The Power of Each Other: Blog - The Power of Each Other: Coaching, Creativity, and Counseling

When people are just mean: How to overcome the hurt and anger

8/25/2017

For the past two years, I've been working in nursing homes, offering counseling to seniors dealing with adjustment issues, depression, anxiety and a host of other mental health concerns. During that time, I've learned that there are people who are polite, and people who are just flat-out mean. I recently had the pleasure of trying to interview a gentleman who could not get over the idea that I was fat, and was very obnoxious about it. Factually, he is right - I am fat. I'm not upset about that - it's the judgment and cruelty in deciding that I am less of a human being because of it that was hurtful.

We'll call him "Mr. Jones" for simplicity. When I went into Mr. Jones' room to introduce myself, he immediately said, "Well, you've put on weight, haven't you?" Not hello, not "how are you," - just an immediate comment on my body. I ignored it and introduced myself and told him I was here to talk with him. He, however, could not get past my appearance. I went to sit down, and he said, "You can't sit on the furniture. You'll break it." I let him know, gently and politely, that I had been sitting on the furniture for over two years without a problem, and that I had a job to do. He said, "you're too fat." At that point, even my patience was shot. I said, "Mr. Jones, I am here as a professional and your comments are out of line. My body is not under discussion. I'll come back again on Friday, and maybe we can try this again."

Depression - Dealing with and Taming the Beast Within

7/14/2014

I think I mentioned this story in another post, but I'll tell it here again because I really like the analogy. This was written by a teenage girl who had been dealing with chronic depression. She wrote that it starts with having a bad day. Everyone has bad days, though, right? You don't think about it too much, and go on living your life. Ok, so you have a few more bad days mixed in here and there, but again - everyone has bad days, so it's nothing to really worry about...Then you realize that you're having more bad days than not, but you don't want to think about it because it might jinx you and bring on more bad days - everyone knows that if you let it get to you, then it gets worse, right? So...finally you realize that the bad days are winning - you feel awful, life doesn't seem to have a whole lot of purpose and the future looks bleak. You realize that the beast has caught up with you again, and that you're depressed.

Depression feels like a heavy weight, a wet blanket, and day upon day of lousy weather all rolled into one. AND, it's more than that. To use the example of an antidepressant commercial, depression hurts in a lot of ways - physically, emotionally, mentally, and interpersonally. You feel rotten, it's hard to think clearly and/or move, life sucks and nobody around you seems to understand or care, or care enough. You feel like things will never change or get better. It's bleak.

I'm not going to lie and say there's an easy way out - there isn't. Honestly, what I've found works the best is a combination of medication and psychotherapy, and I'll tell you why. From what I've seen, it's like fixing a house with a cracked foundation. Having the foundation cracked doesn't mean that the house is broken or useless - far from it. It means that some repair work needs to be done, and that the house can be and is worthy of saving.

So...to begin the repairs, you first have to shore up the house, right? Using medications is like shoring up the foundation - it helps get the biological, chemical piece working again so you can get at the root cause and work on that. That's where psychotherapy comes in. Even if there is no deep, dark past to examine, therapy can help you figure out what triggers depression for you, how to recognize it and the warning signs, how to cope when it hits, and how to let other people know how to help you. Therapy also gives you a chance to really let loose and talk about what it's like to feel and deal with depression - with someone who's not going to judge you, tell you to "pull yourself out of it," or try to fix your problems for you. It will give you someone to talk to, who's got some training in how to deal with it, and can help you develop and practice skills for dealing with it.

Now, that said, I realize that for some people depression is more biochemical than anything else - therapy can help you too, though - in the ways I mentioned above. If you do happen to have things in your past that are affecting your mood, therapy will almost certainly help you with that - but you don't have to have had trauma, abuse, or other painful past experiences in order to benefit from therapy.

Ok, before I start sounding too much like an informercial...what can you do on your own? As trite as it sounds, I usually recommend that people start at the beginning. Accept the reality that you're dealing with depression. For some people, that alone is a huge step - there is still stigma out there about "mental illness" and many people don't understand what depression is, or how it affects you. So, accept reality and then realize you have a choice in how you're going to deal with it. (Yeah, I'm taking a page from my DBT training - radical acceptance again!)

Dealing with depression takes a LOT of energy. Depression is a condition that saps your strength - emotionally and physically. It feels sometimes like you're trying to slog through thick, sticky mud and is every bit as exhausting. You can choose, though, whether you're going to stay in it or not, and there are consequences either way.

