Lyme Is The New AIDS

Lyme is the new AIDS.

I’m not the first one to say it. But I would like to take the time to repeat it. On May 26, 2008 Robert Buelteman shared his neurological Lyme experience with San Francisco’s online news platform SFGATE. He wrote:

I have Neuroborreliosis, also known as Lyme disease. Since October, my physical and mental health declined to the point where I was no longer able to work, drive, cook, think, maintain a social life, read, write, stand with my feet together, sleep without chemical aid, and most important, make the art that is my calling and the sole source of income for my family of four.

Buelteman goes on to explain that Lyme diagnoses are rising at four times the rate of AIDS and is becoming America’s most misdiagnosed disease.

Five years later, a 2013 literature review entitled Lyme disease diagnosis and treatment: Lessons from the AIDS epidemic found in the medical journal Minerva Medica, outlined the need for Lyme to be researched in the same way HIV was in order to improve testing and find innovative forms of treatment. The article states: Currently, diagnosis and treatment of Lyme disease is hindered by the lack of a uniform case definition that adequately reflects the clinical presentation of the disease, poor laboratory test sensitivity, and high treatment failure rates using short-term monotherapy.

On May 25th 2016, Writer David Michael Conner posted a thoughtful piece on the Huffington Post site LIFE entitled And the Band Plays On: A New Plague Met With Silence, Denial. Again Conner writes: May is Lyme Disease Awareness Month. Unlike World AIDS Day, which even Google has indexed on its calendar, and likewise unlike Breast Cancer Awareness Month, Lyme disease awareness activities don't get much publicity.

I don’t have to drag out charts and statistics from the CDC that state an estimated 300,000 people per year will contract Lyme disease. Conner has already shown that. I don’t have to point out that ZIKA, which impacted 544 Americans at the time of Conner’s article received $184 million, while Lyme disease funding is nowhere near that. Conner also made that clear in his article.

Conner also wrote a very thoughtful article on someone who would be best to confirm this idea that Lyme and HIV have more in common than most people are aware. In Conner’s June 2016 article for Huff Post, Award-Winning HIV Activist Shines Light On Lyme Disease Devastation, Conner interviewed HIV and Lyme activist, Fred Verdult. Fred has dedicated his life to shining light on the overlap between HIV and Lyme because he has both. Of the two conditions Verdult stated that in many ways the battle for healthcare equality and respect were much more difficult to find in dealing with Lyme.

I don’t really have any groundbreaking, new information on Lyme disease besides the fact that it continues to grow across world on a pandemic scale. I can only repeat what the other writers in this brief blog have said before, which is that like AIDS, Lyme is being ignored by the medical community and is a national emergency among us today.

This Blog Is A Call To Action

It is a call to the same level of understanding, compassion and resources that it took the AIDS community years to receive as well. If you know someone with Lyme, call them and tell them you are trying to understand their experience. If you are called to give of your time and resources, focus on reputable, community focused organizations such as Global Lyme Alliance. If you are a healthcare provider and want to learn more, check out this training.

If you or a loved one are struggling with mental health or stress related issues associated with Lyme, schedule a time to speak with us today.. You are not alone.

How to Use Positive Psychology to Heal Your Body Image

By Kacie Mitterando, LMSW

Positive Psychology is one go-to resource I use in sessions when discussing body image. I wanted to offer a few helpful tips in hopes that this may end up as the beginning of some healing for you.

The National Eating Disorders Collaboration defines body image as “the perception that a person has of their physical self and the thoughts and feelings that result from that perception.” (1)

Because of many factors such as social pressures, media, and family patterns, we have been mislead to believe this idea below:

A positive body image means that we love, or even just like, the way that we look and that we feel confident in the skin that we’re in the majority of the time.

and on the other hand…

A poor body image is when we dislike our bodies, feel inadequate in our own skin and may elicit behaviors that hide our bodies from being seen.

I offer this reframe below:

A positive body image means that we accept our body and respect it for what it can do. This doesn’t mean that we think our body is perfect and we may have days where we feel uncomfortable in our skin but we are able to appreciate our body and move on.

and on the other hand…

A poor body image is placing value on our body outside of its function and believing that our body is an object rather than instrument.

This may not feel practical at first; however, there are ways to begin implementing this belief system into your every day life to start the steps of transitioning into a true positive body image.

