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Your crazy is your best clinical tool

2/15/2019

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"Your pain is evidence of your participation in the world, not a liability to your therapy practice."
We are all in the same boat. It’s easy to brush this idea off, or pay it lip service, but leaning into the truth of our shared reality and struggle, particularly as therapists, is a hard and often unclear path. We are taught seemingly conflicting practices in our graduate programs—don’t assume the expert role, but also if you’re going to be effective you have to be an expert. The problematic message beneath this dichotomy is that healers are well and their clients are sick. So what happens when the healer isn’t as well as her role seems to require her to be?

I have a long history with Major Depressive Disorder. I currently meet criteria for Postpartum Depression. I’ve experienced intense suicidal ideation in the past and intrusive thoughts of ending it all were my cue to start meds after I had my last baby. Throughout two rounds of PPD, and at least 5 depressive episodes, I have also been a therapist full time, working with people presenting with symptoms that sometimes weren’t as severe as my own. Six months into starting my private practice 7 years ago, I had a big depressive episode, triggered by a bad breakup. Sleeping all the time, barely eating, telling almost no one, I felt myself slipping into the grips of a debilitating black hole. The worst part of that episode wasn’t the symptoms though, it was the imposter syndrome that showed up every time I sat down across from a client. I wondered if they could tell my eyes were puffy from crying, if they could hear how hollow my voice sounded. My shame voice screamed, “How can you possibly help anyone when you can’t even help yourself?”

Then a miracle happened. Through the fog of my depression and shame, I noticed that my clients were actually doing great, better even than they were before I hit my low. When I stepped back and looked at the content of my sessions, we were going deeper, connecting more profoundly, uncovering more hurt than I ever had when I was comfortable and well.

I did some major work on my underlying narrative of self during that depressive episode. I checked all the boxes for managing depression from meds to therapy to exercise to meditation. I rode it out and nurtured myself back to a place that was certainly more balanced and peaceful than I had ever been in my life. As the symptoms slowly dissipated, I had some time reflect on what had made such a painful time for me such a productive time in my practice. I realized that the more I owned my experience of sadness, hopelessness, and hurt, the more empathy and insight I had available to offer my clients. I didn’t have to just imagine what it felt like to be in my clients shoes, I was living it.

As I’ve worked to ditch the shame around my own depression, and have reframed my experience of mental illness as an asset to my work, I’ve started to develop a different relationship with self-disclosure. My story has a different purpose now than it did when I was living the worst part of it. The memory of depression, and the steps that worked to get me out of it, now have a new usefulness, helping me to connect with clients from a place of hope and acceptance. Nothing is more powerful at eradicating stigma around mental illness than saying “hey, me too.” And no skill is more effective at building hope than someone’s lived experience of healing.

That’s not to say I start every session with “have I told you about how depressed I used to be?” Skillful disclosure has two features: 1) Full acceptance and integration of your own struggle as evidenced by minimal shame or willingness to lean into shame and 2) Clear purpose for moving a client forward without egoic gain on the therapists’ part. You’ll know when you have work to do around integrating your own hurt when you feel triggered, resentful, or frustrated by a client whose presenting problem sounds eerily familiar to your own experience. Once  you’ve done acceptance work, you can be intentional about sharing your story or parts of it when you hear a client struggling with shame around their illness or minimizing their need for care or support. Non-egoic self-disclosure targets a specific need for validation, connection, or insight.

If you are therapist with a history of disordered eating, and you are sitting across from a young woman detailing frantic calorie restriction and over exercising, your history is a path to healing. If you survived an abusive relationship and have a client that is struggling to break away from her own abuser, your story is her hope. Your pain is evidence of your participation in the world, not a liability to your therapy practice. Our role as experts neither protects us from difficulty nor requires that we live a struggle-free life to be effective or legitimate. Chances are, many of you were called to this field as a result of your own suffering. What if that wasn’t an accident?

I’d love to hear how you are using your whole story to better serve your clients. Drop me a line on Facebook or Instagram @drcandicecreasman or email me at drcandicecreasman@gmail.com.
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F***ing Motherhood

10/26/2018

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Today's post is brought to you by the letter "F" and the number "0."  Because sometimes being a good therapist means being a whole, strugglin-ass person.
 
It’s raining, it’s cold, and it’s been one of those weeks (months?). I have two boys, two and a half and 4 months who alternate not sleeping, not listening, coughing, crying, pooping, and injuring themselves, ratcheting the cumulative suffering odometer up to an 8 or 9 in any given moment. Right now, I want to run away. Not just head to New York for the weekend, but get on a plane to Canada, take a bus, then a moped, then a pack mule into the wilderness, bang on the door of the first monastery I come to and devote my life to the Dharma, the blissful shaved-headed, robe-wearing, life of a nun that would free me from all this mothering bullshit.

