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Automatic Negative Thoughts (ANTs) are those quick, reflexive interpretations that can spike anxiety, shame, anger, or hopelessness in seconds. They often arrive as a sentence in your mind (“I’m failing,” “They’re judging me,” “This will never get better”) or as a vivid image of something going wrong. In Cognitive Behavioral Therapy (CBT), we treat ANTs as hypotheses—not facts—and we learn to slow them down, test them, and replace them with more accurate, compassionate thinking. This isn’t about “positive thinking” or forcing yourself to feel fine. It’s about building a skill: noticing what your mind is doing under stress, understanding the pattern, and choosing a response that supports your well-being and your values. What are ANTs? ANTs are automatic because they show up without effort. They’re negative because they tend to tilt toward threat, loss, rejection, or inadequacy. And they’re thoughts—mental events, not objective reality. Many ANTs are shaped by past experiences, temperament, family messages, trauma, chronic stress, or perfectionistic environments. The brain is designed to scan for danger; when you’re tired, overwhelmed, or emotionally activated, it’s even more likely to default to threat-based interpretations. The tricky part is that ANTs can feel true. They often come with a body response (tight chest, racing heart, sinking stomach), and the body’s alarm can make the thought seem more believable. CBT helps you separate the thought from the fact, and the feeling from the evidence. Why ANTs matter ANTs influence emotions, behavior, and relationships. If your mind says “I’m going to mess this up,” you may procrastinate, over-prepare, avoid, or seek reassurance. If your mind says “They don’t care about me,” you may withdraw, lash out, or stop asking for what you need. Over time, these patterns can shrink your life and reinforce the original belief. The goal is not to eliminate every negative thought. The goal is flexibility: being able to notice an ANT, pause, and respond in a way that’s grounded and helpful. Common ANT patterns (cognitive distortions) CBT uses the term “cognitive distortions” to describe predictable thinking traps. Here are some of the most common ANTs: All-or-nothing thinking: “If I can’t do it perfectly, I’ve failed.” Catastrophizing: “This is going to ruin everything.” Mind reading: “They think I’m incompetent.” Fortune telling: “I already know this won’t work out.” Discounting the positive: “That doesn’t count.” Overgeneralizing: “This always happens to me.” Emotional reasoning: “I feel anxious, so something must be wrong.” Should statements: “I should be able to handle this.” How to work with ANTs: a simple CBT thought record A thought record is a structured way to slow down and examine an ANT. You can do it on paper, in a notes app, or with a worksheet. The key is to keep it specific and concrete. Situation (facts only): What happened? Who, what, when, where? Automatic thought: What did your mind say? Write it as a sentence. Emotion + intensity: What did you feel (0–100%)? (Anxiety, shame, sadness, anger, etc.) Evidence: What supports the thought? What doesn’t support it? (Aim for real evidence, not more thoughts.) Balanced thought: What’s a more accurate, fair, and helpful way to see this? If you want to go one step further, add: “What action would I take if I believed the balanced thought?” That turns insight into behavior change. Example thought record Situation: My supervisor emailed, “Can we talk later?” Automatic thought: “I’m in trouble. I’m going to get fired.” Emotion: Anxiety 85%. Evidence for: I made a mistake last week. Evidence against: My supervisor has praised my work; I’ve never been written up; “talk later” is vague and could be about scheduling or a new project. Balanced thought: “It’s possible they want to discuss the mistake, but it’s also possible it’s about something neutral. I can prepare calmly, ask for clarity, and handle feedback if it comes.” Quick tools when ANTs hit fast Sometimes you don’t have time for a full thought record in the moment. These brief tools can help you create space: Name it: “I’m having the thought that…” This simple phrase reduces the sense that the thought is a fact. Check the distortion: Is this catastrophizing, mind reading, or all-or-nothing thinking? Ask the evidence question: “What do I actually know right now?” Try a compassionate reframe: “If a friend had this thought, what would I say to them?” Common obstacles (and how to handle them) If you’ve tried reframing and it feels fake, that’s normal. A balanced thought should feel believable—not overly optimistic. Aim for “maybe” and “more likely” rather than “everything is great.” If your mind argues back (“Yes, but…”), treat that as more data. You may be bumping into a deeper core belief (for example: “I’m not safe,” “I’m not good enough,” “People leave”). In therapy, you can work at that deeper level while still practicing the day-to-day skill of catching ANTs. When to get extra support If ANTs are frequent, intense, or tied to trauma, depression, panic, or chronic pain, working with a therapist can help you build skills faster and tailor them to your nervous system and history. CBT can be especially effective when it’s personalized—identifying your most common distortions, practicing new responses, and pairing cognitive work with emotion regulation and body-based strategies when needed. With practice, ANTs become easier to spot. You may still hear them, but they won’t run the show. The win is not “never having the thought”—it’s noticing it sooner, believing it less, and choosing actions that move you toward the life you want.

Chronic pain and PTSD can shrink your world, but you are not powerless. Key points Chronic pain and PTSD often reinforce each other, but the cycle can be broken. Avoidance and catastrophic thinking make physical and psychological pain worse; active coping helps. Mindfulness and challenging unhelpful thoughts can change your pain experience. You can live a live worth living, even if pain remains part of your story. If you experience chronic pain and PTSD, you might find yourself stuck in a loop of unhelpful thinking and avoidance behaviors that backfire over time. Research shows that people with both chronic pain and PTSD have higher pain sensitivity, more psychological distress, and greater impairment than those with either condition alone (Reed et al., 2021). Often, care is siloed—physical pain managed by medical providers, psychological pain by mental health providers—missing the benefits of an integrated approach. The good news: trauma-informed strategies that address biology, thinking patterns, and avoidance together can lead to real improvements in pain, function, and quality of life. Overlap of Chronic Pain and PTSD Chronic pain and PTSD are deeply intertwined at both psychological and brain levels. Abdallah and Geha (2017) note that both conditions: Share Brain Circuits: Both involve the limbic system—especially the amygdala, hippocampus, and ventromedial prefrontal cortex, which are central to learning, memory, and emotions. Reinforce Negative Memories: Both are marked by replaying pain or trauma, reinforcing suffering. The brain overgeneralizes, warning us to avoid movement or vulnerability. Cycle of Stress and Pain: Each can trigger the other, leading to inflammation, brain changes, avoidance, and increased vulnerability. Behavioral Patterns: Avoidance, hypervigilance, and catastrophizing are common, making it harder to break the cycle. The Thoughts That Trap Us Catastrophizing—expecting or focusing on the worst—is a major risk factor in both chronic pain and PTSD. People with both conditions often feel less control, are more emotionally affected, and buy into catastrophic thinking more than those with pain or PTSD alone (Kind & Otis, 2019). Common Catastrophic Thoughts Might Include: Pain equals harm. If my pain is bad, I can’t do anything. It’s not fair! It’s my fault. It’s not safe to move. My doctors should be able to fix this—they’re failing me! I can only do what matters if I’m pain-free. When I move and it hurts, I must be damaging myself. This will always be unbearable. I am broken. There’s nothing I can do to reduce the pain. I can’t take it anymore! These thoughts are understandable, but not always accurate—and they can make symptoms worse. The Body Remembers Trauma isn’t just a memory—it’s an experience in your body. Traumatic events can leave a lasting imprint on how your nervous system processes sensations. Sometimes, pain is a re-experiencing symptom—your body’s way of remembering what your mind wants to forget. For some, symptoms like muscle tension, headaches, or gut issues are direct echoes of trauma (Kearney & Lanius, 2022). You might also feel paralyzed, unable to move or act when pain flares or memories surface. This “freeze” response is common after trauma—not a personal failure. Restoring movement, even in small ways, helps your body learn it’s no longer in danger. Kinesiophobia and Avoidance Many with chronic pain develop a fear of movement (kinesiophobia), believing activity will cause harm. This leads to less movement, more weakness, more pain, and greater disability—a vicious cycle. Avoiding movement actually increases pain and disability over time. Similarly, PTSD often leads to avoiding certain places, people, or situations, fearing they’ll trigger distress or danger. This shrinks your world, increases anxiety, and reinforces the