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Anxiety is NOT just in your head

11/27/2019

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As a mental health expert specializing in working with elite and professional athletes, playing a sport won't "solve" or "cure" issues related to mental health.
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What I generally observe is a disconnect occurring between the mind and body, affecting performance, and ultimately affecting emotional safety and health. This cycle circulates in one big loop, or what I love to phrase as a "pattern". 

At the same time, it is also important to recognize that an athlete is still a human being under the helmet or uniform he or she wears.
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Just because a person can compartmentalize and carry pain well does not mean it is not heavy for that person. 
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Part 1: Trauma, Dissociation, and The Brain

10/5/2019

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With Eye Movement Desensitization Reprocessing (EMDR) therapy becoming popularized as a mental health treatment, I would like to spend some time with you today talking about the various mechanisms of trauma and how it affects our brain and its functioning.

A primary question I often receive centers on the question of "what is dissociation" and "will I dissociate during EMDR?". Dissociation is a survival oriented process. Dissociation is the way the brain has the ability to take something that is so overwhelming when a patient cannot escape a stressful event and/or is caught in the freeze response.

So for example, there might be a child being hurt by a caregiver. Children are often too small to run away or fight back. They are the victim of the grown up. What the brain does during this type of scenario is that it allows the child to be there and not be there at the same time. In other words, the dissociative process of the brain is protecting the child so they can survive the experience.

EMDR therapy helps patients move through the dissociative process, which is inherent in any kind of trauma. EMDR helps the patient move through the experience with a much reduced rate of emotional arousal.

For the previous thirty years when trauma and Post Traumatic Stress Disorder (PTSD) were added to the Diagnostic Statistical Manual (DSM), it only categorized trauma as specifically large or “Big T” events. However, adverse life experiences or “little traumas” can also have a major impact on social, emotional, psychological, and physiological functioning.

I personally choose not to define trauma by “little” or “big” events. What is significant to me in my professional opinion is how the smaller, more repetitive patterns of events become recorded in the nervous system and because of its repetition, these experiences gradually accumulate in the brain.

Where in the brain does this all get stored? Please allow me to introduce to you, if you have not already learned about the amygdala. The amygdala is within the right hemisphere of the brain, known for responding to a heightened sense of arousal. The amygdala translates information that it receives from the other parts of the brain into an emotional response. This type of response can manifest in a variety of ways within the body (e.g. heightened blood pressure, more rapid breathing, blood moving from the central part of the body to the peripheral, and the release of adrenaline). ​

In my next post, I will continue to discuss two key symptom behaviors that are congruent with trauma: avoidance and rumination. Stay tuned! 
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Meeting of the Minds with Kacie Main and The Better You Podcast

9/17/2019

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I am so excited to share the news of this freshly released podcast episode with you! 
I recently sat down for a conversation with Jacksonville local, Kacie Main, who is both the author of her book "I Gave Up Men for Lent" and host of "The Better You" podcast. 
Kacie beams with joy and she is clearly passionate about learning and inspiring others. During our conversation, Kacie (with permission of course) picked my brain about my most favorite topics in mental health, including EMDR therapy, the neurobiology of trauma, and mindfulness! 
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Click here for the link to Episode 7 of my conversation with Kacie for Apple 
Click here for the link for Episode 7 of my conversation with Kacie for Stitcher

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This community continues to surprise me in the most incredible ways and I am so thrilled to be here in Ponte Vedra Beach knowing people like Kacie are here shaping the world into a better place. I know I for sure look forward to hearing more from Kacie. Something leads me to believe she is on to something special with the work she is doing. 
If you have not done so yet, please give a follow to the incredible Kacie Main Instagram account @kaciemain_writes and of course, tune into and give a follow to the podcast @thebetteryoupodcast. 
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High Performance Athletes & Mindfulness

8/5/2019

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Athletes face various challenges in their career on and off the sports field. I feel that a greater knowledge of the conceptualization of mindfulness and its impact on psychological skills could truly shift the way athletes maintain and even improve performance before, during, and after game time. In the unforgiving environment of professional sports, dysfunctional thinking can impact and interfere with performance. 

