By Alex Diaz, PhD

In any team sport, creating a robust team dynamic is always the greatest challenge for any coach. Team members differ in personality styles, attitudes, motivation, and behaviors. A coach fixated in believing that his message will equally resonate with each player will fail to create a cohesive team approach as individual’s differences are not being considered. To achieve an effective teamwork atmosphere, leaders shine in their ability to unite individuals by seeking a common goal while supporting their emotional behavioral differences.

An individual’s emotional behavior results from the combination of personal genes and life experiences, both supportive and upsetting. Such experiences mold a neurological imprint in our brains leading to the development of behaviors whose roots lie in implicit, subconscious, emotional memories. These memories cannot be intentionally brought up. According to psychologist Peter Levine, emotional memories are “felt-sense emotions such as surprise, fear, anger, disgust, sadness, and joy.” These memories lie just below the neo-cortex. Giving an oral presentation before a large audience may bring an array of felt-sense emotions, such as calmness or nervousness, which are derived from implicit memories based on prior experiences.

Hierarchically, our brain develops implicit memories first and explicit ones later. We feel butterflies in the belly and later verbalize them as anxiety. A tennis player, who is serving to win a grand slam match, will feel rapid heartbeats and shallow breathing. If the player is from Australian, such felt sense awareness will be verbalized in English; if the player is from Japan, the same felt sense sensations will be spoken in Japanese. Both players feel implicit memories based on past experiences. Human beings experience non-verbal awareness before sensations turn into a verbal language.

To be coherent between what we sense and what we express is the result of how emotionally regulated we are. When athletes are asked about the experience of losing a very close game, they rationalize their feelings by either minimizing its emotional content or expressing a rationalization aimed at, subconsciously, diverting the attention from that of feeling upset. An emotionally regulated athlete not only feels the upsetting emotion by embodying a faster heart palpitation, but also by verbalizing it. When leaders attune to the emotional needs of self and others, an implicit level relationship takes place. It is at this implicit human connection that meaningful interactions are forged, bringing trust, safety, healthy relationships.

Being emotionally met allows for channels of communication to open up between leaders and team members. A team member will be more cooperative if he/she feels an inner sense of trust. In a survey presented at the 2015 World Class Performance Conference, the first leading factor for top Olympic performances rested on the coach-athlete relationship over other factors such as athlete self-awareness and having optimal training environment. In a 2008 Coach Survey Summary Results: Evolution of Athlete Conference, it indicated that focusing on the athlete as a whole person was more valuable than seeking techniques to improve performance.

On the other hand, when leaders seek inter-connectivity by using explicit language, it leaves a sense of emotional disconnection. Hence, a perceived lack of emotional safety is felt. More importantly, it leads members to having second thoughts about their own self-worth or thinking they have done something wrong. On the other hand, connecting with team members by supporting their hard work or frustration, praising when sincere effort is performed rather than taking such a behavior for granted, and encouraging when mistakes are made lead to promoting a higher sense of understanding and appreciation.

Holistic approaches aim at self-regulating emotions by eliciting implicit language attunement. Yoga, mindfulness, breathing relaxation, visualization of positive experiences, and somatic psychology embrace connecting at a non-verbal language. These practices help to develop a greater sense of tuning in to our felt-sense awareness and, as such, enhance our capacity to regulate emotions and maintain meaningful relationships.
At the core of who we are as humans, the emotional connection is what has kept us alive and able to survive for so many years. Whether we are part of a sports or corporate team, we owe it to ourselves to enhance our capacity to regulate emotions at an implicit level as such experiences will only bring a greater sense of human connection and an enhanced present moment awareness.

​By Jan M. Bergstrom, LMHC, SEP, DaRTT

It never fails to surprise me that I receive many calls from my clients that are completely stressed out. In my 24 years of practice, I see my clients in a constant state of rev in their nervous system. Rev is when the sympathetic branch of the nervous system gets into a chronic state of hyperarousal. The sympathetic branch regulates arousal and gets us ready for action. So, when you are in a chronic state of sympathetic arousal or rev, the experience of your life feels like “always having the gas pedal on”. Here are some great interventions from my new book called Traveling the Journey Home, coming out this June 2019 for your use during these challenging times. Enjoy!

