Self-Care

Welcome to Creighton University! We are excited to have you join our community and want to help facilitate your transition to college.

Going to college and adjusting to a new lifestyle involves many changes. It can be thought of as going from one culture (high school) to a very different one - with a different language, norms, and expectations. Changes can be both exciting and sometimes scary. However, the more you can begin to think about and prepare for these changes, the more successful (and happy) you well be at the university. We at Creighton University Counseling Services want to offer you a few things to think about as you adjust to your college courses, social life, distance from family, and self-reliance.

College is an exciting, scary and growing experience. Counseling Services ishere to facilitate your journey while in college. Our staff is composed of psychologists who are trained to offer a variety of services to students-from individual or group therapy, career counseling, to providing outreach services to residence halls. Our services are free and confidential. When you arrive on campus, take some time to find our office and say hello. Once again, Welcome to Creighton University!

Academic Adjustment

Academics - College is often very different from high school. In high school your teachers often remind you of tests, assignments, and ask you to turn in your work if it is late. In college, you are given a syllabus at the beginning of the semester and are expected to be prepared throughout for exams and turning in your work. In addition, you are given more freedom and responsibility to attend classes. The challenge for many students is to decide whether they want to be a passive learner (i.e., an empty container; that just waits for a professor to fill it) or an active learner(i.e., someone who ensures that they learn what they need and will take initiative in the learning process).

Social Adjustment

Social Life - Will you be attending with friends from high school or will you be the only one you know when you arrive at CU? Those first couple of weeks of college can be difficult for some people. You may want to think about how you might want to meet friends. Often this takes a realization that you need to take some risks- for example, being the first on to initiate social contact or participating in activities for new student.

Living - We encourage students to live in a residence hall. This is the best way to learn about campus and meet new people. Seniors often tell us that their best friends are those they meet their first year in the residence hall. Residence halls can be fun and exciting. One of the changes for many students is that living in the residence hall requires them to SHARE their room. You may want to begin to think about how you negotiate in order to make living in this new home as positive as possible.

Family Adjustment and Homesickness

Family - Going to college is often the first time that a student leaves home. The student and family need to negotiate some new rules. How often should one call? Is it okay to talk about how one is doing in school? What happens if the student is not doing well either academically or socially? How often should the student go home? Starting to talk about these new ‘rules’ will make this transaction easier for the entire family.

Freedom and Self-Care

Freedom - You will, in many ways, be on your own. How are you going to handle this new freedom? Will you go ‘wild’ or will you find balance between fun and academic requirements? Think about your goals and how you want to achieve them while on your own. 

There are changes in responsibility:

There are differences in academics:

There are differences in the ways you access resources & support:

Book Recommendations

• Callings: Finding and following an Authentic Life (Levoy)
• Everything You Need to Know Before College (Turner)
• The Defining Decade: Why Your Twenties Matter–And How to Make the Most of Them Now (Jay)
   

Source: MNADE Publication

What is Anxiety?

Stress and worry are normal, but chronic, exaggerated stress or worry is not. Some stress can be helpful – it can help motivate us, or protect us from harm, and it can even help increase our ability to focus. However, sometimes stress and worry can become excessive and tip the scale into the realm of anxiety. For some people anxiety may be mild and manageable, but for many it can be debilitating and can lead to panic or extreme physical responses to perceived threats or unidentifiable stressors.

Symptoms of Anxiety

• Headaches
• Trembling, twitching
• Lightheadedness
• Difficulty concentrating
• Nausea
• Difficulty breathing
• Sweating, hot flashes
• Change in appetite
• Frequent need to use bathroom
• Startle easily
• Lump in throat, difficulty swallowing
• Knot in stomach
• Sleeplessness
• Restlessness
• Muscle tension
• Fatigue
• Feeling panicky
• A sense that the “walls are closing in”
   

Why Worry?

People with anxiety often worry and experience stress about the same problems as everyone else: money, school, health, families, jobs, relationships, etc. The problem is some people worry excessively and constantly. People without anxiety can put worries on hold and focus on daily tasks without being consumed, while people with anxiety can often be distracted by their worries and find it difficult to think of anything else. Many people with anxiety also feel constant anxiety with no apparent cause. They may wake up feeling anxious and can never pinpoint why, and the feelings last throughout the day.

Anxiety likely has more than one cause. In short, anxiety has both physiological and psychological components. It appears to run in families, so there is likely a genetic factor. A major traumatic or stressful event may sometimes trigger anxiety. Another theory is that the person with anxiety has internal psychological conflicts which have yet to be resolved. It may begin in childhood or later in life.

Treatment

A person with excessive anxiety should seek treatment by first having a medical examination. An exam will rule out other possible causes of anxiety. Once good physical health is confirmed, the person should meet with a mental health provider. Treatment generally includes therapy, medication, or a combination of both. No one treatment method or medication works best for everyone. Cognitive-behavioral therapy (CBT) is an effective treatment for many people with anxiety disorders. With CBT, the person learns relaxation and coping skills. Psychodynamic therapy may also be effective in helping the person resolve and cope with various issues and conflicts. Regular exercise, enough sleep, healthy eating, managing stress, and a strong support network can reduce the intensity and frequency of anxiety symptoms.

Adapted from: https://twu.edu/counseling/mind-body-wellbeing/self-help-resources/menta…

What is Clinical Depression?

Clinical depression can affect your body, mood, thoughts, and behavior. It can change your eating habits, how you feel and think about things, your ability to work and study, and how you interact with people.

Clinical depression is not a passing mood, a sign of personal weakness, or a condition that can be willed away. Clinically depressed people cannot simply “pull themselves together” to get better.

Depression can be successfully treated by a mental health professional or certain health care providers. With the right treatment, 80 percent of those who seek help get better. And many people begin to feel better in just a few weeks.

Symptoms of Depression

• Sadness, anxiety, or “empty” feelings
• Decreased energy, fatigue, being “slowed down”
• Loss of interest or pleasure in usual activities
• Sleep disturbances (insomnia, oversleeping, or waking much earlier than usual)
• Appetite and weight changes (either loss or gain)
• Feelings of hopelessness, guilt, and worthlessness
• Thoughts of death or suicide, or suicide attempts
• Difficulty concentrating, making decisions, or remembering
• Irritability or excessive crying
• Chronic aches and pains not explained by another physical condition

A less intense type of depression, dysthymia, involves long-term, chronic symptoms that are less severe, but keep you from functioning at your full ability and from feeling well. In bipolar illness (also known as manic-depressive illness), cycles of depression alternate with cycles of elation and increased activity, known as mania.

Suicide Risk

Thoughts of death or suicide are usually signs of severe depression. “If you’re feeling like you can’t cope anymore, or that life isn’t worth living, get help,” advised Darrel, a student who tried to kill himself during his freshman year. “Talking to a professional can get you past those intense feelings and save your life.”