What bullshit you ask?

I’m sick of broken sleep. The kind of shitty sleep that that comes with a risk of death if you operate heavy machinery.

I’m completely over trying 5 different positive parenting strategies to get my kid to stop yelling/jumping on the couch/running in the street only to end up resorting to yelling in the end anyway. Cue the sense of incompetence and guilt, because all the research indicates that yelling has a similar impact on development as violently abusing your kids, so I’m writing their tickets to juvie with every impotent outburst.

I’m bone tired of the sense of dread that shows up at 3 PM everyday when my husband is getting ready to go to work, and I see the expanse of the next 4-5 hours ahead—here we go again with my oldest son’s nerve-janglingly loud “inside voice” that can make my highly sensitive self want to scream, the inevitable 30 minutes to an hour of pacing up and down the floor with the baby in the carrier while he fights his nap, each step sending an ache up my leg and into my back because, childbirth? I don’t even know. The inevitable powerlessness of trying to meet the needs of two helpless beings at once when I am barely managing my own ADLs at this point.

I hate cutting their nails, feeling like an inept brain surgeon trying not to maim them for life with an errant slip of the clippers.

I’m beyond sick of how the same sweet little baby whimper can either galvanize the super nurturer in me or trigger the urge to scream and damage property. He just. Fucking. Ate.

I could do without battles over food, not recognizing my own body in the mirror anymore, no break from being needed, the endless stupid mess of the house.

I hate how much I love them, and how frequently I feel like I fail them; how much I want to be happy with them, and how hard that seems to be for me to manage. I want to be a whole person and a whole parent, but this week (year?) it seems unlikely that I will be more than a shadow of either.   

I’m not going to wrap up this self-pitying manifesto with some Hallmark “but it’s allllll worth it when you see their sweet faces looking up at you.” That couldn’t be farther from my truth today (the next 18 years?). I will say that what I wish for myself, and what I wish for you if you feel this way too, is to find my capacity for grace. I hope that I will be gentle with myself as I take stock of my efforts and my failings. I hope that I will rediscover my sense of wholeness and peace and be willing to do whatever it takes to maintain it once it shows up again. I hope that instead of berating myself for being a light weight who can’t handle the typical ups and downs of parenting decent, objectively low-maintenance kids, no matter how many long weekends they get with their grandparents, I will say to my raw, busted, overstimulated heart “yes, this is real.” I hope that instead of allowing my struggle to turn into a rageful urge to chronicle all the ways my husband fails me (read: “if you didn’t suck so bad, I wouldn’t be a hot mess right now.”) I will remember that no one is responsible for from saving me from myself, and no one ever sucks as bad as it seems when you’re losing it.

May you have happiness and the causes of happiness, may you be free from suffering and causes of suffering, and may you have all that without running away to a monastery—the world needs moms more than it needs nuns.

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Why do I keep settling in relationships, and how can I make it stop?

5/4/2018

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You workout 4 times a week and think rock climbing is the best weekend activity ever, but you’re dating someone who can quote every Lord of the Rings movie because they spend all their free time watching DVDs. You are active politically and feel passionately about the causes you support, but you just started seeing a guy who prefers not to rock the boat and has difficulty taking a stand about what restaurant to go to for dinner. You are a successful woman with a career you love, but your partner is a high school dropout who complains constantly about how lame her retail job is.

On a scale of 1-10, how judgmental do you feel just thinking about how problematic these differences are? If you rated anything over a 1, you are likely putting critical personal values on the shelf in the interest of not being a bitch, and your romantic life is suffering for it. When it comes to dating deal breakers, women are taught that we must bend and mold ourselves to fit any partner that doesn’t seem like a serial killer. If a prospect is employed, mildly attractive, and legitimately single (i.e., no wedding band tan lines), we feel we must either mold ourselves or mold our partners to make any other potential non-compatible aspects fit as best we can. This is scarcity mentality at its most intrusive, and it makes dating suck majorly. We end up wasting time on people that were never going to work out due to fear that whatever we see in front of us is as good as it gets.

I get that dating feels like an episode of Survivor—the pool of partner options can seem incredibly limited. A direct consequence of this perceived scarcity is to start to compromise on what we want. Add to that equation a society that encourages women to view their value in terms of what they are willing to sacrifice, and you have a formula for self-denial and settling in relationships that inevitably leads to dissatisfaction and potentially to a break up.

