Thursday's Therapy ~ Sleep Therapy

Thursday's Therapy

Sleep Therapy

Sleep Better with Cognitive Behavioral Therapy for Insomnia

Do you lie awake night after night, struggling to catch the sleep that eludes you...then feel exhausted and miserable during the day? Don't just suffer stoically—insomnia is serious! It increases the risk for high blood pressure, obesity, diabetes, anxiety and substance abuse. What's more, although insomnia often is considered a sign of depression, new research reveals that the insomnia can come first and double a person's risk of developing depression.

Sleeping pills may seem like a quick fix, but don't be too hasty in taking that route. Though these drugs do help some people, they also can have bad side effects...and according to one study, long-term use is associated with increased risk for early death.

There's a much better option that can get you the deep, blissful sleep you need. It's completely safe and drug-free, and because it addresses the underlying causes of insomnia (unlike medication), its benefits persist even long after treatment ends. It's called cognitive behavioral therapy for insomnia (CBT-I), and just a few sessions can go a long way to restore normal sleep patterns. CBT-I has been shown to relieve insomnia for a wide variety of people, including older adults and those who suffer from chronic pain, fibromyalgia, cardiovascular disease, mood disorders and other health problems. It can even help people who have been taking sleeping pills for years. Here's what you should know about CBT-I…

IS THIS SLEEP SOLUTION RIGHT FOR YOU?

For insights, I turned to Donn Posner, PhD, a leading expert in CBT-I. He is a psychologist at Palo Alto VA Medical Center in California and coauthor ofCognitive Behavioral Treatment of Insomnia: A Session-by-Session Guide. Dr. Posner confirmed that chronic insomnia is a serious disorder that should be treated. However, he also noted that a few restless nights should not be considered insomnia (important to know so that you don't feel overly stressed about an occasional bad night!).

True chronic insomnia means difficulty initiating or maintaining sleep, despite adequate opportunity to sleep, that occurs at least three times a week and lasts for at least three months, according to Dr. Posner. How long can it take you to fall asleep before it's a problem? Most experts in the field consider 30 minutes of lying awake, either before first falling asleep or after having woken up in the middle of the night, as the cut-off. In addition, Dr. Posner said, "insomnia leads to some daytime consequences—for instance, fatigue, memory problems, difficulty concentrating, poor work performance or even anxiety about being unable to fall sleep. Insomnia is not just a nighttime disorder...it’s a 24-hour disorder.”

If you think that your sleep pattern fits the above description of insomnia, talk to your doctor—a medical problem could be interfering with your slumber, and you may find that sleep comes more easily once that underlying condition is addressed. If your insomnia persists, however, you should strongly consider trying CBT-I.

WHAT TO EXPECT DURING TREATMENT

The first step with CBT-I is for you to find a sleep specialist who offers it. To do this, ask your doctor for a referral to a qualified professional with expertise in CBT-I...or find a practitioner through the Society of Behavioral Sleep Medicine or contact the nearest certified sleep center and say that you’re interested in CBT-I.

Once you choose a sleep specialist, you can expect to undergo a thorough evaluation ofall areas of functioning to determine all the factors that are contributing to your sleep problems, Dr. Posner said. Genetic makeup, internal rhythm, social life, home life and work life are all evaluated...and you are instructed to keep a sleep diary to help pinpoint problematic patterns. Your therapist also tries to determine whether an emotional issue or even another sleep disorder precipitated your insomnia. When the evaluation is complete, the therapist creates an individualized treatment plan, typically consisting of four to six weekly one-hour sessions.

Then the real work begins. As the name implies, CBT-I involves both behavioral and cognitive elements. Though therapy is tailored to each patient, a typical protocol includes the following...

• Stimulus control. You are cautioned against using your bed at any time of day for anything other than sleeping or sex. That means no lounging on the bed to read, watch TV, talk on the phone or surf the Internet. For times when you do go to bed and do not fall asleep (or fall back to sleep) within 15 to 20 minutes, you are told to get up and go do something in another room, returning to bed only when you feel sleepy again—and repeating this instruction as many times as necessary.

The rationale: When a person habitually struggles to fall asleep, he "works" at what should be a natural process...and he becomes conditioned to associate the bed with anxiety, frustration and effort. In contrast, by getting out of bed whenever he cannot sleep, he gives up that struggle. If he applies this rule consistently, over time the bed becomes a trigger for sleep rather than for wakefulness, Dr. Posner explained. That association between bed and sleep is further reinforced when he avoids using the bed at all while awake. The only exception is sex. "If we asked people to give up the bed as a place for sex, they wouldn't comply anyway. But more importantly, during sex you presumably are not trying to sleep, so it doesn't present the same problem as, say, reading in bed with the intention of getting to sleep. It is really sleep effort above all that we try to eliminate," he said.

