Freedom from the Destructive Pattern of People-Pleasing

Freedom from the Destructive Pattern of People-Pleasing

Those of us who have lived through relational trauma typically have a challenging time setting healthy boundaries for ourselves. We’re either too rigid or too flexible.

 

In my work with clients, I hear a lot of things like, “I do so much for her. She would never do for me what I’ve done for her.” Or “Why am I always the one bending over backward for everyone?” And “Everything is always up to me. Why doesn’t anyone offer to help me get things done or make decisions?”

 

We do a lot. We do for others, hold things down at work and home, support our loved ones, and take care of our responsibilities. We’re in weddings. We go to baby showers and birthday parties. We make sure gifts have been wrapped, and cards have been sent.

 

We also have days when we can’t seem to pull ourselves out of bed to make into work on time. Laundry piles up. Our budgets are neglected. It takes us forever to get out the door because we’re slogging through a million things and can’t seem to cross the threshold to the outside world.

 

A lot of us feel overburdened and underappreciated at work, at home, or in our relationships. Sometimes this is because we’re tired and vulnerable. Sometimes it’s because we’re doing too much. And some of us chronically do too much, give too much.

 

We say yes too often, take on too many responsibilities, do too many favors, caretake, and neglect our own needs. We give gifts, make trips, invest ourselves in finding solutions to problems, accommodate, and excuse behavior. None of these behaviors are inherently problematic, but too much too often and with the wrong intention makes us feel imbalanced and resentful.

 

If I’m constantly trying to find ways to accommodate coworkers, clients, friends, and family members, anticipate peoples’ needs, and please everyone all the time, I’m probably going to find myself wondering when people are going to offer me the same in return. I’ll be waiting a long time, though.

 

That’s kind of how this works.

 

In psychotherapy, we look at schemas. A schema is a framework for how we live and relate. It’s information we’ve accumulated from life and stored in our brains and bodies. That information helps our brain decide what it believes, how we should respond to our beliefs. It helps us have expectations. To our human brain, assumption equals truth. It’s an “If this, then that,” process. Most of our schemas were programmed during childhood.

 

Those of us who habitually over-accommodate and people-please often have schemas that tell us something like, “I have to overextend to get love. I am not ok as I am.” We believe that we’ll lose relationships if we don’t constantly give to and please others. And we usually bring this attitude to work, our relationships, and our homes. At that rate, we’ll feel resentful and exhausted in no time flat.

 

We do these things because we believe we have to, not because we want to. Sometimes it’s mixed; we enjoy seeing the look on someone’s face when we do something nice for them but we also need to do something that elicits that response for us to feel good about ourselves, loved, and worthy. It’s a lot like getting a fix.

 

Once we find out what we’re doing, why we’re doing it, and that it doesn’t work for us, we feel kind of trapped. The whole point is to keep overdoing it so that we’ll feel lovable and worthy. The compulsion is to keep doing more and more and more. How could we ever imagine pulling back and doing less for others?

 

It’s not an easy transition to make. Like any new habit, it feels awkward and uncomfortable at first. What’s worse is that it comes with flawed logic that, for so long, has felt like truth. Chances are, we don’t know why we feel this way. We probably don’t, “I do too much. I give too much of myself in order to keep my relationships and feel loved.” We probably think, “I do what I’ve always done.”

 

Some of us have moved hundreds or thousands of miles away from our triggers only to find that they have followed us, a sort of “the call is coming from inside the house” situation.

 

We find ourselves in similar situations and relationships to the ones we left. The scenery has changed, but the narrative is the same.

 

We’re bending over backward for people and not considering our needs. We feel underappreciated and taken for granted. We store our resentments, and they leak out in other ways.

 

And whether we’re aware of it or not, we’ve defined ourselves by our people-pleasing behaviors. It’s been our way of relating to our world for a long time. Mourning the loss of this identity will come with its own process.

 

So, what do we do?

 

First, we should approach our transition out of over-accommodating and into healthy boundaries slowly and deliberately. When faced with an urge to caretake or accommodate, we can ask ourselves, “Who is this for?” It will feel a little clunky at first. The question is a great start because it reminds us that we have choices in our interactions.

 

Our first answers to this questions will probably be something like, “It’s for them! They need something, and I can make it happen.” We might think, “It’s for me. I love to help people.” While these statements might be true, beneath the surface lies a whole world of expectation- that the person will do the same thing for us, that they’ll love us more, that they’ll see how irreplaceable we are, that we’re special.

 

We can also ask ourselves, “What do I want from this interaction? What am I expecting from the other person?” Running through this a few times is a great exercise in self-awareness and mindfulness. It also teaches us to consider ourselves, an act of self-care.

 

We can follow up with running through a previous scenario with the same person. “How often have they met my expectations before this situation? Am I expecting a brand new behavior from them because I want it or because they’ve taken legitimate steps toward that behavior?”          

 

Be prepared to be uncomfortable. When we’re used to getting our self-worth from acts of service, performing fewer of those acts will be anxiety-producing. (And somehow, simultaneously, a relief.) Reconditioning ourselves is slow-going and scary.

 

If we’ve found ourselves saying, “This person would never do for me what I’ve done for them,” there is probably wisdom in that. And more than meets the eye. If someone wouldn’t do for us what we’ve done for them, why not? Do they value their time more than we value ours? Are they selfish? Are they better at prioritizing where they give their favors? Could we learn from their boundaries?

 

If we consistently find ourselves in relationships where we’re giving more than the other person, we need to look at a) who we’re forging relationships with and b) our beliefs and patterns of behavior in relationship.  

