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Ask a Therapist: Column #8

Sarah Joy Covey

Q: I have heard of people keeping a gratitude journal.  Why might that activity be helpful for someone’s mental health?

A: The celebration of Thanksgiving encourages us to revisit the importance of gratitude in our own lives. Perhaps it is the perfect springboard to consider incorporating gratefulness into our daily lives, even once all the leftover turkey has been eaten!

For many years, psychological study was focused on identifying problems and providing helpful solutions but, in recent years, some of the most interesting research has shifted to consider what constitutes a life that is lived well.  This research on thriving has led to many important findings about contentment and satisfaction in life and these concepts form the basis for much of the Positive Psychology movement.

Gratitude has been identified as a key practice that contributes to health and wellbeing for a number of compelling reasons. Some of the benefits of giving thanks include mood elevation, increased satisfaction with work and home life, less emphasis on consumerism and materialism, higher levels of energy, greater resiliency, and protection against burnout. With a list like that promising so many benefits, it’s no wonder that many have called it a “super tool” in the pursuit of mental health.

Gratitude is a mental exercise that orients your thinking to what is right in your world and is a way of overriding a natural (and unhelpful) tendency to focus on what is wrong.  The positivity associated with cultivating gratefulness is an effective counterbalance to the tendency to complain or get caught in negative thinking patterns. It is a way to intentionally choose a focus of attention that is healthy and helpful and that contributes to a greater quality of life as it is practiced consistently over time.

It may be of interest to note that gratitude can be incredibly helpful in stabilizing and building strong relationships when it is expressed freely and sincerely.  Your parent, friend, or partner may be uplifted tremendously by the acknowledgement and affirmation that gratitude brings to the relationship dynamic and its positive effects should not be underestimated. If you are able to acknowledge the contributions of your co-workers you will find that your teams will collaborate more effectively and experience greater acceptance and confidence in the workplace.  Even a little thanksgiving can go a long way towards a positive workplace culture. 

A gratitude journal provides a space to note things that you are thankful for and can be a visual reminder of the incorporation of this attitude into your daily life.  Many people find that the discipline of simply noting three new things that they are grateful for each day is enough to move their thinking in the right direction.  Journalling in general can be a foundational tool that supports healthy emotional and psychological processing so including gratitude as a therapeutic component of that practice is a great idea.  

Setting a small but manageable goal to offer thanks at least three times each day will certainly be a worthy pursuit and a healthy intervention.  Simply writing a text, email, or handwritten thank you card each week to express sincere appreciation would be an invigorating task. Though it may have fallen out of fashion in some cases, thank you notes are always appropriate and appreciated and good for both the sender and the recipient. 

Meditating on gratefulness, contemplating abundance and contentment, and offering prayers of thanksgiving are all strategies that help nurture deeper spiritual connections as well as reaping the benefits from a psychological perspective.

Some families like to create a gratitude jar where they collect little slips of paper on which things they are thankful for are noted each week.  Sometimes these jars are opened on special occasions – like a birthday, New Year’s Eve, or, of course, Thanksgiving – to offer a tangible way of reflecting on all the blessings of that year.

Research also indicates that the more specific you are about why you are grateful and the more detail you provide about what you are thankful for, the more you will reap the rewards of a life steeped in the attitude of gratitude. The idea is that the more frequently, consistently, and earnestly you offer thanks, the better it is for your wellness. You’ll never regret making the effort!

Challenge yourself to keep Thanksgiving alive by adopting one of these simple practices into your daily routine and you’ll harvest wellness throughout the whole year.

To submit YOUR question for consideration in a future column or for more information about psychotherapy services that could help you cultivate a gratitude practice in your own life, email sarahjoycovey@gmail.com. You can follow on Instagram @sarahjoycovey and @anewleaftherapy or visit sarahjoycovey.com for more content and connection. 

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Ask a Therapist: Column #7

Sarah Joy Covey
Q:  In the last column you talked about the reasons that breathwork is important to manage anxiety.  Could you provide some practical examples of strategies that we could use?

A:  There are many techniques for deep breathing that can be explored easily with a Google or YouTube search bar; however, it is putting these techniques into practice that tends to be challenging for people.  Often, having simple go-to options is ideal so that you can build a habit of anchoring to your breath.

