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Friday, September 27, 2013

Four Things You Need to Know About Menopause

Although women often joke about menopause, most of us agree that it can be a challenging time.  You may experience moodiness, lack of sexual desire, hot flashes, sleep disturbance, or vaginal dryness, due to decreased hormone levels. As you enter your 50's, It takes more work to maintain a healthy weight, and your energy levels begin to decline, making it more difficult to get everything done. There is a silver lining, however. Things will get better before they get worse. Research on happiness shows many people report their 60's and even 70's to be the happiest years of their lives. With old roles changing and new challenges to face, these are the years to really focus on YOU and growing from the inside out.

This month I am happy to be a speaker at the Embrace the Change Menopause Health and Wellness Summit, along with other authors, physicians, and wellness coaches. There is a link at the bottom of this post for you to find out more.

Below are four tips and pieces of information that will help you cope better during menopause:

(1) Menopause Does Not Equal Mental Illness

Researchers have surveyed thousands of women from all over the world and concluded that although there is some increase in depressed mood during peri-menopause/menopause, there is no increase in actual mental disorders such as Major Depression or Anxiety Disorders. Some women are more vulnerable to mental health problems than others - women with a history of depression or severe PMS, those experiencing  severe hot flashes and sleep disturbance, or women encountering other major life stresses at this time may be more at risk. However, many women weather this transition with only minimal disruption. 

(2) Negative Mood During Menopause May Not Be Biological

Some of the mood & sexual desire change you experience during peri-menopause or menopause is due to hormones fluctuating and eventually decreasing. But some of it may not be caused by biology at all. Today, many women in their mid-40's and 50's are a "sandwich" generation, often facing the dual task of caring for kids and aging parents, leading to stress overload. Kids reaching adolescence may change family relationships. Financial stress of paying for college and retirement, and onset of chronic diseases, such as arthritis, heart disease, or diabetes or layoffs and age discrimination are just some of the challenges you may be dealing with. The good news is that if you're feeling down because of a situational stress, rather than messed up hormones, there's more opportunity to use your psychological coping strategies, such as taking mindful breaks, reaching out for support, or changing your thinking about the situation.

(3)  Mind Over Matter - If You Don't Mind, It Doesn't Matter

Your attitude towards menopause can make a big difference to the experience. Research by Professor Carol Dweck shows us that if we have a 'fixed mindset" and see our skills and abilities as unchangeable, we will have a worse outcome than if we adopt a "growth mindset," believing that we can adapt and grow our skills. A major life change, such as menopause challenges you to learn new ways of communicating with your partner about sexuality and emotions. You may need to learn new skills to guide your kids through adolescence or communicate with aging parents. You may face unexpected losses or even divorce. You may also need to reach out more and find new friends who can support and understand you, and perhaps find new creative outlets to help you discover and express who you are at your core and what is most important to you.

(4)  Pay Attention to What Your Body is Telling You

Research shows that maintaining a healthy weight, having adequate nutrition, and staying active, during menopause can make symptoms and sleep disturbance less bothersome and can also decrease your risk of getting diabetes, cancer, or heart disease.  This may be the time to start a new exercise routine that works for you, as a woman in her 50's.  It is important to find an exercise, and way of eating  that you enjoy and can maintain over the long haul, rather than going for the "quick fix."  Prolonged stress can worsen menopause symptoms, so this may be the time to take up meditation or yoga, schedule more regular date nights, start a gratitude diary or vision board, or go hiking with a friend.

There is a lot of menopause information out there, but not all of it is research-based. Research supports the use of some treatment methods and supplements, but finds some to be ineffective.  Don't believe all the hype. Do your own research and form a partnership with an experienced and compassionate health professional who can advise you.  A psychologist with a specialty in health psychology can help you address mood and mind-body issues.

To hear the expert speakers in the Embrace the Change Menopause Health and Wellness Summit or find out how to purchase the entire set, click here:

To read more about my therapy practice or ask about online coaching, click here:

Wishing You a Mindful Week,


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Thursday, September 19, 2013

What is Acceptance & Commitment Therapy (ACT)?

Have you spent a lot of time and money on psychotherapy or self-help books, yet you still feel stuck in unhealthy habits?.  Knowing why you are depressed, anxious, or feeling pain  doesn't necessarily make you feel any better.  Understanding what is most meaningful to you in life (such as commitment to your health, family, or work) and committing to taking specific, manageable actions to achieve your goals in these areas can put you back in the driver's seat of your life. Acceptance and Commitment Therapy/Training (or ACT) is an intervention approach used in psychotherapy or workplace setting.  It can help you to break out of negative thought cycles, accept what you can't control, stop running away from pain, and be more able to tolerate risk, failure, and uncertainty to reap the rewards of living a meaningful, engaged life.

