“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/

Knowledge is a powerful resource for navigating life. We have endless internal dialogues that assist with interpretation of information and decision-making. Knowing why we think the way we think is the gold standard for healthy functioning. It affords us an opportunity to appreciate where we are in life and to choose where to go from there, a starting point for change.

Unhealthy thinking is, in large part, a function of negative belief systems, often installed by others and reinforced by our childhood experiences. Many people exhibit profound self-doubt, blame themselves, apologize profusely, and excuse their parents’ abusive behavior. This constellation of negative beliefs and behaviors presents in conjunction with stories of verbal and physical abuse that begins in childhood and follows people into adulthood. The longer we think a particular way, the harder it is to change our thoughts and beliefs.

I am a psychotherapist in private practice. Here is a hypothesis for consideration: Parents raise their children in their own image to fit into the world the way they see it. I ask people who come to me for therapy to stop and think about the developmental and environmental realties of their childhoods. I remind them that kids are captive learners who have no choice, no voice, and no mobility.

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There is a big difference between grieving that you didn’t get what you needed as a child and spending your life blaming parents for your life as an adult. A middle-aged man told me he had stomped out of a doctor’s office because his physician asked him how he felt about being hit by his father. He tearfully pointed his finger and said, “My dad was a good man, a hard worker, and I probably deserved what I got.” It was a clear message to me that the subject was off limits. It was a defensive response.

Interestingly, the man’s presenting issue was that he was “at his wit’s end” trying to cope with a 30-year-old son’s excessive pot smoking and slovenly behavior. The daily arguments were driving him and his wife crazy, but neither had successfully implemented and enforced boundaries in their own home.

Why did a middle-aged man protectively defend his deceased father when, as an adult, he never tolerated being hit by others? He relied on a system of justifying his dad’s abuse while blaming himself because it once worked. He learned to be a peacekeeper at a young age. It reduced the likelihood that his dad would get angry and violent. However, this role did not allow the man to honor his true feelings about being hit, berated, and shamed.

He was profoundly uncomfortable, consumed with constant doubt about his worth and ability. He’d worked for five companies but had been let go because he was “a loyal employee but an ineffective leader.” His home life was less than satisfying. The worse things got, the more he loved and the harder he tried to make peace. He parented his son from this place of low self-esteem. He was incapable of setting reasonable limits, highly deferential to the needs and wants of his wife and children. His coping system ceased to work, but he didn’t know how to change it.

We owe it to ourselves to identify why we do what we do. Then, we may decide whether we still want or need to stay with the program. Defensive responses are protective and serve a purpose. A great example of this is the use of avoidance. Most people who avoid refer to themselves as “lazy” or say “I’m a procrastinator.” Two significant things are successfully happening. One, they internalize the blame. It may not be pleasant to criticize oneself for being lazy, but it reduces the likelihood of argument. This is terrific for people who hate conflict. Two, it bypasses being angry with others and helps us feel in control.

Early coping strategies for dealing with life, especially for navigating interactions with others, are rooted in familiarity. People rely on and repeat these even when the results are painful and no longer work.

Anger gets a bad rap in our culture, which suggests that to be angry is to be out of control. It is an appropriate affect in certain situations. There are normal ranges for angry expression, as there are for all emotions. Anger is frequently role-modeled in extremes—demonstrations of screaming, verbal put-downs, and physical violence.

Early coping strategies for dealing with life, especially for navigating interactions with others, are rooted in familiarity. People rely on and repeat these even when the results are painful and no longer work. The human drive for consistency pulls dominance over curiosity for exploring new ways of coping. These methods worked well at some point in life, especially during childhood, when they were appropriate for emotional and physical survival.

Compartmentalization and detachment are subconscious coping mechanisms. The same man adamantly defends his father’s dictatorial parenting style but parents his children with a “marshmallow” approach—no rules or consequences. One part of him agrees with and condones his dad’s treatment of him. Another part parents in a diametrically opposed manner. It’s fascinating to observe these disconnects in action. People complain about feeling stuck. Change is challenging and often feared. Familiarity and years of reinforcement make moving from negative to positive thinking difficult. I guide people on a journey of awareness and choice. We nonjudgmentally search relevant files of experience to identify significant influences and resulting patterns of thinking. The pace of raising awareness is based on each person’s comfort level and learning style.

Awareness is a starting place. The brain does not have a delete button for experiential files, but it is possible to update and integrate files. The password for reprogramming? Choice.

Have you ever called yourself “stupid” just because you made a mistake?

