Insomnia Tips

Sleep Difficulties

Most of us will experience insomnia at some point in our lives, and for different reasons. Whether your insomnia is a longstanding pattern or something new, problems with sleep can negatively impact your physical health and psychological wellbeing, including thoughts, emotions, behaviors. Left untreated, the consequences of short-term and long-term insomnia can cause the following difficulties:

Typical symptoms experienced with insomnia:

  • Increase in depression and sadness

  • Increase in anxiety and restlessness

  • Increase in body sensations, aches, pain and tension

  • Feeling tired and worn out throughout the day

  • Mood instability such as irritability, anxiousness, agitation and numbness

  • Difficulty concentrating and attending to tasks

  • Making errors, mistakes or being accident prone

  • Avoidance of usual activities

  • Increased risk of health problems

You are likely all too familiar with how you feel when struggling with a bout of insomnia. To improve your ability to sleep and reduce insomnia, make it a goal to increase behaviors that improve sleep in addition to reducing the behaviors that disturb sleep. Even small changes in your sleep behavior can have a positive impact on your wellbeing. The goal is to once again love sleep, which is the opposite of the dread you may be feeling at bedtime. You may be wondering what causes insomnia and disrupted sleep.

Common Habits and factors that contribute to insomnia:

  • Uncomfortable sleep environment

  • Daytime napping

  • Stimulating activities too close to bedtime (watching tv in bed, video games, smart phone, computer)

  • Eating too close to bedtime

  • Circadian rhythm disrupters such as Jet lag, travel between time zones, shift work

  • Stressful concerns such as finances, work, school, family, divorce, death or illness of a loved one

  • Lower performance at work

  • Slowed reaction time

  • PTSD and nightmares

  • Depression and the symptom of early morning awakening

  • Anxiety disorders

  • Grief

  • Medical conditions (chronic pain, asthma, GERD, cancer, diabetes, heart disease, overactive thyroid, Parkinson's disease and Alzheimer's disease, as examples)

  • Prescription drugs and medications

  • Caffeine to close to bedtime and alcohol

  • Sleep apnea

  • Hormonal disruptions (perimenopause, menopause, post-partum)

  • Aging which changes sleep patterns

  • Increased risk of substance abuse as an attempt to achieve sleep

  • Having a family member with a sleep disorder

Things you can do to Decrease Insomnia and improve sleep

  • Keep your room dark

  • Avoid alcohol and caffeine close to bedtime as it leads to sleep difficulties (tea, coffee, chocolate, cold/allergy medication

  • Do not nap during the day

  • Avoid going to bed too hungry or too full

  • Relax and create ritual which signals that it’s time to unwind. Read a book, take a bath, incorporate gentle yoga or stretching, listen to non-stimulating music, go offline for several hours before bedtime

  • Exercise 30-60 minutes as many days as possible and no later than 4 hours before bedtime

  • Develop a regular routine to keep your circadian rhythm regulated which means going to bed and waking up at the same time each day

  • Make your bedroom comfortable and only use it for sex and sleeping

  • Get up and leave your bed if you do not fall asleep within half an hour and do something relaxing (no tv)

  • Keep your bedroom slightly cool and ensure that your mattress is comfortable and that your bedding is restful and soft.

  • Avoid activities such as watching TV, working, studying or any other mentally stimulating activities

  • Challenge the belief that you cannot function without a perfect nights sleep. This is not true. Reality is that you’ve functioned in the past on little to no sleep and you can do it again. You will get through the day and the evening

  • Consider seeing a medical or mental health professional who offers cognitive behavioral therapy (CBT) or supportive therapy. Medication is also an option as well as herbal/natural remedies.

When to Seek Help for your insomnia 

If you do not experience success with following the above suggestions, consider seeking help from a professional. Among options are cognitive behavioral therapy (CBT) for insomnia, psychotropic medications, and seeking an evaluation with a sleep specialist. Insomnia can be an overwhelming experience where you unlearn how to sleep, and learn how to dread sleeping. You don’t need to suffer. With help and support you can learn to sleep again.

Depression & Disordered Sleep

It’s common knowledge that one of the results of being depressed is disordered sleep – either sleeping too much or too little. Many of you have seen the much discussed article in the New York Times on the research that shows how addressing sleep deprivation through cognitive behavioral techniques or CBT, also helps resolve depression. This is very good news for the depressed and sleepless — fix the insomnia and sleep issues and the fog of depression may lift.

