Depression

Body Image, Self-Esteem and Self-Confidence

Body Image, Self-Esteem and Self Confidence

Our mental health is directly impacted by how we feel, think and act. It makes sense then, that body image and self-esteem can significantly affect our emotional well-being.

Body image is the mental picture we have of ourselves, along with the feelings we have when we look at our reflection. A person with a healthy body image accepts their body as it is and is not actively trying to change it.

Self-esteem is the image you have of yourself as a person. A healthy self-esteem reflects a perspective of respect and appreciation for who you are, as you are right now.

The truth is, we all struggle at times with our body image and self-esteem. We all need an accurate understanding of what impacts our thoughts and feelings about ourselves and our bodies, both negatively and positively, so that we can respond intentionally. And sometimes we need feedback and support from outside of ourselves to gauge the accuracy of our understanding and give ourselves the opportunity to develop a healthier perspective and habits.

If you’re feeling stuck and are looking for ideas about how you can improve your body image and self-esteem, support is available. Kristine Proctor is an experienced, licensed clinical social worker with a practice dedicated to helping people become the best they can be through various talk therapies and experiential therapies, including Eye Movement Desensitization and Reprocessing (EMDR) and the Emotional Freedom Technique.

Kristine can help you to identify the contributing factors to your feelings and thoughts about yourself and give you the support and tools to increase your self-esteem and self-confidence, have a more stable mood, improve your body image and lead to a general overall improvement in the quality of your life.

Reach out to Kristine Proctor at 386-473-1062 or send her a message now.

Find yourself, and be that.

 

 

Licensed Clinical Social Worker
        EMDR Certified Therapist
        112 W. New York Avenue, Suite 205
        DeLand, FL 32720

 

 

Good Faith Estimates: What You Should Know

Good Faith Estimates: What You Should Know

As of January 1, 2022, there is a new law called the No Surprises Act that requires all health care providers to give clients who don’t have insurance or are not using insurance an estimate of the bill for medical items and services they are to receive because the provider is out-of-network for their benefits.

“Surprise billing” is when you receive a bill with an unexpected balance. This can happen when you cannot control who is involved in your care, such as when you have an emergency hospitalization and a service is provided by an out-of-network provider at an in-network facility.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. In the case of mental health, it refers to the number of sessions you are likely to have with your mental health professional (a licensed social worker, mental health counselor, marriage and family therapist or clinical psychologist).

Your health care provider should give you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure you save a copy or picture of your Good Faith Estimate.

If you are a client of my practice, you will have been sent a Good Faith Estimate through the client portal. To view and acknowledge receipt of your Good Faith Estimate, log into your client portal. Your Good Faith Estimate was created based on our current meeting frequency and your session rate but may likely be overestimated, in order to provide you the maximum amount of out-of-pocket expenses for treatment. If additional services are recommended, your Good Faith Estimate will be revised to reflect the change. The estimated costs are good for 12 months after the date of the Good Faith Estimate.

Remember, this is not a bill. If you do not have as many sessions this year as are listed in the estimate, then your costs will be lower than estimated. The Good Faith Estimate includes additional information about your rights and how to learn more. And as always, feel free to reach out to me with any questions you may have.

For more information about your right to a Good Faith Estimate or how to use the dispute resolution process, you can visit www.cms.gov/nosurprises or call 1-800-985-3059.

** The No Surprises Law has already seen several revisions, so it is subject to change. This document on the CMS website currently has an expiration date of 3/31/22.

Find yourself, and be that.

 

 

Licensed Clinical Social Worker
        EMDR Certified Therapist
        112 W. New York Avenue, Suite 205
        DeLand, FL 32720

 

 

Self-regulation and Mindfulness

As explored in our last blog, the ability to cope with the many challenges of life, whether big or small, and our emotional responses to them, has a relationship with something called self-regulation. Remember, self-regulation is the ability to manage one’s emotions, behavior and body movement when faced with difficult situations.

