Category: General Information

What You Should Know If You Have Been Diagnosed With Borderline Personality Disorder

Here is the truth: BPD, or Borderline Personality Disorder, has a historically bad rap with mental health professionals. I’m going to give you some truths to what you should know to not only think about this clearly, but to consider your options in terms of the person you want to be and the person you want to become.

BPD was historically known for “bordering” on the lines of neurotic vs. psychotic. In the olden days, clinicians who didn’t know if a person was living in the confines of “reality” could put them in a category that didn’t really fit either one. Historically neurosis has to do with issues related to anxiety, mood, and depression. Neurosis can also be related to trauma, vigilance, and paranoia about bad things re-occurring. Psychosis is related to problems hearing and seeing things that others do not see or hear, and is often associated with schizophrenia. “Borderline” has often been referred to as a category that doesn’t really fit any category, and in some cases has been the in- between of no-place.

BPD is also historically written about from an extremely pejorative and hopeless point of view. Words like “manipulative, gamey, cagey” are often used, and mental health professionals often refer to this diagnosis when talking about people that bug them, that they do not like, that get them enraged, and people that can tie up crisis hotlines and emergency rooms. In many cases, labeling someone with BPD has become a substitute for observing and describing behavior, providing useful feedback, and encouraging people to behave in ways that make them competent and more effective.

Here are some truths that you should keep in mind if a mental health professional has “informed” you that you have BPD:

Mental health diagnoses are not valid nor reliable. This means that (in terms of validity), if the same professional assessed a person over time (such as an assessment 20 years ago, 10 years ago, and 5 years ago), the likelihood that that professional would give the same person the same diagnosis is unlikely. It also means that if many different mental health professionals assessed the same person it is highly unlikely the all of them would come to the same conclusion about diagnosis. This is assuming that the only measure of giving a diagnoses is a working familiarity with the DSM-TRV, or the “psychiatric Bible” of diagnostic criteria (which is highly controversial. Be aware that homosexuality was once considered a psychiatric disorder, and now it is not). Mental health diagnosis may be more reliable and valid if the diagnosis is given based on a range of valid and reliable assessment batteries; thus if you have had some comprehensive personality assessment and testing this may be less of the case for your situation. Bear in mind that most people in the counseling profession are doing nothing more than giving you their clinical opinion; hence my point about reliability and validity. Also, there are some counseling programs that don’t cover concepts such as instruments of mental health measurement.

For some mental health professionals, telling someone they have BPD can sometimes be a communication of frustration. In a helpful world, telling someone what diagnoses they have can be useful and even helpful- it can validate if a person really is depressed or help figure out specific treatments. In the case with BPD, the “right treatment” is more complicated and may not be readily available. If your mental health professional is telling you have BPD, you might want to consider: So what? How it is it helpful or useful? Does it help people have the resources or tools for solving painful problems? Is it specific enough to describe what behavior shows up- and how behavior can be changed? Does it provide access to literature that is actually helpful? For some people, being diagnosed with BPD can only serve to increase shame and self-loathing. Literature is not always helpful and mental health professionals don’t always shore up resources for how to move forward to obtain resources and supports. Is the expectation to hide in a corner the rest of your life and not tell people who you “really” are? And do you seriously want to live this way?

There is a lot of confusion for most people around diagnosis being a cause. Diagnoses are actually descriptions of behavior, and mainly identify patterns of responding or behaviors that are typical for a person. Many people, including some mental health professionals, actually believe that they are describing reasons or causes of behaviors when giving someone a diagnoses. For instance, if the way that you behave is because you have a disorder, then someone people think they have adequately not only explained the reasons you behave the way you do, but they think they know why you behave the way you do. In terms of diagnosis, this really is not the case. The failure of the mental health system is that people think they are being helpful (“You have problems because you have a disorder”) rather than addressing causes and potential solutions for behavior change. In this case, many problems of pain are not being solved as the focus of attention is on the “correct” diagnosis, which, in my opinion, is a rather useless pursuit. It can be akin to a parent who has several children; one of them is determined to be “bad.” Instead of figuring out how to prevent problem behavior, solve problems, and tend to the child’s needs; the parent simply attributes all problem behavior to the child being “bad.”