The primary goal of deep breathing is to move away from our tendency to breathe in a shallow manner that expands our chests instead of our stomachs. You can check to see how you are breathing in any given moment by simply placing your hand on those areas to notice where the breath is expanding in your body.  Typically, and certainly when we are anxious, our breath is shallow and quick. In breathwork, you want to remind your body to slow down and go deeper by pulling the breath all the way into your core.

The techniques that I recommend also provide a mental focus for attention that doesn’t require intense or complex thinking to use. Part of effective breathwork is the choice to hit pause and take a quick and quiet mental break from the noise of the day and such methods provide just enough distraction to be effective.

The first option I call the 3-3-6 method.  This method involves slowly counting to 3 on the inhale (pulling the breath fully in to expand the stomach, usually through the nose), holding the breath for 3 counts, and then releasing the breath fully while counting to 6 (usually through the mouth).  The numbers and counting are just enough of a distraction and focus that your mind can divert its attention from the negative or ruminating thought patterns and instead create some peace in body and mind.

Another option is more visual or tactile, (depending on how you implement it) and this can appeal to people who respond to imagery or touch more than numbers.  This strategy is called the box method and it is practiced in one of two ways. In both cases you are choosing to trace the outer perimeter of a square as you breathe.

In the first variation, you can simply close your eyes and visualize the outline of a box in your mind’s eye.  On the inhale, you mentally trace the first side of the box, slowly imagining that you are drawing the line as the breath enters the body.  Then you proceed to draw another side while holding the breath, then an exhale follows for a third side, and finally you will hold again as you trace the final side and return to your starting point in the square.

The other option is to take your index finger and physically trace it around a box perimeter as described in the visualizing option but on your thigh (or other surface) so that you can tangibly feel the square being drawn as you breathe.

With both variations, the more slowly and deliberately you trace the box, the more your breath will have time to deepen and create a sense of calm.

Practicing 5 or 6 rounds of the 3-3-6 or box breath method will often be enough to reset your system but you can use these strategies over the course of a specific time period if it feels helpful.  Simply set a timer to keep you focused on the practice for a designated amount of time. This short meditation of even 2 or 3 minutes can make a big difference.

The beauty of these simple methods is that they are accessible to you at any time and in any situation and the people around you do not even have to know that you are using them!

I often encourage clients to create a habit by attaching their deep breathing technique to a common, frequent occurrence in the day.  Perhaps you try a few rounds every time you take a seat, or have a cup of tea, or stop at a red light or stop sign when you are driving.

If you train yourself to do this as you go about your regular day, you will find that you are creating a proactive habit that is restorative to your mental health. It will release the natural stress build up that each day brings and it reminds your brain – and your body – that you are safe and in control.

While I have provided only two simple strategies today, there are many options available to you to suit your preferences and needs. It is important to find something that works for you so that you will be consistent in practicing a live-giving, stress-reducing connection to your breath.

To submit YOUR question for consideration in a future column, or for more information about psychotherapy services that could help with breathwork practices or anxiety management, email sarahjoycovey@gmail.com.

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Ask a Therapist: Column #6

Sarah Joy Covey

Q:  I’m really sick of people telling me to “just breathe” because I don’t understand how this is an actual solution to my anxiety.  Why is there such a focus on breathing in psychotherapy?

A: I can totally relate to this inquiry. If I’m honest, I felt the exact same way for many years.  It wasn’t until I studied and read more about the subject of “breathwork” that I fully understood it’s profound impact on mental health and wellness.  Since becoming a psychotherapist and engaging in several practices that involve breathwork, I am a believer in it’s effectiveness when it comes to protecting against the overwhelm of anxiety and as an intervention that works in managing active anxiety in the moment.

I think people are hesitant to take breathing techniques (or perhaps unsolicited advice) seriously because they seem too simplistic.  Don’t we breathe naturally every day?  How is that going to actually help?  Can’t you give me an intervention that has more substance?

The truth is, working with our breath is probably the most basic but also the most profound way to check in with ourselves and foster restoration in our system.  When we mindfully control and deepen our breathing we tell our brains that we are okay and that communication changes the way our whole being is functioning.

