Sleep Better

 

 Click  to watch this video on improving sleep

Having trouble sleeping is common. You are not alone. Let’s stay hopeful and overcome this challenge.

Your body is designed to welcome sleep. It needs sleep to rejuvenate and get you ready to have a productive day when you wake up in the morning. You can start by reminding yourself the simple fact that sleep is a natural part of life, and you deserve a restful sleep. Normalizing this process can reduce the anxiety you might have about sleep.

When you are trying to sleep, by focusing on not being able to sleep or reasons behind having trouble sleeping, you probably are not going to fall sleep. When you focus on problems with sleeping, or any upsetting thoughts, you won’t feel relaxed. Such thinking can activate your nervous system and make it harder for you to go to sleep.

Instead of worrying about sleep, let’s create a supportive bedtime ritual. I am going to describe an example of such a ritual that you might find helpful.

As a start, when lying in bed, take a minute and remind yourself of few things you feel grateful about the day you just had. It could be something simple like you feel grateful for having a pleasant lunch with a colleague or having fun playing with your pet. Just a simple reminder of good things you experienced today along with feeling of gratitude is good enough. By practicing gratitude, you are starting your sleep journey on a positive note.

In general, embracing gratitude can help your body and mind shift into a calming state. A daily gratitude practice is a simple way to invite positive emotions into all aspects of your life including sleep.

 

After practicing gratitude, take a minute or two and give yourself a loving hug. Fold your arms around your body, positioning them in a way that feels comfortable, and squeeze yourself with just enough pressure to feel a pleasant sensation. All you need is just a moment of feeling good because you deserve compassion.

You can try this self-hugging practice anytime you wish because loving yourself is a foundation for loving everything else.

After the gratitude and self-hugging practices, remind yourself you are making a conscious decision to sleep. Affirm the fact that sleep is good for you. Perhaps a part of you might not want to sleep. By telling yourself that you are making a choice to sleep, and you believe a good night sleep is essential for your health, you might be able remove all doubts about not sleeping.

Again, your body is designed to welcome sleep when you need it. Sleep is one of the gifts your body offers you toward good health. So, normalize the sleep process as much as you can.

When you are in bed, instead of focusing on negative self-talk or anything else that might be on your mind, try to connect to your body in a positive way. For example, focus on the support of the mattress that your body is receiving. Our bodies love to feel supported.

By taking a deep breath and bringing your awareness to comfort and the sense of support your body is receiving from the mattress that you are lying on, you can help your nervous system shift to a calmer state. Often the anxiety about not being able to sleep can activate your nervous system and keep you awake.

Your body and mind can work in complete harmony and support your sleep. Focusing on safety, and comfort that you experience in your body, can relax your mind. Give yourself permission to smile when you feel relaxed. The act of a gentle smile can also help you to feel safe and relax before falling sleep.

After practicing this bedtime ritual, just relax and surrender to the wisdom of your body. Again, your body knows how to go to sleep and your mind supports that process. No need to overthink it. Just let yourself drift into a peaceful sleep.

What I just described is one approach to a better sleep. I hope you find it helpful. There are so much more to be said about this topic which I plan to present in upcoming talks.

On a side note, always talk to your physician for any health-related concerns including trouble sleeping. In some cases, there may be underlying medical issues that might contribute to having challenges with sleep, and it is very important to treat those issues.  

 

© Dr. Payam Ghassemlou MFT, Ph.D. is a mental health counselor in private practice in West Hollywood, California.  www.DrPayam.com

 

Authoritarianism and the Harm to Psychotherapy by Payam Ghassemlou Ph.D.

 

My journey of becoming a psychotherapist with a passion for serving the LGBT community started over three decades ago. In those days, AIDS was devastating our community, and I wanted to make a difference. I started my counseling internship at the Los Angeles Gay and Lesbian center with a focus on helping people living with HIV/AIDS. As I look back on my journey of studying psychology and becoming a psychotherapist, I am realizing an obvious point. I learned how to practice psychotherapy in a democratic society. This is a crucial point because the kind of society where mental health services being offered makes a substantial difference.

