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Alchemizing Fear: From Enemy to Ally

Posted on by Mountain Valley Treatment Center

Last week, on the Fear Less Podcast, we released Episode #36: “Fear, Fatherhood, and Transformation: Zack’s Journey to Becoming Dad.” In this episode, I reflected on the biggest life transition I have made to date—becoming a father. In my reflection, I talk about the role fear and anxiety played throughout my journey into fatherhood, and how impactful my fear was in helping me refine who I am and who I wanted to be as a father.

For many of us, we have an adverse relationship with fear. We associate fear with being an enemy—something that taunts us, holds us back, and keeps us small. And for many of us, we have good reason to feel this way. Fear and anxiety are incredibly powerful and incredibly uncomfortable to feel. Fear can be all-consuming to the body and mind, leading us to think thoughts we don’t want to think, feel sensations we don’t want to feel, or take actions we don’t want to take.

For many of us, when we feel fear, we feel trapped. Its all-consuming nature paralyzes us and we become enslaved, losing our sense of agency and no longer able to act as freely as we desire. As commonly quoted from the bestselling book series and now Academy Award-winning movie, Dune, “Fear is the mind-killer.”

However, if you are familiar with the book or the movie series, you will remember that this quote is part of a larger mantra that goes like this:

“I must not fear. Fear is the mind killer. Fear is the little death that brings obliteration. I will face my fear and I will allow it to pass over me and through me. And when it has gone past, I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain.”

I love this mantra, as I think it aligns with my personal experiences with fear, Mountain Valley’s philosophy on fear, and the ethos of the Fear Less Podcast: it is not about being fearless, but it is about making your fear less.

We don’t want fear to go away. We don’t want to avoid it. We don’t want to get rid of it. We want to acknowledge it, we want to face it, we want to lean into it, and we want to learn from it. In fact, most of the time, on the other side of fear is a better, more refined version of you.

Fear can be an incredible teacher and a catalyst for personal growth. Fear is the part of us that shows us where things might go wrong, so we can try to make things right. Fear is the mirror that reflects back to us the things we need to change. Fear can be an ally rather than an enemy, a friend rather than a foe.

But fear needs to be in its proper place. It can’t be in the driver’s seat; it needs to be in the passenger seat. Fear should be someone you bring along with you to inform your decisions, not the final decision-maker.

Here are some thoughts on how to alchemize fear for transformation:

Face It – When you feel fear coming on, look at it. Really look at it. Ask yourself, “What am I afraid of? What am I afraid might happen?” Allow your mind to explore and allow it to travel to all the dark places and all the worst outcomes. Be present with what fear is trying to show you. Don’t avoid it, face it head-on.

Example from Podcast: My fear told me that I would not be a good father to my son if I continued to live my life the way I was. It showed me how my current actions would lead me to be a distant father, disconnected from my wife and my children. A man who is tired, stressed, and a shell of the passionate and loving man I once was. As hard as it was to do, I had to take time to acknowledge that, be with it, and really see that future playing out. I had to feel the pain that would cause me and cause those that I love.

Reflect Honestly – Once your fear has shown you the potential danger and all the worst things imaginable, ask yourself the honest question, “Is this true? Or could this outcome happen?” Before you do an honest, rational, and objective self-inquiry, it’s important to be in a good headspace. Being honest with yourself is very challenging, and it can be painful to come to terms with your fears and any role you may have played in them coming true. Be honest, but be kind. Taking a good look in the mirror is never easy, but always fruitful for helping you move forward.

Example from Podcast: As my fear began to show me all the ways in which I was going to fail as a father, it was painful, but many of them were true. If I continued to prioritize my work to the detriment of my relationships, my interests, and my health, I would not be able to be a good father for my son. As much as it hurt, I needed to see that and feel that to change.

Connect to Your Values – Fear can be an incredibly powerful tool for helping you establish or re-establish your values. When we are scared, what is important to us often becomes abundantly clear. Furthermore, knowing our values and what is important to us can be an incredible asset when trying to navigate the dark waters of fear. In the podcast, I talk about values serving as a compass, helping us to find our way when we feel lost. Fear, when in its proper place, can set us on the right path.

Example from Podcast: On the other side of the pain, my mind was clear as I can remember. I had taken the time to establish my values before, but through this experience of facing down my fear, they shined through more prominently than ever: Faith, Family, Service, and Health. These are the pillars that I need to build my life upon so I can become the father I was always meant to be.

Take Action – Although being with your fear and owning it is challenging, that is only half the battle. None of that matters if you don’t DO something about it. You must face your fear and move forward courageously. Once your fear connects you back to your values and highlights the pathway forward, take action towards those values and face your fears through living and being differently.

Example from Podcast: Although my son Micah has only been in our lives for five weeks, I am living differently. I am leaving work earlier to spend time with my family. I am eating cleaner and resting more. I have taken up trail running again and not a day goes by where I am not outdoors moving my body. My fear showed me where I needed to go, and although I am not there yet, I am on my way.