sense you’re not safe. Avoiding trauma reminders strengthens fear and keeps symptoms alive. Harm vs. Pain: Rethinking the Connection Harm: actual tissue damage (like a broken bone or traumatic event), often accompanied by pain signals. Pain: an unpleasant sensory and/or emotional experience that could either signal harm, or reminders of harm (as in the case of chronic pain or PTSD). With chronic pain and PTSD, your body’s alarm system is stuck on high alert and is sending pain signals even when there’s no ongoing injury (Kind & Otis, 2019). Chronic pain says pain means damage; PTSD says fear means danger. Learning to distinguish between pain and harm, fear and danger, is key to reclaiming your life. Opening up to movement and experiences with low risk is called active coping. The Power of Active Coping People who use active coping—pacing activities, seeking support, facing reminders of trauma that are not actually dangerous, and challenging unhelpful thoughts—recover faster and experience less pain (Kind & Otis, 2019). Pacing is important: break tasks into manageable, time-based chunks with breaks; if pain increases, dial it down. If pain is fairly stable, see if you can gently increase over time. Gentle movement (walking, stretching, yoga) with smooth, slow breathing and self-compassion can help retrain your body and mind. Pacing is similar to exposure work in PTSD treatment. Facing safe experiences you’ve been avoiding, little by little, helps you reclaim your life. Over time, your body and mind can learn to tell the difference between danger and harm vs when fear isn’t signaling true danger and pain isn’t signaling real harm. Thoughts That Turn Down the Pain You don’t have to get rid of unhelpful thoughts—just notice them and remind yourself of what’s helpful and true. Try: This pain flare will pass. Pain isn’t always a sign of harm—sometimes my body is just scared. I can handle this moment. I’ve gotten through it before; I can do it again. I can reclaim activities, relationships, and places where I can build comfort, safety, trust, joy, and connection. I can find a pace that works for me to care for myself and maintain my health. Reflection Questions What are your most common pain-related thoughts? PTSD-related thoughts? Can you notice the exact body sensations that come with pain or trauma triggers? Are there activities you avoid because of pain? What might happen if you tried a little, safely? If chronic pain and PTSD were not calling the shots, what would you like to do? Support for Both Chronic Pain and PTSD If you are experiencing both chronic pain and PTSD, you don’t have to navigate this alone. Find a provider who understands the mind-body connection and can help you integrate your care. Look for someone willing to collaborate with your other providers and support you as a whole person. Integrated, trauma-informed care is not just possible—it’s a key step toward reclaiming your life. Jaimie L Lusk Psy.D., ABPP - website References Abdallah, C.G., & Geha, P. (2017). Chronic pain and chronic stress: Two sides of the same coin? Chronic Stress, 1, 1–10. Kind, S., & Otis, J.D. (2019). The Interaction Between Chronic Pain and PTSD. Current Pain and Headache Reports, 23:91. Kearney, B.E., & Lanius, R.A. (2022). The brain-body disconnect: A somatic sensory basis for trauma-related disorders. Frontiers in Neuroscience, 16:1015749. Reed II, D. E., Cobos, B., Nabity, P., Doolin, J., & McGeary, D. D. (2021). Comorbid chronic pain and posttraumatic stress disorder: Current knowledge, treatments, and future directions. Pain care essentials and innovations, 211-227.

The traditional office was a physical place with a heavy door and a clear exit strategy. When you left at 5:00 PM, the work stayed on the desk. Today, that door has been replaced by a glass rectangle in your pocket that buzzes, pings, and glows at 10:00 PM. We no longer "go to work"; we live inside a digital ecosystem where work is an omnipresent guest. Workplace mental health has undergone a radical transformation. It has shifted from a "nice-to-have" perk—relegated to a dusty brochure in the back of an HR manual—to a core driver of performance, retention, and organizational culture. In our current "always-on" world, defined by constant notifications and blurred boundaries, burnout isn’t an occasional crisis or a seasonal fluke. For many teams, it has become the background noise of professional life. What “Always-On” Burnout Looks Like: The Subtle Erosion Most people imagine burnout as a dramatic, cinematic collapse—a "Take This Job and Shove It" moment followed by a hasty exit. In reality, burnout is rarely that loud. It is more often a steady, quiet erosion of human capacity. People may remain “functional,” appearing in every Zoom meeting and hitting every deadline, but the internal costs are mounting. When we normalize the "always-on" state, we stop noticing the red flags because everyone around us is waving them, too. Here is how that erosion manifests: The Inability to Disengage: This is the hallmark of the digital age. It’s the "just checking one more email" habit before bed or the phantom vibration of a phone during dinner. When the brain never gets the signal that the "hunt" is over, it stays in a state of low-level hyper-vigilance. Cognitive Narrowing: As burnout sets in, the prefrontal cortex—the part of the brain responsible for creativity, empathy, and complex decision-making—begins to struggle. You might find your team making safe, repetitive choices or struggling to solve problems that would have been simple six months ago. The "Cynicism Shield": Emotional numbness or irritability isn't just a personality quirk; it’s a defense mechanism. When an employee feels they have nothing left to give, they stop caring as a way to preserve what little energy remains. The Sleep-Stress Loop: Persistent fatigue combined with "revenge bedtime procrastination" (staying up late to reclaim personal time lost during the day) creates a cycle of exhaustion that caffeine cannot fix. When these symptoms become widespread, organizations often mistake them for “the new baseline.” They assume this is just the cost of doing business in a fast-paced market. However, the downstream effects—high turnover, chronic absenteeism, expensive errors, and total disengagement—are measurable, compounding, and devastating to the bottom line. Why Mental Health Is Now a Core Business Driver The hard truth that many leaders are starting to accept is that employees do not leave their nervous systems at the home office door. Stress, anxiety, grief, and relational strain are not "personal life" issues that magically disappear when a laptop opens. They travel with people into every brainstorming session, every customer interaction, and every high-stakes leadership decision. Historically, mental health support was treated as a reactive "break glass in case of emergency" tool. You offered an Employee Assistance Program (EAP) phone number when someone was already at their breaking point. But by the time someone reaches for that number, the organization has already lost weeks or months of productivity, and the individual has likely suffered significant harm. The Performance Connection High performance requires high recovery. Professional athletes understand that the "off-season" and the hours between training sessions are where the actual growth happens. If you train a muscle 24/7, it doesn't get stronger; it tears. The same logic applies to the human brain. A workforce that is constantly red-lining will eventually stall. The War for Talent and Retention In a post-pandemic economy, workers are no longer prioritizing just the salary. They are prioritizing psychological safety and sustainable pace. Top-tier talent is increasingly moving toward organizations that demonstrate they won't burn them out in eighteen months. Well-being is no longer a perk; it is a competitive advantage in recruitment. The “Proactive Care” Model: From Crisis-Driven to Ongoing Maintenance The medical world long ago realized that preventive care is cheaper and more effective than emergency surgery. It’s time the corporate world applied that same logic to mental health. Proactive care reframes mental health as ongoing maintenance—more like the routine servicing of a high-performance vehicle than a trip to the body shop after a wreck. Instead of waiting for a breakdown, a proactive model builds the "infrastructure of resilience" into the daily workflow. In a proactive care model, support is woven into the culture: Early Pattern Recognition: Instead of waiting for a formal performance review, regular 1-on-1s should include "energy audits." How is the workload affecting the person’s ability to disconnect? The "Pre-Mortem" for Stress: Organizations can identify predictable high-stress seasons—such as a product launch, a fiscal year-end, or a reorganization—and increase support before the stress spikes. This might mean temporary "meeting-free" days or additional coaching resources during that window. Boundary Literacy: We teach employees how to use new software, but we rarely teach them how to set boundaries. Proactive care includes training on emotional regulation, communication, and how to "shut down" digitally. Holistic Support: Recognizing that stress at home (caregiving, financial strain, relationship issues) impacts work. Providing resources for the "whole person" reduces the spillover stress that leads to burnout. The goal isn’t to eliminate stress—stress is a natural part of growth and challenge. The goal is to build the capacity for recovery so that stress remains an acute event rather than a chronic condition. What Leaders Can Do This Week: Four Tactical Shifts If you are a leader looking to move from a "perk" mindset to a "core driver" mindset, you don’t need a multi-million dollar budget. You need a shift in behavior. 