Wednesday, December 23, 2015

100% Success Rate

Today is two days before Christmas.  I'm not sure how that happened. One minute it's summer, and the next Christmas carols are wafting up the stairs at work.  Frankly, the weather hasn't been very cooperative in this venture. It's in the sixties outside and raining... not what you'd ordinarily expect from Georgia in December.  If I could send some of this water to any of you in California, I would.

Amidst all the scrambling to find the right things for the right people and squeezing clients in before the office building closes for the holiday, I find myself thoughtful about the year and how it's gone. Have I made the right decisions in my work? Am I being a good mother to my children? Have I been a good steward of my resources? Have I helped my clients find what they need?

Now, I have a unique knack for picking things apart as they apply to me, and I am not sure all of my answers to those questions are positive or accurate ones. Probably, I am a little hyper-critical. I stumbled across something the other day, however, that made me smile.  I have no idea who said it first, so, if it was you, I apologize for the lack of attribution.  Anyway, the quote said, "Remember, you have a 100% success rate in surviving everything that has happened to you so far."  What a thought!

This, I suppose, gives me some perspective.  Whatever my faults and failings as a person, a therapist, or a parent, I have come through everything life has thrown at me.  I can certainly think back on some situations that I thought I would never get done with or escape, but somehow I am here today and have the luxury of complaining about the rain.  I'm not always sure how I got through, but I have.

When I consider the trauma survivors with whom I have had the honor to work, I find that this quotation has far more meaning.  Clients of mine have been through fires, hurricanes, domestic violence, emotional neglect, emotional abuse,  sexual abuse and assault, physical abuse, violent crimes, and other overwhelming experiences. Many of them present to me with shame about skills they have used to cope: drugs, alcohol, sex, etc.  To them I say that, whatever they have had to do in the past, the primary focus is that they survived.  Many people in traumatic situations do not have support systems to help them develop safe and life-affirming coping skills. Whether you had to hide, fight back, numb out, or run away, you did what you had to do to get through.  You also have that 100% success rate.

So, as the year winds up and many of us are focusing on giving to others, give yourself the gift of affirmation that you have had the strength to survive everything life has sent your way. Odds are good that you will continue to do so.  If you need to talk about what you've been through, however, I hope you'll come find me.  I'm happy to listen.

Friday, November 27, 2015

McDonald's and Relationships

Awhile back, I was talking with a client of mine, and she was discussing her previous treatment. She stated that her previous treatment had not been very helpful. As we probed into this further, she divulged that she had not told her previous therapists that she had a trauma history. Because the therapists did not have that information, they could not address the real issue.

Now, I firmly believe that clients tell us what they want us to know when they are ready. I am not writing this to be critical of the client for not telling her previous therapists. The reason I bring it up is that it occurred to me that we, as therapists, often assume that we understand what is going on and don't always think to ask directly about other options. Training is becoming more "trauma-informed" these days, and clinicians are instructed to ask everyone directly whether trauma has been part of their history.  If that training had been more present before, I wonder if my client would have had more helpful treatment?

People, in general, tend to make similar assumptions. We say something to a friend, family member, or significant other, and we assume that they understand what we mean. One person's idea of doing the dishes might be putting them in the dishwasher, where another person might include wiping down the stove, the counters, and the table as well.  Frequently, we get frustrated when we have asked somebody to do something and they do not do what we expect.  Similarly, we will often  say something to someone else anticipating a particular response and then find ourselves angry or hurt when we do not get that reaction.

As I have thought about this in my own life and experience, I have come up with a technique I call "The McDonald's Method of Communication."  Picture yourself coming up to the drive-thru at McDonald's. ("I don't go to McDonald's!" I hear you say, "The food there is terrible for you!"  Just go with me on this one, okay?)  When you get to the speaker, what do you do? Do you say, "Hmm, I don't know.  Whatever you feel like giving me is fine?" Do you say, "Don't you know? If you don't know already, I'm not going to tell you"? Generally, I would think not.  You say, politely,"I'd like a Big Mac, large fries, and a Diet Coke" (or whatever you prefer).

Think about what this form of communication does.  It is brief, specific, and respectful.  You communicate exactly what you would like, in an appropriate manner, and there is no question about what you need.  Furthermore, if the person working the window is on their toes, they will either repeat the order to you or ask you to check the screen to verify that the order is correct. This, again, helps to make sure that the communication is effective.  Finally, if you find a mistake in your order at any point, you have an option to correct the problem.

I wonder how much less frustration we would have in our lives if we spoke to each other the way that we speak to the people at the drive-thru? "Would you please wash the dishes and make sure that you wipe down the surfaces as well?" "Can you give me a hug? I've had a rough day." "When you did not say 'thank you' to me the other day, I felt taken for granted. Can we talk about it?"  All of these express needs and feelings appropriately and invite others to respond specifically to your request.  It may not feel as romantic or special to be so specific, but it greatly increases your chances of getting what you want.  Others cannot read your mind, and you may not realize that you are asking or expecting them to do so.

A therapist I admire once told me that the secret to doing therapy was to "be present and assume nothing."  This advice, I believe, carries over well into the everyday.  I need to remember not to assume that others know what I want or what I am asking for. I need to remember to ask all of my clients about whether or not they have experienced trauma, had suicidal thoughts, or misused substances.  I cannot assume that they will volunteer the information, and I might be missing out on important elements of their lives.

How would your life be different if you were more direct and specific? What might you be missing by not digging deeper?  This all sounds very easy, and it is -- in theory. Self-esteem issues, traumatic history, lack of trust, depression, and other factors may make this much more difficult. If this seems overwhelming, I hope you will find me. I look forward to being present with you and assuming nothing.