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A Play-Based Summer

Posted on by Mountain Valley Treatment Center

Although the impact of social media and technology on mental health, especially youth, has been in question for some time, it has become quite the “hot topic” in the public media recently. Approximately one year after issuing a public health advisory about the impacts of social media on youth mental health, on June 17th, 2024, Surgeon General Dr. Vivek Murthy published an opinion piece in The New York Times outlining the dangers of social media and the role it is playing in the youth mental health epidemic. This “call for action” was further explored in major media outlets such as NPR, ABC News, The Washington Post, and many more.

Another big reason the conversation surrounding this topic is gaining traction is the recently published book The Anxious Generation by Dr. Jonathan Haidt, which hit the public in March of 2024 and instantly became a New York Times best seller. In this book, Dr. Haidt dared to do what many other researchers and psychology experts have not: use research data to make the claim that the relationship between social media usage and mental health challenges is not merely correlational but causational. I will not get into the weeds of the research that Dr. Haidt used to make this claim, as that is not the emphasis of this article, but he has made all of his research, as well as other helpful resources for families trying to navigate the challenges of technology, available at his website. You can also simply Google Dr. Haidt’s name and you will find endless links to podcast episodes, videos, and news articles where he is featured speaking about his work.

Although the claim that social media has had a causal role in the rise of youth mental health disorders is bold and brave, my favorite part of Dr. Haidt’s new book is that he moves beyond just identifying the problem and its causes and provides realistic and tangible steps to address the issue on an individual and societal level. Here is a summary of the “collective actions” he calls for government, schools, and families to rally around:

  • No smartphones before high school
  • No social media before age 16
  • Phone-free school
  • More unsupervised, free play for children

As an Occupational Therapist (OT), the action that really hit home and appears most immediately within our control was collective action #4. As a society, we have moved so far away from the type of play that we know is beneficial and necessary for healthy human development. Play is crucial to the physical, emotional, social, cognitive, and overall well-being of all people, but especially children and adolescents. Play is where we explore, pretend, create, and discover. We learn about ourselves, we learn about others, and we learn about the world around us. Play is a place where we can try new things and fail safely, and through the process of doing that, develop resiliency and a stronger sense of self.

Anxiety, a growing concern among youth, is often exacerbated by constant connectivity and the pressures of social media. Engaging in play can serve as a powerful antidote, providing a natural and enjoyable way to reduce stress and anxiety. Through play, children can express their emotions, work through fears, and build coping mechanisms in a safe environment. Encouraging play-based activities not only promotes mental well-being but also helps in mitigating the anxiety that many children and teens experience today.

As we reach the mid-point of summer, I encourage everyone to consider how they are or are not facilitating and/or engaging in a “play-based summer.” According to the Occupational Therapy Practice Framework (2020), “play” is defined as:

“Activities that are intrinsically motivated, internally controlled, and freely chosen and that may include suspension of reality (e.g., fantasy), exploration, humor, risk-taking, contests, and celebrations.”

Although this definition is broad and gives room for including technological play (i.e. playing video games, etc.), I think given the work by Dr. Haidt and others, it is safe to say we are recommending that we make a push towards other forms of play that include “real life,” in-person experiences. Here are some suggestions on how to engage in a more “play-based summer” from the perspective of a Mental Health OT:

Allow children/teens to play unsupervised – Although this sounds scary, if you are around my age or older (born in 1994), you did it too! You went out in the neighborhood, with no phone, and you played with friends and returned at certain checkpoints (lunch, dinner, etc.). Set up some social supports in your local community and take a community approach to “watching the kids.” Let them practice independence and show them that you trust them to manage themselves. Children and teens want and need to take risks; set up a way for them to do this safely.

Allow children/teens to feel bored – All emotions and feelings have their place…on the other side of boredom is innovation and creativity. Do not structure every waking moment of your child’s life! Let them initiate and drive their own engagement.

Get outside and engage in the senses – Ride a bike to an ice cream shop…go explore a local park, creek, or river…climb a tree…jump on a trampoline…sword fight with sticks…whatever it takes, help them move, get fresh air, engage their bodies, take some risks, and explore their inner and outer worlds.

Balance fun with competition – Fun is at the heart of play. Inherent in play is the idea that things “aren’t so serious.” However, if you haven’t noticed, almost all children and adolescents are enthralled with competition. They want to know “where they fit” in the social hierarchy of the world. This is totally normal and important for them to explore. Just be sure that competition does not come at the expense of enjoyment.

Channel your inner child – If you are hoping and wanting to engage in this play-based summer with your child/adolescent, it’s time to tune in to little you. Do not bring your adult rules and “reality” to your child’s play. Let go of “the way things are” and allow yourself to “explore what could be.” The best way to do this is to follow your child’s lead; fantasy and imagination are a child’s expertise!

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Zack’s Anxiety Hacks – Facing Your Fear

Posted on by Mountain Valley Treatment Center

Fear is an inherent part of the human experience, woven into the fabric of life. It has been explored by ancient philosophers, is present in stories and myths, and is actively studied and ‘treated’ in the world of medicine and science. Fear is fundamental, and therefore, you never know when and where you might find yourself learning about it.

