The Power of Each Other: Wellness and Well-Being
  • Home
    • About Laura
    • Contact Dr. Burlingame-Lee:
    • News!
  • Resources & FAQs
    • Resources
    • FAQs >
      • Coaching FAQ
      • DBT FAQ >
        • How does DBT work?
        • What are the goals in DBT?
        • How does a DBT Skills Training Group Work?
        • Assumptions about our participants
        • What are some problems that might come up?
        • DBT Skills 1: Introduction and Mindfulness
        • DBT Skills 2: Interpersonal Effectiveness
        • DBT Skills 3: Emotion Regulation
        • DBT Skills 4: Distress Tolerance, Part 1
        • DBT Skills 5: Distress Tolerance, Part 2
      • Payment and Insurance
      • First Appointments: What to expect >
        • What to expect at your first coaching appointment
        • What to expect at your first therapy appointment:
    • Forms
  • Blog: Posts for the Journey
    • Blog Survey!
  • Love the Questions Journal Prompts

Depression - Dealing with and Taming the Beast Within

7/14/2014

0 Comments

 
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: thepowerofeachother@outlook.com

0 Comments

You Are Not Your Mood

7/14/2014

0 Comments

 
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: thepowerofeachother@outlook.com

0 Comments

Loneliness: When the World Seems to Go On Without You

7/14/2014

0 Comments

 
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: thepowerofeachother@outlook.com

0 Comments

It's the Little Things...

7/14/2014

0 Comments

 
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: thepowerofeachother@outlook.com

0 Comments

CBT: Dealing with Stinkin' Thinkin' and The Shoulds

7/14/2014

0 Comments

 
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

0 Comments

CBT: What is "Stinkin' Thinkin'"?

7/14/2014

0 Comments

 
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.

0 Comments

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

0 Comments

 
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

0 Comments

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

7/13/2014

0 Comments

 
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

0 Comments

Assertiveness: An Introduction

7/13/2014

0 Comments

 
"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.

0 Comments
<<Previous

    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!

    Need to find something? Search the blog:
    View my profile on LinkedIn

    RSS Feed

    Home

    Archives

    August 2022
    July 2022
    September 2017
    August 2017
    January 2016
    October 2014
    August 2014
    July 2014
    April 2014
    March 2014

    Categories

    All
    Acceptance
    Accountability
    Accountable
    Accreditation
    Accredited
    Achievement
    Achieving
    Action
    Action Planning
    Active Trust
    Affirmation
    Affirmations
    Afraid
    Alone
    Anger
    Angry
    Antidepressant
    Antidepressants
    Anxiety
    Appointment
    Appointments
    Art Journal
    Assertive
    Assertiveness
    Attitude
    Beck
    Behavior
    Black Or White Thinking
    Boundaries
    Boundary
    Care
    Caring
    Cat-I
    CBT
    Certification
    Certified
    Chain Analysis
    Change
    Changing
    Checking In
    Check-ins
    Choice
    Choices
    Coach
    Coaches
    Coaching
    Code Of Ethics
    Cognitive Behavioral Therapy
    Cognitive Behavioral Therapy For Insomnia
    Cognitive Distortions
    Cognitive Errors
    Cognitive Triad
    Comfort
    Comfortable
    Commitment
    Commitment Planning
    Commitment Strategies
    Compassion
    Compassionate
    Compassionate Detachment
    Control
    Controlling
    Copeland
    Coping
    Coping Skills
    Counseling
    Counselor
    Counselors
    Courage
    COVID
    Cruelty
    Daily Hassles
    DBT
    Depressed
    Depression
    Dialectical Behavioral Therapy
    Dichotic Thinking
    Differences
    Discomfort
    Distorted Thinking
    Distraction
    Distress Tolerance
    Dream
    Dream Analysis
    Dreaming
    Dreams
    Dream Symbols
    Effective
    Ellis
    Emergency Room
    Emotion Regulation
    End
    Ending
    ER
    Ethical
    Ethics
    Ethics Code
    Evaluating Goals
    Fear
    Forgive
    Forgiveness
    Frustrated
    Frustration
    Fun
    Goal Planning
    Goal Progress
    Goals
    Goal Setting
    Goal Strategizing
    Grief
    Happiness
    Happy
    Heal
    Healing
    Health
    Healthy
    Helpless
    Helplessness
    Hero
    Heroes
    Hopeless
    Hopelessness
    Hospital
    Hospitalization
    Hotline
    Hotlines
    Hurt
    ICF
    Identity
    Image Rehearsal Therapy
    Insight
    Insightful
    International Coaching Federation
    Interpersonal Effectiveness
    Introversion
    Irrational Beliefs
    Irrational Thinking
    IRT
    Journal
    Journaling
    Joy
    Judgment
    Judgmental
    Letting Go
    Licensed
    Licensure
    Loneliness
    Lonely
    Mean
    Measurable Goals
    Medical
    Medication
    Mindfulness
    Minimization
    Mistrust
    Mood Stabilizer
    Mood Stabilizers
    Motivate
    Motivation
    Move
    Moving
    Moving On
    Negative Thinking
    Negative Thinking Patterns
    New Normal
    No
    Nonjudgmental
    Nonjudgmental Stance
    Obstacles
    Opposite Action
    Organization
    Organizing
    Overgeneralization
    Pain
    Painful
    Personality
    Personalization
    Plan
    Planning
    Play
    Playful
    Playing
    Positive Psychology
    Post Traumatic Stress Disorder
    Posttraumatic Stress Disorder
    Precipitating Event
    Prioritize
    Prioritizing
    Process
    Process Writing
    Procrastination
    Progress
    Prompting Event
    Psychologist
    Psychologists
    PTSD
    Rabbit Hole
    Radical Acceptance
    Reaching Goals
    React
    Reacting
    Reaction
    Reinforce
    Reinforcement
    Relationship Skills
    Relax
    Relaxation
    Resiliency
    Resources
    Responding
    Responsibility
    Responsible
    Rest
    Restful
    Resting
    Results
    Reward
    Rewards
    Role Play
    Role-play
    Sadness
    Safe
    Safety
    Saying No
    Schedule
    Self Acceptance
    Self Assurance
    Self Awareness
    Self Care
    Self Control
    Self Esteem
    Self Liking
    Self Soothing
    Self-soothing
    Setting Goals
    Should
    Shoulds
    Skills
    Solitude
    Stigma
    Stigmatize
    Stigmatizing
    Stinking Thinking
    Stop
    Stopping
    Strategies
    Strategizing
    Strategy
    Suicidal
    Suicidal Feelings
    Suicidal Thoughts
    Suicide
    Suicide Hotline
    Suicide Hotlines
    Support
    Supporting
    Supportive
    Taking Action
    Task Management
    Termination
    Therapist
    Therapists
    Therapy
    Thinking
    Thinking Patterns
    Thoughts
    Time
    Time Management
    Tough Times
    Trained
    Training
    Transition
    Transitioning
    Trauma
    Traumatic
    Traumatized
    Trigger
    Triggers
    Trust
    Trust The Process
    Uncomfortable
    Visual Journal
    Voice
    Vulnerability
    Vulnerability Factors
    Wellness
    Wellness Action Recovery Plan
    Wise Mind
    WRAP
    Write
    Writing

Proudly powered by Weebly