First Steps To Understand and Stop Binge Drinking

By Kacie MItterando, LMSW

Binge drinking is a form of short term escape from stress. Binge drinking also causes a tremendous amount of long impacting stress to our bodies, relationships and wallets. This article breaks down the seeming appeal of binge drinking, it’s downsides and ways to start taking control of your drinking.

We All Need An Escape From Reality

In Johann Hari’s book Chasing the Scream, Hari draws a comparison between using substances as an adult and the ways in which each and every once of us have used mechanisms other than substances to escape our own realities. In this comparison, Hari discusses times in which we have all gotten “high” without using substances. Take for example an occasion in which you were a young child and spun around and around to the point where you became so dizzy you couldn’t even see or walk straight. Or even a time in which you enjoyed riding a roller coaster and dropping down so far and so fast your body and mind were almost separate from yourself.

The idea of escaping our reality by mentally or even physically removing ourselves from it is a normal mechanism that all of us has attempted, whether under the influence or not. In fact this is not only something humans do but rather, something that can be witnessed throughout the animal kingdom as a whole including: reindeer have been known to eat a hallucinogenic mushroom called Amanita muscaria, the wallaby (a small kangaroo-like animal) have been reported not only eating poppy plant but running around in circles until they pass out and dolphins have even been spotted pushing around a pufferfish- a fish known to produce the toxin, tetrodotoxin which can easily get an animal high (1).


Any one person may drink for a variety of reasons. The environment may be a perfect setting- a few of your favorite co workers grabbing drinks at happy hour or a holiday party that ends up much more fun after a few cocktails. From a social perspective, drinking has become incredibly “normalized.”  Recent studies have even shown that if a college campus has a strong drinking culture, students will in turn drink more than if the social norm was the opposite (2). While all of these reasons are valid and understandable, I’d like to dive deeper into one particular reason someone may drink:



More specifically, what is binge drinking and how does this attempt at coping increase our stress?


While binge drinking may be a term that’s thrown around loosely, there are specific requirements set around what’s considered “binge drinking.” The National Institute of Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that will raise an individual’s blood alcohol concentration to .08. While the amount of alcohol needed to get to this level varies based on a few different biological factors, as an estimate this equates to four drinks for women and five drinks for men in a two-hour time frame (3).


Binge drinking causes an increase in the disruption to our body’s stress regulation system, which attempts to keep our Cortisol levels in balance. When this process is interrupted, symptoms of not only depression and anxiety increase but various physical impairments as well such as heart concerns. Overall, binge drinking negatively impacts efforts to maintain and improve our mental health. The key piece here is that you don’t need to have an alcohol diagnosis to reap the negative benefits of binge drinking. The negative impacts of binge drinking influence anyone who binge drinks. Therefore, while having a drink or two with a coworker (similar to spinning around in circles as child) may not be harmful, letting that drink lead to four or five because you have had a rough day at work may end up doing more harm than good (4).


Below you’ll find some ways to de-stress daily before a night with coworkers leads to binge drinking:

1.     Preparation:

Is a tough family event coming up that seems impossible to attend without a few drinks? Set up defense mechanisms now for the impact that this future event may have on you. One activity I enjoy doing with my clients is picking each emotion that you may experience at this event and developing a “Safety Plan” around this emotion. For example, if you’re preparing to feel overwhelmed, pick one or two things you can do to decompress once feeling overwhelmed such as stating you have a phone call to make and actually going for a brief walk. Write these down on an index card and bring with you for a reminder if needed.

2.     Find activities that you love outside of alcohol:

I’d like to reiterate that it is normal to want to feel outside of reality and a healthy experience that everyone has. However, if binge drinking is a coping mechanism you find yourself using every once in a while after a stressful week, do some soul searching for a different activity that you enjoy. This may be a competitive sport that you can join a league for or creative pursuits such as music or painting.

3.     Support:

Lean on your healthy support systems when feeling stressed and plan a day/night/weekend to do relaxing but enjoyable activities together. Possibly consider cooking a new recipe together, going to a new restaurant or having a spa day.