I recently encountered teachings about fear in two unexpected places. Although I already knew the lesson well, it was a reminder that it holds deep truth, a lesson we proudly preach at Mountain Valley. One of these moments occurred during a birthing class I attended with my wife. As we expect our first child, I was surprised to spend the first portion of our birth education course learning about the role of fear in childbirth. We discussed how the physiology of fear impacts labor and practical strategies for managing it. We also participated in two different exercises where we took time to identify our fears, list them, and share them with others in the room. “We know that naming what you fear is the first step in learning how to manage it,” stated our instructor. Wise words from the teachers at Dartmouth Hitchcock Women’s Resource Center.

The next time this message appeared was later in the week when I sat down to watch Dune on our weekly movie night. Not long into the movie, the infamous Frank Herbert quote sent chills down my spine:

“I must not fear. Fear is the mind-killer. Fear is the little-death that brings total obliteration. I will face my fear. I will permit it to pass over me and through me. And when it has gone past, I will turn the inner eye to see its path. Where the fear has gone, there will be nothing. Only I will remain.”

For those of you not familiar with the bestselling novel and Oscar-winning film, the quote above is called the “Litany Against Fear.” It is a prayer or mantra that various characters use throughout the story when facing fear. The prayer is said to help them recognize and lean into the feeling of fear, transforming it from paralyzing anxiety into a superpower – deepening their focus and attuning them to the challenges ahead.

Acknowledging your fear, not avoiding it. Leaning into it, being with it, allowing it to pass. Does any of this sound familiar? All too often, we see the fundamental principles of exposure therapy expressed and reinforced in the world around us. By facing your fears, you fear less.

But leaning into fear when you are in the thrills of it is easier said than done. No matter how true the message is or how often it is reinforced, the battle against a cascade of hormones, physiological symptoms, and intrusive thoughts is no easy feat to overcome.

At Mountain Valley, we teach residents how to lean into fear through a skill from Acceptance and Commitment Therapy called “The N’s: Name, Notice, and Neutralize.” This skill gives people a simple “1-2-3” method for overcoming avoidance, embracing their fear, and harnessing its power.

Name – Just like the exercises in my birthing class, the first step is to name your fear. Acknowledge that you are feeling scared. Name what you are afraid of and what might happen. Say it out loud, tell a friend, write it down – whatever you do, name it.

Notice – Bring your awareness to your body. Notice what you are feeling. Notice your heart beating in your chest, the feeling of the blood coursing through your veins. Look around you, find your senses, notice where you are.

Neutralize – Focus your mind. Slow things down. Take a breath and get grounded. Maybe come up with your own “Litany Against Fear” or some other affirmation that helps put fear back in its place.

Whether you’re new parents facing the anxieties of childbirth, a fictional hero in a well-known fantasy series, or a person trying to work up the courage to tell someone how you truly feel, to overcome fear, we need to face it – and by naming it, noticing it, and neutralizing it, you might just be more equipped to do so.

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Supporting Teenagers with Anxiety and ADHD

Posted on by Mountain Valley Treatment Center

Parenting a teenager comes with its own set of challenges, but when your teen is struggling with both anxiety and Attention Deficit Hyperactivity Disorder (ADHD), the journey can feel especially daunting. As therapists, educators, and caregivers, it’s essential to understand the unique intersection of anxiety and ADHD in teenagers and how to provide effective support.

Anxiety and ADHD often coexist in teenagers, creating a complex interplay of symptoms that can significantly impact their daily lives. ADHD is characterized by difficulties in attention, hyperactivity, and impulsivity, while anxiety manifests as excessive worry, fear, apprehension, and avoidance. When these conditions intersect, they can exacerbate each other, leading to heightened stress levels, decreased functioning, and an increased risk of academic, social, and emotional difficulties.

Parents and therapists should be vigilant in recognizing the signs of anxiety and ADHD in teenagers. Symptoms of ADHD may include difficulty concentrating, impulsivity, forgetfulness, disorganization, and restlessness. On the other hand, anxiety symptoms may manifest as excessive worrying, perfectionism, avoidance of social situations, somatic symptoms such as stomachaches or headaches, and difficulty sleeping.

Effective support for teenagers with ADHD and anxiety requires a collaborative approach involving parents, therapists, educators, and other supporting professionals. Collaborate on developing a comprehensive treatment plan that addresses both ADHD and anxiety symptoms, taking into account the teenager’s individual needs and preferences.

Empower teenagers to become active participants in their treatment journey. Educate them about ADHD and anxiety, helping them understand how these conditions affect their thoughts, feelings, and behaviors. Teach practical coping skills for managing stress and anxiety, such as deep breathing exercises, mindfulness techniques, and time-management strategies. Encourage teenagers to advocate for themselves and communicate their needs effectively.