Below is a follow-up article by my colleague, Joel Bennett, M.Ed., which explores the potential for improving our self-regulation through several mindfulness-based interventions. Joel shares how you can add to your mental health toolbox and positively increase your capacity for self-regulation in several simple, easy to apply ways.

Find yourself, and be that!

 

 

Licensed Clinical Social Worker
         EMDR Certified Therapist
         112 W. New York Avenue, Suite 205
         DeLand, FL 32720

Self-regulation and Mindfulness
By Joel A. Bennett, M.Ed.

Often, through unwritten or unspoken norms, we perceive that our value and worth is tied with action and production. While it is better to think ahead, make previsions for the unknown, and get the laundry done, an often-overlooked aspect of self is quiet mindfulness.

Is mindfulness the property of Eastern thought and religions? Not according to a study that looked at the correlation between different interventions and their impact on self-regulation (Pandey et al, 2018). Remember, self-regulation includes focusing and maintaining attention, regulating emotion and stress response among many other descriptors (Blair and Raver, 2015, Pandey et al, 2018). With constant action and minimal or unintentional awareness of what “is”, our ability to control our emotions and stress responses suffers.

What is mindfulness? Mindfulness can be defined as practicing awareness of what is, internally as well as externally (Pandey et al, 2018). Okay, but what framework would support me in learning to perform mindfulness activities? I will give three examples of what mindfulness activities may look like.

Mindful Breaths

When you control your breathing, you can control many parts of how you experience life. When you sit up straight, you allow your nerves and air way to work as they were designed. Breathe in through your nose slowly. Feel the air filling your lungs and then pushing down into your belly. Sit with your belly full for 4 seconds and then let the air escape slowly out of your mouth. We will call this 4-4-4 breathing. 4 counts in, 4 counts hold, and 4 counts exhale. Go ahead, pause and practice right now. (Sit straight, with feet flat on the floor, count out loud or in your head. Think: inhale, hold and exhale.) Build up your tolerance for how long you can sustain this purposeful breathing activity. Most individuals struggle doing this for more than a minute at first. The Navy Seals do a similar activity they call squared breathing. They count to 5 and they add the empty lungs to the end of the activity just described. Pick a time during the day and practice your mindful breathing. Prevention and habit have been shown to impact emotion and stress responses (Galla & Duckworth 2015).

Foghorn

Another breath activity is called the Foghorn. This is an interesting option for those that are not self-conscious or are able to have a few minutes in a location no one is able to hear you. Sit up straight or stand and correct your posture, place your fingers on your neck just below your jaw, and feel the vibrations as you exhale through your mouth, supported by your diaphragm. Make a low rumble type noise like a foghorn. This works with your mouth open or closed. This activity engages the vagus nerve and helps to calm emotions.

Planted Seed

Make your spine straight again. In this activity you will choose an external quote or phrase that you believe to be true towards you. You might think of the words of a friend sharing their appreciation for your kindness and generosity. For someone with a spiritual frame of reference an example might be a Biblical promise such as Deuteronomy 31:6 which says, “Be strong and courageous, do not be afraid. The Lord your God will never leave you nor forsake you”. Now pick one of the words or words that attracts your attention, such as kind, generous, courageous, or never leave you and imagine it is a little seed. Imagine planting that little seed inside your heart. Do the mindful breaths and imagine it growing and growing inside of you. Sit with the seed. Imagine those words seeping into your bone marrow.

Remember, the phrase you choose must be something that you truly believe.

Build the Habit

There are myriad frameworks to practice mindfulness. Don’t allow the sheer volume of options overwhelm you. Choose one or two and begin to make it a daily habit. By so doing, you will improve your body’s ability to regulate emotions and stress responses.

Joel Bennett, M.Ed.

Blair, C., & Raver, C. C. (2015). School Readiness and Self-Regulation: A Developmental Psychobiological Approach. Annual Review of Psychology, 66, 711-731.

