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Focus Areas

Anxiety

We often find ourselves in situations that make us feel nervous, tense, and hyper-aware of our surroundings. When there is a threat in the environment or we feel there is a lot to lose, we may find our hearts beating, hands shaking, and butterflies in our stomachs. We might feel dread or apprehension, restless, or even a blankness in our minds. This is normal. It is our brain’s way of telling us that we are in a situation that has high stakes. It is a protective mechanism so that we recognize the weight of what we are about to do and give it all that we have got. However, when these symptoms become constant and prolonged, causing us loss of sleep at night, increasing irritability and fatigue, affecting the way we physically feel, and lowering our ability to concentrate, our minds may no longer be protecting us. Generalized anxiety disorder, and other anxiety-related disorders, occurs when our minds perpetuate uneasy feelings even in times when the situation doesn’t warrant that level of anticipation.

One of the most common reasons people seek therapy is due to anxiety, and therapists have many tools to help manage and eradicate anxiety symptoms. Your therapist may recommend that you see a psychiatrist or psychopharmacologist to manage your medications, since some increase anxiety, and others reduce it. What is important, however, is to discover the thoughts and experiences that perpetuate your anxiety, so it can better be managed. While medication can ease the symptoms, therapy prevents them from recurring in the future. Some therapy techniques you may have heard being used for anxiety are cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), or dialectical behavioral therapy (DBT). These therapies all help us recognize the level of the validity of our thoughts, so that we can choose our reactions to them and our behaviors. Anxiety often feels like a loss of control, and working with a therapist, you can gain back your control over your thoughts and emotions.

The problem with allowing anxiety to rule our every thought and emotion is that it often causes us extra worry and precautions, wasting our time and energy. It can rob us of our sleep and disrupt our physical health. When our bodies are fatigued, instead of working at full capacity, which is the protective intention of our brains’ worry in the first place, we are less able to concentrate or think productively. At The Compassion Practice in NYC, our therapists all understand that step one to healing is to acknowledge that there is a better, more calm and safe way to approach our daily lives. Our therapists help clients discover how to develop a better relationship with anxiety through compassionate approaches and evidence-based practices. We use the aforementioned therapies as well as active and intuitive listening, so that every client experiencing anxiety can feel at ease, starting in therapy sessions and continuing outside of the office. We understand that it can be scary to take the first step and call a therapist, and we encourage you to take your time in finding a therapist who makes you feel validated and safe. By filling out our form through the link below, you can have us call you. We’ll direct the conversation, so there is no pressure on you, and we can finally help you ease your symptoms and truly live with more intention and with less stress and suffering.

Depression

Being sad on occasion is not only a “normal” human experience, but also a useful one. When we allow ourselves to feel sadness, one of our core emotions, we can discover what it is that we may find most comforting and what can give us a sense of purpose and meaning. A feeling of sadness may be evoked when a social justice issue is unmet, and we discover that it matters to us and fills us with passion. Sadness may alert us to how much we love someone else when they are hurt. Allowing ourselves to feel sadness can also help us validate our own losses when we are grieving. When fully felt, sadness can pass through us and release. However, sometimes it feels like we are stuck in a constant state of sadness and this is obviously no longer helpful and can be detrimental to our physical and mental health. When that constant sadness is accompanied by hopelessness, emptiness, worthlessness, anhedonia (loss of joy and interest), sleeplessness, a change in appetite, and a lower will to live, you may be experiencing depression. Depression paints our worlds in perpetual pain or numbness and can make life feel incredibly difficult to live. Thankfully, there are treatments that have been proven effective. 

