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Self-Compassion

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Author: Corinne Terhune

­­­­­­­­When people talk about compassion, what comes to mind? What even is compassion? Often, we think about compassion and empathy towards others, but when was the last time you extended that grace towards yourself? 

When we think about extending compassion towards others, that looks like recognizing their experiences and struggle, and then offering your presence and gifts to honor that suffering. Now, imagine what that would look like to offer those things to yourself, utilizing self-compassion. Instead of avoiding or ignoring your pain, recognize it and give grace towards it, like you would anyone else. 

The first step towards self-compassion is recognizing that you are human. All humans make mistakes, have imperfections, and have growth areas. This is part of the human experience! Can you begin to extend the same grace you extend a friend or family member when they show their shortcomings? In extending this compassion, we solidify our own self-worth. Self-worth is not just identifying strengths but having compassion for our growth areas. Your pain or struggle is worth looking at and recognizing. Through this recognition, you can begin to practice self-kindness versus self-judgment. Be curious about your actions rather than judge. 

So how do we put this into action? 

Mindfulness is a great first step. The idea behind this practice is that we allow the thought to pass by instead of dwelling on it. For example, the thought comes into your head that you should have remembered it was your friend’s birthday. How could you forget?! Instead of dwelling on this thought, letting it consume you, and taking a trip down the shame spiral, notice this thought and allow it to pass by. You could’ve remembered their birthday, but you forgot. You are only human, and you will try to do better next time. Imagine the thought drifting down a river: you notice it, and then it continues downstream. You can find instructions for this particular exercise down below.

In conclusion, our hope is through practicing self-compassion, you can begin to extend yourself compassion so that you can gain a better relationship with yourself and others. As therapists, we know that compassion towards yourself and others can be hard, and if you find yourself wanting help and guidance in this, call the Refuge Center to set up an appointment. You can do so at: 615-591-5262 or go to refugecenter.og

If you are interested in more information about self-compassion, visit self-compassion.org for great resources and information.

Mindfulness Exercise on observing thoughts

Here is an example of a meditation on observing thoughts (Harris, 2019):

(1) Sit in a comfortable position and either close your eyes or rest them gently on a fixed spot in the room.

(2) Visualize yourself sitting beside a gently flowing stream with leaves floating along the surface of the water. Pause 10 seconds.

(3) For the next few minutes, take each thought that enters your mind and place it on a leaf… let it float by.  Do this with each thought – pleasurable, painful, or neutral.  Even if you have joyous or enthusiastic thoughts, place them on a leaf and let them float by.

(4) If your thoughts momentarily stop, continue to watch the stream.  Sooner or later, your thoughts will start up again.  Pause 20 seconds.

(5) Allow the stream to flow at its own pace.  Don’t try to speed it up and rush your thoughts along.  You’re not trying to rush the leaves along or “get rid” of your thoughts.  You are allowing them to come and go at their own pace.

(6) If your mind says “This is dumb,” “I’m bored,” or “I’m not doing this right” place those thoughts on leaves, too, and let them pass.  Pause 20 seconds.

(7) If a leaf gets stuck, allow it to hang around until it’s ready to float by. If the thought comes up again, watch it float by another time.  Pause 20 seconds.

(8) If a difficult or painful feeling arises, simply acknowledge it. Say to yourself, “I notice myself having a feeling of boredom/impatience/frustration.”  Place those thoughts on leaves and allow them to float along. 

(9) From time to time, your thoughts may hook you and distract you from being fully present in this exercise. This is normal.  As soon as you realize that you have become sidetracked, gently bring your attention back to the visualization exercise.

Written by Corinne Terhune, Masters Level Intern at The Refuge Center for Counseling

Other resources:

Harris, R. (2019). ACT made simple: An easy-to-read primer on acceptance and commitment therapy. New Harbinger Publications.

Neff, K. (2020, July 9). Definition and three elements of self compassion: Kristin Neff. Self. https://self-compassion.org/the-three-elements-of-self-compassion-2/ 

Self-Care: Prioritizing Your Body, Mind, and Soul

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Author: Taylor Musarra

“Rest and self-care are so important.

