Holiday Survival Guide

The holidays are marketed as a happy time of year, and they may be for some people, but for many the holidays are a very difficult time.   The holidays are full of nostalgia and visions of a perfect family which can bring up feelings of loss and sadness for those who did not have idyllic childhoods and happy homes.  The version of a holiday that we see in the media juxtaposed with our actual memories of holidays past or visions of holidays current can be troubling.  The stressors of visiting our families, financial constraints, travel, and other complications of the holidays can leave any person in need of extra support. Some ideas on taking care of yourself this holiday season.  These may not apply to everyone, but they are common complaints about the holidays:

1. You are dreading visiting your family - This may sound simple, but make your stay as short as possible, a day trip if at all possible.  Many people try to squeeze in so much family time around the holiday that it becomes overwhelming.  If your family makes you feel bad, take them in small doses.

2. You are strapped for cash for presents - Tell your friends and family that you are not exchanging presents this year, that you don't need anything from them.  For those who are special to you, write them a nice card expressing your appreciation for them.

3. You are lonely - We are told that the holidays are a time of happiness, togetherness, and cheer, but the reality is that many people lack support around the holidays.  If you are lonely, reach out to others who are lonely.  Volunteer at a soup kitchen or a blanket drive, join a local support group, have a "friend holiday" with a buddy or two, and look around for other types of support.  Remember, you are not the only one who is lonely around the holidays so seek out others who understand.

4. You're feeling depressed - Be kind to yourself.  You're not the only person who feels this way at this time of year.  The weather, the overwhelming holiday cheer, and feelings from the past can creep up on anyone and turn happy into blah.  Know that it is normal, you are allowed to be sad, and it will end on January 2nd.

Find Your Happiness

Who has it?  What is it?  How do we get it? Happiness is subjective for everyone, but happiness must be defined by every person in order to be tangible.  How does one achieve a goal without measurable tasks?  It seems impossible to seek happiness but not know what must be done daily to have it.

So what is happiness?  I ask clients to pretend as though they have a magic wand which they will use to make their life happy overnight.  Then I ask, 'what has changed?'  I often hear crickets to this question because it is difficult to envision what needs to change in our lives in order to achieve happiness if we do not examine the elements that make up our own personal happiness.  Many psychotherapists, psychologists, and others in helping professionals claim to be happiness experts, but in reality, everyone who comes to therapy is the master and expert of his or her own happiness.  It takes applied self-exploration to know what comprises happiness for you. 

What does happiness mean to you?  Is it feeling fulfilled by your job and family?  Is it obtaining a goal, like a college degree or promotion?  Or is it living in the moment and taking in the beauty of your surroundings? Is happiness comprised of other emotions, such as relaxation, excitement, energy, concentration, sadness, despair, or contentment? These are great questions to ask, but the deeper question left unanswered is, what measurable/attainable tasks must I accomplish each day in order to achieve my goal of happiness?

other considerations

Instead of thinking that happiness is something that happens to you, a passive state, try to conceptualize happiness as something that you cultivate and nurture daily.  If your goal is to feel happiness and fulfillment for most of your day every day, the tasks of meeting this goal must be concrete and based on knowledge of yourself to inform your choices (e.g. eating ten cupcakes might make someone feel happy in the moment but may cause lethargy, anxiety, or depression in the coming hours or days. The net outcome is not happiness.) 

Maintaining a mostly happy life involves hard work and dedication to your cause at times. For example, I know that 30 minutes to an hour of exercise every day makes me happier, calmer, and feel better. I still struggle to do this because it does not bring immediate satisfaction to me personally. It is hard work to put in the time to maintain happiness through exercise but I KNOW that if I broke down the net outcome hour by hour the net outcome would be happiness. It would look something like this:

exercisedoodle.jpg

Being happy and fulfilled can be exhausting, taxing, and overwhelming, especially if you struggle with depression, anxiety, or other life stressors. If this is the case, start small! Create a goal of feeling happy (or whatever positive feeling it is that you wish to feel) for 5 minutes, 15 minutes, or an hour every day. Don't focus on big, overwhelming goals, but rather look for small things that bring you happiness like drawing or painting, listening to music, dancing in your house, smiling, playing with an animal, or anything else that brings on feelings of happiness without detracting from your overall well-being.