When you look in the mirror, do you curse your reflection for not being attractive enough?

Do you make silent, sarcastic remarks to yourself after you speak?

When you engage in self-criticism, it’s like having your very own personal bully living inside your head.

Whenever you try something new, the bully is there to taunt you. When you think about taking a risk, the bully lets you know you’ll probably fail. And when it comes to relationships, the bully is the first to point out your flaws and weaknesses, all the reasons no one could ever really love you.

The bully loves to control you. It’s the bully’s “thing.”

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Your bully is happiest when you’re anxious about screwing up, or else feeling like you already screwed up. That’s what gives bullies their power.

If you want to ditch the bully, you’ll need to take your power back. But before you can do that, make sure you really want to get rid of the bully inside your head.

“What?” you may ask. “How can you even ask me that? Of COURSE I want to ditch this bully!”

Are you sure?

The bully in your head is there for a reason. The bully is there to keep you on your toes. What if you didn’t have a bully pointing out how badly you’re doing in everything? How much worse might you be?

Taking your power back by rejecting the lie (i.e., there’s something wrong with you) is much easier said than done. But what does it feel like to consider the possibility that you’re just fine exactly as you are?

The real bully is your belief that there’s something inherently wrong with you. How ready do you feel to let go of that?

As long as you suspect there’s something wrong with you, you’ll need a bully to keep you on the right track.

Taking your power back by rejecting the lie (i.e., there’s something wrong with you) is much easier said than done. But what does it feel like to consider the possibility that you’re just fine exactly as you are?

Take a few moments to mull it over.

What does it mean if there is really, truly nothing at all wrong with you? It could mean a lot of things, not all of them pleasant. For example:

• You’ve been treated worse than you deserve to be treated.
• You’ve turned down opportunities that might have made your life better.
• Your expectations of yourself may have seemed too high, but have really been too low.
• Your expectations of others have been low or nonexistent.
• You wasted years not following your dreams for fear you didn’t deserve them.

Taking back your power from the bully in your head is not without cost. The cost of taking back your power is regret—for all the years you let the bully control you.

Go ahead and feel the regret. You earned it and it won’t kill you.

Then take back your power by saying no to the bully who insists there’s something wrong with you.

There’s no special trick to it. Just do it.

Act as if there’s nothing wrong with you. You’re a good person. You won’t do bad things just because no one’s there to criticize you anymore.

You trusted the bully to take care of you all these years, but it cost you some self-esteem. Trust yourself now. Ditch the bully.

When the bully calls you stupid or unattractive, say, “I disagree.” Then mentally walk away from that criticism.

That’s how you take charge. One thought, one moment, at a time.

Good luck taking on your bully. Let me know how it goes.

Confidence is something we all struggle with from time to time. We want to feel sure of ourselves, but those little whispers of self-doubt show up whenever we want to put ourselves out there, take risks, or try something new. They tell us to play it safe and do things the way we’ve always done them to avoid getting hurt, embarrassed, or rejected, but you don’t always have to listen to them. In fact, doing things your conscience deems unsafe or out-of-the-norm is a great way to build confidence.

Cultivating confidence is the first step toward healthy self-esteem and personal growth, but it isn’t easy for most people. In order to foster confidence, you may have to do something you’ve never done or think in a way you haven’t thought. This can be scary, but know that cognitive restructuring and adjusting behaviors are essential parts of many types of effective therapy.

To help you on your journey to become more confident, here are eight suggestions to get you started:

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1. Face a Fear

Fear is usually at the root of a lack of self-confidence. When you’re scared of the outcome of something, you aren’t likely to go into it feeling assured. Until you face your fear head-on, it controls you and makes the voice of self-doubt louder.

Think about a fear you faced and recall how you felt afterward. Perhaps you felt liberated and proud; you might have even wanted to do the thing you were afraid of again.

Make a commitment to do something that scares you every day, once a week, or once a month and watch your confidence quickly grow.

2. Befriend Failure

If you haven’t failed, you haven’t tried. In order to truly be successful, you have to be comfortable with the possibility of failure. The more you fail, the more you’ll learn and grow. Accept your mistakes and use them to propel you forward.

Failure often seems like the end of the road, but it’s probably just the beginning. Once you accept the initial disappointment, you’ll be able to move forward better equipped to succeed the next time. By taking risks and being willing to fail, you’ll learn to believe in yourself and your capabilities.