Grounding and Centering Practice in Action

Grounding and Centering are two other practices that reconnect you directly with the resources that are naturally available in your own body. It is important to reestablish your relationship to both the ground and to your body’s center, the place where action and feeling originate. These functions are compromised during trauma reactions. In trauma, you lose your ground, so an important part of healing is learning how to find your ground and center again. As you ground and center yourself before each exercise below, it will help you create a feeling of safety, and a sense that you are in charge. Here is how you do it.

Grounding Technique

1. Sitting in a chair, gently push the heels of your feet into the ground. Notice the sensations in your legs when you engage the muscles and release the muscles. Experiment with finding just the right amount of pressure in your feet. 
   
   
2. Bring your awareness to what your feet feel like in your shoes as they are resting on the floor. Wiggle your toes and name the sensations that arise. Become aware of your feet on the ground.
   
   
3. Begin Deep slow breathing – explore pace breathing by Marsha Linehan (Linehan, DBT Skills Training, Handouts and Worksheets, Guilford Press, 2014), where you slowly inhale to a count of five, completely expanding the rib cage and belly, then slowly exhale to a count of seven until your rib cage has contracted and your shoulders have dropped. Do this at least five times. 
   
   
4. Gain physical support from a comfortable chair. Bring your awareness to your buttocks as it sinks into the chair and your back as it is being supported. Name the sensations that arise. Experiment with slumping over and then sitting up straight, lengthening the spine as you do so. Imagine having a string pulling you up straight. Notice any and all sensations as they arise. Does your back hurt? Your vertebrae creak? Can you feel the blood leaving your head? Do you feel taller? More in control? Become aware of each sensation, whether physical or cognitive. Don’t judge these sensations, just greet them.
   
   
5. Focus non-judgmentally on the sensations you can feel throughout your whole body. Start scanning your feet and slowly move up through your legs, abdomen, torso, into your arms and hands, finishing off at your neck and head. Just allowing whatever shows up to be there.
   
   
6. Tense, then relax your muscles. Try using an exercise ball if you have or can get one. If you don’t have one, try a beanbag, a roll of socks, a crumpled towel—anything that you can hold in your arms or between your legs and squeeze tight, hold for five seconds, then relax for five seconds. Notice the sensations and the difference between the engaging muscles and releasing muscles.  
   
   

This same practice can be done with movement, such as Tai Chi, Qi Gong or Yoga. Take a class and see if you can focus on what is happening in your body moment by moment rather than thinking about your day or what is in the future. If you start thinking about the past or future, don’t worry. Just gently bring yourself back to your body awareness and breathing.

As with the Mindfulness practice, this Grounding Technique will help you to calm yourself, control your thoughts and triggers, and enable you to bring yourself to the present at will—whenever you find your thoughts and anxieties spiraling into the past or worries of the future.

The Grounding Technique becomes even more powerful when it is combined with the Centering Technique. This technique is a bit more unique, but every bit as transformative.

Centering Techniques

1. Place one hand on your heart and notice what happens in your body when all thoughts are dropped, and you focus on just your hand. Observe the weight of the hand, its temperature, the sensation of the hand itself and the sensation of it resting over your heart. Notice any changes in your breathing, your heartbeat, even the energy you feel in your hand. Visualize in your mind’s eye a warm ball of golden energy swirling around in your hand as it rests upon your heart. 
   
   
2. Keeping your hand on your heart, gently place the other hand on top of your head. Apply a slight pressure on the top of your head to create a sensation of being grounded to the earth. With the hand on your heart, focus on channeling warmth and empathy throughout your body through this hand.
   
   

With practice, you will find these techniques are effective in helping you to gain and remain calm and detaching yourself from the thoughts and memories that haunt you. By learning how to become aware of your thoughts and the sensations they awaken in your body, you will gain mastery over them. 

