The Beauty of Journaling

Cluff Counseling - The Beauty of JournalingSome of the most influential people in history kept detailed journals of their lives. Those journals are both a permanent record for posterity, as well as a cathartic release for the people writing them. Even if you don’t think you need either, keeping a journal has benefits you can enjoy immediately.

Imagine you had a friend you could share everything with–literally everything: when you feel frustrated or hurt by your partner, when you are stressed because of work, when you feel guilty after making a mistake or hurting someone else, or even just when you feel discouraged because of social media comparisons. Yes, you may have a friend, family member, or a partner in whom you can confide, but that person may not always be available and/or what you are facing may be too private, at times, to discuss with others. This is the beauty of journaling.

Journaling is powerful. It is an incredible tool that we can tap into when life is overwhelming, wonderful, or anything in between. When stressful events occur, writing through emotions and feelings has long been known to cause improvements in health and psychological well-being. This is because expressive writing reduces intrusive and avoidant thoughts about negative events and improves working memory. In addition to stress management, these enhancements free up our cognitive resources for other mental activities. There are so many positive benefits to journaling, but today I would like to focus on the following four:

  1. Journaling helps you organize. To do’s, goals, and dreams come out while journaling; it is all part of your stream of consciousness. Not only that, but if you are facing a problem in life, journaling can help you problem solve. A clear plan of action often surfaces when journaling, which is so helpful if you are feeling scattered, disorganized, or overwhelmed!
  2. Journaling clears your emotions. As you write freely in your journal, you will experience reduced feelings of scatteredness, increase focus and stability, release pent-up feelings and emotions, bridge outer events and inner thinking, and detach from the past. There is no greater way to be present in day-to-day life than to regularly clear your emotions and start with a clean slate. In fact, you can even reduce your stress by journaling!
  3. Journaling solidifies learning. I cannot tell you how many times I have read something I learned but had forgotten from my own journal. Writing down experiences and lessons learned reinforces them, and enables you to remember details you might not otherwise remember.
  4. Journaling leads to gratitude. No matter what mood you are in when you begin writing, journaling has the power to naturally steer you towards thankfulness–towards appreciating what you do have and strengths you do possess. When we pause to consider all the good in our life (and I recommend taking the time to write down your gratitude list), a cascading effect occurs and we inevitably realize we have more than we originally considered.

So how can you get started? There are infinite options! In the resources section below, I included one of my favorite possibilities, “The Five Minute Journal.” There are prompts divided into a morning section (to start your day off awesome), as well as a night section (to reflect on what happened throughout the day). Prompts include things like, “I am grateful for…,” “What would make today great..?” “Daily affirmations: I am…,” “3 amazing things that happened today,” and, “How could I have made today better…?” These prompts foster meaningful thought and do not take much time to answer.  A quick google search will render many additional ideas on how you can get started writing in your journal today.

There is great power in picking up a pen and writing freely in your journal for a few minutes every day. While some sources recommend writing for 20-30 minutes at least once day, I often tell my clients to start with what feels natural. If you want to write for five minutes at the start of your day, try it. If you prefer summarizing the day before going to bed, go for it! I recently started bullet journaling because it seemed easier than paragraphs; though many of my entries morph into traditional journaling format, I enjoy following what feels natural to me. Let your creativity run free and journal the way that feels most natural to you–that is how you will get the most out of it. If you have questions about journaling or would like to schedule a session, please do not hesitate to contact me or set up a session today!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.


Eating Disorders 101

Eating Disorders - Cluff Counseling, Denton TherapistUp to 30 million Americans suffer from an eating disorder. According to the National Eating Disorder Association, anorexia nervosa has the highest mortality rate of any mental disorder. Understanding this epidemic is the first step to getting help–either for yourself or for someone you care about.

Everywhere we look we see ads, movies, tv shows, billboards, and models all flaunting perfect bodies: skinny legs, impressive thigh gaps, flat tummies, chiseled abs, massive biceps. With social media at our fingertips, it is easy to compare our body to what we see in the media. Other times, social comparisons are not at the root of an eating disorder–it may be that you are watching you parents go through a divorce, or you did not make the cut onto the Varsity team, so you look for an outlet to feel some sort of control over your life. When controlling your food intake becomes extreme or obsessive, it is called an eating disorder.

