Anger Outbursts
Do you have problems with anger? I know many people have difficulty managing their emotions, and especially the issue of anger. This is an approach I use called "Stop, Think, Act" for people who have a hard time controlling their anger.
Regarding anger, there really is nothing wrong or abnormal about being angry. Everyone gets angry. The problem comes when the way you express it becomes harmful for others. One of the most basic tools I teach clients about anger outbursts is the "Stop, Think, Act" approach. Normally, people who have anger outbursts do these outbursts sort of as an automatic reaction to a trigger. They don't even think about it. It just comes "naturally" because this has been their habit for many years. But "Stop, Think, Act" will help you to take a breath, and pause before you do or say something you will regret. To stop first, you have to do or say something pretty firmly to interrupt that coming anger outburst. I tell people to do something like clap your hands once and say to yourself, "STOP!" You have to do something radical like this to interrupt the predictable, toxic reactions your normally give out. Many people go " zero to sixty" in their anger, it happens fast - no time to stop or think. So make yourself PAUSE briefly by telling yourself to stop first. Then, just think. Think about why you are angry. Think about what you are going to do about it. Is this something that can be handled differently? Can you take 5 and excuse yourself and go for a walk to cool down? Do you need to do that to avoid "blowing someone's hair back?" Do you need to address this issue right now? Is this the best time to do that? Can you calmly communicate your frustration, and refrain from accusing someone?
Do you see how many options you have here at "Think"? You have many ways to process after you stop.
Then the final one, "Act". Now you have choices. Now you are not boxed in to your old, toxic cycle of verbal abuse or unnecessary conflict. Now you can move forward with the response you REALLY wanted to do in the first place.
What do you think about this? Do you have difficulty managing your anger? Do you have difficulty being able to express your anger in a diplomatic and positive way?
The Need For Self Care
One of the most important aspects of healthy mental functioning is having and engaging in proper self-care. As a therapist, I help people understand many different aspects of their mental health, including what we call “psychoeducation, “ which helps people understand the ins and outs of issues like depression, anxiety, panic attacks, and other things related to mental health disorders. I also discuss proper medication management as an adjunct therapy, describing the various types of medications which are available to those who experience mental health disorders and their symptoms. I also use cognitive behavioral therapy, and how powerful our thought life can be. Our thought life really defines what our feelings and behaviors will be. So it’s very important to get a handle on addressing negative and distorted thoughts.
But the issue of self-care is equally important to all the above approaches. Self-care is about taking the time to attend to your own physical, emotional and spiritual needs. It involves making sure you have time and opportunities to recoup and recharge. We all are actively engaged in life, and life is at times overwhelming. We have work, our families, extra-curricular activities, gatherings, meetings, deadlines, and other stressful things that find their way to our calendar. We have much that demands our time, and often, there are not enough hours in the day to address these things and people which require our urgent attention.
This overwhelming barrage of information, and the imposition of others’ agenda creates a significant withdrawal from our emotional bank. We can often find ourselves literally depleted of energy, emotional capacity, and strength. It is no wonder so many people get burned out. Navigating competing requests from many people can make us feel insufficient and unable to sustain a healthy and functional day to day workload.
This is where self-care comes in. We have to make time to take care of ourselves. With you, the work you do cannot continue to go on. Without you, there is no paycheck, no job, no meaningful relationships. You simply must take care of yourself, if you are going to continue to live your life on purpose.
How Do I Start?
First, make a list of things that bring you joy, encouragement, rest, and relaxation. This will be different for every person, depending on your own interests. Think about everything you absolutely love to do. Then write each one down. Some very common self-care options include:
Riding your bike
Going for a run or a walk
Having a cup of tea or coffee while enjoying a good book
Patronizing your favorite bookstore, and reading and people-watching!
Playing an instrument, painting art, singing karaoke with friends
Swimming, playing tennis
Working out at the gym
Second, find at least one activity per week that is worthy of going into your calendar. By now, you have likely mastered the art of your daily tasks. You have a calendar, a smart phone, and you know when certain tasks are due. You have written them all down, and there they sit, neatly recorded in your calendar, diary, or phone scheduler. But there is a good chance that attending to your own self care does not find its way to your daily calendar. We need to see self-care tasks as not something to cause us work, but cause us to relax, rest, and recharge. Once we understand this, we can be diligent about making sure that our self-care plans get put into our calendars, so that they can actually have a chance at coming to pass.
Third, make sure you have holes in your week with lots of margin for these fun things. Margin means room, or space to sit back and enjoy your fun activities. Don’t simply cram your week with work. Leave time in your week for taking care of yourself.
So now it is up to you. What do you enjoy doing? What makes you happy and fulfilled? Give it some thought this week and create some time to do the things that help you rest and relax!
The Relationship Between Panic & Control
Having a panic attack is a terrifying experience. If you have experienced panic attacks before, you know full well about this - heart palpitations, shortness of breath, and feeling like you are having a heart attack! It’s no fun to say the least.
Like anxiety, panic is all about a perceived threat. Your mind and body begin to respond to what is perceived as a real threat to you in some way. You are compelled to do one of three things: flight, fight, or freeze. So why is this such a terrifying experience?