Therapists can help individuals with depression and sleep difficulties by offering effective and simple ways to improve sleep. When you find a psychotherapist who understands how to address sleep problems, you may also discover that symptoms of stress, anxiety, PTSD, physical illness, concentration/work efficiency, marriage difficulties, parenting, transitions, resiliency and other problems are eased.

The American Psychological Association has now recognized sleep psychology as a specialty. What exactly is insomnia? Insomnia is defined as at least three months of poor sleep that causes problems at work, at home or in relationships. The treatment called CBT-I is based on the concept that chronic insomnia is sustained by a variety of factors and poor sleep hygiene.

Sleep Disorders & CBT-I

Treatment using CBT-I includes tracking sleep times and practicing sleep hygiene to address unhelpful patterns. Many insomnia patients who lie awake worrying and thinking learn to associate bed not only with sleep but a place to be awake, and even begin to dread their beds. CBT utilizes stimulus control instructions such as using the bed only for sleep and sex.  Another helpful technique includes using a sleep diary as well as the concept of sleep restriction which limits the time in bed thus increasing the body’s drive to sleep.

Another important piece of the CBT cognitive therapy model helps insomnia patients recognize and modify unhelpful, inaccurate thoughts that affect one’s ability to sleep. For instance, many patients hold the belief that they “cannot function well without 7 or 8 hours of sleep” which puts additional pressure to fall asleep resulting in escalating tension and anxiety, and of course, no sleep. Patients using CBT will be taught “worry control” and learn to exchange rigid beliefs with more accurate evidence-based thoughts such as “I once flew across the country, slept 2 hours and was focused and effective during my meetings.”  Will you feel your best? No, probably not, but you will be fine. Should worry creep in the next night, try a sleep mantra like – you know how to sleep, you’ve slept before and you’ll sleep again, as well as pre-bed meditation and sleep relaxation and guided imagery.

Relaxation training is used to help quiet the mind and relax the body. There are a number of techniques that can be taught such as muscle relaxation, deep breathing and biofeedback. Find what works for you. I often teach diaphragmatic breathing and progressive muscle relaxation and suggest helpful relaxation CD’s that I’ve had good success with. Patients who feel tense before bedtime benefit the most from these strategies.

It is not necessary for patients to discontinue sleep medication to benefit from CBT-I, however many patients are able to gradually taper off their sleep medications once they have learned alternative techniques to manage their insomnia.

HOLISTIC PSYCHOTHERAPY & WELLNESS NYC

Philosophy

For nearly twenty years, this holistically-oriented NYC Psychotherapy & Wellness Practice has blended what I’ve found to be the most effective practices in psychology, neurobiology, attachment, alternative practices, nutrition, coaching and mind-body medicine working with individuals and couples. As a holistic psychotherapist, I believe it’s important to address the root cause of emotional and psychological suffering. It’s important to know that we all make the most therapeutic progress in a compassionate and non-judgmental environment. I make every effort to ensure patient comfort and ease. Countless studies have shown that finding the right "fit" with a therapist is more important than the technique that is used. As a trauma-trained therapist I am influenced by humanist and existential philosophy, relational theory, attachment theory, psychoanalytic concepts, mindfulness, and somatic, mind and body psychology. My couple and marriage counseling work is influenced by Gottman Method, Internal Family Systems and Emotionally Focused Therapy (EFT). As neuroscience now shows us, the body and mind are inextricably linked—my 20+ years of experience with mindfulness, yoga therapy, and meditation greatly influence my work as a mental health provider. A Holistic and comprehensive therapy model ensures that you thrive in the many aspects of your life—including your relationship with your self and others. You will enjoy a more satisfying, rewarding, and joyful life, no matter your struggles, challenges, or diagnoses. I enjoy continuing education, and I’ve received extensive training and certification in a range of evidence-based and cutting-edge approaches to offer you this holistic model of care. Together, we work with practices designed to create an environment that supports optimal physical and mental health wellbeing. Lasting change and transformation is possible when given the right tools to thrive.

