experiencing or witnessing a traumatic event, impacting both mind and body. When confronted with trauma, the body's nervous system initiates a complex cascade of responses aimed at survival. Understanding the neurobiological impact of trauma can shed light on the symptoms individuals may experience, such as hypervigilance, flashbacks, and emotional dysregulation.

Understanding PTS must involve the nervous system's role in trauma, which illuminates how our body reacts to perceived threats. Traumatic experiences can dysregulate the autonomic nervous system, leading to a state of hyperarousal or dissociation. This dysregulation can disrupt the body's ability to distinguish between real and perceived danger, resulting in ongoing feelings of fear and vulnerability. By learning about the nervous system processes at play, individuals can gain insight into their symptoms and recognize that they are not signs of weakness but rather adaptive responses to overwhelming circumstances. This knowledge can also inform treatment approaches, emphasizing interventions aimed at regulating the nervous system's stress response.

Treatment for PTS often involves therapeutic modalities that target both the mind and body. Polyvagal theory helps to pay attention to nervous system signals and to use this information to create safety in the mind and body. Dialectical Behavior Therapy (DBT) helps individuals become skillful in mindfulness, emotional regulation, interpersonal skills and distress tolerance, while somatic experiencing focuses on releasing stored trauma from the body. Eye Movement Desensitization and Reprocessing (EMDR) and Brainspotting harness the brain's natural healing mechanisms to reprocess traumatic memories and alleviate distress. These approaches not only address psychological symptoms but also aim to restore balance to the nervous system.

Despite the challenges posed by PTS, there is hope for recovery. With the right support and resources, individuals can learn to regulate their nervous system responses, reduce symptoms, establish safety and cultivate resilience. It's essential to approach treatment with compassion and patience, recognizing that healing is a gradual process that unfolds over time.

In conclusion, understanding the neurobiological impact of trauma is crucial for navigating post-traumatic stress with compassion and efficacy. By integrating this knowledge into psychoeducation and treatment approaches, we can empower individuals to reclaim agency over their healing journey. Remember, recovery is possible, and there is hope for a brighter future beyond trauma's shadow. Next week’s blog post will be about Post Traumatic Growth. 

Radical Acceptance is a core skill in Dialectical Behavior Therapy (DBT). This skill falls into the category of Distress Tolerance skills. We reach for this skill when we are navigating something big and hard in our life that is outside of our control or influence. The idea behind Radical Acceptance is that we can work to improve our wellbeing even in the midst of the big and hard things.
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To appreciate what Radical Acceptance can offer us, we must first understand the difference between pain and suffering. Pain is an inevitable part of being human in our world. We will all experience pain at different times in our life. Suffering, however, is caused when we make choices that make painful circumstances harder for ourselves. Radical Acceptance seeks to accept pain and reduce suffering. When we reduce suffering, we grow in emotional resilience and wellbeing. 

​Radical Acceptance is the act of fully acknowledging and embracing reality without judgment or resistance. In other words, Radical Acceptance is a choice to stop fighting against reality. Likely something is happening in our life that is hard and beyond our ability to change it, and we are left with the decision to accept (radically) or reject the reality of the situation. The radical part of Radical Acceptance speaks to the complete and total nature of our choice to accept reality. Radical Acceptance is not resignation or apathy, rather it is a conscious choice to yield to what is real. Radical Acceptance also does not require our stamp of approval on the difficult circumstances, instead a simple acknowledgement that it exists and that we will stop fighting against it. Suffering comes when we fight against painful events that we don’t have the power to change, and Radical Acceptance offers us a peaceful alternative.

DBT offers us some step-by-step guidance on how to execute the choice to Radically Accept painful circumstances.

1. Observe the internal resistance to pain or painful circumstances
2. Notice and describe the emotions or sensations related to this resistance
3. Embrace the reality of the present moment
4. Find and acknowledge peace in accepting things as they are

​We can draw upon other DBT skills as tools to help us in this process. Mindfulness skills help us notice what is happening internally and externally and bring awareness to the present moment. Additionally, mindfulness skills call us to self-compassion and nonjudgmental observation of emotions.  We may have an opportunity to reframe negative thoughts about our reality and notice growth opportunities or unexpected benefits. Some nourishing activities like journaling and spending time in nature can help promote acceptance. Often times, Radical Acceptance requires patience and practice, as most painful events will require us to choose acceptance over and over again.

Disclaimer: Radical Acceptance is not an excuse for harmful or abusive dynamics, but it may be a starting point for being honest about the harm that exists. May this honesty open doors for healing and support.

Written by Allison Harvey

Trauma survivors have gone through something that challenged every part of them, most significantly their sense of safety. Their needs are personal, unique to their personality and circumstances, and often quite delicate. Naming these needs creates space for trauma survivors to feel safe, work toward healing and maintain connection with loved ones.

Physical Needs
On a very basic level, trauma survivors have a need for safety and security. Through their traumatic incident(s), they learned to be on guard and watchful. Trauma survivors need a physical location where they can let their guard down and rest. Trauma survivors also need access to medical and psychological care—professionals to come alongside them and nurture their physical and emotional self back to health. Trauma survivors also need adequate nutrition and sleep. Tending to these basic needs helps to heal a nervous system that felt a strong lack of safety.

Emotional Needs
Those who have survived trauma(s) have a strong need for emotional understanding, empathy and validation. When they are ready to share about their story, they need to be received with compassion, support and validation that says “what you are feeling makes sense to me.” Trauma survivors can also be supported with emotional skills that help them navigate trauma triggers and a large emotional burden while they are healing.

Social Needs
Trauma healing happens within a safe, understanding and supportive relationship(s). Those who have survived trauma need their people to remain open to them. Trauma healing can be messy and indirect, so survivors need compassion and grace to learn to feel safe in relationships again. Survivors may need more accommodations so that they can stay regulated, and this may look like them setting boundaries or asking for certain changes. Connecting with others who are healing from trauma can be very beneficial as well.

​Psychological Needs
Professionals who are supporting trauma survivors should be trauma-informed and have a path toward healing in mind. Psychological care should be gentle and paced by the survivor. Professionals should respect the trauma survivor’s wishes to tell their story or not, knowing that healing can happen either way. Trauma survivors benefit greatly from learning and practicing coping mechanisms and stress management techniques. All of these activities support the survivor to rebuild trust, regain resilience and personal strength.