Name that Shame

Has perfectionism ever kept you from doing something you really want to do? Let's give it another name: SHAME. What is it and how do we keep it from sabotaging us? (SPOILER: Shame almost kept me from making this video!!) If you like this video, please subscribe to my YouTube Channel for more videos like this one :)

As referenced in the video, here is Brené Brown's website - I highly recommend reading her first and/or second books - I Thought It Was Just Me But It Isn't or The Gifts of Imperfection - if you are interested in learning more about shame :)

Are you "needy"?

I'm on my soap box today and the topic is having needs. I'm not exactly sure how words like "need" and "attention" became negative words in our vernacular,  but this needs to be discussed. So I'm calling all parents, children, teachers, friends, spouses, and everyone in any relationship: let's settle this. 

this is the deal...

Every human being has needs and one of those needs is attention. When we are infants, we need food, warmth, and complete care. When we are children we need to be kept safe by our loved ones but we also need room to explore. Teens need love and support but also need peer interaction to be able to begin to formulate independent ideas about the world and create identities separate from loved ones. As adults we need attention from our families, our friends, our significant others, teachers, and a host of other people around us in order to feel loved, connected and accepted. It's part of our hard-wiring to tune in with those around us. We must have these needs met from the time that we are born (or we suffer dire consequences) and we continue to have needs throughout our lives. This is the normal, natural, and healthy template that our brains and bodies follow. The well-researched and documented scientific research of attachment and neurobiology is clear cut on this issue. (But for curious minds, please read: John Bowlby, Mary Ainsworth, Alan Schore, Daniel Siegel, Bonnie Badenock, Arlene Montgomery, and many other talented minds in the field of interpersonal neurobiology and attachment.)

Our specific needs change as we develop over time, but it is normal and healthy to have needs. It is normal and healthy to want and have the attention of the people around you, especially those who are closest to you. I think that the negativity toward "neediness" occurs when someone appears to need more than another can give or more than he or she should developmentally require. For example, developmentally speaking an adult who has been given love, consistency, and affection throughout his life should not require constant affirmation and admiration to maintain healthy self-esteem and relationships. His antithesis, an adult who was not given love, boundaries, and affection would have experienced what Freud called "narcissistic injury," or what contemporary researchers might call hurt, abandonment, and a rupture in attachment, and could become some version of a person who we would call selfish, needy, or even narcissistic. 

No wonder the word "needy" gets a bad rep. We associate it with an extreme sense of selfishness or even pathologize having needs because there are some people who, because of intense pain and other injury, have unmet needs that cannot be met on a conscious level. Their wounds are so deep that we cannot heal them with singular interactions. We now use the word "needy" to describe the experience of being with a person who has no room for our own needs

We would be better served by separating the experience of not having our own needs met rather than focusing on labeling someone as "needy" or "attention-seeking". 

why it's important...

When we label people as "needy" and denigrate the idea of having needs, we allow ourselves to diminish the importance of honoring our very real and legitimate needs. In separating ourselves from that which we do not want to emulate, we detach ourselves from a basic human function. To need becomes shameful instead of normal. 

In my work with teens and adults it is abundantly clear that being taught that we should not express (or even have) many needs has negative impacts on self-esteem, self-worth, and the ability to maintain healthy relationships. The inability to express and have needs leads to abuse in relationships, low expectations, regret, resentment, and most conflicts between children and parents are born in the tug of war between unmet needs and expectations. Our denial of need is powerful, silencing, and  grows exponentially from adolescence into adulthood (e.g. chronic care-givers, co-dependent behavior, enabling, "doormat syndrome" etc.) 

The denial of needs creates shame, distance, and thwarts attempts at closeness and success in relationships. It creates scenarios in which people are labeled "attention-seeking" because they have grown desperate for healthy, loving attention and compassion but may have no idea what defines healthy. When our basic human needs go unrecognized and unacknowledged it can even create heartbreak that is so overwhelming that people hurt themselves to feel as though some kind of need is being met. They may cut their skin, or throw up their food, or control and restrict so that they feel like there is a semblance of boundaries and safety in the world around them. I am not suggesting that these are healthy ways of meeting one's needs, but that cutting, eating disorders, and many other outward shows of self-harm are a desperate attempt at being heard, seen, acknowledged, and cared for.

If there is one other thing that treating teenagers has taught me, it is that Google searches are very informative - not necessarily the content, but the prediction of the search. If you are not in contact with teens, I'll spell it out. When young people feel or think something, they often turn to Google as a way to validate or clarify these thoughts and feelings. As an illustration, I started by typing, "need" and this is what I got...

Google search prediction: need

That's not great. Someone typing the word "need" is likely to be typing the word "needy". Then I tried "why am I needy". Here are the results...

Google search results - why am I needy

The results don't instill much confidence that having needs is normal. The message seems clear that you should "stop" being "needy" and "clingy" whether "in relationships" or "with friends". And "needy people"...

Google search results - needy people

We find some articles on assertiveness and narcissism, but the evidence of the socially constructed pathology of needs is clear. 

My point is not to discount any of the above articles or resources, but to highlight the disparity between the plethora of help for those who are allegedly "too needy" and help for those who have needs and want to know that it's okay to have them. Many people who self-report as "needy" fall into the category of having healthy, normal, and appropriate needs. 

so what do you need?

While I can't say exactly what you may need, I can say that most people who have been called "too needy" by their partners, parents, and friends are actually seeking healthy relationships. I can also estimate that the most pervasively unmet need among all people is that they do not feel valued, understood, heard, or seen by important others. In short, we need to feel loved and there is nothing wrong with that. Whatever your needs and wants may be, it is helpful to think and talk about them. Getting your needs met is a life-long process, ever-changing and not always easy, but definitely worth the time and effort.

