Now What? What To Do If You're Feeling Blue, Blah, or Blechh!

If ever a single day of the year gets a big build-up, it's December 25th. Literally billions of dollars are spent on gifts, advertisements, holiday food and drink, travel--and the list goes on. All culminating with, hopefully, convivial gatherings, reunited families, festive moments with friends, grinning and satisfied children, and a few moments of contemplation on the inherent goodness of our fellow earthlings.

Followed by a giant exhale and the inevitable question: now what?

After the frenzy to make the season bright, special, happy and merry, the aftermath can arrive as a letdown in contrast to the many-week build up. With no more gifts to buy or unwrap, no holiday meals to prepare, no more festive gatherings, no special foods, no cards or calls-- we ask ourselves, now what?

For some, the answer is simply, move on to the new year. Take down the tree and store the lights and ornaments until next year. Get back into the routine of work (or searching for it if you're between jobs), muddle through the mundane, toast the New Year, go on that diet--and get on with it.

For others, the void left by the holiday is harder to shake. It's the absence left by families and friends that go back home. Disappointments in holiday expectations weren't met. Frustration with the economic realities--and bills--of the coming January. And, for some, the shorter days--no longer punctuated by bright holiday lights--can bring on the blues.

What can you do? Well, here are a few ideas that might help.

Count your blessings. Yes, as down as you might feel, you are blessed. Focus on what you have. Make a list of people, circumstances and attributes you are grateful for. Write down one blessing, how ever small, on a note pad each night.  At the end a year you'll have 365 notable blessings that are yours.

Reality test your self-talk. I've mentioned self-talk in a previous post. We all have self-talk, mostly without moving our lips. If you're telling yourself things that bring you down, stop and ask yourself: Is that statement really true? How accurate am I being with myself? Can I edit out any drama? And...what can I do to make things better?
If your negative self-talk isn't true, then stop it. If it is, focus on things you can do to bring the situation more into your control. If you can't do anything to change it, entertain the concept, What would it be like to accept things just as they are? And, related to finding the positive...

Surround yourself with positive people. Negative people can drag you down, making the post-holiday blues seem downright bleak. Practice being a positive person yourself, finding ways to say "yes," be cooperative and generally add to the betterment of your days and others'.  Pepper your interactions with more "please" and "thank you," and less #*%&!

Start your new year as a volunteer. It doesn't really matter what you volunteer to do, just do something! Studies show that people who volunteer tend to feel significantly better about themselves than people who don't. And your activity in service to others will likely take your mind off the things that bring you down. Bag groceries for the local food bank, read to the blind, tutor the young, sit and visit with shut-ins. They will be grateful for your interest and effort--and you'll benefit far more than they.

Look forward, not back. Plan something special. It doesn't need to be expensive or lavish. Plan to visit with an old friend you've lost touch with. Pack a sandwich and eat in the park or by the beach. Set aside a little money each week--if possible--for a special treat you'd like in the future.  Window shop, make your special soup and share it with a friend, plan a "me day" and pamper yourself as you're able.  The looking forward to special events can be as satisfying as the events themselves.

And finally, move! Get off the couch, up out of your office chair, out from in front of the TV or computer screen--and move! Check with your doctor first to be sure that even mild exercise won't hurt you--and then just walk.  Studies have shown that a brisk 20-minute walk every day can lighten your mood, and your scale!  You needn't be an Olympic athlete to be a winner from the benefits of exercise.  Weather in the way? Put on your favorite music and dance, march in place, sway--just move.

More on the holiday blues and winter blahs as we move into January.

Until then, Happy New Year, and thanks for listening.

Do You Hear What I Hear? The Quiet Of The Season.

It may just be my imagination, but along about the 23rd or so, a calm seems to descend upon the frenzy that is Christmas.  By now, like it or not, we're only two days away and most of what needs to get done is either done, or isn't going to get done.

Said another way, the rush is dying down and the calm is growing.

It feels like we can take a collective breath, admire what's been accomplished, allow for what has not, and look forward to whatever Christmas traditions that beckon 48 hours from now.

For those who take a break from work, however brief, there's likely a pause from routine, and a chance to reflect on what Christmas (or Hanukkah or Quanza) means to us.  Regardless of how we feel as adults, it's almost impossible to ignore the excitement of children, the beauty of the decorations, and the majesty of the music.

The season--for all its commercialism--is a time to pause.  It could be my optimism showing through, but people seem to be a little kinder.  They let you guide your sleigh--ok, your car--into the lane you need to be in. The clerk at the hardware store smiles.  The bagger at the grocery grins and asks if you're "ready" for the holidays.

The season gives us all kinds of permission. Permission to be a little silly. People don goofy Santa hats, glowing Christmas light necklaces and even elf shoes.

Permission to break the ice in a communication stalemate--after all, who could fault you for sending a holiday card or calling to wish season's greetings?

Permission to treat yourself with an occasional cookie, eggnog or other indulgence. Even permission to snag that bargain sweater for a gift, and maybe one for yourself.

Permission to reconnect with your faith--no matter how lapsed it might feel or how long it's been.

And, yes, Virginia, it gives us--in the face of an awful economy, political unrest, unpredictable and destructive weather, war, need, and loved ones far away--permission to renew. To look for the star in the east. And permission to hope.

With that, I bid you joy in your hearts this season.

Until, next time, thanks for listening.

Dance Of The Holiday Invitations, or Send In The Clones.

With the Thanksgiving holiday dinner behind us, we now shift into the December holiday rush: parties with friends, work receptions, holiday open houses and family dinners. The difficulty becomes: How can I (we) be at two places at once?

With non-family functions, the pressure is somewhat diminished by the fact that, while invitations are, in effect, gifts of time and (often) refreshment, they are NOT command performances. That is, we can often find graceful ways to say "no" that don't devastate the host.

Family, however, can be another matter.

Parents, in particular, can and do have a difficult time sharing sons and daughters with in-laws.  Depending on the degree of dysfunction, families can (and do) exert both implicit and explicit pressure on family members to share the joy of the season--with US!

Clients have reported an array of family tactics designed to turn an invitation into an offer you can't refuse.

Often-used , and quite effective is familial guilt: Don't worry about spending the holidays with us. It will break your father's heart, but we'll be fine. After all, there's always next year...assuming we're all here. Does it make you feel bad? Well, it's designed to do just that. Seems ironic in the season of "good will," doesn't it?  And yet, in an effort to orchestrate, arrange and otherwise control, some families deck the halls with guilt, not gilt, to get what they want.

The antidote? Honesty. Yes. Simply tell the truth. Mom, we just can't make the trip this year. With two kids and two car seats, all the toys and the difficulty of travel, we just can't do it.  Or, I know you're disappointed. So am I. But we want to experience a holiday in our own home this year. And we'd love to see you here,...visit in January...come for your birthday, etc. Once you've invoked the honesty clause, stick to it.  You love your relatives? Tell them. But stick to your guns. The only result of caving will be that you end up where you don't really want to be, feeling resentful and not so jolly.

Another is the "logical argument." It makes the most sense that we spend the holidays at your sister's house. She has all that room, and we'll all be so comfortable there. Yes, yes, I know you'll have to fly across the country, but don't you see how this plan is best for everyone? It can seem logical to everyone who must make the least effort, but not so much to those who have to submit to the rigors of holiday travel. Ask yourself, Can we undertake the effort, time and expense of this plan? If the answer is "yes," then succumbing to logic will sit well with you. If, however, circumstances make "the plan" undoable for you, you need to ask for what you need.

The antidote? Tell the truth.  Dad, the truth is, we don't want to travel during the holidays. And, for the first time, we'd like the kids to wake up in their own beds on Christmas morning--just like I did when I was a child. We're creating our own traditions here. And we'll share the ones with you that we can. Again, if you end up caving--even to a logical request--you'll likely end up resentful, tense, irritable and more like Scrooge than Santa.

And loved ones sometimes invoke....Passive-aggressive manipulation. This can take the form of silence, overly "cordial" emails and phone calls, or feigned indifference after you have asked for the holiday arrangement you really want--and need. The communication can be overt or subtle, but the intent is the same: to let you know that someone is not pleased with you.

To counter such behaviors you might try...name that elephant. Calmly and with as much affection as you can muster, you might say, Mom, I know that you want us to spend the holidays at your house, but, as I said before, we will be staying with Ted's family this year. I know you're disappointed. We'll be talking with you all during the holidays, and sending you photos, etc....

As much as gathering, greeting and giving can create fond holiday memories, keep in mind that that holiday traditions are meant to serve us--not the other way around. What was fun and easy when you were single and 20 or 30 may not be fun--or even reasonable--now. Lives, and circumstances, change.

