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Recognizing and Understanding Panic Attacks

I have heard it described many times before.

It usually starts with, “I didn’t know what was happening to me.”

They then go on to describe an overwhelming feeling of fear. Feelings of dizziness and or being a little lightheaded come on. Palms sweat and sometimes shake. Their face feels flushed. Blood pressure goes through the roof.

Often the first time it happens it is shrugged off as just an odd episode. It’s not until it happens a few more times that the person realizes it is time to seek some help. They are usually thinking that they must be ill. What they learn is that they are not in fact ill, but are experiencing panic attacks.

Anyone can suffer from a panic attack. Many people who experience them do not immediately recognize the source of their discomfort.

The good news is that panic attacks are easily explainable and with the guidance of a therapist they are also treatable.

What is a Panic Attack?  

Mental health professionals describe panic attacks as sudden rushes of intense dread or distress which are often accompanied by a number of physical symptoms that can include: dizziness, sweating, a racing heart, chest pain, difficulty breathing, trembling, numbness, and even disorientation.

Inside the brain, things can be just as concerning. During a panic attack one will often experience thoughts of fear and dread as well as a fear of doing something uncontrollable or of dying.

Panic attack sufferers are not actually dying. Their blood is pumping with adrenaline. Their bodies are reacting in the same way it would if an immediate threat was present.

In simple terms, their body has triggered their “fight or flight” response in order to protect the individual.

Obviously, there is often no immediate threat when a panic attack sets in. The mind realizes this, but the body ignores this information. The body is saying run. The mind is saying stay. The confusing signals between the mind and body will cause the person to stay in one place.

What Can Cause a Panic Attack?

There is no typical profile for a person who is prone to experience a panic attack. Typically, someone who experiences panic attacks has their first panic attack as a child, but not always. Women tend to experience them more than men, and some research points to genetic dispositions.

Even though panic attacks can seemingly sneak up out of nowhere, they can be triggered by a lack of sleep, drugs, caffeine, alcohol, as well as chemical or hormonal imbalances. Many times they are also often connected to traumatic or challenging life situations, most often ones that have occurred in the past 12 months.

Individuals who experience regular panic attacks cannot often predict when they’ll strike. They find they are more susceptible when they are under extreme stress. Other times they will strike seemingly randomly.

What Can You Do if Experiencing a Panic Attack?

If someone has been diagnosed with panic attacks, they can often make simple lifestyle adjustments to reduce symptoms. Things such as getting more sleep and exercising more regularly can help.

Although they are not recommended for frequent use because they can be habit forming, anti-anxiety medications such as Xanax can be useful for specific situations that are likely to induce panic such as sailing on a boat or flying on a plane.

If panic attacks start to occur frequently, there is a possibility that the the individual has a panic disorder. In the case of a panic disorder, the individual becomes so worried about having a panic attack that their anxiety becomes a source of more anxiety.

To avoid having another attack, they will try to stay away from situations, people, or places that trigger their symptoms. If they feel panic setting in, they will try to fight the fear, which unfortunately, usually makes it worse.

Panic disorders can be managed in the short-term with antidepressants, but are best treated through cognitive behavioral therapy. Cognitive behavioral therapy is a treatment that tries to help patients tap into the thoughts and feelings that drive their actions. Through this therapy they can identify and examine the fears that trigger their anxiety.

The goal is to break the cycle of panic through anxiety counseling. By understanding what causes the feelings of panic, an individual does not have as strong of a physical or emotional response to it. With this new found understanding, they can recognize the feelings of panic for what they are and adopt coping skills.

If you experience panic attacks and are ready to get started learning why, you can contact us to schedule your first appointment.

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Is Facebook Bad for Your Mental Health?

Facebook is bad for your mental health.Ping. Ping ping ping. Swoosh. Ping.

Oh hi. Hello. I’m sorry, I didn’t see you there. Ping. Sorry. Okay, I’ll put this thing away. I posted a video of my dog on Facebook this afternoon; he learned to hula hoop. I had to share. The people love it. Ping ping ping.

That’s one way to start a conversation with a friend, a business partner or a would-be lover.

Personally, I prefer to communicate, to become acquainted with others in analog.

