Education & Awareness

What dissociation really is and why it’s not as bad as you think?

Dissociation (often misspelled/confused as disassociation, which is incorrect) means disconnecting from own thoughts, feelings and emotions. Formal definition describes it as: separation of some aspects of mental functioning from conscious awareness, leading to a degree of mental dysfunction or to mental conditions including dissociative identity disorder.


Whenever I talk to my clients about dissociation, I start with the first part, while many people have the latter part in mind. Dissociation sounds scary and serious, mysterious and odd, something from a psychological thriller. In reality, almost everyone experiences mild forms of dissociation, not necessarily involving stress or danger. For example:


  • “Zoning out” while working out, physical labor, or other repetitive activity that frees up your mind.
  • “Running on auto-pilot” while you’re driving a well-known route and not remembering how you got there, or bored sitting in traffic your mind drifts to your shopping list or the busy day ahead of you, you are engaged in a type of dissociation.
  • “Losing time” because you’re captivated by a book, a movie or an activity or a hobby


The ability for literature or film to transport us mentally, and imaginatively, is a mild, adaptive form of dissociation.


  • Purposefully ignoring your body’s signals to use the restroom or stopping to eat — even delaying sleep — when you’re on a tight deadline or want to make it to your vacation destination.


In these ways, dissociation serves us and doesn’t present a problem unless we miss that the light has changed and get honked at to move along.


Dissociation and Trauma


However, in many situations, the mind’s ability to dissociate is an adaptive response to trauma. Some people with trauma histories, employ dissociative strategies to escape the pain of horrible memories.


May it be a life-threatening accident, sexual assault,  combat trauma, chronic stress, chronic physical abuse in childhood or emotional abuse in a relationship in adulthood. By dissociating, the client is allowing the mind to leave, even when the body is trapped.


Clients often report feeling disconnected from the environment as well as their body sensations and find it hard to assess the passage of time. Clinically, this is also called dissociation, and it’s best understood as a well-honed coping strategy; mastering the ability to mentally escape when it’s impossible to physically escape a potentially threatening situation. In some sense, dissociation is the opposite of integration – some aspects of ourselves, emotions, memories, and traits become unbearable and they can no longer be integrated into our sense of self. Research has identified several different types of dissociation that clients can experience.

5 types of dissociation:

  • Depersonalization – a disconnection from body and emotion, sometimes described as an “out-of-body” experience, for example, looking in the mirror and finding own face unfamiliar.
  • Derealization – a sense that the world isn’t real, for example, sensation as if seeing things through a fog, colors appearing too bright, like in a badly edited movie, or being in a video game.
  • Identity Disturbance – a sense of being a different person, or confusion about the self, for example, a client who is morally opposed to drinking alcohol ends up doing so at a party and enjoying it.
  • Identity Alteration – a more extreme version of identity disturbance in which someone cannot control variation in personality or actions, for example, a client reverts to a child state without any conscious awareness of their adult self.
  • Dissociative Amnesia is an extensive inability to recall important personal information or memories, sometimes called losing time”, for example, a client was involved in a car accident but cannot remember why they were driving in the first place.

Clients may experience just one of these forms of dissociation, or any combination of them at various times. And some of them may still be serving an adaptive function.


However, experiencing dissociation does not automatically indicate the diagnosis of Dissociative Identity Disorder (DID), or even a milder type, Dissociative Disorder Not Otherwise Specified (DDNOS). While it is important to be mindful of our emotional well-being, we should always consult our concerns with a mental health professional – we are not alone.

How can therapy help?

  • Grounding – It’s hard to do therapeutic work in a state of defense. By using grounding strategies such as breathing exercises, butterfly hug, 54321 technique, we can help clients return to their window of tolerance.
  • Backtracking – It’s important to find where the freeze response originated, both to avoid triggering it again and to begin to heal that hurt part. So notice, what was happening when you began to freeze? Was it a response to fear or shame? It can be helpful to ask, “What were you aware of? What did that experience remind you of?”
  • Mindfulness- learning how to be present in the here and now. By exercising focusing on sensory and emotional experiences you practice mental anchoring to the present through objects, sounds or smells.
  • Psychoeducation – we can use psychoeducation to help you identify dissociative symptoms and to explain how your responses were created, and why they were adaptive to have. This can help to reduce the shame around the response, and to initiate further work.

Do I have to worry?


If you see yourself in any of the dissociation forms or symptoms, don’t hesitate to reach out to a mental health professional.


Symptomology may sound confusing and contradicting to a lay person but a trained therapist will be able to shed light on your concerns.

Here are some other symptoms that may be part of dissociation:

  • You may have self-worth and shame issues. You may, too often, experience intense emotions or memories. You sometimes get triggered when someone expresses compassion to you. You have unexplained physical pain. You may feel shame. Anxiety can shoot up rapidly from an otherwise peaceful state.  You have nightmares. You can quickly change from a place of high confidence to self-hatred. You may even hear voices, which, by the way, does not mean these voices are a psychotic response.
  • More commonly, they are your echo originating from childhood trauma.