Techniques to Help Stay Grounded and Centered

There always comes a time when you find it hard to stay present with an emotion or body feeling. This is totally normal, and you may find yourself wanting to stop your investigation of the material that is coming up. No problem! In fact, it is important to know when to stop and what to do. I recommend healthy alternatives rather than medicating your feelings by eating, drinking, taking drugs or engaging in self-abusive behaviors. Here are some healthy techniques for staying grounded and centered. You may have heard these suggestions a thousand times and, like anything we hear a thousand times, they may go in one ear and out the other. But this time, try something different., Try at least three of these exercises, just once. Afterwards, reflect on how your body feels, and how your mind feels. Then do them again, another day. You’ll be surprised with the difference such simple activities can have on both your body and your mind.

1. Go outside and take a walk in your favorite place. If you find your thoughts spinning off into worries as your feet carry you along the pathway, bring your mind back to the moment. Observe the sky above you, the earth below you, the flora and fauna. How many birds can you see? Smile at the people you pass. When you get home, see how many things you can recall from your walk. The more alert you are to the world that surrounds you, the less space there is in your mind for worries.
   
   
2. If you have a dog, take your dog for a walk or go to a dog park. Use the time to truly enjoy your pet’s own joy for the outdoors.
   
   
3. If you have a cat, pet and play with it. There is a reason we call our pets “pets.” Just petting the fur of a dog or cat can have a comforting effect on both the pet and ourselves, as our endorphins are stimulated.
   
   
4. Call a close friend and reach out for support. If you are in recovery, call a fellow member or your sponsor. Be sure to listen and be there for your friend, as much as your friend is there for you. If your friend is unavailable for such an emotional call, don’t judge your friend. They might be in the middle of taking care of their own needs. Ask them to call when they have more time, and call someone else. Remember, we are all struggling. The more thoughtful you are of your friends’ time and needs, the more thoughtful they will be of yours.
   
   
5. Work out moderately at the gym or at home. If you haven’t worked out for some time, start small. If you find yourself watching TV, use the commercial breaks for short spurts of exercise. Try finding a five- or ten-minute YouTube video you can work out with. If you go to the gym, start with twenty minutes, work up to half an hour, and make a fifty-minute workout three times a week your goal. Don’t push yourself too hard. Be gentle with yourself. You’ll get there.
   
   
6. Dance to your favorite music, journal your feelings, draw or use some medium for an artistic expression of what you are feeling. Indulge in your playful side. You never lost it—you just learned to ignore it as you matured. Let it out!
   
   
7. Move your body and open your arms and spread them out to create a circle. Experiment with expanding the size of this ‘container’ until it is “big enough” to hold all the feelings and sensations or “all of the parts” of your pain. 
   
   
8. Use your body to put one palm on the side of each knee: push arms against the outer part of the knees while simultaneously pushing out with the legs. Or use the arms to push against the side of the body. This creates resistance and engages your muscles to fight back, which can give you a feeling of empowerment.
   
   
9. If you have a flashback or start to dissociate or “fade out,” become aware or what is called “orienting” to the external environment (or room). This technique can be a helpful way to “come back” into the room. To do it, just choose and describe three things in the room that you like and reflect on why like them.
   
   
10. You can also turn your head and neck and slowly as you focus on objects in the window, the wall, the door, the lamp, the bookcase. Or focus on objects that might be comforting such as your most favorite object, or cues that tell you where you are.
    
    

Mind’s Eye Imagery

Mind’s eye imagery is a technique that draws on images to calm and ground the body. Remember all these resources I’m referring to are those internal or external cues that help you to find a safe place to return to when you become triggered as you navigate through your childhood trauma. 

I usually ask my clients to think of a time in their life when they traveled somewhere, had a favorite animal they loved, connected with someone special and experienced a felt sense of calm, acceptance, grounding, centeredness, and safety. Once they find this experience (or several experiences), I ask them to write them down. These visual image resources will be used throughout the rest of the book for any of the processes that we journey through. They will act as anchors. An anchor is like a ballast. It gives stability in times of need. And that is just what you are seeking.