• Sleep hygiene. Typically patients are advised to avoid caffeine after noon...and to avoid exercise, alcohol, heavy meals and nicotine within two hours of bedtime. Your sleep therapist also reviews your bedroom environment to make sure it is dark and cool enough to be conducive to sleep. (Many people keep their bedrooms too warm for good sleep.)

• Anxiety abatement. The therapist teaches you how to deal with the anxiety you may feel before heading to bed. For instance, you may often think, I'll be a wreck if I don't get to sleep...or I can't stand lying awake like this! As you learn to counteract that "catastrophic thinking" with rational thoughts—I can function OK even if I don't sleep for eight hours...or Insomnia is unpleasant but hardly unbearable—your anxiety lessens and sleep comes more easily. You also may be shown relaxation techniques to practice during the day and at bedtime. And you learn to avoid staring compulsively at the clock, which only makes you fret more as you calculate how much sleep you're losing. If you need an alarm clock, you may be told to use one without illumination...or to place the clock under your bed where you can't keep checking it.

Commitment is key: Too many people try one or two of the techniques for a few nights, and then if they don't immediately start sleeping better, they get frustrated and give up. "There is nothing magic that will work tonight. It takes dedication and commitment to make CBT-I work because you have to rebuild your innate sleep drive and realign your body's natural rhythms before you'll be able to sleep well," said Dr. Posner. Be forewarned—during treatment, sleep problems often get worse before they get better...but that’s a sign that the protocol is working. It can take a week or two to start seeing real progress. “Given that most people with chronic insomnia have had the problem for years, a couple weeks of work should be a good trade,” Dr. Posner added.

Source: Donn Posner, PhD, CBSM (Certified in Behavioral Sleep Medicine), psychologist, Palo Alto VA Medical Center, Palo Alto, California. A clinical associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University in Providence, Rhode Island, he also is coauthor of Cognitive Behavioral Treatment of Insomnia: A Session-by-Session Guide (Springer).

Entire Article:

http://www.bottomlinepublications.com/content/article/health-a-healing/sleep-better-with-cognitive-

behavioral-therapy-for-insomnia?utm_medium=Email&utm_campaign=2014-05-29%20DHN%20NL%20(1)%20remainder&utm_content=&utm_source=Newsletter&cid=46040939&spMailingID=46040939&spUserID=NTE4NTQ2NjcxMTAS1&spJobID=443799612&spReportId=NDQzNzk5NjEyS0

Wednesday's Woe/Thursday's Therapy - Will I Ever Get 8 Hours of Sleep Again in This Lifetime?

Our grandbaby girl as a newborn...sleeping "like a baby"...

Wednesday's Woe/Thursday's Therapy

Will I Ever Get 8 Hours of Sleep Again in This Lifetime?

Why is it that insomnia comes with Child-Loss Grief? Our bodies are exhausted. Our minds are exhausted. Our souls are spent with the daily struggle. So why is it that we cannot seem to get a good night's sleep? We know the healthy habits to do. We practice those things. But Child-Loss is bigger than we are.

Losing a child changes you in ways most people can never understand. It scars your psyche with an ineffaceable wreckage. It strains your soul with abominable confusion, leaving you questioning the very faith that once provided stabilization to your being. It shadows your heart with a disconsolate burden that never leaves; it may be temporarily distracted or even momentarily forgotten but the deep sadness always hovers just under the surface, waiting to resurrect when you least expect it. It impacts every facet of your life with a shroud of grief that forever darkens the atmosphere of your world. Like Chinese handcuffs, it grabs you and will not let you go, until you submit to its forces and let go your resistance; then you will be released, if only for a few moments...

As one of our child-loss cohorts stated when trying to clarify to a friend who is a civilian to our Child-Loss Grief War after he overheard that the friend had chastised Tommy as to why Tommy and I weren't "getting over" our loss: 

"Sometimes your mouth overrides your brain (leaving out the expletives he included)! You don't understand child-loss, and you never will. I lost my child. You need to understand that although I am not hurting as much as I once did, still, I am always hurting, and I always will." 

So how does this constant trauma affect our sleep? As one Child-Loss mother says,

When Tommy's blood-pressure shot up high recently, his doctor surprisingly said to him, "Oh, your shoulder is hurt! When the body is compromised in some way, the blood pressure will shoot up." I guess a similar principle is at work in our poor grief-stricken bodies.