Without getting into all the complex neuroscience, deep and controlled breathing may be the most effective way to communicate to our brains that we are safe and that we are in control.  When the amygdala (our survival brain) hijacks the rest of our brain to ensure our survival when under attack, we experience what most would call the fight, fight, or freeze response.  This response kicks in when our thoughts, emotions, and/or bodily reactions tell our brain that we are threatened, even when that is not the case.

Anxiety is a fear-like response based in future-thinking, so we are not actually under attack when we are experiencing anxious symptoms.  We really do feel as though we are threatened but we are actually safer that we think and we need to remind our brains of that reality.

In contrast, if a tiger was lunging toward you at this very moment, legitimate fear (not anxiety) would activate the survival response you need where only what is necessary to keep you alive is active in the brain.

For example, when the tiger growls, you don’t need your executive brain functioning to help sort through your monthly budget, you are just hoping and praying that the tiger spares your life!  All your energy – and brain chemistry – is focused on keeping you safe; other details can wait because they don’t matter in the face of a legitimate threat.

In the case of the tiger attack, your life is in jeopardy but when we are anxious we just feel that way.

Anxiety tricks the brain into thinking a tiger is attacking and the amygdala takes over even when it doesn’t need to intervene.  If you can pause in that moment of panic and engage with your breath in a way that is methodical and clearly controlled, your brain begins to reconnect as a whole and realizes that, in fact, the tiger is not there.

So, even when your mind and body experience the realities of anxiety, you can tell yourself the truth with the way you breathe.  There are lots of tips and tricks that psychotherapists teach and recommend that can help you build breathwork practices to support the management of anxiety. As trite as the advice may sound, your breathing can be incredibly persuasive and a powerful technique to harness for your wellbeing.

To submit YOUR question for consideration in a future column, or for more information about psychotherapy services that could help with breathwork practices or anxiety management, email sarahjoycovey@gmail.com.

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Ask a Therapist: Column #5

Sarah Joy Covey

Q:  I’m starting to get anxious about the back-to-school changes for my family.  How can I simplify my planning and preparation to reduce the stress that we feel? 

A:  With back-to-school less than two weeks away, it’s not surprising that it is occupying your thoughts!  Most families experience a sort of bittersweet reality when the longer, less-structured summer days begin to give way to the fall weather and school routines.  As with most seasons of life that come to a close, the back-to-school start up is greeted with mixed feelings.  Some kids are excited to return to their friends with a freshly sharpened set of pencil crayons in hand.  Others may feel nervous about the social atmosphere of school and want to stay curled up in their rooms with Harry Potter instead.  Still others may be starting at a new school and they don’t know what to expect or how they are to navigate an unfamiliar building. Some parents can’t wait for their kids to have structured days and be out of the house again while others are sad to see them go and wish summer didn’t have to end. Whatever you and your family members may be feeling, there are a few things to consider that may help facilitate the transition and give you all greater peace of mind.

Normalize the stress. Any type of transition holds a certain amount of stress that can’t be avoided.  Part of moving from what is comfortable and familiar into the unknown is to feel somewhat apprehensive and worried but it’s important not to let those concerns dominate your head space.  As a proactive measure against the natural stress of this changing season, consider increasing your self-care over the next few weeks to allow for some decompression.  Maybe book a massage, increase your time in nature or on the yoga mat, plan a tea break with a friend to chat back and forth and encourage one another in your concerns, or set up a session with a counsellor to process your thoughts and feelings. Take whatever steps you need to release that stress on a daily basis so it doesn’t build up to an unmanageable point. And don’t forget past successes! Even though stress can increase as a result of the new school year approaching, remind yourself that you have navigated transitions before and have survived!  You are resilient and so are your kids!

Anticipate the best. Most anxiety is future-oriented; that is, we worry about something in the future that has not yet happened based on a “what if” scenario.  For example, what if my daughter’s best friend is not in her class this year?  What if my son doesn’t like his teacher? What if the kids can’t get back to a regular sleeping schedule?  What if I buy back-to-school clothes and then they don’t fit in October because of a growth spurt? What if she still can’t do long division? You get the idea. This anticipatory anxiety is often rooted in catastrophic thinking where we assume the worst case scenario instead of the best case scenario.  The truth is, we really don’t know how it will work out for our kids at school this year but, in the absence of concrete evidence to the contrary, we can choose to anticipate the best instead of fearing the worst.  Why not reframe those “what ifs” to paint a more positive picture of what is equally possible?  If we can harness the excitement of anticipating the best, we will reduce that unnecessary worry and set ourselves up to welcome (not dread) this next phase in family life.  You never know, this may be the year of the best teacher, indoor shoes that fit for 10 whole months, and long division mastery!