Eating disorders are very serious; many young women and men die each year from complications associated with their disorder. Both genders can develop an eating disorder, although rates among women are higher than among men. Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life.

Eating disorders are psychological conditions with both physical and emotional symptoms. The three most common eating disorders include anorexia nervosa (voluntary starvation), bulimia nervosa (binge-eating followed by purging), and binge-eating disorder (binge-eating without purging). Today, we will take a deeper look at each of these three types of eating disorders and discuss how to overcome them.

Anorexia nervosa
Those with anorexia nervosa see themselves as overweight, even when they are dangerously underweight. People with anorexia nervosa weigh themselves repeatedly, severely restrict the amount of food they eat, and eat tiny quantities of a small variety of foods.  They relentlessly pursue thinness–it consumes their life. Common symptoms seen in those with anorexia is an intense fear of gaining weight, distorted body image, low self-esteem (one that is heavily influenced by perceptions of body weight and shape), and a denial of the seriousness of his/her low body weight. The long-term effects of anorexia include but are not limited to infertility, thinning of the bones, anemia, muscle weakness, brittle hair and nails, severe constipation, low blood pressure, damage to the heart, brain damage, and multiorgan failure.

Bulimia nervosa
The next eating disorder I would like to discuss is bulimia. This is where the individual eats excessively large amounts of food and then purges by vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. Unlike anorexia nervosa, those with bulimia nervosa usually maintain a healthy or relatively normal weight. Their binging and purging behavior gives them a feeling of control. Some of the negative symptoms include an inflamed sore throat, swollen salivary glands, worn tooth enamel (plus increasingly sensitive and decaying teeth as a result of exposure to stomach acid), acid reflux disorder, gastrointestinal problems, intestinal distress and irritation from laxative abuse, dehydration from purging of fluids, and electrolyte imbalance (which can lead to stroke or heart attack).

Binge-eating disorder
Like the other types of eating disorders, binge-eating disorder involves a person completely losing control over his/her food intake. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. Thus, those with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the United States. Symptoms include eating unusually large amounts of food in a specific amount of time, eating even when he/she is full or not hungry, eating fast, eating until he/she is uncomfortably full, and eating alone or in secret to avoid embarrassment.

An eating disorder is considered a process addiction, meaning the person is dependent upon a behavior– instead of a substance– for power, control, or satisfaction. I have worked with many patients who struggle with various types of addiction, and I know that recovery is possible. When a mental illness (such as depression or anxiety) is present along with the eating disorder, medication may be needed. Lasting recovery for eating disorders may also include regularly working with a dietician in order to establish and maintain a personalized, healthy goal for caloric intake. These actions, coupled with regular counseling from a qualified therapist, will address the physical and emotional factors of the eating disorder, and can lead to a full recovery.

The earlier an eating disorder is detected and the sooner help is sought, the greater the chance for a full recovery. If you or someone you care about struggles with an eating disorder, now is the time to make a change. Health, happiness, and recovery is possible, and I am here to help. Please contact me today or click here to set up your first session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.


Reliving the Horrors: PTSD

Reliving the Horrors - PTSD - Cluff Counseling, Trauma & EMDR TherapyPTSD is powerful and can change how people think, feel, act, interact with others, and see the world. It is estimated 8% or 24.4 million Americans will experience PTSD at a given time…that’s the entire state of Texas!

PTSD stands for post-traumatic stress disorder and can develop in someone who experiences a shocking, scary, or dangerous event. Examples of traumatic events that can lead to PTSD include, but are not limited to, the following: community violence like shootings, terrorist attacks, muggings, burglaries, physical or sexual assault, and bullying; sexual and/or physical abuse, natural disasters;  being in or witnessing a serious car accident; sudden unexpected or violent death of someone close; a serious injury like severe burns or a dog attack; a major surgery or a life-threatening illness; war or political violence.