Suicidal feelings, thoughts, impulses, or behaviors always should be taken seriously. If you are thinking about hurting or killing yourself, SEEK HELP IMMEDIATELY

• Staff at the student health or counseling center
• A professor, coach, or advisor
• A local suicide or emergency hotline (get the phone number from the information operator or directory)
• A hospital emergency room
• Call 911

If someone you know has thoughts about suicide, the best thing to do is help him or her get professional help.

What Causes Depression?

The causes of depression are complex. Very often a combination of genetic, psychological, and environmental factors is involved in the onset of clinical depression. At times, however, depression occurs for no apparent reason.

Genetics - Depression often runs in families, which usually means that some, but not all, family members have a vulnerability to developing the illness. On the other hand, sometimes people who have no family history also develop depression.

Stress - Psychological and environmental stressors can also contribute to a depressive episode, though individuals react differently to life events and experiences. College can present students with a large degree of stress due to academic demands, being on your own in a new environment, changes in family relationships, financial responsibilities, changes in your social life, exposure to new people, ideas, and temptations, awareness of your sexual identity and orientation, and preparing for life after graduation.

Self-Esteem - Psychological make-up can also play a role in vulnerability to depression. People who have low self-esteem, who consistently view themselves and the world with pessimism, or are readily overwhelmed by stress may be especially prone to depression.

In coping with stress and low mood, some people find writing in a journal, exercising, or talking with friends helpful. But in clinical depression you need some form of treatment (usually medication and short-term psychotherapy) to start feeling better soon. Regardless of the cause, depression is almost always treatable.

I had a period of nearly constant turmoil when I wanted to “come out” to my friends about being gay but didn’t want to be treated like an outsider. A good friend made jokes about homosexuals and I was afraid of what he’d say about me. That stress played a big part in my becoming depressed. - Josh

My family wanted me home every other weekend and I didn’t fit in there anymore. I’d argue constantly with my father, who still treated me like a child. My sister thought I was “uppity.” Everyone was miserable, and I felt guilty and depressed. - Kim

How to Recognize Depression

The first step in defeating depression is recognizing it. It’s normal to have some signs of depression some of the time. But five or more symptoms for two weeks or longer, or noticeable changes in usual functioning, are all factors that should be evaluated by a health or mental health professional. And remember, people who are depressed may not be thinking clearly and may need help to get help.

I kept asking myself, “How could I be depressed? I’d had a normal family life, had been getting good grades, and hadn’t experienced any big trauma - where did my depression come from?” - John

Getting Help & Treatment

If you think you might be depressed, discuss this with a qualified health care or mental health professional who can evaluate your concerns. Bring along an understanding friend for support if you are hesitant or anxious about the appointment.

Several effective treatments for depression are available and can provide relief from symptoms in just a few weeks. The most commonly used treatments are psychotherapy, antidepressant medication, or a combination of the two. The best treatment for an individual depends on the nature and severity of the depression.

Sharing your preferences and concerns with your treatment provider helps determine the course of treatment. Certain types of psychotherapy, particularly cognitive behavioral therapy, can help resolve the psychological or interpersonal problems that contribute to, or result from, the illness. Antidepressant medications relieve the physical and mood symptoms of depression and are not habit-forming. In severe depression, medication is usually required.

Asking for Help

Don’t let fear of what others might say or think stop you from doing what’s best for you. Parents and friends may understand more than you think they might, and they certainly want you to feel better.

I knew I was depressed but thought I could pull out of it by myself. Unfortunately, friends reinforced this attitude by telling me to just toughen up. When that didn’t work, I felt even worse because I had ‘failed’ again. When a friend suggested I talk to his counselor, I resisted at first. In my mind, professional help was for weak, messed up people. But then, I hit a bottom so low that I was willing to try anything. - John

I decided to try treatment when my friends got fed up with me. They didn’t want to talk about my problems any more, but my problems were the major focus of my life. I needed someone who could help me understand what was happening to me. I’d seen ads for the counseling center and decided to give it a try. - Kim

When I began considering suicide, I knew I needed serious help. My resident advisor helped me call a local hotline where I got some good referrals. It was just a phone call, but it was the starting point that got me to the professional help I needed. - Leah

Actually, while the depression was painful, working to get better has taught me a lot about who I am and how to stay healthy. - Marta

Getting treatment definitely changed my life for the better and helped me avoid flunking a semester. - John

Helping Yourself

Don’t give in to negative thinking. Depression can make you feel exhausted, worthless, helpless and hopeless, making some people want to give up. Remember, these negative views are part of the depression, and will fade as treatment takes effect.

Take an active role in getting better. Make the most of the help available by being actively involved in your treatment and by working with a qualified therapist or doctor. Once in treatment, don’t hesitate to ask questions in order to understand your illness and the way treatment works. And, if you don’t start feeling better in a few weeks, speak with the professional you are seeing about new approaches.

Be good to yourself while you’re getting well. Along with professional help, there are some other simple things you can do to help yourself get better, for example: participating in a support group, spending time with other people, or taking part in activities, exercise, or hobbies. Just don’t overdo it and don’t set big goals for yourself. The health care professional you are seeing may suggest useful books to read and other self-help strategies.

Helping a Friend

The best thing you can do for a depressed friend is to help him or her get treatment. This may involve encouraging the person to seek professional help or to stay in treatment once it is begun. The next best thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation or activities and be gently insistent if you are met with resistance. Remind that person that with time and help, he or she will feel better.

Source: NIMH: http://www.nimh.nih.gov/ NIH Publication No. 97-4266

Book Recommendations

• The Feeling Good Handbook (Burns)
• Queer Blues (Hardin & Hall)
• An Unquiet Mind (Jamison)
• You Mean I Don’t Have To Feel This Way? New Help for Depression, Anxiety, and Addiction (Dowling)
• The Depression Workbook (McKay)
• Cognitive Behavioral Workbook for Depression (Knaus)
• The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness (Williams)
• Self-Compassion: The Proven Power of Being Kind to Yourself (Neff)

It can be hard to tell when drug and alcohol use becomes problematic, especially in a society and college culture that normalizes excessive use. Addiction concerns can be understood best by using this continuum:

1. Experimental use (trying something out)
2. Recreational use (regular use for fun)
3. Medicinal use (using it as a coping mechanism)
4. Dependence (becomes harder and harder to refrain)
5. Lastly, addiction.

It is important to recognize that addiction is an illness and not simply a matter of choice, that like any other mental illness, there are environmental, genetic, psychological, and experiential factors that lead to addiction. The only substances that are physically addicting are alcohol, nicotine, and opiates, but there are other substances that can be used excessively and can lead to dependency, though not addiction.

In college, there are numerous reasons students use drugs and alcohol: for stress relief, to help manage excessive homework or course load, out of curiosity, by peer pressure, or for fun. Some of the most commonly used drugs of choice on college campuses are alcohol, marijuana, Adderall, and ecstasy.