Choosing to try to move out of it means choosing that you're going to move, even if it's just a little bit. It's a form of opposite action. It may mean something as simple as getting up and taking a shower, or making yourself go outside for a few minutes.I tell the people I work with that I don't underestimate how much of an accomplishment getting out of bed is. It might be the only major movement someone has made in days or weeks. Moving may mean more - calling a friend, a doctor, or someone you trust and asking for help (and believe me, I know that's HUGE.) Either way - if you're going to choose to deal with it, it means YOU have to do something. And, as I always say (and mean), seeking help really is a sign of strength, and not a weakness in any way, shape, or form. Moving - and then moving consistently are important parts of this process.

If you choose not to deal with it, then you have to be willing to take those consequences - it may mean that someone else has to make decisions for you, if you're not able to do so. It may mean giving up some control so that someone can get help for you...it may even mean hospitalization for some.

One thing I want to make crystal clear here is that I don't think that being hospitalized is shameful. In fact, I believe that it's helpful, and that getting well and being able to function is the goal - and I realize that there are many of you who disagree with me, and I respect your right to do so. After all - I'm not walking in your shoes. However, if you're not able to or are unwilling to make decisions for your care - or if you're self-harming or threatening to self-harm, hospitalization is a possible outcome for your safety and well-being.

The point of all this is that I'm assuming you don't want to deal with feeling depressed. You can't control what's coded in your genes, but you can choose how you're going to deal with it. And I'm not saying that positive thinking, affirmations, etc. are going to magically pull you out of it. These may help, but depression is a lot more complicated than just negative thinking. You can choose to shore up your foundation with meds, or you can choose not to. You can choose to use therapy, or not. You can choose a combination of the two - the point is, you have a choice.

When you're in the throes of a major depression, it may not feel like you have any choices, or that no matter what you do it's not going to work. This is where you have to use your active trust - your emotions are not necessarily giving you the best information, and you may have to let your head overrule your heart on this one. Get help if you need it, and help yourself. Depression is nothing to be ashamed of, any more than kidney disease or diabetes is. It's a treatable condition, and there is hope.

Does getting help mean it's going away for good? For some people, maybe...for others it means that the beast is pushed away again for a while, but will keep following you. For you...well, learning about your triggers, symptoms, etc will help you. Learning this stuff also helps you feel more in control and stronger - nice side effect, huh? One great program, developed by a lady who both does therapy and has bipolar disorder is called the "WRAP program."

WRAP (Wellness Recovery Action Plan) is a system that helps you recognize your triggers and symptoms, and put into place a plan to help yourself feel better. If that plan doesn't work, WRAP also helps you develop a plan that tells who you want involved in your care, how you want to be treated, and who can make decisions for you. It's a great system, and Mary Ellen Copeland (the creator) has some great articles on her website: www.mentalhealthrecovery.com. The purpose of WRAP? "Getting well and staying well." Copeland is also the author of several wonderful self-help books/workbooks for coping with depression and manic-depression - her work is widely respected and used. (I highly recommend her books both to clients and non-clients.)

So, bottom line is that even if it feels like there is nothing you can do or that nothing you do works or has an effect, there ARE things that will help. Talking to a therapist (heck, talking to someone you trust, period!), working with medications, using some great self-help resources, and your own strength all help. (And yes, you ARE strong - it takes a lot of energy to deal with this!) Cognitive behavioral therapy is one route that seems to help a lot of people - Copeland's books actually use a lot of CBT-style work. DBT skills help too - trying them won't hurt, and you have a lot to possibly gain.

Just remember - you're not alone, even if it may feel that way. There are many, many people who are dealing with and have dealt with depression. I have tremendous respect and admiration for those of you dealing with this, whatever the root cause may be. It takes a lot of energy and strength, and pulling yourself out takes even more. You're not alone - really.

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: [email protected]

You Are Not Your Mood

7/14/2014

Emotions are weird. They have a way of changing so fast we hardly know what hit us, and they can change our outlook on a situation, person or perception nearly as quickly. It helps to remember that as much as our emotions affect us, they do not define us. We are more than our emotions.

A few months ago, I struggled with this. I was feeling down - I was being impatient and it seemed like nothing was going right. Now, if you've been reading these blogs, you know as well as I do, that this is not the case. Red Flag #1 - feeling down about things does NOT mean that the feeling is reality. Ok, good enough - and I was still feeling lousy.