When working with professional athletes, I love collaborating with my clients to develop specific strategies to address dysfunctional thinking patterns and other challenges. Coping strategies offer athletes additional psychological opportunities to enhance his or her chances of performing at his or her highest level under very demanding, stressful, and sometimes even hostile conditions. 

Before going any further in this blog post, I believe it is important to give credit to where credit it is due. Mindfulness is popular and used generously among mental health professionals as treatment for a variety of mental health disorders, including most notably, anxiety and trauma-related disorders. My two personal favorite types of Mindfulness interventions are Mindfulness Based- Cognitive Behavioral Therapy, and Dr. Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction (MBSR). I was first introduced to Dr. Kabat-Zinn and MBSR in graduate school. Although I attended Stony Brook University, I was offered the opportunity to enroll in a research-based elective, dually offered by Columbia University and it's Advanced Consortium on "Evidence Based Practices", and in reflection, I am so happy I accepted the opportunity! 

High performance athletes can experience a variety of performance-inhibiting stressors. Most frequently, my clients come to session and process topics that induce stress such as: unrealistic expectations because of perfectionism, competition anxiety, anger and other negative emotions, fear of failure, perceived pressure, and avoidance behavior. Additionally, other factors that can negatively impact performance include: having an avoidant coping style, interpersonal problems, or life-balance difficulties. 

However, similar to the most successful surgeons, athletes have the distinct superpower to transform stressors automatically into fuel in order to meet the specific demands of the game. In other words, athletes use this automatic process, similar to autopilot as a way to use stress as energy, resulting in enhanced performance. Most frequently this superpower is an alternative label for more well-known defense mechanisms such as "compartmentalization" and "sublimation". 

So if athletes have metaphorical black belts in compartmentalizing and channeling emotional and psychological stress into elite performance fuel, why are we focusing on Mindfulness? Mindfulness focuses on changing the function, not the form of behavior, emotion, thinking, or how we experience things. Mindfulness aims to change the relationship of thoughts and emotions. Mindfulness has no desire to change the content of those thoughts and emotions.  How can this be integrated into elite sports? Perhaps breathing exercises can be introduced in a non-sport setting. Athletes can integrate mindfulness exercises directly during a big play when they focus on the breath or letting go of thoughts of pain or discomfort. One of my favorite techniques is using a body scan exercise. Again, thinking of how this can be woven into the tapestry of sport, a body scan exercise can be easily completed during the cool-down at the end of practice or training. 
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I don’t want to suggest that using mindfulness will automatically lead to major shifts in performance overnight. But down the road with further inclusion of mental health support in professional sports, I think we will start to see a happier and overall healthier group of professional athletes and role models.
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Happiness and Your Brain

6/25/2019

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Your brain is not wired to make you happy.
​Your brain is wired to have you survive
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Read that one more time: YOUR BRAIN IS NOT WIRED TO MAKE YOU HAPPY. YOUR BRAIN IS WIRED TO SURVIVE.

Generally speaking, we are taught and conditioned from a very young age that being happy all the time is "normal" and represents a standard of "good health". What I am about to share with you right now may cause some cognitive dissonance, but please try to keep in an open mind: there is no survival value in being happy. You aren't more likely to be successful. From my experience and observation as a mental health professional, I notice fear and anxiety steering the wheel for my clients, driving him her to get things done. Having fear and anxiety driving the vehicle towards completing tasks and obligations is actually pretty normal and healthy. And really, it is not all that bad if we are looking at these motivating behaviors through an evolutionary lens. Why? Your brain is programmed to get things done under the assumption he or she may have to confront an unknown perceived danger or threat.

So you might be asking, how does this have to do with happiness and survival? As our human ancestors evolved over time, they began colonizing into groups, forming communities of hunters and gatherers. Humans who would have most likely hesitated when they saw something in the woods or came across unfamiliar terrain on a hunt, were more likely to survive. Over time, this specific trait began appearing more frequently in the genetic material passed down to future generations.