Warning Signs

There are warning signs to watch out for with substance use, and it is important to distinguish where you or a friend might fall on the continuum mentioned above. There are 4 main aspects that distinguish addiction from dependence. You know someone is addicted to a substance when they experience:

1. Withdrawal – a physical response to the absence of drugs/alcohol, such as shaking, nausea, sweating, headaches, etc.
2. Cravings – an intense, urgent longing for the substance, making it hard to go without
3. Loss of control – use continues despite consequences; increase in recklessness
4. Increased tolerance – it takes more and more of substance to get desired result

Other warning signs to be aware of include: rapid mood swings, changes in sleeping habits, behavioral changes such as stealing, lying, or isolation, noticeable weight change, and dangerous patterns of use or reckless behavior. When numerous warning signs are present for you, a friend, or a family member, it may be time to seek professional help.

Book Recommendations

• It Will Never Happen to Me: Children of Alcoholics (Black)
• Running with Scissors (Burroughs)
• Smashed: Story of a Drunken Girlhood (Zailckas)
• When AA Doesn’t Work For You: Rational Steps to Quitting Alcohol (Ellis)
• Living Sober (Anonymous)
• Ninety Days: A Memoir of Recovery (Clegg)
• The Addiction Workbook (Fanning)
• I’ll Quit Tomorrow (Johnson)
• Adult Children of Alcoholics Syndrome (Kritsberg)
• Perfect Daughters: Adult Daughters of Alcoholics (Ackerman)

What are Eating Disorders?

The majority of eating disorders begin between ages 18 and 25, and can be life threatening. Since we live in a culture that fixates on thinness and diet fads, it can be challenging to identify when a person’s thinking or behavior has become dangerous. You may know someone with an eating disorder or you may be questioning whether you have one yourself. The person may try to hide it, but when someone as an eating disorder, the focus of everyday life centers – obsessively – around food, body image, and/or weight. As in all cases with mental health issues, there are many environmental, psychological, cultural, and genetic components that play into the development of eating disorders.

Some people with eating disorders will restrict their eating, while others over-eat beyond the sensation of being full. Some people make themselves throw up or use drugs to help food pass through their body quickly. All of these can result in poor nutrition and other serious health problems. There are three major types of eating disorders.

• People with anorexia nervosa have a distorted body image that causes them to see themselves as overweight even when they're dangerously thin. Often refusing to eat, exercising compulsively, and developing unusual habits such as refusing to eat in front of others, they lose large amounts of weight and may even starve to death.
• Individuals with bulimia nervosa eat excessive quantities of food, and then purge their bodies of the food and calories they fear by using laxatives, enemas, or diuretics, vomiting and/or exercising. Often acting in secrecy, they feel disgusted and ashamed as they binge, yet relieved of tension and negative emotions once their stomachs are empty again.
• Like people with bulimia, those with binge eating disorder experience frequent episodes of out-of-control eating. The difference is that binge eaters don't purge their bodies of excess calories.

Who suffers from eating disorders?

According to the National Institute of Mental Health, adolescent and young women account for 90 percent of cases. But eating disorders aren't just a problem for the teenage women so often depicted in the media. Older women, men and boys can also develop disorders. And an increasing number of ethnic minorities are falling prey to these devastating illnesses.

People sometimes have eating disorders without their families or friends ever suspecting that they have a problem. Aware that their behavior is abnormal, people with eating disorders may withdraw from social contact, hide their behavior and deny that their eating patterns are problematic. Making an accurate diagnosis requires the involvement of a licensed psychologist or other appropriate mental health expert.

Warning Signs

If you notice these warning signs, the best thing you can do is ask for help from a professional. You can call the Counseling Center, who can help begin treatment, complete an eating disorder evaluation, and transfer you to more appropriate care should you need it.

Source: Renfrew Center Foundation

Why is it important to seek treatment for these disorders?

Research indicates that eating disorders are one of the psychological problems least likely to be treated. But eating disorders often don't go away on their own. And leaving them untreated can have serious consequences. In fact, the National Institute of Mental Health estimates that one in ten anorexia cases ends in death from starvation, suicide or medical complications like heart attacks or kidney failure.

Eating disorders can devastate the body. Physical problems associated with eating disorders include anemia, palpitations, hair and bone loss, tooth decay, esophagus and the cessation of menstruation. People with binge eating disorder may develop high blood pressure, diabetes and other problems associated with obesity.

Eating disorders are also associated with other mental disorders like depression. Researchers don't yet know whether eating disorders are symptoms of such problems or whether the problems develop because of the isolation, stigma and physiological changes wrought by the eating disorders themselves. What is clear is that people with eating disorders suffer higher rates of other mental disorders -- including depression, anxiety disorders and substance abuse -- than other people.

Does treatment really work?

Yes. Most cases of eating disorder can be treated successfully by appropriately trained health and mental health care professionals. But treatments do not work instantly. For many patients, treatment may need to be long-term.

Incorporating family or marital therapy into patient care may help prevent relapses by resolving interpersonal issues related to the eating disorder. Therapists can guide family members in understanding the patient's disorder and learning new techniques for coping with problems. Support groups can also help.

Remember: the sooner treatment starts the better. The longer abnormal eating patterns continue, the more deeply ingrained they become and the more difficult they are to treat.

Eating disorders can severely impair people's functioning and health. But the prospects for long-term recovery are good for most people who seek help from appropriate professionals. Qualified therapists such as licensed psychologists with experience in this area can help those who suffer from eating disorders regain control of their eating behaviors and their lives.

From the American Psychological Association

National Eating Disorders Association * Website: www.nationaleatingdisorders.org

• Main Phone: 800.931.2237
• Helpline: 1.800.931.2237 
• Crisis text hotline: Text "NEDA" to 741741
• Treatment directory

Book Recommendations

• Making Peace with Food (Kano)
• Telling Ed No! (Kerrigan)
• Life Without Ed (Schaefer)
• Eating by the Light of the Moon (Johnston)
• Hope, Help, & Healing for Eating Disorders (Jantz)
• When Perfect Isn't Good Enough: Strategies for Coping with Perfectionism (Antony)
• The Self-Esteem Workbook (Shiraldi)
• Overcoming Bulimia Workbook (McCabe)
• The Self-Compassion Diet (Fain)

We at the Creighton Counseling Center affirm the value and importance of LGBTQIA+ people in our community, neighborhood, campus, and world. If you are struggling, counseling can provide support and help you develop a positive view of self-identity. There are many ways that counseling can offer help.

Identifying and clarifying issues. Sometimes, people who seek counseling are not sure about what is wrong, but they know that they are not happy. Counselors are skilled at helping people understand themselves and their feelings. The process of recognizing and understanding gender identity and sexual orientation often involves a confusing set of thoughts and feelings. Counselors can help an individual clarify and sort through some of the confusion.

Identifying, clarifying, and expressing feelings. Often people have difficulty understanding, labeling and/or expressing feelings. This is particularly true when people are under stress. Feelings can be confusing and may often seem to be out of control. Most counselors are particularly good at helping people handle and understand their feelings.