Last but not least, even receiving a dissociation diagnosis is not bad news – research says that with the right treatment even more severe cases of DID can be treated and the separate parts of the identity can be integrated into one self again.


If you would like to learn more about my services, please feel free to call our office for more information.




How to Recognize Signs of Depression

If you have ever felt like you truly understand Eeyore from Winnie the Pooh, or have been told to stop being a “downer”, then you may be familiar with seeing life through a perspective of sadness.

It is a perspective that others will turn a blind eye to, but which we can’t help but see.

A perspective that makes us feel like our arms and legs are made of lead, making it feel impossible to function, even when we want to.

A perspective of ourselves that makes us feel unworthy, helpless, and hopeless.


This is likely not just “being down” or experiencing sadness. This is depression.


It might be hard to understand the difference between feeling sad a lot and experiencing depression.


There are a lot of tough things in life that can bring us down. Some of us might not recognize having depression because we don’t want to, because, well… it’s depressing. Some of us might not recognize having depression because when we’ve actually opened up about how we’ve been feeling, we’re told to “get over it” or “it’s all in your head” by our friends or family members. For those of you out there who need to hear it, it is not all in your head and there’s simply no “getting over” anything that feels as all-encompassing as depression.


Depression is a clinical mental health diagnosis (officially it is called Major Depressive Disorder), meaning it needs to be diagnosed by medical or mental health professionals.

Folks all across the world (in the hundreds of millions) experience depression in their lifetimes. Women tend to experience it more than men (6% and 4%, respectively), but it also becomes more common the older we get (about 5.7% of older adults, compared to 4.4% of children experience depression).

Depression may occur as a result of multiple, stressful (or outright painful) life events, but it can also occur simply because our DNA says so. (Insert Eeyore sigh here). Other indicators that can make us vulnerable to depression: medical conditions, other mental health conditions, military service, and/or having survived domestic violence.


That said, depression is NOT: grief, disappointment, nor feeling “bummed” or “down”.

Here’s why: symptoms include more than just feeling sad and are time sensitive. Below are indicators of Major Depressive Disorder:

  • Feeling sad or having depressed mood
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite (such as, weight loss or gain unrelated to deliberate diet changes)
  • Trouble sleeping or sleeping too much
  • Loss of energy or increased fatigue
  • Increase in purposeless physical activity (as in, inability to sit still, pacing, handwringing) or slowed movements or speech; these actions must be severe enough to be observable by others
  • Feeling worthless or guilty
  • Difficulty thinking, concentrating, or making decisions
  • Thoughts of death or suicide
  • Symptoms must last at least two weeks and must represent a change in your previous level of functioning


Diagnoses can get really specific, so tracking how long symptoms have lasted, whether they come and go, how severe symptoms have been, as well as how symptoms have interfered with day to day life, can be essential in getting a correct diagnosis.

In case it’s not complicated enough, please keep in mind, there are different types of depression:

  • Persistent Depressive Disorder – the one where it seems like the depression never goes away
  • Depressive Psychosis – the one where a person can be out of touch with reality (aka, experiencing delusions and/or hallucinations)
  • Perinatal Depression – the one where depression occurs either during or after pregnancy (prenatal depression and postpartum depression, respectively)
  • Premenstrual Dysphoric Disorder– the one that is based on a person’s menstruation cycle.

Please note: this list does not include ALL the different kinds of depression, but does represent some of the most common forms.


If you are recognizing these symptoms in your personal experience, we encourage you to see a medical doctor first, just in case there might be something medical happening that can explain the symptoms.


If a medical doctor lets you know there’s nothing to physically indicate a reason for experiencing depressive symptoms, we encourage you to seek out mental health professionals who can help. Either mental health counseling or psychotropic medication, or a combination of both, is usually recommended as treatment for depression. (If this gets your attention, you might want to check out the Heart to Heart video our CEP team made for Mental Health Awareness month, where we talk about different types of mental health treatment). 


At CEP, we are dedicated to being a support to people wanting to learn if they are experiencing depression as well as what to do about their symptoms. Our team recognizes that people are more dynamic than characters in a franchise, like Eeyore, and we are here to help with any signs or symptoms of depression. If you’d like more information about how we can help, please contact (915) 209-1234 for more information.




American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Parents of Teens or Young Adults Coping with A Substance Use Disorder

We have all heard or read about the horror stories being shared by news outlets, titles such as “Rises in Teen Drug Abuse” and “Increased Drug Use Amongst High School Students” run rampant in our daily news feeds.

While there is some truth associated with the growing epidemic of substance use disorders as reported by the CDC (Centers for Disease Control and Prevention, 2022) and other organizations, there also remains an importance behind deconstructing stigma associated with a SUD (substance use disorder) diagnosis.

If you are a parent to a teen or young adult that is coping with substance use, or a substance use disorder, know that your experience is valid, and you are part of a growing number of parents that are helping their children navigate social pressures and other factors that influence them to seek substance use as a coping mechanism for emotional dysregulation.

