I recently had the honor and privilege of attending a workshop with renowned art therapists Cathy Malchiodi and Kate Webb in San Diego, CA, entitled Trauma-Informed Art Therapy and Positive Psychology. To say I was inspired, confirmed, validated, and energized by the experience is truly an understatement.

As a licensed clinical social worker, I often have drawn from the expressive arts as a means of helping my clients work through grief, loss, and trauma in psychotherapy. Art making, whether via collage, painting, drawing, sculpting, dancing, making music, and drama, has the potential to help individuals heal through very traumatic circumstances. The workshop focused on the evidence-based use of art making interventions and the intersection with neurobiology and somatic experiencing to help clients work through trying life challenges.

In my 20+ years of psychotherapy practice, I have called upon art intervention with the following populations: child witnesses of domestic violence, abuse survivors, hospice patients and their families, preschool children who witnessed L.A. riots, bereavement support groups, students struggling in academic settings, children of incarcerated parents, and mothers experiencing perinatal depression.

Art allowed clients to transcend their emotional pain, create a narrative through image of their trauma/loss, and subsequently “master” the trauma, thereby releasing the painful memory from its grip in the brain. Art continues to be transformative in my practice with clients and also in my own personal life.

[fat_widget_trauma_ptsd_right]As Malchiodi and Webb stated in their conference, we as humans all experience traumas across the lifespan. These incidents can be as “minor” as a traffic jam to as life-changing as the death of a family member. All traumas, no matter how seemingly big or small, are encoded in the brain’s amygdala where they are registered as potential alarm bells. The hippocampus then takes on the role of organizing these traumatic images, but struggles to encode them in such a way that makes sense to the cognitive (higher thinking/verbal) areas of the brain.

Art making taps into the lower-level (somatic/limbic) areas of the brain and also allows the client to release trauma in a somatic (physically manifested/preverbal) manner. Some individuals are rendered speechless in moments of trauma. As researchers have indicated, Broca’s Area in the brain has the potential to shut down verbalization of trauma, as an individual is in a hyper-alert state of fight or flight.

Art making accesses the somatic elements of the brain, enabling a client to express emotion which at times cannot be verbalized initially. Art making creates containment, safety, encouragement, validation, and an opportunity to narrate the traumatic experience in such a way that the trauma is then organized in the brain so that the individual’s somatic experiencing of the trauma is reduced.

Relaxation exercises coupled with art making bring about great relief for many clients. Playing music that matches a resting heartbeat has been proven to induce a state of calmness in many trauma survivors. Some clients are compelled to also engage in other forms of expression, such as drum playing and dancing. Discharging the trauma physically (exercise, music making, etc.) and through the use of creativity in art allows the client to move through the experience with a sense of self-compassion, mastery of the trauma, and a restored sense of trust in one’s surroundings.

To summarize the workshop I attended in a small article would not lend justice to all the incredible learning experienced. Suffice it to say my education of expressive arts is ongoing, and continues to be a driving force in the work I am honored to provide along the people who come to see me for therapy. Truly, belief that the client has the power of self-determination and the awareness and knowledge within to interpret their own art making is essential in nonjudgmentally supporting the client.

Ongoing training in the cutting edge juxtaposition of art and science in expressive arts and neurobiology is incredibly exciting and groundbreaking. Mindfulness and positive psychology also weave their way into the expressive arts as a form of healing which empowers clients to transcend trauma and loss and evolve to a place of healing and wellness.

The following is a list of titles I have found to be inspiring and helpful for psychotherapists wishing to learn more on the path of incorporating expressive arts in their work with clients:

1. Malchiodi, Cathy. (2002)The Soul’s Pallete: Drawing on Art’s Transformative Powers, Shambhala Publications
2. Malchiodi, Cathy. (2006)The Art Therapy Sourcebook, McGraw-Hill
3. Allen, Pat . (1995) Art is a Way of Knowing,Shambala Publications
4. McNiff, Shaun (2004). Art Heals: How Creativity Cures the Soul, Shambhala Publications
5. McNiff, Shaun (1992). Art as Medicine: Creating a Therapy of the Imagination, Shambhala Publications

“That’s so Zen,” people say, meaning peaceful, accepting, and soothing. But what is Zen, exactly? You might picture a room filled with fluffy pillows decorated in blues and grays, lavender incense, and synthesizer sound waves punctuated by gongs. I’d probably like hanging out on those pillows, but Zen is much more than relaxation. It’s a way of life emphasizing the value of meditation and intuition, and realizing one’s true nature—the purpose of Zen.

We complain about stress, about losing ourselves in the hectic din of constant activity, always on the go, busy, and in touch. We even sleep with our phones kept handy on the nightstand, so we can be available 24/7. That is too much stress, but stress is not only a bad guy, it’s a good guy, too, often supporting growth.

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Think of how stress helps in the gym. Muscles get bigger with resistance training—which is a form of stress (on the muscles). “No strain, no gain” and “use it or lose it” are popular refrains, but we have to find the optimal amount of strain that promotes growth. We need to work those biceps with the proper weight. Too much will tear our muscles, and too little will leave us with spaghetti arms. This is where a trainer in the gym, or a meditation teacher, a spiritual leader, or a psychotherapist, can come in handy, making sure that the stress you’re experiencing is optimal, be it physical, cognitive, spiritual, or emotional. We need to balance stress and relaxation.

Zen practitioners develop a sense of balance, as well as simplicity, order, and harmony. Right diet, regular exercise, enough sleep, right livelihood, and mindfulness activities such as meditation, yoga, prayer, and other techniques help us recover from too much stress. When we quiet the mind and the body, we have a better chance of finding the true self. That’s the goal of Zen—finding the deep self, who you really are, a key to a more rewarding life, and why psychotherapists often include meditation techniques as part of their treatment plan, although it is not a replacement for psychotherapy.

Zen is a peaceful way of life which avoids killing or harming another living thing, shuns stealing, promotes sexual responsibility, and practices truthful speech that does not hurt anyone. Drinking and drugging, anything that diminishes consciousness, is to be avoided. The Shakyamuni Buddha simplified what a Zen life looks like when he said that Zen means “to do no evil, to cultivate the good, and to purify one’s mind.” These are down-to-earth principles which help us live the good life, without too much stress.

A central aspect of Zen is meditation. Often it’s wise to start a meditation practice by resolving to meditate every day, at the same time if possible, and for a period of perhaps five minutes, so when your meditation time is over you want more and you’re ready to start again the next day. You can use a timer, if you wish; just choose a sound that you like. There are some really good apps for that! You can gradually lengthen the time spent meditating.

Meditation practice is simply sitting quietly while maintaining good posture and focusing on one thing, often the breath. Watching the outbreath is emphasized because the outbreath is a relaxing breath by its nature. We breathe out, let go, and then wait through the pause and on to the next breath, a bead in the necklace of your life’s breaths.

While you meditate and focus on the breath, you try not to get caught in the endless thoughts, stories, and fantasies that our brains are constantly spinning. Each time you catch sight of your thoughts, you simply say “thinking without judgment,” and then you return your attention to the breath. The “without judgment” part? I say it twice; it’s that important. NO JUDGMENT. Meditation is not a self-improvement program. It is a getting-to-know-and-accept-yourself program, after which you can get to know and accept other people, too.

People often get angry with themselves when they catch themselves thinking instead of meditating. They might feel like failures, but it’s exactly the opposite. Catching yourself thinking is the sweet spot. You didn’t do something bad, but just the reverse—you noticed, you woke up and were aware; this is the essence of meditation, the gentle road to mindfulness which leads inside to your true nature. Mindfulness is an extended awareness, throughout the day, noticing, not simply reacting.