What you can do if you have, or think you have, or someone else thinks you have BPD:

Don’t think you are permanently impaired, hopeless, or beyond help. Fear and shame keeps may people paralyzed from acting with self-respect, doing things that are meaningful, and putting oneself out there in the universe. Universally, fear and shame can prevent anyone from living a decent life. You are not an exception.

Learn to talk about yourself and your behaviors in a descriptive, non-judgmental, and matter-of-fact ways. This will make you competent, understandable, and respectable. This also means that if you go around and tell everyone you are disordered, people may treat you as fragile, incompetent, incapable, or helpless. Create and practice ways to talk about yourself outside of the realm of “mental illness.”

Pay attention to providers, mental health professionals, or family members who attribute your behavior to being “mentally ill” or “bad” or “personality disordered.” Realize that everyone has vulnerabilities and that many, many people struggle with giving accurate, helpful, and specific feedback. Consider how giving and receiving feedback is either helpful or not helpful, and don’t seek out relationships where blame seems to be an acceptable solution for reducing pain or resolving differences. Finding “fault” only works if the consequence is taking responsibility and making changes; not amplifying shame and paralysis of action.

Be aware that if you do delve into literature on BPD, you may encounter a wide range of confusing terminology that attempts to define you; which may not only be disconcerting but also downright confusing. You might encounter terms like object relations, transference, countertransference, self-objects, self-soothing self-objects, object mirroring, intrapsychic processes, or projections. Don’t get bogged down by mental health-ese. Bear in mind that some mental health professionals have a lot of trouble observing and describing behavior and giving useful feedback and sometimes hide behind their own jargon.

Find other things that provide you a sense of identity, that define you, that make you the person you are, and that you value. Consider roles you take on in society; engage in them and be proud of them. What is important to you? Why would you let a diagnoses get in your way with pursuing what is important to you? In what ways do you not “show up” because you have shame around a diagnosis? Life is bigger than the world of “mental health.”

Bear in mind that many mental health professionals are obsessed with political leaders that they believe to be personality disordered. In truth, political leaders are still political leaders, and political leaders have made great gains, influenced many, changed laws, and maintained power. Being diagnosed with something “bad” hasn’t deterred people from being politically active, advocating, having power, or being influential. There is no good reason why you have to be shamed from participating in the universe just like everyone else- people with a lot of problems still manage to be successful and competent in a myriad of different ways.

Finally, feel free to visit the National Education Alliance for Borderline Personality Disorder, a nonprofit that may be more helpful than the general google search. Their website (www.borderlinepersonaltydisorder.com) has some useful non-pejorative literature, trainings, and free services for friends and family members.

What’s The Fuss About? A Super Brief History Of Behaviorism, Cognitive Behavior Therapy, And What Is Really Meant By Third Wave Behavior Therapies.

Behavior therapies have been around for a long time in helping people address problems of depression and anxiety. Here is a short article about old ways of thinking about behaviorism and what newer “third wave” therapies have to offer.

Old behavior theories are often criticized for this idea that there is no “person” on the “inside”, rather everything was a matter of stimulus and response. For instance, the presence of a stop sign (stimulus) would prompt the behavior or stopping (response), and behavior could be controlled by stimulus in the environment. Criticisms of this way of thinking included the lack of free will or choice. Behaviorism in the current way of thinking would take into account learning history, which would explain how different persons have different responses to the same situations. It also takes into consideration how the context of the situation may influence the outcome, such as snowy weather conditions or the fact that a person was busily distracted with their cell phone when coming to the intersection.

Old paradigms of thinking about behaviorism include methodological behaviorism; the gist of it being that if behavior was not observed, it did not exist and was not worthy of study. Clearly this created problems for people who want to understand emotions. Current ways of thinking of behaviorism (radical as opposed to methodological) refutes the idea that behavior has to be publicly observed in order to exist. All the “stuff” that occurs within the skin (emotions!) are alive, real, in existence, and worthy of study. The more global way of understanding behavior is that any behavior is worthy of analysis and understanding. Thus, an emotion or a highly conflictual altercation (the stuff that comes up in therapy) is clearly worthy of study.