Not unlike anxiety, medication is often prescribed to help lessen the negative feelings that come with depression. It may take a few tries to find the correct medication for you, because different medications target different neurotransmitters in the brain. During this time, it is important that you find a therapist who can help you manage your symptoms and to provide you a space to discuss your treatment options. Regardless of whether you are on medication for your depression or not, therapy can help discover the cause of the depressive thoughts and how to combat them. Instead of just abating the symptoms, you can learn to live more joyfully and mindfully. Mindfulness based cognitive therapy (MBCT), in particular, is an evidence-based treatment that helps clients become more present in their daily lives and is proven to help those who have had recurrent episodes of depression. Dialectical Behavioral Therapy (DBT) is also proven to help clients manage their feelings and thoughts associated with heightened levels of distress, thus preventing depression from rising to an unbearable extent in the first place. Another effective modality is Cognitive Behavioral Therapy (CBT), which aims to reduce unhelpful core beliefs and resulting harmful cognitions and behaviors. Also, Acceptance and Commitment Therapy (ACT) is effective in separating oneself from their thoughts and accepting a life full of meaning and joy.

While these and other therapies have been proven to be helpful with depression symptom management, it is important that you find a therapist who has used these tools before and understands what you are going through. Part of healing is knowing that you are not alone, and at our NYC practice, we understand that your feelings are valid and are here to help you address them with compassion and care. The Compassion Practice therapists have all been trained in the reduction of depressive symptoms. We understand that there are many causes of depression, including racial, gender, sexual, or religious forms of discrimination; underlying health issues or chronic pain; trauma or a history of being abused; and stress, anxiety, or distress tolerance issues. We help you learn to move forward mindfully and with self-compassion, so that you are truly thriving. You may feel comfortable with your constant state of depression; people often feel safer not changing. That is understandable, and we are here to show you what is beyond that feeling of comfort. Click the link below to book a free 15-minute phone consultation so that you can learn more and give yourself the better future that you deserve.

(Disclaimer: if you or someone you know are experiencing suicidal ideation, call 911 or go to your nearest emergency room.)

Panic

Panic is the intense, physical manifestation of anxiety. While experiencing repeated, uncontrollable panic symptoms or attacks may mean that you have a panic disorder, many of us experience isolated panic symptoms, and they are not any less valid, distressing, or frightening. Panic symptoms can include breathlessness, dizziness, heart palpitations, sweating, shaking, and even faintness. The symptoms of a panic attack may be mistaken for the symptoms of a heart attack, which can perpetuate feelings of panic and distress. Panic differs from classic anxiety in that it can suddenly creep up on us in a severe form, sometimes with seemingly no connection to what we were thinking or doing. Our subconscious can spring it on us without warning, and this can not only be a frightening experience, it can be disruptive to everyday living.

Therapy is often used to treat panic. Firstly, talking through symptoms and gaining reassurance that you will be okay is an important step in managing your distress. Next, discovering what is causing those symptoms can help us deal with and confront those issues. You may also learn breathing or grounding techniques to help you calm down and even prevent panic onset. Common breathing techniques taught in therapy include 4-7-8 breathing, diaphragmatic breathing, deep breathing, meditation practices, and box breathing. Some grounding exercises that are taught are: splashing cold water on your face, the 5-4-3-2-1 senses grounding exercise, progressive muscle relaxation, and meditation as well. Depending on your panic triggers, other skills and practices can also be used in session to help manage distress, process trauma, or plan for interactions. Exposure therapy, Cognitive behavioral therapy (CBT), dialectic behavioral therapy (DBT), and acceptance and commitment therapy (ACT) can all be helpful in learning to face that which makes us afraid while thinking rationally about likely outcomes and learning to tolerate normal levels of distress. Role play may also commonly be utilized.

If you would like to get started with therapy to compassionately process and heal your panic symptoms with a therapist for anxiety in NYC, please reach out to us at the Compassion Practice for a free phone consultation. All consultations are held to the utmost confidentiality, and our therapists are trained in the above modalities and more so that you can trust that you are in good hands. We center our practices on foundations of compassion, mindfulness, and optimization of wellness for all clients.

