A Somatic Approach on Working with Depression and Negative Self-Talk By Payam Ghassemlou MFT, Ph.D.

Depression is common and treatable. It can strike anyone at any age. Consulting with your physician or a licensed mental health provider is the best way to find out if you are suffering from depression and the type of depression you might be having.

A person with depression can experience a few or many of the following symptoms:

Feelings of sadness and emptiness

Feelings of anxiety

Experiencing restlessness or irritability

Losing interest in all or most activities

Problems with appetite that can lead to weight gain or weight loss

Sleeping problems

Loss of interest in sex

Low energy that can include feeling tired much of the time

Difficulty with concentration or making decisions

Feeling negative towards oneself including worthlessness or excessive guilt

Feeling hopeless or helplessness

Crying spells

Increased use of alcohol or drug use in order to cope with a depressed mood

Thoughts of death/suicidal ideation

Many people might not have the awareness that the underlying cause of the above-mentioned symptoms is depression; therefore, they cannot get the treatment they need. It is difficult to treat something that one has not identified yet. Over time, serious levels of depression that are not addressed get worse and can lead to other health-related issues. It can even lead to suicide.

There are different kinds of depression; hence, one person’s needs will differ from those of someone else. Psychotherapy is the most common treatment for depression. Psychotherapy can help on many different levels including integration of the clients’ body experiences in relation to their thoughts and emotions along with resolving or coping with issues that may contribute to their depression. Most mental health providers agree treatments for depression with suicidal ideation or other serious symptoms require a combination of antidepressants and psychotherapy. Some patients who might not show progress with standard treatments for depression might need additional resources.

In my counseling work with people who suffer from depression, I often notice that they have an inner critic which constantly makes them feel discouraged, inadequate and in many cases worthless. When the inner critic is the dominant voice inside a person, depression is likely to be present. Identifying the inner critic can be done by encouraging clients to pay attention to their body and their nervous system activation. For example, when Jack noticed his neck and shoulders curved forward, his head looking down, and unpleasant tension in his jaw, he was invited to become curious about this body language. The body language is a voice that does not use words and always tells the truth. He discovered an inner dialogue associated with this body posture, and it involved the following thought, “I am going to lose my job.” He realized how often he tells himself that his job is at jeopardy. When he was invited to examine all the reasons that he won’t lose his job, and all the resources that can help him to find another job in case he was let go, he noticed a shift in his body. He started sitting up straight with his shoulder pushing out, his jaw loosened, and he reported feeling more confident. He was encouraged to embody this new level of confidence by noticing all the positive shifts in his body including his deeper breath and feeling more relaxed in his shoulders. By tracking his pleasant bodily sensations that he was experiencing as result of identifying helpful resources, he was creating a physiological event in his body which led to regulating his nervous system. This can be a powerful approach to help someone suffering from negative self talk to use their body as a resource to modify such self-defeating dialogue.

There are many ways to work with negative inner dialogues and painful emotions that accompany them. It is helpful for clients and therapists to explore different treatment options as they work together. A collaborative therapeutic approach helps people to feel empowered and  in control of their recovery from depression.

Working with a mental health therapist to explore treatment options for depression is an important step toward healing. I hope anyone who is suffering from depression reaches out and gets the help they need. Everyone’s pain is unique, and no one deserves to suffer in silence. Reaching out and asking for help is a courageous act that people can do in response to suffering from depression.

© Dr. Payam Ghassemlou MFT, Ph.D., is  a marriage and family therapist in private practice in West Hollywood, California. www.DrPayam.com    www.SomativAliveness.com 

Resource is Power in Dealing with COVID-19 By Payam Ghassemlou Ph.D.

COVID-19 is the uninvited guest that has crashed our daily lives. This virus has forced us to take a collective “time out,” and shelter in our homes. Most of our plans are now on pause, and we are living with a great deal of uncertainty. For many of us, fear, helplessness, and confusion are among the common reactions to the coronavirus outbreak. It feels scary to deal with an invisible enemy that can attack the respiratory system and jeopardize our well-being or the health of our loved ones. No one should feel judged for having an emotional reaction to this pandemic. It is important to have empathy for our painful feelings, and our struggle dealing with this situation. Everyone’s pain is unique, and no one deserves to suffer in silence. Reaching out and asking for help is a courageous act that we can do in response to our need for support.