1. Audit “Always-On” Expectations Culture is defined by what is modeled, not what is written in the handbook. If a VP sends non-urgent emails at 11:00 PM, the "norm" is that everyone should be awake and working at 11:00 PM. The Fix: Clarify response-time norms. Use the "Send Later" function for late-night thoughts. Explicitly tell your team: "I am sending this now because it’s on my mind, but I do not expect a response until Monday morning." 2. Normalize Proactive Support Talk about therapy, coaching, and mental health maintenance the same way you talk about professional development or gym memberships. The Fix: When leaders share their own strategies for managing stress or mention their own use of coaching/therapy, it removes the "stigma tax" that prevents employees from seeking help early. 3. Train Managers as "First Responders" Managers are the front lines of company culture. They need to be trained to spot the early warning signs—withdrawals, changes in tone, or decreased participation—and respond with empathy rather than just performance metrics. The Fix: Provide managers with a script for checking in that focuses on the human: "I've noticed your energy seems a bit different lately; how can we adjust the structure of your week to give you some breathing room?" 4. Make Recovery Real "Unlimited PTO" is often a trap where no one takes time off because they don't want to look less committed than their peers. The Fix: Protect breaks. Implement "No-Meeting Fridays" or "Focus Blocks." Encourage "true" vacations where the employee is expected to delete Slack from their phone for the week. Lead by example: when you go on vacation, truly disappear. A Closing Thought: The Human Operating System When workplace mental health becomes part of the operating system—not just an "add-on" app—the results are transformative. People do better work not because they are being pushed harder, but because they have the psychological bandwidth to be brilliant. We are moving into an era where the most successful companies will be those that treat human energy as their most precious, non-renewable resource. Proactive care helps individuals and organizations move from merely surviving the digital deluge to sustaining long-term, high-impact success. The question for leadership is no longer "Can we afford to focus on well-being?" but rather "Can we afford not to?"

Learn 4 CBT strategies to improve your tolerance of uncertainty. The 'intolerance of uncertainty' is associated with health anxiety. One key strategy to improve health anxiety is to learn how to tolerate a little uncertainty about health. Learn several cognitive behavioral therapy (CBT) strategies to help improve tolerance of uncertainty. Everyone experiences uncertainty at times, and that’s normal. But for some people, the need for absolute certainty can become overwhelming, taking over daily life. This is called the “intolerance of uncertainty” (IU). IU involves interpreting uncertain situations as threatening and assuming that unknown outcomes will inevitably be negative. In other words, if you can’t be sure about what will happen, you might feel certain that the outcome will be terrible and unmanageable. People with health anxiety often have particularly high levels of IU. They may believe it’s possible and necessary to be 100% certain that they won’t experience a negative health outcome. In reality, certainty about the future is impossible, and health is no exception. Those with high IU often make three assumptions about uncertain situations: that uncertainty predicts something bad will happen, that the bad outcome will be catastrophic, and that they won’t be able to cope if it does. For example, noticing a random headache might lead to assuming it’s a brain tumor, and imagining that if it is, treatment won’t help, and the worst will happen. The good news is that IU can be addressed. The goal is to gradually become more comfortable with uncertainty, especially regarding your health. Learning to tolerate even small amounts of uncertainty can help you stop equating minor unknowns with disaster and reduce the exhausting need for complete control. To reframe your approach to uncertainty, it helps to adopt three adaptive beliefs. First, uncertain situations will probably turn out okay. Second, even if something negative occurs, it probably won’t be catastrophic. Third, even if the outcome is negative, you are likely capable of coping, and medical interventions are usually effective and manageable. Comparing these beliefs with your usual thoughts about uncertainty can reveal how much unnecessary worry and anxiety you may be carrying. The key takeaway is that tolerating uncertainty reduces the desperate need to control every health outcome. When you practice accepting uncertainty, you also reduce excessive worry, compulsive checking, and other safety behaviors that maintain health anxiety. To start building this skill, there are practical strategies you can implement right away. By taking small steps to face uncertainty and challenge catastrophic thinking, you can gradually retrain your mind to handle health-related ambiguity more calmly and confidently, ultimately reducing anxiety and improving your quality of life. Strategy 1: Identify & Challenge Thinking Errors When you have health anxiety, it’s common to jump to conclusions about symptoms, think in black-and-white terms, or assume the worst-case scenario. For example, you might notice a headache and immediately worry it’s a brain tumor, even though it’s far more likely to be something minor like tension or dehydration. These thinking errors often play out automatically and can make uncertainty feel unbearable. The key is to notice these patterns and challenge them. Ask yourself questions like: Am I assuming something bad will happen just because I don’t know the cause? Is it just as likely (or even more likely) that there is a neutral or benign explanation? Have I faced uncertainty before, and it turned out to be okay? What aspects of this situation are within my control, and what isn’t? By practicing this, you start to see that your thoughts are not always facts and that uncertainty doesn’t have to mean catastrophe. Strategy 2: Embrace the Beauty of an Uncertain World It can be terrifying to live with uncertainty, especially when it comes to health. But uncertainty also allows for surprises, growth, and unexpected joy. Imagine if your world were 100% predictable. Imagine if you knew exactly what was going to happen every day, from the taste of your food to every interaction with others. Life would be predictable and boring. Try reflecting on times when something unexpected turned out to be amazing. Maybe it was meeting someone important, getting a promotion, having a brilliant idea, discovering a new passion, or experiencing a meaningful life change. These positive experiences only happen because the outcome was uncertain. Recognizing the beauty of unpredictability can help you feel less threatened by uncertainty and more open to life’s surprises, even when it comes to your health. Strategy 3: Harness Your Existing Skills Even if you struggle with health anxiety, you already tolerate uncertainty in other parts of your life, often without realizing it. Think about the small risks you take every day: cooking new foods, walking across a busy street, sending your kids to school, or letting someone else handle a task. You accept these small uncertainties because the risks are manageable, and the benefits outweigh the potential downsides. You can transfer these skills to health-related situations. For example, you already have experience managing small amounts of risk without disaster. Remind yourself that just like other areas of life, tolerating uncertainty about health is possible. Focus on the benefits of living fully rather than trying to control every outcome. Your ability to cope is stronger than you think. Strategy 4: Practice Sitting with Uncertainty about Symptoms When you notice a new symptom, the instinct is often to get answers immediately, whether by checking online, asking loved ones, or visiting a doctor. The Waiting Experiment is a practical way to build tolerance for uncertainty. Choose a minor symptom or bodily sensation and deliberately pause before seeking reassurance or engaging in body checking. This could be for a few hours, a day, or even a week. During this time, you will likely feel an increase in uncertainty and anxiety. This is expected and is a sign that the exercise is working. By resisting the urge to seek immediate reassurance, you practice tolerating the anxiety and uncertainty that naturally arises. At the end of the period, reflect: Was the anxiety unbearable, or could you manage it? How did it change over time? Was the symptom serious, minor, or gone entirely? Repeated practice reduces compulsive behaviors and helps you see that uncertainty is tolerable and safe. Your Homework Try these strategies out this week to build your tolerance of uncertainty. It won't happen overnight, but you will likely notice improvement if you put a little work each day into strengthening this muscle. Brittney Chesworth, Ph.D., LCSW - Website - Blog -