4.     Peace:

Get in touch with whatever it may be that brings you peace. Whether this means attending a spiritual event, going for a walk through nature or listening to music. Consider spending some time doing things that help bring you back to a calm, peaceful state.


If you need further assistance navigating Safety Plans and developing healthy coping skills, schedule a 15 minutes session with us today.


1. No, Coyotes Don't Get High-But These Animals Do. (2016, February 24). Retrieved from

2. Why Do People Drink? (n.d.). Retrieved from

3. The Neuroscience of Binge Drinking. (n.d.). Retrieved from

4. Stress About Alcohol? Heavy Drinking Versus Alcoholism. (n.d.). Retrieved from

Letting Go of Guilt To Be A Better Leader

Feeling guilty at work?

Do you feel guilt for asking your employees to stay late to work on projects? What about feeling guilty for asking upper management for more support? Or maybe you feel guilty for taking your vacation?

Guilt is an emotion that helps us stay within our values. It is a clear and sometimes painful signal that we have done something wrong. In it’s useful form, guilt can reinforce core values that make us descent humans. At it’s worst, guilt can be used to instill fear, promote low self worth and encourage an inner drive that tells us we are never going to be good enough.

That is what I refer to as irrational guilt. Irrational guilt is when we experience guilt outside of breaking a core value or belief or feel pressured and manipulated into feeling guilty for no good reason. Some of us may have been raised to believe that guilt (even when unwarranted) was a powerful motivator. As a child we may have been guilted into any doing number of things that your parents, religious organizations or others in places of authority told us to do simply as a tactic of control. This toxic understanding can be something we carry with us into adulthood and act out toward ourselves or others in the workplace. Some examples of irrational guilt interfering with our quality of life at work include:

  • Guilt for holding boundaries. You always have the right to say no. Oftentimes high pressure work environments foster a culture where employees are afraid to say no to bosses and managers are afraid to say no to employees. Both of these are super unhealthy. Knowing our limits at work makes us and everyone around us feel more secure.

  • Experiencing guilt because of other people’s emotions. Sometimes when we start to set healthy boundaries people get upset. This is understandable because people prefer things to stay the same. When we set a boundary and someone has an emotional reaction, we do not have to take responsibility for or feel guilty over their emotions. Outside of intentionally abusing someone, the only person’s emotions you are responsible for are your own.

  • Feeling perpetually guilty for a mistake. Maybe you really did do something that warrants feeling guilty. Ok. Fine. We are all human and we all make mistakes. Irrational guilt can also come in the form of torturing ourselves over one mistake.

  • Being manipulated into feeling guilty when the blame is actually on someone else. Oftentimes emotionally unhealthy individuals will try to manipulate and place blame on others in an effort to avoid responsibility. Be mindful of colleagues trying to pass feelings of guilt onto you.

The one most important thing to know about irrational guilt is that we need to set internal and external boundaries to protect ourselves against this type of toxic thinking. We can do this in 3 ways:

  • Set clear boundaries and practice them. Practice saying no. Practice telling others what you need. Practice standing up for yourself even if it feels uncomfortable.

  • Take note of your irrational thoughts. Jot down when you find yourself apologizing for no reason or feeling guilty for something that has nothing to do with you. Just noting it on paper can be tremendously helpful.

  • Talk to your therapist or trusted loved one about feelings of guilt. We all make mistakes. There will always be someone to help you put things in perspective.

Need help with managing guilt? Schedule a 15 minute session with one of our therapists today.

Coping with Loss During the Holiday Season

By Amanda Polster, LMSW

Grief and bereavement are natural experiences of life, and none of us are immune to this type of pain. At some point in our lives, we have experienced grief – a death of a loved one, a loss of a job or financial security, divorce or relationship separation, an estranged family member, a miscarriage, ongoing trauma that compromises senses of safety, etc. Although a healthy response to loss, grief can lead to suffering and symptoms of depression if we are unable cope and feel supported during these tumultuous experiences.


