Many people who frequently procrastinate don’t endorse their own behavior or speak about it proudly. Many who experience repeated procrastination want to change. This desire and motivation to change is most acute when time is running out and the person procrastinating is in the throes of an emotional storm of anxiety.

The procrastinator often repents during his or her peak time of displeasure. For example, the academic or executive preparing for a big meeting, after staying up past 4 a.m., vows never again to put himself or herself through this self-inflicted, sleep-deprived, caffeine-infused pain. “Next time, I won’t wait until the last minute,” he or she says. However, when the next time comes, the vow is broken and boundaries of time are again played with dangerously.

It’s estimated that about 50% of college students and 20% of older adults procrastinate chronically (Harriet and Ferrari, 1996; Day, Mesnick, and O’Sullivan, 2000). But if it’s so painful, why do so many procrastinate? Are they masochistic or lazy? Let’s take a look at different reasons why people procrastinate and identify some tips to help those who do.

1. The Masochistic Procrastinator

[fat_widget_right]Bringing yourself to despair and surviving it can create a feeling of triumph and exhilaration. “I did it,” says the masochistic procrastinator. The excitement of just making it to class or to a plane in the nick of time can be a joyous rush or regressive return to adolescent rebellion. For others, the joy or pleasure of procrastination is less apparent (or more disguised). Unresolved Oedipal issues leading to guilt or ambivalence about success may drive these procrastinators to get in the way of themselves.

A tip for breaking the cycle: A deep dive with a psychodynamically informed therapist may help the masochistic procrastinator examine unconscious self-sabotaging behaviors. Understanding the motivations behind taking risks and how to sublimate this desire can help. Letting go of feelings of guilt about success or other similar feelings can help a person become more comfortable with assertiveness and embrace healthy aggression to move toward goals.

2. The Hedonistic/Self-Regulation Procrastinator

The hedonistic type of procrastinator, who often experiences self-regulation issues, may not have low self-esteem or confusion about goals. Instead, this procrastinator may struggle because he or she cannot delay gratification. Recent research suggests that this may be the most influential variable contributing to procrastination (Sirois, 2014).

People who experience self-regulation procrastination are drawn to what interests them in the moment. Facebook, fantasy football, Instagram, or Twitter may simply feel a better than working on a paper, prepping for a meeting, or calling back a client.People who experience self-regulation procrastination are drawn to what interests them in the moment. Facebook, fantasy football, Instagram, or Twitter may simply feel better than working on a paper, prepping for a meeting, or calling back a client. The hedonistic type of procrastinator often pushes away the negative feelings and consequences by instead indulging their immediate desires.

A tip for breaking the cycle: Think about your desired future self. Focus on the consequences that will result if you engage right now in what your priorities are. For example, fill in the blanks in this statement:

If I start now, the benefit will be _______ and I will feel _______. If I wait and procrastinate, I will feel _______ and the consequences will be _______.

3. The Sense of Self Procrastinator

Research (Shanahan and Pychl, 2007) indicates when you have an unstable sense of self, you may be more prone to procrastinate. In other words, if you do not feel connected to who you are, it often makes it difficult to feel connected to a task. For example, taking the steps to apply for a job in computer programming is less motivating and something you may avoid if you are unsure this is a career you want. Having a good sense of self can make tasks more meaningful and increase your motivation to engage in them. If you are passionate and have a sense of who you are, it may be easier to harness energy to complete tasks with more fervor and dedication.

A tip for breaking the cycle: Spend more time on thorough self-exploration to determine what you really want rather than what other people expect from you. Some individuals out of desperation pick a path or tasks in an attempt to free themselves from the existential anxiety of not knowing where to go in life. Being able to tolerate the unknown and discover what ultimately matches your personality and life goals, although time consuming, can help foster passion and success.

4. The Fear and Self-Esteem Procrastinator

Self-doubt and low self-esteem can sometimes make ordinary tasks appear daunting. When you doubt yourself, tasks at hand may be more difficult as you imagine trying to conquer an unbeatable opponent. This may lead you to engage in more pleasurable activities that have a short-term payoff. Unfortunately, avoidance of important tasks can also lead to self-loathing and feelings of guilt.

A tip for breaking the cycle: When climbing a mountain, it’s helpful not to look up. Instead, focus on what is in front of you. Focusing on subcomponents of a task rather than the end result can help people who feel overwhelmed or experience self-doubt.

5. The Self-Handicapping Procrastinator

By putting things off until the last minute and performing below their capabilities, many self-handicapping procrastinators protect themselves against negative feelings by saying, “I could have done better if I worked harder.” Living in a world of “what they could potentially accomplish if they worked hard” may be more comfortable than discovering strengths and weaknesses.

A tip for breaking the cycle: Reframing failure or success can be helpful. Try to view success as confronting a task and putting effort in regardless of whether you obtain the goal. Facing struggles in this way and learning from mistakes throughout the process will also help build strengths.

6. The Successful Rationalizing Procrastinator

This type of procrastinator has been doing it for years and, on the surface, has gotten away with it. A major rationalization such a person may rely on for his or her behavior is his or her success. Despite procrastinating, this individual may have received promotions at work, obtained excellent grades, and may be perceived by others as competent.

Relative success often leads this person to continue procrastinating, since he or she is able to function and achieve despite the behavior. Although successful, this type of procrastinator may not be living up to his or her true potential. Furthermore, the ghosts of uncompleted assignments often haunt the rationalizer. Although they may be confident they can get things done at the last minute, doing so has a psychological cost. Anxiety and feelings of emptiness can result from this type of procrastination.

A tip for breaking the cycle: Viktor Frankl, the renowned psychiatrist who wrote Man’s Search for Meaning, advocates making meaning regardless of your situation. Engaging tasks with all your energy and in a way that is meaningful to your environment makes life richer and fills it with purpose.

References:

1. Day, V., Mensink, D., & O’Sullivan, M. (2000). Patterns of academic procrastination. Journal of College Reading and Learning, 30, 120-134.
2. Harriott, J., & Ferrari, J. R. (1996). Prevalence of procrastination among samples of adults. Psychological Reports, 78, 611-616.
3. Shanahan, J.M., & Pychl, A.T. (2007). An ego identity perspective on volition action: status, agency and procrastination. Personality and Individual Differences, 43 901-911.
4. Sirois, F (2014). Out of sight, out of time? A meta-analytic investigation of procrastination and time perspective. European Journal of Personality, 511-520.

Being a good parent can be difficult. We are never really taught how to raise children effectively, and generally tend to repeat behaviors we have learned from our own parents. If we grew up in a dysfunctional environment, this can lead to our replicating the same mistakes we witnessed and experienced as children when our turn to become parents comes around.

Many parents who come to see me ask how they can learn better parenting skills. They often feel ineffectual when trying to discipline their children, but do not know what they can do differently. The following are some effective tools to use in order to bring about a little more order in your household:

1. Praise Your Children

Any time you catch your child being good, make sure you let him or her know how appreciative you are of his or her good behavior. Everyone responds in positive ways to praise, children included, so this will encourage your child to behave in desirable ways.

2. Use Behavioral Incentives

In order to inspire your kids to do their chores, put a chart or calendar up on the wall listing, day by day, the tasks you want them to complete. This could include things such as taking out the trash or setting the table for dinner, but you can also include behaviors such as doing their homework, brushing their teeth, or being nice to siblings.

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When the child performs the desired behaviors, he or she gets to put a sticker on the chart for the day. As your child accumulates a certain number of stickers, he or she can earn special incentives that are known ahead of time. These could be anything from choosing a favorite dinner, going on a special outing, watching a movie that your child has been looking forward to, or anything else he or she would enjoy.

For very young children, it can be helpful to break down the day into shorter periods in order to reward desired behaviors more quickly. You may want to have them be able to earn three stickers a day, for example—for the morning, afternoon, and evening. Even if they are not successful for the entire day, they can at least be rewarded for shorter time periods and will gradually want to earn more and more stickers and rewards.