Many people have a very real root perception of being and feeling literally out of control in many areas of their lives. When you think about some situations that are threatening - the loss of income or a job, loss of ability to come and go as one pleases due to the pandemic, potential losses which may be coming soon, a divorce, moving to a new city, and many other situations - these things can leave of feeling very much NOT in control of our finances, our relationships, or our future. This is exceptionally threatening to our sense of security and well-being.
When these threats live inside our head, swirling about with negative possible outcomes and scenarios, fearful and worrisome thoughts, we allow them to affect us deeply. We don’t discuss these fears, we don’t do anything to acknowledge their presence in our thoughts, and so they debilitate us.
One of the first steps to addressing panic is understanding our need for comfort and security. We have happy feelings when we know the certainty of important things and people in our lives. When certainty turns to uncertainty, it stresses us. We begin to feel out of control - that certain things are in motion, and there is no way to stop the bus!
The terrible symptoms of panic are only reactions to that which is going on inside of you. “But,” you might say, “I’ve had panic attacks at times when I wasn't thinking about anything!” This is true, panic attacks do come at these times. However, the latent worrisome fears are in your mind, but simply not presenting themselves at that moment.
Start taking your control back. Start becoming aware of those fears loving inside you, recognize their presence, and begin to manage them. My approach to this is, “I might have some anxiety but anxiety will NOT have me!” Give yourself permission to feel the symptoms, and to acknowledge them. Then, give yourself permission to take the steps to feel back in control. You can use your self-talk narrative to reduce your fearful thoughts. You can use deep breathing. You can use guided imagery to reduce your thoughts. You can take medication. You have lots of options.
Self-Talk Narrative for Panic
When You Aniticipate a Possible Panic Attack
I am about to do something, encounter something or someone that has created fear for me in the past. I understand that fearful situations are going to show up in my life. But I choose right now to manage those situations, and refuse to allow panic to overcome me.
I choose to be calm. I am safe, and I am secure. I have nothing to fear. I am comfortable here, at rest and at ease. I am shaking off any perceived threat to my sense of well being and security. Because I am safe here, and secure, I will be relaxed, and manage this coming situation with peace and a sense of calm in my heart. Nothing is going to take my peace away. I am confident, and will be successful in this situation.
I am secure, as I take deep breaths and release them, feeling the peace and calm overtake my thinking and my behaviors. I am not in a rush, and will take my time.
There is nothing wrong, and there is no threat of being hurt or being fearful. This threat is not real, and I will help myself to restore calmness and tranquility. I am safe, and there is nothing really here to fear. I will make sure my thoughts are accurate, helpful, and positive.
When You are Getting Through a Lengthy Commitment
I am going to get through this situation. It will only be a few more minutes, and I will be back to my safe and secure environment.
(Name), you are safe and secure. You are going to do another 15 minutes of work, then you will take a break. You can make it for just a few more minutes. It’s alright. You are going to be okay. Nothing to fear. Juist get to this one next thing, then take yourself a break and relax. You are doing just fine, and nothing will hurt you. Just keep going for a few more minutes.
I am going to focus on this task at hand. I am going to notice the things I see around me, which are X,Y,Z. I am going to listen for the sounds around me, which are X,Y,Z. I can hear X,Y,Z right now. I am safe. I can touch X,Y,Z right now, so I am present here. Nothing to fear. This task will only take a few more minutes and I can take a break and relax.
I am not going to focus my thoughts on anything but what is happening here in this moment. I give myself permission to rest, relax, and feel confident that this task will be completed soon, and i can enjoy my break time.
Reparenting and Talking Yourself Down
Anxiety can be painful and overwhelming, just like life. These skills really are about giving you back control of your life - using your own legitimate self-love to take care of and nurture yourself. This is a difficult concept for people who have grown up without a nurturing and loving parent. I believe you have everything you need inside of you to be this nurturing person for yourself.
Self-talk is one of the best skills you can develop to calm yourself and soothe your anxious mind and heart. I often advise my clients about the idea of reparenting. Imagine if you had a six year old child who was very afraid. Maybe there is bad weather coming, and he or she is afraid. As a parent, you might also have some worrisome thoughts about a coming tornado. But I'll bet you would hold that little girl and promise her everything is going to be alright. You would speak to her gently, reassuring her that she is safe.
Now think about yourself. Imagine yourself at that same age. Think about all the things you experienced - fear, painful circumstances, transitions. There are many things that would have made you fearful, anxious, and sad. Re-parenting is all about becoming your own parent. You have learned a lot since you were a child. You likely take care of yourself, have responsibilities, and hopefully, family members with whom you connect. And while you are an adult today, there is a good chance you may be “stuck emotionally” at a certain age. Much of the current negative feelings we experience today are due to the ways in which we experienced life’s difficulties earlier in life. There was no one to help us, soothe us, comfort us, and tell us everything was going to be okay. So now, you as the adult have the opportunity to speak to your “inner child” and help him or her process what is happening. You can talk yourself down from anxious and negative situations.