Focus on health over how your body looks

Often times we may go into a diet begin to lose weight and feel so much better! Because of this, it is very common to equate the great way that we’re feeling to the weight loss. Therefore, when we gain the weight back we equate not feeling well with the weight gain and believe as though weight loss is the answer. However, this traps us in a cycle of poor body image. One of the ideas to begin to explore is was I feeling good because I lost weight or was I feeling good because I changed my behaviors that made me feel better? For example, you may have been exercising more, which increases “feel good” hormones; you were most likely drinking more water and less alcohol and overall, increasing your total self-care. All of these behaviors help you feel good each and every day! In moving forward, practice mindfulness surrounding behaviors that make you feel good rather than behaviors that make you look good.

Work on neutrality instead of liking our bodies

I promise that I won’t make you look in the mirror each morning and tell yourself that you’re beautiful ten times over. I understand that this can just be painful and if it doesn’t feel real, it’s not going to work. The most recent research on body image shows that we are better off practicing appreciation and functionality of our bodies rather than developing a positive attitude towards the way we look. This means that when we’re feeling insecure about our stomach, focus on one thing your stomach did for you today. Did it help you digest your delicious lunch? If you’re feeling as though you don’t like the extra fat on your arms, can you remember the last person you comforted with a hug from those arms?

Separate from social media if needed

It is OK to unfollow people on social media who are not serving your positive body image purpose. When scrolling through social media, pay attention to the images you see and when you notice yourself comparing, it may be time to remove this person. Removing people off social media doesn’t mean that you dislike them or don’t want to be in their lives but is a practice of you protecting your own emotional health.

Ask yourself these questions

Below I’ve listed some questions that will help reflect on your relationship with your body:

  1. What would your 99-year-old self appreciate about your current body?

  2. Would I talk about someone I respect’s body the same way I am talking about my own?

  3. Is the reason I love the people in my life because of their bodies?

  4. How much time do I spend thinking about how I would like my body to be?

  5. If you’d like to discuss your answers to these questions some more, schedule a phone consultation to get started with therapy today.

1. 3 Positive Body Image Activities & Worksheets (2019 Update PDF). (2019, February 14). Retrieved from

4 Tips for Regulating Emotions

By Amanda Polster, LMSW

Do you ever experience deep and intense emotions that are so challenging that you find yourself at a loss for how to manage them? You might even have thought that “there is no way out” and you won’t be able to overcome these overwhelming and agonizing experiences.

We all have gone through stretches of time where we experience overwhelm and gloom, but when these emotions linger for long periods of time, they can have repercussions on our overall health and quality of life.

Distress tolerance skills, also known as crisis survival skills, support us when we are feeling intense emotional pain. Distress tolerance skills can help us cope in moments of extreme discomfort to bring us back to a more balanced state.

In times when we are experiencing intense escalation of emotions, it is normal to try to self soothe with strategies that might help us in the moment, but can have harmful consequences. Some common self soothing strategies that can help us relieve pain immediately but do not resolve, and might actually make these problems worse, include using substances, binge eating, gambling, excessive or unsafe sexual practices, and/or self harming behavior.

Distress tolerance techniques seek to provide us tools to help us relieve pain immediately AND keeping us safe and healthy in the long run.

Distress Tolerance Tool: TIPP

Mindfulness practices are at the core of distress tolerance tools due to their focus on using body sensation awareness as ways of coping in the present moment. A very helpful distress tolerance tool that is used universally to help calm us down when we are at an escalated emotional state is called TIPP. TIPP is a creative acronym for different body awareness techniques we can use to help us de-escalate and get back to a more balanced state. TIPP stands for Temperature, Intensive Exercise, Paced Breathing, and Paired Muscle Relaxation.

T for Temperature

Temperature in the TIPP distress tolerance technique is most often used with ice or cold temperatures. For this practice, try holding an ice pack or a cold towel over your face for 30 seconds. This technique will trigger your mammalian diving reflex, a natural reflex in mammals that is triggered by cold water sensations. When this reflex is stimulated, our body chemistry changes - “our heart rate drops down immediately and our parasympathetic nervous system is activated to prompt a relaxation response” (Sevlever, 2019).

*It is key to keep the water above 50 degrees Fahrenheit to ensure a safe temperature for the body during this activity.

