Sleep is so important that almost every single diagnosis in the Diagnostic and Statistical Manual for Mental Health Disorders (or DSM) has a disrupted sleep component to it. That's why I ask every client about sleep on the initial paperwork when entering counseling. I have conversations about sleep so frequently in counseling sessions, I decided I needed to gain more information and new ways to explain what happens while we are sleeping. There happened to be a great article about this topic in the November issue Counseling Today, a periodical published by the American Counseling Association. 

It turns out there are two critical periods to your sleep cycle. The Stage 3 NREM phase is crucial for physical health. Your immune system and cells regenerate. It's called recovery sleep. The system in the brain which creates the stress response (the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system) is powered down. We spend the most time in this kind of sleep and it seems to be akin to recharging our batteries. 

The Stage 4 REM sleep phase enhances our emotional health, allowing us to keep our feelings in check so that we can function in our day. Emotional memories are encoded during this phase and are separated from the actual emotional response, allowing us to retrieve these memories from a distance and not get so overwhelmed in them again, as if they were happening all over. People with trauma histories have a particularly disrupted Stages 3 NREM and 4 REM cycles, resulting in the inability to process memories and deactivate the stress response. 

See the below graphic for more details about all the stages of sleep.

For more on sleep hygiene and an excellent sleep diary, visit the National Sleep Foundation. You can improve your sleep by avoiding caffeine, alcohol, and heavy meals in 2-3 hours leading up to bedtime. It also helps to have a bedtime ritual at the same time every day, engaging in an activity like reading, relaxation exercises, gentle stretches or drinking herbal tea in the hour before bedtime. And exercise in the early afternoon seems to have a positive effect on sleep quality. 

Here's to a restful night's sleep!  

The healing power of setting foot in a counselor's office...it's a thing.

A client and I were recently wondering, is there a name for this? I don't recall learning about it in school, or reading research about it. I don't recall a textbook definition of one word that sums it up. 

Then, it happened again. Another client says to me after several weeks of appointments and lots of emotional work, that the most powerful part of counseling was the decision to come and keep coming back.  Then a few weeks later, again, I hear the sentiment in an initial session with a new client. "Just by coming here today, I feel a relief." In these statements, I hear that to have sought out help, made the call or sent the email, set up the appointment, and stepped foot in the door...these actions alone make a difference. 

I like metaphors. They are helpful in giving us new perspectives on old material. So for instance, we may have an idea of what counseling is about. We may have an idea that it's for people who are broken. Or that it's for people in crisis. Or that it's for people who are severely mentally ill. Or that it's an absolute last resort when nothing else works. These associations are powerful. That's our old material at work.

But what if we create new material here? What if we think about counseling as a sunrise, a dawning of a new day? Let's imagine the last time we couldn't sleep at night...how frustrating it is not getting the sleep we want, worrying about what will happen the next day if we don't sleep. Then we imagine ourselves putting our insomnia to work for us. Maybe we walk to the kitchen and make a cup of tea and sit with ourselves and reflect. Maybe we take a hot bath to calm our nerves. Maybe we massage our hands or temples to create ease. All of these steps are actions that make a difference in our insomnia. We greet a new morning, perhaps not with a great night's sleep, but with a sense that we cared for ourselves through the process.

Likewise, the steps toward seeking out counseling are actions of self-care. They are messages to ourselves that we are worth it, that a new day can dawn, and that we can connect to another human being even in the midst of pain. Pain has a purpose in this way. It can bring us closer to others, to what we seek, and to our true nature. 

Carl Rogers believed, and research has shown, that the power of the therapeutic relationship is what creates change through counseling. The connection to another human being is the substance of change and hope. The permission one grants themselves in arranging the words of their story and sharing them with another person with the intent to make change...this is the mechanism by which counseling works. This is the way that new perspectives, new beginnings, and new sunrises are born.

So my responsibility as a counselor is to continually invite these moments to occur in the lives of others. And to meet each person and each story with unconditional positive regard, empathy, and honesty. The dawning of a new day is a brilliant display to witness.