Simplify the routine.  Start with the basics – sleeping, eating, and exercise – and begin to move towards a routine that will work for the transition to school.  Bedtimes tend to be less predictable and structured in the summer so if you are able to gradually work back into a sleep schedule that will compliment the school routine over the next couple of weeks, you may all find that the early morning is less of a shock to your system. Getting adequate sleep for all members of the family is an essential element in stress reduction and overall resilience throughout the transition.  Think ahead about the nutrition that you want to have available for your kids that works well for school lunches and stock up so you don’t have that last minute shopping stress!  Get into the habit of prepping food on the weekends for the week so that healthy snacks are readily available. Make time to move your bodies every day and think about how some time outdoors can be a part of your routine, even after school starts up again. If you look after those basics, you’ll build a solid foundation for a healthy transition.

Take it as it comes.  No matter how much we plan or prepare, we will still have to take things one step at a time. Inevitably, something will be forgotten in the back-to-school shopping but, thankfully, you can still find scientific calculators and white-out in September. Consider an after school point of connection – maybe at snack time or dinner – where you can check in with your kids about their highs and lows or their laughter and learning so that you can have a pulse on how things are going as you all get used to the new routine.  With ongoing communication and feedback we can respond and adjust along the way to refine the routine to suit our family’s needs as they emerge.  In general, we can minimize anxiety by consciously and intentionally living in the present moment and not getting ahead of ourselves. Try to balance that planning with proactive and positive thinking and enjoy each day as it unfolds!  Summer isn’t over yet!

To submit YOUR question for consideration in a future column, or for more information about psychotherapy services that could help with stress management or transitions (for teens or parents), email sarahjoycovey@gmail.com.  

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Ask a Therapist: Column #4

Sarah Joy Covey

Q: I am finding it so hard to take care of my ailing loved one and I feel so guilty for not having a better attitude about it.  Why am I so exhausted and frustrated? 

A: You are not alone. It is common for caregivers to have personal difficulty with maintaining the care of a loved one.  Whether you are caring for an aging parent, a sick child, or someone with chronic illness, caregiver stress and fatigue are real challenges and require understanding and compassion. Caregivers are often labeled the “silent sufferers” because they don’t feel entitled to speak about how much this role impacts their own well-being.  Unfortunately, this leaves many depleted and in need of care themselves and less able to help their loved ones in a way that feels congruent for them.

Many caregivers do not feel that they have the right to complain or report difficulties because it is their loved one that is actually experiencing “real” duress.  This is an example of a common cognitive distortion known as dichotomous thinking.  Sometimes called black-and-white thinking, dichotomous thinking is a way of categorizing things as “either/or” and not “both/and”  In this caregiving example, it seems that either the caregiver or her loved one is entitled to be struggling; however, a more realistic assessment of the situation is that both are suffering in their own ways.  Caregiving can be incredibly taxing – physically, emotionally, psychologically – and acknowledging that reality does not have to be at odds with also being honest about a loved one’s pain.

Here are a few simple ACTION steps that you can take to care for the caregiver:

Ask for help.  Caregiving is not a one-person job.  You need to stop carrying this burden alone.  Ask for help from other family members or friends whenever possible.  Perhaps this help can come in the form of a visit, a meal, or a gesture of financial support that would free you up from the tremendous weight of all the responsibilities of this role. Seek out community services or groups that might be relevant to your needs.  Consider getting some at-home care; hiring a nurse, a personal service worker, or a housecleaner might be the ticket to a welcome reprieve.  Try to let others do the parts that don’t have to be done by you so that you save your energy for the caregiving that makes the most difference if done by you, specifically.

Consider the relationship. It may be that the relationship you have with your loved one is compromised or complex and the stress of this time may exacerbate previous grievances or personality clashes making the caregiving that much more difficult. Consider to what extent the past or patterns in the relationship are contributing to the current challenges.  Work through some of those factors as needed to help alleviate any unnecessary tension or hurt.

