At one point or another anxiety will impact you. Most of us have an experience with anxiety that makes us feel scared and stressed. Anxiety is the body’s emotional and physical response to a stressful situation or anticipation of a real or perceived difficult circumstance.

It’s important to understand that anxiety is largely a physical reaction to a real or perceived stressor. Calming your body down when anxious allows you to engage the coping skills you have at your disposal. When working with clients presenting with anxiety one of the first things we do is focus on techniques to cope through physical exercises such as diaphragmatic breathing or progressive muscle relaxation. After clients possess the skills to calm their bodies down when anxious, we are able to work on the emotional, relational and intellectual aspects of this difficult emotion.

Anxiety can often take the role of a secondary emotion – an emotion that presents itself as an attachment to your primary emotion. For example, if you are feeling sad, lonely, stressed overwhelmed you might get a general sense of anxiety. Knowing that anxiety is sometimes a secondary emotion helps you to know dig deeper to see what is really going on. Addressing the previous emotions in a specific and deliberate manner helps anxiety lessen.

It might seize you in the middle of the night, or perhaps at the beginning of a work meeting, or maybe while driving your kids to soccer practice. Wherever it happens, it can overwhelm you. Your mind won’t stop running. Your body is tense. Your heart is racing. You can’t breathe! You can’t relax and enjoy yourself. If you have ever felt a combination of these sensations, you have probably felt anxiety—a common experience among adults and adolescents. Whether you accept it or not, anxiety is part of a normal, healthy life. Diagnosable anxiety disorders, however, are different than normal, everyday anxieties. A hallmark characteristic of an anxiety disorder is excessive fear or anxiety about a real or perceived threat (DSM-V).

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), nearly 40 million people in the United States suffer from an anxiety disorder in a given year. That’s 18 percent of the population! Specific anxiety disorders include generalized anxiety disorder, selective mutism (failure to speak in social situations even when able to speak in other situations), specific phobias (fear of animals, objects, etc.), social anxiety disorder, panic disorder, or agoraphobia (fear of having a panic attack or other embarrassing symptoms in locations such as public transportation, standing in a line, etc.). Some anxiety disorders, such as phobias and generalized anxiety disorder, most often begin in childhood around 11 years old and can continue into adulthood if left untreated. These two disorders are the most common anxiety disorders in adulthood according to SAMHSA.

Because of their belief that things will not change, or that they just need to get over it, many suffering with an anxiety disorder do not seek treatment. The good news is that anxiety is treatable! Your biology has a lot to do with an anxiety disorder; therefore, a first step in reducing anxiety includes dealing with the body’s physical response to stress.

Diaphragmatic Breathing

Your body’s internal organ regulator, your autonomic nervous system (ANS), has two applicable parts of the solution. First is the sympathetic nervous system (SNS), which is in charge of your fight-or-flight responses. This part, for example, pumps up the mailman’s body so she can outrun that dog hiding in the bushes. Second is the parasympathetic nervous system (PNS), which aids in calming your body. This part helps her body deescalate after she has escaped that dog so she can return to delivering the mail as usual.

When you feel anxious, your SNS is engaged. To help calm your body in these moments, the key is to activate your PNS. The exercise outlined below (partially adopted from The Anxious Brain: The Neurobiological Basis of Anxiety Disorders and How to Effectively Treat Them) triggers this part of your ANS.

How to do it:

1. Lie down, stand, or sit in a comfortable position. Make sure you are “grounded” by creating an open posture with both feet on the floor and your back against a chair or bed. If you are crying, in the fetal position, or hunched over, this technique is difficult to do.
2. Breathe in deeply. Picture a water balloon being filled with water as you first fill up your abdomen with air and then your chest. Feel the warmth and the weight of the air as you breathe in.
3. Breathe out with an elongated breath—longer than it took you to breathe in. Purse your lips as you breathe out. This will slow your breathing. Breathing out slowly will help activate the PNS, which helps calm your body—the whole purpose of this breathing technique.
4. As you breathe in and out, focus on the physical sensations you experience. Focus on your feet touching the ground, your abdomen and lungs expanding and contracting, the feel of air rushing over your tongue and through your pursed lips. Notice how your head, arms and hands feel. Doing this will help you be present and in-the-moment.
5. Practice! This is a skill that must be developed. Try doing it while you are at work, stopped at a traffic light, or at home. Do each cycle (breathing in and breathing out) ten times or more, as you learn to engage your PNS.
6. If you feel dizzy, light headed or out of breath, do not continue this technique. If your breathing is restricted or obstructed there may be other issues to consider. Speak with a therapist or doctor about the appropriateness of this exercise for you. This technique is a good start to help reduce anxiety in the moment, but is most successful when done in conjunction with therapy.

