How Are You Sleeping?
/in CARE Counseling, Health + Sleep /by MarketingHow Are You Sleeping?
How are you sleeping? If you find yourself feeling anxious and having a harder time sleeping, excess fear may be a factor. When our bodies are in a high-alert stress state, sleep is often disrupted. This is known as hypervigilance which is a common trauma- related response.
While safe spaces were created to help marginalized individuals feel physically and emotionally safe, the purposes of a safe space is not limited to these two areas. In trauma work, creating a sense of safety and stability is important to help one feel grounded. One way to do this is through visualization and mindful meditation. One of my favorite images used in visualizations is the image of a tree. The tree can be found in many different nature scenes and is a good visual to help feel fully present, alive, and connected to the earth.
Visualize your feet on the ground, feeling the contact your bare feet make with the surface as you are firmly “rooted” with your feet on the floor. Your body is strong like a tree trunk, able to withstand the weather—rain, snow, wind. Your branches gently sway with the wind. The leaves change along the seasons. You change. During times of intense storms, a few branches may break but your roots run deep and are able to withstand the storm. Your tree is able to receive what it needs—nutrients from the ground, water, sun. You are strong. During times when resources are scare, your tree survives. You are a survivor. Not only does your tree survive, but it is also able to thrive. Its roots grow deep, the trunk matures, and the branches reach high towards the sky. You radiate with positive energy.
A mindfulness meditation designed to use at night that I enjoy is called the Safe/ Calm Space Guided Imagery. This exercise incorporates the concepts of a safe space and visualization as part of mindful meditation. It helps you visualize your personal safe place that you can return to whenever you need to. Nature scenes can be incredibly powerful with their vivid imagery. The possibilities are endless—only limited by your imagination. These can be tailored based on what language and images are meaningful to you.
The Safe/ Calm Space Guided Imagery starts off by asking you to get into a comfortable position where you can relax. I like to do this while lying in bed. Start off by noticing your breathing—taking deep belly breaths in and out. Scan your body for any areas of tension. Relax and allow your mind to visualize your safe space. Incorporate the five senses to notice what you see, hear, feel, taste, and smell. Allow yourself to be fully present and immersed in your safe space. It is a place that you can access when feeling afraid, uncomfortable, or at unrest as you regulate and calm your body through deep breathing.
For the full, detailed Safe/ Calm Space Guided Imagery Script, click here
Written By: Charlotte Johnson, MA, LPCC
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Coping Over The Last Year… How Did We Do It?
/in CARE Counseling, CARING for the Community, COVID-19, Depression + Anxiety, Health + Sleep, Identity, Mental Health, Relationships & Self-Care, Social Issues, Telehealth, Trauma, Weekly Session Plans /by MarketingCoping Over The Last Year… How Did We Do It?
As a follow up to reflection of a therapist blog, I wanted to capture strategies and themes that have helped build resilience and coping within our clients over the last year. Online therapy has been an amazing platform. It has been a privilege walk alongside individuals and families during this time in our history. Here is just a glimpse of the interventions and the themes that were helpful with coping.
• Maintaining continuity of care using telehealth
• Seeking out and maintaining social connections through quarantine
• Creating new routines and setting goals
• Laughing and play to help reduce depression
• Remembrance and mourning during grief/ loss
• Processing ambiguous loss and trauma
• Finding ways to build community to strengthen the community
• Taking action and showing support
• Showing kindness and expressing gratitude
• Focusing on self-care
• Caring for those who are suicidal, misusing drugs or alcohol, or in recovery
• Caring for those who are hurting, engaging in self injurious behavior
• Creating meaningful rituals and celebrations
• Focusing on priorities—understanding what “really matters”
• Connecting with self, family/ friends, pets, nature, and/or spirituality
• Communicating and setting boundaries
• Learning coping skills
• Investigating emotions with suppressing them
• Working with unhelpful thinking patterns
• Tuning into our bodies
• Engaging in movement
• Using mindfulness to help reduce anxiety and improve sleep
• Practicing mindfulness- including mindful eating and mindful sex
• Practicing self-compassion
• Increasing ability to cope with uncertainty
Written By: Charlotte Johnson, MA, LPCC
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Women & Mental Health
/in Anxiety, CARE Counseling, Clinician Resources, Depression, Family, Identity, Mental Health, Race, Ethnicity & Cultural Identity, Self-Esteem, Women's Health /by MarketingWomen & Mental Health
According to the National Institute of Mental Health, nearly 1 in 5 adults live with mental-illness. While the rates for mental health are similar for all adults, there are unique differences that impact women-patients across all cultural and socioeconomic backgrounds such as depression, anxiety, trauma, and eating disorders.