Meditation reduces stress by increasing positive feelings and decreasing anxiety. As you get to know yourself better and learn to treat yourself and others with greater kindness, your ability to navigate your emotional reactions with more skillfulness also leads to a greater ability to get along with yourself and with others. Self-acceptance, again, is key.

There have been many scientific investigations into the benefits of mindfulness. An early one was the relaxation response developed by Dr. Herbert Benson, who founded the Mind-Body Institute, affiliated with Harvard University. He reports that meditation produces healthful changes in metabolism, heart rate, respiration, blood pressure, and brain chemistry. The National Institutes of Health concur. Other findings reveal that long-term meditators have increased grey matter in their brains, and an increase in alpha-wave activity.

Meditation can be an important part of your daily life. With patience, you will reap great benefits of consciousness and emotional development. Following basic Zen principles of compassion and nonviolence, and establishing a regular meditation practice, makes for a satisfying life with less stress—and provides the tools to handle stress when you need to. A Zen mind-set can go a long way toward teaching us to deal with stress. You don’t have to make a huge change to gain its benefits.

Recommended reading:

• The Wisdom of No Escape by Pema Chodron
• The Trauma of Everyday Life: A Guide to Inner Peace by Mark Epstein
• Peace Is Every Step: The Path of Mindfulness in Everyday Life by Thich Nhat Hanh, Arnold Kotler, and H. H. the Dalai Lama 
• Mind and Life: Discussions with the Dalai Lama on the Nature of Reality by Pier Luigi Luisi with Zara Houshmand

When you go to your doctor for some problem you are having, there is no question that you want an answer to what it is. Not only does it ease your mind because you have clarity, but it also means that there may be treatment for that problem/disease and you will hopefully get better.

It’s not quite so apparent when it comes to our mental health. You may have heard of the Diagnostic and Statistical Manual (DSM), which is like a bible of diagnoses for mental health. Originally compounded by psychiatrists (MDs), it reflected doctors’ beliefs that mental health issues are like diseases, and can be treated once diagnosed.

The most recent version of the DSM, put out in 2013, has been updated to reflect current research and practices. It is used to label mental health issues so that insurance companies know what and how to bill. But for many practitioners it is also a useful way to define a client’s condition. So, is it helpful or not?

On the plus side, there are times when having a label to your experiences gives you peace, as you have a name for it and don’t feel you are “just crazy”. It is also critical in determining medication interventions. If one is diagnosed with attention deficit issues (ADD) or bipolar, for instance, it is likely that the right medication(s) can greatly improve quality of life. Having such a diagnosis—and very clear criteria to make that diagnosis—aids therapists and clients in collaboratively identifying courses of treatment.

[fat_widget_right]Labeling also often helps clients in explaining unexplainable behavior to their significant others. Imagine, for example, that your spouse is constantly late, procrastinates, forgets everything you tell him, and seems to space out a lot. Perhaps you are angry because he doesn’t seem to be trying to improve these problems.

If your partner is diagnosed with ADD, that gives a lens through which you can now understand your husband’s behavior, and it allows you to problem solve together, set realistic expectations for change, and, of course, get appropriate help in the form of therapy and/or medication.

On the down side, labeling can be highly stigmatizing and can even limit treatment options. Certain diagnoses come with all sorts of judgments—even on the part of therapists, who should be aware of these judgments, but aren’t always. Clients can become stuck on their diagnoses, instead of working on the solutions.

Most diagnoses don’t come with a clear and definite treatment, like a medical problem might. For instance, a diagnosis of depression might be treated with medication, cognitive behavioral therapy, hypnosis, mindfulness, or dozens of other options, depending on the client’s needs and the therapist’s skills. So some therapists prefer to look at the constellation of symptoms, and decide how to approach them without needing to put them in a box.

Having a label can be freeing, and can allow you and your therapist to come up with the right plan for you without adhering to strict labels. Another serious concern about labeling is that mistakes are made quite often! It could be the result of an unskilled therapist, or perhaps that clients share only selective information or inadvertently leave things out because they don’t know it’s important to share. Sometimes it takes years to piece together the whole picture and fully understand a person.

Whether you believe in labeling or not, it is always wise to do your own research, get a second opinion, ask lots of questions, and trust your gut!

Known as the body’s natural “feel-good” chemicals, endorphins stimulate feelings of pleasure, well-being, and pain relief, making them an essential component in a balanced, happy life. Endorphins are neurotransmitters secreted in response to stress and pain, which we all feel from time to time.

Thankfully, there are a variety of ways to tap into the mood-boosting, stress-relieving benefits of endorphins and get their full, opiate-like effect flowing. Though endorphins are commonly associated with the “runner’s high” achieved through vigorous exercise, the positive mood shifts associated with them don’t necessarily require strenuous physical activity.

The following are seven endorphin-boosting activities to turn to in times of trouble, or when you just need a little lift.

1. Exercise

By moving your body and increasing your heart rate with cardiovascular exercise, you can stimulate the production of endorphins in the bloodstream. As soon as the heart starts pumping and sweat glands start perspiring, the rush of feel-good chemicals kicks in to reduce the brain’s perception of pain. However, you may have to push through that initial stage of discomfort to fully experience the endorphin-induced exercise high.

As an added bonus, if you’re trying to kick a harmful habit, exercise is considered a highly effective coping mechanism in most forms of addiction recovery; the natural endorphin high offers respite from incessant cravings for drugs, alcohol, or junk food.

So take an exercise class, go for a run or a bike ride, or do some calisthenics (lunges, squats, leg lifts, etc.) in your spare time. Cleaning, gardening, yard work, or something as simple as a brisk walk or a midday session of yoga or deep breathing and stretching will also kick endorphins into gear.

2. Eat chocolate and chili peppers

Chocolate is celebrated cross-culturally as a pleasurable indulgence, and endorphin release is just one of many reasons to enjoy its blissful effects on the body. The mood-boosting and inflammation-reducing benefits of chocolate consumption are well established and widely used to justify indulging in it regularly (Stoppler, 2007).

If you can stand the heat, chili peppers are another edible endorphin releaser. According to researchers, chili peppers contain a chemical called capsaicin that triggers the pain-relieving, feel-good effect in response to this fiery food’s heat—the hotter the pepper, the better (Carollo, 2012).

And, of course, there’s always the dark chocolate-chili pepper combination. From rich hot chocolate drinks to chocolate bars that blend the two, a number of options are available if you’d like to sample this combo for a double dose of endorphin release.

3. Drink wine

While this is only applicable to individuals who are of age to consume alcohol legally, several studies can confirm: wine can enhance those feel-good chemicals.

According to research published in the Journal of Neuroscience, enjoying a small amount of alcohol, especially wine, at the end of the day can boost endorphins (Ireland, 2014). Both red and white wine contain antioxidants, and red wine contains resveratrol, which has been shown to reduce inflammation, slow the aging process, and protect against arterial damage (Hendrick, 2010; Mayo Clinic, 2011).

Another study published in Science Translational Medicine examined the effects of alcohol-induced endorphins on the brains of social drinkers and “problem drinkers.” They concluded that endorphins play an enormous role in the desire to keep drinking once the initial rush of feel-good chemicals have been released. This is true for social and problem drinkers, though those who are prone to addiction will be more likely to drink to excess (Simon, 2012).

So be mindful and drink in moderation when indulging in this pastime. One to two glasses should suffice to get you basking in the mood-enhancing, ethanol-endorphin glow.

4. Have sex

Engaging in regular sexual activity feels good, relieves stress, and releases endorphins. In fact, endorphins are largely responsible for the anxiety– and pain-reducing effects of sex (Newsmax Health, 2013).