3. Use Consistent Discipline Techniques

When your children misbehave, they need to understand the specific behaviors you do not want them to do. Let them know what they are doing wrong, then provide a warning. Your explanations should be very clear and simple, so that they understand exactly which were the problem behaviors.

When your children misbehave, they need to understand the specific behaviors you do not want them to do.

If a child continues to misbehave, put him or her in a designated area away from the rest of the family that has been chosen for time-outs. Make sure that the child remains in the designated spot for the entire time-out period. The time-out should not last more than several minutes, but the child should not be allowed to talk or play during this time.

At the end of the time-out period, reiterate to your child the reason that he or she was put in time-out and ask for an apology. Consistency is very important when it comes to teaching children appropriate behavior, so the time-out strategy should be used every time your child misbehaves after having been given an initial, unheeded warning.

4. Communicate with Your Child

If your child is acting uncharacteristically poorly, attempt to find out what may be going on. Children have a tendency to act out when they are being picked on at school or sense tension within the family. Try talking with them to find out if they are upset about something you are unaware of so you can address any potential problems.

5. Maintain a Structured Routine

Children respond well to structure, so try to have meals and bedtime at the same time every day. When kids become overly tired, they may be more prone to acting out, so make sure they are getting enough rest.

Using the techniques above can help to make for a more peaceful home environment. If you are still having problems managing your child’s behavior or your child has recently become more fearful, angry, or aggressive, meeting with a psychotherapist may be helpful in order to explore the underlying reasons for the behaviors and to get your child back on track.

“I’m trying to imagine ethics without an awareness of power. That would be like trying not to step on anyone’s toes, without an awareness of one’s feet.” —Susan Mikesic

The power differential is the inherently greater power and influence that helping professionals have as compared to the people they help. Understanding both the value and the many impacts of the power differential is the core of ethical awareness. Written codes for ethical behavior are based on the strong positive and negative impacts of this power differential.

People seeking help are in a position in which they must trust in the knowledge and guidance of their caregiver. This results in a greater-than-ordinary vulnerability. Consequently, people are unusually susceptible to harm and confusion through misuses (either under- or overuse) of power and influence.

Examples of Power Inequality

“The impact of the role, control, and power difference between client and therapist is very strong and also very subtle, and thus demands a strong ethical stance. In brief, your role as the therapist [or any helping professional] is to create a safe space, empower your client, protect your client’s spirit, and to see a wider perspective.” —Hakomi Institute Code of Ethics preface

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Stated another way, there is a power inequality whenever you take on a role that gives you authority over another or creates the perception that you have authority. Power differential roles include: supervisor, clergy, body worker, healer, lawyer, coach, group leader, therapist, counselor, doctor/nurse, mediator, teacher, social worker, massage therapist, guide, and social worker.

Personal Power and Role Power

In talking about the power differential, it is necessary to clearly describe and distinguish between two kinds of power. This distinction is important because it makes clear that the increased power that accompanies a position of authority is role-based and not the same as personal power.

• Personal power is our ability to have an effect and to have influence.
• Role power is the added-on power (and responsibility and opportunity) that accompanies a positional role.

I like to show the difference between these two powers with scarves. When I am a therapist, I have my personal power, of course, but I wear my added-on role power as if it were a scarf. When I leave my office, I take my role-power scarf off. My personal power stays with me. It’s like my scarf has access to and stores information related to the enhanced power that belongs to my role. With my scarf on, I can remember multiple details about my clients’ processes. When I take my scarf off, I can and need to leave those details and responsibilities behind.

This is not a purely black-and-white thing. Of course I continue to have concern about the people I work with in therapy, and I am known as a therapist or teacher even when I am not in these roles. But many misuses of power are a result of the person in the up-power role over-identifying with his or her role power, forgetting that this is a role-based add-on power.

My friend Nancy’s husband, Daniel, is a commercial airline pilot. Until they understood this dynamic, their marital relationship was quite compromised each time Daniel came home and acted as if he were still the airline pilot—a commanding position. Things changed when Daniel ritually took off his hat with the symbolic words, “I’m hanging the pilot on the hook now.”

Up-Power and Down-Power

I refer to those in positions of increased role power as having “up-power” and those in corresponding positions of lesser power as having “down-power.” These are simple and directional terms not intended to indicate disrespect, disempowerment, exploitation, manipulation, better, worse, power over, or power under. Instead, these terms are intended to denote role differences in responsibility and vulnerability.

Up-power and down-power positions have cognitive, emotional, and somatic differences. As an exercise, I ask my students to walk around the room imagining walking with someone up-power to them. My students notice a variety of things—feeling smaller, more cautious, protective, turned inward (or, for some, feeling relaxed, eager, relieved). Then, when imagining walking with someone they are up-power with, they notice feeling more spacious, focused on the other, taller, kind, caring, and alert. It is very clear to them that the two roles are experienced differently. For most, this is a surprise. A student described the difference in this way: “When I’m a practitioner, my personal needs and ‘stuff’ are behind me resting against my shoulders, and when I’m a client, my personal needs and ‘stuff’ are sitting right there in a huge ball on my lap, visible and available.”

We move back and forth daily between being in up-power positions and down-power positions.

We move back and forth daily between being in up-power positions and down-power positions. (Like putting on a scarf or robe when in a role and taking it off when leaving the role, we move from up-power therapists to a down-power supervisee, or up-power doctor to down-power patient, for example.) We are usually unaware of the shift. This unconscious shifting of roles makes it more difficult to clearly understand the dynamics and impacts.

Some up-power roles carry a stronger differential—and, therefore, a stronger risk of harm—than others. For example, the president or a police officer or a therapist has a greater power difference than the chair of a committee or a clerk in a store. But all up-power roles have impacts and dynamics.

Value of the Power Differential

In the helping professions, the power differential has great value. Used wisely and appropriately, it creates a safe, well-boundaried, professional context for growth and healing. More specifically, when used ethically and effectively, the power differential offers people in therapy, students, supervisees, and patients some important assurances:

• Confidence in their caregiver’s knowledge, training, and expertise
• Security, safety, and protection
• Role boundary clarification and maintenance
• Assessments of progress
• Sensitivity, respect, fairness, and care
• Allocated responsibilities
• Provision of direction, focus, treatment, guidance, and support
• Overview and access to a bigger picture and wider view of persons and situations
• Chain of accountability
• Facilitated accomplishment of task and purpose
• Final decision-making authority

These values can be reduced to six categories:

1. Safety, kindness, and boundaries
2. Larger frame
3. Expertise
4. Assigned responsibilities
5. Accountability
6. Assessment and productivity

Think about it. When you go to a therapist, doctor, or teacher, you want to be in an environment where you can get what you need. You want the environment to be different than just talking to a friend. When you get on a plane, for example, you want and need the pilot to look and act competent. Wearing jeans and a T-shirt just won’t do. You need him or her to be skilled, to embrace his or her role, and treat you with respect.

Understanding and Owning Your Power and Influence

Because the power differential is role-dependent, it is easy to over-identify with (or get inflated by) this increased or enhanced power. However, it is just as easy to misuse this increased power by under-identifying with it. The central idea here is the necessity to understand and own your role power so that you can be conscious and informed.

Here are several misunderstandings that illustrate the multiplicity of the impact of the power differential for both helping professionals and people who seek help:

• Believing in equality, you may find it difficult to accept that your role creates a power inequality, and that this inequality is actually essential to your effectiveness.
• Rushed for time, you may underestimate the power differential and over-focus on technique or useful information. Effective use of your role power involves balancing technique with the essential need for relationship connection and repair when needed.
• In fear of manipulative and wounding abuses of power, you may find it difficult to understand that, to be able to use it for good, you must own the power you have. Under-use of power is also a misuse of power.
• Misunderstanding your elevated role power as confirmation of your wisdom and a mandate to take charge, you may inadvertently disempower, disregard, or disrespect the people who turn to you for help.
• Motivated by a desire to be of service, you may find it difficult to comprehend that your impact may be different from your intention, and that it may be experienced as confusing or harmful.