Thursday, November 19, 2015

Gratitude and Positivity

It's funny to me as I sit here writing this, because it's coming up on Thanksgiving and I am writing a post about gratitude.  In my head, I never want to be trite, and this seems to lend itself toward that, but I promise this is not a Thanksgiving post.  Over the last few days, I've found myself feeling grateful for the job that I have and for the wonderful people I have encountered doing it.  I started off the year in a dark place and felt stuck. I was sure nothing was ever going to change or get better.  I could not have imagined feeling the way I do now.  I am so thankful for having had the opportunities I have that have allowed me to reconnect with my love for counseling and for the people I have the honor to serve.

Does my life still have struggles? Sure.  Those are always present in life, I think. Certainly, it's better when they don't all pile on at once. It seems, though, that when we can find an anchor, struggles are easier to bear.  This experience has served to remind me that nothing stays the same and that time, indeed, does give some grace.

So often, particularly when people are depressed or have a history of severe pain and hurt, things feel fixed -- not repaired, but stuck.  Studies show that, when we are depressed or overwhelmed, our creativity decreases.  I take this to mean that we literally cannot imagine the possibility of change. Sometimes, I guess, we need others to hold on to that hope and belief for us. I have been fortunate in having supports who have helped me in that way before and continue to do so as I need it.

One of the aspects of my work that I feel is sacred is holding onto hope when my clients cannot hold it for themselves.  Hope is more than a wish.  We can wish for anything: a million dollars, a unicorn, Prince Charming, etc.  Hope involves actual belief that something can happen.  It may be difficult, it may be a long time coming, but it is possible.  Many times, clients come to me feeling hopeless. They are in pain, feeling overwhelmed, and afraid that the pain that they have will never stop.  I try to be an anchor for them to create a safe place for them to rest and grow until they can hold hope for themselves.

Sometimes hope can build from new perspectives. Focusing on steps taken rather than those left to take can foster a sense of progress and capacity. Identifying positive choices and aspects of self can help build self-confidence and self-trust.  Meditating on those things for which we are grateful can help us focus more on the positive aspects of life and not just those that do not work.  I think we need to be honest with ourselves, but that involves not just acknowledging our weaknesses, failures, and losses, but also our strengths, courage, and potential.  For a balanced picture, we need to look at both.

I wonder what you have done well today.  I wonder what little gifts there may be in yourself or your life that you are not seeing. Take a moment and look around you and inside you. Is there something to be thankful for? Give yourself permission to be grateful or glad or proud of yourself. All of those help to create hope. If you are having trouble with that, I hope you will find me and allow me to hold it for you until you are able to do so yourself.  Thank you for taking this time with me.

Wednesday, November 11, 2015

Acceptance and Forgiveness - Brief Thoughts

If acceptance is different than approval, what might you allow yourself to accept? Acceptance involves recognizing what things are and not expecting those things to be different.  This could apply to anything from the weather to aspects of ourselves and our loved ones.

If forgiveness is not permission, what might you be able to forgive? Forgiveness relates to acceptance in that it is acknowledging that someone has done something and that nothing you or they do can change it. Secondarily, it involves giving yourself permission not to put more energy into trying to change what happened.

Acceptance and forgiveness are strong words, and I believe that we accept and forgive when we are ready, but I wonder if changing the understanding of the words takes some weight away from them.  Perhaps you can even learn to accept and forgive yourself.

Sunday, November 1, 2015

Lean on Me...

When I was in eighth grade, I was struggling a lot with figuring out how to interact at school. I was shy, and we had only been in that city for about a year.  In that city, in particular, everyone knew everyone else, and social status and history were very important. Being new and not having any social status to speak of, I didn't know how to engage.  As a result, I was pretty quiet. I had this one enrichment class with Mr. Suits.  He was creative and funny, and I really enjoyed his class. My class had ended up with a seating chart, and I was stuck in a back corner. This left me feeling isolated and intensified my quiet. One day, as we were waiting for the bell, I heard Mr. Suits saying, "Stephanie, just shut up! We can't get a word in edgewise with all your racket! Gosh!" In case it isn't clear, he was kidding with me. I started smiling and laughing, and I began to feel connected and engaged. He had noticed me, and I mattered. That was a clear turning point for me and one I remember with great fondness.

Lately, I find myself struggling with the business side of counseling.  When I decided to become a therapist, I, like many others, focused more on the relationship in the room and less on the business of finding people to come into that room. I am used to being a behind-the-scenes person, and marketing requires me to bring myself and my work to the fore. In many ways, this reminds me of work I need to do -- both for myself and for my business.

While in the shower today, I found myself pondering what I value in the work I do. I have worked with people with many and varied struggles: depression, anxiety, bipolar disorder, schizophrenia, PTSD, relationship problems, low self-esteem, and many others.  What is it, in particular, that I bring to the room, and what do I believe helps to facilitate needed changes?  As a counselor, I can list all kinds of techniques and ideologies that influence my work, but most of that would sound like gobbledygook to anyone outside the profession.  The more I thought about it, I realized my core focus is connection.

Most of the struggles I see in my clients reflect some element of disconnection. Grief, for example, involves loss of connection with someone or something we value.  Depression involves disconnect from engagement with the world and with friends/family/relatives. Psychosis involves disconnect from reality.  PTSD involves disconnect from others and even from self.   With all of that disconnect, developing connection can help bring healing.

What does that connection look like? In a very real way, that connection starts with the relationship in the room. Sitting with someone who will listen and try to understand without judging or creating harm can start to build a sense of safety and trust that allows for attempting other challenges. Learning to share needs and feelings in an appropriate way helps needs get met and feelings get respected. Trying new things with a safe person helps develop confidence and skills.