The endorphins produced during sexual arousal and shared affection also stimulate the production of oxytocin, aptly referred to as the “love hormone,” as well as other neurochemicals like dopamine (Stoppler, 2007). The combination of these chemicals creates a blissed-out, deeply satisfying sensation throughout the body during and after sexual contact.

(This tip is for consenting adults who are practicing safe sex.)

5. Get a massage

Touch-oriented modes of healing and pain management such as acupuncture, massage, chiropractic adjustments, and hydrotherapy are known to stimulate endorphin release (O’Sullivan). This is part of what makes these treatments so popular—they leave you feeling relaxed, relieved, and revived.  Plus, you don’t have to do anything but sit or lie down and let the good feelings flow.

6. Meditate

Simply relaxing and focusing the mind on meditation triggers the release of endorphins and also helps increase dopamine, serotonin, and melatonin. This cocktail of chemicals flooding the bloodstream leaves the meditator feeling calm, happy, and content. One study found the effects of running and meditation on mood to be very similar—both activities produce endorphins and lead to positive feelings (Harte, Eifert, and Smith, 1995).

For someone new to meditation, the following tips may help you ease into its pleasing effects.

• Find a quiet spot free from distraction. Ideally, this will be a place where you can sit or lie down comfortably.
• Consider lighting a candle and/or listening to soothing music.
• Shift your attention away from the myriad thoughts and worries that tend to flood the mind in the initial moments of meditation. Repeating a simple mantra may help.
• Breathe slowly, deeply, and consciously. Allow your breath to guide you into a state of deep awareness and relaxation.

7. Laugh

Laughing lifts the spirits and relieves tension. This is somewhat of a given for anyone who has ever experienced a good belly laugh. But did you know that part of the reason laughing feels so good is because of the endorphins that stream through your system when you do?

According to research presented at a meeting of the American Physiological Society (2006), just knowing that laughter is coming boosts endorphins and sets the feel-good vibes in motion. Stress reduction and improved immune functioning are added perks of letting loose with laughter.

References:

1. American Physiological Society. (2006, April 3). Just the expectation of a mirthful laughter experience boosts endorphins 27 percent, HGH 87 percent. Phys.org. Retrieved from http://phys.org/news63293074.html
2. Carollo, K. (2012, February 20). The world’s hottest pepper: Brings pleasure and pain relief. ABC News. Retrieved from http://abcnews.go.com/Health/capsaicin-ingredient-hot-peppers-offers-medical-benefits/story?id=15727011
3. Harte, J. L., Eifert, G. H., and Smith, R. (1995, June). The effects of running and meditation on beta-endorphin, corticotropin-releasing hormone and cortisol in plasma, and on mood. Biological Psychology, 40, (3), 251-265. Retrieved from http://www.sciencedirect.com/science/article/pii/030105119505118T
4. Hendrick, B. (2010, August 4). Resveratrol may slow aging in humans: plant extract resveratrol suppresses inflammation, study finds. WebMD Health News. Retrieved from http://www.webmd.com/healthy-aging/news/20100804/resveratrol-may-suppress-inflammation-in-humans
5. Ireland, K. (2014, February 10). How to boost endorphins. Livestrong.com. Retrieved from http://www.livestrong.com/article/88275-boost-endorphins/
6. Mayo Clinic. (2011, March 4). Red wine and resveratrol: good for your heart? Diseases and Conditions. Retrieved from http://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/red-wine/ART-20048281
7. Newsmax Health. (2013, July 8). Regular sex makes you look 7 years younger: researcher. Retrieved from http://www.newsmaxhealth.com/Health-News/sex-aging-health-benefits-endorphins/2013/07/08/id/513728
8. O’Sullivan, B. What are endorphins? The Road to Health Newsletter. Retrieved from http://www.road-to-health.com/64/What_are_Endorphins_.html
9. Simon, G. (2012, January 18). Alcohol and endorphins: ‘feel good’ chemical key to problem drinking? Counselling Resource. Retrieved from http://counsellingresource.com/features/2012/01/18/endorphins-and-alcohol/
10. Stoppler, M. C. (2007, March 15). Endorphins: natural pain and stress fighters. MedicineNet.com. Retrieved from http://www.medicinenet.com/script/main/art.asp?articlekey=55001
11. WebMD. (2012, July 23). Exercise and depression. Retrieved from http://www.webmd.com/depression/guide/exercise-depression

The thinking/feeling dichotomy was first connected to individual differences in psychological types (personalities) by Carl Jung. It is used in the Myers-Briggs Type Indicator’s personality typology and addresses natural differences in how individuals make decisions and experience emotions.

It is also the cause of a great deal of tension and conflict for couples that naturally differ on this dichotomy.

The terms used for descriptive purposes here can be misleading. For instance, someone with a feeling response orientation is not inherently more able to feel or less able to think than someone with a thinking response orientation; and someone with a thinking orientation is not inherently more able to think or less able to feel than someone with a feeling orientation (Reinhold, 2007).

These terms are used to address fundamental differences in the perceptual and experiential processes automatically triggered when thinking- and feeling-response-oriented individuals are sorting out and expressing what they are thinking and feeling. (Please note that this interpretation differs significantly from those of Carl Jung and the authors of the Myers-Briggs Type Indicator.)

Although human beings are aware that people differ in how they come to conclusions and experience and express emotions, few understand that these differences in self-expression are driven by innately different perceptual and experiential frames of reference. Of particular note is a fundamental difference in the experience of emotions when conflicts arise—a difference of such magnitude that role-reversal comprehension is not possible. These differences are a constant in interactions between thinking and feeling individuals, easily confirmed by observation of one’s personal and professional relationships.[fat_widget_right]

Those with thinking response orientation:

• Process thoughts and experience emotions with an objective, fact-based frame of reference.
• Base decisions on objective criteria of cause and effect.
• Automatically seek a logical explanation for what is happening when conflicts arise.
• Have a self-grounded sense of logical consistency in thought, action, and emotion.
• Interpret anything expressed or done that does not make logical sense as automatically invalid.

Those with feeling response orientation:

• Are wired to facilitate harmony in human relationships.
• Have a natural sensitivity to issues of fairness and inclusion.
• Are tuned in to the tone of communication. If it is not said nicely, it is not nice.
• Are susceptible to feeling guilty or bad out of proportion to objective reality when conflicts arise.
• Have a susceptibility to feeling hurt and rejected when responded to in an emotionally neutral or blunt manner.

Thinking/Feeling Couples

The usual cause of difficulty for couples that differ on this dichotomy comes from a fundamental difference in how they experience and express emotions. The moment harmony is disrupted, most feeling-response-oriented individuals feel bad, as if they have done something wrong. Knowing they have not, in fact, done something wrong does not usually help. They feel bad anyway.

When these feelings are triggered, they may immediately apologize, hoping to restore harmony and neutralize the guilt they are experiencing, or they may get upset with their partner for doing something that caused them to feel that way. Neither of these responses makes much sense to a thinking-response-oriented individual.

Why would a person feel guilty and bad simply because someone disagreed with them; much less suggest that the other is at fault for causing them to feel that way? From the thinking-oriented perspective these responses do not make logical sense and are therefore invalid.

Choice is not an option here. Very much like the degree to which someone is left-handed, right-handed, or ambidextrous, the manner in which feeling- and thinking-oriented individuals experience and express thoughts and feelings is natural and normal—just different.

The Challenge in Communication

In essence, two naturally disparate perceptual frames of reference for making sense out of the same reality have been activated. The feeling partner seeks validation for how they are feeling about the situation, while the thinking partner seeks validation for why they think their partner’s feelings do not make logical sense. Neither can provide a response that meets the other’s criterion for being heard.