Mind’s Eye Imagery Practice in Action

While in this grounded and embodied state, sit somewhere where you are comfortable, and close your eyes to contemplate these scenes below. Allow yourself at least a minute for each scene. Notice your felt sense or bodily sensations. See if you can put words to them. Some examples might be: calm, relaxed, soft, warm, centered, tight, airy, spinning, or whatever words describe the sensations. Remember, don’t judge the sensations—just find a word that best describes the sensations you feel as you contemplate the scenes that follow.

1. Sitting on your favorite beach listening to the ocean waves
   
   
2. Hiking up your favorite mountain, reaching the top overlooking a beautiful valley
   
   
3. Looking across the Grand Canyon and the river that flows through it
   
   
4. Being on a tropical island 
   
   
5. Sitting in a cozy cottage with a warm fire burning in the fireplace, the snow gently falling outside
   
   

Did these scenes calm you? Excite you? What changed in your internal state as you contemplated these scenes? Did you find one that brought you instant calm? If you didn’t, think of a time when you were traveling or in nature and you loved what you were seeing and feeling. If so, you have created a room in your mind where you can find instant comfort. When stressed, anxious or triggered, go to this place and relax. There’s no admission to be paid, no taxes or mortgages you must come up with, no applications to fill out. This place is yours, available to you whenever and wherever you find yourself. Welcome!

​By Dr. Cedar Barstow,  M.Ed., C.H.T., D.P.I.

Power, simply the ability to have an effect or to have influence, is a magnetic, addictive, and corrupting force. Research shows that taking on higher role power or having higher rank power inevitably changes you. You are given gifts, actually privileges, from the outside world that change how you see yourself, how you see and relate to others, and how they see and relate to you. The greater the power difference the greater the effect. These privileges change you whether your intentions are for service or for selfish gain.


What is it about power that is corrupting? Why are we so corruptible?


These are questions that Julie Diamond asks in Power, A User’s Guide (Diamond, 2016. It gets right down to the bottom of things. Power is the ability to have an effect or to have influence. We all have power. Even a baby has power. Think about the effect of a baby's cry or a baby's laugh. This is personal power. It is personal and unique. It is part of part of our identity. We may use it wisely and well. We, or the people around us, may inflate it or diminish our awareness or access to it, but as long as we are alive we have the ability to have an effect.


It is another kind of power that is corrupting—role power. Role power is the increased power that is embedded in a role or position you are given. Your role power is not your identity. Your role power is like a scarf or mantle of extra power that is added on to your personal power. It is attached to the role and should come off and on with the role. Teachers, Clergy, Therapists, Presidents, CEOs, Policemen, Politicians are roles that come with increased power. The power that comes with higher rank also changes people and how others experience them. Rank power can also be corrupting. Wealth, higher education, experience, celebrity, white, male and even parenting are examples of higher rank. In summary, personal power is immutable, role power is earned, won, or assigned, and rank power is mutable by culture and is sometimes earned. In this article the primary focus is on the privileges of role power and how to mediate the perils. (Barstow, 2015, p. 303-307) Some of the greatest perils of power come from the tendency to blend personal, role, and rank powers instead of seeing role and rank as add-ons to personal power.


Here's a taste of research that describes some of the changes power brings. Studies show that once people assume positions of power, they’re likely to act more selfishly, impulsively, and aggressively, and they have a harder time seeing the world from other people’s points of view. Dacher Keltner calls this the paradox of power: "The skills most important to obtaining power and leading effectively are the very skills that deteriorate once we have power” (Keltner, 2007). These skills (what most people want from leaders) are characteristics of what could be called social intelligence: modesty, empathy, engagement with the needs of others, and skill in negotiating conflict, enforcing norms, and allocating resources fairly. (Barstow, 2015, p. 316-318).


[In another study,] when researchers give people power in scientific experiments, those people are more likely to physically touch others in potentially inappropriate ways, to flirt in more direct fashion, to make risky choices and gambles, to make first offers in negotiations, to speak their mind, and to eat cookies like the Cookie Monster, with crumbs all over their chins and chests (as quoted in Keltner, 2008, Barstow, 317-318).
Research shows that power leads people to act in impulsive fashion, both good and bad, and to fail to understand other people’s feelings and desires. . . . 