Cognitive Behavior Therapies (CBT) often emphasized the thought process that ensues when a person reacts to a situation. People have a tendency (especially when panicked or a in a bad mood) to think the worst will happen, jump to conclusions, and make assumptions about situations and people that are not accurate. Cognitive Behavior Therapies have often emphasized the thought process/ thinking/ cognition; and often challenged persons’s perceptions of reality. This can get tricky when dealing with paranoia, post-traumatic stress, or psychotic thought processes; and can create even more problems when people are told their perceptions of reality are not, indeed, real. Focusing solely on cognitive ways to solving problems can result in trying to think one’s way out of pain and discomfort, which sort of backfires when people have problems with rumination, over-analyzing, or overthinking. That being said, CBT has been helpful to numerous people and has had a key role in reducing suffering, depression, and anxiety.

Exposure therapies are often considered under the umbrella of cognitive behavior therapies and include specific treatment for anxiety disorders. This is where a person comes into contact with a feared stimulus and behaves differently from the typical response. The goal is to increase one’s tolerance to anxiety, increase the repertoire of responding adaptively, and not let feared stimuli control one’s life. Here are some typical examples of treating anxiety through exposures: Obsessive Compulsive Disorder (people that are disgusted by dirty things are encouraged to touch dirty things such that they become less bothered by dirty things over time: watch the move Dirty Filthy Love), Social Anxiety (people are encouraged to join a small group and share more openly than they otherwise would and feel less isolated and have better social abilities), and Borderline Personality Disorder (exposures help people tolerate emotions better such as practicing breathing when angry instead of ranting angrily or picking a fight).

Behavioral Activation is a treatment for depression that includes engaging people in life situations that increase natural reinforcers. In a nutshell, the behavior of depression is often one of detachment, withdrawal, inhibition of activity, loss, flatness, tearfulness, loss of focus, and sometimes aggravation. Activating behavior may include increasing pleasurable activity, engaging in meaningful behavior, doing things to build mastery and challenge oneself, managing stress and time management, and decreasing commitments that result in being overwhelmed. These are ways of managing mood that don’t include medication. (A really great book on this is Overcoming Depression One Step At A Time, which can be found under “books I recommend.”)

The newer behavior therapies or “Third Wave” therapies are often considered an offshoot of Cognitive Behavioral Therapy. Technically, behavior is given an emphasis over cognition. This is because behaviorists consider the thought process to be only one aspect of behavior and is not given any kind of special treatment. For political purposes (and for the general lay population) this distinction can be confusing and for some, probably not necessary. However, all behavior is open to analysis and one’s thought process is not the only focus of treatment. The idea of Third Wave therapies is a return to radical behaviorism (hence the analysis of behavior), an acknowledgement of the ways behaviorism has been both hurtful/ helpful/ misunderstood, and an expansion of how behavioral ways of thinking have been making phenomenal comebacks (and changes) on intimate, psychotherapeutic relationships.

Third Wave behavior therapies are different in that they are interested in two things: 1) Context and 2) Function. Behavior (which can include anything you want to analyze for the focus of your therapy session, such as an emotion) can happen anywhere in time and space. Current conditions (ie., the context under which behavior occurs) will influence behavior. Behavior does not happen in a vacuum and is not situationally isolated. It is fluid and subject to change. Consider how “repressed” memories “show up”, and if you more or less likely to remember repressed memories if you have a warm, caring therapist who is expressing curiosity about your past. How you remember, what you remember, and what you are willing to tell this person are all influenced by the current context. If, in your learning history, people are not to be trusted; a warm caring person asking you this personal information may result in you changing the subject or talking excessively. Learning history clearly plays a part in how a person will respond to a therapist, and again shows how the overly simplistic stimulus-response models of early behaviorism fall short.