Without intention or awareness, the explanations that each provide for justifying their own natural and normal responses de facto invalidate the natural and normal responses of their partner. Issues of little import can trigger emotionally charged exchanges that leave both parties psychologically battered, blaming each other for the damage done, while the issues themselves remain unresolved. The conflict resolution challenge is significantly magnified when the couple also differs on the extroversion-introversion dichotomy.

Conflict Resolution Approach

I have been using a natural differences questionnaire based on the Myers-Briggs Type Indicator with all couples and families since 2000. Information on natural differences has proven to be consistently accurate.

In fact, the accuracy of the information above is such that most thinking-response-oriented partners have been able to accept its validity. Feeling-response-oriented partners have usually been more ambivalent. Although the information provides concrete validation regarding their emotional sensitivity and reactivity, it does not provide them with much relief from the feelings that get triggered when conflicts arise.

If they accept the premise that natural and normal differences in response orientations are at play, they have to acknowledge that their partner

1. cannot experientially relate to how they are feeling when conflicts arise and, therefore,
2. is not at fault for the feelings their comments can trigger.

The inequity inherent to this difference in experiencing emotion is such that some feeling-response-oriented partners have great difficulty accepting it. Fortunately, once most thinking-oriented partners have a logical explanation for their partner’s feel-based responses, they have been able to soften their responses in general and become more considerate and accommodating when conflicts arise. This change has helped many feeling partners contain the resentment they automatically experience during conflict.

The intensity of the explosive exchanges that some thinking/feeling couples are dealing with is such that adherence to a timeout rule is an absolute necessity if they hope to replace their destructive conflict resolution process with a healthier one. It is understandable why some feeling-response-oriented partners have a hard time adhering to this time out rule. After all, extroverted/feeling-oriented individuals have a particularly difficult time letting go before their partner has acknowledged the validity of how they are feeling.

The fact remains that once an issue has become emotionally charged and abusive, the possibility of a meaningful resolution no longer exists. Partners with strong extroversion, intuition, and feeling-response orientations may have a particularly difficult time accommodating this timeout rule.

The level of psychic distress (disruption of self) that some experience is so extreme that efforts by their partner to withdraw may trigger desperate, even violent behaviors to prevent their partner’s exit before a resettling response has been provided. However, a way must be found to contain these emotions if they hope to replace their destructive process with a healthier one.

Consequently, depending on the perceived volatility of the conflicted exchange, the person calling for a timeout may:

1. Agree to a future time to reconvene and try again, before their next counseling appointment.
2. Wait until their next counseling session to address the issue.
3. Contact the counselor to see if an earlier date can be scheduled to meet.

The timeout is almost always called for by the thinking partner and resented by the feeling partner.

Tip for thinkers: Seek to understand and accommodate your partner’s areas of sensitivity rather than attempt to help them understand why they should not feel that way.

Tip for feelers: Use logic-based constructs when explaining why they are upset. Example: “Even though you do not understand why I get upset when you say that, the fact remains that every time you say that I get upset. Given the predictability of my response, why do you keep saying that?”

Once most couples realize that natural differences are at play, and that neither is intentionally responding the way they do in order to get his or her own way, they are able to accommodate and compromise in areas that had not been possible before.

Reference:
Reinhold, Ross. (21 March, 2007). E-mail correspondence.

Professor Martin S. Bergmann died January 22, 2014, at a little less than 101 years old. In style, he was the quintessential European gentleman of a certain age and class. Although his reputation made him seem forbidding, he was in fact charming, humorous, flirtatious, and even a bit of a tease sometimes. He was kind, generous to deserving students, and compassionate in his understanding of the human psyche.

When he was still in his eighties, I decided that I wanted to study with him; after all, he embodied the history of the development of psychoanalysis. Who better to study with than someone who had lived it?

Professor Bergmann was a master teacher and analyst, famous for his classes in the New York University postdoctoral program in psychotherapy and psychoanalysis, at the National Psychological Association for Psychoanalysis, my alma mater, for his many books, for his presentations at countless conferences, and for his private seminars, one of which I hoped to join.

He was old school and highly cultured. I wrote a formal letter asking to be admitted to one of his classes, telling him about some of our mutual interests—the Holocaust, psychoanalytic theory, best practices for patient treatment, and his book about Western religion, which was an important reference in my doctoral dissertation. We also knew some of the same people, and I had the necessary references, so I earned a place at his seminar table, which I prized.

I was invited to join the Thursday group, composed of seven or eight mature men and women, although we were all youngsters to Martin. The room where we gathered to study together was, like him, elegant—beautiful furniture, famous works of art, Oriental rugs, luxurious, all framed by stunning views of Central Park. The conversations were as rich as the surroundings, and I saved my notes—two manuscript-sized boxes worth, a trove of explanations and ideas for possible future research.

Bergmann’s teaching methods were clear and simple, well grounded in theory, and characterized by his open-mindedness, excitement about learning, and his questioning attitude. He was never satisfied with anyone’s easy answers, including his own, and encouraged us all to press on until we reached the bedrock of our understanding. His persistence was enlivened by his use of metaphor, his playful mind, his courtliness, and the twinkle in his eyes. The Bergmann seminars were electrifying.

He wrote countless articles and  books, including Generations of the Holocaust, The Evolution of Psychoanalytic Technique, The Anatomy of Loving, In the Shadow of Moloch: The Sacrifice of Children and Its Impact on Western Religions, and (with son Michael Bergmann) What Silent Love Has Writ: A Psychoanalytic Exploration of Shakespeare’s Sonnets. His last book, published in 2013, is The Unconscious in Shakespeare’s Plays. Martin loved Shakespeare and often referred to his writings to elucidate psychoanalytic theory. Studying psychoanalysis with Martin was like taking a seminar in art, music, and literature.

Bergmann edited the classic psychoanalytic texts, Generations of the Holocaust (with Milton E. Jucovy), The Hartmann Era in Psychoanalysis, and Understanding Dissidence and Controversy in the History of Psychoanalysis, which received the Gradiva Award. He was honored with the Sigourney Award for outstanding contributions to psychoanalysis and the Distinguished Psychoanalytic Educator Award.

He considered the development of what he called the “psychoanalytic blackboard” his most important contribution to teaching psychoanalysis. The blackboard was a translation of a person’s narrative about his or her life. I will let Martin explain in his own words, in a speech he delivered last year at his 100th birthday party, hosted by NPAP.

To various degrees, most patients are willing to tell their life stories. The question is how to translate what we hear into an analytic relationship, and here many treatments fail. I coined the term active listening, which translates the story of the patient into a workable “psychoanalytic blackboard” that consists of a series of abstractions that we make out of the patient’s story. In our mind we then compare what we have heard with another fiction: the normal person who encountered no obstacles and no traumatic experiences in her or his childhood. This imagined comparison tells me what was less than optimal in my patient’s development and therefore how to proceed. …

Teaching psychoanalysis, working with patients, and writing and presenting at conferences was not enough, however—Martin liked trying new things, and he took a turn at acting. He appeared in three movies: Schindler’s List, Crimes and Misdemeanors, and The Century of the Self.

Most of all, Martin Bergmann loved working as a psychoanalyst. He concluded his birthday speech as follows:

I remain thankful to psychoanalysis for protecting me from an early retirement and the swimming pools of Florida, and for enabling me to still work and teach at the age of 100 and to still make discoveries and write. I have been told more than once that I had a love affair with psychoanalysis, and this may explain why, as the lover of psychoanalysis, I find it exhilarating to be an analyst.