If we are going to build meaningful, lasting relationships, we must be willing to show up to potential partners with our values on full display, not hidden away for fear that being true to ourselves means we will end up alone. This means acknowledging that what we want goes deeper and is more complex than just wanting someone who is unmarried and breathing.

So, what matters to you? What kind of person do you want to be in your family relationships, your community? How do you want to show up to your career, your spiritual growth, and your free time? Think about people you admire and ask yourself how you would describe them. Are they ambitious, respectful, curious, laid back, committed to family? The qualities we admire in others point directly to our own values and provide guidance around how we want to show up to our own lives. Once we know what is important to us, we can more effectively seek a partner who will share our values.

​The great thing about values is that they don’t lock us into rigid expectations of others. My husband loves camping. It’s safe to say that I loathe camping. But, I love the outdoors, and a deeply held value of mine and my husband’s is spending time in nature. Even though the ways we act on this value don’t always match up, the shared value is there, making it possible to find common ground in how we spend our free time that we both find satisfying. If you’re worried that setting an expectation around shared recreational values will limit you to one guy who also loves extreme knitting that you’ll likely never meet, know that we can manifest values in a variety of ways and still be on the same page.

It is not shallow to require a partner share your values. I have heard countless clients say that they felt bad for judging a new romantic interest for not being employed, or not having as much education as they have, which I promptly tell them is completely unjustified guilt. The negative judgment we feel when we encounter differences in employment, relationship goals, educational attainment, etc., is pointing to a value that we likely need to have in common with a partner. I have a doctorate because I deeply value learning, my husband doesn’t have a doctorate, but devours books on topics he’s interest in. Again, same value, different manifestation. We do not have to buy into the belief that we should offer ourselves equally to any potentially partner who meets a few basic criteria in the interest of being nice. You know what’s really not nice? Pursuing a relationship with someone who doesn’t share your values and allowing the resentment you will inevitably become filled with to turn you into a hypercritical harpy.
​
If you’re sick of dating, and sick of settling, then make a list right now of the 5 values you most want to have in common with a partner—they could be related to money, to learning, to activism, to charity, to anything! Start thinking about what you want more than dwelling on what you don’t want or what you imagine you will have to settle for, and your dating life will take a turn for the satisfying.
 
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Using meditation is session with therapy clients

3/3/2018

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Mindfulness is a central idea to many of the most successful therapies available today. Dialectical Behavior Therapy has an entire module on the process of becoming mindful due to the direct impact that a mindful state can have on decreasing harmful behaviors and increasing the likelihood of skillful choices. But how do we get our clients to use meditation to become mindful? Answer: make meditation one of your go-to, in-session techniques. Let's talk about when and how to use meditation in-session to enhance the therapeutic experience.

Mindfulness is a state of consciousness in which we "pay attention, on purpose, in a particular way, non-judgmentally," (John Kabat-Zinn) to whatever is happening right now. Meditation is one process through which we cultivate mindfulness by taking specific steps to engage with the present moment. We breathe, hold our bodies in an alert way, and turn our attention away from the chatter of the mind and toward the now.

Our clients are often experts at getting caught up in mindlessness--that state of being swept away by thoughts, judgments, emotions, and beliefs--and are likely in counseling as a direct result of the struggle to be present, though they probably won't articulate it in that way. For the anxious client, what is anxiety if not a preoccupation with negative predictions about the future, their abilities, or the treatment they will get from others? One antidote for anxiety built on past and future mind stuckness is present moment awareness. Eckhart Tolle brilliantly and annoyingly says in The Power of Now, "in this moment, there are no problems," which can shock us into the realization that our minds buzz furiously with content that we feel we have to act on or avoid when in reality, thinking, worrying, and planning are often bigger contributors to our anxiety than the situations that trigger the mental activity in the first place.

Teaching clients how to be mindful by engaging them in meditation helps them to see an alternative way of experiencing their inner worlds. Anxiety can be experienced mindfully (and tolerated) as a set of physical sensations and mental formations, reducing the urgent need to avoid anxiety at all costs. When anxiety can be tolerated, clients can dig deeper into the origin of their anxiety without fear that they will trigger emotion that will overwhelm them completely. 

