Some people live their lives in extreme fear, approaching life with a constant sense of terror. The simplest activities of living can become fraught with dangerous possibilities. Feelings of risk and leaving safe spaces can require a person to make a careful assessment of the world before venturing out. People I’ve worked in therapy with who have this terrorized way of relating to their environment often come into treatment expressing misery and self-hate. They blame themselves for their unhappy lives and have little understanding of how they came to feel terrified all the time. They desperately want more freedom in their lives, and just as desperately, they’re afraid to be free.

The first time Joe came to into my office he looked uneasy as he sat down and stared at me vacantly. “What brings you here?” I asked.

Joe mumbled as he bent his head to the floor, “I hate my life, I hate myself. I have no life. I’m afraid of everything. If I’m alone, I can’t travel, drive, or even leave my neighborhood without fearing that something terrible will happen and no one will be there to help me.”

[fat_widget_right]

This was my introduction to 47-year-old Joe, whose story helped me understand what it means to be terrorized from early childhood experiences. I wanted to help Joe understand his terror so he could relinquish his guilt and self-hate and begin to move toward more freedom in his life.

Joe, an only child, grew up in a household with an absent father who was a workaholic and a controlling mother who was depressed and also likely experienced bipolar. His father died of a heart attack on the job when Joe was 16; his mother died by suicide from drowning herself in the bathtub when Joe was 23.

Joe described his childhood: “Before I started school, I have memories of my mother singing and dancing with me and telling funny stories. Growing up, my father was always working, so Mom would sometimes take me to the yard and play catch or goof around. As early as I remember, she would get very depressed. She’d take to bed and be irritable and mean to me. I had to be very quiet and not disturb her or she would scream that I was killing her. I would sometimes hide in the closet with a book or toy, and I wouldn’t make a sound. I was very scared and I knew if I bothered her she would come at me in a rage and threaten to kill herself. I never knew which mother would be around at any time. I could leave my happy mom and go to school and come home and find her slumped on the kitchen table crying that I didn’t love her, or my father was mean, or why didn’t I stay home from school because I knew she needed me. It was so confusing and scary. By junior high, she usually had things she wanted me to do, like cook or help her with chores. She insisted I come straight home from school. She didn’t like me to bring friends home or go to a friend’s house or even participate in activities after school. It felt like she was totally in charge of me. I knew if I pushed back she would get weepy and angry and tell me she was going to kill herself and what a terrible son I was. I felt as if I’d destroy her if I wasn’t careful. But I loved her and we were close. “

When Joe’s mother died by suicide, he was living on his own just a few streets from his mother’s house. He had been trying to reach her by phone. After several hours of not answering, he told me, “I just knew she had done it. I called a neighbor and asked her to meet me at the house. We found her in the bathtub. It’s been a lifelong struggle not to blame myself for her suicide. Rationally, I know it’s not my fault, but maybe I could have done something to prevent it.”

Joe and I spent many months working on his feelings of responsibility for his mother’s death. We considered that restricting his life and his freedom could be a way to punish himself. While this guilt likely contributes to Joe’s paralysis in engaging the world, more recently our work has focused on the ways in which growing up impacted Joe’s development into a terrified person.

Becoming Terrified in Early Childhood

As Joe became more able to talk about his experience of being terrified as a child and young adult, it became clear to both of us what a visceral experience it was. We understood that Joe wasn’t an ordinary scared child experiencing fear. Rather, that child with his toy in the closet was scared to death; he was terrified. His mother terrorized him. The danger he feared of making a sound while his mother was in her bed felt life threatening. Joe did his best to fend off her rages, attacks, and shaming behavior.

He recalled, “She’d get so cold and absent, or shout ‘You’re killing me,’ or ‘You want me dead, you’re stupid, you’re weak.’ She criticized everything.”

The threat of death was very real in Joe’s house. He explained, “She would tell me, ‘You’re going to find me dead one of these days if you can’t help keep this house clean,’ or, ‘If you don’t get home from school on time,’ or, later when I was in college, ‘If you don’t call me every day.’ ”

Joe’s father played no role in mitigating his mother’s destructive behavior. Joe coped alone with the possibility of his mother’s death. Her destructive communication and unpredictable emotional presence left him feeling unsafe, unprotected, and fearful for his own survival. If Joe didn’t consciously feel that his life was threatened, unconsciously he was terrified of his own annihilation.

In treatment, Joe began to develop a more compassionate attitude toward himself as he learned to appreciate how, as a terrorized child, it was necessary to find ways to protect himself and survive the threat of losing both his mother and himself. He simply could not allow himself to visualize engaging in any activity on his own. His was a dangerous world where no one could save him in an emergency. He hadn’t been able to keep his mother safe, and now surely he was not safe.

As we explored Joe’s terror of venturing into the external world, it became clear that he hadn’t developed the ability to enter his internal world. He wasn’t free to play with ideas about his life or to wonder about new and exciting possibilities. He had to be prepared to respond to his mother’s demands. Unconsciously, he had to dissociate his own needs and desires. Clearly, he had not been able to separate and individuate from his mother.

Developing Freedom to Individuate

Joe had learned to rely on his mother to define his identity and for his positive feelings. She needed him to be dependent and used the threat of her death or his annihilation to keep him controlled and connected. He had internalized his mother’s voice, which, in his adult years, continued to govern him. Even when a parent is deceased, terror can live on in their child’s psyche. Could Joe lessen the influence of this voice that kept him in a constant state of vigilance?

I believed Joe needed to emotionally recognize that he had kept himself imprisoned in the service of keeping his essential self alive in protective custody. If he could allow himself to enter his internal world, he would be able to discover his own wishes, desires, and needs and develop an identity separate from how his mother defined him. We had to consider his unconscious resistances to growing his self and leaving his mother’s voice behind. We explored the downside of “leaving” his mother. Joe realized that he still wanted to protect his memory of her.

“She was so fragile and depressed. I still can’t hurt her or blame her. It wasn’t her fault; she did the best she could, given the deficits of her life,” Joe said.

“I know it’s time to stop protecting her. Even though I don’t believe it’s safe yet, I tell myself the risk is not so great—the pleasures and satisfactions in the world are worth the try. I’ve got to try.”Joe has struggled to overcome his resistance to separating from his mother. He is more able to acknowledge her destructive behavior and experience some anger and disappointment. This could empower him, make him less terrified, and help resolve his conflict so he could choose his self-growth rather than continue to protect his mother.

“It’s hard. I spent my life protecting my mother and myself from death. I’m still protecting my image of her as a good mother who will take care of me. Maybe I believe that if I have my mother with me—even my dead mother—it will protect both of us. I know it’s time to stop protecting her. Even though I don’t believe it’s safe yet, I tell myself the risk is not so great—the pleasures and satisfactions in the world are worth the try. I’ve got to try.”

One doesn’t have to have a parent experiencing suicidal ideation to feel terror about their own survival (consciously or unconsciously). Parents terrify their children in many ways. For example, children can feel terror about their parent’s ability to survive and keep their child alive. Terror can also occur when a child is physically or emotionally abused or result behavior that is shaming, controlling, and/or emotionally withdrawn. Anxious or unpredictable attachment can leave a child in a terrified state.