Talking yourself down is about literally talking to yourself in a way that is calming and nurturing. You might ask, "But what do I say to myself when I've never done this before?" Here are some suggestions. But first, use your first name when talking to yourself :
You are going to be okay
Nothing bad is going to happen to you
This is all going to pass, it won't last long
You are strong and courageous. You've got this. You can handle this.
There's nothing to be afraid of
Let's get ourself together. We can do this.
You are safe and secure, nothing to fear
You can get through this.
This might feel strange, as you have never done this before. Remember, when it comes to our thought life, the loudest voice wins. This means that we speak to ourselves in our mind, but we seldom speak to ourselves verbally and out loud. The loudest of these two voices is the one that will determine what you feel and do. That is what thoughts do. They influence our feelings and behaviors. Speak to yourself and talk yourself down as you feel anxious or sad. It works!
Challenging Negative Thoughts
Have you ever heard that expression, “Don’t believe everything you hear”? This is really true when it comes to negative thoughts. This is the process of being able to stop thinking thoughts that make you feel sad, guilty, anxious, depressed, or otherwise bad. Challenging negative thoughts is about having that “wait a minute” moment. Maybe you have had this type of thought before. You are thinking something, then you stop yourself. You realize what you are thinking, and that you may “spiral down” if you keep thinking it.
Some of the more common negative thoughts we think are…
I’m so stupid
No one will ever love me
Nothing I do is ever good enough
I am unlovable
I cannot do anything well
I’m such a failure
You are not alone if you’ve had these thoughts. We have these ruminations that happen on auto-pilot. They seem to never stop. But how do we challenge these thoughts? Ask yourself the following questions:
What has recently triggered me that I would feel this way?
Who told me this is what I am or what I do?
What evidence is there that this is true?
What do I know about myself that proves this is not really true?
What will happen if I keep on believing this?
What would happen if I stopped thinking about this?
There. You have taken the first step to challenging and questioning whether these negative thoughts are true. So take some time and really think about your answers to these questions. These negative thoughts have been with you for so long, they feel familiar and true, almost like a part of you. But it’s time to let them go.
Next week I will share about how to replace these negative thoughts with thoughts that are positive and lifegiving. You don’t have to live with pain. You have control over what you think.
Core Beliefs
I want to introduce you to a concept called Core Beliefs. This is such a critical part of your growth and healing process. You will understand more as we go along here.
We all have thoughts that we think about every day. These thoughts can be positive and uplifting, or negative and self-critical. I wish we all would only have those good thoughts, right? You know - those thoughts that make you feel good about yourself, excited about life, or loving and warm thoughts and people and things we love. I sure like those kinds of thoughts. But the truth is, many people who experience depression or anxiety have a real problem with negative, distorted, and critical thoughts. It can be so bad that these thoughts come to us automatically. These thoughts can be so awful, self-deprecating, so mean and hateful towards ourselves, that we identify with them as part of our personality. Negative and distorted thoughts can be the first thoughts that come into our mind in the morning, and the last thoughts that come into our mind at night before bed.
What makes these thoughts so powerful is that they are never vocalized. It's called an "inner dialogue." They live inside our heads, always reminding us how awful we are. Eventually, they help to form our "core beliefs" about ourselves, others, and the world around us.
Core beliefs are so strong, they try to define us: "I am stupid, I am a failure, I am not good enough, I am an idiot, I can never be successful." They are usually not true. But we sure believe they are true. And so we begin to see everything in our lives through this lens of our belief system. It's hard to talk us out of it.
Where do our core beliefs come from? There are many factors that contribute to these core and foundational ways in which we see ourselves:
Our Caregivers - This usually means that our parents contribute to these beliefs. While this is true, caregivers can also include extended family members, coaches, teachers, adn any other adult who has some responsibility or influence in your life in your growing up years.
Our Experiences - The experiences in life often help in creating our negative self-statements. One example could be interactions at work. Work colleagues, clients, customers - these groups of people sometimes provide very negative interactions with us. Think about the ways in which you were spoken to and managed by past employers and managers. Consider the past interactions with others - an angry or dificult customer or colleague, and others you might have encountered. Another example is our own efforts to do something important, complete a task, earn a degree, solve a problem, find a job, keeping a relationship going. These experiences, if they were negative, would have a direct impact on your beliefs about yourself.
The issue about how these beliefs are formed, is that people, interactions and experiences send a message to us - sometimes intentional, but many times simply be default. If your mom or dad worked all the time to pay the bills and put food ont eh table, he or she was likely doing this out of love for you. After all, what greater responsibility would a parent have than to make sure you have the proverbial “roof over your head and food to eat”? While that is true, the message you might perceive from their constant absence in your life is, “I am not important; I am not lovable; I am not worth people’s time.”
That message is incredibly powerful, and creates negative core beliefs.
So how can we deal with such negative thoughts about ourselves? There are three steps I use in cognitive therapy that will help you with this:
Identify your negative thoughts about yourself. This is the first step. Through counseling, i will help you to thoroughly examine past experiences and caregiver interactions. I will help you process past situations hich have been painful for you. It’s important to understand that most parents didi the best they could given their own background. The goal is notto demonize your parents, but to simply identify any negative thoughts you have been thinking as a result of being in their home.
