This Therapist's Take
Thoughts, reflections, and ruminations
about life, therapy, and relationships
about life, therapy, and relationships
I have sat and stared at this blank document many times over the past week. Part of me doesn’t know what to say about everything going on because I don’t have the words. Part of me doesn’t know how to make sense of the jumble of racing thoughts, emotions, and feelings I am experiencing as I sit with clients, speak with my family and friends, watch the news, and scroll through the variable rainbow of reactions on social media. So please bear with me and give me some grace as I try to make sense of it. I hope that my words help you to not feel alone in your reactions and in turn bring you some peace.
In many ways, this situation is putting things into perspective. We are being forced to reflect on what is important to us and this time is serving as an opportunity and reminder to slow down. While we can get caught up in the news and scrolling on social media which makes our minds race, we also are being given an opportunity to take a step back and turn things off and separate a bit from the chaos. We are so lucky that this is happening in March and not in December. We are able to get outside, go for walks, hikes, and bike rides. We are given the opportunity to not rush around to this activity and that, and instead we can read the book we have been meaning to pick up or play the board game that has been sitting in a box for who knows how long with the people we are closest to. I also have been reflecting on the fact that I am actually thankful that this is happening now, in 2020. I am reminded of riding on Spaceship Earth in EPCOT as a child and seeing the scene where the son and father are speaking with each other over the computer while the father is away somewhere in a different country. How strange and foreign that seemed and here we are, in a place in our world that we are able to telecommute more readily and I am grounding myself in the thankfulness I have that both on the federal and state level we, as mental health providers, are being supported in utilizing teletherapy so that we can continue to support our clients through this unsteady and uncertain time.
So many people are responding to the craze in our grocery stores and with an obsession of hoarding materials that do not always seem helpful or necessary for this current situation. But, as I reflect on this, I begin to understand. As humans right now, we feel unsettled, and wholly and completely out of control. There is so much that we do not know about this virus and how different it is from others like it, that we do not know how to react. As humans, anytime our feeling of being in control is rocked we feel uncomfortable and we react, grasping at any possibility of gaining that control again. In my therapy sessions, I challenge my client to think of someone in the ocean, that feels their footing disrupted even temporarily. They begin treading water, to flail and splash and try to find their way to solid ground again. Many of these reactions are not helpful and may in fact create a worse situation as they tire themselves out. They fight against the current, not realizing that by letting go of trying to be in control, may in fact be the best way out and the quickest way back to control again. What I try to help my clients to see is that if the person has the skills to ground him or herself, they would know that the ground that they were standing on solidly before is still there, that they just need to put their feet down and find it. This is what is happening around us right now. Because the waters we are in right now feel so foreign to us, we are not sure if we feel safe to put our feet down and find the ground that will make us feel safe.
One thing that I am sure of, is how beautiful it is to see that that majority of the people in our country are understanding the significance of our current situation. While we still experience the naysayers that are comparing our reaction to this to reactions to pandemics past, most of our country is seeing that by staying home and keeping our distance, we are trying to learn from what happened in the past. We know that our actions are part of working toward preventing the number of those lost with COVID-19 from reaching the numbers of those that were lost in past experiences. We have to remember that we will never know if this was an over-reaction, but I, for one (and, I know I’m not alone), would not want to see what would happen if we did not react enough.
We are also seeing how we are all in this together. I am trying my best to focus on the beauty of people helping people, instead of my own fear of how this virus will affect me personally. We are seeing those who have, give to those who do not have. We are seeing celebrities not only give money to charities, but also reading to children, sharing the gift of their voices in song, and share how they are coping with being at home with their children and offering support. We are seeing landlords give residents free months in order to take the weight of bills piling up off their shoulders. We are seeing internet companies offer free services to children who need to connect in order to continue their learning. We see restaurants making the most of being shut down by setting up a system in which people can buy food from their business to be delivered straight to hospital workers in their communities. Applications are offering free access to their content in order to stay fit and healthy at home. I can go on and on, and when I think of these people, these organizations, these companies I am finding some peace because it restores my faith in knowing that when it comes down to it, we aren’t red or blue, left or right, we are all humans. This is where I am finding my ground, in being human, in being in this together.
As we approach Valentine’s Day, attention is commonly drawn to celebrating love and relationships. You may be thinking about celebrating your current relationship with your significant other with a romantic dinner, chocolates and flowers. If there are some stumbling blocks in your current relationship, you may also be reflecting on your partner and whatever struggles you both may be going through. If you are single, your focus this week may be on your desire for a romantic relationship while you process through feelings of loneliness or sadness. This can also be a time to reflect on past relationships, reflecting on why they may not have worked out. You may not even be focusing on romance at all and instead gearing up for an epic celebration of your friendships with some Galentine’s or Palentine’s fun.