Joe has a come a long way in working on his terror and his ability to feel safer in the world. I tell his story with the hope that others who have lived their lives in terror as the result of their early family experiences don’t have to be doomed to self-blame, hopelessness, and forever be imprisoned and terrorized. When those who work on themselves in therapy understand how they became terrorized people and emotionally comprehend the visceral feelings of terror that have been endured since early childhood, they can be helped to give up the need to protect significant others who terrorized them. Often, this is the start of a transition from self-blame to freedom of self-development.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

Bed bugs.

The mere mention of these critters sends shivers down my spine and can bring immediate itchiness to anyone aware of these pests and their elusive nature. Bed bugs are small, parasitic insects that tend to take up habitation in—you guessed it—the beds of us poor, unsuspecting humans, then feed on our blood when we sleep. They are in the news frequently and may have even sprung up in your area. Perhaps you have encountered bed bugs in your home or in your travels. This has been an epidemic for several years, but when a person is struggling with an infestation it is rarely talked about.

Unfortunately, bed bugs carry with them a certain stigma. There is a misguided perception they exist only in homes or dwellings that are not clean. Also, people may be “bugged out” when they find out someone has a bed bug issue. Perhaps they have read how easily they are transmitted from one person or place to another and want as much distance between them and the other person/place as possible.

At least that’s what many people with bed bugs fear—and what can keep them from turning to others for emotional support.

[fat_widget_right]

On top of the sense of isolation people may experience because of bed bugs, they must contend with the simple knowledge that in their own sanctuary, the place they call home, they have been invaded by a near-invisible parasite that feeds on you in your most vulnerable state. Argh! If your skin is crawling just reading this, welcome to the experience of a person living with bed bugs.

Bed bugs may have invaded your space, but they do not need to take up all the space in your head!

Not only is treating a bed bug infestation costly both socially and financially, it can take a serious toll on mental health. I have worked with countless individuals dealing with these pests. I have also had my own bed bug scares, nearly sending me off the deep end. What I learned from others’ experiences and my own is that these bugs don’t simply impact our physical environment; perhaps worse, they invade our minds and can lead to an experience of extreme stress and isolation.

Perusing the internet on the topic of bed bugs could bring any person to a panic, whether they are struggling with the issue or not. My goal with this article is to provide anyone dealing with an infestation with some tips and tools to help them calm down and emotionally cope with their unexpected visitors. Bed bugs may have invaded your space, but they do not need to take up all the space in your head!

How to emotionally cope with bed bugs in eight steps:

1. First, know you are not alone. A simple walk around my neighborhood in Philadelphia showcases countless mattresses thrown outside in what may mark a first panicked attempt at getting rid of bed bugs. A simple internet search on bed bugs yields thousands of results, indicating this problem is being experienced by way more people than just you. You may feel like a social pariah when dealing with bed bugs, but the truth is, due to the stigma and secrecy associated with bed bugs, you never know who else is dealing with them. Take refuge in the simple knowledge you are not the only one suffering the insufferable.
2. Use some positive self-talk. Say to yourself, “I am a separate person from this problem. This is simply just a problem I am coping with, and it is not my entire life, nor does it represent who I am.” Think about all your positive roles and qualities. Parent, teacher, kind person, clean person—whatever makes up who you are, remind yourself of these things and that you are not just a person who has bed bugs. Each time the thoughts creep back in regarding the bugs, actively change your thoughts. It is not worth it to obsess about them; all you can do is proactively try to take care of the problem, and otherwise try to give your mind a break.
3. Get outside. If the weather permits, do yourself a huge emotional favor and go for a walk. Sit under a tree. Bring a book. Nature has the power to heal us and bring us back to our sanity. In this case, it also gets you out of your hellhole of a home! Remember, you do not deserve the stress of these bugs. You deserve a break from the environment they have invaded, as well as a mental and emotional break.
4. Remember that bed bugs are not really any different than other types of bugs. Think of them as less dangerous mosquitoes. Unlike mosquitoes, beg bugs are not known to be vectors of disease. Yes, they are gross. No, they can’t kill you.
5. Use deep breathing. Breathe in, breathe out … slowly. Count your breaths as you focus on the sensation of breathing in and out. What does it feel like as the breath enters your nose, travels down to your lungs, and then begins to release? See, you already forgot about the bugs. Deep breathing is a form of meditation that helps us focus on the experience of the body rather than the constant thoughts roaming around our heads. Give yourself a moment to stop thinking about the bugs and to relax your nervous system.
6. Get some exercise. Exercise has the power to not only increase your endorphins (feel-good chemicals in the brain), but it can get your mind off the problem. Exercise IN your home. Take back YOUR territory while pumping iron and gaining a sense of power and control. If you can’t stomach the thought of spending another moment near the source of the infestation, go to the gym or exercise outside. Special note: Yoga is wonderful for stress and can help you be kind to yourself during this terrible time.
7. Tell someone! Don’t keep this to yourself. Yes, it can feel intimidating telling someone about an issue you might feel embarrassed about, but the relief of bringing someone into the experience of this issue can be a huge help and can take away the sense of isolation often incurred when someone has bed bugs. Tell a few people if you can, and make sure they know you don’t want this information passed around. Ask for a hug, if you feel so inclined; physical touch can be comforting.
8. Lastly, do everything in your power to get rid of the bugs. Call an exterminator and follow all advice they give. The bugs CAN be beat and you WILL conquer them. Don’t allow the bugs to make you feel incapable and powerless—you are not.

In the end, you will get rid of the bugs. For now, the true goal is maintaining sanity and not allowing the bugs to wreak havoc on both your emotional and physical health. As with many other challenges we face, the worry is the worst part.

Wired for connection, baby daughter looks into her mother’s eyes needing to see delight reflected back to her. What if, instead, baby’s gaze is met with emotional emptiness? Lights out. Nobody home.

And what if this blank stare isn’t the manifestation of a temporary hormonal condition but instead indicative of something more troublesome? What if mom’s emotional tank is perpetually low and she has little or nothing to give her daughter?

If mom didn’t get the love and affirmation she needed when she was young, then her daughter, in the role of the “good daughter,” learns quickly that mom’s needs—and not her own—are at the center of the relationship.

The emptiness mom feels inside can threaten to swallow both mother and daughter. There simply aren’t enough good feelings to go around. And like a bucket with a slow leak, the narcissistically defended mother’s good feelings about herself are in constant need of a refill. In response, the daughter learns to put her own needs on the back burner as she works to fill mom up.

[fat_widget_right]

Many a “good daughter” learns making mom happy is necessary for their own emotional survival. To this end, the “good daughter” manages to subvert/suppress/deny her own needs to take care of mom.

The “good daughter” learns to:

1. Look good for mom: The “good daughter’s” demeanor, appearance, and accomplishments must reflect well on mom.
2. Act happy for mom: The “good daughter” acts cheerful, enthusiastic, and puts on a positive face so as not to overwhelm mom. Bad moods, setbacks, and struggles must be short-circuited, if not hidden.

The Cost of Being the ‘Good Daughter’

In the normal course of development, the “good daughter,” attuned to her mother’s needs, may bury her own needs for the mother’s sake. Understandably, these needs and feelings do not disappear. When these repressed needs surface, the “good daughter” may feel like a fake.

Sadly, when the “good daughter” of the narcissistically defended mother needs support from mom regarding loss, disappointment, or struggle, she may find that mom has little to give.

