Healthy is Too Hard!! Answers On How To Implement Positive Change

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If you are someone who is interested in making positive changes in your life, I imagine you are reading this blog among many others. It is my hope that you read with an open mind and take things away that are pertinent to you or speak to you in some manner, but leave behind the advice or suggestion that doesn’t speak as easily to you. In my work as a therapist, personal trainer, and wellness coach, I spend a great deal of my time with my clients working on the issues that they are hoping to work through or heal from; along with a great deal of energy dedicated to how to make positive changes. As I have heard in the voice of many of my frustrated clients: “Healthy Is Too Hard!”

Yes, it is incredibly challenging to make, implement, and maintain positive changes that you attempt in your life. A lazy, sloth-like, fast food eating, indulgent lifestyle are much easier to pull off in our society full of convenience, sensory overload, and consumerism that pushes us to “buy”, “eat”, “compete”, “drink”, and live in a manner that is not in alignment with a wellness based goal of balance, health, and long-term care of our spirits.

Sometimes it is easier to ask yourself, “why bother?”. I find the answer to this question to be grounded in the idea that many people who are not taking good care of their health and wellness are unhappy, unfulfilled, lack work/life balance, and are completely living a life that does not feel in alignment with who they always believed themselves to be (if in fact they are aware of who that is). Sometimes they have anxiety, depression, impulsive shopping problems, work/life balance issues, no real quality time with their children, or no idea about who they are and where their passion lies, or chronic health problems. Maybe they drink themselves to relaxation every evening to relax.

Wellness is about integration between many different components in your life in which you have health including: emotional, spiritual, mental, vocational, physical, family and financial. Often we are good in one area in our lives, but not another. If for example, you are doing a great job working out and eating well each day but you are working 14 hours a day at a desk and having no time to explore your emotional well-being – you are not living a life of wellness. It is the integration of these components that makes up a complete picture.

This discussion gets complicated because the first step in working towards improving upon your life is to take an honest assessment of where you are. I use an integrated wellness assessment I have created with my clients, but you can even write down the 7 areas I mentioned above and check in with each section by asking yourself, “How am I doing?”. You must be brutally up front with yourself if you are going to be able to truly take a current day snapshot. Most of us have one or two real problem areas in our life and struggle with having to face the facts around our behaviors and how they are affecting us.

The next step is to grab one of your problem areas and set yourself up with 2-3 goals using the S.M.A.R.T. format listed in the graphic above. You literally just start somewhere positive. Pick one (maybe the area you tend to feel the most negative consequences in your life from). You can learn more about setting smart goals here:

http://www.wikihow.com/Set-SMART-Goals

Pay special attention to being specific and having goals that are achievable. We often attempt to set goals that are too vague or general and have very little chance of success. If you are not honest with where you are currently in regards to the behavior, you have very little chance of setting up an achievable goal that targets it effectively. For example, if your goal is to start exercising and you are currently at 0 times per week. Your smart goal would look like: I will walk 20 minutes on Tuesday and Thursday mornings from 7-8 beginning 9/15. It must be that specific, and as you can see, it needs to start with an achievable amount of time and days involved. Going from 0 to 2 X per week is a great start. Keep it up for a few weeks and re-evaluate if you want to, but don’t create a goal that has you working out 7X per week straight out of the gate. You will set yourself up to fail.

Speaking of failing, one critical step when setting a new goal, is to always be mindful of also setting up a plan to fail. That is, put down a plan for what happens if you fall off the wagon. It happens to all of us, no matter how motivated we are to get started, so you want to anticipate it ahead of time. It is always incredibly helpful to say your new goal out loud to someone who can hold you accountable, or post it on social media…maybe you want to hire a wellness coach to help you along. Whatever it takes. Wellness is a life long journey that will require tweaks, updates, and constant monitoring to check in with yourself and how you are feeling within your individual life.

I am lucky to have worldwide readership on this blog; however, for those of you who may live in or are close to Silicon Valley, I am offering a special program to help this process along for my clients. I am offering it only for a limited time to help kickstart some of my readers and clients (and their friends) to get started on improving your wellness. Please see my flyer below for more details.

