As therapists, we know the importance of addressing invisible issues such as stress, depression, and anxiety. But what about dyslexia? Let’s add this one to the list. Did you know that more than 40 million American adults have dyslexia—yet only 2 million know it? It’s likely that 1 in 10 of the people you work with in therapy will have it.

To illustrate why this matters, I’d like to share my story.

As I was growing up, my family never talked about my dyslexia. Although I got help in a public elementary school by means of a tutor named Mary, no one (including myself) understood how this was impacting my life and relationships.

While my school had a plan for me, home was a very different story. My parents separated when I was 6 months old and got a divorce when I was 6 years old. I lived with my mom and sister, who were very close and talked to each other about everything. I didn’t fit in well in our family of three. And unfortunately, no one took the time to try to understand my experience. As a result, I felt quite alone growing up.

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My mother and sister were fast talkers, so their conversations flew right by me. With my unrecognized dyslexia, their joyful ritual of reading and discussing the newspaper each morning at breakfast felt like a tedious chore to me. I went off to school each morning already feeling disconnected. Family dinner conversations also felt strained and out of sync. I couldn’t remember many of the details of my day, so it was hard for me to participate and share entertaining stories the way my sister did. My mother seemed enraptured by everything my sister said. I sat silently at the table and let her do most of the talking. Each day was repetitive and lonely. Somehow my grades were always passable and I never got in trouble, so my mom seemed to think everything was fine with me. We lived in the house together like two ships passing in the night.

I had no real academic problems until I went away to Grinnell College in Iowa, far from where I grew up in Cambridge, Massachusetts. Over time, I began to feel like I was drowning … barely able to keep afloat under the pressure of my classes and sinking grades. Each semester became an endurance battle, an experience that left me feeling depleted and insecure. My mom would get my grades in the mail and immediately question my work ethic. Her mantra to me became, “Please just try, Sarah. For one semester, just try.” I was furious, seething with anger at her, because little did she know—I really was trying. It just wasn’t going very well.

And we still never talked about my dyslexia.

Even after those difficult college years were behind us, the tension persisted between my mother and me. We were not close. I felt angry and misunderstood. My mom wanted to feel connected and reassured. She needed reassurance in order to feel like everything was going to turn out all right in the end. I refused to give her any degree of satisfaction. We were stuck in the quagmire of our mutual misunderstanding.

Eventually, she suggested we see a therapist.

We met several times with an experienced counselor. We talked with him about our fights and frustrations, but we never really delved into the root of the problem. At the time, I still didn’t understand my dyslexia. While I received academic support throughout elementary school, no one ever talked to me about how this processing difference was playing out in my everyday life. In fact, to the best of my recollection the term “dyslexia” was never used. I knew I had a “learning disability” of some kind or other, but this sounded vague, and it wasn’t clear what this actually meant. Adding to that, I didn’t get any support in college, and nobody had ever suggested I needed any. I had this grave misunderstanding that whatever learning difficulty I had, maybe I had grown out of it.

So while we talked with this therapist about all sorts of topics that dealt with the stressors in our relationship, we missed the elephant in the room—namely, the legacy of dyslexia and attention-deficit hyperactivity (better known as ADHD) in our family. Here was this unique moment in time, where my mom and I chose to work on our relationship, and no one knew to talk about learning differences. What a lost opportunity!

My hope and intention is to bring more awareness and consciousness to the therapy community. Just as unrecognized addiction issues can make therapy less effective, I strongly believe that unrecognized learning differences can make therapy a superficial experience—or at the very least incomplete.

Eventually I ended up at the Simmons College School of Social Work in Boston. While I was getting my master’s degree, I visited one of the people I was helping at her home. It was like walking into my grandmother’s house. I saw total disorganization. Papers were strewn everywhere. She had trouble finding necessary everyday things—her purse, wallet, house keys. For me, that was a light-bulb moment. Whatever was troubling her was the same thing my grandmother had. It was ADHD.

Shortly thereafter, I ran into my elementary school tutor, Mary, and asked about our time together. I said to her, “I know I didn’t have dyslexia because I didn’t reverse my letters … so why did we meet?” She looked at me and said, “Oh, but Sarah, you do have dyslexia.” This was another watershed moment. I had dyslexia then, and I still have dyslexia now. It doesn’t go away. At 29 years old, I was finally beginning to understand my family and myself with clarity.

So why am I telling you this story? Realizing that many families must share multigenerational struggles with dyslexia, ADHD, and other learning challenges, I decided to make a film about my efforts to get my family to better understand dyslexia and to look at themselves as well. The result is my award-winning documentary, Read Me Differently. In addition to the film, I have put together a comprehensive viewing guide that provides detailed suggestions about how therapists can best use the film with the people they work with in therapy.

Unfortunately, for me, it wasn’t through therapy that I found insight, information, or relief. Instead, I figured it out though my own almost accidental detective work. Understanding dyslexia doesn’t have to be such an anonymous quest.

My hope and intention is to bring more awareness and consciousness to the therapy community. Just as unrecognized addiction issues can make therapy less effective, I strongly believe that unrecognized learning differences can make therapy a superficial experience—or at the very least incomplete. With more tools and information readily available, therapists can become better informed about addressing these invisible learning differences.

Dyslexia Awareness: Tips for Helping Professionals

Become more informed:

• Talk to your friends and colleagues to learn more about their experiences with dyslexia, ADHD, executive functioning, etc.
• Check out websites such as: understood.org, www.parentseducationnetwork.org, and www.eyetoeyenational.org.
• Watch films such as mine (Read Me Differently) or Being You
• Read books: too many to list!

Keep in mind that the people you work with in therapy may not know if they have learning and/or processing challenges. You may need to take the initiative to help them discover their learning difference.

Conduct a thorough intake of new clients, realizing that not all will be comfortable with filling out a written form. Note: this is a red flag! Go through a written history with the person. Ask questions:

1. “Have you ever been identified with a learning difference (dyslexia, ADHD, executive function, etc.)?”
2. “Is there a family history of diagnosed or undiagnosed learning differences?” Follow-up questions: “Do you or anyone in your family have trouble with reading, spelling, written communication, tracking information (i.e., working memory … remembering details, sequencing information in the right order)?”
3. Ask about their school experience. “Did you ever receive extra assistance? Was school easy or hard? Did you get in trouble a lot or fly under the radar?” Explore these responses.
4. “Did anyone in your family have trouble staying in school or drop out?”
5. “What can you tell me about your family’s expectations for performance? How did that play out in your family? How did you compare to your siblings or friends? Do you feel like you have met your own expectations (in school, work, family, etc.)?”
6. “Do you use or abuse drugs or alcohol? Is there a family history of drug use/abuse?” (This can be a coping mechanism.)
7. “Is there a family history of anxiety, depression, or avoidance?”
8. “How would you rate your self-esteem on a scale of 1 to 10?” (Often, self-esteem is a significant issue for this population.)
9. Ask about the person’s work history. “Has there been a lot of stability on the job or have you experienced employment disruptions? What type of work do you do? Is this your top choice or do you feel like an underachiever?” (These are all ways to determine if learning differences are impacting daily life.)
10. “How would you rate your communication with friends, family, and coworkers?” (ADHD, working memory, and executive functioning can impact relationships.)

October is Dyslexia Awareness Month. Let’s #saydyslexia and bring visibility to this invisible difference.