You're sold on meditation, but want to know how to use it in session. Great news! You don't have to be yoga certified, have spent weeks or months in silent meditation, or be at some other arbitrary point of guru development to lead your clients in meditation. In fact, there are so many apps for meditation out there that you may not have to lead the meditation at all. Your job is to recognize when mindfulness is needed. 
  1. Know the signs-- Clients can benefit from mindfulness any time, but can have really transformational experiences if they meditate during intense emotional distress. If a client is becoming tearful, agitated, dissociating, or showing signs of a panic attack, a meditation can help them to be still with their emotion. Additionally, when clients are stuck in cognitive distortions and you feel yourself trying to convince them that there could be an alternative way of seeing a situation, meditation can help connect them to flexibility in thinking. Finally, when clients are processing difficult memories, meditation can create a compassionate, loving inner space for hurtful experiences to arise and be integrated. 
  2. Know your tools-- If you are dipping your toe into meditation in session, and would rather stick with scripts or prerecorded guided meditations, check out Insight Timer. You can sort through thousands of guided meditations based on length and key words like "anxiety," "hopelessness," or "anger." The app is free and available for Apple and Android.
  3. Introduce the idea using validation-- Meditation isn't an effort to get rid of any emotion or thought, though it will likely serve to reduce the intensity of discomfort.  When I use meditation to address an issue in real time, I start with validation--"I can see in your body language and hear in your voice that you are feeling a big feeling right now, can we do a quick mindfulness to see if we can make it a little more tolerable for you?" It's important to communicate that the goal is to reduce the suffering around the feeling not get rid of a "bad," emotion or internal experience.
  4. Meditate! Use a prerecorded option or lead your own (for more info on leading your own meditations, check out my webinar on May 18th).
  5. Debrief-- I like to ask non-leading follow ups after a meditation such as "what did you experience?" In this way, we make room for clients to have positive, negative, and neutral experiences without feeling they did something wrong or getting too attached to a specific outcome. I'm almost less excited when clients have incredibly positive experiences after a meditation because that can turn into an expectation that will not always be met. We allow whatever shows up, to show up. Their feedback gives me opportunities to offer positive reinforcement, and strengthen the likelihood that they will meditate again. You might reflect on the client's willingness to try something new, or bravery for leaning into something painful. Authentic reflection helps clients tune into their inherent resilience and wisdom, which they often discredit or ignore.
Meditation can seem daunting, but it is a natural expression of our healthiest state of being: presence. When we help clients connect openly to the present moment we are teaching them a skill that can dramatically improve their lives. Your willingness to dive into meditation in session will increase client buy-in, help dispel any misconceptions they may have about meditation, and will cultivate awareness that can only deepen the therapeutic experience. Take a chance on yourself and give it a try!
 
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Finding Yes in a World of No

10/25/2017

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Frustrated, feeling small, annoyed before the conversation even starts, Claire is filled to the brim with the noise of her crying baby, the task of dinner and the weariness built up from a day of isolated motherhood.  She yells to her husband upstairs “If I don’t get some help down here, I’m going to lose my mind!” This is the first he’s heard about her need for help, but he feels guilty, a failure, nonetheless.  Another argument ensues.

When we become accustomed to not getting what we want, we begin asking from a place of “no.” Learned over a lifetime of being rejected, put down, or dismissed, this place of no becomes a way of seeing the world that is not a choice, but a fact of life. We are angry for not getting what we want before we’ve even put our request out there, and inadvertently lessen our chances of getting what we want through our ineffective asking style.  We ask with frustrated tones that trigger defensiveness in those around us, confirming our assumption that people don’t actually care about us, and the world is a place of scarcity.

In order to move out of this place of no, and in to our Yes Mind, we have to take a look at what the assumption of rejection is protecting in us. Sometimes we avoid asking openly, clearly, and effectively for what we want because deep down we doubt that we deserve it. Maybe I don’t ask for that promotion assertively because I imagine the new role would expose me for the charlatan I am; I’m lucky to have gotten this far without being found out.  We may also believe that the disappointment we brace for is somehow more manageable than disappointment that comes after our best effort is put forth with an open and hopeful heart. Regardless of the reason, in order to find our yes, we have to heal the wounds of no. We heal by acknowledging and accepting. In order to get yes from the world, I have to say yes to myself in my entirety. I see those places that need kindness in myself and offer love and acceptance to those places so that the world can follow suit.

If I recognize my fears and see how they manifest in the way I put my wants and needs out in to the world, I can then decide to take the risk of really transforming. Asking for change or for more becomes an exercise in abundance. I feel my value as a truth that goes deeper than my experience as a woman who is never taken seriously, a person of color who is denied access due to perceived dangerousness, a “poor” person who isn’t classy enough to belong. All of my experiences of no have within them the seeds of yes.