So, I thought...if I were the client, what would I be doing in therapy? (Yeah, I know... I'm a therapy geek.) Most likely, I'd be looking at the situation and testing out whether my emotions were really reflecting reality, or whether they were masking reality. How do you do this?

Marsha Linehan has a really cool tool that she uses in DBT called "chain analysis." You start with the event, behavior or situation that was the problem. In my case, I looked back to when I started feeling down, and the even had nothing to do with what seemed to be the situation. I was feeling lonely on the afternoon before, because I couldn't reach my family members to talk. That spiraled into feeling somewhat depressed. Specifically, I remember thinking, "I guess no one wants to talk to me. I might as well not exist." Red Flag #2: I was getting caught up in "Stinkin' Thinking."

In doing a chain analysis, you identify the event/situation that started the problem, describe the event, including what you were feeling and/or thinking at the time or what you did as a result of what you felt, and then describe how intensely you behaved, thought, or felt. In my case, the loneliness, sense of failure and depression were pretty strong. I ended up thinking, "I"m never going to be able to do this. I might as well just quit." Red Flag #3 - Stinkin' Thinking again. The idea here is that you want to describe all this in as much detail as you possibly can. Here's a good litmus test: Could someone recreate *exactly* what you went through? If so, then you've done it.

Next, you describe what led up to the feeling, thoughts, or behavior. In my case, not being able to talk to someone was the situation. This "precipitating event" (also called a "prompting event") is usually what we point to when we say that "such and such" caused the problem.

From here, you do a detailed description of all the things that affected the situation - Linehan calls them "vulnerability factors." In my case, I was tired from not sleeping well, I still had an annoying cough from a cold and didn't feel well, I was stressed by all the details stemming from running a new business as well as being worried about several emotionally intense client situations. I was overwhelmed, tired and not feeling good. I was also feeling emotionally exhausted by family situations and childcare issues.

Ok, here's where chain analysis gets tedious - you describle in minute, excruciatingly clear detail the chain of events - starting with the all the way at the beginning with precipitating event(s) and going all the way to the consequences. Ok - here goes: I called my mother and got her answering machine. I then called each of my sisters in turn and had the same result. I started feeling like I didn't matter. I called my husband, who was out at the park with our kids, and he didn't pick up. I started feeling depressed, and went to work on my task list for this week concerning my business and the paperwork I had to complete. Looking at the things I had to do, I felt overwhelmed and incompetent, and felt more depressed. I remember thinking, "Why bother?" and which led to a deeper negative mood. The consequences were that I was not present when my husband did come home and wanted to talk. Right then, I just wanted to be left alone to marinate in my own misery.

At that point, I recognized what was going on, and took steps to counteract the mood. The last step in the process is to describe in detail a prevention strategy and what you are going to do to repair negative consequences that resulted from your behavior or mood. In my case, my prevention strategy was stay mindful of my moods and to write. Writing in my journal, for me, is a safe place to vent and analyze what's going on. When I write, I feel better and so that's a good strategy for me to use. I can also go for a walk, and/or do something artistic. I could take a bubble bath, or have a hot cup of tea. Those are all things that help me - developing a list of what helps you will help you have something to turn to when you get feeling low. Nurturing and caring for yourself really IS important and necessary.

Luckily, the interpersonal consequences here were small. I went upstairs and apologized to my husband, and explained what was going on. I also told him that I needed some extra time to myself to write and sort out the depressed feelings.

If you're interested in more information on doing a chain analysis, you can go to a great website called DBT Self Help (www.dbtselfhelp.com) to get an idea of what this might look like in therapy or in practice. This website has an incredible array of tools, worksheets, handouts and articles.

Hope this helps - DBT helps with a lot of things - I highly recommend looking into it. Even if you don't go for it, learning about these coping tools and other tools available to you can help you get through these tough situations.

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: [email protected]

Loneliness: When the World Seems to Go On Without You

7/14/2014

Loneliness is something we've all probably experienced at one time or another, and quite frankly it sucks. In my experience, feeling lonely is one of the most intensely uncomfortable, depressing, and isolating feelings that exists. When you're feeling lonely, it seems that the world is going on around you, and that you're invisible or worse, that no one cares.

