Bustan Therapy, Los Angeles, CA (2025)

12/05/2025

Adrenal Fatigue is a condition that occurs when the adrenal glands are overworked and unable to produce enough cortisol and other hormones. CPTSD (Complex PTSD) leads to adrenal fatigue by keeping the body’s stress response system (HPA axis) constantly activated, flooding the body with stress hormones like cortisol and adrenaline, eventually causing the adrenal glands to become overwhelmed, depleted, and dysregulated.

How CPTSD triggers adrenal fatigue:
1. Chronic Activation.
Trauma, especially childhood trauma, can permanently sensitize the brain’s threat detection system, making it perceive everyday situations as dangerous.

2. Constant “Fight-or-Flight.”
This keeps the HPA axis firing, continuously releasing adrenaline and cortisol.

3. Adrenal Overload.
The adrenal glands work overtime to produce these hormones, getting “exhausted” or “depleted” from the sustained demand.

4. Hormonal Imbalance.
This results in deranged cortisol levels and altered adrenaline, disrupting normal body functions.

5. System Adjustment (Dysregulation).
The brain may try to down-regulate its response to the overwhelming signals, leading to a state where the body feels perpetually exhausted and less reactive, even if cortisol levels are technically high.

Symptoms experienced:
1. Profound Fatigue: A common symptom as the body can’t recover from constant stress.
2. Apathy & Depression: The system becomes so dysregulated that normal reactions fade, leading to emotional numbness.
3. Physical Pain: High cortisol can increase pain sensitivity, and tension from hypervigilance causes muscle aches.
4. Sleep Disturbances: Cortisol surges at night can wake you up, leading to poor sleep.
5. Brain Fog, Memory Issues, Anxiety, Mood Swings:Affects cognitive and emotional regulation.

12/04/2025

Love can be considered unconditional, a deep feeling for someone’s well-being, while relationships are built on conditions like mutual respect, shared values, and specific agreements, making them conditional and requiring effort to be sustainable. A relationship cannot survive solely on “unconditional love” if it lacks the conditions necessary for partners to coexist and thrive, such as clear boundaries and mutual effort. Healthy relationships have to have conditions otherwise every last one of us could behave however we wanted to and rest on our laurels that relationships wouldn’t go anywhere.

Unconditional love:
• A core feeling: Unconditional love is often described as a feeling or state of being that exists apart from any specific action or outcome. You might feel it for a child even if they make mistakes.
• Not dependent on action: It’s the idea of loving someone for who they are, rather than for what they do. This love can persist even if a relationship fails.
• An expression of self: Some see unconditional love as an expression of your kindest self, which can be maintained even if a relationship ends.

Why Relationships are not unconditional:
• Agreements and boundaries: Relationships require agreed-upon expectations, rules, and boundaries that both people must uphold to work. • Mutual effort: Relationships are a partnership that requires active participation, effort, communication, and compromise from both sides.  • Conditions for success: Key conditions for a relationship include mutual respect, trust, and effective communication. • Consequences: You can love someone unconditionally but still choose to end a relationship if the other person’s behavior is consistently harmful or if you are not being treated with respect.  .

12/03/2025

Distraction:
• Purpose: To temporarily shift focus from overwhelming feelings to self-soothe and re-regulate.
• Benefit: Can help lower immediate distress, slow heart rate, and block pain signals. It can be a healthy coping skill when used intentionally and briefly.
• When to use: When you need a short break to regain perspective, especially for stressors you cannot immediately act on.
• Examples:
* Going for a walk or exercising.
* Listening to music or a podcast.
* Mindfulness or meditation.
* Calling a friend to talk about something else.

Avoidance:
• Purpose: To numb out painful emotions and completely avoid dealing with a stressor, fear, or problem.
• Consequence: Does not solve the problem, and can lead to compounding issues, isolation, and negative consequences over time.
• When to use: Never, as it is a maladaptive strategy that hinders progress and emotional growth.
• Examples:
* Avoiding a difficult conversation with a partner.
* Staying home to avoid triggers after a traumatic event.
* Binge-watching TV all night instead of doing an important task.
* Turning to substance abuse to numb feelings.

How to tell the difference:
The same activity can be either distraction or avoidance depending on the context and your intent:
• Context is key: Playing a video game is a distraction when you can’t do anything about a problem right now, like waiting to hear back about a job interview. It is avoidance if you are playing video games instead of studying for a test you are unprepared for.
• Agency matters: Distraction is a temporary “time-out” to give you strength, with the intention of returning to the problem. Avoidance is when you are not moving toward the problem at all, and it becomes a way to actively run from it.