Our hearts are broken, so at some level, our body must know there's a crisis it needs to be attending. There's not enough peace inside for our bodies to allow us the calm for a good night's sleep.

Pictures: Our grandbaby, mine; Sleep graphic, thanks to "Help Stop Abuse on Women"

Tuesday's Trust - Little Lambykins

Tuesday's Trust

Little Lambykins

Tommy surprised me today with an early Christmas present! I think it then surprised us both when I cried in response!!! I think we all have a little "inner-child" in us no matter how "grown-up" we are... especially if we have gone through major trauma like all of us have who have lost our child. It was super sweet of him to do this for me. My lamb is cuddled up next to me even as I write this post :)

It all started when Tommy discovered one of his brothers (name nondisclosed for tough-boy-macho-reputation purposes!) was checking himself into a sleep center tomorrow. So Tommy went by the toy store and, lo and behold, he discovered "Little Lambykins" as we call him although the official title is "Sleep Sheep." What Tommy knows, that no one in the entire world but family would know about this big, tough, macho brother who is quite a successful professional in town, is that as a little boy, he had a "little lambykins" of a different make and model in those days of course, that he would drag around with him, and Tommy's then-little-brother would often be found fallen fast asleep, (even in the front yard, as evidenced by the family's home videos) cuddled up with his "little lambykins" while sweetly sucking his thumb! So it was just too priceless to pass up this little prize awaiting Tommy at the toy store for his sleep-clinic-bound "little" brother. After all, the box did say it "plays soothing sounds for better sleep," and that it is for "All Ages"...

The lamb, besides being absolutely adorable, indeed should be great for those of us with sleep issues. It has four different soothing sounds from nature (a mother's heartbeat, falling rain, ocean waves, and whales playing in the ocean) to choose from by the press of one of the four buttons, along with a choice of options of 23 minutes or 45 minutes on a timer, and a rotate on/off and volume switch, all on a little machine that tucks neatly into lambykins' back! No, this is not an advertisement; it is just a description shared by a sweetly-comforted grieving mother!

And, speaking of lambs ~ I am already imagining holding my lamb, like God is holding me...

And how amazing it is that God loved me and my lamb enough to send His own Lamb to us at Christmas-time...

The Son of God who came to earth at Christmas-time came for the purpose of saving us (and our children) from the Enemy whose very purpose was to steal-kill-and-destroy us.

It is also sweet that He came to us as His Word describes, as

"the Lamb of God who came to take away the sins of the earth." ~John 1:29b

The very Son of the Living God humbled Himself as the sacrificial Lamb, ultimately to die for your sake and mine that we may be made right with God and given life after death so that we may ever live in the safety of the Lamb's arms forever and ever.

Merry Christmas everyone! May we all respond to the Loving, Living Lamb who longs to hold us in His loving arms forever. And ever. And ever. Amen.

Jesus and the Lamb

~Katherine Brown

Jesus is the Lamb of God, and is also our Shepherd:

"Come, let us bow down in worship, let us kneel before the Lord our Maker; for He is our God and we are the people of His pasture, the flock under His care."

~Psalm 95:7

This sweetly inspired picture is on Merry Katherine's grave stone, across from a picture of her, along with the Scripture passage from below:

He gathers the lambs in His arms and carries them close to His heart.

~ Isaiah 40:11b ~

(The prophet Isaiah prophesying about this same Christ who came to us at Christmas)

This picture and scripture is also posted at all times on the left side bar of my blog.

*****

The next day John was there again with two of his disciples. When he saw Jesus passing by, he said,

"Behold! The Lamb of God!"

John 1:35-36

*****

The blood of the Lamb has whitened all the saints who are in Heaven; they sing of Him who loved them, and saved them from their own sins in His own blood...

"And from Jesus Christ, who is the faithful witness, and the first begotten of the dead, and the prince of the kings of the earth.

Unto Him (Jesus Christ) that loved us and saved us from our sins in His own blood, and hath made us king and priests unto God and his Father; to Him be glory and dominion forever and ever. Amen."

(~Revelation 1:5-6)

There is no whiteness in heaven but what the Lamb has wrought, no brightness there but what the Lamb has bought; everything there shows the wondrous power and surpassing merit of the Lamb of God.

~Charles Spurgeon

"And every creature which is in heaven, and on the earth, and under the earth, and such as are in the sea, and all that are in them, heard I saying,

"'Blessing, and honor, and glory, and power, be unto Him that sitteth upon the throne, and unto the Lamb forever and ever.'"