Mom isn’t evil, although her actions are frequently destructive. Simply put, a mother who is narcissistically injured is consumed with preserving and replenishing her impoverished sense of self. Her emotional tank is empty. The narcissistic defense means mom is forever in a relentless pursuit of the emotional supplies she did not get during pivotal times in her own development. Additionally, mom may feel the need to disguise her neediness, which may result in denial, defensiveness, and manipulation of her daughter.

When mom experiences deep insecurities, her parenting may be slightly or profoundly impaired.

Healthy functioning is restored when both mother and daughter are free to be themselves and no one needs to “be good” for anyone else.

Because the daughter has subverted her own needs, she runs the danger of becoming disassociated from those needs. She becomes “good” at the expense of being real. This can result in the “good daughter” feeling like an impostor, a fake, just waiting to be found out.

Because she is disconnected from her authentic self, the “good daughter” worries underneath it all that she isn’t good enough.

Since her sense of self is rooted in making another person happy, she is at risk for codependency in her relationships. And because she is used to making another person’s happiness the basis for her feelings of self-worth, she may base her sense of self-worth on her own daughter’s successes.

This is how being “good” for mom isn’t necessarily good for daughter. Or daughter’s daughter, for that matter.

Healing is possible, however. The “good daughter” must get in touch with her authentic self and start to mend the places within that she has long denied. In doing so, she enables herself to parent from a place of wholeness and confidence, and to empathize and accept both her own needs and her daughter’s. By becoming aware of and reclaiming forgotten parts of herself, the daughter of a mother with narcissism can end the cycle of maternal narcissism.

Healthy functioning is restored when both mother and daughter are free to be themselves and no one needs to “be good” for anyone else.

Note: The generalizations above may not apply to all dynamics in a family affected by parental narcissism. Also, although this article refers specifically to a mother and daughter for the purpose of narrative cohesion, any gender combination of parent and child can be similarly touched by narcissism.

Shame has a bad reputation. Let’s face it: it doesn’t feel good. I mean, who really wants to feel shame? It’s uncomfortable, even downright painful at times.

Here is something to consider, though: shame (closely related to guilt and regret) is an essential part of our survival and functioning and, in fact, is a gift from Mother Nature.

Let’s back up here a bit and first talk about the functions of emotions generally. Emotions are hardwired into our brains and help to warn us, facilitate connections to other people, and work through challenges. “Positive” emotions such as joy, pride, and love tend to feel good, while “negative” emotions such as anger, shame, and sadness tend to cause discomfort. It is easy to want to push away and avoid the “negative” emotions, but it is important to note that both types of emotions are necessary in order to function in the healthiest way possible.

[fat_widget_right]

Now let’s get back to our friend, shame. Shame’s function is pretty important. Basically, it helps to keep us in check. Shame is a signal that there has been some sort of action that could harm others or ourselves. This could be an action that hurts a relationship with a loved one, something that could get us in trouble somehow, or a behavior that would be dangerous or harmful to us.

When we utilize shame appropriately and feel the right amount all the way through, it can be corrective and preventative in that it helps us to not make the same mistakes again. Having shame also helps us to repair when an action has caused harm to relationships. It helps us to identify and take accountability for our actions, and when others see we are experiencing some degree of shame, defenses usually go down and healing conversations can take place. When we feel shame about something self-inflicted (drinking, drugs, putting ourselves in dangerous positions, etc.), we can assess the steps we need to take in order to prevent doing future harm to ourselves.

We all do things that warrant feelings of shame, guilt, and remorse. It is part of the human experience. Making mistakes is an important part of learning, and shame is an excellent teacher.

As great as shame can be, sometimes we can have too little or too much. In doses that are too small, we do not get the full opportunity to learn from the experience. Our system is not able to fully register that we have engaged in a behavior that warrants some degree of remorse. As a result, we may be more likely to engage in the damaging behavior again, possibly with negative life consequences.

Too much shame can overwhelm us and distort the experience. We may blame ourselves for things we should not take accountability for (like someone else’s actions) and end up in an impossible position where we are trying to learn someone else’s lesson. The system becomes confused when shame is distorted because we are not able to control or prevent future actions of others.

Finding the right dose of shame is key. When assessing whether you have too much or too little shame, ask yourself: Did I engage in a behavior (or behaviors) that caused harm? If the answer is no, it is important to assign correct responsibility and to check in with yourself to make sure you are not taking on another person’s lesson. If the answer is yes, ask yourself: How much harm was caused by the behavior and would it be harmful if repeated? It is often helpful to use objective others as sounding boards when assessing your level of shame so you can learn from the situation and move forward.

We all do things that warrant feelings of shame, guilt, and remorse. It is part of the human experience. Making mistakes is an important part of learning, and shame is an excellent teacher.

Being close to someone who is suffering because of trauma can be a difficult, bewildering experience. Trauma symptoms may appear suddenly, sometimes surfacing many years after a traumatic event. Or symptoms may creep up gradually. You might notice your loved one seems “off”—not like their usual self. Or their emotions can flare up suddenly and intensely for little apparent reason, even to the person. Some trauma survivors seem unusually flat or numb. They may become needy or clingy. Or they may withdraw, refusing help entirely.

Although symptoms may differ, responses to trauma have a similar underlying cause: a nervous system stuck in threat. Understanding what happens inside a person experiencing posttraumatic stress (commonly referred to as PTSD) provides a pathway to compassion, clarity, and possible solutions. This article is not therapeutic advice, and the advice of a qualified psychotherapist should always be sought. Think of this article as a general guide for families who suspect that a loved one has been impacted by trauma.

Trauma and stress are not the same thing. Stress refers to the body’s response to threat—a physiological and biochemical cascade of bodily changes designed to ensure survival. Informally, “stress” can also refer to subjective experiences: how it feels to be experiencing the challenge in the environment and in the body’s responses.

[fat_widget_trauma_ptsd_right]

The difference between stress and trauma is one of degree. Not all stress is bad; we need some challenges to stimulate us and encourage our growth. Trauma (or traumatic stress), on the other hand, refers to an internal state of overwhelm. This is an important point, and it explains why something that is “no big deal” for one person can be extremely traumatizing for another.

Trauma comes from overwhelm—when environmental circumstances are perceived as bigger than the individual’s capacity to handle them. When overwhelm happens, the body automatically mobilizes a survival response to deal with the threat, just as it does during stress. However, when the threat is too big or lasts too long and there is no effective response, it becomes trauma. For example, a person being cruelly taunted may not fight back because if they do, they may get into legal trouble and make the threat even worse. Not fighting back may be the smart thing to do, but the overall result is the body’s automatic survival response is ineffective against the threat.

When there is no way to fight back or run away, instead of deactivating, the mobilized survival response becomes “stuck” in the “on” position. It wants to complete and turn off, as it would if there had been a successful resolution of the threat, but it can’t. As a result, some bodily functions are stuck on “on.” For example, there may be lasting changes in blood pressure, heart rate, digestion, muscle tension, hormonal levels, and emotional reactivity.

Both stress and trauma involve the activation of the body’s threat response cycle. This survival response is hardwired into all vertebrate animals. Under threat, the unconscious brain and the body attempt to:

• Orient to the perceived threat (stopping, looking, listening, etc.)
• Evaluate the perceived threat
• Then, based on that evaluation, respond with either fight, flight, or freeze
• If the stimulus is determined to not be a threat, return to normal (called “deactivation”)

When stress happens, deactivation is possible. Traumatic overwhelm makes deactivation nearly impossible.

