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CBT: Dealing with Stinkin' Thinkin' and The Shoulds

7/14/2014

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Ok - in the last post, we ended on kind of a "down" note (reminds me of "The Empire Strikes Back - who wanted it to end with Han Solo getting iced and Luke losing his hand? C'MON!)   Anyway - back to CBT...

In this post, we're going to talk about what to DO with these shoulds, absolutes, and other negative thought patterns that get in our way. CBT is, as I've mentioned, a very flexible orientation, and there are many systems of therapy that are based in CBT concepts (like DBT, for example.) So, instead of going into a whole lot of specific techniques based in one system, I'm going to touch on some general techniques that you'll find a lot of CBT therapists using.  I've mentioned a few of them in the first post, but I'll review those here again.

One thing I mentioned in the first CBT post bears repeating again: this is NOT a "quick fix" solution to problems. These techniques, and change itself require commitment to practicing the techniques and to changing the way you think and interpret things. This takes time, and does not happen overnight. CBT has been accused also of being a feel-good way of saying that if you think happy you'll be happy. While this criticism has some merit, it's just not that simple. CBT does assert that if you change the way you think, you'll likely feel somewhat better, but does not promise results (like any therapy) and is way more complex than the simple "if you think better you'll feel better" platitude.

Ok - on to the nuts and bolts again. When you're involved in doing CBT or going through one of the many CBT-based workbooks you can find in the self-help section, you will see that there are many commonalities. First, you are likely to be asked to either talk about what the problem is (to help the therapist understand your interpretations and perceptions as well as your thought patterns) and/or fill out some paper-pen type questionnaires (called "inventories" in the clinical field.). These inventories will ask about a variety of symptoms (to help therapist or you get a handle on what's going on.) For example, if you come in thinking or feeling depressed, you might be given something called the "BDI" (Beck Depression Inventory - guess who developed that? ) This questionnaire asks you to rate the severity of common depressive symptoms that you might be experiencing. There are other inventories and symptom checklists that are useful as well. Well and good, so when do we get to the CBT stuff?

A-ha...remember the "B" part of CBT? That stands for "behavior" - in order to work well here, your therapist (or you, if you're working in a workbook) needs to know what you're experiencing and doing, as well as what you're thinking. There really is a reason behind the stuff we do - promise! How we act often reflects the way we're thinking - we interpret things, we feel an emotion related to the interpretation, and we act based on the interpretation and the emotion. Ok...so you've filled out the inventories, done all the paper work, described the situations and what you've been feeling - now what? 
That's where the "behavior" part - what we do - comes in. A lot of the "homework" and activities in CBT is, quite frankly, behavioral. 

Here's where the workbooks and being in therapy differ some. The workbooks will go straight into the things that we typically call "homework," where a therapist will explore the situations more in-depth, provide support, and help you see and work with the stuff that brought you in. This is why I really recommend therapy (ok - I'm biased, too - I admit it). The workbooks can be really valuable resources; I use them myself as part of the work I do with clients sometimes. I've recommended them to clients, and I use them in session, when appropriate - they make my job easier because I don't have to reinvent the wheel here in terms of homework. BUT, they don't provide you with that ongoing sense of support and empathy that you get with a well-trained therapist. It's a choice you make, though. 

When you're working with a therapist, the therapist will help you identify the thought patterns that are getting in the way for you - are you thinking in absolutist terms? Are you overwhelmed by "shoulds"? What about feeling like everyone should like you - or that you should do everything to make people like you? You get the idea...the therapist will spend time talking with you and helping you identify where your thinking and/or interpreting get in the way of you feeling better. The workbooks may have you answer a lot of fill-in-the-blank questions or do a lot of sentence completions, but the goals are the same: helping you identify the types of negative thinking or interpreting that are not helping you.

Typical homework assignments include keeping a record of your thoughts and how those thoughts affected your emotions and behavior, or keeping track of how many times you catch yourself sliding into one kind of thought pattern. There are also behavioral challenges or assignments to help you practice a new way of interacting with and intepreting the world around you. I once kept track for a week of all my "shoulds" - I filled an entire 70-page mini-notebook! It's really eye-opening when you realize how often we engage in these ways of thinking, and how much they affect our moods and behavior - which is, of course, the point of the exercise!

Next, what may happen is that you may be asked to work on contradicting or "softening" these patterns. For example, if you're overly harsh with yourself, you might be asked to come up with thoughts or phrases or sentences to tell yourself that are loving, accepting and/or nonjudgmental. If you're stuck in a pattern where you're overgeneralizing things or magnifying/minimizing, you might be asked to come up more realistic interpretations. Many times, some of this work is done in the therapy room with the therapist helping you, because for many people in therapy these thought patterns have become habits. It may have happened out of ongoing abuse or neglect - these patterns are likely part of what helped you survive, or it may be something that's resulted from some situational things going on like, "I've been out of work for a year, and I'm worried I may not have enought money left to meet my or my family's basic needs"  or "I can't seem to get myself to feel better even though it's been two years since my great-aunt Clara passed away". 



Situations have a LOT of power - we tend to interpret our stuff in terms of the situation ("I was speeding because I needed to get home to a sick child") but we tend not to give others the same benefit of the doubt ("They were speeding...what jerks. I bet they cut everyone off and run red lights too"). As a side note: If you've taken introductory psychology, you'll probably recognize a few concepts here: self-serving bias, fundamental attribution error, actor-observer effect...

So, your therapist may use some gentle challenges, some reflecting, some humor (when appropriate), summations, "check-ins" (making sure they understand what you're telling them), etc. In therapy, you may also use some of the "workbook techniques" - they're very useful as homework.

With both the workbooks and in therapy, you'll also examine what triggers the thoughts, the emotions, and the behaviors - you may find that a certain style of thinking or way of interpreting things is behind the way you feel or behave. Or it may be something in your environment - a certain authority figure that reminds you of someone in your past who'd been critical, or a certain place, smell, sound that triggers memories and experiences from a a traumatic event - it's hard (or even impossible) to think clearly and well when you're re-experiencing something traumatic. (Here's where working with a therapist is really helpful - the therapist can help with the PTSD symptoms as well as the cognitive stuff.)  From there, you can work to change, heal and hopefully start to feel better.

One thing I want to say about triggers: If you're dealing with PTSD or things that trigger severe emotional distress, please see a therapist. The therapist can provide a safety net where you can work on and process these triggers, and can again provide support for you while you're working on these. Any time you're dealing with severe or chronic emotional distress, it's best to see a professional who can do more than anything you'd find in a workbook or web site. A therapist can also help you go more in-depth and safely explore the event(s) or trauma behind the triggers. Workbooks and web-sites can provide tremendous support and information, and  they don't take the place of a really good therapist. I don't want to diss support groupgs and websites - they are incredible and filled with fantastic people who have been through, treated or supported people through some pretty traumatic stuff. However, if you're in the throes of serious distress, adding a good therapist to that mix will only help you.

Ok - back to nuts and bolts: Another area you'll want to concentrate on, again with both the self-help stuff and in therapy, is what to do to help you maintain any changes you make and/or improve on them. Changing things in your lifestyle may help (for example, if you're dealing with depression, building in some exercise into your routine will likely help you feel better), as would continuing to use some of the tools you've used in therapy (like the mood log, or examining realistic vs unrealistic thinking). These aspects of therapy or self-help can help you manage situations in the moment and help you realistically process and think about them afterward.

