Healthy Conflict

Recently, the New York Times lead health and science reporter Jancee Dunn took a look at the role confrontation plays in our daily lives and in our overall wellness. In her article, which can be read at nytimes.com, she interviewed Karen Osilla, an associate professor in psychiatry and behavioral sciences at Stanford Medicine. She posits that not only are disagreements inevitable, they can have benefits. Research suggests that resolving conflict in healthy ways increases your well-beinglowers stress and improves self-esteem. Productive disputes, for all their challenges, “are pathways to a bigger life,” she said.

They offer the following tips for ways that even the most conflict avoidant among us can navigate their way through healthy conflict:

Start with people you trust: If confrontation puts you on edge, practice disagreeing with people you trust, said Seo, “because honest, open-minded disagreement requires psychological safety.” Try getting comfortable saying, “I actually disagree with that,” she said. Think of healthy dissent as a muscle you can build over time, she added.

Ease into the discussion: First, take a deep breath, Dr. Osilla said, which reduces anxiety and helps you stay calm. Next, in a polite tone, concede that you don’t know the other person’s intentions. People often waste time imagining the other person’s motivations, she said, but these are impossible to know for sure. “Either way, the impact of their action is the problem you want to solve,” she said. Then, calmly share your concern, focusing on how the situation has affected you. You might say something like, “Hey, you may or may not be aware, but I’m cleaning up after your dog regularly in my yard.”

Describe your emotions: After you express the effects of their actions or words, communicate your emotions, and invite the other person to share theirs. An example would be, “I’m frustrated,” she said, or, “That comment you made stung.” Don’t bottle up your feelings, because they can manifest as passive aggression, or translate into anger or accusations, she said. “Better to name emotions,” Heen added, instead of using them to “blame and attack.”

Shift to a “learning conversation.” Once you’ve shared your feelings, have a “learning conversation” to trade perspectives and solve the problem together, Heen said. She suggested asking, “What worries or concerns you most about this?” and “What do you think I’m missing?” Listen, ask follow-up questions and suggest possible solutions, she said. If, for example, a friend keeps canceling plans, you could discover that the person has had a major life event. From there, you can brainstorm other ways to stay connected.

Remember that you can only control your actions: Even if we say everything right, we don’t have any control over how the other person will react, Dr. Osilla said. “In those moments, be compassionate with yourself,” she said. “Tell yourself: ‘I’ve said my piece. I’ve done what I can.’

Your Brain on Music

How is your summer playlist looking? According to researchers, a good list of tunes can be an important contributor to your sense of wellbeing.

In a recent NPR article, Rob Stein interviewed a team of neuroscientist at McGill University. They shared that music can evoke a sense of wonder and awe for humans by stimulating pleasure and reward centers in the brain, specifically the amygdala, ventral tegmental area and the nucleus accumbens which, in turn, produces dopamine and endogenous opioids. They share that “neurons in the brain even fire with the beat of the music, which helps people feel connected to one another by literally synchronizing their brain waves when they listen to the same song.”

As all of this happens, music can produce a calming effect, slowing our heart rate, deepening our breathing, and lowering stress hormones. This makes us feel more connected to other people as well as the world around us, especially when we start to dance together. It can even “counter the epidemic of our times, which is loneliness,” according to researcher Dacher Keltner.

So what are you listening to this summer? Need some inspiration? Below is one of Spotify’s recent top playlist. Turn it on, call over a friend, and sing along!

Trust Your Gut

The number of publications describing the brain/gut connection has increased significantly in recent years. There are consistent findings that he connection between our mind and gut isn’t just metaphorical. The mind and gut are in constant communication via the brain-gut axis, a “information superhighway” that provides updates on what’s going on at both ends. That sinking feeling you get when taking in bad news or the way your gut twists when you’re anxious or stressed is the superhighway at work.

The folks over at Calm.com recently published a full article describing this connection as well as giving some advice on how to take advantage of this connection, but also how to become more attuned to and make use of our instincts. Some of this is summarized below, but be sure to read the full article at Calm.com.