When it comes to asking for help, it is important to notice where we experience our distress. We often notice our overwhelming emotions and our intense thinking patterns when it comes to stressful situations. It is important to start with how our body experiences the threat of the COVID-19 pandemic, particularly its impact on our nervous system. Everything that happens to us starts with how our nervous system receives it. Our body comes with a built in autonomic nervous system (ANS) that provides many vital functions including helping us experience safety. Relying on neuroception, a term coined by Porges, the ANS helps our body differentiate between safety, danger, and a life threat. Our nervous system gets affected by what happens around or inside us. For example, the cues of danger that many of us sense by just making a short trip to our neighborhood grocery store is enough to dysregulate our nervous system. It is very difficult to function optimally when we are in a constant state of dysregulation caused by the threat of the coronavirus. As human beings, we need a sense of safety. We can’t thrive without it.

At times like this, we need to help our body feel safe and learn how to regulate our nervous system. We need to protect ourselves from getting infected by the virus or recover from it without getting paralyzed by fear and stress. Luckily, by providing the right resources, our body can become a vessel of safety to settle ourselves. A settled body can become a protective container during these turbulent times.

Our best ally to help our nervous system deal with the COVID-19 pandemic or any life challenge is accessing resources. What is a resource? A resource is power. It is anything in the universe that can empower us, support our wellbeing, help us feel safe and create a healthy connection with others. A resource is not only about what can help us thrive but also how helping ourselves can positively impact others and the Earth. A resource can be as simple as listening to calming music that can relax us or practicing physical distancing with others that can reduce our exposure to the coronavirus. We all have resources, and some of us might need support to identify them. It is very difficult to identify resources if we feel anxious, overwhelmed, or dealing with chronic habits of negative thinking.

We can start accessing  our resources by being present in our body. When we identify a helpful resource, we can notice our body’s reaction to it. For example, when we witness and slow down our breathing, along with silently repeating a meaningful mantra, we might be able to help our nervous system shift toward the experience of calmness. According to many scientists, slow breathing can stimulate the vagus nerve and help us go into the parasympathetic mode.  Moreover, for some of us by having body awareness during slow abdominal breathing, we can track positive sensations such as relaxation or calmness. Such tracking can help us  befriend our internal sensations and contribute to our nervous system regulation.

It is important to note not everyone finds meditation or slow breathing helpful. One size does not fit all. A resource needs to be tailored to the needs of the individual. For instance, some of us find certain dances or movements helpful. Our body might respond positively to such  experience by releasing tension. Other people might notice feeling lighter in their body after watching a comedy. No one should feel judged for not finding certain resources helpful.

The right resources can help with nervous system regulation and help our body experience safety. A regulated nervous system helps with creating a strong foundation to cope with the stress of the COVID-19 pandemic. In addition, there is magic in a breath that flows from a person with a regulated nervous system since it can add harmony to the collective nervous system. Everyone has a nervous system and embracing the oneness of our humanity can include awareness of our collective nervous system. Since we are all part of one humanity, our attempt to create inner peace is good for everyone’s nervous system.  If a virus can be spread so quickly and globally, peace can too.

We can create a list of the resources that can assist us dealing with the impact of this pandemic. We can create it on our own, with the help of a therapist or a trusted person. Again, it is okay to reach out and ask for help even when it comes with resource making. As we make this list, we can bring awareness to what it is like on the inside knowing we have resources. For many, resource-making can be an act of self-care that can lead to a sense of aliveness. It can also be empowering and help our body experience a sense of safety. Peace, serenity, and a sense of safety can be very empowering for the immune system. In addition, resources can help us collectively. For example, a collective breath is a resource that can help us pause and change our old way of living. As our life story with COVID-19 unfolds, let’s reflect and realize a crisis is not always about danger but also the opportunity to transform.

© Dr. Payam Ghassemlou MFT, Ph.D. is a Licensed Marriage and Family Therapist (Psychotherapist), in private practice in West Hollywood, California.  www.DrPayam.com    www.SomaticAliveness.com