Threat responses are unconscious, hardwired, and involuntary. People cannot control these responses. When trauma has occurred, the person’s nervous system may still be involuntarily responding to prior circumstances more than to what’s actually happening.

Most importantly, threat responses are unconscious, hardwired, and involuntary. People cannot control these responses. When trauma has occurred, the person’s nervous system may still be involuntarily responding to prior circumstances more than to what’s actually happening. (This is what causes flashbacks or other re-experiencing of traumatic circumstances.) Posttraumatic stress responses are essentially the body’s survival alarms going off at the wrong time, because they have never been able to completely turn off.

Posttraumatic survival responses also occur much more quickly than conscious thought. In fact, intense activation of the threat response cycle shuts down the cortex, the area of the brain responsible for rational thought and verbal communication. This is why logical arguments don’t work when a person is in a posttraumatic stress response. They may be, literally, “too angry for words.” This also means that, for the most part, people with posttraumatic stress don’t intend to respond inappropriately to things going on in the environment around them and may feel very badly after the event is over, but at the moment, their automatic survival wiring is running the show.

Even when acute trauma triggers are not causing posttraumatic survival responses, a person whose nervous system is stuck in some phase of the threat response cycle is likely suffering. Eventually, they may start to numb out (dissociate) to protect against the ongoing awful feelings. Others become caught in cycles of addictive behaviors in order to try to manage the distress.

When a Loved One Is Experiencing Posttraumatic Stress

Loved ones who understand this can respond with compassion; however, this does not mean putting up with hurtful or dangerous behaviors. Some trauma survivors might even seem okay on the surface, but underneath, managing the unresolved trauma is using up some of their strength and energy. Unresolved trauma also tends to build up inside, making the person more emotionally and physically brittle over time. Eventually, symptoms may appear after a relatively mild stressor, such as a small fender bender.

The ultimate goal of treatment for posttraumatic stress is to foster deactivation of the nervous system and restoration of resilience (flexibility and the ability to “bounce back”). With this comes the ability to be fully present—instead of being partly stuck in the past—and to respond appropriately in the current moment. The neurological term for this resilience/responsiveness is self-regulation.

Here are several suggestions to keep in mind while supporting a loved one impacted by trauma:

• Obtain knowledgeable professional help. Your family member’s deep survival energy going off at the wrong times is most likely bigger than you can handle (or want to handle) on your own. Furthermore, it is unlikely to go away without professional support. Helping professionals working with trauma survivors should be certified in (not just trained in) a reputable method of trauma resolution.
• Get good psychoeducation about posttraumatic stress. This enables you to be your loved one’s strongest advocate when needed. Understanding reduces hopelessness and bewilderment. Accurate knowledge makes it possible to perceive and work toward solutions.
• Practice good self-care. Self-care supports self-regulation, which is likely to have a calming and stabilizing effect on your loved one. Self-care will help protect you from getting drawn into unhealthy coping behaviors. Plus, you’ll likely genuinely feel better.
• Do not expect the trauma survivor to “be strong,” “get over it,” or “just move on.” Their nervous system won’t let them “just get over it” because their body thinks it’s an emergency now! They are already “strong” enough in just having to live with their nervous system going off like this all the time. Healing has no timetable, nor should it.
• Focus on the importance of downregulating. This means learning to move out of a traumatic state and into calm alertness. This is the foundation, the “bread and butter” of trauma therapy. You will not be helping your loved one if you try to get them to talk about the traumatic events before they learn to reliably calm themselves when their survival systems are activated by trauma triggers. Otherwise, symptoms tend to worsen as the person’s nervous system floods and gets even more overwhelmed. This is another reason to get qualified help so your loved one can access what happened in a safe way.
• Orienting to the present can often be helpful for someone having a flashback or otherwise feeling stuck in the traumatic past. To help a “stuck” person return to the present moment, encourage them to look and/or listen carefully to details of what’s around them. They should be using their eyes and ears in this process, as well as their neck, to turn their head as they’re taking in the current environment. For example, in my practice, I often have people look around and name five blue things they can see or four things in my office that interest them. This may shut off the trauma response.
• Support the survivor in feeling safe. We want to help our loved ones turn the threat response off, or at least way down. The details of what makes a person feel safe (or unsafe) probably depend on the specifics of their traumatic experience(s). Someone who was abandoned may need trustworthy people around them. Others who were intruded upon may need solitude or increased personal space. If someone needs to sleep with a radio on at night to feel safe, leave a loud social event early, lower the volume on the television, or perform other non-dangerous rituals, we usually want to support that.
• Be aware of whether treatment is moving toward healing and self-regulation. During some periods in trauma treatment, people may appear to temporarily get worse as they uncover threatening experiences—essentially trading depression (“freeze”) for anxiety (“flight”). Overall, however, the trend should be toward healing and effective self-regulation. If you’re not sure this is happening, the person and/or family should talk with appropriate helping professionals and revisit the treatment plan.

To sum up, it can be incredibly distressing to be living in a nervous system that feels disobedient and unpredictable. However, as Dr. Peter Levine has said, humans were designed to withstand incredibly difficult conditions. With the help of a good practitioner, trauma survivors can access their underlying restorative ability of mind, body, and spirit, and continue on with their lives.

Note: I would like to acknowledge Phyllis Stein, PhD, SEP, for her editing contributions to this article.

References:

1. Butler, E.A., & Randall, A.K. (2012). Emotional Coregulation in Close Relationships. Retrieved from http://emr.sagepub.com/content/5/2/202
2. Center for Substance Abuse Treatment (U.S.). (2014). Treatment Improvement Protocol (TIP) Series, No. 57. Ch. 3. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK207191/
3. Levine, P. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. Berkeley, CA: North Atlantic Books.

Where do you feel safe? For me, it is not in my husband’s arms, it is in his heart. It is in a deep knowing that he will hold me there and that he feels me there even when I am not immediately in his presence. That with him I can take deep breaths and breathe in the love and affection he provides. The safety. What must it be like to have never had this feeling?

I didn’t have this feeling consistently before him. I trusted me, and I took care of me because that is what I learned to do as a child. Children who don’t feel “seen” by their parents often have an emptiness that grows with them as they move into adulthood.

What if you have carried this feeling with you for years, and now here you are, sitting in a therapist’s office, trying to “open up” and share your trauma history and heal from past abuse? How do you learn to trust the person who is supposed to be helping you, the one who is sitting across from you saying they will be with you in your journey, who holds you gently in their heart, looks at you with knowing eyes, and talks to you about your worth? The one who says they won’t judge you even before you share your most painful secrets?

[fat_widget_right]

As a therapist, when I sit with someone who has never felt seen, I ask myself, “Why do I know you? Why can I feel you? What is it about your pain that is also mine?”

We all have parts of ourselves we wish we didn’t know, parts we say to ourselves, “That’s not me” or, “Who is that person?” We reject these needy, angry, or acting-out parts of ourselves in the same way they were rejected by the very people who were supposed to hold us fiercely in their hearts and minds: our parents.

We tell ourselves, “If they couldn’t love me, those people who bore me in their bodies, how could anyone else?”

And then we give up trying to explain these ugly secrets to ourselves, to others. We hide them, lock them away in the attics of our minds, put them in files, into containers, send them away. When an experience is too much for the minds of children to bear, this can happen in a fraction of a second.