Connection also involves building awareness of your struggle and how it shows itself. Mental illness and other life struggles do not define the people they affect, but they certainly make functioning difficult.  If I can connect with my stressors/problems enough to understand their signs, symptoms, and patterns, I can find new ways to manage them more effectively. Maybe I can make healthier choices in what I eat or how I practice my self-care. Maybe I can find safe people to talk to when I am having problems. Maybe I can learn some skills to help prevent things from getting worse or to help things get better. When I know what I am dealing with, I can make educated choices.

Connection with safe others is also important. Cultivating a support system and identifying safe people helps create a safety net when we are struggling. Safe relationships can give a sense of fulfillment and a sense that we make a difference in the world.  Love, in its truest sense, is very healing.

Finally, connection with self creates a stable base from which to grow.  If I can know who I am, strengths and weaknesses alike, I can decide what I want to change and what I want to keep. I am not subject to the whims of other people in defining myself. I can know what I want and need, how I feel, what I like and don't, and where I want to go next.  This connection with self can be very difficult when trauma, depression, psychosis, and other life stressors tell us that we are not good enough, that no one will love us anyway, or that others want to harm us. It can take great courage to look at ourselves, and therapy can help with this.

I enjoy creating connection with my clients. My goal is to meet them where they are and help them develop the connections they need to make the changes they want to make. I believe connection is healing. I also believe it is a necessary life skill. Learning to develop connection is not always easy, but I definitely believe it is worth the effort.  Feeling disconnected? I'd love to help.

Saturday, October 17, 2015

The Next Step vs. The Final Step

For the first 20 or so years of my life, I knew I was going to be an elementary school teacher.  I could envision writing on the chalkboard, decorating the room, and being the person holding the big book up front with all the answers in it.  I had my own little chalkboard, and I used to teach my dolls my homework.  I used to cut out Christmas trees for December calendars and hearts for February calendars.  I used to help my teachers grade papers in elementary school, and I thought that was fun. I was absolutely certain I was going to be a teacher when I grew up and would be one for the rest of my working life.

I went to college and majored in Elementary Education. Somewhere around the first semester of my senior year, I began to sense that teaching was not my calling, but I persevered.  I slogged my way through student teaching, and I eventually found a job teaching middle school science.  To be fair, neither middle school nor science were my target demographic, but that was where the job was.  After two years of struggling with class discipline, lesson plans, and difficult parents, I knew I needed to do something else.  I was taking a Disciple bible study class at the time, and I thought "I could talk about that all day." I also thought that I would prefer to teach college where classroom discipline was not such a big deal and where I could connect with students outside the class in office hours. So, off I went to seminary to work toward a Ph.D, so that I could teach something religion-related in college.

Seminary and I did not agree with each other as well as I might have liked.  Other things were happening in my life that did not help, but I ended up taking a year off in which I reconsidered my options.  I found theology and philosophy interesting, and I had enjoyed learning about the history of the church, but I realized that I did not think like the other students who were going into Ph.D. programs.  I didn't have a specific theologian or belief system that I wanted to research for several years. I was interested in the impact of beliefs and tenets on people, but not as interested in the beliefs and tenets themselves.

During that year off, I got a job at a department store and had a lot of time to think.  What I realized was that I wanted to connect with people, and I had hoped that I could do so through whatever subject I taught.  Eventually I thought, "cut the middleman" and realized I could be a therapist and do what I wanted to do without having to go through another medium.  I went back and finished my M.Div, and then enrolled in a counseling program.  That program made sense to me and fit the way I understood people and life. I found joy in studying the material and found my internships energizing and exciting.

As I look back, a part of me says that I should have been a psychology major, gone straight to counseling school, and have skipped all the in-between steps (my bank account would certainly prefer it).  Another part of me, however, realizes that those other experiences helped set the stage for what I do now.  My experience in education helps me with groups and with explaining terms and concepts to my clients. It helps me to understand how people learn and various ways to reach them.  My experience in theology helps me respect and process my clients' religious and spiritual views in a way I might not have been able to before. I not only learned about Christianity but about other belief systems as well.  If philosophy is how one understands life, and theology is how one understands God (or lack thereof), then counseling allows me to address both together.

So, what is my long-winded point?  My clients often come to me laden with heavy decisions about what to do next in their lives.  They think about the next forty steps in any possible direction and get exhausted and bogged down to the point of intellectual paralysis.  It can help to reframe the decision as the next decision rather than the  ultimate decision.  Very few decisions cannot be worked through or changed. Certainly, those decisions require much thought and deliberation. Otherwise, however, all we can do is go with what seems best at the time.

We can never know in advance everything that will happen.  We don't have control over everything. We cannot control other people's choices, the weather, the economy, etc. After a point, all we can do is take appropriate precautions and trust ourselves that we can get through whatever choices we make.  Every choice is not the be-all end-all, but it can certainly feel that way.  Trauma survivors, in particular, tend to struggle with trusting themselves and getting overwhelmed by everyday decisions.  A safe person in your life can help you explore your decision-making process and grow in trusting yourself.  A different perspective can be very helpful.

Your path may not always seem to follow a straight line, but I believe that, if you trust yourself, the line will take you where you need to go. If you can allow yourself to look for the next step rather than the last step, it can free you up to go places and learn things you never knew you could.  You can learn a lot about yourself along the way. I wonder what your next step might be? I'd be happy to help you figure it out.