  1. Get in touch with your feelings – Research shows that the quality of your gut instincts depends on your overall emotional intelligence (EQ) aka your ability to recognize, understand and manage your emotions and the emotions of those around you. Luckily, it’s possible to strengthen your EQ, which in turn, will strengthen your intuition. In order to build your EQ, you’ll need to get more in touch with your emotions. Use the Feelings Wheel to expand your emotional vocabulary. Learn how you experience emotions with the Emotions Series and use this information to help you Label Your Emotions. Try this meditation to Check-in with Your Emotions each day, helping you stay connected to your feelings.
  2. Tune into your body – Most of the time, gut feelings express themselves through a range of sensations in the body. That may look or feel like: “Butterflies”, nausea, or turning in the stomach Clammy or sweaty palms Muscle tension or tightness Increased heart rate Tightness or sense of calm in chest Goosebumps or prickling on skin Sometimes they are faint, sometimes they are strong, but either way if you don’t take the time to slow down and tune into your body you may miss the signs. Practices like a Body Scan help you build your body awareness so you’re able to recognize (and listen to) your gut feelings in the moment. 🔹 Let Jay Shetty teach you about Sensations vs Emotions. Learn to tune into your body and raise your EQ at the same time
  3. Find small opportunities to practice – Taking the time to practice listening to your gut, especially when the stakes are low, is a great way to strengthen your intuition. When faced with a daily decision like what outfit you want to wear, where to go for lunch, what type of workout you want to do, or even what tv show you want to watch at night, pay attention to: Your first thought: what is the first thing that comes to mind when you approach this decision? How you feel about the choices: how does your body feel when you consider different choices. Tight or loose? Excited or Shut down? How you feel after: once you make a choice and have followed through, notice how it plays out and if it feels like the right decision after the fact.

Again, be sure to read the full article and learn more tips at Calm.com!

Wellness Basics: Finding a Therapist

Finding a therapist pre-2020 was difficult and, for many, finding one now feels almost impossible. Factors include geographical limitations, accessibility of telehealth options, insurance coverage and overall cost, and goodness of fit for your concerns. That is why Andrea Muraskin at NPR create a step-by-step guide to finding a therapist. The full story can be read at https://www.npr.org/sections/health-shots/2023/07/02/1185661348/start-therapy-find-therapist-how-to, below is an abbreviated version of her recommendations.

Step 1: Figure out what you need help with: There are lots of reasons to consider seeing a therapist. Maybe you feel depressed, or unlike yourself. Maybe you’re feeling burnt out or under pressure with family obligations. Knowing this helps you seek out a therapist who matches your goals.

Step 2: Assess your financial resources: Therapy can be expensive – or not, depending on where you go for care or whom you see. Know your coverage options and budget before deciding where to look for a therapist. If you have health insurance, your insurer will typically provide a directory of covered therapists on their website. However, bear in mind that payment often works differently for mental health providers than medical doctors. Instead of a copay, many therapists will ask for the full payment at the time of your appointment. Then it’s up to you to submit your receipts to your health insurer for reimbursement.

Free and low-cost therapy: Some county mental health departments and non-profit organizations like Mental Health America provide free and low-cost therapy for people on Medicaid. Some health centers that receive funding from the federal government also offer low-cost or free mental health care. Find federally-funded health centers in your zip code using this searchable directory. If you are employed, another free option worth exploring is if your workplace offers an EAP, or employee assistance program. EAPs are time-limited, typically five to six sessions. Cooper partners with Carebridge for this, more info at https://wellness.cooperhealth.org/carebridge/. Finally, many local universities offer free or sliding scale services with their mental health trainees. These include Temple, Drexel, and La Salle among others.

Step 3: Do some searching – and understand credentials: Now that you know the lay of the land cost-wise, start hunting. The directory at psychologytoday.com and goodtherapy.org are useful for learning about the therapists in your area and targeting your search. Many share bios, photos or short videos about themselves. You can search by issue, like “depression,” “addiction” or “marriage counseling,” or by type of therapy. You can also search by age, gender, ethnicity, language, sexuality, and insurance accepted.

Step 4: Assess if they’re a fit for you, personally and culturally: While it can be meaningful to work with a therapist from a similar background, Nguyen recommends prioritizing matching goals over race or ethnic group in your search – especially because the demand for therapy is so high right now.

Step 5: Reach out, and persist: It can be a struggle to find a provider with availability because therapists have been overwhelmed with demand since the pandemic. If you feel comfortable asking around your social circle, you might get some valuable recommendations. And if you have friends or relatives who work in mental health, consider telling them you’re looking. They might be able to reach out to their professional network, or point you to a resource you hadn’t considered. It’s an irony of the system that at a time when you need help, dogged effort might be required to find it. And when we are feeling distressed and overwhelmed, we don’t have the energy. It can actually be a great idea to ask for help finding help, she says. If you have a trusted friend who’s able to make some phone calls for you, even just to find out, you know, this clinician doesn’t have any availability, that can be a reasonable way to go. And if you are a friend or family member of somebody who’s really struggling, and if that’s something that you’re willing to offer to do, that may be really, really helpful to someone.