First Thing’s First

You are not alone.

The Centers for Disease Control and Prevention (CDC, 2022) estimate that as many as 15% of high school students have reported using some form of illicit drug or prescription opioid. The numbers reflect the direct correlation between the developmental stage that teens are going through– in developing identities and forming relationships, as well as partaking in higher risk behaviors, which in many instances include drugs and alcohol (CDC, 2022).

Teens and young adults are at a transcendental time in their lives, a period where there are many discoveries to be made, both good and bad. It can be difficult as parents to be witness to the mistakes that these developing minds may make, but it is vital to approach these mistakes with grace and understanding, and to realize the value of understanding where an unhealthy behavior may be coming from.

Your Child is the Expert

What do I mean by this?

At the end of the day, it is your child that bears the pressures of everyday adolescent/teen life, so they are the experts on their day-to-day experiences. Teens and young adults are under an immense amount of pressure due to an ever-changing world that seems ever more uncertain.

These feelings of uncertainty about the world, coupled with social pressures to fit in, or to dress/act a certain way can make way for feelings of stress, anxiety, and in some cases depression, amongst others. These big feelings can be difficult to process–let alone manage–for a developing mind.

In turn, many teens and young people might turn to substance use in order to help sedate large feelings, and they can use guidance with regards to alternative methods to help with cognitive and emotional coping and processing.

For many others, the rapid growth being experienced by the brain, without appropriate stimulation to explore the growth (think extracurriculars such as tennis, boxing, chess, robotics, etc.), can many times lead to feelings of boredom or frustration.

As a result, a similar coping mechanism takes place, and these young minds might explore substance use in order to stimulate the brain, unaware of the negative effects it may have on their development. It is not unusual for teens and young adults to experience ambivalence with regards to seeking help, this tends to be a necessary step in the road toward recovery. The importance is that the support and access to resources is readily available so that when the ambivalence has cleared appropriate help can be sought out.


As a mental health counselor, I may be biased in always primarily recommending psychotherapy to help with substance use disorders or other addictive behavior. However, there are a plethora of resources that can be accessed outside of the therapy room.

  • Self-help groups.
    • These groups are usually formed by community members with a special interest in helping others in the community by providing psychoeducation opportunities, or serving as a liaison for seeking and informing about additional resources in and outside of the community that can be used to provide support. Some common self-help groups that exist for addiction/addictive behavior are SMART Recovery (
    • Some more commonly known self-help groups also include NA (Narcotics Anonymous) and AA (Alcoholics Anonymous), a simple Google search using the aforementioned keywords might help you locate these resources in the community.
  • Support Groups
    • Smart Recovery along with AA, and NA offer support groups for parents of children struggling with addiction or substance use disorders. More information can be found online by completing a Google search such as “support for parents of children coping with a substance use disorder.”


Substance use, substance use disorders, and addictions are all complex, and there is no one definitive answer for how to overcome these issues when they arise. The development and progression of these types of disorders are complex as well, and it can be difficult to witness their progression.

However, there is hope.


Research remains ongoing for best practices when treating and diagnosing this class of disorders, but the research has shown that with appropriate support and by building and maintaining motivation, overcoming addiction/addictive behaviors is within reach.


I would like to leave you with the hope that this too shall pass, your efforts to understand and help your child be the healthiest version of themselves does not go unacknowledged.



Adolescent and School Health, D. of. (2022, September 29). High risk substance use in youth. Centers for Disease Control and Prevention.



Chavez, B. (2021, August 25). Dea in El Paso sees 60% rise in Teen Drug abuse. KVIA.


Zamboni L;Centoni F;Fusina F;Mantovani E;Rubino F;Lugoboni F;Federico A; (2021). The effectiveness of cognitive behavioral therapy techniques for the treatment of Substance Use

Disorders: A narrative review of evidence. The Journal of nervous and mental disease.



Trust: The Most Important Ingredient in Any Relationship

Dear Reader,

What do we do when we have experienced a rupture in a relationship that feels beyond repair?


What do we do when we feel broken inside?  How can we gain trust after feeling so betrayed?

If you are asking yourself these questions, you are not alone. 

Ruptures and betrayals in relationships are common, yet hurtful to cope with.

In my clinical and professional practice, I have come to learn how difficult it can be to overcome these types of relationship injuries.

According to Dr. Mario Martinez, betrayal is one of the most difficult relationship wounding to recover from.  This notion matters because it helps normalize the complexities and time it may require from healing from such hurt.

To begin the healing process of relationship injuries, betrayals, or ruptures; we must first start by defining trust.

Like Dr. Dan Siegel says, “When we can name it we can tame it.” Naming things can help us by providing us with a tangible roadmap of what might initially felt abstract and impossible.

Hence, what is trust?

To do so, we will use Brene Brown’s definition of trust using acronym BRAVING:

B– stands for boundaries.  We are more likely to trust others who respect and honor our boundaries.  The same is vice versa.  People are more like to trust us when we respect and honor other people’s boundaries.

