Mental and Physical Wellness

Mental and Physical Wellness

By: Jodi Sheffield

Co-collaborator: Dr. Lola Ashaye

Summer is here and in full force, which often means frequent daily trips to the local pool, family vacations, and time spent outside (Bless those of you who are attempting to enjoy Texas preheating to 100+ degrees). Summer time also means finally having the time to schedule and attend your annual physical exams and check-ups with your healthcare providers as well as to prioritize the self-care plan that was part of your New Year’s resolutions in January that have been neglected since January 15th.

So how can we ensure that we get the highest quality of care at our summer appts with our PCP, our therapist, our OBGYN, our gastroenterologist, etc? How can we prepare our hearts, minds and bodies to be the healthiest versions of ourselves from head to toe? Funny you should ask. I have some thoughts on the matter.

Over several years, I have had the privilege of working as a therapist with a variety of client populations with diverse acuities and presenting concerns. In this time, I have noticed a consistent pattern. A pattern of hesitancy and fear to create a treatment team composed of their healthcare providers, to give permission for their healthcare providers to communicate with one another in order to provide the highest quality of care. Where does this hesitancy come from? What is the source of these fears and doubts surrounding their healthcare providers communicating as a team?

A possible answer to these questions is simple, yet complex in its powerful influence over the way our communities understand mental health. Stigma. Even with the increased attention from the media sources like TikTok & Reddit, mental health continues to be disparaged as a moralized, “made up” issue that is divorced from physical wellness and care. As a stigmatized matter, mental health issues are often overlooked and misdiagnosed, which leads to continued suffering for those in deep emotional and psychological pain that can, if unaddressed, lead to physical illness. Put simply, “there is no health without mental health” (WHO). Stigma has led to negligence in caring for our minds as well as our bodies.

We also may be reluctant to provide consent for continuity of care due limited knowledge on how mental and physical health are intricately linked. Ignorance regarding the direct relationship between one’s mental and physical health that, at its worst, could lead to significant health risks for more severe, acute mental and/or physical health conditions. To avoid this, I start educating clients on this crucial connection before I even meet them for our first appointment. When you schedule an appointment with a therapist, you receive intake paperwork to complete prior to your first meeting that involves answering questions regarding demographic information, current and past relational dynamics, psychological and emotional concerns and medical conditions, including physical symptoms and current medications. This intake paperwork is crucial to helping your therapist become aware of your presenting concerns, ie. emotional, psychological and physical symptoms, to paint a more holistic picture of who you are. The more whole the picture, the more effective the assessment, diagnosis and treatment process will be.

Knowledge is more than power when it comes to our healthcare decisions, it could be a life changer, a life saver. The research suggests that “there are multiple associations between mental health and chronic physical conditions that significantly impact people’s quality of life…” (Canadian Mental Health Association). For example, we often underestimate the impact of stress on our physical health. According to Dr. Lola Ashaye, a Family Medicine and Lifestyle Medicine at InTouch Primary Care Sugar Land TX, stress can actually make you physically ill. Dr. Ashaye explains that when we're stressed, it affects our body in many ways. It changes how our cardiovascular system works, how our metabolism functions, and even how our digestion works. It can also make us more sensitive to pain. These effects are widespread and contribute to 50 to 80% of illnesses, according to research studies. So, stress isn't just something we should brush off – it can have a real impact on our well-being.

Stress impacts our well-being in various ways, in particular our gut. Yes, you heard it right. Our gut. Scientific evidence reveals that there is a connection between the brain and the gut. John Hopkins Medicine describes this connection in their article “The Brain Gut Connection”, stating “ If you’ve ever “gone with your gut” to make a decision or felt “butterflies in your stomach” when nervous, you’re likely getting signals from an unexpected source: your second brain. Hidden in the walls of the digestive system, this “brain in your gut” is revolutionizing medicine’s understanding of the links between digestion, mood, health and even the way you think (2021). As our second brain, our gut is composed of nerve cells that line the digestive tract and “communicate back and forth with our big brain” (John Hopkins Medicine, 2021). Our digestive system experiences the weightiness of our emotional and psychological distress in a tangible, painful way that embodies the intimate communication between our brain and our gut.

To seek holistic health for ourselves and our loved ones, it is of utmost importance to understand how interrelated our mental and physical health is to make more informed healthcare decisions. Creating a collaborative treatment team of providers is a great place to begin to bridge the mind-body gap that exists in our communities and healthcare institutions. The bridge begins with you, the client!

Citations

Connection Between Mental and Physical Health. CMHA Ontario. (n.d.). https://ontario.cmha.ca/documents/connection-between-mental-and-physical-health/#:~:text=The%20associations%20between%20mental%20and,of%20developing%20poor%20mental%20health.