Over time, the need for a higher volume of food supplies, weaponry, shelter, and children increased as a result of our human ancestors focusing more on safety and its positive impacts such surpluses would provide, ultimately ensuring the continuation of passing on the strongest genetic material to future populations. The more successful these early humans were, the stronger the genetic material would be, ensuring the continuation of a species that would evolve and continue to evolve over time to survive and adapt to changing environments and climates.

Here we are today in the modern world. Being careful often hurt us, and "threats" are not typically life threatening. This is where anxiety tends to show up in our lives. Our brains are programmed with the unique ability to process information so that we can survive. Survival includes connection, communication, and community. Your unique genetic material does not have the data to compute beating yourself up emotionally for not being a happy person.

In the experiment of life, survival is the Independent Variable (IV). Happiness is the Dependent Variable (DV). The DV is assumed to be affected by the IV, hence the term 'dependent' (its value depends on the state of the IV).
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Your Mind and Body Be-Lung Together

5/14/2019

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Breathing is seriously underrated. Did you know you could improve your mood, contain anxiety, enhance sports performance, and pump the breaks just by taking a few breaths? 

In previous posts, I have talked about the vagus nerve and parasympathetic nervous system. In short, the vagus nerve connects the brain to everything from the tongue, pharynx, vocal chords, lungs, heart, stomach, and intestines to different glands in the body that produce enzymes and hormones, influencing digestion, metabolism, and much more. 

The vagus nerve's influence on your lungs and heart and the connection to your brain is pretty awesome, considering this trio combined controls your body and governs your mind. To manage your state of mind and stress levels, all you have to do is activate the calming parasympathetic branches of the nervous system. 

Note: we typically do not have direct control over our nervous system, and we can't just press a button to turn the parasympathetic pathways on like a light switch. However, if you try to hold your breath for just a brief moment and then intentionally exhale very slowly, you can stimulate the vagus nerve and begin to feel grounded within your body and mind. 

In other words, I am encouraging you to train your breath. Swimmers are exceptionally good at this skill. Yoga is another activity that focuses on breath with movement. By actively focusing on your breath and the movements of your diaphragm, your autonomic nervous system will begin to communicate with your lungs, heart, and other organs for instant relaxation. 

Try to activate your own vagus nerve! How? Simply breathe out very slowly. Can you feel how your heart rate slows and your mind relaxes instantly? 

Although I am writing about a new skill, I am still encouraging you to learn from yourself. You are your best friend. Nobody knows you and your situation better than yourself. If and when you need the support, I will be here for you. Just let me know if I can help. 
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The Yips: What are they? And how do you know if you have them?

4/30/2019

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What are the Yips? 

The yips are technically defined as sudden motor skill failure. A perfectly executed pitch is necessary to strike out the opponent at bat; a football kicked in between the goal posts can be the game winning goal; or a single short putt is necessary to win the tournament. Suddenly the athlete's hands or feet cramp up, and the shot or pitch goes wide. There is no clear explanation as to why pro athletes become inflicted by the yips, but studies suggest the yips are due to abnormalities in the electrochemical dialogue that occurs between neurotransmitters in the brain. 

From a mental health perspective, overthinking appears to intensify the yips. In other words, concentrating too much may overshadow other important areas in the brain activated during sport, such as balance and timing. From my experience, athletes have a unique responsibility to compartmentalize on and off the field. With this in mind, sometimes the mental real estate being occupied and compartmentalized become overwhelmed. Thoughts, stressors, traumas, and underlying mental health issues such as anxiety, obsessive compulsive disorder, and post-traumatic stress disorder begin colluding with the areas of the brain that are focused specifically on sport performance. In my professional opinion, this is where I have found to be the sweet spot where athletes will get in his or her own way of performing a skill.