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I will continue to write tips and ideas on how to integrate wellness and find a way towards authentic living in a mindful, balanced and fulfilling manner. This is my greatest passion and I believe strongly that we need to focus on all of the areas of our life to have a true understanding of how we are living. Our lives are so very precious and short. We owe it to ourselves and our loved ones to live it as fully as we are able.

Stacey Neil, LMFT, CPT is a licensed Psychotherapist, Wellness Coach and Certified Personal Trainer who is in private practice in Los Gatos, CA. She is also the Co-Founder of TotalFit Solutions, Integrating Mind & Body. She can be reached at 408.827.5139, or http://www.totalfitsolutions.com

Or you can fill out the form below and I will get back to you!

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Shhhh…The Secret To Finally Starting an Exercise Program

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My clients ask me all the time about exercise programs. As a Personal Trainer and Licensed Psychotherapist, I tend to meld both backgrounds into my transformational work with my clients incorporating the importance of moving your body, practicing mindfulness and also looking to implement positive change in dealing with struggles that individuals face with anxiety, depression, loss, or trauma. Exercise is amazing for many aspects of well-being that go far beyond physical health and include re-wiring the brain.

Scientific studies are finally beginning to catch up with my soapbox preaching around the importance of exercising to overcome mental health issues. Now you can pull up your favorite search engine and type in “the benefits of exercise for mental health” (I tried Google) and get over 78 million responses. I believe that every Doctor and Psychiatrist should have a section for “exercise prescription” on the medication pads. I don’t think medication should be prescribed without a discussion on the benefits of exercise to go along with your chemical cocktail of symptom relief. If you are going to take pills to feel better (and often that is absolutely necessary) it is equally important to get that body of yours moving.

So what makes it so hard for all of us to grab our bodies and begin an exercise program when we know it is SO good for us? In my experience with clients it boils down to a feeling of overwhelm. There are so many individuals who are mass marketing programs that guarantee you results in “3 Months”, “30 Days”, “14 Days”, or even (believe it or not) “The 3 Minute Exercise Solution” that it is impossible to know where to start. To add even more confusion to the mix is the conversation around what you “should” be doing as a part of a complete exercise program such as the baseline debate over which is better: cardiovascular exercise “cardio” or strength training. In addition, once you even whittle down past these two main categories, there are literally hundreds of different exercise options available.

As a prospective new exerciser begins to look into how to work out, what exercises to do, or how to plan a program – worries begin to arise. The opposite of positive thinking occurs, and instead the only increase that comes up for someone is a spike in his or her stress levels. I have heard these concerns. Everything from: “I don’t want to bulk up”, “I am too old”, “I am going to get hurt”, “I’m too overweight to do that”, etc. pops into consciousness as attempts to find the best possible excuse to forget getting started on a new program in the first place arise, and going to the pantry to get a snack begins to sound like a much better idea instead.

I know it’s intimidating because I hear it from clients all of the time. That’s why I want to share the number one secret that I have learned to getting started on any exercise program. The best thing you can do to assure that you are going to get started, and more importantly, stick with an exercise program is to find something you enjoy doing. This cannot be overstated and does not need to be more complicated. If you find something you enjoy doing, you will stick with it. If you like to walk in the evenings with your dog, go out for a walk starting for 20 minutes and work your way up to 30. Don’t like dogs? Grab a bike, go for a swim, try a class, take a hike, or find a friend to join you. Hire a Personal Trainer to explore ideas with you if you want. But try something. If you don’t know what you like, give yourself permission to try a lot of different things. There is no perfect science to finding out your likes and dislikes other than having the courage to give it a shot.

I promise you that if you are able to find something you enjoy you can begin to create a new healthier habit. This takes 6-8 weeks to do, so you may find yourself needing to self motivate until the habit gets established, but this will become routine, and your body will start to look forward to whatever activity you begin to practice. Yes, there are ways to change the way your muscle structure looks through exercise, or lose weight, or even improve upon you metabolism; however, this is not necessary to focus on, when learning how to get your body moving. What is important for improved health is as simple as it is stated below in the American Heart Association Recommendations.