Training

  • Somatic Experiencing® International (in progress)

  • Eating Disorders, Compulsions & Addictions (EDCAS) Certification

    William Alanson White Institute of Psychiatry, Psychoanalysis & Psychology

  • EMDR Advanced Level EMDR Practitioner - Laurel Parnell PhD

  • Brainspotting - Lisa Schwarz, MEd

  • Positive Neuroplasticity Training Certification - Rick Hanson PhD

  • Nutrition and Integrative Medicine for Mental Health - Leslie Korn PhD

  • IFS Immersion: Integrating Internal Family Systems Across Clinical Applications - Frank Anderson, PhD

  • Dialectical Behavior Therapy - Behavior Tech Institute

  • Advanced CBT Certification - New York University

  • Psychodynamic Psychotherapy Certification - New York University

  • Advanced Clinical Practice Certification - New York University

  • Clinical Approaches to the Addictions - Certification New York University

  • Clinical Practice with Adolescents - Certification New York University

  • Mindful Self-Compassion Training - Christopher K. Germer, PhD & Kristen Neff PhD

  • Executive Life Coaching - New York University

  • Institute for Life Coach Training

  • Urban Zen Integrative Therapy Training Program

  • Institute For Integrative Nutrition

    Additional Professional Training: Gottman Institute for Couples, Emotionally Focused Therapy, Hypnosis for Trauma & PTSD, Focusing Institute, Whole Body Focusing with Glenn Fleisch, Ph.D

    Ongoing workshops: Ester Perel, Bessel van der Kolk, MD, Dan Siegel, MD, Peter Levine, Ph.D, Gabor Mate, MD, Richard Schwartz, PhD, Sue Johnson, IFS, Somatic Experiencing, Trauma-Focused Treatment, Yoga Therapy, Phoenix Rising Yoga Therapy

Expertise

  • Depression (major, postpartum depression, SAD, bipolar disorder, atypical depression, dysthymia, situational depression, chronic sadness)

  • Anxiety (panic disorder, generalized anxiety, phobias, social anxiety, PTSD, fear, worry, insomnia, emotional regulation), stress management, insomnia

  • Women’s hormonal health, perimenopause and menopause mental health assessment/coaching, chronic pain

  • Trauma resolution and PTSD therapy

  • Crisis counseling, life-challenges, transitions and overwhelm

  • Obstacles, blocking beliefs and feeling “stuck” in your life

  • Dysfunctional relationship dynamics and patterns in professional and personal relationships, communication difficulties, divorce, separation

  • Fear of success and fear of failure, harshly critical of oneself and others

  • Spiritual or existential concerns, shadow work, life purpose, energetic blocks, boundary work

  • Difficulties with work and life balance

  • Addictions, behavioral addictions, substance abuse, alcoholism and compulsions

  • Performance blocks, perfectionism, self-blame, negative self-image and self-sabotage

  • Feeling unworthy, undeserving, “not enough”, personal empowerment, identification of needs and trouble saying “no”

  • Compliance, accommodation, conflict avoidance, communication difficulties and impasses

  • Narcissistic abuse identification and recovery

  • Empath and highly sensitive person (HSP) coaching

  • Codependency, family conflict resolution, submissiveness and recovery from family enmeshment, ACOA adult children of alcoholics

  • Grief, loss and bereavement

  • Recovery and post-rehab support (for individuals in all stages of recovery from addictions, alcohol, eating disorders, anxiety, depression, trauma, pre-rehab, post-rehab, residential step-down support, wellness planning, new habit maintenance and self-care)

  • EMDR Therapy, Trauma Resolution, Unblocking & Manifesting

  • Celebrity mental health expertise and high-profile, VIP clients, therapy for entrepreneurs, executives, creatives, medical professionals

Modalities

  • Psychoanalytic, Relational & Interpersonal Psychotherapy

  • Attachment-Focused Couple Therapy (traditional, non-traditional, alternative lifestyle couples)

  • Cognitive Behavioral Therapy (CBT), DBT Skills

  • Solution-Focused Brief Therapy Consultation

  • Advanced level EMDR Therapy, Parts Therapy, Integrated Internal Family Systems (IFS)

  • Couple Therapy (Traditional, Non Traditional Couples)

  • Sexual Counseling (Traditional & Alternative Lifestyle)