The power difference between therapist and person in therapy, or other similar pairs, is the dynamic that creates down-power vulnerability. Down-power vulnerability, based in a role, is what creates the need for ethical guidelines to protect people from harm.

People I work with in psychotherapy often tell me how they manage bothersome thoughts or worries: “I just try not to think about it.” This process of mental avoidance—trying not to think about specific thoughts or feelings—can actually trigger unwanted thoughts. For example, if I instruct you not to picture an elephant, what happens? Do you not think of an elephant?

Our ability as humans to distract and compartmentalize our problems and emotional experiences is part of an evolutionary and complex mental system. Avoidance is not inherently good or bad as a widely applied coping skill. However, the way one avoids stress may affect his or her level of engagement with others. Mentally speaking, avoidance is a typical response to stressful thoughts and events. Crossing the street so as to not pass by someone walking in your direction is an example of physical avoidance. The paradoxical effect of anxiety and mental avoidance leads us to a new therapeutic model.

Acceptance-based behavioral therapy (ABBT) is from the third wave of cognitive behavioral therapy (CBT) approaches. This new flood of therapies incorporates mindfulness practices. ABBT, for its part, focuses on the management of cognitive avoidance. It addresses the omnipresent suffering that encompasses the mind’s ability to project into the future and dwell or ruminate on the past. Our thinking in this department is more complex than for any other mammal on the planet, but to a fault.

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The worry that we create through habitual patterns of thinking serves as a form of avoidance from the present moment experience. The avoidance becomes automatic or habitual over time, so we tend not to be aware that we are avoiding things. We might not realize that the worrying or our perception of an association in the future distracts us from other emotional topics.

This is especially resonant in American culture. Westernized values center on productivity and success as determinants of self-worth. This egocentric position ingrains our fixation on what the future will bring. It is eloquently framed the “intolerance of uncertainty.”

Worrying or attempting to not fixate on an idea or memory is viewed by ABBT as a “natural response” rather than inherent pathology. The worrying takes place as a way to reduce physiological arousal around something aversive or feared, but allows us to avoid more distressing issues. One of the ways this directional thinking or grasping (i.e., future or past) causes us so much stress is that the observation becomes self-identification. An inability to tolerate the ambiguity of an uncertain future creates a tendency to respond in a negative way. Negative prediction or judgments of the future lead us to further worry, which we then try to manipulate as the cycle perpetuates.

Take an invitation to public speaking as an example. If you are asked to give a presentation in front of a group of coworkers tomorrow, you might start thinking about material to reference or what the room looks like that you will present in. Then you ponder how many people will be in attendance. You consider what type of attire you should wear and how people will be staring at you. What if you make a mistake? The thinking and worrying narrows your focus toward potential social threats (the coworkers watching, the bosses evaluating, etc.).

The associations can begin to entangle the person and they become hooked by their own mental processes around the potential experience. The cognitive aspect pairs with physical reactivity such as increased heart rate or a sinking feeling in one’s stomach to condition the anxiety. Rather than noting this experience as anxiety, people often self-define as saying or thinking, “I’m really anxious!” The idea of being anxious is fused with the person. The person views himself or herself negatively and further worries about how he/she will respond in this perceived state of mind. A conclusion often stems from personal judgments around the anxious state and can come in the form of a belief: I am weak.

If your way of operating includes attaching to these beliefs, certain states of mind (fear, sadness, anxiousness) become framed as personal deficits or flaws. Put more simply, the idea that there is “something wrong with you” is cemented. When a person believes there is something wrong with him or her, often the thought is that if I could just fix [insert a perceived deficit], then my life would be better. The self-criticism and judgmental thinking—not the perception of stress or deficit—tends to be the issue needing addressing. Awareness of your state of mind throws a wrench in this way of thinking and changes the operating system.

Acceptance-based behavioral therapy facilitates a system of operation with an emphasis on active awareness of one’s mind. Thoughts and feelings are not being replaced or altered. You recognize or observe what is occurring in the present moment.

Acceptance-based behavioral therapy facilitates a system of operation with an emphasis on active awareness of one’s mind. Thoughts and feelings are not being replaced or altered. You recognize or observe what is occurring in the present moment. Initial worry manifests as a thought and not who you are. However, beginning to worry about the worry and the avoidance strategies that accompany that way of operating is the process ABBT is directed toward. It also arranges a structured framework for therapists to work with the reactions of people in therapy (i.e., the behavioral component to the CBT coin).

The ABBT approach presents as a new way of operating for some people. Think about the functional change that occurs in the transition from desktop computers to mobile devices for using the Internet. The first major step of ABBT is being connected. It is like finding a Wi-Fi network to link with. The connection enables you to cultivate an expanded awareness or Wi-Fi signal as opposed to the narrow Ethernet cord-to-wall technology of the desktop computer. One must carry this signal of awareness and not be tangled up or fused with internal experiences (i.e., thoughts, rumination, etc.). The second step is a willingness to read or face the news of your experience (i.e., feeling states). The analogy here is once you are connected to a signal, you can open up a single web browser like Google or Internet Explorer. Engaging with the browser (don’t be tempted by random advertisements, Facebook or Twitter) offers the third metaphorical piece to ABBT: mindfully participating in personally meaningful behaviors.

As humans, we all benefit from increased awareness and empathic responses to environmental changes. Cultivating this practice of momentary acceptance while observing one’s own internal states will intrinsically create meaning within the activities one engages in. Put simply, if you are open and willing to put out a clear signal and connect with the world, your options for engagement are boundless.

Reference:

Roemer, L., & Orsillo, S. M. (2014). An Acceptance-Based Behavioral Therapy for Generalized Anxiety Disorder. In: D.H. Barlow (ed.) Clinical Handbook of Psychological Disorders. Fifth Edition. New York: The Guildford Press, pp. 206-236.

Can an old dog learn new tricks? Can we change in adulthood? Many of us struggle with this question as we make New Year’s resolutions that we fail to meet: eating healthier, exercising, overcoming behavioral habits that keep us from living up to our personal and relational goals.

Sometimes we blame our genetics—it’s our DNA that is keeping us stuck! Or we blame our childhoods—if only we had better parenting, we could reach for the stars! There is no question that we are each born with a temperament, and that genes play a role in our abilities and limitations. And early childhood experience does shape our brains. In fact, neuroscientists these days look at the interplay between genes and environment, or G x E. But does that mean once we have survived childhood we are fixed, set in our ways, determined by our nature and early nurture?

Neuroplasticity in Adulthood

Until a decade or so ago, many scientists thought that while children’s brains are malleable or plastic, neuroplasticity stops after age 25, at which point the brain is fully wired and mature; you lose neurons as you age, and basically it’s all downhill after your mid-twenties. Fortunately, this rather grim view of the aging brain has been upended by more recent research. We now know that the human brain is capable of change throughout life. It’s true that a typical child’s brain is more plastic, more capable of change and new learning than a typical adult brain. And we do lose neurons as we age. But it’s not all downhill; the adult brain can create new neuronal connections and even new neurons born from neuronal stem cells. In addition to these gray matter (neuronal) changes, there can be change in our white matter, the pathways between neurons and the myelin that allows neurons to communicate efficiently.

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What Promotes Neuroplasticity?

We are not guaranteed vibrant, flexible brains as we age, however. A lot depends on how we live our lives. The adult brain needs oxygen and stimulation to stay sharp and capable of change.

Researchers have identified the following three habits as facilitating neuroplasticity as we age: physical exercise (which increases blood flow to the brain, delivering much-needed oxygen), paying attention, and learning new things. Once I learned about the impact of physical movement on neuroplasticity, I increased my exercise to daily from twice a week. And I see the difference in both body and mind! While an aerobic workout is great, even walking briskly for half an hour will increase blood flow and feed oxygen to hungry neurons.