PTSD manifests in a multiplicity of ways that is unique to the person and specific to his or her trauma. For example, someone attacked by a shark may never want to get in open water again. A person in a car accident may develop a fear of riding or driving in cars. Because the term PTSD often gets thrown around, I have included the list of signs and symptoms that mental health and medical professionals assess to diagnose PTSD.

You may have PTSD if you have the following symptoms for at least one month (as always, I would encourage scheduling an appointment with an experienced, licensed psychologist to get an official diagnosis):

  • At least one re-experiencing symptom:
      • Vivid nightmares
      • Frightening and/or intrusive thoughts
      • Flashbacks–reliving the trauma over and over
  • At least one avoidance symptom:
      • Staying away from places, events, or objects that remind you of the traumatic experience
      • Avoiding thoughts or feelings related to the traumatic event
      • Changing personal routines (like not driving or riding in a car after being in a car accident)
  • At least two arousal and reactivity symptoms:
      • Being easily startled
      • Feeling tense or “on edge”
      • Having difficulty sleeping
      • Having angry outbursts
      • Physical re-activity after exposure to traumatic reminders
  • At least two cognition and mood symptoms:
    • Trouble remembering key features of the traumatic event
    • Negative thoughts about oneself or the world
    • Distorted feelings like guilt or blame
    • Loss of interest in enjoyable activities
    • Feeling isolated
    • Emotional distress after exposure to traumatic reminders

It is natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a month, seriously affect one’s ability to function, and are not due to substance use or medical illness, it is called PTSD. Some people with PTSD may not show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or an anxiety disorder.

Children, teens, and adults alike can get PTSD–it is a respecter of no one. Children under the age of six may exhibit behaviors like wetting the bed (despite having mastered potty training), forgetting how to or being unable to talk, acting out the scary event during playtime, or being unusually clingy with a parent or other adult. Older children and teens will likely respond more like adults (listed above). It is estimated that 7.8 percent of Americans will experience PTSD at some point in their lives, with women (10.4%) twice as likely as men (5%) to develop PTSD.

It is important to note that not everyone who lives through a dangerous event develops PTSD. In fact, most people will not develop the disorder. Possible resilience factors that can decrease the likelihood of PTSD include seeking support from friends and family, finding a support group after a traumatic event, learning to feel good about one’s own actions in the face of danger, having a positive coping strategy, and being able to act and respond effectively despite feeling fear.

There is hope for those with PTSD. Depending on the severity of the PTSD, the individual may need psychotherapy (also known as talk therapy), medication, or a combination of the two. Treatment plans vary depending on the individual’s circumstances, limitations, and needs. I utilize and have been trained in Eye Movement Desensitization and Reprocessing (EMDR), a type of trauma-focused psychotherapy, which has been shown to be effective in treating PTSD. EMDR involves using bilateral stimulation while the client keeps in mind various parts of the trauma (which helps your brain work through the traumatic memories). Please contact me to discuss which type of treatment might be most effective for you.

Living with anxiety, trouble sleeping, traumatizing dreams, repetitive flashbacks can make it hard to enjoy the simple pleasures of life. Seeking support and guidance through a friend, family member, or a therapist can assist you in the healing process. Call me today to set up your first session and allow me to help you find stability, health, and happiness again.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.


Doing the Things You Enjoy Can Help Your Anxiety

Cluff Counseling, DFW Marriage and Family Therapy - Hobbies for Anxiety ReliefLife is stressful. Whether it is deadlines at work, final exams in school, a breakup with a significant other, or simply the daily rig-a-ma-roll of life, chances are high that you feel anxious from time to time. Anxiety is a normal part of life in our society; everyone experiences it in some degree or another. In fact, 40 million American adults deal with an anxiety disorder of some kind! The question is not if or when you will feel your heart palpitating, have weak legs, or feel queasy about an impending event… the real question is how you will deal with your anxiety when you experience it. In this blog post I will share 6 hobbies that can help keep that anxiety at bay…or at least keep it at a manageable level.