Wednesday, October 7, 2015

On Trying Something New

I remember well the day that I chose to leave my last job.  Things had been stressful there, and I knew it was time to move on, but the decision was difficult to make. Despite the stress, I had a regular salary. I was never going to get rich off of it, but I was able to do most of what I needed to do. I liked and cared about the population I was serving.  I also had benefits like health insurance and life insurance that helped to protect my family and me. More than that, I knew how to do what I was doing there, and the routine was familiar.  As much as I knew I needed to leave, the choice to move on was scary.  Ultimately, I worked with my support system and found the courage to move into private practice. I am blessed to have the support I do, and I am grateful.

The transition has been interesting and challenging. The world I am in now is very different from the one I left. I've been reconnecting with myself as a therapist and enjoying being in an environment in which I can continue to learn and grow both as a person and as a therapist.  I still miss some of the "benefits" of my old job, but I am finding much more benefit in what I am doing now.

All of this change has led me to wonder what allows change and how to face it.  What I find is true is that change happens under specific circumstances.  Generally, it occurs when we are at a point that not changing is more painful than the idea of change.  Frequently, it happens in the course of a crisis. "If I don't leave this relationship, my spouse might start harming the children and not just me." "I've been fired from my job. Now what do I do?" "My spouse just got transferred to another state. How am I going to handle this?" "I'm having nightmares and I'm afraid to sleep."  People often come to therapy because they have hit a crisis point.  Crisis is beautiful in that it gives us the energy to make change and take on opportunities.

I think, though, that crisis is not the only motivating factor.  Support is a huge facilitator of positive change. When we feel that others are behind us and that those relationships are safe, it is easier to find the courage to try something new.  I moved more often than I would have liked in my childhood, and it was always hard to make new friends. I didn't have cooties or anything, but I was shy and somewhat insecure. What was almost universally the case was that I became more confident and more outgoing as I developed connections and friendships. I would even take on leadership positions that I would not have dreamed of in the beginning. For me, it took time and connection for that courage to build and for me to allow myself to change.

Therapy is helpful because it provides a safe space to practice new things. We therapisty types talk about "safe spaces" a lot, and perhaps that can be unclear. Safety and comfort are two different words.  Change will be uncomfortable. In the therapist's office, however, you can try new skills and take risks without the threat of being insulted, made fun of, ridiculed, attacked, or embarrassed. I tend to focus on effort rather than outcome, and I enjoy helping people build on their strengths. My goal is to accept my clients where they are and not to impose my idea of change on them. The safety lies not only in knowing that you will not be abused in my office but also in knowing that you do not have to be any particular type of person or feel any particular kind of way to be accepted.  Who you are and what you need will be respected. When we know that we have a safe space to fall, it is easier to take the leaps.

The other piece that I am trying to embrace as I face this change is recognizing that this is simultaneously like what I used to do and very different from what I used to do.  I have to be careful not to impose unrealistic expectations on myself. How do I do that? Well, what I am trying is to allow this to be a new experience and to try to explore it as a new thing rather than expecting myself to have it mastered already. I am trying to be childlike in looking at it in different ways and exploring different options. I know I have necessary skills to do what I want to do and will continue to learn more, and I know what my ethics are, so I do not have to worry about those components not being available to me. This frees me to allow the experience to unfold organically and to allow myself to learn without being embarrassed or ashamed at not already knowing everything. I expect to make mistakes, and I plan to learn from them. We all make mistakes as we learn, and I can accept that.

Have I mastered the art of change? I don't think so. Do I have the perfect answer? Probably not. For that matter, my answer may not work for you, and that's okay. We're all different. I enjoy learning from you, too. If you are having trouble making the change you want, I encourage you to build your support system. Obviously, I am a strong advocate for therapy, but support can also come from family, friends, faith groups, community organizations, and other sources. Having a sense that you matter and that others care about you very much helps with taking the risk of change. Every change does not work out the way we would like, but at least you can credit yourself with taking the courage to make a change for yourself. I definitely think that is an accomplishment to be proud of.

Monday, September 28, 2015

I Second That Emotion

The first taste of fall has arrived in my area, and I am thrilled.  The weather is cooler, there's a snap in the air, and the trees are just starting to change color.  I associate fall with family time, fires in the fireplace, and pumpkin everything.  When the temperatures start to drop, I start getting more energetic and excited. This is my time of year.

At the same time, however, fall brings other thoughts. Sinus headaches loom, my kids get the snots, and I worry that my daughter will have another string of ear infections.  I wonder where the money will come from for Christmas presents, and I find myself hoping that my clients will get through safely.

It amazes me how many emotions can be present at one time. When my son was born, I was excited, tired, overwhelmed, scared, protective, and a little sad considering the loss of the life I used to have with just my husband.  Somehow, childbirth was not the experience I had seen on TV. I knew it wasn't going to be, but I hadn't known what to expect.

Often times, my clients tell me that they shouldn't feel the way they do. "I shouldn't be angry at my parents." "I should be happy for what I have."  This thought process is problematic for a couple of reasons. First, there is no "should." Who can say what the appropriate or inappropriate emotions or timing are? Certainly there are extremes that can be problematic, but to be sad, angry, scared, etc., is usually a normal human function.  Second, emotions just are. We do not get a choice about how we feel about something. We have a choice about what we do about something, but the feelings are there by nature.

 We have societal expectations that the Holidays should be a joyous time and that families should be supportive, but these things do not always come to pass.  For some, the Holidays are a reminder that they don't live in a Norman Rockwell family or that they never got the things they needed as a child.  For some, the idea of family is terrifying or disheartening. They say, "If my family doesn't love me, why should anyone else?" These feelings and responses are normal and are meant to be honored and respected.  Hopefully, with time there can be changes in those responses, but they are legitimate all the same.