Reference:

Conolly, A. (2015). Dyslexia facts and statistics. Retrieved from http://www.austinlearningsolutions.com/blog/38-dyslexia-facts-and-statistics.html

In my therapy practice, I dedicate considerable time to helping people understand what’s happening deep inside of them, in the layers of the nervous system where the conscious mind blurs into the unconscious. This is the part of us that some therapists call the “bodymind.” Understanding the communication of the bodymind creates the ability to “talk” with our inner self: to understand what it is trying to tell us, and even to work with it in its own “language.” It is my experience that the bridging of this gap is ultimately what eliminates most symptoms.

My previous article on self-regulation explains that most symptoms that bring people to therapy are the result of, or strongly related to, difficulties in maintaining this biological balance. It’s important to be aware of this underlying process. After all, we can’t manage things if we’re not aware of them!

This article expands on our understanding of self-regulation. It’s about developing our capacity to be calm, aware, and present, even in stressful situations. For those who have genuinely struggled with this despite repeated and intense efforts, it’s time to stop blaming yourself. As it turns out, this capacity is largely biological. And although we often forget this, biology is the platform upon which social and emotional interactions play out.

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Self-regulation of the autonomic nervous system (ANS) can essentially be broken down into two opposing functions: it goes up or it goes down!

In a car, we can press the gas pedal to access more energy, or the brake pedal to slow down or stop. Similarly, the ANS has two parts, or branches: the sympathetic nervous system (SNS), which makes us go up into greater arousal, and the parasympathetic nervous system (PNS), which helps us come down into calmer, less aroused states.

Upregulation means there’s more firing of nerve cells (neurons) along a nerve pathway. So, upregulation of the SNS refers to when this “going up” branch of the nervous system is more active. This “pressing of the gas pedal” increases the amount of energy available in the body. This is why the SNS is often referred to as the “fight-or-flight” nervous system, although it can also upregulate in pleasant situations requiring more energy.

Its opposite, and the focus of this article, is downregulation. Sympathetic downregulation brings down the charge along the pathways of the SNS. At the same time, the PNS upregulates, which helps the SNS downregulate. (We will examine the important exception to this general rule in a future article.)

Both upregulation and downregulation of the SNS are biological processes that we can feel and experience happening within us. Recently, a woman I work with in therapy was able to describe the involuntary muscular tensions, unpleasant pangs, and fluttering sensations of her anxiety (upregulation). She also described the wonderful (downregulation) sensations of her body finally letting go into blissful sleep when she settles down in bed at night.

As most of us can intuit, SNS upregulation can feel terrible when it’s a response to something stressful happening. However, SNS upregulation can also feel great when it’s in response to something fun or exciting: our team scoring a touchdown, or dancing when our favorite song comes on. In contrast, SNS downregulation almost always feels soothing, calming, or relaxing.

I am focusing on SNS downregulation because it’s incompatible with states of anxiety, rage, or stress. Additionally, SNS downregulation keeps the SNS in check, so that it doesn’t “overshoot” and produce too much stress to effectively cope with a problem.

So, then, how do we encourage SNS downregulation? How do we help the body settle down into a state in which it can rest, digest, and repair? For that matter, how do we know when we’re in a downregulated state?

Well, here’s the catch. Downregulating the stress response is an acquired capacity. It’s like a muscle: you have to build it over time in order for it to be strong.

Although infants are born with the capacity for stress response (fussing, crying, etc.), their parasympathetic pathways, which help downregulate the SNS stress response, are not online at birth. This means babies can go up, but they can’t come down on their own. (They will go into a “freeze” state if ignored long enough; this looks calm, but it really isn’t.) The baby’s nervous system develops the ability to calm down through thousands and thousands of supportive, soothing interactions with caregivers. At first, the caregiver is essentially functioning as the child’s parasympathetic nervous system. The development of this “braking system” continues throughout childhood, through continued positive interactions that meet the child’s needs.

There are many situations in which a child may not receive enough soothing in order to learn to downregulate sufficiently. These situations are not always the fault of the parents. Perhaps the child’s mother had a lot of her own unmanaged anxiety, was depressed, and/or experienced posttraumatic stress. Or maybe the family lived in poverty, with constant stressors impacting everyone’s sense of safety. Perhaps someone in the family passed away or suffered a major illness, rendering them unavailable for care. Maybe the child grew up in wartime or, unbeknownst to their parents, was frequently bullied at school.

Great things happen when we are parasympathetically dominant. Our breath is full, slow, and deep. The digestive system works well. The body can focus on repair, including reduction of inflammation, tissue repair, and hormone production. Subjectively, people feel fully present and alive. Many report feeling a pleasant softness and warmth, perhaps even throughout their bodies.

It’s important to point out that disconnecting from stress is not the same as resolving (downregulating) it. Alcohol and drugs, eating disorders, exercise or sexual compulsion, or even “zoning out” on the internet may make the chronically stuck upregulation of the SNS seem to go away for a time. However, as the people I work with in the therapy room could tell you, it’s not the same as sinking into a lovely, full-body sense of calm and relaxation.

Great things happen when we are parasympathetically dominant. Our breath is full, slow, and deep. The digestive system works well. The body can focus on repair, including reduction of inflammation, tissue repair, and hormone production. Subjectively, people feel fully present and alive. Many report feeling a pleasant softness and warmth, perhaps even throughout their bodies. When the SNS is on “standby” and the PNS is more active, people have a “buffer” for stress. They have energy to get through their day, but they can stay calm and present in challenging situations.

One of my first tasks in therapy is to assess and support the person’s ability to downregulate their stress responses. After they are provoked by something, how quickly and smoothly does their system deactivate? Are they still bothered by a small aversive event hours or days afterward?

Here’s a vital point often overlooked by therapists who haven’t had sufficient training in this area: In therapy, it is essential to make sure the person has the ability to downregulate the stress response before going into highly stressful material. In other words, you should never go into material that’s overwhelming, because overwhelming inherently means it’s bigger than your capacity to deal with it. So instead of the issue resolving, more symptoms arise. The way around this is to first support the capacity for downregulation. Then, only after this “braking system” is on board, take the difficult material a small bit at a time.

If someone doesn’t have a strong enough ability to come out of the stress response, how can they develop it?

• Therapy: Working with downregulation of the stress response can be tricky, as it involves the deepest survival energies of the body. It is advisable to work with a therapist who has extensive training in this area. Remember, SNS downregulation was originally designed to come online under the guidance of another person (usually a parent) whose nervous system is well-developed.
• Relaxation: Some people benefit from seeking activities or situations that cause the relaxation response and then deliberately spending time “feeling into” the resulting good sensations in their body. However, in relaxation states, some people experience a rebound in tension, stress, or anxiety. This is called “relaxation-induced anxiety” (RIA) or, in severe cases, “relaxation-induced panic.” In my experience, people with RIA are well served by working with a trained practitioner.
• Physical exercise: Exercise is often helpful, as it tends to burn off excess SNS charge and encourage the production of endorphins. Exercise promotes good mood, self-esteem, and a sense of accomplishment.
• Meditation: There are many forms of meditation, some of which specifically aim to produce downregulated states. However, in my experience, meditation can be unhelpful for some people who have a lot of traumatic response stored in their nervous systems. In these cases, their nervous systems simply won’t cooperate, and those around them may not have the awareness or tools to work with this issue.
• Resonance: Simply put, resonance is the feeling you get from being around another person or other living being. I usually explain it by asking people to think of how they feel when they place their open palm onto the rib cage of a calm, happy dog. That feeling of warmth, relaxation, and well-being is a downregulatory feeling obtained via resonance with the dog’s nervous system. Of course, when others around us are tense, our bodies tend to pick up on that and become tense too. Thus, being around stressed, anxious, or angry people is usually the opposite of what’s needed to develop SNS downregulation.

