Infertility When Everyone Else Is Pregnant

Posted on April 28, 2023 by Alisa Hafkin

Infertility affects 12% to 15% of couples in the United States. The emotional pain caused by infertility can be quite intense and can be triggered by almost anything: the sight of children, a pregnant woman, or an invitation to a baby shower. Well-intended comments may inadvertently add salt to the wounds. I help many clients gain strength as they go through infertility treatment while their friends and loved ones are having children.  

If you are experiencing strong emotions, depression, or relationship problems due to your infertility, please seek out the help of a therapist who specializes in infertility counseling. One of the main focuses of my practice is helping both individuals and couples who are experiencing infertility, and I can provide strategies and communication skills to help heal the hurt and improve your relationships while you work towards building your family. 

Dealing with family and friends

In my experience, I have found that many individuals and couples are reluctant to discuss their situation with family and friends, which can increase feelings of depression, anxiety, and loneliness. This can be very triggering, especially if you’re getting comments like “So, when are you going to start having kids?” 

Your family, if you feel they are there for you, is your natural support system, and your friends are your chosen support system. Don’t leave them unaware of the most important issue you’re dealing with right now. They will want to know how to support you and what to say and not say.

Here are a few suggested conversations you can have with those closest to you:

  • Please recognize the intensity of the emotions I am feeling and do not try to minimize them with statements that are intended to be helpful but diminish our struggle. Statements like “Just relax and it will happen” or “Well, at least you get to do what you want without a baby to deal with” will only make me feel worse. Comments like “I’m so sorry you have to go through this” and “Please let me know how I can help” are helpful to me and make me feel loved and supported.
  • Please don’t compare me to other people by telling me what worked for your friend. I’ve probably heard it all, and I already know there are cases of people who get pregnant right after they adopt, by “just relaxing,” or after taking certain supplements. If I ask you, please share what you’ve heard. If not, please know that I’m trying everything already.
  • If you’re pregnant or have been pregnant, please don’t complain or say “You’re so lucky you don’t have to deal with morning sickness/swollen ankles/hormone fluctuations/stretch marks.” I would gladly endure all those things.
  • Please don’t talk too much about other people who are having lots of babies or gush over the latest newborn. Yes, if my sister has a baby, I’m happy for her, but it will probably make me feel sadder for myself, so please don’t overdo the discussion in my presence, because it will feel like “rubbing it in.” Please don’t be offended if I can’t bring myself to go to a baby shower. I will send my love and a gift, but an extended celebration of someone else’s baby is too painful.
  • At the same time, please don’t shut me out of the family because you want to spare my feelings. Please invite me to things. I want to be there. I will judge for myself based on how I’m feeling if I can attend, and believe me, I am trying to work on my emotions so that I have a healthy emotional outlook and can comfortably attend events and rejoice in other people’s families as I work to build my own. But understand that it will take time. 

These are some suggestions to get you started interacting honestly with the people who are most important to you in your life. 

Dealing with co-workers

You do not owe any information to co-workers. If you receive off-hand comments such as “So when are you having a baby?” You can choose to be polite and tell them, “This is a sensitive topic for me and I prefer not to talk about it.” For a person who tends to be rude or obnoxious and whose opinion will not affect your job, you can just tell them it’s none of their business. 

If a co-worker is pregnant, congratulate her. If she is talking a great deal about her pregnancy or showing ultrasounds, try to politely extract yourself, or tell her that while you are happy for her, it is difficult for you, and you are probably not the most appreciative audience. Suggest she talk to another co-worker who you think would appreciate her stories and pictures.

If your direct superior needs to okay your frequent doctor appointments or breaks for medication, you may give him or her just the basic information necessary. Otherwise, do not share any details with co-workers, even friends, because things tend to get around the office. 

Dealing with your own inner voice

We often don’t recognize our own self-destructive patterns of thought without the help of a trained therapist. In my practice, I utilize psychodynamic and cognitive therapy approaches to help people understand their unique thought processes and help them make more conscious choices with regard to their emotions and their lives. 

Women who experience infertility often experience depression or anxiety or blame themselves for past mistakes that they believe caused their infertility. They may feel “unworthy” to be a parent. They may allow themselves to develop resentment or envy toward pregnant women or mothers with young children. When these feelings are directed toward family members or friends who are able to conceive, the feelings are extremely destructive. Please reach out for help. 

