Karuna Counseling’s Newsletter Articles

November 23, 2011

Personality Drive: A Holistic View

By Metta Sweet Edge, LCSW

It’s becoming increasingly well known and accepted that thoughts, feelings, and physical experiences are interrelated and deeply inform and impact one’s daily life.  For example, a single thought (“I’m running late”) almost instantaneously causes a feeling (such as fear or worry) which triggers a physiological response such as rapid pulse rate and sweaty palms.  A holistic perspective—holding head, heart, and body as equal and interconnected aspects of the human experience—can also add to a deeper discovery and understanding of one’s personality drive.

The teachings of the Enneagram (please refer to the first and second articles on the Enneagram for more information) include distinctions between what are called the “Triads” or “Centers”: Feeling (heart), Thinking (head), Instinctual (gut/physical).  The personality drives fall into each of these as follows:

Heart/Feeling Triad:

  • 2 (Helper/Be Loved)
  • 3 (Achiever/Performer)
  • 4 (Individualist/Be Special)

Head/Thinking Triad:

  • 5 (Thinker/Researcher)
  • 6 (Loyal Skeptic/ Safety/Security)
  • 7 (Enthusiast/Adventurer)

Gut/Instinctual Triad

  • 8 (Challenger/Self-Reliant)
  • 9 (Peacemaker)
  • 1 (Reformer/Be Right)

The three personality drives in each triad/center have a shared “root” emotion/issue that each drive responds to and defends against either by over expression (2s, 5s, 8s), under expression (4s, 7s, 1s), or denied existence (3s, 6s, 9s).



For the Feeling triad (2s, 3s, and 4s): their power lies in ability to feel emotions (2 feel too much of only positive emotions, 4 feel too little positive emotion, and 3s deny their authentic emotions all together).  The root issue of the Feeling triad is shame and hostility:

Root: SHAME and HOSTILITY

  • 2s deny hostility and act as an idealized person to compensate for the shame
  • 3s deny shame and then try to fill the gap by being what they achieve
  • 4s try to fix the shame by shoving hostility down deep never finding it

For the Thinking and Doing triad (5s, 6s, and 7s): their power lies in ability to think and take action (5s think too much and therefore act too little, 7s act too much and think too little, and 6s deny their thoughts and actions value all together).  The root issue of the Thinking and Doing triad is anxiety and dread:

Root: ANXIETY and DREAD

  • 5s dread/are afraid of the world and overwhelmed by people, go inside their heads to knowledge/thoughts (source of all power to 5s) so can be free of the anxiety and dread.
  • 6s don’t trust their own thinking and doing, so they look outside themselves to the world to handle the anxiety and dread for them so they won’t have to deal with it, to make safe from the anxiety/dread
  • 7s run away from the anxiety/dread to lose self in the excitement and adventure of the world

For the Instinctual/Physical triad (8s, 9s, and 1s): their power lies in ability to instinctually, from the gut, take impulsive action (8s are overcome with aggressive “animal” instinct to quickly and blindingly, 1s repress their animal instinct, and 9s deny their gut’s very existence).  The root issue of the Instinctual triad is aggression and resentment:

Root: AGRESSION and RESENTMENT

  • 8s express aggression and say “deal with it”
  • 9s deny aggression and resentment not wanting to rock the boat
  • 1s sublimate aggression into idealism and perfection.  Try to make aggression sublime (not just repressing it, shoving it down and having it come up as righteousness and doing the right thing)
Knowing your personality drive’s place within the triads can be very helpful in discovering not only the root issue that needs healing, but also where the key to your power lies for optimal personal growth.

Resources

There are many resources on the Enneagram, but the ones I work with most are from Riso & Hudson’s Enneagram Institute (www.enneagraminstitute.com) and The Wisdom of the Enneagram, Daniels & Price’s The Essential Enneagram, and Concept Synergy’s Harnessing Your Personality Drive Through Exploring the Enneagram as well as PPV Enneagram: Forging the New Self.

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June 28, 2011

Book review: The Mindful Way Through Anxiety: Break Free from Chronic Worry and Reclaim Your Life, by Susan M. Orsillo, Ph.D., and Lizabeth Roemer, Ph.D.