When you take time to replenish your spirit, it allows you to serve others from the overflow. 

You cannot serve from an empty vessel.” -Eleanor Brown

When you hear the phrase “self-care”, what comes to mind? For some, it may be treating yourself to something nice. For others, it may be taking a trip and exploring somewhere new without any distractions or obligations of the busy world. It could be a spa day, an afternoon away from your phone, or even taking a “mental health” day. Sounds fun, and like something we would want to do, but is it a priority? 

Mental health awareness has become more prioritized over the recent years; it’s at “buzzword” status even. Isolation during COVID-19 caused many people to evaluate their own mental health during this time. Work-life balance was now intermingled as many individuals used their home as both their office and a place for living. It was easy to overlook self-care when you felt like there was no space to really implement it. Or when you felt like you were caring for yourself (and others) by simply being home. 

Now, post COVID-19, we continuously aim to work on arranging our lives and wellbeing so that we can feel a healthy balance between work and life. The world keeps spinning and often times we may feel like we need to move in conjunction or the earth will fall of its axis and us along with it. It can be so easy to lose ourselves in the midst of a busy life. It can feel overwhelming when priorities shift and when we feel like we can’t ever catch a break. For a lot of us: We often take care of others so much that we forget to take care of ourselves.  It can seem selfish, but in reality, it’s far from a selfish thing to do. 

“Self-care is done with the intention of caring for yourself, not with the intention to harm or take from others.”– Stephanie Grunewald

So how do we do it? Self-care can be split into four areas.. the things we do to recharge physically, mentally, emotionally, and spiritually. This can look different for everyone and it should. Each person needs something different in order to replenish themselves fully.

Physical self-care can involve anything that helps to improve your physical well-being. Taking a walk, running, working out, dancing, eating healthier, getting a good amount of sleep, or playing sports are all examples of this. But you might be thinking, “My life is so busy, I don’t have time to do any of that.” While that may be the case, there can be ways to integrate physical self-care even during your busiest days. Things like going to bed a little earlier, taking the stairs instead of the elevator, taking a walk during a phone meeting, or even packing a healthy meal instead of going out to eat during your lunch break can all contribute to ways of implementing physical aspects of self-care in your life. 

It can be hard to practice self-care when our bodies are mentally and emotionally exhausted. It can be difficult to turn your attention to yourself when there are so many things going on in both your life and the world around you. But it is important to check in with yourself mentally and emotionally from time to time. Practicing self-care mentally and emotionally can look like numerous things. One of my favorite ways to practice caring for my self is taking part in mindfulness exercises and reminding myself to be present in the moment. You could simply take a moment to ask yourself the question of “How am I feeling right now?” Taking 30 seconds out of your day to focus on deep breathing to help relax yourself can be a great self-care practice. You could even set aside 5 to 10 minutes a day to sit in the quiet and journal or reflect on how you are feeling in the presently.

Next, how do you take care of yourself spiritually? This form of self-care can also look different from person to person. Spirituality is a way to help individuals find a sense of connection whether it be religiously, with others, or with the world around them. It can also help people find a sense of meaning and purpose in their life. Spirituality self-care can involve praying, meditation, deep mindfulness exercises, or even spending time in nature. Checking-in with yourself spiritually by keeping a journal or focusing on your goals and values is another great practice of spiritual self-care. 

Self-care will look different for every person. When we learn how to take care of ourselves, we can take better care and serve those around us. It is so easy to lose yourself in life because you are being pulled in a hundred different directions. Prioritizing others can be easier than prioritizing yourself, but I implore you to try to take time to implement self-care in your daily routine. It is important to keep in mind that self-care tasks should not feel like a burden or a chore but rather something you enjoy doing or find peace or pleasure in. Here are some a few great resources to find different self-care practices if you are not sure where to start.

Finally, reaching out to a mental health professional can be another great resource to utilize and an incredible self-care tool. Here at The Refuge Center, we are prepared to walk alongside you through your self-care and healing journey. We can work with you to find that balance between your busy life and prioritizing yourself, while also arming you with strategies to implement better self-care habits that can contribute to a more balanced mental health. 