The intensity of grief is often related to the attachment to the person or thing we lost. For example, if we lose someone very close to us - a partner, a friend, a parent, a sibling, a child - we will be more impacted and challenged to accept reality that this person is no longer here.


The correlation between our attachment to someone and the impact their loss has on our lives is not to discourage healthy and strong relationships at the fear of potential loss; it is the contrary. By experiencing healthy attachment relationships, we gain a greater connection with our identity and needs. If we are challenged with a sudden loss and are left questioning how to repair or fill this void in our lives, we are given an opportunity to identify our needs during this difficult life experience. We can ask ourselves questions that can prompt a greater sense of self compassion and connectedness. Anodea Judith, an American author, therapist, and public speaker grounds her work in internal healing methods, and suggests asking ourselves these questions in time of grief and crisis:


“Why was this person in particular so special to me?” 

“What did this person bring to me that I am missing in myself?” 

“What part of me was particularly bonded to this person, and what does that part need?” 

 “What have I lost touch with in myself as a result of this ending, and how can I nurture and regain that part of myself once again?” (Judith, 278)


Along with these thoughtful questions, below are some additional practices that can move us from pain towards healing in times of emotional adversity.

Connecting to Our Heart Center

“When our heart is heavy with grief, it is hard to open, even hard to breathe. When grief is denied, we become numb to our feelings and our aliveness. We become hard and cold, rigid and distant. We may feel dead inside. When grief is acknowledged and expressed, however, we find a vital key to opening the heart. Tears are shed, truth expressed, and the heart lightens. The breath deepens. There is a sense of spaciousness that emerges, allowing more room inside for our spirit. Hope is reborn. Coming to terms with our own grief leads toward compassion for others”


Grief challenges and counteracts the heart’s connection to ourselves and others, and makes it feel closed and heavy. For this reason, feelings of isolation and disconnect are common in times of need. In these distressing times, it is important to allow ourselves to share our pain with others to relieve the heaviness of these moments. Times of grief are a perfect opportunity to validate that not being ok is ok, and feeling pain is part of our humanity. Validating our state of grief allows our hearts to open during this process to begin working through the pain.


Using Mindfulness Practices to Grieve

“Grief, after all, is not a pathology or an illness, but a natural part of life that causes us to experience suffering. Since the goal of mindfulness practices is the cessation of suffering, it can only make sense to bring the two together” (Stang, 10).


The good thing about mindfulness practices is they are easily accessible - all you need is yourself. Mindfulness allows us to pay attention to our bodies with observance and curiosity, eliminating acts of judgment that come naturally, especially during times of grief. Mindfulness can help relieve various emotional expression: stress that come with expectations to grieve within a certain period of time; anger that comes naturally with the loss of someone or something we are attached to; denial that the information in front of us cannot be true.

Qualities that come from using mindfulness to work through grief:

            -improved self-perception

            -improved sense of strength

            -improved level of compassion

            -better relationship with others[1]


Breathe. A helpful mindfulness practice during bereavement is focusing on our breath. When grief causes panic, focusing on our breath can be very soothing and calming, and relieve us of the immediate overwhelm during adversity.



Tapping Into our Support System

When we lose someone close to us, it can feel disturbing or discontenting, as if pieces of our identity have been removed or lost as well. In these times, it can be easy to try to fill that void by taking on the role of healer and making sure loved ones around you are safe and supported. This act of kindness can demonstrate our unconditional support for those closest too us. While this might feel powerful and helpful as a distraction, it is important to ask ourselves:

“What do I need right now?”

“Am I allowing myself the time to grieve?”

“Why is it important to me to help others at this time?”


Additional Resources

Honor yourself for your openness to explore this time of adversity with hope and optimism.


Grief is very powerful.