The function of behavior has to do with the purpose it serves. The same behavior of two people can have very different purposes, show up in different settings or circumstances, and have different outcomes or consequences. The behavior of vomiting after eating (such as the case of bulimia) can serve to communicate, validate, express anger, maintain privacy, prove a point, assert independence, or prevent the discomfort of feeling full. The fact that the same behavior does different things for different people and has different consequences makes it such that two people with the same diagnosis can need very different treatments. This is partly why there is so much confusion and controversy over mental health diagnoses and their varying treatments, and why any one “template” approach doesn’t work the same way for any two people.

Third Wave Behavior therapies are also coming to terms with spirituality. While past therapies focused on making unwanted emotions/ thoughts etc. dissipate, new wave therapies are getting people to look at what they want more of, what they value, and what is important to them. Instead of saying “What do you want to avoid or get rid of in your life?” they are saying “What do you want more of in your life?” or “How are you missing out on what is important because anxiety/ depression gets in the way?” There is a renewed focus on mindfulness and acceptance and a recognition that painful thoughts and emotions are part of human existence.

We’ve worked really hard to eradicate pain and that hasn’t worked, so what can be done instead? Making peace with our discomfort by not letting anxiety and our depression control our life is done through some applied principles from Bhuddism, mindfulness, and the concept of being “zen.” Spirituality clearly has helped many people cope, come up with their “why”, and rely on powers outside of their control to help them survive emotional pain. (Ie., “Let go and let God”). The shift in Third Wave Therapies is to look towards a more expansive way of thinking and also addresses a more existential concern. You don’t have be clinically depressed to benefit from examining values, enhancing your quality of life, and growing as a person. And at least one of these treatments, ACT, is being used in non-psychotherapy settings such as organizational and business consulting. (The Association for Contextual and Behavioral Sciences is the umbrella organization of the growing interest in Third Wave Behavior therapies, and offer an annual international conference to interested parties. Click here to visit their website.)

Third Wave Behavior Therapies are generally considered to be Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), Functional Analytic Psychotherapy (FAP), and various mindfulness and compassion based therapies. DBT was somewhat of an early forerunner in bringing acceptance based practices to psychotherapy, the “dialectic” being that of acceptance vs. change. This was somewhat in response to the fact that Cognitive Behavior Therapy, despite the multitude of people that it helped, was a therapy based solely in principles of what needed to be changed. DBT skills include prayer, radical acceptance, finding meaning, and value-based goal setting. DBT’s founder, Marsha Linehan, grew up Catholic and developed the treatment based on her exposure to Eastern thinking and Bhuddism; she has written multiple articles on spirituality.

ACT is complex and a bit tricky to explain, but here are two principles that ACT encompasses: 1) Flexibility, or a flexible repertoire of responses to life’s challenges. A metaphor I heard recently was like a car hitting a pot hole- a car with no “bounce” or “give” is like a person who has difficulty adapting to life’s bumps. The more shock absorption that a car has, the more likely the car can navigate the pot holes and not get “tied up” or “stuck”. 2) Impermanence, or “self-as-context”. This means that the self that is “you” will change over time but still be the same “you”, and this “you” can change perspective in time and space. This matters in the sense that people who are really and truly “stuck” sometimes experiences their situations and self-criticism as permanent. The self-as-context concept often entails compassion focused exercises that allow you to see yourself differently; with compassion, and as an observer who can take a step back form being “fused” with emotional pain and rigid thought patterns. Compassion based practices have capitalized on the approach and address concerns related to extreme self-hatred, shame, and the ubiquity of human suffering. (Compassion Based Therapy is also considered it’s own independent treatment).