Anxiety disorders affect millions. Those who suffer with anxiety often feel there is no solution. But basic biology tells us differently. Activating our PNS through breathing techniques really does work—give it a try next time you feel anxiety creeping in. You might be surprised at how effective these simple breathing techniques can be!

Originally published on Utah Valley Health and Wellness Magazine

Written by Dr. Triston Morgan

All of us, from cradle to grave, are happiest when life is organized as a series of excursions, long or short, from the secure base provided by our attachment figures. – Dr. John Bowlby

Have we really cracked the code on love and romantic bonding? Perhaps. Scientists, poets, and lovers have long grappled with the question: “What makes romantic love work?” Through the work of Dr. Sue Johnson and the development of Emotionally Focused Therapy, it looks like we have an answer.

Through decades of research on the importance of emotional bonding and what it is like to feel disconnected, isolated, and alone, relationship researchers are starting to unravel the mystery of love and adult romantic bonding and how to mend loving ties. The truth is, we are all hard-wired to connect to one another. This drive to connect is infinitely stronger in family and romantic relationships. To be emotionally isolated is harsh on our brains. Loving connections offer us a safe haven to go to where we can maintain our emotional balance, deal with stress, and respond more lovingly to our romantic partners. Essentially, when those connections are secure and strong, love is safe; love flourishes.

Unfortunately, disconnections between couples do happen and frustration, sadness, and anger are all too common in marital relationships. When those secure and loving bonds are threatened, emotional “primal panic” and a cycle of negative interactions ensues. These wounds can be difficult to repair for couples when left to their own abilities, and therapy is often the last step before looking to end the relationship. Unfortunately, many well-meaning therapists utilize their individual-based, time-tested techniques and attempt to apply them to relational interactions, which usually has little effect in restoring their loving bonds. In addition, many therapeutic techniques focus on helping partners change behaviors or thoughts, or teaching them communication skills. The common result from these approaches and techniques is that they usually struggle to gain traction, and the couple leaves therapy with less hope than before.

But there is hope. Within the last 25 years, a substantial amount of research has emerged that gives hope to couples on the brink and helps them tune in to their underlying emotions, identify their negative patterns of interaction, repair their attachment, and eventually create new patterns of bonding and positive interactions. This model is Emotionally Focused Therapy.

Grounded in the theory of attachment, Emotionally Focused Therapy (EFT) is an experiential, short term, structured, and tested model of therapy designed to help couples identify their negative communication patterns, interrupt this pattern, and create more positive, bonding, and secure emotional patterns. EFT does not see individuals as “sick” or unskilled, but rather “stuck in habitual ways of dealing with emotions with others in key moments.” As the title reflects, priority is given to emotion as a key organizer of inner experiences. EFT looks within the emotional experience of the couples and how they navigate their emotional connectedness. Dr. Sue Johnson has said, “The EFT therapist has a map. A map to relationships and how they work. A map to how they go wrong. And map to what is needed to put them right.”

A substantial body of research has shown promising results of the effectiveness of EFT. Research studies find that 70-75 percent of couples move from distress to recovery and approximately 90% show significant improvements. EFT is being used with many different kinds of couples in private practice, university training centers and hospital clinics, and many different cultural groups throughout the world. These distressed couples include partners suffering from disorders such as depression, post-traumatic stress disorders and chronic illness.

In my work with couples, EFT has resonated with them on many levels. No longer are couples focused on fights and long-standing disagreements about specific content or trying to change the other person. When couples go through the process of EFT, perpetual problems are framed as negative disconnections that are about protests by each partner for a more loving connection and emotional safety. EFT takes the blame out of conflict and resentment and moves to fighting together against a common enemy—the negative pattern. As couples progress through the stages and steps of EFT and begin to accesses deeper emotions that underlie their struggle for connection, a new interaction emerges as individual partners see and experience each other differently. When partners experience each other as more accessible, responsive, and engaged, old wounds and negative patterns are healed, and love and emotional safety thrives.