 

 

When we’re caught in a pattern of people-pleasing, the language of over-accommodating spins both ways. We believe that we have to do more than we can do to be lovable and maintain the relationship. We also believe that others should over-accommodate us if they really love us. If they don’t, it means they don’t love us or that we’re not as important to them as they are to us. This is pretty hard to live up to (especially if the other person isn’t aware of the rules).

 

If people-pleasing is our love language, we’re going to have no trouble finding people who would love for us to please them. We will have trouble finding people who will put up healthy boundaries for us.

 

If you want to talk about your struggle with people-pleasing and are curious about how you can establish healthy boundaries for yourself, I’d love to talk with you!

 

Love and Be Loved,
Natalie

 

Natalie Mills San Francisco Psychotherapy and Coaching, San Francisco Counseling, San Francisco Therapy, San Francisco CA Therapists, San Francisco CA Therapist, San Francisco CA Couples Counseling, couples therapy san francisco ca, couples therapist san francisco ca, San Francisco Marriage Therapy, San Francisco Marriage Counseling, San Francisco Coaching, EMDR therapists in San Francisco, EMDR therapist in san Francisco ca, EMDR therapy in San Francisco CA, psychologist in san francisco, female psychotherapist san francisco, female therapist san francisco ca, psychotherapist in san francisco, marriage and family therapist in san francisco, relationship therapy in san francisco, help with intimacy therapy san francisco, help with intimacy San Francisco, help for depression in san francisco, depression treatment san francisco, anxiety treatment san Francisco, help for anxiety san francisco, anxiety treatment san francisco, addiction treatment San Francisco, alcoholism treatment san francisco ca, substance abuse treatment san francisco, eating disorder treatment san francisco, anorexia therapy san francisco, bulimia therapy san francisco, binge eating disorder therapy san francisco, EMDR, Eye Movement Desensitization and Reprocessing, self-compassion therapy san francisco, eating disorder therapist in San Francisco ca, eating disorder specialist san francisco, couples therapy san francisco, couples therapist San Francisco, eating disorder recovery san francisco, eating disorder therapy san francisco, treatment for anorexia san francisco ca, treatment for bulimia san francisco ca, treatment for binge eating disorder san francisco ca, addiction treatment san francisco ca, treatment for substance abuse san francisco, eating disorder treatment San Francisco, mental health san francisco, mental health therapist san francisco, mental health professional san francisco, healing from shame san francisco, trauma recovery san Francisco therapy ca, trauma treatment san francisco ca, mental health support in san francisco, treatment for shame san francisco, sexual abuse specialist san francisco ca, treatment for sexual abuse san francisco therapy, trauma treatment San Francisco, PTSD therapist in San Francisco ca, therapy for PTSD in San Francisco ca, trauma specialist san francisco, PTSD specialist san francisco, treatment for obsessive compulsive disorder san francisco ca, anger management therapy san francisco, stress management therapy san francisco, help with communication san francisco, attachment-based therapy san francisco, attachment-based therapist san francisco, sex therapy san francisco, sex therapist san francisco, sexuality specialist therapy san francisco, treatment for sexual abuse san francisco, psychospiritual therapy san francisco ca, grief therapy san francisco ca, feminist therapy san francisco, marriage counseling san francisco, attachment-focused therapy san francisco, internal family systems therapy san francisco, internal family systems therapist in san francisco, choosing a therapist in san francisco, choosing the right therapist in san francisco, how to choose a therapist san francisco, find a therapist in san francisco, female therapist in san francisco, finding the right therapist san francisco, ethical non-monogamy affirming therapist in san francisco ca, ethical nonmonogamy affirming therapist in san francisco ca, polyamory affirming therapist san francisco ca, treatment for sexual abuse san francisco, treatment for sexual assault san francisco, treatment for sexual bullying san francisco, support for sexual bullying san francisco, trauma specialist san francisco ca, attachment trauma treatment san francisco ca, relational trauma treatment san francisco ca, treatment for codependency san francisco ca, codependency therapy san francisco ca, relationship therapy san francisco ca, relationship therapist san francisco ca

I am a licensed mental health professional serving Portland, OR. 97205.

Trusting Yourself in Times of Failure

Trusting Yourself in Times of Failure

So many of us gravitate toward challenging ourselves and our status quo- The Whole 30, New Year’s resolutions, 100 pictures in 100 days, Couch to 5K, creative writing competitions, training for a race. I love getting to see people who want to better themselves preparing to accomplish a new thing or hit a new goal. There’s something inspiring about being around other people who are plotting their next achievement.

 

A pretty major defining part of a challenge is that it’s hard. We are confronted by parts of ourselves that don’t think we can finish or maintain, parts of ourselves that are afraid of being uncomfortable. We get overwhelmed or don’t see results as fast as we want them, or we lose steam or skip a day/week/month, and we give up and forget about our goals.

 

This is why we’re encouraged to participate in group challenges and tell other people about our goals. We need each other for support, to hold one another accountable, especially when the going gets tough.

 

And even then it’s still so easy to slip out of the new routine we’ve created. Little by little or all at once, we find ourselves letting go of progress. We feel defeated, and we berate ourselves for failing to accomplish another goal. We make excuses. Sometimes we punish ourselves. Sometimes we let ourselves off the hook.

 

But we have another option. There’s another opportunity available to us that doesn’t involve making excuses or punishing ourselves or letting ourselves off the hook. We can begin again.