Unfortunately, most people forget about the most important relationship of all – the one that we have with ourselves. When you think about it, you are the person that you spend the most time with. You are the person that you talk to the most, the one with whom you are having the deepest, rawest, and most honest conversations. How often do you take the time to focus on the relationship that you have with yourself? How often do you focus on growing self-love and self-appreciation? The way we see ourselves and the way we treat ourselves directly affects how we relate to the world and how we build relationships with others. When we do not offer ourselves love and grace, it is very difficult to build healthy relationships with other people in our lives.
It is, at times, astonishing to me how our society has created such a world that makes it so difficult to find self-love. We are often surrounded by messages of being not enough, messages that tell us how to “fix” ourselves or become better versions of ourselves. We are shown snapshots of others’ lives that appear perfect in their well-filtered images, images that we could never live up to in our real lives because they are not reality in and of themselves. These messages are in our face and at our fingertips all the time. They define how many people choose to measure themselves as they appear to be directed by what society sees as the ideal. Messages hit us from every angle and every form of media, constantly reminding us of what we need to do to change ourselves in order to create happiness. How does one find self-love and happiness when all the messages being received are focused on reasons not to do so? And, how do we avoid the anxiety that we experience when we feel like we can never measure up?
So, when we think about these societal ideals and the messages we ask ourselves about what it would take to create this self-love and happiness, a lot of it comes back to how we set goals. Goals can be a very funny thing in that they can both drive us forward, while also making us feel poorly about ourselves when we don’t think we are getting to our end goal quickly enough. Don’t get me wrong, I am all for goals. I am all for wanting to grow, wanting my clients to become the best version of themselves. I could not and would not be able to do what I do each day without the belief that we all have the ability to create and manifest better versions of ourselves. But, one of the biggest struggles my clients face when it comes to goal-oriented discussions, is how to be both okay with who they are in the present and finding happiness with their accomplished progress, while also continuing to work toward achieving their ultimate goals and not feeling setbacks when they don’t achieve their goals as quickly as they would like.
One of my favorite things to remind my clients is that you can be both a work in progress and a masterpiece at the very same moment. You can have pride in who you are, what you have persevered through, and how you have grown and kept pushing yourself forward to bigger and better things. For some people, it is too easy to get trapped in fear that if they express pride in their progress throughout the process of working toward goals, that they will become complacent and let go of the motivation that was driving them in the first place. Too often in sessions, my clients are struggling with feeling like they are not doing enough and therefore not measuring up to whatever image or status by which they are determining their worth or the progress they are making, and therefore create stories that convince them that they are not enough. These stories affect their ability to maintain the self-love that is so important to developing a healthy relationship with one’s self. Many clients also begin beating themselves up the minute they have a minor setback or the first time they may stray slightly from the very narrow and very straight path that they believe is the only way to get to their ultimate goal. Sometimes the symptoms of both anxiety and depression are rooted in their struggles to see their strengths and abilities and then fuel the negative stories that they tell themselves. Other clients struggle once they achieve a goal. They convince themselves that the value of that goal is no longer enough, never allowing themselves to relish in the positive feelings or accomplishment that they should be allowing themselves to experience. Sometimes, being able to acknowledge a goal being achieved is anxiety provoking as well because it proves to a client their own strengths – something that is difficult to face for a person who struggles with fostering self-love and appreciation. Again, by refusing to see progress and personal strengths, my clients keep riding these merry-go-rounds of emotions and maintain their mood and anxiety symptoms.
So, let’s get off this merry-go-round, lets focus on our accomplishments and our strengths. Let’s realize that we can continue to move forward BECAUSE of these strengths. Let’s give ourselves grace for the stumbling blocks on our path and allow them to show us our strengths, not just our weaknesses. Let’s accept the reasons to love ourselves that are right in front of us each and every day.
Grief is a funny thing – it is something that is hard to fully understand because it affects everyone in their own unique ways and can be expressed differently as well. Some people express their grief outwardly – they post about it, they show their sadness through tears and words, they wear their grief like a badge of honor for all to see. Others keep their grief inside. They internalize it, keep it for themselves, hold it in their hearts. Some people react with sadness, others with fear, some with anger, guilt, emptiness. Sometimes grief also comes with waves of relief if the loved one we lost had been suffering with illness or pain. Our grief can depend upon the age and life of the person that we have lost. When we lose someone who lived a long full life, and a person that filled our lives with that love, we grieve differently than if it was a young person that had much more life to live. We grieve about what that person may have brought to our lives and the world had they lived on. It really is complicated.