What I think can be more confusing for clients, especially trauma survivors, is having multiple feelings about the same person or event.  Many of them, for instance, are confused that they can love their abusers and be hurt and angry about what their abusers did. They may love their children but fear being around them because they might hurt them. They might be excited to get married and terrified that their significant other will turn out to be an abuser. It is perfectly normal to have multiple feelings at the same time, but this can be frightening to people who want the world to be black-and-white.  Part of therapy is learning to hold both feelings at once and acknowledging that both are part of one's experience.

Therapy in itself can be emotionally confusing.  While one part of a person may want fiercely to get better, another part may be afraid of what that change will entail. We may want to improve but fear that improvement means we were unacceptable before. Is it possible to be acceptable and still have room for positive change? I think so. It is important to remember that recovery does not happen all at once.

My clients often express frustration that they cannot be over and done with their recovery in a short time.  My response to them is that, if I were to wave a magic wand and all your problems were gone, that would be traumatic, just like the problems that brought them to therapy in the first place. If, all at once, your reality were different, you would not know who you were or how you got there. By allowing the time to heal and take things step-by-step, the change can happen at a pace that makes it not as overwhelming and allows you to have some control of the process.  Will there be new challenges and responsibilities as you recover? Of course. Remember, however, that you will be in a different place then than you are now. When you were in kindergarten, you could not imagine solving quadratic equations. Eight or nine years later, the prospect made much more sense.

Give yourself time to grow and change in your recovery. Take time to honor yourself and your needs. Grieve your losses and respect your history.  Therapy can help you through these things and help you learn to acknowledge and balance mixed emotions.  There is hope for change.

Sunday, August 30, 2015

That whole self-care thing...

When I was in second grade, I had an accident.  You know the kind I mean. I can almost tell you the exact day it happened because we were dressed up as pilgrims and Indians (yes, they're Native Americans, but this was the early 80's) in preparation for Thanksgiving.  I was not overly thrilled with my outfit, but it was the best we could do. I had a faux patchwork skirt on and a yellow shirt, I think. I don't remember the color.  We were sitting in class, and I realized I really needed to go to the bathroom.  I raised my hand, but we had these dividers that were supposed to keep us from cheating off of each other's papers.  My teacher did not see me, and I was afraid of getting in trouble if I got up without permission or if I interrupted. Eventually, the inevitable happened. Naturally, I was quite embarrassed, my classmates had varying unpleasant responses, and I had to change into other clothes when my mother came.  My teacher later told me that, in case of that kind of emergency, it was okay for me to go without waiting to be acknowledged. Good to know.

Never would I ever have guessed that some 30 years later I could actually forget that I needed to go to the bathroom. It happens, though.  The urge comes to me, and I deliberate about how inconvenient it is and whether or not I really need to act on it. Much of the time, particularly if I am away from home or alone with my kids, I put it off.  What's funny is that it doesn't take very long to manage, and I know it cannot be good for my body for me to hold it for so long. At the moment, though, it just feels unnecessary and irritating.  It seems strange to put off such a basic function, but it is representative of a larger tendency many of us have to put off self-care.

When I mention self-care, most of my clients think of big, grandiose gestures: taking a week's vacation in some resort away from their children, having someone else do the housework for a month, quitting their jobs/relationships, losing 80 pounds, etc.  One former client of mine, however, brought it into perspective. She lived in an abusive situation with her family-of-origin.  She felt unable to work, and she did not have the means to live away from them.  When we got to discussing self-care, she brought the conversation back to basics: "I need to make sure I eat. I need to make sure I drink enough water. I need to take my medicine."  She did not have the resources to do much in the way of getting away from her situation, but she recognized what she could give herself within the situation. I really admired her insight and awareness.

Many of us tend to ignore self-care as inconvenient. We forget that it is a necessity. There are many analogies to the problem: cars need gas, flowers need water, babies need nutrition and love.... I think we suffer the delusion that trying to make ourselves work and complete tasks is the same as being productive.  I taught school for a couple of years, and the second year we had a snowstorm that kept us out for several days. To compensate, the school board decided to take away spring break that year. The kids came to school, but none of us were very productive.

Ironically, taking time for self-care actually improves productivity.  If we have the right nutrition, rest, and hydration -- not to mention exercise -- we are more able to do what we need to do and to do those things more efficiently. Anyone who has raised children is aware of the importance of young children taking naps. Life gets really ugly when they don't, and everyone is miserable.  Conversely, if they take naps, everyone catches a break, and all are better equipped to face the rest of the day after. Taking a break takes time away in the beginning but gives it back on the other side.

I have a pet theory that depression exists, in part, because we do not take care of ourselves and address our needs, so our minds and bodies shut down and narrow our vision until we can only focus on ourselves. Often, when we can start to address our own needs and listen to ourselves, the depression can lighten or disappear.

So, I suppose I need to be making bathroom visits more often. It's not convenient, but I sure can focus better when I have. Nothing is much longer than 60 minutes with a client when you really have to go. I wonder what little changes you could make in your life that might make a difference? Can you make sure you eat? Try to eat healthy foods more often? Drink more water? Go for a walk with a friend? Give yourself time to sleep? Journal? Listen to music? Do artwork?  Self-care does not have to be grand. It just needs to be. Giving to yourself not only helps you become healthier physically and mentally, but also shows you that you care about yourself, and that is a message we all need. Find something small to do for yourself, and then ice the cake by being proud of yourself for doing it. Who knows? It might become a habit.

Thursday, August 27, 2015

Reconnecting with you

When do you feel most yourself? Is there something that you do or someone you spend your time with such that you become utterly un-self conscious?  Maybe you lose yourself in music, doing artwork, exercising, volunteering, or playing games. Maybe you have a friend or a spouse who sees you as you are and encourages you in being yourself. What did you enjoy doing as a child? Can you recall someone from your childhood who made you feel loved and safe?