What does a state of happiness look like to you?  And what do you have to do daily to feel happy?

How to Find the Right Therapist

"How do I find the right therapist?" I am often asked this question and would like to preface my opinions by saying that they are just that – opinions. Therapists are as diverse as their clientele and I presume that all would have something to add to this discussion, or perhaps an entirely opposite perspective. If you are looking for a healing, caring, supportive, and emotionally challenging experience, this is my take.

The Basics

1. All therapists are different, but I would say that the primary characteristic of importance in your therapist is that he or she tries to make you feel comfortable and wants to be present with you.

2. Having said that, everyone will be nervous at the beginning of therapy, your therapist included if he or she is human, so give yourself a few weeks to settle in. If you feel inclined, talk to your therapist about feeling nervous and he or she should response empathically.

3. Therapy can be funny and light-hearted at times, but you should not feel the need to impress or entertain your therapist.

4. Therapy can be humorous, intellectual, and emotional, but remember that intellectualism and humor can be used to defend against difficult emotions. Therapists are in the business of emotions, so you may be challenged to access your own at times.

5. You should feel safe in therapy at all times and your therapist should be able to create that safety with you.

Soap box:

Many of the clients I see have discussed "settling" with their previous therapist(s).  He or she would listen most of the time, or was good enough is not an ideal therapeutic situation.  You have the right to the right fit for you.  If it isn't ideal, talk to your therapist about what is missing.  If he or she responds in a way that upsets you, say that you're upset.  If it gets to the point where you want to end the relationship because of this disconnect, talk about it.  A relationship with a therapist should enhance your ability to have relationships in the real world.  As a model of relationship, a therapist should encourage honesty, even when it is difficult, and should always have your interest first on the list of importance.

Step 1. Assess your needs.

What do you need and what do you want? You can have both needs and wants met in therapy with the right person. Read the following questions for guidance on your needs and wishes for therapy.

Are you going through a life transition like college, marriage, divorce, parenthood, or late adulthood?

Are you a member of an oppressed group? Is it important to you that your therapist is a part of this group or has special training around your difference?

Will it be difficult for you to speak to a stranger for the first time?

Have you had therapy experiences in the past that did NOT work? What was missing?

Are you depressed, anxious, sad, or do you have a dominating emotion that comes to mind?

Have you consulted a medical professional and if so, what does he or she recommend?

Do you just want to talk and have someone listen?

Do you want to explore your past or focus on the present? Or both?

Do you want to be challenged or supported unconditionally?

Do you want to talk about goals and be accountable to your therapist in attaining them?

Do you seek structure or freedom in therapy?

Are you more comfortable with a particular gender, and why? Would it be helpful to you to have a therapist representing the gender of comfort or perhaps to have a new experience with the gender you do not prefer?

Are you comfortable with a particular age group, and why? How would your experience be enhanced or compromised with different age groups?

What are you able to pay for therapy?

Step 2. Find a recommended therapist

Word of mouth is the most helpful way of finding a clinician but more and more, therapists are advertising and promoting themselves online. There are some websites that verify the credentials of the therapists who are advertising (psychologytoday.com, goodtherapy.org) so make sure that the therapists you read about have credentials.

Money is usually an uncomfortable topic for most people, but prospective therapists should be clear about charges when asked. Some therapists work on a “sliding scale” basis, meaning that they have different rates depending on financial need. If you are in need of financial assistance, think about what you are able to pay and ask the therapist if the rate would be acceptable.

Credentials:

LPC-i and LPC – These therapists are master’s level professional counselors who are seeking or have obtained a clinical licensure. You can expect to pay more to see an LPC than an LPC-Intern.

LMSW and LCSW – These therapists are master’s level social workers who are seeking or have obtained a clinical licensure. You can expect to pay more to see an LCSW than an LMSW.