The nice thing about CBT is that what you do and how you do it really is individualized. It's not about unconscious motives, Oedipus complexes, penis envy or any of that - it's about what YOU can do to help yourself think in a healthy manner, feel better and change your behaviors so that you're interacting with the world in a way that creates a better life for you. It's not a one-size-fits-all orientation either - CBT, through research, is always working to incorporate things that help and are validated by research. That said, sometimes it can seem "manualized" and "remote" - if this is the case, bring up how you're feeling about it in therapy, and process that with your therapist. If you're using a workbook, ask yourself what you're hoping to see in the workbook, and where you're missing what you wanted - then get recommendations for something new, or scale down your expectations and continue to work the program. (And expectations are a whole AREA of cognitions to work on, by the way!).

So...if you have questions about specific techniques, or want to know more about a specific area of cognitions and/or disorder where CBT may be helpful, feel free to comment or send me an email. I'm always happy to help, and answer all the comments and emails I get.

Take care and think well!

Please Note: The content on  this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.

If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help. Email me at: thepowerofeachother@outlook.com

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CBT: What is "Stinkin' Thinkin'"?

7/14/2014

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Now that you've gotten a pretty good idea of what CBT is and how it might work, let's take a more in-depth look at understanding how negative thinking and interpretations of the things around you affect you. Let's start with the kinds of negative thought patterns that are related to feeling rotten (I know - great way to start, huh?) Albert Ellis and Aaron Beck are two guys in our field that are pretty much the founding fathers of CBT. They both start with types of negative thinking or information processing - Ellis calls these "irrational beliefs" and Beck calls them "errors in information processing." (Ellis, by the way is the dude who came up with the phrases "stinkin' thinking," "catastrophizing," and "don't 'should' on yourself". The man is blunt, but he does know how to turn a phrase!) The gist of these is that we get caught up in unrealistic and unhelpful ways of thinking, interpreting and perceiving ourselves and the world around us.

Ellis has 11 "irrational beliefs" that he describes:

  • It is essential that a person be loved or approved of by virtually everyone in the community
  • A person must be perfectly competent, adequate, and achieving to be considered worthwhile
  • Some people are bad, wicked, or villainous and therefore should be blamed and punished
  • It is a terrible catastrophe when things are not as a person wants them to be
  • Unhappiness is cause by outside circumstances, and a person has no control over it
  • Dangerous or fearsome things are cause for great concern, and their possibility must be continually dwelt upon
  • It is easier to avoid certain difficulties and self-responsibilities than to face them
  • A person should be dependent on others and should have someone stronger on whom to rely
  • Past experiences and events are the determinants of present behavior; the influence of the past cannot be eradicated
  • A person should be quite upset over other people's problems and disturbances
  • There is always a right or perfect solution to every problem, and it must be found or the results will be catastrophic.
These are pretty harsh statements, don't you think? While some may be true in part, having these roiling around in your mind as absolutes can really make it hard for you to see things as they are. Beck's list is somewhat similar (but shorter!):

  • Arbitrary Inference: Coming to a certain conclusion without any evidence or in the face of evidence to the contrary. (Example: "I'm an idiot.")
  • Selective Abstraction: Pulling out one little bit of a situation and ignoring other meaning ful pieces, followed by labeling or interpreting the whole thing based on that one little bit. (Example: I got a "C" on my exam. I'll never get into grad school. I'm going to flunk out, I just know it.")
  • Overgeneralization: Making a general rule out of what really should be an isolated incident - then using it over a whole range of situations. (Example: The driver of that car was an idiot - he cut me off! Ah, he's from California...the people there don't know how to drive. I'm sure he's a hippie, too.)
  • Magnification: blowing something out of proportion (Example: You ruined this whole trip by not sharing a room with me. This whole thing is just a mess now.) Minimization: the opposite of magnification - making things that significant seem insignificant or nonexistant. (Example: An abusive spouse, who after hitting someone says, "It was just a tap. It wasn't anything.")
  • Personalization: Thinking it's all about you, even when there's no reason to think so. (Example: "Oh it just figures it would rain. It's MY prom day, and of course, there's bad weather.")
  • Absolute and/or dichotomous thinking (Also called "black & white" and "either/or" thinking): Not seeing the "gray area" or middle ground, and categorizing people, "I'm the worst mother in the world" or "Nobody will ever like me" or "I'm a failure.")

Another type that is common here - and probably falls across a lot of these categories is the "should." Ellis had a phrase that I love: "Don't 'should' on yourself," and I have to tell you that as true as it is, it's also hard to break the habit of shoulding. And, quite frankly, not all shoulds are harmful - some of them are the glue holding our society together: we should follow the law, we should not harm other people, we should respect other people's boundaries, etc. However, there are a LOT of shoulds that can and (pardon the pun) should be examined - do they help us or not? Even becoming aware of all the shoulds is a tough process - a lot of them are so ingrained in how are and who we are that we don't even think of them as "shoulds" anymore. Things like, "I should not complain, even when ________ hits me," or "I should not air my family's dirty laundry" (even when doing so would stop abuse). "I should be over it by now" "I should be a better ________" " I should do _______ better/more often/less"...you get the idea.

Beck thinks that, with people who are depressed (and my guess is that this this true for people in a lot of situations), there is a cognitive triad that is essentially a cycle that is on a downward spiral. The first part of the triad is seeing the self as being fundamentally flawed or defective. The second piece is that the person interprets things as being negative, even when they're not or if there is evidence that they aren't. Life here is always getting in the way and is never good, so the everday aspects of living feel overwhelming and impossible. The final piece of the triad is that the future is probably going to be bad, and the person expects failure to happen.

I don't know about you all...but I see myself in a lot of this. "Stinkin' thinking" and "shoulding" are easy patterns to slip into, easy to make a habit out of. It's especially true when there are others who get let off the hook and gain from us doing this -  they tend to reinforce us thinking this way. There are ways out, though - and as I said earlier, it takes commitment and practice. On that pleasant note...on to the next bit, which will be a lot more upbeat.

So, next up: Dealing with Stinkin' Thinkin & the Shoulds (sounds like the name of a band, doesn't it? "Stinkin' Thinkin' & the Shoulds")

Please Note: The content on  this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.

If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help. Email me at: thepowerofeachother@outlook.com.

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CBT: An Introduction to Cognitive Behavioral Therapy

7/14/2014

 
Ok...I'll be the first to admit that I"m not perfect when it comes to having wonderful, positive, affirming thoughts about myself. One of the reasons I went into counseling psychology as a graduate student was because I wanted to learn everything I could about it, so that I could help myself.  I have a LONG history of working on self-esteem issues, negative thinking patterns, and dealing with unnecessary guilt. The reasons don't matter at this point (to me anyway) but dealing with these issues does. I'm imagining that a lot of you are dealing with this too, so I'm going to share some tricks from the therapists' bag. 

The cool thing is that you can find a lot of these and more help at your local bookstore. So, a lot of these "tricks" (everyday people-ese for techniques) come from a branch of therapy called "Cognitive Behavioral Therapy" or CBT. CBT has a long history, most of which I'll avoid here except to throw out a couple of names when appropriate. The bottom line with CBT is that therapists with this orientation (and trust me, there are many) ascribe to the idea that our thoughts affect our behavior, and that if we work to change the way we're thinking, then our behavior will be easier to change and we'll feel better. The nice thing about CBT is that a lot of research has been done on it, and most of the research is very positive - it's something that generally works, if done long enough and well enough. 