Trauma

Trauma is our minds’ reaction to extreme events that have impacted our sense of selves, sense of the world, or sense of others. Common causes of trauma include near-death experiences, prolonged exposure to instability at home, hate or discrimination, war, poverty, sexual assault or abuse, and natural disasters. Our bodies all react differently to stress, but here are some common effects that trauma can cause:

  • Numbness, repression or denial, shock
  • Irritability and loss of control over one’s emotions
  • Flashbacks, outbursts, nightmares
  • Relationship troubles, trust issues
  • Physical symptoms and addictions
  • Depression, anxiety, PTSD, or suicidality 
    • (note: if you are experiencing suicidal ideation, please dial 911 or go to your nearest emergency room)

The most important thing to recognize when impacted by trauma is that the event that caused you to feel the way you do is not your fault. It never was your fault, is not your fault now, and never will become your fault. Being the victim of any tragedy is not something someone willingly intends to become, though directing blame inward can be a common reaction to trauma. It can feel protective to accept blame and quiet our anger so as to avoid feeling rage toward others or outward bitterness. Recognizing that you are not at fault is vital to healing, as is learning to cope and move forward. 

Some therapies that are used to facilitate the healing of trauma are progressive exposure (PE), cognitive processing therapy (CPT), dialectic behavioral therapy (DBT), compassion-focused therapy (CFT), and acceptance and commitment therapy (ACT). These therapies can help clients to discover their strengths that have gotten them thus far and will continue to help them be the courageous fighters they are. As well, clients can learn to move forward with meaning, mindfulness, distress tolerance skills, and radical acceptance of themselves and what they lived through. Finding a therapist who can help you navigate the complicated emotions that come along with trauma, especially complex trauma (c-PTSD), can be a daunting task. Our NYC therapists at the Compassion Practice have been trained in trauma-informed, evidence-based therapy modalities and are skilled at helping you gain back your sense of self with compassion and acceptance. Reach out to book your confidential, free phone conversation, and find a therapist who is the right fit for you. You can heal.

Grief and Loss

Both grief and loss are complex emotions that take time to heal. We often associate those words with death of loved ones, relationship breakups, and permanent losses. Though this is often the case, grieving and feelings of loss are not exclusive to extreme tragedies. For example, one can grieve the loss of a friendship or a life that could have been. Feelings of loss are common when people begin aging and wish they had spent their lives some other way. It is normal to feel loss over missed opportunities and times gone by. It is also normal to grieve parts of ourselves that we lose when we break up, come out, or shift in our family roles. The Stages of Grief refer to mourning but can easily be translated to other areas of life. They are:

Denial– Denial can come in forms of avoidance, repression, shock, confusion, or silence. It is our brain’s way of protecting us from feeling the excruciating levels of sadness and loss in the immediate aftermath of a tragedy. With time, our brains ease up and allow us to grasp the full magnitude of that which we lost.
Anger- When we allow ourselves to recognize what has occurred, it is a harsh reality to face, and feelings of bitterness and anger may begin to settle in. This is a normal part of the grief cycle, and it is healthy to feel our feelings. Anger is not a feeling to be ashamed of, especially in the context of grief. You may also feel a heightened sense of anxiety.
Bargaining- Coming out of the anger stage, you may feel desperation to make things right and find meaning in the grief. This can include reaching out to others, constructing a narration, and thinking about alternative endings to the story. You may find yourself alternating between anger, sadness, and acceptance. Remember, healing is not linear.
Depression- Once the support has abated and heightened emotions are less present, depression and helplessness may set in. You may feel overwhelmed by having to face life in a brand new way. You may feel hostile toward those who have moved on without you or in their own ways. Again, it is normal to feel your feelings. Healing takes time, and adjustment can be hard. This is a good time to recognize which of your thoughts may or may not be bringing you comfort. Your envy of others’ healing can help you recognize where you would like to end up.
Acceptance- Acceptance is when life takes on new meaning, and your new reality is one that you can face in a healthy way. You may have made adjustments in your daily routine, and you now feel that you can manage it. It does not mean that you have forgotten the loss of a loved one or what life once was; it just means you can embrace your current situation with acceptance and gratitude. The bad days may still come, and that is okay. Just remind yourself again that healing is not linear.
Healing can be hard to do alone. Whether you are grieving the loss of a loved one, your childhood, or another cherished part of your life that once was, speaking to a therapist to help you get through your stages of mourning can be helpful so you feel less stuck and are more able to approach your current life with meaning. Life does not have to feel miserable until you reach the acceptance stage. There are ways to begin incorporating skills into your routine as you begin your healing process. Some modalities that are especially therapeutic in grief are compassion-focused therapy (CFT), narrative therapy, and acceptance and commitment therapy (ACT). Call the Compassion Practice, an NYC-based practice, to book a free phone consultation and find a therapist trained in one of these modalities. We are here for you.