His exhilaration, compassion, elegance, and intelligence enriched his many students and patients, who miss him. His life will be celebrated at a memorial to be held in the spring.

There is a range of both situational and organic causes of depression. Genetics can also play a role in depression; new studies in something called epigenetics have proven that it only takes one generation of mice to pass down a fear of something that parental mice had a bad experience with.

The theory which drives much of present-day pharmaceutical intervention, espousing that low serotonin is a cause of many depressive states, has not been proven. What we do know is that making serotonin more available in the brain can shift the depressive symptoms. However, it is now becoming clear that people who take antidepressants (most common are serotonin reuptake inhibitors) are more susceptible to recurrences of depression through their lives than people who do not use these medications.

I am concerned that this approach may be prescribing a life sentence of an ongoing struggle between depression and medication for people who take antidepressants rather than allowing a natural state to facilitate change and growth. Also of grave concern to me is the way that we have forever shifted culture by trying to rid ourselves of uncomfortable symptoms while perpetuating a belief system that only positive feelings are acceptable. This is not in sync with the cycles of nature in any way.

We forget we are of the natural world. This approach does not understand that symptoms are only a small part of what really needs our attention. Our culture’s classic symptom-oriented response leads to exactly what the word depression describes: a condition of “pressed-down energy”—-stuck energy that may be very important to look at, exploring the meaning of the situation and allowing it to influence our life choices, leading eventually to change that will re-establish and support the life flow.

The Role of Serotonin

Regarding current chemical trends in treatment, let’s look briefly at what we do know about serotonin: it (along with melatonin and other chemicals) is a neurotransmitter and neural protector that is incorporated into every neural network on the planet, as well as within the human body. Serotonin acts as an information carrier (neurotransmitter), a hormone transmitter, and a modulator of various tissues. It regulates neural networks that refine the communication between the brain and the heart, allowing them to work as a cohesive system.

Serotonin plays a huge role in neuroplasticity (growth of new neural networks in the brain), which is necessary for any living adaptive system. It helps to unify the entire brain into a cohesive biological system by modulating the brain and central nervous system, and continually altering the chemistry of target neurons. It influences form, influences sensory and motor neurons in order to track the source of stimuli from outside the system, and regulates the information that comes to us through our senses.

Serotonin neurons are in our heart, brain, digestive system, and immune system, and are activated by stimuli outside of the body. Serotonin exists (in the body) in any place we touch the outside world and the outside world touches us; it is the interface. As information touches the neural network the serotonin neurons coordinate our physiological response.

The serotonin chemical is highly reactive to any kind of change in the environment. It modulates the information received through our senses, the sensory gating channels. As sensory inflows occur it narrows or opens the gates to what becomes our awareness. In depression it would appear that these gating channels are narrowed and do not allow the sufferer to have a complete picture of his here and now situation.

The Body Connection

Over 70% of the serotonin in our body is manufactured in the gut, so I would assume this would be a good place to begin the exploration of dealing with depression—looking at the condition of the gut flora, the diet, and the overall physical health of the person with depression. Some depressions are simply caused by poor physical health which needs to be remedied.

For others, depression may be situational. In this case, I think it is important not to seek to suppress the experience, but to facilitate the cycle that one is in, so that the meaning of the mood issues can be perceived and lead to a new way of being rather than be pushed back to status quo. Herbs that can support this process as well as other etiology will be listed later in this paper.

These days, it is rare to find a person whose depression hasn’t been perceived from the perspective that to be “down” is an illness, rather than a part of the rhythm of life. And while I understand the extremely high severity and difficulty in some cases, I repeat that I think we have exacerbated depression through suppression of a natural cycle.

Situational depression happens for more reasons that we can count, and many that we don’t understand. Some causes are that a person might be recovering from loss or trauma, or dealing with unmet needs from another stage of life. Especially potent are the unmet needs of childhood that leave some aspect of the person stuck in an earlier stage of development, despite the progression of the body through time. This is seen as soul loss in some cultures.

Depression is often related to the feeling of helplessness that leads to a state of despair and of giving up. It is extremely important for the person to explore and acknowledge the meaning of the depression and take the difficult steps to remedy their situation—whether something is not working in their present day reality, or there are unprocessed stimuli from a past experience, as seen in posttraumatic stress (PTSD) or soul loss.

Often it may be a combination of the two, the present-day situation triggering the old issue and making it difficult to perceive the present accurately. When we look at the role of serotonin and how it modulates information from outside it is easy to see how, if we ignore either the difficult life situation or the old material, we can upset the inherent regulatory balance of the chemicals involved.

Depression: Physical, Psychic, or Both?

My main orientation to mental health and depression grows from a Reichian perspective—anything that is suppressed will come out in other ways, because energy needs to move. Energy is just information, something that comes to do the work of informing us of something. This is similar to the way electric currents run through a wire or water through a hose. Its nature is to move.

In my work at Body-Psychotherapy of Seattle, I look to open the compromised system and restore the flow of life on the five levels of existence: the body, emotions, thinking mind (thoughts), actions (will/ behavior) and the “big mind” (spiritual/etheric influence of a person). The point is to create an integration of a person’s life experience between these five realms so they work in coherence with one another rather than, for example, overusing the thoughts to justify one’s actions or to deny one’s difficult emotions.

Working physically with the body is important to me because whatever physiological and muscular reaction we have to the external environment become involuntary reaction patterns wired into the nervous and muscular systems. These responses are set into motion when the body senses something that remotely resembles a past compromising situation, even if that is not happening in the present. Over time, chemical reactions and the associated muscle memory create strong, overused muscles that become an actual physical armoring that keeps us stuck reliving our early life experiences over and over again.

One of the major challenges of depression in our culture is the necessity to be high functioning all of the time. I would approach depression very differently if we had a society that had built-in flexibility to allow people to adjust to these natural cycles when they beckon. Chronic stress and feeling a lack of meaning in life contribute to, if not cause, depression. This creates a real dilemma in finding healthy responses.

Putting Phytotherapy into Practice

Herbs can play a major role in supporting a person’s entire system to meet the demands placed on it while undergoing a difficult change process. It is important that an herbalist refrain from trying to be the sole health care provider for someone with serious depression. It is important to have a guide (or several) working together to negotiate all levels (body, emotions, thinking, behavior, etc.) into synchronicity.

I am less and less comfortable giving out lists of herbs for certain conditions. I think that an herbalist must have his or her own allies to call upon in order to promote health in another. It is our relationship and our experience with the plants that that charge the treatment. But I can suggest some approaches to choosing herbs.

First, be sure to think about the person’s constitution and match herbs to the unique disposition. In Ayurvedic medicine, there are three dosha, which are elements that make up a person’s composition. Everyone has a different combination of these elements, which may become unbalanced to unhealthy levels. Different substances can affect the traits of the dosha in different ways, so it’s important to tailor the remedy to the person.

For example, do not give a drying herb to someone with an aggravated dry (Vata) state; this is a person who might have dry mucous membranes and an airy personality, and be easily distracted. Nor should you give sweet herbs to a Kapha, a person who is overly earthy, lacking expression, and slow moving. They would do better with spicy or bitter remedies, those that might confuse and exacerbate the symptoms of a Vata person.

As you can see, the symptoms of depression will manifest differently in different constitutions; basically each constitution will be exaggerated in its imbalanced state. A Pitta person may be agonizingly irritable and restless, a Vata will demonstrate confusion and lack of concentration, and a Kapha will cover all of the windows and stay in bed for months.

All of these are common symptoms and may co-occur in one person, but look closely to see the subtleties and with practice you will be guided in choosing appropriate herbs. Overall, herbal remedies for depression need to be stimulating (to get things moving) as well as nourishing to the body and soothing to the nervous system.