Men also have strong emotions about infertility, which differ from those of women. They can become angry, feel guilty, or feel like their virility or “manhood” is in question or diminished by infertility. Men are less likely to show these feelings, so they may bottle them up which might affect their marriage or their work. 

Besides addressing the emotions of the individuals, I help couples find ways to communicate their needs to each other and find things they can enjoy together that strengthen their bond, irrespective of children in their lives. 

By taking the time to work through your own interior struggles you will grow closer as a couple, be less triggered by people and events around you, and be able to handle the fertility treatments with more peace in your heart. You will be stronger as a couple, as you look forward to the future hope of being a strong family. Reach out to me to see how I can help you.

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Insurance and Infertility

Posted on April 14, 2023 by Alisa Hafkin

New York is one of only 15 states that require insurance companies to cover some infertility treatments. In New York, insurance covers most fertility tests and procedures. This means one less stressor for an already very upsetting situation. 

An estimated 6.7 million couples in the United States have difficulty conceiving each year. Approximately 12% to 15% of all couples are unable to conceive after one year of trying, and 10% after two years. Many couples will begin to seek medical intervention when conception does not occur naturally. This adds another level of stress to the trying situation since fertility treatments can be very expensive. 

But you still need to complete paperwork, which can be stressful and feel intrusive to your privacy. You may also find that some procedures are not covered. For instance, if your employer self-insures, the employer is exempt from the requirements of the law. Additionally, New York law provides up to three IVF cycles (fresh embryo transfer or frozen embryo transfer) to patients in the large group insurance market (100 or more employees). However, it excludes coverage for IVF in the individual and small group markets, GIFT, and ZIFT. It also does not cover more than three IVF cycles, reversal of elective sterilizations, or experimental medical or surgical procedures.

All the medical appointments, treatment decisions, stress, and strain can seem overwhelming. But you don’t have to work through it on your own; I can support you through the ups and downs. One of my specialties is infertility counseling, supporting both couples and individuals. 

Being diagnosed with infertility triggers an array of emotional responses that can disrupt a person’s self-image, relationships, and view of the future. Financial strain adds to the tension in relationships and can further intensify the emotional spiral.

If you find you need some emotional support and strategies to help you, as an individual or as a couple, navigate the medical treatments, insurance hassles, and emotional storm, contact me. I can give you develop a toolbox of resources to help you get through this time and come out stronger on the other side. 

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Questions to Ask in Couples Therapy

Posted on April 12, 2023 by Alisa Hafkin

After years of helping couples here in NYC, I know that the hardest step in marriage counseling is showing up. If you are both there, hopefully, it is because you both see your relationship as worth repairing. Attending couples therapy does not mean you are on the verge of a breakup or divorce. In fact, couples therapy is most effective, and most quickly effective, when problems are addressed before they have time to hemorrhage or fester. 

To get the most out of therapy, develop an understanding of the methods your therapist offers. Make sure your therapist is experienced in couples therapy and uses a method that you have researched and understand. In my practice in NYC, I use psychodynamic and cognitive behavioral therapy, which I adapt to each unique couple’s needs. 

Before attending counseling, take some time to think through some hard questions. You should both think them through separately. You can take a few simple notes as memory joggers, but don’t write out long paragraphs that you intend to read at your sessions. The key to therapy is to speak honestly, from the heart. 

And remember, therapy is not about verbally “beating up” on your partner, blaming your partner for all your problems, and getting your therapist “on your side.” A good therapist will see through this and direct the discussion on a more productive path. 

Here are some questions to think through. They may not all apply to you, and they are not in any order of importance, because each couple is different, so their most important questions also differ. 

Some big-picture questions:

  • Why are you here? What made you take this step?
  • Do you feel counseling is necessary, helpful, or a waste of time? What are your expectations from counseling?
  • Are you just going through a rough time or is there something longer-term at play?
  • What questions are you hoping won’t be asked? (This is a sign that these are the biggest pain points and actually need to be addressed)
  • Are you both putting effort into the relationship?
  • What do you each expect from the marriage?
  • What are the main issues? Which are most important?
  • Do you want to save this marriage/relationship? What about your marriage is worth saving?
  • How can you grow as individuals as well as a couple?
  • How do you see the future if you don’t fix these issues? How do you see the future if you do?