LGBTQIA+

Life is full of color, and embracing ourselves with our full identities is becoming more evidently vital. Identity is at the core of our beings. Our likes and dislikes, hopes and desires, and meaning and purpose are part of defining who we are as humans. Part of these defining innermost aspirations and tendencies are the spectrums of sexuality and gender. Some of us gravitate toward masculinity more than femininity and vice versa, others toward both, equally, and yet others toward neither. Some of us seek male partners, female partners, genderqueer partners, all, or none. While sexuality and gender are defining parts of our identities, they are unrelated, and the intersectionality of the two can be more or less complex. It is important for us not to be ashamed of our identities, and yet there is still much stigma surrounding the LGBTQIA+ community in the world at large. Queer-affirming therapy is therapy that is provided in the context of our unique identity, affirming that our feelings and preferences with regard to our gender expressions and sexuality are valid. It is the recognition that we live in a nonbinary world, full of color and fluidity. 

If you are the parent of a child who has come out to you as queer, here are some terms to familiarize yourself with:

  • LGBTQIA- lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual
  • Lesbian- women and femmes-loving women
  • Gay- men and mascs-loving men
  • Bisexual- individuals who love women, men, and genderqueer individuals
  • Transgender- individuals whose gender does not match assigned sex at birth
  • Queer- describes folks who identify outside of the gender binary or heterosexuality
  • Intersex- individuals born with both male and female physical attributions
  • Asexaul- a spectrum of lesser or no sexual attraction
  • Demisexual- sexual attraction develops solely through emotional attraction
  • Nonbinary (nb)- does not identify with male or female stereotypes
  • Genderqueer- all-inclusive term to describe the NB and trans community
    • Please note that there are many other terms, and a quick Google search can teach you other commonly used queer terms.

A quick note about pronouns: You or your child may identify as genderqueer and may not want to be defined as “he/him” or “she/her.” They/them or ze/zir (and other, less common neopronouns) can be used to describe someone who is gender non-binary or just doesn’t want to live within strict masculine or feminine constructs. Respecting your child’s or friend’s pronouns, by referring to them as they request you do, is supportive and validating. It is difficult for people to come out, and you can help them build security and confidence by affirming their pronouns. Not respecting their wishes doesn’t change them to your liking, it only hurts them.

If you are struggling with your own identity, your family member’s identity, or you are simply looking for a queer-affirming therapist in NYC or virtually within New York State, the Compassion Practice can be the place for you! Our queer and queer-affirming therapists are trained to help cultivate self-acceptance and affirmation, compassion, and identity navigation. Reach out to us for a free phone consultation today!

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder, also known as OCD, is a common and often debilitating form of anxiety. We all have experienced obsessions at some point or another. We may be obsessively concerned over the welfare of our aging parents. We may feel envious of our siblings and have a hard time tearing our minds from their success we wish we had too. Perhaps we ruminate over something thoughtless we said to a coworker of ours. These, and other such examples, are likely familiar in some capacity. Notice as you read those examples how you may have been feeling a level of discomfort around the subject. Obsessions are uncomfortable. In those who experience OCD, that is where compulsions come into the picture. Compulsions are the brain’s way of convincing a person that they can take control of their obsessive anxiety. The brain convinces a person with OCD that if they perform the compulsion, the obsession will be abated in some way. Often this looks like magical thinking, or one thinking that their actions will control outcomes that are typically uncontrollable. For example, Rebecca constantly worries about her son’s health. A spiritual person, Rebecca believes that prayer and meditation will bring positive manifestation into her life. There is nothing wrong with spiritual or religious beliefs; in fact, many psychologists will agree that they are a positive protective factor. However, in Rebecca’s case, she finds herself meditating in the car, while shopping, and at work. Basically, whenever she thinks of her baby son, she begins to meditate, believing if she does not, something terrible will happen. Rebecca finds cars honking at her behind red lights, her work is slacking, and shopping trips to the grocery store begin to take her 3 or more hours. 

