Thanks for your thoughtful question. I’m going to do my best to answer it and to alleviate some of the concerns you have expressed.

The most important thing to address here is your statement that if your personal issues were to get out, it would be damaging to your reputation. I’m not sure how much you know about the ethics of counseling and therapy, but one of the most important guidelines is that anything that a person shares with his or her therapist is confidential (with the exception of imminent risk to self or others or in the case of child/elder/dependent abuse). There are other, less common situations where confidentiality is not protected, but those are very rare. Also, the laws may differ by state, but by and large those are the two most common cases where confidentiality isn’t guaranteed. With that said, I understand your concern about privacy and your desire to be sure that you are protected as best as you can be. I hope that this knowledge will help you to feel safer as you consider whether to seek a therapist.

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As for the next aspect of your question, it is not uncommon for people to seek out therapists with similar belief systems, especially when it comes to religion or spirituality. After all, some people tend to feel more comfortable with someone who shares those beliefs. There are some therapists who have no problem sharing their beliefs with a person considering therapy, and even those who specify their spiritual or religious affiliations up front. The other aspects you’re looking for (political, social) in your therapist might be more challenging to find, as many therapists might not feel comfortable discussing those views so early in the therapeutic relationship, if at all. It is quite likely, in fact, that a therapist will not discuss those issues, as they are intensely personal and private matters. Ethically, the therapist is not prevented from discussing personal views so long as it is in service to a person’s progress, but I would venture that many would feel that answering those questions prior to an appointment might be out of bounds.

As you already mentioned, therapy is not about your therapist but rather about you and your process. While you might feel more comfortable with a therapist who has similar views, it is quite possible that you may not find someone who meets your expectations. I do wonder why you feel that you can work only with someone who shares your beliefs. Given the laws and ethics governing confidentiality in therapy, whatever you tell the therapist (outside of the rare exceptions I outlined above) will remain confidential. Unless what you are sharing with the therapist is putting you or others in imminent danger or involves abusing others, you are protected. Regardless of political, social, or spiritual beliefs, ALL therapists are bound by this code of conduct. Not only is violating the confidentiality of a person in therapy unethical, it is illegal. That protects you far more than a shared belief system.

Your letter also mentions that you live in a small community. That factor alone makes it more difficult to find a therapist in your area who will share your beliefs because there are likely to be fewer therapists to choose from. If that is the case, I would hate for you to not seek therapy as a result. I wonder if your desire for your therapist to share your beliefs isn’t a way to limit the possibility that you will seek help if you can’t find the “perfect” fit. I hear that you feel vulnerable, and I want to acknowledge that this process can be very scary and feel risky. Indeed, it is risky to trust someone with your deepest secrets, and I applaud you for considering taking this journey.
I would also like to invite you consider your other possibilities. There are therapists who may not share your beliefs but who can be great catalysts for change nonetheless because what facilitates change in a therapeutic relationship is not shared values or similar beliefs—it’s the relationship between the therapist and the person in therapy. That je ne sais quoi of the healing relationship is not something that can be predicted by anything other than a mutual willingness to engage in the process.

I encourage you to reconsider your position given the information I have shared and to at least explore some of your options. Call and make some consultation appointments. Go meet some therapists and see how you FEEL when you are with them. Talk about your concerns about confidentiality and how you feel vulnerable undertaking this process. Give them a chance to see you and be seen. You might be pleasantly surprised to find that even someone whose belief systems are unknown to you can be very welcoming, accepting, nurturing, and can be a great agent of change.

Best wishes,
Lisa

Anxiety is a surprisingly common problem in children. If your child has sensory processing issues or sensory hypersensitivity, you may have already witnessed how these can bring about or intensify anxiety. These sensory issues aren’t always limited to one type of sensory input. Hypersensitivity can be found in any sensory system, and affect a person in one, two, or several systems at once. The intensity of experience common to sensory hypersensitivity, sensory processing issues, or other sensory issues can be a challenge for anyone, but for a child it can be overwhelming.

For instance, to children with tactile hypersensitivity, a sock seam might feel like the scratchy side of Velcro on tender skin. A voice that seems perfectly normal to most people might be painfully loud. Children who experience sensory input this intensely may naturally avoid or try to delay situations where they will be overstimulated by the offending sensations.

Anticipating future situations like these naturally leads anxiety-prone children to worry. A child may worry so much that anxiety becomes a day-to-day response. As parents, we are in a very good position to help our children avoid these pitfalls, and to develop good-feeling, healthy habits and attitudes.

There are many positive and healthy ways to manage anxiety that stems from sensory issues. Three examples of anxiety neutralizers are understanding, fun, and mindfulness.

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Understanding

Understanding is key—both understanding oneself, and feeling understood by others. Understanding the relationship between one’s own hypersensitivity and anxiety can be empowering for children. Feeling understood by others, especially by parents, makes a big difference. Both of these will ease fears, and as parent, you are in the perfect position to help.

Feeling Understood

Children need to know that their parents understand where they are coming from, and that they are not being judged. Parents can ask questions, acknowledge their children’s feelings, and help them develop an action plan.

For example, if your child has a fear of leaving the house before school, listen carefully to your child and seek out the underlying problem. Convey that you understand. Help your child express herself using words, so that instead of reacting to her anxieties with a tantrum, she can explain the discomfort. Feeling understood helps your child feel nurtured and supported, and helps promote positive coping skills.