For instance, studies have found that people given power in experiments are more likely to rely on stereotypes when judging others, and they pay less attention to the characteristics that define those other people as individuals. Predisposed to stereotype, they also judge others’ attitudes, interests, and needs less accurately. . . . Power encourages individuals to act on their own whims, desires, and impulses. . . . Perhaps more unsettling is the wealth of evidence that having power makes people more likely to . . . interrupt others, to speak out of turn, and to fail to look at others who are speaking. . . . Surveys of organizations find that most rude behaviors—shouting, profanities, bald critiques—emanate from the offices . . . of individuals in positions of power (Keltner, 2008, Barstow, p. 318).


Some additional research does indicate that people with a moral center made up of attitudes and values such as kindness, humility, honesty, respect and fairness, are less affected by the corrupting effects of elevated power (Lammer, Stapel, 2009, pp 279-289).
I find this information both unsettling and liberating. I have long wrestled with how to understand what is called evil. With an infusion of empathy and compassion, I see, through the lens power, that, not only do we all have the capacity to misuse power, but we are all subject to the addictive trance of elevated power that reduces our empathy and inhibitions and pulls us toward prioritizing our own needs and interests because our higher role or rank allows us to. It takes a mighty commitment to self-awareness and the well-being of all to be able to mitigate these effects. This is a life-long engagement with understanding and refining your impact on others.


We have all, mostly inadvertently, caused harm in minor and sometimes major ways, and we have all been hurt by misuses and abuses of power. This is human. I'm thinking of the teacher who says she was open to feedback but gets defensive and angry when she hears critical words; the therapist who has an emotional affair with his client; the CEO who begins to think of her employees as simply cogs in a wheel; the doctor who offers choices without medically evaluating the options; the banker who makes money from giving a bad loan; the policeman who privileges people with rank; the parent who offers authority with no love, or love with no authority; the Priest who mixes up love relationships with congregant relationships; or the politician who thinks only of re-election strategies rather than what is best for her constituents.
I wonder how many of these could have been reduced or prevented if this information about the corrupting nature of power were part of everyone's basic education.


Why are we so corruptible? 

This is the second part of Julie Diamond's question (Diamond, 2016, p. 49 ff.). She goes on to say that "Something happens to us like being under the influence of drugs. . . . This creates a deadly cocktail of opportunity and immunity." Since everyone is affected, we need to take a moment to feel compassion for ourselves as human beings. We are all vulnerable to the deteriorating effects of elevated power. The greater the power difference, the stronger the effects, and the more tempting the perils. 

I'd like to take you on a journey to help you understand more about how the changes that come with power feel and the impact they have on you. Disneyland has a ride called Thunder Mountain. Now, please imagine that, with a group of other leaders, you are climbing not Thunder Mountain but Power Mountain. You are excited. You've just been given a role with increased power. You want to use it for the good of all. The higher you walk, the further away the village and the villagers look. The higher you climb, the greater your role power and the greater the power difference  between you and the people you are responsible for. You climb up the path, for example, from student to graduate student to teacher to assistant professor to dean to college president. The higher you get the greater the view and the rarer the air.* 

Along the way you will receive four gifts or privileges that will support you in doing your job and fulfilling the responsibilities of your role. These are the four gifts that power gives to everyone, no matter what their intention. These are the gifts that will impact and change you, inevitably. You have not earned these gifts of power, although you may have earned the power role. They are not given because you are good or bad. Each weaves its own spell. 

Receive now your first gift, symbolized by a coin: Access to resources and opportunities, including money, people, information, supplies, and control. The functional leadership purpose of this gift is to provide you with the support you need to fulfill the responsibilities of your role. As you take in this gift, notice how this alters your inner experience and how you see others. What perils can you feel or imagine? 