Here's the problem though - a lot of people think that since it seems to be based in common sense, it should be easy and quick. Creating change using CBT isn't a "quick fix" - in fact it takes a lot of commitment and practice to get to where you want to be. If you're really looking for change, though, it's likely that you're feeling lousy to start with and will do what it takes to feel better. And CBT generally helps. 

The basics of CBT are grounded in the idea that what we think and how we think about and interpret the world around us affects how we behave. Cognitions are the things that go through our minds: thoughts, interpretations, judgments, hopes, dreams, expectations, reasonings, rationalizations, plants, motivations, doubts, images - pretty much anything that goes on in your conscious mind is a "cognition." (I use conscious mind deliberately here because CBT therapists generally don't work with the subconscious or unconscious mind - that's a more psychoanalytic approach.) 

Here are a couple of examples of how these work:, "Geez, that driver is such an IDIOT! He cut me off! He saw me, and he cut me off anyway!" is a cognition that can be taken apart for analysis: the observation: "he cut me off,:, the interpretation: "he cut me off deliberately," the assumption:"he saw me," and the judgment:"what an idiot!" And another: "I can't do anything right. No one wants to be around me anymore because I'm such a failure. I absolutely nose-dived that interview, and I know I came across as stupid. I should have had a job 6 months ago, and I keep screwing it up. No wonder I can't find something." And here's the analysis: The observation: "I don't have a job," the interpretation:  "I'm stupid," "I keep screwing up," the assumptions: ""no one wants to be around me," "I can't do anything right," the judgments: "I'm a failure," "I come across as stupid," and "I should have had a job 6 months ago." And this is just one way to take it apart! 

On to the "nuts and bolts" - what do you do in CBT? Well, when you're working with a therapist, generally we're pretty empathetic people. We're not out to tell you, "Geez, get your act together...honestly!" Frankly, if most therapists were judgmental, mean people we wouldn't have much worth, now would we? Generally, therapists will sympathize with you and check in with you to see if they're understanding you - a process we call "reflection." It works like this: 

Client: I've been feeling really depressed lately. I just look at where my life is and I think I"m just a huge failure. I feel like the worst person in the world. 
Therapist: I'm hearing a couple of things here...first is that you've been pretty down lately, is that right? 
Client: Yeah, pretty much. I still don't have a job and I just can't seem to get out of this hole. 
Therapist: So it seems like you've been pretty hard on yourself...I heard you say that you felt like the worst person in the world. That's pretty harsh. (therapist's interpretation of client's statements) 

So, you can see that a therapist - of any orientation - is likely to be sympathetic. From there, where you go with your therapist depends a lot on their orientation, or what style of therapy they do. A CBT therapist will focus on the way you're thinking and how it affects you. The therapist will gently challenge you on negative thinking (or "stinking thinking" as we sometimes call it), and encourage you to think of other interpretations that aren't so negative in nature. Using our earlier example, this is how a CBT therapist might continue: 

Therapist: I wonder where that idea that you're the worst person in the world came from? (exploration) 
Client: Well, I can't seem to do anything right. Nothing seems to work out the way I want it to. I can't get a job, I can't do things right with my husband. Even my kids are mad at me. 
Therapist: Wow...that's a lot of stress. (empathizing) You know, though...somehow I think there are people who are probably a lot closer to being  "the worst person in the world" than you are...you know...maybe guys like Hitler? Somehow, I'm guessing that you're a little higher up than he is on that scale. What do you think? (gentle challenge, with a little humor) 
Client: <laughing a little> Yeah, you're probably right on that one. I still feel pretty lousy about myself though. 
Therapist: I know you've really had a tough time with the job stuff and what's going on at home. Is it possible that maybe it's not all because of you, though? What else could be going on? (reframing) 
Client: Well...I guess the economy is probably making it harder to find jobs now. I still feel like I should have gotten something by now. 
Therapist: <making time out signal> whoah...hang on there...time-out. Do you remember how we talked about "shoulds"? How they're like guilt-trips inside your head? I just heard  you "shoulding" on yourself... (gentle confrontation) 
Client: yeah...I guess I am pretty hard on myself. 
Therapist: What would it be like to ease up a little? What would change? (challenge and exploration) 

And so you see, that the therapist here is working with the client's pattern of thinking negatively about herself. We use gentle challenges, reframing things ("what else could cause this"), turning negative thoughts into positive thoughts, and give clients "homework" - thing to practice and use between sessions. It's actually a pretty cool system. If you've read my posts on DBT (Dialectical Behavior Therapy), you'll recognize some of this. DBT is a specific form of CBT. Another cool thing is that you can find CBT-based self-help in a LOT of places. New Harbinger, a publisher of self-help materials, has a lot of self-help workbooks that have a CBT orientation for dealing with all kinds of issues: depression, anxiety, stress and relaxation, obsessive-complusive disorder (OCD, and I would recommend working with a therapist if you're dealing with this), PTSD, anger, and grief and sorrow. And I'm sure this is only a partial list! 

The point is, CBT techniques are relatively easy to teach and learn - the tough part is putting it together, practicing them in real-life and actually continuing to use and practice them. This kind of therapy can help you learn a lot of things: coping skills, relationship skills, and all the nuts and bolts stuff we talked about: reframing, thought changing, challenging negative or all-or-nothing thinking, and a whole host of other things Next up: "Stinkin' Thinking" - how to work with negative thought patterns and some more tricks from the therapists' bag. 


Please Note: The content on  this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral. If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help. 


Email me at: thepowerofeachother@outlook.com to ask questions or get information.

What Makes You Happy?

7/13/2014

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Here's a story: One day the Master announced that a young monk had reached an advanced state of enlightenment. The news caused some stir and some of the monks went to see their younger brother. "We heard that you are enlightened. Is it true?" they asked. "It is true," he said. They asked him, "And how do you feel?" And the younger monk replied, "As miserable as ever."

What I've found through working with and being around a lot of people is that often we don't know what makes us happy. We seek it in many places, some of them harmful when carried out to excess: drinking, substance use, gambling, spending money. We also seek it in relationships, where we yearn to be with someone who "completes" us (cue Jerry Maguire, "You complete me.") We seek it in doing things, being busy, being "successful" or as perfect as we can be - at many, many things. How often, though, do we look inside and really ask ourselves, "What makes me happy?" If you do it, the answers may surprise you.

There's a whole branch of psychology that is dedicated to understanding happiness - it's relatively new and goes under the heading "Positive psychology." Two of the leading people in this field are David Myers and Martin Seligman - both of whom wondered why psychology focused so much on the negatives. Research in this area has found that (to quote Madame de la Fayette) "if one thinks that one is happy, that is enough to be happy."

Now I know this sounds like a "pat answer platitude" that oversimplifies things. And to some extent, it is - but there is also wisdom in this saying. As I've discussed before, how we think about and perceive ourselves and the world around us affects how we feel. This is definitely true for negative emotional states like depression and anxiety, but it's also true for positive emotional states. It's not a fixed, easy answer, but rather a factor in what makes us happy.

So what are happy people like? Well, David Myers wrote in his book, The Pursuit of Happiness (1992) that the "best predictor of future well-being is past well-being" (p. 106). Does that mean if you've had a miserable, abusive, or depressed past you can't be happy? Heck no. Does it mean that it's one factor in a whole group that affect happiness - yes, and only that. Myers wrote that happy people in general tend to like themselves, feel like they can choose or have power over their destinies, are hope-filled and outgoing. Ok...this is great as far as it goes - what if you don't like yourself, feel helpless or that your life is out of control, feel like there's no hope and that you're an incurable introvert? Well, honestly - you're probably not happy.