Given my experience with living or visiting other parts of the world, especially in places ruled by authoritarian regimes, I have learned psychotherapy can be a transformative process when practiced in a free society. It is difficult to help individuals reach their true potential in a closed society where fear dictates people’s lives. In places where freedom of speech is protected, it is much easier to openly discuss all external events that can impact a client’s mental health including relevant sociopolitical issues. For example, in my Los Angeles based counseling practice, I have helped many people from all walks of life including lesbians, gays, bisexuals, transgenders, and queer or questioning people to become comfortable with their identity. Learning how to love themselves despite their homophobic and transphobic upbringing has been transformative. Practicing psychotherapy in a free society makes it possible to validate my client’s pain regarding homophobia, transphobia, sexism, racism, xenophobia, Islamophobia, anti-Semitism, classism, ableism, and other degrading situations. The safety to openly discuss and condemn such obstacles is necessary for many clients’ healings process. Those of us who are trained in somatic psychotherapy and have studied the impact of trauma on the autonomic nervous system, know how hateful acts can dysregulate the nervous system. In a free society, it is much easier to help the body and mind to heal from the impact of trauma.

Since the Trump Presidency and all the divisiveness and rampant polarization that came with it, I have noticed a troubling shift in American politics. For me, the notion that someday there would be a competition between democracy and autocracy in the Unites States of America was unthinkable. Especially as a foreign-born gay man who found America as a safe refuge. I cannot imagine the possibility of living under authoritarian regime again. I know how precious democracy is because I have experienced how oppressive autocracy can be. Now, my nightmare about autocracy over democracy is beginning to feel real. The other day I found myself defending voting rights talking to another therapist who believed voting is a privilege and not a right. Moreover, I have spoken with many Fox News viewers who are willing to shift toward autocracy if such a regime would ban abortion, uphold conservative values, and keep non-White immigrants out. They do not realize what is it like living in autocratic countries like China, Russia, and Iran where people are miserably oppressed. Autocratic leaders do not care about issues like human rights, climate change, and the freedom of press. They lock up or execute anybody who challenges the way they govern. I understand the U.S. is considered a republic and not a democracy. However, no matter how I define it, America, unlike an autocratic country, makes it possible for a psychotherapist like me to provide a socially responsible way of practicing psychotherapy.

Despite of all the positive elements that make this country great, many of us are noticing disturbing situations that are jeopardizing our freedom. For example, some U.S. Supreme court judges were nominated by presidents who did not win the popular vote. These conservative judges, who do not represent the American majority, are making decisions that are negatively impacting our lives. Also, the continued use gerrymandering coupled with the voting restrictions in various states is paving the way toward totalitarianism. Many mental health therapists are concerned about the future of psychotherapy and its transformative potential as American democracy erodes. If the anti-democratic trend continues, and our freedoms keep getting chipped away, it would be only matter of time before they start policing our counseling profession. Some of us already are being restricted and controlled by some health insurance companies for greed and profit. Once a dictatorial system of government begins to dominate the U.S., it will have major impact on how we conduct psychotherapy. For one thing, I will not feel safe to freely explore how clients’ emotional pain might have something to do with the environment they live in. Also, since the mental health of the individual and sociopolitical factors are deeply intertwined, how a country is being run can impact people’s well-being. The stress of living under an authoritarian rule can lead to depression, anxiety, hopelessness, low self-esteem, and suicidal thoughts.

I hope I am wrong about U.S. democracy being replaced by an autocracy which could negatively impact the delivery of therapeutic services. Before the events of January 6, 2021, when a racist mob attacked the United States Capital, I would not have entertained the notion that U.S democracy is at risk. Now, I do. The events that led up to January 6, and the role that many far right politicians played to shape such assault on U.S. democracy has made many freedom lovers in this country alarmed. Many Americans do not feel safe knowing a major portion of the population are manipulated to believe a strong leader, who does not have to worry about oversight from Congress and elections, is good for them. Many of them believe a strong Caucasian leader can protect their European heritage, which is central to their identity, from cultural diversity. Moreover, some believe a forceful leader can protect their so-called Christian values. Some uneducated low information voters believe a Putin-like leader is necessary to stop homosexuals from turning their children gay and imprisoning doctors who provide abortion services. These individuals, who are brainwashed by right-wing media to believe in such absurdity, are part of our current problem with the rise of autocracy in the U.S.