 

Sometimes we’ll need to reassess so that we can begin again. It will be hard for us to keep up with the goals we’ve set for ourselves if they’re too advanced for our current skill set or if we’re not listening to ourselves. When we embark on a challenge, we’ll be more successful if we are honest with ourselves and start where we are, not where we wish we were. It’s critical that we listen to ourselves and go back to the drawing board if something isn’t working for us.

 

Beginning again is an essential ingredient to meeting a challenge. There will, of course, be days where we don’t feel like going for the run, eating the clean meal, sitting down to meditate, going to our wellness appointment, reading the articles, writing the articles. There will be days where we do feel like it, but something prevents us from sticking to the plan. We will have to begin again.

 

There will be times when we are in the middle of a run or a mediation or a meal or a plan and know that we’re phoning it in or not fully present. There will be moments when our commitment falters. This is an expected and built-in part of any challenge. We’re allowed to struggle and we will. We can accept it and begin again. (Some days, I begin again 25 times during a run. I’ve begun again countless times during meditations.)

 

We can practice a “begin again” mindset with any challenge, including the daily challenges of life and being a person. We can apply it to driving when we discover our feathers have been ruffled by our fellow road warriors. We can begin again when we’re in the middle of a disagreement with someone, and we don’t like how we’re acting. We can begin again at work.

 

We can make it as momentous or pedestrian as we want. We don’t have to go anywhere or close our eyes or have a special ritual. It can be as simple as taking a breath and beginning again.

 

Beginning again marks its own challenge. Play around with it and see what works for you. Be curious about when it seems to be easier and when it’s harder.

 

Love and Be Loved,
Natalie

 

 

I am a licensed mental health professional serving Portland, OR. 97205.

“It’s Chaos. Be Kind.”

“It’s Chaos. Be Kind.”

“You think your pain and your heartbreak are unprecedented in the history of the world, but then you read. It was books that taught me that the things that tormented me most were the very things that connected me with all the people who were alive, who had ever been alive.”

-James Baldwin

 

 

Not often enough is each of us asked, “What’s it like moving through the world as you?” We are not often asked about our fears and insecurities, hopes, frustrations, and about what makes us feel alive. We are not often asked about what we’re thinking, what we’re wondering about, or if we’re worried.

 

Some of us experience racism and homophobia. Some of us experience ableism or transphobia or sexism or classism or ageism.

 

Some of us suffer from depression, crippling anxiety, post-traumatic stress symptoms, chronic pain, or addiction. Some of us are navigating the complicated mourning process and feeling what can only be described as unyielding fragility. Some of us are numb.

 

All of us are grappling with something- marital problems, financial instability, a terminally ill child, a best friend dead from aggressive cancer, panic about the future, historical or intergenerational trauma, chronic mental or physical illness, a break-up, discrimination, sexual harassment, the aging process, our own inexorable thoughts.

 

I get the pleasure and honor of creating a space for people to sit down and tell me about what it’s like for them as they move through the world. I get to see couples learn, for the first time, in a deeper way what it’s like for their partners to be them. I have made a career out of witnessing what happens when people speak honestly and listen compassionately.

 

Not everyone has the privilege of making this their daily life, and I’d like to help make it as accessible as possible. It’s the act of intelligently tuning into our own experience and seeing what’s there. It’s the act of deepening our understanding of ourselves and another.

 

When we become attuned to and present with our pain, we can tune into and be present with another’s pain. The reverse is also true, that when we are present with and attuned to another’s pain we can also be present with our own. We are complex creatures, capable of many things, some being empathy and compassion.

 

When we open space for ourselves to be present and attuned, it’s easier to listen to what is really being said. It’s easier to see someone for who they are instead of our projection of them.

 

We can’t do this all the time, but we can do it more often. We can slow down and drop in.

 

A client recently recommended I watch Patton Oswalt’s “Annihilation” performance. In it, he talks about his late wife, writer Michelle McNamara, and her belief system. He quotes her as saying, “It’s chaos. Be kind.”

 

There is chaos. And there is kindness.

 

I wonder, what’s it like moving through the world as you?

 

Love and Be Loved,
Natalie

 

I am a licensed mental health professional serving Portland, OR. 97205.

As It Turns Out, Time Doesn’t Heal All Wounds.

As It Turns Out, Time Doesn’t Heal All Wounds.

Have you ever noticed that one guy at work, the one who you’ve never liked, but couldn’t put your finger on why? Or the neighbor who, for some reason, when she smiles at you, you feel irritated? Or why you can’t stand the smell of a certain laundry detergent? Or why, even though you’re accomplished in your field, you feel like an idiot before you give a presentation?

We all have an information processing system hardwired into our brains. This processing system has evolved to help us integrate emotional turmoil into our mental health and is essential for healing. This system helps us to let go of what is not useful information and make connections to what is useful about an experience so that we can adapt, grow, learn, and face similar situations more intelligently.

Here is an example:

You have a stressful interaction with your mother-in-law while she is visiting for a holiday. You feel angry, disappointed, and resentful. Your chest is tight, and your stomach is in knots. You think negative thoughts about her (“She’s always such a cold, demanding jerk.”) and about yourself (“What is wrong with me that after so many years, I can’t seem to avoid these situations with her? Is it me?”)

You keep mulling over what happened, talk about it with friends, maybe even have a stress dream about it that night. The next day, you still feel a bothered by it but not nearly as much. You’re able to think more clearly about it and understand that you two interpret things differently and that there are ways that you can skillfully manage this. This is your brain’s information processing system at work. It’s transformed this disturbing situation into a learning experience. (You can also thank your REM sleep phase for this since this is the time during which wishes, learning/lessons, survival/stress experiences are processed through the action of “synaptic pruning.”