In summary, the ability to go within and really settle oneself is developed during infancy and childhood. This capacity to downregulate stress states is important in maintaining health, relationships, and happiness. Those whose life circumstances didn’t permit development of this capacity during childhood can still develop it through awareness and work with a skilled professional.

References:

1. Dychtwald, K. (1986). Bodymind. New York, NY: Pantheon Books.
2. Hamblin, J. (2012). Relaxation-induced anxiety. The Atlantic. Retrieved from http://www.theatlantic.com/health/archive/2012/11/relaxation-induced-anxiety/265313
3. Moore, M., Brown, D., Money, N., & Bates, M. (2011). Mind-body skills for regulating the autonomic nervous system. Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. Retrieved from http://www.dcoe.mil/content/Navigation/Documents/Mind-Body%20Skills%20for%20Regulating%20the%20Autonomic%20Nervous%20System.pdf
4. Sharma, A., Madaan, V., & Petty, F. D. (2006). Exercise for mental health. National Center for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658
5. Yuan, J., McCarthy, M., Holley, S., & Levenson, R. (2010). Physiological down-regulation and positive emotion in marital interaction. UC Berkeley Information Services and Technology. Retrieved from http://www.learningace.com/doc/1047040/bc95860e894457e838c865c3b7297551/206-physio-down-regulation-and-posemo-in-couples

“Most of our troubles are due to our passionate desire for and attachment to things that we misapprehend as enduring entities.” —Dalai Lama

Attachment is inherent to our nature, as is the desire to have pleasant experiences. We are attached to feeling good, comfortable, and secure and to things we think will bring us happiness. Attachment is the emotional dependence we put on situations, objects, or people. Strong attachments come in many forms—including overindulgence in or pursuit of food and drink, sex, power, fame, even principles or ideas—and can manifest in potentially harmful ways, such as gambling and addiction.

Living without desire is unrealistic. There is nothing wrong with wanting, but when we are too attached to our desires, we risk becoming captive to them. An attachment to pleasure, for example, becomes an obstacle when it continually compels us to chase it, even when it may be unwise or unhealthy to do so. So, while pleasure is a good thing, these powerful forces—attachment and desire—can cloud our reality. Reality is always changing and includes a mix of pleasant and unpleasant experiences. When we pursue desire to the exclusion of reality, suffering can happen, and happiness may become harder to attain.

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When the fulfillment of a desire is obstructed or when what we want slips out of our grasp, it may give rise to fear and anger. Reducing our dependence on desired outcomes is critical. We can pursue our desires, but we must be able to drop them when needed. We can embrace our desires, but we must not be bound by them. Our desires should not run the show.

Controlling the Desire for Control

In our desire to control the external, we may lose control over the internal. The more we want to control things, others, or situations, the angrier we may become when things don’t turn out the way we expected. If we understand that our desire for control is the source of our anger and a hindrance to our happiness, we can change our perspective on desire. We can aspire to reduce our need to control situations or other people and accept the feelings that result from not getting what we want.

If we set our expectations as a “wish list” rather than a “need list,” we may experience less anger.

As human beings, we cannot avoid having expectations. Expectation is the gap or discrepancy between what we have and what we want. With expectation comes disappointment, which may lead to anger. By having expectations, we give power away. Accordingly, to reduce disappointment and anger, adjusting our expectations and decreasing our attachment to them is imperative. If we set our expectations as a “wish list” rather than a “need list,” we may experience less anger.

If we want to be empowered, we have to own our expectations and the choices we make as well as the feelings that result from those choices. No one can make us feel angry; our expectations lead to anger. Again, expectations are a part of life, but it is up to us as to whether we are attached to them.

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Reversing Desire and Achieving Happiness

In their book The Tools, Phil Stutz and Barry Michels describe a method to overcome or “reverse” desire. The goal is to embrace the opposite of our attachment tendency. Instead of clinging to our desire, we welcome pain so we can continue moving toward our goals. Once we accept pain, we notice that our state of feeling moves from attachment (clinging energy) to non-attachment (flowing energy), a state in which we are free and open to all experiences. This state of accepting whatever comes is, in a word, happiness.

I want to end with a word from Thich Nhat Hanh, the well-known Buddhist philosopher and peace activist. His powerful quote summarizes this article: “Letting go [of attachment, desire, and expectations] gives us freedom, and freedom is the only condition for happiness. If, in our heart, we still cling to anything—anger, anxiety, or possessions—we cannot be free.”

Reference:

Stutz, P., & Michels, B. (2013). The Tools: 5 Tools to Help You Find Courage, Creativity, and Willpower—and Inspire You to Live Life in Forward Motion. New York, NY: Spiegel & Grau.

I hear from so many men and women whose marriages and relationships are in crisis. “How did I get here?” they wonder. We all know it takes two to tango. What we may overlook is our ability to ignore warning signs. Upon further analysis of the relationship in counseling, we may wonder what messages we missed and what we can learn from them.

Take, for instance, the woman who is thinking of divorce because she found out her husband is having an affair, one of many she has recently discovered. While her husband’s behavior and choices lend evidence to his lack of respect for her, we can also find small clues along the way that she may have dismissed—red flags, if you will, signaling danger.

One night, a few years back, her husband was on the phone late at night. When she asked who he was talking to, he gave a general answer about work. She immediately felt the hairs on the back of her neck go up, and her stomach flip-flopped. She had an intuitive feeling he was not being truthful. In order to keep the peace, however, she said nothing further.

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The next time she felt that same distressing sense, he did not call her for his nightly check-in when he was on a business trip. She had already been uneasy that he was going to dinner with both female and male colleagues and having after-dinner drinks. When he didn’t call her as usual, she called him but got no answer. She texted him but got no answer. She stayed up extra late to wait for his response, but it didn’t come. A nagging feeling told her something wasn’t right, but when he came home and minimized the missed calls and texts as her “overreacting,” she felt foolish for thinking anything could be wrong with their relationship.

Another time, she found a gift of female lingerie in her husband’s gym bag. She chose to say nothing, hoping the lingerie would wind up being a surprise for her. She waited. And waited. She eventually brought it up and received a strange answer that didn’t sit well with her, nor make any sense. Yet she ignored her feeling that danger was near.

When she eventually found out he was having affairs, she exclaimed, “I knew it!”

So why do we ignore the red flags in our relationships? I think there are several answers, and all of them are complicated by love, devotion, and sacrifice.

Often, we don’t want to know the truth. We would have to change something—our lives, the place we live, our finances, perhaps even ourselves—if we found out the truth.

First, we ignore red flags because we are afraid they are telling the true, painful story. We may ask questions of our partner about their behavior and receive answers, but we leave the answers alone even if they don’t quite fit. Often, we don’t want to know the truth. We would have to change something—our lives, the place we live, our finances, perhaps even ourselves—if we found out the truth. That can simply be too exhausting to think about. Even if we are certain it’s happening, we don’t want our partner to say they are having an affair because of what that would mean for us, our families, and our lives.

Second, we ignore red flags because we think our intuition is wrong. It simply cannot be right. So we engage in denial and carry on as if nothing is wrong because it’s easier to deny than to go through the pain of conflict. Surely your beloved partner would NEVER do that to you, right? They vowed they wouldn’t. We ignore our gut feelings, signs of disconnection, inappropriate conversations, and foggy details. We assume, after hearing our partner’s explanation, that we must be “crazy” and their explanation is the complete truth. Challenging our intuition is a dangerous game because it blocks us from knowing primal truths.