When it comes to offering psychotherapy services, theoretical approaches are an integral part of the therapeutic process. Such theoretical approaches can provide a framework and guidance for therapists to help their clients. I believe, any psychological theories that teaches people to differentiate, and not remain a sheep in the flock is a threat to fascism or any type of dictatorial government. For example, a psychotherapist who utilizes feminist theory could have a tough time working under a fascist type of establishment since such theory focuses on gender inequality and discrimination among many other themes. Moreover, therapists who specialize in helping young people embrace their sense of curiosity, sexuality, and independence could become a threat to a system of government that thrives on repressive family structures, fear of authority, and sexual repression. Psychotherapy, as I know it, will change and therapists may no longer be allowed to help clients in cultivating a free mind. We could lose our freedom to choose our theoretical orientation when America becomes one of those autocratic countries, and any books including psychology books that are not ardent in its support of dictatorial government may be burnt.

As a cis gender gay man of color, I understand we currently have a lot of problems with racial injustice, sexism, homophobia, and transphobia in America, especially, for African Americans who have suffered so much from racial inequality. As of now, we are not a fascist state yet. I hope everyone including mental health professionals who care about freedom of speech and the right to free elections take the current push toward autocracy very seriously. Far-right hate groups in America have gotten stronger. Once we completely lose our precious American freedoms, everyone including psychotherapists may be required to adjust to the authoritarian order and submit to it. I hope that day never comes. There is still time to save American democracy.

 

 

© Dr. Payam Ghassemlou MFT, Ph.D. is a Licensed Marriage and Family Therapist (Psychotherapist), in private practice in West Hollywood, California.  www.DrPayam.com , www.SomaticAliveness.com

A Queer Perspective on Somatically Befriending Vulnerability By Payam Ghassemlou Ph.D.

 

Since being vulnerable does not always come easily to many of us, it is important to have empathy for anyone who struggles with it. The internet is flooded with writings and talks on encouraging people to show vulnerability. Having trouble expressing it often gets associated with a lack of authenticity. Such judgmental interpretations can frequently trigger shame in people who don’t feel safe enough to be vulnerable due to certain socio-demographic factors. There is a misconception that expressing vulnerability is a matter of courage or just making a mental decision. By helping others reclaim it, I have realized the issue has little to do with bravery or honesty. It has more to do with the state of one’s nervous system. By having a somatic perspective on understanding vulnerability, we can open a new path toward befriending it.

There are many different paths toward befriending vulnerability which includes using the body to build a greater capacity to embrace it. Our response to many emotional experiences can be felt in our bodies. For example, Lucas, a 30-year-old cis gender gay man, disclosed having difficulty asking guys on dates. Doing so makes him feel very vulnerable. Among other bodily reactions, he reported tightness in his chest along with uncomfortable restricted breathing when faced with uncertainty to his invitation. Lucas has a history of growing up with the stress of homophobic mistreatment. He often felt unsafe at school due to the devastating experience of being bullied or called derogatory names. Fight or flight was not an option when he was feeling helpless and hopeless dealing with his traumatic school environment. Instead, his body resorted to numbing and shutting down. This response became his default whenever faced with overwhelming situations like entering a vulnerable state. Lucas’ reactions to becoming vulnerable had nothing to do with a choice or a lack of courage. It had more to do with his body’s threat alarm being frequently on.

In general, LGBTQ children are often at risk for being bullied, and they need protection. Lucas and many other queer youngsters growing up place their trust in individuals and institutions who were supposed to protect them from harm. Failure to receive such a protection at a critical developmental phase became a source of hurt and betrayal. The trauma of growing up gay in a world that did not embrace LGBTQ identity with kindness and acceptance led Lucas and many others to associate vulnerability with fear and betrayal. Given his traumatic history, Lucas needed help learning how to feel safe in his body when becoming vulnerable. Regulation of his psychophysiological arousal in response to vulnerability has been an important healing task for Lucas, especially when it came to making connections with other single gay men.

Taking a somatic approach toward working with vulnerability involves understanding the role of the autonomic nervous system (“ANS”). The ANS is the part of the nervous system that governs the fight, flight, or freeze instinct and is responsible for the unconscious bodily functions like breathing, digesting food, and regulating the heart rate. It also plays a vital role of supplying information from our organs to our brain. This system works automatically (autonomously), without a person’s conscious effort. The ANS is central to our experience of safety, connection with others, and our ability to bounce back from life’s overwhelming experiences. Relying on neuroception, a term coined by Dr. Stephen Porges, our ANS can differentiate between safety, danger, and a life threat. Neuroception, as Deb Dana (author of The Polyvagal Theory in Therapy) explains, is automatic, and it does not go through the thinking part of our brain. Everything from sound to smell to temperature in our environment, people’s tone of voice, and eye contact can influence our neuroception. It is like “internal surveillance” that looks for cues of safety and danger inside the body, in one’s environment, and in relationship with people. It helps us take immediate action in the face of danger or threat. The goal of neuroception is to keep us safe and alive. Based on my training in Somatic Experiencing®, Touch Skills Training for Trauma Therapists, Polyvagal Theory, and other body inclusive approaches, I have learned the autonomic nervous system is a relational system that has been shaped by experience. We now know previous negative life experiences and traumas can significantly affect how our neuroception accurately assesses safety, danger, or a life threat. This can explain why many people including Lucas with history of being judged, humiliated, and violated often avoid entering a vulnerable state. Their faulty neuroception causes them to feel unsafe in the absence of real danger.  