In the true spirit of the holiday, give what you can in terms of gifts, talents and time. And also remember to give yourself the gift of autonomy: the right of self-government or self-determination.  Despite the fact that you have friends and relatives who want you to behave in a certain way this holiday season, remember that you also have a wonderful and timeless gift that is uniquely yours: a voice.

Until next time, thanks for listening.

What Child Is This? Or, Navigating The Holidays As A Grownup.

If I've heard it once, I've heard it a thousand times: "Christmas? Oh, it's really for the children."

Oh really?

I've also been told: "Oh, let's not exchange gifts this year. It's really about the children."

Is that so?

In my experience, the holiday season can bring out the very best--and worst--of us.  And, let's face it: we all enjoy being thought of, remembered if you will, with a token, a keepsake--a gift.  Gift giving sends a message: I thought of you. I made an effort to give you something I thought you might like. You are special.


If you think this isn't true, try not giving gifts to those with whom you have traditionally shared an exchange.  Unless the change is entirely mutual, timed at exactly the same moment, and completely owned by all, it's likely to result in some hurt feelings.

After all, we're human.  And, after years of completely unscientific data-gathering which includes friends, family--and reports from clients--it turns out that the majority of folks don't care so much what you spend on them. It's the gift--no matter how little it cost of how home-spun.

In this, a struggling economy, it think it's fair to say that most everyone realizes that funds are tight for alot of people who never--ever--thought they would find themselves without jobs or with reduced means.  Which means that many people who were lavish in the past may not be able to repeat the generosity of Christmases past.

So, what can you do to gracefully recognize the shift?  First of all, with family, talk with your adult relatives. Acknowledge their, or your own, economic reality and adjust family traditions to this new reality.  This means considering more than just the amount spent on gifts.

"You mean you're not having your holiday open house? But why?"

Or, "Why can't you come east for the holidays? We always meet at mom's?"

These questions, and others like them, asked unwittingly, can bring reactions ranging from acute embarrassment to stares as icy as an east-coast December.

Mindfulness is one answer.  It's an internal process that reminds us that circumstances change. Others'--and our own--situations may be different this year than last.  Mindfulness, however is more than increased awareness. It's a boost in thoughtfulness.  

Mindfulness can mean increased directness: "We won't be able to entertain this year the way we used to." Or, "It's been a difficult year for us financially. We hope you can understand we can't exchange gifts...fly out to see you...donate to your charity...etc."

Mindfulness can also mean increased tact and awareness. When others express discomfort with maintaining holiday traditions, it just might be that they can't afford them this year.  Despite outward appearances, unbeknownst to us, friends and family may have experienced the economic downturn in a way that limits their ability to spend or participate.

Children, by definition, have limited ability to delay gratification and accept what they cannot have. Young children sometimes resort to tantrums.  As adults, we have the capacity--if we choose to exercise it--to temper our disappointment with acceptance--and hope for better days.  As adults, we also possess the ability to experience the holidays as a time to connect--and sometimes re-connect--with those we care about.

As adults, we are equipped with tools and talents that can nurture the holiday joy, and reduce the stressors.  Read others' social cues.  Listen between the lines. Adjust expectations. Make it ok for others--and yourselves--to share the joy in ways that they can comfortably afford--and enjoy.

Only then does the true meaning of the season shine through. Only then do we give--and receive-- the true gift of the season.

Until next time, thanks for listening.

The Most Wonderful Time...Or, How To Navigate The "Holiday Corridor."

Well, it's here. The "most wonderful time of the year," according to Andy Williams.

I call it the "holiday corridor," that rush of days that starts sometime after the last Halloween pumpkins have been tossed, and kicks into full gear along about the week before Thanksgiving.  And, while it does have many wonderful connotations, from the perspective of the therapist's chair, it's also a time when my clients--and friends and family, for that matter--report rising levels of stress.

In the next few posts, I'll be talking about recurring issues that many of us are faced with during the holiday season: expectations we have, realistic and unrealistic; holiday stress, from without and within; what happens when the family gets together; ghosts of Christmases past: our roles with parents; and, the inevitable "shrinking day:" when 24 hours seems to go by in a blink.

There's also what I call "general holiday fatigue." I can remember when the holiday (specifically, Christmas) season was officially launched on the Friday after Thanksgiving. I have blurry memories of bundling up and riding in my mother's Ford to the Sears parking lot, waiting for Santa to arrive via helicopter.  It was late November, cold (often snowy on the east coast), and Christmas arrived in a scant 30 days or less.

Now, our exposure to everything "holiday" (the politically correct moniker now) can start as early as mid-October. Yes, on any given evening of TV watching, Halloween ad "boos"  are now interspersed with  holiday ad "ho! ho! ho!s" At worst, it confuses children. At best, it's an annoying reminder to adults.

But back to Christmas fatigue.  In my former advertising career, a statistic we bandied about with clients was the fact that, on average, human beings were bombarded with about 300 "messages" a day from different sources. At that time, those sources did not include Internet/mobile pop up ads or emails. It's likely that the number of messages is somewhat higher today--and rising.  By my unscientific estimate, by the time we have weathered the holiday corridor, if we are exposed to even, say a conservative 100 messages a day, we will have endured a mind-numbing 6,000 messages--most with a holiday theme.

Add to this the holiday shopping, cards, meals, travel--is it any wonder we experience holiday fatigue?

Don't get me wrong. I love the holidays--in my case, Christmas. I also am a big believer in self-care, which is why, over the next few posts, I'll be talking about the challenges of the season, and ways we can minimize humbug and maximize joy.

Until then, thanks for listening.

Don't "Should" All Over Yourself, Or Knowing When To Let Yourself Off The Hook.

I work with a wonderfully wise and equally unassuming older client who I'll call, "Charlotte," who is approaching 95. She, like others in the senior therapy group I hold each Friday, deals with the usual difficulties of aging: physical decline, illness, problematic relationships with adult children and the work of "life review"--a look back at accomplishments, disappointments, highs and lows.

One Friday morning, as the group was hitting its 10 a.m. stride, an introspective group member I'll call "Colleen" shared a story about her relationship with her sister and a rift that occurred between them when they were young. Now, almost 60 years later, she voiced disappointment in her own actions many years ago: "I should have done something sooner. I should have helped her. Things would have been different."

The group, rapt with attention as the story concluded, exhaled a collective sigh. It was a sad recollection. We all mused silently for a moment.

The silence was broken by Charlotte: "Well, that may be true.  Or... things might have not been any different at all." And, after a pause for dramatic effect, "Don't "should" all over yourself. Let--it--go."

The group skipped a beat, looked at her quizzically, realized what she had said--and what she had NOT said--and broke into laughter.  Charlotte smiled a wry smile and chuckled a bit herself.

Colleen asked, "How did you come across that. I mean, how did you find you could...do that?  You know, stop the "shoulds?"

"Do you mean, who gave me permission to stop beating myself up?" replied Charlotte. "I did. Myself. Just me."

Now, I don't know many "secrets" of happiness, well-being or contentment but, for my money, Charlotte is on to something.

How often are we critical of ourselves? How many times do we lament things we cannot change, could not change and will not change?

Think about it.  The job not taken. The apology not issued. The unkind words that spewed out in the heat of an argument.  The relationship we could have repaired, but didn't know how at the moment. Missed opportunities for a better outcome. We all have lived through them, and will likely live through more, God willing.

A few years ago,  while in consult with "Bennett," a wiser, more seasoned therapist, I mentioned one of my own missed opportunities, my own "mistakes," and my remorse over my actions.  He looked at me intently, and asked, quite seriously, "So. How long are your going to have to beat yourself up over this? A week or two? A month? How long will be enough?"

"What do you mean how long?  I don't know...I never thought about it like that."

"It's an interesting question, isn't it?" he replied. "I introduces the idea that we actually have control over our own lamentation. Over our own self-punishment. You might want to give it some thought. After all, life's too short."

Armed with that simple but profound idea, I began to actually think about a time frame in which to forgive myself--to free myself from my "should." Now,  I personally subscribe to the idea that we can stop beating ourselves up. That we can let go. That we can actually take whatever learning we gained from unpleasant, unproductive and unflattering behaviors--and move forward. Leaving the guilt behind, investing that "guilting" energy into the life ahead.

Are you "shoulding" all over yourself?  Ask yourself: 1. Is this behavior making my life any better?  2. How could I do things differently or better next time? And, 3.  How much longer do I need to beat myself up over this?