It is not uncommon for my clients to deal with anxiety–I would say 4 out of 5 struggle with a degree of anxiety in some area of their life. In most cases, my clients simply need guidance for managing their anxiety. Some of my other clients, however, have more severe anxiety, and I may recommend medication in order for them to find and achieve balance and equilibrium. I often tell these clients that life with severe anxiety without medication is like drowning… you are disoriented and cannot tell up from down, as you struggle for breath.  On the other hand, life with severe anxiety with medication is like swimming with your head above the water… you are in control, you have air in your lungs, and you can see clearly. Medication will not take your anxiety away; instead, it will help you cope better and be in control of your life. Such cases where medication is needed require a diagnosis from a certified individual, like me, a licensed therapist. Optimal results come when medication is coupled with counseling and self-care.  If you feel you have chronic anxiety, come see me for an assessment and to begin creating a plan to address your anxiety.

Certain hobbies have been found to naturally help clients overcome and alleviate anxiety. When participating in hobbies to help combat anxiety, you are in control. Choose something you like and you are interested in. Here are six suggestions to get your started:

  • Paint or write in a journal. Take a break from the endless social media scrolling, and release your inner artist. There is something so therapeutic about creating with paint and/or words!
  • Joy read or watch an engaging TV show. Escape your own troubles momentarily by losing yourself in other people’s stories.
  • Get outside. Barrie Sueskind, a therapist specializing in anxiety, says this is her go-to: “Fresh air and sunlight are proven mood boosters.”
  • Practice mindfulness. This is all about quieting the madness in your head while still being present. Yoga, meditation, or even a quick walk can steady those racing thoughts.
  • Work out. No secret here–exercise is great for curbing stress, depression, and anxiety!
  • Take a self-improvement class. Yes, you are experiencing anxiety because life is busy and stressful… so adding an extraneous class to the mix may seem counter-productive. However, improving your cooking skills, learning a language, or learning a new hobby is an incredible way to focus on the present and not worry about the future!

Remember, these are merely suggestions. You are in the driver’s seat and can control what and how much you do to ward off those feelings of anxiousness…because they will come! If you have questions, or feel your anxiety is interfering with your ability to enjoy life, contact me today.


Depression Is Not A Life Sentence

Treating Depression - Cluff Counseling, DFW Marriage and Family TherapySociety has made leaps and bounds in understanding depression; it used to be misunderstood as a common ailment of the weak and a manifestation of their inability to overcome all of the emotions that fell under the once-ambiguous umbrella of “feeling sad and/or tired.” We now know–and have research to boot–that depression is very real and surprisingly common.

Last month I wrote this post in which I hoped to destigmatize mental illness. 1 in 5 adults have a mental illness–a health condition involving changes in thinking, emotion or behavior that is associated with distress and/or problems functioning in social, work, or family activities. What many of us do not realize, however, is that depression is a form of mental illness–one of the most common, in fact. Chances are high that you or someone you know has experienced depression. You may find it surprising to know that 1 in 3 women will experience a major depressive episode in their lifetime! While depression is far more common than we realize, the good news is that it is also one of the most treatable mental illnesses.

It is likely you know someone with depression, or have experienced it yourself.  Depression is near-constant feelings of sadness and apathy and can make itself manifest at any time, though it typically appears during the late teens to mid-20s. It may be caused by biochemistry, genetics, personality, environmental factors, age, and even gender. (Stay tuned for my future blog post about mental illness and gender.) A dear friend of mine wrote the following about her depression: “Living with depression is like having a constant high-pitched ringing in your ears that won’t stop, or a person who walks too close behind you and keeps bumping into you without stepping back.” According to the American Psychiatric Association, symptoms range from but are not limited to the following:

  • Feeling sad or having a depressed mood
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite — weight loss or gain unrelated to dieting
  • Trouble sleeping or sleeping too much
  • Loss of energy or increased fatigue
  • Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
  • Feeling worthless or guilty
  • Difficulty thinking, concentrating or making decisions
  • Thoughts of death or suicide

It is important to note that depression is different from grief and bereavement in the sense that depression is constant for (at least) two weeks, whereas the depression symptoms found in grieving the loss of a job or death of a loved one will dissipate slowly with time. Simply “feeling depressed” is on one end of the continuum, with a major depressive episode on the other end, and varying degrees of depression in between. You can feel depressed without having depression.