The second factor that increases neuroplasticity, paying attention, is the opposite of acting on automatic pilot. Most of the time we do function on automatic, which is easier and less tiring than thinking through and being aware of our every move. This automaticity can be to our advantage, as we easily ride our bike or whip up our favorite recipe. But living on automatic can mean that we miss precious moments, forget to smell the roses, or take for granted a majestic mountain vista. Waking up to our experience allows us to be present. It also allows the brain to be more active and flexible. One of the best ways to pay attention is to engage in mindfulness practices, whether through a formal practice of meditation or in more informal ways.

The third stimulus to brain plasticity in adulthood is learning new things. This comes naturally to a young child, for whom everything is new. By contrast, adults tend to be less open. We get comfortable with the familiar; we like to kick back, relax, and do the same old, same old. This may feel good, but it does not contribute to neural flexibility. And if we combine same old, same old with not exercising—being a couch potato, television, potato chips and all—we are depriving the brain of the nutrients of neuroplasticity.

Mind-Sets about Change

Some of us are more open to change than others. Carol Dweck’s research offers a fascinating glimpse into our mind-sets about change. Some people, she says, have a fixed mind-set; they are not interested in changing, or assume they are incapable of change as adults. This is epitomized in Popeye’s famous statement, “I yam what I yam.” By contrast, people with a growth mind-set assume they are capable of change and growth in their lives.

Change in Couples

Some folks come eagerly to therapy, looking forward to the possibilities of learning and transformation. Others are hesitant, defending their right to be as they are. It’s not uncommon in a couple that one partner takes the “let’s change and grow” position, while the other comes to therapy reluctantly.

Old habits have quite a hold on us and are hard to change. To wire in a new set of behaviors, we have to repeat them over and over again. Eventually, these new behaviors become the new normal.

For hypothetical example, Tina, feeling increasingly disconnected in her marriage and frustrated that Joe doesn’t share her enthusiasm for deep, emotional conversations, drags him to therapy to improve their relationship. Joe comes to couples therapy because he loves his wife and doesn’t want to lose her. But he is resentful. He says, “I’m the same man you married—the strong and silent type. You’re the one who has changed!” For Joe, Tina’s evolving needs and her pushing him to change are the problem. Joe has a fixed mind-set, and he defends his right to stay the same. Tina has a growth mind-set; for her, transformation and growth are vital nutrients. Their “meeting of the mind-sets” is the first challenge we will face as we work together. I will help Joe see the positive payoffs of change, and I will help Tina back off from her campaign to reform Joe.

Most of us don’t want to “be changed” by someone else. We want to author our own change. Tina sees change as a transitive verb with a direct object: “Tina changes Joe.” But Joe doesn’t want to be the direct object of Tina’s change agenda. He wants some autonomy to choose his change. Family therapists have long observed that the only person you can change is yourself. Both Joe and Tina may decide to change in order to revitalize their relationship—but this needs to be a choice for each of them. Authoring your own change can be empowering; having change foisted on you can breed resentment.

Making Change Last

Let’s come back to those New Year’s resolutions. We have great intentions, and do engage in healthier habits for a while—only to find a few weeks in that we are backsliding. It’s too cold to go to the gym. There’s no time. We are great at coming up with excuses. Why is it so hard to live up to our goals and make new changes last?

Once again, neuroscience points to the answer. Habits become wired into the brain; once established through constant repetition, circuits of neurons keep our habits in place. Old habits have quite a hold on us and are hard to change. To wire in a new set of behaviors, we have to repeat them over and over again. Eventually, these new behaviors become the new normal.

When I started swimming as an adult, every trip to the pool was an effort as I worked to coordinate my breathing with my strokes. My brain and body were not accustomed to an aquatic life. Now, after years of regular visits to the pool, I crave my morning swim; I feel so natural in the water, I wonder if I was a fish in a former life.

Embracing a Growth Mind-Set

Whether we like it or not, things change. Our brains and bodies are evolving all the time—getting stronger as we exercise mentally and physically, getting weaker as we age or become couch potatoes. We can’t stop the process of time and aging, but we do have some choices over how we deal with our lives and relationships.

We can opt to live in a way that nurtures neuroplasticity—or we can close our hearts and minds to the new. We can exercise body and mind, or we can let our physical and mental faculties slide. Our mind-sets and our habits affect the brain, for better or worse. Choosing change, a growth mind-set, allows us to nurture neuroplasticity in our brains and promotes flexibility in our personal and relational lives.

Which mind-set will you choose?

References:

1. Doidge, N. (2007). The brain that changes itself. NY: Viking.
2. Dweck, C. (2006). Mindset: The new psychology of success. NY: Ballantine.
3. Fishbane, M.D. (2013). Loving with the brain in mind: Neurobiology & couple therapy. NY: WW Norton.
4. Ratey, J.J. (2008). Spark: The revolutionary new science of exercise and the brain. NY: Little, Brown & Co.

A seizure is a sudden and unexpected loss of control accompanied by abnormal body movements or convulsions, a loss of consciousness, or both. Though epileptic seizures are caused by sudden, rapid, and chaotic electrical discharges in the brain, not all seizures are epileptic.

Psychogenic nonepileptic seizures (PNES) are not caused by abnormal discharge of electrical brain signals, but instead are emotional in nature and usually triggered by stress or anxiety. Although these seizures are rarely discussed, they are not rare. PNES have a prevalence similar to that of multiple sclerosis.

Statistically, one in five people sent to epilepsy centers experience PNES rather than epilepsy. In fact, a team of physicians and psychologists at Johns Hopkins Hospital reported that more than one third of patients admitted to the inpatient epilepsy monitoring unit were experiencing stress-triggered seizures rather than true epileptic seizures.

Diagnosing Psychogenic Nonepileptic Seizures

Because PNES can mimic epileptic attacks, they are often misdiagnosed. At least 80% of patients experiencing PNES are treated with antiepileptic drugs for several years before a correct diagnosis is made.

[fat_widget_right]The source of this dilemma is multifaceted. Most physicians do not have access to electroencephalogram (EEG) video monitoring, and even those who do can easily misread an abnormal EEG without video if they have not been specifically trained in epileptology. A 2005 study of 46 patients published in the Neurology journal revealed that 54% of EEG readouts were misinterpreted as epilepsy.

Epileptic seizures tend to be more serious than PNES. If there is any doubt, a neurologist will usually treat the more serious condition. If medication fails to treat seizures, a patient is then referred to an epileptic center, and it is often there that the diagnosis of PNES is made.

With proper equipment and specialized knowledge, an epileptologist can easily distinguish between epilepsy and PNES. An EEG-video monitoring system monitors a patient for several hours and sometimes days until a seizure occurs, though there are techniques that can be used to trigger a seizure to speed up the monitoring process if necessary or desired. By analyzing the video of the seizure, a diagnosis of PNES can be made with 100% certainty.

Causes and Risk Factors

PNES is a somatoform illness, meaning that emotional stress creates physical illness in the body. These seizures are emotional in nature—induced by stress—and often result from traumatic experiences, some of which may have been repressed or forgotten. Such traumas may include divorce, physical or sexual abuse, death of a loved one, incest, or any other great loss or sudden upheaval in one’s life.

Individuals without developed coping skills may be more susceptible to PNES than those with a high level of resiliency to stress. A team of neuropsychologists and neurologists at Johns Hopkins University School of Medicine found that people with PNES don’t necessarily have a higher frequency of stress and/or trauma than others, but they seem to lack effective coping mechanisms to deal with stress and are thus more affected by it.

Coping with Diagnosis and Stigma

Psychosomatic illnesses like PNES are often misunderstood by family members and even by physicians and other health care professionals. A person may be reluctant to accept the diagnosis and become upset when told the seizures are psychological. Some people completely refuse to accept the diagnosis and continue to take antiepileptic drugs even as symptoms continue. This places responsibility on the physician to stop administering the drugs.

A lack of public knowledge and awareness of PNES only increases the misconceptions, misdiagnoses, and stigmatization of the illness. Somatoform illnesses like PNES are real—resulting from real stressors and traumas—and should be treated as such.