Psy.D. or PhD. - Psychologists are doctorate level clinicians who perform therapy and also focus on psychological assessment or testing. Psy.D. is a newer degree plan focusing on clinical psychotherapy as well as research and testing. You can expect to pay more for a doctorate level clinician than an LPC or an LCSW.

M.D. or D.O. - Psychiatrists are medical doctors who are primarily focused on psychobiological assessment and medication management for patients. Some psychiatrists are trained in psychotherapeutic techniques but most have little training in psychotherapy. You can expect to pay the most for a psychiatrist since he or she has a medical license and can prescribe medication.

Unfortunately, when assessing therapists one can rarely tell which will be a fit on paper. You may be able to read a bio on the therapist that may help you get a feel for his or her personality and theoretical leanings, but having a conversation is the best way to assess goodness of fit.

Use the questions from Step 1 to guide you in expressing your needs and ask about their training, specialties, and areas of practice. Despite the traditional hierarchy, you may find your needs anywhere in this ranking of therapists.

Step 3: Get to know the therapist

In order to assess fit, one has to “talk the talk” in some ways to understand how a therapist operates. Read up on types of therapies and you may find that one resonates with you.

Psych Central's article on Psychotherapy - check out the types of therapy on the left index

Ask questions and expect to get your needs met!  This principle is basic to living a life with healthy self-esteem and self-care.

As always, take care.

Power, Privilege, and Therapy

Why therapists must be allies and advocates for clients of different races, religions, sexual orientations, sizes, ethnicity, genders, and any other point of diversity.

I wrote this post after an incredibly fulfilling discussion among colleagues about power and privilege in the therapy room.  A colleague bravely disclosed that she feels that she should bring up the different racial backgrounds between her and a client of several months.  The client is Latina and the therapist is white.  The therapist feels at times that she is missing some of who the client is because she's a "white lady" talking to a person of color and that the client could be holding back parts of herself in therapy because race has not been addressed.  Some felt that she should wait for the appropriate time to bring it up and some said that she should bring it up as soon as possible.

We arrived at the conclusion that as a therapist, we are put in a position of power from the beginning of every session.  We automatically sit in the chair with privilege as we delineate the "rules" of therapy, collect payment from clients, and are the ones to say when time is up.  When the therapist is in the position of power as the therapist and is in a position of power and privilege in society, it is doubly important to bring up issues of difference in the room so that the client can be free to explore, tell the truth, and be him/herself.

Here is how it could play out.  A white, female therapist sees a  black woman who comes to therapy every week.  The client talks about work stress and her family life but feels she must leave out any mention of racism at work or family dynamics that are central to her culture because the therapist may reject her thinking.  One day, the therapist brings up their difference; "you are black, and I am white.  What's it like to talk to a white person about this?"  It may be an uncomfortable moment for one or both of the two women, but now, the topic of race is on the table.  Perhaps the client can label racism at work or explain family dynamics within her home and the black community once the issue is opened by the person who is seemingly in power.

When we hold power over our clients, we limit them from being able to have power in their own lives.  Clients should feel empowered in session, even if not in society, to talk about issues of race, gender, sexuality, religion, language, or any other topic of dis-empowerment in their lives.  The key to making this happen as a helping professional is a) recognizing your own privilege, and b) bringing up the difference between yourself and the client in session any time it could affect the therapy.

Our privileges can be things that are not conscious in our minds, like money, having a healthy marriage, having children, dressing nicely, speaking a certain way, being educated, feeling confident, being physically fit... it doesn't take a white, straight, male to trigger feelings of inadequacy, privilege, and power in a client.

Here's the really important part for clinicians and what I learned from the wisdom of the group; waiting until it's "comfortable" to talk about issues of diversity is a privilege as well.  When I say that, I mean that when we think to ourselves, 'gosh, it's just not the right time,' or 'that would make things really awkward right now, I'd better wait,' the person who is on the other side deals with that discomfort every day, everywhere he or she goes, and with everyone he or she meets.  If you are gay, you don't have the privilege of avoiding the topic of being gay.  Straight people, however, do have the privilege of avoiding the topic of being straight because it's "the norm" in our society.  (I put "the norm" in quotations because it is a terrible social construct that I do not wish to reinforce but is a more than prevalent thought, conscious and unconscious, so prevalent that we cannot ignore it if we are to disassemble it.)