Filed under: 2011 Articles,Anxiety,Lisa's Articles,Mind-body-spirit Integration — karunacounseling @ 2:37 pm
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Mindful Way Through Anxiety
A book review by Lisa Anyan Smith

We live in a stressful world.  Anxiety is a part of the human condition.

Many people complain of feelings of anxiousness, ranging from occasional mild worrying to full-blown anxiety disorders such as Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, Social Phobia, or a specific Phobia.

Although anxiety is a normal human emotion, we find feelings of anxiety unpleasant and typically try to avoid experiencing them.  Attempts to avoid  anxious feelings may include overeating, drinking alcohol, watching TV, taking prescription medications, or staying away from situations or people that may trigger anxiety. In their new book, “The Mindful Way Through Anxiety: Break Free from Chronic Worry and Reclaim Your Life,” Orsillo and Roemer propose that avoiding anxiety or attempting to control it does not ease pain and suffering.  Rather, avoidance brings its own costs.  The authors suggest that to break free from anxiety, instead of avoiding anxious feelings, we practice coping strategies that allow us to turn toward and pay close attention to anxiety.  Turning toward something that we would usually avoid and taking a fresh look at habitual responses are crucial components of mindfulness.

Before exploring how mindfulness can help us break free from the grip of anxiety, let’s look at an example of what anxiety is.

Jody recently moved to New York City from Alabama to start a new job.  Heading into a corporate meeting, she notices that most of her coworkers are already seated and chatting with one another.  She takes a chair between two groups already engaged in conversation and begins shuffling through her papers.  She feels her anxiety rising.  Some of the thoughts that go through her mind include, “I don’t fit in here,” “My clothes are all wrong,” and “They must think I’m an idiot.”  She feels her face flushing, palms sweating, and pulse quickening.  Thinking of the friends she left behind at her former job, she feels a wave of sadness and regret.  She despairs as she thinks about the years ahead of her, just knowing that she will always feel alone.  For the duration of the meeting, she keeps her eyes downcast, contributing nothing to the discussion.

As this story illustrates, components of anxiety include thoughts, emotions, physical sensations, and behaviors.  Evolutionarily, humans are hardwired to feel fear.  Fear is actually a helpful warning that alerts us to potentially dangerous situations.  When we perceive a threat, the fight-or-flight response kicks in to ready us to combat or escape from harm.  The physical symptoms we experience when this response occurs (increased heart rate, rapid breathing, adrenaline rush, etc.) are merely side effects of the body getting ready to fight or flee.

Compared to fear, anxiety is a more subtle but chronic state.  Whereas fear is an automatic response to a threat we perceive as immediate, anxiety includes thinking about or imagining some possible threat we may come up against in the future.

Orsillo and Roemer’s research indicates that our struggle with fear and anxiety does not come from any actual harm caused by the physical sensations of these emotions.  Rather, it arises from our reactions to these emotions and the thoughts, sensations, and images that accompany them.  Criticizing ourselves for feeling fear or anxiety is what hurts us, not the fear and anxiety themselves.  This is where the turning inward is helpful.  Mindfulness can help us replace self-criticism with compassion.

Simply put, mindfulness is a specific way of paying attention.  It involves “purposefully expanding your attention to take in both what you are experiencing inside – your thoughts, feelings, and physical sensations – and what is happening around you.” (p. 81)  The key concepts of mindfulness include 1) Noticing – becoming fully aware of the thoughts, feelings, physical sensations, and images that you experience, as well as the details of your environment; 2) Curiosity – approaching experiences with openness; and 3) Self-Compassion – acknowledging that the reactions we have are part of being human, accepting what cannot be controlled, and treating yourself with kindness and care.

The authors provide a series of exercises progressing from a 5 minute breath exercise through a number of informal and formal techniques to practice mindfulness.  Readers are also encouraged to download audio recordings from the book’s website to listen to while practicing or to record their own scripts.

Shane trembled as she waited her turn to stand behind the podium and deliver her speech.  She had agreed months ago to make a presentation before her colleagues at the real estate convention, even though she was terrified of public speaking.  As the previous speaker was concluding his remarks, Shane felt her stomach churn.  Her neck felt tight and sore, she felt the blood rushing to her face as she blushed, and she began sweating profusely.  “Why, oh why did I ever agree to this?” she thought.  She recalled the incident in high school when she had forgotten her lines in the school play, and now she relived those old feelings of embarrassment.  “It will be just like in high school!”  “These people will think I’m so stupid.”  “No one will ever refer any business to me again, ever!”