~Revelation 5:13

Picture of "Lambykins" thanks to Amazon.com

Picture of "Jesus and the Lamb" by Katherine Brown:

http://www.christcenteredmall.com/stores/art/brown/jesus_and_the_lamb.htm

Quote from Charles Spurgeon: http://www.spurgeon.org/sermons/2329.htm

Tuesday's Trust - Insomnia and Self-Blasting Amidst Child-Loss Grief

Tuesday's Trust

Insomnia and Self-Blasting

Amidst Child-Loss Grief

Confusion and restlessness along with attacks on self and all else that's good are an indicator of the Evil One attacking.

~St. Teresa of Avila

Lately, I have been plagued with insomnia. After a few hours of sleep, I am wide awake. And that's when the war begins. There is an onslaught against myself that leaves me restless and agitated, yet paralyzed to do anything about it. But it won't leave me alone; it keeps swirling around in my head, keeping me trapped and despondent. ...AND Sleep-Deprived. It is downright maddening. I had chalked it up to,

"Whew...this grief process is something else! Why won't my mind stop racing when it needs to be resting?"

So when I read St. Teresa of Avila's quote, it was such a RELIEF!

I suddenly realized, "So it's not just

• GRIEF and
• TRAUMA and a
• TRANSFORMATION PROCESS into "a new normal" (or more likely "a new creation") I am in (which is really quite enough, thank you), but also
• EVIL ATTACKS that, with God's help and in the name of Jesus, I can stand against.

My, what a complicated mess we're in... amazing, overwhelming at times.

I guess that's why they call Child-Loss Grief "Complicated" Grief...and Trauma!

Such Complicated Grief is depressing and traumatizing, and its accompanying extreme vulnerability leaves one open to the denigrating attacks of the Vile One.

Here is the full quote from St. Teresa:

Recognizing the devil's hand

I have had so much experience of the devil's doings by now that he knows I can recognize him and therefore torments me less in these ways than he once did.

You can detect his part in an experience by the restlessness and discomfort at the beginning and the confusion he causes in the soul while the experience lasts, as well as by the darkness and affliction into which he plunges the soul and its subsequent aridity and lack of zeal for prayer or any other good thing.

He seems to stifle the soul and squeeze the body, rendering both useless. True humility is quite different. The soul knows it is wretched . . . but there is no accompanying confusion or restlessness.

~St. Teresa of Avila

The following devotional proved to be extremely helpful to me amidst one of these middle-of-the-night agitated states I had recently. I could not sleep. My mind wouldn't stop racing, with my heart feeling the familiar chill that creeps in, filling it and surrounding it when I feel taunted by my grief, wondering,

"Where is my deep grief going to leave me if I can't overcome its traumatic impact and function any better than this?"

I pulled out the flashlight I keep under my bed in case of electricity-squelching storms. I began to read Amy Carmichael's devotional:

"Dr. F. B. Meyer once told me that when he was young he was very irritable, and an old man told him that he had found relief from this very thing by looking up the moment he felt it coming, and saying, 'Thy sweetness, Lord.'

{Just reading this one tender phrase brought my sweet Lord's tender presence into my deep agitation, and I burst into tears, the kind that renders your body shaking along with the tears. I hoped I was not going to awaken Tommy amidst my wracking tears... I continued to read...}

"...'Thy sweetness, Lord.' By telling this, that old man greatly helped Dr. Meyer, and he told it to tens of thousands. I pass it on to you because I have found it a certain and a quick way of escape. Take the opposite of your temptation and look up inwardly, naming that opposite;

Untruth--Thy truth, Lord;

Unkindness--Thy kindness, Lord;

Impatience--Thy patience, Lord;

Selfishness--Thy unselfishness, Lord;

Roughness--Thy gentleness, Lord;

Discourtesy--Thy courtesy, Lord;

Resentment, inward heat, fuss -- Thy sweetness, Lord, Thy calmness, Thy peacefulness.

"I think that no one who tries this very simple plan will ever give it up. (It takes it for granted, of course, that all is yielded--the ' I ' dethroned.) Will all to whom it is new try it for a day, a week, a month, and test it?"

~Amy Carmichael

This devotional ministered so deeply to my hurting soul that I was able to quiet my spirit, blow my nose, close my eyes, and fall into the deepest, most peaceful sleep. Fortunately, none of this awakened Tommy. God is good.

Picture thanks to Fan photos from Beautiful Quotes And Inspirational Wallpapers

St. Teresa of Avila quotes from God Seekers: Twenty Centuries of Christian Spiritualities by Richard H. Schmidt (2008)

Amy Carmichael devotional from Edges of His Ways by Amy Carmichael (1955, 1970, 1975)