Step 6: Interview a prospective therapist: There’s a limit to how much you can learn about a person online or second-hand. Some therapists offer brief consultations for free, typically about 15 minutes. You’ll probably want to know about their past experience and expertise, and their experience dealing with the kinds of issues you’re facing. Questions can be open ended, like ‘Can you tell me about your experience working with adult ADHD?’ You may also ask questions about length of therapy, or number of sessions, if you can expect to see gains after a certain amount of time, what might therapy look like, and so on.

Step 7: Try at least three to five sessions: After a first appointment, if you think you might be able to work with this therapist, give it three to five sessions to see if the fit is right. Some discomfort is normal, especially if this is your first time in therapy. But early on you can kind of tell, is this a person that I can slowly let into my life? Do I feel like I can be honest with myself and be honest with them?

Promoting LGBTQIA+ Wellness Year Round

As we close out Pride Month 2023 it is important to drive home the point that, as for all people, but especially those who are consistently discriminated against which harms wellness, we should be promoting wellbeing and health year round. As such, we are including here a list of resources compiled by Main Line Health aimed at not just those in the LGBTQIA+ community, both those who seek equality along side them.

American Psychological Association – Lesbian, Gay, Bisexual and Transgender Health
The information and resources provided on this page represent an ongoing effort by the APA’s Office on Sexual Orientation and Gender Diversity to bring together recent and ongoing policy and advocacy work in LGBT health disparity areas, and both in government agencies and the non-profit health care community to address these issues.

Centers for Disease Control – LGBT Health
In addition to considering the needs of LGBT people in programs designed to improve the health of entire communities, there is also a need for culturally competent medical care and prevention services that are specific to this population. Social inequality is often associated with poorer health status, and sexual orientation has been associated with multiple health threats. These pages provide information and resources on some of the health issues and inequities affecting LGBT communities.

GLMA – Health Professionals Advancing LGBT Equality
GLMA’s mission is to ensure equality in health care for lesbian, gay, bisexual and transgender (LGBT) individuals and health care providers. Through the expertise of its members and in collaboration with other LGBT civil rights and health organizations as well as with health associations and policy-makers at all levels, GLMA is a major force in the effort to ensure the health and well-being of LGBT individuals and families. 

National Alliance on Mental Illness – Find Support for LGBTQ
The lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) community faces mental health conditions just like the rest of the population. However, you may experience more negative mental health outcomes due to prejudice and other biases. Knowing what challenges you may face as a member of the LGBTQ community and how to find and work with LGBTQ-inclusive providers can help ensure more positive outcomes.

PFLAG
PFLAG reaffirms that unity and inclusion and a shared commitment to human dignity of all people are critical to fight discrimination and bigotry in any form so that all families can live free of fear. We commit to fight for fairness inclusive of people’s sex, race, ethnicity, national origin, socioeconomic position, religion, level of mental or physical ability, age, sexual orientation, gender identity, gender expression, or any other perceived or actual characteristic. 

The Fenway Institute
The Fenway Institute at Fenway Health works to make life healthier for those who are lesbian, gay, bisexual, and transgender (LGBT), people living with HIV/AIDS, and the larger community. The Fenway Institute is an interdisciplinary center for research, training, education, and policy development, focusing on national and international health issues. Its mission is to ensure access to quality, culturally competent medical and mental health care for traditionally underserved communities, including LGBT people and those affected by HIV/AIDS.

The National LGBT Cancer Network
The National LGBT Cancer Network works to improve the lives of LGBT cancer survivors and those at risk by educating the LGBT community about its increased cancer risks and the importance of screening and early detection; training health care providers to offer more culturally competent, safe and welcoming care; and advocating for LGBT survivors in mainstream cancer organizations, the media and research.

William Way LGBT Community Center (Philadelphia)
The William Way Community Center seeks to encourage, support, and advocate for the well-being and acceptance of sexual and gender minorities through services, recreational, educational, and cultural programming. The center serves the LGBT community of Philadelphia and its allies 365 days a year. From social groups, networking events, and counseling and support services to art exhibitions and cultural experiences, the Center consistently strives to provide new and innovative programs for the LGBT communities of Philadelphia.

World Health Organization – HIV/AIDS Topics
This section contains comprehensive information on key topics related to the work of the WHO HIV Department, including HIV in key populations HIV in key populations such as men who have sex with men, people in prisons and other closed settings, people who inject drugs, sex workers, and transgender people. You’ll also find resources about prevention and treatment, such as HIV testing, post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP).