Orsillo and Roemer would say that Shane is experiencing “muddy” emotions.  This occurs when we bring in memories of past events – and conjecture about future possibilities – into the current moment.  If Shane were to take a moment to be mindful of the immediate challenge, she would realize that she is muddying her current anxiety by worrying about “what if” rather than focusing on “what is.”

The authors write in a style that is easy to follow and offer many vignettes to provide examples.  They also address the questions that many readers may be asking:

But isn’t mindfulness a Buddhist principle?  Is it a new age fad? What if I have different spiritual beliefs?  

The term mindfulness indeed originated with Buddhism, but the idea has recently been included in research and therapeutic settings.  In fact, mindfulness practice has been shown to decrease anxiety, insomnia, stress, risk of coronary heart disease, substance use, chronic pain, and fibromyalgia, and increase attention, sexual functioning, quality of life, and immune system functioning.  The book does not focus on the religious aspect of mindfulness.

How can I find the time to practice mindfulness?

While research suggests that more practice is associated with greater benefit, the authors offer a variety of techniques including exercises that only take 5 minutes a day.  They also point out activities that you can do mindfully, such as eating, walking, washing dishes, folding laundry, petting your dog, cooking, listening to music, or hugging a friend.

How can mindfulness help with anxiety? 

By this time you may be thinking, “Gee, thanks, but no thanks.  I’m already acutely aware of my anxiety.  Why on earth would I want to focus on it more?”  Yes, it is seemingly counterintuitive, but mindfulness can actually help us notice what we are experiencing and make choices about how we want to respond, rather than automatically reacting in ways that hold us back from fully engaging in our lives.  Let’s look at one more example that illustrates the value of mindfulness:

Sam was on a third date with Chris.  He had been single for a long time and knew that he wanted to develop an intimate relationship.  He was quite fond of Chris, and was getting signals that the feeling was mutual.  As the talk turned more personal, he felt his pulse quicken, his chest tighten, and his mouth get dry.  He felt the urge to change the subject so he wouldn’t risk feeling vulnerable and getting hurt.  He watched Chris for cues, and thought he saw a frown of displeasure when Sam talked about a low point in his life.   What Sam really wanted to do was excuse himself, pretend to go to the bathroom, and run like hell out the back door of the restaurant.  However, he really wanted to build a connection with Chris, so he chose to remain in the situation.

Often the things that really matter to us, like loving people, forming emotional connections, taking on challenging tasks, or caring for those in pain and suffering, bring with them emotional pain.  In these cases, living a fulfilling life means that we notice the pain and allow it, rather than trying to make it go away.  Mindfulness can help us to embrace our entire range of emotional experiences, making it easier to make these choices and enrich our lives.

 

Additional Reading:
Boyce, Barry (Ed.). The Mindfulness Revolution. Shambhala Publications,  Inc., 2011.
Germer, Christopher. The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions. Guilford Press,  2009.
Matheny, Kenneth B. & Riordan, Richard J. Stress and Strategies for Lifestyle Management. Georgia State University Press, 1992.
Nhat Hanh, Thich. Peace is Every Step: The Path of Mindfulness in Everyday Life. Bantam Books, 1992.
Siegel, Ronald. The Mindfulness Solution: Everyday Practice for Everyday Problems. Guilford Press, 2010.

August 3, 2010

Managing Anxiety and Depression Using Diet, Nutritional Supplements and SAM-e

by Darby Christopher, LMSW

Please note: This article should not be taken as advice for how to treat any particular condition. Individuals should always consult with their doctor before making any lifestyle or dietary changes, as some natural substances are harmful to specific medical conditions. Never stop taking any prescription medication without the advice and care of your doctor.

 

Introduction

The decision of whether or not to take prescription medication for anxiety or depression is a personal choice an individual makes based on many factors. This choice is made in conjunction with a doctor and often with the help of a therapist. For many individuals, prescription medication is not only a good fit, but the best fit for their particular constellation of life experiences, genetics and environment.

