Why you shouldn’t buy a light therapy device from Costco (how to find a good light therapy device)

Here in Portland, up to 20-30% of the population suffers from decreased mood and fatigue during the dark and cloudy days of winter. This has been called the “winter blues” and more serious variants of this are typically called Seasonal Affective Disorder.  By a long shot, the most well researched and effective treatment for this kind of seasonal depression is light therapy. Light therapy is fairly simple and typically involves sitting in front of a special kind of light every morning. It works really well and most people respond within in two weeks of beginning the treatment. If you have symptoms of seasonal affective disorder or the “Winter Blues” you should seriously consider getting light therapy device.

Unfortunately, the manufacture and sale of light therapy devices is completely unregulated by the government. This means that there are a lot of people out there buying devices which are not effective and who may end up concluding that light therapy does not work for them, when actually they bought a poorly-made device. It’s not easy to tell scam light therapy devices from legitimate ones, but below I’ll give you some tips that might help.

Typically, a good light therapy device is a little expensive. If someone is selling you a broad spectrum light therapy device for under $150, you should probably be suspicious (though there are some exceptions). It’s likely that it has not been manufactured to the standards used in the research studies and could be ineffective or potentially dangerous for your vision. Tested devices are typically 10,000 lux (a measure of intensity) and should say something about being “broad spectrum” and have shielding from harmful “UV rays.” It’s the UV rays that are put off by fluorescent lights that can harm your eyes.

Unfortunately, one of the biggest sellers of questionable light therapy devices is Costco. I was at Costco the other day and was able to take some shots of the product they are selling:

It would be hard to tell why this device won’t work, unless you know a bit about light therapy devices and also look at the small print below:

Fortunately, they actually specify how much light it is emitting so that you can tell that it won’t work. The light above only provides 4,500 lux at 6 inches from your eyes. A well manufactured device provides 10,000 lux at a comfortable distance (typically 12-24 inches). Who would ever sit with a light only six inches from their eyes? And even if they did, it would still not be strong enough to be effective without spending a lot of time in front of it. If you spend your money on this device, it’s wasted.

So my bottom line recommendation is DO NOT BUY THIS DEVICE. It will not work.

If you would like some advice on products that are worth the investment, here are two recommendations:

#1 – Carex Daylight classic

This device is probably the best one available on a consumer website like Amazon. The benefits are that it is up on a stand, which makes it more likely that the light will be positioned above your eyes, which is key for light  therapy to work. The downside is that the device needs to be about 12″ away from your eyes to be at the recommended 10,000 Lux that has been used in studies. If you carefully follow the directions, and sit with it relatively close to you, then most people get good benefits. This is the device suggested by the Center for Environmental Therapeutics, which is a non-profit dedicated to making light therapy more accessible.

#2 – Philips goLITE BLU 

Like the other light by Phillips, this is a quality product but at a more affordable price tag.  An additional bonus is that this product is better suited for packing up and taking with you. This light is based on newer research about the how blue light affects our eyes and circadian rhythms. It’s not quite as proven as the broad spectrum light above, but is a good alternative to the brighter, white lights if those bother your eyes or you want to try something more portable. Just make sure when you are using it that you are looking at something below the light (the light needs to hit your eyes from above).

Update: Don’t be fooled. Costco continues to sell the Verilux light above, but with a new name. The box for the new light says it’s a bit brighter, but still needs to be 6 inches from your eyes to work. That’s an impractical distance for most people. Don’t buy it. The new name for the questionable device is the “Verilux Happylight Liberty.” Given the poor track record of this company, I’d consider this new device similarly questionable. Avoid it. 

If you’d like some suggestions on other light therapy devices, or general info about SAD, click here.

Gratitude — It’s not just for Thanksgiving anymore

“Gratitude bestows reverence, allowing us to encounter everyday epiphanies, those transcendent moments of awe that change forever how we experience life and the world.” –John Milton

It’s a rainy, cold November day. Everyone is home from school and work. Uncle Fred from Umatilla and Aunt Betty from Wenatchee are sitting on the couch arguing about who’s going to win the big game. Is that turkey I smell?…Wait, it must be that special day when I’m supposed to be thankful!

Thanksgiving is a beautiful tradition. It’s one of my favorite holidays. And yet, once the last bit of stuffing has been stuffed and the last antacid has been swallowed, what happens the thankfulness? Like champagne, gratitude seems to have become a “special occasion” sort of thing; we indulge in it when it’s a big event, but it’s not really a part of our everyday life.