AHA Recommendation

For Overall Cardiovascular Health:

-At least 30 minutes of moderate-intensity aerobic activity at least 5 days per week for a total of 150 minutes.

OR

-At least 25 minutes of vigorous aerobic activity at least 3 days per week for a total of 75 minutes

(You can visit http://www.heart.org for more information on this)

If you enjoy walking your dog in the evening and want to make this your exercise routine, you can make sure you are going at a moderate-intensity if you can still talk but have increased your breathing rate. Maybe you need to take Fido up the hill for a stroll to accomplish this, but you can make this the only exercise routine you need if your exercise plan is to walk according to the guidelines above.

It can be overwhelming to listen to all the fitness programs available, and at times having access to so much information can lead us to shut down instead of take charge. Fitness professionals are master marketing moguls and typically have killer bodies to boot. From Beach Body, to Jillian Michael’s Fat Shredder, to P90X; the options for exercise promises and benefits are numerous, but rest assured that for you to improve your mental health, relieve depression, and feel happier and healthier, you just need to find something enjoyable to you.

So get out there and ride a bike, join the Y, rescue a pet that needs to be walked, or take a class. Check in with yourself after a few days and see if you can feel the difference in your mood, you self-esteem, and sense of well-being. Becoming mindful of this feeling of accomplishment and improved health will keep you going. Good Luck On Your New Plan!

Stacey Neil is a Certified Personal Trainer and Licensed Psychotherapist in private practice in Los Gatos, Ca. She can be reached at 408.827.5139.

Refused Consent: How HIPPA Can Hurt the Families of Adult Children with Mental Illness

A first year graduate student interviewed me last week for a paper she was writing for her law and ethics class. She asked me what was the most challenging legal or ethical issue I have yet to face in my work as a therapist. I thought for a moment about so many of the challenging issues I face in my work with clients. These are not simple answers. When you are sitting alone in an office one on one with a variety of different clients, presenting with their own unique struggles, a myriad of things come up all the time. As a therapist, I must be mindful of my legal and ethical obligations as almost a second nature. I have found that this gets easier hour after hour sitting with another human being but is never uncomplicated.

I thought about her question to me and reflected back on some of the hardest legal/ethical issues that have come up. Some hurdles I’ve had to navigate have to do with the mandatory reporting of child abuse cases, the sometimes strange laws surrounding minors engaged in mutually initiated sexual acts, and the moral dilemma about taking clients rights away to place them on a 5150 hold (due to their threats of harm to self or others). As intense as these issues are, however, these legal and ethical challenges are not the toughest to deal with for me because I can feel an internalized sense of “right or wrong” in handling them.

What I have struggled with the most has to do with the limitations that HIPPA (the Health Insurance Portability and Accountability Act) places on the families I work with who cannot participate in the care of their loved ones if they have not been given consent by their adult child .  Historically this act was put into place in 1996 with the best of intentions around protecting health information and allowing individuals to have privacy around the medical care they seek.  To use an extreme example, if you are suffering with HIV, HIPPA allows you to have confidential treatment that your workplace, who handles your medical insurance, has no access to.  This has freed up many individuals to safely seek medical attention and care for issues that they may otherwise want to keep hidden.  It has been a really powerful ally in client’s rights; however, like many of the mandates that are put into place, there have been consequences to the righteous  limits of HIPPA that may or may not have been anticipated, but nonetheless, have been heartbreaking for some of the families I work with.