Women and Mental Health
Source: World Health Organization, Center for Disease Control, & National Institute of Mental Health
Depression and Anxiety
• Depression is 2Xs more common in women than in men.
• Generalized anxiety is also 2Xs more likely in women.
• Depression, posttraumatic stress disorder, anxiety, and suicidal ideation are common among women who have experienced physical, sexual, and other forms of violence.
Eating Disorders
• A lifetime prevalence of anorexia nervosa was 3Xs higher in women.
• Binge eating disorder was 2Xs as high.
• Prevalence of bulimia nervosa was 5Xs higher in women.
• Teens and young adult women are especially at risk of developing an eating disorder.
Hormonal Changes
• Mental health symptoms can be triggered by hormonal changes such as depression with pregnancy, postpartum, menstruation, or perimenopause.
• Approximately 1 in 8 women in the US experience symptoms of postpartum depression; in some states this is as high as 1 in 5 women.
Rape, Sexual Assault, and Violence
• 91% of rape and sexual assault victims in the US are women.
• Nearly 1 in 5 women will experience rape or attempted rape in their lifetime.
• Neary 1 in 4 women have experienced severe physical violence from an intimate partner in their lifetime.
• 1 in 3 women globally experience violence.
Objectification, Harassment, and Microaggression
• Objectification of girls/ women, sexual harassment, and repeated microaggressions can lead to violence and negatively impact mental health including self-esteem.
Risk factors for women include inequalities in socioeconomic status including low income/ social status, experience of gender-based violence, and being a primary caretaker. Historically, women in the US have been denied opportunities based on gender as well as individuals and women within the LGBTQIA+ and BIPOC community. It can feel empowering to talk to another female about these concerns within the safety of a therapeutic relationship. While you and your therapist may not share the exact lived experience, there is power in bearing witness to one’s story—the beauty and the pain.
For online resources specific to mental health for women, check out the Massachusetts General Hospital (MGH) Center for Women’s Mental Health Productive Psychiatry Resource Information Center. https://womensmentalhealth.org/resource/
Written By: Charlotte Johnson, MA, LPCC
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How Meditation Can Help With Getting A Better Night’s Sleep
/in Anxiety, CARE Counseling, Health + Sleep, Mental Health, Sleep /by MarketingHow Meditation Can Help With Getting A Better Night’s Sleep
If you are struggling with getting a good night’s sleep, consider the benefits of meditation. Meditation that focuses on sleep helps one be present in the moment. Meditation can help create a calm state, by clearing the mind in preparation for sleep.
Distraction can be a great way to cope with anxious thoughts during the day but what happens when it is time to sleep? Do you start engaging in mental activities such as counting sheep? Perhaps scrolling through social media out of boredom but find your mind overstimulated and even more “cluttered”. Do you check the time and realize you “should” be sleeping by now? Focusing on difficulties falling and staying asleep can make things even more stressful!
Mindful Meditation is a great practice that can be combined with other strategies such as guided imagery to help get a better night’s sleep. Meditations that utilize mindfulness-for-sleep may include sensory rich details of relaxing images of places such as the beach or a mountainside with softly drifting clouds or gentle flowing water. While these techniques incorporate an element of distraction, these serve more as relaxation strategies because they can shift one’s focus to positive distractions as part of a relaxing meditation.