Establishing Structure and Routine

Consistent structure and routine are crucial for teenagers with ADHD. Help them create a daily schedule that includes time for homework, relaxation, exercise, and social activities. Break tasks down into manageable steps and provide clear expectations to reduce overwhelm and improve focus.

Encouraging Self-Care

Encourage teenagers to prioritize self-care activities that promote physical, emotional, and mental well-being. This may include regular exercise, adequate sleep, healthy eating habits, and engaging in hobbies or activities they enjoy. Model healthy coping strategies by practicing self-care yourself and prioritizing your own well-being.

Seeking Professional Support

Encourage teenagers to seek professional support from therapists, counselors, or psychiatrists specializing in ADHD and anxiety. Therapy, such as cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP), can be highly beneficial in helping teenagers develop coping skills, challenge negative thought patterns, and reduce anxiety symptoms. Medication may also be prescribed in some cases to alleviate symptoms of ADHD or anxiety.

Fostering Open Communication

Create a supportive environment at home where teenagers feel comfortable expressing their thoughts, feelings, and concerns. Foster open communication and active listening, validating their experiences and providing reassurance during times of distress. Encourage teenagers to share their successes and setbacks, celebrating their achievements no matter how small.

Remembering Patience and Compassion

Above all, remember to approach the journey with patience, compassion, and empathy. Supporting a teenager with ADHD and anxiety can be challenging, but with understanding, support, and guidance, they can learn to navigate their challenges and thrive. Celebrate their strengths, celebrate their progress, and remind them that they are not alone on this journey.

Supporting teenagers with ADHD and anxiety requires a multifaceted approach that addresses their unique needs and challenges. By working collaboratively, empowering teenagers, establishing structure and routine, encouraging self-care, seeking professional support, fostering open communication, and practicing patience and compassion, parents and therapists can provide effective support and help teenagers reach their full potential. Together, we can navigate the journey and empower teenagers to overcome obstacles and embrace their strengths.

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When the Holidays Aren’t So Happy

Posted on by Mountain Valley Treatment Center

For many years, I’ve kept a secret from many of my friends and coworkers: I really don’t like the holiday season. For many of us, the holidays are a time of stress, anxiety, and even loneliness and isolation. Those of us who don’t naturally boil over with holiday cheer can feel alienated from the festivites around us and fear being labeled a grinch by the apparent sea of revelers around us. There is a guilt that comes with not feeling festive during the holidays, and that can drive us into a vicious circle of further anxiety and depression.

There are many reasons many of us feel less-than-merry during this time of year. Among them are:

Social Expectations: The holiday season is often associated with spending time with loved ones and engaging in festive activities. For those who don’t have close relationships or struggle with social connections, the emphasis on togetherness during this time can intensify feelings of loneliness.

Comparison with Others: The holiday season is frequently portrayed as a time of joy, family gatherings, and celebrations. Seeing others seemingly enjoying these aspects of the season can lead to feelings of inadequacy or exclusion in those who don’t have similar experiences.

Loss or Grief: For individuals who have experienced the loss of a loved one or are going through a challenging time, the holiday season can be a stark reminder of their absence. This can contribute to feelings of sadness and loneliness.

Isolation: Some people may not have a strong support system or may be physically isolated from friends and family during the holidays. This sense of isolation can contribute to feelings of loneliness.

Financial Strain: The pressure to give and receive gifts during the holiday season can be financially stressful for some individuals. Those who are unable to participate in gift-giving due to financial constraints may feel isolated or left out.

Seasonal Affective Disorder (SAD): Some people experience a form of depression known as Seasonal Affective Disorder, which tends to occur during the winter months. The lack of sunlight and colder weather can contribute to low mood and feelings of loneliness.

Unpleasant Past Experiences: Negative past experiences associated with the holidays, such as family conflicts or traumatic events, can lead to an aversion to the holiday and a reluctance to participate in festivities.

So what can we do about this if we’re feeling any or all of the above, or other related emotions during the holiday season? Coping with anxiety or sadness during the holidays can be challenging, but there are several strategies that may help improve your emotional well-being. Keep in mind that everyone is different, so it’s essential to find what works best for you. Here are some general tips that might be helpful:

Acknowledge Your Feelings: It’s okay to feel anxious or sad during the holidays. Allow yourself to acknowledge and accept your emotions without judgment. Understanding your feelings is the first step toward addressing them.

Reach Out for Support: Share your feelings with someone you trust, such as a friend, family member, or therapist. Talking about your emotions can provide comfort and support, and you may find that others can relate to what you’re going through.

Set Realistic Expectations: Don’t put excessive pressure on yourself to create a perfect holiday experience. Set realistic expectations for what you can accomplish and focus on what brings you joy rather than adhering to societal expectations.

Establish Boundaries: If certain holiday activities or gatherings contribute to your anxiety, consider setting boundaries. It’s okay to decline invitations or limit your participation in events that may be overwhelming.

Create New Traditions: If past traditions are associated with negative emotions, consider creating new ones. This can help you reshape your holiday experience in a way that feels more positive and aligned with your current needs.