 It seems so much of our time is spent meeting obligations and trying to be some vision of ourselves that we think we ought to be that we often end up losing our true senses of self. I wonder what would happen if you engaged in an activity that you used to love or made time to be with someone with whom you feel safe and accepted? If we connect with and listen to ourselves, we can make better decisions and we have more confidence to do what we need to do.  Give yourself a break and spend some time being with you.

Friday, August 21, 2015

Hope... and other emotions

My birthday was this week. For the most part, it passed pleasantly and quietly. My family was generous and thoughtful. When I left my office today, however, I decided I wanted to treat myself to a lunch out. This does not happen often, and I thought it would be a gift of self-care to me.

So, I went to Olive Garden. It isn't overly swanky, but I don't have to cook, and I don't have to clean it up, and I don't have to take care of  kid crises while I'm there.  I had an excellent server, and I enjoyed my lunch.  Somewhere in the midst of all of that, I realized I was feeling hopeful.  I have been working hard lately to make changes in my practice and to grow both as a professional and as a person, and this can be stressful and daunting at times. Today, though, I had a sense of calm and of hope. This does not happen as often as I might like, so I decided to take the moment and just let it sink in. I didn't question why it was there or how long it would last. I just accepted the gift.

Funny, isn't it, how we tend to go on auto-pilot with our emotions? We go through the day focused on the next thing we have to do, telling ourselves we don't have time to think about how we feel. (Thinking about how we feel is a strange statement, no?) Often, when I ask my clients how they have felt in the last week, the answer is "I don't know."  That answer can come up for a number of different reasons.

Sometimes people say they don't know because they don't want to face the question. When that comes up, we have to work through the discomfort, and sometimes accept the discomfort as a feeling. Other times, they haven't stopped to notice their feelings, and the question takes them by surprise. Still other times, my clients don't have the answer because they have stopped paying attention to their feelings.  This last is particularly true of my clients who are in recovery from trauma.

Many times, survivors of trauma -- particularly childhood and/or chronic trauma -- have lost their emotional vocabulary. When they went through the traumas they survived, their feelings were ignored, devalued, or suppressed. At that time/those times the feelings were not useful to survival. When survival is the focus, emotions just add confusion and detract from the function of staying alive.  The problem is that survivors often struggle to reconnect with the emotions when the trauma has ended.  They learn to focus on other people and read them and to ignore themselves and their own needs.  Recovery involves reconnecting with oneself, and this means getting to know and listen to one's emotions.

I remember a comedian from the 80's (yes, I'm dating myself) who joked that he had figured out how to solve the problem of the blinking 12:00 on his VCR. He simply took a piece of black electrical tape and put it over the display. Voila! He didn't have to see it anymore. We do this with emotions as well. We tend to fear anger, sadness, and shame, in particular. These so-called negative emotions seem overwhelming, and we tend to avoid them until we cannot do so anymore.

The fact is that emotions are not good or bad in themselves. Their purpose is to give us messages. I equate them with the "dummy lights" in a car ("check engine," that glowing red gas pump, etc.). Those lights tell us when there is something we need to attend to in the car to keep it running safely. If I put electrical tape over the gas gauge because I don't have the money or the time to stop for gas, I will eventually end up on the side of the road with a problem. If, however, I can find a way to put gas in my car (taking the time, and/or asking a friend or family member for support) and I keep an eye on the gauge, I will find that the red gas pump stops glowing, and I know that the situation is managed for now.

Emotions are the same.  If we listen to them and respond to their messages, we can make changes we need to make and know how we are doing internally.  If we attend to our feelings, they will pass on their own. If we shove them down, we miss important information, and we start experiencing secondary issues like depression, anxiety, and physical health issues such as headaches, stomachaches, and other digestive issues.

It takes courage to look at those feelings, and this is where therapy comes in handy. It provides a safe space to explore how you are feeling and what messages your feelings are giving you.  When you have that information, you can make an informed decision. Therapy can help you identify your feelings, learn to trust them and respond to them appropriately, and learn to trust yourself. I enjoy doing this work with my clients, and I feel honored when I have that opportunity.

I wonder what you are feeling right now and what it is telling you? I'd love to help you figure it out. Until then, I will enjoy my feeling of hope and hold on to some hope for you, too.

Sunday, August 16, 2015

Thought to ponder...

It seems to me that you cannot have responsibility if you do not have control.  If this is true, how would this change your perception of your life and yourself? What do you give up if you accept this?

Saturday, August 8, 2015

The Gift of Time

There have been many "never"s in my life. "I'm never going to finish this paper." "I'm never going to find someone to marry." "I'm never going to find a job." "I'm never going to be able to get out of this job." "I'm never...."  The list goes on.  What is interesting is that I was wrong about all of those "never"s.  I managed to complete all the papers, I found a wonderfully loving husband, I got out of a job that was painful and hurtful to me, and I have found a job that I love. A primary component of all of these changes was time. To be fair, it was not as simple as sitting and waiting. I actually had to write the paper, go out on dates, apply for jobs, and make decisions to leave and to take new opportunities.  The point, though, is that things changed with time.

People say that "time heals all wounds." Though I am not sure that I agree completely, I think time presents another gift:  time is always passing. Things are constantly changing. Change can be a scary proposition, but its inevitability can be comforting.

Many times, my clients come to me feeling stuck and at least somewhat convinced that nothing will ever change in their lives. Depression, in particular, can give you the sense that everything is hopeless, that you are worthless, and things will always be that way.  At its worst, it can lead people to suicidal thinking.  Suicide often is not about wanting to die but about feeling there are no other options. People feel stuck and trapped in overwhelming situations and suicide sometimes feels like the only way out, or a last resort to have some control over their situations.