Third, we ignore red flags because we have been indoctrinated to believe that marriage and committed relationships are hard work. As a couple, you are supposed to struggle and compromise, right? Marriage and relationships are indeed hard work, but they shouldn’t be so hard that you feel disrespected and at war with your own intuition.

When I ask people in counseling, “What red flags did you choose to ignore?” most often I get a puzzled expression that turns into a knowing look and then to acknowledgment. Upon reflection, most of us know what we ignored and allowed.

For a clearer picture of your relational distress, ask yourself what you are ignoring and denying. Are you brave enough to see the red flags? And finally, do you have the courage to do the arduous work of repair or healing?

I’m always happy when couples tell me they’ve been together for 30 or 40 years, even if they happen to be in my office because of a relationship issue. Like aging, relationship issues are inevitable. I like to talk with these enduring couples about what’s kept them going, kept them connected, and where they’ve struggled. I’ve learned that there are some issues that are common to long-term relationships. Some of these are related to life stages—the challenges of aging, changing, medical issues, and the like.

Growing Apart

When you’re young and newly married, it can seem like what you feel and think is going to be the way you’ll always feel and think. Then life happens—education, careers, kids. Time passes. Your focus changes and you concentrate more on outside things and less on your relationship. You get into a routine, devote your energy to simply getting done what needs done, and the playfulness and fun go out of your day-to-day interactions. You aren’t intimately connecting the way you used to.

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Fast forward 10, 12, or 15 years. All of a sudden you see your life and your life partner differently. Your giddy young love has changed into something you don’t recognize. You feel isolated, walled off, and unsure how to reach out to your partner. You’re each living your own separate life despite sharing a home. You’ve grown apart.

Life Stages and Aging

Everyone handles different life stages in their own unique way. For some, aging is a breeze, even welcomed; for others, not so much. Our self-image and feelings about our bodies can change. Sexuality and our physical abilities change. Even our identity may change.

We don’t feel the same at 45 as we did at 25. At 65, we often wish we felt like we did at 45.

Many couples are unprepared for these changes, and if they’re not talked about, they can cause partners to begin to pull away from one another. Medical issues, menopause, and physical changes can also affect our interactions with a partner.

Keeping Your Connection

So how do we deal with the issues of aging, life stages, and time in a long-term relationship? How do we keep the closeness and connection we had at the beginning? Communication is crucial.

Many couples are unprepared for these changes, and if they’re not talked about, they can cause partners to begin to pull away from one another.

Stay close with your partner by talking as best friends and confidants. Share your worries and fears about the stages of life you’re entering. Open up with each other about how things are changing in your minds and bodies.

Talk about how your relationship is changing, too. Plan together. Take time to dream about what life will be like in the future. What you will do when the kids move out? Will you travel? Take a class together? Take up a new hobby?

Be curious about your partner’s feelings about the changes that come with aging. Adapt to your changing physicality and sexuality. Focus on one another, excluding outside influences, routines, and demands. Make it about your relationship. Be in it together.

Realize that your love has many facets and you need to stay on the same page in all of them. Be vulnerable, show your partner your authentic self, and determine to never give up on yourselves as a couple. Never lose sight of the friendship, kindness, companionship, and playfulness that has allowed you to be together all these years.

Changes are inevitable, but they don’t have to change your relationship for the worse. Consciously choose to move forward together, no matter what the future may hold.

“In the beginner’s mind there are many possibilities, but in the expert’s there are few.” ―Shunryu Suzuki

To view life with a beginner’s mind is to look at the world through the eyes of a child. The world becomes a place that is full of curiosity and wonder. I’ve witnessed this when I watch children at play. Sometimes they are amazed, open, and playful, but at other times they may be sad, restless and cranky. Yet no matter their mood, there is almost always a willingness to start anew: they are open to the next experience.

In contrast, we as adults can be guarded and cautious with our feelings. We tend to turn away from pain, and when joy arises, we want to cling to it. This conditional way of approaching life can have a negative impact on our emotional well-being, as it tends to create a limited sense of self and a narrow view of the world.

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Look at the world through a child’s eyes.

Sit with a young child for even a few moments and your perspective on life can shift. Children look at the world with eyes of interest and fascination, drawing joy from the experience of playing in the snow or simply watching leaves being blown by the wind. They also readily feel and express all emotions. Children cry when sad, laugh when happy, express anger when disappointed or scared, and play when the opportunity presents itself. In short, they experience life fully, with few expectations or judgments about how things should or shouldn’t be.

When we put away childish things, we lose our innocence and wonder.

“We don’t have to create joy. It’s an innate quality that at times is hidden or dormant. As innocent babies we all have a natural joy. When we’re not overwhelmed by stress and suffering this natural state becomes revealed.” —James Baraz

As we move from adolescence into adulthood, we often lose our connection to our natural joy and openness, the sense of wonder we experienced as children. It’s as if somewhere along the passage to adulthood, we learned that being authentic and experiencing life fully was no longer acceptable.

When we lose our ability to be open to what’s happening, we often instead find ourselves trying to manage and control things, people, and experiences that are beyond our control. We no longer maintain a connection with the joy, vibrancy, and realness contained in every moment of life but connect instead with our thoughts about how life should be. This attempt to control is reactive and is often driven by our aversion to what is happening in our lives.

 Our ability to see life as a mixture of pain and joy allows us to experience life to its fullest extent. We learn to open to joy when it arrives, to take it in through our senses and appreciate it, with the knowledge it is a visitor that comes and goes.

By cutting off our vibrant connection to life and diving into the murky world of thoughts, judgments, anxiety, and worry, we lose access to what is healing, joyful and transformational. Sometimes, we can become stuck in this virtual world and lose sight of reality.

Coming back into balance with life.

“And could you keep your heart in wonder at the daily miracles of your life, your pain would not seem less wondrous than your joy.” —Kahlil Gibran

The truth is that life is not divided solely into sorrow and joy. Neither of these extremes reflects the reality of life. Together, they represent life as it is. Our ability to see life as a mixture of pain and joy allows us to experience life to its fullest extent. We learn to open to joy when it arrives, to take it in through our senses and appreciate it, with the knowledge that it is a visitor who comes and goes.

Eventually we learn to do the same with all other experiences and open ourselves to all feelings: sadness, anger, joy, happiness, and grief. We stay present in the face of pain and sorrow and respond with compassion and kindness. The power of the compassionate heart is such that it helps us stay open to painful experiences in ways that can heal and transform us. It is when we open ourselves to pain that we realize how precious life can be and that we don’t know when it will end. In doing so, we may learn how to better appreciate life, with all its joys and sorrows, instead of avoiding certain experiences.

Sometimes joy is felt when we are at our most vulnerable because that is when our hearts and mind are open to taking in life as it is. 

I’d like to share a personal example of a challenging and painful time I went through with my family.

In 1997, I waited with my son and family in the coronary care unit of the hospital where my father had been admitted. His prognosis was grim, and we had all come together to support each other and our mother. In possession of the painful knowledge that our father was dying, it was challenging to stay present, and we were all caught up in a state of worry, grief, and fear.

Eventually someone said something—I can’t tell you what was said—and what happened next took us all by surprise: My son, who was 4, laughed out loud.