7 quick tips about needs

  1. The fact that someone cannot give you what you need is not evidence that you should not need it.
  2. No one, as in not one person, can provide everything that you need all the time. It is important to build a support network for this very reason. 
  3. Other people will have feelings about your needs, especially when they are in contrast with his or her competing needs. That doesn't mean that either or both people's needs are illegitimate.
  4. We may go about getting our needs met in unhelpful or unhealthy ways (e.g. passive aggression, withdrawal, or aggression) if they are unmet for long enough, but that doesn't mean that one should not have love, support, respect, attention, and care in relationships. It is never too late to directly ask for what you need.
  5. If you don't know what you need, it is unlikely that others will know what you need. There is an all too common, unfair expectation, especially in romantic relationships, that people should anticipate the needs of others without knowing what they are. Be as open as possible about what you need when you need it.
  6. You will face disappointment when someone inevitably does not meet your needs after working so hard to assert them. It's okay; we are all imperfect and need second and third chances. Try again and again. If you express your feelings about your experience and you are still not being respected, don't be afraid to set a boundary then go to someone who will respect and hear you.
  7. Trust yourself. Your life begins and ends with you, so trust that you know what's best for you.

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.

10 Therapy Hacks

1. Say no. No is a good word, not a bad one. When you say 'no' you are simply acknowledging that you have met a limit or capacity. We have a capacity for giving, being awake, running, eating, and everything else that we do. When you say 'yes' and mean 'no', you may feel resentful, angry, numb, overworked, and used, among other painful emotions.

2. Know the difference between acting out and being assertive. Try to avoid acting out, but if you do, reflect on the choice and note the consequences. Be assertive.

3. Connect with other people. We were built to connect and wired to be with one another. Like a car without an engine, we do not work if we do not share ourselves with others.

4. Chose wisely when sharing yourself with others. Trust yourself when you are with another person. The voice that says, “dislike” or “run” is there for a reason. If you find yourself running from everyone, return to number 3.

5. You will never be one thing, so accept that you will be many things. Behaviors do not define us but are temporary. It is incredibly difficult to be a feeling, intelligent, complex human being because contradictory feelings co-exist with one another within all of us (e.g. love & anger, resentment & longing, desire & fear, fatigue & happiness). You are not how you feel or what you are doing. You are you. As complicated as it is to be you, it is far more rewarding than being chained to any label that has been thrust upon you. And since you are you, you do not have to think, feel, or act like anyone else.

6. Be kind to yourself and then be kind to others when you can. Say nice things to yourself in your head. Take it easy on yourself. Only good things come from this. You will not get more done if you are mean to yourself or others. It does not make you a “bad” or “selfish” person to show kindness to yourself. Ultimately, you cannot offer more kindness to others than you extend to yourself so you must practice on yourself first.

7. Be honest with yourself. Honesty is not universally the “best policy” with others, but it is necessary to know your own truth to live a conscious, connected life. Never use honesty to hurt or belittle someone. Rather than hiding behind honesty and moral platitudes, use honesty first and foremost as a gauge for yourself. How do you honestly feel, even if it is confusing? What defense mechanisms may be in place that keep you from accessing honest feelings or truths about yourself?

8. Accept that anger is a normal, acceptable and useful emotion. Anger gets a bad reputation because we associate it with scary, violent, or unhealthy expressions of anger. Expressing healthy anger should not frighten or intimidate. It may feel uncomfortable to talk about feeling angry, but it might set you free from anger.

Example of expressing anger in a healthy way: "I felt angry when you said I was slow because I am self-conscious about my speed. It makes me feel like you don't know me (or: misunderstood, unimportant, invisible) when you say things that I'm sensitive about in such an insensitive way." You may tack on, "it makes it hard for me to trust our friendship when you are insensitive toward my feelings." And if it is true, "I'm telling you this because I want us to be friends and I want to be able to trust each other. Next time this comes up, can you treat me with sensitivity by being supportive?"

9. All feelings and thoughts are acceptable. It is only ACTION that can hurt you and/or other people. Actions like yelling at someone or punching someone in the face hurt others and you. The hurt is fairly obvious to the recipient of acting out in anger, but the angry person can face a range of consequences as well. The person who acts out in anger may feel deep shame after yelling at someone and have no relief from anger, he or she might break a hand, or there may be legal consequences for physically harming someone. In this scenario, we have a perfect example of how acting out can end up harming the person who was initially hurt and angry instead of the intended target or aggressor.

10. What to do with the feelings and thoughts if not act them out? Process them with someone you trust. I'll continue to use anger as an example but any feeling can be inserted in it's place. Be clear that you have no intention of harming anyone but your feelings of anger and thoughts of punching someone in the face are bothersome. What caused the anger? What feelings did you experience as a result of the incident(s) that made you angry? Going forward, how can you talk about your feelings that lead to anger instead of bottling them up? Expressing these feelings allows you to place them where they belong and prevents them from hurting you. The feelings of hurt and anger can become powerful motivators to assertively set boundaries when faced with the choice of acting out or speaking up in the future. Connecting the dots between how our interactions and behaviors influence our relationships is a crucial part of growth and connection.

Final words: do all of these steps imperfectly and seek help along the way. Practice is the only way we learn to change habits and form better relationships. You will not get it right every time, but you can apologize when you have regrets and behave differently and consciously next time.

 

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.