I'll tell you that for a very long time, my self-esteem was in the toilet. I felt like I didn't have control, that the future was hopeless, that I was ugly and stupid, and that I was always going to be that way. Obviously, something changed. I won't like and say that everything is sunshiny goodness and happy-happy-joy-joy every day - that's just not realistic for anyone. Overall, though - things did change AND I still struggle with feeling the way I used to sometimes.

The thing is, changing these factors means working on change in yourself. There are certainly things in life we can't control, and we have to learn how to accept and deal with them. Changing ourselves doesn't mean putting on a mask and pretending that everything is hunky-dory fine, either, though. (I have to admit that there are days when it's pretty tempting, though.) What it means is that we learn to look at the world through a different set of lenses (not always rose-colored, either). Ok - you don't like yourself - what do other people like about you? Feel like you can't do anything right? Make yourself write a list of things you have done right. If you feel like everything is out of your control and you're helpless - examine and list everything you CAN control. For example - you can control your reactions to the world around you. Certainly others' actions, words, and ways of being affect us - BUT we choose how we react to those things.

The idea here is that we "act as if." It's a pretty well-known CBT and DBT trick - even if you're not feeling happy, act as if you are. You're not "putting on a mask" because when I say "act as if" I mean completely, fully, and totally immerse yourself in this acting. "Putting on a mask" implies just looking as if you're happy - I'm suggesting not just looking as if, but acting as if and even trying to think and feel as if. It's hard work - I won't lie, but if you try it for a little while you may be surprised at the results.

When people come to see me professionally, they (and/or others) are usually focused on what's wrong. As in, "What's wrong with me/him/her?" One of my favorite questions, when we have a certain amount of trust built is, "What's right with you?" It's a powerful question, and we almost never ask it. It's worth thinking about: What's right with you? Right here, right now. Really - what is right with YOU?

One other thing that I see a lot of people doing is looking for something outside of themselves to fill the emptiness and sadness inside. Things, substances, relationships - none of those can make you happy long-term if you're not accepting and growing inside. Again - they certainly affect how we feel, but if we're looking for things to make us happy long-term, nothing outside will ever completely work. It has to come from inside at its core. While "Jerry Maguire" and other movies may promote the idea of the relationship that fills us, in the end we have to be complete in ourselves before we can truly create a "complete" in a relationship. Asking someone else to fulfill us and fill us up is asking too much of anyone - they can't read our minds, predict what we want when we want it, or somehow just know exactly what we need - we have to communicate and reciprocate for a relationship to work, and that means we have to have to have a strong sense of self from which to work from. (And yes, that's hard experience talking as well as training!)

So, being happy comes as much from us as is it does to us. Which brings me back to my original question - What really, truly, deeply makes you happy? Think about it - and you might just be on your way to finding it.

Until next time...I'll be on the other side of the couch, waiting to hear from you.

As Always:

Please Note: The content on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.

If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help. Email me at: thepowerofeachother@outlook.com

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Being "Cooped Up: Finding Freedom and Safety to be Ourselves

7/13/2014

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Have you ever noticed how kids act up and get into trouble when they're forced to be in a small space for a long period of time? It might (or might not) surprise you, but we "big people" are pretty much the same. These thoughts occurred to me last summer as we drove from our home in Colorado to visit my mom in Utah and from there to visit my husband's folks in Idaho

Now my kids are generally pretty good travelers, and we bring lots for them to do. I found that *I* got pretty cranky though, and felt antsy when I couldn't move a lot. Psychologically, we're like that too - when our minds and spirits are "cooped up," we tend to get irritable, cranky, and antsy.

"Cooped up" is obviously not a psychological or clinical term, but it's good for how we feel when we can't be ourselves - we're mentally and emotionally locked in a room that we can't leave for a variety of reasons. Maybe we're a little eccentric and people just don't understand us or think we're weird. Maybe the people and environment around us is toxic and it's not safe for us to be ourselves. Maybe we risk punishment in a variety of ways (ostracism, abuse, denigrating comments or discrimination) if we truly show who we are. My point is that we can't always be ourselves and that we suffer as a result.

Our world doesn't tolerate diversity and difference very well - we seem to be the kind of being that has to learn the hard way that our behaviors toward those who are different are hurtful and cruel. Sometimes, we don't realize this until we experience it ourselves and our eyes are opened. Some people never realize it, and some people never experience or recognize what it's like to be different. As painful as some of the experiences are, I think that coming through and overcoming them makes us stronger, more compassionate and more willing to change our own behaviors. In short - we grow, and become better people for the growing.

However, being emotionally and/or spiritually "cooped up" damages us while it happens. Part of being human is being able to express ourselves and who we are - it's what brings us joy and peace. Acceptance allows us to feel safe in sharing those soft vulnerable places where we let our humanity shine through. And being safe is crucial to being able to be who we are. When we're not safe, when we feel judged, or when we have to hide who we are, we wall off a part of ourselves that is crucial to being psychologically healthy. We lose the ability not just to play, but to grow, to thrive, to experience and fully immerse ourselves in joy and vitality.

Over time, we become anxious, depressed, angry, lonely, and maybe even traumatized (especially if abuse - ongoing or not - is occurring or has occurred.) We find ourselves "just getting through" - we may have trouble even knowing how to cope in healthy ways. We start to lose respect for and acceptance of ourselves as worthy, beautiful and interesting people. We may become isolated. It's tough to see the beauty in everyday life when we're focused on surviving and making it through instead of on living and thriving. It's next to impossible to feel free when you're cooped up by yourself or others and are unable to even think of breaking out. We become afraid - not just of the what will happen if we be ourselves, but of the punishments that hurt us and break our spirits. Fear becomes the companion of everyday life rather than joy - and the cost is locking up and losing ourselves.

I watch my children develop, and I really try to encourage them to be themselves, even if no one else understands.My son Aidan is different from other people, because he's on the autistic spectrum. Here's the thing - I celebrate those differences even as I worry about how he'll cope with being different once he's in school. My hope and goal, though, is that by showing him acceptance and by celebrating the things that make him unique - the things that make him Aidan - that he'll have the confidence to continue to be himself and have confidence in himself. I try to make his world safe and accepting while also showing him the realities of living in this world. We talk about how people are mean, and that it's ok to ignore that. It's ok to like "red balls" (marker balls), light poles, and power poles and not worry what other people think.

I try to use all the "tools" in my "toolbox" to help not just my kids, but myself break through and let go. I'm not completely successful yet, but realizing that this is a process helps (and that's one of the tools, too!) I use my DBT skills, my mindfulness skills, and my art skills to work on this - and I encourage the same in my children. Together we are curious, and go on "adventures" to see what's out there. I learn so much from THEM, too - noticing small things and seeing the world from such a different place...drawing on the sidewalk, splattering paint, using big, wide strokes to paint the world...there is a lot to learn from children.

We ALL need this kind of safety to grow. Without that safety, we may physically "grow up" - but inside there remains a scared, insecure side of ourselves that is "cooped up" and waiting to be able to run. Art therapists key into this when they encourage us to let go and play. The hard thing is that most of us don't know how to let go. Despite years of training, 
I include myself in this - even as I watch and encourage my children, I long to be able to release that side of myself.