A body scan meditation brings mindful awareness to different parts of the body, noticing the different sensations as one scans each part of the body. It is common for one’s thoughts to wander. Be kind to yourself as you gently bringing back your awareness to your breath and body. Focusing on breathing can help create a sense of calm as one is doing the body scan. Techniques such as breathing in calm and breathing out tension are often practiced with a body scan meditation as we help our bodies naturally relax.
Noticing worrisome thoughts and placing these on an object such as a leaf on a gently flowing stream or a cloud and watching it drift away is a strategy that incorporates mindfulness with cognitive diffusion that many clients find helpful. With mindfulness, whatever worrisome thoughts are present, including the anxiety of not being able to sleep, practicing letting these go, allowing and trusting the body’s ability to relax.
The Sleep Foundation has an excellent list of Nine Mindfulness Principles. Thought patterns consistent with these principles (rather than focus on the negative) can help reduce anxiety and promote a better night’s sleep. These include: a beginner’s mind in your approach to thoughts about sleep/ expectations, non-striving as sleep is not a result of a forced effort, it just happens. Letting go which include letting go of judgments or non-judging, and acceptance. Sometimes you may get a good night’s rest and other times you may not. Trust in your body’s ability to regulate sleep and have patience in the process. Finally, gratitude, allowing yourself to focus on the good things and showing generosity to others can be positive distractions that can re-shift focus.
Meditation can help when it is used regularly before bed and getting into the habit of daily meditation can help receive optimal health benefits.
Written By: Charlotte Johnson, MA, LPCC

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Tune Into Your Body To Increase Resiliency and Happiness
/in Anxiety, CARE Counseling, Clinician Resources, Couples Counseling, Depression, Family Counseling, Mental Health, Premarital Counseling, Relationships & Self-Care, Self-Care, Self-Esteem, Sex, Sleep, Weekly Session Plans, Women's Health /by MarketingTune Into Your Body To Increase Resiliency and Happiness
Rather than just focusing on the neck up, therapists are incorporating body work by taking a more holistic approach and integrating the rest of the body! Specialized therapeutic approaches such as somatic psychotherapy utilize the mind-body connection to bring awareness to one’s body and integrate the body within the healing process.
The nervous system plays a key role in body work; tuning-into-your-body-can-make-you-more-resilient. Amid threat, our body goes into “fight or flight”; this serves as a protective, survival response. The sympathetic nervous system plays a key role in triggering this response whereas the parasympathetic nervous system works to calm the body’s response. Our body works hard to keep us safe, healthy, and calm! Body-based interventions can help soothe our body when our brain is sending out signals of distress. By increasing somatic intelligence, one can better understand the-stress-response and learn techniques that help regulate stress responses and contribute to overall healthiness.
BREATHING & RELAXATION
One of the first places we can focus on regulating our nervous system is through breathing by using deep abdominal breaths which is known as diaphragmatic or belly breathing. Breathing can be paired with deep sighs or humming to calm. Breathing can also be combined with soothing words or images as part of meditation and guided imagery relaxation exercises.
Check out this link for steps how to do deep breathing exercises to include diaphragmatic breathing, rib stretch breathing, and numbered breathing: https://www.healthline.com/health/diaphragmatic-breathing#steps-to-do
PHYSICAL TOUCH
There are many benefits-of-touch in response to reducing stress and calming the nervous system. This includes the body’s release of the hormone oxytocin which is released during activities that utilize physical touch such as hugging, massage, cuddling, and sex. Soothing activities such as petting an animal also offer these benefits. Meditation activities that incorporate touch and self-compassion such as placing one’s hand on their heart and offering kindness is another intervention that utilizes physical touch.
MOVEMENT
Use of movement and therapeutic approaches that use movement such as yoga and tai chi often combines deep breathing along with fluid rhythmical movements that help calm the nervous system. Incorporating mindfulness for “mindful movement” with activities such as walking or yoga helps relax both the mind and the body. Simple movement activities such as shifts in posture and stretching also easy activities that you can do anywhere.
INTEGRATE ALL THREE!
Breathing/ relaxation, touch, and movement can be combined. A technique called grounding is helpful with moving through distress (especially with trauma) as it helps one feel connected to the ground/ earth. This can be paired with sensory-soothing interventions to feel fully connected and present such as physical touch and eye contact in addition to breathing.