Self-Understanding

Likewise, your child needs to understand himself. Educate your child about his brain function. Explain that a special part of his brain works to keep him safe. When this part of the brain gets a message from a sensory organ (such as the skin, eyes, nose, tongue, or ears), it responds accordingly.

For instance, when nerves on his hand send a message to his brain that the stove feels hot, his brain responds quickly by moving his hand away from the heat. Likewise, if his brain receives a message that something seems wrong or unknown (like intense smells, loud sounds, etc.), his brain does its best to understand (interpret) the sensory information and respond in ways that might keep his body safe.

In people with hypersensitivities, the signals from the sensory organs send some messages to the brain that are intensified, amplified, or confusing. This is why the brain might send a message saying “Be anxious!” to the body so that it will be ready to run, hide, or maybe even fight.

Just knowing the cause of anxiety won’t make it go away, but it’s a beginning. Your child may need the support of a licensed, qualified therapist to develop positive and healthy coping skills, but learning to pay attention to their own feelings when anxious can be very helpful right from the start.

Fun

The sensations linked to having fun can be powerful against worries and sensory intensities. Fun is not a direct antidote to be applied during an emotional crisis or time of heightened anxiety, but rather a component to build upon and reinforce.

Habitual anxiety can distract a child’s natural inclination toward play, humor, and wonder. Facilitate your sensitive and anxious child’s sense of adventure. Point out when you notice joy and positive feelings. Laugh together (but never laugh at your child). Identify and help your child find humor, and use a sense of humor as a positive coping skill.

Mindfulness

Serenity, feeling calm and at peace, is the opposite of anxiety. One way serenity can be found is by breathing naturally and being fully present in the moment. This type of focus on the here-and-now is called mindfulness. Presence of mind comes with practice. For some, mindfulness is second nature. For the rest of us it’s a state we can learn to live in.

There are specific skills and habits that can be adopted to build a more mindful way of living. Mindfulness techniques have been proven to reduce anxiety, which in turn can reduce the intensity of sensory overstimulation. It is worthwhile to make time to teach your children how to focus on the present moment, and to be more mindful.

Learning about your child’s sensitivity or anxiety, communicating your understanding and support, and focusing on positive feelings can go a long way toward promoting excellent mental health. Your attitude as you travel this path is very powerful. Hold firmly the belief that your child can find peace and calmness. This can generate confidence and mastery. Your approach will be reflected in your attitudes and expectations, which can encourage your own efforts and help your child better cope, overcome difficulties, and ultimately thrive.

References:

1. Brown, A. P., Marquis, A., Guiffrida, D. A. (2013). Mindfulness-based Interventions in Counseling. Journal of Counseling and Development, 91(1), 96-104.
2. Engel-Yeger, B, Dunn, W. (2011). The Relationship Between Sensory Processing Difficulties and Anxiety Level of Healthy Adults. British Journal of Occupational Therapy, 74(5), 210-216.
3. Felver, J. C., Doerner, E., Jones, J., Kaye, N. C., Merrell, K. W. (2013). Mindfulness In School Psychology: Applications for intervention and professional practice. Psychology in the Schools, 50(6), 531-547.
4. Gourley, L., Wind, C., Henninger, E., Chinitz, S. (2013). Sensory Processing Difficulties, Behavioral Problems, and Parental Stress in a Clinical Population of Young Children. Journal of Child & Family Studies, 22(7), 912-921.

We’ve all heard the stereotype of the dumb jock, but a new study suggests that high school sports may actually be good for students’ brains. About 55% of high school students are athletes, and between 23% and 40% of all high school students report feelings of stress, depression, or anxiety. Students may be able to reduce these feelings by participating in sports, and the study suggests that high school sports participation may even have long-term mental health benefits.

High School Sports and Mental Health

The study surveyed nearly 850 students attending 10 different Canadian schools. Students completed surveys about sports participation every year for their five years of secondary school. Then, three years after graduation, researchers asked students about symptoms of depression and stress levels. Students were also asked to rate their mental health on a scale of 1 to 5.

Students who had a history of high school sports participation did better on all three measures of mental health than students who did not play sports. They had lower rates of depression, less stress, and perceived their mental health to be better. Researchers aren’t sure why high school sports positively benefited mental health in the students. They speculate, though, that increased social activity, a connection to their schools, and the chance to bond with their peers may all help reduce the risk of mental health challenges. 

Other Benefits of High School Sports

The latest study isn’t the only one to show major mental health benefits for high school athletes. Previous research has shown that high school sports participation can confer the following mental health benefits:[fat_widget_right]

• A reduced risk of teen pregnancy.
• A decreased likelihood of using drugs such as cocaine and marijuana.
• Higher self-esteem, with student athletes about three times as likely as non-athletes to say they feel good about themselves.
• Feeling socially accepted. Athletes have better social skills and are more likely to say their friends care about them.
• Better grades and test scores.

References:

1. Jewett, Rachel; Sabiston, Catherine M.; Brunet, Jennifer; O’Loughlin, Erin K.; Scarapicchia, Tanya; O’Loughlin, Jennifer. (2014, June 11). School Sport Participation During Adolescence and Mental Health in Early Adulthood. Journal of Adolescent Health. DOI: 10.1016/j.jadohealth.2014.04.018
2. National Campaign to Prevent Teen Pregnancy. (2007, July 26). Not Just Another Single Issue: Teen Pregnancy and Athletic Involvement. Retrieved from http://www.education.com/reference/article/Ref_Not_Just_Another/
3. Sports Promote Psychological and Emotional Health. (2013). DatalysCenter. Retrieved from http://datalyscenter.org/wp-content/uploads/2013/06/Sports-Promote-Psychological-Emotional-Health.pdf
4. Study shows high school athletes perform better in school, persist to graduation more than non-athletes. (2014, January 24). Retrieved from http://news.ku.edu/2014/01/15/study-shows-high-school-athletes-performed-better-school-persisted-graduation-more-non

They are frightening, disturbing, inconvenient, and happen when you are supposed to be rejuvenating your body and brain: the nightmares that follow a traumatic experience.