One of the projects I've been involved with for a couple of years is a self-esteem seminar through Project Self-Sufficiency. I'm lucky enough to have been one of the facilitators, and one of the things I loved to do during that time was take part in providing safe and sacred space for the participants to let go and be who they were. I'd love to work on a "Letting Yourself Go" workshop, where I provide a safe place for music, dance, art and quiet time, all with the idea of breaking out of feeling "cooped up" and letting out who we are inside.

Just like children who get stuck in cars or planes or rooms or houses - we also get cooped up. We also need space, fresh air, play, safety, and love - and those things are not "extras" or "rewards" - they're basic human needs and if we didn't get them when we were little, let's work to have them now. Not just for ourselves - but for everyone. For the children who never get it, for the people we encounter everyday who are "cooped up" by jobs, bills, daily hassles, etc - we can ALL provide the breath of fresh air and just a little permission to let go.

Take care and remember to play! 

As Always:

Please Note: The content on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.

If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help. Email me at: thepowerofeachother@outlook.com

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Assertiveness: An Introduction

7/13/2014

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"Oh, you want me to organize the next women's group? Well, I've got a lot on my plate, but if you really want me to, I guess I could do that..."

"Ok, I'll get this report done by the end of the day..." (followed by getting caught up in other tasks, conversations, etc.)..."I'm so sorry, things just got out of hand. I'll just try again tomorrow; I might be able to get to it then."


"I'm so tired. But if you need this right away, I guess I can get it done."


Do any of these situations sound familiar? One of the workshops I offer teaches assertiveness skills. I'll admit something to you here: Being assertive is something I still work on, and probably will be working on for a while. So let's start at basics: What is assertiveness?

Assertiveness is first of all a way of communicating. It's worth discussing what assertiveness is not as part of this definition: it's not aggressive, disrespectful, or mean - it's not looking for a fight. Assertiveness is also not passive or passive aggressive - it's not doing things behind someone's back even if you think you're right, it's not giving in or letting someone run roughshod all over you. It's not a tactic for getting your own, way, either. In both of these methods, you have trouble saying "no" or maintaining and respecting boundaries (your own, or someone else's). I've talked about saying no and boundaries in other posts, so I won't spend a whole lot of time on these, other than to say that assertiveness is more than these two important factors. These are also skills that are used in DBT, in the Interpersonal Effectiveness module.

Ok, so what IS assertiveness then? As I mentioned, it's a style of communication. Here's a quote from a workbook I use (and draw upon heavily):

...it recognizes that you are in charge of your behavior and that you decide what you will and will not do. Similarly, the assertive style involves recognizing that other people are in charge of their own behavior and does not attempt to take that control from them. When we behave assertively, we are able to acknowledge our own thoughts and wishes honestly, without the expectation that others will automatically give in to us. We express respect for the feelings and opinions of others without necessarily adopting their opinions or doing what they expect or demand" (Paterson, 2000, p. 19).

The bottom line is that being assertive means being respectful of ourselves and of others. It means being aware of what we want and need, and working to meet those needs in honest, open, and respectful ways, and respecting other people as they try to do the same. Learning to say and hear "no" and developing, maintaining and respecting healthy boundaries are techniques used in assertiveness - they are part of it, but not the whole. Here's some examples of an assertive statements:

"I can't join this committee now. I'm on two other committees and I need to have some 'down time' to take care of myself."


"I just bought this book yesterday, and I noticed today that there is a page missing. I'd like a replacement, please."


"Excuse me, I'm next in line."


So, what gets in the way of being assertive? Lots of things. Again, drawing heavily from Paterson's book, our own fears, the reactions of others to us being assertive, power differences in relationships (e.g., employer/employee, doctor/patient, parent/child, man/woman - I'll address the gender thing in a bit), stress (this is hard work!), our own beliefs about what being assertive means. Stress reactions can be calmed with stress reduction and relaxation techniques. I don't want to minimize the importance of these, but they are a different set of skills and can be covered in a different post.

The other stuff leads up to the stress component, so let's focus on those things. Our own fears and beliefs about assertiveness get in the way for several reasons. First, we may worry that we'll offend someone, or that they'll be angry at us. And the reality is, that may be true. Let's go back to our working definition of what assertiveness is, though - they are responsible for their emotions, reactions, and behavior. Your job is to take care of yourself, in a way that's respectful - and that means respectful of yourself as much as anything. Dealing with someone else's anger is tough, I'll admit. (When you're in a relationship where abuse is possible, it can be downright dangerous, and this is where you want to have support - people you trust and that can help, a place to go if you need it, and a safety plan. This post isn't meant to address abuse situations.) Anger comes up a lot when you're changing your style of interacting - if you've always been passive before, seeing you change may be a shock to the people who are used to having their own way. And you know what? They'll adjust. Your fear, though, can get in the way.

So what do you do? Well, imagine you're a coach - what would you tell your client or athlete? First of all, ask yourself what you're afraid of? What is the worst that can happen? Are your fears realistic? If so, how can you help yourself, respect yourself and still be assertive? (Tough question, I know!) Second, try it out. See what happens - you may be surprised. Maybe you can find a less stressful or lower intensity situation in which to practice. Success is the best reinforcer here; if you succeed and have a good experience you'll be more likely to do it again. As the title of one book says, "Feel the fear and do it anyway." Here's the thing - if our fears get in the way, we tend to act out of our fears rather than acting out of the need to respect and meet our needs. The result is, we don't get our needs met.

Your other beliefs about assertiveness can get in the way as well. Do you belief that being assertive is unladylike or bitchy? Do you believe that it's selfish, or that other people's needs come first? These are all things that women who are assertive face in this society, by the way - there's that gender thing. Do you think it's impolite to disagree or say "no"? Many of us were raised to disrespect our own needs and focus on others. Being assertive after all this training otherwise is hard. Examine these, and look at how these beliefs affect your behavior. Then try an experiment - just try, once, to contradict one of these and be assertive anyway. See what happens.

Ok - now what about how everyone else reacts? Well, we've already noticed that other people may react by being angry, offended, or puzzled by your new assertiveness. This is where your boundaries become important. Don't back down, but don't get aggressive either. It's important to keep and maintain those boundaries.

Here's a good rubric for being assertive:

  • Decide whether to be assertive
      Is this a problem?

      Is this the time and place to be assertive?

      What are my chances of success?

      Am I willing to do this? It's going to take time, energy and maybe some risk.

      Will I be able to handle the stress of doing this?
  • Decide what to say
  • Decide what to do
  • Assess the results:
      What did I do?

      What happened?

      How did I feel about it?

      What could I do differently, if anything?
Ok, believe it or not, this is just a little part of the workshop. (It's a long post, I know). 


As Always:
Please Note: The content on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.

If you are in crisis or danger, or are thinking about hurting yourself, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help. Email me at: thepowerofeachother@outlook.com

References:
Paterson, R.J. (2000). The Assertiveness Workbook. Oakland, CA: New Harbinger.

Stephen Ministry Leader's Training Manual. (2000). T-6, Assertiveness: Relating Gently and Firmly. St. Louis, MO: Stephen Ministries.

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Dealing with "No": How to Say It, How to Take It

7/13/2014

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"No" is one of the first words we learn to speak, and it's loaded with a lot of emotional baggage. When we first learn to say "no" as a toddler, we have likely heard it enough times that we know what it means, and it's a first expression of our individuality and independence. We learn that "no" means stop doing something, it means we can't have what what we want, and it means annoyance, disappointment and sometimes, hurt. However, we also learn to say "no."