Blog written by Master’s Level Intern, Taylor Musarra

West Tennessee Healthcare. Why self-care is an essential for your mental health. (2021, April 27). https://www.wth.org/blog/why-self-care-is-an-essential-for-your-mental-health/

Restorative Counseling. Is self-care selfish? (2023) https://rcchicago.org/self-care/#:~:text=2)%20Self%2Dcare%20is%20done,resources%20without%20depleting%20someone%20else’s.

Building Appreciation in Your Relationship

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Author: Kat Thompson

If someone asked you what the culture of your relationship is, what comes to mind? If you’re honest, maybe words like complacency, stress, chaos, bickering, or even numbness come to mind. If so… you are not alone. As relationships grow and adjust through different seasons of life, it is common to lose the feelings of romance, spontaneity, and excitement that are commonplace in the beginning stages of your relationship. Though relationship dynamics ebb and flow naturally, one foundation to a lasting and successful relationship is building a culture of appreciation. 

Whether your relationship is struggling or you feel like you’re in a great place, focusing on building appreciation for your partner is one of the best investments you can make in your relationship. 

Here are some practical tools and ideas to help you cultivate a culture of appreciation with your partner: 

First, think small things often. Changing the culture of your relationship doesn’t have to take a huge demolition and gutting; you can work on one small renovation at a time. Relationship researchers John and Julie Gottman give these ideas for incorporating small things into your daily routine.

1. Before leaving for the day, share a kiss lasting at least 6 seconds

2. When you think kind and appreciative thoughts about your partner, say it!

Think: what’s something I love about my partner’s personality and when did they display it, catch your partner doing something right, and tell them, write a quick love note, send a text to let them know you’re thinking of them

3. Use loving touch by holding hands, hugging, holding, kissing

4. Implement routine date nights

5. Build an appreciation ritual into your day. Can you set aside 5 minutes at the start or end of the day where you share a few things you love or appreciate about each other?

Still not sure where to start? Here are some conversation starters to prompt appreciation and connecting conversations. 

Gratitude and Appreciation

  • “Thanks for supporting me when I talked about my ….”
  • “You are a great parent. I love watching you ….. with the kids”
  • “I really appreciate you being so affectionate lately.” (Give specifics)
  • “I really appreciated our conversation about…” 
  • “When you …. it really made me feel prioritized”
  • “I am really proud of you for…. “
  • “One of the qualities that I love most about you is…”
  • “You really helped me by…”
  • “Thank you for cooking…. I loved it”

Fondness and Admiration

  • “Something I find so endearing in you is…”
  • “What was your favorite date we’ve been on?”
  • “The first thing I noticed about you was…”
  • “I think you look great in this photo….”
  • “I really enjoyed …. With you”
  • Talk about the moment you decided to commit to the other person
  • Describe your favorite romantic relationship moment
  • Discuss the first time you met 

Connection and Discovery

  • “What’s a vacation you dream of?”
  • “Something only you know about me is…”
  • “I love watching you succeed in…”
  • “What’s something you want to do together this weekend?”
  • “What are your expectations about… (an upcoming event)”
  • “What’s your favorite way to spend an evening?”
  • “What turns you on?”
  • “What’s the best gift you’ve ever received?”
  • “What are you most looking forward to right now?”
  • Talk about your common goals
  • Talk about how to improve lovemaking

My hope is that you find these lists helpful to start thinking about new ways to build a foundational culture of appreciation within your relationship. As therapists, we know that relationships are hard, and if you find yourself wanting more support individually or as a couple, call The Refuge Center today to set up an appointment.

I challenge you to find a prompt that stuck out to you and do it. My hope is that in committing to doing small things often, the culture of your relationship will change to become more connective, supportive, and satisfying. 



More resources: The Gottman Card Decks app – click here to download; Small Things Often podcast – click here to listen

Gottman, J. M., & Gottman, J. S. (2017). Small things often: How to build a positive, lasting relationship. The Gottman Institute, Inc. 

Crisis: Knowing When to Call

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Crisis: Knowing When to Call

Simply put, a crisis is when you need serious and urgent help from others because your own ways of coping are not effective enough at the moment.