It can change your relationship to others, your worldview, and your relationship to yourself. The energy that comes with grief can influence our physical, mental, spiritual, and emotional capacities. However, we have the power to determine how we grieve. We have the ability to allow grief to either hinder our progression or become an opportunity for self reflection compassion, and acceptance. This form of acceptance does not mean we have to fully accept that our loved one is no longer with us, but we can accept our ability to move forward and to have a different yet still personal relationship with someone who holds a special place in our hearts.


If you are seeking additional support to work through your grief, we can help. Contact Us Today for a free 15 minute consultation.


1.      Judith, Anodea. Eastern Body Western Mind. 2004. Anodea Judith.

2.      Stang, Heather. Mindfulness and Grief: With Guided Meditation. 2014. CICO Books.

[1] Stang, Heather. Mindfulness and Grief: With Guided Meditation. 2014. CICO Books.

Using Cognitive Behavioral Therapy (CBT) to Manage Holiday Stress

By Kacie Mitterando, LMSW

Holidays are stressful. In fact, in a recent study it was discovered that over a quarter of Americans report “extreme stress” during holiday season and a remarkable 45% would prefer to skill the holidays altogether (1).


Holidays can also be exciting, entertaining and even an opportunity for much needed relaxation with family and friends (especially if they’re some you haven’t seen in a while). However, there’s no denying that the stress can pile up especially if you’re someone who’s already experiencing anxiety.


While the Hallmark Channel and having dinner with loved ones can be fun, the holidays also lead to the feeling of a never-ending to-do list. There’s the responsibility of entertaining guests, cooking, shopping and often times traveling. Additionally, almost all of these occurrences cost money and after a while those little costs here and there may add up to what can feel like a financial burden.


On the other end, often times the holidays can feel extremely lonely. It’s no secret that each family has their own arguments, disagreements and imperfect ways of coping so coming together in forced harmony and peace can easily become not enjoyable.

Below are some tips that might ease a bit of the burden you’re feeling:


If your holiday stress is unpleasant family members:

The holidays are a great place to practice the Cognitive Behavioral Skills you may have learned in therapy. Interacting with family members is a great place to practice reframing.

In a Pyschology Today article by Hal Shorey PhD, shares some top tips for reframing interactions with family members.

  1. Consider lowering your expectations to match the world as it is, instead of your dream of how it should be.

  2. Take responsibility for what you are thinking and what you are saying to yourself in your head. Change the way you think and you will change your emotions and how you behave.

  3. Ask yourself, “what would happen if I let that comment go and don’t respond? Would it really make a difference in the long run?”

Allow each person that is unpleasant or unhealthy for you to be a chance to practice your coping skills and communication. Let’s face it; we’re not going to enjoy everyone we need to be around all the time. Therefore, if we can use the moments where we are in this position to run-through positive techniques, we’ll become more equipped and confident for the next time we’re faced with this dilemma.


If your holiday stress is that you’re feeling lonely:

If you’re away from family that you want to see, open the door for new ways to communicate. Think of possibly Face Timing these family members for dessert or even creating a Facebook Live session where multiple family members can join in. Often, there are other people in our social networks that are away from family as well, such as coworkers. Taking a chance with someone you may not normally spend as much time with could end up being an unexpectedly pleasant experience.


If your holiday stress is that you’re packed with too many responsibilities and commitments:

Stick with your daily routines and ultimately, do less of the “mandatory” holiday obligations. Work with your therapist or talk to someone about better prioritization.

Prioritize what is important to you during the not-holiday season, such as working out or spending your Wednesday nights catching up on your favorite TV shows. Studies show that our brains actually thrive off of habits and routines; therefore, it may help to reduce some stress if you continue to do what feels comfortable. While we often go overboard during the holidays- an abundance of shopping, sending out cards and attending each and every event we get an invite to- pick one responsibility that feels too much and tell yourself “no” this year. Use the time you would have spent on this event/activity to do something for YOU instead.