  • Somatic Psychotherapy

  • Positive Psychology, Positive Neuroplasticity Coaching

  • Nutrition & Integrative Medicine For Mental Health

  • Transformational & Wellness Coaching

  • Urban Zen Integrative Therapy, Reiki, Energy Medicine

  • Nutrition & Integrative Medicine For Mental Health, Nutritional Amino Acid Protocols (using precursor amino acids, fatty acids, herbal medicine, supplement recommendations for mood, anxiety, ADHD, addictions, cravings, brain fog, PTSD, and more)

  • Clinical Hypnosis

Transform

If traditional “talk” therapy has not been enough to resolve your distressing symptoms, it might be time to try a different model of care. I’ve trained in many modalities, but I find myself returning to EMDR again and again. EMDR Therapy changed my practice years ago because it works and it changes lives. It is the one treatment method that is consistently powerful and transformative for my patients, especially when other highly-effective therapies such as IFS, CBT and Somatic Experiencing are integrated into sessions. Therapy is highly-individualized, and depending on your unique needs, chosen therapy modalities may include: EMDR, Psychodynamic Psychotherapy, CBT, Internal Family Systems, Mindfulness and Somatic Experiencing®. I completed EMDRIA-approved EMDR advanced Levels I & II training and supervision many years ago and have used it in my New York City psychotherapy private practice consistently and with excellent results.

EMDR therapy is highly-effective at getting to the root cause of underlying beliefs and blocks that cause many to not benefit from traditional therapy or life coaching. EMDR treatment can elegantly help you transform surviving into thriving so you can lead a life without disruptive symptoms. Reprocessing difficult, disturbing or traumatic memories with EMDR leads to enhanced resiliency and vitality in the nervous system. EMDR treatment is an extensively researched and evidence-based method to help people recover from distressing life experiences, trauma, anxiety, panic, phobias, accidents, medical trauma and much more. EMDR is not just for trauma, it is also an excellent technique to enhance performance for athletes and creatives, or work and professional endeavors. It is especially helpful for clients who have worked hard in therapy or coaching, and find themselves wrestling with the same obstacles and patterns that initially led them to find a therapist or coach. We learned during the pandemic that EMDR can be offered to many patients virtually. Virtual EMDR is an effective and powerful tool to add to your therapy healing journey, as an adjunct to your existing therapy or as a stand-alone solution. LEARN MORE ABOUT EMDR

Teletherapy

faqs about online therapy in nYC: how does remote therapy/video therapy work?

While the technology for telemedicine has been available for decades, the pandemic made virtual therapy a necessity. Never did we imagine that so many individuals would benefit from online virtual therapy, but they did. Like many NYC therapists, I’ve been conducting virtual sessions for some time now, so I’m quite comfortable working with technology. Teletherapy is not a good fit for every person seeking counseling, and many simply prefer to conduct psychotherapy sessions in-person.

How does Online therapy work?

This New York City holistic psychotherapy and wellness practice understands that busy New Yorkers can’t always take time out of their day or week to commute to NYC therapy suites. Virtual therapy, as well as telephone therapy, is a modern option that has become the preferred way to conduct therapy and counseling for many, especially those who work or travel, couples with young children and different schedules, young adults, college students and expats. Online sessions make therapy easier for individuals struggling with social anxiety, agoraphobia, chronic illness, physical disabilities and those who reside in various parts of New York. After scheduling your online virtual session, I’ll send you a session link from my secure, HIPPA-compliant platform SimplePractice. You click on the link to my online waiting room and I admit you to my private virtual therapy office. It’s up to you to create an emotionally safe space in your home or office for our conversations. All you need is robust access to the internet. You can use your computer, IOS/Android phone, iPad, or any other tablet-enabled device. Most laptops have a built in videocam and mic, which makes it very easy.

What kind of therapy is offered virtually?

Online sessions are treated the same way as face-to-face sessions, using the same evidence-based therapy modalities, including Cognitive Behavioral Therapy (CBT), EMDR, Internal Family Systems (IFS), trauma therapy, psychodynamic psychotherapy, somatic psychotherapy, life coaching, wellness coaching and stress management. In fact, we’ve learned that remote EMDR can be just as effective for trauma resolution and other concerns as in-person EMDR. Of course, not everyone or every situation should be treated remotely, therefore, it’s important to reach out to potential therapists to determine if your situation is appropriate for virtual therapy. If you feel hesitant about discussing issues over video, you can even turn your webcam off, so that you can see your therapist but not be seen. Research now demonstrates that therapy sessions conduced by telehealth are just as effective as face to face therapy. Read the research.