I truly believe that my wise friend Charlotte and my sage/mentor Bennett are on to something. Try it. It might take some practice. But, sometimes, the worthwhile things take time to perfect.

Once you catch on to the art of letting go, you just might feel better.

Until next time, thanks for listening.

Looking Inward: Why We're Wary Of What Lies Within.

‎"We have been to the moon, we have charted the depths of the ocean and the heart of the atom, but we have a fear of looking inward to ourselves because we sense that is where all the contradictions flow together." Terence McKenna, Author, Philosopher


Perhaps the most difficult task of therapy is the journey inward.


Over the past year I've worked with a young woman, Thea (no real names are used here), who has had, over the years, difficulty with co-workers, tradespeople, and most significantly, with her domestic partner of 12 years. 


As we began our work, Thea sat across from me, exasperated with the  conduct of the rest of the world. Can you believe the way they treat me....?  Thea was frustrated, often angry. Her coworkers failed to see the value of her suggestions for their performance; in fact, they had begun to avoid her in the break room. But, this is all constructive criticism! They should thank me for my insights.  With a neutral and curious tone I asked, "Did they ask for your input?" No! They simply don't see what I see. They don't like it when I point out their obvious shortcomings." 


Similar frustrations surfaced around the performance of young man who cleaned her house. Thea: I suggested he might clean his other houses in the way I want my house cleaned--and he told me they seemed satisfied with his way. His way is inferior! He is so ungrateful!


The most distressing rift was the one with her partner, Jerry, a software engineer who spent long hours at the office, and was "tired" most of the time at home.  Thea: He's tired all the time. I spent an afternoon on the computer researching fatigue and its causes, even printed out an exercise and nutrition regimen guaranteed to improve energy levels. And has he started it? He said "thank you" and the printout is still sitting on the kitchen counter. No matter how I try to help him improve himself, nothing seems to happen. How can he let this happen to me?


A few months into our work together, Thea arrived for her session looking exhausted. Her eyes were red and swollen. She had been up all night, crying.  Thea: I try and I try...it seems like no one can see it my way! I want to help, but I'm just ready...to give up. No one appreciates my insights. It's as if...I don't matter.  Thea sobbed. When the sobbing subsided, she asked, What is wrong...with me?  


And so our real work began. It wasn't so much what was wrong or for that matter, right, with Thea. It was the fact that Thea was willing to look inward.


As much as we would like to change others in our lives, therapy can only affect the person or persons sitting in the room. As much as Thea wanted others to recognize her insights and suggestions, she was the person that they all had in common. She had been getting feedback from them for some time now, and she was not able to take it in.   


Only when she began to consider, Is it possible that I am contributing to my own distress in the world? were we able to help her see herself as others saw her. It was only then that Thea and I could begin to explore the messages and values she got as a child--from her parents and others--and how she incorporated those messages into her world view. 


Over time, Thea has begun to view the world from other points of view. While it is still frustrating for her that others cannot see things as clearly as she does, she has stopped offering advice--however constructive. And we have been tracking the reactions of those around her. 


Looking inward can be scary. But it can also be entertaining and enlightening.  It's where we can finally begin to see ourselves as--perhaps--others might see us.  It gives us a new perspective from which to  navigate our relationships.  


Not as lone mariners, but as privileged members of a larger crew.


Until next time, thanks for listening.

On A Personal Note: "The Help," Memories of Pattie And Why You Can't Talk Trash About My Family.

I just finished reading The Help, and I have to say, I'm left feeling a handful of emotions. If you haven't read the book, read it.  The film version, while somewhat (necessarily) abbreviated, is also a gem. Go see it.

Living in California, it's not often that I run into anyone who shares my southern roots, much less even a passing understanding of what it was like to grow up in the south of the 1960s. So I felt a wave of familiarity--a dull ache of nostalgia--as the book swept me back to a different time.

There are similarities between the book and my upbringing. And differences, too. But the flavor--the summer heat, the humidity, the southern drawl, the way of describing things--was so accurately recreated on the pages of The Help. It was a time long passed. A time that predated political correctness. The south of my childhood has seen many positive changes since that time. What follows is a memory of what was, as it was.

My family employed a wonderful, powerful black woman by the name of Pattie.  Unlike the fictional Phelans, our family was not wealthy, plantation-dwelling or steeped in the deep traditions of Mississippi. We lived in a comfortable, upper middle-class neighborhood in Virginia, where the men worked and most of the women stayed home to raise their families--often with the help of a "colored girl," a decidedly racist term that was likely used more out of ignorance and habit than malice.

To the best of my knowledge, Pattie came to work for my mother when I was two or three. She came five days a week, doing the housecleaning and laundry.  My early memories of Pattie were the scents of Niagara Spray Starch and Lucky Strike unfiltereds.  I can picture her at the ironing board, Lucky dangling from her lips, humming over a the collar of one of my father's white shirts, delivering a perfect shot of spray starch to the collar. And then, the hiss of the iron as it glided over the cotton, leaving behind its perfect wake of flattened fabric.

Pattie arrived on the 7:55 morning bus. My mom picked her up at the bus stop and Pattie was at work by 8:00 sharp.  In the summers, Pattie arrived with bags of fresh produce, usually half-runner beans and white corn, my father's favorites. Sometimes there were beets and squash and heirloom tomatoes. As a child, I never questioned how Pattie got the produce--it just came with her.

What I learned, years later, was that Pattie, in order to get to the morning farmer's market, got up an hour early, took the 6:20 bus, shopped, then changed buses twice to get to our house as usual. I also learned that Mom never asked for this kindness, and always offered to pay Pattie for the vegetables.  It was their "dance." Mom would offer, Pattie would say, Put yo money away, Miss Frances, and turn and walk out of the room. Mom would follow, repeat the offer, get the same answer. Then, when she was certain Pattie wasn't looking, Mom would stick a carefully folded five- or ten-dollar bill in Pattie's purse.

Pattie knew it was there. Mom knew it was there.  It was how they worked it out.

Along with Pattie's pay each week (I don't have any idea what Pattie was paid), Mom set out a bag containing a carton of Lucky Unfiltereds, a small bag of Brach's butterscotch candies, two ribeye steaks, greens, a 48 oz. bottle of Schlitz beer, and whatever seasonal produce that was at market.  It was "Pattie's bag" and Mom make it clear we children were not to touch it. Mom would set it by Pattie's satchel next to the front door just as she prepared to take Pattie home for the day. Sometimes I would ride with them to Pattie's house. In those more racially divided days it was in an area called "colored town," as white--and black--people called the area adjacent to Williamson Road.

In later years, when Pattie was coming only three times, then twice, then once a week--I would drive her home myself.

Pattie sat in the front seat with Mom. She sat in the front seat with me.  I never remember her talking about her personal life, civil rights, segregation, Martin Luther King or any reference to racial segregation.  I know she had opinions. And I know that, after she retired and Mom called or visited her, Pattie shared personal feelings with Mom--and Mom with her. They remained friends until Pattie's death in early 1975.

Kathryn Stockett, author of The Help, explains, in an afterword to the book, about being a southerner in an environment that doesn't understand southerners.  I, too, left the south as an adult to work in larger cities in other parts of the country. Here in California I occasionally come across someone who has recently seen a film about the south, changed planes in the Atlanta, Hartsfield airport, or spent a brief time in one of the southern states. After one such brief southern encounter, one particular acquaintance whom I see from time to time,  let fly some unflattering comments about how "all southerners are so slow," winking at our dinner companions as if to underscore the unspoken translation: All southerners are so stupid.

Without so much as a hesitation between bites of bean salad from a Berkeley organic grocery I caught her gaze and steelily replied,  Careful. You're talking about me, my mom and dad and the rest of my family and by the way just how much time have you spent in the south? Have you ever lived there? Know anyone--personally? And--just, by the way--what if I generalized that way about you and your family. How do you think it would feel?

So, there you have it. To paraphrase Ms. Stockett (and with apologies): With all its faults (and there were and are many) the south is like my family. I'm allowed to complain about her all I want, but God help the person who raises an ill word about her around me, unless she is their family, too.

I'll get off my soapbox now.  Thanks for listening.

On A Personal Note: Glimpses Of Childhood, The Birth Of Self-Esteem And The End Of Summer.

When I was a child, the beginning of summer was just that: a beginning. It was a time of what seemed to be endless possibilities. The countdown to the end of school usually started some time in the middle of May and built to a feverish crescendo that climaxed on or about June 5th, when the last textbooks were stacked in the multipurpose room and we were released into the warm June heat of the Virginia summer.