And then we give up trying to explain these ugly secrets to ourselves, to others. We hide them, lock them away in the attics of our minds, put them in files, into containers, send them away. When an experience is too much for the minds of children to bear, this can happen in a fraction of a second.

Later, as adults, we may berate ourselves for this. But children cannot handle the types of trauma or even harsh words from a loved one the way most adults can. They crack more easily.

Other times, forgetting doesn’t come so easily or quickly. We have to focus our attention on trying to forget. Eventually, the more parts of ourselves that are hidden, the more we reject and disavow ourselves of them, the larger and more intense they grow. Sometimes they develop a life of their own.

When parts of the self develop their own life, memories, experience, belief systems, and values, when they have their own sets of thoughts and feelings about experiences, they are so separate we call them “alters” or “self states”—parts, in other words. These parts are out of our awareness or just on the other side of it. Dissociation should be thought of not as mental illness but rather mental injury, born out of the anguishing kind of pain that comes from feeling empty or from being filled with rage, feeling unloved, unwanted, used. You feel unrelatable and unknown, even to yourself. Getting to know these discarded parts of the self can be scary.

I know you likely will not trust me, that you may not be able to bear looking into my eyes. That it will become more painful as you get to know me and start to expect me to be there. That just when you think you are starting to feel hope, you will become the most terrified you have ever been. Because you will have finally been seen. And while you have waited your whole life for this, it may very well be more petrifying than you imagined.

That is why I will forever be in debt to you, the person in therapy—for allowing me to see into your eyes, your past, your most feared parts of the self. I will wonder to myself why and how I know you, why you are in my life, and how it is I can “feel” your presence. I will remain separate from you and yet walk beside you for a time. I will try to be a vessel worthy of your sorrow.

Have you ever felt like your emotions are so overwhelming they will never stabilize? Maybe you have an intense urge to return to unhealthy or risky behaviors to make yourself feel better. Dialectical behavior therapy (DBT) has a whole module that focuses on crisis survival skills. These are skills that help you hang in there, or cope, when emotions are overwhelming. It doesn’t make the feeling go away, but these skills can help you get through the intensity of these emotions.

Here is a brief overview of DBT’s crisis survival skills.

Distraction

These strategies are used to distract yourself from distressing thoughts, feelings, or situations that feel overwhelming. The acronym “ACCEPTS” can help with recall in the moment.

[fat_widget_right]

• Activities: Do something. Read, play a sport, or clean.
• Contributing: Do something kind for someone else. Put the dishes away, write a thank-you note, volunteer your time.
• Comparisons: Compare your situation to someone else’s. This can help shift your focus away from your situation.
• Emotions: Making yourself experience a different emotion can help distract you. Watching funny online videos, listening to love songs, or catching up on your favorite soap opera are all examples of how you can distract yourself from overwhelming emotions.
• Pushing away: Don’t allow yourself to think about it. You can use a timer to set a limit on your thoughts or type it all out in an email draft (or go “old school” and write it on paper), and put it away so you don’t focus on it for the time being. This skill is a two-parter, though. When you feel more able to hang in there, go back and address whatever it is you pushed away. Otherwise, it will just keep growing.
• Thoughts: Distract yourself with other thoughts that make it difficult to think about anything else. Say the alphabet backward, count down from 100 by 7s or 3s, or do a crossword or Sudoku puzzle.
• Sensations: Intensify other physical sensations. Eat a strong mint, pet your dog, or squeeze a stress ball.

Self-Soothe with Six Senses

These strategies can help you feel better and in control by using your five senses (and a sixth: movement) to ground you to this person, place, time, and situation.

• Vision: Look at photos that put you in a good mood, or go to a beautiful place and admire the views in person. These can be related to friends and family, nature, animals, or more.
• Hearing: Listen to relaxing music or the sounds around you.
• Smell: Find smells that relax you. Lavender is a solid go-to if you need help getting started.
• Taste: Eat or drink something calming, such as mint or herbal tea. Focus on how pleasant it tastes.
• Touch: Touch something relaxing. Curl up in your favorite blanket or pet your cat.
• Movement: Move around. Dance, go for a run, or do some other exercise.

IMPROVE the Moment

You can’t necessarily change the fact something is happening, but you can change the way you feel, think, or react using these skills.

• Imagery: Use guided imagery, or even your own imagination, to visualize more pleasant outcomes or circumstances.
• Meaning: My mother loves to say “everything happens for a reason.” Being able to understand or acknowledge why something happened, or its purpose, can help you feel better about the fact it is happening.
• Prayer: You can either pray in the traditional sense or use this skill as a form of meditation or journaling. Basically, you can use prayer as a way to connect spiritually or reflect on past, current, and future circumstances.
• Relaxation: Indulge in something relaxing. Go to the beach, get a massage, or even take a nap.
• One thing in the moment: Focus on one thing in that moment. You can focus on your breathing, the sounds you hear, or the way your chair feels.
• Vacation: This can be an actual trip or a “mental vacation.” If you can’t leave the situation or you’re unable to take a physical vacation, escape in a book or a movie.
• Encouragement: Use positive self-talk. Pin inspirational quotes on your Pinterest page or write them in a journal. Reflect on how awesome you are. Reflect on what you’re doing well right now.

Pros and Cons

Considering the short- and long-term pros and cons to a decision can be helpful in deciding how to react to a situation or feeling.

TIPP the Scale

This is a newer skill set introduced in the latest update to the DBT Skills Manual for Adolescents. These skills are used when managing extreme emotions or urges. Using these strategies may help adjust your body chemistry.

• Temperature: Run cool water over your inner forearms or chew on ice to physically “chill out” and “cool down.”
• Intense exercise: Do 20 jumping jacks, 10 push-ups, or run in place for 1 minute.
• Paced breathing: Slow down and count your breaths. You can use “square breathing” (count to four as you inhale, hold for four counts, count to four as you exhale, hold for four counts, repeat).
• Progressive muscle relaxation: Concentrate on squeezing one muscle, then release. Move on to the next muscle group in your body. You can find scripts online that walk you through this or do it on your own.

It is important to note that one skill might not be enough depending on how intense your emotion or urge is. You might need to try a few to find what works best for you. As with anything, it’s also possible that something might work in one moment and not in another. Have a willing attitude as you give these skills a try, and partner with a therapist trained in DBT if you want support.

Reference:

Rathus, J. H., & Miller, A. L. (2015). DBT skills manual for adolescents. New York: The Guilford Press.

Many therapists have dreams of one day starting their own private practice. Following through on these aspirations, however, requires taking a number of things into consideration.

There are definite pros and cons. Having worked as a therapist for a number of community organizations prior to having my own private practice, I can attest to the validity of both. Some of the issues to consider include:

Business Concerns

Starting a private practice requires exploring the laws in your city that apply to owning your own business. You will typically need to obtain a business license from the city you live in and renew it on a yearly basis.

[fat_widget_right]

Work Schedule

Owning your own business means having the freedom to limit the number of days and hours worked. However, you also need to be able to accommodate people when they are available to come in, which may require having to work evenings and/or weekends.

Marketing

Being in private practice requires taking the steps necessary to generate business, which many therapists feel uncomfortable doing. Establishing a web presence is important in order to attract individuals looking for the specific services you offer, the therapeutic approaches you use, and any areas of expertise you may have. Effective ways of advertising include creating a practice website, writing a blog, and maintaining one or more professional profiles on online therapist directories such as GoodTherapy.org. All of these efforts take time and some financial investment.