If you’ve noticed the phrase “executive function” popping up everywhere—on social media, in school meetings, and in parenting conversations—you’re not imagining it. Interest in executive function tools and early screening for neurodivergent kids (including ADHD) has grown quickly, and many parents are asking the same questions: What does executive function actually mean? Is my child struggling? And what helps? What “executive function” really means Executive function is a set of brain-based skills that help kids manage everyday life. Think of it as the “air traffic control system” for attention, emotions, and actions. These skills help children: Start tasks (even when they’re not fun) Stay focused and shift attention when needed Remember instructions and keep track of materials Plan, organize, and manage time Regulate emotions and impulses When executive function is developing differently, kids may look “unmotivated,” “careless,” or “defiant”—when they’re actually overwhelmed, stuck, or working much harder than it appears. Why interest is rising right now There are a few reasons families are hearing more about executive function and ADHD than ever before: More awareness of neurodiversity: Parents and educators are learning that brains develop in different ways—and that support can be tailored rather than one-size-fits-all. School demands have increased: Organization, multi-step assignments, and independent work show up earlier, so executive function challenges become more visible sooner. Families want earlier answers: Many parents are trying to avoid years of “wait and see” when a child is clearly struggling. Tools are more accessible: Checklists, planners, apps, and coaching strategies are widely shared—sometimes helpful, sometimes overwhelming. Executive function challenges can be a sign of ADHD (but not always) ADHD is often described as a difference in attention regulation and impulse control—but at its core, it’s closely tied to executive function. Many kids with ADHD struggle with starting, sustaining, and finishing tasks, especially when the task is boring, complex, or emotionally loaded. At the same time, executive function challenges can also show up with anxiety, learning differences, sleep issues, sensory processing differences, giftedness, or stress. That’s why early screening and a thoughtful evaluation can be so valuable: it helps you understand the “why,” not just the behavior. What parents can watch for (by age) Every child has off days. Patterns over time are what matter. Here are a few common signs that executive function support may be needed: In preschool/early elementary: Big reactions to small frustrations; difficulty calming down Trouble following multi-step directions Frequent “forgetting” (shoes, jacket, lunchbox) beyond what seems typical In later elementary/middle school: Homework takes far longer than expected (even when they understand it) Difficulty planning projects or studying without heavy adult support Losing track of assignments, materials, or time In high school: Avoiding tasks until the last minute, then panicking Strong ideas but difficulty turning them into finished work Burnout, shame, or anxiety tied to school performance A gentle note about “tools” Executive function tools can be wonderful—visual schedules, timers, routines, checklists, and coaching strategies. But tools work best when they match your child’s brain and your family’s real life. If you’ve tried “all the tips” and nothing sticks, that’s not a parenting failure. It often means your child needs a different kind of support—one that addresses attention, emotion regulation, learning needs, or underlying stress. Why early screening can help Early screening doesn’t label a child—it clarifies what’s going on. When families understand a child’s strengths and challenges earlier, they can: Reduce conflict and power struggles at home Advocate for the right supports at school Build skills without relying on shame or constant pressure Protect self-esteem by naming the struggle accurately Next steps: learn more and get support If you’re wondering whether ADHD or executive function challenges may be part of your child’s story, you don’t have to figure it out alone. Learn more about ADHD and children on our website, and reach out when you’re ready to talk about next steps. If you’d like, share what you’re noticing—school, home routines, emotions, or attention—and we can help you think through what kind of screening or support fits best.

Understanding the signs of depression is crucial for early intervention and support. Depression is more than just feeling sad or having a bad day. It is a serious mental health condition that affects how a person thinks, feels, and handles daily activities. Recognizing the signs early can make a significant difference in recovery and quality of life. Common Signs of Depression to Watch For Depression can manifest in many ways, and its symptoms vary from person to person. Here are some common signs that may indicate someone is struggling: Persistent sadness or low mood: Feeling down most of the day, nearly every day. Loss of interest or pleasure: No longer enjoying activities that were once fun or meaningful. Changes in appetite or weight: Significant weight loss or gain without trying. Sleep disturbances: Trouble falling asleep, staying asleep, or sleeping too much. Fatigue or loss of energy: Feeling tired even after rest. Feelings of worthlessness or guilt: Harsh self-criticism or blaming oneself for things out of control. Difficulty concentrating: Trouble focusing, making decisions, or remembering things. Physical symptoms: Unexplained aches, pains, or digestive problems. Thoughts of death or suicide: Expressing a desire to die or self-harm. These signs can be subtle or obvious, and they often interfere with daily life. If you notice these symptoms lasting for more than two weeks, it may be time to seek professional help . A quiet park bench symbolizing solitude and reflection How to Differentiate Normal Sadness from Signs of Depression Everyone experiences sadness or stress at times, but depression is different. Here’s how to tell the difference: Duration: Sadness usually fades with time or changes in circumstances. Depression lasts longer and may not improve without treatment. Intensity: Depression often causes intense feelings of hopelessness or despair that affect daily functioning. Physical impact: Depression can cause physical symptoms like fatigue and changes in appetite, which are less common in normal sadness. Impact on life: Depression interferes with work, relationships, and self-care, while sadness typically does not. If you or someone you know is struggling to manage these feelings, it’s important to reach out for support. How do you explain depression to someone? Explaining depression to someone who may not understand it can be challenging. Here are some tips to communicate effectively: Use simple language: Avoid medical jargon. Explain that depression is a medical condition, not a weakness or character flaw. Share examples: Describe how depression affects mood, energy, and thoughts. For example, "It’s like feeling tired and sad all the time, even when there’s no clear reason." Emphasize it’s common: Let them know many people experience depression and that help is available. Encourage empathy: Ask them to imagine feeling hopeless or exhausted every day. Offer resources: Suggest professional help or reliable information sources. Being patient and compassionate during this conversation can help reduce stigma and encourage understanding. A notebook symbolizing reflection and understanding Practical Steps to Support Someone Showing Signs of Depression If you recognize signs of depression in a friend, family member, or colleague, here are ways to offer support: Listen without judgment: Let them share their feelings openly. Encourage professional help: Suggest they talk to a therapist or counselor. You can share resources like this link for finding local support. Offer to help with daily tasks: Small gestures like cooking a meal or running errands can ease their burden. Stay connected: Regular check-ins show you care and reduce feelings of isolation. Be patient: Recovery takes time, and setbacks may happen. Educate yourself: Learn more about depression to better understand what they are going through. Supporting someone with depression requires empathy and ongoing commitment. When to Seek Professional Help Recognizing when professional intervention is necessary is vital. Seek help immediately if: The person talks about suicide or self-harm. They show signs of severe withdrawal or inability to care for themselves. Symptoms worsen or do not improve with time. There are physical health concerns related to their mental state. Mental health professionals can provide diagnosis, therapy, and medication if needed. Early treatment improves outcomes and helps prevent complications. Moving Forward with Awareness and Compassion Recognizing the signs of depression is the first step toward healing. Whether for yourself or someone you care about, understanding these signs can lead to timely support and recovery. Remember, depression is a treatable condition, and no one has to face it alone. If you or someone you know is struggling, consider reaching out to a mental health professional. Resources like this link can help connect you with qualified therapists who provide compassionate care. Taking action today can make a lasting difference in mental health and well-being.