I for Intensive Exercise

Emotion is created by motion. Whatever you’re feeling right now is related to how you are using your body” ~Tony Robbins

Intense Exercise can be intimidating. For this activity, any change in body movement can help shift our current state of emotions. Physical activity has been proven to reduce anxiety and depression, and improve self-esteem. Similar to the temperature technique, intensive exercise has proven to change brain chemistry - exercise naturally releases endorphins that act as organic painkillers and help minimize discomfort in the body (Domonell and Burn, 2016). Examples of intense exercise ranges from doing a full workout routine to doing 25 jumping jacks just to get our bodies moving and heart rates beating faster.

Paced Breathing

Paced breathing is a mindful method of relaxation that helps us be intentional and aware of our breath in the present moment. When we breath quickly, we send a signal to our brain that something is wrong, which can cause us to feel threatened and scared. When we begin to slow our breath down with paced breathing, we send a counter signal to our brain that everything is ok, allowing our bodies to relax and feel calm. A common paced breathing exercise is belly breathing for 4 seconds in and 6 seconds out. We can take a few moments here to practice paced breathing: Placing one hand on your belly and one hand on your heart, gently count as you slowly breathe in 1, 2, 3, 4 seconds and slowly breathe out 1, 2, 3, 4, 5, 6 seconds. During this exercise, notice the belly expand as you breathe in for 4 seconds and contact as you breathe out for 6 seconds.

Paired Muscle Relaxation

Paired muscle relaxation is a mindfulness technique to help us notice changes in our bodies when we tense up and relax our muscles. Tensed muscles are typically a physical sign that we are feeling emotional tension as well, like stress and overwhelm. Releasing tensed muscles and relaxing them can help our bodies and minds begin to relax together. This practice can be paired with paced breathing; while breathing in deeply for a count of 4, slowly begin to clench your fists. As you breathe out for a count of 6, slowly begin letting go of the tension in your hands. Notice any difference you feel after releasing the tension. This exercise can be practiced will all different paired muscle groups in the body - hands, feet, legs, arms, etc.

It is normal to prefer some of the TIPP techniques over others. It is also normal for these practices to take time to fully work in helping us calm down, which is why they are called practices. These techniques take practice to work, and the more we are dedicated to using them in times of distress, the more effective they will be in relaxing us in the present moment and helping us build safer and healthier lives.

Sevlever, Melina. 2019. Dialectical Behavioral Therapy (DBT) Distress Tolerance Skills: TIPP Skills. Manhattan Psychology Group, PC.

Domonell, Kristen and Daily Burn. 2016. Why Endorphins (and Exercise) Make You Happy.


By Paul Triggs, LMSW

Stress is a common reaction to challenges that everyone could relate to at one more point or another over the course of their lives. For example, in a 2015 survey by the American Psychological Association they found nearly 25% of participants experienced “extreme stress” (Welch, 2016). Although, this was a small study nearly a quarter of the participants disclosed periods of extreme debilitating stress. Stress can occur in many different situations both in public and private settings with no way to avoid it completely. That fact is particularly true in the city that never sleeps and is always asking for more. Here are a few tips to decompress and ground yourself before the next challenge arises.

⦁ Paired muscle relaxation

Pair muscle relaxation is a technique which incorporates deep breathing and physical movement to take your attention away from the stressor. For example, during paired muscle relaxation you could clinch your fists during each breath in and slowly let them go during the exhale. Another way this could be done is a public setting is with your feet. In other words, you would squeeze your toes as hard you can during the inhale and slowly let go on the exhale. The advantage of the second technique is the exercise would be less obvious and could be utilized in public settings where added attention is not wanted.

⦁ Write a note or a letter to explain why you feel stressed.

One benefit to writing a note or a letter is this will provide an outlet to get what is bothering you out instead of ruminating about the situation. The letter or note will also allow you to review your thoughts and decide whether they are even worth your time. Another benefit of utilizing this technique is you can say whatever is on your mind no matter how mean or cruel and there will be no outside judgement.

⦁ Listen to music or another type of entertainment that promotes positive feelings.

The benefit of listening to music or a podcast is they provide a distraction from your current stressful situation and promote more positive vibes. For example, studies have proven that listening to music can reduce the release or cortisol which is your bodies main stress hormone (Heid, 2018). Additionally, music has been proven to reduce feelings of pain and has even been considered beneficial before surgery to improve a patient’s outlook (Heid, 2018).

⦁ Try some vigorous exercise such as pushups and jumping jacks.

The benefit of exercise is you can take your mind off the stressful situation and increase your health at the same time. The use of exercise such as pushups and jumping jacks do not require much space or time but could yield good results. For example, physical activity has been proven to increase endorphins which are known as “feel good hormones” (Healthline, 2019). Additionally, vigorous exercise yields many health benefits such as strengthened immunity and better sleep which will reduce the frequently of high stress situations (Healthline, 2019).