12/02/2025

1. Box breathing.
This technique helps regulate a fight-or-flight response.
Inhale slowly through your nose for a count of 4 seconds.
Hold your breath for a count of 4 seconds.
Exhale slowly through your nose for a count of 4 seconds.
Hold your breath again for a count of 4 seconds.
Repeat this “square” cycle for a few minutes.

2. 4-7-8 breathing.
This breathing exercise looks a bit different from the previous one, being that it requires you to hold your breath and exhale for longer intervals.
Sit or lie down comfortably and exhale completely through your mouth with a whooshing sound.
Place the tip of your tongue against the roof of your mouth, behind your upper front teeth.
Close your mouth and inhale quietly through your nose to a mental count of 4.
Hold your breath for a count of 7.
Exhale completely through your mouth with a whooshing sound for a count of 8.
Repeat for up to four cycles.

3. Hum breathing.
This method can activate the vagus nerve for a calming effect.
Inhale through your nose.
As you exhale, close your mouth and make a deep, humming sound.
Feel the vibrations in your body.
Repeat several times.

4. Physiological sigh.
This last research-backed exercise also focuses on activating our vagus nerve to induce relaxation. For this exercise, you will take a deep breath in through your nose, and at the very last moment when you feel you can’t take in any more air, you will take another brief breath in (essentially two inhales), before exhaling for longer than your inhale and making an audible sighing noise. To make it simpler, try breathing in for approximately four seconds, before taking another quick inhale for two seconds, and then sighing as you exhale for eight seconds. Repeat the cycle as many times as necessary.

12/01/2025

Back in ancient times, our stress response was built for survival. Our biological systems, brilliantly designed for short-lived physical threats like surviving a storm, are now chronically activated by modern psychological stressors that don’t go away.

This conflict between our ancient biology and our modern culture is the root cause of why so many of us feel worn down and get sick. Our bodies are stuck in an emergency that, for our nervous system, never ends. Below are a few differences between survival instincts in ancient vs modern times.

Ancient survival mode:
* Triggered by immediate, physical threats: The “fight-or-flight” response was primarily activated by existential dangers like hunting, being hunted, or natural disasters.
* Focused on physical survival: The body responded with a cascade of physical changes: increased heart rate, adrenaline, and tense muscles to prepare for immediate action.
* A necessary tool for life: This biological response was essential for survival and not a source of chronic stress in the same way it is today.
* Examples of stress: Famine due to a failed harvest or a siege, which threatened physical survival.

Modern survival mode:
* Triggered by non-physical stressors: The same “fight-or-flight” response can be activated by psychological threats like work deadlines, financial worries, or relationship problems.
* Leads to chronic stress: The body’s stress response can be activated so frequently that it becomes a near-permanent state, often described as feeling “stuck” or “on edge”.
* Strains the body: This chronic activation can lead to exhaustion and affect physical and mental health over the long term.
* Examples of stress: A looming work deadline, a friend’s falling out, or an unexpected bill.

11/30/2025

We all have limits emotionally just like we all have limits physically. And just like you can increase your physical strength, you can also increase your emotional strength. Emotional capacity is your ability to take on emotional discomfort in a healthy manner. Some emotional experiences are uncomfortable, but ones that you can handle. They are inside your capacity. Whereas other emotional experiences go outside your capacity and take some training to navigate.

Tips to increase emotional capacity:

1. Practice mindful awareness.
Pay attention to your thoughts and emotions without judgment. Try to notice and name the emotion you are feeling, which can reduce its intensity.

2. Lean into discomfort.
View emotional challenges as opportunities to build strength. Actively engaging with feelings, rather than avoiding them, strengthens your “emotional muscles”.

3. Track physical sensations.
Notice how emotions feel in your body. You can start with a small amount of emotion and track its physical sensations, such as a pit in your stomach or heat in your face.

4. Challenge negative thoughts.
Replace negative or unhelpful thought patterns with more positive and realistic ones. Identify the stories you tell yourself and evaluate their accuracy.

5. Use grounding and regulation techniques.
When emotions feel overwhelming, use techniques like mindful breathing or softening muscle tension to help balance your nervous system.

6. Prioritize self-care.
Ensure you are getting enough sleep, eating regularly, exercising, and avoiding mood-altering substances to maintain emotional resilience.