World Professional Association for Transgender Health (WPATH)
This is a non-profit, interdisciplinary professional and educational organization devoted to transgender health. Its mission is to promote evidence based care, education, research, advocacy, public policy, and respect in transgender health. Its professional, supporting, and student members engage in clinical and academic research to develop evidence-based medicine and strive to promote a high quality of care for transsexual, transgender, and gender-nonconforming individuals internationally.

The GLBT Helpline: 888.340.GLBT (888.340.4528)
Fenway Community Health’s GLBT Helpline and the Peer Listening Line provide information, referrals and support with issues such as coming out, HIV/AIDS and other relevant topics. Open every evening.

From https://www.mainlinehealth.org/specialties/lgbtq-inclusive-care/resources

Mental Health America: Pride and Mental Health

As we continue to observe Pride Month we are invited to continue to understand the relationship between Pride and mental health, and what we can do about it. As such, Mental Health America has put together a useful guide on this issue. The full resource can be found at https://mhanational.org/lgbtq/pride, and a summary is provided below. We encourage everyone to continue to explore these resources to promote equality and good mental health for all.

“Pride Month is a time for LGBTQ+ folks to gather and celebrate their freedom to live authentically. The LGBTQ+ community deserves affirmed, safe, supported, joyful, and mentally healthy lives. Anti-trans legislation, hate-based crimes, and discrimination shouldn’t overshadow Pride, but they can’t be ignored. We hope those struggling with their identity or living in unsupportive environments find these resources helpful to living a life of well-being and resilience.”

Exploring and affirming your gender

Affirming your loved one’s gender exploration and identity

Providing gender-affirming mental health care

Pride Month: Offering Good Support

Recently, Allison Young, MD and Kaitlin Sullivan at Everyday Health set out to offer some advice on ways to support those who just came out as trans. They shared that for queer people who are transitioning — which can mean many things — getting support throughout their lives is critical, especially specific inflection points of transitioning. The authors spoke with José A. Romero, the director of community advocacy, research, and education for the Pride Foundation in Washington and Corinne Votaw, PsyD, a psychologist and gender diversity advocate based in Denver. Their advice is summarized below, and can be read in full at https://www.everydayhealth.com/healthy-living/ways-to-support-a-friend-whos-transitioning/

  1. Respect Their Identity: Romero says that the first thing you can do is believe them. When they tell you they are becoming who they truly are, respect their identity as their truth. “Trust the person who is transitioning. Believe that person. There are going to be a lot of people who do not,” says Romero, who is nonbinary.
  2. Learn About the Trans Community: If you don’t know where to turn first, Romero suggests that people reach out to education-focused LGBTQ+ organizations such as the Pride Foundation. Romero also recommends looking through the Digital Transgender Archive for historical information and resources on transgender folks.
  3. Decide What Kind of Support You’re Willing to Offer: Your role as the friend of a person transitioning may be decided by that person, but there are some considerations you need to contemplate yourself, Romero says. He says to ask whether you are willing to drive your friend to another state to support their physical transition. Are you willing to donate money or meet with legislators? Decide what it is and commit.
  4. Don’t Over Apologize if You Make a Mistake: Each person has their own preference for how they’d like to transition socially, which includes that person’s name and pronouns. Ask — never assume — what they’d like to be called. Then do your best to incorporate those choices into your vocabulary. Be sensitive, acknowledge your mistake, move on, and work to adopt the person’s true name and pronouns into your language.
  5. Drive Change: Supporting a friend who is transitioning often doesn’t just involve being there for that person one on one. It can also take the form of working to create a safe, supportive environment for queer and transgender people. This will depend on where you live and who you are, but driving change should start by looking at your own life and beliefs. “What’s important, more than external advocacy on behalf of whatever counterpart they came out to, is a period of reflection of what you do that might be harming the trans or gender nonbinary community,” Votaw says. “Start to look into your own life and look at what is not in harmony with being a supporter or family member or friend or even coworker.”

Read the full article at https://www.everydayhealth.com/healthy-living/ways-to-support-a-friend-whos-transitioning/

Relief Through Forgiving

Some time ago Archbishop Desmond Tutu began writing extensively on the transformative power of forgiveness. He reflects on his role as an anti-apartheid and pro human rights activist during some of the most difficult years in South Africa’s history and the role forgiveness played in moving things forward. So Archbishop Tutu would not be surprised by the findings offered by the International REACH Forgiveness Intervention, a multi-site randomized controlled trial that, amongst other things, explored what forgiveness can do for us in terms of, among other things, reducing symptoms of depression, anxiety, and PTSD.

Ready to learn more? Check out this recent article from the New York Times or visit the REACH website at https://osf.io/8qzgw/.