Some core principles of ACT are:

(1)  Experiencing the Present Moment

Similar to Mindfulness practitioner, ACT therapists use exercises to help clients remain present and focused on the breath or their moment-to-moment thoughts and feelings, rather than trying to avoid them or judging them. Feelings themselves are momentary, changing experiences in our body and mind. However, because of childhood learning experiences, we often develop judgments about them and what it means about us that we have them - such as "You're depressed again - You're such a loser!"    When we experience pain or negative feelings directly and describe the feelings in objective terms (e.g., my chest feels tight - seems like anxiety), we are able to tolerate them better and realize that we are not going to die or fall apart and that they will pass. Watching feelings rise and fall in our body, gives us a sense of them as transient experiences, rather than part of who we are in essence.

(2) Being Willing to Be Where You Are

Acceptance is a term that is often confused with passivity. In ACT terms, acceptance means "being willing to experience the present moment, even if it's not what we would have chosen."  Acceptance can also mean accepting that our lives were as they were, including trauma or suffering, and realizing we can never completely obliterate or make up for these experiences. At the same time, we have a choice about what we do with our lives now. We do not have to let our views of ourself and our actions be determined by these old habits. Like any habit, though, change takes time and effort. Therefore, we need to be willing to be uncomfortable, to work hard, and to persist even when our efforts aren't bringing us any concrete rewards, we don't see any major change, or we have a temporary relapse. It takes time to change our brain pathways or to have other people notice we are different and behave differently towards us. Like losing a lot of weight, we have to work hard for a long time before seeing any demonstrable result.  Being willing means we no longer avoid uncomfortable thoughts, feelings, or situations by zoning out, not showing up, engaging in addictive behaviors, covering up our vulnerable feelings with anger, or procrastinating. If we want to be healthier, we first need to be able to look at and experience how unhealthy we are right now. At the same time, we can commit to doing what we need to do in small bits, each day, to be a little bit healthier. Lifting the veil of self-deception or avoidance can go a long way towards getting us on the right track.

(2)  Defining Your Core Values

Core values are the things in life that are most meaningful to us and that enrich our lives. They include such things as "Being healthy," "Taking care of our families,"  "Being honest and accountable," or "Contributing to society."  When people come to therapy, they are often so overwhelmed with distress, feelings of self-pity or anger, or struggles with pain or addiction, that they have lost touch with what really makes them fulfilled. Even if they know in principle that "I want to be a good parent," their day-to-day behavior may not reflect this because they are preoccupied with seeking escape from daily stress, thoughts about past, painful events, or trying to prevent an anticipated future threat.  ACT therapists use imagery and writing exercises to help clients define their individual core values and gain motivation to reconnect with activities and people that enhance these values in our lives.

(3) Committing to Motivated Action

ACT therapists educate clients that, to live according to your values and live meaningful lives, we need to choose  take risks, get out into the world, and tolerate uncertainty and anxiety. Exercises focus on setting manageable, attainable, meaningful goals - commitment to taking specific, small steps that help you live according to your values. The focus is on taking action, not expecting a particular result, since outcomes may be at least partially out of our control.  To be successful is not necessarily to always feel happy or pain-free, but to live a full life despite the anxiety or pain. By facing what we fear, the fear will eventually lessen, and, even if it doesn't we will know we have done the best we can. This takes us out of the cycle of self-doubt, regret,  and second-guessing ourselves.

(4) De-Fusing Your Self From Your Thoughts

A fundamental principle of ACT is that our thoughts, feelings, and sensations are not who we are. ACT includes mindfulness, imagery, and language-based exercises to help us connect with our "observing ego" or consciousness that can observe our thoughts and experiences, and can deliberately choose now much attention to pay to them. Although our thoughts feel true, they are not necessarily the truth, because they are biased by our expectations from past experience and our inability to see ourselves as an objective observer would.  A major ACT principle is that we do not need to let our thoughts and feelings determine our behavior. We can choose how to behave, based on our direct experience (what we see, hear, feel - independent of our thoughts or judgments about these events) and our core values. We may think about a thought: "Is it kind? Is it truthful?,.." and so on. Based on the answer, we may take the thought seriously or let it pass on by. Rather than changing the content of our thoughts, we can choose to change how to interact with them and how much to let them influence us. Thinking we are stupid or fat does not make us stupid or fat - it's just a thought, even if it feels like reality.

Issues and Populations Addressed

ACT Therapy  has been used with substance abusers, people suffering from chronic pain and illness patients with obsessive thoughts, anxiety, and depression. ACT works well with clients  who are tired of letting uncontrollable symptoms rule their lives and are willing to take a more active role in managing their lives.

According to SAMHSA's Registry of Effective Programs,

"ACT has been shown to increase effective action; reduce dysfunctional thoughts, feelings, and behaviors; and alleviate psychological distress for individuals with a broad range of mental health issues (including DSM-IV diagnoses, coping with chronic illness, and workplace stress)."

For more information about ACT, go to this link:

Contact me today via my Psychology Today therapist profile to receive a free 20-minute consultation about how ACT can help you.