From my experience working with many athletes who have struggled with the yips, it is my professional opinion that athletes are not all doomed the first time they feel like they are experiencing this level of sport anxiety. I encourage coaches, athletes, and sports personnel alike to talk about the yips and mental health. Working with a mental health professional, or coach for the brain and body can greatly help athletes address the underlying issues causing the yips so he or she can get back in the game.


Signs and symptoms of the Yips:
-Physically responding in sport with jerking movements or freezing on a skill that was previously easy to execute
-Muscles feel tight or sore, interfering with ability to complete a skill
-Anxiety, tension, and feeling overwhelmed about completing a skill or task
-Performance anxiety about what others will think
-Repetitive and intrusive thoughts about the outcome of a skill and/or incompletion

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Most frequently, the first line of defense is to search for quick fixes, promising lasting results with high rate of failure and relapse.

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Beach please, I am a Therapist!

4/15/2019

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Welcome to a new week! I want to briefly revisit a really cool moment I had this past weekend. The way the sky transformed during sunset on Saturday evening reminded me of something super important: without darkness, you really can't appreciate the light. Try and repeat the words in the sentence out loud: 

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Without darkness, you really can't appreciate the light. ​

If you notice the contrast between the two images below, you can really observe how the colors in the sky become even more vivid as the sky begins to darken. With this being said, we all experience dark moments in our unique lives. As a therapist, I generally notice the most significant pain my clients have endured stems from a moment in time he or she lost hope.

Instead of taking a "what is wrong with you?" approach, I specifically become curious to learn "what is strong in you?". THAT right there is the source of light. If a client can give himself or herself permission to touch the wound and go towards the darkness just for one moment, he or she can truly begin the healing process. Gradually clients can then begin to understand his or her story with greater compassion and appreciate just how strong he or she truly is. SPOILER ALERT: therapy doesn't "make" someone stronger. Good therapy empowers a person to become self-aware and recognize that he or she already has tremendous strength. 

This is a personal thing that I do as a therapist and each therapist has his or her own style of conducting therapy: I frequently check in with my clients and evaluate the progress he or she is making in therapy. Checking in during the thick of the therapeutic process is critical in not only ensuring that a client and therapist are on the same page but to also offer a moment to pause in therapy and celebrate progress the client has made since the first session. No matter the speed or direction, progress is continuous movement towards a desired goal.  

Shift happens. 
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Jacksonville Jaguars x Pure Barre x 904

4/8/2019

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Last Saturday I was so fortunate to take part in a Pure Barre class at the Jacksonville Jaguars Flex Field. The class was led by the owners of the Jacksonville and Ponte Vedra Beach Pure Barre studios and the field was packed! Pure Barre among other activities such as looking for shark teeth, surfing, are just some of the ways I nourish my own wellness. When I am well, I am able to connect with my clients, be more attentive and creative in my work. In taking time to prioritize my own wellness, I am able to be authentic and nurture my razor-sharp ability to attune to the needs of my clients.
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Wellness is one of the critical factors in being a mental health care provider. Wellness is especially important because mental health providers are one of the primary instruments in their own work. I feel it is incredibly important to walk the talk when it comes to offering a model of wellness or self care for clients.
There are a variety of existing methods already in place to improve self-care. However, self-awareness is the first step to identify and configure a formula that will work best to create homeostasis between work, play, giving and receiving, accomplishing tasks, and doing absolutely nothing. The key to ongoing and lasting change is to pay attention to you and your body. Whatever profession you are in, the work itself can get in the way of your own wellness. And although you may be full of wellness tips for others, knowledge doesn't always translate into action for yourself. Awareness is the catalyst to change and if you can give yourself permission to change one thing, start small. Perhaps you will decide to change routine on your way home from work by practicing sets of deep breathing at each red light. Or take a moment to go outside just to feel the warmth of your sun on your skin during a bathroom break. How do you incorporate wellness into your routine? Share by leaving a comment below!

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Finding a Therapist you Vibe With

4/1/2019

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Connection between client and therapist is so important, if not the MOST important factor in any type of helping relationship. And like meeting new friends or dating, you aren't going to click with everyone and that is okay!