Who can benefit from virtual therapy?

Just about anyone can enjoy private, confidential and convenient access to high-quality therapy. The decision to seek therapy with a highly-experienced psychotherapist can help you have healthier relationships, gain new perspectives, reach your goals and remain resilient during stressful and challenging times. Therapy can help you feel less alone with your problems, as well as feel supported as you work to improve your circumstances. Life in New York City offers a unique set of challenges. A fast-paced lifestyle and hectic schedules lead to high levels of stress and little time for rejuvenation and restoration of the nervous system. If you are experiencing feelings of anxiety and depression, loneliness, loss or are struggling with substance use or unresolved trauma PTSD, you are not alone. Holistic Psychotherapy & Wellness Manhattan offers highly-effective, evidence-based counseling and therapy practices, as well as an integrative psychotherapy philosophy that incorporates a range of helpful, healing strategies, individualized to meet your unique needs. Because I am a licensed psychotherapist in New York, I can see you whether you live in the NYC metro area or anywhere in the state. You have many modern options to help you get the therapy you need, including BetterHelp, TalkSpace, and of course, all the licensed psychotherapists and psychologists on Psychology Today who continue to offer high-quality therapy in the US and worldwide.

Using you health insurance benefits to assist with the cost of therapy

Holistic Psychotherapy & Wellness Manhattan is In-Network with BCBS & Aetna, and Out-of-Network with most health insurances. I have also been reimbursed by Aetna, Cigna, BCBS, Emblem, Oxford, United and many more for out-of-network mental health services. Most of my clients are compensated for about 50-100% of my fees. Your insurance will refund a large portion of each session, as long as you have met your Out-of-Network deductible. If you have an Out-of-Network plan and have met your Out-of-Network deductible, your health plan will mail the partial refund in the form of a check to your home within a few weeks after each appointment.

How can an Integrative Psychotherapy & Wellness Practice enhance your life?

  • Gain support through a personal crisis, transition, loss, trauma or challenging situation that causes personal or relational distress

  • Heal codependency and feel empowered, autonomous, safe and secure in your life as self-esteem naturally increases

  • Find relief for sadness, depression and chronic depression with interpersonal psychotherapy, cognitive behavioral therapy and EMDR

  • Uncover unconscious conflicts and blocking beliefs that may be sabotaging your success and happiness

  • Address dissociation, body image, eating disorders, compulsions, addictions, substance use or abuse and obsessions

  • Learn to identify important thoughts, feelings, emotions, motivations and unconscious internal conflicts with insight-oriented therapy

  • Develop enhanced self-awareness as well as empathy and compassion for self and others with relational therapy

  • Break through blocks in intimacy, detach from unhealthy relationships and break patterns of repetition in significant relationships

  • Learn to identify triggers that lead to anger, confusion and relationship dysfunction in couple and relationship counseling

  • Develop effective, assertive communication skills to benefit personal and professional relationships

  • Learn more adaptive coping skills, self-care rituals, self-acceptance and mindfulness to create a healthy work-life balance

  • Uncover patterns of crippling perfectionism that interfere with achievement, success and personal happiness using EMDR

  • Process and heal painful feelings of loneliness, disappointment, sadness, loss, grief, guilt, shame, anger, envy and fear

  • Resolve trauma and abuse symptoms, develop healthier boundaries and heal early attachment wounds with EMDR Therapy

  • Recommendations for protocols using precursor amino acids, fatty acids, herbal medicine, supplements for mood, anxiety, ADHD, addictions, cravings, brain fog, PTSD

  • Diagnose & identify reproductive hormone-related (peri-menopause, menopause) anxiety, depression, insomnia, brain fog, low energy, pain, migraines, IBS, fibromyalgia

  • Learn self-care, meditation, breathing techniques, energy medicine & somatic therapy practices to regulate the nervous system

  • Obtain consultations for referrals to psychopharmacologists, psychiatrists, psychologists and other allied professionals