Coping Toolkit

Here are some tips to aid in managing distress and discomfort, as a resource until you schedule a session with Dr. Giardina, or as a supplement to your therapy.

Clear Communication

Relieve distress by communicating your needs to your "team" of family and friends. Let people know when you need help, or to be left alone. Before venting to someone, indicate whether you want advice, support, or a quiet listening ear. Acknowledge that people are not mind readers, and without direct communication, your spouse cannot be expected to know what a sigh or an "I'm fine" really means.

Setting Reasonable Goals

Stress is often self-created by stretching yourself too thin, or setting yourself up for failure. On New Years Day, don't set a goal of running a marathon in February with no prior training. Set a goal of running a mile by February. Then move your goal forward appropriately. Good goals are reasonable, and based on past experience, knowledge, and timelines. Goals should be well-defined and clear cut, not vague or subjective.

Distraction and Self Soothing

Sometimes the obvious, the tried and true answers are the best. Distraction from your worries and woes is a fair, honest means of coping. Instead of ruminating on the negative, why not get into a good movie or book, talk to a friend, spend time at a sporting event. Your focus is then on something more neutral or positive. Self Soothing is a catch all term for activities and behaviors that reduce mental distress via social, spiritual, physical, sensual or other means. Everyone finds their own methods. For some, chocolate, sex, red wine, and jazz may be soothing. For others, it is fresh fruit, a long run, or saying a prayer. The key is to know your go to techniques and make an "emergency kit" or list, so you can take action as soon as distress strikes.

Give to Get

One of the best ways to manage your own distress is by tending to someone else's needs. Not only is it an excellent distraction, but you will come away feeling more positive, a sense of accomplishment, and with some good karma as well. In addition, you may feel less guilt about taking support or assistance from others if you know you have given to others (maybe even those same supporters) in the past. Be careful, however, about assuming someone now "owes you" because you did for them. This creates additional distress and miscommunication. Give with no agenda!

Time for Reflection

Dr. Giardina advises everyone set aside 10-20 minutes a day for quiet self-reflection. This does not need to be a formal meditation practice, or a scripted activity in a certain place. However, it is suggested that you include time to ponder the accomplishments of the day, the things for which you are grateful. In addition, recognize what is needed, what is missing, what should be sought out in your future. Finally, reflection time is sometimes best spent simply being. Quietly. Sitting still.

Let It Out

People at times mislabel their emotions, or spend too much time trying to find the perfect label. Dr. Giardina thinks of all emotions as energy, which at times needs release for relief. So, whether you are sad or mad, running or exercising may help. Regardless of the target or cause of your emotion, the energy can be released to anyone in any setting (and may not even be transferred to a person at all). Sometimes, the best venting of emotion comes via media as a trigger, as the needle to pop the emotional balloon. Dr. Giardina likes films and songs as a means of tapping into and expressing a personal emotion, in a way that may feel safer because it can be felt through the character or singer rather than oneself.

Accept It or Change It

Whether you know it as the "serenity prayer," the AA prayer, or as a simple equation - Dr. Giardina believes in the notion that all of life's woes fall into one of two categories: 1) Things I have the power (and must have the courage) to change; 2) Things I must have the serenity to accept. By labeling your problem appropriately, you will better be able to move forward, through either action or acceptance. But to be clear, virtually anything that is distressing to a person falls under one of these two headings. And depending on the problem, which label you affix may be frustrating. But, it is what it is.

Practice Better Sleep Habits

People in the medical field refer to good sleep habits as good sleep hygiene. You brush your teeth and floss to maintain oral hygiene, but what do you do to manage your sleep hygiene? Most people don’t even think about this. Sleep affects mood, stress, impulse control - your ability to cope in general. Here are some tips for a better night’s rest: • The bed is a place for sleep and sex only – you don’t want your mind to associate any mentally stimulating activity (watching tv, reading, etc) with the bed. • No caffeine, nicotine, or excess alcohol (more than a glass) in the last few hours before your goal bedtime. • No physical exertion just before sleep, but do try to be as active as possible during the day to tire yourself out. • No naps (unless this is the only way to get any sleep, in which case, nap away but don’t be surprised that you’re awake at 3 am) – the body prefers 8 hours in a row and at night, but 6-8 hours daily, however you get it, is good. • Watch how your medications affect your sleep. • If you don’t fall asleep in the first 20 minutes being in bed, get up and do something else, and return to bed later when you are more tired. Lying awake in bed trying to sleep tends to be a futile task. - Finally, keep a "worry pad" by your bed. Any distracting or awakening thoughts should be written in pen on a pad in the dark, to be dealt with when the sun rises. Not in the middle of the night via obsessive rumination.

Deep Breathing, Muscle Relaxation and Imagery

What follows are links with Dr. Giardina guiding you through exercises in rhythmic, diaphragmatic breathing, progressive muscle relaxation, and imagery. These techniques somewhat mirror self-hypnosis, but be clear, this is not hypnosis. Some tips for success:
>Settle into a room without other people or distractions
>Adjust the volume (or use headphones) before settling in
>Exercises are not intended to be used all at once or in sequence – pick the one that best suits your needs for that day
>Do not use while driving or engaged in other activities (sedation and fatigue may occur)
>Be careful to avoid any muscle tensing exercises in areas of the body where pain or injury may be worsened by such tension (the second button/exercise is meant for chronic pain patients)
>If you are prone to breathing-related difficulties or conditions, be cautious when engaging in the deep breathing exercises as hyperventilation, light-headedness, panic attacks and the like may occur in some patients

diaphragmatic deep breathing CD - progressive muscle relaxation CD