Some personal questions:

  • What is your happiness level currently and how does it affect your relationship?
  • What makes you happy?
  • Do you love your spouse? What kind of love do you feel towards him/her?
  • What bothers you most about your spouse? What do you like best?
  • Do you feel attracted toward your spouse physically? Do you desire intimacy?
  • Do you trust your partner? What do you or don’t you trust?
  • How can trust be rebuilt? What needs to happen?
  • Do you feel like you are trying harder than your spouse to heal the relationship?
  • Are you romantically attracted to or involved with someone else? Have you thought about it?
  • Do you have difficulty communicating? Do you think your partner communicates well?
  • Do you feel loved? Safe? Comfortable together?
  • What are you willing to do differently in order to improve your relationship and make your spouse and yourself happier?

Some “history” questions:

  • What brought you together in the first place?
  • In the recent past, how have you responded when your spouse has hurt or disappointed you?
  • How has your spouse spent his/her time this past week? (This is checking for your degree of attentiveness to your partner and what kinds of things are memorable for you)
  • What mistakes may have been made in the past that need to be addressed?
  • Are there any specific past events in the marriage that are still causing pain?
  • Do you have any “triggers” from your past that may be causing these problems? 

Remember, you both need to think through and answer these questions. It will be difficult for you to answer them, and it will probably be even harder to hear your spouse answering them about you. To prepare yourself, look through them and change them to your spouse’s perspective:

  • What bothers you most about me? What do you like best about me?
  • What mistakes have I made that have hurt you?
  • Do you love me? Are you attracted to me?
  • Do you trust me? How can I regain your trust?
  • What am I willing to do to make you happy? 

If you have good communication with your spouse and the issues are limited, you may be able to make significant progress in your relationship just by addressing a few of these questions lovingly and calmly. However, most couples benefit from a neutral party who can guide them in constructive conversation and advise on some strategies that will work now and in the future. If you are in the New York City area, contact me at (917) 331-6075 to see how I can help you.

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Managing Long-Term Infertility

Posted on March 9, 2023 by Alisa Hafkin

About 15% of American couples experience infertility, which is defined as the inability to conceive after a year of trying. About 7% of couples will conceive in the second year. But that leaves many couples struggling with infertility over an extended period of time.

Infertility causes a tremendous strain on mental health and relationships. As a psychotherapist focusing on couples therapy including infertility, I encourage you to seek counseling support early in the process of dealing with infertility so you have the help you need right from the start.

Up to 60% of individuals dealing with infertility, both men and women, report psychiatric symptoms of some kind, but the incidence rate seems higher among women. Nearly 41% of infertile women report experiencing depression and 87% experience anxiety. Men may deal with more emotional issues than they are willing to admit. 

It’s important that both of you get counseling support because infertility can contribute to partnership and marital discord. The desire to have a child together should not be the cause of your breakup. It is a beautiful desire and should be nurtured and protected from the emotional stress that infertility can cause. 

A major source of stress can come from the people around you and their often unintentionally hurtful questions and comments. Be sure to set clear boundaries with family, friends, and loved ones about who you will discuss your infertility with and how much. 

Close family may have a strong desire to help you and support you and may offer advice that they consider helpful. It may be helpful, and perhaps should not be discounted out of hand, but you must set clear parameters with them. I often help my clients come up with plans and wording to help put boundaries on relationships while avoiding damaging those very relationships that you need as support.

But not all relationships deserve the same level of familiarity. While your employer may need to know why you have frequent doctor appointments, your co-workers don’t. If you choose to tell them that you are undergoing treatments to conceive, be very clear that this is not for office discussion. 

Keep your options open. For instance, some couples disregard out of hand the idea of adoption. Although adoption is not for everyone, just knowing that it’s an option can help ease your mind that you can, one way or another, have a family.

Finally, take care of yourself. Find ways to get your mind off of your infertility, things you can enjoy individually and as a couple. Pick up a new hobby or return to an old favorite. Find something you both like to do together, especially if it’s good for your health, like biking or ballroom dancing. Enjoy intimacy together just for the love of each other, not with the primary intention to conceive. Eat calming foods, not those high in sugar and carbs that can cause your metabolism to rev and then crash. And get plenty of rest.