We can certainly learn skills for making effective requests, but if we don’t work with our no wounds, the success we get back will be limited—a mirror constantly pointed toward the space that needs nurturance. The path to your fullness, your success begins with healing the no and embracing your yes. I am a whole person, yes. I am an asset with a full purpose, yes. I am more than any no I have received, yes.  What yes is waiting to be fully realized through your healing?
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Of Course: Facing the Challenge of Sitting with Difficult Emotion

10/18/2017

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Anyone who has spent any amount of time in meditation has likely encountered discomfort-- the discomfort of sitting in a forced position, the discomfort of wishing we were doing something more entertaining, the discomfort of being with raw emotion. Many of my clients have bailed on meditation altogether in the face of some of these difficulties, which led me to look at strategies for helping them through those tough times.

I spend a lot of time talking to my clients about compassion. For some the idea resonates immediately, comes naturally, and manifests in all kinds of positive ways quickly. For others, maybe most, compassion is at best a lofty idea that is hard to put in to practice and at worst, an experience that seems completely unavailable to us for one reason or another. Compassion is essential for healing, and is an incredible tool for increasing our discomfort tolerance so that growth can happen. In an effort to make compassion more accessible, we need to understand what it is and how to get our minds in on the task of opening ourselves with kindness and curiosity.

Compassion is essentially empathetic acceptance. I get in someone's shoes (possibly my own), acknowledge their reality, their perspective, and then without any push for change, I say lovingly and with a full heart "I feel that with you." The key to compassion is acceptance. What we are often experiencing in an uncomfortable mediation sitting is an absence of acceptance. We are so used to acceptance being followed by negative judgment that the notion of allowing our thoughts and feelings to arise just as they are feels defeating, draining. When we take the next step from acceptance in to compassion, we not only allow what is, but we also allow the impact of what is to be relevant. We interact with ourselves more gently, with more kindness.

Rather than keep browbeating myself in to being compassionate (because that would surely defeat the purpose), I've started engaging compassion on the sly, using the phrase "of course." When a difficult emotion arises that I feel the urge to turn away from or push down, I say to myself "of course I feel this way, and of course I don't want to feel this feeling." "Of course" has the flavor of logic about it-- the phrase gives us the sense that we have rationally come to the conclusion that something is inevitable, which acknowledges a fundamental truth of the universe that nothing comes from nowhere, so if something is, it must be. "Of course" then gives us permission to be kind to ourselves and to connect more compassionately with whatever is showing up in meditation. If a feeling is unavoidable, which "of course" would suggest, then I don't have to struggle with myself over its existence, and can instead use my energy to nurture myself through the difficult experience. "Of course" allows us to interact with mental and emotional difficulty as we would a physical injury. If you cut your finger and cry out, it would be easy to say "of course you are in pain, you cut your finger! Let's get a Band aid."

We might also use "of course" to connect the dots between the experiences that have trained us to be avoidant, anxious, or judgmental and our current difficulty. Let's say I am struggling to sit with negative self-judgment. In meditation, I seem to constantly berate myself for not sitting long enough or for getting distracted. If I can make those judgments the object of my attention, I might create just enough room to ask "where is that coming from?" Maybe my early caregivers were very hard on me any time I made a mistake, or perhaps I grew up in a dangerous place where any misstep could end in violence. Regardless of the cause, if we open ourselves up enough, we get to the "of course." Of course I'm critical of myself, because I've been trained to be that way. We use this not to pass the buck of our suffering, but to allow for the reality of difficulty without writing ourselves off as failures. 

Next time you are struggling to sit through something uncomfortable, try opening yourself to the power of compassion by telling yourself gently "of course."
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Deconstructing Defensive Pessimism

10/11/2017

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Have you ever told yourself something along the lines of "it will definitely rain today since I just got my hair done," or "I'll probably hit every red light in town since I'm running late?" These seemingly benign thoughts are the seeds of defensive pessimism, and a major barrier to joy.  Defensive pessimism is about predicting negativity as a protection against disappointment or pain.  My husband is probably going to leave me some day, so I should probably think about how I would support myself.  Going back to school would just leave me in the same cut-throat job market with more debt, so why bother? There are kernels of practicality in these statements, so we feel justified in our acceptance of them.  But these negative narratives disempower us, separate us from joy, and can actually work against our goals.

We have our understanding of strength all backwards.  There was actually an episode of Bones where Temperance Brennan (main character, forensic anthropologist, I watched a lot of TV while pregnant) says that her relationship with her partner has changed her from an impervious substance to a strong substance.  Impervious substances are not responsive to the forces acting upon them, and as such remain separate and isolated.  Strong substances are in flow, allowing for the natural processes of change, growth, decay.  Personal strength requires this same allowing, built on the confidence that any negative feeling or experience can be tolerated without fear of coming apart.  Defensive pessimism uses negative forecasting to protect us from future pain, but for it to "work" we have to also buy into the story of our weakness.  Defensive pessimism insists that our ability to brush up against loss, rejection, disappointment is bounded.  Our heart and mind, the space of our experience becomes smaller and smaller as we fill it with fear and doubt.  The truth of our potential cannot be actualized when we quit before we start to avoid the pain of failure.