We’re Here to help
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We’re united by our commitment to providing effective, relevant, and innovative mental health support at all stages of your journey. Click Here to find out more about who we are, where we come from, and how we live out CARE’s mission every day.
The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.
How to Practice Mindfulness and How Shame Can Affect Your Eating Habits
/in CARE Counseling, Depression, Disordered Eating, Emotional Trauma, Health + Sleep, Mental Health, Relationships & Self-Care, Self-Care, Self-Esteem, Self-Harm /by MarketingHow to Practice Mindfulness and How Shame Can Affect Your Eating Habits
Eating is a daily practice that helps nourish our bodies by keeping them strong and healthy. It is the “fuel” that provides energy for the day. Eating habits may become unhealthy patterns ladened with guilt and shame. It is important to become aware of maladaptive core beliefs and the internalized messages that come along with eating habits and feelings about weight, appearance, or overall body image.
Shame is an emotion that can greatly affect eating habits whether it be mindless eating, restricting, binging, purging, struggles with weight and/ or body image. Feelings of shame are often present with behaviors that are done in secret and may be associated with rigidly held beliefs including “food rules” that affects-eating-habits. Mindfulness can help bring awareness to unhelpful thoughts that contribute to feelings of shame. Mindfulness can help us sit with the discomfort these feeling bring, being present in the moment and approaching eating habits with curiosity. In our moments of pain and suffering may we find compassion for ourselves. Oftentimes it is much easier to show compassion for others while the inner critic is unleashed on the self. Offering yourself kindness and compassion during a difficult situation is a great mindfulness practice which can help work with feelings of shame.
Here are some guidelines how to practice mindfulness while eating that incorporates simple-practices-for-daily-life.
1) Notice What You are Eating. Make mindful choices that nourish the body and soul.
2) Savor Your Food. Take time to notice the aroma, taste, and texture. Allow yourself to connect and enjoy these sensations.
3) Create a Pause. Activities to slow down and then enjoy the food such as breathing or a prayer before eating can help with the transition to meal time.
4) Be Mindful of Where You are Eating. Do you eat on the couch in front of your TV, at your desk while working, or in bed? Take the time to prepare a special place for meal time, even if it is a place setting for one.
5) Listen to Your Body Signals. Learn to recognize and appropriately respond to signals of hunger and fullness.
The Center for Mindful Eating provides some great information on mindful eating as well as mindful meditations: https://thecenterformindfuleating.org/FREE-Meditations
If you are struggling with shame around eating habits, please schedule a time to talk to a therapist with specialty working with eating disorders https://care-clinics.com/ or a specialty clinic that provides treatment for eating disorders.
Melrose Center: https://www.healthpartners.com/care/specialty-centers/melrose-center/
The Emily Program: https://www.emilyprogram.com/
Written By: Charlotte Johnson, MA, LPCC

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Stuck on Negative Thinking
/in Anxiety, Depression, Disordered Eating, Emotional Trauma, Mental Health, Post-Partum & Pre-Partum Depression, Self-Care, Self-Esteem, Self-Harm, Suicidal Thoughts, Traumatic Loss / Suicide, Witnessing Traumatic Experiences / PTSD /by MarketingStuck on Negative Thinking
For many of us, we tend to get stuck on negative thinking. For some reason, our brains defer to the negative. According to the National Science Foundation, 80% of our thoughts are negative and 95% of our thoughts are repetitive. WOW. That is a lot of negative, repetitive thoughts!
We all have thoughts and feelings about ourselves and important aspects of our life—relationships, work, school. We may find our brain “stuck” on the past, unable to let go. Anxious and depressive thinking can impact our ability to be fully present in the future, especially when expending time and energy worrying about the future.
Exactly how many thoughts do we have? Researchers at Queen’s University in Canada estimated that we have 6,200 thoughts-every-day. Researchers were able to establish a way to identify when a thought ends and begins thorough isolating “thought worms” which are moments of being fixed on the same idea.