If you’re dealing with infertility and you need some help navigating your emotions and relationships, I’m here to help. I’ve helped many couples through the ups and downs of fertility issues to come out stronger on the other side, both as individuals and as a couple.

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Mental Health and Working From Home

Posted on March 9, 2023 by Alisa Hafkin

So many of us moved to NYC to enjoy the hustle and bustle, the people, and the many cultural and entertainment opportunities. Now, many of us are working from home and are feeling isolated. 

Whether you live in the city, suburbs, or country, working from home can be a challenge. It’s important to take care of your mental health and develop habits that keep you both productive at work and happy in your personal life. 

Loneliness

If you’re home alone all day and the primary source of communication with co-workers is email or the company messaging system, you may begin to feel very alone. This feeling can sometimes lead to depression and isolation. Don’t let that go on for long – as soon as you realize you’re feeling alone and isolated, start taking steps to reverse it. 

What you can do: Consider using a co-working space or working with a friend who also works from home. That way you can bounce ideas off each other, take a coffee break together, and take a walk together during lunch. Ask your employer to set up a group communication system like Google Hangouts, Slack, or one of many other options. Meet with a friend during lunch. Schedule regular in-person or video hangouts with friends and family so that at least every day you’re seeing someone’s face while talking with the person. Attend cultural events and develop hobbies that involve other people. 

Blurred work/life boundaries & distractions

It can be very difficult to separate work and home life when they’re both taking place in the same space. This is especially true if a spouse, kids, or pets are vying for your attention while you’re working. If you stop working to interact with them but you still need to put in your hours, you may find yourself working into the night, thus feeling like you’re “always working.” And when communication with co-workers takes place via email or text, they may feel they can reach out to you any time and expect a response. 

Maybe the distractions come instead from your cell phone, people texting you, or your social media pinging all day. Looking at “just one thing” on your phone can have you coming up for air an hour later and realizing you just wasted time that you can’t bill for and that you still have all that work to do. 

What you can do: You will need to communicate your boundaries, both to the people you live with and the people you work with. Clearly state to co-workers and supervisors the times of day that you will be available and when they can expect replies from you. Clearly state to those who live with you what interruptions are permitted and not permitted during the hours you work.

If your employer allows you to structure your own hours, you could structure your work around your family’s needs. Have a family meeting to discuss work hours that will allow you to spend time with them, have time for yourself, and still get your work done. Then, short of something really important coming up, stick to it.   

As for technology, if at all possible, keep your phone out of sight and away from your work area. You can check it during break time and lunch (but set a timer so you get back to work on time!). Turn off alerts on your social media and your texts (except family and co-workers) so they don’t pop up or ping and you only see them when you look.

When your work is done, put your work away. It’s important your work is out of your living spaces when you are “off.”

Feeling untrusted or unsupported

Some supervisors become very over-reaching, demanding an accounting of your every minute to make sure you’re working and not goofing off. On the other hand, some supervisors aren’t good at communicating with off-site employees, which may cause a delay in getting the information you need to work efficiently. When your supervisor is both – demanding an account of every moment and yet not giving you the support to be efficient – frustration can lead to anxiety and anger. 

What you can do: It may be difficult, but you’ll have to talk to your supervisor about the situation. Be sure to have documentation to show not only that you can be trusted, but also that you are not getting the information you need. If you have documentation of the emails or calls requesting the needed content, the time it took to get it, and the work that you did (or were unable to do) while waiting for it, you will be able to show that you are conscientious but need a better flow of support to be as efficient as possible. 

It’s very important not to use an accusatory tone with your supervisor. Present the situation as something that you and your boss need to collaborate on in order to solve the problem together. But it’s ok to admit your frustration and your unhappiness about the situation. Hopefully, your boss is open enough to work with you to resolve the situation. If you have a toxic boss, another option may be to begin job-seeking. No one can work long under an uncooperative and unpleasant person and maintain a healthy mental attitude. Find a situation that is better suited to you and your work style.

If you need some help coming up with ways to work from home successfully and happily, reach out to me and we can find the solutions together. It may just take a few sessions to help you step back, look at your situation, and create a really healthy and satisfying life plan working from home.