As I mentioned, depression is among the most treatable of mental illnesses. The first step to healing is seeing a family physician or psychiatrist to rule out other illnesses. Because several medical conditions like thyroid problems, a brain tumor, or vitamin deficiency mimic symptoms of depression, it is important to have a thorough medical evaluation. Once depression is diagnosed, it can be treated with medication (to balance out the chemicals in the brain), and various forms of psychotherapy, including DBT and CBT. A combination of psychotropic medication and counseling is often the most effective form of treatment. Of course, the classic self-help and coping mechanisms–exercising regularly, getting quality sleep, eating a healthy diet, and avoiding alcohol–are essential to practice for a balanced, healthy life (read my recent post about self-help). With proper diagnosis and treatment, the vast majority of people with depression will overcome it.

Depression is a very real illness but help is readily available. You are not alone in this… there is hope! There is healing and happiness, and a life free of that high-pitched ringing in your ear. If you are experiencing symptoms of depression, set up your first appointment with me today. Please do not be dragged down by the feelings of self-loathing and deprecation that depression often invites; you are worthy of love, happiness, and life. Depression is treatable; take the first steps towards a healthier, happier you! Contact me today.


Taking the Stigma Out of Mental Illness

Taking the Stigma Out of Mental Illness | Cluff Counseling, Dallas Mental Health TherapistDo you shy away when you hear the words mental illness? For years, there has been a stigma about mental illness in our society. It was taboo–something uncommon and misunderstood; some even ventured as far as to say it was made up by the “weak” as a ploy to receive attention. However, over the past two decades, much has been learned about mental illness and a fair amount of resources have been developed to educate mental and medical health professionals.  Mental illnesses are very real; in fact, 43.8 million, or 18.5% of US citizens are affected. Mental illness influences the way one thinks, feels, behaves, and relates to others and to his/her surroundings. Those with mental illness often feel tense, anxious, and/or sad to the point that it is difficult for them to function normally.  That is no way to live! If you feel you or someone you love may have an undiagnosed mental illness, now is the time to get help. My purpose in writing this post is to increase understanding and awareness of mental illness in order to help you or someone you know who is suffering. Let’s begin with some basics on mental illness:

  1. What is a mental illness? According to the National Alliance on Mental Illness, a mental illness is a condition that affects a person’s thinking, feeling or mood. Such conditions may affect someone’s ability to relate to others and function each day. Mental illnesses come in different types and with varying degrees of severity. The most common types are depression, anxiety, schizophrenia, bipolar mood disorder, personality disorders, trauma and eating disorders.
  2. Who has a mental illness? While some studies show that mental illness can be hereditary, we are all susceptible. In fact, 1 in 5 adults in the United States experiences mental illness in a given year! Mental illness can affect anyone regardless of age, gender, income, social status, race/ethnicity, religion, sexual orientation, background or other aspect of cultural identity. It can occur at any age, but 50% of mental health conditions begin by age 14, and 75% of mental health conditions develop by age 24.
  3. How do you get a mental illness? Although the exact cause of most mental illness is not known, researchers are finding that many of these conditions are caused by a combination of the following factors and not personal weakness or a character defect (as was previously believed):
    a. Heredity (genetics passed on from affected family members)
    b. Biology (imbalance of neurotransmitters)
    c. Psychological trauma (emotional, physical, or sexual abuse; a significant early loss; neglect)
    d. Environmental factors (death or divorce, a dysfunctional family life, changing jobs or schools, substance abuse)
  4. Are mental illnesses treatable? Certainly! Much progress has been made the last two decades to better understand mental illness and how to treat it.  A full recovery from a mental illness is not simply a matter of will and self-discipline. With therapy and/or medication, a full recovery is absolutely possible.

I hope that better understanding mental illness will remove the stigma and allow more people to seek the treatment they need. It is very real and it is very treatable. If you suffer from mental illness, I want you to know that there is hope! There is nothing shameful about a mental illness, and there are a myriad of resources available to you today–the foremost being a trained and experienced therapist to be your coach and advocate along the way.  Start treatment early and be an active participant in your own recovery process. Contact me today to set up your first appointment!


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