Part of what is important at that time, aside from ensuring current safety, is to remember that things do change.  I tell my clients that tomorrow will be different from today.  Their hair and fingernails will be longer, the Earth will be in a slightly different place in space, and the weather will be different. None of this may solve the current problem, but it promises the possibility of situational change, new ideas, new resources.

If I ask a client to track his or her mood over the course of a week, they will find that they are not always at the same level of depression or anxiety. Some days might be an 8 while others are more of a 5 or 6.  When people are depressed, they tend to miss these changes and have the sense that they have always felt as they do right now.  So we discuss times that they have not felt that way and what was true about those times  Often, we find patterns related to depression and can identify how those patterns emerge and change. Recognizing that change has happened and will continue to happen can be very liberating.

However bad today is, tomorrow will be different. Time keeps coming, providing opportunities for change and growth. There is grace and hope in time. Odds are that the sun will come up again tomorrow, and we can try again.

Mary Ann Rademacher said: "Courage does not always roar.  Sometimes courage is that small voice at the end of the day that says, 'I'll try again tomorrow.' "  I think she said it well. Let's get to tomorrow and see what happens.

Wednesday, August 5, 2015

Comparing Apples to Jackrabbits

I spend a lot of my life observing.  I have long been a fan of people-watching, and I daresay it led me somewhat to the profession I am in today.  People fascinate me. I love their intricacies and the little details that make them who they are.  In all of this observation, however, I frequently find myself looking at others and comparing myself to them.

Many skills I do not have. I like to tell people that I have "all the coordination of a three-legged elephant with a short leg." Sports will never be my thing. When I was in kindergarten, I was pulled out of regular academic studies for remedial P.E. Things did not improve much from there in terms of my athleticism.  Similarly, while I love music, I am not a musician. I played the flute for eight years, but I was never able to produce the sweet, rounded tones that some of my compatriots could. Could I have practiced more and become a better athlete or musician? Yes, I suppose. Has it been worth it to me? I guess not.  I've learned to accept that I will never be a gymnast or a concert flutist, but I can enjoy the talents of others in those areas.

What can be harder for me is when I compare myself to people in my field. I find that people with whom I was in school now have doctorate degrees or have been in management positions in companies or have publications in journals. I catch myself wondering why I have not made their achievements and wondering whether I am good enough.

The answers to those questions are varied. Could I have gone to school for a Ph.D? Probably. I suppose I still might, but when I got done with my Ed.S program, I really wanted to get experience with people.  Similarly, I have never felt a strong pull to do research and develop that sort of writing. As far as management positions go, I have preferred to work directly with clients rather than focusing on the administrivia of management.

As I consider my answers to those questions, what I find is that who I am and what my skills and preferences are differs from those people with whom I am comparing. This makes me different, but not better or worse.  My path has been my own, and I have become the person I am today. As I head along that path, I will continue to change. With that point of view, comparing becomes irrelevant.  No one else has had my life and my particular circumstances, and even if they had, their responses might be totally different. The only person I can compare with, then, is myself.

Many times, clients come to me frustrated that they are not as successful as others that they know. They identify success in terms of money or relationships or attainments.  As we continue the conversation, however, we often find that they have been very successful in other ways.  Many of my clients have suffered abuse in childhood or adulthood. Many have gone through debilitating depression and great losses.  In these cases, it seems success may need to be redefined.  For trauma survivors, the survival of the trauma is a success. For people who struggle with depression, success can be as simple as getting out of bed, getting dressed, or taking a shower.  Those things may not look like much to others, but anyone who has been there is aware of what a challenge those things can be.  Comparing themselves to those who have not faced those struggles is like comparing apples to jackrabbits. I also say, "You can't compare pain." Two trauma survivors may have similar or different stories, but their pain will be unique to them and their paths will be their own.

Furthermore, many of my clients are hyperfocused on their lack or their "failings" and ignore some impressive strengths. Resiliency, courage, creativity, compassion, and other gifts tend to be glossed over or belittled.  They have the latest mental technology to detect faults and defects, but their tools to detect their strengths and positive attributes are stuck in the stone age. Much of how we see ourselves depends on our perception and interpretation, and learning to change those can be challenging.

One of my favorite exercises to do with clients is to have them list everything they have done right that day. I encourage them to note everything, even if it seems silly or minuscule: "I brushed my teeth. I got the toothpaste on the toothbrush without dripping it in the sink. I remembered to spit rather than swallowing my toothpaste. I spat in the sink and not on the counter." Etc, etc.  As we read over and add to the list in session, clients begin to laugh and smile and get excited about adding more. Often times, they will say, "but that's not an accomplishment. You're supposed to do that." My response is to ask whether there have been times they could not do those things, and the answer is usually yes. In that case, I say, it's an accomplishment.

Ultimately, we all have areas in which we need to grow and areas that are more well-developed.  It helps to be able to be mindful in our self-assessments, meaning that we note what is there without placing judgment on it. What is is. Should doesn't matter. Finding a balance in our focus on ourselves and being able to accept the good as well as the less helpful aspects can help us to make better decisions and have the courage to take next steps.

I like to tell my clients that they are my heroes, and I firmly believe that.  I have great respect for the people who go through all of these struggles and still face the world everyday. It is an honor to learn from them and to grow with them. My hope is that they can learn to value themselves at least as much as I value them. They are worth it.