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Heartbreak and infertility – What to Do

Posted on January 13, 2023 by Alisa Hafkin

Yes, it is another year and still no baby. I work with many couples just like you who are struggling with infertility. If you’ve been at this for some time, you are probably sick and tired of doctors, drugs, surgery, and exploring medical options. You’re also sick and tired of nosey questions, well-meaning advice, and yet another baby announcement.

Coping with infertility is not easy, but it is possible. One of the focuses of my practice is infertility counseling, and I have helped couples develop a strong, stable platform from which to face the challenging steps to building a family in the face of infertility. 

In order to move forward in a healthy way, you need to learn to manage your emotions in both internal and external ways. By that I mean, both you and those around you may need to make some changes.

Communicate

The first major hurdle is communication. Infertility is not uncommon, and therefore many people are capable of showing great compassion and sensitivity if they know this is something you’re dealing with. So the next time someone says to you, “So, when are you two going to start your family?” you can politely say, “This is a sensitive topic for us and I’d appreciate you not asking. When we have good news, I’ll be sure to let you know.” That should work for most people. For the rude person who doesn’t take the hint, feel free to be blunt.

For friends and family who give well-intentioned advice, your response may change from person to person, depending on how helpful they really are. But if someone, even Mom (and sometimes especially Mom!) keeps asking or suggesting, you may have to be firm.

I can help you develop a strategy for dealing with close relatives without damaging relationships. You need your family for moral support, but that doesn’t give them license. We can work on a strategy to stop the painful comments without cutting them out of your life.

Communicate with your spouse/significant other, too, about what kind of help you need. Do you need a shoulder to cry on? A massage? A shared activity that gets your mind off things? Tell him/her. Your spouse probably also has stress and heartbreak but may cope very differently. Talk about how each of you deals with your stress about infertility and respect each person’s feelings. At my sessions with couples, we discuss ways couples can work together to help each other manage disappointment and move forward with a stronger relationship.

Give yourself boundaries

Just as you’ve instructed others on their boundaries in communicating with you, give yourself boundaries, as well. For instance, you may want to try the “20-minute rule” by limiting yourself to 20 minutes a day of talking about infertility. This can help you turn your mind to other things. And if going to a baby shower is too painful, don’t go. You’re not obligated to do something that causes you emotional pain. Send a congratulatory note and a gift if you can, or ask someone to pick up a gift for you (you can pay them back) and send your best wishes.

Care for yourself

Self-care is a critical part of mental health. Working together, we can find ways to help you relax. I know many people have probably said to you, “Oh, just relax and it will happen.” This can be so painful to hear when you are struggling with infertility that is caused by something other than simple stress. But when you start to take care of yourself, you can at least give yourself some peace as you go through the journey. We will discuss what lifestyle changes may help you during this time.

Look forward

This is your time to take care of yourself and your relationship with your spouse. It’s a difficult time for both of you, but reframing your situation and finding ways to grow closer together can reap great rewards in the long run.

And don’t be afraid to explore non-medical options. Many women and couples have sat in my office adamant that they will not adopt or use a surrogate. But the truth is that just starting to talk or explore the issue can give you peace and a feeling of hope. And sometimes couples find peace and joy in each other and develop a life plan for the two of them that is filled with expectation and satisfaction.

For many couples, talking to a counselor who is expert in the specific needs of infertile couples is just the help they need to move forward in a healthy way. Give me a call to see how I can help.

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Winter and Depression – Be Prepared

Posted on January 13, 2023 by Alisa Hafkin

If you tend to get depressed during the winter months, you’re not alone. Many people feel a drop in their mood during the winter, and for some people, that drop is quite severe. This phenomenon is often called “winter blues.” More severe cases are diagnosed as seasonal affective disorder, or SAD – aptly named.

Winter conditions are conducive to a drop in our moods. Here in NYC, it can get quite cold, with occasional severe snowstorms and fewer events and activities available. You may leave for work in the dark and return in the dark. You may live in a tiny apartment and feel like the walls are caving in. Maybe you are susceptible to illness, so either you’re sick a lot or you stay away from people. Any or all of these conditions can lead to feeling depressed, sad, or lonely.

It is sometimes difficult to not give in to these feelings. There are many simple lifestyle changes you can make that will help improve your mood. If you find it difficult to do on your own, we can work together to define a plan that can help you. 