Originally published by Utah Valley Health and Wellness Magazine

Written by Dr. Jeremy Boden

As I work with individuals and couples, I like to educate them on how our brains and our bodies impact our relationships. Understanding the correlation between these elements seems easy enough, however, I often get the question, “How do I change my brain?” The answer to this question is a great starting point to create healing and allow new interactions to take place.

Our brains are wired for connection. Each interaction we have either strengthens or weakens the connections in our brains, thus influencing the relationships with those around us. The ability to allow one or two more heartbeats before reacting or responding to one’s partner is the ultimate goal. The better you are able to emotionally regulate (by allowing more heartbeats before reacting), the more positive your interactions with others can be.

There are many ways you can impact emotion regulation and the ability to create new experiences that improve relationship interactions. Some are easier than others, and some have been targeted to help with other areas of life. I’d like to highlight two very important ways to help increase heart rate variability and improve cognitive functioning so you are better prepared the next time you might want to fly off the handle. They are exercise and sleep.

Everyone knows that exercise is good for physical health, but it also has great implications for mental health and relationship health. Increased exercise impacts the way your heart pumps blood. Long-term exercise increases your heart’s efficiency in pumping blood to the body. It doesn’t have to work so hard, and this increases heart rate variability, or the amount of time in between heart beats in a given minute. Increased heart rate variability means more regulation (more parasympathetic, or calming, influences) on the heart, and thus, more flexibility in emotional responses. This means that you have more capacity to keep the breaks on when your fight or flight response is triggered, allowing you more time to thinking critically, solve problems, or socially engage before flying off the handle and reacting to environmental stimuli.

Additionally, exercise increases the volume of the prefrontal cortex—the area in the brain associated with learning and memory. Exercise also stimulates the growth of cells by releasing chemicals in the brain. These new cells are then cleaned, solidified, and bonded together to create new memories for individuals.

We have all heard that sleep is important and should be a priority. Sleep does a lot of thing for us—it helps with creativity, remembering physical tasks, and making decisions. Sleep also does two important things in the brain: creates and consolidates memories and clears out toxins. As neurons fire together (and therefore wire together), sleep helps to connect recent memories with earlier memories. This allows individuals to remember how they reacted in past situations, and react differently next time if they desire a different outcome.

Cleaning out toxins in the brain increases attention and memory, helps individuals think clearly, and even impacts the regulation of insulin. Not getting enough sleep inhibits the ability to clear out the toxins, which can be harmful to the connections that are trying to take place in the brain. Sleeping allows us the opportunity to create new and improved experiences each day.

There are many ways individuals can have more influence on emotional responses. These are only two, but by changing our brains and our physiology in the body, we are prepping ourselves for better interactions. Being mindful of how we can impact the physiology of our bodies allows us more control over how we interact with those around us. We increase our capacity to engage more positively and be more satisfied in our relationships.

Originally published by Utah Valley Health and Wellness

Written by Dr. Kayla Mennenga

A couple I once worked with in therapy some time ago—let’s call them Kevin and Gloria—seemed to have a lot going for them: Kevin had a good job and Gloria was active in her community, and they were raising four healthy kids. They reported, however, that as family pressures had built up they had felt a growing distance from each other, and each time they tried to talk about their individual or family challenges, criticism and defensiveness soon followed, and one or both of them would get hurt or angry while nothing was resolved.

Through therapy, they learned how to create a safe space for each other to open up and go a bit deeper. A big breakthrough came when Kevin started sharing about intense criticism he had felt as a child. He talked about his fear of his own children going through the same thing. This helped explain why he felt so strongly about a particular issue. Gloria then shared her own experiences as a mother, comparing herself to other mothers, and her fear of failing to live up to expectations. This helped Kevin better understand the challenges Gloria faced every day.

Although they still disagreed on many issues (and probably always will), they deeply understood each other. They felt a desire to support each other, and suddenly some of the issues didn’t seem so big anymore. Each expressed a feeling of relief, like a weight being lifted off of their shoulders, and more confidence in their relationship.