Since its inception in February 2004, Facebook has been used as a gathering place to meet like minds and to like faces; to stay connected with old friends; and of course, to share cat memes and argue over Dexter’s fate. But these days we argue over other things too, real life things with real consequences. Now, instead of bringing people together our collective constant presence on Facebook is tearing them apart.

Facebook might be bad for your mental health.

Arguments. The comments section. It’s all compounded by the comparisons. Your college roommate has it all: the husband, the house, the baby. Her life is perfect. Or it seems that way. Her life may be great, but yours is too. That’s hard to remember sometimes when filters so easily mask credit card debt and sleepless nights.

The truth is, Facebook is making us all pretty unhappy. A Danish research firm, the Happiness Research Institute, has the evidence to prove it. A study conducted among 1,095 Facebook users asked participants to not log in to the site for a period of seven days. A control group was instructed to maintain normal activity. At the end of the study period, those who abstained were 55 percent less likely to feel stressed and reported many fewer instances of restlessness or loneliness. Of the control group, 81 percent reported feeling ‘happy’ while 88 percent of non-Facebook users felt happiness.

“Facebook is a constant bombardment of everyone else’s great news, but many of us look out of the window and see grey skies and rain, especially in Denmark.” said Meik Wiking, CEO of the Happiness Research Institute said. “The main takeaway from this study is awareness of the negative aspects that social comparisons have, and how we should be mindful of how Facebook and social media affect how we evaluate our lives.”

It’s true of Denmark, and of Washington DC and Bethesda MD too. When envy and conflict rise over community and the generous spirit of sharing good tidings, it might be time to consider taking a break — for seven days or longer. Spend the time you’d take to share the video of our friend’s hula hooping dog, and read a book with your toddler; linger a little longer over the dinner table; and take care to take care of yourself first.

Prioritize Your Mental Health in 2017

make your mental health a priorityWhile your friends and family are resolving to cook more dinners at home; to lose 50 pounds; to travel more; or to check seeing Tom Petty in concert off the old bucket list, but you’re starting smaller: with yourself. You’ve decided the year 2017 is the year of you.

2017 is the year you have chosen to make your mental health your priority.

Your mental health affects how you think, how you feel, and how you act every day, in every situation. Your mental health affects the way you perceive yourself and how your friends, loved ones, and strangers perceive you too. Your New Year’s resolution for 2017 is to become a better — nay, the best version of yourself by improving your mental health.

Meditate.

The practice of meditation has been shown to offer a variety of health benefits, including improved sleep and decreased anxiety. But it is a practice. To reap the rewards — even and especially when the status quo is ‘busy’ — set aside ten minutes per day to quiet the noise. Take a few moments to reflect on the day; express gratitude for the blessings in your life, and focus on becoming fully present.

Commit to regular exercise.

Exercise is great not only because it releases endorphins in your brain that make you a happier version of yourself, but it helps you work toward that other goal of losing weight. Even better, when the weather is nice, get outside. Research has suggested that walking outdoors surrounded by nature has even more mood-boosting power.

Find your tribe.

Winter is cold and it’s dreary, and for those who struggle with Seasonal Affective Disorder (SAD) it’s even worse, but getting out of the house — social connection and bonding are imperative to mental health, so go on. Get out of the house and do something fun; make new friends. Go to the beach, or schedule a car service for a night on the town. It’ll be worth it.

Eat well.

Healthy eating leads to healthy bodies and healthy minds. Strive to incorporate many different types of fruits and vegetables in your diet, and other tasty brain boosting foods like walnuts. Don’t skip meals, and stay hydrated, and you’ll be well on the path to prioritizing your health and mental well being all year long.

Schedule an appointment with your Washington DC psychotherapist.

The wisdom and guidance of a professional psychotherapist in Washington DC can help you onto a path of self-discovery, and toward more effective methods of dealing with depression, stress, anxiety, and every day life.

Contact Keith Miller Counseling & Associates to discuss how psychotherapy in Washington DC can help you achieve your goal of a happier, healthier you in 2017.

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Mindfulness & Self Care Are Key to Relieving Holiday Stress

Stress & Anxiety During the Holiday Season | Washington DC psychotherapistIt’s the hap-happiest season of all
With those holiday greetings and gay happy meetings
When friends come to call
It’s the hap-happiest season of all

For some of us, the holiday season dredges up more feelings of stress and anxiety than it does feelings of comfort and joy. The family gatherings, buying gifts and the travel to relatives: You may have every intention to celebrate, but something is holding you back. Maybe you just can’t wait for it to be January?