Because of this uninterrupted time to process, your brain was able to associate the memory of the interaction with your mother-in-law and useful information already stored in your brain (from other stressful interactions with her and others) to create resolution. You remember what happened, what worked, what didn’t, and that it isn’t personal, that this is just the way she is and that you have useful tools for interacting with her. The intense emotional reaction you felt the day before is gone.

Unfortunately, our brains do not adaptively store all of our experiences in this way. Sometimes we encounter traumatic experiences or otherwise stressful experiences that overwhelm our brain’s capacity to process and adaptively store information received during these experiences. This is often referred to as “going off-line.” It’s kind of like short-circuiting.

When we encounter extreme stress, the emotional and physical reactions we experience during the event keep the brain from identifying useful information about the situation; there is no resolve. What happens instead is that the event and its information is maladaptively stored. This means that the event and its components are stored in the brain and body as it happened. Everything you saw, heard, felt (physically and emotionally), tasted, smelled, thought remain in their original, unprocessed form.

You do your best to move through it, but whenever any of these senses are triggered, your emotional disturbance level sky-rockets and you have a reaction. Many times, multiple unprocessed events are linked to one another in such a way that if one is triggered, all are triggered. These events, while often linked to one another, are stored in isolation so that they are not linked to anything adaptive.

No amount of time will help them to integrate. It’s as though these events are frozen in time. An event could have happened 40 years ago, but when triggered it’s as though it is still happening or just happened.

Our personalities, coping skills, perspectives, and beliefs about ourselves and others can develop through the lens of these unprocessed events and impact our emotional and physical capabilities.

Research shows that it’s not just clearly identifiable traumatic events that are responsible for this outcome, but any event or pattern that our brain experienced as overwhelming.

It could be the way someone spoke to you as a child, your interpretation of someone’s behavior you witnessed at three years old or making a mistake during an academic oral exam in second grade. We don’t always know how our brains will store an event.

The good news is that we’re not stuck here. There are therapeutic tools that can help us to free ourselves from the suffering of an unconscious cycle or unprocessed event. One of the most efficacious and reliable tools is EMDR (Eye Movement Desensitization and Reprocessing) Therapy. This therapy helps us to safely contact the disturbing event or maladaptive cycle and process it, giving us a new understanding of the situation so that we can use its information intelligently.

If you would like to know more about EMDR Therapy, please call or email me. I would love to talk with you more about this process and see if it’s right for you. If you’re not quite ready to reach out yet, that’s ok, too. You can find more information on EMDR Therapy here and here.

 

Love and Be Loved,
Natalie

Why Are Relationships So Hard?

Why Are Relationships So Hard?

What We Want:

We all long for fulfilling, stable, and safe connections to others. We want to be understood and hope for people to experience us as we experience ourselves. We long for someone who will take care of us and reassure us that everything will be ok. We want to feel held and contained. We want our rage and defiance to be tolerated. We want to feel that someone understands our experiences of the world and we want those our feelings about those experiences to either be validated or soothed.

Why That’s Challenging:

We will often be misunderstood by and misunderstand others.

We don’t always know how to tolerate someone else’s rage and defiance. Some of us were taught that rage and defiance are intolerable and unacceptable. We were taught that in order to be lovable we had to be “good” which meant being pleasing and accommodating.

We all have some degree of self-idealization, over-inflation of certain qualities and that is often in conflict with a) others’ self-idealization and b) others’ self-concepts. It gets in the way. I might think of myself as a smart, fantastic listener and you might consider yourself a smart, effective communicator. If we come across a misunderstanding or a fair amount of tension during an encounter in our relationship, depending on how psychologically flexible we are, both of us might jump to the conclusion that the other is not as smart as they think they are or not a great listener/communicator.

We are a complex constellation of inner experiences and reduced to words as a means of communication.

Some of us have been deeply hurt by intimacy. Some of us respond to this wound by avoiding intimacy. Others respond by developing a preoccupation with it. Depending on the experiences endured in childhood, we might view safety as either boring, untrustworthy, or elusive. (And plenty of people would say that safety is downright illusory.)

A lot of us don’t know how to manage our own difficult emotions, let alone tolerate high emotionality in others.

What We Can Do:

 We can begin by learning to accept that we are never going to be completely understood by nor completely understand others. Having some understanding can be enough.

At any moment, we can slow down and label what is happening to give us space from the immediate interpretations calculated by our brains.

We can look at our expectations.

We can start to be more curious about which narratives we’re living by that aren’t serving us.

We can remind ourselves that, at the core, what we want from others is often what they want from us and that we might define this differently.

We can learn to balance between our attunement to others’ needs and our own.

Listening is an ineffably effective tool. When we’re willing to listen to ourselves and others we create an open, stable environment. Listening allows us to contact an experience on a deeper level and then make choices that are more in alignment with what is needed.

As always, none of this exhaustive but it’s off to a good start. Happy relating!

 

Love and Be Loved,
Natalie

6 Steps to Trusting Yourself

6 Steps to Trusting Yourself

“The suffering itself is not so bad; it’s the resentment against suffering that is the real pain.”
-Allen Ginsberg

 

When I first started my own work with mindfulness and radical acceptance, I found myself saying, “I’ll accept this feeling/ this symptom so that I don’t have to have it anymore.” That’s… not really acceptance but it was the best I could do at the time. Since working with clients around mindfulness and radical acceptance, I have heard this sentiment hundreds of times. It’s hard to get behind the idea that accepting our pain or feelings or aversive experiences has therapeutic value, that it could ever help us to make positive changes. Acceptance and Commitment Therapy is driven by just this, accepting the hard-to-accept.