More Tips for Internal Stability During Depression

People in any depression should avoid as many environmental toxins as possible; eat organic foods; and avoid caffeine, sugar, and processed foods. They should surround themselves with a natural, nonstimulating environment.

Promote healthy gut flora through the use of probiotics and regular elimination practices. If one’s feces smell strongly, be sure to take this as a warning sign from the gut.

For a period of time, promote good elimination through the use of herbs like Aloe, Rhubarb, Licorice, and Pasqueflower, or use bitters such as Dandelion or Gentian Root. This is going to be especially important in working with people with the cold, damp constitution, as they will tend toward a slower metabolism. But the Pitta and Vata may also have absorption problems for different reasons.

After creating a well-functioning environment in the gut, use alteratives (a category of herbs with tonic effects) to support the liver in removing toxins from the body. Dandelion and Pasqueflower, as mentioned above, are also categorized as alteratives. Many good blends are available. One I make for myself includes Ashwaganda, Burdock, Red Clover (for the blood), and Yellow Dock.

Extremely important is the use of nervines—beneficial plants—throughout the treatment course to soothe the nervous system and calm anxiety. Some of my favorites: Lemon Balm, Scullcap (especially helpful for racing or obsessive thought patterns typical of a Vata or Pitta person), Rosemary, Passion Flower, and Milky Oats (which would be good for a Pitta person, as it is so cooling and damp). And, of course, the use of St. John’s Wort should also be considered in depressive states—although studies suggest it works best in moderate cases. The sun herbs, like St. John’s Wort, Hawthorne, Rosemary, and Frankincense (as aromatherapy), are especially good in seasonal depressive states.

All depression treatments must include getting out into natural light on a regular basis; even if it is dark and cloudy, this will have a positive effect. Moving the body through walking or exercise is also crucial, but especially hard to facilitate in the person with a Kapha constitution.

After supporting the liver and the nervous system, look to adaptogens—stabilizing herbs—to put some zing back in the kidney and adrenal systems, as these are heavily taxed in depression. There are many wonderful adaptogens; I vary my blends regularly to get a sense how the different herbs work and work together.

Always use herbs you are familiar with, so you can sense how they are affecting you or, if you are a therapist, your client. I love Schisandra, Ashwagandha, Polygonum, Gotu Kola, Astragalus, Rhodiola, Dong Quai, Ginseng, and Motherwort.

Wisdom in Worldly Healing

For me, the most important treatment guidance is taken from the practices of other cultures. In South America and Africa, shamans travel between the worlds to resolve soul loss, some of which is described above. Much of the work I do involves treating soul loss of several types, but, different from the indigenous practices, I like to make sure that I have fully prepared all aspects of a person’s system so that they can retain the results long after the treatment ends. I do the scouting and the guiding, but my style also puts the onus of the work on the client: with my help they bring awareness to their old patterns and interrupt them via interventions (for example by thought-stopping, a cognitive behavioral therapy intervention).

I teach them how meet the old underlying need, building relationship and nurturing the young parts of themselves from within. Over time and with vigilance, the information that once ran through neural network systems in predictable, outdated, and problematic patterns can begin to pool as if in a dam, and finally overflow to form new neural networks that better fit the current reality.

Another model that I always have in mind with depression is from ancient mythology involving the underworld. Persephone is a Goddess who was abducted to the underworld by Hades. She faced many challenges there. But up above her mother Demeter searched and held ground for her until she was returned. Innana of the Sumerians traveled the same journey, having to face the fierce Goddess Ereshkigal in the underworld until her time came to be released. This is this same journey that one takes through the belly of depression. An herbalist working on these levels might consider using Spagyric Essences, alchemically prepared herbal remedies which can positively affect depressive states. They are prepared by first distilling the essential oil, the Soul, out of the plant; then leaving the hydrosol and plant matter to ferment and distilling the alcohol from that. This is the Spirit level of the plant. The remaining plant matter is purified through fire until it is reduced to white ash from which the mineral salts, the Body of the plant, is extracted. All three are put back together to form a remedy that works on the etheric levels to create change beyond the body. That change trickles down to the body and facilitates health. Organic Unity carries a line of Spagyric Essences that are made from wildcrafted plants, prepared according to corresponding astrological influences and infused with healing prayers and love. In my experience, this care makes a huge difference in the potency of the remedy and its impact on the client. I highly recommend them.

Finally, I think that the most important thing to keep in mind when working with a severely depressed person is that they must not be left on their own. Like Demeter, someone must hold space for them and watch for them from above, creating an anchor to the larger world. This space must be held by someone who is not afraid of the dark. Someone who is patient and kind, wise and strong. A practitioner with knowledge of the territory, a big loving heart, and good boundaries!

My work with people often drives me to explore themes that are currently showing up in my counseling practice. If you are a counselor, you know what I mean. You may have many clients or therapist consultees presenting with the same needs, perhaps some who are saying similar things of late. That’s not to say that these issues are the “same,” for they are not. Nevertheless, there are topics that may repeat themselves. I pay attention to these because I believe that there is much to explore and learn by being aware of patterns.

A pattern I have seen of late is related to eye movement desensitization and reprocessing (EMDR) work, specifically about the process of being “ready” to do EMDR. I have had a lot of therapists inquiring about their clients’ readiness to do EMDR. Keep in mind that if you are doing EMDR, you are always doing EMDR; it just depends on the phase you are in. If you are one of my EMDR clients or therapist consultees, you know how much I emphasize this as key to understanding the EMDR therapy model. Keep this in mind: EMDR is a process, a model, and not a technique.

EMDR’s preparation phase is phase two of the eight phases of EMDR. EMDR therapists look for people to have a minimum of two state-change skills as part of this phase. In phase two we are making sure that the client has the ability to not only tolerate emotion, but also to shift into a relaxed state, a para-sympathetic response. In other words, can the person bring up a disturbing event, be “in it,” but then also utilize a relaxation skill or calming technique to then change states if needed?

Keep in mind that the concept of changing states may be something that sounds easy, but for many it is not. Some folks seeking to utilize EMDR therapy as part of their trauma recovery may need more extensive preparation-phase support. This is especially true in the case of those struggling with dissociation and addictions.

In its simplest form, a state change means being able to utilize a relaxation skill to settle down one’s system. State-change skills can help the EMDR client to become calmer and more settled while still maintaining “dual attention”—i.e., being present while bringing up traumatic disturbance(s). In contrast, and though it may appear like it, the ability to utilize state-change skills does not mean changing states via dissociation. Certainly, one’s ability to dissociate may appear similar to a state-change skill, and is a survival skill, but dissociation keeps us “away from” traumatic material and from integrating the somatic, visual, emotional, and cognitive aspects of it to then heal.

For example, dissociation takes one away from the present moment because the past feels as if it is happening now and it feels safer to leave the present. But to be able to heal and integrate the traumatic material requires that state of being present. We just have to learn the dance between feeling the disturbing material and being able to shift into a contrasting, calmer state.

In exploring the concept of EMDR and state-change skills, addictions can also be explored as an attempt to chemically or behaviorally illicit a state change. I often explain to people that substance abuse is often driven by an ill-fated attempt to chemically dissociate. One can easily become entrenched in the vicious cycle of using addictive substances and behaviors to shift “out” of traumatic material in order to feel something, anything, and everything different from the pain of a traumatic history. And, for many people, addictions have become a way to change states, to feel away from and out of traumatic material.

The bottom line is that to heal, trauma histories beg to be accessed, stimulated, and reprocessed. The challenge can be in our making sure that EMDR clients are fully supported in having the state-change skills in place to be able to come back, to ground, and to stay present first. Therefore, creating and implementing these state-change skills can be the key to supporting EMDR clients in their recovery and throughout EMDR’s eight phases.