One of the main goals of relationship therapy is to help couples (1) open up and (2) learn to be ok about the messy details of their own and each other’s lives. Trying to be perfect, individually or as a couple, can add a lot of pressure, which can turn a couple against each other and create a cycle of fighting and withdrawing that hurts the relationship. If, in the middle of all of this mess, both partners can learn to really listen to each other and just be there for each other, things will get much better. To do this, we need to listen, and open up.

Listen

Have you ever tried to talk to someone about something you are struggling with, only to have them ignore what you said and start rattling off all of the pressures they are facing? How useful was that? But how often does this happen to partners under stress! It can be hard to listen to your partner’s troubles when your mind is so full of your own, but when two people are both trying to be heard, it means neither of them are listening.

Listen to your partner. Set aside, for a moment, your own issues and give them as much space as they need. You will disagree with some of what they say, I can almost guarantee it, but this isn’t the time for resolution or debate, this is the time to show your partner you care and that you want to understand them. After all, the best research we have says that 70% of all relationship differences are never resolved anyway, so let’s stop beating our heads against the wall, and start listening with the intent to understand. The goal is just to listen, not to resolve.

Opening Up

Opening up is more than just sharing our complaints and opinions. Sometimes we will need to do a bit of self-exploration first. Maybe when your partner arrived home late without texting and you were angry, underneath that was the memory of your own father arriving home late or not at all, and the hurt you felt associated with that. The anger will push your partner away, but the painful memory may help him or her connect with you and want to support you.

There may be many other secrets or hidden thoughts, feelings or memories you hold back from your partner out of embarrassment or fear of rejection. However, consider the power of feeling loved for who you are, even though there are some parts of you you’re not especially happy about. When we stop holding back the messy parts of ourselves, we are showing trust for our partner’s capacity to love us unconditionally.

Made Strong Through Weakness

Strong relationships aren’t created by perfect people—they become strong when we are willing to drag all of our imperfections out into the open and say, “Here I am, in all of my mess, can you still love me and stick with me?” This is the glue that holds a relationship together, even in the hard times: needing someone, and feeling needed at the same time.

Written by: Sam Ryland, LCSW

Originally published on Utah Valley Health and Wellness

When I ask couples what I can help them with, the most common response is “communication problems.” In my mind, this term has become a catch-all expression for couples who aren’t really sure what is wrong or who haven’t yet been ready to face deeper issues. They don’t realize they are actually communicating through non-verbal body language, yelling, or even the silent treatment. Problems arise because, as individuals, they don’t recognize the message being sent to them or even the message they are sending to their significant other. After exploring their situation further, I often find that there is much more going on than simple communication problems.

Let’s break down the idea of “communication problems” to see what could really be lurking underneath:

1. Uncomfortable emotions– Our primary emotions are often difficult to feel because they are uncomfortable (hurt, loneliness, jealousy, etc.). Because they are uncomfortable, we often cover them up with another emotion. Enter: Anger. Anger loves to disguise what you are really feeling. It gives us the illusion that we are dealing with the issue, when in fact, we are getting further and further away from it by trying to satisfy and quench our anger. When you find communication breaking down and yourself getting angry and lashing out at your spouse, ask yourself this question, “What am I really feeling?” This will help you dig deeper in order to recognize, feel, and cope with what’s really going on. Anger obviously leads to communication problems because it masks the real issue.
2. Displacement– You have heard of Dad coming home after a bad day at work and kicking the dog in the driveway because he almost tripped over him. The dog did nothing to deserve it other than being alive, but still got the brunt of Dad’s frustration. Similarly, we often displace our difficulties onto our partner. Sometimes we don’t tell them what’s really bothering us and sometimes we do. But either way, communication problems arise because we are struggling with work, children, in-laws, money, self-esteem or other issues not related to our partner. I suggest that when you find yourself displacing issues on your partner, recognize that you are doing so and talk to your partner about what you’re really struggling with. You might find a helping hand waiting for you.
3. Past Injuries– We carry past problems and emotional injuries with us through life. What happened to us last week, during the first week of marriage or even when we were a child can impact how we relate to our partner today. If our partner has hurt us in the past, we are less likely to feel emotionally (or even physically) safe. In our attempt to guard our emotions, we put up walls or distance ourselves, which increases communication problems. I suggest that when a past injury is lingering, address it with your partner. If you are unable to solve it, then seek professional help. When your leg is broken, you go to the doctor; when your relationship is broken, you go to a therapist. They are trained to help you through these difficult issues.
4. Lack of communication skills– Sometimes we don’t communicate well because we simply don’t know how. Learning basic principles of communication will empower you to express yourself in a healthy manner. By going to school, we learn how to be doctors, teachers, or lawyers, but we don’t learn the basics of human interaction and communication. The learning process doesn’t just come naturally to everyone. Deliberate learning and application will help you become an effective communicator. When it comes to marital communication, John Gottman (The Seven Principles for Making Marriage Work) and Susan Johnson (Hold Me Tight) have paved the way through research and practice. Read these books and practice with your partner. You will get better.