I don’t know what he saw or heard that elicited such a joyful response, but that isn’t important. What is important is that the sound of his laughter was like a balm to our broken hearts. It wasn’t just my family who was affected by it. His laughter, like a ray of sunshine on a cloudy day, shifted the energy in the room. It didn’t make the sadness or the deep hurt of losing a loved one go away, but it helped us to see that there can still be joy, even in the midst of deep pain and sorrow. In that moment I could see that life is a truly a miracle, filled with both joys and sorrows.

I believe that to be present and open to experiencing all of these joys and sorrows truly is a blessing.

May you be well.

At times, the people I work with in therapy ask questions that lead to rich exploration of their intimate lives. Years ago, Marty (not his real name) burst into my office wondering, “Why is it easier for me to talk to my friends about past sexual experiences than it is to talk about what really—secretly—turns me on?”

I laughed and reminded him it had taken a long time before he’d been willing to talk about what I call his “arousal template” with me, and we were only just beginning to explore it.

My focus has never been on the sexual performance—how long, how much, or how many—of those I see in therapy. Instead, I focus on the shame– and judgment-free acceptance and appreciation of the arousal template, or what my colleague Jack Morin calls our core erotic theme (CET). (This may be why a high percentage of the individuals I work with actually prefer to conduct sessions by phone.)

When Marty and I began our work together, his CET was well hidden. He sought me out when his wife insisted he call a therapist when she discovered, to her horror, hundreds of file folders filled with pictures Marty had cut out from magazines. These cutouts all depicted parts of the female body. When he showed me the folders, I noted that they were not all of nude bodies—many of the bodies portrayed in the images were clothed. Each was carefully cut from magazines such as Playboy and mounted on black paper. [fat_widget_sex_right]

Marty’s wife, who thought her findings meant he was addicted to sex, blamed the pictures on the demise of their sexual relationship. But when I asked him how often he was masturbating while looking at the images, after he explained to me that he and his wife had stopped being sexually intimate, he looked startled.

“Not at all,” he told me. “I do have some fantasies, but my cutouts help …” He paused before telling me he liked to organize them because they made him “not think.”

I reminisced about how I had really loved stamp collecting during my childhood in a household affected by alcoholism.

He beamed. “It’s soothing, isn’t it?”

Collecting stamps was my personal mood-altering experience. Collecting and arranging photographs was Marty’s.

We began to talk about what sex meant for him and explore the ways it could enrich his life and his relationship with his wife, whom he loved dearly. Together we began to cultivate an atmosphere of what I call compassionate curiosity.  I shared with him the idea that we are all sensuous and sexual as babies, that we become erotic as we receive and experience messages about ourselves from our parents or primary caregivers. Gradually, we incorporate these messages with our own experience of touch and the profoundly personal emotions that go along with it. Through this process, we develop our CET.

Marty laughed. “It’s not just what we do or don’t do in bed, then, is it?”

I agreed. “What you and I get to do here is explore your erotic landscape in its entirety, because your CET has a profound effect on the difficulties you’re experiencing in your marriage right now, doesn’t it?”

He nodded. We discussed some of the particular childhood challenges that may have formed a blueprint for arousal that then wrought havoc when it fused with the loneliness and isolation he had experienced throughout most of his life. As Marty began to understand, accept, and even embrace his CET, he stopped judging and criticizing himself, and his fear diminished. People who struggle with sexual patterns that distress them usually want to change these patterns, but the conflicts they hope to resolve can produce hurricane levels of anxiety.

Marty began reaching out to his wife, who had remained suspicious, and they were able to reconcile. Recently, I received a photo they had taken together in Bali with the words, “Passion grows, though my hair no longer does!”

Changing Sexual Patterns

Change is essential to the erotic adventure, but the difficult erotic patterns are often the most resistant to change. As Buddhist wisdom teaches, “What we resist, persists.” What we struggle against becomes stronger. And troublesome arousal templates can trip us up!

People who struggle with sexual patterns that distress them usually want to change these patterns, but the conflicts they hope to resolve can produce hurricane levels of anxiety. Many of those who are challenged by erotic themes they find problematic often feel compelled to repeat them. And repeat them. And repeat them.

In The Erotic Mind, Morin identifies what he calls seven pivotal steps that lead to positive change:

1. Clarify your goals and motivations.
2. Cultivate self-affirmation
3. Navigate the gray zone.
4. Acknowledge and mourn your losses.
5. Come to your senses.
6. Risk the unfamiliar
7. Integrate your discoveries

The only way out is often through.

Reference:

Morin, J. (1995). The erotic mind: Unlocking the inner sources of sexual passion and fulfillment. New York, NY: Harper Perennial.

In today’s world, it is hard to stay truly connected with others. We are so used to our digital, screen-to-screen interactions that having in-person, face-to-face conversations can feel difficult to manage.

Dialectical behavior therapy, also referred to as DBT, has an entire module dedicated to offering skills and ways to help people communicate more clearly and interact with others more meaningfully. This module is called Interpersonal Effectiveness and it focuses on how the way you communicate and engage with others impacts the outcome of your interactions.

There are three main skills sets within DBT’s Interpersonal Effectiveness module, each related to a different goal or priority.

Skill Set No. 1: GIVE

If it is important for you to keep and maintain the relationship you have, you will want to focus on the first skill set. DBT offers the acronym GIVE as a way to easily remember these skills:

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• Gentle: Being gentle means being kind and nonjudgmental. Keep a moderate or low voice. Keep from yelling, name-calling, or saying mean or hurtful things, even if you’re “just joking.”
• Interested: People love to talk and be listened to. If you act interested, people will want to keep spending time with you. Acting interested includes maintaining appropriate eye contact (no staring), nodding, and asking questions. Even better than acting interested is being genuinely interested. In my experience, you can always find something interesting or fascinating about a person by discovering what they are passionate about, or relating their story to an experience you’ve had.
• Validate: Everyone wants to be understood. When you validate someone, you are letting them know you understand their emotions, thoughts, and/or experience is real. This is not the same as agreeing with someone’s opinion. Validation is letting someone know you respect their experience.
• Easy manner: Chill out. Relax. Be flexible and easygoing. This doesn’t mean ignore or abandon your values, but realize that not everything has to be a battle to the death. People like to spend time with people who are easy to be with. If everything is an argument, or tensions continue to run high, people tend to end those types of relationships.

Skill Set No. 2: DEAR MAN

If you are wanting someone to do what you want, DBT recommends using the skills in the second skill set, often referred to by the acronym DEAR MAN:

• Describe: Before you can ask for you want, you need to describe the situation objectively. I highly recommend keeping this simple and behaviorally specific.
• Express: Express your emotions and opinions using “I feel” statements. When the other person knows what you’re feeling, you don’t leave them needing to guess or, worse, assume what your emotional experience is.
• Assert: Ask for what you want and say “no” clearly. The other person isn’t a mind-reader, so be as plain and simple as possible, even if it may seem obvious.
• Reinforce: Reinforce for the other person how responding to your request benefits them positively. If they know what’s in it for them, people are more likely to respond in the way we want them to respond.
• Mindful: Maintain focus on your goal. Don’t get sidetracked or off-topic. Ignore attacks, and avoid distractions.
• Appear confident: If you don’t look confident, it’s going to be difficult to be taken seriously by the person you are engaging with. Maintain eye contact, keep good posture, and don’t mumble.
• Negotiate: If all else fails, be willing to negotiate. Getting some of what you’re asking for is better than getting none of what you’re asking for. Ask the other person what they’d offer as an alternative solution to the problem. Also, know when to “agree to disagree” and walk away from a discussion.