If your holiday stress is that your anxiety/depression is becoming too much to handle:

First, think of some of the small things you can incorporate into your days to decrease some of the anxiety/depression you may be experiencing- such as going for a run, practicing meditation and getting adequate sleep. However, if your mental health is feeling like “too much” and these coping skills aren’t significantly reducing your worries and concerns, talk to a mental health professional. With New Years coming up, now is the ideal time to make the commit to begin to address your mental health with therapy.

Most importantly don’t be afraid to ask for help.

If you’re traveling and will be away from the area during this holiday season while still seeking support, we currently offer video sessions and will be happy to meet online.

Also, if you are in a crisis and please contact National Suicide Prevention Lifeline

They can help prevent suicide. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.


1. Holiday Stress | Managing Holiday Stress | Stress During the Holidays. (2018, August 09). Retrieved from

4 Great Therapies for Treating BPD (That Aren't DBT)

Today’s blog is all about finding alternatives to the Dialectical Behavioral Therapy Model (DBT) of treating Borderline Personality Disorder. I decided to focus on this because I have had a lot of calls recently from clients seeking treatment for BPD. Most of these clients have said something like “I’ve done DBT for a long time and I’m not getting the results I want.” Those results often look or feel like deeper connections to the people around them, having more moments of satisfaction in their experiences and being able to trust their decision-making.

DBT is a fantastic treatment modality and has been the gold standard for BPD treatment since it’s development in the 1980s by Marsha Linehan, a psychologist at the University of Washington. Dialectical Behavioral Therapy is traditionally a structured intensive program that addresses issues of safety such as –  mood swings leading to self harm including suicide attempts and harm to others, as well as alcohol & substance abuse. In one study, the use of intensive DBT led to up to 77% of participants no longer meeting the criteria for a DBT diagnosis.  While this is super impressive and many people benefit form DBT, it isn’t for everyone.

So what do you do when you feel DBT isn’t working or isn’t enough?

Consider Treating Trauma

One place where the DBT model falls short is the actual processing a trauma that may be present in those with DBT. If you’ve completed a DBT program and still feel there is work to do, finding a trauma-focused therapist may be a helpful second step. Here are some great types of therapy to address trauma.

1.      Internal Family Systems Therapy  (IFS) – If you are someone that has really learned the skills of DBT and maybe even made great progress but still have trouble trusting others or making decisions, IFS may be a great option. IFS is a type of therapy that is done individually with your clinician (not to be confused with family therapy). IFS is a system of understanding how to work out the many different conflicts we have internally. It is also a great therapy for healing from trauma. Here is a great article by Martha Sweezy from the American Psychological Association on the promising results of Internal Family Systems Therapy on addressing unresolved trauma in people struggling with DBT.  


2.      DBT Informed Hypnotherapy – While hypnotherapy might not be the first thing you think of as an additional treatment for DBT, finding a hypnotherapist who is DBT informed can be extremely powerful.  Hypnotherapy is great for so many things from addictive behaviors to emotional regulation to finding increased satisfaction in our lives. DBT is also great for reducing feelings of panic and overcoming social anxiety. I often recommend this as an addition to DBT (plus its my favorite type of therapy😊


3.      Yoga-Therapy – Another no-brainer combo for DBT in my book is yoga=therapy. Yoga-therapy (not to be confused with a yoga class) is an individualized treatment session that uses body awareness, breathwork, philosophy and compassion-building to deepen a client’s relationship with themselves and the world around them. BPD can be super isolating and painful. Yoga-therapy helps to relieve that.


4.      Art Therapy – Another common experience of someone with BPD is feeling unheard, misunderstood and generally neglected. Art therapy sessions are generally focused around emotional expression and the ability to understand situations in a new way. Art therapy is also a powerful tool to process trauma.


No matter where your next step in your healing journey, its always good to look for practitioners who are familiar with standard practices in treating BPD. That combined with another type of therapeutic framework can be truly transformational.

Need help deciding which type of therapy might be best for you right now?

Let’s hop on a call and chat!