R– stands for reliability.  We are far more likely to trust someone who is reliable, more like to follow through with what they say.  The same occurs for us.  People will trust us when we follow through with what we say while providing congruent and consistent actions.  This is the connection between what we say and do.

A– stands for accountability.  When there is a rupture, a mistake, or misunderstanding and the individual accepts responsibility versus blaming, deflecting, minimizing, or denying, we are far more likely to trust them.  This applies to us as well.  When we genuinely accept responsibility for the actions, missteps, or errors made on our part, individuals are more like to trust us as well.

V– stands for vault.  This means that whatever is shared in confidence is kept private.  When we share something private to someone and they do not divulge it to others, we are more likely to trust them.  The same occurs if the individual practices respecting other people’s privacy.  When we practice privacy for others, especially things that are sensitive or confidential in nature or when asked to, others are more like to place their trust in us as well.

I– stands for integrity.  We trust individuals who have a sense of integrity, meaning their words, values, and actions are congruent.  We are less likely to trust someone who says one thing but does another action that does not match.  We normally call this dissonance or incongruency which causes discomfort for the self and others.  The same occurs for us.   People are likely to trust us when we practice congruency, as best as possible, with what we say, value, and do.

N– stands for nonjudgment.  This is an important element that applies to criticism.  Feedback can be constructive and helpful; however, like Dr. Julie Gottman explains, criticism can hurt.  When there is open mindedness and compassion (non-judgement), we are more likely to trust individuals.  The same applies to us.  When we practice nonjudgement by being open minded and compassionate to others, individuals are more likely to trust us.

G– stands for generous assumption.  This last concept is a difficult one to apply, yet an important one.  When there is trust in a relationship, instead of assuming the worse in others, the practice is to make the most generous assumption (providing the benefit of the doubt) when we are missing information.  Likewise, when we feel that people assumed the worse in us, it leads to feelings of mistrust and doubt in the relationship.  However, when we feel that we were given the benefit of the doubt, it helps increase levels of trust.

This acronym may not make the feelings of a rupture or betrayal disappear.  However, it can help us understand where and why we experienced hurt in the first place.  This can help us begin exploring, “What was important to me and what was missing in this relationship?”

Finally, trust is a treasure that is so vital in any relationship.  It’s not immediate and it takes time to cultivate.  Yet, it can be hurt in seconds, moments, or over time.  My hope for you is to have tangible information that can help better understand the definition of trust.  Granted, trust is not exclusive to these elements, however, it can help us reflect on the things that are missing or working in any given relationship.

With warmth and kindness,




Gottman, J. M., & DeClaire, J. (2002). The relationship cure: a five-step guide to strengthening your marriage, family, and friendships. New York: Harmony Books.

Martinez, M. E. (2016). The mindbody code: how to change the beliefs that limit your health, longevity, and success. Sounds True.

Brene Brown (2015) “Anatomy of Trust.”

Siegel, D. J., & Bryson, T. P. (2012). The Whole-Brain Child : 12 revolutionary strategies to nurture your child’s developing mind. Bantam Books.

¿Qué es la mente inconsciente?

Para comenzar debemos reconocer que hay una división de nuestra mente, se divide en dos, sólo que no son mitades, puesto que una de ellas, la mente consciente representa no más del 5%, mientras que la mente inconsciente representa el 95% o más.

Para poder expresarlo más gráficamente imaginen un iceberg, o incluso un cubo de hielo sumergido en agua, se alcanza a notar que sólo una punta del mismo emerge del agua y el resto (aproximadamente el 95%) permanece bajo el nivel del agua. Podemos decir que la sección que emerge del nivel es la mente consciente, mientras que el 95% sumergido es la mente inconsciente.

Ahora bien, la mente inconsciente posee una serie de características:

  • Primera, es que es un receptáculo de toda la información recogida durante nuestra vida, desde que nos encontramos en el vientre materno.
  • Segunda, no tiene sentido del humor, es completamente literal, de forma tal que toda información que recibe la toma exactamente como la recibe.
  • Tercera, no reconoce temporalidad, para ella no existe el pasado, el presente o el futuro, por ello se pueden presentar manifestaciones que involucren temporalidad.
  • Cuarta, pueden coexistir sentimientos contradictorios, por ejemplo el odio y el amor, que no se excluyen el uno al otro, lo que nos puede confundir.
  • Quinta, no hay un sentido de contradicción, en ella pueden convivir, por ejemplo, odio y amor, rechazo y aceptación y todo ello sin conflicto uno al otro.
  • Sexta, maneja lenguaje simbólico, regularmente se expresa a través de símbolos, en forma muy similar a como se expresan los sueños.
  • Séptima, no le es posible hacer juicio de valor, esto quiere decir, que un suceso muy importante puede tener el mismo impacto que otro que no sea importante.
  • Octava, predomina el principio de placer, lo que le lleva a orientarse a eludir situaciones displacenteras, a buscar el placer sin juicio previo.
  • Novena, inconsciente colectivo, esto es, en ella se encuentra información acumulada y compartida con muchos otros seres humanos, en todo el planeta, además de información ancestral, de donde proceden además temores, rechazos y manifestaciones instintivas.
  • Décima, lo que Freud llamó el inconsciente reprimido, que por la carga emocional que conlleva, sus manifestaciones suelen presentarse como acciones y emociones sin explicación aparente y en forma de pensamientos sin control o de sueños.