But it doesn’t have to be that way. You can take good care of yourself without completely unplugging from your family’s ritual and tradition. Perhaps it means skipping an event or two to lower your stress level. Try to find your own way to enjoy family time the way you want to.

Talk to a few family member about how you’re feeling.

Do you have a trusted family member — maybe it’s that aunt, a sibling, or a favorite cousin — you can confide in? Confide with cheer. Share what’s on your mind and know you’re not alone if you feel stressed or anxious about spending so much time with the family. Make a plan to get away together; go out for coffee, pack your hiking boots, or download some relaxing meditations to help you let go when it all gets to be too much.

Get involved.

Sitting on the sidelines can amplify our anxiety. Sometimes our level of satisfaction is directly linked to our level of feeling invested, even though it’s more effort and work. Maybe this is the year you offer to host the family’s Christmas Eve gathering. Or perhaps you only do one part with gusto —,you plan plan the menu, find the centerpieces, or concoct the holiday cocktail. Think about your own interests and energy level, and offer to do something you feel good about doing.

Give back.

You don’t have to spend all of your time with your family. Take a few hours this holiday season, and spend them giving back to your community; volunteer opportunities may be available through local places of worship, homeless shelters, or animal shelters.

Be mindful of your own mental health.

Only you know your own triggers for stress. If going caroling with the family is going to put you in a sour mood, plan ahead and talk it through with family so they’re in the loop about what could make the activity more enjoyable for you. Maybe hire a car service to drive you to holiday parties or shopping? Maybe this is the year you decide to accept your uncle’s choices and let go of the burden of feeling responsible for his behavior. And if the general hubbub of the season leads to overwhelming anxiety that overtakes your daily thoughts and feelings, stop and reach out for help.

Everyone needs a little extra support every now and then; there is absolutely no shame in seeking out the help you need. Talk to a trusted family member or a friend, or:

Contact the experienced Washington DC psychotherapists at Keith Miller & Associates for an appointment to discuss how you can relieve holiday stress.

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When Your Way is the Right Way: The Methodology of Persuasion

Persuasion methodology | Bethesda psychotherapistTo be persuasive is an important skill that can help you get ahead — and make you happier — at work, at home, and in social situations, too. But that’s not all it’ll do: Learning the tricks of persuasion can also provide unique insight into how and when they’re being used on you.

Consider the following subconscious, but very persuasive techniques.

With these simple techniques, and a little practices, soon you’ll convince everyone around you that your way is the best way, and leave them wondering why they ever thought differently.

Use framing to influence thought.

Framing, put simply, is a way to change how we sort, categorize, associate, and assign meaning to events, objects, or behaviors. An example? A pessimistic person would say, “This glass is half empty.”, thus calling specific attention to the empty part of the glass, while an optimist uses language to point out the full portion of the glass.

There is where the power of framing as a tool for persuasion lies. The word you choose will conjure images that carry positive, negative, or neutral connotations, thus influencing how the person to whom your are speaking feels or thinks about a subject.

Use the mirroring technique.

This practice of mimicking the movements and body language of the person you are trying to persuade creates a sense of empathy; he or she will understand that you understand their problem or need, and will more readily accept the solution you have offered.

Mirror hand gestures; lean forward or away from the person; or mimic various head and arm movements. The truth is, we all do this naturally, and becoming aware of its power will only work the tool to your advantage. But take care to be subtle, so your actions won’t be seen as mocking.

Use herd behavior to influence a decision.

It’s the concept of herd behavior that you’ll find at play behind peer pressure, and herd behavior that caused your mom to say, “If So-and-So jumped off a bridge…” But when employed under just the right circumstances, this tactic has the invaluable power to position you as an effective leader.

Human beings as a species are observant; we watch what those around us do before deciding how to act ourselves, for no reason other than we crave acceptance. It’s for that reason that we are far more likely to follow or be persuaded by someone we like.

Be charming and confident; praise a leader the person whom you are trying to persuade admires; trigger positive thoughts in that person’s mind, and they’ll likely associate those same qualities with you.

To be persuasive is a skill that will help you get ahead and make you happy, and one that requires at least a basic knowledge of human psychology; for more information, and help influencing those around you, contact Bethesda, MD’s experienced psychotherapists at Keith Miller Counseling & Associates.