"I'm not a pessimist, I'm a realist." That is the mind's way of acting on fear by convincing us that it is somehow more legitimate or accurate to live in worry and fear.  When we imagine a negative future in the service of "realism" we aren't getting any closer to the truth, and are actually distancing ourselves from joy.  To truly assess the future from a realistic standpoint, we would have to acknowledge that we have no idea how things are going to go down-- meaning that worry and hope are equal in their predictive uselessness.  We would have to lean in to groundlessness, and often the pain of uncertainty seems far greater than the pain of a negative outcome.  What we fail to see, because our fearful minds get in the way, is that we experience the story of loss the same way we experience actual loss.  We can't feel our feelings in advance and get them over with, but we can double our dose of pain by imagining negative outcomes.  The cost of this pain preparation is that we disconnect from presence, from our non-judgment, from our pure, unedited experience of right now.  Eckhart Tolle has boldly said that there are no problems in the present moment, and while I initially bristled at this (well, he sure hasn't experienced my present moments then), eventually that truth worked it's way in. The stripped bare present moment has no goodness or badness attached to it like the calm still lake before the fish jumps or the moment before the gun goes off to start the race.  Even if our defensive pessimism doesn't stop us from making changes or taking risks, it hijacks our peace of mind and limits our capacity for happiness in each moment.

Defensive pessimism does its worst work when disguised as flexibility.  I recently asked a client what she wanted in a partner and she began her answer with "I would be ok with..."  I stopped her right there and more forcefully told her not to tell me what she would be ok with, but to say out loud what she wants.  I was feeling particularly stuck with another client who was struggling to find work with a disability and realized that we weren't getting anywhere because we didn't know where he wanted to go.  Asking him to connect with what he truly wanted from his life felt like too great a risk because he was so used to being disappointed in his efforts toward any goal.  What I have learned from clients and from my own experiences of lowering my standards to accommodate what I felt was possible or worse, what I felt I deserved, is that we will not embrace our best selves by settling.  It's not always easy to know the difference between being openness and defensive pessimism.  I know I'm being open when I change my expectations with a clear and non-judgmental mind.  I know I'm being defensively pessimistic when I feel the air go out of me, my shoulders slump, and my mind starts to tell me stories about how I shouldn't have wanted so much anyway.  We aren't going to always get what we want, and there's no object or experience out in the world that carries the full weight of our happiness.  But we can connect with basic goodness by acknowledging our basic worthiness to ask for what we want.  Defensive pessimism whispers "you may as well not even think about what you want because you are too broken, too undeserving, too unimportant to even ask for it."

Just for the next week, try noticing all the ways defensive pessimism shows up in your own life and you'll uncover important information about where your heart may need to soften to let go of some fear.  The hardness of defensive pessimism does nothing to protect us from pain, and ends up protecting us from our own potential for joy and meaning. 
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Values-based goal setting

10/4/2017

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Our American culture loves to set some goals.  Television shows like The Biggest Loser encourage us to set (unrealistic) weight loss and fitness goals.  Bosses set performance goals and our kids strive for academic success measured by standardized testing and graduation rate goals.  This society is infatuated with achievement and progress, for better and worse.  Many of my clients decide to start therapy because they are struggling to meet health, relationship, or general life goals and until recently I took the same approach to everyone-- define the goal, determine how the goal will be measured, identify barriers and resources, and set a deadline.  When deadlines rolled around, the results were mixed.  Some had done what they set out to do and felt a sense of mastery, while others had missed the mark and felt disappointed and ineffective.  So I've changed my strategy.  Rather than helping clients set concrete, rigid goals that require will-power to be met, I now focus on values-based goals that are inherently flexible and more manageable.  Let's talk about rigidity, will-power, and values.

I was having a conversation with my husband about the most recent results of some swim meet at the Olympics.  As we were discussing who won what, I realized that I was separating the contestants into those who won (got the gold) and those who lost (everyone else).  If you've seen Talladega Nights, you're familiar with Ricky Bobby's mantra, "if you're not first, you're last."  I realized how bought in I was to this all or nothing approach to goals.  We decide on a specific outcome-- winning the gold, weighing a set amount, running a set distance in a specific amount of time-- and then any other outcome becomes unacceptable-- a failure. It's easy to see how this approach is ultimately setting us up for perceived failure most of the time and robs us of the opportunity to celebrate the process of change.