7. Start small.
You don’t have to tackle huge emotional challenges at once. Practice with something slightly unpleasant to build your ability to sit with and work through it.

11/29/2025

1. Self-soothing touch.
•The Butterfly Hug: Cross your arms in front of your chest, with each hand on the opposite collarbone or upper arm. Gently and rhythmically alternate tapping one hand, then the other.
•Gentle Massage: Lightly tap or massage your face, head, neck, chest, and shoulders to help calm your nervous system.

2. Breathing exercises.
•Longer Exhale: Inhale through your nose for a count of 4, then exhale through your mouth for a count of 6 or longer.
•Three-Fold Breath: Exhale completely. Inhale slowly through your nose, moving the breath from your stomach up into your chest and finally to the top of your head. Hold briefly, then exhale through your mouth.

3. Grounding and sensory exercises.
•5-4-3-2-1 Method: Name 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. This pulls your focus into the present moment.
•Feel the Ground: Stand with your bare feet on the floor and focus on the sensation of the ground supporting you. You can also try standing on one leg or your tiptoes to focus on balance.

4. Movement and embodiment.
•Alternating Leg Taps: Sit or stand and gently tap your right thigh, then your left, alternating between legs. This activates the right and left sides of your brain, helping you to re-orient yourself away from repetitive thoughts.
•Expressive Movement: Put on some music and move your body in any way that feels good, whether that’s dancing, gentle stretching, or simple, intuitive movements.
•Shoulder Shrugs: Inhale and lift your shoulders up toward your ears, then release them completely on the exhale. Repeat this to release physical tension that often accompanies mental tension.

11/28/2025

1. Moving my body.
Our bodies need to move. They need to stretch, reach, twist, bend, step, sweat, to whatever degree works for our unique shapes and constitutions. They don’t care if it’s at the gym, out in the neighborhood, or in your living room—they just need activity. It’s not just about “staying in shape.” It’s about your immune health and your mental health, as well!

2. Pausing before reacting.
Pausing before reacting creates space between a trigger and your response, allowing you to shift from a fear-based, automatic reaction to a more thoughtful, self-aware choice. This break helps calm your nervous system, engage your prefrontal cortex for rational thought, and prevent impulsive or destructive reactions that often stem from trauma-related survival instincts. By developing this skill, you can regain a sense of control, improve emotional regulation, and foster healthier responses in difficult situations.

3. Contributing to something greater than myself.
Volunteering and contributing foster a sense of purpose and community, which reduces isolation and improves mental well-being. Engaging in meaningful activities activates the brain’s reward system, releasing “feel-good” chemicals like serotonin and dopamine, while also providing structure and opportunities to build social skills and confidence.

4. Connecting with nature or another safe person.
Connecting with nature and people is important for trauma recovery because both provide a safe, non-judgmental space to regulate the nervous system, reduce stress, and rebuild a sense of self and belonging. Nature therapy lowers stress hormones like cortisol and boosts “feel-good” chemicals like serotonin, while human connection in groups like peer support can help process emotions and combat isolation.

11/27/2025

We often hear how important family is, especially during the holidays, when every media platform depicts a wholesome, perfectly put-together family portrait. But for most people, it’s not this idealized image. There are lots of definitions of what a family looks like, and they’re not always about sharing the same DNA or being legally linked. Chosen family is specifically focused on a connection with people based on a mutual support system rather than a biological connection or because they’re the people you grew up with. The connection in a chosen family is purely based on support, love, and respect.
Below are a few ways chosen family can aid in the healing journey and help survivors navigate and overcome their trauma.

1. Healing relational wounds: Chosen families can help heal the “relational wounds” from a lack of nurturing or safety in one’s biological family. These intentional relationships replace the obligation of biological ties with mutual love, respect, and understanding, allowing for positive experiences that reshape a person’s view of what healthy connections look like.
2. Building new attachments: They provide a chance to build new, healthy attachments and re-learn how to trust and connect with others in a supportive way.
3. Psychological safety and validation: They create an environment of psychological safety, providing much-needed validation for mental health struggles and past traumas that may have been dismissed by others.
4. Sense of belonging: They offer a reliable source of love and belonging, making individuals feel less alone and more connected.
5. Creating new rituals: Individuals can actively create new traditions and rituals within a chosen family, which helps build a sense of shared meaning and history separate from past trauma.

11/26/2025

At Thanksgiving, people may grieve the loss of loved ones, the loss of a relationship, or the loss of old traditions. Below are some common situations that might feel especially challenging right now and tips to cope.