Take your own difference and use it to have empathy for others.  

Happy New Year/National Hangover Day!

I joke, but it must be true! Hangovers can be particularly brutal because they can come with so much mental, physical, and emotional turmoil.  Most commonly, those who suffer from severe symptoms find that their hangovers come with lots of anxiety.  People feel badly about themselves, ashamed of their behavior, and generally feel negatively about life when in this state.

Hangovers can cause extreme anxiety as a symptom of the withdrawal from alcohol or other substances.  Alcohol is a depressant, which means it slows the central nervous systems and blocks the brain's ability to produce stimulating chemicals.  The withdrawal from this state of depression turns the system up-side-down.  If we think of depression and anxiety on a spectrum, with depression at the far right and anxiety at the far left side, you can picture a pendulum swinging from one extreme to the other.

While withdrawing from alcohol, the body overcompensates by "swinging" to the left, toward anxiety.  The central nervous system is very activated and the brain is producing stimulating chemicals, but the body and brain are tired, unrested, and confused.  Especially for those who suffer from anxiety naturally, this can be a powerful and awful experience.

Tips for getting through a hangover:

1. Take it easy on yourself. If you are turning your anxiety inward, meaning you are thinking bad thoughts about yourself, know that they are chemically induced.  Have a mantra and repeat it - "these thoughts aren't real and I'm ok." Don't make any big decisions or sweeping judgments while in this state - that may not be possible but try not to act on any of them!

2. Despite your urge to eat the entirety of the fast food menu, eat something good for your body.  A salad with veggies or some fruit can get you on your way back to health.  Alcohol also dehydrates the body so drink lots of water.

3. If you can bear it, exercise.  Exercise stimulates all the right chemicals in your brain to release and ease your body and mind.  It can also speed the release of toxins so that you can feel better faster.  Even a brisk walk can make you feel better since some say that fresh air is a cure to hangovers.

Happy New Year!  Take good care of yourselves.

How to Have an Emotionally Supportive Argument

Making space for your feelings and your partner’s feelings during heated moments

Do you ever have an argument or discussion with your partner and think, 'I have no idea what to say right now' or 'I'm so mad that I can't even hear you'?  This post is meant to help guide you through a difficult conversation and manage feelings between you and your loved ones.  I will use the word "partner" because communication between couples can be particularly difficult, but it could apply to a family member, a colleague, or a friend.

Step 1: Put yourself on hold, temporarily

When you're in the heat of the moment or don't understand your partner or loved one, it can be difficult to step outside yourself and hear your partner's needs.  It is particularly difficult to hear those needs if you feel criticized, blamed, or inadequate because of the language they are using (which we will discuss at length later) or because of your own internalized feelings, history and unique makeup.  In short, many people talk about their needs and desires by criticizing what the other is doing rather than asking for what they would like for their partner to do.  Perceived (or real) criticism often triggers feelings of inadequacy, anger and distrust which inevitably creates disconnection and neuro-chemical shut down (fight, flight or freeze responses.)

I would encourage you to momentarily put your feelings aside next time your partner complains or criticizes in order to find the need behind the complaint. You can start by taking a breathe and saying something like, “I really want to hear you right now but I’m feeling ______ (criticized, blamed, sad, scared, angry) and I need to breathe/take a 15 minute walk/ask you to be more gentle with me.”

This shift alone can defuse relationship bombs instantly and can lead to fuller understanding of one another. It can also make one or both partners very angry. If this is the case, establishing a routine in which you both have a “cooling off” period when things get heated could make or break your relationship. If this is a pattern when you have disagreements, have a conversation with your partner when you’ve calmed down about making space during heated moments. Make an agreement that at any time either of you feel overwhelmed you can take some space to calm down and come back to the discussion. Set a time limit, tell your partner how long you’ll be cooling off and what you’ll be doing. Oftentimes, partners can feel abandoned in moments like these unless they know that you are intentionally taking action to be more present and available - take a walk, leave the room, move your body, or any other activity that helps you discharge emotion. It is healthy to take a break in these moments when you know you’re not available to be compassionate and empathic.