 

Acceptance and Commitment Therapy was created by Steven Hayes in the early 1980s and tested by Robert Zettle in the mid-1980s. It is a form of Cognitive Behavioral Therapy (CBT) and is based on Skinner’s Radical Behaviorism. Acceptance and Commitment Therapy’s (ACT) main objective is to help participants turn toward their feelings and symptoms instead of resisting them. The protocol helps participants learn how not to overreact nor underreact nor altogether avoid the associations with these feelings and symptoms. With ACT, we learn to accept ourselves and the experience we are having in the present moment so that we can commit to a behavior aligned with our values.

 

ACT succinctly describes the change in psychological flexibility in this way:

 

We go from F.E.A.R.

 

F- fusion with our thoughts

E- evaluation of our experience

A- avoidance of our experience

R- reason-giving for our behavior

 

To A.C.T.

 

A-accept our reactions and be present

C- choose a valued direction

T- take action

 

In the book, Acceptance and Commitment Therapy: The Process and Practice of Mindful Change by Hayes, Strosahi, and Wilson, we’re given the six core principles to help us develop psychological flexibility:

  1. Cognitive de-fusion: Learning methods to reduce the tendency to reifythoughts, images, emotions, and memories.
  2. Acceptance: Allowing thoughts to come and go without struggling with them.
  3. Contact with the present moment: Awareness of the here and now, experienced with openness, interest, and receptiveness.
  4. Observing the self: Accessing a transcendent sense of self, a continuity of consciousness which is unchanging.
  5. Values: Discovering what is most important to oneself.
  6. Committed action: Setting goals according to values and carrying them out responsibly.

 

ACT emphasizes mindfulness because presence of mind/contact with the present is the only way to change behavior. Now is the only time that we can truly choose a behavior. We habituate to looking at the world in a certain way which makes us miss important external and internal cues to help us determine what is happening in the present moment by thinking about the past or the future. Awareness of the present moment helps us to differentiate between what we are afraid is happening and what is actually happening. It helps us to describe what is happening and then make choices in response. Jon Kabat-Zinn describes mindfulness as “paying attention in a particular way, on purpose, in the present moment, and nonjudgmentally.”

 

The “acceptance” part of ACT is problematic for some. “So then, if I’m supposed to accept my feelings and my experience, does that mean I’m supposed to accept abuse and maltreatment?” The answer to that will always be no. When we accept our feelings and experience, it means we accept the information that we are receiving and can make choices based on that information. It means that we accept that this is how it is right, not that this is how it should continue to be.

 

When we practice acceptance of what’s happening we can mindfully make choices that are in alignment with our values. I like to use this phrasing in my own life and when working with clients: “I’m going to keep choosing the same behavior of ______ because I care about______.” Or “I’m going to change my behavior to ______ because I care about ________.” So, someone might say “I am going to keep choosing the same behavior of confronting people when they treat me with disrespect because I care about my feelings and how I’m treated.” Or “I’m going to change my behavior to respectfully disengaging from an argument when it no longer feels productive because I care about my feelings and this relationship and I know that continuing in unproductive conversation usually leads to hurt feelings and resentment.”

 

Sometimes the choice is hard to make. For instance, “I choose to go to bed earlier so that I can wake up feeling more refreshed” is a great behavior goal. But what if it means sacrificing quality time spent with loved ones? This is where present moment focus and acceptance of your experience comes in handy. You might prefer to spend the time with your loved ones and wake up feeling a little more sluggish.

 

I know it’s hard to identify choices so let’s do it together. If you want to talk more about Acceptance and Commitment Therapy, changing behaviors, or anything else, please call or email me.

 

Love and Be Loved,
Natalie

How Do I Know If I Need Therapy?

How Do I Know If I Need Therapy?

“So about how long should it take until I feel better?” “How long do you think I’ll need therapy?” “How many sessions should I expect to attend before my problem is solved?” I have asked all of these questions during time spent on the other side of the couch. I know what it’s like to want concrete answers and expectations met. Everyone wants a sure thing in the face of so much uncertainty.

Therapy is not exactly a sure thing. Surely, it can and does help, but it’s not as simple as basic input of time and results yielded. Results depend on client honesty (with themselves and the therapist), right fit with a therapist, client’s commitment to the work both in and out of the therapy office, and right fit with whatever therapeutic modality is used.

Therapy is almost never a quick fix, but there are quicker-fix type/brief therapeutic modalities available. Whether or not these protocols are right for someone depends on a lot- personality, history, diagnosis, whether or not a person has experienced complex trauma. Even in the best of scenarios, it still requires the practice of skills through time to maintain results.

Under the psychotherapy umbrella, there are five really (really) broad categories we use to organize treatment strategies:

Psychoanalysis and Psychodynamic Therapy:

Makes the unconscious conscious, insight oriented. Emphasis on client-therapist relationship. Brief therapy model (20 session maximum) is not the rule, but is available for single-incident trauma like an attack, rape, catastrophic event, targeting a single life shift.

Examples of Psychodynamic Therapy: Jungian, Dream Work, Attachment-based

Often used for: Increasing self-compassion, improving self-concept, self-actualization, mood disorders, relational problems, trauma, developing insight to identify and manage internal conflict, shifting external locus of control to internal locus of control, couples, families,

*Psychoanalysis: Multiple times per week. The therapist is a blank slate onto which client projects their beliefs and experiences. Relies heavily on free association.