Practice Self-Care: Take care of your physical and emotional well-being by engaging in self-care activities. This could include getting enough sleep, eating nourishing foods, exercising, and practicing relaxation techniques such as deep breathing or meditation.

Focus on Gratitude: Reflect on the positive aspects of your life and the things you are grateful for. Gratitude can shift your perspective and help you appreciate the good things, even during challenging times.

Limit Social Media Exposure: Comparing your holiday experience to others on social media can contribute to feelings of inadequacy or loneliness. Consider limiting your time on social media platforms if it negatively impacts your mood.

Volunteer or Give Back: Helping others can be a powerful way to lift your spirits. Consider volunteering your time or making a donation to a charitable cause. Acts of kindness can bring a sense of purpose and fulfillment.

Seek Professional Support: If your feelings of anxiety or sadness persist, consider seeking help from a mental health professional. Therapy can provide valuable support and coping strategies tailored to your specific needs.

Remember that it’s okay to prioritize your well-being and make choices that support your mental health. Taking care of yourself during the holidays can be the best gift you can both give and receive.

 

Spending time at a residential treatment program can be a challenging experience for young people. Click here to read about what the holiday season is like at Mountain Valley.

 

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Monitoring the Voice of Anxiety: “The Critic, The Coward, and The Coach”

Posted on by Mountain Valley Treatment Center

As human beings, we all have an internal voice – an inner dialogue that narrates our everyday experience, helping us to determine what is happening in our environment and dictating how we respond to the events unfolding in our life.

Our ability to have awareness of our internal dialogue is distinctly unique to the human the experience. We have evolved beyond our animal counterparts, to develop what we call in psychology, “metacognition” – or an awareness of our own thoughts and thinking processes. Monitoring our own thought processes, the way we think about ourselves and our life circumstances, is a key component to cultivating good mental health, and an integral part of conquering fear and anxiety.

In this article we will discuss three common “voices” that often arise in the face of fear: The Critic, The Coward, and The Coach. This article is meant to further develop your metacognition, helping you label and become more aware of the dialogue that consume your mind when you’re anxious. With this awareness, you can then intervene, fostering a healthier and more effective inner voice.

The Critic – This inner voice is “demanding” in nature. It has high expectations of what you “should” be able to do. In moments of fear and anxiety the inner critic can be brutal force, shaming you for what you are not capable of, which often leads you to mask your emotions, push too far beyond your limits, and eventually burnout. The inner critic is associated with an exaggerated “fight” response, except the person you are fighting is yourself. Therefore, rather than building you up, the inner critic breaks you down, leaving you less capable of approaching and conquering your fears.

Example: “You can’t speak up to your boss, he is smarter and more experienced than you. You need to work harder and establish yourself before your even qualified to voice your opinion.”

The Coward – This inner voice is “protective” in nature. It senses a threat in your environment and encourages you to step down or step away to avoid any potential pain. In moments of fear and anxiety the inner coward tells you to “be small and stay small” as means to avoid conflict, challenge, and other forms of distress. The inner coward is associated with exaggerated “flight” response, holding you back from confronting situations that could lead to your personal growth. Therefore, rather than stepping up, you step down, holding you back from achieving your potential.

Example: “You can’t speak up to your boss, if he senses any confrontation from you, he could fire you or let you go. It’s better to keep these thoughts to yourself.”

The Coach – This inner voice is “supportive” in nature. It is the balance of the critic and the coward. The inner coach responds to fear and anxiety by breaking down the threat, , assessing your skills and capacity, and providing practical steps forward on how to bridge the gap between you are capable of and what is required of you. The inner coach provides an honest evaluation of what you can currently do, while recognizing your future potential. Therefore, rather than being too hard on yourself, or to easy on yourself, the inner coach provides the necessary feedback, support, and encouragement you need to face your fears, find growth, and become all you can be.

Example: “You have feedback for your boss, but he has more knowledge in this area. You should do some research first and come to him with a list of questions related to your concerns. This will be hard but not impossible. I know you can do it.”

As you read this, I hope it became clear that the goal is to develop a strong and healthy inner coach. Therefore, when facing fear and anxiety, you want your inner dialogue to do what all good coaches do:

  • Assess the situation – Objectively break down the feared situation and the tasks that need to be completed.
  • Assess your skill set – honestly appraise your strengths and weakness as it relates to managing the feared situation.
  • Create a plan – provide practical steps that can support you in approaching the situation with confidence.
  • Express confidence – provide yourself positive encouragement and remind yourself that you are capable of growing and learning through practice and experience.

Additional Tip: If you are fortunate enough to have encountered an effective coach and are looking to further develop your own inner coach, it may be helpful to reflect on that experience and to try to channel their voice until you have become more effective at making that voice your own. If you have never had the experience receiving support from an effective coach, expose yourself to the ideas, principles, and practices of effective coaches presented in common media (books, movies, podcasts, etc.)