Galla, B. M., & Duckworth, A. L. (2015). More than resisting temptation: Beneficial habits mediate the relationship between self-control and positive life outcomes. Journal of Personality and Social Psychology. 109(3), 508-525. Doi:10.1037/pspp0000026

Pandey, A., Hale, D., Das, S., Goddings, A. L., Blakemore, S. J., & Viner, R. M., (2018). Effectiveness of Universal Self-regulation – Based Interventions in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatrics, 172(6), 566-575. https://doi-org.wgu.idm.oclc.org/10.1001/jamadediatrics.2018.0232

Self Regulation Introduction

In dealing with the pandemic and the plethora of problems it has brought into people’s lives over this past year, many have recognized the necessity of intentionality in the area of mental health. This new, or renewed, curiosity about how to keep oneself healthy in the face of experiencing such a variety of disruptive events, has elicited many varying responses. These high levels of emotional bombardment and our responses can often generate additional anxiety and stress, and in some instances can lead to higher incidences of depression. The ability to cope with many of these things has a relationship with something called self-regulation, which is the ability to manage one’s emotions, behavior and body movement when faced with difficult situations.

When attempting to understand this phenomenon, it is not uncommon to confuse “self-control” with “self-regulation.” Self-control is the ability to keep emotions and impulses in check, both when alone and in social situations. Many of our current situational responses to mask-wearing for example, have to do with self-control, whereas the fears or anxiety one may feel about the pandemic has more to do with self-regulation. However, both are skills that can be developed over time.

In my practice, I have found that many clients struggle with self-regulation, not knowing what it is or how to help themselves. These struggles often lead to greater difficulties in responding emotionally in certain situations where one might find conflict between the ability to self-regulate and self-control.  This mismatch often increases stress and anxiety, has implications with anger management, and communication with others.  It can cause despair and depression, relationship difficulties, or in extreme cases even violence or abuse.

In learning to practice better self-regulation, one might improve self-esteem and self-confidence, as well as find an overall reduction in some of the symptoms related to the distress and psychological turmoil they may be feeling.

Below is an article by my colleague, which explores the potential for improving our self-regulation. Several followup articles will explore the concept further, sharing examples of what self regulation really is and how to improve it through techniques such as mindfulness-based interventions, cognitive reframing (changing thoughts), and other emotional regulation strategies.

Find yourself, and be that!

 

 

 Licensed Clinical Social Worker
         EMDR Certified Therapist
         112 W. New York Avenue, Suite 205
         DeLand, FL 32720

Introduction to Self-Regulation of Youth and Adolescence
By Joel A. Bennett, M.Ed.

“Why can’t you control your meltdowns?” “Why is it so hard to focus on what you are working on?”   “Why do your emotions swing so far so fast?” As a parent and educator, with 15 years in both the classroom and the home, I have heard these questions and others like them from many other parents, as well as pondered them myself. Is it only anecdotal stories that make me think that Americans are decreasing in their ability to control themselves, their emotions, their responses?   Psychology has developed the umbrella idea of self-regulation which encompasses our ability to self-monitor, –evaluate, –react, –judge.   It includes focusing and maintaining attention as well as physiologically controlling our stress response (Cellar et al, 2011, Blair and Raver, 2015, Pandey et al, 2018).

Wow! That sounds exactly like the types of problems parents and my colleagues have been noticing! Because my personal and professional observations align with these observations, I wondered, “If this umbrella idea of self-regulation has been identified, is there evidence on how to improve these abilities?” I looked at 18 peer-reviewed articles focused on youth and adolescence (2-18-year-olds) and found clear demonstration that, YES, SELF-REGULATION CAN BE IMPROVED!  

A very helpful way of looking at improving self-regulation is to break the problem into two realms of focus: biological and cognitive (Cole, Ram, & English, 2019). Think of this scenario: You are walking from your room for your morning coffee when you step on your child’s cars that were left in the hallway. You went to bed late, woke up with a tremendous agenda that may or may not get finished before you must run your kids to appointments.   You are not biologically at your peak.   Maybe not even in your top 75%.   If you have had a moment like the one I just described, you may recall responding in a way you were regretful about later. I know I have asked for forgiveness after moments like this. Cole, Ram, and English (2019) lump exhaustion, hunger, lack of rejuvenation, and the like into the biological realm.