Por todo lo anterior, cualquier profesional de la salud mental tiene que estar versado en estas características, pues de otro modo corre el riesgo de dejar pasar situaciones que le harán difícil o imposible comprender motivos, actitudes, comportamientos, sentimientos, respuestas, etc. de sus clientes.

Si gusta más información sobre la hipnosis, no dude en llamar nuestra oficina (915) 209- 1234.


Guillermo Castañeda, Hipnotista Profesional

Fibromyalgia and Mental Health

What is Fibromyalgia?

Fibromyalgia is a term used and suffered by many but understood by the few. It is a chronic disease that many professionals do not really understand or even believe is an illness.

According to the National Institute of Arthritis and Musculosckeletal and Skin Diseases (NIAMS, 2021), fibromyalgia is a chronic long lasting disorder that creates widespread pain and tenderness. It also causes fatigue, sleep disturbances, and sensitivity to pain. Scientists do not really know why people get fibromyalgia and unfortunately there is not a cure (NIAMS, 2021).

Fibromyalgia is most commonly seen amongst middle aged women, however, further studies have identified fibromyalgia amongst men and people from all ages (NIAMS, 2021).

Other studies have also identified it through genetic dispositions and those with no familial history of fibromyalgia. Fibromyalgia is an enigma within the medical sciences and its young discovery has not given researchers opportunity for full studies and exploration on the subject. According to Dellwo (2022) and NIAMS (2021) common symptoms of fibromyalgia include,

  • Sleep difficulties
  • Exhaustion/fatigue
  • Depression/anxiety
  • Brain fog
  • Memory issues
  • Concentration issues
  • Headaches
  • Ringling or numbness in hands and feet
  • Pain in face or jaw (at times TMJ is diagnosed)
  • Abdominal pain (like menstrual cramps)
  • Bloating
  • Constipation
  • Chronic widespread pain throughout the body or pain in multiple places at once in the body
    • Often felt in the arms legs, head, chest abdomen, back and buttocks
    • Described usually as aching, burning, throbbing or needle sensations
  • Heightened sensitivity to light, noise, odors, and temperatures
  • Muscle and joint stiffness
  • Allodynia (skin sensitivity or pain usually with clothes or touch)

The symptoms can be overwhelming alongside with the journey of getting the proper diagnosis. Hence why mental health for people with fibromyalgia, depletes. Fibromyalgia is only a little more than 30 years old from its discovery and identification.

Because it has not been that long since its finding, many doctors and medical personnel do not believe it exists or place importance on the detriment it has on the people who suffer from it.

Fibromyalgia and mental health

When getting diagnosed with fibromyalgia, it can be a tedious, frustrating journey. Not only are you having to go from doctor to doctor explaining how you feel, the symptoms you are having, but having to undergo every physical, blood, and neurological test doctors can think of only to say, “All tests came back negative, you are fine.”

This creates feelings of disappointment and frustration with not only the symptoms that you are feeling, but with the medical sciences that are supposed to help, not dismiss. You begin to think it is all in your head and doctors start override your case and become unempathetic as well as blaming you for not being better at your own health. Comments such as, “It’s your weight,” “you’re not exercising enough,” “you’re not eating right,” etc… create deterioration in your mental health.

According to Dellwo (2022) 27% through 58% of people with fibromyalgia report having feelings of hopelessness, depression, and thoughts of suicide. This is due to factors of being dismissed, difficulty managing symptoms, and there not being a cure.

Fibromyalgia however, has also been linked to many other forms of mental health disorders including anxiety, depression, and trauma (Johnson et al., 2006).

Trauma is a change in our psychophysiological chemistry. Trauma affects how the chemical and anatomy of our brain function (Johnson et al., 2006). Trauma and prolonged stress in adulthood influences brain modulatory circuit of both pain and emotions (Romeo et al., 2022).

It is important to also understand that when high forms of trauma—or prolonged trauma such as childhood ongoing trauma—dissociation (separation from consciousness) can occur. Some dissociative disorders include psychoform (psychological separation from consciousness) and somatoform (body dysfunctions).

Researchers have found high levels of both these forms of dissociative disorder symptoms with people who have rheumatic disorders and medical unexplained disorders (Romeo et al., 2022). In a study conducted by Romeo and colleagues (2022), they found high levels of psychoform and somatoform dissociation with fibromyalgia and a relational connection between childhood and prolonged trauma.