When communication with your partner becomes difficult, remember that the underlying problem may not simply be that one of you lacks communication skills. Think about what could be hiding beneath the growing anger or distance between you. As you search this out, you may discover deeper issues that you can discuss and deal with together or that, if necessary, you can receive help with from a therapist.

Written by: Triston Morgan PHD, LMFT

Originally published by Utah Valley Health and Wellness

“Could you make sure to clean the kitchen today?” My wife asked, eyebrows raised. I hesitated trying to think of something to say. I felt my chest tighten and my breathing get shallow. She cocked her head, “What’s wrong?” I stumbled to explain everything I had to do that day without actually saying “No.” Tension began to fill the room. I knew she was comparing her structured nine to five job to my odd therapy schedule that gives me more time at home. I knew she was wondering why more didn’t get done around the house, and I thought about what it must look like from her perspective, to leave in the morning with me at my computer, and come home eight hours later to find me in the same place. How hard is it to fold some laundry, after all? Her forehead crinkled, “I don’t understand why you can’t put thirty minutes aside and clean the kitchen.”

This is a pretty mundane example of the type of things married people argue about. It seems like a pretty simple matter on the surface. The discussion was about doing chores. So why did I feel cornered? Why did something as simple as cleaning the kitchen make me feel so much anxiety? This argument was about more than simply cleaning the kitchen. I felt torn between two demands of great importance: my career or my wife’s good will. I keenly felt the burden of my family’s future resting on my shoulders, and what seemed like an endless to-do list. How could I stop working on that to do something as trivial as cleaning? What good was a clean kitchen if we were drowning in student loan debt? But not cleaning the kitchen meant the evaporation of marital bliss. How could I focus on my work with an upset wife on my mind? Either way, I was in trouble.

Any fly on the wall seeing our argument probably would have thought the issue was as simple as a lazy husband not wanting to do chores. But as in almost every argument, there was something deeper going on below the surface. To my wife, this was not merely a matter of having a clean kitchen. For her, it was about peace of mind. Coming home to a messy house after a hard day adds more stress. When the house is messy, it makes her mind feel chaotic and disordered too. Not only that, but a dirty house reminds her of the instability of growing up with a father who had bipolar disorder and refused to take his medicine. The issue of cleaning the kitchen was proxy for some deeper concerns. For me it was about earning enough to take care of my wife and to prepare for children. For my wife it was about feeling safety and peace in her own home.

Arguments can draw a couple closer together, or they can drive a wedge between them. What makes the difference? That question has a few answers, but one of the big things is whether we ever get to the deeper meanings under the surface of the fight. If we stay on the surface, we may have conclusion, but we won’t have resolution; whether I did the cleaning or not, I would have had stress and felt disconnected from my wife. That’s because what I needed, and what every person needs, is to know and feel that their partner understands and respects them. The reason we had an argument had nothing to do with cleaning at all, it was really about her basic need for safety, and my basic need for competence. We couldn’t fix the problem until we acknowledged the source of our strong emotions and what the fight was really about.

The moment we feel understood by our partner, we can think clearly, and then it’s easy to do problem solving. Next time you’re arguing and feeling upset, ask yourself about the deeper issue behind the disagreement. Find out from your partner what their position means to them. Empathize with their thoughts and feelings, and see how much easier it is to resolve arguments.

Originally published on Utah Valley Health and Wellness

Written by: Kenneth Jeppesen, LAMFT, MMFT

Kenneth is a therapist at the American Fork Center for Couples and Families and is a licensed associate marriage and family therapist. He enjoys helping individuals and couples find peace and happiness and spends the rest of his time learning about everything!