Sunday, July 26, 2015

The Importance of Perspective

My husband and I have a unique distribution of labor.  He cooks. I clear the table. He loads the dishwasher, and I unload it.  I do most of the heavy lifting, and he takes the kids back and forth to daycare. There are many reasons for this set of circumstances, including physical limitations and personal preferences. My husband thinks Home Depot is a land of torture, and I enjoy fiddling with things and looking at possibilities there. My husband does the laundry and I do the folding. Honestly, he would do the folding, but I tend to be particular due to years in retail. If I want it done a certain way, I had best do it myself.  Anyway, this all leads up to a story that really brought home for me the importance of perspective.

When my husband and I were first living together and we had started dividing up the laundry chores, I used to come to bed and find a pile of clothes on the bed waiting to be folded.  My interpretation was that my husband wanted me to fold the clothes on his timetable. I was irritated. I was aggravated.  I felt pushed and taken for granted. I was worried that he thought I was lazy and just did not say so. Needless to say, I have a vivid imagination that I need to put a rein on. I was chasing rabbits in my head and becoming more and more upset.

Finally, I decided I needed to approach him about my frustration.  I talk to my clients all the time about being assertive, and I thought I'd best practice what I preached.  So, I went to him and said that I wanted to talk to him.  He agreed, and I mentioned that I felt pushed by finding the clothes on the bed, and I felt aggravated that I found them at night when I wanted to go to sleep.  I asked him if he thought I was lazy or wasn't doing enough.  He got a funny look on his face and said, "Stephanie, I don't think you're lazy.  I dump the clothes out on the bed because I need to empty the bag so I can reload it to do more laundry.  That's just the most expedient place to put it."

I was chagrined. The more I thought about it, the more I realized that my husband is not passive-aggressive and is not that invested in my choice of activity.  I realized that I had put my fears and my perspective on him rather than looking at things from his point of view.  Ultimately, I asked him at least to warn me if there were clothes on the bed so that I could fold them before it was bedtime.  He agreed, and we've not had any more trouble since.

So many times, we bring our pasts, our fears, and our perspectives to the table and assume that others see us the same way we see ourselves.  Often, when I speak with my clients and they describe other people's thoughts and criticisms of them, we find that those are their thoughts and criticisms that they fear others share. It can be so difficult to check our own thoughts or to speak with others about our fears and get their interpretations. What we think in our heads often sounds very real and true until we say it aloud or write it down.

Therapy can be a helpful place to work through those thoughts and learn to explore alternate perspectives. One of the lessons that can be hard to learn is that others see us differently than we see ourselves.  They do not live in our heads, do not have our histories, and, generally, do not pay as much attention as we think.  The ideal may be not to worry so much what others think, but this can be hard to come by. Recognizing that they do not always share our perspectives and looking for other interpretations can be helpful steps. I like to say "keep your perspective in perspective." It always helps to remember where you are coming from and what influences you.  Some people may be judgmental and hurtful, but many people are caring and giving and see positives in us that we may not see in ourselves. It pays to keep an open mind and keep your perspective in perspective.

Wednesday, July 15, 2015

On Readiness

My 8th grade algebra teacher was a very kind and patient woman named Mrs. Collier. Math has never been my thing, and I found myself totally at sea in her class.  She never embarrassed or shamed me, and she was available if I wanted help in solving the problems at hand. Somehow, I scraped by with a C. I had always been a good student, and the C was upsetting to me on its own. To cap off the embarrassment I felt, my teacher recommended that I retake algebra the next year in high school.  The idea of having to retake a class felt humiliating to me. What she told my parents, though, was that I was not ready to move on to geometry and that I had not understood the principles of algebra enough to move on to higher math. I agreed, but I was hurt.

As it turned out, I took algebra again the next year and ended with a 98 average.  Things made sense that year in a way they hadn't before, and I was able to feel a sense of accomplishment rather than shame or fear about my skills. Now, this did not set me up to be a mathematician by any stretch of the imagination, and I was glad to be done with math after my junior year, but, looking back on it now, I can see Mrs. Collier's point. I wasn't ready.

The important thing to consider about readiness is that readiness is different from willingness, eventual capacity, or interest.  Readiness is about having the necessary skills and resources to do something.  I wanted to learn algebra. I wanted to do well in the class. I was not at a point where my brain was equipped to handle that information in a useful way. That was not a reflection of me as a person. It was just the way things were.

Clients often come to me and express frustration with themselves that they are not "over" their trauma or loss or that they haven't conquered their anxiety or depression yet. These changes do not happen because we want them to but because we take the steps and develop the skills and the readiness for those changes.  If your depression "magically" disappears, how will you know how to cope with it if and when it returns? If you force yourself to "forgive" and "be over" your trauma before you have worked through it, you may well find yourself with increased anxiety, depression, or physical health problems.

Similarly, clients sometimes talk to me about having been in therapy before and not having accomplished what they wanted to accomplish.  Often, as we discuss where they were at the time and what was going on in their lives, we find that they were not in a good place to make the changes they wanted. They weren't ready.

Truly, we sometimes have to make changes before we are ready (moving, changing jobs, having a baby), but I think ideally the most effective change comes organically. I very much believe that therapy is about learning to listen to and honor yourself and your needs and feelings. With that comes the need for acceptance.  Acceptance is not approval but simple acknowledgement that things are as they are. If I want to take a trip to Europe, that's fine, but I don't get there by wanting to be there. I have to plan, save money, and make arrangements. Once I finally start the trip, I have to wait the time it takes to get there. I have to acknowledge and accept where I am before I can make the appropriate next steps.

Therapy is a journey that takes preparation, effort, and time. Ultimately, all of that creates a self-awareness and engagement with life that does not often occur without those elements. The journey itself is a gift and should be appreciated.  You'll get there when you're ready.