Receive now your second gift, symbolized by a scarf that you put around your neck: You become bigger than yourself. You are bigger because, to others, you are now a role--an add-on to your personhood. The needed leadership purpose of this gift is to provide you with the increased ability to have an effect and to have the influence that you will need to fulfill your role. As you embody a role in addition to being a person, notice your inner experience and how others may see you. What perils can you feel or imagine? 

Receive now your third gift, a piece of paper with slits cut in it to symbolize changes in your vision and how you are seen: You gain social distance and prerogative to enable you to see the big picture and not get too caught up in the details or with individuals. As you take on more distance, notice your inner experience and how it changes your perceptions of others. What perils can you feel or imagine? 

Receive now your fourth gift, symbolized by a wand: Freedom to act with limited interference, and significant immunity from the impacts. This will allow you to make decisions in a timely and direct way. As you feel this freedom and immunity, notice your inner experience and how you approach making decisions and taking action. What perils can you feel or imagine? 

Now you have reached the top of the mountain. You hold your gifts. You are at the summit. You have a great deal of role power. The gifts enable you to do your job. They are privileges and they are empowering. Take a minute to notice what they allow and help you to do. They also change you in corrupting ways. Take a minute to get a sense of the perils that come with the advantages. Notice the magnetic pull toward being self-serving, toward less empathy, toward impulsiveness and control.
 
Here at the top of Power Mountain you must choose how you will use these gifts. The gifts pull like a magnet toward being self-serving. When you have so much intoxicating power, why would you choose to use it in service to others? As in Star Wars where the dark and the light are of the same genetic pool, you must choose. 

Here's where you get to decide whether or not you will fully embrace and say "yes" to your role and rank power. This is a humbling and sacred moment. You can decide that your good intentions will be enough ensure your right uses of power. You can take a "wait and see" attitude and let bumpy experiences be your teacher. You can decide to pretend these negative aspects don't exist or don't apply to you. You can make power itself the enemy and deny that you have greater power. You can choose to use your power in the service of your own wealth, fame, and ego-gratification. Or you can let the impact of the drug of power pull you to use your powers for wealth, fame, control, or self- aggrandizement. Or you can make the most challenging and ultimately rewarding choice: owning and using your role power in service of others and for the good of all. 

Here's an interesting thing: only if you choose socially responsible power, do you need to understand both the gifts and perils and how they are affecting you. (To misuse your power, you do not need to know the intentions and strategies for right use of power.) If you don't choose to monitor and mediate your own shadow tendencies and vulnerabilities, you will blindly and inevitably misuse your power. Power is a strong teacher. You will have many opportunities to look again at this choice. 
If you are paying attention, you will be able to take advantage of the great teachings power has to offer you through mistakes, self-reflection, and self-correction. Your relationship with power is a life-long engagement with your impact, vulnerabilities, limitations, and mistakes. This relationship with power, in itself, will prove to be an extra gift. What do you choose? 

Next we descend and return to the village where you can find out more about how you are changed and how differently you are responded to. One more thing. Choosing to understand both the privileges and perils of increased power is surely and deeply humbling. Humility is an under- acknowledged value for leaders, and yet, honored and appreciated by those they serve. "If you don't have a way to incorporate the humbling experiences that come with elevated power, you will have to depend on your role alone to carry through or to legitimize your behavior" (Rosenholtz, private conversation, 2016). 

Here is a chart that describes, in the left column, the perils that come with the four gifts and privileges. The right column lists some activities that can help empower you and also mediate the changes, temptations, habits, and tendencies. This is a big light to shine on territory that has not been much named or explored. Be compassionate and curious as you look over this chart. In the perils side of the chart, think about harm caused by over-uses, under-uses or unconscious uses of power from your own life experience or that you have heard of or read about. Thoughtfully notice several perils that you may be particularly vulnerable to in your work in the world. Then look at the mediating activities and make a commitment to be self-aware and pro-active. 