Everyone, and I mean EVERY one of us, is entitled to our own experience and perception. One of the gifts of a relationship is having more than one outlook or experience on any given situation. We do not have to feel or think or experience the world in the same way to connect with each other. Try to see that your partner’s unique experience of the situation does not need to be right, wrong, factually correct, or the same as yours. Your partner’s experience does not invalidate your own - it simply means you are two different people.

Step 2: Inquire about the problem or need of your partner.

After taking a breathe or a walk, here are some suggestions that can help clarify and deescalate the conversation:

a) "I want to understand how you’re feeling. I want to meet your needs/be a good partner/listen/help you.” Be open, loving and clear. Don’t jump into “fixing” the problem. You are here to listen and understand.

*If you feel defensive, try telling yourself that the way that your partner feels may have nothing to do with how you have acted or spoken, but rather how they perceived the situation. Perception is not an insult, it is our unique way of seeing the world. We only have our perception to go on until we are really connected to another person. This process of making space for your partner’s feelings and understanding their perception builds trust and helps both partner’s know that no matter what they are perceiving, their partner’s intentions are good. It helps us give the benefit of the doubt in tough situations. And over time, it makes these conversations less and less charged.

b) Ask your partner how he or she is feeling.  After an "I feel..." statement.  "Tell me more about how you feel."  Explore what it is like for your partner and trade places in your mind.  Focus on their experience of the problem. Imagine what it would feel like to be them.

c) Repeat feelings back to your partner.  "So you felt lonely when I left and went to the party without you." Think of a time when you felt lonely and if you feel compassion say, “I hate it when I feel lonely and I hate that you feel that way. That sucks.” Be open to correction or elaboration.

d) Have an attitude of curiosity and openness.  "I want to understand how you're feeling." Be open to the idea that we all feel and express emotions differently and the only way for you to really know how your partner feels is to listen as they describe it.

e) Avoid talking about how you feel or perceive the situation until your partner is finished explaining their side.  Avoid at all cost becoming defensive - "you do the same thing," "I only did that because you told me to," etc.  Just listen and take it in, not as a criticism of you, but as an unmet need of your partner.

*Important note: Everyone, and I mean EVERY one of us, is entitled to our own experience and perception. One of the gifts of a relationship is having more than one outlook or experience on any given situation. We do not have to feel or think or experience the world in the same way to connect with each other. Try to see that your partner’s unique experience of the situation does not need to be right, wrong, factually correct, or the same as yours. Your partner’s experience does not invalidate your own - it simply means you are two different people.

Step 3: Address the need

By this point, hopefully your partner has been able to articulate what need is driving his or her feelings. The need may have simply been the need to be heard and understood. If there is another request (e.g. do the dishes or put your phone away while we’re talking) try to hear that request and let your partner know if you think you can meet the request or not. If you intend to make a change in your behavior in service of the relationship, let your partner know that you might need reminding or how you would like to be approached if you forget.

Your partner may say, "I need for you to be here more often," but get more specific.  "I'm hearing that you want to spend more time together.  What would you like to do during that time?  When would you like to spend that time together?"

Underlying most complaints is the need for companionship, love, or support.  Try to get to the underlying need, not just the complaint. Vague complaints like, "I want you to care more," or "I want you to want to be with me," leave no room for specific adjustment.  Ask for a concrete solution to the problem like going to a movie together, snuggling on the couch, talking openly, hugging, touching, or spending time with family.  Ask how often your partner needs those things and ask them to continually speak up when they need it.

*Important note: You are never obligated to meet the need of a partner if you don’t want to. It is important to tell your partner if/when you feel as though you cannot do what they are asking.

Step 4: Make an agreement

Agree to meet the needs of your partner in a way that feels good to both of you.  Again, make the agreement specific and realistic. Assume that you won’t do it perfectly and be clear that you will need help/reminders/gentle words when you falter. Let them know that you are trying when you’re trying. Let them know that you forgot when you forgot but you care and are committed to this task.

