by Kambria Kennedy-Dominguez

​We just wrapped up our very first art therapy series at Flourish, and it was a great success. We found the physical and emotional expression of painting images, shapes, and colors on canvas to be a soothing exercise. Painting, drawing, and creating are ways to do something with emotional experience. Counseling is often about defining what you feel. And often clients ponder this question out loud, "so I know what I feel, what do I do with it?" Most often I answer, "accept". You don't need to do anything with the feelings, except acknowledge and accept.

What you do is better based on what you value, not on what you feel. 

Still, sometimes we need some kind of release, expression, resolution, and way to cope with the myriad of emotions that most of us feel every day. Anger, sadness, worry, regret, indifference, fear...to name only a few....are difficult to sit with. So if we can take a walk or a run, go a yoga class, snuggle with our partner or our pet, read a good book, take a warm bath, or paint a picture, these activities may help us endure and sit with the feelings. 

Because of the success of the first art therapy 5 week series, we are offering it again, and hope to make it a staple of our services at Flourish. During the series, participants will learn how to use art as a relaxation exercise, how to incorporate meditation into the creative process, and how to build self-compassion. Part of our mission is to help others find what healing practices work for them, whatever that happens to be! Check out all of our groups here.

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.

Yoga is an ancient practice that originated far away. It has made its way around the globe in a wave of both physical healing and spiritual awakening, while simultaneously becoming a multi-billion dollar industry in the US.  Some of the yoga teaching in the west has been simplified to a mostly physical practice by this commercialization and popularization, however yoga's philosophical foundation as a way to live a good life endures as well. These days, yoga is practiced not just in affluent studios, but also in schools, prisons, hospitals, and apparently on aircraft carriers (love this picture.)

Thanks to modern science and research, we also know much more about how yoga impacts physical and mental health than ever before. Let's explore some things we know about how yoga helps, and then describe how this knowledge can be incorporated into a traditional talk therapy session. 

From Ross, A., & Thomas, S. (2010). The health benefits of yoga and exercise: A review of comparison studies. Journal of Alternative & Complementary Medicine, 16(1), 3-12. doi:10.1089/acm.2009.0044 

Physical Effects

• Powers down the sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) stress response which leads to disease
• Decreases cortisol, blood sugar levels, heart rate, blood pressure, inflammation
• Increases immunoglobulin A and immune response
• Decreases sleep disturbance
• Increases strength and flexibility
• Depending on type of yoga, may or may not improve physical fitness

Emotional Effects

• Decreases symptoms associated with anxiety, depression, schizophrenia
• Increases sense of well-being
• Decreases fatigue and experience of physical pain

Psychosocial Effects

• Increases social and occupational functioning
• Increases quality of life

Here's a description of how I combine yoga and counseling. Other therapists/yoga teachers may do it differently, and chances are, my own style will keep evolving the more I learn from my clients what works best.

Individual Sessions

Individual counseling sessions can include yoga, if and only if, the client thinks it will be helpful. Yoga in session can range from simple seated stretches, to intentional work with the breath, to standing and seated poses on the floor. In the intake and beginning phases of counseling, personal goals are identified, and as we explore these goals through talk therapy, I will be thinking about how certain yoga postures or sequences may be helpful. We will talk about using yoga in this way, then plan a time to incorporate it, or go ahead and use it at that moment. The way that yoga is used in counseling is always up to the client, and my suggestions as counselor are just that... suggestions.

For instance, a client who is struggling with self-image may be asked to try a yoga sequence that feels familiar and accessible, and notice their self-talk during the movement. How compassionate are their thoughts toward self? Are thoughts about self-image coming up? Are they critical? Then the client may be cued to work through a more challenging sequence and notice how the self-talk changes. After a few minutes of yoga (usually 15-30 minutes during an hour counseling session), I will sit with the client either on our yoga mats in an adjacent studio or back in the counseling office to discuss their experience, share what internal self-talk arose, describe how their physical or emotional state changed in response to the movement, and so on. 

Another example is a client who is experiencing social anxiety. The client may have a goal of learning new ways to manage anxiety so that it doesn't stop them from going out with friends. The client may notice a tightness in the chest or throat when thinking about going out with friends. So to address it, I might ask a client to imagine that they are about to go out with friends, notice in detail the sense of constriction or tightness they are experiencing in the chest and throat, then use some guided breathwork and throat opening stretches, while seated in the counseling room to work with the sensations. 