Our children find themselves in this predicament many times, too. Many parents instinctively pack snacks, create routines for sleeping, exercise, fresh air, and quiet time into the day-to-day rhythm. Galla and Duckworth (2015) found that building beneficial habits provides the strongest positive life outcomes. A quick snack or regular waking and sleeping schedule may address an individual’s ability to control impulses, maintain focus or self-awareness and become the least costly solution to improved self-regulation.

The second realm to consider when looking at ways to improve self-regulation is the cognitive. Do we have the neurological pathways to respond, to control, to become aware of ourselves? These neuropathways are developed in the context of our relationships rather than individually. It has been demonstrated that high doses of parent-child “attunement,” a neurologically synchronized give and take, co-creation experience, have significant impact in the youth who experienced the ongoing activities with the parents (Davis, Bilms, & Suveg, 2017). Another give and take role playing model was found in the Tools of the Mind preschool and Kindergarten curriculum. This curriculum utilizes mature, dramatic play to improve executive function (Diamond, Barnett, Thomas, & Munro, 2007). It ought not to be a surprise that traditions from the past that have been cast aside, such as family dinners where people look at one another and engage in the give and take of creating a space or Holy Days with traditions and engagement or walks in nature, were more valuable than we previously thought.   These former traditions provided regular and routine opportunities to attune to our loved ones and invest in their neurological abilities to self-regulate!

And while it is true that past traumas of rejection, attachment issues and disorders, or harms play a strong role in self-regulation, we can make progress and strengthen the positive alternatives to dysregulation by considering the push and pull relationship between the biological and the cognitive.  

Blair, C., & Raver, C. C. (2015). School Readiness and Self-Regulation: A Developmental Psychobiological Approach. Annual Review of Psychology, 66, 711-731.
         Cellar, D., Stuhlmacher, A., Young, S., Fisher, D., Adair, C., Haynes, S., …Riester, D. (2011). Trait Goal Orientation, Self-regulation, and Performance: A Meta-Analysis. Journal of Business and Psychology, 26(4), 467-483. https://doi-org.wgu.idm.oclc.org/10.1007/s10869-010-9201-6
         Cole, P.M., Ram, N., & English, M.S. (2019).   Toward a Unifying Model of Self-regulation: A Developmental Approach. Child Development Perspectives, 13(2), 91-96. https://doi-org.wgu.idm.oclc.org/10.1007/s10802-010-9418-x
         Davis, M., Bilms, J., & Suveg, C. (2017). In Sync and in Control: A Meta-Analysis of Parent-Child Positive Behavioral Synchrony and Youth Self-Regulation. Family Proces, 56(4), 962-980. https://doi-org.wgu.idm.oclc.org/10.1111/famp.12259
         Diamond, A., Barnett, W.S., Thomas, J., & Munro, S. (2007). Preschool Program Improves Cognitive Control. Science, November 30; 318(5855): 1387-1388.
         Galla, B. M., & Duckworth, A. L. (2015). More than resisting temptation: Beneficial habits mediate the relationship between self-control and positive life outcomes. Journal of Personality and Social Psychology. 109(3), 508-525. Doi:10.1037/pspp0000026
         Pandey, A., Hale, D., Das, S., Goddings, A. L., Blakemore, S. J., & Viner, R. M., (2018). Effectiveness of Universal Self-regulation – Based Interventions in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatrics, 172(6), 566-575. https://doi-org.wgu.idm.oclc.org/10.1001/jamadediatrics.2018.0232

Suicide Prevention: What Can You Do? Kristine Proctor, MSW, LCSW

Suicide Prevention: What Can You Do?
Kristine Proctor, MSW, LCSW

Suicide is a difficult topic. Many of us would like to believe that we will not ever have the need to deal with this reality but unfortunately, at some point in our lives we may have to either for a friend, family member, coworker or for ourselves.

There are many misconceptions about those who have suicidal ideation and how friends or family can be supportive. It is important to understand as much as you can about how you can help a family member or friend, or when you might need to reach out for help for yourself.