Challenge these negative thoughts. I will help you through the process of gathering evidence that will support the notion that your are not what these negative messages communicated to you growing up. We will together talk through these positive situations and evidence about who you are. I will help you to see the great disparity between what you heard growing up, and who you truly are.
Restructure these negative thoughts into positive and accurate self-statements. Together we will form a positive self-talk narrative that truly describes your unique personhood.
You need to know that core beliefs can change! They can be challenged. Through this process, I want to help you identify those lies, those false beliefs about yourself that you've been telling yourself forever. I want to help you identify the false evidence that allegedly supports your negative and distorted belief system. Then once this is completed, I can help you replace distorted thinking with true and accurate thoughts.
I will provide some reading for you to help along the way if you like. Let me know what you think about this…
Surviving a Panic Attack
Panic attacks are stressful and terrifying. Those of you who have experienced them will understand just how difficult it is to make it through one of these. They can come literally out of nowhere. They can paralyze you and interru[pt your day to day activities.
I have always advocated for creating an environment and approach that puts you in control. Panic attacks render you helpless and feeling very much out of control. Here are some things that will help you maintain a healthy sense of calm and peace as you move forward.
If you are on medications, stay consistent. Keep taking your medications. Don’t try to change things around without consulting with your psychiatrist first. If your medications do not seem to be working, don’t be alarmed. Some anxiety medications are helpful for daily anxiety, but not sufficient to address panic attacks. Talk to your prescribing doctor to find out if there are anxiolytics that might be taken as an adjunct to your SSRI in emergencies like travelling on an airplane, or speaking in front of a group..
Think ahead and be prepared. Be aware of the triggers you experience related to anxiety and panic. What coping mechanisms have helped you in the past? Some people use foods like mints and gum. Others use something tactile to hold in your hands like a ball, a spinner, or other object that distract. There are many options, including calming music, calming scenery, guided imagery, and deep breathing.
Have a Self Talk Narrative ready to use. Self Talk is your best bet to address anxious thoughts. The reason is, your brain cannot process two opposing thoughts at the same time (“I am safe” versus “I am in danger”). The thought that wins is the loudest thought! That means verbally saying something that is positive, calming, and accurate will override anxious and fearful thoughts. Using your voice will overpower any inner negative dialogue every time.
Let me know if you continue to experience panic attacks and we will work together to get you more resources to help you.
Increasing Your Self Esteem
Many people go through life unsure about themselves, questioning their competence, value, and worth. It is truly sad to not feel secure, important, and loved. This brief article will help you understand how to raise your sense of self worth.
It is important to understand that we have this particular level of self worth - of lack thereof - because of people with whom we have interacted throughout our lives. Perhaps your parents, or extended family members said things to you that made you feel small…
“You’ll never amount to anything.”
“Why aren’t you smart like your brother?”
“How could you be so stupid?”
“You’re such a failure”
The list of messages we get from our parents and caregivers is ongoing, and can be hurtful and debilitating to our growth and development.
The answer to dealing with this lies in the way we talk to ourselves, and how we ignore or acknowledge the evidence that supports that you are not as these negative messages have informed you. It’s so easy to see the negative and distorted evidence against us, isn’t it? Those messages ring loudly in our mind about how worthless, stupid, and unloveable we allegedly are. That’s because we have rehearsed them thousands of time through our inner dialogue.
I want to encourage you to look for evidence that supports just how wonderful of a person you truly are. Evidence proves a case, just like we see on TV in the courtroom dramas. Evidence of worth and value will quickly expel and reject all those false narratives and distorted message we heard growing up.
What do you inherently know about yourself?
This is a great place to start. Think of all the really good, noble. Kind, and prolific things about you that you cannot ignore - things like…
being kind to others
the ways in which you excelled in school or college
how you have overcome certain obstacles in your life
How you present yourself to others throughout the day
How you dress or what you wear
Your commitment to the pursuit of excellence, decency, sincerity, truthfulness, and other positive traits.
What do others whom you trust say about you?
Think about those compliments you routinely ignore or brush off, as if you don’t deserve them. What if those compliments are true? What if you truly have impressive qualities? Maybe some things people say about you are right!
In the end, this is a matter of being able to distinguish between a lie and a truth. Accept the truth, reject the lies, know yourself well. You deserve to live a life free from fear, and believing the best about yourself, even when you disappoint yourself. Mistakes will happen, and do not define us.
You are worth believing the best about yourself. Be kind to yourself and do this!
Why Am I So Anxious?
One of the difficult parts of being anxious is having absolutely no idea why you are anxious. This can be really frustrating. You might find yourself at work, out with your friends, or simply by yourself at home, and suddenly be gripped with anxiety. So here are some things to be aware of that can help you attempt to identify the reasons why you are anxious. In doing this, you will understand how to address it.
It’s true that anxiety comes from the stressors in our lives. Stressors can be events, people, or situations that cause us significant angst in our lives. One of the most common stressors are relationships. Relationships which are difficult, toxic, estranged - these relationships can be quite stressful. You can be in such a relationship where you literally don’t know how to move forward. You have no idea how to talk to a certain person - family member, co-worker, or other person. The inability to communicate with or resolve problems with this type of person can make us terribly anxious.