Here are some common examples of negative thought patterns:
Pessimism:
• Our “mental filter” focuses on the negative. We may minimize the positives and may “spiral” into depressive thinking.
Catastrophizing:
• Making small problems into big problems or “worst case scenarios”, assuming the worst will happen.
Rumination:
• Repetitive thought(s) in which your brain tends to get “stuck” on negativity.
• Individuals may find that they have a hard time moving on. They may struggle with obsessions and experience anxious distress.
Perfectionism:
• Placing unrealistic high standards on self.
• Individual may find themselves being hyper-critical; feeling like a “failure” when standards are not met.
Negative and repetitive thought patterns are present in both anxiety and depression. There are many cognitive-distortions present in negative thinking. These distortions can be treated with cognitive-behavioral therapy, using techniques such as cognitive-restructuring.
Other helpful interventions include:
• Practicing gratitude
• Surrounding yourself with positive people
• Increasing awareness of negative self-talk and replacing it
• Establishing new rituals/ habits within your routine
• Learning how to “let go” of negativity and practice self-compassion.
Written By: Charlotte Johnson MA, LPCC
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Seasonal Depressive Disorder
/in Ambiguous Loss / Sense of Self, Depression, Depression + Anxiety, Mental Health, Self-Care, Sleep /by MarketingSeasonal Depressive Disorder
SAD? Are you feeling tired, lacking energy, experiencing fatigue, and a loss of motivation? These are common in those with a seasonal pattern of depression.
Seasonal Affective Disorder (SAD) is viewed as a form of major depression. In addition to depressed mood and/ or decreased interest or pleasure activities. Additional symptoms often include a tendency to oversleep, difficulties concentrating, and irritability.
Seasonal affective disorder tends to begin in the fall (Sept/ Oct) and last through the spring (March/ April). January tends to be an especially difficult month for many individuals, exacerbated this year by the stressors of the pandemic.
A study by the Kaiser Family Foundation found that over half of the US adult population (53%) have reported negative mental health impacts due to COVID-19 related stress. The duration the pandemic, combined with the winter months have experts concerned winter-and-pandemic-stressors-could-be-double-whammy-for-mental-health. For those of us experiencing Minnesota winter where the days are shorter, the sun sets sooner, and the temps are frigid it can be harder to get outdoors and enjoy the sunshine.
• Did you know that for those with visual impairments, the risk of developing seasonal-affective-disorder is almost three times higher?
• Women are especially at risk, as 4 out of 5 people with SAD tend to be women.
• Susceptibility to seasonal depression may also be influenced by eye color due to the amount of light the eye can process and melatonin production. #Why-blue-eyes-keep-the-blues-away.
Changes in the amount of sunlight appears to trigger seasonal-affective-disorder. These changes may negatively impact one’s “biological clock” which controls sleep-wake patterns and disrupt the functions of neurotransmitters such as serotonin and dopamine. Serotonin helps regulate mood.
These are several theories about the causes of SAD. Research suggests nimh.nih.gov/health/publications sunlight is an important factor that aids in the maintenance of normal serotonin levels. For those with SAD, these are problems with regulation that result in decreased serotonin.
Melatonin production may be another factor as producing too much melatonin increases sleepiness. Melatonin is a hormone that is important in maintaining a regular sleep-wake schedule.
Low vitamin D levels could also be a factor as it is believed to promote serotonin and those with SAD tends to receive less vitamin D through exposure to sunlight.
One interesting thing that I recently learned from my optometrist is the connection between eye health and mental health. This is a friendly reminder that if you have not had a recent eye exam, now may be a good time to schedule one. It is also the perfect time to see a therapist!