Nightmares are quite common among people who have experienced a traumatic event. The aftereffects of a nightmare often follow them into the next day, which can affect their emotional well-being and ability to function. Nightmares can be quite scary and negatively impact the amount of restful sleep a person is getting. They can feel like one is re-experiencing the traumatic event, and the thought of going to sleep can become anxiety-provoking. The less sleep a person gets, the more difficult it is for the brain to process a traumatic event and file it away correctly. Sometimes the symptoms that are present due to trauma are the very barriers that get in the way of a person’s ability to heal.

The Function of Dreams

According to Hartmann (1996), one theory regarding the function of dreaming is that it allows the brain to make connections more efficiently and effectively than the conscious mind. In other words, it is the time when the brain reviews information that has been observed and then sorts and organizes it in a way that makes sense.

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Hartmann (1998) also states that dreaming is a way for the brain to work through trauma, and the dreams are often based on the main emotion the person experienced during the trauma or experiences when they recall the trauma. This is important to the healing process but, as discussed above, can be problematic when the person’s nightmares interfere with their sleep and their ability to function day-to-day. According to Leskin et al. (2002), people who had a diagnosis of posttraumatic stress had a significantly higher rate of sleep problems. They state that 96% of participants in their study who were diagnosed with PTSD experienced nightmares and 100% experienced insomnia.

So what can a person do to work through unwanted trauma nightmares?

1. Keep track of your dreams and nightmares and discuss them with your therapist. Dreams can contain information that is significant in therapy work. I often encourage people in therapy to write down the basic themes of their dreams and nightmares so we can investigate their significance to the trauma treatment work we are doing. I often find that the information gathered from dreams is directly related to the themes that are increasing or continuing the disturbance related to trauma (for example, a sense of helplessness).
2. Develop coping and self-soothing skills. Practice self-soothing and anxiety-reduction techniques before sleep and/or if you wake up from a nightmare. Continue self-soothing throughout the day as needed to deal with the aftereffects of a nightmare. Some of the tools people in therapy have found most useful include guided meditations, body scans, progressive muscle relaxation, and mindfulness exercises. Another tool that many find particularly useful is called “container.” Essentially, the person experiencing the disturbance creates a container (real or imagined) wherein they can keep the things that bother them most (thoughts about the event, flashbacks, or even the nightmares or other disturbing material) until a time when he or she able to sort through the material with his or her therapist. When the disturbing material comes up, the person can allow whatever it is to go into container until therapy, where we can decide what should be addressed. Some containers that are common are safes, boxes, vaults, and jars. The container should have a lid or door of some type. A person can imagine this container in the form of a picture in the mind and imagine the disturbing material going into the container. Alternately, the person can have a physical container and write down the disturbing material on a piece of paper and then place it in the container.
3. Don’t stay in bed if you can’t sleep. Often, when awakened from a nightmare, going back to sleep may be difficult. Also, the act of initially going to sleep may be anxiety-provoking for fear that the nightmares or other symptoms the person may be experiencing will return. If you are not able to go to sleep in a reasonable amount of time, get up and do something self-soothing. It may take time before sleep comes, but it is better to engage in self-soothing exercises than to get yourself worked up and more anxious because sleep won’t come.
4. Make changes to your sleep environment to avoid associating anxiety with the place you sleep. When a person has repeated nightmares, the sleep environment may become a trigger for anxiety and other trauma symptoms. Making changes to the sleep environment, such as moving furniture around, getting new bedding, or changing the decor, may be helpful in starting with a clean slate when it comes to sleep.
5. Remind yourself that your brain is trying to heal. Healing is not always a comfortable process and it takes time. As uncomfortable as nightmares are, your brain is giving you the information it needs you to work through. Nightmares can bring to light issues that you may have been unaware of during your awake time. Work with a therapist so you do not feel alone in this process. A therapist can normalize what you are going through and can help you to process your symptoms in a way that may make them less overwhelming.

References:

1. Hartmann, E. (1996). Outline for a theory on the nature and functions of dreaming. Dreaming, 6(2), pp 147-170.
2. Hartmann, E. (1998). Nightmare after trauma as a paradigm for all dreams: A new approach to the nature and functions of dreaming. Psychiatry: Interpersonal and Biological Processes, 61(3), pp223-238.
3. Leskin, G.A., Woodward, S.H., Young, H.E., and Sheikh, J.I. (2002). Effects of comorbid diagnoses on sleep disturbance in PTSD. Journal of Psychiatric Research, 36(6), pp 449-452.

This is a gut-wrenching position you find yourself in. On the one hand, you’ve done some great work with this therapist and built a strong relationship with her; on the other hand, the work seems to have stalled because you are preoccupied with her potential departure. Should you stay or should you go?