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On July 16th, the new number for the mental health crisis changed to an easy to remember three digit number, 988.  So many people hear about crisis resources and helplines, but never believe they will be in the situation where they need these resources for themselves. Even the word “crisis” elicits all sorts of ideas from different people. Maybe you think about someone who is suicidal or someone who seems “out of control.”

While these are common and important examples of what a crisis might be, there are other types of crises that you may have not considered. A family who is going hungry due to lack of food resources, an elderly person in need of healthcare access, or someone who needs to get connected to metal healthcare providers are all additional examples of what a crisis may look like.

When you experience a crisis, you may feel certain sensations in your body. Your breathing may be strained, your heart may race, or your chest may feel heavy. Internally, you may feel confused, angry, helpless, shame/guilt, vulnerable, anxious, or hopeless. It may be difficult to self-regulate during a crisis and bring your body back to its natural equilibrium state.

Simply put, a crisis is when you need serious and urgent help from others because your own ways of coping are not effective enough at the moment.

Many external and internal factors can lead to a moment of crisis. Perceived loss and traumatic experiences can cause someone to depend on coping and problem-solving skills to regulate. When these skills are not sufficient for the individual to return back to a state of being emotionally regulated, this increases the individual’s anxiety and fear. Often in this elevated state, external regulators such as substances, other people, or belief systems may be utilized. An individual usually comes out of crisis once the situation or internal experience is changed in some way. Making a call is one of the best ways to deescalate the situation.

Luckily, making the call in a crisis has become simpler and easier than before. Tennessee offers two numbers, the 211 helpline and 988 hotline.

When to call 211

The new Tennessee helpline is now active and ready to provide callers with the resources they need. The 211 helpline is active 24/7, 365 days a year. The professionals on the other end have access to 10,000 health and human service programs, so you can be pointed towards the arms of others waiting to help. If you need immediate food, water, shelter, or safety, call 211. If you need housing or employment assistance, call 211. If you are struggling with your mental health, but not in crisis, call 211 to get mental health resources.

When to call 988

Another important three-digit number to remember is the 988 Mental Health Crisis and Suicide Hotline. If you or anyone you know is in crisis, especially if that includes considering suicide, calling this number will connect you with trained mental health professionals to deescalate the situation. Depending on the intensity of the need, the professional on the other end of the line will help walk you through your moment of crisis, refer you to local mental health providers, or provide you with immediate emergency services. The 988 line is there to serve you no matter if you are experiencing a panic attack or actively wanting to complete suicide. 988 also works for text or you can even chat online at 988lifeline.org.

Regardless of your circumstances, if you find yourself in a situation and don’t know the way out, just dial three numbers and speak with someone who can offer a helping hand. You don’t deserve to sit in the darkness alone, there is hope at the other end of the helpline.

If you are unsure if you are having a crisis, it never hurts to call 211 or 988. There is no shame in saying “I need help.”

If you do not believe you are in crisis and would like to get connected to mental health professionals, The Refuge Center for Counseling is also waiting with open arms. To make the first step and schedule an appointment, call 615-591-5262.

If you would like additional information on the new 211 helpline, you can find it here https://www.unitedwaygreaternashville.org/211-helpline/. If you would like additional information on the new 988 mental health crisis hotline, please visit https://www.samhsa.gov/find-help/988.

Blog written by Master’s Level Intern, Madison Josey and edited by Weatherly Hulsey

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Healing and PTSD

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Healing and PTSD

"Our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well-being. " -Bessel Van Der Kolk

I’m fine. Everything is fine. If I just close my eyes and take some deep breaths my heart will stop racing. I’ll just keep rubbing my palms on my jeans. This is ridiculous. 

 

It was only a text. Just a stupid text. So why are my breaths so shallow? Why is the room spinning? 

 

She curls up on her bed, hugging her knees to her chest. Raggedy, guttural crying only adds to the shaking. Nobody is there to hold her. Her children hesitate on the other side of her bedroom door, listening to their mom’s stifled sobs.

 

What is wrong with me? This is not a big deal. I wasn’t beaten. I wasn’t raped. I wasn’t tortured or shot at … It was just a text from him … the man I finally walked away from. 