Skill Set No. 3: FAST

Are you looking to maintain your self-respect after an interaction? You’ll want to refer to DBT’s third skill set in this module, FAST:

• Fair: Act according to the rule. Be fair to yourself and the other person.
• Apologies: Don’t offer apologies or over-apologize if you are just being you or when making a legitimate request. But apologize where appropriate, and don’t under-apologize if you’ve wronged or hurt someone with your actions, behaviors, or words.
• Stick to your values: If something is important to you, stick to it. Don’t change or “sell out” in order to “fit in,” get what you want, or avoid saying “no.” Sometimes, doing the thing that feels right can also feel most uncomfortable. This doesn’t mean you should avoid it.
• Truth: Be honest. Don’t lie, make excuses, or exaggerate circumstances. Take ownership for your thoughts, behaviors, and emotions.

If you keep these skills in mind, you should have little to no trouble keeping and maintaining important relationships in your life.

Reference:

Rathus, J. H., & Miller, A. L. (2015). DBT Skills Manual for Adolescents. New York, NY: The Guilford Press.

Maddy: “I hate myself. I’m just like my mother. She always bossed my father around and was so controlling with me and my brother. Now I do the same things with my husband and kids. I don’t know why I can’t stop myself from always telling them the right way to do everything. I’m her all over again.”

Frank: “I feel like a terrible person, no different than my father: so rational and unempathic. Ugh! I hated that about him; how can I be just like him? I don’t like myself when I’m that way, especially with my wife. I know it’s hurtful, but I don’t seem to be able to change.”

Ellen: “I can’t believe I’m doing to my son exactly what my mother did to me. She made me crazy with her anxiety, and now I’m doing that to him. He just graduated, and I insisted he go to a close-by college. I was so worried. I know that was selfish and not best for him. My mother’s worry always limited me. Why didn’t I stop myself from doing the same to him?”

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Maddy, Frank, and Ellen are bewildered when they find themselves repeating relationships with their parents that had a negative impact on them. Consciously, these behaviors feel unwanted and dysfunctional. They don’t wish to inflict the hurt and pain they experienced in their childhoods on their significant others. They recognize the repetition and seem puzzled and unable to understand why they feel helpless to stop.

Ambivalence About Giving up Repetitive ‘Bad’ Behaviors

Each of these individuals consciously expresses self-hate when they recognize they are hurting loved ones in the same way a significant other hurt them in childhood. They identify that their own hurtful behaviors make them feel like bad people, out of control and/or hopelessly mean. Yet they also express ambivalence about changing these behaviors. When we explore and try to make sense of their resistances to change, each person, in their own way, embraces the behaviors of the parent who offended.

Maddy: “I don’t want to be this way, but honestly, it’s hard to imagine giving up control. I really believe I do many things much better than my husband and kids. In the end, I think it’s to their advantage to do it my way.”

Frank: “I know I’m an awful person because it’s so hard for me to appreciate my wife’s feelings. But she’s so irrational. Really—does it make sense that she’s so beside herself when her friend gets annoyed with her? It drives me crazy. I know I should be more caring and understanding, but I really think she needs to get more control of herself.”

Ellen: “I know it’s selfish and wrong that I’m such a worrier and my son has become a worrier. But I’m relieved he’s extra careful and cautious in his life. He said he wanted to go away to college. But I know him, and in my heart I believe he was relieved when I said he had to go to a local school. I think he feels taken care of when I worry.”

These three individuals reflect about their actions in similar ways. Rationalizing, they believe their behaviors are acceptable. At the same time, they attack themselves for repeating with people they love in the present what was hurtful to them in the past. The contradictory notions about the effect of their behaviors make change difficult to embrace.

Even though they rationalize and describe positive outcomes from repeating the behaviors of their parents, they experience bad feelings about themselves when they hurt and create conflict with loved ones. More than experiencing themselves as hurting people they love, the idea that “I’m just like my parent” is anathema. The idea of being “just like my parents” is not simply the feeling of “similar to.” Rather, it feels like “I am my parent.” This unwanted and intolerable experience of self can interfere with feelings of self-confidence and self-esteem and can play a role in the development of anxiety and depression.

With the unending pushes and pulls (between rationalizing and self-attack) to both enact and avoid repeating these old family patterns, stuck-ness in the repetitions and conflicts is solidified.

The Role of the Unconscious

These folks are not aware of any unconscious dynamics that may be keeping them anchored to their untenable positions. But if change is to occur, an understanding of the role of the unconscious in resisting change and perpetuating early parent-child relationships is essential. The aim is to uncover the unconscious meanings of holding onto the status quo and how repeating these behaviors serves each person (even when, consciously, that doesn’t make sense to them).

I will focus on my work with Frank to describe how we explored and became familiar with his unconscious and how that helped him with his conflicts and the repetitions of his early father-son relationship.

When Frank walked into my office, I sensed a man in conflict. He was assertive and self-assured but also vulnerable and defensive. He came into therapy concerned he wasn’t cut out for marriage but wanted to work on making the marriage work.

“I love my son,” he told me. “I suppose I love my wife, too, but I don’t know about me and marriage. If only for my son, I want to make it work. It’s hard to think of her needs. I get contemptuous when she doesn’t do or see things my way. I can be mean. I hate that it makes me feel just like my father. I could never do anything right—right meant doing it his way. He was a bully. I don’t do that with my son. But I bully my wife and I can be condescending with my colleagues at work. I feel horrible when I behave like my father. He made me feel like I was nothing, and now I keep doing it to others.”

If change is to occur, an understanding of the role of the unconscious in resisting change and perpetuating early parent-child relationships is essential. The aim is to uncover the unconscious meanings of holding onto the status quo and how repeating these behaviors serves each person (even when, consciously, that doesn’t make sense to them).

Frank and I spent many sessions talking about his relationship with his father. He was close to his mother, who was also bullied and couldn’t protect him from the onslaught of demeaning and destructive behaviors he encountered. Frank had some ideas about how, because of his father, he became tough and resilient:

“I probably was about 6 and I remember telling myself I would never let him get to me. I’d never cry or give him the satisfaction that he hurt me. I never asked for anything. I left home when I graduated high school and moved to another state. I stayed in touch with my mother, who would always talk about my father. I guess I stayed curious about him. I hated him, but I never stopped wishing he would be nice to me or give me the feeling he cared. On one rare visit, I told him I was doing really well and was getting a CPA, but he didn’t say much. [Sigh.] I wish I could have made an impression on him. He died right after I got my CPA. I hate to admit it, but I never stopped wanting him to be my dad. It’s too late now.”

Frank and I became aware of how conflicted his relationship with his father was. He hated him but appreciated how his behavior drove him to seek recognition by becoming strong, independent, and ambitious. Fundamentally, Frank’s strongest feelings resided in his abiding wish for his father to “be my dad.”

When I asked Frank what “being my dad” meant to him, he was thoughtful, then tearful: “I wish he was a dad like I am. My son knows I love him. I listen to him, praise him, show him affection. I play with him. He knows how important he is to me. I never had any of that.”

The more we talked about Frank and his father, the more in touch Frank became with his longing for a father—a dad. We puzzled over what made it difficult for Frank to let go of the hated father in him. Frank began to wonder: “You and I talk about my unconscious. Maybe my unconscious believes if I hold onto my hated father long enough, I’ll get the dad I so badly want. With my son, I’m not my father, I’m a dad. Now maybe I have to let go of the father in my unconscious and be the ‘dad’ with the people I care about in the world. I sort of get that I’m struggling with this, but I don’t know how to pull it off. Maybe if I could be more of a loving dad with the people in my life, I could let go of the bad dad inside me. Then I might feel better about myself and feel recognized and appreciated in the world. How do I get there?”