Deciding what to do. Feeling stuck and uncertain is common when people are having difficulty determining alternatives, such as whether or not to come out to friends or family, or whether or not to begin the process of transitioning. Usually, there is more than one choice in how to behave. Counselors are adept at helping people uncover and discover options and alternatives that work best for the individual.

Developing and enhancing relationship skills. Building a support system and developing close interpersonal relationships is especially important to most people. Yet there are some individuals who seem to have difficulty getting what they want from a relationship – whether it is from family, friends, or partners. Dealing with relationships may be a primary focus of counseling and counselors. It is also an essential part of developing a healthy sense of self. Resource: Counseling Services, Kansas State University (1997)

For additional information on how counseling may be of help to you, you may contact Counseling Center at (402) 280-2256; the staff includes trained professionals who hold advanced degrees in counseling and clinical psychology and are committed to delivering supportive and affirming services.

Correcting Myths

Myth #1: Homosexuality is “Unnatural” THE TRUTH: From a scientific point of view, it is “natural”. Any animal, including humans, can respond to homosexual stimuli. Research suggests that homosexuality is almost universal among all animals and is especially frequent among highly developed species. There has been evidence of homosexuality in all human cultures throughout history. In fact, one anthropological study of non-Western cultures found that 64% of their sample considered homosexuality “normal and socially acceptable” for certain members of society.

Myth #2: Homosexuality is “Just About Sex” THE TRUTH: “Being gay or bisexual is more than being sexually active with a person of the same sex. Homosexuality/bisexuality influences the entire span of experiences that life has to offer. This includes such private matters as love, affection intimacy, spiritual, and emotional support as well as more public matters such as maintaining a household, combining finances, filing joint tax returns, and even whom you choose to dance with at a party. Sexuality is not just a component of our lives, but it deeply informs our identity. Though many say homosexuality/ bisexuality is and should remain a private matter, such a reference belittles the impact that sexual orientation has on the social, economic, and intellectual aspects of our society. It is a simplification often used to limit the rights of GLB individuals and to limit their ability to fight for those rights. People are political beings. What we read, what we eat, and who we socialize with are all political statements. Though there are some aspects of life that are more personal while others are more public, there is simply no clear split between the two.” From Leigh University and the Campaign to End Homophobia

Myth #3: There are Specific Gender Roles in Gay Relationships THE TRUTH: There are a variety of forms of gay relationships, just as heterosexual relationships. Sometimes there may be specific roles for each person; sometimes these roles are very flexible. Original butch/femme roles may have come from imitating heterosexual roles.

Myth #4: Gay People Could Change If They Want To THE TRUTH: Research as repeatedly shown this is not true - - that sexual orientation is something we are born with. Examples of people who claim to have changed their orientation usually indicate someone who has changed their behavior in response to internal or external pressure to be heterosexual. This is often at great cost to self, because basic feelings haven’t changed. Sexual orientation emerges for most people in early adolescence without any prior sexual experience. And some people report trying over many years to change their sexual orientation from homosexual to heterosexual with no success. For these reasons, psychologists don’t consider sexual orientation for most people to be a conscious choice that can be voluntarily changed. The American Psychological Association has made several official statements that conversion therapy is unethical.

Myth #5: Gay People Do Not Have Stable or Long Relationships THE TRUTH: Even though gay and lesbian relationships do not have the social supports which heterosexual relationships have, many gays and lesbians form long-term, monogamous, stable relationships and consider themselves to have a lifetime commitment to each other. Many heterosexual people have trouble forming stable relationships; so do some gay, lesbian and bisexual people.

Myth #6: Gays and Lesbians Don’t Know How To Be Good Parents THE TRUTH: The adoption and foster care screening process is very rigorous, including extensive home visits and interviews of prospective parents. It is designed to screen out those individuals who are not qualified to adopt or be foster parents, for whatever reason. All of the evidence shows that lesbians and gay men can and do make good parents. The American Psychological Association, in a recent report reviewing the research, observed that “not a single study has found children of gay or lesbian parents to be disadvantaged in any significant respect relative to children or heterosexual parents,” and concluded that “home environments provided by bay and lesbian parents are as likely as those provided by heterosexual parents to support and enable children’s psychosocial growth.” That is why the Child Welfare League of America, the nations’ oldest children’s advocacy organization, and the North American Council on Adoptable Children say that gays and lesbians seeking to adopt should be evaluated just like other adoptive applicants.

Myth #7: Coming Out Is A One Time Process THE TRUTH: For most gay people, coming out is a lifetime process. In any new situation or relationship, the gay person must decide how out to be. These situations can include simple activities (i.e. shopping, opening a joint checking account, picking out furniture, buying jewelry, taking your child to the doctor, attending parent night at school, or having company over to your home).

Myth #8: LGBTQ Persons Have No Interest in Spiritual Life or Religious Identity. THE TRUTH: Nothing could be further from the truth. LGBTQ persons were born into families that have connections, often very strong connections, to religious traditions. LGBTQ persons therefore have elements of their identities that seek for an understanding of God and a belonging to a religious tradition. These longings and questions are part of every person’s identity. The problem comes when certain religious traditions hold beliefs about homosexual identity or homosexually directed behavior as being “wrong.” Some religious traditions hold that homosexual persons are valued, as are all persons, but that the sexual orientation is “disordered” and homosexual behavior is wrong; while there are other religious traditions that hold that both the behavior and the person are to be condemned. There are also religious traditions that welcome LGBTQ persons and hold that LGBTQ behavior is as good as heterosexual behavior. As in all religions, there is variation from church to church and from individual to individual.

Book Recommendations

• Coming Out: An Act of Love (Eichberg)
• This Book is Gay (Dawson)
• Outing Yourself (Signorile)
• Is It a Choice? (Marcus)
• God Doesn’t Make Mistakes: Confessions of a Transgender Christian (Scott)
• The Velvet Rage: Overcoming the Pain of Growing Up Gay in a Straight Man’s World (Downs)
• Unladylike: A Field Guide to Smashing the Patriarchy and Claiming Your Space (Conger)
• The Queer and Transgender Resilience Workbook: Skills for Navigating Sexual Orientation and Gender Expression (Singh)
• The Gender Quest Workbook: A Guide for Teens and Young Adults Exploring Gender Identity (Testa)
• Torn: Rescuing the Gospel from the Gays-vs.-Christians Debate (Lee

The death of someone we care about is distressing, and the sense of loss and grief which follows is a natural and important part of life. It is not a sign of weakness, but rather a healthy and fitting response - a tribute to someone we loved and lost to death.