I think the same thing can happen in intimate relationships. When we first enter into an intimate relationship, we often go out of our way to do those thoughtful little things for our partners — flowers, cooking a special meal, giving a backrub. And, in the beginning, we are also usually pretty conscious about expressing our gratitude for things, in part, because those things are pretty obvious and easy to notice. But time passes, toilet seats are left up, dog hair accumulates, soccer practices seem to multiply, and amidst that everyday life, we become less aware of the ways in which the people in our lives continue to do loving things for us. And if we’re not aware, it’s tough to be grateful.

And yet, even though there may be less flower-giving and candlelight dinners, it may be the case that if we stop to notice, we’d see our partners doing all sorts of loving things for us and for the relationship — you know, like offering to pick up dinner when they know you’ve had a busy day or taking the dogs for a walk even though it’s raining and it’s technically “your day” to walk them. Noticing and expressing gratitude for these “everyday interpersonal gestures” (that’s psychobabble for thoughtful behaviors) is not only a nice thing to do, it appears to be very important in terms of maintaining connection and satisfaction in long-term relationship.

Researchers at the University of North Carolina at Chapel Hill, the Universities of California, Santa Barbara, and Los Angeles found that expressing gratitude for these “everyday interpersonal gestures” can have profound impact on long-term romantic relationships. When a partner expressed gratitude for something their partner did, both partners reported feeling significantly more connection and deeper satisfaction in the relationship. In another study, researchers found that when they asked people to notice things for which they were grateful, those people reported being 25% happier at the end of 10 weeks than were people who were asked to notice either hassles or just regular events. So, it’s pretty clear that expressing gratitude is beneficial both for the receiver and the one expressing the gratitude.

As I said above, the first step in increasing how grateful you are in your intimate relationship is noticing things for which you are grateful. So, here are a couple of ideas you might want to incorporate into your “everyday-can-be-thanksgiving” tradition:

  1. Practice a gratitude meditation: There are lots of them available out there on the web. Here is one gratitude meditation that I like (It’s titled – Guided meditation on Kindness & Gratitude and you’ll find it on the middle of the page under “Other meditation practices)It doesn’t have to be anything complex. Just commit to spending a specified amount of time every day in quiet, reflecting on those things for which you are grateful. You could even do this with your partner.
  2. Start a gratitude listserv: Gather together a bunch of friends and family that would all like to work on this idea of gratitude. Once a week, everyone sends an email to everyone else in the group stating at least one thing for which they are grateful. You may be surprised at how it also deepens your relationships with those in the group.
  3. Carry it with you: Find a symbol to remind you of your intention to be more grateful. It can be a rock, a leaf, or just an index card that says “gratitude”. Put it in your purse or wallet. Then each time you see it, see if you can notice one thing for which you are grateful right in that moment.
  4. Make it a ritual: When you are talking about your day with your partner, make sure that among the “My boss is stressing me out” and “What are we going to do about that roof leak” you also tell your partner something you noticed that they did for you or your relationship that you appreciated.
  5. It’s not all about the things: When you’re focusing on being grateful for your partner, don’t just focus on the things that he/she does for you. Also let your partner know how grateful you are for who they are as a person. Is your partner funny, or thoughtful, or creative, or hard working? When you notice those qualities in your partner that you appreciate, tell him or her about it.

Just the other day, I received an email from a friend and colleague and she closed it with “Have a happy gratitude day.” How lovely! Consider making gratitude a more central part of your relationship every day, not just when you break out the good silverware. You won’t be disappointed in the results.

Riding the Wave: Using Mindfulness to Help Cope with Urges

Changing a habit is hard. Anyone who has tried to change their eating habits, quit smoking, start an exercise program, or stop drinking or using drugs can tell you how difficult it can be at times to change old habits. In my last post I discussed how slipping (i.e., falling back into an old habit) can sometimes set us up for a relapse (i.e., continuing a habit beyond the initial slip) due to a phenomenon known as the Abstinence Violation Effect. In this post, I’d like to talk about a technique that can help you before you slip, a technique called “urge surfing.”

What is Urge Surfing?