It sounds like the therapeutic relationship is actually bringing out some of the relational issues you are working to address—fear of abandonment, distrust, and generally feeling unsafe. While it is deeply uncomfortable, and I in no way wish to minimize that, this can be a powerful way to work through these issues. The therapeutic relationship is different from any other relationship in large part because it is designed to serve the needs of one person—the person who sought therapy. You can raise the issues you are having in the relationship and deal with how they are affecting you, how they are connected to the past, how they are connected to other relationships in your life, and perhaps most importantly, how to heal from them. You do not need to be concerned with how your therapist is affected by this. If necessary, she can take care of herself through supervision and her own therapy. This relationship is 100% about you and your healing and growth.

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It seems like you are having a very difficult time engaging in this process because of the deep-seated fear you have of her taking another extended leave. Presumably, if she were to go on another maternity leave, there would be a period of time for the two of you to work on preparing for this. Maybe you could even have a joint session with your therapist and the therapist who would cover for her during the leave, so that you three could talk about where you are in treatment, how you could best be supported during the leave, and what could be worked on. While it would not be easy, this sort of process could really contribute to your healing.

Finally, while your therapist has acknowledged that she may not be the safest therapist for you due to potential maternity leaves, it seems important to acknowledge that there are no guarantees in therapy. There is no therapist on the planet who can promise, beyond a shadow of a doubt, that he or she will be able to be there for you from the start of your work until you reach resolution. Illness, death, relocation, job change, and other issues can come up for anyone, including therapists, at any time. This is a frightening and painful truth about life, and this therapeutic relationship just might help you come to terms with that. I suspect that would be deeply liberating for you.

Best wishes,
Sarah

“Go into your grief, for there your soul will grow.” —Carl Jung

Grieving is a powerful and personal journey. It is an inevitable part of living. Eventually we all grieve something or someone. If you’ve lost a child or parent, or a friend, lover, or spouse, you know that grief has the power to transform.

We usually live within the illusion that we are in control. That is, we live a certain way until something happens to shatter our perception. The resulting dissolution—or you might say dis-illusion—that follows is actually the beginning of a remarkable process of being healed. It marks the first stage in the grief journey.

Stages of Grief

In 1969, Elisabeth Kübler-Ross, a Swiss American psychiatrist, introduced the “five stages of grief.” Her work with people who had terminal cancer led her to define the five distinct phases a dying person goes through while coming to terms with their fate:

• Denial: Disbelief, shock, and numbness after hearing the “bad” news.
• Anger: When the numbness lifts, anger may be easier to feel than the intense pain associated with what is being lost. This free-flowing anger can be directed inward toward the self or outward toward doctors, nurses, friends, family, spiritual advisors, and/or God.
• Bargaining: For some, bargaining can be a reaction to the vulnerability that occurs when feeling the sorrow of loss. It can be an attempt to feel more in control of a situation where control just isn’t possible. It is characterized by an attempt to seek the impossible; to find a way out.
• Depression: The full impact of the unmasked impending loss of life finally hits, and feelings of sorrow, sadness, and depression follow.
• Acceptance: Coming to terms with what is happening and finding a way forward.

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While many have applied these stages to the process of grieving the death of another person, it was not Kübler-Ross’ intention that they be used this way when she created the model. There are other models that are more specific to grieving the loss of a loved one that are used by grief counselors and therapists. While the stages described by these models differ somewhat, like Kübler-Ross’ model they all chronicle a journey-type process that leads to acceptance and the eventual ability to once again move forward.

Acknowledging Brokenness; Being Present

When the shock of sudden loss subsides, the numbness that initially accompanies that shock wears off as well. A pain-filled state ensues when the harsh reality of loss is realized. This early phase of grief is about brokenness. When we experience a loss, the bond that once attached us to the other—whether the other is a person, place, or thing—is severed. When the bond that ties is severed, we feel as though we have been broken. It is a painful and searing state; a state that can’t be rushed.

What a grieving person in this stage needs most is to feel that those they are closest to can accept the pain they are experiencing. Unfortunately, many people are uncomfortable with their thoughts and ideas about endings and death. The feelings that arise with grief are just too much for them. Their attempts, aimed at getting a grieving person to feel better and leave the sorrow behind, only serve to prolong the grief process.

A kind touch and a shared quiet moment that honors the feelings of a grief-stricken friend can be the best offering of condolence. A willingness to simply be present, to witness and accept the raw emotions of grief, is the first step in a transformative and healing process for both the bereaved and those who surround them.

Support Groups

The feelings that come with grief are powerful. Grieving takes time, and often the family and friends of a grief-stricken person are ready to move on long before the grieving one can or wants to. Support groups are a viable option for those who find themselves alone in their grief. Being able to share the experience with others on the same path may be a relief. Since the grieving process is different for everyone, a support group can accommodate these differences. Some studies suggest that men and women grieve differently, with women needing to speak about and share their intense feelings with others while men often deal with their own intense emotions by taking action. In a support group setting, all experiences can be heard, shared, and validated.

Widows and widowers in the gay community often have difficulty finding the support needed while experiencing the grief of bereavement. Even finding a support group can be difficult. Blogger Dan Cano writes poignantly about his experience after finally finding a support group where he could speak freely and be understood:

“I started my lesbian and gay bereavement group a few weeks ago, and every Thursday night we gather to tell our stories. We share of our history with our partners, lovers, husbands and wives. We share the trauma of losing the most central person in our lives. We tell of our difficult goodbyes, and of the daily anguish that we must now endure. We talk about being left behind, of feeling lost, of struggling with a new identity. We talk of people’s well intended, but missing the mark, words. We cry, we laugh, we listen.”