In other words, prolonged, cumulative, and childhood trauma affects the brain chemistry in which changes the ability for the brain to process pain, possibly creating fibromyalgia. However, it’s important to realize this does not mean “it’s all in your head”. It is a true and valid illness that was created by chemical changes in our brain by trauma in which we were exposed to. The pain is real, the symptoms are real, the suffering is real.

Ways to cope.  

Coping with fibromyalgia is hard.

It is not only a physiological coping strategy, it’s also a psychological, spiritual, and social support form of coping.

It takes motivation, determination, and self-care to be able to feel functional, FUNCTIONAL, when managing fibromyalgia. Sometimes to world around us does not understand and it is hard for them to empathize.

However, it starts with our own self-empathy. When we learn to empathize with our symptoms and how our body is managing stressors, and past traumas, we learn to appreciate the strength we generate throughout our every day lives that we wake up. Other important forms of coping techniques include,

  • Exercise
  • Stretching
  • Massages
  • Acupuncture
  • Physical therapy
  • Chiropractic exercises
  • Hobbies
  • Meditation
  • Yoga
  • Healthy eating
  • Educating self on symptoms
  • Swimming/water aerobic exercise (my personal favorite)
  • Anything that makes you feel whole, alive, strong.

As someone who has had to cope living with fibromyalgia, I realized it is a journey. It is a journey with the pain, learning the struggle, empathizing with myself, determination to continue, hope that I will feel better, strength that I have gained, and resilience.

The more I learned about my pain, the more I was able to comprehend and empathize with myself and fall in love with my strength to manage the everyday pain and adjustments of fibromyalgia.

If you would like to learn more about our practice and different mental health counselors please contact (915) 209-1234 for more information.




Dellwo, A. (2022, October 19). The 7 types of fibromyalgia pain. Verywell Health.

Johnson, L., Zautra, A. J., & Davis, M. C. (2006). The role of illness uncertainty on coping with fibromyalgia symptoms. Healthy Psychology, 25(6), 696-703. Doi: 10.1037/0278-6133.25.6.696.

NIAMS. (2021, June). Fibromyalgia. National Institutes of Health.,a%20heightened%20sensitivity%20to%20pain.

Romeo, A., Tesio. V., Ghiggia, A., Di Tella, M., Geminiani, G. C., Farina, B., & Castelli, L.             (2022). Traumatic experiences and somatoform dissociative in women with fibromyalgia. Psychological trauma: Theory, Research, Practice and Policy, 14(1), 116-123.   







How Sleep Impacts Mental Health

Sleeping too much or too little?

Is your sleep being interrupted or you simply cannot stay asleep? At some point we all have experienced what it is like to not get a good night’s rest. This can be apparent during the day in many different ways, such as: being irritable or moody; having difficulty concentrating, remembering things, learning, or even completing daily tasks.

Why sleep is important? What happens during sleep?

Adults need about 7-9 hours of sleep. During sleep, the brain goes through 5 stages of sleep. 4 stages are non-rapid eye movement sleep and the last is rapid eye movement (REM) sleep.

It begins with the first stage when you are drifting off to sleep. Here, your brain produces alpha and theta waves which soothe you into relaxation and lasts about 5-10 minutes.

During the second stage, brain waves begin to increase drastically, lasting about 20 minutes. This stage is ideal for waking up from a nap, since it will make you feel energized and not groggy.

In stage three and four, also known as deep sleep, the brain begins to produce delta waves. During this stage, the brain undergoes memory processing, growth, and muscle repair.

During the fifth stage, or REM sleep, there is an increase in eye movement. Dreams occur during this stage. The brain processes emotional and learning information from the day and stores important items in long term memory while discarding unwanted information. This stage usually occurs about 5 to 6 times throughout the night.

How can he lack of sleep can affect mental health?

It is important for the brain to go through the five stages of sleep in order to regenerate, process, and filter information. When this process is interrupted or unfulfilled, connections within the brain become severed, impacting your thought processes, mood, and energy.

A mental health problem can affect sleep and in turn, lack of sleep can worsen symptoms due to a mental health problem.

Anxiety disorders can make falling asleep difficult due to the constant hyperarousal from worry or fear.

Depression can lead one to sleep too much, and even experience insomnia.

With bipolar disorder, sleep patterns are constantly changing due to mood change resulting in either getting too much sleep or too little.

Trauma can disrupt the sleep cycle by experiencing flashbacks and night terrors.

Even side effects of medication may also affect your sleep.

It is very important to be able to identify what may be impairing your sleep cycle to determine how to properly improve it.

 Ways to improve sleep

Here are some ways you can start improving your sleep:

1. Environment- Adjust your area to create a relaxing environment by considering temperature, lighting, and noise.

2. Exercise- 10-30 minutes of exercise during the day can improve your sleep.

3. Exposure to natural light- Our bodies have a natural sleep-wake cycle that repeats every 24 hours. Having an exposure to sunlight can help your body maintain this sleep cycle.

4. Avoid screen time- Exposure to screens and artificial light can alter your sleep cycle and stimulate your brain, making it more difficult to wind down.