Group Sessions

We can also work with yoga in group sessions. My ideal way to combine yoga and counseling in a group is to use a mixture of both physical yoga postures and discussion and/or personal reflection. My experience of vinyasa flow sequences is that often emotional "stuff" will come up as we move the body. As we work into the creaky, rarely accessed parts of our joints and tissues, an emotion may arise. Then from that emotion, a chain of thoughts may arise: memories, anticipations, judgments, regrets, etc. Taking time after a yoga practice to reflect on these emotions and chain of thoughts can help to move through them, put them away, or take more time attending to them. This can be accomplished through internal self-reflection, group discussion, or both. 

​In this upcoming group yoga workshop, we will practice a one hour vinyasa flow class, then we'll take a short break and come back together to process our experiences. I will provide some paper and pencils to help participants process their yoga experience through writing or drawing. I will provide some prompting questions to help participants explore their wellness in several core areas shown below. I like this "Indivisible Self" model because it prompts us to think globally about what impacts wellness. (Myers, J. E., & Sweeney, T. J. (2005). The indivisible self: An evidence-based model of welIness (reprint). Journal of Individual Psychology, 61(3), 269-279. )

After we've processed internally, I'll offer a chance for participants to share and discuss their self-reflections. This part is absolutely optional, as some might prefer to keep their reflections private. A very important component of using yoga with group counseling is that all members agree to keep one another's shared thoughts and feelings confidential.  Maintaining confidentiality is a key guideline and expectation for the participants in this type of group.

In summary, we know that a regular yoga practice is helpful for many different conditions, ranging from chronic illnesses, to mental illnesses, to adjustment-related problems, to general stress and anxiety. We also know that talk therapy is helpful for these conditions. Combining yoga and counseling involves, first and foremost, respect for the client's autonomy and ability to choose the direction of therapy, along with gentle reminders toward self-compassion, self-acceptance, and an attitude of self-exploration in both body and mind. 

-Kambria 

Imagine yourself here on the edge of this lake. You have all day to spend here and you are trying to decide what to do next. How do you know whether you want to stay here at the edge, take a swim, or go to the other side? If you want to go to the other side, how do you get there? Do you go straight across, or go around the edge? If you want to take a swim, how long do you stay and what comes next when you're done?

These questions are a lot like what happens in the goal-setting process in life. 

• There are countless options of what to do next. 
  
• There are countless ways to achieve a goal once we've set it. 
  
• There are countless ways to judge whether we've reached our goals. 

Why is goal setting important? Why can't we just drift about day-to-day doing what comes naturally at any given point?...Because humans are inherently goal-driven, and if you're drifting about without a goal that you can name, you may likely feel guilty, empty, or lazy. 

And goals don't have to be monumental. They don't have to be pie-in-the-sky, dream-big kind of goals. They certainly can be, and I would argue that most successful people do, indeed, dream big. However, setting and reaching goals involves small, ordinary everyday accomplishments too. Here are four steps to mindfully setting goals that matter.

2. Define your expectations. Project into the future a bit, and use your imagination to create your best life. When you consider the values most important to you, how do you want to be living them out in 5 years? Imagine the specifics of your everyday life in 5 years. Who will you be with? What job will you have? Where do you live? What do you do for fun? 

Now, take time to reflect again on the accomplishments you've already made.

3. Make a plan.  And be sure you are capable of accomplishing it. Work your way back in time towards now, and identify what actions do you need to take now to reach your 5 year goal? What is likely to get in your way, and hold you back? 

When making your plan, consider these important parts. What small daily or monthly tasks will help you reach your goal over time? What are the outcomes that you can measure to tell whether you've succeeded?

Now acknowledge this work you've done to make a plan. 

4. Re-adjust your goal and plan as needed. It's the most important step! Re-adjusting, giving yourself latitude, being honest with yourself...these are all components of self-compassion, or simply stated, being kind to yourself. Self-compassion is what will keep you moving forward even when things don't work out how you'd planned. Because things are bound to not work out sometimes. Your attitude toward yourself in the challenging moments will shape how you feel about your goal in general. Self-compassion will keep you resilient and help you recover from setbacks. 

And again, as you adjust your goals and plans, take time to reflect on what you've already accomplished. Praise yourself. How often do we say to ourselves, "I really did well today," or "I worked hard on this project," or "Even though I haven't reached my goal, I'm still a capable and worthwhile person and will keep trying." For most of us, not often enough. 

I hope you can take these steps and use them to define your goals. Whether you want a new job, a new house, to start a business, to start a relationship, to deepen a relationship you already have, or really any other life circumstance, taking time to clearly define your goals based on your values will increase the likelihood you will reach them...and feel good about your efforts.

Sometimes stepping back, stripping away the labels, and reassessing our thinking can dramatically change our outlook from dreary to hopeful, from hopeless to grateful, from angry to accepting.

This is a very simple lesson indeed, but a powerful one. What wisdom of children!