Anxiety can also be the result of events in life that happen every day. For example, if you are particularly introverted, just the thought of making a presentation in front of people, giving a speech, or having to attend a large gathering can make you anxious. Other events that are anxiety-producing are having a meeting with your supervisor; having a difficult conversation with someone, or having to defend yourself against an accusation.
One particular situation that causes anxiety is change and adjustment. Adjustments in life happen when a significant change occurs. For example, if you are going through a divorce, this is a very significant adjustment. You might have been married for many years, only to find yourself having to proceed with a divorce, being alone for the first time in years. Such a change can be overwhelming. One might be faced with many unknowns, leaving one to feel vulnerable.
Other situations which could cause an adjustment to happen is changing jobs, moving into a new location or state, attending college for teh first time and moving away from home. Such adjustments require a lot of patience, planning, and having the necessary coping skills to manage your anxiety.
First, Consider the Antecedents - you might be wondering what this means. An antecedent is a precipitating event or situation that happen to you. It is sort of like when you lose something valuable. Has that ever happened? You have to retrace your steps and find something, right? You might be thinking, “Okay, I lost my keys. What did I do when I got home last night? Which room did I go into? What jacket was I wearing?” You are going to think through every detail of what happened if you misplaced those keys. Tracing an anxiety stressor is kind of similar. You might ask yourself:
Where was I the day before I felt anxious?
What was I doing that day and night?
Who was I with?
What situations were going on during that time?
Look for the clues that relate to causes for making you stressed - things like preparing for a big test, having a meeting at work with a stressful person, or having to perform some dreaded task. Think about the above questions, and you will get some idea of what is stressing you.
Second, Consider Your Thoughts. What exactly were you thinking when that situation happened? What were you beginning to worry about? Remember that worrisome thoughts sometimes are stealth! They are under the radar. You can have recurring anxious thoughts that are so common, that they are on auto-pilot. You may not even be aware that you are thinking about them.
One of the most common types of automatic thoughts is “catastrophizing.” This happens when something fearful or threatening happens, and we begin to ‘spiral.” Maybe you have felt at times that you were spiraling, either with depressive thoughts or anxious thoughts. Spiraling is that action of obsessing over certain dreaded, possible negative outcomes to the point where you are reaching for the worst possible result that could happen. For example, let’s say you come in late one day for work. Your supervisor sees you come in late, and looks the other way. He doesn’t greet you like he normally does. Now is when the thoughts begin. You start to question why he didn’t say anything. You worry that he is upset ad angry with you. And you start to imagine that this might be the last straw for him. He is so tired of you, upset with you, adn disappointed with you, that you imagine he is considering firing you. Now you are jobless. Now you are going to lose your home. Yoru car will get repossessed. Your friends will find out and mock you. Do you see how this works? Catastrophizing pictures a doomed ending to a negative situation. Spiraling leaves you feeling out of control.
Third, Challenge the Thoughts. Don’t allow negative thoughts to “rent space” in your mind. These anxious thoughts can be debilitating. Refuse and reject them. Prepare for possible recurring events when negative thoughts come: a weekly staff meeting, a weekly class, and other similar things.
I use the term, “wait just a minute!” when trying to challenge thoughts. It is that moment when you realize you are spiraling. Say to yourself out loud, “wait just a minute. I am thinking ______. This may not be true for me. I am not 100% sure thjis is true. Should I really be thinking this?
Then fourth, Reframe the Thoughts! Change the thoughts into positive and accurate thoughts. Replace the negative language with positive wording. For example, start with that catastrophizing thought, “Oh no, my boss is upset and I might get fired.” After you have your “wait a minute” moment and challenge the thought, say to yourself, “My boss might be upset that I am late but that does not mean I am about to be fired or homeless. This is not rational. I give myself permission to reframe this irrational thought. I think it is more realistic to assume that he may not be pleased with my tardiness. I am a good and consistent employee, and I am secure here at my job.”
Following these steps will help you grow in your self-worth and sense of peace.
Having Difficult Conversations
We often find ourselves at the same table with people with whom we have had disagreements, or some type of hurtful exchange in the past. It could be at your family dinner table, at the office, or other event. Sometimes there are certain subjects among friends, co-workers, and acquaintances which are left unresolved, and certain situations when we feel like an apology is owed. What can you do in this kind of situation?
First, decide what you want to accomplish before you even arrive at this function…
Do you want to just leave that “sore subject” alone?
Do you want to possibly have a private conversation to try to make things right?
Do you want to avoid this person completely?
Do you want to be able to connect with them at the function, but keep things light?
It really helps to be prepared, knowing a particular person might be present. So let’s cover a few options for you…
You can just stay home. You might laugh, but if you are so angry that you may cause a scene, and you don’t trust yourself, just take the pressure off yourself and don’t go. Don’t worry about hurting anyone’s feelings. No need to make other people happy. Be more concerned about your own feelings in this situation!
You can talk with him/her, but keep the conversation light. Be prepared to talk about things on which you agree. Maybe you can show photos of the family, or ask about their family. Work is always a good subject to keep a conversation going. Ask questions that are open-ended, as it makes the person feel as if you are interested in what they say.