Step 5: Taking care of your needs

Through this process of communicating about your partner's needs, you may find that you have unmet needs as well.  After you have resolved your partner's issue, approach your needs in a way that models healthy communication to your partner.

"When we disagree, I often feel badly about myself when I hear statements like 'you do this all the time' or 'you never do this.'  I would appreciate it in the future if you could just tell me what you are needing from me in the moment rather than telling me that I do things wrong all the time.  It just makes me feel [insert feeling]."

Or...

"I'm happy to give you the time that you are asking for and agree that we should spend quality time together.  I also think that we need time apart and with our friends.  Can we have an agreement that on Mondays we do our own thing?"

Relationships are not easy and communicating is a learned skill.  Be patient with yourself and your partner.

Depression's Best Friend Anxiety

Depression and anxiety go hand in hand. At times they are confusing bedfellows, but it is nearly impossible to have one without the other. For example, a woman says, "I feel depressed and can't get out of bed. Then my husband comes home and I just want to bite his head off. I'm such an awful person." This person isn't awful, she's suffering from a complex combination of anxiety and depression. Her anxiety may be manifesting as lashing out (or acting out behaviors) and one of depression's lesser known side effects is irritability, which can lead to such thoughts and behaviors.

SPOTTING DEPRESSION

The obvious definition of depression is "a depressed mood for most of the day and a diminished interest or pleasure in activities" in the words of the Diagnostic and Statistical Manual-IV-TR (DSM). Another tricky depression antic is that it can be symptomatic in the form of low self-esteem or low self-image. You may hear someone saying things like "there's no excuse for the way I've messed up my life," or "it's my fault that I didn't go to work because I'm lazy." The DSM also points out "excessive and inappropriate guilt" as a symptom. This might manifest in an "I can't get over it" attitude or an "I'm totally unworthy of anything fun or good" campaign.

Other signs may be excessive crying, severe change in appetite, sleeping all the time or not sleeping at all, feelings of worthlessness, indecisiveness, lack of concentration, recurring thoughts or images of death, and at it's worst, ideas of suicide.

SPOTTING ANXIETY

Anxiety can take on many forms like panic attacks, fears about being in public or socializing, and reactions to traumatic events, but in terms of depression, general anxiety can also be the perfect compliment to its counterpart, depression. Anxiety often produces excess chemicals in the brain that leave us feeling on edge, in hyper drive, overwhelmed, fatigued, unable to concentrate, irritable, tense, and not sleeping like we should.

TREATMENT

It is important to understand the interaction of depression and anxiety on the mind and body to understand how to treat it. When a person is in a state of arousal (anxiety), the body and the brain work hard to calm the system, but over time those biological functions become overworked and no longer soothe our anxiety. We have to learn how to "override the system" in order to control our anxiety - namely, taking long deep breaths (in the nose, from the belly, and out the mouth), and changing our thought patterns when we become anxious or depressed.

Next time you think, "I'm such an idiot," and you can feel yourself turning red, feeling keyed up, or your heart beating quickly, stop and take 5 deep breaths while telling yourself something realistic about the problem. "I'm only human, and humans make mistakes." "This won't matter in one week's time." "I'm very smart, I just rushed and made a mistake that I can fix." Or, try to externalize the anxiety: "Anxiety is attempting to intrude on my mind and body right now, but it will not overtake me. I know how to breathe through this."

If you are feeling depressed, my best advice to you is to be kind to yourself and seek help. If you can lie in bed for an extra hour, and you feel like you need to, then do it. If you want to comfort yourself in some way to not feel so badly and it won't hurt you in the long run, I encourage it. We are taught to be so hard on ourselves and it is very important to fight the urge to push yourself to your limit all the time. Loved ones are the best antidote to depression, even though it may seem scary or impossible to share what you are going through. If you sincerely and repeatedly reach out to loved ones and still feel alone, seek help online, find a local support group, or get in touch with an organization who helps people in your situation. It is important that you feel understood and connected when experiencing depression and anxiety.