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Embracing Peaceful Holidays at Mountain Valley

Posted on by Mountain Valley Treatment Center

As the holiday season approaches, images of festive cheer and family gatherings flood our minds. However, for teens and young adults grappling with anxiety, obsessive-compulsive disorder (OCD) or related challenges, this time can often amplify their struggles. The bustling environment, family dynamics, and the break from routine can trigger intense anxiety episodes. In this context, Mountain Valley Treatment Center emerges as a sanctuary, offering a therapeutic alternative to the traditional holiday experience. Here’s why spending the holidays at Mountain Valley can be a transformative experience for these young individuals.

1. Empowering Through Exposure and Response Prevention

Mountain Valley Treatment Center takes a proactive approach to the amplified stress the holiday season can bring for those with anxiety, OCD, and related challenges. Instead of simply providing a refuge from triggers, the center engages young people in Exposure and Response Prevention (ERP) therapy, an evidence-based treatment highly effective for anxiety and OCD. This therapy involves gradual exposure to feared situations or thoughts, coupled with guidance on how to refrain from typical anxiety-driven responses.

In the controlled and supportive environment of Mountain Valley, ERP allows individuals to confront their fears incrementally. This approach reduces anxiety and enhances the ability to cope with triggers. By building resilience and empowering young people to face their fears with reduced apprehension, this therapy integrates specific holiday-related scenarios, under the guidance of skilled therapists. Participants learn to manage these situations, gaining confidence and tools to handle their reactions. This structured approach provides immediate relief and equips them with long-term skills for emotional stability and resilience, making the holiday season a time of significant therapeutic progress.

2. Specialized Care and Attention

The holiday season often leaves little room for the focused care required by these conditions. Mountain Valley’s experienced therapists and caregivers provide personalized attention and treatment, addressing each individual’s unique needs, a challenging task in the often hectic family holiday atmosphere.

3. Building Coping Skills in a Real-World Setting

Mountain Valley is more than a retreat; it’s a real-world learning environment. The center offers various programs and activities to build coping skills for use beyond the holidays. This immersive experience is invaluable in equipping participants to manage anxiety and OCD symptoms effectively in their daily lives.

4. Fostering Independence and Self-Confidence

Spending the holidays away from home can be empowering, allowing young individuals to develop independence and self-reliance. Mountain Valley’s safe and nurturing environment encourages steps towards managing their condition, fostering self-confidence and a sense of achievement.

5. A Community of Understanding

A significant benefit of Mountain Valley is the sense of community. Being surrounded by peers who understand and share similar challenges creates a supportive and non-judgmental environment, particularly therapeutic during a time when feelings of isolation can be pronounced.

6. Continuing Education and Growth

For young adults, the Center ensures that their educational growth continues uninterrupted. With programs accommodating their learning needs, the holiday season at Mountain Valley becomes a period of personal and academic development, rather than a stressful break.

7. Balancing Treatment with Holiday Traditions

Recognizing the importance of the holiday spirit, Mountain Valley Treatment Center thoughtfully balances its therapeutic program with the essence of seasonal celebrations. For those who wish to experience the festive cheer, the center hosts low-key holiday events on-site. These celebrations are mindfully designed to be joyful yet not overwhelming, allowing young people to engage in the festive spirit in a manner that respects their therapeutic journey. Whether it’s a serene Christmas gathering or a peaceful Hanukkah celebration, these events are infused with the warmth of the season, providing a sense of normalcy and joy.

For some, going home for a few days to celebrate with family is an integral part of their emotional and psychological well-being. Mountain Valley supports these short home visits, viewing them as opportunities to apply newly learned coping strategies in a familiar environment. This flexibility in the treatment approach underscores the center’s commitment to holistic care, blending the healing process with the valuable experiences of family traditions and warmth. By doing so, Mountain Valley ensures that the holidays can still hold a special place in the hearts of its residents, offering a blend of therapeutic progress and festive joy.

While the holidays are traditionally a time for family, for teens and young adults with anxiety, OCD, or related challenges, the unique offerings at Mountain Valley present a valuable alternative. It’s a place where the holiday season can be a time of healing, growth, and peace — a truly transformative experience that arms them with resilience and skills for the future.

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Surgeons General Connect on Mental Health at Dartmouth

Posted on by Mountain Valley Treatment Center

One of the many benefits of Mountain Valley’s beautiful location in the Upper Valley region of New Hampshire is our proximity to Dartmouth College and its world class medical school and teaching hospital. Mountain Valley’s relationship with Dartmouth provides us with many benefits, such as Dartmouth psychology interns and psychiatry fellows doing clinical rotations in Mountain Valley’s therapeutic milieu, our residents undergoing exposure work on the Dartmouth campus, and ample cultural and recreational activities for our residents to enjoy on the weekends. Occasionally, it also allows us the fortune of being first-hand witnesses to historic events such as Dartmouth hosting U.S. Surgeon General Vivek Murthy and his seven living predecessors for a panel discussion titled, “Future of Mental Health and Wellness.”

During the discussion, Murthy and his predecessors discussed their concerns about the national mental health crisis and how to combat it. This comes on the heels of Murthy releasing a new Surgeon General Advisory calling attention to the public health crisis of loneliness, isolation, and lack of connection in our country.