 

Behavior Therapy:

Focuses on conditioning new behavior. Uses brief therapy model.

Examples: Applied Behavioral Analysis, Aversion Therapy, System Desensitization

Often used for: Phobias, Addiction, Anger issues, Impulse control problems, self-injury

 

Cognitive Therapy:

Focuses on changing thought pattern. Uses brief therapy model.

Examples: Rational Emotive Behavioral Therapy, Cognitive Behavioral Therapy

Often used for: Phobias, Addiction, Schizophrenia, Bipolar Disorder, Suicidal ideation, Anxiety disorders

 

Humanistic Therapy:

Focuses on cultivating personal accountability and reaching highest potential. Emphasis on free will. Uses both brief and long-term therapy models.  

Examples: Gestalt, Client-Centered, Transpersonal, Solution-Focused, Adlerian  

Often used for: Improving self-concept, self-actualization, improving communication with others, cultivating self-awareness, shifting external locus of control to internal locus of control, couples, families, existential crises  

 

Integrative or Holistic Therapy:

Often referred to as “Eclectic Therapy.” (Some practitioners will basically fight to the death in disagreement over whether or not Integrative is also Eclectic.) Uses various modalities depending on what is indicated for each client. One therapeutic modality combines various features of the previous four categories. Uses both brief and long-term therapy models.  

Examples: EMDR, Narrative, Cognitive Behavioral, Dialectical Behavior, Internal Family Systems, Gottman Method, Transactional Analysis

Often used for: All of the above

 

Some people prefer to see the same therapist for various issues they’d like to target while others seek out a different specialist to treat each issue. There’s no right way to do this, just whatever feels like it’s working for the client. Some clients come with an agenda and leave when their goals have been reached. Some stay for a while after because they like having a professional to talk to who’s all about them. Plenty of people try therapy and find it difficult to give themselves over to the process, take a more passive route to treatment, get frustrated and give up. Sometimes this is because traditional psychotherapy is not a good fit for them right now, maybe ever. There are so many other great therapeutic options. Traditional psychotherapy is not the only way to heal or feel better.

 

I know it’s overwhelming to look for a therapist and decide which kind of therapy would be best for you, especially when you’ve been dealing with a problem for years, and you’ve finally decided to take the plunge and ask for help.

 

If you describe the issue and a little bit about yourself, many of us will be able to direct you in the right direction. There are plenty of therapists who won’t do this because they are sure that they can handle it regardless of their training and orientation. While I would like to believe that this is mostly the exception rather than the rule, it happens. If you feel too overwhelmed or busy or exhausted to educate yourself on various therapeutic tools and modalities, remember that you can interview multiple therapists at a time to see who feels like the best fit for you. (You can also do this regardless of your stamina to self-educate.) Once you start seeing a therapist, you can audition us. If you’re not feelin’ it for some reason, you can switch. It’s ok not to like your therapist or to like them, but feel like they’re not actually helping you. Therapy is an investment, and you have the right to switch providers at any time for any reason. If you’re feeling like you need to discontinue treatment, I usually recommend addressing this with the therapist; sometimes it just takes a little direct communication to shift things. Even if you don’t plan on continuing your work with the therapist, honest feedback is good for both sides.

 

If you’d like to talk more about this, please email me or call and I would be happy to answer any questions. This is one of my favorite subjects!

 

Love and Be Loved,
Natalie

Resources, Not Defense Mechanisms

Resources, Not Defense Mechanisms

There is a brokenness
out of which comes the unbroken,
a shatteredness
out of which blooms the unshatterable.
There is a sorrow
beyond all grief which leads to joy
and a fragility
out of whose depths emerges strength.

There is a hollow space
too vast for words
through which we pass with each loss,
out of whose darkness
we are sanctioned into being.

There is a cry deeper than all sound
whose serrated edges cut the heart
as we break open to the place inside
which is unbreakable and whole,
while learning to sing.

-Rashani

 

I’m a huge fan of meditation and mindfulness. I’m thrilled by the research that continues to pour forth in support of these practices. Having a regular practice that includes mindfulness and meditation has improved my quality of life, my clinical practice, and the lives of many of my clients.

 

Like anything, though, there are misunderstandings about how to apply these practices. It’s easy to misinterpret phrases like “let it be,” and “just allow it,” and “radically accept,” and other concepts of meditation and mindfulness.

 

I often hear, “Yeah, I tried mindfulness and meditation, but it didn’t really work,” or “Nothing happened,” or “I still feel overwhelmed,” “There’s always some new challenge in my life. Meditation and mindfulness can’t help me.”

 

A couple of things might be happening when we feel like this:

 

1) We might not be focusing on cultivating a regular practice (which, when we do, helps us to achieve the highest benefits they have to offer us).

 

Like anything, meditation and mindfulness serve us best when we commit ourselves to a regular practice. The same is true for exercise, eating our vegetables, studying, and pretty much everything else. We practice whatever we want to get good at, right?

 

We also practice whatever we have learned to practice. Some of us practice perfectionism or worrying or self-criticism or blaming or avoidance. Then it can sort of feel like a battle of the practices. We try to observe our thinking (mindfulness practice) then we notice how worried we feel so; we worry about it (worry practice). We can and do go back and forth with this. When we get tired and frustrated, whatever we have more practice doing is what prevails.

 

This is why it’s so important for us to practice using our resources every day. We are more likely to grab whatever we have more familiarity with and rely on it when we are in a crisis or when we’re feeling uncertain. If we’ve been practicing using our resources when we are feeling calm, in a neutral state, or less activated, we will have laid the critical groundwork needed to trust that they will be there for us. We will be well-rehearsed when a feeling or an experience throws a wrench in our sense of well-being, and we’re more likely to have the patience to find an adaptive response to it.