Steps to lift your winter blues

Limit screen time

Many of us turn to technology to fill the void when we’re home. A lot of evidence suggests that this is not good for us. Besides making us sedentary, internet content consumption can be very bad for mental health. The news often increases anxiety. Studies show that use of social media can actually increase feelings of loneliness and thoughts of self-harm, and worsen body image problems and eating disorders. There is also evidence that screen time causes sleep disruption. Therefore, it’s important to replace use of technology with healthier behaviors.

Choose foods that boost your mood

This doesn’t mean eating “comfort food;” this means eating foods high in nutrients. For instance, eating a source of protein at each meal can enhance your mood and limit between-meal cravings for sweets, which are known to depress your mood. Eat foods high in Vitamin D, such as fatty fish and fish oil, as well as foods fortified with Vitamin D such as yogurt and orange juice to boost your mood and your immunity.

Develop healthy physical activity

Physical activity is a proven mood-enhancer. A brisk walk can reduce mild-to-moderate depression as effectively as prescription drugs. Start slowly if you’re new to exercising, and break your sessions into smaller chunks throughout the day to spread out the good feelings from exercising. 

Develop a sleep routine

At the same time, develop a healthy sleep plan, with a routine that helps you relax and get sleepy. That may include drinking a cup of chamomile tea, having a foot soak or warm bath, reading a relaxing book (a real book – moving one’s eyes back and forth across the page may help relax the mind), turning down the lights, and not using technology in your bedroom. In the morning, turn on a light as soon as possible to awaken your brain.

Get some light

Get out into the sunlight as much as you can. Take a walk during your lunch break, or sit near a bright window if it’s too cold out. If you feel your mood is strongly connected to a lack of light, get a light box and spend time in front of it every day, preferably in the morning.

Get help to develop a plan

If you’re already feeling low motivation, you’re probably going to find it very difficult to start making these changes on your own. Enlist friends or family to make some of these changes with you and help you both stay accountable. It’s always more fun to do things together with a friend or loved-one. 

But even those you love may have trouble making these plans. If so, let’s talk together about what changes may help you, and then you can enlist loved-ones to join you.

That said, your low mood may be caused by more than just the weather. Maybe you aren’t where you want to be in life. Maybe you want a better job but first, need some new skills. Or you want to find a significant other but are scared to put up an online dating profile. For many, self-care is the path to happiness, but they think it is all about bubble baths and manicures. 

Give me a call. We can talk about what fills your cup and then we’ll work together to find more time in your schedule to do what you love. We can also put a plan in place to get you to where you want to be in life.  With a little help and guidance, you can soon be on the path to mental health and life satisfaction.

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What Do You Want to Change for Next Year?

Posted on December 21, 2022 by Alisa Hafkin

If you want to make some changes in your life, having a start date can be very helpful. Many people use the beginning of a new year for this start date and make New Year’s resolutions, but you could really pick any date that’s important to you, such as your birthday. Whatever date you choose, don’t get caught in the usual traps of goal-setting that cause most people to give up on their New Year’s resolutions before the month of January is out. Set smart goals and be reasonable. 

SMART goals

Brainstorm and think of the top three things you would like to accomplish or change in the new year.

We often associate New Year’s resolutions with self-improvement, but your resolution may include starting a new hobby or growing in your career. Once you have your top three, it’s time to set your SMART goals. 

The acronym SMART has helped many people develop goals that work. SMART stands for Specific, Measurable, Achievable, Realistic, and Time-limited. So a SMART goal is one that is clearly stated, realistic, and something you yourself can accomplish. Give it a timeframe and measure your success. 

Let’s say your top three are to quit smoking, lose weight, and get promoted. Here’s how SMART goals would work in these examples. 

Quitting smoking is achievable and measurable, because you are in control of your own actions and because many people have quit smoking. Make it a realistic goal by developing a success plan. Overcoming the smoking addiction requires a plan of action, such as avoiding situations that will make you want to smoke, having gum or something healthy in your mouth instead of a cigarette, etc. Do your research and determine the steps that will help you succeed. Give yourself a timeframe – for instance, no cravings to smoke for one whole month before your next birthday. 

For the goal to lose weight, pick a reasonable number of pounds and give yourself a reasonable amount of time. You will not be able to lose 50 pounds in a healthy manner in one month, but you could lose 10. That’s achievable and reasonable if you have created a healthy plan of diet and exercise. It is likely not achievable or reasonable if you have not created such a plan. 