Insurance Panels

Working with insurance companies can provide an ongoing stream of referrals and new business. Many individuals will contact only therapists who accept their insurance. In addition, many insurance companies will transfer payments electronically into the therapist’s bank account upon request, which can be quicker and easier than receiving checks in the mail and having to make trips to the bank. On the other hand, it can be a lengthy and difficult process becoming a provider for many of the insurance panels out there. The applications are often long and time-consuming to fill out, and they can take anywhere from three to four months to be processed. In some parts of the country, a number of insurance panels may already be saturated, making it difficult to join and limiting the number of individuals you are able to see. Reimbursement rates are also often quite a bit lower than many therapists’ typical rates, and it can often take up to 30 days to get reimbursed. If claims are not submitted in a timely manner and/or there are problems with the claims, this can also slow down the reimbursement process or even prevent the therapist from getting paid. Calling insurance companies to check on claims can also be tedious, as their call lines tend to be busy.

Expenses

Going into private practice requires taking into consideration the overhead and other expenses that apply when one owns a business. Some of the expenses to account for include the need to lease office space; the cost of utilities; furnishing the space; marketing efforts; obtaining office supplies and business cards; and the price of medical, dental, and liability insurance. You will also need to decide whether to do your billing yourself, which can be time-consuming, or hire someone to do it for you. If you are just starting out, you may want to consider subletting an office on a part-time basis (for example, on weekends and/or one or two evenings a week) to start building your practice before quitting your full-time job.

Fluctuating Income

Although a private practice can be profitable, it can also be unpredictable at times. Whereas you are typically guaranteed a certain monthly income when working for an agency or organization, a private practice does not provide the same level of security. The number of individuals seen, as well as the income generated, tends to vary from month to month. It can also take time to build up sufficient business for you to live off of, and you have to set aside money for taxes and/or make quarterly estimated tax payments, as this will not be done for you. You also need to keep in mind you will not get paid for any time off, so you will need to have a cushion set aside in order to account for any vacation or sick time.

Going into private practice can be profitable and rewarding, but it can take a lot of time and energy before you get to that point. The risks associated with any type of business are not for everyone, but the dream of starting your own private practice can become a reality if you are willing to take a leap of faith and put in the work needed in order to succeed.

It isn’t uncommon for us to move away from certain feelings. We have all kinds of methods to help us numb out our emotions. Many times we do this without even being conscious of it. As soon as we begin to feel something a bit uncomfortable inside, we find ourselves turning on the television or eating something as a way to avoid it.

If you were to investigate why you tend to avoid a particular feeling, one thing you may discover is a belief, either conscious or unconscious, that you can’t tolerate the feeling. If instead of moving away from the feeling you turned toward it in the present moment—meaning you allow your experience to be there without trying to change it—you would discover that hidden underneath that feeling lies a precious gem that belongs to you.

Mike had a good day at work, but when he got home he noticed he could not stop thinking about it. His mind was fantasizing about getting a promotion, making a lot of money, or becoming a hot shot at his company. He then felt an urge to have a glass of wine. Typically, Mike wouldn’t have thought twice about this and would have immediately poured himself the glass. However, Mike had recently begun reading a book on emotional intelligence that emphasized the importance of paying attention to inner experience, so he stopped and questioned his experience. He asked himself, “What’s going on? How come I want this glass of wine so bad?” He also paid attention to his body sensations and tried to know what he was feeling.

[fat_widget_right]

As he paid attention to his internal experience, he noticed there were some uncomfortable sensations inside that he didn’t want to feel. He continued allowing his experience to be there without trying to change it. He then began to notice anxiety. He continued to be with it and noticed his whole body felt prickly and uncomfortable. He noticed then that the urge to drink intensified, but he took a deep breath and allowed the intensity to be there with curiosity and interest.

Behind the prickly, uncomfortable sensations, he noticed the sensation of a “hole” in his chest. As he allowed the hole to be there, a wave of sadness came through and tears began to flow down his cheeks. Suddenly he remembered painful memories from childhood that related performance and self-value. His parents used to focus excessively on achievement and accomplishment, and celebrated him only when he achieved things in school. He realized how his sense of worth was tied to how well he did at work. He wept deeply.

Before long, he noticed his experience was much more tolerable. The sadness now had a sweetness in it, and he experienced himself in an open, soft, and receptive way. He was relaxed and at ease, and the desire for wine was gone. He also noticed a deep sense of well-being and, specifically, a sense of value that was not dependent on his work or achievements. He was experiencing value simply by being.

Although Mike’s story is fictional, it illustrates a process that can happen when we are engaged in inner work. As Mike allowed his experience to be what it was without trying to change it, he realized he didn’t need to avoid it. As he continued to stay with it, he was able to see clearly an unconscious connection between performance and value. As he saw through those old templates, he was able to access a true, intrinsic sense of self-worth that wasn’t dependent on externals.

By becoming more open toward our experience instead of avoiding it, you too can access deeper aspects of yourself and encounter deep, intrinsic sources of well-being. Here are some ways to help you stay in the present moment as you encounter difficult feelings.

1. Widen Your Perspective

There are times when we can be with our feelings directly, with our awareness on them like a laser beam. This is particularly true when the feeling is vague, unclear, or not very intense. However, when we are experiencing a difficult emotion, it can be overwhelming and it may be wise to regulate how we are with it. At times like this, we may want to shift our attention from a narrow awareness of the difficult emotion to a wide, inclusive awareness.

Picture a balloon-like sphere (this represents you). Now, inside the balloon, picture a smaller sphere full of spikes (this is the difficult feeling). If you are contracted and tight around the spiky sphere, you will feel the spikes puncturing your inner lining, and you may even burst. However, if you allow spaciousness to come in, your balloon will inflate and expand. The spiky sphere will not touch your inner lining, and you won’t be hurt by the spikes. The spiky sphere will simply be a small particle in a vast container.

There are other methods you can use to expand your awareness. You can do it visually, somatically, or with breath. To do it visually, it can be helpful to be outside. Perhaps you can look at the sky, the ocean, or anything that reflects vastness, and let the emotion be held by it. You then notice how the emotion changes as the vastness is holding it. To do it somatically, instead of just feeling the area where the difficult emotion is located (which will typically be in the chest solar plexus area), you include the rest of your body in your awareness. You feel your feet, arms, head, and so on without denying the area of difficulty, and you notice how it becomes easier to tolerate the intensity. With breath, you simply take deep breaths into the emotion and notice if it becomes more tolerable.

2. Experience the Intrinsic Pleasure of Being Emotionally Intimate with Yourself

If we are able to stay with an emotion from beginning to end, we typically notice a pattern of increasing and decreasing discomfort. As we continue to stay with it, it will eventually cycle through and a discharge will naturally occur. At that point, if we pay close attention, sensations of pleasure will arise as the nervous system comes to a relaxed state.

The key here isn’t to try to get rid of our needs for external gratification, but to bring more consciousness to our inner process. The more aware and conscious we become about our needs, the more freedom we have from our compulsions.

Just as we can stay with the difficulty, we can stay with the pleasure of regulation; we can notice how our nervous system naturally releases tension, and that can feel pleasant. Take in that goodness and soak in the relaxation! As you do this, you may learn that the capacity for soothing lies within. We have the capacity to feel pleasure and well-being without external rewards. However, don’t underestimate our tendency to look for them. This desire is deeply ingrained in the brain. From the moment we’re born, we depend on externals for our survival.