FAP at its heart has based its tenets on the principles of Awareness, Courage, and Love. (Known as the ACL model). Clients are encouraged to consider how their relational problems outside of session also show up inside of session, and to bring these similarities under direct observation as they show up in the relationship with the therapist. Immediacy (ie., What are you feeling right now as you are telling me this?) can evoke the discomfort clients often feel when in intimate situations, and encourage clients to develop more meaningful and fulfilling relationships via the interaction with their therapist. FAP is highly evocative, and clients grow in the courage to address things in therapy they tend to avoid. Because lack of intimacy is associated with mortality, intimacy and connection is a value that shows up consistently across FAP. If you think about this treatment from a behavioral standpoint, the environmental context (how a therapist responds) can have a profound influence on generating change. If the relationship with the therapist had no influence on the client, there would be no such thing as psychotherapy. Thus the focus on the environment (ie, the behavior of the therapist) is consistent with a behavioral approach to treatment.

The best way that I think of behaviorism is that there is no permanent, fixed, or reification of private experience such as thoughts, emotions, or sensations. The fluidity and impermanence of how we experience “self” changes across time, contexts, and situations. Problems often ensue when our thoughts are treated as structures, things, or objects. Problems crop up when we think we “have”, possess, or own the experiences within our skin. In order to “not have” depression, something would have change. Consider the difference between “having” depression vs. “experiencing” oneself as depressed. Which do you think is more hopeful, temporary, and subject to change? Third Wave Behaviorism, or “radical” behaviorism is making its comeback.

 

 

 

Manchester By The Sea- A Psychologist’s Point Of View On How To Work With Lee

Recently I went to see an excellent movie: Manchester By the Sea. Here are some thoughts I have about how I would work with Lee.

As a provider of clients who experience intense, severe, and painful emotions; Lee really does fit the bill. General questions that I might consider asking include: What would it take to reduce pain, survive loss, and manage or cope in a way that made things better? What would help Lee feel less stuck? What resources or connections could sustain him better, enable him to bear the weight of his pain, or enhance his quality of life? What could him grieve more fully and to get through this crisis? What is he doing that is working, and what is he doing that is not working? Could he be more likable to himself, sustain the burden or his guilt, or have more fulfilling relationships?

One agenda item I have is getting Lee to stop doing things that could potentially make his current situation worse. Often times I have clients who have severe emotional pain and it is so intense and unbearable that they are looking for any distraction to take away the pain. The distractions sometimes have a short-term effect of feeling better, which makes them hard to stop. However, in most cases these distractions can make problems worse- and are not effective long-term strategies to mitigate the severity of what they feel.

So one treatment agenda is to reduce risk taking or crisis-generating behavior. Specifically, Lee tends to get drunk, pick fights, and throw punches. The natural consequences for this behavior can result in serious injury, concussions, brain damage, head injuries, broken jaw, soreness, swelling, or other various medical trauma. Drinking heavily can result in poor decision-making, hangovers, dehydration, and liver damage. Other natural consequences of his behavior include legal problems, court dates, jail time, being seen as a threat in the community, increased relationship conflict, and isolation. Grabbing the gun of an officer might result in unintended harm to other people. Not only would Lee have the current dilemma of living with the intense and painful losses he has suffered, but he would have to address the above consequences in addition to everything he has already gone through.

Some people actually believe Lee’s behavior is justified. They would say that because he is in unbearable pain, he should be able to act the way he does. Or he should be let “off the hook” because his behavior is understandable. I would encourage those people to consider: Would you recommend your closest confident or best friend- who is deeply hurting- do something that could result in head trauma? Liver disease? Incarceration?

Another “justification” for Lee’s behavior is that he has significant guilt and self-hatred and he is trying to punish himself. After all, the law did not punish him enough! What would be an effective punishment, and how long does he need to punish himself for his actions? Are self-inflicted/ high-risk behaviors actually effective in making him feel less guilty? What if a police officer was shot by accident? What type of effective repair work needs to be done? What lifestyle habits could he change to prevent bad things from happening in the future? What would he need to do to redeem himself in the community? And what would it take for members in the community to find forgiveness, employ him, or tolerate him being around?