We all have many wounds. Broken hearts, shattered dreams, abuse, and trauma all leave battle scars that may not be outwardly apparent to others, but can cause a lifetime or even generations of experiencing the same issues, as patterns are often repeated and handed down as part of the family legacy.

The pain sustained throughout the years frequently leads us to develop defensive shields that serve to protect our vulnerable hearts from being wounded once again. And yet, this outer armor ends up not only closing us off from others, but also ultimately from the beauty and wonder of our own souls.

As a psychotherapist working from a depth perspective, I have been fascinated and privileged to have been able to witness the soul at work every day in my interactions with clients, as well as out in the world. The soul always strives to attain a state of wholeness or unity and seeks to reestablish harmony when an imbalance exists.

For example, I have frequently noticed that individuals with deep inner wounds often spend a lot of time engaged in outer pursuits in order to avoid looking within and facing the discomfort that they feel, yet at the same time they often experience a deep yearning for something more meaningful in their lives. If the gap between their inner and outer state becomes too painful to bear, they may finally feel compelled to explore their inner world through some type of creative endeavor, spiritual practice, or by entering into an empathic therapeutic relationship. This type of inner work can lead to an inner transformation that creates a more balanced perspective.

One of our fundamental needs as human beings is to be deeply heard and understood. When we experience pain in silence, we tend to feel cut off and separated from others and unable to enter into satisfying relationships. Unfortunately, as we grow up, we are taught that certain aspects of ourselves are unacceptable and unlovable, which in turn leads us to feel different from others.

We therefore start to reject those traits and identify only with the characteristics that are deemed pleasing to others in order to try to fit in. But deep down, we are aware of this inner conflict that is going on between our outer persona and our inner authentic being, which can lead us to feel unworthy of love and disconnected from ourselves and from others. In order to heal, we often require the presence of an empathic other to help us to examine more closely the inner dynamic that has been occurring.

Soul work involves shining a light inward in order to begin to integrate more and more aspects of our being that we have learned to repress. Individuals who have gone through trauma or abuse especially can end up with deep scars that lead to feelings of unworthiness, low self-esteem, and fear of true intimacy. They frequently learn to hide their true nature behind a false self as an adaptive measure designed to protect them from the trauma or abuse that they have suffered.

In so doing, they inhibit all of the characteristics that they believed to be unlovable or unwanted, but that actually make up a vital part of their essence. By turning their gaze inward, however, and exploring the aspects that they had originally rejected—often because they were deemed unacceptable or shameful—they can reconnect with their ability to love on a deep level and become more compassionate and understanding of others, as well as of themselves.

The Apaches have a legend that exemplifies this inner soul work. They believe that our spirits are born with us in the form of raw diamonds and that our goal in life is to obtain as many facets or cuts on our spiritual diamonds as possible. Each facet polishes the diamond and makes it shine a little more.

A new cut is formed every time we are faced with a problem or difficulty in our life and we use the opportunity to try to learn something new about ourselves. All of the struggles and suffering that we are faced with therefore become occasions for us to grow and fulfill our purpose for living. At death, the Apaches believe that our diamond spirit is returned to the Eye of God, to shine within the heavens for all of eternity. Each facet becomes another sparkle in the Eye of God.

In the same manner, I believe that turning our attention inward and doing our own soul work is our true purpose in life, which can lead us to experience a greater sense of wholeness and unity. By starting to look at the deeper patterns at work in the soul and how these are played out in our lives and in the world, we can begin to see our interconnectedness with all beings and things.

Each individual soul has a particular path to follow that intertwines with all of the others around it. By working to become more conscious of our own particular role and purpose in the world and how we relate to others, we can begin to heal from our sense of isolation as separate beings and come to feel that we are all truly connected on a deep soul level.

Thank you for your letter. I’m sorry to hear that you aren’t experiencing the therapy you’re receiving as helpful, and I hope that I can provide some assistance. I’m going to start by offering a brief description of psychodynamic therapy and how it works.

Psychodynamic therapy is one of many “depth” psychotherapy processes. It is insight oriented, and a lot of the work is based on free association, where the client simply talks about whatever is on his or her mind at the moment. Eventually, patterns and processes stemming from past experiences and unconscious drives become apparent. The focus of the therapy then goes to the client becoming aware of how these patterns and drives are affecting his or her life. The goal of psychodynamic therapy is not simply to make symptoms go away but to improve one’s life in general. Those are lofty and worthwhile goals that often require some amount of time to accomplish. The experiences one has in life, including trauma, abuse, and neglect, become embedded in the way that person interacts later in life, and it may take some time to work through these more complex aspects of being. There is really no set time that anyone can give on how long one would be in psychodynamic therapy, as it is all dependent on many individual factors that are specific to the client, his or her needs, and the therapeutic relationship.

Now for the specifics of your question: It sounds as if your therapist is well credentialed and doing well by engaging in her own therapy. That indicates that she is a responsible professional, but, of course, without knowing her personally, I can’t say with any certainty one way or another.

What I can tell you with some measure of certainty is that one of the necessary conditions for optimal therapy is that there is a relationship between the therapist and the client. This means a relationship of trust, honesty, respect, healthy boundaries, and mutual willingness to work together. If any of those conditions aren’t present, the therapy process will not go as well as it could. Without knowing you, the therapist, or the relationship between the two of you, it’s hard to say what could be slowing down the process. However, as you reflect on your relationship with your therapist, I would invite you to explore the ways in which you engage in the therapy. Is there a part of you that withholds in therapy? Do you feel like you have allowed yourself to trust the therapist? You mentioned that you haven’t allowed yourself to “go there” with your therapist, and I’m curious if that is holding back the process in any way.

Because one of the most important pieces of a therapeutic relationship is mutual honesty and trust, I would suggest that you start with speaking openly and honestly about your concerns with your therapist, if you feel comfortable. If you can raise your concerns to your therapist, even when it might be a bit uncomfortable, you will be taking another step in trust and vulnerability with the therapist, which can serve to help the relationship. If you do so and you feel as though your concerns are still not resolved, the relationship hasn’t improved, and you don’t feel some sense of resolution, then it may be time to consider moving in a new direction.

If you do decide to go another direction with therapy and your therapist is not able to recommend anyone, GoodTherapy.org’s search engine can help. If you decide to go that route, I suggest that you take your time in finding someone new to work with and that you interview the therapist on how he or she works, what he or she expects, and how he or she anticipates the therapy progressing. If you decide to go with another therapist, take your time and make sure that it is the right fit for you, your needs, and your goals.

I applaud your willingness to seek out therapy and to ask for help when you need it. I trust that you will continue your journey with courage.

Yours truly,
Lisa

Recently, my son told me of a situation he had decided to avoid. To sum it up, he said, “I’d rather protect than subject.” I thought this encompassed many lessons in a concise way.

How often do we subject ourselves to situations we know will be unpleasant? How often do we choose to see people we know will deplete us, go to an event we would really rather skip, or say yes when every cell is screaming no?

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Healthy self-care depends on our ability to set boundaries. Assertively creating the life you want includes saying no—and sticking to it, as opposed to saying no and letting people cajole you into saying yes. By staying true to your goal of treating yourself well, you can push out of the comfort zone of not disappointing anyone and actually say no as many times as is necessary for someone to hear you. Typically, this takes a few repetitions. The good news is you just have to repeat yourself. There’s no need to say it in a different way. The easiest response is often, “I am sorry I won’t be able to do that; I have other plans.” No one needs to know what your plans are. You may want to spend the afternoon staring into space, writing a dissertation, or taking a nap. It doesn’t matter. Just saying the same sentence again and again in a kind, patient, gentle way will do the trick.

