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Do you experience shallow breathing proven cialis soft 20mg, diarrhea, sweating, your heart pounding, headaches, tension in your jaw or shoulders? Are you 69 70 • Mindfulness Medication normally aware of the physical sensations you have in response to stressful thoughts and emotions? As you begin to concentrate on what your body’s feeling, you’ll find that your muscles automatically begin to release some of their tension. You’ve also learned that your thoughts are very powerful things and that it’s easy to identify with them and get carried away. By bringing your attention to the physical expression of your thoughts and emotions, the experience is more distant and ‘selfless’. You can experience them more as a sensation rather than identifying with them by using the very personal “I”, as in, “I am angry” or “I am sad. Understanding thoughts and emotions as a physical experience may be the most direct, as well as the easiest, way for you to recognize your various states of mind. Body- awareness allows you to catch stress and short-circuit it before it gets really out of control. You can actually use this awareness as a kind of barometer, a window to your emotional and mental status. Are these sensations squeezing, pulsating, throbbing, hot, sharp, dull, jabbing, or heavy? Bring your awareness to the nature of your physical sensations as you H think about an upsetting event. Take a few moments to breathe deeply and calm yourself before returning to the book. Were you able to feel the nature of your body in response to a mental and emotional upset? Could you just be present to what you were experiencing without any need to change the experience? Mindfulness and the Body • 71 I would now ask you to observe what happens to your thoughts and emotions, in response to an upsetting situation, as you bring your awareness solely to the physical expression of the upset in your body. Close your eyes and observe what happens to your thoughts and emotional reactions in H response to an emotionally upsetting event as you focus on your body. As you stepped out of the story and focused on the physical feelings of the upset state, did the energy of the mental tension start to dissolve? What you’re trying for when you focus on what’s going on in your body when you’re stressed is to no longer be the “I” who is starring in an upsetting story. Instead, you refocus on the physical experience that’s occurring in response to the story. The next time you’re mentally or emotionally upset, consciously focus your attention on your body and its sensations instead of the storyline that’s talking about how upset you are. You explored in the last chapter how breath control can make your mind and body relax when your mind doesn’t seem to want to. Bringing your attention to your body and focusing your breathing into the place of physical tension is a wonderful way to help further release this body stress. In this next exercise, you will be imagining that you’re directly focusing your breathing into the area of physical tension. Then consciously take a deep and calm breath and imagine that you’re breathing directly into and out of any areas of tension. Imagine that your breath is 72 • Mindfulness Medication coming into and flowing out of the tense body part. With every breath out you’ll let go of some tension and promote a natural relaxation response. Think of an upsetting situation and consciously direct H your breath to the area of physical tension. What happened to the body tension as you directed your breath, in a calm and deep manner, to that spot? The following are exercises that you can practice to help develop mindfulness of your physical sensations. For five to ten minutes in the morning and/or evening, sit quietly and simply observe the physical sensations in your body. During the day, whenever you can, try to be aware of the physical sensations that are present in the body. Whenever an upsetting event arises during the day, pause and pay attention to what you’re feeling physically. Whenever a happy event arises during the day, pause and pay attention to what you’re feeling in your body. Choose an environmental cue that will remind you to be mindful of the physical sensation that you’re experiencing at that moment. This could be, for example, before you eat, brush your teeth, wash your face, take a walk, or answer the phone.