I mark a difference between loneliness and solitude. Solitude is when YOU want be be alone - it's a very different thing from wanting to be around others but not being able to. There are many reasons for loneliness, among them shyness or social anxiety, or depression and/or thinking that no one wants to be around you (Remember the "stinkin' thinking"? This is an example).

Feeling lost in the crowed or different from everyone around you is a factor. Loneliness can come up in different situations - when you're single among couples, childless among families, ill or emotionally traumatized around people who seem healthier than you, a member of a minority group surrounded by the majority...there are any number of situations which may trigger loneliness.

There are no easy answers for changing loneliness - this is one of those situations where, if I did have a magic wand, it would be useless. (And trust me, I wish I did have one.) The basic reason there are no easy answers is because the causes are so varied. Cognitive Behavioral Therapy (CBT) helps with some causes like social anxiety, depressive thinking, or dealing with "Shoulds" or "Stinkin' Thinking". Ok...well, that's fine and dandy. I change my thinking and I just feel better, like that?

Uh, well...not really. I wish it was that simple. CBT will help you work with your thought patterns AND with the behaviors that get in your way. This is where the "homework" stuff comes in again. If you want to counter loneliness stemming out of anxiety or depression...guess what? You have to interact with people. Typical homework assignments in this realm might be something like, "Talk to five people about a current news topic" or "Compliment 3 people sincerely." The idea here is to get you out and getting experiences that contradict your fears.

And also - loneliness is a feeling. I know...some of you are saying, "Well, DUH!" Here's the thing though - you can use your skills to deal with feelings that are overwhelming. Call it "riding the wave," DBT, Coping, Self-Care, Self-Soothing - whatever. The idea is you use the skills you've got and have learned to help yourself feel better. "Emotion Regulation" and "Distress Tolerance" have these names for a reason!

Ok, so CBT and DBT help. What if you're stuck in a situation where you really DO "stick out like a sore thumb"? Those are a little harder, to be honest. Your differences will likely be harder to hide, and it may feel as if the situation around you is moving on and leaving you behind, or worse, ignored. I can't tell you what to do in these situations, but I can share what's helped me.

First of all... if I seem to be in a completely different, alien, strange, unsual environment or group, I look around and see if there's someone else who seems something like me. By this I mean, "Is there one other person here who looks uncomfortable - for whatever reason - like I do?" If so, then I gather up my assertiveness and interpersonal effectiveness skills and introduce myself. I'll ask an open question like, "What do you think of all this?" and then LISTEN. Nine times out of ten, this helps.

Err...what about the 10th time? When the person just kind of looks at me as if I'm an alien from another planet, or as if I've just spilled spinach juice and red wine down the front of my shirt? Well..I politely say, "It was nice to meet you," and then move on to something else. At that point (and this may seem silly), I look for someone who has one thing in common with the way I look, or one thing about them that is intriguing to me - maybe it's wearing the same color, or a similar hairstyle, or style of outfit...maybe it's that the person is wearing some outrageously bright colors that I adore, or has eyes that seem to smile. SOMETHING I notice and can comment on.

Y'all are going to think that I'm a pain in the tushie with how I do things, but again, I go up and introduce myself, and say, "Those shoes are so cute! Would you mind telling me where you got them? I love those colors." Or I might say, "You know, I don't know many people here...and honestly, you look like someone I might be able to chat with. I'm Laura. What's your name?"

Here's the thing - fundamentally I am a VERY shy person. (You'd never guess it watching me now, but I swear - it's true.) It took me years of practice and yes, therapy to get over it. During this process I learned, though, that most people are generally nice. I also learned that if I say something completely stupid, or fumble for words, saying, "I feel a little awkward - I'm worried I look like a fool" and then laughing, most of the time people will laugh with me. Do they laught AT me? I'm sure some people do. I know for a fact when I was younger, people did.

And the sad fact is that there are some people who are judgmental and mean. Appearance seems to be a particularly favored target, and it sucks. People have judged me on my appearance, both when I was thin and now that I'm fat. And you know what? I survived. No matter what other people think of me, my sense of who I am is intact. It took YEARS to get here, and I'm not going to say that other people's perceptions don't matter - they certainly do. What matters the most, though, is what YOU do and what YOU think of yourself. I decided that I would try to like myself, no matter what anyone else thought. I don't know about everyone, but for me it was a choice and a conscious decision. And it took hard work.