As we get older, though, saying "no" gets harder. We learn pretty quickly that saying "no" to Mama and Daddy doesn't work too well. Saying "no" to teachers doesn't work at ALL well. We hear "no" more often too. Women especially learn that saying "no" is harder because we're expected to be nurturing, kind, caring - all those things that fly in the face of an honest and sometimes appropriate "no."

Dealing with "no" and setting/maintaining healthy boundaries is a big part of CBT, DBT, and Assertiveness Training Skills - with good reason. Many of us don't learn what good boundaries are and have little to no idea of how to set and maintain our own, or how to deal with others' boundaries.

Saying and receiving an appropriate "no" is a boundary issue and something that we have to learn to deal with everyday in a multitude of situations. For example, I recently learned that I did not get a job I for which I'd hoped to hired. This was a clear "no." Whether it was appropriate or not (my opinion certainly differs from the hiring committee!) isn't the issue here - the issue is how I deal with hearing "no." I won't lie and say I wasn't disappointed, but I'm also not getting into a death-spiral-funk about it either. My boundaries and sense of self are intact enough that I don't take this as a reflection on me as a person.

And that is the trouble with hearing "no." Often, we take it as meaning that we are not good enough or right enough when we hear it. Like children, "no" may mean not getting what we want and we equate it with "no, you're not worthy of/good enough for __________ (fill in the blank)." It may feel like a personal attack, or that the person saying "no" doesn't love us enough, want us enough, or care about us enough. Hearing "no," though, really doesn't mean that it's a reflection on who we are - it simply means that the person saying "no" simply can't or won't meet our need at that time. The reason doesn't matter, what matters is how we deal with "no."

Honestly, there are a lot of ways we can do this. We can do the emotional equivalent of having a temper tantrum and yell, insult, or fight with the person saying "no." (You see this all the time in comments sections under articles or stories on the net.) We can turn the cold shoulder and freeze the person out. We can try and try to change their mind, even when it's a clear "no." However, all of these methods are boundary violations - we are violating the boundaries of the person who said "no."

So how DO you deal with it? First, recognize that it's not a reflection of your value as a person or your value to the person saying "no." That's a hard pill to swallow, I know - many of us learn through life experience that our value to others depends on pleasing them, and we alternate between trying to do that and rebelling against that internalized message. The idea here is "no" simply means "no" and that it doesn't mean we're bad people or that the other person doesn't care about us.

Next, ask yourself how you would want the other person to act if you had to say "no" to them. (I know - I can hear a lot of you saying, "but I wouldn't say "no" to them!" Just go with me on this, ok? :) ) Would you want them to scream, cry, threaten you, insult you, try to change your mind? Somehow, I don't think so. This is where the "golden rule" really has value - treat them the way you'd want to be treated.

Also, if you have to vent - if you think the "no" was unfair, was mean, etc - vent in your journal or to someone else. Venting is not a bad thing; you just want to use it appropriately. Venting at the person saying "no" isn't going to help and may in fact damage your relationship with the person beyond repair. So think about how you want to react to them, and where you REALLY want to vent - and then do it in a way that is safe and respectful. Respecting the other person's boundaries is something we all have to learn to do.

So, what if you need to say "no"? Well, again the golden rule applies: we don't want to be mean, sarcastic, threatening or insulting. The goal here is to first respect our own boundaries and then be respectful of the other person's. Assertiveness training and skills come in handy here, but generally a kind but firm "no" is all it takes. You don't have to explain it (you can if you want), and you don't have to change your mind, even if the other person doesn't respect your boundaries. You can use what is called the "broken record" technique if you need to. "I'm really busy that day and can't drive you to the picnic." "I'm really busy that day and can't drive you to the picnic," etc.

If the other person is not respectful of your "no," you have the right to remove yourself from the situation or to be firm and clear about your "no." You don't have to be angry or threating in your tone of voice (although you may feel justifiably irritated and annoyed!). Women especially have a hard time saying "no" appropriately because we've been socialized to be the nurturers and caregivers. Saying "no" contradicts the "take care of everyone else before you take care of yourself" mantra that is the undercurrent around traditional women's roles. Saying "no" is an important skill.

So here's an idea for you: Keep track of how many times someone says "no" to you and to how you react. Also, keep track of how many times you wanted to say "no" and didn't, and how you felt about yourself and the other person. Finally, keep track of how you did say "no" to others, and how you felt. It's an interesting exercise and very eye-opening. Even simply paying attention to the pattern can help you see and work on appropriate boundaries. And that, my friends, is a very good thing.

As Always:

Please Note: The content on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.

If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help. Email me at: thepowerofeachother@outlook.com. You may also call me at (970) 776-6043 for information.

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Dealing With Trauma - Coping

4/28/2014

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Due to the length of this post, I am dividing it into two sections for readability. If you have any comments or questions, please feel free to contact me: thepowerofeachother@outlook.com.

During my training, I developed an analogy I'm going to share with you here. Using medication and therapy together is like working to fix a house with a crack in the foundation. The first thing you have to do before you fix the crack is shore up the house, right? Using medication is like shoring up yourself - it takes care of the biological and chemical aspects of what is going on. One thing I want to emphasize - these medications are not addictive! They help stabilize you and bring you up to feeling normal, NOT feeling "high." From there, you work to fix the crack in the house - this is where the therapy piece comes in. If you try to fix the house by shortcutting either one of these steps, guess what? The foundation is going to stay cracked, get worse, or possibly break again. Using both tools (medication and therapy) will help you heal the foundation and make your house - you - stronger by helping you learn to recognize problems and deal with them in a way that keeps you healthy and whole.

With these things in mind, there are things you can do to help yourself as well. Among those things are some of the techniques I mentioned earlier in the "Coping with tough times" posts. The difference here is that there is a slightly different focus. When you are dealing with recovery from trauma and/or PTSD, anxiety and fear are huge issues that don't simply "go away." When you're working with anxiety, self-soothing to reduce the anxiety, worry and fear that you feel is crucial. So, the same things I mentioned before: listening to relaxing music, meditating, journaling - whatever you find soothing and helpful that does NOT become hurtful - will help some.

The cognitive - or "thought" - piece that's different is that you want to recognize and acknowledge the emotion specifically related to the trauma or experience - "Ok, I'm really anxious and feel like I'm coming apart at the seams. What is behind this anxiety? Am I afraid that <insert whatever traumatized you> will happen again?" If that is the case, asking yourself, "how likely is it that it really will happen again?" may help.  In some case, the likelihood might be high - you'll want to work on what you can do to protect and shelter yourself if that's the case, and working with professionals in many fields (police, medical, psychological) may be part of that process. In other cases, the likelihood of the event reoccuring may be low - in that case, reassuring yourself that you're safe, that you're doing everything you can to keep yourself safe may also help. Please - again realize that you don't have to do this alone. The support you'll receive from a good therapist can really help you feel better.

Another area in which you may want to work involves your boundaries. Especially for those of you who were victims of abuse, rape or other traumas where your physical and emotional boundaries were violated, setting and maintaining healthy boundaries is crucially important AND very hard work. For those of you who are in situations where your boundaries are still being violated, setting and maintaining healthy boundaries may threaten the person violating them - for you, I would strongly recommend seeking the support of a professional in working on these issues, creating a safety plan, and having an escape ready if necessary. You will need support and possibly protection, and working with a professional - whether it's a medical doctor, psychologist, therapist, or clergy - will help you get the physical and mental protection and support that you need. Do not hesitate to call 911 if you need help!