Frank was well on his way to getting there when he had the profound recognition of his holding onto his father as a way of trying to experience the dad he had longed for since early childhood. It is not unusual for repetitions of hurtful early parent-child relationships to be repeated in adulthood with the unconscious wish to transform a negative or hated significant other into the idealized parent that the adult continues to long for. The holding onto the destructive parent, by taking on the parental behaviors and repeating them as one’s own, feeds the unconscious wish for having the parent under one’s control, but it doesn’t provide the wished-for, idealized parent.

When one can recognize, as Frank did, that the perpetuation of the hurtful parent doesn’t and will not provide what was missed, it is easier to let go of the repetitions and embrace a more positive role model in one’s own behavior. As a result, more positive self-feelings emerge and facilitate more loving relationships.

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

Many people struggle to understand how our culture defines domestic violence. Some believe that to constitute domestic violence, a person must be beaten or violently struck in some way. However, domestic violence behaviors do not necessarily include physical assault. While it may include sexual, emotional, and/or physical abuse, the most consistent component of a domestic violence relationship is an ongoing effort to maintain power and control over one’s partner.

The National Coalition Against Domestic Violence (2016) lists several abusive behaviors that are earmarks of domestic violence:

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• Frequently accusing one’s partner of lying and/or cheating: “You were 15 minutes late getting home. Who were you having sex with?”
• Controlling finances. For example, the abusive person may make eight times the wage their partner earns, yet insist they split household bills equally. The abusive person may insist they control all the money and offer an allowance they control rather than share equally in financial responsibilities.
• Forcing sexual acts, sometimes minimized with comments such as, “I just had too much to drink,” or, “I knew you really wanted it.”
• Isolating the person. This can appear in the form of behaving rudely or in other socially inappropriate ways to discourage their partner’s friends and family from wanting to be around them. The abusive person may find ways to keep their partner from spending time with family or friends, monitor their partner’s conversations, and forbid their partner from communicating with others.
• Preventing a partner from working or advancing their education.
• Destroying a partner’s property.
• Hurting, or threatening to hurt, a partner’s pets.
• Belittling a partner for not doing things “right” (in the abusive person’s opinion).
• Intimidating by creating an environment where a partner feels the need to “walk on eggshells”; the world revolves around keeping the abusive person from being disturbed.
• Treating the abusive person’s partner as if their needs and feelings do not exist, or as if they are a servant. At times, the abusive person may promise to change, but their behavior does not improve for long, if at all.

Abusive individuals often want the people they abuse to believe they are at fault: “If you would only ____, I would not get angry. You provoked me. You are crazy.” To be clear, there is nothing any person can say or do that provokes or deserves abuse. While a person may behave in ways that could benefit from modification, those are relationship issues. Domestic violence is not a relationship issue; it is in many cases a criminal act.

Abuse loves when we don’t talk about it; it thrives in silence. By giving a voice to those who feel they have none and talking about their pain, we give abuse nowhere to hide.

In many states, a domestic violence charge does not necessarily need to include touching a partner. Destroying property, stalking, and harassing—including menacing texts and phone calls—can constitute domestic violence. Domestic violence may be addressed in three different types of court: criminal, civil, and family (American Bar Association, 2001). Abusive people will sometimes attempt to pressure or manipulate a partner into dropping charges or to lie to help minimize the consequences of the abusive person’s behavior.

Often, a domestic violence relationship may seem like any happy relationship in the beginning, but becomes more controlling and abusive over time (National Coalition Against Domestic Violence, 2016). Because of this, people who have been abused sometimes report feeling shame for not recognizing the signs of abuse sooner. It is not unusual for someone leaving a domestic violence relationship to state they realized they were in a domestic violence relationship only after they felt it was too late to leave, and that they wanted to leave sooner but did not believe they could materially survive alone. However, many resources are available to assist with safety plans, housing, legal advocacy, and other resources.

Getting Help for Domestic Violence

If you or someone you care about is in a domestic violence relationship, you are not alone. To speak confidentially with a trained advocate, call the National Domestic Violence Hotline at 1-800-799-7233. Live, private chat is also available at http://www.thehotline.org/. Information and thousands of resources, including counseling, across the United States are available to people in an abusive relationship and to friends and family of a person they believe to be in an abusive relationship. Contact a trained therapist if you need further guidance or support.

Abuse loves when we don’t talk about it. It thrives in silence. By giving a voice to those who feel they have none and creating spaces for them to talk about their pain—and offering support as they do so—we give abuse nowhere to hide.

References:

1. American Bar Association. (2001). Know your rights: Domestic violence. Retrieved from http://www.americanbar.org/content/dam/aba/migrated/publiced/domviol.authcheckdam.pdf
2. National Coalition Against Domestic Violence. (2016). What is domestic violence? Retrieved from http://ncadv.org/learn-more/what-is-domestic-violence
3. National Domestic Violence Hotline. (2016). Is this abuse? Retrieved from http://www.thehotline.org/is-this-abuse/

Dealing with grief and loss is a reality we all must confront at some point. The experience of grief is different for everyone, and it has no timetable. Grieving, however, is a necessary part of the coping and healing processes.

The recent death of a friend’s son has created within me a vision of the world through which only the lenses of my eyes can see and the beat of my heart can feel. His death has inspired the desire and passion to live my best life every day while giving service to others. This could have easily gone the opposite way, leading to feelings of utter isolation, depression, and loneliness.

For all the pain it brings, grief holds many lessons:

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• Grief teaches us that loss is inevitable.
• Grief teaches us not to take loved ones for granted.
• Grief teaches us about our faith.
• Grief teaches us to be patient.
• Grief teaches us that we should live every day creating memories that will comfort us after our loved ones are gone.
• Grief teaches us about our feelings.
• Grief teaches us that it is necessary to grieve. It allows us to move forward.
• Grief teaches us to find our purpose in life.
• Grief teaches us that pain and joy can coexist.
• Grief teaches us to be true to ourselves.

What has your grief taught you?

The Kübler-Ross Model of Grief

Loss can leave us with a wide range of emotions. The experience of each emotion signals that a deep bond has been broken. One day we may be in denial, anger, or depression. Other days, we might feel like we can go on. Until, that is, the cycle starts all over again.

In her 1969 book On Death and Dying, psychiatrist Elisabeth Kübler-Ross introduced what came to be known as the “five stages of grief,” which represent the typical series of experiences for those who have faced loss:

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1. Denial: “This isn’t happening.”
2. Anger: “How could this happen?”
3. Bargaining: “Please make this not happen. In return I will ___.”
4. Depression: “I’m too sad to do anything.”
5. Acceptance: “I’m finally at peace with what happened.”

As stated earlier, each person experiences grief in different ways. Thus, it’s important to emphasize that while the Kübler-Ross model serves as a general guide for how grief is often processed, not everyone experiencing grief or loss may experience every stage, let alone in order.

How to Help a Grieving Friend

If someone you know has lost a loved one, the following suggestions may help:

• Listen: Follow the advice of musician Michael McLean. When someone is grieving, “show up and shut up.” The grief-stricken person needs to be heard and feel that someone cares. Grief is a personal experience, an experience that belongs solely to the person experiencing it, and you must allow them the respect and time they deserve. Listening to someone who grieves is an invaluable gift.
• Be a gatekeeper: In an intensely painful and overwhelming time, offer to be the person through which information is filtered for dissemination. You may find that other friends, family members, and acquaintances ask for information about your friend. Normalize grief with responses such as, “They have good days and bad days—and probably will for a long time.” Or, “Grief never really ceases. It is something you carry with you in different ways for the rest of your life.”