 

2) We might expect fewer challenges in life, for life to be easier.

 

Been there, done that. I, too, expected life to get easier and to experience fewer challenges once I started meditating and practicing mindfulness! I was pretty disappointed when I didn’t get a pass from pain and suffering. I thought, “Oh, am I maybe doing it wrong?” When I was super frustrated, I thought, “Yeah, this is crap and doesn’t work.” I would either abandon my practice for a while or strive even harder for the perfect practice.

 

It’s a pretty common experience. It’s also pretty common to try to barricade ourselves against life using the tools we have acquired. And we come by it honestly. We try to avoid pain and anxiety and whatever else by employing blame and perfectionism and addiction so, why not do the same thing using meditation and mindfulness and spirituality and religion and recovery?

 

The resources we seek are tools to help us manage life in a more fulfilling and sustainable way. They are here for us so that no matter what is happening, we can connect to the reasons why we love our lives and why we appreciate being alive. We practice using our resources so that we can use our thoughts, feelings, and behaviors in a more productive way, to connect with our presence and resilience.

 

They are not meant to be a defense against life or a means by which to avoid it. The goal is not to avoid ever feeling sad or anxious or angry or pain. We’re not going to, one day, feel like perfect humans with perfect confidence and a light-pink filter over the pictures of our lives feeling like everything is all good.

 

We’re still going to worry. We’re still going to feel shitty. We’re still going to move through periods of our lives when we feel like we’re not sure if we can keep going. We’re still living in an uncertain world. We will still feel vulnerable knowing that we and our loved ones will die in an unknown way at an unknown time. The goal is to feel all that stuff, all of it, and grow from it. The goal is to feel all of life, allow it, and to let the feelings, thoughts, and experience guide us toward growth. That’s the point. Resources and tools can help us to stop tensing against life, to manage it, bring our best selves to it, and find fulfillment.

 

Love and Be Loved,
Natalie

90 Second Eternity

90 Second Eternity

The natural lifespan for an emotion is 90 seconds. From the time the emotion is triggered until it passes through our nervous system, 90 seconds pass. Something special happens to turn those 90 seconds of emotion into a mood or a type of day- our thoughts. Most of us aren’t sad or angry or irritated or frustrated or anxious for 90 seconds until we feel better. No, we think some thoughts, feel unpleasant feelings, think some more thoughts, feel a few more unpleasant feelings. We’ll get our behavior involved and maybe yell at the car in front of us or brush hurriedly past someone. Then, we’ll think some more thoughts and feel some more feelings. This can last so much longer than 90 seconds.

 

You know how it goes. You wake up and realize you over slept. First thought of the day, “No!! Why?!!” As you grab your phone to shut off your alarm, you notice that people have already texted and emailed with questions and concerns about pressing issues. You walk the dog, but he takes his sweet time making any progress on his business. You start taking an inventory of all the things you have to do today, all the things that will need your attention until you can finally relax at home again. Your stomach tenses. A neighbor, retired, stops to say good morning and casually chat. You feel kind of bad for pulling your dog away from her and toward home. You take your dog back home and grab everything you’ll need for the day- almost. You forget your lunch. You run to the train stop relieved to see that it hasn’t come yet. You notice that there is an inordinate amount of people waiting at the stop. You can see on train stop display that the wait time is longer than usual. You’re pissed again. Eventually, your train comes, and it’s crowded beyond measure, but you manage to climb in and hang on. You’re glad that you’re moving in the right direction and allow yourself to think, “Maybe because it’s so crowded, the driver won’t make the usual stops, and I won’t actually be that late.” Thanks to the fact that neurons that fire together wire together, your brain is used to feeling anxious about getting to the next thing so, it fires off more thoughts about how much you have to do, how stressful it all is, and how infuriating it is that you are wedged in between what feels like the entire population of the city. You arrive to work, find that people are impatiently waiting for you. As you start to think, “At least I have my delicious lunch waiting for me at lunchtime,” until you remember that you left it sitting on the table in your haste to make the train.

 

Yikes. This morning sounds stressful. We’ve all had them. Sometimes we’re able to regroup and make the next half of the day better, other times we just don’t think we have it in us. We’ve all definitely blamed a bad mood, bad day, even a bad week on a morning like this. Together, the frustrating events and our thoughts created a perfect storm for continued feelings of unpleasantness. (And we all know that it doesn’t even necessarily take an event in tandem with thought to cause more uncomfortable feelings. We can do it all by ourselves armed with only our thoughts.)

 

The thing is, it’s pretty much always our thoughts that create the unpleasantness. Traffic jam got you upset? Thoughts. Colleague irritating you? Thoughts. Afraid you won’t get what you want at work? Thoughts. Resentful that your spouse hasn’t once thought to clean the baseboards? Thoughts. Tired and cranky and stressed and busy? Thoughts.

 

Don’t get me wrong, thinking is totally a part of the human experience, and there is no way to avoid it (unless we experience major cognitive decline). And I’m not saying thoughts are bad; they’re not. They can be really useful to us. It’s the meaning we make of them and the rumination that challenges us. We decide that an event means a certain thing so we think thoughts associated with that thing and they gain momentum. Ultimately, the fear is that we are not ok/will not be ok as a result of it.

 

When we experience and unpleasant feeling, think thoughts associated with it, fear is often at the heart of it; we are usually attuning to some kind of vulnerability of life.