Murthy said that in the face of unprecedented loneliness and mental health issues, community is one of the keys to repairing the crisis. Murthy brought the conversation to the challenge of community and interpersonal connection. “For a lot of us this issue is very personal,” he said, asking the audience to raise their hands if they or someone in their lives had struggled with mental health or loneliness; almost everyone in attendance in the basketball arena raised their hand.

This discussion prompted me to reflect on how loneliness in particular can have profound and far-reaching effects on mental health, impacting various aspects of well-being. We humans are social creatures, and a lack of meaningful social connections can contribute to a range of emotional and psychological challenges, including debilitating anxiety. It is no coincidence that coming off the devastating effects of the COVID 19 pandemic and the explosion of social media and other immersive online experiences that our country is facing epidemics of both loneliness and anxiety.

Loneliness and anxiety are interconnected, and the relationship between the two can be complex. Loneliness, characterized by a perceived lack of social connection or meaningful relationships, can have various effects on anxiety.

Here are some ways in which loneliness can impact anxiety:

  • Increased Stress Levels: Loneliness often leads to heightened stress levels. The absence of social support can make it challenging for individuals to cope with life’s stressors, contributing to increased feelings of anxiety.
  • Negative Thought Patterns: Social isolation can give rise to negative thought patterns and self-perceptions. Individuals who feel lonely may be more prone to self-doubt, negative self-talk, and a heightened sense of vulnerability, all of which can contribute to anxiety.
  • Rumination and Overthinking: When individuals are lonely, they may spend more time ruminating on negative thoughts and experiences. Overthinking and dwelling on perceived social inadequacies can exacerbate anxiety symptoms.
  • Impaired Coping Mechanisms: Social connections often serve as a crucial support system for coping with life’s challenges. Loneliness can limit the availability of these coping mechanisms, making it harder for individuals to manage stress and anxiety effectively.
  • Physical Health Impact: Loneliness has been linked to various physical health issues, including increased inflammation, cardiovascular problems, and compromised immune function. The stress associated with loneliness can contribute to these health issues, potentially worsening overall well-being and increasing anxiety.
  • Social Anxiety Development: Long-term loneliness may contribute to the development or exacerbation of social anxiety. The fear of judgment, rejection, or negative evaluation can intensify in the absence of positive social interactions, further isolating individuals and perpetuating a cycle of anxiety.
  • Sleep Disturbances: Loneliness can disrupt sleep patterns. Difficulty falling asleep, staying asleep, or experiencing restful sleep can contribute to fatigue and irritability, which are common symptoms of anxiety.
  • Reduced Emotional Regulation: Social connections play a role in emotional regulation. Loneliness may impair an individual’s ability to regulate emotions effectively, leading to heightened emotional reactivity and an increased susceptibility to anxiety.

Addressing loneliness involves not only building social connections but also addressing the underlying thoughts and beliefs that contribute to feelings of isolation. Seeking support from friends, family, or mental health professionals can be crucial in breaking the cycle of loneliness and alleviating associated anxiety symptoms.

This is why the importance of group therapy, exposure and response prevention (ERP) therapy, and the therapeutic milieu approach to treatment are so invaluable in confronting the epidemic of anxiety and loneliness that is currently confronting young people across the country. ERP has many benefits, but one of the greatest in this context is breaking the cycle of avoidance. It’s important to note that the relationship between loneliness and anxiety is bidirectional. While loneliness can contribute to anxiety, individuals with anxiety may often struggle with forming and maintaining social connections, creating a vicious circle of reinforcement of maladaptive behaviors and responses.

Regina Benjamin, surgeon general from 2009 to 2013, emphasized the complex challenge of mental health issues. “Health does not occur in the doctor’s office or in a hospital alone,” Benjamin said. “It occurs where we live, where we learn, where we work, where we play, where we pray — everything that we do.” Treatment that takes place within a therapeutic residential milieu allows those struggling with anxiety to heal and learn not simply in the siloed isolation of an office, but alongside peers in a collaborative environment that enhances feelings of autonomy and self-efficacy.

When loneliness and anxiety have reached a crisis point, the therapeutic milieu fosters a sense of community and belonging. Individuals often share common experiences and goals, and the supportive environment encourages social interaction, reducing feelings of isolation and loneliness, and promoting a sense of connection. A therapeutic milieu plays a pivotal role in the holistic approach to mental health treatment. By emphasizing safety, community, and collaboration, it creates an environment where individuals can feel secure, connected, and supported on their journey toward recovery. The sense of belonging, mutual support, and normalization of daily activities within the therapeutic milieu contribute to the overall well-being of individuals receiving mental health care.

MOVING MOUNTAINS

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Interoception – Making Sense of Our Inner World

Posted on by Mountain Valley Treatment Center

As the external sensations of our world continue to become more abundant and all consuming, we often overlook the sensations of our inner world. One of the most important and foundational sensory systems we have is our interoceptive system. Interoception is our body’s internal radar of the condition of our body, conveying information about the state of what is happening within the bounds of our skin.