Learning to set boundaries takes practice and work. I've done completely separate posts on working on boundary issues, but for now, let's first discuss what boundaries ARE. The basic idea here is that a boundary is something that separates you from everything else. Your skin is a boundary between your insides and the outside world, and protects you from injury. Likewise, psychological boundaries are the ways that you know you are separate from everyone else around you. To quote the title of a popular book on boundaries, they are "where you end, and I begin." ("Boundaries: Where You End and I Begin" Anne Katherine). Another book described boundaries this way: "They define what is me, and what is not me" ("Boundaries" Henry Cloud & John Townsend). When your boundaries are violated, you are being told "it doesn't matter who you are, what you want, or what you need. What I need or want is what counts, and I'm going to take it whether you agree or not or whether you say no or not." For many of us who have experienced trauma, our boundaries have been severely violated and compromised; this leads to a sense of helplessness, fear, anxiety and/or depression. The best thing you can do at this point is first realize that your boundaries have been violated (and that you have a right to even HAVE boundaries), and from there, work on realizing what they are and how to set and maintain them. This, as I know from experience, is hard work.

Working on boundaries though, also helps you work on and deal with trauma. By building boundaries, you are saying that you have the right to be whole, the right to control who and what has access to your body, your thoughts, and your feelings. Dealing with trauma also involves understanding and working with your feelings. Emotions can be very frightening and very threatening sometimes, especially if they are powerful or intense, like anger/rage, depression, or anxiety. It may feel like they are going to engulf you, drown you, and/or never end. This is where envisioning the emotion as a wave can be helpful (see the previous post for more information.) If you feel you can't stand it, that you are going to do something harmful like cut yourself, hurt yourself or someone else - get help - call 911. If you're not to that point - do something that will help yourself - call a friend (or sponsor if you're in a 12-step program), distract yourself if it helps, write it out, something that will help you. The thing is, the emotion WILL pass, and you WILL survive it.

In "dialectical behavior therapy" - one of my areas of expertise - we teach people some skills for "emotional regulation" and "distress tolerance." These skills help people deal with the overwhelming sensations that their emotions are going to engulf them. What I've described for you in the coping skills post are some of those skills. I will write more about DBT in coming posts, as it is a very helpful system for dealing with trauma, emotional storms, and coping in general.

Trauma is also isolating - we may feel that we're all alone in this, or that we'll be punished or embarrassed if we talk - a common phrase I've heard is "we don't air our dirty laundry to others." The thing is, the "dirty laundry" that is being aired is often the very stuff that is traumatizing. Opening up - say, in the context of a trusted relationship or a support group, can be the most healthy thing you can do - you'll find out you're not alone, and that other people have experienced similar things. You may feel like you don't belong, or that you're alone, or that you're somehow "damaged" - being with other people who have experienced similar things or with someone you trust can help you see that you're not damaged and not alone.

The final thing I want to say at this point, is have a safe space. Someplace where you CAN relax - at least a little - and feel safe just being and healing. This might be your bedroom, a special spot in nature, going to your place of worship, or even just creating a safe spot in your mind, wherever you happen to be. While you're in this safe space, breathe slowly and deeply. This is part of learning to soothe yourself, and is part of healing. If you experience triggers related to your trauma, get help if you need it - take care of yourself! If you don't need immediate help, do what it takes to get through it.

Please Note: The content on  this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.

If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don't have to be alone in facing these things - there are people who care and who will help.

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Coping With Tough Times, Part 2: Coping Skills

4/28/2014

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Ok, so what do you DO if things are still tough? "Tough Times" can be found in relationships, financial troubles, work situations, family issues - a whole range of things. What's "tough" for you, may not be tough for someone else, and what's tough for them might not be for you. So, given that these things are different for different people, what are some things that pretty much everyone can use? First of all:

If you have been feeling down for two weeks pretty much every day and for most of the day, if you have thoughts of hurting yourself and/or others, or if you're having trouble functioning, please see your doctor right away -  you may be dealing with clinical depression. If you are feeling that you might hurt yourself or someone else, please call 911.  Please also realize that seeking help really is a sign of strength and belief in yourself and not a sign of weakness.

As part of my training and my work with people in various situations in their lives, I learned a lot about coping skills - the fancy name for "learning to deal with it" - whatever "it" is. As you might imagine, this is a pretty important topic for therapists and their clients. And to be honest - I practice what I preach, and use these myself. There are a LOT of good self-help workbooks out there - I'll give a list at the end of this post - and these may help you structure your coping, if that's what you need. So - on to the meat of the post:

Let's start with things that end up being harmful.  Basically it boils down to two things: Stuff that gets you in trouble, and stuff that ends up hurting you and/or someone else. Stuff that gets you in trouble includes excessive drinking, using mind-altering substances, excessive spending, sex, gambling, not fulfilling responsibilities like going to work, etc. Stuff that hurts you and/or someone else includes: excessive eating or undereating, exercising too much or not enough, losing your temper and abusing yourself or someone else, physically hurting yourself or someone else, beating yourself or someone else up emotionally, getting caught up in or laying on guilt trips, calling names, insulting yourself or others, and talking or thinking in absolutes (like, "I'll never be able to get out of this hole" or "You always ruin my day"). If you're feeling out of control with these things, please find help for them, if for no other reason than it helps yourself and your loved ones.

So what are the things that may help?

First of all - when you're feeling down or really anxious, realize that emotions are like waves - they build up, peak, and then pass. This idea is not new; Marsha Linehan's "dialectical behavior therapy" uses this concept. To cope with strong emotions that really feel like they're going to knock you down, it can sometimes help to remind yourself that the emotion will not last forever, and that it WILL pass. You are not your emotions - your feelings are reactions to things in your environment. Just as your situations change, so will your feelings. For me, I visualize an ocean wave as it builds, swells, and washes over me. You might like this, or maybe a gust of wind - whatever works. The point is, the feelings WILL pass.

Second, you can help the wave pass by distracting yourself. There are many things you can do - I work in my journal, create art, go for a walk, listen to calming music, surf the internet, etc. What you want to do is find something that will take your mind off the "down" feelings - it doesn't have to last forever, but distracting yourself will pay off, even if you only are able to distract for a few minutes. It's at least a few minutes that you weren't focusing on feeling "down" or anxious, right?  There are an infinite number of ways to distract yourself - just use your imagination and see what you can come up with (and yes, this in itself is a distraction!) However, be careful with distractions - don't let them turn into "target behaviors" (the things that get you in trouble or harm you or someone else.)

One thing is important if you're feeling "down"  or super-anxious - do something positive for yourself every day, such as exercise, get involved in doing something you enjoy - a hobby or pastime - , enjoy some quiet time to yourself, etc. Treating yourself as you want other people to treat you (a twist on the golden rule) or as you would treat other people  is very important - you really are worth the effort and deserve to be treated well.

Third, try reframing your thoughts. This is admittedly sometimes a tough thing to do, especially when things feel hopeless or that a situation will never change or end. Sometimes working on changing your thoughts is a conscious effort; if you keep at it, hopefully the positive thinking will feel more natural. If you're having a tough time doing this, try writing down all the negative things you tell yourself and then contradicting them. Here's an example: With my work life, I admit to feeling like sometimes I'm spinning my wheels and not getting anywhere. I remind myself of what I've done (developed a private practice and found work with an amazing group of women at Beyond the Mirror), what I've achieved (my Ph.D., passed my licensing exam), and where I realistically am at (working on new content, expanding into new areas like life coaching, and applying my passions to my work) Reminding myself of the postives can help contradict the negative feelings.