Or you can have a serious conversation, but I would encourage you to keep a few things in mind…
-Wait until a few minutes before you leave before you have the conversation
-Make sure no one else is around, so that it remains very private
-Try to make it very casual, and not “serious” with drama…”Hey John, I was just thinking about the other Saturday when you and I were headed to the store. I remember that talk we had and I just didn’t feel right after I left. I would love to talk with you about it.”
-Use “I” statements, don’t use accusatory language. This means saying, “I was just thinking about that day, and I remember just feeling very hurt that I was maybe misunderstood,” as opposed to , “You ALWAYS talk down to me and make me feel stupid!”
-Affirm anything that you know is good with the relationship before you say something difficult: “John, I really appreciate you man, you have always been there for me. I did want to share something with you though…”
-LISTEN! And I mean REALLY listen. Let him/her know you are listening. Try to understand the feelings and thoughts.
Managing Depressive Symptoms
Depression can be extremely difficult to manage. It can rob you of your joy, your career, and your relationships. The symptoms can feel overwhelming. Here are some of the significant symptoms of depression:
Sadness
Fatigue
Loss of motivation to do enjoyable things
Loss of motivation to do anything meaningful
Changes in appetite
Suicidal thoughts
Inability to concentrate or focus
If you are experiencing any of these symptoms, you likely have depression. Let’s discuss some possible conflicts and obstacles to dealing with depression.
One obstacle is the stigma of being labled with a disorder. This is a common concern for people. Having a particular diagnosis can result in a perceived loss of standing in one’s work environment, as well as one’s social circles. I completely understand how this might affect some people who have a negative view about this. It’s important to note that the reality of mental health concerns is widely and more frequently viewed as acceptable, and specifically connected to the principle of wellness, well-being, and self care. These concepts have attracted the attention of human resource executives, supervisors, and other middle management and upper management personnel in many different organizations. There is a distinct emphasis on self care and work-life balance which we have not experienced heretofore. It is so important to understand that the majority of the workplace powers that be understand this concern, and proactively advocate for proper self-care and work-life balance. Employees are demanding it and corporate America has listened. Your mental health needs are important, and it is understood that difficulties encountered in mental health can negatively affect worker productivity and overall happiness.
Another obstacle is the idea that we “should be” self-sufficient; that the idea of having need of outside help is just not okay. For example, I have heard many clients who suffer from depression say that they are called “lazy” and “procrastinators” because they have no motivation to accomplish needed tasks. This type of person would feel severe sadness, fatigue, and lethargy. These symptoms cause a severe lack of motivation, thus causing one to think they are somehow intentionally avoiding responsibilities. This is absolutely not true! Sometimes, good, conscientious employees, husbands, wives, and children need a bit of help to accomplish certain things. It is okay to be not enough sometimes. It does not imply weakness to ask for help.
I would ask you to carefully consider these obstacles to wellness next time you are tempted to be self-critical. No one ever asks to be depressed or anxious. This is not something we choose.
Here are some brief thoughts about how to manage your depression.
First, get some therapy. If you are reading this, you likely are already getting therapy, which helps a lot. You need therapy to help you untangle the thoughts you are thinking, and the feelings you experience. Many times, the notion of therapy is frowned upon by family members. I do believe that you can step away from this dysfunctional way of thinking and choose therapy. Finding a good, caring, and empathetic therapist can be incredibly beneficial. One particular benefit of therapy is simply having someone to talk to, and with whom you can process your thoughts and feelings. There are many people who simply do not have the support system they need to have such a person in their life. Other people often feel like a burden to their loved ones, and don’t want to intrude upon them with their problems. While most loved ones would be happy to oblige you and lend a listening ear, many people choose not to do so. We as therapists are trained to be good listeners. We understand you need a safe place to process difficult and painful feelings. We get it!
Second, examine your thoughts and beliefs. This is what we do in therapy. We help you identify distorted, irrational, and negative beliefs that affect your mental health. Many times, thoughts simply go unchecked, free to roam about your mind at will. This type of thinking will rob you of joy and peace. We can work with you to examine, identify and challenge certain beliefs that make you depressed. Negative thoughts will almost certainly cause negative emotions. This is important because many times, thoughts become set to “auto-pilot.” We think certain things without any effort. We have thought so frequently about certain negative things, that it just becomes second nature. Therapists can help you process this issue, identifying negative and dysfunctional thoughts about yourself. We can help you differentiate between healthy and unhealthy thoughts, and assist you in restructuring these thoughts to be more affirming, positive, and truthful.
Third, move around. I know this sounds simple, but behavioral activation is all about getting moving in your body, and creating a new momentum physically, based on consistent movement. This could be taking a walk, running, playing tennis, racquetball, or just getting on an exercise bike at the gym. You could walk on a treadmill, as well. If you begin taking the time to do this, you will begin to sense a bit of renewed energy, and this will greatly enhance your motivation.