 

We can’t and don’t need to avoid or thoughts, but we could learn how to guide them. We could learn how to use our thoughts instead of being used by our thoughts.

 

Some people are fine with this and don’t experience that much suffering with their thoughts, or they do, but they find purpose in their suffering. To those, people I say, great! Looks like you’ve figured out what works for you and you don’t need me to tell you anything. To everyone else, I feel you.

 

And some of you might say, “Whatever, dude, stuff is stressful!! I can’t just not be stressed. I’m not flakey enough. What, am I suddenly just not going to care about being on time, what my boss thinks of me, or if I’m doing life right?!” And the answer is… kind of. You can be less stressed though it certainly won’t happen suddenly. (And you will also see that you are doing life just fine, but we won’t get to that yet.)

 

When we care about how we feel, we are more deliberate with our thoughts. If we don’t care about how we feel, then we allow ourselves to fall down the rabbit hole of rumination or put our happiness in the hands of other people, places, and things. The trick is to remind ourselves that we care about how we feel. The other trick is to ask ourselves these questions:

 

1)Do I care about how I’m feeling?

2)What am I observing about my experience right now?

3)It’s hard to feel __________.

4)What can I do about the situation I’m in?

5)What can I do to make myself happier/more at peace/neutral (whatever feels doable for you) in this moment?

 

It’s natural to think about what we have next on the agenda, what we have yet to accomplish, the miles to go before we sleep. And feeling time-poor and responsibility-rich is challenging. I’m not saying that you have to get to a place of rapturous joy on that crowded train with your whole day in front of you, but maybe you can feel a little less dread and discomfort. You can feel a little more grounded.

Because we have nervous systems, we won’t always be able to respond like this. And that’s ok. It’s ok to be humans having human experiences.

 

Love and Be Loved,
Natalie

Take Some Space

Take Some Space

“Between the stimulus and the response there is a space, and in this space lies our power and our freedom.”
-Victor Frankl

 

We have so many goals and desires. We want to engage in purposeful, fulfilling work. We want to have enriching relationships. We want to be healthy, financially secure and loved. We want a lot out of life, but we don’t always allow ourselves to achieve it. Frequently, I talk about why we might block ourselves from accomplishing our goals, and today I’m going to talk about how we block ourselves.

And no one wants to hear about the ways in which we get in our own ways or things we do and think to sabotage ourselves. Most people don’t like to think about our part in unpleasant experiences. We like to blame it on other people, things, past experiences. Most of us find personal accountability pretty challenging.

Speaking for myself, I can say confidently that two things are true about myself: 1) I’ve set goals and 2) I have worked really hard to resist making space for myself to achieve those goals. Most of us do it with something. It’s not conscious. We think we’re fighting our hardest and fiercest to get what we want. And we are fighting, vigorously and ferociously. We just aren’t always fighting for ourselves; we are fighting ourselves, everything we don’t want (and sometimes, everything we do want). We get too handsy with the goal don’t allow for what we want to be a part of our narratives. We want to reach our goals, but we fight them.

I’ve heard stories like this from clients and friends for many years. We want something; we go after it, but somehow we end up creating an even bigger challenge. We get frustrated. Sometimes we give up and walk away. And resistance can be so sneaky. It can totally appear to us that we are taking steps toward our goals. But, then why do we feel further away from accomplishing them than when we started?

Take this common problem: “We’re not getting along.” Ok, I get it. We’ve all been there. We’re figuring out an issue with a partner, trying to see eye-to-eye on something, effect some compromise, maybe but it just… isn’t happening. We start talking about it, disagree, fight, and someone either blows up or walks way. (Sometimes both, am I right?) And we think, “But I’m trying to talk about it. I’m trying to help us reach an understanding. Why isn’t it working?” Sometimes it’s not working because we’re not allowing for the change. We’re not making room in our relationship or our communication style to allow anything different to happen. Instead, we are suffocating the possibility for change with a closed mind and heart, forceful confrontation, and poor emotion management. This approach resists the very change we want to see.

When I first started my private practice, I knew that I needed an office to see clients, but I didn’t have any clients, so I wasn’t sure how I was going to pay my office rent. But if I never got an office, how could I see people? And I would just go around and around like that, sometimes for days at a time. Intellectually, I knew it would work out, but my fear wasn’t so sure about it. Eventually, I took the plunge and experienced the change I wanted to see. If I had never made space for this change, I probably would have given up a long time ago. Sure, there were obvious actionable steps I had to take in getting there, but first I had to allow for this thing I wanted by making space for it.

We have to make space to allow for the changes we want to take place. It’s true for any of these pretty common concerns:

“They don’t appreciate me.”

“I can’t lose weight.”

“I’ll never save enough money.”

“How long will it take until I feel better?”

“My life is one big clusterfuck.”

“I’m always so stressed out.”

If you’re finding that you feel you’ve been fighting for what you want and seeing low to no results, try this:

 

Step 0: Look into starting a mindfulness practice (get acquainted with how space feels)

Step 1: Step back from the situation (make space for yourself)

Step 2: Look at your situation (make space for possibility)

Step 3: Ask yourself if you’re forcing an outcome (more space)

Step 4: Extend compassion for how hard it is not to force an outcome (compassionate space)

Step 5: Be interested in other possible responses to your frustration and feelings (constructive space)

Step 6: Try some of them (adventurous space!)

Step 7: See what happens (curious space)

 

Sometimes we have to have a knock-down-drag-out fight for what we want. Sometimes we just have to allow space for it to be.

Love and Be Loved,
Natalie