Most of us try to avoid uncomfortable emotions. Who likes to feel sad, depressed, lonely, hurt, scared or betrayed? Don’t we try to NOT feel this way? Some may even engage in unhealthy behaviors to avoid their emotions.  I encountered this as a common theme in my work at drug and alcohol rehab facilities.  Though it may be unpleasant, I propose that if we want to feel the comfortable emotions in life, we have to get good at feeling the ones that are not so comfortable.

It is important to realize that uncomfortable emotions are not bad.  We all experience a myriad of emotions; some make us feel better than others.  Because of the discomfort that comes with some, many try to avoid them all together, take them out on others, or deal with them in unhealthy ways.  The trick to dealing with emotions in a healthy manner is not to get rid of them, but rather to embrace them and then let them go.  As I work with couples or individuals in therapy, I often review three simple steps to dealing with emotions:

1. Recognize: Identifying what we are feeling is the first step. If we don’t know what we are feeling, then we will not be able to do anything with it. It will unwittingly control us. When I ask a client what they are feeling they will often reply, “I’m angry.” Anger, however, is what I call a false emotion. It only exists as it attaches itself to what we originally felt. For example, if someone were to post something mean about you on social media it might make you feel hurt. What is our natural reaction to something like this? We might want to lash out at that person. This is us embracing anger instead of hurt. In this case, the anger covers up the hurt and offers the illusion that it is protecting us—that it is keeping us safe from future hurt—when all it is doing is making it so that we remain hurt. Anger is insatiable. It can never be satisfied. Have you ever felt good after embracing your anger? No. We feel even more angry. That is why I call anger a false emotion. Let anger be the first sign that you are actually feeling something else. Ask yourself the question, “What am Ireally feeling?” in order to recognize your true emotions.
2. Feel: This is the hardest step. After we have recognized that we feel hurt, for example, we usually don’t want to embrace that feeling. This goes back to not wanting to feel uncomfortable feelings. When we allow ourselves to feel these emotions, we then have power to do something with them. Consider the following example: You have a couch in your house that you really detest. This is the ugliest, most horrible piece of furniture ever created. It is so ugly that no one will touch it. How do you handle it? You can’t magically make it disappear—you actually have to pick it up and move it yourself. It seems ironic that in order to move something out of your house that you don’t like, you actually have to get closer to it and touch it. The same goes for our emotions. When we feel them (get closer to them, touch them, pick them up) then we have the power to do something with them.
3. Cope: This is the step most people want to skip straight to. We want to cope with or let go of our emotions without feeling them. But doing this can get us into trouble. When we try to cope with our emotions without first picking them up, what we are really doing is distracting ourselves from feeling something uncomfortable. This is similar to taking a blanket and covering the ugly couch in our house—it’s still there! What we choose to distract ourselves with (i.e., social media, pornography, substances, food, work) then becomes our go-to every time we feel uncomfortable, and an addiction is born. Coping with an emotion involves not forcing it to leave and not forcing it to stay. We let it go after it has run its course. Then we can do something that helps us recover—such as reading a book or talking with a friend.

Learning to deal with uncomfortable emotions can feel counterintuitive at times. Our initial response may be to react with anger or push them away.  But, as we practice embracing our feelings in order to let them go, we will develop habits that will improve our emotional health and overall internal peace.

Originally published on Utah Valley Health and Wellness

Written by: Triston Morgan, PhD, LMFT

Dr. Morgan is a director and co-owner of Center for Couples and Families, a counseling center, in Utah Valley. He is licensed as a PhD marriage and family therapist, and is originally from Oregon. He and his beautiful wife, Cristina, love to travel and see the world.

Kenneth Jeppesen joined the American Fork Center for Couples and Families in 2015. He is a master at knowing what it takes for couples to be successful in their relationships. Kenneth uses the “Gottman Method” in the counseling room and has presented all across Utah Valley on this topic. This method is based on decades of successful marital research by John Gottman. With skill and precision, Kenneth helps clients apply these findings in a way that produces happiness in relationships.

Kenneth specializes in marriage counseling, depression, anxiety and faith-based crisis counseling.