Knowing what to look for is a good place to start. According to the CDC, there are 12 warning signs to look for:

Feeling like a burden

Being isolated

Increased anxiety

Feeling trapped or in unbearable pain

Increased substance use

Looking for a way to access lethal means

Increased anger or rage

Extreme mood swings

Expressing hopelessness

Sleeping too little or too much

Talking or posting about wanting to die

Making plans for suicide

So then, how can you respond if you have concerns? Here are a few ideas to help:

Ask directly if they are thinking about suicide. You might say, “Have you ever felt/Do you feel so bad that you’ve thought about suicide?” It’s okay to talk about it. Research shows that by asking you are not “putting the thought in their head” and that inquiring about suicidal thoughts does not prompt suicidal thoughts. Remember, if you don’t ask, you may not know. Additionally, just because someone is thinking about suicide does not mean they have a plan, the actual intent or the means to follow through. Asking directly helps you understand what their current thoughts and feelings are and helps you know how to respond.

Listen to their answers. Many times the way someone talks about their thoughts of suicide are indirect. Or a hint might be said in a joking manner. Don’t assume they are joking. Pay attention to statements like, “I just want to curl up in a ball and die.” Or “I just want to sleep and never wake up.” Or “I’ve got no reason to live.” These statements alone do not necessarily indicate that someone is suicidal but could be a clue taken in the larger context of their behavior and moods.

Make sure they are safe. Ask them about whether or not they have the means to follow through on a plan that they’ve discussed. Removal of weapons, medications or drugs and even access to their car can help ensure safety.

Don’t keep secrets. While it may be difficult to reach out for help, safety is essential. Let them know you’ll help with a plan to get them the mental health support they need. You will be able to deal with the fallout of a friend or family member’s frustration at some point later, after knowing they have the help they need.

Encourage them to get help from a professional. Unless you are a mental health professional, it is best to encourage or even facilitate getting help. In case of emergency, immediately call 911. The National Suicide Lifeline 1-800-273-8255 can be called 24/7 for one to consult a medical professional for advice. It is a confidential resource. For those hard of hearing, you can chat with a Lifeline counselor via suicidepreventionlifeline.org.

If you would like to find out more about how you can recognize a crisis and the warning signs that someone might be contemplating suicide, an excellent resource is The QPR Institute (Question, Persuade, Refer) at QPRInstitute.com. Many health departments and school districts offer free training opportunities.

Kristine has many years of experience working with individuals feeling sad, depressed and anxious. Feel free to reach out to her if you believe counseling is needed for you or someone you care about. Kristine offers two appointment options: a) face-to-face in her downtown DeLand, Florida office or b) via an online, HIPAA compliant video chat. Online therapy is not the best option for everyone. Some issues are best addressed face-to-face.

If you are in crisis, call the National Suicide Prevention Lifeline, a free, 24-hour hotline at 1.800.273.8255. If your issue is an emergency, call 911 or go to your nearest emergency room. Kristine Proctor, MSW, LCSW, LLC does not offer crisis counseling or emergency services.

Reach out to discover the best fit for you and your journey. Wishing you peace and courage.

Find yourself, and be that!

     

 

Licensed Clinical Social Worker
       EMDR Certified Therapist
       112 W. New York Avenue, Suite 205
       DeLand, FL 32720

How Well Do You Bounce? Part 4: Taking Care of You Kristine Proctor, MSW, LCSW

 How Well Do You Bounce? 

Part 4: Taking Care of You

Kristine Proctor, MSW, LCSW

Carl Jung said, “The privilege of a lifetime is to become who you really are.”

With developing resilience being our goal in our past few blogs, we’ve been intentionally tuning in to our mental and emotional processes to identify our stressors, adapt a growth mindset and get to know our true selves better.

Now you’ll want to take continuous advantage of the “privilege of a lifetime” Jung referred to. In order to do that, you’ll need to create a plan to follow. This will ensure that you maintain this priority. Your plan can be like a budget in the sense that it is a goal, your ideal. Know that at times it will need to be altered based on your circumstances and current emotional state. And now that you’ve got more information about how you tick and what you need, it will be easier to create a plan that is realistic and one that really fits you.