Good self-care also requires a willingness to look at one’s life and see where it could be more balanced. Are you spending an inordinate amount of time at work? Are you experiencing compassion fatigue from caring for a relative? Does your life feel swamped with errands and chores? Are you studying into the wee hours? Exercising to a state of exhaustion? By taking a look at the major areas of your life, you can quickly see if you are giving short shrift to rest, relaxation, social time, solitude, quiet, dancing, nature, journaling, music, or anything else that rejuvenates your body, mind, and spirit. Start by carving out even five minutes to sit quietly, have a cup of tea, or close your eyes. Making the conscious decision to take time to be still can be far more challenging than staying on the activity treadmill. Once you give yourself the gift of stopping and simply being, the rewards will keep you coming back.

Protecting yourself from your own internal litany of self-criticism is also important. How do you talk to yourself? Are you quick to put yourself down? Sometimes, protecting yourself means learning to be more tender with your own feelings, including your emotional responses to life’s slings and arrows. Creating an inner dialogue of supportive, positive, loving messages will have a profound effect on your relationship with yourself. A good way to start is to read a list of affirmations and write down a few that really resonate with you. I am especially fond of Louise Hay’s approach: Look in the mirror every day and say, “I love you. I really, really love you.” As supremely simple as this sounds, it is amazingly powerful.

On a more mundane level, self-protection entails daily rituals of eating, sleeping, and getting some fresh air. How conscientious are you with these basic life tasks? Most Americans get far too little sleep, which sets the stage for disease, crankiness, and deep fatigue. How is your diet? Are you eating five to nine servings of fruits and vegetables a day? It is not that hard to do. Try a handful of baby carrots, a bowl of bean soup, some fruit and cereal, a stir-fry or salad. Each of these foods will improve your mood, bolster your immune system, and provide you with the energy you need to better navigate your day. Make eating well a priority and watch your sense of well-being improve. While you are at it, make sure you eat frequently enough. Eating infrequently is another emotional saboteur, as low blood-sugar levels wreak havoc on your ability to feel stable, patient, and resilient. So, don’t let more than four hours pass without a snack or meal—and please eat breakfast.

On the topic of food, there is an ever-increasing amount of research being done on the beneficial effects of probiotics on all aspects of health—especially immunity and mood. Whether you eat sauerkraut, tempeh, yogurt, kefir, cheese, or dark chocolate (yes, chocolate is a fermented food), having some of these every day ensures a healthy gut.

Last, but not least, being aware of how things affect you is crucial to doing everything I’ve mentioned. Whether it is awareness of how you respond to someone’s tone of voice and asking them to speak to you differently, paying attention to feeling tired and actually going to sleep, or eating before you are starving, the greater your awareness, the greater the chances you will take better care of yourself. If you find yourself rushing through your day, try to carve out some solitude for yourself. By sitting with your breath and watching the parade of thoughts as they pass across your mind, you soothe your nervous system and begin to understand the transitory nature of everything.

Remember, you are a work in progress. The next time you think you have subjected yourself to someone or something that was disturbing, unhealthy, or even toxic, use it as an opportunity to be more aware in the future. Growth and change happen incrementally. Be thankful you could be aware of the situation’s effect on you, and resolve to head it off at the pass the next time.

Recently I watched a YouTube video of comedian Louis CK being interviewed by Conan O’Brien in which he was discussing his reasons for not allowing his kids have cell phones. It was really funny but also quite profound. He talked about how cell phones (and other gadgets) prevent us from feeling sadness. He described an experience he had while driving down the road listening to the radio. He said a song came on that reminded him of his past and made him sad. He noticed the urge to pick up his phone and text his friends in an effort to derail the emotion. Instead, he decided to let the emotion come. He said he pulled over on the side of the road and cried, then felt a surge of happiness afterward, which he explained as gratitude for his ability to feel. He pointed out how when we cut off our ability to feel sad, we cut off our ability to feel happy, too. We coast along in an emotionally dulled state, not feeling too much of anything.

How often we distract ourselves with technology, eating, substances, sex, shopping—and the list goes on—when we feel a pang of sadness heading toward us. It’s understandable; sadness doesn’t feel especially good. But there is a price to avoiding it. When we don’t allow ourselves to feel sad, we stunt the intensity of our other emotions (including joy and happiness) as well. It’s impossible to selectively repress an emotion, so when we limit one, we limit them all. Also, by dodging sadness, we may lose confidence in our ability to handle difficulty. We may start to think sadness is too much for us to deal with, and facing it becomes an overwhelming proposition. However, when we allow ourselves to move toward difficult emotions, we are reminded that we can handle it, and that it usually isn’t as bad as we expected. In my experience as a chronic sadness avoider, I find that when I move toward the emotion instead of running as fast as I can away from it, I’m often surprised by how quickly the sadness comes and goes. I’m reminded that emotions are like waves; they start small, build, crest, then begin to subside. Of course, some waves are bigger than others and go on for longer, and they may return over and over again; but they are usually less difficult to navigate than I expected.

I’ve also come to believe that by avoiding sadness, we stunt our ability to connect with others. In times of profound sadness, I’m reminded of the commonalities of the human experience. It is something we feel physically in a similar way. The throat feels restricted and sometimes painful; there is a pressured feeling in the chest; an empty feeling in the stomach; sometimes we cry. By allowing myself to experience sadness, I’m able to feel more compassion for others. From this compassion comes a sense of gratitude and equanimity. When we move through life emotionally numbed out, we are likely to feel disconnected and alone. Western culture makes it really hard not to avoid emotions. There are so many enticing distractions immediately available and pushed on us every day. Attending to emotion is definitely moving against the cultural current.

[fat_widget_left]Finally, by allowing ourselves to fully experience all of our emotions, we have the opportunity to connect with inner wisdom that informs us about who we are and what we need. For example, recently a client in my practice felt a wave of sadness and allowed herself to explore it in the session. Through this process, she identified her feelings of loss around a disappointing relationship with a parent. As she sat with this emotion and allowed it to run its full course, she uncovered a need to accept this reality—that her parent couldn’t and would never be the ideal parent she had always wanted. Even though this was a tough realization, it allowed her to move forward exploring ways she could parent herself as an adult rather than being paralyzed by a desire for what was not possible.

As an experiment, consider intentionally focusing on your emotional “waves” for a few days. See if you can identify your urge to avoid or distract (whether you choose to distract or not), and if a good moment presents itself, spend some time sitting with it, observing what it is like for you to feel this and reflecting on what information or insights you glean from it. You may benefit from journaling about these experiences as well.

Practically speaking, most of us won’t be able to be mindful of every emotion that comes our way. The realities of our lives interfere with that. Maybe we feel a wave of sadness coming during the middle of a business meeting or in a conversation with our boss when it would be to our detriment to allow the feeling to take hold. Also, emotions are always present and quickly shift and change, so to be constantly mindful would be a full-time job. There are as many ways of practicing emotional mindfulness as there are people, but I can tell you how I do it. When I notice a particularly strong emotion present at a time when it isn’t in my best interests to fully allow it, I make some time later to recall the incident that triggered it and allow the emotion to come forward again. Though it isn’t “in the moment,” I’m often able to recreate it in a context that works better for me. Also, at times when I start to feel sad and there is an opportunity to allow the feeling, I create some space for it by minimizing distractions and choosing not to pick up my cell phone or look up something random on the Internet (my frequent go-to escapes). I also work on not judging myself harshly when I avoid emotions; after all, I am human, and humans by nature don’t like to feel pain.