This is what OCD looks like. Of course, it takes on many forms. Religious OCD is only one manifestation of the disorder. Other types of OCD may include counting, checking, patterns, need for symmetry, skin picking or hair pulling (trichotillomania), among other compulsions. Superstition and perfectionism can easily become OCD, especially when one lives in a constant state of neglect, chaos, trauma, or anxiety. The common factor among all of these is a lack of control, and people who experience OCD often are vying for a sense of control. Of course, the disorder provides them with a false sense of comfort, which can cause people to fall deeper into the clutches of its confines. OCD is a painful disorder and is understandably disruptive to social life, work, relationships, and relaxation. The more someone gives in to the compulsions, the harder it becomes to break the cycle. 

That is why therapy is vital to manage symptoms of OCD. Discounting magical thinking and catastrophization, learning to distract or sit with a feeling without acting upon it, and discovering alternative ways to protect, plan, or practice religion are all skills a therapist can help you with. ACT (click here to learn more), CBT (click here to learn more), and exposure therapy are great ways of learning that compulsions are not protective. At the Compassion Practice in NYC, our therapists are trained in the above therapies and are ready to help you heal. OCD can come with feelings of shame, and we are here to help you with compassion and non-judgment so you can live a better life. Reach out for a free phone consultation today!

Pregnanacy Issues and Loss

Pregnancy can bring amount a multitude of both positive and negative emotions for cisgender women and transgender men. Pregnancy brings with it a change in biological, psychological, and social factors. Physically, the pregnant individual experiences ever shifting hormonal changes, issues with sleep and changes in appetite, increasing lower back pain, and morning nausea among others. The most obvious physical change is absence of menses and increasing abdominal size.

Psychologically, pregnancy brings with it a change in identity. A pregnant individual often asks themselves, “who will I become?” or “how will I be as a parent?”. Pregnancy brings with it mood swings and, depending on the trimester, may bring about specific changes in depression and anxiety. Postpartum the pregnant individual may experience anxiety, depression, even psychosis. Entangle with the psychological is the social. The pregnant individual must interact much more regularly with their medical team that is not always possible depending on health insurance. Pregnant individuals inquire on who amongst their friends and family are individuals they can count on. A major factor is the presence of absence, both physical as well as psychological, of the parent of the child.

At times, having a child may not be in the pregnant individual’s best interests. As laid out in the landmark Supreme court case Roe v. Wade and New York State’s Reproductive Health Act, the pregnant individual has the choice of whether or not to terminate the pregnancy or put the child up for adoption. To discuss abortion can oftentimes be taboo, yet the reality is that, per the Guttmacher Institute, approximately one in four cisgender women will have an abortion during their childbearing years. At The Compassion Practice, we are here to discuss this difficult decision. Whether it be processing whether or not to make the decision, preparing for the termination itself, or coping with what comes next, we are here for you.

At other times, pregnant individuals experience a miscarriage. Some view a miscarriage as a loss of the self, a child, and a potential future. The suddenness of a miscarriage can be traumatic for many, not just the pregnant individual. Complications and procedures after a miscarriage only further damage the psyche of the formerly pregnant individual and those around them. Oftentimes, particularly near the end of a pregnancy, parents are left with an empty baby room, now useless toys, and clothes collecting dust. We are here for you as you aim to come to terms with what you just experienced. Together we can form a new start.

A special note must be made for transgender men. The experience of pregnancy among transgender men can be a mixed bag. On the one hand, it offers the man the individual to give birth. On the other hand, it also reminds the transgender man that they still experience female events, leading to gender dysphoria. This is amplified via the forced discontinuation of testosterone due to its effect on a developing fetus. LGBTQIA+ therapists should be competent of this reality to address the complexity of pregnancy among transgender men.