Using the following as a guide, think of some things you’ll want to include in your self-care plan:

What does my body need?

What does my mind need?

What does my spirit need?

What do I want to accomplish?

What are some potential obstacles?

Who are the supportive people in my life?

The plan should be recorded but use any format that works for you. You might make a word document, write your plan in a journal, use a calendar and pencil in specifics, or draw a diagram that includes your priorities.

Next, find a visible place for your plan so that it will be convenient to review on a regular basis. Your self-care plan is an affirmation of you. Research shows many of us spend lots of time setting priorities and goals and making strategic plans in our work lives but then fail to follow through and just let our personal lives unfold. Why not spend some valuable time investing in yourself? I guarantee the reward will be worth it!

Find yourself, and be that!

How Well Do You Bounce? Part 3: Know Yourself Kristine Proctor, MSW, LCSW

How Well Do You Bounce?

Part 3: Know Yourself

Kristine Proctor, MSW, LCSW

One of the ways to increase our coping capacity is to develop our resilience, defined as the ability to recover quickly from difficulty. In part 1 and 2 of this series, we looked at characteristics of individuals who have the ability to bounce back from adversity in order to give ourselves a benchmark for our own level of resilience. We asked ourselves, “How well do I bounce?”

In addition to adapting a growth mindset (see part 2), there are additional strengths we can develop or improve to be more resilient. Essential to our ability to grow is our self-knowledge. Of course, we already know a lot about ourselves! In this instance, I am talking about getting to know your true self by thinking about some of the deeper aspects of your inner being that are not often part of your day to day thinking.

For example, ask yourself a series of questions such as these to help you understand what you believe and how it is influencing your life choices.

What is my belief about myself in this situation? What is my behavior? And what is the outcome of those? How is it helping me? What is this belief costing me? How can I change the belief to increase benefits & reduce costs? What are the triggers? What thinking trap is being coupled with the belief?

As part of this assessment, you may have identified some patterns you’d like to be different. This is the first step, as you can’t change what hasn’t been acknowledged. Remember, tracking your thoughts and behavior and observing with compassion is the lens you’re using. Remind yourself that change takes time and that your greatest goal is to know yourself better, not to find faults and beat yourself up. Start small and work on one issue at a time so as to keep from becoming overwhelmed. Apply that growth mindset you’ve been adapting from part 2 of this series.

A third helpful step is to assess how vulnerable you are to stress. This can be accomplished by taking a step back and looking at how full your life is currently and whether or not what you spend your time on fits with your true priorities. What are the major stressors in your life right now? What can be controlled about each of them?

If you recognize there are factors outside your control, you can choose to recognize your ability to choose your response to those things. Challenge the negative thoughts and put things in perspective.

One way you can accomplish this is to: a) Acknowledge the negative thought, b) Tell yourself to “Stop that thought.” and c) Replace it with a positive thought. Then, d) Repeat as often as needed.

Another option is to practice reframing your challenges as opportunities. For example, instead of a response of “Not THIS again!” you can reframe it as “I’ve done this before. I’ll be done in no time.” Or shift your naming of a task from “have to” to “get to.” Believe it or not, your brain doesn’t know you don’t fully mean it and will respond in a more positive, adaptive manner. And over time you’ll start to recognize a true shift in your perspective, as well.

Here’s wishing you much courage and fulfillment as you continue your journey to knowing your true self better.

Find yourself, and be that!

 

Welcome to Kristine’s Mental Health Blog

Hello,

This blog includes my professional reflections and comments, as well as hyperlinks to articles and videos that can be beneficial to your mental health. Visit this page to find up-to-date information to support your journey.

Find yourself, and be that!

 

Contact Kristine



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    Kristine has an innate ability to meet her clients wherever they are at. She simplifies complicated issues by identifying the root causes and makes applying mental health principles to real life — like healthy boundaries — manageable.  — P.L., Deland, FL

    March 26, 2020

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