How would treatment move Lee towards growth, movement, and decreased pain? There are several ways to approach this- the key being a sensitivity and flexibility to what Lee would be able to handle at the time he seeks help. One is a baseline ability to talk about what happened. As he pieces together his story, there may be parts that are difficult to talk about. Avoiding these topics might show up in the form of escaping, not talking about it, dissociating, becoming numb, becoming argumentative, keeping one’s distance, staying detached, avoiding intimate relationships, leaving, drinking, or even picking more fights. The difficulty is that there are multiple reminders (or stimuli) that will show up throughout his life that he may not be able to avoid. These may include:

  • Conversations about young children
  • Seeing a house fire in the news
  • Talking to his ex, Randi
  • Seeing Randi’s newborn
  • Getting news that young children die or are dying
  • Randi saying “I love you”

For instance, what if he is watching the evening news and suddenly there is coverage about a house fire? What if Lee has a building tenant who loses a child to death, and Lee is present when the tenant tries to discuss it with him? What if Randi tries to contact him again or “shows up” in an unexpected manner? Maybe Lee can try to avoid these situations in the short term, but inevitably life, reminders of life, and young children are the life that surrounds us.

Therapy would work on staying present with emotional discomfort when these topics come up; and doing so in the presence of one or more people. That means not attacking, hiding, or getting drunk. It means being willing to experience grief, pain, discomfort, or tears. It means staying in a conversation and having a willingness to tolerate the stuff that seems unbearable. The more Lee does to avoid it, the worse it is going to get.

Healing results when a person’s grief can be managed, survived, and tolerated. Healing is about experiencing, talking about, and coming to terms with what happened in the presence of others. Healing happens when people can forgive themselves and each other and can make changes to prevent bad things from happening in the future.

Healing doesn’t happen when a person is literally “stuck” in blocking out all things reminding them of pain, and lives a life where they are blind and deaf to such triggers; avoiding any stimulus in real life that will inevitably show up at some point.

Healing doesn’t happen when emotions literally control lives, and people can’t engage a full, meaningful, rich, and productive life as a result. Healing doesn’t happen when there is no compassion for self or others, when there is no forgiveness, and when there are no second chances.

 

Depressed? Anxious? Here’s What You Can Gain and Obtain

Most people who have more than their fair share of depression and anxiety are often seeking ways to decrease depressive and anxiety symptoms. In other words, they want to not be depressed and not have significant anxiety. If the symptoms are extreme or significant the person may start to avoid a lot of things, such as getting out of bed and going to places to that prompt panic attacks. Lifestyles can become restricted and the person may stop going to events or venues where they have the feelings they don’t want. Medications might be pursued, evaluated, and re-evaluated to see if they “work” or they “don’t work”.

If you are a depressed or anxious person, it might be worth considering what it is that you want more of, you would like to have, or what you value in your life. Instead of thinking what do I want to avoid start thinking about what you want to have more of in your life. What is it that would make your life more fulfilling, more engaging, more interesting, more desirable, or more alive? What is actually important to you? Sometimes people are so focused on what they are trying to get rid of they stop pursuing what they want.

Figuring out what you want more of ties in to your values, your energy, and your time. Are you sacrificing what is important to you because you are avoiding negative feelings? Have you stopped seeking activities that give you pleasure, fulfillment, obligation, a sense of contribution, or the opportunity to enhance an important relationship? If depression and anxiety interfere, this is a good time to evaluate what you might have to tolerate to go after more of what you want.

Sometimes, if people have more of what they want, their buffer against depression and anxiety can be tolerated more naturally. Some people get panic attacks at work, but because their job is important to them, they find a way to bear with them. Sometimes people get depressed when important things are lost, but because they have other important and meaningful activities in their life, the depression is bearable.

People who have fulfilled lives often have a wide range of things that give them pleasure, provide a sense of work/ mastery, invest in important relationships, and find new relationships when important ones end. Diversity and stability of the good things can help people shore up more resources when things go south and important jobs and relationships end.

 

 

 

 

10 Reasons why you need The Emotional Extremist’s Guide to Handling Cartoon Elephants book this holiday season

1. The Cartoon Elephant book, after being temporarily unavailable through Amazon, is now back on the market. The retail price is $26.95, but sometimes Amazon will let it go for a bit less.