Treatment and Outcomes of PNES

Overall, PNES can be treated if properly diagnosed. The earlier the diagnosis, the better the outcome may be. About 70% of people who receive adequate treatment for PNES eventually experience a complete disappearance in seizures. The recovery time will vary from patient to patient depending on the severity of the traumas and stressors involved, as well as the person’s established coping mechanisms and resiliency to stress.

While a neurologist typically treats epileptic seizures, PNES tends to be treated by a psychologist or other mental health professional. Someone who has been newly diagnosed and has been taking antiepileptic drugs will need to work with a neurologist to gradually come off the drugs rather than stopping use abruptly.

About 70% of people who receive adequate treatment for PNES eventually experience a complete disappearance in seizures.Treatment for PNES typically involves various types of psychotherapy. Cognitive behavioral therapy (CBT) may be used to help people develop adequate coping skills to deal with life stressors. Relaxation techniques and biofeedback are also used to help manage and cope with stress.

For those whose seizures are a manifestation of past trauma, PNES is typically treated as posttraumatic stress. In this case a physical seizure may be the body’s way of expressing what the mind cannot. Some physicians have also found eye movement desensitization and reprocessing (EMDR) to be an effective treatment for PNES.

EMDR is a synthesis of many different therapeutic approaches including CBT, psychodynamic, interpersonal, body-centered, and experiential therapies. This information-processing therapy occurs in eight phases—attending to past traumas that contribute to the pathology being treated; the current situations, beliefs, and sensations that are triggering the dysfunctional emotions; and the positive experiences needed to improve mental health and well-being in the future.

The costs of being treated for misdiagnosed epilepsy are high and should not be ignored. As the incidence of misdiagnosed PNES continues, it is important for neurologists, psychiatrists, and psychologists to work in collaboration to raise public awareness, remove the stigma, and provide proper diagnosis, treatment, and support.

References:

1. Benbadis, S.R. and Heriaud, L. Psychogenic (Non-Epileptic) Seizures: A Guide for Patients and Families. (n.d.). Comprehensive Epilepsy Program: Tampa General Hospital & University of South Florida College of Medicine. Retrieved from: http://hsc.usf.edu/COM/epilepsy/PNESbrochure.pdf
2. Desmon, S. (2012, April 10). Symptoms that Mimic Epilepsy Linked to Stress, Poor Coping Skills: Patients with “Pseudo-Seizures” Often Misdiagnosed. Johns Hopkins Medicine. Retrieved from: http://www.hopkinsmedicine.org/news/media/releases/symptoms_that_mimic_epilepsy_linked_to_stress_poor_coping_skills
3. The Truth about Psychogenic NonEpileptic Seizures. (n.d.). Epilepsy Foundation. Retrieved from: http://www.epilepsy.com/article/2014/3/truth-about-psychogenic-nonepileptic-seizures
4. What is the actual EMDR session like? – EMDR International Association. (n.d.). Retrieved from http://www.emdria.org/?120

His name was Zack. Zack was a 150-pound, 2-year-old Newfoundland dog—my buddy. Wild at heart—at best only ever semi-domesticated—he loved nothing more than to escape from our three-quarters-of-an-acre fenced yard and head toward the hundreds of acres of forest and trails that lay just up the road from our house.

I came home from work late one afternoon and discovered Zack was gone. I parked my car, got out, and then heard the screech of brakes, a loud, dull thud, and one heart-breaking yelp. I ran up the road to the crest of the hill and saw that my worst fears had come true. Lying in the road— illuminated by the car’s headlights—was Zack, tongue hanging out from the side of his open and bleeding mouth, his bear-like chest still. He was dead, killed by a car traveling over the crest of the hill, by a driver who could not see him until it was too late. I felt devastated.

For the next several weeks, as I traveled this same road, each time I came over the crest of the hill where this tragedy had occurred, the image of Zack’s lifeless body, lying in the road, involuntarily came to mind accompanied by all the associated feelings of grief. The sight of the crest of the hill had become a trigger for activating painful memories.

A couple of months later, I attended a weekend workshop focused on something called neuro-linguistic programming, or NLP for short. NLP is the study of how thought and language impact and influence personal experience.

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During the NLP training, the two facilitators—Rick and Ricky—asked that we each find a partner to complete an exercise. In this exercise, one person was to act as the “client” and the other as the “therapist.” The client was directed to pick a memory that was still bothering him or her. The therapist was directed to guide the client through the steps of an NLP procedure called the “swish pattern.”

We were told that when using the swish pattern, it was not necessary for the client to reveal the contents of his or her memory to the therapist. This meant the entire process could be completed without the therapist even knowing the client’s issue.

For this exercise, I opted to play the role of client. As the “client,” here are the instructions I received and followed:

1. Select a specific “unpleasant memory” you want to change.
2. Close your eyes and mentally re-create that unpleasant memory to the best of your ability. Imagine it in detail as if it was happening to you now. Be in the experience and see, hear, and feel what you would if it were happening now. (Note: for this exercise I recalled coming to the crest of the hill, finding Zack dead, and feeling devastated.) This original unpleasant memory will soon become the cue for triggering a new “pleasant substitute memory.”
3. Next, create an alternative mental image of what you would prefer to recall—a pleasant substitute for the original, unpleasant memory. (In my case, I wanted the crest of the hill to automatically trigger a pleasant image of a time spent with Zack instead of triggering the unpleasant memory of his lifeless body lying in the road. The pleasant memory I selected was an image of Zack standing on his hind legs, front paws hanging over the fence, black tail wagging, and happy to see me.) Imagine this new alternative “pleasant memory” as if it was happening to you now. Be in the experience and see, hear, and feel what you would if it were happening now. This is now your new substitute pleasant memory.
4. Now, once again, imagine a big, bright picture of the unpleasant memory you wish to change (your original cue image). In the bottom right-hand corner of this mental picture, construct a small dark picture of your new “pleasant memory” that you would prefer to experience instead.
5. Now, quickly and smoothly expand the small, dark image of the pleasant memory so that it grows to become a big, bright image right in front of you—completely replacing the unpleasant memory. This quick exchange of images (from unpleasant to pleasant) takes about a second. Swap the images in the time it takes you to say, “swish.” The key point is to make the exchange sudden and very fast.
6. Repeat steps four and five 10 to 12 times.

I listened attentively and followed all of the therapist’s instructions. This was my first experience with the “swish pattern.” Was it effective? Last week, I drove to the old house. As I passed over the crest of the hill, sure enough, the first memory that came to my mind was the happy image of Zack standing on his hind legs, front paws hanging over the fence, black tail wagging and happy to see me—just like we programmed my mind to do in this exercise first completed a quarter of a century earlier.

Is the swish pattern magic? No. Does it always produce such impressive results? Probably not. But when you have a troubling memory, is it worth giving it a try? Absolutely!

Relationship issues and communication problems are frequent reasons many individuals and couples come to see me for therapy. One aspect of the work is to explore feelings and conflicts in relationships and empower people to engage with their partners with the aim of understanding and being understood. To do this, we look at what interferes with the ability to be empathic to the other’s experience. It would seem that understanding where the other person is coming from and seeing their point of view would not create difficult problems in relationships. However, it turns out not to be so simple. The loss of one’s sense of self in the process of engaging another’s feelings must be addressed.

The Risk of Empathy

As I engage with these people in therapy, I often discover that there is a limitation in the ability to be empathic in relationships, especially in situations where there is disagreement. Some believe that acknowledging empathy when there is conflict puts them at risk because the other will mistake their understanding for agreement. If that should occur, the empathic person can feel like their thoughts and feelings have been dismissed and negated. They fear that their expression of empathy will be seen as acknowledging the rightness of the other and they will be the loser. The feeling is not just of losing the argument, but a loss of some piece of the self.

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Glen and I were working on his feelings of helplessness with his partner, Alan. They had been a couple for six years, but to Glen’s disappointment, he could not get Alan to agree to move in together. Each time Glen suggested they give it a try, Alan got angry and told Glen to stop nagging him. He would say he loved Glen, but had no interest in living together. Glen would feel hurt and pushed away.