Nail biting is an overlooked body-focused repetitive behavior (BFRB). Key points Nail-biting is a common BFRB that causes real harm but is often dismissed as a harmless habit. Onychophagia has complex roots—emotional, neurological, and behavioral—not just stress or boredom. Evidence-based treatments can help reduce nail biting and improve quality of life. Nail-biting deserves the same clinical attention and compassion as other body-focused repetitive behaviors. When body-focused repetitive behaviors (BFRBs) are discussed, the conditions that typically come to mind include trichotillomania (hair pulling) and excoriation disorder (skin picking). However, one of the most prevalent—and often underaddressed—is onychophagia, or chronic nail biting. Though frequently dismissed as a harmless habit, onychophagia can significantly affect both physical health and emotional well-being. Understanding Onychophagia While many individuals engage in occasional nail biting, particularly during periods of stress or boredom, chronic nail biting can be distressing in its persistence and compulsivity. For those affected, the behavior may be automatic and or difficult to control. Over time, it can lead to visible physical damage, including infections, dental problems, and changes to nail structure, as well as psychological distress resulting in shame, anxiety , and social withdrawal. Despite its prevalence, onychophagia is often trivialized or dismissed as a simple nervous habit. In reality, when it leads to significant impairment, chronic nail biting falls within the spectrum of BFRBs, alongside conditions such as trichotillomania and excoriation disorder. Like these related disorders, onychophagia is driven by complex psychological and neurological factors. It is a legitimate psychiatric disorder that merits recognition, understanding, and appropriate care. What Drives Nail-Biting? Like many BFRBs, onychophagia is heterogeneous and is thought to arise from a combination of genetic, neurological, emotional, and environmental influences. Common contributing factors include: Emotional Regulation : Nail biting may serve as a means of managing anxiety, tension, or overstimulation, and can also provide stimulation during periods of boredom. Perfectionism and Grooming Behaviors: Individuals may feel compelled to correct perceived imperfections, such as uneven nails, triggering a cascade of repetitive grooming actions. Sensory and Motor Components: The tactile sensation of nail biting may be inherently soothing or satisfying. Over time, the behavior can become a reinforced pattern. Neurobiological and Genetic Links: Research suggests that BFRBs may share genetic and neurological similarities with conditions such as obsessive-compulsive disorder, attention-deficit/hyperactivity disorder , and Tourette syndrome. The Consequences of Chronic Nail-Biting While onychophagia is frequently perceived as socially acceptable or benign, the long-term effects can be significant: Dental Complications: Chronic nail biting may contribute to misalignment, enamel wear, and even fractured teeth. Infections: Repeated biting can damage the skin around the nails, creating entry points for bacteria and leading to painful infections such as paronychia. Gastrointestinal Risks: The introduction of bacteria through oral contact with the nails may increase the likelihood of gastrointestinal illness. Psychosocial Effects: Individuals often experience embarrassment or shame related to the appearance of their hands, which can lead to avoidance of social interactions or professional situations. Other Lesser-Known BFRBs But nail-biting, hair-pulling, and skin-picking are not the only BFRBs. BFRBs encompass a group of self-grooming behaviors that result in damage to the body, despite repeated efforts to reduce or stop the behaviors. Other lesser-known BFRBs include: Onychotillomania (nail-picking, manicuring): Recurrent picking or excessive grooming of nails, often causing pain or tissue damage. Lip Biting: Persistent biting of the lips, which can result in sores, scarring, or discomfort. Cheek Biting: Habitual biting of the inner cheeks, leading to tissue damage, swelling, or irritation. Tongue Chewing: Repeated chewing of the tongue can cause soreness, bleeding, or lesions. Treatment and Management Strategies Onychophagia cessation requires more than simple willpower. A variety of therapeutic strategies are effective: Habit Reversal Training: This behavioral approach involves increasing awareness of triggers, adjusting the environment, and replacing them with a less harmful, competing response. Use of Physical Barriers: Methods such as applying bitter-tasting nail polish, keeping nails trimmed, or wearing gloves can help interrupt the habit loop. Sensory Substitution and Mindfulness: Engaging in alternative sensory activities (using textured objects, chewing gum, or mindfulness practices) can fulfill similar needs without causing harm. Cognitive Behavioral Therapy: CBT addresses the emotional, cognitive, and behavioral components of the behavioral pattern that may be driving the behavior. A wide range of traditional cognitive-behavioral therapy interventions, acceptance and commitment therapy skills, and dialectical behavioral therapy skills may be used to change the behavior and orient the individual toward a rich, meaningful life. Treatment of Co-Occurring Conditions: If nail biting is associated with underlying conditions such as anxiety, ADHD, or OCD, addressing those disorders can reduce symptom severity. You Are Not Alone If you or someone you care about struggles with chronic nail biting, it is important to recognize that support and effective treatment are available. While change may not happen overnight, meaningful progress is possible with the right tools and guidance. Nail-biting, like all BFRBs, is a valid and often misunderstood condition that deserves both clinical attention and compassionate support. With greater awareness and evidence-based care, meaningful recovery is not only achievable but can also foster a stronger sense of self and resilience. Marla W. Deibler Psy.D., MSCP, ABPP - website

Trauma can leave deep emotional and psychological scars that affect every aspect of life. Healing from trauma is a journey that requires patience, understanding, and the right support. Specialized therapy offers a path to recovery by addressing the unique needs of trauma survivors. This article explores how trauma therapy can help individuals regain control, find peace, and rebuild their lives. Understanding Trauma Recovery Trauma recovery involves a comprehensive approach tailored to the diverse needs of the community. Trauma can result from various experiences such as accidents, abuse , loss, or violence. Each person’s response to trauma is different, making personalized therapy essential. Specialized trauma therapy focuses on creating a safe environment where individuals can process their experiences without judgment. Therapists use evidence-based techniques to help clients understand their trauma, manage symptoms, and develop coping strategies. The Resilience Center offers a range of trauma recovery services, including individual counseling, group therapy, and family support. These services are designed to support people at different stages of healing, from immediate crisis intervention to long-term recovery. Therapy room designed for trauma recovery in Houston The Importance of Specialized Therapy for Trauma General counseling may not always address the complex effects of trauma. Specialized therapy is crucial because it targets the specific ways trauma impacts the brain and body. Trauma can cause symptoms such as anxiety , depression , flashbacks, and difficulty trusting others. Specialized therapists are trained to recognize these symptoms and use techniques that promote healing. These may include: Cognitive Behavioral Therapy (CBT): Helps change negative thought patterns. Eye Movement Desensitization and Reprocessing (EMDR) : Uses guided eye movements to process traumatic memories. Somatic Experiencing: Focuses on releasing physical tension stored in the body. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Designed for children and adolescents. These therapies help individuals regain a sense of safety and control. They also teach skills to manage triggers and reduce the impact of trauma on daily life. What is the Best Therapy Treatment for Trauma? Choosing the best therapy for trauma depends on the individual’s needs, the nature of the trauma, and their personal preferences. No single therapy works for everyone, but some treatments have shown strong results. Eye Movement Desensitization and Reprocessing (EMDR) is widely recognized for its effectiveness in reducing trauma symptoms. It helps the brain reprocess traumatic memories so they become less distressing. Cognitive Behavioral Therapy (CBT) is another highly effective approach. It helps individuals identify and change harmful thought patterns related to their trauma. Somatic therapies are beneficial for those who experience trauma physically, such as through chronic pain or tension. Many therapists combine these approaches to create a personalized treatment plan. The goal is to help clients feel safe, understood, and empowered throughout their healing journey. Therapist taking notes during a trauma therapy session How to Find the Right Trauma Therapist in Houston Finding the right therapist is a critical step in trauma recovery. Here are some practical tips to help you choose a qualified professional: Look for specialized training: Ensure the therapist has experience and certification in trauma therapy. Check credentials: Licensed psychologists, social workers, or counselors with trauma expertise are preferred. Read reviews and testimonials: Feedback from other clients can provide insight into the therapist’s approach. Consider accessibility: Choose a therapist whose location and schedule fit your needs. Trust your instincts: A good therapeutic relationship is built on trust and comfort. Houston has many resources for trauma therapy. You can start by searching for trauma therapy houston to find local providers who specialize in trauma recovery. Practical Steps to Support Trauma Healing at Home Therapy is a powerful tool, but healing also happens outside the therapy room. Here are some actionable recommendations to support your recovery: Establish a routine: Consistency helps create a sense of safety. Practice mindfulness: Techniques like meditation and deep breathing reduce stress. Stay connected: Build a support network of friends, family, or support groups. Engage in physical activity: Exercise can improve mood and reduce anxiety. Limit triggers: Identify and avoid situations that cause distress when possible. Express yourself: Journaling, art, or music can help process emotions. Remember, healing is a gradual process. Celebrate small victories and be patient with yourself. Moving Forward with Hope and Strength Healing from trauma is possible with the right support and strategies. Specialized therapy offers a path to reclaiming your life and finding peace. Whether you are just beginning your journey or continuing your recovery, know that help is available. Houston’s trauma recovery services provide compassionate care tailored to your needs. By seeking professional help and practicing self-care, you can overcome the effects of trauma and build a brighter future. If you or someone you know is struggling, consider reaching out to a trauma therapist for expert guidance and support. Your journey to healing starts today.

Love your child for who they are today, but think about tomorrow too. Key points Each parent has different values and goals for their child. You can't make your child happy or confident, but you can help them to achieve those goals for themselves. Goals like kindness, optimism, and integrity can be nurtured, but not necessarily how you think. Good parenting means helping your child gain the tools they need to make a good life. Each of us has our own ideas of what it means to live a good life. These ideas are influenced by our personality, values, culture, education, and life experience. That means that each of us who are parents has unique goals for our children, which means we also need to find our own unique approach to parenting that takes those goals into account. Some Possible Goals for Your Child It helps you be the parent you want to be if you think consciously about your long-term goals for your child, and use those goals to guide you in your lived priorities, day by day. This is true from your child’s birth and well into their adulthood. Here are some common goals parents might have for their children. You want your child to be happy. Your responsibility is to give your child what they need to make their own happiness, but they have to take it from there. Do what you can to find your own happiness, and don’t try to take over your child’s responsibility for their own happiness. You want your child to be kind and empathetic. Some people are genetically more empathetic than others, but everyone can learn to act with kindness and empathy . Talk to your child about your feelings, and help them attune to their own. Help them learn to regulate their own emotions and behaviors in ways that take others’ feelings into account. You want your child to be optimistic. Encourage an attitude of gratitude , and your child is likely to be more positive and optimistic, as well as more energetic, enthusiastic, empathetic, resilient, and mindful. You want your child to be honest. Support your child in understanding how honesty and integrity are better choices than lying, cheating, or stealing. If your child behaves dishonestly, focus on your connection with your child, not on the lie, the cheating, or the theft. Help your child learn that trust, openness, and respect feel a lot better than getting away with stuff or having new things. You want your child to be responsible. Give your child as much age-appropriate responsibility as you can, as early as you can. Household chores are a great way to do that. Chores not only help your child become responsible, but also lead to increased competence, confidence, resiliency, pride, and family connection. You want your child to be resilient. It’s obvious how some of the goals described here (think positivity or responsibility) support your child in becoming resilient. You may not realize, however, that daydreaming, unstructured play, outdoor discovery, and creative exploration also help you in your goal of raising a resilient child. You want your child to be healthy, strong, and fit. Aiming for good health means ensuring your child experiences g ood nutrition, enough sleep, and lots of exercise and outdoor play . It also means you eating and sleeping well, in addition to getting exercise and spending time outdoors yourself. You want your child to be intelligent. A curious, well-developed, and well-disciplined mind is an advantage in most activities, from school to work to relationships. Raising intelligent kids is simpler and more basic than many parents realize. It's not about buying expensive toys, providing challenging academic activities starting in infancy, or sending your child to an expensive school. Quite the reverse—it's all about taking good care of yourself, and slowing down so you can be loving and present. You want your child to be creative. Children who learn to be creative have a stronger sense of well-being, are less anxious , more resilient, and have stronger immune systems. Creativity begins when your child finds something that engages their interest, so pay attention to your child’s curiosities and enthusiasms, and support them in developing those interests into abilities. You want your child to be confident. Your child’s confidence is built on experiences of competence in areas they both value and find challenging. Encourage your child to welcome difficulties as opportunities for learning , not as insurmountable obstacles. Be positive about your child’s strengths—especially persistence in the face of challenges and failures—but resist any temptation you might have to praise too easily or too often. You want your child to have good relationships. Living happily with others is a skill that will enhance every dimension of your child's life going forward. Model how to show respect to family, friends, neighbors, and strangers. Listen to your child when they describe problems with others, and get help if those problems persist. You want your child to be successful in their career. Do what you can toward all these other goals, and you’re doing all you can to support your child’s successful engagement in all the challenges life brings, including building a successful career. What’s most important is that you love your child just the way they are. It’s also important, though, to be mindful of the adult they’re in the process of becoming, so you can support them in creating the life they want. Think about your priorities, and emphasize what matters most, day by day. Dona Matthews Ph.D. - website