5. Avoid stimulants- This can include alcohol, caffeine and tobacco.

6. Consistency- Creating a routine such as going to bed and waking up at the same time, reading, meditating, etc., can help your body determine when it is time to start unwinding.

Achieving the five stages of sleep is a natural process that needs to occur in order for us to be able to feel well rested, focused, emotionally stable and be able to properly function throughout the day.

It is important for our brain to have the time to restore, although it may be a challenge knowing that symptoms of some mental health problems may hinder this process.

If this is something that resonates with you or you simply want more information, please feel free to contact our office.

-Karime Aziz, MS, LPC, Associate Supervised by Guillermo Castañeda, LPC-S


Centers for Disease Control and Prevention. (2022, September 13). Tips for better sleep. Centers for Disease Control and Prevention. Retrieved November 10, 2022, from

Mental health and sleep. Sleep Foundation. (2022, November 4). Retrieved November 10, 2022, from

YouTube. (2020). How sleep affects your emotions | Sleeping with Science, a TED series. Retrieved November 10, 2022, from

Stages of Change in Therapy – how understanding of ourselves helps us progress

When clients first come to therapy, they often wonder: “What do I want to gain from this? How can I get help if I don’t even understand what’s bothering me?”.

Maybe they tried therapy before and it “didn’t click” or they lost motivation, or simply couldn’t find time to commit to weekly sessions. What they DO know is they need help, they just need to find out what to do.

These feelings are very common when facing a big step such as going to therapy. The understanding of our motivation is one of the essential parts of getting better – not only knowing what the issue is – also the knowing why I want to change.

What to expect from the process of change?

How fast can I move forward?

What if I fail?

Being prepared will make us more confident and less anxious about the changes and will let us navigate the process in a more mindful way.

The Stages of Change or The Transtheoretical Model of Change is a clinical theory developed in the 1970’s by James Prochaska of the University of Rhode Island and Carlo Di Clemente.

The stages can be best explained as interrelated steps we go through with our thoughts and emotions when we are confronted with a difficult situation that needs changing.

The concept can be applied to anything from quitting drinking to breaking up an unhealthy relationship to healing from grief after losing a loved one. The stages follow an order and each of them has a purpose in creating change. They also occur gradually – from initial resistance and denial, a commitment and progression is created, and relapse is an expected part of the process.

Read more

When the Caregiver Needs Inner-Care

Dear Reader,

 As a provider, I have come to understand the importance of providing care to others.  In many walks of life, we all engage in providing care in one form or another.

Caregiving is a benevolent and altruistic practice.  Caregiving can range from providing care to children and adults, helping meet the needs of others, or providing support.

Caregiving has many forms, variations, and levels of depth.  Some individuals require more support and others need less.  Every individual and situation is unique to its circumstances and necessities.  In some cases, there are seasons where individuals may need more or less from us.

Normally, when inquiring about why caregivers engage in such practice, it derives from values such as kindness, a deep sense of contribution, and a desire to help others.

However, what happens when the role of caregiving becomes all-consuming or encompassing?

In some cases, the caregiver may over-function, overwork, over give, and hurt. 

Dr. Gabor Maté eloquently points out in a lecture how caregivers are honored in obituaries for selflessness, always being there for others and putting themselves last, and working until the last minute of their death.  In his lecture, he cautions the audience of how these individuals needed to receive care when receiving fatal diagnosis and continued to perform in caregiving roles at the expense of their health, and prioritizing others when they themselves needed support.

This is a grim and sobering observation of the caregiving spectrum.   On one end, it can have a positive and adaptive function, and on the other it can lead to maladaptive and negative consequences.

It reveals the cost and impacts caregiving may lead to when over-functioning, over giving, and not taking the time necessary to rest or recover.  Dr. Maté’s message emphasizes the importance of caregiving for the self.

Now, if you are in a role where you are providing care to another individual, the following items are signs that you might need to prioritize your own self-care:

  1. Resentment

If you find yourself resenting others who are receiving of your care, this might be a sign that you are likely over giving or over functioning.  Resentment is an important emotion that signals the body that we need something.  In some cases, both the mind and body may need physical or emotional nourishment, care, and rest.

One way to address resentment is by recognizing and understanding that we are emotional human beings who have needs.  Of course, this begins with self-awareness and listening to ourselves.  Our body, mind, and heart are talking to us all the time. Once a need is acknowledged, boundaries can be established, and needs can be expressed.

  1. Sickness and Illness

This occurs when a primary doctor or provider has pointed out the importance of taking time off, self-care, or reducing stress.  This might mean that the body needs time to recover or rest.  There is a strong correlation between inflammation, stress, and chronic illness.  In some cases, stress can exacerbate the symptoms of sickness or illness.

A way to address this is by asking for help.  Like mentioned above, it starts with recognizing what we need.  When this occurs, we might recognize that we need help and that’s okay: we are human.  This may mean that some tasks or projects need to be delegated appropriately, revised, or entirely removed.