⦁ Use your lifeline and phone a friend.

The next time you feel very stressed and need to vent call a friend. The benefits of discussing challenges and obstacles has been empirically proven because it works. On the other hand, sometimes your friend may not know what to do in certain high stress situations and a professional may be the right solution. If you feel consistent levels of high stress and would like to apply all these techniques more under the watchful eye of a dedicated professional reach out to our team. The first step of using your lifeline may be hard but you deserve to feel better and we are trained to make that a reality.

Welch, A. (2016). Why So Many Americans Are Feeling More Stressed Out. Retrieved from:

Heid, M. (2018). You asked: Is Listening to Music Good for Your Health? Retrieved from:

Healthline. (2019). Exercise as Stress Relief. Retrieved March 26, 2019, from:

Why You Need a Therapist Even if You Have Great Friends

By Kacie Mitterando, LMSW

This past week I came across a post on Instagram regarding friendships and therapists that led me to do some thinking about my practice with clients, friendships and psychotherapy in general. In this specific post, an individual was asking what the difference is between a friendship and a therapist but more specifically they were wondering if we have healthy friendships in which we feel open talking with them about our emotions, is seeing a therapist necessary?

This question got me thinking…

Healthy friendships are undeniably important and having friends that we feel like we can reach out to during good times along with the bad can make a huge difference in our well being. Research has consistently shown that healthy relationships with those around you can be an indicator in longevity as well as overall health. More recently, studies have shown that older individuals who haven’t maintained friendships are more likely to develop chronic diseases such as heart disease, diabetes and depression (1).

Seeing a therapist is also important and can help increase our overall wellbeing and feelings of support as well! A relationship with a therapist can even seem similar to a friendship in some ways but also has some major differences. For example, therapists disclose much less about themselves and the therapeutic relationship does not extend into one’s personal life, such as celebrating an event like a birthday together. However, while we have conversations with our friends, therapy often isn’t a conversation and rather, can feel a lot like learning. This learning isn’t the typical learning such as sitting in a science class but rather, learning about yourself as well as tools you may use to help conquer some of your current concerns (2).

Despite this, there are many parts of friendships that can feel therapeutic. In fact, there’s an activity I’ve been using with my clients lately that I wanted to share as an activity that can definitely be done between trusted and caring friends.

For your next wine night, TGIT Shondaland date, or just a typical-hang out, use the “Miracle Question” with your BFF to help think about your goals and ways in which you may want to tailor your life to reach these goals.

Begin with this prompt:

"Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, you notice that a miracle has happened and your most positive dreams for the future have come true. Remember, a miracle has occurred and you have just woken up to your life as you would ideally like it to be.”

After this prompt, some things may come up for us: we might be thinking about a beautiful home we would have purchased or having the fastest car on the recent market. However, it can be more difficult to plan what our day to day would actually look like. I like to start by asking:

1. “How do you feel when you wake up?”

After allowing them to respond I normally repeat what they said, “So you wake up, you feel content and then…”

2. “What is the first thing you will do?”

3. “Afterwards, your best friend comes over. As soon as they arrive they noticed that something in your life has drastically improved. What is this improvement they have noticed?”

4. “Your best friend leaves, what is it that you do next?”

5. “What does the rest of this day look like?”

6. “What day of the week is this?”

7. If it is a weekend: “What does a weekday look like?” If it is a weekday: “What does a weekend look like?”

The Miracle Question is an example of an activity from a model of psychotherapy called Solution Focused Therapy. This therapy is centered on each person’s goals and the steps needed to take to reach these goals (3).

I hope you enjoy spending some time bonding with your most trusted friends. If you feel ready to add a therapeutic relationship into your life and complete more activities such as The Miracle Question, reach out to us to schedule a phone consultation.

Why Do We Need Friends? Six Benefits of Healthy Friendships. (n.d.). Retrieved from

Are Therapists Just Rent-a-Friends? (n.d.). Retrieved from

Cool Intervention #10: The Miracle Question. (n.d.). Retrieved from

5 Ways Tidying Up Can Improve Your Mental Health

I remember as a girl coming home to what looked like a completely different house. This happened around season changes and times of conflict between my parents. The furniture would be re-arranged and we would have a brand new set of throw rugs in the bathroom. Why? Because my mother knew the power of the KonMari method long before there was such a thing. When mom needed to regroup, relieve stress and gain some emotional clarity, the house would get a good old fashion Spring cleaning - Spring or not.