Our internal organs like our heart, lungs, intestines, bladder and even skin have receptors that send signals to our brain about the condition of those major organs. Interoception is our body’s ability to recognize and respond to those signals. For example, interoception includes awareness of changes in heart rate, blood pressure, body temperature, or sensations of pain, hunger, thirst, and other autonomic functions. Interoception also plays a significant role in emotional regulation, as emotions are a cascade of autonomic internal physiological responses that need our interpretation.

As with all things, when it comes to interoception, balance is key. People with limited interoception experience a disconnect between their mind and internal states, therefore they are often unaware of their emotional experiences and have challenges appropriately responding to the cues and signals their body is sending.  A common situation most of us have probably had at some point is the phenomenon of being “hangry.” When this happens, we are disconnected from our bodies and missing the cues for hunger, resulting in irritability or dysregulation. On the other hand, some people are hyperaware of their internal sensations. To provide a similar example, this is when we have a hard time focusing on a meeting or class before lunch because all we can think about how our stomach is growling and feeling empty.

Whether you have limited or heightened interoceptive awareness, building a better relationship with your body’s internal cues is valuable for emotional wellness.

Limited Interoceptive Awareness 

If you experience limited connection to your internal sensations and are often unaware of what is happening in your body, here a few ways to foster a stronger mind-body connection:

  • A guided body scan meditation that cues you to focus on the sensations happening in specific parts of your body.
  • Yoga, Tai Chi, or other movement practices that require you to be attuned to sensations such as breathing, heart rate, etc.
  • Biofeedback is the process of conducting vitals or using a heart monitor to practice recognizing what different states of arousal feel like inside your body.
  • Expand your vocabulary and practice using a variety of different language to describe your internal experiences.  Communicating a visceral experience to yourself or others can be really challenging! Practice naming and describing sensations like their location, intensity, texture, size, color, etc.

 Heightened Interoceptive Awareness 

If you experience hyperawareness, and maybe even a little anxiety about your internal sensations, engage in interoceptive exposures to develop resilience to rebuild your relationship with those internal experiences. Examples of interoceptive exposures include:

Breathing: hold your breath for 30 seconds or breathe through a straw for 60 seconds.

Heart Rate: engage in intense exercise (burpees, running up and down stairs, jumping jacks) for 30 or 60 seconds.

Dizziness: shake your head side to side for 30 seconds or spin in a chair for 30 seconds.

Derealization: Stare at yourself in a mirror for 2 minutes or stair at a wall without blinking.

Temperature: Turn the cold water in the shower for 30 or 60 seconds or sit in a sauna/steam room for several minutes.

*These can be graded up or down according to your comfort level and can be increased as you build interoceptive tolerance.*

With each exposure, try to turn towards the internal sensations that you are having or practice diffusing the from the sensation (i.e. removing judgement and objectively observing and describing what is happening). As with all exposures, the most important part is to REFLECT on your experience. What happened? What did you learn? How does experience change how you might engage with your internal sensations moving forward?

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Motion through Emotions

Posted on by Mountain Valley Treatment Center

Ever wonder why we rock babies to sleep, get dizzy when we spin, or find swinging in a hammock so relaxing?

All these activities engage our vestibular system. Although it is not commonly discussed, our vestibular system is one of our seven sensory systems (touch, smell, sight, hearing, taste, proprioception, and vestibular) and plays a vital role in our functionality from a physical, psychological, and social perspective. On the level of the body, our vestibular system helps us find a center of gravity, stay balanced, and feel grounded. From a psychological perspective, a well-functioning vestibular system helps support self-awareness, organized thinking, and stable sense of self. Due to its role in stabilizing the body and mind, it influences how we respond to our environment, including our social surroundings.

Engaging in activities that challenge the vestibular system and improve vestibular processing lead to higher levels of cognitive, emotional, and physical functioning. It is recommended that people of all ages get out to move their bodies and challenge their vestibular processing to achieve a general a sense of general well-being.

However, for the purpose of this hack, we want to equip you with ways to engage the vestibular system to quiet the mind and body during intense anxiety. Here a few simple ways to use vestibular input to soothe the nervous system:

  • Rocking– use a rocking chair, office chair, or simply sway back and forth if it is socially appropriate to do so. Focus on slow, rhythmic, movement forward and backward.
  • Swinging– set up a hammock, go to a playground, or swing on a porch swing. Focus on slow, linear movement, either front-to-back or side-to-side.
  • Yoga– engage in slow, rhythmic movement that incorporate changes body and position, challenging one’s balance.
  • Sit on an exercise ball or unstable surface– slowly bounce on an exercise ball or try to practice being still and balanced on an unstable surface such as a trampoline, balance board, or balance beam.
  • Paced walking– walk in a slow rhythmic pattern of either back and forth, a circle, or a “figure 8” pattern.
  • Ride a bike–focus on pedaling a slow, controlled, and consistent pace or bike in a circle or figure-8 pattern.

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