When you have the sense that you are not just OK, but that you are a worthwhile, interesting, and caring person, loneliness has a harder time getting in. I won't lie - it sure does get in on occasion. But - I have a stronger sense that I can do something important, that I matter, and that I have gifts and talents to share. That goes a long way in pushing loneliness out the door. Even if no one listens, or no one seems to care, I know I matter.

So, when I start feeling lonely...well, I do something to kick it on it's butt out the door. I'll go talk to someone, engage myself in something I enjoy, write, read, take a nap, go sit outside, pet my cat... you get the idea.

And you know what? You don't have to be lonely - I'll talk with you. Seriously. Send me an email message, and I'll get in touch. I know how hard it is to feel lonely, and I want you to know that you're not alone. Really.

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: [email protected]

It's the Little Things...

7/14/2014

Have you ever noticed how something small can be a "tipping point" that changes your day from "good" to "bad" in an instant? It can be a critical comment from someone at work, or a family member saying or doing something that makes you pause and think, "Wow...that was out of line." It can be something impersonal, like getting flipped off or cut off in traffic because someone else is in a hurry and not driving carefully...there are any number of things that can really mess up our day, and leave us feeling drained, irritated and/or angry, and feeling like everything's going downhill.

Frankly, it sucks. We've all been there, and know what it's like. I'm not going to lie and say I never get stuck in it. It's easy to let things add up and take over, and may feel like we're riding a wild, out-of-control, roller coaster. So, what do you do? Well...as usual, there are some answers and tips from the therapeutic couch that may help. These aren't necessarily the only things you can do, or "THE ULTIMATE COSMIC ANSWER" - rather, they're things you can try to help YOU feel better. Unfortunately, there's no magic wand to change the world around you, and we can't make your husband/kid/boss/coworker/"idiot on the road" change. That's just beyond our control. (In therapy I sometimes take a kid's pretend magic want, whap it on the table or chair and say, "See? It's broken - it doesn't work! NOW what do we do?")

Well...now what do we do? The first thing, in my experience, is to try and separate yourself from what's going on. You can't make your boss be nice, or make that person on the road or in the grocery store be polite and reasonable. You can't make your family members stop making comments about your appearance. However, you can set up some good boundaries and realize that you don't have to allow them to get you upset. I'll fully admit, though - some situations are easier to do this with than are others.

Easier said than done, isn't it? Trust me, I know - from tons of personal experience myself. And yet, it's important to know what's your stuff and what's their stuff. (Remember the definition of a boundary? It's where you end and I begin.) Eastern faith traditions call this compassionate detachment - you can look at what's going on and realize (or even say to yourself) that "this is what's going on for him or her. If I have something to apologize for, I can do it. But their anger or their irritation is NOT me."

It sounds a little weird, I'll admit. And it does take practice to become a habit. But if you think about it, it's incredibly freeing to realize that you're not responsible for someone else's anger, or even their feelings in general. Now, don't get me wrong - certainly what we say or do affects the way other people feel - this isn't a "get out of jail free" card to say or do whatever you want. In fact, our actions can be the tipping point for someone else - so it pays to watch what you say and do as well.

Anyway - realizing that you are separate from someone else's emotional reaction can help you deal with what's going on in a more rational "wise mind" kind of way. (If you don't know what "wise mind" is, see the post for DBT Skills, Part 1 )

So, knowing what's you and what isn't you helps. Another trick from the DBT bag is to try "opposite action" - this is where you do the exact opposite of what you want to do (part of the DBT Emotion Regulation skills). I know...it sounds hard, and it is. When you want to spit back a sarcastic response, you instead say something nice. "Thanks for your input. I hope you have a great day from here on." It might be the last thing in the world that you want to do - and it does help. You'll have to trust me on this one - but think of it this way - if nothing else, it confuses the heck out of the other person!

Another thing to do is just take a quick breathing break - practice distress tolerance skills (another DBT post: Distress Tolerance Skills) or relaxation and stress reduction skills: breathing, distracting yourself, self-soothing (a coffee or tea break can work wonders), a little bit of exercise (say a walk at lunch), or anything that helps you feel better (and doesn't harm anyone - including the person who ticked you off to start with ;p ). All these things can help. Finally - all the CBT stuff I talked about earlier will also help.

These may not completely turn around your day, but they can help you feel better. The key point is to remember that you don't have to let someone else's bad mood or bad day ruin yours. So...have a great day, and remember that someone out here is rooting for you!