What We Learn from Grief

When we sit in stillness and accept the waves of grief that wash over, eventually there will come a time when the urge to move will stir. It will be quiet, unassuming, and almost imperceptible. From intense feelings over what has been lost there will arise a feeling of gratitude for what is remaining. When experiencing the loss of a loved one, an inevitable gratitude for life and living unfolds. The gift of grief is ultimately a strengthening of the ability to truly appreciate and value the process of being alive.

References:

1. Greenspan, Miriam. Healing Though the Dark Emotions: The Wisdom of Grief, Fear & Despair. Shambhala Publications Inc. Boston, Massachusetts, 2003.
2. Hanson, Rick, Ph.D. (2007). Grief Recovery: Implication of Neuroscience and Contemplative Wisdom. Retrieved from: http://www.wisebrain.org/KaraSlides.pdf on 21/06/2014.
3. Cano, Daniel (2009). Gay Grief. Retrieved from http://daninrealtime.blogspot.ca/2009/11/gay-grief.html on 22/06/2014.

Here are a couple of questions for you. What happens inside you when you when you read or listen to the daily litany of abuse of power, suffering, injustice, murder, war, and destruction of the earth? What do you do when someone close to you has been hurt by unethical actions?

Asking around, these are the things I’ve heard.

“I just get numb because I don’t think I could bear the amount of pain I would feel.”

“Well, I get mad at the news companies because they just seem to look for the bad stuff and don’t give us a balance. There’s good stuff happening too, but I guess that doesn’t sell.”

“I find I can’t see violent movies anymore even if they are Academy Award winners. Hurts too much.”

“I glaze over so I can subdue my feelings.”

“I feel so upset and helpless that it turns to hopelessness. When it’s hopeless, I disempower myself because there’s nothing useful I can do anyway, so why bother?”

“When something gets to me, I can’t sleep at night.”

“I feel disappointed in people. We know better than what we do.”

“I just don’t read the paper or listen to the news anymore. I don’t want to support this kind of newscasting.”

“I try to offset the bad news with looking at the bright side. I think I do this too quickly in an effort to avoid feeling bad.”

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Do any or many of these responses feel familiar to you? Anything you want to add?

Of course, how we deal with human suffering is one of the universal core life questions that each of us must find an answer to. This question has two dimensions—how will you BE with suffering and what will you DO about it? This article speaks to the kinds of inner doing that can help you be with terrible and disturbing things.

Recently, I was singing in a chanting group. One of our songs was a lament. We were to let go in wailing sounds for some minutes, and then we sang the words of the lament. Stefan Waligur, the leader, reminded us that wailing and keening are an historic and current form of individual and group response to suffering, grief, and injustice. Wailing is often, though not always, the work of women on behalf of the whole community or the whole family. Wailing walls. Wailing in the streets. Wailing over the bodies of the dead. For many people and many cultures, this is the appropriate way to respond to terrible things.

For me, the lamenting sounds felt good and relieving. I was surprised because I tend toward stoically managing my feelings. Lamenting as a chant made it more acceptable for me. It felt good to let my whole body move and sound with the expression of deep grief. Stefan suggested we should make a place for group laments in response to a school shooting, flood, or insurrection.

Public or private lamenting, full of sound and movement, is a good antidote to the responses of fury, numbness, and hopelessness that have become our normal reactions.

My friend Robert said he noticed he regularly shut down about, as he called it, “news of the terrible.” He now has a practice of covering his eyes with his hands and taking a moment to let his grief travel through his body and soul after hearing something distressing. He says it helps him stay alive and real. When you numb yourself about bad stuff, you numb yourself about good stuff, too. Numbing is not selective.

Public or private lamenting, full of sound and movement, is a good antidote to the responses of fury, numbness, and hopelessness that have become our normal reactions.

A study comparing meditation masters and ordinary people in terms of how they respond to disturbing images found that the people in both groups responded to the disturbing images with an equal level of pain and upset. The only difference was that the meditation masters were more resilient and returned to their normal state of equanimity much sooner. Their emotions were quick spikes, whereas the non-meditators stayed in their distress for a significantly longer time. I think regular lamenting could have the same effect of increasing resilience.

My friend Charna suggests a Buddhist practice of consciously breathing in suffering and breathing out love. “We live in a field of energy,” she says. “When I focus on the suffering-and-love exchange, I feel like I am keeping my own system healthy and contributing to the health of the energy field.”

The TV series Nova has a program about the earth atmosphere that showed equipment measuring a remarkably constant global electronic signature of 8 megahertz. This is kept regular by the spikes of lightning that are constantly spread through the atmosphere, steadying the electrical charge. Globally, there are some 8,640,000 lightning flashes worldwide every day! It seems even nature keeps in balance by quick energy spikes.

The process of consciously lamenting could be an often-missing link to maintaining personal balance and resilience. It could help us stay emotionally open and respond to news of the terrible with grief and lamenting instead of rage, numbing, and hopelessness.

Please try making a place for lamenting in your life, and let me know in the comments section what you find out.

Twisted lips, contorted mouth; you know the look of someone who is biting the inside of their cheeks when they are stressed. Why do people do that? Most of us understand it as a bad habit similar to nail biting because on the surface, it would seem like a benign repetitive behavior. However, under further consideration, the behavior may be a byproduct of an obsessive and compulsive reaction to stress and anxiety.