Normal Grief Reactions

When experiencing grief, it is common to:

• Feel like you are “going crazy”
• Have difficulty concentrating
• Feel sad or depressed
• Be irritable or angry (at the deceased, oneself, others, higher powers)
• Feel frustrated or misunderstood
• Experience anxiety, nervousness, or fearfulness
• Have an upset stomach
• Feel like you want to “escape”
• Experience guilt or remorse
• Be ambivalent
• Feel numb or empty
• Lack energy and motivation
• Have difficulty sleeping or have nightmares
• Feel helpless or hopeless
• Feel a sense of disbelief

Whatever feelings and reactions you have are ok. Criticizing yourself for your feelings or thinking that you should “just pull yourself together” is usually not helpful, or frankly, realistic. Grief is as individual as a fingerprint; however, the need to grieve is universal.

Grief as a Process

Seldom does a person go into one side of grief and come out the other side the same as before the loss. Think of going through your grief, rather than getting over the loss. The length of the grief process is different for everyone. It is important to note that the grief process is not linear, but rather is more often experienced in cycles or waves. Grief is sometimes compared to climbing a spiral staircase where things can look and feel like you are just going in circles, yet you are making progress. Being patient with the process and allowing yourself to have any feelings about the loss can help.

With time and support, things generally do get better. However, it is normal for significant dates, holidays, or other reminders to trigger feelings related to the loss. Taking care of yourself, seeking support, and acknowledging your feelings during these times are ways that can help you cope. By seeing the process through, you can develop personal strengths to cope with other types of loss and difficulties that may come up later in life. Acceptance of the loss means gaining a perspective - a new sense of self and what you can do with your life.

Though we all are touched by death and loss, suicide loss can present a unique set of challenges. Suicide loss is extremely painful and can differ from other types of loss in that survivors often struggle more with questions of meaning-making around the death, feel higher levels of guilt or blame, and can experience heightened feelings of rejection or abandonment, along with anger towards the deceased. If your loved one died by suicide, this can complicate grief and there is additional support available. For starters, the Suicide Survivor Guide (link to doc, Maddie has) is helpful.

Culture, Rituals, and Ceremonies

Your cultural background can affect how you understand and approach the grief process. Some cultures anticipate a time to grieve and have developed rituals to help people through the grief process. Grief rituals and ceremonies acknowledge the pain of loss while also offering social support and a reaffirmation of life. Some people find solace in creating their own unconventional ceremonies, such as a ritual with personal friends in a private setting.

Coping with Grief

Running away from grief postpones inevitable sorrow; clinging to grief prolongs pain. Neither leads to healing. Each one of us has our own way of coping with painful experiences. The list below may help you generate ideas about how to manage your feelings of grief.

• Talk to supportive family or friends frequently about your feelings and memories
• Keep the routines of life going (e.g., classes, work, interests, and friends)
• Do the basics: exercise, eat healthy foods, and get plenty of rest
• Express yourself creatively through art or writing
• Seek spiritual support
• Take time to relax
• Join a support group (one is offered at Creighton, call and inquire at the front desk)
• Spend time with others doing enjoyable things
• Listen to music
• Be patient with yourself
• Allow emotions, and allow a break from emotions
• Seek counseling
• Don’t make any big or sudden decisions about life
• Avoid extra responsibilities during this healing time
• Give yourself permission to grieve; don’t try and rush things along

You may want to experiment with these ideas or create a list of your own. Healthy coping skills are important in dealing with a loss and helping you move forward in the healing process. Try to resist the temptation to “throw yourself” into work, school or other diversions. This leaves too little time for the grief work you need to do. Be patient with yourself. It takes time to heal. Some days will be better than others.

If you feel stuck in your grief, talking to a counselor or a supportive person may help you move forward in the healing process.

Supporting Others Who Are Grieving

As the shock of the loss fades, there is a tendency on the part of the griever to feel more pain and sadness. Well-meaning friends may avoid discussing the subject due to their own discomfort with grief or their fear of making the person feel bad. As a result, people who are grieving often feel more isolated or lonely in their grief. People who are grieving are likely to fluctuate between wanting some time to themselves and wanting closeness with others. They may want someone to talk to about their feelings. Below are some ways that you can help a friend experiencing loss:

• Be a good listener
• Ask about their feelings
• Just sit with them and let them be sad
• Share your feelings
• Ask about their loss
• Remember the loss
• Acknowledge the pain
• Don’t wait for permission or guidance on how to be a support for them; just DO
• Be available when you can
• Do not minimize grief

Book Recommendations

• Man’s Search for Meaning (Frankl)
• When Bad Things Happen to Good People (Kushner)
• Option B: Facing Adversity, Building Resilience, and Finding Joy (Sandberg)
• The Year of Magical Thinking (Didion)
• Motherless Daughters (Edelman)
• Healing After the Suicide of a Loved One (Smolin & Guinan)
• The Healing Sorrow Workbook (Mayo)
• Seven Choices: Taking the Steps to New Life After Losing Someone You Love (Neeld)
• When Parents Die (Myers)
• The Empty Room: Understanding Sibling Loss (DeVita-Raeburn)

Is Your Relationship Healthy?

Being in a HEALTHY RELATIONSHIP means …

• Loving and taking care of yourself, before and while in a relationship.
• Respecting individuality, embracing differences, and allowing each person to “be themselves.”
• Doing things with friends and family and having activities independent of each other.
• Discussing things, allowing for differences of opinion, and compromising equally.
• Expressing and listening to each other’s feelings, needs, and desires.
• Trusting and being honest with yourself and each other.
• Respecting each other’s need for privacy.
• Sharing sexual histories and sexual health status with a partner.
• Practicing safer sex methods.
• Respecting sexual boundaries and being able to say no to sex.
• Resolving conflicts in a rational peaceful, and mutually agreed upon way.
• There is room for positive growth and you learn more about each other as you develop and mature.

If you are in an UNHEALTHY RELATIONSHIP …

• You care for and focus on another person only and neglect yourself or you focus only on yourself and neglect the other person.

• You feel pressure to change to meet the other person’s standards, you are afraid to disagree, or your ideas are criticized. Or, you pressure the other person to meet your standards and criticize his/her ideas.

• One of you has to justify what you do, where you go, and who you see.
• One of you makes all the decisions and controls everything without listening to the other’s input.
• One of you feels unheard and is unable to communicate what you want.
• You lie to each other and find yourself making excuses for the other person or to them.
• You don’t have any personal space and must share everything with the other person.
• Your partner keeps his/her sexual history a secret or hides a sexually transmitted infection from you or you do not disclose your history to your partner.
• You feel scared of asking your partner to use protection or s/he has refused your requests for safer sex. Or, you refuse to use safer sex methods after your partner has requested or you make your partner feel scared.
• Your partner has forced you to have sex or you have had sex when you don’t really want to. Or, you have forced or coerced your partner to have sex.
• One of you yells and hits, shoves or throws things at the other in an argument.
• You feel stifled, trapped, and stagnant. You are unable to escape the pressures of the relationship.