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: [email protected]

Dealing With Trauma - Coping

4/28/2014

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: [email protected].

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.

Coping With Tough Times, Part 2: Coping Skills

4/28/2014

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: [email protected] . 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: [email protected]

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

Coping With Tough Times, Part 1: Move

4/28/2014

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: [email protected]. 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.

I Wish There Was a Magic Wand...

4/28/2014

I wish there was a magic want. I really do. But...There really is no magic wand.

There. I've said it. It stinks, it hurts sometimes, it's depressing. And it's true: there is no magic wand to wave and make our troubles just disappear.

I always wanted to be Samantha on "Bewitched" - even if she got into messes, she could twitch her nose and all would be well. (Of course, she did have to put up with that dork of a husband Darrin...anyway...) Wouldn't it be nice if we could make ourselves look the way we want, make other people behave the way we want and do the things we want? If we could control everything and have it our way? (OK, there's an Endora streak in me too - I admit it.)

Well, believe it or not...no. As hard as it is sometimes, we learn from our struggles. We don't choose or deserve many of the things that happen to us or are done to us - but we have a choice in terms of learning to how deal with it without letting it control us. I know that sounds harsh, and I apologize - I never, ever want to minimize someone's pain by being flip. Here, though - this really is our choice. Recovery, healing, and moving forward are all "dealing with it." No matter what happens - we always have a choice: We can choose how we react and what we do with it,

The thing is, it's awfully easy to let whatever happened or whoever hurt us control us and I know that from experience. Emotions and mood states are POWERFUL, and can distort how we perceive reality. These things are also REAL - depression, anxiety, PTSD, anger, fear - they all are very real and affect us deeply. As tough as it is, our task is to try to see ourselves objectively and to try to do the best we can without further hurting ourselves or hurting other people. And doing so is not easy at all. It's a growth process, and a rebirth in many ways. It IS a process.

This process is not an easy thing to learn either. When I was doing my training, I used to keep a kid's magic wand in the little office where I did my counseling. Sometimes people would come in and would want to change someone else - like their children or spouse, their boss or coworkers, or extended family members. Other times, I'd hear people talk about how unfair things were and how others should do things/see things their way, or how life should be different. At this point, IF I'd established good rapport with my client, I'd take the magic wand and bang it on the end table or chair and say, "Look...it doesn't work. NOW what are we going to do? We've got to figure how to handle this, because the magic wand doesn't work!"

This almost always got a laugh - and made an important point. There is no easy fix for a lot of these issues. In fact, many of the issues that people talked about WERE unjust. However, we can't change other people, and sometimes we can't change what happens to us.

What we can do, however, is change ourselves. Again, it's not easy - this really is hard work. It involves letting go of our "shoulds" for others, our attempts to make them do what we want them to do or treat us the way we want them to treat us. Our challenge is to accept them as they are, and deal constructively and effectively with the things that happen to us. (For the record: Accepting other people as they are does NOT mean approving of, liking, or agreeing with their behaviors, the harm they do, or the hurt they cause. We're not condoning or accepting in any way, shape, or form abuse or other harmful/hurtful behaviors. What we're doing is letting go of trying to change them, and instead focus on what we can do to help ourselves.)

This is the essence of psychological healing, in my opinion. Therapy ideally gives someone a safe place to learn about and practice letting go, acceptance, and self-change. It's not a magic wand, but it can be a magic place because the work that's done in the therapy room, when successful, is transformational.

The old analogy of the caterpillar going into the cocoon and emerging a butterfly really is apt. It's a cliche, but it's one that fits. The struggle to emerge from the cocoon is not only difficult, it's necessary for the butterfly to survive. Helping the butterfly emerge - even when well-intentioned - kills the butterfly. Human birth is similar - the process of being born and being pushed/squeezed out the birth control compresses the newborn's lungs, so that when s/he emerges, they expand to bring the infant the breath of life. (With humans, we've learned to compensate - the "magic wand" of medical science helps here.)

The point with these analogies is that the "magic wand" - the quick fix, easy way out, getting someone else to do it for us, etc. - robs us of our ability to grow into the person we're meant to be. Without that struggle, we don't get to learn and grow in quite the same way. In my field, we call this ability to "bounce back" and heal resiliency - and resilience can be developed and strengthened over time. We learn to develop healthy boundaries, we learn to cope with strong emotions and tolerate distress, we learn to think in a healther and more effective way, we learn to be mindful of ourselves and all of these things as we grow and heal. We learn - or relearn - how to interact with other people and grow relationships.