  1. Misplaced Responsibility

This normally occurs when we feel a deep sense of responsibility for others.  Granted, there are real and valid situations where we do hold a responsibility for others’ wellbeing such as parenting or leadership roles.  However, misplaced responsibility occurs when we feel responsible for things that are truly outside of our control.  This can lead us to feeling exhausted, discouraged, and hurt.

One way to address this is by accepting both what is within and outside of our control.  Acceptance is an antidote to those things which are not within our control.  This does not mean we are giving up; however, it may mean that we can redirect our efforts in a more adaptive or helpful ways.

  1. Insatiable Expectations

No matter what we do, it feels as if it’s not enough.  As human beings we have a potential to do extraordinary things; however, if unaware it can lead individuals to over perform or overwork.  Like mentioned before, this may be due to misplaced responsibility on ourselves such as things are truly outside of our control.  This can lead us to limiting our ability to be present and enjoy the process.

A way to address this by setting realistic and achievable expectations.  To do so, we may start by prioritizing and clarifying what is truly important for us.  Ideally, the goal would be to shift our expectations from focusing on the outcomes and instead focusing on the quality of the process.  In other words, enjoying the journey.

  1. Over-Identifying with the Caregiving Role

This can occur when we confuse our identity with the caregiver role.  The self is made up from different parts, values, and life experiences.  However, in some cases either because of adverse childhood experiences or through social learning experiences we might forget who we are.  Hence, we might confuse the caregiving role as a form of identity.  Very reasonably, it might be a very important part of who we are, however, the invitation is to take into consideration that even then, it’s not all of who we are.

A way to reframe this, is to make room for other parts.  This requires awareness of ourselves: to make room for both the caregiving part of ourselves and other parts.  Hence, this may begin by exploring all our parts such as our strengths, our roots, our values, and needs.   There is more to us than the caregiving role.

In closing, caregiving is a beautiful and rewarding experience.  However, the caregiver needs love, too.  My intent is to invite the caregiver part in you to make room for inner care.  Like Maya Angelou once said, “Love liberates,” it does not confine.  Caregiving is an act of love that liberates the self to express and receive love.  In essence, my hope for you is to live the life your heart longs for.

With warmth and kindness,



A., V. D. (2015). The body keeps the score: Brain, mind, and body in the healing of trauma. New York (New York): Penguin Books.

Martinez, M. E. (2016). The mindbody code: how to change the beliefs that limit your health, longevity, and success. Sounds True.

SCSASmithers. (2013, March 6). When the body says no — caring for ourselves while caring for others. dr. Gabor Maté. YouTube. Retrieved August 11, 2022, from

La Hipnosis en las Fobias


Las fobias son conocidas como miedos “exagerados” que pueden (y a menudo ocurre) incapacitar a quien la sufre, de tal modo que no puede llevar una vida normal.


Es clasificada como un trastorno de ansiedad y se refiere a situaciones, objetos o seres que en realidad no representan una amenaza real.


El Manual Diagnóstico y Estadístico de los Trastornos Mentales V (DSM-V) la clasifica dentro de los problemas de ansiedad.


Hay una serie muy grande de disparadores de las fobias, que van desde situaciones, como ocurre en la fobia social, en donde la persona no puede relacionarse efectivamente, no puede acudir a sitios donde se reúnan dos o más personas.  De hecho, pudiera llegar a presentar ataques de ansiedad, de pánico y hasta posiblemente trastornos físicos.


Los animales, gatos, perros, etc., y por supuesto los insectos, son uno de los motivos que, con frecuencia, llegan a provocar una fobia. Hay aproximadamente 470 tipos de fobias.


Es muy importante señalar que existe una diferencia muy grande entre un miedo y una fobia, en una fobia el miedo es más allá de toda proporción, impide por completo que la persona pueda acercarse de cualquier forma a la situación que la produce, logrando con ello inmovilizarla.


Existen varias estrategias para enfrentar el trastorno, por ejemplo, la terapia cognitivo conductual, terapias basadas en un acercamiento gradual al motivo y otras.


Sin embargo, la hipnosis ha demostrado una efectividad muy grande en la resolución del problema, en lo que respecta a los tiempos de recuperación la hipnosis ha demostrado que es una terapia sensiblemente más rápida, por lo que se le conoce como una terapia breve.


Es importante apuntar que, si bien la hipnosis es más rápida, no basta con una sesión, se requiere de cumplir con un protocolo, a fin de lograr los resultados esperados y abundo en el concepto.


Un sujeto en hipnosis siempre estará consciente, que la hipnosis es un estado de profunda relajación, más allá de la meditación, en donde se establece una comunicación con la mente subconsciente y se pueden reprogramar hábitos, sentimientos, conductas, emociones, y siempre con la aceptación y consentimiento de la persona.


Si gusta más información sobre la hipnosis, no dude en llamar nuestra oficina (915) 209- 1234.



Guillermo Castañeda, Hipnotista Profesional

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