Early on as a child, I found, to my profound disappointment, that I was a failure on any number of sports courts and fields. Despite endless hours of practice with my naturally athletic cousins, I failed to find either proficiency or personal satisfaction on the baseball diamond, basketball court, or football field--three of the staple neighborhood sports at which boys that age usually excelled.

You can imagine my surprise--and delight--when, at the age of six, I discovered that I could swim! Not only stay afloat, but, with training and determination, I could traverse the length of the pool with enough velocity to compete with--and sometimes beat--my opponents.

It's no wonder that I looked forward to summer so much. I grudgingly suffered through three of the four seasons: football, basketball and baseball. But when the fourth season arrived--swimming--it was my time to shine. Relatively.

For a child who was routinely picked last--or nearly last--for most sports teams, I reveled in my 4th, 3rd, 2nd and the occasional 1st place ribbons I earned each Monday night from June through August.   My parents, to their credit, never provided me with either excuses or rationalizations about my wins--or my losses.  When I ended a swimming event--all splash and fury--only to find out I had finished an honorable "4th" I wasn't consoled with "You had a bad lane," or "You were swimming with the sun in your eyes," or worse, "The lane judge disqualified you because he doesn't like our team." (And believe it or not, I actually heard parents feeding their kids those lines when I was a swimmer, as well as years later when I was the coach of the team).

 In fact, I wasn't really consoled at all. Instead, when I began my own rationalizations, my mom (usually) or dad (sometimes) would hand me a dry towel, look me in the eye and ask calmly:  Did you do your best? As difficult as it was to admit that my "best" had only netted me 4th or 5th place, I would soberly reply, Yes. To which my parent(s) would reply, Then you did your best. And, today, in this race, others swam a little better then you did. Next week there will be another race.

Forty-odd years later, I can remember these moments as if they had happened yesterday.  I came to look at these as our "no-excuses" moments. Just a realization that my best sometimes wouldn't be as good as somebody else's. And, more importantly, that my best was just fine. Now I suspect there may be some parents out there who will be horrified at my next statement, but here goes: Not only was my best "just fine," 4th, 5th--god forbid last--place was just fine, too. Because I gave it my all.

And, wet and shivering at pool's edge in the early evening chill of a June evening--my self-esteem was born.

Don't get me wrong. Satisfaction with my best didn't mean settling for 4th, 5th or last. It meant pushing myself to whatever personal best I was capable of. And, the summer I turned 14, for a few glorious weeks between our regional meet and state finals, I held the state record for the 50-meter backstroke. There were no parades, no newspaper articles, no celebrations of any kind that I remember. Just the self-satisfaction that, for a handful of days, not only had I finally beaten our city's golden-boy swimmer, Richard Hughes (his real name--sorry Richard) but I had--for just a moment--set the bar for that event. My best, for that brief time, was the best.

I'm not sure what caused that sweet memory from so long ago to surface now. Perhaps it's the fact that it's August and, my sense memory still lingers--August means that summer is winding down. School will be starting soon (in those days we squeezed every drop out of summer, starting school after Labor Day). Perhaps, it's because I see clients often struggle with the competitive nature of jobs--and life--in the Bay Area.  Maybe, it's just the fact that, sometimes, the events of the world remind me that this is a time that feels...complicated. And the memories of affirmation--and brief victory--feel simpler, purer, more true.

Now, I'm the first to admit that my memory can be selective, embellished, and optimistic. But, in this instance, the memory of my experience--and the values imparted to me--is pretty much true to the time.

In the Virginia summer of my childhood, this would be the time of summer heat, humid nights, fans blowing cool breezes, lighting bugs at dusk and the winding down of lazy days. 

Years later, I still feel late August is a time of anticipation. Of a new beginning. Of a new season.  Of things unseen and unknown. And, because of my parents' refusal to rearrange reality to suit my life disappointments, I feel blessedly prepared to meet the unknown. Head-on.

Next week there will be another race.

Thanks, Mom and Dad.

And thanks for listening.

Gaining Perspective And Getting Out Of Your Head or, The Rx For Depression: Volunteer.

Because I'm not a physician, I can't, of course, prescribe medication. However, I have found, in both a personal and professional realm, that a powerful tool in treating depression is participating in volunteer activity.  It can be as simple as serving at a soup kitchen, reading to the elderly, assisting teachers in the school setting, distributing magazines and flowers at a hospital...and the list goes on.

The difficulty when you're depressed, however, can be inertia.

Making that first phone call can be monumental hurdle. And, yet, clients (and friends) report that once the call is made and they overcame their first discomfort with a new challenge, they felt something they had not felt in some time: they were needed. They mattered. They had a contribution to make.

I've related in a previous blog my path to becoming a therapist. Looking back, I'm not certain I was clinically depressed, but I was feeling despondent about my career in advertising. I didn't have a someone special in my life. And I was outside of the US, geographically far away from people I loved. Consequently, I was working hard to "figure out" my life. I was spending alot of time in my head, sometimes spinning in details of my life journey to date: my choices, my talents and shortcomings, my relationships and my loneliness.   A friend (who probably was tiring of my constant self-examination) suggested volunteering. Her rationale was sound:  You have the time, you're good with people, and the worst that can happen is that they can fire you. So you wouldn't be any worse off than you are now, right?

The first step in that journey was becoming a volunteer at the palliative care ward in a local hospital. The training was great and the experience even greater. 

If I had to boil the benefit down to one word it would be: perspective. 

When we're trapped in our own heads with our own thoughts, the perspective is short, narrow and limited.  When we can interact with others on a personal basis, forgetting for a moment our world and its limitations, we're free to develop an amazing quality: empathy. 

The folks at Merriam-Webster define empathy as the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another... When you think about it, it makes perfect sense. It would seem almost impossible to be able to "understand, "  "be aware," and "vicariously experience" another's world if we're trapped in our own world view.

Interestingly, the same folks at Merriam-Webster have the following to say about "depression:" ...a disorder marked especially by sadness, inactivity, difficulty in thinking and concentration,...feelings of dejection and hopelessness....  My clients often use words like "stuck" and "spinning in my own stuff."

When a task, service or responsibility becomes about anything but you, your perspective is forced to change--just for a time. But change it must. That's when you "leave your head" and concentrate on the needs of others.  It can be a freeing change of scenery.

I remember, several years ago, when my father's best friend, Ron, retired from a lucrative career that was a major part of his life for more than 40 years.  After retiring, he became grumpy, withdrawn and generally difficult to be around.  His wife, in an effort to simply get him out of the house, insisted he volunteer--anywhere. Reluctantly, Ron volunteered at a local after-school program teaching six-year-olds to read. 

It makes for an interesting image. Picture a six-foot-four, 200 pound bear of a man sitting in a tiny little chair, at a tiny little table, holding a tiny little book in front of...yes, a tiny little six-year-old. As the kids learned to read, Ron began to have purpose again. He began to engage others, to laugh, to talk with pride about "his kids," the ones he was teaching to read.  His sense of humor returned. He not only became a favorite of the kids, but his long-time friends were glad to have the old Ron back.

Was Ron depressed? I couldn't say. But, when he went from being in charge of a company to having no business influence,  he certainly seemed to have lost purpose. It took a six-year-old to bring that back. He went from being "stuck" in his own head to being relevant. And needed.

Will volunteering cure your depression?  "Cure" is asking alot. But could it help? My personal and professional experiences say that it certainly won't hurt.  And, if things are looking particularly bleak, how can you argue with a change of scenery?

Until later, thanks for listening.

It's All About You--Part II: Keeping Healthy Boundaries.

Last time, I shared my thoughts on the therapist's self-disclosure in session, and why I feel the focus should always remain on you--the client. In this post, we'll look at the nature of the professional client-therapist relationship, and a few ways to maintain healthy boundaries.


Our relationship is professional. Personal details can blur the lines.
I genuinely care about my clients and their well-being. I'm honored that they choose to share personal and intimate details about their lives. I hope my clients can feel my compassion for their difficulties and my satisfaction in their therapeutic accomplishments. However, despite the caring nature of the relationship, it is first, foremost and always a professional one.


For example, I can feel great satisfaction for a client who has worked to improve interpersonal skills in order to secure a job, and in session, I will congratulate this client for his success. However, I choose not to send cards, make congratulatory calls, and won't--under any circumstances-- go out to dinner to celebrate. 


My relationship with you as a client will never be a social one. We meet in a professional setting, and maintain professional boundaries. Because of confidentiality, if we happen to pass each other on the street, I will not acknowledge you unless you have given me explicit permission to do so in advance. If you think about it, if you're with other people and I say, "Hello," the natural question can arise: So, how do you know each other? Ethically, I cannot tell anyone that you are my client, and this conversation puts you in the potentially awkward position of having to disclose that you are in therapy. It may seem cold, but it's an ethical boundary that has served my clients well.