If your depression is to the point of suicidal thoughts or urges or thoughts of harming anyone, you should immediately seek help from a professional! Better yet, seek help from a professional before your symptoms are life-interfering. You do not have to wait until you are incapacitated to ask for help. 

Therapy Demystified: It's All in the Relationship

In the presence of darkness, we break, we wound, and we crumble inside; in the presence of kindness, openness, and love we heal with one another. When asked what my "style" of therapy is, I spout an eclectic mixture of therapies like "psychodynamic, supportive, and relational psychotherapy," but I truly believe that the most important element that can lead to healing in a therapeutic relationship is the connection between the therapist and client.  This is not a typical connection, because it is not reciprocal; it is only intended to serve the client's interest. But it can be even more powerful in healing broken hearts and wounded souls because of the commitment of the therapist to the client.

Many esteemed researchers have come to the same conclusion through different avenues.  Scholars like John Bowlby, Alan Schore, Daniel Siegel, and Robert Karen would liken this connection in therapy to healing wounds from lost or ruptured attachments in childhood and adulthood.  There is neurological research proving that being in connection with another person can actually create new neurocircuitry, or pathways, in the brain in order to form new attachments to others (Schore, 2003). The authors of Relational-Cultural theory discuss connection as a "growth fostering relationship" leading to a fuller, happier life, as opposed to disconnection as "empathic failures" and missed opportunities (Jordan, Kaplan, Miller, Stiver, & Surrey, 1991; Jordan, 1997; Miller & Stiver, 1997).  The arrival at this conclusion, that people heal in relationship with one another, is empirically undeniable.

But what does this look like in the therapy room?  Many will experience it as discomfort at first because it feels unusual to have someone in front of you who needs nothing from you and is there to openly explore your psyche.  I hope to alleviate some of that discomfort for those of you who are reading because therapists are humans too and we are both engaged in the process of relationship building the moment you walk in the door.

The experience "in the chair" can be enlightening for some in that it brings up feelings that are universal throughout the person's life.  For example, a person comes to therapy with severe social anxiety.  He tells the therapist this piece of information and the therapist responds by saying, "what a brave move you have made coming here since you are so scared to leave the house."  The client may feel discomfort, vulnerability, and like he is being seen and heard, feelings he is uncomfortable with in the outside world and in the therapy room.  The question is, what do you do with those feelings?  Is the therapy room safe enough to explore those feelings of discomfort?

It is the therapist's job to make sure there is as much safety as possible for the client.  In order for there to be safety, the client must understand that the therapist will be non-judgmental and genuinely caring.  She must also know that the things she says are confidential and will be kept safe with the therapist.  The client must also know that the therapist is taking care of herself and will continue to do so throughout the relationship.  For example, the client must know that his therapist will show up on time, will hold to their agreements, will have taken care of her own needs so that she is present, follows her code of ethics in order to maintain a practice, and is working in the best interest of the client.

This is not to suggest that the skills therapists learn from other empirical research is useless.  There is skill involved in exploration and presence while witnessing such important work.  However, we heal through one another and it should be known that if you are experiencing emotions like discomfort, tension, frustration, resentment, happiness, or any other feeling, especially toward the therapist, they should be welcomed in the therapy room.  They are incredibly helpful keys to unlocking closed doors in our minds and discovering how we behave in the outside world.  They can also lead to healing old wounds and finding new ways to open one's heart to others.

Find Yourself Friday!

The Journey

One day you finally knew what you had to do, and began, though the voices around you kept shouting their bad advice— though the whole house began to tremble and you felt the old tug at your ankles. "Mend my life!" each voice cried. But you didn't stop. You knew what you had to do, though the wind pried with its stiff fingers at the very foundations, though their melancholy was terrible. It was already late enough, and a wild night, and the road full of fallen branches and stones. But little by little, as you left their voices behind, the stars began to burn through the sheets of clouds, and there was a new voice which you slowly recognized as your own, that kept you company as you strode deeper and deeper into the world, determined to do the only thing you could do— determined to save the only life you could save.