The brain-gut connection. JHM. (2021, November 1). https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-brain-gut-connection

BOUNDARIES: WHAT TO PROTECT & WHAT TO AVOID

In my previous blog post, I discussed what boundaries are, their importance to the

health of relationships and the different types of boundaries. Some would say they are the

fundamental core of relationships (Gotta keep the apple puns coming!). I would agree.

Boundaries are our relational apples that help us maintain healthy, balanced relationships and

protect what is most important to us: our time, physical space, sexual/romantic relations and

intimacy, emotions, possessions and ideas. Boundaries also protect one’s values, tangible and

intangible, such as pets, traveling, spirituality, UT Football (Hook em!), passions, and hobbies.

When we do not establish and express our boundaries in relationships, we are putting

ourselves at risk for what is called a boundary violation.

If boundaries function as protections to “allow people to express their needs, feelings,

and opinions without fear of judgment, rejection” or lack of emotional, psychological, and

physical safety, boundary violations, whether intentional or not, lead to fear, disrespect of or

apathy towards our partner’s needs, feelings, and opinions (Gilles, 2023). Boundary violations

primarily occur for two reasons.

1) A partner has not established boundaries with his or her partner OR A

partner has established boundaries but has not explicitly verbalized

boundaries to his/her partner due to assumptions that his/her partner

should know his or her boundaries without explicitly communicating them.

2) A partner has established boundaries with partner explicitly and his/her

partner has unconsciously or consciously decided to cross established

boundaries. If a partner consistently and unconsciously violates his/her

partner’s boundary, it is a telltale sign of indifference and disconnection in

the relationship. If a partner consistently and consciously violates his/her

partner’s established boundary, it is often a sign of abuse where power and

control are present, and trust and safety are absent.

To avoid the causes of boundary violations, it is vital to identify and to express

boundaries with one’s partners, friends, colleagues, etc., so there is little confusion of where

“you end, and the other person begins” (Katherine, 2010). According to Gilles (2023),

“boundaries distinguish what is your responsibility in the relationship from that of your

partner’s. What is each person in the relationship responsible for? Their individual bodies,

words, emotions, attitudes, values, and preferences.” When boundaries are established in a

relationship, there is less risk for “blame,” for “blame is almost always a maneuver to deflect

ownership of a problem. When you take responsibility for your part in the misunderstanding,

conflict, or harsh treatment and your partner is willing to take responsibility for their part,

resolution of the problem becomes much easier” (Gilles, 2023). Boundaries provide a

framework that outlines what is and what is not your responsibility in the relationship (Gilles,

2023). Boundaries offer protection for things that matter most to you, the things that make life

worth living, such as safety, autonomy, and free will. When boundaries are violated, one if not

all of these are threatened.

So, what do boundary violations look like? Gilles (2023) offers a couple of common

examples.

1. Saying “yes” to your partner, when in fact you’d rather say “no” – this is usually done to

please the other person or to avoid conflict.

2. Saying “no” when it might be perfectly appropriate to say “yes” – this is often done to

keep a partner at arm’s length or punish him or her. Good boundaries require honesty.

Neither of these behaviors are honest ways to communicate.

3. Making your partner read your mind instead of saying specifically what you’re thinking

or feeling.

4. Trying to control your partner’s thoughts or behavior through aggressive or subtle

manipulation (passive aggression, sarcasm, gossip)

So, how do we protect what matters most to avoid boundary violations?

Below are tips from TherapistAid (2017) and Gilles (2023).

1. Know your limits. Before becoming involved in a situation, now what’s

acceptable to you, and what isn’t. It’s best to be as specific as possible, or

you might be pulled into the trap of giving just a little bit more, over and

over, until you have given far too much.

2. Ask your partner what they are feeling versus guessing. Each of you has your

own thoughts and feelings, and each person is responsible for putting them

into words in order to be understood. This way, your partner doesn’t need to

guess.

3. Know your values. Every person’s limits are different, they’re often

determines by their personal values. Know what is most important to you,

and protect it.

4. Express your feelings as belonging to you without blaming your partner. For

example, it’s much better to say something like, “I feel hurt and

misunderstood in this conversation” than to say, “You made me feel hurt

because of the way you talked to me.” The former is simply expressing an

emotion; the latter is blaming your partner for the hurt feelings.

5. Listen to your emotions. If you notice feelings of discomfort or resentment,

don’t bury them. Try to understand what your feelings are telling you.

Resentment, for example, can be often traced to feelings of being taken

advantage of.

6. Have self-respect. If you always give in to others’, ask if you are showing as

much respect to yourself and what you need as you show to others.

Boundaries that are too porous might be due to misguided attempts to be

liked by elevating other people’s needs above one’s own.