Source: http://www.advocatesforyouth.org

Coping with a Break-Up

The realization that “it’s over” can truly hurt. Losing a deep connection with another person is something you can never really prepare for, and when it happens it can be hard to cope. Whether you decided to end the relationship, or it was ended for you, you may experience symptoms of grief and periodic despair. In many cases, the partner was also the best friend. Coping with relationship loss can be particularly difficult if the couple has relied on each other as best friends. By having limited options to confide in, the ‘newly’ single person may feel isolated, lonely, and frustrated.

“It took work to develop a bond between two people. With that bond being severed, it will take time to rebuild. If you find yourself watching the telephone in hopes of getting a call or listening to romantic songs as you reminisce about your ex and the way it ‘could have been’, you may be holding on and need to incorporate some strategies for transitioning to your new life of independence.

It is important to make time for the healing process. Too often, we are encouraged to be ‘strong’ and keep it all inside. This method only serves to keep the former loved one on your mind and you frustrated. There needs to be a grieving period. Whether you care to admit it or not, that person did mean a great deal to you at one time. You honor the love that you shared by validating the relationship as a worthwhile experience with grief.

Engage in ‘self-help’ practices. Some people benefit from reading self-help books. Others enjoy creative writing or art as a means of healing and expression. Find a way that complements your personality and do it! Whether it’s reading, writing, or singing, expressing your feelings is a great way to learn about yourself and your current needs.

Realize that you might not be functioning at your best right now. Give yourself some space to ‘be’ without pressure or high demands. Efforts to organize the more routine activities of your life may be helpful to streamlining your energy expenditure. Do the activities that you need to and leave your remaining time for nurturing, self-discovery, and healing.

Mobilize your support system. Spending time with affirming friends is essential. In addition to venting your emotions as you sort through your next step in life, you can share the relationship’s shortcomings. Also, your friends can help you avoid an unhealthy reconciliation by providing true accounts of the circumstances.

Use this time for self-renewal. When you are involved in a relationship, the other person receives your attention and focus. Being single offers you the opportunity to redirect that attention to yourself. Connect with areas of your life that have been neglected as a result of the relationship. Recharge your body through exercise. Reflect on your spiritual awareness and life journey. Replenish by engaging with nature. Renew your commitment to yourself to be the best person possible.

Spend some time each day doing something pleasurable. It is important to enjoy key aspects of your life while other components are mending. Find joy again in the small things and do something that just makes your body feel good.

Highlight the reasons that the relationship was less than perfect. During times when loneliness sets in, the reason why the relationship ended may not be so clear. It may be

helpful to remove rose-colored glasses and review your thoughts about the relationships in a way that is more accurate or representative of reality.

Most research indicates that it takes about half the time the relationship existed in order to heal from the pain. Even then, many carry a portion of the painful memories for longer periods of time. Time does help ease the discomfort of relationship loss. However, it usually takes a while to feel better. Remembering the suggestions above may help as you patiently discover the relationship with yourself again.” (Texas Women’s University, 2018).

This information was received from the Texas Women’s University, https://twu.edu/counseling/mind-body-wellbeing/self-help-resources

Sexual Assault remains a serious concern for women today. Current statistics reveal that 1 out of 4 women will be sexually assaulted in their lifetime. This number is even higher for college-aged women, 18-25. Creighton University recognizes the importance of this issue and strives to provide education regarding sexual assault occurrence and prevention, as well as providing services for victims of sexual assault. In addition to the Counseling Center, the Violence Intervention and Prevention Center (link) can be an informative support resource for you or anyone you know who has experienced sexual assault or intimate partner violence.

Sexual assault may be defined as “sexual penetration, no matter how slight, of the genital, anal, and/or oral opening of the victim by any part of the perpetrator’s body or by the use of an object, without the victim’s consent or against the victim’s will where the victim: (1) is forced or has a reasonable fear that the victim or another will be injured if the victim does not submit to the act; (2) is incapable of giving consent or is prevented from resisting due to physical or mental incapacity, which includes, but is not limited to, the influence of drugs or alcohol; (3) suffers from a mental or physical disability.”

If You Believe You Have Been Sexually Assaulted

You do not have to work through this alone! The professional staff at the Counseling Center is trained and ready to help you through your reactions to this experience. Below are helpful steps that you can take…

• Call Public Safety after hours at 402.280.2911, and you can ask them to have an on-call counselor contact you. You may also call 911 for immediate assistance.
• Call a close friend or relative.
• Seek medical attention immediately. Call Student Health and 402.280.2256 during business hours or go to your nearest emergency room.
• Do NOT bathe, shower, douche, or change clothes until you have talked with the police.

Your Rights…

You have the right to file a report with the police. The VIP Center can help you with this process step-by-step.

• Creighton Public Safety 402.280.2104
• Omaha Police Department 402.444.6500
• Douglas County Sheriff 402.444.5600
• You have the right to file a complaint with the Office of Community Standards and Wellbeing (link) at 402.280.2775.
• You have the right to seek civil action (contact an attorney).

Common Responses to Sexual Assault

Many victims have common responses to the experience of being sexually assaulted. While these responses are common, that does not make them any less important or difficult for the victims to deal with.

• A survivor may feel ashamed, guilty, fearful, or numb. Often a survivor’s self-esteem is diminished after an assault. It is important to remember that the attack is not his or her fault.
• A survivor may find it difficult to trust and to be intimate with others.
• A survivor may experience flashbacks of the incident.
• A survivor may experience fear of being alone.
• A survivor may experience nightmares or other sleep disturbances.
• A survivor may not be able to concentrate and focus. This can affect academic and/or job performance.

Ways to Take Care of Yourself

• Get support from friends and family – try to identify people you trust to validate your feelings and affirm your strengths.
• Talk about the assault and express feelings. You can choose when, where, and with whom to talk about the assault and set limits by only disclosing information that feels safe for you to reveal.
• Use stress reduction techniques – hard exercise like jogging, aerobics, and walking; relaxation techniques like yoga, massage, music, hot baths; prayer and/or meditation. LINK
• Maintain a balanced diet and sleep cycle as much as possible and avoid overusing stimulants like caffeine, sugar, and nicotine.
• Discover your playful and creative “self.” Playing and creativity are important for healing from hurt. Find time for noncompetitive play-start or resume a creative activity like piano, painting, gardening, handicrafts, etc.
• Take “time outs.” Give yourself permission to take quiet moments to reflect, relax and rejuvenate - especially during times you feel stressed or unsafe.
• Try reading. Reading can be a relaxing, healing activity. Try to find short periods of uninterrupted leisure reading time. There are suggested books at the bottom of this page specifically related to sexual assault if that interests you.
• Consider writing or keeping a journal as a way of expressing unfiltered thoughts and feelings.
• Release some of the hurt and anger in a healthy way: Write a letter to your attacker about how you feel about what happened to you. Be as specific as you can. You can choose to send the letter or not. You also can draw pictures of the anger you feel for your attacker as a way of releasing the emotional pain.
• Hug those you love. Hugging releases the body’s natural painkillers.
• Remember you are safe, even if you don’t feel it. The rape is over. It may take longer than you think, but you will feel better.