Fourth, look into getting some helpful medication. I know this is a real sore spot for many people. I have heard many great people say they do not want to depend on medication at all. Others don’t like the way medication makes them feel. So you have to make a personal decision for yourself. I will never steer any person towards something they do not want. I do want to underscore that certain types of severe depression may be greatly and positively affected by even a short-term regimen of medication. You always want to speak to your psychiatrist or family care physician about this to find out what is best for you. But in the end, medication is all about helping you function - as a spouse, employee, father, mother, and any other hat you are wearing. If you cannot function at all in any of these areas, you may want to consider medication.
These are some brief tips, and I hope this helps you!
Dealing with Trauma
It all begins with an idea.
Trauma is very common, and can take many forms. For those who have experienced severe trauma, many times a diagnosis of PTSD is appropriate.
Trauma happens due to a fearful or threatening event. This could be some act of violence, a car accident, an act of God such as a hurricane or tornado, or any situation in which you feel threatened in your bodily safety.
How could one know if he or she has been traumatized? Some of the common symptoms of trauma are…
Experiencing intrusive, negative thoughts about a certain event. These are thoughts that show up frequently, and they are unwanted. Yet they come into your mind and one can feel powerless against them
Having nightmares. Nightmares happen when someone has been through a traumatic event.
Feeling hypervigilant. This would mean that you feel “hyper-alert” to possible threats around you. Maybe you are looking over your shoulder, or waiting for something troubling to happen.
Experiencing an exaggerated startle response. This could happen when something minor occurs, but your mind and body experience it much more dramatically.
Avoidance of particular places or things that remind you of a traumatic event
Having a deep shift in moods, such as anxiety, depression, and outbursts of anger.
Feeling emotionally numb
Feeling a sense of detachment from people
Our reaction to a traumatizing event is usually one of three things: fight, flight, or freeze. You would either feel the need to fight, to run, or simply feel so fearful that you would be literally immobilized. Many people feel this “freeze” sensation whenever a threat is perceived.
How does one address traumatic events? How could one finally begin to feel some peace instead of turmoil?
I use Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization Reprocessing (EMDR) to address trauma. These two approaches, used together, will help you identify negative and toxic thoughts, challenge them, and replace them with positive, accurate thoughts. You will be empowered to deal with these negative thoughts, and stop them from causing pain, fear, anxiety, and phobias. Using EMDR, I will help you to reprocess painful memories through an approach called bilateral stimulation, using your eye movements to help you target a traumatic memory.
If you are experiencing trauma, I am here to help. Feel free to inquire about these powerful approaches to reducing trauma.
Setting Appropriate Boundaries
It all begins with an idea.
One of the aspects of codependency is that we make attempts to please others at the expense of our own needs. People who are codependent thrive on making others happy, even when it hurts themselves. The goal is to try to make everyone else happy and to never expect happiness yourself. In this codependent way of living, we tend to devalue ourselves. We fear rejection and abandonment, and so the need to please others feels like a mandate for ourselves, lest we find ourselves alone and abandoned.
One of the healthy actions we can engage in is to set appropriate boundaries with others. The idea of boundaries is about seeing yourself in a different way - someone who deserves to be treated with respect and dignity. There will be a need to set a boundary when we feel our sense of self-concept and value is being violated. Boundaries place a fence around yourself - in a good way - to protect you from intrusive actions which can intrude upon your sense of dignity and respect. There are people who can say and do things that are guilt-ridden, demeaning, mean, unkind, belittling, argumentative, and many other types of intrusions.
Some people think that the process of setting boundaries is a “big event.” But that’s not true. Setting boundaries happens incrementally as you interact with the people around you, one situation at a time.
One of the most important ways we set boundaries is by creating boundary statements. These are phrases you can adopt that best express your thoughts in an amicable, clear, and assertive manner. Here is some examples:
“No, I can’t do that.” When someone is expecting you to do something, and you don’t wish to do it, to decline them would mean them possibly rejecting or guilting you. You have to be able to love yourself enough to guard your time and resources. There is no need to explain your reasons why, as that is not their concern.
“I can see that you are really upset about this issue. You really need to decide what you’re going to do about that.” When someone brings up a problem, sometimes that problem is not about you, but about their own issues. Boundary intruders are good at blaming and want to overpower you and see you retreat and apologize, and even more so when you are not to blame. You have to refuse to accept responsibility for the feelings of others. Allow accusers to take responsibility for their own perceptions and actions and triggers.
“If you continue to yell at me, I’m going to leave for a while.” You need never be anyone’s verbal punching bag. There is no rule of relationships that says you must listen to another person berating you, cursing at you, or otherwise verbally abusing you. Again, love yourself enough to exit quickly when the yelling starts.
Some helpful pointers to remember as you have conversations with boundary intruders
First, resist the urge to apologize. People-pleasers are famous for feeling the need to apologize at every turn when they sense they are disappointing someone. No apology is necessary in most cases. When you have to decline someone, you can say…
“I appreciate the opportunity but have to pass for this one. Maybe another time!”
Read this statement and notice how there is no indication of “I’m sorry” “Please forgive me” or “I hope you don’t mind.” These terms put you at a huge disadvantage with another person when discussing perceived expectations. Apologizing is about acknowledging a mistake you have made. Notice how it is not a mistake to decline a request or demand. The person is asking something of you, and you are simply not making yourself available. So why do we apologize so frequently?