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Monday, September 9, 2013

Marin Health Psychologist Blog: How Mindfulness Can Help You Heal Your Emotions

Marin Health Psychologist Blog: How Mindfulness Can Help You Heal Your Emotions: What is Mindfulness? Dr Melanie :  “Developing an observing ego, becoming CEO of your own mind.” Why is Mindfulness so popular ...
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Why You Are Stressed at Work & How Therapy or Job Coaching Helps

National statistics show that American workers are working more hours, but are less satisfied with their jobs than ever before.  According to the American Psychological Association 

Jobs and careers are an important part of our lives. Along with providing a source of income, they help us fulfill our personal aims, build social networks, and serve our professions or communities. They are also a major source of emotional stress.

Stress at work can affect your mood, self-esteem, health, and relationships.  Coming home grumpy, zoning out with your spouse or kids, drinking too much and being too tired to exercise can create a negative cycle in which your physical and mental health suffer. Job stress or burnout is a major problem that brings people to therapy. Feeling unfairly treated at work or facing a major disappointment can erode your self-esteem and make you question your own perceptions and abilities. 

Below are some of the most common reasons you may be stressed or dissatisfied at work.

1. Fear of losing your  job due to downsizing, mergers, or management changes

2. Not feeling appreciated or compensated sufficiently

3. Toxic office politics & poor leadership

4. Lack of meaning and monotonous work

5. Not feeling like you are growing or learning new skills

6. Age discrimination

7. Lack of opportunities for advancement

8. Too many or unclear demands

9. Lack of resources

10. Low employee morale

Dr Greenberg was recently interviewed by Tim Muma of The Wisconsin Job Network on the topic of job burnout. 

Listen to the interview here:

Play Now! 
Job burnout is often mistaken for stress - in a way, yes, but worse. Although stress at work is one contributing factor, job burnout has its own causes and effects. Essentially, the extremes of the workplace are what brings about burnout - monotonous, boring work or overwhelming hopelessness - and it affects people's feelings of worth, competence and well-being. Melanie Greenberg, Ph.D., fills us in on the signs and symptoms of burnout and some guidelines for improving our overall well being as it relates to work-life balance.

Life vs. Work examines the delicate balance of running a business while ensuring the satisfaction of employees and management. From home life to health to time constraints, we consider what measures can be taken to understand the human side of human resources - and still be productive.

Duration: 27 Minutes 

A skilled therapist or job coach can help you understand the negative patterns that no longer serve you, such as self-sacrifice, perfectionism, reactivity to criticism, or avoidance and how these may keep you stuck or interfere with your progress and satisfaction at work. Therapy can also help you set goals for work-life balance and prioritize healthy self-care that can keep you strong and motivated to withstand the uncontrollable ups and downs at work. 

Dr Greenberg has helped many clients cope with job stress and reboot their careers. For more information, read her therapist profile here:

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How Mindfulness Can Help You Heal Your Emotions

What is Mindfulness?

Dr Melanie :  “Developing an observing ego, becoming CEO of your own mind.”

Why is Mindfulness so popular these days?

Dr Melanie: “I think part of it is that the science has advanced and mindfulness has been supported by brain science. People like hard evidence. Furthermore Google and other respected corporations have become interested in Mindfulness and Google even has a Mindfulness Officer. When Google does something, businesses and people follow. And then a third reason is the times. We live with changes in the work and financial environment due to the global recession, the wars in Iraq and Afghanistan… I think that people feel they have less control over their lives. Faced with uncontrollable events the usual problem-solving coping strategies do not work as well anymore. People are looking for different solutions.“

What are some benefits of practicing Mindfulness?

Dr Melanie: “Improved relationships, less anxiety and better health – less stress, better life balance. Studies have shown decreased blood pressure and decreased chronic pain as well as brain changes related to empathy and emotional control.”

How can I begin to practice Mindfulness?

Dr Melanie: "Mindfulness means deliberately and gently guiding your attention to whatever you are noticing, thinking, perceiving, or sensing right at this moment.  You can begin in the shower or while washing dishes. Notice the warmth of the water, the smell of the soap, the sight of the bubbles, the feeling of being clean or making something clean. Notice what you are thinking and feeling. Are you in the moment or is your mind already doing the next errand or planning your day? Can you begin to slow it down and gently bring it back?"

Why choose a therapist who integrates Mindfulness with psychotherapy?

Dr Melanie: "Mindfulness is a new way of relating to your thoughts and feelings that can help you feel more comfortable with them, deepen your emotional experience, while at the same time making it more peaceful and less frightening. When psychotherapy leads to recollection of painful memories, Mindfulness is a powerful tool to keep you grounded and stop your brain's fear centers from taking over. With repeated practice, it can have an uplifting effect, making you more resilient and positive and less emotionally reactive. This helps you make faster progress in therapy with less pain and distress. You will have a powerful new tool to deal with feelings and calm your brain down."

This month, I was interviewed by the Dutch website PrioTime as part of their Mindfulness Month.  

Read the full excerpt of the interview here:

If you would like to be notified about new posts on this blog or to contact me about therapy services,  enter your e-mail in the link below.

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