From Texas Woman’s University Counseling Center.

Myths and Realities of Sexual Assault

MYTH: Rape is a sexual crime, impulsively committed by a man for sexual gratification.
REALITY: Rape is a crime of violence and aggression. It is intended to overpower, degrade, and humiliate the victim.

MYTH: Rape does not happen very often.
REALITY: Rape is the most frequently committed violent crime in the United States.

MYTH: Most rapes are committed by a stranger in a dark place, at night.
REALITY: It is estimated that 50% to 70% of rapes are committed by someone the victim knows. Nearly half of all assaults occur in the victim’s home. Many acquaintance rapes occur in the context of a dating relationship.

MYTH: Rape is the victim’s fault. Women provoke rape by how they behave, dress, or where they choose to go.
REALITY: Rape is NEVER the victim’s fault. If a woman wants to be involved sexually with a man, force or threats of physical violence would not be necessary.

MYTH: In a dating situation, when a woman says “no” she really means “yes” or “maybe.”
REALITY: This myth has been perpetrated to deny the man’s responsibility. That fact is that NO means NO.

MYTH: Women report rapes to get even with men or to protect their reputations.
REALITY: According to the FBI, fewer than 2% of reported rapes are false, which is the same percentage for the false reporting of other crimes.

Dater’s Bill of Rights

• I have the right to refuse a date without feeling guilty.
• I can ask for a date without feeling rejected or inadequate if the answer is no.
• I may choose not to act seductively.
• If I don’t want physical closeness, I have the right to say no.
• I have the right to be myself without changing to suit others.
• I have the right to change a relationship when my feelings change. I can say “We used to be close, but now I want something else.”
• If I am told a relationship is changing, I have the right not to blame or change myself to keep it going.
• I have the right to an equal relationship.
• I have the right not to dominate or to be dominated.
• I have the right to act one way with one person and a different way with someone else.
• I have the right to change my goals whenever I want to.
• I have the right to stop physical intimacy whenever I feel ready to stop.

If Someone You Know Is Sexually Assaulted

Sexual assault is often not only traumatic for the victim, but often for their loved ones. The experience of a sexual assault can put a great deal of strain on the relationships that the victim has with friends, family members, coworkers, and lovers. If you know someone who may have been sexually assaulted be aware that you may be more affected by their experience than you anticipate. There are resources available to help you as well. For more information, see the following suggestions and resource list, or call the Counseling Center or the VIP Center to set up an appointment to speak with a counselor about your reaction to your loved one’s victimization.

How You Can Help

DO…

• Be supportive
• Share your feelings
• Listen
• Communicate that your friend is not responsible for the violation
• Make sure he or she has a safe place to stay
• Realize that you, too, have been affected and seek counseling if necessary
• Allow your friend to regain control by making his or her own decisions
• Make yourself available to accompany your friend to the hospital or counseling center

DO NOT…

• Attempt to seek revenge
• Make jokes
• Be angry or disappointed with your friend
• Force your friend to talk
• Ask your friend how he or she could have “let this happen”
• Assume you can understand how your friend feels
• Take control
• Discuss the incident with others unless you have permission from the victim (professional mental health counselors are the exception)

Book Recommendations

• Sexual Assault: Will I Ever Feel Ok Again? (Scott)
• Extra-Curricular: A Novel of Rape on Campus (Hasselbrack)
• A Girl’s Gotta Do What A Girl’s Gotta Do (Baty)
• Life, Reinvented: A Guide to Healing from Sexual Trauma for Survivors and Loved Ones (Carpenter)
• Rid of My Disgrace: Hope and Healing for Victims of Sexual Assault (Holcomb)
• We Believe You: Survivors of Campus Sexual Assault Speak Out (Clark)
• Can I Kiss You?: A Thought-Provoking Look at Relationships, Intimacy, and Sexual Assault (Domitrz)
• I Never Called it Rape (Warshaw)
• If She is Raped: A Book for Husbands, Fathers, and Male Friends (McEvoy & Brookings)
• If You are Raped (Johnson)

By Amanda McKinney, Senior

It’s the night before a big test. You have studied all afternoon and you feel confident you will do great. You want to get to bed early so you can be fresh tomorrow morning for the test. At 10:30pm you turn your light off and close your eyes. However, you soon realize that you’re not sleepy, so you might turn the TV on for a while and try to doze off, yet nothing happens. Constantly you are looking at the clock to see what time it is. You try everything from counting sheep to playing soft music, yet you can’t doze off.

We all experience sleepless nights; however, they can become a problem if experienced frequently. Sleeping problems can lead to feelings of ill-being, fatigue, and impaired concentration during the day. A normal, healthy individual needs 7 to 9 hours of sleep per night.

Symptoms

According to the National Sleep Foundation, 60% of adult Americans experience sleeping problems. People with sleeping problems may experience:

• Difficulty falling asleep.
• Frequently waking up in the night.
• Waking up too early.
• Feelings of grogginess and lethargy.
• Inability to focus in waking hours

Causes

You may be wondering what exactly causes sleeping problems. Well, there are a variety of reasons, varying with individuals, but here is a list of possible causes:

• Anxiety (excessive worry or fear)
• Stress (from school or work, relationships, etc.)
• Physical disorders (such as painful conditions, bladder problems, restless leg syndrome, breathing conditions)
• Environmental factors (noise, light, or room temperature)
• Lifestyle factors (staying out late at night, irregular sleep patterns, diet)

Tips & Tricks for a Better Night’s Sleep

• Exercise regularly, particularly in the afternoon.
• Develop a regular sleep pattern. Go to bed and wake up at regular times every day.
• Don’t try to force yourself to fall asleep. If you can’t sleep, don’t stay in bed; it is best to get up and watch TV or listen to relaxing music until you feel sleepy, then try going back to bed.
• Avoid large meals before going to sleep and don’t go to bed hungry.
• Don’t consume alcohol before bedtime.
• Take time to relax during your last few hours of the day. Avoid stressful situations or strenuous mental activity.
• Reduce caffeine and nicotine consumption.
• Avoid non-sleep activities in bed, such as your schoolwork or watching tv, to develop a strong association between the bed and sleep.
• Do not take naps during the day.
• Vary the firmness of your mattress.
• If noise is the problem, try using ear plugs, fans, or sound machines to drown out the noise.
• Keep your room temperature between 60 and 70 degrees.
• If pain is causing you to lose sleep, analgesics are better than sleeping pills. Consult a doctor if pain is severe and/or persistent.
• Don’t check the clock at any point in the night, as this often causes additional anxiety or agitation about not being able to sleep and can worsen the issue.
• Practice relaxation and mindfulness exercises for sleep, such as deep breathing or progressive muscle relaxation
• If you notice ruminations or “to do lists” when you lay down at night, it may be helpful to keep a pad of paper by your bed where you can “brain dump” and get the to-dos out of your head and onto paper. You can also take time to do this throughout the day, so that thoughts don’t pile up by the end of the day.
• If emotional problems such as depression and anxiety disorders are causing you insomnia, consult a therapist. Getting emotional support will help you sleep better.