Getting Support for Grief

The grieving process can be long and lonely. If you are grieving, take the time you need, meet any challenging emotions that arise within you with self-compassion, and accept support from others. Talking about grief is an important part of healing. Receiving reassurance and feeling empathy expressed for your loss may help make the recovery process seem a little less daunting. If you need or desire further support, I strongly encourage you to contact a licensed therapist who works with grief and loss.

References:

1. Kübler-Ross, E. (1969). On death and dying: What the dying have to teach doctors, nurses, clergy, and their own families. New York: Macmillan.
2. McLean, M. (n.d.). Hoping. Retrieved from http://www.michaelmcleanmusic.com/page/47

The world is full of people who survived the experience of being bullied while growing up. The wounds bullying can inflict on one’s self-esteem can ooze throughout life. Sticks and stones may break your bones, but names can, in fact, hurt you. The good news is people can heal from bullying. Psychotherapy can help promote that healing.

Children and teens may be bullied for any number of reasons—weight, gender, sexuality, ethnicity, clothes, social difficulties, interests, and behaviors related to mental health conditions among them. The terms bullies use to label their victims, such as “fat,” “stupid,” “ugly,” etc., may be absorbed into the victim’s self-identity at a tender, vulnerable time in their development. If fully digested, the bully’s taunts may become the victim’s inner voice. The negative judgments may become distorted core beliefs.

Distorted beliefs can limit the choices survivors of bullying make in their social and professional lives. Children who start out as outwardly expressive may turn inward to protect themselves from further ridicule. They may gravitate toward compassionate adults for social interaction rather than peers. Many survivors continue to reenact their role of disempowered victims in the workplace and social spheres. It may be difficult to see themselves as adults rather than the defenseless children they once were.

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Others may lack empathy for lovers and friends (“Nobody ever cared for my feelings, so why should I care about theirs?”). Or they may become loners and/or disdainful of humanity in general. Some project their conditioned self-hatred onto people with whom they engage. When victims of bullying hear others whisper or giggle, they may become paranoid they are the brunt of malicious jokes. They may keep to themselves in the workplace and be regarded as cold or unfriendly by coworkers.

Children tend to benefit from parents who offer comfort and invalidate the bully’s actions. Kids who seek comfort from their parents but are ridiculed instead (“Don’t be a crybaby,” “Grow up,” etc.) may have deeper scars. Children who are bullied or abused at home have a greater risk of being bullied at school as well. They may conclude that if a majority of people in their life regard them negatively, they have it coming. Their wounds can be profound. A large number of male survivors do not report bullying to parents or school staff because they feel shame and emasculation from the abuse. Keeping the abuse a secret and receiving no comfort, support, or invalidation of the bully from others may leave them with hurt feelings, damaged egos, and severe emotional scars.

Many survivors of bullying have an abundance of empathy for others. They report that hearing about or observing others being bullied is triggering for them. Even as they are quick to comfort and support others, however, they may be strangers to the concept of self-empathy. The shame and self-hatred that resulted from being bullied may have arrested their development of this important life skill. Labeling themselves as “garbage” because they were treated as such can lead them to falsely believe there is something inherently lacking in their personhood. Consequently, they can feel like outcasts.

Cognitive therapy and strengths-focused counseling are essential components in therapy treatment for survivors of bullying. The goals include:

1. Adult Perspective to Replace the Traumatized Child Perspective

In treatment, the individual is encouraged to understand that their adult perspective on the bullying should be vastly different and more logical than their child perspective. The child’s perspective of the survivor (which deems the bully’s opinion as expert and still dominates the adult survivor’s beliefs) must be put to rest—just as other childhood beliefs such as Santa Claus, the Tooth Fairy, and the Easter Bunny have been.

Consider an individual who was teased about their weight and called unflattering names by their bullies. The child self could be convinced that people of a size that is larger or smaller than average deserve to be shunned by others. The grown-up self can see the ignorance and cruelty in such a claim. The survivor’s new perspective must be reality-based: the bullies did not have the right, life experience, empathy, or education to be valid evaluators of anything except whether ice cream is cold.

If the survivor was bullied by their parents, a new perspective would be that the parents’ judgments were verbally abusive and false. The individual must accept the painful fact their parents were profoundly limited in their ability to parent properly and were most likely perpetuating a pattern of abuse that their own parents had imposed upon them.

2. Empowerment

Personal power is an important therapeutic concept for a survivor of bullying: Each individual has personal power (feelings of well-being, self-worth) which can be kept or given to others. Bullies are thieves of others’ personal power. Therapy helps the survivor understand that they have given up enough of their personal power to those long-ago cruel kids in the schoolyard, many of whom had only recently learned to tie their shoes. The survivor will be mindful that others who cruelly judge people deserve no endorsement (agreeing with their opinion).

3. Self-Empathy and Self-Validation

Because the survivor internalized the bully’s words or hatred, they may have lost the ability to see their self-worth. With the therapist’s help, the survivor learns to love and validate themselves.

Bullies are thieves of others’ personal power. Therapy helps the survivor understand that they have given up enough of their personal power to those long-ago cruel kids in the schoolyard, many of whom had only recently learned to tie their shoes.

4. A New Relational Style

Many bullying survivors develop an interpersonal style that is submissive and passive. Others develop a hypervigilant and aggressive style to defend themselves from further attacks. The goal is to evolve to an assertive relational style which seeks reciprocity and respect from people in the survivor’s social orbit.

5. A Balanced View of People

Due to bullying, the survivor may have concluded at a young age that all people are cruel and cannot be trusted. In therapy, they may come to understand that this is black-and-white thinking. The survivor widens their perception by acknowledging that while there are people who hurt others, there are also people who extend kindness and trustworthiness. The survivor develops an ability to distinguish between these two types of people.

6. Recognition That Bullying Is About the Bully, Not the Victim

Many children do not have the wisdom or cognitive ability to understand the above statement. They tend to regard peers as valid critics. In reality, many bullies have been bullied themselves, either at school or within their own home. Bullying others allows them to reenact their experience from a position of power. Bullies detect a vulnerability in their victims and target that vulnerability. The victim is essentially the bully’s scapegoat.

7. Positive Core Belief and Improved Self-Esteem

In therapy, the survivor learns to let go of the distorted negative core belief (“I am ugly,” “I am stupid,” “I am a loser”) that the bully planted. The survivor comes to understand that defining themselves by others’ words and treatment is a losing plan that can fluctuate depending on the company we keep. The survivor develops a vigilance for correcting the automatic negative self-talk that they have carried since childhood. The result is an enduring positive and reality-based core belief and self-esteem derived from the survivor’s values, behaviors, and accomplishments.

There is a lot of work to be done in closing the wounds left by bullying, as the above goals indicate. Because “old habits die hard,” the survivor must be patient as they proceed through the healing process. Baby steps toward self-love may begin to occur from the start of therapy. In time, the self-confidence a survivor develops in therapy may provide new positive ways to navigate life. It may also afford the survivor new opportunities that were once falsely believed to be out of reach.

References:

1. Lyness, D. (2013). Helping kids deal with bullies. Retrieved from http://kidshealth.org/en/parents/bullies.html#
2. Support the kids involved. (n.d.). Retrieved from http://www.stopbullying.gov/respond/support-kids-involved