2. Cartoon Elephants approach painful emotions with humor. If there is an elephant in the room in your family, this book is the starting point for approaching avoided conversations. You will recognize yourself and others in this book. There is no finger pointing or blaming.
 
3. Cartoon Elephants is something you can put on your coffee table. Because it is a graphic book with pictures and fun fonts, it is an easy read. The elephants will fit nicely next to big picture books about Africa and Asia.
 
4. The Cartoon Elephant book is being used to teach people in Dialectical Behavior Therapy skills groups about emotions. Loaded with psycho-educational material and teaching points, it cleverly accomplishes the task of making people think they are reading something fun yet giving them something valuable.
 
5. This book is not hard to read. There is no “plugging away” at chapters. If you want to bring something to someone’s attention in a way that is universally applicable, this book will do the trick. You don’t need to have painful emotions to appreciate elephants- you just need to have emotions.
 
6. If you are going to buy someone a self-help book for Christmas, this is safe bet.
Whether they believe it or not, everyone has cartoon elephants. The research proving this to be true is cited in the back of the book.
 
7. This book can be used and re-used, read and re-read. You can share it with family members, friends, or long lost relatives. It won’t go out of style. Emotions, as a rule, will be with you as long as you live.
 
8. You will get some food for thought about how and where you see yourself in relationship to your elephants. This is great for discussion groups, weekend retreats, and writing workshops.
 
9. This book is great for people of all ages. If you’re trying to get your kid to read something important, heavy, and deep, you can give them this book. It won’t take long to read and it is much more fun with illustrations.
 
10. The book will be the perfect introduction for my live series on emotions starting January 20, 2014. Of course you don’t need the book to sign up, but if you have the book you will have a better appreciation for cartoon elephants in general.

 

 

Loneliness and the New Year

Loneliness may have to do with a feeling as if something is missing. A loss of connection, a loss of relationship, a loss of well-being, or a loss of what could or should have been.

New Years Eve may bring up a loneliness for several people, and may be related to anxiety or discouragement regarding:

  • Personal failures or setbacks over the course of the year
  • Uncertainty about how to be around the people currently in your life
  • The relationships you think you should have but don’t
  • Comparisons to others who may be having “more fun” or “a better time” than you
  • Not being invited or included in the way that you think you should be
  • Not feeling a sense of connection to anyone
  • Anxiety about what it means for you (on this particular day of the year) to not be in the place you want in your life right now

Loneliness can happen to people who are surrounded by family during the holidays, to married couples, to engaged couples, to divorced people, to single people, to people who are with the people they want to be with, and to people who have a wide range of established connections and meaningful relationships.

Just like pain, loneliness doesn’t discriminate across ethnicity, class, gender, age, or social economic status.

There is always someone who is lonely!

Suggestions:

  • If anxious indecision is part of your pain, accept whatever it is you have chosen to do (who you are with and how you will spend your time) to bring in the New Year
  • Find a way to acknowledge loneliness, even if the only thing you are doing is reading this blog post
  • Bear in mind that loneliness is not a reflection of personal failure on your behalf
  • Spend the holiday in such a way that is the most meaningful to you despite your loneliness
  • If there is someone you could reach out to or make a connection with- consider doing it
  • Remember that this too, shall pass

When trauma forces us to look at what matters: Newtown, CT, and surviving emotional pain

Traumatic experiences have a tendency to shake us to the very core, calling into question our beliefs about humanity, safety, influence, power, control, and faith. When traumatic things happen, our vulnerabilities are exposed. We may feel raw, defenseless, or powerless.

Trauma cracks open our humanity in ways that may bring out the extremism in all of us.  Some people may react to the experience of helplessness by shutting others out. This might be manifested through withdrawal, avoidance, criticism, verbal attacks, or vigilant efforts to control everything and anyone.  Others might reach out, remember what really matters, or connect more deeply to those around them. Some are suddenly more conscious of what they cannot control; thus seeking to strengthen relationships, deepen their faith, or work harder to protect those they love.