Urge surfing is a technique attributed to the late psychologist Alan Marlatt, Ph.D., a pioneer in the field of addictions treatment. We can think of an urge as an impulse to engage in an old habit, such as drinking or using, and they are often experienced as physical sensations in the body. Urges are like waves in that they rise in intensity, peak, and eventually crash.

Here’s a brief exercise you can do to explore this technique: Stop for a moment and think about an urge that you recently experienced. As you think about this urge, see if you can notice all the sensations that come up as you think about it; see if you notice how these sensations shift across time. Use your breath to help you ride out the waves (i.e., the urge); like a surfboard, you can simply observe your breath as you ride out each wave that arises. Congratulations! You just successfully surfed your first urge!

Urges usually peak between 20 – 30 minutes, if we let them. What I mean by this last phrase is this:  if we adopt an open and curious attitude about the urge and watch it without doing battle with it, then the urge will subside. However, if we go to battle with our urges (e.g., “I can’t stand this urge! I have to get rid of it right now!”), they will subside more slowly. Worse, by giving into urges we can actually strengthen them and we can lose confidence in our abilities to change our old habits.

How to Surf an Urge

There are slight variations of the urge surfing technique, but most include the following steps:

  1. Take a few moments to notice where you experience urges in your body. You can do this by taking some time to sit in a quiet place, and if you are comfortable doing so, closing your eyes, and just allowing your attention to go to the place(s) in your body where you tend to feel urges. For some people they notice that urges are most connected to sensations in their abdomens; for others, they notice urges in their mouth (e.g., their mouths water when experiencing an urge to drink). There is no right or wrong place for an urge to be located. What is most important is that you notice where in your body you most notice urges when they show up. If you are having trouble noticing urges, think back to a time when you experienced an urge to engage in an old habit. If you are concerned that thinking about a particular instance when you had an urge will lead to doing the habit, pick a situation where the urge was less strong or you successfully prevented yourself from acting on the urge. Picture the situation as clearly as you can in your imagination. Once the situation is clear in your mind notice where in your body you are experiencing the urge.
  2. Once you have noticed what part of your body is most connected to the urge, focus your attention on it (if you notice that more than 1 area of your body is connected to an urge, start with the place that you most intensely notice the urge). Take note of the sensations you are having in this body part. What do the sensations feel like? Does it feel like pressure, tingling, warmth, or coolness? How much space do these sensations take up in this place in your body? Try to draw an outline around the place where the sensations are felt. See if the sensations have any movement. Some people tend to associate sensations with colors or temperatures. Check to see if you notice any colors or temperature associated with these sensations. For some people it can be helpful to silently describe the sensations in an objective and non-judgmental manner (e.g., I notice warmth and tingling in my belly). If more than one part of your body is associated with an urge, go through this exercise with each body part.
  3. Bring your attention to your breath. You do not need to change your breathing at all. Notice your breath for the next 1-2 minutes. Some people find it helpful to bring their attention to a particular place in their body where they notice their breath (e.g., the abdomen); some find it helpful to say phrases like “breathe in,” “breathe out” as they inhale and exhale.
  4. Gently shift your attention back to the part(s) of your body where you notice the urge. Allow yourself to notice whatever sensations come up in these places. If it becomes overwhelming to notice the sensations, gently return your attention back to breath for a few moments and then go back to noticing the sensations connected to the urge. You may find it helpful to imagine sending your breath to the parts of your body that are associated with the urge (e.g., you can breathe into your shoulders and let your breath fill up that part of your body). Notice if and how the sensations change as you watch them. Be sure to practice this step for at least 1 minute, but longer is probably better.
  5. This next step is optional, but I have found it to be helpful in my own life and in working with people with addictions. Imagine that the sensations connected with your urge are a wave. Watch the wave rise and fall over and over again as the intensity of your sensations peak and subside. Your job is to use your breath as a surfboard to ride these waves. No matter how big the wave gets, no matter how much you feel as if the wave will consume you, you are a skilled surfer and you will use your breath to ride each wave as it comes. Practice this for at least 1 minute, but again, longer is probably better, particularly the first few times you practice this.
  6. As you’re riding the wave (or just noticing the sensations), you may find it helpful to silently describe the sensations in an objective and non-judgmental way (e.g., I notice warmth in my belly that is increasing…the warmth in my belly is decreasing and my belly feels cooler).
  7. When you are done surfing the urge, take a moment to thank yourself for taking the time and being willing to do something different with your urges. You can also use this time to set your intention for the next few minutes, hour, or day.