SAD Treatments Include the Following:
- Increasing exposure to light during the winter
- Exercising outdoors
- Using light therapy such as a SAD lamp
- Psychotherapy
- Antidepressants
- Vitamin D
Written By: Charlotte Johnson MA, LPCC
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Being Mindful and Compassionate in Tough Conversations
/in Ambiguous Loss / Sense of Self, Anxiety, Couples Counseling, Death of a Loved One, Depression, Disordered Eating, Divorce, Domestic Violence/Abuse, Emotional Trauma, Family Counseling, Grief & Loss, LGBTQ+, Long Term Illness, Mental Health, Parenting, Post-Partum & Pre-Partum Depression, Race, Ethnicity & Cultural Identity, Relationship Issues, Sexual Addictions / Pornography, Sexual Function / Dysfunction, Sleep, Social Issues, Substance Use & Addiction, Telehealth, Trauma, Traumatic Loss / Suicide /by MarketingBeing Mindful and Compassionate in Tough Conversations
Reflecting on the last year, there are many tough conversations that have started, are taking place in the present moment, and have yet to be had.
Tough conversations often create discomfort and can lead to avoidance. There may be reluctance to speak up due to fear of consequences. What will people think? How do I manage my own anxiety? Consider for a moment that remaining silent during tough conversations also communicates a message. What message do you wish to convey?
Having tough conversations, including conversations about racial inequalities and social justice is important as we share responsibilities in our responses, and act in alignment with our values. At CARE, we are committed to diversity and human rights; therefore, we seek to create space for dialogue while being mindful and compassionate.
As we encounter others within conversation, being mindful and compassionate can make a huge difference.
Here are Some Ways to Practice Being Mindful and Compassionate in Tough Conversations
• Recognize and embrace our common humanity.
• Take care of yourself to be fully present for others.
• Step outside your comfort zone and lean into discomfort.
• Focus on relationship building. This includes people who are different than you.
• Practice having intentional dialogue using interpersonal effectiveness skills.
• Listen to understand. Be patient with others.
• Hold space for others’ pain—their stories, others’ experiences, and viewpoints.
• Notice what is going on in your body.
• Practicing mindfulness and self-compassion, offering yourself and others loving-kindness.
Written By: Charlotte Johnson MA, LPCC
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Why is Therapy Valuable?
/in Anxiety, CARE Counseling, Depression, Grief & Loss, Health + Sleep, Identity, Mental Health, Premarital Counseling, Relationships & Self-Care, Self-Care, Self-Esteem, Self-Harm, Social Issues, Suicidal Thoughts, Trauma /by MarketingWhy is Therapy Valuable
Imagine success…becoming the best version of yourself. That is one of the many amazing benefits of therapy. Since mental illness alters a person’s thoughts, feelings, and/ or behaviors in distinct ways, therapy helps one gain better control of these areas.
I like to reframe the benefits of therapy for anyone who is struggling with understanding, expressing, or coping with their thoughts, feelings, or behavior.
Therapy provides a safe space to talk, an outlet to express, and a nonjudgmental ear to listen.
Clients come to therapy for many different reasons. Some people feel alone, misunderstood, isolated. Others feel overwhelmed and anxious. Life is stressful and you do not need to go through it alone. Therapy helps normalize these experiences and provide a “roadmap” how to navigate through them.
Therapy is a place where you can be vulnerable, to feel seen and heard. To work through stressors or trauma and process uncomfortable emotions such as shame.
The benefits of therapy can directly impact one’s view of self and others. It can lead to increasing understanding through gaining insight. The therapist can assist with questions to ponder, and techniques that may offer a fresh perspective.
Skills and strategies learned in therapy offer long-term benefits not only for one’s emotional health but also physical health. It leads to improved feelings of self-worth and confidence. Therapy can improve relationships and boundary setting. It teaches and builds healthy coping skills. Your therapist can help you develop daily habits that set you up for success.
Whether you have been thinking about seeing a therapist for many years or have recently thought about therapy and would like to take a proactive approach, here is what wellness looks like:
• Expressing thoughts & feelings
• Coping with stress & setbacks
• Having a sense of purpose & meaning
• Using your knowledge & skills
• Maintaining physical health (diet, nutrition, sleep, exercise)
• Creating a pleasant & safe environment
• Finding satisfaction with financial & work situation
• Developing healthy relationships & supports
Written by: Charlotte Johnson MA, LPCC

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The professionals at CARE are actively collecting and creating resources to help with what you need. We’re Here for You.