A few reminders as you look at this chart. First of all, since power has a neutral meaning of the ability to have an effect or to have influence, it is not power itself that is corrupting. It is role power that changes us. As Julie Diamond puts it, "Something happens to us when we step into roles of power: its like being under the influence of drugs or alcohol or having someone cast a magic spell that alters our perceptions and emotions. As though slipping on Sauron's Ring of Power, when we step into a position of power, we think, feel, and behave differently. The role itself allows for its own corruption. It is a magic that must be carefully 
managed" (Diamond, 2016, p. 31). 

The second reminder is that your personal power is the foundation that you need to stand on, rest in, and be nourished by. Personal power is what we all need to do things, to accomplish our goals, and to engage well with other people, and to make the world a better place. Role power "is based on the external, [while] personal power is self-sourced. . . .Your personal power can thus be independent of the validation of others. In fact, it is the only power that can transfer from context to context" (Diamond, 2016, p. 63). "Cultivating personal power starts with knowing and valuing who you are. Growing our personal power is our greatest asset for good and strongest weapon against the corrupting influence of power" (Diamond, 2016, p. 67). 

The third reminder is compassion: compassion for ourselves, compassion for others. We are all affected by the magic spell of role or rank power. We all feel its pull toward being self- serving and less empathetic. The news is overloaded with horrific examples and images of abuses of power. And yet, most people care about the well-being of those close to them and have good intentions at heart. Again, drawing on Julie Diamond's wisdom, although "corruption implies an illegal act, it also refers to non-conscious, unintended, unpremeditated acts that break or stretch social and relational bonds, and in so doing, inflict harm. . . .By and large these are unconscious actions carried out by someone with high rank, good intentions, and benign neglect" (Diamond, 2016, p. 51). 

Understanding the spell of role and rank power is one of the primary reasons for working with this chart. 

Each bullet point ( • ) on this chart is a nugget to which numerous stories and examples could be added. 

​
​About the Author
Cedar Barstow, member of the USABP, is the Founder and Director of the Right Use of Power Institute, she has been designing, developing, and teaching this approach since 1994. Two books explore these ideas in depth. Right Use of Power:  The Heart of Ethics is a resource for people in the helping professionals. Living in the Power Zone: How Right Use of Power Can Transform Your Relationships, written with her husband, Reynold Ruslan Feldman is right use of power for everyone. Internationally,  she  offers Right Use of Power (RUP) workshops and trains' others to present their own RUP programs, and develop e-courses and other materials.  She also serves as a consultant in ethics and power issues for individuals, groups, and organizations.   

​By Sharon P. Austin, PsyD

Currently, tick-borne diseases (TBDs) are the fastest growing vector-borne diseases in the US. Statistics on Lyme Disease, the most prevalent TBD, estimate over 300,000 new cases of Lyme every year in the US alone, with some estimates up to one million/year, 40% of these are children.  This is not including all the possible coinfections (e.g., Anaplasmosis, Ehrlichiosis, Babesiosis and Bartonella), which are also transmitted by ticks. The Lyme pathogen has been reported in all 50 states.

We must therefore anticipate many of our clients who have either moved from high endemic areas with TBDs, or have traveled to such areas have a greater likelihood of having contracted a tick-borne disease unknowingly.  Without early detection TBDs can evolve into multi-staged and multi-systemic illnesses that mimic and/or coincide with many medical and psychological conditions.  Two of the primary symptoms are chronic pain and fatigue. “Chronic” TBDs wreak havoc on couples, families and individuals.  Mental health practitioners can play a critical role in helping clients and their families navigate the complexity of these diseases.

 The challenges faced by clients with TBDs are daunting.  Some examples include:

1)     Chronic TBDs are often not considered a common or legitimate medical condition.  This can mean clients often do not receive adequate support from their practitioners, friends, family or employers.

2)     Thus far there is no reliable test for the various strains of the Lyme pathogen and the co-infections.

3)     Outdated beliefs have a negative effect on treatment.  These include: 
   a)     Lyme disease testing is seen as reliable
   b)    Lyme disease is hard to catch
   c)     Lyme disease is easily treated
   d)    One can feel a tick bite
   e)    Lyme disease always presents with a bull’s eye rash

4)     TBD symptoms may not be apparent for weeks, months or years. The early symptoms may appear flu-like, therefore dismissed.  Undetected pathogens can then spread throughout the body.