The key here isn’t to try to get rid of our needs for external gratification, but to bring more consciousness to our inner process. The more aware and conscious we become about our needs, the more freedom we have from our compulsions.

3. Notice the Changing Nature of All Experience

Experience is constantly changing, but when we’re caught up in difficulty we tend forget this. In fact, when feeling difficult emotions we tend to believe they are going to stay like this forever. We also tend to concretize them, making them appear solid and unmovable.

The truth is all of our experience is in constant flux. If we’re able to notice the changing nature of experience when we’re experiencing difficulty, it can become easier to ride the feeling. For instance, when bringing your awareness to the changing phenomena in your experience, notice how it all has a beginning, a middle point, and an end. Understanding this constant movement can help you begin to dissolve even the most reified and apparently solid emotional experiences.

4. Share the Burden

Having a language for our emotions and being able to share them with others makes them much more manageable and digestible. In a way, therapy is a training ground for us to become more comfortable with our feelings by talking about them. There are all kinds of support groups out there that operate under this principle. To be able to talk freely about what ails us is an amazing way to make it more tolerable.

There are many ways to allow spaciousness into our difficult emotions. You may want to experiment and find out what works for you, or you might want to contact a therapist who can help guide you. This isn’t about ignoring the difficulty or making it go away. Rather, this is about letting the experience be held in more spaciousness.

One of my favorite books is Paulo Coelho’s The Alchemist. It’s a story about a shepherd boy who journeys in search of a treasure about which he has dreamed. What I love about the story is that there are so many life lessons embedded in it. Where you are in your life determines what the salient messages are for you. I will do my best to impart some of the lessons that ring true for me without giving away too much of the story.

1. We must be able to make choices about how to move forward, and perhaps the best way to seek an answer from ourselves is to ask specific questions that require a yes-or-no answer.

There’s a point in The Alchemist when the shepherd receives two stones, one black and one white, signifying “yes” and “no.” The purpose of the stones is to help the boy “read the omens,” or understand the signs the universe is giving him as well as what his intuition is telling him. He is instructed to make his own decisions but is told to ask the stones a clear, objective question, if he struggles, and then go with the answer (black or white stone) he pulls from the bag.

[fat_widget_right]

People who have trouble making decisions sometimes put them off indefinitely, leaving themselves feeling stuck. There are often “signs” that signal us which way to go, but if we are stumped and don’t really know how to proceed, it’s still best that we make a choice. Soon enough, we will know if we are on the right track, and if we aren’t, we can course-correct. The point is to move forward. If we don’t choose, we are electing to stay still and let things remain the same. Not choosing is often the equivalent of not taking action.

When you ask questions of yourself regarding what to do, ask specific ones that reflect what you really want so that the concrete answers you generate propel you forward rather than mire you in further confusion.

2. How we perceive our circumstances has everything to do with motivation, perseverance, and psychological well-being.

There are several examples of this in the story. As the shepherd encounters an unfamiliar place, he originally labels it as “strange” only to subtly change its description to “new” upon further consideration.

If we learn to strategically put our fears aside, and really consider the possibilities that are available to us, we can continue to take steps toward our goals.

The protagonist also shifts his view of himself from “victim” to “adventurer.” And when he takes stock of the fact he has chosen to remain in one spot for a long time on his journey, instead of bemoaning it, he recognizes “he was actually two hours closer to his treasure … the fact that the two hours had stretched into an entire year didn’t matter.” He took note of the progress rather than dwelling on the length of the journey ahead or how long he remained in one particular spot.

Shifting his perception toward the positive and that which was encouraging energized him and enabled him to recommit to his goal of reaching his treasure, rather than retreating to what was safe and already known.

3. Our beliefs about ourselves are incredibly powerful and can enhance or inhibit what we ultimately accomplish.

“Whether you think you can or you can’t, you’re right.” —Henry Ford

The boy in The Alchemist is tested time and again on his journey. Each time, he is forced to determine just how important his goal is and whether the love he feels and how attuned he is to his inner voice outweighs fear and the discouragement or challenges he receives from others. It is because he so clearly believes in the possibility of his treasure that he is able to persevere in search of it.

4. Fear is what keeps us stuck.

“There is only one thing that makes a dream impossible to achieve: the fear of failure.” —The Alchemist

Coelho illustrates how we hold ourselves back with fear, surrendering to thoughts that tell us we can’t or we aren’t worthy or we might suffer in the process of trying to attain that which we seek. He addresses the fear of failure as well as the fear of success. Coelho points out that “the fear of suffering is worse than the suffering itself.” The fear of suffering is often what results in anxiety. It’s being paralyzed by the thought, “What if the worst happens?”

If we learn to strategically put our fears aside, and really consider the possibilities that are available to us, we can continue to take steps toward our goals.

5. Awareness is key. Be able to recognize opportunity.

The Alchemist makes many references to omens, encouraging its protagonist to pay close attention to the here and now, implying that if he is alert he will become more aware of what action to take next. The story explores the concept of the universe offering us clues to see us through to our goals. It suggests if we lose the capacity to pay attention to those clues (by becoming cynical, focused on the negative, or close-minded), they become more scarce, “abandoning” us.

If we approach life’s choices with a sense of clarity and purpose and are aware of the gentle nudges we receive along the way (our intuition and the messages the “universe” seems to send us), if we can separate that from fear and negative beliefs we have about ourselves and the world, then we can carve a path to the things that are important to us, the treasure reserved for each one of us.

What can YOU take away from reading The Alchemist? (If you haven’t read it, I urge you to.)

Reference:

Coelho, P. (2006). The Alchemist. New York, NY: HarperOne.

When you find yourself between jobs and under pressure to find a new one as quickly as possible, depression and anxiety are real risks. Attending interview after interview and receiving rejections—or, worse, hearing nothing—can be discouraging, especially when the interviews seemed to go well, and feelings of frustration, anger, and depression can develop. Anxiety can accompany these feelings: What if I mess up this interview? What if I can’t find a job? How will I pay my bills? How will I provide for my family?

These thoughts can be debilitating. They may loop repeatedly, keeping you up at night, affecting your mood, and causing more stress. Thought patterns like these also have the potential to affect productivity and the ability to think clearly, which can have a negative impact on the job-hunting process.

To improve your outlook and ability to think clearly, deeply, and strategically during your job search, try the following tips:

[fat_widget_right]

Separate Planning from Doing

When you are anxious about your career prospects, you may find yourself wanting to do something—anything—to get a job. But anxiety can narrow your thinking tremendously. You may find yourself making list after list, plan after plan, but stall before completing these tasks. Separating planning from doing can make it easier to stay productive and focused on realistic goals. Planning the steps you will take in the following days and weeks can be helpful, but carrying out the steps you’ve listed is not only likely to help you feel a sense of achievement, but may pay off in the form of a job.

Write It Down

Set aside a specific time every evening to write down how you will make the best use of the next day. Doing it in the evening is key. If you try to do this in the morning, there is a sense of urgency that compels you to just do something, and this is likely to detract from your focus rather than increase it. Actually put pen to paper so your plan can be by your bedside when you wake up and so you can cross things off when you finish them. Making a plan for the next day at night can also help you relax before bed: you’ll already know what you need to do the next day, and you can take a break from thinking about it.