The medical term for the behavior is chronic cheek bite keratosis, which is a body-focused repetitive behavior (BFRB) comparable to hair pulling, nail biting, and frequent blinking. It is categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under obsessive-compulsive and related disorders, and is complementary with anxiety-related types of problems. Body-focused repetitive behaviors, such as cheek biting, most often begin in late childhood and can last throughout adulthood.

Since we often cannot escape the stress of daily life and the resultant anxiety associated with it, behaviors such as this manifest as a subconscious solution to ease emotional overload. While not an ideal choice, it does serve a purpose to those who use it as a coping method. Other times, it is common for boredom and inactivity to trigger the behavior. Cheek biting is self-injurious yet compulsive in nature since it feels almost normal and necessary in the mind of the biter. The compulsive nature is what makes it difficult to stop.

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Since this behavior usually happens mindlessly, damage to the mouth tissue can occur. It is not uncommon for the biter to bite too deep and injure the mouth. Often, cheek biters have a favorite area to bite and repetitively break the skin in the same place inside the mouth. What’s worse is that when the cheek skin has been chewed and is raw, the skin feels broken and jagged, creating an additional compulsion to smooth out the affected area by biting again. This endless cycle can create physical complications only a dentist or oral surgeon can see.

Biting the soft skin inside the cheek over and over again can lead to oral trauma such as mouth sores and ulcers, but is reversible with avoidance of cheek biting, according to the Oral Cancer Foundation.

Whether it is an anxiety-related problem, an obsessive-compulsive issue, or just a bad habit, it is clear that the behavior is not ideal and potentially harmful. However, stopping the biting is a challenge because the biter is not immediately aware of when it is happening and why it is being used as an answer to stress and anxiety. The first line of defense is to lower the affected person’s stress level and provide alternative and healthy anxiety solutions. Stress and anxiety can be lowered multiple ways, most effectively by exercising regularly and eating healthy. After that, removing stressful situations and triggers should be evaluated. Additionally, treatment including mindfulness training and meditation is almost always useful. Learning to be aware and present in each moment allows the person to be in control of behaviors. While easier said than done, mindfulness and meditation are empirically proven to improve mental health.

Often, body-focused repetitive behaviors such as cheek biting respond well to talk therapy that includes techniques drawn from cognitive behavioral therapy and its subcategories dialectical behavior therapy, habit reversal therapy, and acceptance and commitment therapy. Although no one approach works for everyone, an eclectic sampling may work well. These therapies are based on the idea that obsessions and compulsions, like body-focused repetitive behaviors, help people experience stress, anxiety, and emotions without reacting negatively to them in the form of a behavior. The goal is to experience life without needing a compulsive outlet, like cheek biting, to handle what comes.

Feeling angry is an incredibly natural response to the feelings of betrayal that come from infidelity. Your husband broke your trust. Your relationship has been damaged. All of this is very real and comes with legitimate emotional reactions.

Anger is a powerful emotion, and it can mask other feelings. I’m guessing you are also tremendously hurt. Anger may feel like a safer way to manage your pain, but it will slow your healing. Admitting and confronting the pain behind the anger is essential, and it requires vulnerability—which is hard when you are dealing with this kind of breach of trust.

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Time, of course, helps in the healing process. I wonder, though, what it is you might need from your husband to help you with that healing. I’m guessing that right now apologetic words and acts of contrition are not helping you let go and move on. Often, when we have been hurt, we need to feel that the other person truly understands the pain we are experiencing and gets how serious the emotional pain and betrayal really are. Your husband may think he has accepted responsibility and gets how hurt you are, but it can take time for the empathy you need to feel from him to actually be heard and felt in a meaningful way. Until that happens, the rest of the healing—grieving, letting go, reconnecting—can’t really move forward.

There are many ways people choose to apologize, and some really are better than others. “I’m sorry” alone rarely makes us feel better. “I’m sorry for everything” can also feel general and unsatisfying. If, however, we hear, “I’m sorry for doing [specific action] and making you feel [accurate reflection of feeling],” we can feel understood and see that person showing empathy and taking responsibility, which helps us move forward.

While you are waiting to feel that empathy, however, there are steps you can take to reduce your distress. Although your husband’s actions created this situation, his actions alone won’t necessarily change it. Ultimately, that is because other people cannot make us feel a certain way—we have a part in choosing our own reactions. What we feel often comes from the meaning we make of an event. What does this affair mean to you? What are you telling yourself about it?

For example, are you telling yourself that his affair means he doesn’t love you or doesn’t love you enough? Are you dealing with fear that it will happen again? Are you stuck on the message, “I didn’t deserve this. How could he do this to me? This isn’t right”? By uncovering those messages, you can look at the ones that are keeping you stuck in a place of anger and work to let those go. This will take time and work. You can’t just flip the angry/not angry switch. Having an open conversation with your husband about the time you need to work through your thoughts and feelings can be helpful. Letting him know what you need from him during that time can help engage him in the healing process and also start the two of you working toward becoming partners again.

One common message that betrayed spouses struggle with is, “It’s not fair. He/She had an affair and ‘gets away’ with it because I want to stay married.” That is a fallacy that keeps you stuck in an angry, resentful place. In truth, nobody is getting away with anything. Both of you have lost the relationship you had. You are suffering, and he is likely aware that his actions are at the root of that suffering. If he cares about you, that awareness is a source of pain for him. Also, you “get” to be the forgiving spouse, and he is stuck being the one who “did you wrong.” That’s not a fun role to play no matter how deserved it might be. I don’t say this to minimize your pain. You are entitled to feel angry and hurt. If, however, you are able to recognize that he may be in pain as well, you may have an opportunity to connect with each other.