Emotional strength is a vital part of living a balanced and fulfilling life. It helps us navigate challenges, recover from setbacks, and maintain mental well-being. Therapy offers a powerful path to unlocking this strength by providing tools, insights, and support. In this article, we will explore how therapy can help build emotional resilience, why it is important, and practical ways to cultivate it in everyday life. Understanding Emotional Strength and Its Role in Mental Health Emotional strength refers to the ability to manage emotions effectively, stay grounded during stress, and bounce back from adversity. It is not about suppressing feelings but rather understanding and regulating them in a healthy way. People with strong emotional resilience tend to experience less anxiety and depression, have better relationships, and perform well under pressure. Therapy plays a crucial role in developing emotional strength by: Offering a safe space to explore feelings without judgment Teaching coping strategies for difficult emotions Helping identify and change negative thought patterns Encouraging self-awareness and self-compassion For example, cognitive-behavioral therapy (CBT) helps individuals recognize unhelpful thoughts and replace them with more balanced perspectives. This process strengthens emotional regulation and reduces vulnerability to stress. Therapy room providing a safe space for emotional healing The Importance of Resilience Therapy in Building Emotional Strength Resilience therapy focuses specifically on enhancing a person’s ability to recover from challenges and maintain psychological well-being. It combines various therapeutic techniques to build skills such as problem-solving, emotional regulation, and optimism. The importance of resilience therapy lies in its proactive approach. Instead of waiting for a crisis, it equips individuals with tools to handle future stressors more effectively. This can lead to: Improved mental health outcomes Greater confidence in facing life’s uncertainties Reduced risk of burnout and emotional exhaustion For instance, resilience therapy might include mindfulness exercises to increase present-moment awareness or journaling to process emotions constructively. These practices help individuals develop a stronger internal foundation to withstand external pressures. What are the 7 C's of Resilience? The 7 C's of resilience provide a helpful framework for understanding the key components that contribute to emotional strength. These are: Competence - Belief in your ability to handle challenges effectively. Confidence - Trust in your own judgment and skills. Connection - Having supportive relationships that provide encouragement. Character - Possessing a strong sense of right and wrong and personal integrity. Contribution - Feeling that you can make a positive difference in the world. Coping - Using healthy strategies to manage stress and adversity. Control - Believing you have influence over your life circumstances. Therapy often targets these areas by helping clients build skills and awareness in each domain. For example, strengthening connection might involve improving communication skills or expanding social networks. Enhancing coping could include learning relaxation techniques or cognitive restructuring. Notebook showing notes on building emotional resilience Practical Steps to Unlock Emotional Strength Through Therapy Building emotional strength is a gradual process that requires commitment and practice. Here are some actionable recommendations to maximize the benefits of therapy: Set clear goals: Work with your therapist to identify specific areas you want to improve, such as managing anxiety or improving self-esteem. Practice mindfulness: Incorporate mindfulness exercises into your daily routine to increase emotional awareness and reduce reactivity. Develop healthy habits: Regular exercise, balanced nutrition, and sufficient sleep support emotional regulation. Challenge negative thoughts: Use techniques like thought records to identify and reframe unhelpful beliefs. Build social support: Engage with friends, family, or support groups to foster connection and encouragement. Celebrate progress: Acknowledge small victories and improvements to boost confidence and motivation. Remember, therapy is a collaborative journey. Being open, honest, and consistent with your therapist will enhance your growth and emotional resilience. Embracing Emotional Strength for a Healthier Future Unlocking emotional strength through therapy is a transformative experience that empowers individuals to face life’s challenges with courage and grace. By understanding the importance of resilience and actively working to build it, you can improve your mental health, relationships, and overall quality of life. Therapy offers a structured and supportive environment to develop these skills, making it an invaluable resource for anyone seeking emotional growth. Whether you are dealing with current difficulties or want to prepare for future stressors, investing in your emotional resilience is a step toward a healthier, more balanced future. Start your journey today by exploring therapeutic options and embracing the tools that unlock your inner strength.

A key to escaping pain is learning how to mute the body's response to threat. Key points All living creatures have a withdrawal response to physical pain. It allowed life to evolve. There is no automatic protective response to mental pain. Suppressing thoughts and emotions only increases the threat response and worsens repetitive thoughts . The only solution to mental pain is to turn down the heat to minimize exposure to threat physiology. Holding your hand over a hot burner triggers an immediate threat response and prompts action to address that threat. The sequence is part of the protective pain response known as the nociceptive pain system. Numerous cues of danger activate the same response. As your nervous system memorizes dangerous situations, it guides you to avoid the threats. The goal of the nociceptive system is to reduce pain, and it quickly becomes an automatic mechanism. How often must you get close to a hot stove before learning to avoid it? Some of the most intense pain arises from obstructions in internal organs. Kidney stones, gall stones, blocked coronary arteries, and bowel obstructions produce some of the worst pains imaginable. The pains indicate that you have exceeded the structural limits of your tissue or organ system. Unpleasant, threatening thoughts also send danger signals through your nervous system and are processed similarly to threatening physical stimuli. However, options for coping with them 1 are limited. Strategies include using substances to make the pain they generate more bearable; suppressing thoughts, feelings, and emotions; and developing mental rigidity as a protective barrier. 2 Our responses and mechanisms may be effective for a time, but the relentless onslaught wears you down. Your goal in addressing physical pain is to distance yourself from the source of discomfort. You wouldn’t keep your hand over a hot burner. It makes no sense to undergo counseling suggesting that the heat isn't so bad, or to prescribe medications to dull the pain, or to promote self-medication with alcohol or opioids, or to advise you to toughen up and stop complaining, or to immerse yourself in addictions or obsessive activities to distract you from the pain. Positive thinking is another method of suppressing pain, but it isn’t effective. None of these strategies makes any sense if your hand is still close to a hot burner. Yet that is often exactly how we manage mental pain. We have little to no conscious control over repetitive unwanted thoughts (RUTs), or rumination. There is no escape from them. RUTs are driven by the physiology of threat, and RUTs stimulate physiology. In this state, neurotransmitters shift from calming acetylcholine to excitatory glutamate. Immune response cells within the brain, the microglia, lead to inflammation. Among other effects, the speed of nerve conduction doubles. Pain increases. Your nervous system is hyper-reactive, and it takes less stress to trigger unpleasant danger signals. This is a bidirectional problem. What can you do? Turn down the heat! How do you turn down the heat? Calm your nervous system and then redirect your attention. While this isn't difficult, it's impossible without learning the necessary skills. The focus should be on gaining expertise in such skills rather than dwelling on pain. The concepts and strategies are accessible. A growing number of practitioners present these concepts. A key factor in healing is taking full responsibility for your pain, and learning the healing principles. You can create your own toolkit to move your body from the physiology of threat to the physiology of safety, which underlies healing, calm, and connection. Dynamic Healing I refer to such an approach as “dynamic healing.” You learn to manage adversity, more quickly, reducing its impact on your body, and to foster joy, developing new brain circuits. They are distinct, yet interconnected skill sets. The term "dynamic" is important because there isn't a fixed point at which pain permanently resolves. Some days will be great, while others may feel overwhelming, where you’ll enter a state of stress physiology regardless of your skills. You don’t have to stay in that state. How long does it take to escape pain? That is the wrong question. Rather, how willing am I to commit to a long-term daily practice? How long does it take to become a professional athlete or musician? Staying alive involves navigating threats every second. The complexity of threats is infinite. All you can do is navigate your day with the skills you possess. Being free from pain or adversity is not a human possibility. Yet somehow, we intuitively feel that we shouldn’t experience pain. Pain only worsens when you get angry about facing adversity – especially with RUTs. Getting angry turns up the heat. Consider the consequences of lacking the tools to reduce the heat generated by RUTs and other threats. Your hand is truly stuck over the stove. This is one reason pain intensifies over time even without additional trauma . It's not that you've undergone more structural damage—you are wearing down. The dynamic healing model I apply addresses: Input: circumstances The nervous system Output: physiology. These three portals are continually engaged to reduce exposure to threat physiology and enhance safety. At a specific tipping point, when immersed in abundant safety physiology, the body regenerates and heals. This is truly miraculous; life itself, including the ability to heal, is a miracle. The potential reaches far beyond any self-help methods. You can lower the heat. David Hanscom MD - website References 1. Eisenberger N. “The neural bases of social pain: Evidence for shared representations with physical pain.” Psychosom Med (2012); 74: 126-135. 2. Giommi F, et al. The (in)flexible self: Psychopathology, mindfulness, and neuroscience. International Journal of Clinical and Health Psychology (2023); 23:100381. https://doi.org/10.1016/j.ijchp.2023.100381

