We have signed a lease on a new space at the corner of Davis and Winnetka in North Oak Cliff. For Cliffdwellers who frequent Norma's Café or the Kessler Theater, you'll know this building!

​It's a corner office on the second floor that has lots of light, lots of character, and our main reason for moving...lots of space. We will be transitioning both the Buckner office and Sylvan office clients to this new location starting May 1, 2017. 

​We have immense gratitude to Don Zablosky for subleasing his space to us for the past three years at the Buckner office and allowing Flourish to have a place to land in its infancy. And then, we totally lucked out when Sync Yoga and Wellbeing welcomed us into their space 1.5 years ago, honestly one of the most peaceful environments Dallas has to offer. Without their support, the growth of our practice would not have been possible. So many thanks to them!

I'm excited to announce that we are now offering SMART Recovery meetings! I have long been a believer in these free, science-based, addiction support meetings, but have been disappointed by the fact that they seem to missing in the downtown Dallas area. 

SMART is an addiction recovery support network that is based on the ideas of cognitive behavioral therapy, specifically REBT (Rational Emotive Behavior Therapy). I'm currently completing the facilitator training that will last for the next 6 weeks, and want to share some of what I've learned so far. These are some of the official positions of the SMART approach.

Meetings are currently being held on Wednesdays from Noon-1pm at Sync Yoga and Wellbeing. 1888 Sylvan Ave Ste F250. Contact Kambria for more information!

​Learn more about SMART here.

I read these stats in an email from National Council for Behavioral Health today. Pretty eye-opening. More of us need to be aware of these systemic differences in health outcomes for Americans.

Click on the links to see the research.

• LGBT (lesbian, gay, bisexual, transgender) youth are two to three times more likely to attempt suicide than their heterosexual counterparts.
• More than two-thirds of Southeast Asian refugees receiving mental health care were diagnosed with PTSD associated with trauma experienced before and after immigration to the U.S.
• People of color are overrepresented in prisons and jails. Additionally, blacks account for 37 percent of drug arrests but only 14 percent of people who regularly use drugs.
• Native Americans experienced a 236 percent increase in deaths from heroin overdose between 2010 and 2014.

​

Bright and early a few days ago, I had the fantastic opportunity to teach a workshop about yoga to counselors from across our state at the Texas Counseling Association annual conference in Dallas. It was a great time! I shared a presentation, then led the group through a yoga practice so they could experience it for themselves. We ended our morning circling up for discussion.

In the session, we talked about the ancient roots and philosophy of yoga, the different types of yoga classes found in many communities today, and how specific approaches have been developed to use yoga for trauma recovery and mental health. You can learn more about all of these ideas in the complete Powerpoint presentation.

Here are a few key slides that may be very helpful when considering starting a yoga practice. First, a description of some of the terms used to describe types of classes.​

Then some findings of researchers. There's a lot of data that points to the benefits of yoga.

But yoga is not to be used without caution. Here's my advice for choosing the right yoga class:

1. ​Know what type of class you are best suited for, and seek that out. Know the class descriptions above and search for those in your community. If you can't find a class, try yogaglo.com for online streaming.
2. If you are a trauma survivor, be especially selective about your yoga class. Choose a class that is "trauma-sensitive" if you are just beginning to process your traumatic experiences. Know that some teachers provide "physical assists" or adjustments that involve them touching you. If you do not want to be touched, communicate that to your teacher prior to class.
3. Hot yoga (100 degrees +) can be counter-productive if you are overwhelmed by heat or have medical conditions. You should have an established practice of good hydration before you attend hot yoga classes. As an alternative, many vinyasa classes offer a warm room (85 degrees +).
4. Look for teachers that offer modifications of difficult poses and encourage acceptance of your body as it is today.
   

What to know before you go:

1. ​Yoga is usually practiced barefoot.
2. It's best to practice on a mostly empty stomach. You will be more comfortable with heat, vigorous sequencing, or twisting if you haven't just eaten a meal.
3. Some studios will have mats to borrow, or you can bring your own. For sweaty classes, a towel placed over your mat keeps you from slipping. You can use a towel from home, or there are special ones made to go on top of yoga mats.
4. Most studios have a place for your belongings outside of the yoga room. They are usually secured by the teacher locking the outside door before class begins.
5. Studios have differing policies about talking inside the yoga room. Some observe silence and others welcome chatting before class.​

​Here's to finding the best yoga experience to reap the benefits of this ancient practice!