The characteristics of this disease are Pathology edema 20mg cialis soft visa, low blood levels of T3 and T4, weight gain, Disorders of the endocrine system are caused by cold intolerance, fatigue, depression, muscle or underproduction (hyposecretion) or overproduc- joint pain, and sluggishness. In general, Hyperthyroidism results from excessive secre- hyposecretion is treated with drug therapy in the tions of T3,T, or both. Hypersecretion is disorders of hyperthyroidism are Graves disease generally treated by surgery. Graves disease is considerably ciencies result from genetic defects in the glands, more prevalent and is characterized by an elevated surgical removal of the glands, or production of metabolic rate, abnormal weight loss, excessive poor-quality hormones. Also, the eyes are likely to protrude (exophthalmos) because of edematous swelling in Pituitary Disorders the tissues behind them. Thyroid Disorders Thyroid gland disorders are common and may develop at any time during life. They may be the result of a developmental problem, injury, disease, or dietary deficiency. If not treated, this disorder leads to mental retardation, impaired growth, low body temperatures, and abnormal bone formation. Usually these symptoms do not appear at birth because the infant has received thyroid hormones from the mother’s blood during fetal development. Treatment for hyperthyroidism Addison disease, a relatively uncommon chronic may involve drug therapy to block the production disorder caused by a deficiency of cortical hor- of thyroid hormones or surgical removal of all or mones, results when the adrenal cortex is damaged part of the thyroid gland. Atrophy of the adrenal glands is treating this disorder is to administer a sufficient probably the result of an autoimmune process amount of radioactive iodine to destroy the thy- in which circulating adrenal antibodies slowly roid secretory cells. The gland usually suffers 90% destruction before clinical signs of adrenal insuffi- Parathyroid Disorders ciency appear. Hypofunction of the adrenal cortex interferes with the body’s ability to handle inter- As with the thyroid gland, dysfunction of the nal and external stress. In severe cases, the distur- parathyroids is usually characterized by inadequate bance of sodium and potassium metabolism may or excessive hormone secretion. Other clinical manifestations include by primary parathyroid dysfunction or elevated muscle weakness, anorexia, gastrointestinal symp- blood calcium levels. This condition can result toms, fatigue, hypoglycemia, hypotension, low from an injury or from surgical removal of the blood sodium (hyponatremia), and high serum glands, sometimes in conjunction with thyroid sur- potassium (hyperkalemia). The primary effect of hypoparathyroidism is condition begins early, usually with adrenocortical a decreased blood calcium level (hypocalcemia). If Decreased calcium lowers the electrical threshold, untreated, the disease will continue a chronic course causing neurons to depolarize more easily, and with progressive but relatively slow deterioration. In increases the number of nerve impulses, resulting some patients, the deterioration may be rapid. Treatment may also include (glucocorticoids) in treating such diseases as orthopedic surgery to correct severe bone defor- rheumatoid arthritis, lupus erythematosus, mities. When the disease is • adrenal tumor resulting in excessive produc- generalized and all bones are affected, this disor- tion of cortisol der is known as von Recklinghausen disease. Overproduction of mineralocorticoids and Glands glucocorticoids causes blood glucose concentration As discussed, the adrenal glands consist of the to remain high, depleting tissue protein. Each has its sodium retention causes increased fluid in tissue that own structure and function as well as its own set of leads to edema. Other symp- Diabetes mellitus occurs in two primary forms: toms include fatigue, high blood pressure, and exces- • Type 1 diabetes is usually diagnosed in chil- sive hair growth in unusual places (hirsutism), espe- dren and young adults and was previously cially in women. Its onset No specific diseases can be traced directly to a was typically later in life but it has become deficiency of hormones from the adrenal medulla. In type neoplasm known as pheochromocytoma, which 2 diabetes, the body is deficient in producing produces excessive amounts of epinephrine and sufficient insulin or the body’s cells are resist- norepinephrine. These hypersecretions produce glycemia that results may cause cell starvation high blood pressure, rapid heart rate, stress, fear, and, over time, may damage the kidneys, eyes, palpitations, headaches, visual blurring, muscle nerves, or heart. Typical treatment consists of includes exercise, diet, weight loss, and, if antihypertensive drugs and surgery. Oral antidiabetic agents activate the release of Pancreatic Disorders pancreatic insulin and improve the body’s sen- sitivity to insulin. Patients with type 1 dia- duction of insulin or the body’s inability to utilize betes usually report rapidly developing symptoms. When body cells are deprived of With type 2 diabetes, the patient’s symptoms are glucose, their principal energy fuel, they begin to usually vague, long standing, and develop gradually. Hyperglycemia and referred to as diabetic acidosis or diabetic coma, ketosis are responsible for the host of troubling may develop over several days or weeks. It can be and commonly life-threatening symptoms of dia- caused by too little insulin, failure to follow a pre- betes mellitus.