Sometimes it is difficult to know how to react to others who are in pain. One way of addressing our own feelings of helplnessness in these situations is to contribute, share, mobilize efforts to help, reach out, or make ourselves available.

In light of the recent school shootings, I’ve put together some tips for how to be with people in pain. I hope that these tips go beyond today and tomorrow, and that they can be considered useful in the everyday experience that connects us not only to each other but to places like Newtown, CT.

  • Make space for emotions- both your own and someone else’s
  • Acknolwedge pain by allowing it to exist.
  • Instead of platitudes, changes of subject, false reassurances, or noisy chatter try to tolerate discomfort and awkwardness
  • Be direct and invite experiences of emotion to be talked about openly. Name the elephants in the room.
  • The more comfortable you are talking direclty and openly about how you feel, the more of an invitation this will provide for others
  • Be aware that others may not express emotions in the way you expect
  • You don’t have to understand why exactly people behave the way they do in order to be helpful. Try focusing on the what of the feelings instead of the why.
  • Be prepared for ambiguity, uncertainty, and lack of clarity. Being emotionally present is more important than analyzing details or intellectually distancing and describing behavior.

Remember that people sometimes need invitations to experience and express a wide range of intense emotion in the wake of trauma. It is a lonely experience to diminish pain or act like it doesn’t exist- when what is needed most is the experience of not having to face it alone.

7 Tips for handling stressful holiday interactions:

Try to plan your interactions or the time you spend with family in such a way that you can take “breaks” from emotional intensity.  This can include limiting or structuring the time you spend together, planning for short periods apart (ie, going for a walk), suggesting that you need a few minutes to clear your head, or keeping some things routine. Long periods of unstructured time can invite boredom or agitation.

Consider: “My family member is doing the best they can right now.” Instead of thinking “Seriously? That’s all they can DO?” Think of them as limited, finite human beings. Instead of doing this in a condescending way, try a stance of gentle acceptance. We are all bound to be disappointed in people we care about and sometimes it is just hard to deal with.

Appreciations: Try focusing on one thing about each family member that you like, respect, honor, or value. Make it a point to tell this to each family member. Sometimes when people hear what they are doing well they are less likely to generate conflict

If you exit, do it with grace. Don’t add insult to injury, make things worse, or behave in a way in which you would lose your own self-respect. If you can’t do anything to make it better, don’t rub salt in old wounds.  Try to plan ahead how you would cope adaptively if the “worst case scenario” were to happen.

If you are a person who focuses on controlling everything, pick one thing ahead of time that you are not going to try to control. Practice letting go, accepting what is, and acknowledging it openly. No critical comments allowed. 

If loss is a theme for you this holiday, do something special to honor the person in your life who is missing. Talking about what this person meant to you, how much you cared for him/her, or how you spent time together might help. Sometimes family members need to be invited to honor their sadness because they are so busy avoiding it. If no one is there to honor your own sadness with you, see if you can find a way to honor sadness within yourself.

Ways of being together as a family: Topics for everyone to share: Talk about a highlight of the week, a favored memory of a family event, a recent accomplishment, something they did this year to increase their quality of life, what each of you wants 5 years from now, or wishes that each family member has for each other.

The value of revisiting trauma

The value of revisiting traumatic experiences is that it gives a person an opportunity to organize, make sense of, and gain clarity on past events. Many people who suffer from post-traumatic stress experience memories and associated events in ways that are intrusive and beyond personal control. This makes the memory itself something to avoid at all costs.

However, the benefit of revisiting memories and recalling traumatic events is to decrease fear that is associated with the remembering of the memory. When a person can remember the memory without shutting down, avoiding, or dissociating, the person can then begin the journey of grieving and meaning-making. The past becomes clearer- what actually happened, happened.  A person can begin to get their mind around it and talk about in a way that integrates self-experience in the context of space and time.

One way of getting through painful times includes valuing, spending time with, and paying attention to the people you care about. Sadness lets us know who matters and what matters. If we did not have sadness, we would not know what is important. Reality as it is cannot always be avoided, but the sustaining relationships we do have are worth investing in, paying attention to, and fostering.