Here are some of those symptoms to look for when regular drinkers quit drinking, ranging from less to more intense.
​

• Tremors and shakiness
• Eating and sleep disturbance
• Anxiety
• Sweats
• Elevated temperature
• Hallucination and agitation, ranging in severity
• Change in pulse rate, racing in severe cases
• Seizures and/or convulsions
• Delirium, disconnection from reality

​These symptoms appear anywhere from 6 to 72 hours after the last drink, and can last up to 1-5 days based on the level of  physical and emotional dependence. Medically supervised detoxification is absolutely required in severe cases, and there are many local facilities in Dallas that facilitate safe withdrawal. Contact us or check out our Commuity Resources page to find support for alcohol detoxification.  

In the book How to Change Your Drinking by Kenneth Anderson, ​he recommends three ways to prevent alcohol withdrawal.
​

1. Don't drink every day. Have at least a few days of abstinence each week.
2. If you are drinking every day, don't drink more than four. Here's a link to learn how to count your drinks.
3. Don't mix alcohol with anti-anxiety medications like Xanax and Klonopin. 

Reaching out for counseling and support when alcohol becomes a problem can be a powerful step in the road to recovery. It is one of the most dangerous substances to stop using because of the profound physical effects on the body.

by Kambria Kennedy-Dominguez

It's an unseasonably cool day in August today and it seems fall may be coming! I had the wonderful opportunity this summer to take time away from work with my family, rejuvenate and recharge from what's been a very busy past year at Flourish. I am grateful to each and every client that has walked through my door keeping my practice thriving. My sincere hope is that work we've done together in the counseling room allows lives to flourish, self-understanding to deepen, and relationships to strengthen. So much beauty is created through sharing, and in that vein, I'm sharing some images that I've captured thanks to a new photography hobby, a great camera, and our beautiful earth. Some of these images were captured far away and some right here in Dallas.

Noticing beautiful objects, creatures, plants, landscapes, and people in our environment certainly impacts my health and wellness. I hope we are all able to find beauty around us, whether we are in a distant place or right outside our front door.

Have you ever wondered whether you or a loved one has post traumatic stress disorder? While an assessment by a trained mental health professional or doctor is required to diagnose any mental health condition, I'd like to share a few tools that can help you sort out your own experiences and learn more.

First, the Life Events Checklist. Look through the below document and answer the questions. Have you ever had any of these stressful or traumatic life events occur to you, witness them happen to someone else, or learn about them happening to a loved one?

If you've had one or more of these stressful life events occur to you, witnessed it, or learned about it happening to someone close to you, then move on to the following questions. The next questionnaire, called the PCL-9, is designed to help you and your therapist understand 1) whether you have symptoms of post traumatic stress disorder and 2) the severity of these symptoms. 

If you scored 28 or higher on the PCL-9, take these questionnaires to a therapist as soon as you can. If you didn't score that high, but are still concerned about your experience of a stressful life event, talking to a therapist can help you sort out and further assess what you are experiencing.

Please know these questionnaires alone are not meant to diagnose PTSD. However, the way you answered them can help a mental health professional provide an accurate diagnosis and treatment options. The good news is that PTSD is treatable and mental health counseling is often a critical part of treatment. 

Contact us at Flourish if you want to learn more about how we work with trauma to help those with PTSD live a meaningful and rich life, despite the history of stressful life events. 

Let's give anxiety some consideration today. You've likely experienced it over and over. You may have heard about certain types of anxiety like phobias and panic attacks, or diagnoses like Generalized Anxiety Disorder or Panic Disorder. There are lots of levels and experiences of anxiety, and sometimes even different definitions of anxiety from person to person. Anxiety is essentially worrying, feeling afraid, overthinking, and sometime panicking.

The common thread is that anxiety exists and is real for all of us, because it stems from an innate human emotion...Fear.

The DSM 5 (the manual we look at to classify symptoms and diagnose) draws a distinction between fear and anxiety like this:

 The autonomic nervous system, referenced above, pays a particularly important role in anxiety, and has two distinct parts. It revs us up (courtesy of the sympathetic system), then stabilizes us (thanks to the parasympathetic system), when there is a perceived threat in our environment. Imagine a bear chasing you...your heart rate increases, breathing rate increases, blood flows to limbs, pupils dilate, digestion slows, muscles tense. Sometimes tunnel vision and hearing loss occur, as well as relaxation of the bladder and colon. This very physical response to danger has a purpose. Muscles tense to ready themselves for action, blood flows to limbs to enable us to move quickly away from danger. Then, the nervous system slows and reverses this response once danger has passed, initiating relaxation. Our breathing and heart rate slow down, our muscles relax, our body comes back to homeostasis.