 

I am fine. I will get over this.

 

But she wasn’t fine. She was not okay. No matter how much she tried to convince herself, no matter how many times she lied to her heart, she was in no way fine. And she would definitely not be getting over anything … 

 

Not without real help. 

 

Yet she didn’t really know what was happening to her. Clearly, panic had gripped her body and her mind. Her trigger was obvious—the text. But why did just seeing his name on her phone screen cause an uncontrollable visceral reaction?

 

Because this is the veiled face of a PTSD flashback. 

 

This is the face of PTSD that people don’t recognize. It’s the face that you walk around with every day, going to work, cooking dinner, running errands, grabbing dinner with friends. It’s the face that smiles, laughs, lends a listening ear, and offers a kind word. This is a face that just keeps on going, day in and day out. 

 

The feeling of anxiety and tension, staying in high-alert mode, blaming yourself, waking throughout the night, crying yourself to sleep, crying in the shower, avoiding certain places, feeling irritable, startling easily, and feeling overwhelmed have just become your norm. You’re used to it. 

 

It’s just part of your life.

 

And it’s just a little thing called Complex PTSD. C-PTSD is sneaky. It tucks itself away in the corners of your mind and recesses of your body, keeping just enough of a grip on you that you’re not quite sure it’s there … Until some outwardly benign thing comes into view. A phrase, a sound, a look, a song on the radio, a particular restaurant, a simple text. Any of those things might trigger your body and mind so sharply that you feel like you have no control over what’s happening. You feel like something else has overtaken you and you’ve become a prisoner in your skin.

 

When we think of post-traumatic stress, we picture Vietnam War vets who are re-traumatized by loud noises and experience nightmares that cause them to cry out in their sleep. We think of people who have survived a mass shooting. We think of women who survived sexual assault. That’s because we associate PTSD with major traumas. 

 

But there is another common cause of PTSD called complex post traumatic stress disorder (C-PTSD) which is made up of “little t” traumas that happen over and over again. These cumulative, unresolved traumas, like bullying, neglect from a parent or partner, or rejection or abandonment from social supports. These are the kind of traumas that somebody may have told you are no big deal, but our little traumas matter. And healing from those little traumas is possible. 

In the book, The Body Keeps the Score, Dr. Bessel Van Der Kolk highlights four fundamental truths about post-traumatic stress disorder (PTSD) and healing:

  • “Our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well-being. 
  • Language gives us the power to change ourselves and others by communicating our experiences, helping us to define what we know, and finding a common sense of meaning. 
  • We have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through basic activities such as breathing, moving, and touching; and 
  • We can change social conditions to create environments in which children and adults can feel safe and where they can thrive.” 

These truths are meant to help people suffering from PTSD to own their healing journey and become a participant in the process, rather than being a passive patient. They point your healing journey inward and place the keys to healing in the hands of those who are suffering and their community of support. 

 

Relationships and Community

 Dr. Van Der Kolk’s first point claims that while humans have the capacity to deeply wound one another, they also have the radical ability to help in the healing process. This is consistent with the view that humans are highly relational beings, and that when our needs cannot be met by others we are met with suffering. From birth, we cry out to others to fulfill our needs. Unfortunately, we learn as we grow that our cries are not always met with the comfort our souls crave. When our sense of identity and hope is marred by the hands of another, we may run far away from relationships and cling to the fear that we’ll just be wounded again.  Self-protection drives us to make vows to decrease our vulnerability, hoping to never experience the trauma, heartbreak, or suffering again. The ironic thing is that when we decrease our vulnerability, we increase our shame. And shame? Shame weighs on you like a wet blanket.

 

When others see us just as we are, that allows us to understand and embrace ourselves. The problem is that when we are hurting we believe we’re alone. We might know that we need relationship, but we don’t know who would be safe to talk to and let our guard down. You may have tried this. You may have offered your heart on a silver platter only to have it sprinkled with empty platitudes, promised prayers, and a good old broom to sweep it under the rug. If this has happened to you, it is awful. It is not okay.  And those are not your people. 