So, what do I disclose to my clients in session?
Again, for me, the acid test is, what is in the best interest of my client? For example, I have worked with many clients over the years who have lost one or both of their aged parents. At times, I have felt it appropriate to share--briefly--about the loss of my parents in order to to show empathy for my client's grieving process. Again, it's not about getting my clients to take care of my grief--it's about showing empathy for theirs.

 I don't have an "approved list" of self-disclosures. It usually happens in the moment, is brief, pointed, and designed to benefit the client in the moment. If I'm not sure it's in your best interest to share, I pass.

Does this mean if your therapist discloses more or less than I do that it's "wrong?" By no means. As I said at the beginning, therapist disclosure in therapy is a very individual thing. However, if you feel that your therapist is spending more time talking than listening, and you don't feel like the hour is yours, you might want to address it.


Years ago, before I'd ever been in a therapy session, a friend was describing her therapy to me: I go once a week. My therapist is totally focused on what I have to say, never makes it about herself, and doesn't make me feel bad when I admit my mistakes. She's genuinely interested in what I choose to talk about, but gets me back on track when I ramble. It's the one hour a week where I feel like what I have to say really matters. I feel heard.


Feeling heard. In therapy, it can only really happen when one person does most of the talking--you.

Thanks for listening. (I feel heard.)

It's All About You...Or, My Thoughts On Self-Disclosure In Your Therapy--Part I

Individual therapy is a unique relationship between two people. One is encouraged to come in and share any and all details of his/her personal life in an effort to gain self-insight, make decisions around personal growth and change, and process deep and personal feelings and experiences from the past and present.  The other person--the therapist--sits and listens, usually addressing only what the client brings into the room in a professionally concerned manner.

I've been asked more than once, How come I tell you everything and you never say anything about yourself?

Self-disclosure by therapists is...well, very individual. Most therapists are trained, in general terms, to disclose personal information only as it serves the best interest of the client, i.e., you.  The term "best interest" is open to interpretation by each therapist, which means that one therapist may be vastly more self-disclosing than another. 

I tend to err on the side of "less is more." And the reason is simple: this is your therapy, your session, your journey, your time, your money--the only thing about me that should enter the room is an experience, an anecdote or a  personal detail that will specifically be beneficial to you.

Why "How are you?" is a thoughtful, but loaded question.
My clients often settle into a session with a  polite, "How are you?" to which I always smile and answer, "Fine. Where would you like to begin today?"  Clients who know me well, know that I won't say more. The reason? Everyone occasionally has a bad day, even your therapist. However, it's not your job to soothe, cajole or otherwise take care of my needs.  I'll be ok.  And, for some clients, it can be less difficult to divert the conversation to me and my problems, than to talk about their own difficulty. And this can put a roadblock in the way of the real reason you're here. 

My experiences are not the important experiences in the room.
Yours are. How I might react, my history in a similar situation, my personal experience in a similar setting are largely irrelevant, as it's your reaction, your history, your personal experiences that matter. Because we're all unique human beings with different histories and backgrounds, it would be presumptuous--and unprofessional--of me to begin to think that you would react to a given situation or pain the same as I would.  The important information about your distress is about you.


My feelings are not the important feelings in the room.
Again, yours are. If you ask me in session, How would that make you feel?, I'm likely to gently ask you how it made you feel.  Your thoughts, feelings and behaviors are some of the variables that we'll work with in session to help you achieve the changes you're looking for.  My feelings about your experiences--aside from my desire to be non-judgemental and compassionate--are simply irrelevant. My goal is to help you by making it safe to look inward.

 If you spend your time focusing on me, you're not focusing on yourself.
Many therapists, including myself, have spent time in therapy looking at our own issues and difficulties in life.  That said, most therapists can empathize with the fact that, as a client, it's sometimes easier to talk about something other than yourself.  However, it's in your best interest--there's that phrase again--to keep the conversation focused on your experiences, feelings and movement forward toward your therapeutic goals.

Next time: It's All About You, Part II: More about the professional nature of the client-therapist relationship and keeping healthy boundaries.


Thanks for listening.

From The Therapist's Deck Chair: Why Pets Make Good Therapists.

The weekends take me and my partner north of the city to a place overlooking the Alexander Valley. It's a beautiful morning, one of those Saturday mornings where I can hear the sound of dogs, sheep, horses, goats and roosters from the valley below.  Oddly enough, the roosters greet every hour and random minute--not just the dawn--with gusto and abandon.

Close by it would feel like a noisy intrusion. Somehow, in the near distance, it's reassuring that we're not alone on the planet.

Aside from this personal observation (as well as a long and mostly satisfying relationship with George and Gracie, our cats), there is scientific data to support the therapeutic benefits of having pets. Studies have found that human-animal relationships can positively affect mood and health, instill healthy lifestyle changes, and play an important role in healthy aging.

Improved mood and health.  Recent studies have shown:
*Pet owners survive heart attacks longer than non-pet owners
*If you have a pet, you're less likely to suffer from depression
*Pet owners tend to have lower blood pressure in stressful situations
*Pet play can increase dopamine levels in the blood, which can help you feel calmer and more relaxed
* Pet owners have lower blood indicators of heart disease (lower cholesterol and triglyceride levels).

We can attribute many of the health benefits of pet ownership to the power of touch. Stroking or holding an animal can actually provide a calming effect in times of stress. Interaction with our pets is a way we can express--and receive--affection. Some of our furry friends require physical activity, which can motivate us to move with them. And some forms of vigorous exercise are known mood elevators.

Pets and healthy lifestyle changes.  As I mentioned above, pets can help motivate us to exercise. Dog-walking and house play with your cat are two simple ways to get off the couch.

Caring for your pet can also help you feel less isolated and more needed. When you focus on your pet, you are taking your mind off of your troubles and providing nurture for another living thing. The companionship of a pet can reduce anxiety and stress while providing company and comfort.  For those who feel life lacks purpose, many pet care regimens provide structure and purpose on a daily basis.

And, if you've ever visited a dog park you know that walking your dog is a great way to socialize with other animal lovers.

Pets and healthy aging.  As we grow older, we often become less connected to others. We retire, our children move away, health concerns make us less mobile, and, inevitably, we begin to lose friends and family members to death.

In older age, making new friends can be difficult. As mentioned above, a dog can be a great new friend for you, and can also provide a pathway to new friends.

Dogs and other pets also encourage movement, playfulness, exercise and even laughter (just add one kitten to one roll of toilet paper and you'll see what I mean).

And, in a life that may feel less and less meaningful at times, the responsibility of a pet and its care can not only provide renewed sense of purpose, but also increased morale and optimism.

Like many joys, pets require commitment and responsibility.  Before you decide to add a pet to your life, consider the following:

* While a pet can be playful, it's not a plaything.  All pets require daily care and attention. Feeding, walking, litter box care--they all take time and when you neglect these tasks you're neglecting a living being.

* While pets keep on giving, they also keep on costing. Money. Pet maintenance--food, licenses, spaying and neutering, vet care, boarding fees--can amount to significant sums of money. Be sure you're willing and able to make this commitment before taking on the responsibility of a pet.

* Adorable pets can do deplorable damage.  Despite all your best efforts at training your pets, occasionally they can shred, tear, soil and otherwise damage your furniture, rugs, walls, clothing and virtually anything you leave unattended.  You need to consider: pets are not humans and don't understand why we value the items we value.  They will encroach on our territory and our things.

* Some pets carry health risks. The most common health problem associated with pets is allergies. The time to find out about pet allergies is before you take on pet ownership, not after.  And for some older adults, it will be important to match your stamina, mobility and stability to the right pet.

After all that, you may be wincing and saying to yourself, Well, why bother? Any pet owner can tell you why. And, I began all this with the notion that pets make good therapists.  If for no other reason, pets, like a good therapist, listen to us without judgement.  Yes, while some pet owners won't admit it, most of us talk to our pets. We ask them how they feel, if they like their food, and confide in them about our day.

The therapeutic part? They listen without reservation. They don't judge or offer advice we may not want.  They don't take sides or provide rationales that make our reasoning seem lame. They simply listen.  They entertain us. They provide good company.

And wait for the next scratch behind the ears.

Until next time, thanks for listening.

"It's None Of Your Business." And 9 Other Reasons People Say "No" To Therapy.