On the other hand generic cialis soft 20mg visa, Jasmine panics about the bash into the pole; her reaction is the product of her frequent struggles with anxiety and panic. Part I: Analyzing Angst and Preparing a Plan 52 Sometimes people say they really don’t know what’s going on in their heads when they feel distressed. They know how they feel and they know what happened, but they simply have no idea what they’re thinking. If so, ask yourself the ques- tions in Worksheet 4-14 about an event that accompanied your difficult feelings. Chapter 4: Minding Your Moods 53 The Thought Tracker demonstrates how the way you think about occurrences influences the way you feel. Sad feelings inevitably accompany thoughts about loss, low self-worth, or rejection. Anxious or worried feelings go along with thoughts about danger, vulnerability, or horrible outcomes. Pay attention to your body’s signals and write them down whenever you feel some- thing unpleasant. Refer to the Daily Unpleasant Emotions Checklist earlier in this chapter for help. Rate your feeling on a scale of intensity from 1 (almost undetectable) to 100 (maximal). Ask yourself what was going on when you started noticing your emotions and body’s signals. The corresponding event can be something happening in your world, but an event can also come in the form of a thought or image that runs through your mind. Be concrete and specific; don’t write something overly general such as “I hate my job. Refer to the preceding Thought Query Quiz if you experience any difficulty figuring out your thoughts about the event. Worksheet 4-15 My Thought Tracker Feelings and Sensations (Rated 1–100) Corresponding Events Thoughts/Interpretations (continued) Part I: Analyzing Angst and Preparing a Plan 54 Worksheet 4-15 (continued) Feelings and Sensations (Rated 1–100) Corresponding Events Thoughts/Interpretations Visit www. We reveal how distortions in your thinking can make you more upset than you need to be, and we show you how to prosecute your distorted thoughts for the trouble they cause and rehabili- tate those thoughts into clear, beneficial thinking. Finally, we help you uncover the deep, core beliefs and assumptions that may be responsible for many of your distorted thoughts. These beliefs may act like cracked or dirty lenses that you see yourself and your world through, so we help you regrind those lenses for clear vision. Chapter 5 Untangling Twisted Thinking In This Chapter Discovering distortions in your thinking Prejudging yourself Assigning blame n this chapter, we cut to the chase and help you apply the principles of cognitive therapy, Iwhich is based on the premise that the way you interpret or think about events largely determines the way you feel. The great thing about cognitive therapy is that changing the way you think changes the way you feel. With the possible exception of our book editors, all human beings have some distorted thinking. Distorted means that your thinking doesn’t accurately reflect, predict, or describe what’s going on. Perhaps your mind filled with thoughts of dread and images of someone breaking into your house. For example, we have a dog we think is truly beautiful, but most of our friends and neighbors think he’s a peculiar-looking mutt. No doubt our perception is slightly flawed; it’s understandable because we love our dog, but it’s distorted nevertheless. The three types of reality scramblers are: The Information Reality Scramblers The Self-Judging Reality Scramblers The Self-Blame Reality Scramblers Although this chapter makes distinctions among various types of reality scramblers, in real- ity, scramblers often overlap or exist in groups. To put it another way, a single thought can involve several Information Reality Scramblers as well as scramblers involving self-judging and self-blame. The Information Reality Scramblers Information Reality Scramblers warp your perceptions of your world and events occurring around you; they distort how you think about what’s really happening. You may not know that Information Reality Scramblers affect your thinking, but if you give it a little thought, you’re likely to see that they do. For example, suppose a depressed man receives a mediocre per- formance review at work. He’s likely to enlarge this event and turn it into a complete catastrophe by assuming that he’s totally worthless as a person. Without the scrambler, the reality is simply that his perform- ance was considered average even though he would have preferred a better rating. This exercise shows you all the various ways that Information Reality Scramblers can affect your thinking and ultimately the way you feel. Read the description of each type of Information Reality Scrambler and the accom- panying examples in Worksheet 5-1. Think about when your thoughts might have been influenced by the Information Reality Scrambler. Reflect and write down any examples of specific thoughts that you’ve had which might be distorted by an Information Reality Scrambler.