Exercise Daily

Include at least an hour of exercise in your daily written schedule. Exercise can boost your mood, help relieve stress, and help you sleep. An added benefit of exercise is a change of scene: sitting at home in front of a computer or on the phone can make anyone short-sighted. Movement, fresh air, and activity can help you regain perspective.

Try Strength Training

Consider strength training in addition to daily cardiovascular exercise. Strength training does more than build muscles: it can improve self-confidence, which can be a benefit when trying to sell yourself in the job market. A gym membership isn’t necessary: push-ups, crunches, dips, squats, and calf raises are all great exercises that require no equipment. A mini-workout is also an excellent antidote for moments of paralyzing stress. For moments of extreme anxiety, try spending five or 10 minutes doing super-sets.

Don’t Isolate

An item that should be on every job hunter’s daily schedule is social contact. Social contact might be meeting a friend for lunch or even a phone conversation with a supportive family member. Many people instinctively react to hard times by isolating, but this tendency is often a factor in feelings of depression and anxiety. Resisting the urge to isolate can help combat these feelings and may prevent them from developing or becoming overwhelming.

Find Fun Things to Do That Are Free or Inexpensive

Money being tight can have an impact on your typical social activities, but don’t let that keep you stuck in the house.

Money being tight can have an impact on your typical social activities, but don’t let that keep you stuck in the house. Think of things to do that cost little or nothing, and invite someone you care about to join you. Make plans to take a walk, prepare a meal from scratch, or host a tea or coffee social. Keep an eye out for free things to do. Libraries often have daytime, weekend, and evening activities for children or adults, and many museums have free admission one day a month.

Be There for Others

Being in between jobs doesn’t mean you have nothing to offer—you are still the good friend you were when you had money. If it becomes challenging to believe this and self-doubt or self-pity become overwhelming, think of someone who might like to hear from you and give them a call or send a text. Volunteering is another way to fight isolation, and it has the added benefit of allowing you to give back to the community. Volunteering can also provide valuable networking opportunities.

Keep a Regular Sleep/Wake Schedule

Going to bed and waking up at the same time every day can help you stay productive and will also regulate your mood. Set an alarm Monday through Friday, and go to bed early enough to get a full night’s sleep so you are well-rested and ready to do your best in the morning. When you have a whole day to yourself it can seem like you have all the time in the world, but this time goes by quickly. Having a plan for each day can help you make the most of your working hours and help prevent feelings of self-recrimination at the end of the day. A regulated sleep/wake pattern may reduce the risk of depression or be part of a treatment strategy. Eating and exercising at the same time each day can help, too.

Take Time for Reflection to Solidify Learning

Taking time to reflect can increase your chances of learning from your experiences. At the end of each day, look at your list and cross off the things you’ve accomplished. Try writing down what you feel proud of accomplishing that day. Give yourself credit for the steps you took, big or small, toward re-employment and toward staying focused and healthy. Consider whether there is anything you want to do differently the next day. Did you learn any lessons or discover any changes to make? Put your energy into making these changes, not being hard on yourself for any mistakes, in order to have an even more productive day tomorrow.

References:

1. Bayer, R. (2009, February 20). Stress management – 11 tips to help you sail through your job search. Retrieved from http://www.itworld.com/article/2770626/careers/stress-management—11-tips-to-help-you-sail-through-your-job-search.html
2. Landau, E. (2012, June 15). Unemployment takes tough mental toll. Retrieved from http://www.cnn.com/2012/06/14/health/mental-health/psychology-unemployment
3. Warrell, M. (2012, June 12). Bouncing back from job loss: The 7 habits of highly effective job hunters. Retrieved from http://www.forbes.com/sites/womensmedia/2012/06/12/bouncing-back-from-job-loss-the-7-habits-of-highly-effective-job-hunters/#4ee648725b15

“Ending a therapy session is a hostile act.”

This was said to me by my therapist once after we discussed how, regardless of whether I had a “good” session or a frustrating one, I usually felt annoyed at the end. Either I was upset it was over and afraid of losing momentum, or I was upset we didn’t get to the heart of what I wanted to talk about. I’d question whether anything really changed because of the therapy session, and I didn’t recognize the importance of the feelings that arose at the end of a session or what that ending was doing to me.

Unfortunately, that annoyance inevitably dissolved by the start of the next session. A whole other week had passed, and other things had come up. Feelings (as they are wont to do) had come and gone. It was difficult to find a way to process that fleeting end-of-session feeling.

[fat_widget_right]

Holding on to Feelings Between Therapy Sessions

I tried several ways to hold on to the feeling I’d have at the end of a session because I believed it was important. With one previous therapist, I got permission to record our sessions and then listen to the recording on the way to my next session. (I stole this idea from Irvin Yalom.) The idea was to connect each session to the previous one. This technique didn’t last. It was too much of a commitment: spending a whole other chunk of time rehashing the previous week. Also, it didn’t take into consideration what I was feeling at the time of the new session, which was just as valid.

Another tactic I tried was to jot down notes as I left therapy. I’d write down any insights I thought I’d want to return to or ideas I thought about as the session ended. I’d try to record associations I made later that day or that week. This helped a little (sometimes I still do this).

Doing that had reminded me of how I used to go to a coffee shop near my therapist’s office and journal for a while before meeting with her. That journaling became agenda writing: I’d compile a list of all the stuff I wanted to make sure we spoke about.

Gosh, I was working hard. And sometimes we’d get to a lot of that agenda. We’d really get somewhere and I’d settle in to how I was feeling and …

“Time’s up.”

“More to say next week.”

She could end at 45 minutes, but I had to keep living my life. I had to go back out into the world and manage and deal and, well, I wanted to be finished. Complete. My therapist hadn’t done her job because I needed to come back next week, right?

“That’s all the time we have.”

Or my favorite:

“To be continued.”

Those phrases would annoy me so much. They made me feel that, to my therapist, I was only 45 minutes’ worth of purging. She could end at 45 minutes, but I had to keep living my life. I had to go back out into the world and manage and deal and, well, I wanted to be finished. Complete. My therapist hadn’t done her job because I needed to come back next week, right?

It took a long time for me to realize this was anger.

It took a while to express it as anger.

It took quite some time (and another therapist—a man this time) to relate that anger at being “cut off” to all the other shames and endings and cut-offs in my life.

Talk to Your Therapist About These Feelings

The end of a therapy session can provide a lot of important fuel because it brings the feeling toward the therapist. This happens when the person in therapy feels safe enough to let the therapist “have it.” It happens when the person trusts that the therapist isn’t going to become defensive or punitive for expressing feelings they have spent weeks talking about.

This is the relational part of many types of therapy. It’s bringing real-world emotion into the therapy room where it’s most potent, where it can be held and fully expressed.

Written into the process of therapy is that the caring, patient, empathic person you’re paying to listen to you and witness your life will tell you time is up. That should suck. That should make you upset. And you should say all that to your therapist. And if you’re aware of those feelings at the end of a session, let your therapist know you need help expressing them at the next session.

I do the same thing now. I tell people it’s time to end a session and they have all kinds of feelings. Sometimes there’s relief. Often there’s annoyance. Sometimes there’s intense anger. But I’m always glad when they have enough courage to tell me how they feel about it.

Sometimes I’m brave enough to tell my therapist as well.