“He is so mean to me,” Glen said. “I don’t know why I stay with him when he repeatedly rejects me. Can I really believe that he loves me when he treats me this way? You know how scary it is for me to speak up for myself in my life. You and I have been working on that and now that I’m doing better and asking for more, what good does it do me? When I ask Alan for what I want, he still mistreats me.”

I asked Glen: “What do you understand about why Alan, who has stayed with you for six years, won’t move in with you?”

Glen replied: “He says that in his last relationship, living together was a disaster and he and his partner fought constantly. But just because it makes him anxious that our relationship will become like that is no reason to keep denying me what I know will be perfectly fine. I just think he wants to control me. He is talking about his history and absolutely refuses to see us as different. I get so hurt and angry. He can get really sad and even cries sometimes when he tells me how painful that relationship was. But he needs to get over it.”

Glen could see only his own point of view. It was very difficult for him to be empathic—to get him to consider what it would be like if he put himself in Alan’s shoes. He became very irritated with me.

“I don’t get it,” Glen said. “You have helped me to learn more about who I am and what I want, and now you want me to abandon my own thoughts and feelings and wear Alan’s shoes. I need to stay in my own shoes. Alan’s shoes don’t fit me. Maybe he should try my shoes on for size.”

I asked Glen to tell me more about what he thinks the downside would be if he could empathize with Alan. He had no trouble replying.

“If I let myself feel what it’s like to be Alan and recognize his worries and anxieties, it will legitimize his point of view. What I want will lose all meaning. I know I’m right about this. We have had this fight for almost six years and now he would win. I don’t want to be a loser. You know, for the most part we have a good relationship. We spend a lot of time together; we love each other; we have fun. But every time I bring up that if we don’t live together it isn’t a real relationship, we get into a huge fight. Then it feels like we are enemies and neither one of us will give in. I’m afraid that if I stop fighting for this, I will become helpless and powerless in the relationship and disappear. Sometimes I even think Alan would leave me if I gave in because he would think I’m a wimp with no sense of who I am or what I want.”

Glen mistakes allowing himself to understand how Alan feels about moving in together for agreement with Alan. He is stuck on the idea that he will be a “loser” if he is empathic. But his biggest fear is that being empathic means he will betray his own wishes and lose a part of himself.

Identification, Not Empathy

In contrast to Glen, Katy is concerned that she has too much empathy. She came to see me because she was feeling overwhelmed with feelings of having to care for her aging father and, at the same time, attend to her daughter who had just left for college and was having a difficult time adjusting. She described her emotional situation as follows:

“I am so filled with feelings I can’t breathe. My father is very sick with cancer. He’s scared and very demanding. I feel so much empathy for him. I’m frightened, too. We’re so close. What’s going to happen to me when he dies? I’m also on call for my daughter. She can’t seem to settle in at college. She calls me every day. I spend hours trying to soothe and reassure her. I know just how she feels. I remember when I went away to school and my parents would try to help me. She is such a mess. I’m such a mess. My father needs the same kind of soothing she does. I guess I do, too. My husband tries to help, but he thinks I’m over-involved. I don’t know how I could feel any other way. My father and daughter are both in pain, and I can’t help but share their feelings.”

Katy saw herself as a loving and responsible daughter and mother. She believed her response to her family members was the “right” way to feel. While she acknowledged feeling burdened by the demands made on her, she thought that “it’s my duty to give my all and do my best to make them feel better.” She recognized that for months she had given up much of her own life to devote herself to her family. Not only was she exhausted, but it was creating conflict with her husband: “He told me that I’m always anxious and preoccupied and that I’ve disappeared from our relationship. He says it’s OK to worry and help, but he accused me of being consumed with my father and our daughter. He keeps saying, ‘Where are you? I want you back.’ ”

Katy describes herself as feeling empathy for her father and daughter. These intense feelings, however, are not empathy. Empathic feelings occur when one can emotionally imagine what it is like to be in another person’s feeling state. Someone with empathy strongly feels what the other person is feeling but maintains a sense of being separate. In contrast, Katy is identifying with her father and daughter. She can’t maintain her separate self. The feelings she experiences are the same as the feelings her father and daughter suffer. She is identifying with them and taking on their feeling states. She cannot have her own separate, empathic feelings. Her sense of self is lost.

Loss of One’s Sense of Self

The therapeutic work with Glen and Katy could easily focus on the concrete problems each of them brings to their sessions. Glen and I could work on his becoming comfortable with Alan’s refusal to move in together. Or we could look at what makes Glen feel so mistreated and rejected when this occurs. And we do explore those issues. Katy and I could work on her anxiety and guilt about her conflicts and limitations in helping her family members. And we do work on these issues as well as on her relationship with her husband.

Empathic feelings occur when one can emotionally imagine what it is like to be in another person’s feeling state. Someone with empathy strongly feels what the other person is feeling but maintains a sense of being separate.

But the therapy with both these individuals has been most productive when we address the feelings of loss of self. For Glen, conflict in the relationship is exacerbated when he refuses to empathize out of fear of losing himself. For Katy, there is no room for herself when she identifies with the other and becomes overwhelmed and infused with everyone else’s feelings.

As we dig deep into the dynamics of these two relationships, we are left with the necessity of having to explore: What happens to me when I am faced with the other person’s feelings? Glen struggles with considering that he can try on Alan’s shoes and appreciate how they fit Alan, even if they are not his style. He is beginning to recognize that he can like the look for Alan, but know that he doesn’t have to change the style that is right for him. Katy looks at how she responds to her father’s and daughter’s feelings and is learning that she is not the same person as her family members. She is starting to recognize that she can set boundaries and still be a good and loving family member. It is not easy, however, to separate and feel for them, rather than become them.

As Glen and Katy come to understand what has interfered with their being empathic, they are in a better position to relate to their significant others in loving ways while retaining their sense of self.

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

Psychotherapy can be about more than treating symptoms; it can be a path to living a more fulfilling life.

People often begin therapy to alleviate symptoms—a worthy goal, to be sure. But perhaps even more compelling is the ability of psychotherapy to help us counter our tendencies to stay in our comfort zones, and to challenge us to open ourselves to the aliveness and dynamism of the ever-evolving now. It can help us tap into our potential and live happier, more meaningful lives.

Yet it’s not uncommon to hear people say that therapy is like using a crutch, or that therapy makes people dependent on their therapists. In some cases, such claims may indeed be true. However, good therapy is meant to empower us, to help us mature, to stand on our two feet and face whatever comes our way.

Furthermore, therapy is not an easy process. If your therapist is doing his or her job, you will feel uncomfortable at times as you examine uncomfortable feelings and the reasons they exist. Whoever thinks that therapy is a crutch or an easy process clearly has not gone to therapy.

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Therapy Takes Courage

Engaging in the process of therapy is a courageous endeavor that is not for the faint of heart. Successful therapy demands that you see what you do not want to see within yourself. We all have parts that we don’t want to see, parts that scare us and that we have carefully hidden deep inside.

Good therapy is meant to help us uncover those parts. Even in the safety of a strong therapeutic relationship, that is no walk in the park. It requires commitment, emotional stamina, capacity to tolerate difficult emotions, capacity to shift attention to different aspects of ourselves at the right moments, and compassion—lots and lots of compassion. It requires dedication and a willingness to be in (inner) places that we haven’t been before, a willingness to be vulnerable.

Vulnerability Is True Strength

Allowing ourselves to be touched and open to experience in a non-defensive way is a very vulnerable thing to do. The idea that this is a weakness is a delusion; nothing takes more courage than to meet the parts of us that are scared and hidden. As long as we try to force our way into seeing our depths, we will not have access; the way in is through vulnerability and allowing our experience be exactly what is.

Allowing ourselves to be touched and open to experience in a non-defensive way is a very vulnerable thing to do. The idea that this is a weakness is a delusion; nothing takes more courage than to meet the parts of us that are scared and hidden.