In 2011 Marie Kondo published The Life-Changing Magic of Tidying Up. At the time of my writing this blog, her book has sold over 10 million copies worldwide. This didn’t just happen by accident. Marie has been studying the art of tidying since she was a child. She even wrote her college thesis on the topic. Marie’s book (and now Netflix series) briefly touches upon the overall benefits of sorting, organizing, and tending to the objects around us.

In her book, Marie touches on the idea of difficulty letting go of objects (attachments) as a kind of in-between place.This indecision can be a combination of both depressed (sad, nostalgic, longing) and anxious (worried about the future) states causing us to feel stuck.

“But when we really delve into the reasons for why we can't let something go, there are only two: an attachment to the past or a fear for the future.” “The space in which we live should be for the person we are becoming now, not for the person we were in the past.” “Keep only those things that speak to your heart.

Taking inventory of our things can be a powerful action step to finding our way out of stuck emotions. Let’s take a look at some of the ways tidying helps us feel better.

1. It Reduces Anxiety - Tidying can help relieve anxiety in a number of ways. One study looked at obsessive cleaning and it’s impact on anxiety. This article sites A study in the journal Current Biology found a link between temporary anxiety and obsessive cleaning. ... The study's authors hypothesize that in times of stress, people might turn to repetitive behavior like cleaning because it gives them a sense of control over an otherwise uncertain situation.

This article sites common experiences of individuals with anxiety and the benefits they receive from cleaning including likening cleaning to meditation, gaining the benefit of a tangible outcome and making their home a safe and comfortable space to relax.

2. Tidying Improves Focus - “By handling each sentimental item and deciding what to discard, you process your past. If you just stow these things away in a drawer or cardboard box, before you realize it, your past will become a weight that holds you back and keeps you from living in the here and now. To put your things in order means to put your past in order, too.” - Marie Kondo

Marie’s quote illustrates the power of clearing up emotional space as a way to focus. She isn’t just talking about getting rid of stuff, she is talking about looking at our attachments and deciding that it’s time to let go of things that are draining our energy, thus giving us more room to focus on the important things.

According to a study from The Journal of Neuroscience, the less clutter present in our vision, the more focused we can be.  

3. It Boosts Your Mood - Check out the results from a study by UCLA’s Center on Everyday Lives and Families (CELF) (from

A link between high cortisol (stress hormone) levels in female home owners and a high density of household objects. The more stuff, the more stress women feel. Men, on the other hand, don’t seem bothered by mess, which accounts for tensions between tidy wives and their clutter bug hubbies.

Women associate a tidy home with a happy and successful family. The more dishes that pile up in the sink, the more anxious women feel.

Even families that want to reduce clutter often are emotionally paralyzed when it comes to sorting and pitching objects. They either can’t break sentimental attachments to objects or believe their things have hidden monetary value.

Although U.S. consumers bear only 3% of the world’s children, we buy 40% of the world’s toys. And these toys live in every room, fighting for display space with kids’ trophies, artwork, and snapshots of their last soccer game.

4. Tidying Encourages Healthy Habits - Tidying up can help with overall life satisfaction and goal achievement. Being tidy is reflected in the habit of a chef preparing to make a meal. The first thing they do is set up their mise en place or everything in it’s place. Having things in their rightful place gives us a sense of readiness and preparation for challenges and projects.

5. Tidying Fosters Meaningful Relationships - To me this is the most important of all. In our therapy practice we believe that everything is a relationship. We believe that all relationship are significant and whether it’s your relationship to the clothing in your closet or your relationship to your mother, they are all worth examining.  

One very direct way that tidying can improve relationships is the impact a clean home has on romantic couples and domestic partners. In an article from the Huffington Post, two research studies were sited.

According to a 2016 survey of newly divorced people, 30 percent of respondents named “disagreements about housework” as the top reason for the split-ups, which came in third after infidelity (40 percent) and drifting apart (35 percent). A Pew Research Center study from the same year found that more than half of all married respondents (56 percent) said that sharing household chores was “very important” to a happy marriage.

Sometimes Letting Go Is Hard

Need help getting started with your tidying? Therapy is a great place to discuss barriers to getting started with things like the KonMari method. Contact us today for a free 15 minute consultation.