The past cannot be undone. So, you are faced with a choice. If you truly want to stay with him and rebuild a relationship together, you are going to need to choose to let it go. You are going to have to focus on the good that is between you, to let the balance of a life together outweigh the pain of infidelity. You are going to have to connect with each other on a deeper level and recognize that you are both suffering without focusing on laying blame for that suffering at his feet.

The impulse to lash out and hurt when we’ve been hurt is very human but ultimately not helpful if you want to reconnect. You say you don’t want to lose him, but something has been lost. The relationship you had prior to the affair is lost. It is OK to need some time to grieve that loss. It is also OK (and I strongly recommend) that you get some help with all of this. I urge you and your husband to find a couples counselor who can work with you on how to reconnect after an affair. You can build something together, and it can be something beautiful, but it will be something new. You cannot go back to the place you were before, and wishing for that is going to keep you stuck in this place of pain and, yes, anger.

Best of luck,
Erika

Robert’s palms were sweating and his heart was pounding. His big presentation was scheduled in less than an hour and he was starting to panic. What if he forgot his lines? What if he made a complete fool out of himself? His job was on the line and his anxiety was building.

Jenny was also apprehensive. She’d been trying to muster the courage to ask her boss for a raise for several weeks now, but every time she thought about doing so, she became too nervous to say anything.

We have all experienced anxiety at one time or another, although some people tend to struggle with nervousness more than others. Some of the common symptoms of anxiety are feelings of fear or panic, repetitive thoughts about the situation, difficulties sleeping, muscle tension, increased heart rate, shortness of breath, restlessness, nausea, and cold or sweaty palms and feet.

Part of our discomfort stems from our fear of being criticized, ridiculed, or rejected. We all have a basic need for love, acceptance, and validation, and tend to avoid situations that will jeopardize our relationships with others in any way. This is especially true if we have grown up in dysfunctional families, where these primary needs were not met and we were taught instead to behave in certain ways to please others and discount our own needs and emotions.

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We also frequently tend to play over and over in our minds the worst-case scenario, which only leads us to feel even more anxious about the situation. Rather than visualizing the outcome that we are hoping for, we make ourselves sick with our inner horror stories.

So how do we go about coping with anxiety in a healthier way? The following are some helpful techniques to begin to get our fears under control:

1. Take 10 deep breaths, focusing on the sensation of expansion in your chest and abdomen that occurs while inhaling and the release while exhaling.
2. Take some time the day before a stressful event to become physically active. Working out or going for a long walk are ways to decrease your stress levels. Doing so will also help you get a better night’s sleep.
3. Before bedtime, journal about your feelings of anxiety and the obsessive thoughts you have been having. Putting your emotions down on paper can often get them off your chest and prevent you from ruminating about them throughout the night.
4. Whenever you start to imagine the worst-case scenario, try to picture what you would like to happen instead. For example, if you are worried about an upcoming speech that you have to give, imagine remembering your words with ease and receiving a standing ovation afterward.
5. Lower your stress levels by doing relaxation techniques and/or listening to calming music. Help your physical body to relax by lying down or getting into a comfortable position, then progressively focus on contracting each of your muscles then releasing them. Start with your toes and feet and slowly work your way up to your face and scalp.
6. Try to gain some perspective about your fears by thinking about other times in your life that you may have dealt with a similarly difficult or stressful situation. How did you cope at that time? What are some of the strengths that you used then and can call on again?
7. If you are feeling anxious about talking to your boss (or another authority figure) about a specific problem, consider trying to role-play the conversation with a friend or therapist first. Practicing what you will say can help you feel more comfortable when the time comes to actually have that conversation.
8. Use mindfulness to tune into the emotions that you are feeling and allow yourself to feel them fully. Much of the time, we avoid the direct experience of our emotions, especially those that are uncomfortable, such as fear and anxiety. This tends to intensify the uncomfortable feelings rather than diminish them. To experience them, try to tune into the actual physical location in your body where the tension or fear is stored. Do you feel a knot in the pit of your stomach? Are your neck and shoulders tensed up? Allow yourself to fully experience the physical sensations and you will often find that they shift as you accept and honor them.

If you have tried some or all of these techniques and are still experiencing a considerable amount of anxiety, you may want to consider working with an empathic therapist. Although a certain amount of anxiety is a normal part of life, when stress becomes overwhelming and starts to interfere with our ability to function on a day-by-day basis, help is likely needed. Working with a compassionate therapist can assist you with facing some of your fears in a safe setting and bring you back in touch with your innate sense of peace and joy.

Mass shootings are quickly becoming a new norm; over 900 people have died in mass shootings in the U.S. since 2006. And while many people agree that the mental health system needs work, some “solutions” could undermine the rights of people with mental health issues. U.S. Representative Tim Murphy, a psychologist, proposed a bill in 2013 called the Helping Families in Mental Health Crisis Act. In response to several recent shootings, Murphy has begun advocating for the benefits of his bill, but a provision in the legislation could force some people with mental health concerns to take psychotropic medication.

About the Bill

The legislation is more than 100 pages, and offers numerous proposals for addressing mental health issues. One proposal is the use of a treatment protocol called assisted outpatient treatment (AOT). This treatment approach, already legal under some circumstances in 45 states, permits courts to order a person with a history of “medication noncompliance” to take psychiatric medications. Murphy’s legislation would greatly expand the power of courts to force medication on people with mental health issues.