This is no easy task. Our culture advances a belief that we need to “pull ourselves up by our own bootstraps,” but that belief is based in unconscious fear that dominates our experience—in fact, it is an act of violence toward ourselves.

If instead of beating ourselves into action we learned to invite the shaky, scared parts of us to show up, and we hold them with openness and let ourselves directly feel all of their uncomfortable sensations, we are being as courageous as we can possibly be. We are willing to meet ourselves without hesitation.

If we allow ourselves to feel the sense of deficiency (or whatever we are resisting), without defending against it, in time we can begin to experience a palpable sense of strength, courage, and determination that is not based on ideas of what should be, but are actual, felt experiences. Good therapy can help us with this.

Real Therapy Has Results Beyond the Reduction of Symptoms

There are real, tangible benefits to engaging in this process, including an increased sense of freedom. By understanding and unwinding the inner structures we have hidden inside, we are also recovering a great deal of previously frozen aliveness. By learning to see through our emotional and mental defenses, we also gain openness, awareness, and responsiveness. We become more finely attuned to what we need and to what is needed at any given moment.

A simple way to measure psychological well-being is by how responsive we are to the immediate environment without our old filters getting in the way as much. Neither reactive nor passive, we become able to appropriately act in a way that supports our continuous development.

This is not a mental exercise; it includes all of our being. It includes awareness of our mental, emotional, and somatic (physical) states. It requires uncovering our past beliefs and ideas about reality. It also requires getting to know our limitations and our capacities. And it requires us to not be defended—or at least not extremely defended. In a way, therapy can be an adventure into our inner landscapes, a process in which we are willing to be transformed by self-discovery.

By becoming aware of the parts of us that we didn’t know existed, we can begin to know ourselves in a more intimate way. In turn, our satisfaction in life increases, because our actions, emotions, and thoughts come into greater alignment. Furthermore, by understanding our unconscious inner conflicts and relational patterning, we begin to lessen their impact on our well-being and our capacity to respond appropriately to life.

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

When Henry Ford first conceived of the V8 motor, his engineers told him it was simply impossible to cast an 8-cylinder engine block in just one piece. Ford told the engineers to do it anyway. He instructed them to try until they succeeded, no matter how long it took. If they wished to remain employed by Ford, this was their one and only task. After more than a year of trying with no results, Ford told them to continue. Shortly after, the first V8 motor was built.

Our thoughts and beliefs shape both our perception and experience of ourselves and the world around us. Research indicates that nearly 80% of our self talk is negative. Imagine spending your whole day listening to a recording of whining, complaints, and criticisms. What many people fail to recognize is that they are listening to these types of thoughts in their head on repeat every day.

Our programming can become so ingrained in us that we may not be aware of its existence. Thoughts such as “I’m not good at anything,” “Life is hard,” or “People can’t be trusted” may cross our minds so frequently that we begin to recognize them as facts and no longer question the possibility that things could be different.

The word affirmation comes from the Latin affirmare, which means “to strengthen and make steady.” Affirmation statements are affirming that something is true for us. The purpose of positive affirmations is to affirm to ourselves that things are good even if we don’t necessarily feel that way at the time.

Positive affirmations have the power to transform lives. They play a significant role in many therapeutic models—including cognitive behavioral therapy, a treatment for depression. Positive affirmations are also at the forefront of many 12-step rehabilitation programs.

[fat_widget_right]Carefully constructed positive affirmations can “rewire” our brains to break negative thought patterns. Similar to exercise, positive affirmations can actually increase the amount of feel-good hormones in our brains. Positive thoughts create positive emotions, which can actually change our physiology and improve our mental, emotional, and physical health.

Here are 15 positive affirmations that can help change your life:

1. I am worthy of love, happiness, and fulfillment.

This affirmation can increase your self-esteem and self-worth. You are what you believe you are!

2. I have the power within me to create the life I desire.

This empowering statement can help you recognize that you alone have the power to create the life you want. Honor your power to choose by choosing thoughts and actions that positively contribute to your life.

3. Each new day is filled with infinite potential and possibility.

You’ve probably heard the phrase “Tomorrow is a new day.” Every new day brings with it new opportunities. Carpe Diem. Seize the day by making the most of the opportunities available to you.

4. I am so grateful for my life and all its blessings.

An attitude of gratitude can not only boost your mood and increase your awareness of all the blessings you already possess, but it also serves to attract even more good things into your life.

5. I forgive myself and hold myself in a state of compassion.

Forgiveness can free us from past burdens and allow us to operate from a clean slate. Love yourself, recognize that you did the best you could in the past, and strive to continue to learn and do better in the future.

6. I love and accept myself just the way I am.

The simple act of self-acceptance can radically transform your life. A healthy relationship with yourself is necessary if you wish to have healthy relationships with others.

7. I am strong in my values and confident in my abilities.

Strong values and self-confidence can keep you feeling empowered, strong, and capable of taking on life’s challenges.

8. I let go of the past, surrender concerns about the future, and openly receive the experience of the present moment.

When we let go of the past, it no longer has power over us. Choose to live in the present moment and remain open to its possibilities.

9. I continue to learn, grow, and evolve with each passing day.

Remembering that each day is a new opportunity for learning may make it easier to let go of the past and remain excited about the future.

10. I attract experiences that serve my highest good and facilitate personal growth and transformation.

A negative attitude can invite negative experiences. By keeping a positive perspective, we can openly embrace experiences that serve to help us grow and become better people.

11. My life is filled with meaning, purpose, and passion.

Seeking out meaningful experiences that ignite our passions can provide a sense of purpose and fulfillment in our lives.

12. I have positive, healthy, and supportive relationships with my loved ones.

Reminding ourselves that we wish to have healthy and supportive relationships in our lives can remind us to treat others with kindness, compassion, and respect. It can also empower us to stand up for ourselves by creating healthy boundaries in our relationships.

13. I am confident in my talents, strengths, gifts, and abilities.

Being confident in your gifts and strengths can give you the courage needed to put yourself out there and seize the opportunities presented.

14. I have the courage and tenacity to overcome any challenge I face.

There’s no doubt that life can sometimes be difficult. Regularly reminding ourselves of our courage and tenacity can provide us the strength needed to get through even the toughest of times.

15. I freely give and receive unconditional love and acceptance to myself and others.

Life is of little meaning without love. Reminding ourselves to be open to giving and receiving love can be important, especially after loss. Rather than guard your heart, choose to remain open to the love that is all around you.

Our thoughts and beliefs shape both our perception and experience of ourselves and the world around us. Research indicates that nearly 80% of our self talk is negative.The more personal the affirmations are, the more likely they are to work for you. Try using the above affirmations as a guide to aid you in creating your own affirmation statements. Start by identifying your negative thought patterns and creating positive countering statements. For example, a phrase such as “I’m not good at anything” may become “I always do my best.”

Affirmations are most effective when implemented into a daily routine. Your own quotes can be read, spoken aloud, and thought several times throughout the day.  Repetition is key. The more you say it, the more you may believe it.

Affirmations are more than simply repeating words, however. Though the process may seem silly if you’re new to it, affirmations have the power to drastically improve lives by freeing people from their own negativity and self-doubt. Using affirmations is a practice of recognizing and changing your thoughts on a daily basis. Eventually, positive thoughts can transform your cognitive patterns and negative thoughts may become less prominent. The more you can consciously choose your thoughts, the better your life can be.