Both humans and animals alike experience this stress response cycle. Animals and humans differ, however, in the ability to reason, classify, predict, and analyze. We humans can thank our bigger brains and cerebral cortex for that. An animal might encounter that same bear, have a fight or flight response, be able to escape from danger, then quickly stabilize and move on. The cerebral nature of our human brains don't allow us to move on in the same way. We would likely have persistent fear or worry after an episode like that. We may feel afraid of bears, the place it happened, what we did right before it happened, that we may not protect ourselves from it happening again, or that it will happen to someone else. You can see how the human mind's ability to analyze gets us in a pickle here. 

We can get stuck with our fear in the "on" position, even in response to more innocuous stimuli like work or school demands, relationships, financial issues, health concerns, parenting, and other aspects of daily life. Our reasoning and predicting minds create future scenarios to worry about, and sometimes with good reason. If you lost a job in the past because you were late, you may be well served to worry about being late in the future. So in this way, anxiety is a helpful and useful tool that reminds us to pay attention to something specific like not being late to work. However, as we know, anxiety can become problematic when it immobilizes us in everyday life, keeps us from making decisions, disengages us in things we'd like to do, or impedes relationships.

Here's how I describe the anxiety continuum. Remember, fear and anxiety are related to paying attention to our environments and paying attention is a good thing.

​It may be helpful to outline the different types of anxiety disorders listed in the DSM 5.

• ​Generalized Anxiety Disorder. This is a general worry that underlies experience and gets in the way of daily functioning. It may be hard to pinpoint exactly what you are worried about, or it may seem like you're worried about everything. You may feel tense quite a lot and find your mind racing, jumping to conclusions, and thinking of the worst case scenarios. 
  • ​Fear is is generalized to everything.
• Social Anxiety Disorder. This is anxiety specific to social situations. You may worry about what others are thinking of you, that you'll embarrass yourself, that others will reject you, and avoid social situations in which you are likely to have to interact. 
  • ​Fear is about social interaction.
• Specific phobia. This is anxiety specific to a particular object, activity, or situation. Common phobias are of heights, flying, insects, blood, animals. You may feel intense immediate anxiety when seeing or thinking about your phobia, and actively avoid it.
  • Fear is related to something very specific.
• Panic Disorder. This occurs when panic attacks perpetuate themselves through anticipation of another attack. Panic attacks can occur with other anxiety disorders, depression, post traumatic stress disorder, and many other mental health conditions. Panic attacks are episodes of terror that occur for no apparent reason, in which one may feel shaky, sweaty, racing or irregular heartbeat, difficulty breathing, the sensation of choking, chills or hot flushes, and/or nausea. (Remember the fear response to the bear described above...a panic attack is almost just like that, minus the actual danger). Most panic attacks involve a fear of passing out, fear of going crazy, and/or fear of dying. Merely having a panic attack doesn't warrant a Panic Disorder diagnosis, however.  Panic Disorder emerges when the anticipation of more attacks and the avoidance of places or situations that may cause another attack interferes with everyday life. 
  • Fear is of having another panic attack. 
• Agoraphobia. This occurs when there is a persistent fear of public places or situations, including using public transportation, being in either open or enclosed spaces, standing in line or being in a crowd, or being outside of home alone.  Usually thoughts accompanying this fear are "I can't get out of here" or "no one will help me."
  • Fear of a particular situation, usually in public. 
• Substance or Medication Induced Anxiety Disorder. This occurs when anxiety is attributable to the effects of a specific drug, legal or illegal. 
  • Fear occurs as a side effect of a drug.

The body's natural ability to balance itself in response to stress is powerful. Just knowing that the nervous system is able to balance chronic anxiety is the first step. Then, learning and practicing tools that enhance our body's natural ability to balance, will help us move beyond fear and anxiety that might be crippling us. 

In counseling, there are many approaches to working with anxiety. I've found three approaches most helpful:

1. awareness of the breath
2. mindful meditation
3. awareness of habitual, unrealistic or unhelpful thought patterns.

For more information on how we incorporate these approaches into therapy, please contact us! We are happy to help you learn more about how counseling can work to manage fear and anxiety.

Mental health is worth spending time on, just like going to the doctor when you're feeling under the weather. If you're feeling overwhelmed, anxious, sad, angry, hopeless, sleepless, distracted, panicked, these are symptoms, just like a runny nose or a cough, that deserve attention from a professional. This month of April is about spreading the word that mental health support is readily available, and can be easily accessed. Check out Megan and Kambria's bios here to get to know us and see if we may be a good fit for you, and read all about the counseling process here. 

Also, here's a great article about how to make the most of your counseling experience. 

Be well. Breathe easy. Make use of a counselor.

This will be a great opportunity for the general public to learn about mental health and addiction. You must register to attend, but the cost is free.  Hope to see you there!