That’s it! With practice urge surfing gets easier and you may discover that you are an excellent surfer. You can practice this technique in two ways:

  1. You can start urge surfing whenever you notice yourself having an urge.  This can be a particularly useful technique when you notice urges to go back to old habit that you are trying to break.
  2. You can practice this on a regular basis by setting aside time to practice using the technique. Many people find that listening to an audio recording of the technique is useful at first.  Through this kind of formal practice, you can get better at urge surfing so that you’re better at it when you need it.

You’ll find that, with practice, urges will become easier to ride out. You may even start to feel a sense of pride or accomplishment as you successfully surf urges and act according to your values, instead of according to your urges.

If you would like to learn more about how to use techniques like urge surfing to cope with urges, the book below is a good option:

Should I Be Taking “Alternative” Supplements for Anxiety?

More and more, I have clients coming into see me who are taking over-the-counter “natural” or “alternative” products. Sometimes these are recommended by a specialist, sometimes by a friend. I was curious about these alternative products and did a little research about what they are—and whether there’s any evidence of their effectiveness. I came across a helpful 2010 review by Zoberi and Pollard, two researchers at the Saint Louis University School of Medicine, and supplemented their paper with some of my own investigations.

St John’s Wort

St John’s Wort (Hypericum perforatum) is derived from a plant species and more commonly known as an alternative treatment for depression. It’s available in natural food stores in capsule form, tinctures, and even tea. There’s some evidence that St. John’s Wort may be helpful for mild depression, but there’s no research to suggest it helps with anxiety.


I first heard about Valerian (Valeriana officinalis) years ago when it was touted as a sleep aid and even tried it once for sleep (seemed okay). Valerian is a perennial flowering plant that blooms in the summer. It’s been used as a sedative, historically, which is probably why it’s being marketed as a possible supplement for anxiety. Like St John’s Wort, it can be found as capsules, teas, and tinctures.

A review by the Cochrane Collaboration, a non-profit organization aimed at providing the public with summaries of the best scientific medical research, examined available studies on Valerian. Only one study was considered of a high enough quality for the Cochrane authors to seriously consider it.
The Cochrane Review concluded that Valerian had no more of an impact on anxiety than a non-active placebo. Consequently, there’s no reason to believe at this time that Valerian is useful for treating anxiety.


Kava (Piper Methysticum) is a plant found among islands in the Pacific Ocean that many Polynesian cultures traditionally turned into a drink and used as a sedative or relaxant. People still make Kava into a drink, but pharmaceutical companies have also converted it into pill form.

The Cochrane Review also looked at the impact of Kava on anxiety. Their results were a little more promising than Valerian: the Cochrane Review concluded that there is some evidence that Kava may have a small impact on reducing anxiety.

The Cochrane Review didn’t feel the side effects of Kava were anything to worry about, but I have elsewhere read that Kava may cause liver damage. Not everyone has problems with Kava, but some people have required liver transplants because of it. The FDA issued a warning about these dangers in 2002, and my understanding is that government funding for studies of Kava were suspended (Zoberi & Pollard, 2010).

Consequently, it appears the potential benefits from Kava are a little iffy and don’t necessarily outweigh the potential dangers. (At the very least, I’m not comfortable recommending something that may cause liver damage.)

Some conclusions and reflections

It’s hard to sort through information on alternative products, as enthusiasm for them often outstrips the research. Perhaps some of you know people who swear by these products. An important point to consider is placebo.

We often think of placebo as something that doesn’t work, but this is only partially true. Many people respond to being given a pill or treatment—more so than they would have if they were not given the pill—even if there’s nothing active in the pill (i.e., sugar). This is a crucial point: believing that a pill or supplement will work can often result in short-term benefits, even if the product has no actual benefits. (If you’re interested, here’s a great short video on the power of the placebo effect.) Consequently, if you read the Cochrane Reviews that I linked to, you’ll notice that they focused on studies where people were blind to whether they were being given the alternative treatment or something inactive.

Another point is that, as Kava illustrates, a substance can be natural and still toxic. Too often I see people equate “natural” with “harmless.” Much of the time this is true, but it’s important to be careful.

At this point, I couldn’t recommend any alternative supplements for anxiety based on the research I’ve seen.

Anxiety Treatment at Portland Psychotherapy