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Mental Illness Is Not a Four-Letter Word. Know the Warning Signs.

Washington DC Anxiety Therapy“Mental illness isn’t something that can happen to me. Not to my family.”

The thing is, it could happen. You might be surprised to learn just how common mental disorders are; an estimated 54 million Americans suffer from some form of mental disorder in a given year.

Even given these numbers, most families are caught unaware and unprepared to cope with learning their loved one has a mental illness. There will be challenges, physical and emotional, and you might often feel vulnerable to the opinions and judgments of others, but through it all, the most important thing to remember is this:

There is hope, and there is help for coping with mental illness.

Mental illness is not a four-letter word.

A mental illness is a disease, plain and simple — one that causes mild to severe disruptions in thought or behavior, and can inhibit the sufferer’s ability to meet life’s ordinary demands and routines. The American Medical Association recognizes more than 200 forms of mental illness, the more common of which are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders.

Such illness can be caused by, or related to any number of factors such as excessive stress, genetics, biochemical imbalances, or a combination of these things. A patient can often be treated to full recovery with the aid of an experienced Washington DC psychotherapist.

What are the warning signs of mental illness?

There are a number of physical and psychological signs that may indicate the presence of a mental illness. It’s especially important to pay attention to sudden variations in thoughts and behavior; review the lists of potential signs below, but keep in mind that it’s the onset of drastic change that might indicate a serious problem.

In Adults, Young Adults and Adolescents:

  • Confused thinking
  • Prolonged depression (sadness or irritability)
  • Feelings of extreme highs and lows
  • Excessive fears, worries and anxieties
  • Social withdrawal
  • Dramatic changes in eating or sleeping habits
  • Strong feelings of anger
  • Strange thoughts (delusions)
  • Seeing or hearing things that aren’t there (hallucinations)
  • Growing inability to cope with daily problems and activities
  • Suicidal thoughts
  • Numerous unexplained physical ailments
  • Substance abuse

In Older Children:

  • Inability to cope with problems and daily activities
  • Changes in sleeping and/or eating habits
  • Excessive complaints of physical ailments
  • Changes in ability to manage responsibilities – at home and/or at school
  • Defiance of authority, truancy, theft, and/or vandalism
  • Intense fear
  • Prolonged negative mood, often accompanied by poor appetite or thoughts of death
  • Frequent outbursts of anger

In Younger Children:

  • Changes in school performance
  • Poor grades despite strong efforts
  • Changes in sleeping and/or eating habits
  • Excessive worry or anxiety (i.e. refusing to go to bed or school)
  • Hyperactivity
  • Persistent nightmares
  • Persistent disobedience or aggression
  • Frequent temper tantrums

If you or someone you know is in crisis now, seek help immediately. Call the experienced psychotherapists in Washington DC and Bethesda, Maryland for guidance and mental health counseling.

If you or someone you know is suicidal, the best place to go is to your nearest emergency room. You may also find these resources helpful:

National Suicide Hotlines USA
Toll-Free / 24 hours a day / 7 days a week

1-800-SUICIDE
1-800-784-2433

1-800-273-TALK
1-800-273-8255

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Your Brain Deserves a Break This Summer: Take It & Be Mindful

Have a very relaxing summer vacation. Give your brain a break. Be mindful. | Washington DC psychotherapy

The kids are out of school, and pretty much everyone in the office is checked out. It’s vacation season. Nearly half (45 percent) of all Americans who vacation do so in the summer months, July more specifically. To Florida or California, DC or New York, the Caribbean Islands or Europe: We go on vacation to escape, to find a new set of scenes to look upon for a week or more.

We go on vacation because we think that’ll make us happy, but does it really?

Yes.

Well… kind of.

The research indicates that people are happiest while planning, or in anticipation of their vacations, more so than while on or after vacation. But of course there is an exception. The only people who have been found to be happier after vacation are those who can describe their time away as “very relaxing.” That’s the way.

Take a “very relaxing” vacation to maximize happiness all year round.

The secret to a very relaxing vacation isn’t traveling to a specific location, or staying at the most luxurious resorts; no, that very relaxing vacation destination isn’t a destination at all, but a mindset. Mindfulness.