Suppose someone proposed the following to you: 1.) Call a complete stranger on the phone; 2.) Make an appointment to see that stranger to tell her about a distressing or shameful part of your life; 3.) Show up and actually tell that person things about yourself and your personal life that you've never told anyone else on the planet--while the stranger says virtually nothing about herself; 4.) Write the stranger a check.

Is it any wonder that therapy could be feared or misunderstood?

Of course, anyone who has been to a compassionate and competent therapist is likely to give a fuller, more balanced account of therapy.  In fact, about 8 out of 10 people would report that therapy actually helped them feel significantly better.

So, why do people say no to counseling--at least at first? Here are the "Top Ten:"

1. It's a sign of weakness. Sometimes we're taught that accepting help--of any kind--is an indicator that we can't solve our own problems.  But, if we take that analogy to its extreme, that same person would have to believe that it's a sign of weakness to have your appendix removed, your broken leg set in a cast, or your high blood pressure diagnosed.  In fact, it takes a very strong person to recognize a difficult situation and take steps to get help.

2. Only crazy people go to therapy. It's far from "crazy" to have the insight and the intelligence to be able to recognize a difficulty that is causing you distress--and to ask for the help that you need.  A popular definition of "insanity" is repeating the same behavior over and over and expecting different results.  People who take the brave step to enter treatment are ones who are, very likely, tired of the same results and who wish to try a different way.

3. I can't afford it. It's for rich people.  It's true that therapy can be expensive.  However, most health care plans provide for some mental health care benefits. And, more and more, therapists are offering a sliding scale for clients who cannot afford full fees.  In the end, it comes down to the value you place on relieving your distress--and your belief in feeling better.

4. If I tell someone about my horrible experience, everyone will know.  Far from it, licensed therapists are ethically bound to hold confidential your therapeutic conversations. In fact, your therapist cannot even acknowledge that you're in treatment without written permission from you.  There are a few instances that involve your safety and the safety of others that require your therapist to break confidentiality. Please see my previous post to learn more.

5. I don't want to betray my family. A good therapist will be sensitive to strong familial or cultural beliefs that discourage you from "airing the family laundry" with someone outside of the family circle.  Working with your therapist, you can determine how much, and a what point you're ready to talk about family and relationships you have with them. 

6. I wouldn't even know where to start. That's ok. However, the one person in the world who is an expert on you is...you. With your therapist's help, you can learn to talk about how you feel about yourself, your relationships, the way you act and the way you think.  As you move forward, you can determine how you would like things to be different for you at the end of your therapy.

7.  It's nobody's business but mine.  No matter how private a person you are, your life, your actions and your choices can have a big effect on others.  And others' reactions to your life choices can have a profound--and sometimes negative--impact on you. And so the cycle goes.  Recognizing our connectedness in the world can be a first step in actually helping ourselves feel better.

8. Just talking couldn't possibly help.  Actually, imagine talking with someone who will never judge you, never disapprove of your choices, never shame you for your past, and who will listen intently with genuine concern and compassion for your pain.  This is what the therapeutic relationship is all about. And it may be unlike any other relationship you've had in the past.  It can provide you with a safe room to talk about painful things. And, over time, it can allow you to try out different ways of looking at things that have previously felt too "stuck" or shameful to examine.

9. Dwelling on problems will just make them worse. Sometimes, when you first begin to talk about concerns and worries that you've been reluctant to look at before, it can be painful.  However, over time, talking freely, in a safe environment can help lessen the pain and provide clarity for future change and choices.  Remember, you're not alone in the room.

10. Therapists only want to get you on medication.   A competent therapist is going to work to provide you with the best possible care within his or her scope of practice. Unless your therapist is a physician (psychiatrist), he or she cannot prescribe medication for you.  It's true that some therapists may refer you to a psychiatrist for an evaluation for medication which may be helpful in relieving your distress. However, it's important to remember, it's only a referral. You decide whether you want to include medication in your treatment. It's only one part of many conversations you will have with your therapist.

As with any relationship, you and your therapist start out as strangers. But, unlike most other relationships you may have, your therapist, through education, training and a genuine desire to help, puts your well-being and best interest at the forefront of your time together. Without judgement. Without pressure. Without an agenda.  For once, it's truly all about you. Which can be a very good reason to say "yes" to therapy.

As always, thanks for listening.

Confidentially Speaking: What Your Therapist Can--And Cannot--Share.

In principle, the therapy room is "Las Vegas:" What happens here stays here. Well, almost.

If you're in therapy with a licensed therapist in the state of California, your therapist has (or should have) already told you that there are a few instances where he or she must break confidentiality in order to address an issue of safety. These instances are:

1. If you tell me that you're going to harm yourself.  On occasion, you may have heard many people say in a moment of frustration, "I could just kill myself."  Often, this is just taken as a figure of speech, and passed over with no real concern.

However, in the therapeutic setting, even if I really don't think you're serious, I'll discuss the comment with you to understand if you're serious, somewhat serious, unsure or not serious at all about harming yourself.  I take any comment about harm to self or others very seriously, until I'm sure there is no reason for concern.

The standard for reporting a client's self-harm is "reasonable suspicion," that is, if, after talking with you directly about your suicidal thoughts and/or plans, your therapist has a reasonable belief that you are going to hurt yourself, your therapist is obligated to call someone to help keep you safe. Before breaking confidentiality, your therapist may attempt to have you agree to a no-harm contract. If this is not successful, or if your therapist believes that you are not sincere in making the contract, he or she may call in the police, paramedics or other emergency response team trained to assess for suicidalitiy.

If these professionals feel you are an imminent danger to yourself, they may initiate a "51/50" which allows you to be taken to a safe place for observation and treatment.  The length of the hold will depend on the assessment of the mental health professionals involved.


2. If you tell me you're going to harm someone else. Again, a frustrated person may blurt out in anger, "She's such a jerk. I could just kill her sometimes!"  Again, I take the words seriously, and will assess to see if there is any reason to be concerned.  Like the scenario for self-harm above, if I have a reasonable belief that you are an imminent danger to another person, I have an obligation to notify that person (if at all possible) and to notify the police. 


3. If you tell me that a child (under the age of 18) is being physically or emotionally abused. This child doesn't necessarily have to be in your family. I have an obligation to try to identify the child and make a report to Child Protective Services (CPS), or any similar agency in your community.   Physical abuse includes certain forms of hitting, using excessive force in any way and/or sexual abuse. Emotional abuse involves repetitive and degrading behavior, often verbal, designed to intimidate and demean the child. Again, I don't have to have "proof" that there is abuse, just reasonable suspicion.  It will be up to CPS to determine if an investigation is warranted. If so, they will usually make a visit to the home or school to gather more information, clarify facts, discuss the situation with the child's family or legal guardians and take any corrective action needed to keep the child safe from physical or emotional harm.

4. If you tell me an elder (aged 65 or older) is being physically, emotionally or financially abused.
Again, this person doesn't necessarily need to be related to you.  The criteria for physical and emotional abuse are virtually the same as for children.  Financial abuse has to do with unwanted interference with the financial dealings of an elder, theft from assets, cash or accounts, or negligence in the management of an elder's financial matters.  As with all instances listed here, I don't need proof. This will be up to a team of investigators from Adult Protective Services, or a similar agency in your community. Like the other scenarios listed above, I'm required to report a reasonable suspicion of these kinds of abuse with elders.

5. If a judge orders me to release your client records. While it has never happened in my practice, on a rare occasion, a judge will compel a therapist to release confidential psychotherapy records. It can sometimes happen when couples who are divorcing or contesting child custody ask their attorneys to subpoena family psychotherapy records.

I am only authorized to release your records (or any requested information about your treatment) if  1.) you provide me with a written, signed release stating that I may do so, or 2.) a judge overrules my attorney's objections to release your records and orders me to provide them to the court.

Currently, these are the specific instances I'm required to report to authorities, and all are directly related to human physical, emotional, or financial safety.

What about domestic violence? Currently, there is no mandate to report incidents of domestic violence between adults.  While I may work with you to help you decide how to stay safe or access resources so you can ensure the safety of yourself and your children, I cannot, by law, break confidentiality in this instance.

I've been fortunate. I have never been compelled to release client information. On rare occasions, my clients themselves have asked for very specific information about their treatment to be released. I will only release this information if I've had the opportunity to discuss this with my client so that we both can adequately understand the ramifications of release of such information.

A good therapist will freely discuss with you the limits of confidentiality in therapy.  If you're not sure, ask. Neither you nor your therapist should leave disclosure up to a roll of the dice.

Until next time, thanks for listening.

Sitting With Discomfort Or, Accepting What Is.