Take a break.  Caregivers need to give themselves permission to step away from their caregiving to make space for their own personal renewal.  Often the 24/7 demands of caregiving can deplete their personal resources and caregivers need to take care of themselves so that they can continue to do the good work of loving and serving. Off-duty time is essential to a sustainable plan that acknowledges the energy required for this role.

Investigate the impact. It is important for caregivers to have a space to voice their thoughts and feelings. Often, caregivers don’t want to say some things out loud, (particularly to other family members) because they might sound ungrateful, callous, or lacking compassion.  For this reason, therapists can be a viable solution to provide objective and nonjudgemental spaces to share.  Finding at least one person with whom you can express your honest experiences will go a long way in helping you feel validated and understood.

Open up to others. Having supportive community members can be a sustaining presence that will carry a caregiver through a challenging time.  Seeking social support from friends and neighbours or through a local church or community group is a good idea, if it is not already in place.  Reconnecting with others and opening up about what you are going through is  an excellent way to remind yourself that you are not alone.

Navigate grief (or other strong emotions) with understanding.  Caregivers can be experiencing a kind of living grief, especially with elderly parents or chronically ill friends and family.  It can feel like they are experiencing losses along the way and these emotions can be unpredictable and overwhelming.  Give yourself grace to work through your grief journey in a way that feels gentle and helpful, knowing that there is no “right” way to be feeling as a caregiver.

Taking one or more of these ACTION steps may help you care for your own needs in a way that enables you to be fully present to your loved one and to continue to provide the compassionate care that you wish to offer without resentment or burnout.

To submit YOUR question for consideration in a future column, or for more information about psychotherapy services that could help with caregiver stress and fatigue, email sarahjoycovey@gmail.com.  

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Ask a Therapist: Column #3

Sarah Joy Covey

Q: I always feel so emotional towards the end of my summer vacation.  How do I make the transition back to regular life less difficult?

A: To begin, tell yourself that it is okay to have mixed emotions about the end of a trip, a cottage getaway, or a mini-break weekend.  There is a certain letdown that is a normal part of transitioning back to “real life”.  Note that you may also have some feelings of joy or merriment.  Sometimes you will have lingered in deep connectedness to others or to nature.  You will have had times of laughter and times of frustration while vacationing. These mixed emotions are natural reactions to the lived experiences your time away has afforded. To have strong feelings of connection to a place or time means that it mattered, that it was meaningful, that it restored you, and that’s precisely why you prioritized your time away.

Having said that, to keep some more positive vacation vibes alive, here are 5 tips that might help:

Have something to look forward to as soon as possible upon your return.  If you know you are just headed home to an empty fridge, an inbox full of unread emails, and piles of dirty laundry, it might not feel so appealing to be on route. Consider purchasing tickets to a local event soon after your arrival at home to give you that feeling of anticipation.  Maybe you could book a dinner with friends to share about your vacation.  Perhaps there is a house project that you’d like to start.  Whatever you plan, make sure it is something that feels inspiring and motivating to you so that you get that excitement energy working for you. You want to be coming home to something not just leaving from something.

Reflect on why the vacation was so meaningful for you and try to incorporate some of those elements into your regular life.  If time in nature was a restorative factor, make a point of taking more walks in the local park or visit nearby areas that provide that same atmosphere – even if it is just your back porch!  If the slower pace was a welcome reprieve, consider eliminating hurry by being mindful and present and less rushed as you move through your daily routine.  Perhaps the quality time you had with spouse, family, or friends was a joy to you; if so, put a date night, a bonfire with friends, or a planned phone call on the calendar and make room for continued connection. Maybe sleeping in and napping was the best part!  Give yourself permission to rest on the weekend or to take naps on your lunch hour in a way that sustains you.  If having time to reflect was a bonus, create space in your life for some journalling and meaningful conversations with friends so that you don’t lose touch with that valuable insight.

Reminisce throughout the year and anticipate the next getaway.  Vacations are not only enjoyed while on them, the mental boost of anticipation and the joy of reminiscing extend the impact of that holiday on your mental health.  Make a slide show or a photo album of your favourite pictures and revisit them whenever you feel like it.  Share funny anecdotes from your time away or recount the details of your adventures to a friend to remind yourself of the memories you created and how much they meant to you.