This is because we have that conviction that we owe others. We truly believe we owe others our time, attention, and resources. If we have a spare moment in our day, that moment seems to be reserved for the pleasure of everyone else except ourselves. It’s our moment! We can do with that time period whatever we like! We do not owe our time to others 100% of the time.
Second, resist the urge to explain yourself. You see, behind this need is that we want the other person to be okay with our decision to decline. We want them to be happy, and not disappointed in our response. So, to ensure they are completely at ease with our boundary, we feel the need to explain the reason why we must decline. But it’s just not necessary.
However, some people are accustomed to getting what they expect from you. These people will pry and probe at your motive and your calendar. “Well, you’re not busy all day, are you? Surely you can do this after work, right?”, they might ask. It seems logical at first. But you must remember that you do not owe them the request. It is your time to decide how to use it, whether it is convenient or inconvenient for you. You can simply respond by saying, “yeah, as I said, I appreciate the opportunity, but I’ll have to decline for now.”
No explanation. No apology. No expectation that they will be okay with your answer.
Third, have confidence in your response. You get to have an opinion and a vote about how you use your time. Assuming the request is not your boss, you can confidently decline a request. The secret to this, and other responses, is giving yourself permission to have your best interest at heart when deciding whether to agree to a request. Have confidence in that.
Remember, that the people in your life who regularly take advantage of your good nature know you. They know how to persuade you. They know your soft spot. But you can change this. By all means, please continue to be kind and caring. But now you must become unpredictable in your responses. They are expecting the pushover. So be that person who says no. Be the person who has no problem being honest about your feelings and availability.
Finding Support
It all begins with an idea.
There’s probably no greater help to someone experiencing mental health challenges than having appropriate support in life. It doesn’t matter whether one is single, in a relationship, or married. Having meaningful and helpful support from significant people in our lives is an essential part of our wellness journey.
When we think about the subject of finding support, it is important to note that there are many different types of support we might need…
Emotional - this is one of the most important types of support. Having someone with whom you can talk, and in whom you can confide and trust with your thoughts and feelings can lift a heavy burden. There is a good chance this list may not be long, but you’d only need two or three trusted supports to process very vulnerable thoughts, feelings, worries, and cares. This might also include a friend who is encouraging and funny, who knows how to lift your spirits.
Financial - this is a valuable person of support whom you can trust in those moments when financial help is needed. This might be a parent or friend, and even sometimes an employer.
Logistical - this is a person who can provide transportation when necessary, and possible temporary shelter or housing.
Spiritual - having someone who shares your personal spiritual beliefs can help you connect to your Higher Power, and help you with such situations as attending gatherings, connecting with spiritual small groups, and local spiritual events in your community.
Physical - this is the type of support that shows up for specific tasks: helping you pack your home, moving houses, fixing or repairing things, and cleaning, just to name a few common task needs.
Medical and Mental Health - your therapist, psychiatrist and primary care physician all provide much-needed support to help you live a healthy life, mentally and physically. This would also include other medical specialists based on your unique needs.
These are just a few of the types of people you will need for times of support. Think of these supporters as your “team”. Much like a sports team, each team member has a very specific role and function. Your mental, spiritual, emotional, and physical health depends upon your “team” members doing their job, collaborating with you, and providing the unique support they offer.
I want to encourage you to do the following:
Look at the list of needs above- which ones do you need throughout your week?
Make a list of these needs one by one
Now think through the people in your life who have occasionally “shown up” for you. Who are they? Which of the support needs do they fill? You might have some people on your list who provide multiple support functions, like spiritual/financial/logistical.
Create your team! Call your support person and ask if he/she/they would be willing to support you occasionally. You will be pleasantly surprised at their responses!
Reparenting Yourself
It all begins with an idea.
This concept of Reparenting seems strange to many people who have never considered it. But the principle is very clear: we can give ourselves today what we did not have when we were younger. What exactly do we need to give ourselves? Growing up, we may have missed out on…
Unconditional love
Attention
Affirmation and guidance
Emotional regulation
Encouragement
Validation
Comfort, consistency, and security
The idea of reparenting is not necessarily intended to blame your parents, accuse them, or cause problems for them at this time in your life. Most parents did the very best they could with what they had. Rather, reparenting allows you to repair the brokenness of past interactions in your childhood.
One example is the idea of abandonment. There is nothing more painful than emotional or physical abandonment. When a parent neglects you or doesn’t take the time to attend to your needs as a child, it would be easy to perceive a message from your parent that you are simply not important. You would grow up with a very real need to feel loved, to feel secure and significant in the eyes of your parents and family. But what can you do as an adult today? What if mom or dad is no longer alive? What if they cannot provide you with what you need?
The answer is, that you can begin to love yourself. You start treating yourself as if you are important because you are! You can start the process of finding out the parts of life which were missing during your childhood. Then, simply begin giving back to yourself the kindness, love, and nurture you have always needed.
If this concept interests you, let’s talk more about this in our next session. I’m glad to help you discover how to do this.