The Buddy System

Matthew Solan is the executive editor of Harvard Men’s Health Watch. Recently, he and Howard LeWine, MD, Chief Medical Editor at Harvard Health Publishing, produced a piece examining how friendships can help you stay socially active, the health benefits of this, and how to make new friends while maintaining old ones. This can be a challenge for everyone, though compared with women, men especially struggle with making and keeping friends as they age. The full article can be read at Harvard Health, but three good places to start to get your friend journey on the right track include:

  • Get into group dynamics. Join a group activity, such as a walking club; a golf or bowling league; a card, book or chess club; or a continuing-education class at an adult education center. Or ask a current friend to join you so you both can expand your friend circle.
  • Schedule time together. If you already have friends but don’t see them regularly, take the initiative and schedule a set time for get-togethers. Choose a designated day, time and place for coffee or lunch, ideally a setting designed for easy conversation. Begin with a weekly or every-other-week schedule to help everyone ease into the new outing without feeling overwhelmed.
  • Work on a project. Another way to stay connected with existing friends and meet new ones is to launch a group project. Schwartz knows of a group of retired fishermen from Gloucester, Massachusetts, who, once they retired, decided to build a boat together.

Autism and Wellness Week 4: Our Job

As we close out April where we have focused on Autism Acceptance and wellness we are left asking, what practical things can we do to promote acceptance and wellness. Today you are tasked with reflecting on that questions, but you are not alone! Here are some practical things you can do to promote acceptance and wellness in the Autism community.  

Instead of dismissing, try educating. Many folks have been in an awkward situation in a public setting where they or a family member stares at someone who looks different from them or behaves differently from what they typically see. It is completely normal to want to tell yourself or others to stop staring or be quiet because the situation makes you feel uncomfortable. Instead of dismissing that reaction, use this as an opportunity to educate about differences and build understanding. If you see someone with ASD, engage in motor and/or vocal stereotypy such as spinning in circles while humming repetitively, you could say, “Sometimes people do different things when they’re feeling different emotions. It looks like she’s feeling happy. What do you do when you feel happy?” 

Offer support through advocacy. While those with ASD are often able to receive support at school or work either through special education services or 504 accommodations or federal programs, the same supports are not necessarily guaranteed in the community, such as extracurricular activities (e.g., baseball games or birthday parties) or places of worship (e.g., churches, mosques, synagogues, etc.). If you see that another person is trying to advocate for accommodations for their child with ASD, such as creating a sensory-friendly religious service, then have their back. This means offering support through listening to them and learning from them, as well as personally reaching out to the individuals in charge who can make accommodations happen. 
 

Use language appropriate to the individual. While person-first language (e.g., “person with ASD”) is commonly used among professionals and parents, many self-advocates within the ASD community prefer identity-first language (e.g., “autistic person”) as they view ASD as something that cannot and should not be separated from their identity. There is much debate about what terminology to use; however, it is important to use language most appropriate to an individual with ASD in order to show acceptance of their individual identity. This could mean asking individuals or their family members what language they find to be the most respectful and appropriate.

Focus on strengths, not just challenges. Though many children and adults with ASD face challenges, it is important to identify and recognize the strengths that also accompany ASD. For instance, many individuals with ASD exhibit highly focused interests, such as technology or animals, which could make it difficult to form and maintain relationships if these interests dominate their lives. However, if that individual can participate in an activity or group that involves that interest, it becomes a pathway to form friendships. Further, that individual might pursue employment in line with their interests, promoting individual self-determination. Focusing on the unique abilities of an individual will strengthen their sense of self and achievement.
 

Expand your social circle. Many with ASD are socially excluded from a very young age because they engage in behaviors that that are viewed as falling outside societal norms. Expanding you and your child’s network of friendships and activities to include individuals with different abilities, such as ASD, is not only the kind thing to do, but it can also provide opportunities for you and your child to connect with and learn from others from different backgrounds and experiences. This in turn broadens perspectives of the world and teaches open-mindedness to new ideas, beliefs, and values. This includes learning that differing abilities are, as Dr. Temple Grandin has famously said, “different, not less.”

Provide meaningful opportunities for individuals with ASD to be included. Beyond inviting individuals with ASD to social gatherings, you can make a difference by helping to promote and create opportunities to include teens and adults with ASD in the workplace. As noted in President Biden’s Proclamation on World Autism Awareness Day, the Department of Labor’s recent apprenticeship initiative focuses on developing career paths in information technology, healthcare, and other fields for individuals with ASD and other developmental disabilities. Talk to your employer about why it is important to employ differently-abled individuals and how your workplace can do a better job of recruiting, supporting and retaining individuals with ASD as valuable team members.