Typically, as we talk about grief in therapy, we discuss the model of the Five Stages of Grief, which is one of the most well-known models of grief understanding, developed by Elizabeth Kübler-Ross and first discussed in her book On Death and Dying in 1969. When we talk about the stages of grief (Denial, Anger, Bargaining, Depression, and Acceptance) we must remember that these stages are not linear, we can go through all 5 stages in just a few moments as our mind tries to make sense of the loss. We may revisit certain stages years later as we are processing through the absence of a person at different times in our lives. There is no time limit on grief, no rules for the speed by which we process the emotions of the loss.
When I think about grief, I am reminded of a training I went to a few years ago with John Gottman, one of our nation’s foremost researchers on relationships. When he talked about grief, he stated that he believes that we earn our grief in our lives and the relationships we share with people. He believes that the degree to which we grieve, the degree to which we feel the pain of our grief is based on the degree to which we loved. I really thought that this was such a beautiful way to make sense of the intense pain that we often experience in our losses and I often reflect this to my clients when they are coping with the pain of losing someone they loved. When we have a complicated relationship with someone we have lost, we also have a more complicated grieving process. The pain is not always just about who we have lost, but also about the loss of what could have been, the loss of a chance for reconciliation or repair.
Grief also seems to be more complicated when we reflect on the grief that we as a people experience when someone famous has died. I, as I am sure many of you, am feeling a deep sense of grief today in response to the sudden death of Kobe Bryant, his talented daughter, and the 7 others that were on the helicopter with them. To be completely truthful and much to my husband’s chagrin, while I love basketball, the NBA is not really my thing. I typically don’t watch many games, I get excited for former UCONN players when I see them doing well, but overall, I do not call myself an NBA fan. I also did not know much about Kobe before yesterday, other than the fact that he had a long, amazing career and came back from a scandal to become a family man that many could and should look up to. Regardless of my lack of interest in his life, I kept watching the news about the tragedy, listened to tributes by those who knew and loved him, and read articles and messages from fans and friends alike in response to his death. This got me thinking, what is this all about? Why is it that we feel such pain when we lose these people that we have never known personally?
I think this is also a complicated topic. Grieving someone famous and the emotional response that we feel in response is dependent on so many different things. When we reflect on losing someone young, like Kobe and Gianna, some of our grief is around the loss of what may have been. We grieve what that person could have done, what they could have accomplished, the lives that they will no longer be able to touch. In this case, we grieve the loss of Gianna’s future and the loss of the good that Kobe was dedicated to bringing to the world of basketball and beyond.
I also think that the grief we feel so deeply in these losses is felt because we begin to reflect on our own loved ones. We think about what it would be like if someone in our life left the house to do something they do routinely, and they never came back. We think about what it would be like to lose our partners, our parents, our children, our friends, without being able to say goodbye. I can’t count the number of times I have seen the meme about it being an underrated blessing to leave your home and come back safely. People are posting this because they feel it so deeply, because this loss reminds them to reflect on the simple yet important blessings they have in their lives that are often taken for granted. We watch his friends speak about him, through tears and pain, and we think about all our friends and loved ones and think about what it would be like for us to be celebrating with them one day, and then have them gone the next. We simultaneously experience empathy, sympathy, and grief with self-reflection and fear. This isn’t selfish, this isn’t being self-absorbed, it is normal, and natural, and just a part of the grieving process.
So, as we move through these next few days and weeks, and we hear more tributes and see more outpouring of love for a great man and his daughter with such a promising future, lets also take time to understand our emotions in response to this loss. Let’s hold our family and friends close. Let’s say I love you when we hang up the phone. Let’s shoot a few sock-ball baskets into garbage cans. Let’s take direction from Kobe’s passion. Mamba, you will be missed.
Happy New Year! We are one week into 2020 and for me, as I am sure for many of you, in the first week of getting back into my routine after the holidays. This week is the sort of unofficial start to the new year. As I scroll through social media or see news articles, I can’t help but be bombarded with topics around New Year’s resolutions. As I consider my goals for 2020, I reflect on goals I have set in years past and then reflect on both my current personal and professional life. This helps to guide how I set goals for myself in these different areas.