So what about will-power?  The will-power delusion asserts that I just have to want something bad enough to make it happen.  The self-defeating converse is where the problem lies-- if I didn't achieve a goal, it's because I didn't want it bad enough.  I don't know anyone who set a weight loss goal or a substance use reduction goal who didn't want to be healthier with their whole selves.  By insisting that the only barrier to success is a lack of will-power, we automatically short circuit problem solving efforts to manage the more likely barriers such as lack of skill, worry thoughts, emotions, indecision, or environmental challenges.  Will-power is a useful element in the early stages of goal attainment, when motivation is running high, but it will not always be available to us in the same quantity.  Will-power is essentially a combination of the emotions determination and motivation, but like all emotions, determination and motivation will wax and wane due to all sorts of other variables, many of which are out of our control.

"If I'm not using will-power to meet specific goals, then what am I supposed to do?" A values-based approach allows us to be realistically flexible in our goal setting, and avoid the will-power trap.  Before committing to a goal, it's important do some introspection to identify the value driving that goal.  For example, I have been less than happy with my weight since turning 30, and have typically tried to manage my weight by using food guilt and inflexible standards to motivate me to exercise and eat healthily. It wasn't until recently that I more deeply considered the "why"of this goal.  When I checked it out, weight loss is about being strong, capable, and healthy (with a sizeable portion of acculturated beauty standards), but my rigid weight goal was conflicting with values of being compassionate and accepting of myself.  So now I'm working toward weight loss (with help from Weight Watchers) as a function of my deeper values.  If I plan to run 4 miles, but end up running 3, rather than berate myself for a failure, I view my 3 mile run as a success given that I made that choice out of compassion for my sore hamstrings or in recognition that it's 100 degrees outside. Instead of deciding that health is about exercising a certain amount everyday without exception, I act in the service of health and broaden the choices that are consistent with this goal.  Flexibility helps us to honor the willfulness that shows up to let us know that a choice does not match the needs of the moment.

Ironically, the more flexible we are with ourselves, the more emotional, mental, and physical resources we make available for attaining our goals.  We stop wasting precious energy on guilt, shame, and self-degradation, and can channel those resources toward our goal work.  We stop trying to make the moment match our goals, and allow our goals to match the moment.  Here are some tools for assessing your values, identifying meaningful goals, and using a flexible mindset to be your best self.  Remember: more of our life is spent in the process than in the outcome, so learn find joy in the ride.
  • For work-related values, try this assessment
  • A general life values assessment 
  • Flexible goal setting
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Practicing patience in tumultuous times

9/27/2017

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It seems this political season is charged with an uncommon level of conflict and anger.  Maybe I've just reached that magical age when new music sounds awful, I am never without an umbrella, and politics seem incredibly relevant.  It feels like more than maturation, though.  We seem to have reached a social boiling point that I can only hope results in a more unified and compassionate world.  I am absolutely not here to back any particular candidate, but I would like to talk about practicing patience in the face of anger; for working with the energy of anger so that we can make our best choices from our best selves.

The Dalai Lama talks about practicing patience in his book Healing Anger.  He very pragmatically suggests that to work with anger, we have to be skilled in its opposite-- patience.  I don't know about you, but I probably heard "be patient" a thousand times growing up, but no one ever told me how.  As a child, patience was synonymous with waiting, as if there were any other choice but to wait when dinner wasn't ready, or Christmas was still 2 months away. The Dalai Lama provided these step by step instructions:

1) Develop enthusiasm for patience by deeply acknowledging the destructive nature of anger. 
2) Practice patience toward mild discomforts so as to be prepared for more challenging situations.
3) FREEZE

Many of us rely on anger to feel powerful and effective. The energy of anger is useful, the actions of anger are not.  I personally have never acted on my urge to yell at someone, throw something, or punch a wall without some amount of regret.  Even if I felt some mild satisfaction at first, ultimately, acting on anger has left me feeling out of control, embarrassed, and small.  So what does it mean to say that the energy of anger is useful?  Consider the civil rights movement that continues today-- if no one were angry about the unfair treatment of people of color, change wouldn't have happened.  Yet many of those angry people demonstrated peacefully, calling calmly for change.  They used their anger to motivate effective, non-destructive action.  Anger can be the fuel that gets the car going, but it doesn't have to dictate the destination.  When we recognize that acting in anger creates more harm than good, and only serves to increase our negative emotion, we can lean wholeheartedly in to patience.