Discomfort, frustration, disappointment--none are strangers to most of us. And, none are classified as "disorders." However, if you suffer from an anxiety disorder or clinical depression, the ability to "sit" with your discomfort--to temporarily accept what cannot be changed--can be an extremely helpful coping mechanism.


Developmentally, tolerance of discomfort is usually mastered gradually, starting in later childhood and spanning into adulthood.  However, it's a skill or talent, which suggests that we may all have varying degrees of ability in this area. And, given our financial circumstances, physical health, mental health, life stressors--even our diet and drug/alcohol intake--our ability to tolerate mental discomfort can vary widely in different life stages.

I don't like this, I don't want this. But I can't change this. Now what do I do?
According to the Cleveland Clinic's web page on "Emotional Well-being," there are several ways to help cope with things, events--even people--that are causing us distress.

Lowering your expectations. Can you think of a time when you really were expecting too much of the situation? The person? The environment? Or, perhaps, yourself?  Adjusting expectations can be a helpful first step in sitting in the here and now.

Asking others to help or assist you. Sometimes relief is just a question away. Trying to do everything on our own can cause us to feel isolated and overwhelmed. Learning to ask for help can lessen the discomfort. 

Taking responsibility for the situation. Said another way: "Own your stuff." This can be difficult, especially if we're used to trying to share the blame.  You may not be able to change a situation, but if you can own it, you may be able to accept responsibility until a solution comes along.

Engaging in problem solving. Sometimes, it's difficult to look for solutions when we're feeling down or hopeless.  But, breaking the "there's no way out" self-talk can provide an alternative--even in theory--to what may seem to be a dire situation.

Maintaining emotionally supportive relationships. Sometimes, it can be extremely helpful just to talk with someone--someone who knows you, listens to you and can give you what you want in a listener. Sometimes we want someone to listen and provide feedback. Other times, we simply want someone who will let us vent.  Maintaining supportive relationships can give us these outlets.

Maintaining emotional composure or, alternatively, expressing distressing emotions. I've never been a big fan of "holding it in," but there can be therapeutic benefit in not letting our emotions get the best of us. What does this mean? It can be as simple as resisting strong emotional urges: to cry, stomp, throw things, yell--or worse.  Constantly yielding to every emotional urge can lead to feelings of being out of control.  Expressing distressing emotions through discussion, journaling--even art therapy--can provide a socially acceptable outlet for our emotions that doesn't add to our distress.

Challenging previously held beliefs that are no longer adaptive. Self-talk can be central to coping with discomfort.  By listening to our internally-held beliefs and challenging their usefulness in our lives, we have the opportunity to literally change our "internal" minds, and release ourselves from beliefs that no longer serve us.

Distancing yourself from the source of distress. Sometimes "acceptance" takes the form of distance.  If a person or situation is causing emotional discomfort, putting distance between yourself and the source doesn't necessarily solve the problem, but it can make it easier to tolerate. 

Viewing the problem through a religious or spiritual perspective. Using the "filter of faith" can be helpful in relinquishing a problem.  "Giving it up to God, " or "surrendering a problem to the universe" can provide both relief and freedom from a discomforting situation that is beyond your control.

Regardless of which techniques you use, experts agree that coping is a process rather than an event.  You may find yourself using one or more coping mechanisms or alternating between them. 

If you're reading this and finding that you're quietly resisting help at every turn, you may want to ask yourself: What's in the way of my accepting an alternate way of dealing with my distress? Why don't I want to try to lessen my discomfort? 

Unless you live a charmed life devoid of stress or disappointments, you'll likely find that sitting with discomfort is a part of everyday life. If nothing else, take a few deep breaths and take mental stock of your blessings.  Gratitude can be a wonderful healer, too.  But that's a subject for another posting.

Until then, thanks for listening.

Treatment For Anxiety: First, Take Five Deep Breaths And Pick Up The Phone.

As I've mentioned previously, anxiety can present differently in different individuals.  In other words, your anxiety may look very different from a friend's anxiety--and yet, you may both be anxious.

Because anxiety can limit behavior or result in behavior that others may find unusual, when talking with your therapist you may be tempted to minimize or omit information about your behaviors or thoughts because you're embarrassed or ashamed. Even if you know and fully understand that your behavior is irrational, you may find yourself continuing that behavior, because your anxiety is so strong.

I encourage you to be candid with your therapist. Good therapists won't judge or chastise you. They'll work from a place of compassion and professionalism.

So, what methods are used to treat anxiety?

There are many effective methods used in the treatment of anxiety.  Your therapist may use one or a combination of several of these treatment methods:

Cognitive Behavioral Therapy (or CBT). Just as the name implies, this therapy focuses on thoughts (cognitions) and actions (behaviors). The goal of this work is to help you identify and challenge negative thinking patterns and irrational beliefs that may be fueling your anxiety.

Exposure Therapy. Working with your therapist, this therapy helps you confront your fears in a safe, controlled environment.  Through repeated, sometimes graduated exposures, either in real or imagined settings, you will 1.) gradually gain a greater sense of control, 2.) gain experience that negates or disproves your irrational thoughts, and 3.) help you face your fears without being harmed. All of these therapeutic experiences are designed to help diminish anxiety.

Medication. Anxiety medications, known as anxiolytics, are prescribed and monitored by a physician, preferably a psychiatrist.  Medication has been found to be most effective with behavioral therapy(CBT).

Complimentary Treatments.
In addition to traditional therapy, several complimentary treatments have been found to be effective in reducing anxiety, including:

Exercise. Called the "natural stress-buster," regular aerobic exercise three times a week for 30 minutes has been shown to provide significant anxiety relief.  Best results have been attained with one hour of aerobic exercise daily.  Of course, check with your physician before beginning any exercise regimen.

Relaxation Techniques. These include mindfulness exercises, meditation, progressive muscle relaxation, controlled breathing and visualization.  These have been found to lower anxiety and increase emotional well-being.

Biofeedback. In biofeedback, sensors attached to your body measure specific biological functions: heart rate, breathing and muscle tension.  Watching these measures in real time helps you to be aware of and learn how to control the body's anxiety responses through specific relaxation techniques.

Hypnosis. Some studies suggest this therapy to be useful in combination with CBT.

So, how long does treatment take? Results, as in any therapy, are not instant.  Because your anxiety and your symptoms are unique,  there are no cookie-cutter treatments.  What does help is a cooperative therapeutic relationship with your therapist. Together, you and your therapist can formulate your treatment plan, monitor the results, and make adjustments in your treatment as needed. While there are no guarantees, some research indicates that some successful treatment methods show improvement within 8-10 sessions.

One thing is certain: your therapist's work with you is designed to lower anxiety, not add to it.  If you're suffering from anxiety, making that first call to begin therapy can be difficult--but not impossible. So, take five deep, slow breaths and--when you're ready--pick up the phone.

Thanks for listening.

Anxiety: Am I Having A Normal Reaction To Stress...Or Something More?

Anxiety. The very word makes some people, well...anxious. In fact, there are varying degrees of anxiety that we all experience at some points in our lives.  "Normal" anxiety is a reaction to everyday stress. Ranging from "concern" about an issue, to "worry," normal anxiety can be beneficial in our daily lives. Anxiety can help us focus on a task at hand or meet deadlines that may be attached to consequences.  Under normal circumstances, anxiety disappears when the stressful situation resolves itself (after the presentation is over, the test is finished, the in-laws leave).

My anxiety doesn't feel "normal." Could I have anxiety disorder? 
When your anxiety about ordinary things (such as leaving the house or riding an elevator) disrupts the general quality of your life or work, or causes avoidant behavior that limits or diminishes your life experiences, an anxiety disorder may be present. A few things to look for include:

*Are you constantly worried, tense or on edge?
*Does your anxiety interfere with family, work or school responsibilities?
*Are you plagued by fears that you know are irrational but just can't shake?
*Do you believe that something bad will happen if certain things aren't done in a certain way?
*Do you avoid everyday situations or activities because they make you anxious?
*Do you experience sudden, unexpected attacks of heart-pounding panic?
*Do you feel like danger and catastrophe are around every corner?

Keep in mind that anxiety disorders are a group of related conditions that may look very different from person to person.  And, just because you're experiencing symptoms listed above doesn't necessarily mean you have an anxiety disorder.  If, however, symptoms persist and cause you concern, you may want to consult both your doctor and a mental health professional.

Why should I consult my doctor?
Anxiety can be caused by certain general medical conditions including difficulties with the thyroid, asthma, and hypoglycemia, among others. A physician is trained to diagnose and treat these conditions; treatment may help reduce or eliminate your anxiety if it is caused by a medical condition.
If you feel persistently anxious, a medical check-up may be in order.