Stop looking back and instead gaze toward your future. Key points A person's past can direct what they think, what they feel, how they behave, and how they interact. The influence of one's past self can often be unhealthy for one's present self. Empathy, embracing humanity, forgiveness, and acceptance can help people make peace with their past selves. Taking ownership, making amends, being the best version of ourselves, and living our best life are our future. At one level, I’m always amazed at how so many of us allow our past selves to have such a big impact on who we are now and how we think, feel, and engage with our world in adulthood. At another level, I’m not the least bit surprised because our childhood experiences that shape our early selves are met by such inexperienced and naïve versions of ourselves. When we are young, we are unable to put those experiences in the context of our lives and manage the strong and unfamiliar emotions we feel. We lack the pre-frontal cortex development that would enable us to create understanding and perspective, allowing us to manage those early life experiences more effectively. It is not uncommon for me to hear people discuss their early selves using words like hate, blame, guilt, shame, embarrassment, and revulsion, even decades later. They still carry the burden of their childhoods on their shoulders and in their hearts, even though they are vastly different people now, infused with experience, insights, and perspectives that you might think would enable them to separate themselves from those less developed iterations of themselves. And, most painfully, because many people haven’t made peace with their former selves , this inability to live their adult lives based on who they are rather than who they were interferes with many aspects of their current lives including their happiness, personal growth, goal attainment, and relationships . Given these challenges, the $64,000 question is: How do you make peace with your past self so you can live a life of meaning, satisfaction, and joy with the latest version of you? In my professional and personal journeys, I have discovered eight steps you can take to find that equanimity with your earlier self that is required for you to feel that same way with your present self. 1. Empathy Empathy is where your journey to peace with your past self must begin. Without being able to feel what the younger you felt, you won’t be able to accept, much less embrace or provide succor to, that earlier version of yourself. Whatever you did or think you did when you were young, you must understand that you didn’t choose to be that way. Instead, you were a victim of your culture (e.g., family, peer, popular, societal) and just trying to survive what was, in your limited life experience, an overwhelming situation. Looking at your past self through the lens of empathy will hopefully elicit a response of “I really see and understand you now.” It can also evoke feelings of concern, caring, and compassion that will draw your earlier self toward you instead of other feelings of anger and hurt that have caused you to repel that younger you. 2. Embrace Your Humanity A key aspect of what has kept you from making peace with your past self is that you felt ashamed for who you saw, a flawed being not worthy of love or respect. Yet, it is those very qualities that you came to revile that, in fact, make you so worthy of both because those imperfections are what make us human. When you embrace your humanity, you accept that you don’t always act in admirable ways, particularly when you are young and are driven more by your unconscious urges than conscious choices. This acceptance of all aspects of your humanity—the sublime, the mundane, and, yes, even the unprincipled—relieves you of the low (and unfair) opinion you hold of yourself and, in a sense, absolves you of your perceived sins (used in the secular sense of the word). In doing so, you remove the painful emotions I described above that you have felt for your past self for so many years. I use the word “embrace” deliberately because, after perhaps decades of distancing yourself from your past self, giving that earlier you the cold shoulder for being the awful person you believed yourself to be (which only added insult to injury), you can now give your younger self the literal and metaphorical embrace you have yearned for for so long and, along with it, the love you craved then and have craved ever since. 3. Forgiveness From the first two steps, empathy and embracing your humanity, you can now forgive yourself for the perceived transgressions of your youth. You weren’t a bad person by birth or upbringing. You didn’t choose or intend to do bad things. Instead, you were vulnerable, impressionable, in need, and knew no other way to act. As I said above, you were a victim and just trying to manage an untenable situation. Your younger self deserves to be forgiven. And, perhaps even more, so does your current self for carrying the weight of your former self on your shoulders for so long. 4. Acceptance With empathy, embracing your humanity, and forgiveness comes acceptance . You were who you were, you did what you did, and there is nothing you can do to rewrite the past. You have likely suffered sufficiently for your wrongs with perhaps daily self-flagellations and certainly a particularly painful kind of long psychic imprisonment. Accept your past self and then move on. It’s time to grant your past self-parole because, just by being on this journey, you are demonstrating that you have been rehabilitated. Though you can’t change the past, you can create a future that can help you atone for that past. 5. Ownership The four previous steps don’t free you of responsibility for your actions when you were young. You may have acted badly and hurt others. You do not get a “get out of jail free” card just for forgiving and accepting yourself. That might make you feel better, but it doesn’t reverse the harm you may have inflicted on others. To make peace with your past self, you must take what may be the most uncomfortable course of action, namely, to own what you did and take full responsibility for your early behavior (“I did that, I was wrong, and I am so sorry”). That willingness to own your past shows tremendous strength and bodes well for owning your future. 6. Make Amends Wouldn’t it be wonderful to be able to go back in time and correct everything you did that you regretted? Unfortunately, you don’t have that transtemporal capability, at least not for going back in time. But you do have that seemingly magical capacity to go forward in time, and that is where you can make amends. Until you develop the ability to travel back in time, the future is the only place to redeem yourself with good deeds. 7. Be the Best Version of Yourself Another aspect of your ability to alter the future is to make intentional choices to not be the person you once were and to be the person you wish you had been in the past. Who do you want to be? What values do you wish to live by? What attitudes and beliefs do you want to guide your life? And, ultimately, what impact do you want to have on your world? From these deliberations, you will identify and can then strive to be the best version of yourself. 8. Live Your Best Life When you make peace with your earlier self, you remove the weight of your past from your shoulders and are liberated to live your best life. What does “best life” mean? That is a question that is deeply personal, and only you can answer. Defining and operationalizing your “best life” can come from profound explorations of what meaning and purpose you attach to life, what values you prioritize, what your aspirations are, what you find fulfilling, and what brings you joy and contentment. Once you answer these deep questions, you will have a clear path toward who you want to be and what you want to do in the present and into the future. And when you continue your journey with those questions answered, you truly leave your past behind you and can chart a course toward a remarkable future.