Common grief triggers:
1. The empty chair: A person’s absence is often most keenly felt when a place setting, a familiar chair, or an empty spot at the table is a reminder of them.
2. Altered traditions: Activities or rituals that were once joyful can now trigger pain because they are no longer the same.
3. Changes in family dynamics: Loss of a relationship can alter the entire family dynamic, making previously joyous gatherings difficult to navigate.
4. Triggers from others: Conversations with guests or even seeing photos of the person who is gone can bring up strong emotions.
5. Pressure to be festive: The expectation to be happy and grateful can clash with the reality of grief, leading to feelings of sadness or even guilt for not feeling festive.

How to cope with grief:
1. Acknowledge the loss: It’s okay to not feel grateful and to allow yourself to feel your emotions. You can express your grief by setting a place for a loved one or lighting a candle in their memory.
2. Adapt traditions: Find new ways to create meaning, such as creating a memory playlist, sharing stories, or making a favorite dish of your loved one.
3. Set boundaries: Don’t overcommit. It is okay to decline invitations or step away for a break if you are feeling overwhelmed.
4. Connect with others: Talk to people who understand, or find others who are also experiencing grief. You can also reach out to support groups or forums.
5. Practice self-care: Grief is exhausting. Allow yourself time to rest and recharge, and don’t feel guilty for having moments of joy or happiness.

11/25/2025

1. Creating conflict and distance.
* Criticizing and blaming: Constantly focusing on your partner’s flaws and picking fights, which can include using the silent treatment or withholding affection.
* Pushing them away: Emotionally or physically distancing yourself, avoiding intimacy, or “testing” their commitment by pushing them away.
* Avoiding conflict: Instead of resolving issues, you might avoid them or pretend “everything is fine” even when you’re upset, making it difficult to resolve conflict.

2. Lack of effort and commitment.
* Withholding effort: Placing other priorities, like work or hobbies, ahead of the relationship or spending time with people who might jeopardize it.
* Non-committal behavior: Avoids discussing the future of the relationship, gives mixed signals, or ends things abruptly when a relationship starts to become more serious.
* Being unavailable: Being emotionally or physically unavailable, or constantly seeking emotional or physical affairs with other people.

3. Unrealistic expectations and negative thought patterns.
* Unrealistic standards: Setting impossibly high standards for your partner or the relationship.
* Focusing on the negative: You can only see the imperfections and small flaws in your partner or the relationship, and you compare your current partner unfavorably to past ones.
* Negative predictions: Making unfounded negative predictions about the future of the relationship.

4. Control and fear.
* Controlling behavior: Trying to control your partner or their actions.
* Gaslighting: Manipulating your partner into doubting their own perceptions.
* Fear-based actions: Behaviors driven by a fear of getting hurt or abandoned, such as being overly needy or, conversely, excessively distant to prevent perceived rejection.

11/24/2025

Expectations:
* A perfect, picture-like family gathering.
* Effortless joy and gratitude throughout the entire holiday.
* A harmonious experience with no tension or stress.
* A feeling of perfection that matches social media and advertising.

Reality:
* Stress and burnout: The pressure to host, cook, and manage expectations can be overwhelming.
* Emotional dissonance: The conflict between feeling internal emotions and the external pressure to be happy can cause irritability and exhaustion.
* Family dynamics: Unresolved conflicts or complicated relationships can resurface, leading to tension and emotional distress.
* Social comparison: Seeing idealized versions of holidays on social media can lead to feelings of inadequacy.
* Grief and loss: For those who are grieving or experiencing difficult life changes, the holidays can bring up sadness and a sense of loss.

Coping strategies:
* Set realistic expectations: Accept that no holiday is perfect. Focus on what is genuinely meaningful instead of what you think it “should” be.
* Prioritize self-care: Make time for activities that help you relax and recharge. This includes getting enough sleep, eating balanced meals, and limiting alcohol or caffeine.
* Establish boundaries: It’s okay to say “no” to certain invitations or requests to avoid overcommitment and resentment.
* Manage family dynamics: Focus on your own feelings and actions and model graciousness. You don’t have to control others’ behavior.
* Connect in meaningful ways: Focus on quality over quantity. Consider smaller gatherings, one-on-one time, or virtual check-ins if that feels more manageable.
* Honor your feelings: Allow yourself to feel a mix of emotions. Acknowledge grief and sadness as valid feelings, rather than fighting them.

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