Just like you wouldn't want to learn CPR at the scene of a car crash, patience as a skill must be learned and practiced for mild discomforts.  We ultimately practice patience by saying yes where anger says no.  Anger tells us that a situation is unacceptable as it is and fights against a painful reality rather than accepting it.  You can't fix a problem you refuse to see, which is why acting in anger is so often ineffective-- anger characteristically refuses to accept what is.  Patience is accepting a painful reality.  If patience could speak to us it would say, "yes, this traffic is moving too slowly for you to get to work on time, and there's nothing to be done about that, so let's watch those negative judgments about how terribly unfair this is without clinging to them, and allow this moment to pass."  When we practice patience for minor problems like traffic jams, we increase the likelihood that it will be available to us when we find out our child is smoking marijuana, or when we see an incendiary post defaming our candidate of choice.  Patience allows us an opportunity to channel the energy of our anger into actions that are based in compassion and kindness.  Instead of telling that so-called Facebook friend how stupid they are, patience creates the space for real listening, real connection, and increases the chances that our actions will have a positive impact rather than deepen division.

When all else fails, when anger has moved our minds towards plans of spiteful, defensive action, FREEZE.  The more mindful we become of our triggers to anger, the more time we will have to interrupt the process of experiencing an event, judging it negatively, feeling our anger, and acting rashly.  We don't have to be levitating, enlightened monks in order to stop ourselves from slamming that door or hardening our hearts.  We just have to become aware and be willing to take three breaths when anger arises.  Freezing and breathing helps us get back in to contact with the moment and out of the story of our anger.  Patience allows us to interact effectively with our anger instead of being pushed around by it.  Patience makes room for our compassion.

"Genuine compassion is based on the rationale that just as I do, others also have the innate desire to be happy and overcome suffering; just as I do, they have the natural right to fulfill this fundamental aspiration.  Based on that recognition of this fundamental equality and commonality, one develops a sense of affinity and closeness, and based on that, one will generate love and compassion.  That is genuine compassion (Dalai Lama, Healing Anger)."
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Finding your way after abuse

9/20/2017

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One in four women will experience some form of domestic violence in their lifetimes.  This staggering statistic may be too low given how hesitant many women are to report abuse and for good reason.  Fear of retaliation, financial insecurity, and lack of social support create very real barriers to leaving violent relationships.  Those women who have managed to escape often find themselves disillusioned and lost instead of hopeful and empowered.  So many of the women I have worked with, particularly those who have children with an abusive ex, say they worry it would have been easier to have stayed with their abusers than to fight daily to maintain boundaries and move on.  Let's discuss the re-victimization many women experience when they leave an abusive relationship, but have to maintain contact with their abusers.

Re-victimization.  If you thought your ex was controlling and manipulative while you were with them, you can likely expect things to get worse any time you make a move to establish your separateness.  Making reasonable requests in mediation, drawing boundaries around visitation, and signing divorce papers can all trigger escalations in the abusive partner's controlling behavior.  They may use guilt by telling you that you have ruined the lives of your children by breaking up the family, or they may use threats and intimidation.  All of these situations can feel very familiar and put survivors back in a vulnerable state of mind, one in which the goal to stop the hurtful behavior results in submission.

How to deal:  Minimize face to face contact as much as possible.  Make sure you are engaging in rigorous self-care before and after any interaction with your ex.  Working out, eating well, spending time with friends, completing a project, all of these actions put funds into your emotional bank account.  And while a trip to the gym won't magically prevent your ex from being controlling, it will put you in a better position to guard against personalizing his/her destructive behavior. Any effective action we take to build ourselves up lessens the charge of actions meant to break us down.  Finally, consider doing most of your emotional processing with a therapist.  Allowing an abuser to be the main topic of every conversation with friends and family allows the abuser to continue to take up your life space.  Focusing on other aspects of life, however mundane, is not about shame or avoidance, it's about taking out the garbage.  We make room in our relationships, our interactions, and our stories for those lost aspects of ourselves to resurface by refusing to fuel the damaging narratives of inadequacy abusive exes wrote for us. 

If a survivor is to avoid being roped in to a passive and fearful way of being, she must make a choice about her relationship with fear.  Abuse puts us into contact with our fragility as humans and with the darkness of which we are all capable.  It does not feel like a choice to let fear write our stories when danger is so close, but it is a choice.  Fear is a necessary emotion for safety, fear-based living is a chosen way of being.  By fully accepting the truth of our vulnerability we become strong.  By believing that acting on fear will keep us safe from all harm, we paint ourselves as powerless.  Any choice made in courage helps to rebuild the broken spirit, no matter how small we may feel at the start.
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    Dr. Candice Creasman

    Therapist, author, and counselor educator. Articles with tips and tools for living your most authentic and joyful life.

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