If you want a promotion, define clearly the type of position you’re looking for. Then think about what you need to do to make it achievable – additional training, networking, mentoring, etc. Consider a reasonable timeframe in which to accomplish this and whether you need to set mini-goals along the way. For instance, if you’re an accountant in your firm and your goal is to become CFO, determine what steps you need to take to move up to Senior Accountant or Manager within a year and plan out your future career course for CFO in five or ten years.

Setting yourself up for success

First, don’t expect perfection from yourself. Especially in the case of smoking or weight loss, you may sometimes break your resolution. Don’t consider it a failure, though; consider it a learning experience. What caused you to pick up that cigarette or that candy bar? How can you avoid it in the future? Now recommit yourself to your SMART goals and continue. 

Give your top three goals hierarchy. It’s probably not a good idea to try to quit smoking and lose weight at the same time, but one could roll very nicely into the other. Which goal has the most significant impact on your life? You may be able to start taking steps to move up in your career simultaneously while losing weight or quitting smoking, but since work often causes stress, and stress often causes us to self-medicate with habits such as smoking or binge-eating, you may want to wait until your lifestyle is healthier so you don’t fall into any bad habits.

Planning your goals and creating success plans can sometimes be a challenge. If you need help developing your SMART goals or setting yourself up for success, give me a call. We can work together to set you on the right path, and I can provide accountability that can be the key to your success.

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Boundaries for the Holidays

Posted on December 14, 2022 by Alisa Hafkin

The holidays are traditionally an opportunity to spend time with family and loved ones. They are a time for enjoying each other’s company with good food and warm feelings of love and joy. But sometimes those feelings are not so warm. Many people feel stress during the holidays, often from being stretched too thin or from problems with relationships. Whatever causes your stress, setting boundaries will help you enjoy the holidays without undue discomfort.  

Recognizing your stressors

Your stressors could be major issues in your life. For instance, maybe you’re dealing with infertility, and you just know Aunt Sally is going to quiz you about when a baby is coming. Or maybe you just broke up with your significant other and Mom and Dad are going to point out that you’re the only one who isn’t married yet. Perhaps your political or religious views are different from some of your family members, and you don’t want to discuss these topics at a party.

Your stressors may involve what is expected of you. Maybe you don’t want to sleep on an air mattress in the living room. Or perhaps you don’t want to be expected to bring several dishes. Maybe some family parties are too far away, cost too much to travel to, or tend to go on for longer than you like. 

You may love all your family very much and have no issues with anyone, but you’re an introvert by nature and can only handle crowds for a limited time. 

Once you’ve determined what situations or expectations cause you to stress, think about how you can manage them. Think, too, about what you would like your holiday season to look like. 

Planning to manage your stressors

If there is a topic that you want to avoid, make it known. If you have to call a couple of key people to tell them, do it. It’s also helpful to have an ally on your side who will help deflect the conversation. If Aunt Sally didn’t get the memo and she asks about having a baby, your ally can chirp up with a comment such as, “Well, I think that’s a pretty personal question for a public party, Aunt Sally. And by the way, how is Cousin Jack doing in his new job?” 

Give yourself permission to walk away from conversations you don’t like. If you’re not directly involved in the conversation they may not notice. However, if you’re part of the conversation, be polite but firm about your decision to end the discussion. 

If you cannot or do not want to attend a given party, let the host know clearly. Avoid ambiguous statements like, “I don’t think we can make it.” Say instead, “Unfortunately, we won’t be able to make it this year. I hope to see you another time soon.” This goes also for expectations. If the host expects you to bring a casserole, a side dish, a homemade pie, and a platter of homemade cookies, state simply, “I don’t have time to make all of those. I will bring a casserole and a store-bought pie.” 

If you need time to yourself during the party, plan to escape to another room for a nap or to read a good book for a little while. Let the host know ahead of time that you have the need to “recharge your batteries” and ask where you could rest for a bit. Taking a walk can also make you feel better if it’s not too cold where you are. It will help you digest your food, clear your head, and increase serotonin, those “happy hormones” in your brain. 

To avoid disappointment, don’t set your expectations too high. Other people have their stressors, too, and they may not manage them as well as you do. Enter into your family parties with a degree of leniency and humor. Then, when people show their own quirks, you can laugh off a few things without getting upset. 