-Mary Oliver

What's the Use in Being Sad?

One of the most common questions asked in therapy is, "why should I be sad when I can be happy?"  There are variations to this question like, "why would I want to focus on my difficult past when I can move forward and not be in pain?"  Or, "I don't want to suffer anymore.  I came to relieve my pain, not feel it all over again."

I empathize deeply with the idea that revisiting painful memories, events, and feelings can be overwhelming and seems an undue punishment on the path to healing.  However, I also know that the healing process rarely takes place without returning to the old (or fresh) wounds in order to tend to them.  As a therapist, I try to create an emotionally safe environment in which people can explore their feelings and leave knowing that they are cared for and perhaps even feeling better. This Pollyanna version of therapy occurs occasionally, but the reality is that emotions are messy, complex, and can be very overwhelming.  Sometimes digging up hard feelings can make things worse before they get better.  The process of unearthing pain and fear is courageous and facing an unknown process like therapy, while life-enhancing, is hard work.

One of my favorite authors/researchers/story tellers, Brené Brown, discusses the importance of dealing with "the things that get in the way of joy, meaning, and connection" in her 2010 book  The Gifts of Imperfection, which I highly recommend to everyone reading this post. Brené Brown is a fellow social worker (LMSW, PhD) who studies people and their experiences with shame, vulnerability, courage, and worthiness. Her thorough, evidence-based approach to the study of shame and other human emotions allows me to unequivocally recommend her work as an unbiased clinician.  My status as a total Brené-Brown-ophile lends me to speak from a vulnerable, human place of  admiration and to share that her work has changed my life, my work, and my connections with the people I love. If Brené Brown were Elvis, I would be the screaming, crying teenager watching her TED Talks. The following quotation caught my attention while reading The Gifts of Imperfection:

"If we want to live and love with our whole hearts, and if we want to engage with the world from a place of worthiness, we have to talk about the things that get in the way - especially shame, fear, and vulnerability."

We have to talk about, process, feel, and share the things that get in the way of worthiness, connection, and happiness in order to define, look for, and live a life or worthiness, connection, and happiness.  Brené (yes, we're on a first name basis) would call this way of living "wholehearted" and others may call it conscious, purposeful, connected, or self-aware.  Whatever you call it, the sentiment is the same: in order to experience joy and have meaningful relationships we must sort through the pain, hurt, and fear.

You are not alone if this sounds like a daunting, horrifying, or completely foreign concept. I too was among the horrified before finding the safety, patience, and motivation to endure this process. A good therapist was instrumental in this process for me - the safety of a warm, non-judgmental person who was dedicated to my care was extremely powerful through some of my most difficult growth. In fact, it is what drew me into the field of psychotherapy and guides me in my practice of empathy, compassion, and gentle exploration with my own clients.  Pretty powerful stuff.

After reading that paragraph you may be thinking, "ahem. I don't want to BE a therapist.  Why, again, would any NORMAL person want to go through pain, terror, and negative feelings?"  I get it. What makes it worth it? And furthermore, why do we need someone else to witness, support, and be there for us through the vulnerable, life-altering process of healing?  This is my best shot at answering that question:

People are not emotionally wounded alone, they are wounded by and among other people.  The most powerful way to heal wounds is by vulnerably, bravely sharing the pain with another person(s) and receiving a corrective, kind response like empathy, compassion, protection, and care.You may find something more powerful than pain after experiencing it, knowing it, and moving through it.  Over time, you may find that pain is no longer terrifying, but tolerable after working your emotional muscles. You may find that you are your own courageous, badass, superhero.  You might, at last, love yourself not despite imperfection, but because of imperfection.  You might find that you are good enough, just the way you are.

Take care of yourselves and others.

Visit Brené Brown's blog to learn more about vulnerability, courage, and wholehearted living:  www.ordinarycourage.com

Brown, B. (2010). The Gifts of Imperfection: Let Go of Who You Think You're Supposed to Be and Embrace Who You Are. Center City, Minnesota: Hazelden.