Since “how we move through the world is guided by our ANS,” it is important to examine how growing up in a homophobic and transphobic environment negatively affected the working of  the ANS. In my counseling work with gay, lesbian, bisexual, queer identified, and transgender people who have experienced homophobic or transphobic mistreatment, I have noticed their nervous systems are often shaped toward self-protection versus making connections. Repeated past humiliation and rejection by others have made it difficult for many of them to be open and willing to love and be loved. Given the important role that ANS can play in people’s ability to embrace vulnerable situations and form relationships, it is important to learn how to regulate it. When working in a regulated way, the ANS does not enact the response to the present moment situation based on one’s past conditioning.

Autonomic regulation has less to do with talking about our past trauma events and more to do with shifting our autonomic state that can be stuck on FFF (fight/flight/freeze) toward safety and relaxation. When Lucas was invited to share about his history, it was done for the purpose of having greater empathy for his suffering and learning how fear became associated with vulnerability. Lucas’ personal stories with homophobic mistreatment was handled with care and in a titrated manner to avoid re-traumatization. In general, encouraging people to get into their trauma stories all at once can become overwhelming for them because the nervous system cannot tell the difference between the original event and the telling of the event. Healing does not always need to involve re-telling the story. As Peter Levine, the founder of Somatic Experiencing International, stated, “Trauma is not in the event, but in the nervous system.” Based on my personal and clinical work, I also concur that trauma becomes embodied during a person's life and can affect the working of the ANS. Much of the healing from this trauma needs to happen through the body. In particular, the nervous system needs to be regulated.

The work of Stephen Porges’ Polyvagal Theory has brough to light the role of the vagus nerve in how we experience safety and connection. The vagus nerve which is divided into two pathways, the dorsal vagus and the ventral vagus, is the main component of the parasympathetic nervous system. The ventral vagal of parasympathetic system plays a crucial role in our experience of safety in our bodies. Activation of the ventral vagal force in the ANS includes but not limited to awareness and tracking of pleasant bodily sensations. For example, when I invited Lucas to notice his body being supported by the couch, he commented, “I can sense my body feels relaxed and comfortable.” By bringing awareness to comfortable sensations in his body, he began to breathe deeper and noticed a sense of expansion in his chest area along with his shoulders becoming more relaxed. For Lucas, tracking bodily sensations that were comfortable invited the flow of the ventral vagal of safety and connection.

Another useful somatic intervention involved identifying and embodying helpful resources that contributed to his healing journey. For example, attending LGBTQ Pride events and volunteering at the Los Angeles LGBT+ Community Center felt empowering for Lucas. By tracking his pleasant bodily sensations as he was sharing about these helpful resources, he was creating a physiological event in his body which contributed to regulating his nervous system. As the therapy session progressed, he found it easier to imagine and plan on asking a guy he met at his gym on a date without experiencing tension in his body. Repeated awareness of pleasant sensations in his body increased his ability to distinguish sensations of distress versus sensations of well-being. The more he focused on what felt good on the inside the more his autonomic dysregulation settled, and his window of tolerance expanded.

What makes each one of us feel vulnerable is unique and personal. What feels vulnerable to Lucas can feel quite different to another. Regardless of what activates it, the admission ticket to a more meaningful life for Lucas involved embracing vulnerability. It was important for him to liberate vulnerability from years of cumulative stress of dealing with homophobic bullying, and other fearful situations that he had to endure. By welcoming vulnerability and learning how to work with its transformative power, he was able to enrich his life. A “body-inclusive” therapeutic approach offered Lucas tools and practices to lower his activation and regulate his nervous system in response to his life stresses.

 

© Dr. Payam Ghassemlou MFT, Ph.D. is a mental health counselor in private practice in West Hollywood, California.  www.DrPayam.com

*Names and other details have been changed for privacy and confidentiality.