This article is written for individuals who, with the help and consultation of their doctor and therapist, would like to try to use diet and dietary supplements to manage their issues with anxiety and depression without, or in conjunction with, prescription medication. It is also intended to provide information for individuals to explore more fully on their own and with their doctor and therapist.

There are many factors that can affect a person’s mood and energy level, such as diet, proper rest, psychotherapy, exercise, spiritual practices, environment and relationships. This article will focus on diet and biochemistry, while acknowledging that each of these areas are interconnected and equally important.

Why Nutrition Matters

Our bodies need well functioning neurotransmitters, such as serotonin and dopamine, to experience enjoyment, relaxation, focus and motivation. From a holistic perspective, many factors aside from nutrition can affect how well our bodies are able to produce these chemicals. Yet, inadequate nutrition will result in a diminished ability to produce the chemicals we need to feel good. (Inadequate nutrition may result from a tainted food supply, lack of affordable healthy food, absorption problems in the body, and misinformation or inattention to diet.)

What our Bodies Need Nutritionally to Make Feel Good Chemicals

According to Dr. Charles Gant, author of End Your Addiction Now: The Proven Nutritional Supplement Program That Can Set You Free, there are four primary groups of neurotransmitters that are responsible for feelings of well being, relaxation and focus. They include endorphins and enkaphalins, serotonin, GABA, and dopamine and norepinephrine. (Serotonin also contributes to an ability to sleep well.) What our bodies need is to ingest the nutrients necessary to manufacture these items. So, what are these nutrients?

Let’s start with serotonin. Specific cells in our bodies manufacture serotonin using the amino acid tryptophan, working in conjunction with vitamin b6, vitamin c, folic acid and magnesium. Some foods that contain tryptophan include cheese, soy products, seafood, meat, poultry, whole grains, eggs, beans, peanuts and sunflower seeds. Some foods that contain vitamin b6 include tuna, bananas and a variety of green vegetables.

GABA, a neurotransmitter that promotes relaxation, is produced from the amino acid glutamine, working with vitamin b6, vitamin c and magnesium, among others. Foods that contain glutamine include chicken, fish, eggs, beef, beets, dairy, beans and cabbage. A wide variety of fruits and vegetables contain vitamin c, and magnesium is found in specific beans, seeds, fish and green vegetables.

Tyrosine is an important amino acid that contributes to the production of dopamine. Food sources of tyrosine include fish, chicken, pork, whole grains, dairy, beans, nuts and seeds.

The reader may have already noticed that the common admonition to eat a wide variety of fruits, vegetables, whole grains and proteins applies to managing anxiety and depression. As the intention of this article is to provide a broad overview, the above examples are illustrative. The reader is encouraged to research and explore more of the specific proteins, vitamins and minerals that manufacture the various neurotransmitters and which foods support their production.

The Benefit of Whole Foods

Because many of the nutrients that our bodies need to manufacture neurotransmitters now come for sale in a bottle at our neighborhood stores, a word about eating whole foods is in order. In their book Paradox & Healing, Dr. Michael Greenwood and Dr. Peter Nunn discuss the Chinese Traditional Medicine (CTM) concept of “Qi,” or, energy, that is a part of whole foods. They contend, “ …it is the “whole” herb or food which has the Qi and its strengthening properties, not any isolated extract which is called for. In other words, the difference between taking vitamin C in capsules and eating fruit which contains the vitamin is profound.” Recent research into the benefits of phytonutrients found in whole fruits and vegetables corroborates the concept of Qi.

Likewise, in his book Food Rules, Michael Pollan says that, “Foods are more than the sum of their nutrient parts, and those nutrients work together in ways that are still only dimly understood.”  Pollan is a reporter who set out to investigate all of the competing dietary claims in the media. He discovered a very simple truth, which is that the Western diet, with all of its processed foods that he calls “edible foodlike substances,” makes people sick, and traditional diets, no matter what whole, natural foods they consist of, promote wellness. Pollan sums up his discovery of what we should eat in what he calls seven simple words: “Eat food. Not too much. Mostly plants.”

Supplements

Having made a case for the benefit of whole foods, our attention will now turn to the possible benefits of nutritional supplements that come in bottles. Just as in some cases prescription medicine is indicated, there are cases also where nutritional supplements, under a doctor’s supervision, are beneficial. These situations might include cases of nutritional deficiency, attempting to overcome an addiction, as advocated by Dr. Gant, or as a personal preference to combat the effects of anxiety and depression.