Anxiety can also be attributed to reactions to prescription medications, as well as reactions to over-the-counter remedies and supplements.  Be sure to tell your physician about all remedies you are taking.

Also, it's important to remember that anxiety can accompany substance abuse. Questions to ask yourself include: What substances am I putting in my body? Am I using any unregulated (street) drugs that are not prescribed by my physician? Am I taking anyone else's prescription medication?  Am I taking more (or less) of my prescription medications than stated on the label directions? Am I medicating with alcohol or marijuana--and, how do I feel when these substances "wear off?"

After consulting your doctor, if he/she rules out a medical condition and/or substance abuse, then you may want to see a mental health professional.

Next time: Treatment options for anxiety.

As always, thanks for listening.

The Zen of Listening For Understanding or, "When Walking, Walk. When Eating, Eat."

When I Google "effective listening," over 5 million results pop up. Clearly, listening is on the minds of alot of us these days. Currently, there are over 35 research studies that indicate that listening is a top skill needed for success in business.  I might add, it's a skill that enhances a great many relationships, too.

It's estimated that 70% of our time communicating is dedicated to listening.  And yet, some studies show that we may be listening at only a 25% comprehension rate. That can be a discomforting statistic, considering that 85 % of what we learn is through listening.

When it comes to working with couples, "good listener" is on the wish list of most every couple. We want our significant other to hear us.  And, yet, unless we're listening to understand, chances are we're not going to be effective listeners; and it's unlikely our partner will feel heard.

How Do You Listen?

Have you ever met that rare human being who seems to hang on your every word? We leave a conversation with them feeling like we were the only person in the room when we spoke with them.  We feel heard, listened to, valued and...well, important.  And we usually look forward to speaking with them again.

It's likely that these gifted folks are listening to understand.  They have a genuine interest in knowing and understanding what we have to say.  They don't have an agenda. They simply listen. If they ask questions, it's usually just to have us clarify a point.

Here are a few ways we all listen at times.  While these may serve us in some venues, they rarely are effective when trying to improve communication with our loved ones.

Listening to teach.  When we listen to teach, it's likely that our minds are on our response while the speaker is talking. We're taking in some of what we're hearing, but formulating our rebuttal at the same time. We often can't wait for the speaker to finish so we can set him or her straight.  But, when we do interrupt, the message we're sending is I really don't value what you're saying--what I have to say is more worthwhile.  And, preparing your answer while the other person is talking keeps you from hearing everything the speaker is saying.

Listening to compete.  Sometimes we treat a conversation as a way to score points.  However, while we're formulating our strategy to "win" the conversation, we lose our ability to hear the other person completely, which can keep us from fully understanding and seeing things from a different point of view.

Listening to impress. When we listen to impress, we impair our listening by planning our next dazzling comment or brilliant challenge--instead of paying attention to the speaker.  In essence, what we're planning to say becomes more important than what's being said. And most of the time, the speaker will feel our inattention.

Listening to correct. When we listen this way we are, essentially, waiting to be provoked. We're on guard for inflammatory words, phrases and topics that can send us to our self-righteous place that requires defending.  It's no wonder that the speaker feels "pounced" upon, because we've been waiting for just that opportunity.

And finally....

Listening to blame.  Blame differs from correction because the goal isn't just to find fault--it's to shift responsibility back to the listener.  This is listening to deflect. We become "Teflon," allowing nothing to stick to ourselves. And we're so hypervigilent in our defense of self that listening becomes a secondary task.

Because we listen at about 125-150 words per minute but think at 1,000-3,000 words per minute, we have excess capacity to think about what others are saying while they speak.  The best listeners use this capacity to gain clearer understanding of the speaker, not to strategize ways to teach, compete, impress, correct or blame. 

When we listen with any ulterior motive, we're using that spare capacity to prepare our next move in the conversation. And listening suffers.

The Zen part? An old Zen proverb says, "When walking, walk, When eating, eat."

When listening, listen.  It's one of the greatest gifts you can give your colleagues, friends and loved ones.  Sometimes, it's all they need.

As always, thank you for listening.

How Do I Know It's Time To Get Help or, Is This Normal Or...Something Else?

Often, after we've worked together awhile, my clients will confide, "You know, I almost didn't come in that first time.  I was second-guessing myself asking, Why can't you just suck it up and handle this on your own?"  When I ask what tipped the balance in favor of therapy, the answers, in retrospect, range from "I was out of control," to "It was too scary to do this on my own," to "I'd tried everything and nothing was working."

Virtually everyone referred to the one commonality that separates the everyday from the debilitating: severe, prolonged distress.  In almost every case, clients reported that the distress had become too much, for too long, affecting one or more important areas of their lives: relationships, work, health, finances, and legal difficulty. What becomes evident over time is that intense and prolonged distress cannot only cause somatic (in the body) difficulties, but also significant impairment in carrying out the activities of daily living.

So, the symptoms. How do I know this just isn't a rough patch, like everybody goes through from time to time?

Most people don't seek therapy at the first sign of that "rough patch." In fact, I believe that, as a species, most human a beings are remarkably resilient. We tend to endure hardship and bounce back, often many times in a lifetime.  

When you begin to feel like you're not bouncing back and decide to seek clinical help, your clinician (psychiatrist, psychologist, licensed marriage and family therapist, social worker, etc.) is likely to rely on a 900-page publication called the Diagnostic And Statistical Manual of Mental Disorders (DSM-IV) to guide his/her assessment and diagnosis of your condition.  Published by the American Psychiatric Association with contributions from some 1,000 mental health professionals, this manual categorizes, defines and provides specific guidelines for diagnosis. 

While everyone is unique and not everyone experiences mental distress in precisely the same ways, there are two criteria which, in general, surface in the diagnoses, which help clinicians discern what's going on with their clients: intensity and duration of distress.

Intensity or depth of distress refers to "How bad is it?" For example, if you're concerned about depression,  your therapist will likely start out asking you questions about your daily routine. Are you able to get out of bed in the morning? Can you make it to work, or are you missing lots of days? Are you sleeping? How much  or how little? Are you isolating from people you love? What's the degree of isolation?  (Remember from above: relationships, work, health, finances, and legal difficulty?)

For anxiety, a similar discussion might go along the lines of: How does your anxiety show up in your body (what does it feel like)? How is it affecting your relationships? Does it limit your enjoyment of your life (have you stopped doing things your might otherwise enjoy) ? Is it affecting your work or your ability to go to work? Has your anxiety led you to do things that have gotten you into legal or financial trouble?  

Duration simply means "How long has this been going on?"  Many of life's disappointments, difficulties and setbacks resolve themselves in a reasonable amount of time.  But, when your distress has been interfering with your life, work, relationships or daily functioning for longer than the norm (as outlined in the DSM-IV, referenced above), you may benefit from therapeutic intervention.

A few things to pay attention to when considering whether to seek therapy. 

Pay attention to how you feel. If you're not "yourself" for an extended period of time or if you have intrusive thoughts that are disturbing to you, you may need to talk with someone.  If you're having persistent thoughts of hurting yourself or someone else, I would recommend talking with a professional right away. Most communities have crisis or suicide hotlines that can provide immediate help, often round the clock. Remember, you won't be shamed--just helped.

Pay attention to your routine. Are you sleeping more or less than usual? Has your appetite changed? How about school or work attendance?  Are you engaging in unusually risky behaviors or behaviors that  are a bit bizarre for you?

Pay attention to your relationships. Are your relationships at home or work deteriorating or becoming progressively more difficult, with no end in sight?

Pay attention to your body. Are you experiencing new, chronic pains or aches? Stomach or digestive difficulties? First thing, consult your physician to rule out any organic difficulties. If he/she finds nothing organically wrong, your next step might be to consult about your mental health.

Pay attention to your moods. Do your moods swing from euphoric to profoundly sad? Are you more angry now, more often and with more intense behaviors? Are you more sad, worried, easily frustrated, disinterested, confused than usual?  

And finally, pay attention to feedback from those you usually trust. Have friends or loved ones expressed concern about your behaviors, moods, or thoughts? Are you hearing the same concerns from several sources? 

Despite our resiliency, intelligence, and support from others, sometimes it doesn't feel like "toughing it out" is productive or even possible.  If your distress has become so intense that it's affecting many areas of your life, and it's been going on longer than you're used to, you may want to talk with someone. Someone trained to help you determine if this distress you're going through is "normal"--or something else.

Thanks for listening.