“Thoughts become things, choose the good ones.” —Mike Dooley

References:

1. Ford Motor Company Timeline. (n.d.). Retrieved from https://corporate.ford.com/company/history.html
2. Fundukian, L. J., Ed. (2011). Cognitive-behavioral therapy. In The Gale Encyclopedia of Medicine, Vol. 2, 4th ed. (pp. 1061–1064). Detroit, MI: Gale
3. Harra, C. (2013, July 6). 35 Affirmations That Will Change Your Life. Retrieved from http://www.huffingtonpost.com/dr-carmen-harra/affirmations_b_3527028.html
4. Hay, Louise L. (2010, June). How to use affirmations. Going bonkers, Vol. 4, Issue 3, 58–61.
5. Hill, N. (1987). Think and grow rich. New York: Fawcett Books.
6. Maxwell, C. (2014, October 6). Self-Talk: Shifting Negative Thoughts to Positive. Retrieved from http://www.askdrmaxwell.com/2014/10/positive-thinking-self-talk/

If your favorite months are the warm-weather ones, then the transition into fall might represent a tough time for you.

If you have kids, they’re likely back in school—at least when you aren’t shuttling them between extracurricular activities. Work meetings may be more prevalent as vacations end. The calendar is once again filling with overlapping events, and you may wonder how you’ll fit them all in. You may look longingly at your checklist of summer fun and lament the things you never got to. When you leave your home in the morning or as the sun sets, you may notice a distinctive chill in the air.

End-of-summer sadness may be setting in.

Check In with Your Thought Process

Some people struggle with a “time’s up!” mentality regarding all the plans they had for the season. That scarcity-of-time mind-set can lead you down the road to the blues. Shifting your thoughts to ideas and plans for finishing the year in the strongest, most positive way possible may help you think in terms of abundance instead. What other great things are to be experienced this year? (If nothing comes to mind, plan for something!)

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It may also help to remember that without the change of seasons, you could potentially get bored or complacent with the heat and humidity of summer. A period of colder weather gives us a renewed appreciation for summer each year.

People often talk about how sad they are to see summer go. If your inclination is to express despair at the arrival of autumn, check in with yourself. Is that simply an automatic response? Do you have things to look forward to in the fall and winter? While saying goodbye to summer, what are you saying hello to?

Look Forward

Choose to look forward instead of focusing on the rearview mirror. One way to do that is to engage your senses.

Appreciate that new crispness in the air. Relish wearing cozy sweatshirts or favorite sweaters. Discover clothes you haven’t worn in a while; maybe even treat yourself to something new.

Enjoy looking at the seasonal colors surrounding you: the reds, golds, oranges, and browns. The foods we eat tend to switch from light to heartier fare, and from cold drinks to hot ones. Imagine yourself smelling the first fireplace fires of the season and apples baking with cinnamon.

Consider that the new season brings new sports to engage in or watch.

Appreciate the structure that fall brings, and find comfort in that. Also, let the holidays and rituals that coincide with the change in the weather serve as a guide to moving forward and finding fun and enjoyment.

Bring Summer Along for the Ride

Find ways to hold on to summer experiences—frame pictures to remind you of the fun you had, or perhaps display souvenirs to remind you where you’ve been. Download songs that will make you smile when you associate them with time spent with friends.

Look at your calendar and block out certain days, particularly after busy intervals, to ensure that you have time to breathe and regroup. Do your best to keep those days clear of obligations. These can serve as “days of summer” of sorts.

Look at your calendar and block out certain days, particularly after busy intervals, to ensure that you have time to breathe and regroup. Do your best to keep those days clear of obligations. These can serve as “days of summer” of sorts.

Make sure to plan time with friends and family.

Schedule something fun as often as you can so that you don’t find yourself falling prey to winter weather excuses (too cold, too wet, too dark, too tired) that lead to isolation.

Make notes about the kinds of things you’d like to do NEXT summer, so that you can begin taking steps toward manifesting them.

Turn a Transition into a Chance to Reboot

The change of seasons offers an opportunity to reassess and figure out what’s working and what isn’t. It may be the perfect time to begin something new or take on a stimulating challenge.

The fall represents the harvest. Consider the figurative seeds you planted in January and what you’ve since reaped, and how you might improve on your personal “harvest” next year.

As summer ends, another chapter begins, and while there might be angst attached to transitioning into the next phase, there can also be excitement and anticipation of great things—worthwhile challenges, fun times, and new beginnings.

Editor’s note: This is the first article in a two-part series that explores how the Pixar movie Inside Out offers a compelling and accessible way to look the impact of trauma and dissociation. Part II appears here.

It’s rare that I give homework to people in therapy. In fact, as a trauma therapist specializing in complex trauma, I find that more often than not some homework assignments can be triggering. So it is a very conscious choice when I ask people to do homework in between sessions.

When I do suggest homework, it is often with the emphasis on increasing their calming and relaxation skills, or to provide additional psycho-education surrounding trauma recovery. Structural dissociation theory, eye movement desensitization and reprocessing (EMDR) therapy, and the neurological aspects of trauma’s impact on the brain—these topics can present as “heady” or “too academic.” I always look for a more accessible way to describe such topics. Pixar Animation Studios has provided such an opportunity.

To me, the most effective, powerful, inspiring homework and psycho-education opportunities are more organic and experiential in nature.

With this in mind, I recently began asking some people to watch Pixar’s recent movie release, Inside Out. While this article is neither a review nor a place for spoilers, it is a testament to the power of Inside Out to teach people about trauma and dissociation in an inspiring and open-hearted way.

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The ‘Inside Out’ Story

In Inside Out, a girl named Riley, the 11-year-old main character, is faced with the challenges of moving from her family’s hometown. Her primary emotions, joy, anger, fear, disgust, and sadness, are represented as characters by the same names, each with influence over the “control console” of her mind, also known as “headquarters.”

Often, we “reject” our emotions, or other aspects of the traumas, because it feels too risky or too dangerous to fully realize them at the time of the experiences.

As Riley navigates the events surrounding her family’s move and the associated traumatic stressors, the primary emotion of “Joy” is no longer at the helm. “Sadness” becomes more prevalent, creating more core memories surrounding her distress at the move. By a variety of methods, “Joy” attempts to bring headquarters back to “normal,” meaning “Joy” at the controls, but as “Anger,” “Fear,” and “Disgust” take over, Riley’s internal world, and the personality islands associated with things she enjoyed—family life, friends, and her love of hockey—disintegrate. She shuts down.

It is not until all of the emotional states accept and integrate “Sadness,” solidifying that each emotion has its place, that new core memories can be built and her healing occurs.

So what does Inside Out have to do with trauma recovery? More than perhaps is clear at the onset.

Core Memories

As I have written in previous articles, it is our unprocessed and fragmented memories, the traumas that are “locked” in their state-dependent form, that cause distressing symptoms in our now. Our emotions, as well as what we saw, believed, and somatically experienced, are “frozen in time” and contribute to our distressing symptoms in the present.

Inside Out does an exceptional job of showing how our fully integrated, realized, and healed “core memories” can be stored in our headquarters in ways that are adaptive. Our system does have fully processed memories—that is, all aspects are acknowledged and healed. Pixar describes them as core memories symbolized by translucent spheres mindfully placed in a conveyor-like storage system. That said, when traumas are not fully healed, we have memories that are fragmented and displaced, even rejected.

Rejecting or Banishing an Aspect of Trauma

Often, we “reject” our emotions, or other aspects of the traumas, because it feels too risky or too dangerous to fully realize them at the time of the experiences. This is illustrated in Inside Out, where “Joy” cannot accept “Sadness.” “Joy” rejects her. Similarly, as we move forward in time, we, too, can become phobic toward some aspects of our trauma(s). In Riley’s case, “Sadness” had a very important job and was an important part of her moving from Minnesota. In fact, as Riley moved through her process of daily living, “Sadness” kept trying to push through—to touch the other memories in order to be acknowledged and processed.

It is not until the characters, the other emotions, become more accepting of “Sadness” that the full healing can occur. As Riley’s internal system, headquarters, becomes able to fully accept ALL aspects of the trauma, including what was once rejected or deemed dangerous to fully realize, “Sadness” is able to take its rightful place.

In the context of structural dissociation theory, no longer did Riley’s system have to feel phobic of that part of the experience. Riley could not fully realize and heal the trauma of her move until “Sadness” was acknowledged by her whole system. “Sadness” did have a place, and was key to healing the whole memory.