Many studies have shown and proven the efficacy of treating various conditions with nutritional supplements. Conversely, concern for supplement use may include the body subsequently under producing the item being supplemented, or other imbalances. (Always consult a doctor when considering nutritional supplements, as they can be harmful or even fatal in excess amounts or when combined with certain conditions.)

Of the many supplements on the market today, a few examples will suffice here. If increased serotonin is desired, a product called 5 HTP may be indicated. The amino acid tryptophan turns into 5HTP in the body along the way to making serotonin. GABA can be purchased directly, as can the amino acid tyrosine, which the body uses to make norepenephrine and dopamine. Fish oil aids in overall brain health, and multivitamins enable the chemicals in our body to do their work.

Inositol is another nutrient for sale that contributes to brain health and helps the body metabolize nutrients. Dr. Fred Penzel reports success in his studies with inositol and trichotillomania (hair pulling), to cite one example.

Herbs, such as St. John’s Wort and hormones, such as estrogen, testosterone and thyroid, are also sometimes indicated in the treatment of depression. As with any supplement, careful attention must be paid to combining herbs and hormones with other treatments, and should take place only under a doctor’s supervision.

SAM-e and Methylation

A popular and increasingly well known product on the market today is SAM-e, which is a naturally occurring substance in the body whose function is to act as a catalyst promoting the chemical reactions that allow the body to produce desired substances. These chemical reactions are known as methylation pathways. SAM-e’s benefit is in taking the raw materials available in the body and producing the desired result, including the regulation of neurotransmitters. Many studies have shown the benefit of SAM-e to alleviate depression.

Conclusion

Individuals who are seeking ways to address their anxiety and depression without or in conjunction with prescription medication may find that a well balanced regime of exercise, meditation, proper rest, social support, work with a therapist, and attention to diet may give them the help and relief they are looking for. For the diet portion of this plan, whole foods are essential. Supplements can be added under a doctor’s care and may be beneficial, but do not take the place of whole foods. Informed consultation with a doctor or therapist may help determine an individual’s best course of action, and some trial and error may be expected along the way to discovering what combination of elements will work best.

Bibliography and Recommended Reading:

Food Rules, by Michael Pollan

End Your Addiction Now: The Proven Nutritional Supplement Program That Can Set You Free, by Dr. Charles Gant and Dr. Greg Lewis

Paradox and Healing: Medicine, Mythology & Transformation, by Dr. Michael Greenwood & Dr. Peter Nunn

Web site, The World’s Healthiest Foods, http://www.whfoods.com/

Web site, The Podell Medical Practice: Merging Traditional Medical Practice and Alternative Therapies, http://www.drpodell.org

February 10, 2005

Preventing The Recurrence of Depression and Anxiety

Filed under: 2007 and earlier,Anxiety,Depression,Former Karuna therapist — karunacounseling @ 4:41 pm
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by Andrea Schrage, MA, LAPC, CMT

The chronic, recurrent nature of depression and anxiety presents an enormous challenge to sufferers and treatment providers. Combining the use of mindfulness and cognitive behavioral therapy allows for individuals to learn skills that will work more holistically to include mind and body in their growth. Participants can learn to play an active role in preventing the return of depression and anxiety as they watch other areas of their life positively impacted during the process. Through learning these techniques, one will notice a change in how they are able to participate more fully in their life in a conscious and often more peaceful way.

Conscious Choices is a 4-session class designed to teach its members how to combine these two modalities and to give them skills to help them prevent the spiral into reactive moods.

  • Learning to meditate for those who think they can’t.
  • Learning to identify the ongoing flow of critical voices in our heads.
  • Learning to sit with painful emotions and body pains.
  • Learning how to see anxiety and depression coming and make choices to prevent them.
  • Learning to recognize joy and happiness in everyday life.

Effects of this class may include:

  • Increased relaxation.
  • Reduced fear and anxiety.
  • Discontinuation or lessening of depression cycles.
  • Increased happiness and appreciation of life.
  • Feelings of empowerment.
  • Ability to make clearer choices about life.
  • Increased connection with others and self.

by Andrea Schrage, MA, LAPC, CMT

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