Sleeping problems are very common, and we all experience them. However, we do not have to let them control our lives. By following these helpful tips, hopefully you will be able to enjoy a good night’s sleep once more. Of course, if problems continue the friendly staff at the Creighton University Counseling & Psychological Services Office will be more than happy to help you.

References

The Anxiety and Phobia Workbook (3rd Ed.) by Edmund J. Bourne, Ph.D.

Book Recommendations

• Why We Sleep: Unlocking the Power of Sleep and Dreams (Walker)
• The Sleep Revolution: Transforming Your Life, One Night at a Time (Huffington)
• The Promise of Sleep: A Prioneer in Sleep Medicine Explores the Vital Connection Between Health, Happiness, and a Good Night’s Sleep (Dement)
• Sleep Smarter: 21 Essential Strategies to Sleep Your Way to a Better Body, Better Health, and Bigger Success (Stevenson)

How to Handle Stress

By: Jodi K. Caldwell, Ph.D.

Stress is something that we commonly talk about in our society. However, we rarely take time to define Stress. What is Stress? What causes Stress? How do we experience stress? Most importantly, what can we do to manage our stress? Stress is a fairly universal experience for all of us. Regardless of how our personalities vary in terms of intensity, at one time or another, we will all be confronted with a situation that we find stressful.

STRESS is the result of our need to adapt to change. The sources of change, are called stressors:

• Environmental stressors (e.g., weather, pollution, noise)
• Social stressors (e.g., job interviews, examinations, daily responsibilities, family demands)
• Physiological Stressors (e.g., illness, menopause, injuries, poor nutrition, sleep disturbances)
• Cognitive Stressors, i.e. your thoughts. (e.g., need to be “perfect”, interpretation of others’ reactions)

While stress is often discussed in terms of negative impact, it can be beneficial. A healthy level of stress is necessary for optimal performance. However, it is when stress interferes with our functioning, rather than optimizing our functioning, that we begin to experience harmful effects. Consider the example of having a project deadline at work. This is a social stressor that necessitates adaptation. The resulting level of stress can be beneficial: it may cause an end to procrastination, faster work, a sense of accomplishment, etc. However, if adaptation is resisted then the stress can harmful: leading to feelings of helplessness, failure experiences, etc.

The first step to handling stress is to recognize how vulnerable you are to stressful reactions. The second step is to determine how you experience stress. Stress can be experienced in 4 ways:

1. Physical symptoms: headaches, stomachaches, sleep problems, hypertension, etc.
2. Emotional symptoms: fear, anxiety, tension, anger, irritation, etc.
3. Behavioral symptoms: withdrawing socially, increased irritation with others, etc.
4. Cognitive symptoms: irrational thoughts such as “I can’t do anything right”, “I’m a loser”, etc.

The third step is to devise a healthy strategy to manage your stress. There are several resources you can access: self-help books, websites, your own imagination, a counselor or psychologist, etc. The following are just a few suggestions for healthy ways of managing your stress. There is also a list of unhealthy ways people often use to unsuccessfully manage their stress. How many of the unhealthy ways have you used? What healthy stress management tools can you begin to substitute for your unhealthy behaviors?

Mindfulness

Mindfulness is one’s ability to tend to the present moment and observe your physical and emotional experience non-judgmentally. It means tuning in to one’s thoughts and sensations in an accepting, curious way. Currently, mindfulness is a growing field that is used in the treatment of many mental health concerns, especially anxiety.

Opportunities to practice mindfulness are abundant in our daily lives. Walking across campus, sitting in a waiting room, driving to and from school – you can take a moment to slow down, check in, and follow your breath anywhere and at any time. You can also practice mindfulness using guided meditations on our Counseling website or through a variety of different phone apps.

References

• Davis, M, Eshelman, E. R., & McKay, M. (1995). The Relaxation & Stress Reduction Workbook. Oakland, CA: New Harbinger Publications, Inc.

Book Recommendations

• The Anxiety and Phobia Workbook (Bourne)
• Brain Lock: Free Yourself from Obsessive-Compulsive Behavior (Schwartz & Beyette)
• Relaxation and Stress Reduction Workbook (McKay, et al.)
• Stop Obsessing (Foa)
• The Shyness and Social Anxiety Workbook (Antony & Swinson)
• You Mean I Don’t Have To Feel This Way? New Help for Depression, Anxiety, and Addiction (Dowling)
• The Mindful Twenty-Something (Rogers)
• The Gifts of Imperfection (Brown)
• When Perfect Isn’t Good Enough (Swanson)
• The Mindful Way through Anxiety: Break from Chronic Worry and Reclaim Your Life (Orsillo)

Test anxiety can include many of the physical symptoms listed above, as well as cognitive symptoms that may occur before or during an exam, such as poor focus, mind “going blank”, negative self-talk, feelings of dread, fear of failure, social comparison, and/or difficulty organizing thoughts.

Sometimes the greatest contributor to worsened test anxiety is your own thoughts. Thoughts like “I will never get into medical school if I don’t do well on this test,” or “I am not as fast as everyone else during this test, so it must mean I’m not be getting it,” or “I should be smart enough to get straight As,” or “I am never going to understand this!” This kind of self-talk can worsen feelings of anxiety, inadequacy, and self-doubt. Try challenging some of these thoughts by asking yourself: Is there evidence for this belief? Or is there more evidence to the contrary? How can I make this thought more flexible or forgiving instead of demanding or critical? What would I say to a friend in a similar situation?

In addition to challenging your thoughts, you can try some of the relaxation and stress management tools listed below. You can also make a study schedule, so you don’t get caught procrastinating or you can eliminate distractions before and during test taking. This could mean you get a calendar to help keep or organized or you make an appointment with the Success Center to find study habits that might help reduce your anxiety and increase your ability to focus. Or maybe it means you do something as simple as putting ear plugs in during an exam or sitting in a seat that is away from the “fast test takers”. Lastly, know that you are not the only person on this campus with test anxiety and it is a solvable problem to have.

• The Anxiety and Phobia Workbook (Bourne) 
• Brain Lock: Free Yourself from Obsessive-Compulsive Behavior (Schwartz & Beyette) 
• Relaxation and Stress Reduction Workbook (McKay, et al.) 
• Stop Obsessing (Foa) 
• The Shyness and Social Anxiety Workbook (Antony & Swinson) 
• You Mean I Don’t Have To Feel This Way? New Help for Depression, Anxiety, and Addiction (Dowling) 
• The Mindful Twenty-Something (Rogers) 
• The Gifts of Imperfection (Brown) 
• When Perfect Isn’t Good Enough (Swanson) 
• The Mindful Way through Anxiety: Break from Chronic Worry and Reclaim Your Life (Orsillo)