Defined as “a moment to moment awareness of one’s experience without judgment,” mindfulness enhances the capability of memory; it increases your ability to focus, and lessens emotional reactivity; mindfulness also helps make the practitioner more open to change and increases relationship satisfaction.

Take mindfulness on vacation with you.

Vacation is fun, sure, but there’s a reason the majority of us feel more excited and happier before departing. That’s because vacation is also stressful. But if you start now, the practice of mindfulness can mean the difference between feeling stressed and being happy, by keeping you aware of your environment moment-to-moment.

So on this vacation this summer, truly give your brain a break.

Put down your iPhone (or at the very least, turn off your work email). Take a long walk along the shoreline. Do a little yoga. Meditate, or sketch. Try, or do something new. Simply close your eyes and let your senses be overwhelmed by the world around you.

Allow yourself the time, the space and the mental clarity to take in the richness of a new and different environment; and you’ll find the key to being happy, happier, and happiest before, during, and after vacation.

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Can Meditation Help Your Relationship?

Meditation and RelationshipsIt is no secret relationships take a lot of work: communication, dedication, trust, and friendship. Successfully navigating these waters also centers around personal mindfulness, that is the act of staying active and present in a situation. Mindfulness allows you to observe your thoughts and feelings from a distance without inherent judgment on the situation.

Mindfulness meditation is an excellent step towards improving a relationship. When you are clear within yourself, becoming clear in a relationship is easier and more accessible.

Meditation dials down stress.

The most widely known benefit of meditation is stress reduction. Your body and brain, under great stress, falls into a constant state of fight or flight. Meditation allows you to slow down, evaluate your sense and presence of self, and relax your body. The stress reducing effects of meditation have been known to last several hours following a meditation session, leaving you more relaxed and in control of your body.

The impact of your more relaxed state will have an immediate effect on your relationship. When stressed, little things become big problems. Running late, not putting up the dishes, forgetting to return the latest Redbox movie, all of these things can become points of frustration when we are stressed. In a more relaxed state, we are able to better go with the flow and acknowledge that our partners are fallible human beings instead of the perfect person we inadvertently demand they be.

We are able to better communicate and empathize with one another, leading to effective conversations about issues in the relationship or solving misgivings that have occurred.

Meditation helps us understand our feelings.

Research on mindfulness meditation has shown there is an increase in the activation and size of our middle prefrontal cortex, or the mPFC. Neuroscientists believe the mPFC integrates our higher “intellectual” brain areas with our emotional areas. A well-formed mPFC better connects our intellectual being with our emotional being, resulting in a better understanding and control of our emotions.

Being tuned into our emotions, but not controlled by them, allows us to give a calm, rational response to incidents in our relationships. This brings about less misunderstandings and subsequent arguments. We remain in the present and can process what our partner is trying to tell us without letting our defenses flare up. When we enter a conversation from a place of defensiveness, our ability to listen and comprehend what our partner is trying to say diminishes. Our goal becomes to defend ourselves, not work together. Mindfulness meditation helps eliminate this kind of conversation for a healthier relationship.

Having this control over our emotional state also helps us better understand our own emotions and what is causing them. Often, we know we feel a certain emotion like anger or sadness, but cannot properly articulate why we feel this way. Why did we react the way we did to a certain situation with our partner? Mindfulness meditation, along with honing our mPFC, allows us to better understand what we are feeling, why we are feeling this way, and shows us a clear path to correcting feelings of hurt. We can speak to our partner rationally, with an in-depth knowledge of our inner self, and work together to correct any misgivings.

The professionals at the Keith Miller Counseling Center can help you take the steps towards a healthier mind and relationship with mindfulness meditation. Call us today!

Take Psychotherapy to the Next Level with Guided Meditation

Washington DC CounselingMeditation is an excellent way to achieve a state of mental calm and clarity. Numerous scientific studies have shown performing 20 minutes of meditation daily provide countless health and mental benefits. These benefits include: a decrease in depression and anxiety, an increase in disease immunity, and a huge jump in the ability to focus. Meditation creates what is known as a “super mind”, with better memory retention, creative thinking skills, decision making, and information processing. You gain a new control over your life and your mental and emotional states.

However, meditation can be difficult, especially for those suffering from anxiety or depression. The ability to channel your mind is a learned tool and can be overwhelming to start. How can you achieve these amazing benefits when you can’t silence your mind?