Why Forced Medication Is a Problem

Forced treatment is controversial even when violence and severe mental health issues are factors, but forcing someone to take medication simply because of a history of medication noncompliance is even more troubling to many mental health professionals. The Substance Abuse and Mental Health Services Administration and the Protection and Advocacy for Individuals with Mental Illness Program, two government administrations dedicated to mental health care, both oppose forced treatment.

The trouble with forced treatment doesn’t end there, though. Sometimes those with psychiatric issues stop taking medication for good reason. Particularly among people with severe symptoms, medication can cause serious—and sometimes even life-threatening—side effects.

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Not all medications work for all people, which means a person forced to take medication could be forced to undergo serious side effects even though the medication doesn’t improve mental health symptoms. Therapy can be just as effective as medication, and therapy can actually be more effective than medication at treating some mental health issues. By forcing people with mental health issues to take medication, courts privilege one treatment over another.

Perhaps most importantly, forced treatment undermines the autonomy of people with mental health conditions. Courts have repeatedly ruled that simply having a mental health condition does not remove a person’s fundamental rights. Forced treatment, however, destroys the hallowed concept of informed consent. It could also deter people who need help from seeking it.

Is It Legal?

Whether or not Murphy’s bill is legal is an issue for legal scholars. However, legislation can’t generally be ruled illegal until someone brings a lawsuit alleging that a law is unconstitutional. This means that, if Murphy’s bill becomes law, the issue could ultimately be heard by the Supreme Court. Even if the Court rules that the legislation is unconstitutional, it could affect thousands of people before being struck down.

References:

1. Assisted outpatient treatment laws. (n.d.). Retrieved from http://www.treatmentadvocacycenter.org/solution/assisted-outpatient-treatment-laws
2. Grossman, D. (2014, June 4). Scary new congressional bill would force medication on some mentally ill people. Retrieved from http://www.alternet.org/personal-health/scary-new-congressional-bill-would-force-medication-some-mentally-ill-people
3. Mass shootings toll exceeds 900 in past seven years. (2013, December 02). Retrieved from http://www.usatoday.com/story/news/nation/2013/02/21/mass-shootings-domestic-violence-nra/1937041/
4. Nordal, K. C. (2010, November). Where has all the psychotherapy gone? Retrieved from https://www.apa.org/monitor/2010/11/perspectives.aspx

How do you stay married? One way is to be sensitive to each other’s needs and to compromise every now and then. That means taking turns getting one’s way, or finding a third way that suits you both.

I bought tickets to a concert months ago; I bought them because I’m the one who wanted to go, and my husband acquiesced because he is a good sport, better than I am. But when the time came to go (actually, the night before), I saw he wasn’t feeling that great and the concert promised to be a brawl anyway so I suggested we stay home. He agreed immediately because he thought I was tired, he said, even though we must have both known he felt lousy too and never really wanted to go in the first place. He told me he was skipping the concert for my sake. He’s done this before, where he indicates he’s doing something for me but it’s really for him. Occasionally I point that out, but this time I didn’t. And he was right; I was tired. This spring has been a rough time in many ways for us both, and I’m not talking about the weather.

I had bought the tickets looking forward to us having a good time together, but now I didn’t think it would be fun with him punky and me tired, although I felt disappointed. I knew someone who would probably like to go to the concert, so I gave her the tickets and got to be generous twice with one gesture. It all added up: two tickets minus two people who didn’t want to go plus two other people who did want to go equals four happy campers. My math may not be that good, but you get the idea.

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Relationships are not logical like math. The numbers don’t always add up; they are about the space between people, the back-and-forth flow, feeling the whole being of the other. That takes time, determination, an open heart, and a sensitive touch.

Oh, and by the way, on the day of the concert I was very busy and tired and glad to have an early evening. When work was over, my husband and I met at a local restaurant, had a lovely dinner together, and went home feeling happy and connected. We had found the third way, a low-key evening that pleased us both.

Eighteen qualities that help make a marriage last:

1. Trust. Our marriage space is sacred and private.
2. Restraint. We resist temptation and remain true to each other.
3. Intimacy. We are open with each other.
4. Priorities. We both put our marriage first.
5. Difference. We respect each other’s differences, and know that difference lends interest.
6. Sameness. We share basic values, some interests, and tastes.
7. Communication. We speak up and communicate our needs, likes, dislikes, agreements, and disagreements.
8. Fairness. We play fair.
9. Respect. We demonstrate it.
10. Emotion. We get mad at each other sometimes; we are human.
11. Reconnection. We get un-mad. If it takes a day or so, we live with it and work on letting the anger go.
12. Humor. Having a sense of humor helps.
13. Gratitude. We are so glad to be together, and we say so.
14. Truthfulness. If we have to say something that might be hard for one of us to hear, we tell the truth, and we try to say it gently and clearly so that the other person can hear it.
15. Sensitivity. We know where the buttons are and are careful not to push them.
16. Persistence. Staying married takes time, determination, and hard work.
17. Forgiveness. For your partner and for yourself, too.
18. Teamwork. We help each other grow.

I’m sure there are many other qualities that you can think of that help a marriage stay healthy and alive, and I’d love to hear from you. What things do you and your partner consider important? How long have you been together? We first met in 1980 and have been together ever since.