These things said, would I wish abusive, harmful, traumatic, or painful experiences on anyone in the sake of growth? NO. I can't say that emphatically enough - NO. We can't control what other people do or many times We CAN work to heal ourselves and grow, though. We can die in our cocoons, or we can struggle and emerge reborn to face the world. It's up to us. It's not easy. It's not pretty - and there really is no magic wand.

The magic is instead in us, in our ability to overcome.

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: [email protected]

Trust the Process

4/14/2014

In my work as a therapist, I practice a form of therapy called Dialectical Behavior Therapy, or DBT. I like it because it brings in awareness and mindfulness of the present as well as working on behavioral options. I find that there are generally two ways we can work with people. One is to be results-oriented - and in a therapy environment, this is not necessarily a bad thing. We - my clients and myself - want to see that the therapy we're doing is working, right? Makes sense.

The other way we work is being process-oriented. A process orientation involves more than looking for results - it's looking at what's going on between the two people in the room, in terms of how they're relating to each other, and how this relating reflects what's going on outside the therapy room for the client. It also means paying more attention to the deeper meaning of what clients say, and how their words reflect their emotions and experiences, as well as their growth.

Process is even more than that, though. Process is the flow of life that runs through us and with us and by us. How we react to life often reflects the process we're experiencing. Trusting the process means letting go of the illusion of control that's keeping us from growing and trusting that our process - our lives - will eventually be ok.

Letting go in this way is a scary thing to do. It's something I learn and re-learn every day, and have to consciously practice - trusting the process is an active trust kind of thing for me.

I have several "mantras" I use to remind me to trust the process. One of my favorites is, "It is what it is." I usually follow that up with a question that gets at the heart of the issue: "Now, how do you want to deal with it?" or "What are my options?"

There are several situations where I'm currently using this process...and none of them are easy. I'm finding for me, though, that letting go and trusting the process at the very least brings me some peace of mind. I take care of what I need to take care of, and the rest will be what it will be.

To me, one key to being able to trust the process is using one of my DBT skills: Radical Acceptance. The basic idea is that you realize that you first have to see what reality IS rather than what you want it to be, and then next, work on accepting that this reality exists. It's a tough process - but once you're there, you're better able to deal with what is, and won't get caught up on what should be, or what's not fair. Radical acceptance is key to learning to trust the process, because you can't begin to see the process until you accept the reality you're facing. It's that simple.

Another key piece is letting go. For me, this also takes conscious thought and action - I ask myself, "Ok, how important is this really? Am I going to be worrying about this, or be angry at this 10 years from now?" If the answer is no, it's probably a good thing for me to let go of. And I again struggle with this a lot - and am learning that the process is again, worth it.

So, trusting the process means first accepting reality for what it is, and then letting go of our expectations of what's fair or what "should be." What next?

Here's where it gets a little less behavioral...one of the things that DBT emphasizes is mindfulness, and I believe that mindfulness is another important key to trusting the process. Once we've accepted and have started letting go, mindfulness (being aware with compassionate nonjudgment) will allow us to be open to the possibilities and opportunities that DO exist. Mindfulness also allows us to be aware of what's going on around us, what triggers us, and what our choices are - it's an incredible tool for increasing awareness and connection, if we choose to use it that way - it's how we see the process part that's going on here.

The final key in trusting the process is simply, trust. Many have us have learned, and learned well that we can't trust anyone. Life has let us be hurt or injured maybe even by people who were supposed to love and protect us. Other people take advantage of us, or make fun of us, or generally make the world an unpleasant place in which to live. And here I'm telling you to trust. Yeah, right....

Here's where you use active trust (see earlier post). If you've learned to trust no one or anything, it may be time to try and see if the time is right to experiment a little with trust. To trust the process though, at some point, you have to take that leap and just let go and trust. Something, someone, sometime...Use your active trust if it helps, and realize that it's likely going to be worth the effort.

Trust the process - and see where life takes you. Even if you trust no other process than the fact that the sun will rise the next day, it's a start - and a good one. You may find yourself going in a direction you'd never considered, or meeting people you'd never have known otherwise. Let go, let yourself have an adventure...and trust the process.

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: [email protected].