7. Be assertive. When you know it’s time to set a boundary, acknowledge it. Say

“no” respectfully, but without ambiguity. If you can make a compromise

while respecting your own boundaries, try it. For example, if a neighbor asks

you to watch her dog for afternoon, and you are about to leave to meet

friends for a scheduled lunch. You can say, “No, I can’t watch your dog this

afternoon. I already have plans. I would be happy to watch Sparky another

time when I am free.”

8. Consider the long view. Some days you will give more than you take, and

other days you will take more than you can give Be willing to take a longer

view of relationships, when appropriate. But if you are always the one who’s

giving or taking, there might be a problem.

No matter how you slice it, boundaries are of utmost importance to relational health.

They provide protection and safety as well as freedom and clarity. To set and maintain

boundaries allows each partner to take ownership of what he/she can control without

attempting to control one another. The presence of boundaries reveals respect and care

partners have for one another to love each other out of abundance, not scarcity and

desperation. Love and fear are like oil and water. They can’t mutually exist in a relationship and

that’s where boundaries come in. Next blog will focus on characteristics of boundaries to

determine the health of one’s boundaries.

References

Gilles, G. (2023, March 27). The importance of boundaries in romantic relationships. MentalHelp.net. Retrieved

April 19, 2023, from https://www.mentalhelp.net/blogs/the-importance-of-boundaries-in-romantic-relationships/

Healthy Boundaries Tips (worksheet). Therapist Aid. (2017). Retrieved April 19, 2023, from

https://www.therapistaid.com/therapy-worksheet/healthy-boundaries-tips

Katherine, Anne. Boundaries Where You End and I Begin: Where You End and I Begin. Hazelden Publishing, 2010.

The Art of Listening

Listening is truly an art, a skill set worthy of everyone’s intentional effort to attain. It is a master key to great relationships and the door to wisdom. So why is it so hard to do? Why do we struggle with this so important of a skill?

Most likely it’s because it wasn’t modeled for us and no one showed us how to be a great listener. Most of us want so much to be heard, seen, and understood that we get too focused on ourselves and forget to slow down and care about what others have to say to us. The truth is that the path to get what we truly want and need is by taking the road of truly caring to listen to others. As Theodore Rosevelt so eloquently put it, “Nobody cares how much you know, until they know how much you care.”

John C. Maxwell and Jim Dornan teach us a very important lesson in their book Becoming a Person of Influence:

“ A funny thing happens when you don’t make a practice of listening to people. They find others who will. Anytime employees, spouses, colleagues, children, or friends no longer believe they are being listened to, they seek out people who will give them what they want. Sometimes the consequences can be disastrous: the end of a friendship, lack of authority at work, lessened parental influence, or the breakdown of a marriage.”

Simply put: it is crucial that we choose to learn the art of listening and apply it to all of our relationships so that we can have the best friendships, marriage, career success, and parental influence that we desire.

Hearing a person speak and listening are two very different things. Listening implicates you actually taking an interest in what the other person has to say and trying to understand them, even if you disagree with them. Listening leads to more peace and harmony in all relationships. The more we listen the less we will fight and argue and the quicker we get to understanding and resolution. Don't we all want more of that?!!

So...To develop your ability to listen…

Become aware of the key signs that let you know you are not truly listening in a conversation:

• Thinking of what you’re going to say next while the other is speaking

• Waiting eagerly for the person to pause so you can interject your comments and thoughts. Or even worse, interrupting so that you can say your opinions!

• Desiring the other person to understand you and get your point more than you care to understand them

• Seeking ways to convince the other person to agree with you

• Thinking the other person is absolutely wrong and you’re right

• Assuming that you know what the person means by what they say and that you already know what they’re about to say

• Interpreting what someone is saying with your own lens

• Shutting down and thinking about other things while the person is trying to speak with you

Okay, so what does good listening actually look like?

• Staying engaged in the conversation with a genuine interest and desire to understand the other person’s perspective and way of thinking

• Asking curious, open-ended questions to seek understanding

• Making eye contact and attentively hearing what the other person is saying

• Giving your undivided attention without multitasking

• Patiently allowing the other person to express themselves in their own style without interrupting

• Reflecting back to them what you just heard and understood so that they know you are listening and wanting to understand them. Here is an example: “Let me make sure I understand. You really want to ….. because of …., am I understanding that correctly?

Take these tips shared and begin to use them with your spouse, children, boss, and employees; and you will begin to see how your relationships with them get transformed!

It takes time and practice to become a better listener; but I hope that you now have a greater desire to master the art of listening and start to reap the rewards that come with it.

Reference:

Dornan, J., Maxwell, J. C. (1997). Becoming a Person of Influence: How to Positively Impact the Lives of Others (p.84). United States: HarperCollins Leadership.