So, if I am being completely honest, I initially set a goal for myself to start a blog about three New Years ago. I thought it would be a great way to reflect on topics that interest me, share about experiences, process through patterns that I am seeing with clients throughout my sessions, and offer a place for people who are not ready to walk into my office to gain some insight into what therapy may look like. Every fall for the past few years, I have started lists of topics to write about, have started writing posts – in my head – and decide that while I am home over the holidays, I will get the first post written. I tell myself that it’s the first post that I am struggling to write, that once I get through that first post it will be smooth sailing. I will find a groove. I will gain the confidence. But, much like when many of my clients set goals during their sessions that never come to fruition, my holiday breaks have come and gone without a word being typed.
What is this about? Is it that this isn’t a good goal for me? In the classes I teach, I work with my students about how to write goals for their clients. Goals should always be S.M.A.R.T. (who doesn’t love a good mnemonic device?). For those of you who don’t know what S.M.A.R.T. means – here it is – goals need to be specific, measurable, achievable, realistic and time-specific. This way, when you go back and reflect on your goal, you have a measuring stick to see how you did. My goal was all of these. I was specific in what I wanted to do, I could measure whether I did it or not, I knew I was capable of writing a post, it was realistic to think I would do it, and I gave myself a deadline. So, why could I never get myself to do it?
The next question with goals, is whether the person setting the goal WANTS to set the goal for themselves. Don’t get me wrong, this was something I really wanted to try (I thought), and people around me were very encouraging of me doing it. But somehow, I kept allowing life to get in the way of pushing myself toward this goal. That was always my excuse. I was too busy, I forgot, I had too many other responsibilities, I was going to go in a different direction with my focus (sound familiar?).
This is where my good friend Motivational Interviewing (MI) comes in. In MI, we assess the readiness, willingness, and ability for someone to achieve a goal. Typically, we scale these questions from 1-10. I thought overall, that I was ready to write something (maybe a 7 or an 8), and I definitely was willing to give it a try (I’ll say I was at a solid 8 for that). I think what was stopping me was how I assessed my ability. Don’t get me wrong, on a completely rational level, I knew I was completely able to write something. What was stopping me was my confidence in my ability to write something good. What if no one found what I was writing interesting, or helpful, or relevant?
I think this is something that stops people in their tracks with goals all the time. I can’t tell you how often a client sets a goal in a session that is completely S.M.A.R.T. (e.g. I am going to join a gym this week and report back to you next week about my experience) but comes in the next week feeling like a failure because they did not achieve the goal that in their mind, should have been easy. As we continue the discussion about their goals, we dig deeper, we see that they have some thoughts about themselves and the goal that are holding them back. This negative self-talk is preventing them from pushing themselves into achieving the goal, thus maintaining patterns of the negative self-talk and low self-worth (so in the example of joining a gym they may say, “I am so out of shape, that I’m not ready to join the gym yet,” “I’m not comfortable being in workout clothes in front of people,” “what if I don’t know what I’m doing there and people are watching me screw up”).
This got me to thinking both about my clients, and my own personal goals. How can we push ourselves through the anxiety of not feeling like we are enough, and therefore start working toward the goals that we think will make us feel better about the problem that is preventing us from pursuing the goal (did I lose you there?). What I am talking about is the cycle that prevents us from achieving our goals. That is, in our example of joining a gym, (because its January and that is what we are all thinking about right now!) you feel bad about your body image, so you want to exercise in order to lose weight, but, you feel so badly about your body image that you are too anxious to join a gym and then feel even worse about yourself because you aren’t doing the thing that you know will make you start feeling better about your body image. Doesn’t that sound exhausting? The real work needs to focus on challenging those irrational thoughts that maintain the cycle and build confidence in ourselves. We need to remember that even if the step forward we are taking is on shaky ground, it is still a step away from the negative place we were in before.
So here I am, it was a few years in the making, but I finally wrote a post. I challenged some of the self-doubt I had about being good enough. I recognize that even if it’s not perfect, I pushed myself into something uncomfortable and I know I will be better off for it.
I have been practicing therapy for over 10 years and have worked with countless individuals, families and couples. While I do not want to claim to be an "expert" on all things therapy or life (because I always believe that there is room to grow and learn) I have noticed throughout my time connecting with my clients that similar struggles and repetitive patterns present themselves that affect how clients experience and see life. I wanted to take this experience with my clients and the knowledge I have gained and share it here, so that maybe it can touch others lives the way it has helped my clients.