Self-Care For Turbulent Times

By Amanda Polster, LMSW

Social media can be toxic and scary. As much time as we spend on social media, we need an equal (or greater) amount of time mentally recovering from the bombardment of painful images and rhetoric. Today’s blog is all about stressing the importance of being in tune with our energy and checking in with thoughts and feelings that come up during this turbulent political climate.

We can use any activity as self care if we do it mindfully.

Part of implementing self-care is practicing being in harmony with our mind and body. During this blog, practice noticing the emotions and sensations that come up, and acknowledge yourself as courageous for taking this opportunity to learn healthy and sustainable methods of personal growth. At any point during this blog, if you begin to feel uneasy or triggered, recognize that as an opportunity for observation and take the necessary steps for yourself to take a break. Breathe

Breath is the foundational practice of self-care. We can focus on our breath no matter the activity. We can begin to practice it now in this blog.


Mindful Self Care Becomes Even More Important When Tragedy Strikes

This blog hits close to home in the wake of recent national events that have occurred unexpectedly, yet are now occurring ever too frequently. Especially in an era where violence has become more prevalent, it is important to identify ways we can take care of ourselves so to not get consumed by the losses in our community.

The more we practice self-care, the more capable we are at supporting our ourselves, our families and our communities

Below are some tips on how to reframe and implement self-care in our lives.  

1.      Self-Care is Not Selfish – You cannot serve from an empty vessel

You may have heard the saying, “you can’t help others if you are not helping yourself.” Or, as they always say on the airplane before takeoff, “In the event of an emergency, make sure you put your oxygen mask on first before helping the person next to you.” If we do not take care of ourselves, we will not have the capacity to support and serve others. Now, some people are great at helping others as a distraction from dealing with their internal struggles. However, this is not a sustainable practice, and without self-care and proper support, we will eventually reach a breaking point where we feel too overwhelmed and overloaded. In these instances, setting boundaries for ourselves becomes a practice of self-care to identify ways to most appropriately limit the amount we are giving and provide greater opportunity to receive and give back to ourselves. An example of setting boundaries is noticing our triggers and removing ourselves from spaces where we acknowledge triggers may occur. A personal example is recognizing when social media is not serving me and choosing to take a break to limit my access from overwhelming information that comes through my news feed.  

2.      Self-Care is an Opportunity to Grow

Many self-care practices are opportunities to observe and understand our own identities. Self-care practices are things that make us feel happy and provide us with joy and ease. They are activities that give our lives meaning and remind us of the importance of taking care of ourselves, emotionally, physically, and spiritually. These practices help us learn where we feel we are the most supported and areas where we may feel neglected or want additional support. Self-care is also an opportunity to check in our self-talk, and acknowledge the ways we are either affirming and validating our experiences, or judging ourselves for our emotions and behaviors. While we often seek validation and support externally through our support networks, self-care is also an opportunity to learn greater self-compassion and self-gratitude. Mindfulness practices such as loving kindness meditations are a great way of tapping into these self-care practices.

3.      Self-Care is a Priority and Necessity, Not a Luxury

This is my favorite tip, because people often think of self-care as a luxury or privilege. Now, I am not dismissing or denying the fact that not everyone has the same access to a diverse range of self-care practices (i.e. gym memberships, travel opportunities, health care resources). However, many self-care practices can occur internally, such as meditation, self-reflection, self-talk affirmation, that only require conscious awareness. Using our physical bodies as forms of revitalization and energy is often one of the most effective self-care practices. As Tony Robbins states, “emotion is created by motion,” and how we feel is often determined by the physical state our body is in at any given time.

Regardless of if we choose to join a new yoga class, or take a moment to “smell the roses,” self-care requires an investment in taking time for ourselves to remove ourselves from the stressful and often fast-paced environment we live in daily. Taking time for ourselves is not only vital to our mental, physical, emotional, and spiritual capacities, but also supports in our ability to be the best versions of ourselves and aids in our overall quality of life.

If you are in immediate distress please contact the number below:

The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.


If you would like to make an appointment for ongoing care, schedule a time to speak.