I feel that one of the best things about therapy is the abundance of therapists out there, and if you decide a therapist isn't a good match for you, then you don't need to go back! Of course, if you make the decision to find a new therapist, I encourage letting the existing therapist know. He or she may offer a session at no cost to you where he or she can offer a termination session. Termination is a gradual and completely NORMAL process of therapy and technically begins the first session of therapy. Your therapist should support this concept in treatment.

So where to begin? Please keep these things in mind when searching for a therapist you will vibe with:
  1. Ask friends and family if they know of or have a therapist he or she is happy with and would be able to provide referrals.
  2. Shop online and Google it! No, seriously. Google it. There are online directories such as Psychology Today and Better Help you can use to search for therapists in your area. You can also personalize your search by searching for therapists who specialize in the areas you are seeking help (e.g. Anxiety, OCD, trauma, gender, or faith-based counseling).
  3. Once you are on Psychology Today, Better Help, or looking at a Therapists' website, take a look at the photos of the therapist. I know of a saying somewhere that says, "you never get a second chance to make a good first impression". I would personally steer clear of any photos that are similar to the headshots you see in casting photos in a playbill. This also includes photos of the therapist doing other activities in his or her photos. Therapy is about YOU. It is not about the therapist who is supposed to be helping YOU. When you see his or her photo, visualize yourself in a session with him or her. You want to be able to sit across from this person without feeling any type of discomfort. Therapy, especially therapists should not feel intimidating or encourage any feeling of "being better" than you. Just because a therapist may be an expert, he or she is not the expert of YOU. Therapists are human too and your therapist should give you a sense of ease and comfort knowing he or she is your person (with good boundaries of course). If you are having any doubts about a therapist based on what you see in his or her photo, I would listen to your intuition.
  4. Shoot your shot and give a therapist or several therapists a call. Therapist shopping is normal and I encourage it! You don't want to settle for just anyone because he or she has the availability to give you an appointment. Just as you want the best doctor for your physical health or your child's health, you deserve to find the best therapist for you and or your child. Try to remember this: one shoe that pinches someone else will fit another perfectly.
  5. When you are speaking with a therapist, you may want to ask him or her some of these questions directly or do your own research. Where did he or she go to school? Did they complete a formal masters program or online certificate? If a therapist says he or she specializes in a specific type of treatment (e.g. EMDR, DBT, or CBT) is he or she certified? Or did he or she complete a basic training? Is the person a Licensed Clinical Social Worker (LCSW), Licensed Mental Health Counselor (LMHC) , Marriage and Family Therapist (LMFT), or coach? What is his or her background? Is he or she passionate about Psychodynamic and Psychoanalytic therapy? Solution-Focused therapy? Trauma-Focused Therapy? Gestalt Therapy? Does the therapist work with adolescents? couples? Does he or she accept insurance? How does payment work? Is the therapist in good standing with the state issuing him or her a license to practice? Have or has there been any complaints made against him or her to the licensing board?
  6. MOST IMPORTANTLY: NOTICE!!! Notice how you feel on the phone with the therapist. At your first appointment, notice how you feel when you are in the room with him or her. Do you feel heard when you are speaking? Do you notice the therapist talking about himself or herself more than he or she should be listening to you? Does your therapist support your goals? Does he or she practice good boundaries? Do you notice the therapist using his or her cell phone during session? Notice how you feel in that person's presence. Notice everything.
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    Author

    Amy Pope-Latham, LCSW is a clinical psychotherapist in Ponte Vedra Beach, FL.
    ​She specializes in offering Trauma-Focused Cognitive Behavioral Therapy and is a Certified EMDR therapist.
    Amy sees a variety of clients of all ages and backgrounds;
    ​However, she also works closely with elite and professional athletes. Amy specializes and is intensively trained in treating trauma, anxiety, depression,  adjustment issues, and substance addiction/recovery. 

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