A Powerful Psychotherapy

Enter guided meditation, a powerful psychotherapy tool intended to aid in transitioning from hopelessness to empowerment.

Guided meditation is an excellent tool to guide you through the act of meditating without the stress and distraction of attempting to shut your mind off alone. A trained professional leads you through the process gently and confidently, helping keep you on track to achieve mental and emotional clarity and focus. Some techniques utilize written text or video, while others, particularly with counseling professionals, are done by verbal instruction. Music therapy may also be provided as stimuli for relaxation.

Why Use Guided Meditations?

Guided meditations are useful for unlocking emotions and feelings often trapped within. Your trusted professional takes you on a deep journey through your subconscious, where you will be more open to positive suggestions and life changes. The wall blocking you from achieving change is eliminated; despite your brain’s insistence it cannot be done.

What to Expect from Psychotherapy with Guided Meditations

Guided meditation begins with a series of relaxing visualizations. You are instructed on how to breathe, how to channel energy, and how to slowly uncoil the barriers between your conscious and subconscious mind. As you become more relaxed and still, the journey into the deep recesses of your brain begins, accessing your body’s natural relaxation response. Positive energy and thoughts are transferred to your subconscious, focusing on your inner strength. Everyone is equipped with the power to make change within themselves, it’s just a matter of honing those skills and retraining the brain to remember the positive, rather than the negative.

Each session can be individually tailored for the change or exploration needed. Importantly, previous knowledge of meditation is not necessary—you will be literally guided through the process to reach optimal benefits, even if you unable turn off your mind alone. With enough practice, these positive guided meditation sessions will become part of your everyday life. You will feel more confident, more capable, and stronger than before.

Meditate & Be Mindful: It’s Good for Your Health

In the 1940’s, if you told someone you were going running, they probably would have asked, “Who’s chasing you?”

Know what happened next? The scientists charged in, validated the benefits of exercise, and now we all do it – and if we don’t, we feel guilty about it.

Right now, meditation is at the point where exercise was a few decades ago. It is, as Time Magazine put it, a revolution in health and mental health. As a result of the new science, meditation is now being shown as effective at performance enhancement for such elite organizations ranging from Google, to NBA teams, and the US Marines.

The practice of mindfulness is one that is growing ever more widely talked about. The world is moving faster; stress levels are higher; and more and more people are coming to understand the benefits of meditation and mindfulness.

But what are those benefits exactly?

The practice—it is, in fact, something that one must practice—of mindfulness has been proven scientifically to improve the physical and mental well-being of all who take the time to stop, breathe, and meditate.

Mindfulness can diminish the severity of pain.

So much of how we perceive pain is mental; truly, some of it really is all in your head, and meditation can help. A 2011 study published in the Journal of Neuroscience revealed that pain perception is cut nearly in half when the sufferer turned to mindfulness.

Mindfulness lowers stress.

Not only can the practice of mindfulness make us feel more relaxed and calm in the midst of a stressful situation, science has shown that it’s linked with markedly decreased levels of the stress hormone cortisol. Mindful meditation makes us feel less stressed, because it changes the chemistry of your body.

Mindfulness increases our ability to feel empathy.

One study conducted at Northeastern University College of Science found even a brief period of mindfulness improved participants’ levels of compassion by as much as 50 percent; likewise, a different study published in the journal PLOS ONE, the practice of meditation showed more brain activity in regions linked with empathy while meditating than when not meditating.

Mindfulness can make us healthier.

Researchers from the University of Wisconsin School of Medicine and Health found that people who engage in mindful meditation miss fewer days of work related to respiratory issues. When they do fall ill, those with mindfulness practice experience shortened and less severe symptoms.

Mindfulness is beneficial, even when you’re not in active practice.

Your brain’s emotional processing center, the amygdala, is “exercised” every time you meditate. The result is that your brain’s distress tolerance threshold (your “window of tolerance) is expanded, even when you’re not meditating. If you’re stressed or anxious mediation expands your emotional window of tolerance as much or more than anti-anxiety medication.

Mindfulness counseling

Keith Miller specializes in mindfulness-based psychotherapy for anxiety and stress.

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Our fees are between $200-$400 for 50 minutes, depending on your counselor. We do not accept insurance, meaning we are not "in-network" with any health plans.
However, many of our clients submit claims to their out-of-network health insurance and receive 40-60% reimbursement.