Many therapists recommend keeping a "mood diary" or "thought record" where you can keep track of the thoughts you have, the feelings associated with them, how you changed your thinking, and what the result of the change was. Again, if this works for you - if you need and/or want to see your progress - by all means do it. It can be very simple - a piece of notebook paper divided into four or five columns (if you want to include the dates), and simply keeping track. It can be more complex, for example setting up an Excel spreadsheet. Keep in mind that first, the very act of doing this at all is a distraction (being busy tends to distract us from our feelings) and second of all, productive because you're working on helping yourself. 

Mary Ellen Copeland, a therapist who deals with bipolar disorder, has developed some excellent tools for dealing with stress. She recommends creating a "wellness action plan" that includes 5 distinct parts:

1) Developing a wellness toolbox (similar to the coping skills described above) and keeping track of your moods and activities on a daily basis (the "Daily Maintenance List")

2) Listing the things that trigger feeling rotten and planning on ways to deal with those

3) Listing the "Early Warning Signs" of impending mood changes, and planning on ways to cut off mood changes BEFORE they get too bad

4) What to do when things are breaking down - how to deal with crisis situations: what the signs of this are, who to call/contact in case of an emergency, and how to deal with this when/if it happens

5) Developing a Crisis Plan: How to help other people know when you're in crisis, how other people can help you, and again who to contact

Copeland's web site: http://www.copelandcenter.com has some excellent information and resources related to this program. She also has several workbooks in publication and again, I'll list those here at the end.

There are also the things that we hear everyday from all kinds of experts: eat well and moderately, exercise regularly (this really DOES work to help moods, by the way), limit how much alcohol and other substances you put in your body, get enough rest and/or sleep, and see your physician if you're having problems in any of these areas to rule out physical/medical causes.

Specifically getting involved things that are designed to be relaxing may also help. Again, listening to calming or relaxation music may help. Other tools include meditation, relaxing tense muscles/progressive relaxation (for example, tense and then relax each muscle group in turn, starting at head and working down), using deep breathing from your tummy (diaphramatic breathing) - all of these things (and more) help ease stress and help you cope with feeling in the dumps.

The bottom line is that working to change your thoughts, helping yourself relax, and soothing yourself by doing things that make you feel better help you deal with feeling down. These aren't a be-all and end-all to always feeling down, or a sure-fire "cure" for the blues. They ARE things that may help, though, and are time-tested tools that have been shown to help.

If you have any questions or comments, please contact me here or via email: theothersideofthecouch@live.com . I'll be happy to talk to you and listen to your input. 

Please Note: The information on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral. If you are in crisis or danger, please call 911 for immediate help. If you wish to contact me, you can call (970) 776-6043 or send email to: thepowerofeachother@outlook.com

Resources:

The Relaxation and Stress Reduction Workbook, 5th ed. - Martha Davis, Elizabeth Robbins Eshelman, & Matthew McKay

The Depression Workbook, 2nd ed. - Mary Ellen Copeland

Mind Over Mood - Dennis Greenberger & Christine A. Padewsky

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Coping With Tough Times, Part 1: Move

4/28/2014

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Today, I went for a walk. That might not seem like a big deal, but for me it was a change, and I’d like to share its importance with you. I moved, and that IS a big deal. I’ll explain why it’s a big deal in just a bit, so bear with me while I give you some background first.

Like many of you, I struggle in this economy. I try to be financially fair to the people I work with, because I realize that services like mine are expensive, and I want people to be able to get the help and support they need. This has been hard for me, though, because I struggle financially as well. I have been waiting for things to change, which brings me to the purpose of this post and the next few to follow. I’m finding that if I simply sit and wait for things to happen, I feel depressed, anxious and frustrated – and I’m generally not a pleasant person to be around when I’m feeling this way. A lot of us are like this - I know I'm not alone. 

So, I decided to change the way I’m looking at my situation and living my life. Here’s where coping with tough times and moving comes in. There are things I can’t control, like the economy, and the fact that many of the things I'd like to do in my business rely on people wanting what I have to offer. There are a multitude of things I can’t control, and if I focus on them, then it’s an easy slide down to feeling lousy.

However, I CAN control myself and how I choose to react to this situation. After talking to people and experiencing unemployment myself, I know that it’s very easy to slip into feeling helpless, hopeless, and paralyzed about the future. There IS something I can do though. I can move. I can move my body, my mind, my feelings and my thoughts.

Ok, I can hear some people groaning, “Oh no…another Little Miss Sunshine who thinks that if I think good thoughts, everything good will happen to me.” So… hang in here with me. I’m NOT going to promise that if you change your thoughts you will automatically attract good things. What I AM telling you is that if you work to change the way you’re thinking, feeling and being now, you may start to feel better. How do I know this? I do it. It's the simple - I practice what I preach.

What I’m suggesting is that you move, somehow – even if it’s just getting out bed to face the day. Moving can be as simple as reframing your thoughts from “I’m never going to get a job” to “Things are tough right now. I’m doing the best I can.” Moving can be, “OK…I’m feeling pretty crummy right now and I have no money. What CAN I do to help myself feel better?” and coming up with ideas. Moving can be noticing the very little, simple things that make life worth living. For me, this is the smiles on my children’s faces and hearing their laughter. It’s feeling the sunshine on my face and noticing the colors and fragrances of the spring flowers. It's enjoying the feel of the wind on my face. For others, it might be the smell of a freshly-brewed cup of coffee, or the feel of your favorite blanket wrapped around you. The point is, moving – no matter how or how much – is a change that may help you start to feel better. And that’s why my walk today was so important – I moved.

I moved my body, and while moving my body, I moved my mind. Moving my mind (thinking) helped me move my feelings. During my walk, I thought about what I have to offer – what are my skills and talents? What am I passionate about? I thought about how to share what I know with others who might be feeling the same thing. And I felt better about myself, in spite of my job situation. I thought about how to market myself, and what I can do to promote my business. In short, moving helped.

SARK has made some worksheets that come from her book “Make Your Creative Dreams Real” involving what she calls “microMOVEments.” These involve taking baby steps toward creating and realizing a dream that you have. Whether you call them baby steps, micromovements, tiny leaps of faith – it’s still movement.

The world isn’t necessarily going to change because you move (but who knows - maybe it will!).   However, YOU may start to  change because you move. Honestly, this post – and the idea of coping with tough times - came out of my desire to feel better. I am “moving” by writing and sharing my knowledge with you. I can’t change the world, but I can offer my skills and gifts as a way to help me feel better and to hopefully make a difference for others who feel like I’ve been feeling.

I’m going to continue to write on ways to cope in tough times. If you have suggestions on topics you’d like to see, please get in touch with me: thepowerofeachother@outlook.com. I’m always interested in feedback and ideas. For you? Move with hope in your heart and life in your soul!

Please Note: The information on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral. If you are in crisis or danger, please call 911 for immediate help.

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    Laura Burlingame-Lee:

    I am someone who thoroughly loves life and believes in the power we have to help each other. I think that having a hot cup of tea, a good book, and a warm, purring kitty are some of the most soothing experiences available in life, and loving my family, hearing the sound of children laughing, feeling rain on my skin, and smelling the salt air by the ocean are some of the best possible things in life! 

    I believe we all have inner wisdom, and that learning to listen to it is one of the hardest and most rewarding things we can do. I believe we all have gifts and talents to share, and that we have the opportunity every day to learn something new. We learn, we grow, and we shine!


    I'd love to hear from you!

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