 

There is healing when you are seen and heard. There is healing when you find a safe person who allows you to lay your burdens down and rest awhile. But it starts with our own vulnerability. Start with one person you already trust or suspect is trustworthy–it could be a parent, partner, therapist, teacher, coworker, new or old friend, or anyone willing to listen. Start by asking if they’re open to a conversation and if so, take the risk of admitting the hurt and asking for what you need. You may not know what you need yet. That is okay. Your healing is worth it. 

 

Name it to tame it.

 

If you’ve experienced trauma, you may have an awareness of deep suffering but you may not grasp why or even how you are suffering. You may not even know how to put it into words. It may be painful, uncomfortable, or scary to speak the pain into existence. Remember, things fester in the dark. Dr. Van Der Kolk hints at this idea when he describes how language can help us make meaning out of our painful experiences. When you don’t know how to name your suffering, it can feel wildly overwhelming. Shame may kick in and whisper that there is something innately wrong with you and that’s why you have issues. But the truth is that your mind, body, and soul are having reactions to the unresolved pain in your life. 

 

Naming your pain may cause intense reactions such as emotional distress, flashbacks, or physiological symptoms such as shaking, sweating, etc. Having a trusted and qualified mental health professional to come alongside you and address the root of the pain can lead to greater freedom.  If you have PTSD, confiding in a mental health professional can help you understand how your trauma affects your life in the present and how to move forward. And wouldn’t it be amazing to be unstuck? Wouldn’t it be wonderful to see a path forward and walk on it?

 

Self- Regulation

When you are a victim of trauma, whether big or small, you may struggle to function in your everyday life no thanks to intense fight-or-flight responses to normal stimuli, like seeing an abuser’s name. Many combat veterans with PTSD are triggered by sights and sounds like fireworks. A therapist can help you identify your triggers and regulate your fight-or-flight responses in healthy ways. The good news is that there are quite a few ways to interrupt your fight-or-flight response. In Dr. Van Der Kolk’s third point, he states that involuntary actions such as breathing, moving, or touching can help regulate our nervous systems. 

 

You may have already discovered that deep breathing helps when triggers or anxious thoughts arise. When you take long and deep breaths, you communicate to the body that it is safe, that no threat is present. Breathing in, holding it, and slowly exhaling causes your heart rate to slow and the body returns to a sense of safety. 

 

Breathing may not do the trick. You may need to move by doing yoga or going for a walk. Getting physically active can be like balm for an overactive mind and body. Studies have shown that walking, or any bilateral movement, stimulates both sides of the brain. This paves the way for greater emotional processing, allowing your thoughts and feelings to become more coherent. 

 

When walking is not available, some people find tapping on both sides of the body provides similar effects. Whether you choose mindful breathing exercises, gentle movement, or both–utilizing these mechanisms can help calm a heightened nervous system and communicate peace and safety to the body. 

Safe Environments

 

Along with internal work, changing your environment can bring positive change when you have PTSD. Dr. Van Der Kolk emphasizes that social conditions play a large role in creating safe environments for people with PTSD. Participating in theater is a useful tool. People may come in highly unattuned to their bodies and uncertain how to engage with others in the space, so the director intentionally works to slow things down. 

 

A director who works with traumatized teens described to Dr. Van Der Kolk how he structures his theater practices. He first gets the participants up and walks around the room. He uses small steps to create safety. This example shows the need for those with PTSD to engage in social settings slowly and carefully.  Beginning with something like a theater, music, or dance class may help build social skills and awareness that translate to real-world scenarios. Additionally, utilizing the safe space of a therapist’s office may be a good first step if a class with other people seems too daunting. 

 

If you are a victim of trauma, big or small, one or many, know that healing is possible. There is no way to remove your past, but there is a way forward. You are not what happened to you. You are not your past. Your heart is worth healing. 

 

Here at the Refuge Center, we see you and want to honor your unique and valid needs. If you feel that the next step in your healing journey may be to reach out to a mental health professional for help, we would love to meet with you and walk alongside you in the process. You may reach us at 615-591-5262 to take the first steps. 

References: 

A., V. der K. B. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books.

Blog written by Master’s Level Intern, Madison Josey and edited by Shelby Rawson

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