5)     Because of the complexity of the symptom profile from one individual to another and no standard treatment protocol, treatment at various stages of the disease can have mixed results.  Recovery is often complicated and confusing.

6)     Financially TBDs can be devastating from loss of employment, denial of insurance and disability and cost of treatments. One estimate of the financial burden is $1.3 billion/year in medical costs but could be as high as $50-100 billion annual drain on the US economy. Chronic TBDs can cause a wide range of symptoms with relapsing/remitting patterns.  These can include:
            Joint and muscle pain         Extreme fatigue
            Facial nerve palsy                  Meningitis
            Carditis                                      Recurrent fevers, chills, night sweats
            Headaches                                Sensory sensitivities
            Sleep disturbances                 Dizziness, low blood pressure
            Visual impairments                 Gastrointestinal disorders
            Neuropathic pain syndromes
            Susceptibility to autoimmune conditions
             
“Neurological Lyme” is particularly problematic for children and adults alike.  Symptoms under this category can include any of the above symptoms concurrent with reduced functioning in the following areas: 
            Speech and language skills     “Brain fog”
            Memory & concentration       Information processing
            Multi-tasking abilities             Comprehension
            Dementia
            Irritability                                Depression
            New onset ADHD                    Mood swings
            Anxiety, Panic & OCD             Suicidal ideation
            Oppositional Defiant              Declining school performance           
             
Clinical studies suspect possibly one third of psychiatric clients show signs of past infection with the Lyme pathogen.  As psychotherapists we can provide a vital role for these clients as we may be the first to detect the possibility of TBDs as a cause of psychiatric conditions. 

Given the likely epidemic of TBDS, we could ask additional questions when there are confusing, numerous and waxing and waning symptoms.  These include:
-       Have you lived in or traveled to high endemic areas?
-       Have you ever been bitten by a tick?
-       Did you have a rash? Treatment?
-       Do you have a positive family history of TBDs?

For clients with chronic TBDs, we must be aware of dual diagnoses between psychological and medical conditions.  Their presentation may be more than their trauma histories driving the physical symptoms.  It may be more than “schoolitis” or problematic parenting.  We have been trained to recognize how trauma resides in our bodies and how critical attachment experiences are.  Yet we must be willing to look at an even bigger picture that includes the role of infections such as those transmitted by ticks. 

Although we cannot advise on medical or nutritional treatment we can counsel clients on factors that may be exacerbating their physical and emotional conditions.  We help clients be accountable to many wellness factors such as regular medical check-ups, good nutrition, exercise & sleep hygiene, challenging negative thoughts and maintaining healthy relationships.  All of these factors are critical for clients with chronic TBDs. We can also facilitate communication amongst providers. Most of all, as Terry Tempest Williams says so beautifully:

“The unexpected action of deep listening
can create a space of transformation
capable of shattering complacency and despair”

We are trained to listen, be a witness, stay attuned and be patient for our client’s story to unfold.  In a time of numerous doctors, multiple assessments resulting in inconclusive diagnoses, uncertain medical treatment and outcomes clients of all ages with chronic TBDs need our comforting presence and our message, “I believe you and I’m with you!”

These are a few helpful resources:   
http://Lymediseaseassociation.org,
https://www.ilads.org,
https://globallymealliance.org,
http://lymedisease.org,
http://livlymefoundation.org

About the Author
Dr Sharon Austin is a Clinical Psychologist in Fort Collins, CO specializing in Somatic psychotherapy for couples, trauma and chronic medical conditions.  In addition she practices Gestalt Equine Assisted Therapy.  She is a volunteer for the CO Tick-Borne Diseases Awareness Association (COTBDAA) and she is an Ambassador for the Global Lyme Alliance.  She is a Mom of two college students and co-hobby farm owner with her husband, tending to their horses, sheep, dogs and chickens.  Dr. Austin can be reached at [email protected] or 970-493-4093.