Play tourist in your own area. If seeing new things inspired you, then plan some little staycations. Take a drive to a new town or park on a Sunday afternoon.   Book dinner at a local restaurant that is new to you.  Visit local attractions with fresh eyes.  Go out for ice cream or take a walk on a local beach to experience those summertime flavours, sights, and sounds. Train yourself to look for opportunities to take advantage of tourist attractions in your town and that will bolster the vacation vibes at home.

Practice gratitude. Make an ongoing list of all the things that you love about your home and your life there. Count the blessings – large and small – that punctuate your beautiful, day-to-day life. Remind yourself how much you love your own bed, that you get to attend your local farmers’ market, or that you can cozy up in your favourite chair again. Don’t forget to give thanks for the opportunity to have had a vacation and remind yourself of the luxurious gift that it has been.

Of course, it is perfectly normal to experience some mixed emotions at the end of a holiday; but, naming and validating those feelings along with some intentional planning for at-home fun will lift your spirits and help you feel more like re-entry to regular life is not so bad after all.

To submit YOUR question for consideration in a future column, or for more information about psychotherapy services that could help with emotional well-being or life transitions, email sarahjoycovey@gmail.com.  

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Ask a Therapist: Column #2

Sarah Joy Covey

Q:  My work seems to be taking over my life.  How can I create a better work-life balance?

A: We live in a world where busyness is a badge of honour and overwork is rewarded with greater opportunities professionally.  Unfortunately, this culture around work is not conducive to a healthy life.  More and more people are taking leaves from their jobs to recuperate from the toxic stresses of the workplace environment and the pressure of unrealistic expectations.  It is becoming increasingly imperative that individuals take steps to guard their wellness to promote sustainability in their careers and to ensure that they are effective in the work that they do.  Of course, wellness is also an important factor in the ability to enjoy your life outside of work! As mentioned in last issue’s column, self-care is the foundation of a healthy life, but we can only practice self-care if we make space in our lives to do so.  Creating margin and time to rest is essential to maintain work-life balance and establishing boundaries is the best way to ensure that work doesn’t continue to take over your life.

Boundaries on your time: Work will expand to fill whatever time it is allotted and so you need to set reasonable time limits on your working hours, especially if you find yourself in a career that doesn’t have a fixed work day.  Studies have revealed that the quality of one’s work (and, consequently, one’s life) diminishes significantly after more than 50 hours of work in a week; interestingly, the optimal work week for personal health and professional satisfaction is actually slightly under 40 hours a week.  The message is clear: working long hours is neither helpful nor healthy.  Unhealthy workers are less effective and engaged, make more mistakes, and tend to miss more work due to sick time.  In contrast, productivity and quality often increase when we work smarter with fewer hours rather than harder with a never-ending slog.  Many find the practice of sabbath-keeping, even if it is not for religious reasons, a helpful boundary to ensure that at least one day in seven is protected for rest and rejuvenation.  Taking regular vacations from work is important but even something as simple as actually taking your lunch break and getting out of the office for an hour can be an excellent way to promote balance in your work day.

Boundaries on your technology: Another common challenge in creating balance in our work schedules is the way that technology – primarily the smartphone –  has made it possible to be accessible 24/7.  However, just because this is possible, it doesn’t mean that it is beneficial.  Technology is a tool to be managed; it should not manage us.  If you find yourself compulsively checking work emails, consider blocking the notifications so that you are not alerted each time an email arrives in your inbox.  Decide in advance when you will check your email and how much time you will allow for that part of your work.  Maybe your job requires you to do some overtime or work from home but make a conscious decision to say how much is reasonable and when that time is up, shut down and walk away from the computer. Designate a spot in your home where your phone is left each night so work doesn’t go to bed with you. You may decide to only start work after you have had your own personal or family time each morning, even if you could log in earlier. Technology use in the bedroom can cause significant sleep difficulties and going to work well-rested is an important part of minimizing your workplace stress.

When it comes to managing your work, you have the power to make changes through the implementation of boundaries.  Taking action that will protect your time and accessibility will bring more life back into your work-life balance.

If you’d like support in creating a better work-life balance, to submit YOUR question for consideration in a future column, or for more information about psychotherapy services, email sarahjoycovey@gmail.com.