At the age of 18 we are deemed “adults” in the eyes of the law.  This adult status allows us to choose who we do or do not share medical information with.   The challenge this brings up for the families I work with is that they may have an “adult” child (over 18) who is suffering greatly with a severe and persistent mental illness,  who may even still lives in their home, and is in need of more intensive services or care.  If that adult child does not sign a consent form giving their loved ones the ability to share in the treatment of their illness, the parents cannot have access to any information regarding their child nor can they seek out treatment for them even if it is in their child’s best interest.  In extreme cases, I have worked with families who have an adult child living in their home in the midst of a psychotic episode in which they are extremely paranoid.  This paranoia extends to believing that their parent is “out to get them” and they are unwilling  to have their family member speak to their Psychiatrist or Psychotherapist to coordinate the best possible care.  Or even more detrimentally, they may not be receiving treatment at all and the parent is unable to initiate services for them without their permission.

This can be an issue for a variety of clients, for example, consider an adult child suffering from Major Depressive Disorder who chooses to leave their family out of the loop deliberately and refuses consent as a way to isolate from their parents or punitively keep them unable to get involved with trying to support treatment.  Keep in mind that this is an adult child still living in the home causing distress to the entire family as they are refusing treatment for their illness.  This family is trying to stand by their adult child and keep them safe in the home. Families are left frustrated, hurt, and helpless.  Mothers and fathers sit back and watch their cherished son or daughter spiral downward and feel unable to do anything to intervene. Of course, there is always calling the police if their child gets out of control, or forcing the adult child to move out of the home,  but the fear of their child living on the street, or in a homeless shelter, keeps them shackled in a vicious cycle of trying to manage a volatile situation with very few tools on hand.  This situation forces them to tirelessly try to stand by their son or daughter as their symptoms continue to worsen in a tragic manner. Often families will bring in their adult children to therapy in hopes of getting them help.  Sometimes they have to threaten to kick them out of the house unless they come.  As a therapist, this is not always the easiest client to engage with as you are their “punishment” in order to stay in the home.  

As someone who used to work in a county contracted mental health organization, I am familiar with the resources available in the community and the many ways to work with these individual clients and also their family members.   As a provider, without a client’s consent, I am able to receive information from these families so they call me to vent or let me know how their child is doing.  However, I can share no information in return regarding the progress, interventions, or work we do together in session.  I have had parents cry in frustration, lose sleep out of fear, and yell at me from worry for their child, and I still cannot offer any comfort.  I can not share with them that things are getting better, their child is learning new tools, they are finding hope in their illness, that they love you more than anything.  I can say nothing.  It is the hardest part of my job, this inability to provide comfort.

I often wonder if it is because I too am a mother.  I know that mental illness strikes at any time to anyone.  I know that I could just as easily be sitting on the large couch vs. on the therapist chair begging for more information because my child is hurting and I can’t help them.  My child is in pain and he/she won’t talk to me, won’t let me in, won’t sign a simple piece of paper that will allow me to find out how they are doing.  I must speak in generalities, not specific  to their child.  I can teach them about different diagnosis’ and provide education while making no personalized statements that may be meaningful to them.   I am grateful I have learned of something to offer these families.  I  refer them to the best program I know for families of children who are suffering from a mental illness:  NAMI’s Family to Family Program.    It is a program from the National Association of Mental Illness that is taught by families for families  in a small support group format.  It teaches them all about how to be as empowered as possible about caring for their family member as well as how to have self-care and compassion towards themselves.  The families I have referred say it has saved their sanity and given them some strength in what can feel like a vast vacuum.

As a final note, I think it is important to mention that not all families have the best interest of their adult children at heart and can actually be pretty harmful at times in provoking their adult child who is suffering from a serious mental illness.  There are families that have mental illness throughout the genetic lines and a parent who is suffering from a mental illness cannot always be a strong advocate for their child without first doing their own work.  In my experience this is the exception and not the rule in the families that I work with, but it does exist.  Some families have the potential to be toxic and enabling of each other in their illness or addictions.  However, 99.9% of the time, the families I work with are loving, concerned, desperate and short of hope.  This is the toughest legal issue I work with as a therapist.  I wish there could be built- in exceptions to consent forms that took into consideration that just because an individual turns 18 does not always mean they know what is in their best interest or how to best care for themselves.

Yours in Health,

Stacey Neil