Making the holiday that will bring you joy

While you’re planning to avoid what you don’t want to happen, plan something that you do want to happen. Schedule some “me time” in the midst of the frenzy of the season. If an invitation arises that conflicts with your plans, say no – unless it’s something you really want to do. In this case, move your “me time,” but don’t skip it. 

Arranging some activities for yourself will benefit your mental health significantly, but take care of your physical health, as well. We tend to eat a less healthful diet during the Christmas and New Year season, with lots of cookies, candy, hot cocoa, and other sweets. Sugar has a negative effect on mental health and it can weaken our immune systems, just when cold and flu season is at its height. To stay healthy, limit your sugar intake. Talk to a nutritional expert about supplements or foods that can keep your immune system and mental health in tip-top shape.

If you’re having trouble defining your boundaries or getting buy-in from family, we can work together to establish the patterns that aren’t working. I can help you find the words to advocate for yourself in a way that doesn’t cause even more stress. Call me to see how I can help.

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Is There a Connection Between Physical Health and Your Mental Health?

Posted on December 7, 2022 by Alisa Hafkin

There’s a lot of buzz at schools and businesses here in NYC about mental health. The NYC Council recently voted to establish the Mayor’s Office of Community Mental Health as a permanent part of the city’s government. As a therapist and counselor with a background in social work, I applaud any effort to draw greater attention to the importance of mental health and to find ways to address the increasing incidence of depression, anxiety, and other mental health issues. 

But our mental health is not separate from our physical health. A mountain of evidence and our own life experiences tell us that we are integrated beings – body, mind, and spirit; our mental and emotional health affects our physical health and our physical health affects our mental and emotional health. 

The mind-body connection

Many studies have shown strong links between our mental and physical well-being. Research shows that psychological well-being and positive self-talk improve one’s physical health, and good physical health can promote good mental health.

For instance, positivity can reduce the risk of heart attacks and stroke. Moderate exercise can be as effective for treating moderate depression as pharmaceuticals. 

The converse is also true, however; poor mental health frequently leads to physical problems, and physical problems can lead to mental health issues. Sometimes the connection is so close that it’s hard to distinguish which is the cause and which is the effect. 

Mental health effects on the body

One of the most common and most damaging mental health issues today is depression. Depression has been associated with increased incidence of heart disease, irritable bowels, stroke, back pain, and certain forms of cancer. Other chronic diseases associated with depression include diabetes, asthma, and arthritis. 

Schizophrenia is associated with a higher risk of heart disease and respiratory disease. Anxiety is associated with muscle pain, digestive problems, headaches, migraines, dizziness, fatigue, and shortness of breath. The mortality rate from cancer and heart disease is also higher among people with mental health issues. 

Some 50-80% of people with mental health conditions experience sleep disorders, like insomnia and sleep apnea, and sleep disorders can worsen mental health, so it becomes a vicious cycle. 

Physical health effects on the mind

Poor physical health also affects one’s mental health. People who are suffering from chronic illness are very likely to develop feelings of depression, anxiety, or hopelessness. 

For instance, psoriasis, a skin condition associated with red patches and itching, can lead to stress, anxiety, and depression. Being diagnosed with cancer or experiencing a heart attack or stroke often leads to symptoms of depression. In fact, one-third of people with serious medical conditions demonstrate some signs of mental or emotional issues, such as depression, sleep disorders, and reduced motivation. 

Improving the mind-body connection

Taking care of your body – and all other areas of your life – is critical. For most of us, the answer to healing the mind and body is simply a matter of good self-care: healthy food, regular exercise, sufficient sleep, moderate alcohol, no drugs, and regular medical care. 

Making important lifestyle changes can be difficult, but the benefits are significant. Sometimes it helps to make the changes with another person. Share your goals with each other and then make an agreement to help hold each other accountable. 

If you are struggling to make some healthy lifestyle changes or to change your thinking patterns, don’t quit. Get professional help. Do not hesitate to reach out to me or to another expert who has a long track record of helping people recover from depression, anxiety, and other mental health disorders. As a psychotherapist with a psychodynamic and cognitive behavioral orientation, I provide my patients with the guidance and environment needed to foster self-awareness and the motivation to make beneficial changes. Reach out to see how I can help you.

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