3. Doubt Your Doubt

Doubt is the enemy of confidence. It keeps us feeling uncertain and, sometimes, even makes us a bit cynical. If you start doubting yourself, counteract it by doubting your doubt. Question the truth of what your doubt is saying to you.

Perhaps your doubt is saying, “Oh, I’m really not good at this.” Question those limiting beliefs whenever they arise. You’ll likely realize there aren’t many facts to back up the doubtful assertion.

4. Affirm Your Strengths, Talents, and Accomplishments

People who lack self-confidence tend to focus more on their weaknesses than their strengths. Make a list of your strengths, talents, and accomplishments. Be honest with yourself and try reading from this list daily to remind you of your greatness.

Don’t hesitate to write something like, “I am beautiful and wonderful” in red lipstick on your mirror. Though it may seem cliché, it works. We tend to believe in messages we are constantly exposed to—just ask an advertising executive.

Your confidence is influenced tremendously by your daily thoughts, especially recurring thoughts. Consistency is key to lasting change. If you want to be more confident, make a habit of reminding yourself of your unique gifts and abilities.

5. Embody Confidence

Fake it ’til you make it. Ever heard that phrase?

If you want to be more confident, feel more confident. When you find yourself feeling nervous and unsure, stop for a moment, close your eyes, and think of a time when you felt confident and self-assured. Use all of your senses to bring you back to that moment. In doing this, you’ll be more able to cultivate that feeling in the present moment.

Also, consider your posture. Choose a body posture that looks and feels confident. Next, think about your clothing and style. Dress to impress—yourself! Dress in a way that makes you feel good. If you look good to you, you’ll feel good, and feeling good often leads to higher self-confidence.

6. Listen to Empowering Music

Music is a great for evoking emotion. When you want to feel more confident, turn on some music that lifts you up.

If you’ve never used music to inspire motivation, we suggest these confidence-inducing songs:

• “Eye of the Tiger” by Survivor
• “Ain’t No Mountain High Enough” by Marvin Gaye and Tammi Terrell
• “We Will Rock You” by Queen
• “Perfect” by Pink
• “Happy” by Pharrell Williams
• “I Will Survive” by Gloria Gaynor
• “Living on a Prayer” by Bon Jovi
• “I Feel Good” by James Brown
• “Survivor” by Destiny’s Child
• “Just the Way You Are” by Bruno Mars
• “Lose Yourself” by Eminem
• “Beautiful Day” by U2

Press play on one of these tracks and turn the volume up before a workout, job interview, date, or some other event that requires you to summon confidence.

7. Set a Realistic Goal and Take Action to Achieve It

Your achievements contribute greatly to your feelings of self-confidence. By making a commitment and following through with it, you’ll learn to trust yourself and your abilities more.

Often, we make extreme resolutions—think New Year’s resolutions—that require broad, sweeping change. Then we don’t stick to them. It happens every year: people who exercise once a month try to exercise an hour each day and almost inevitably make it about a week or two before they give up. By not following through on a commitment we make to ourselves, we lose trust and faith in our abilities, and our confidence suffers as a result.

New habits take a significant amount of time, effort, and dedication to cultivate. When setting new goals, be realistic and make sure that your goals are attainable. Start slowly and set small goals that you can build on. By following through with your commitments, no matter how small, you’ll learn to trust yourself and gain confidence in what you’re capable of achieving.

8. Make a Difference

Do something to give back and contribute to society. Consider volunteering or making a donation to your favorite charity. Do something for someone else. It doesn’t have to be a major contribution; even something as simple as helping your elderly neighbor carry her groceries will make you feel good (and more valuable).

By making a personal contribution, it reminds you that your individual choices have an impact on the world. Realizing your true significance as an individual will empower you and increase your feelings of self-confidence.

Choose One Suggestion from Our List and Give It a Shot

If you really want to be more confident, consider choosing just one of the suggestions above that resonates with you. Even if it seems quirky, try it. Focus on one thing at a time and adjust a simple thought or behavior and it could go a long way toward building your confidence.

If you try to do too much at once, you may become overwhelmed. Remember that confidence is a state of trust, which, like any therapeutic relationship, takes time to build. Be patient with yourself and know the journey begins with one step. Take baby steps and, before you know it, you will arrive at your destination feeling confident and capable.

Being deserving means having an expectation of goodness in your life. It is the goodness of people, relationships, and situations that we all want and deserve in our lifetime. We are all deserving of:

• a safe place to live and work
• relationships and people who love us
• colleagues and employers who respect and support us

The idea of being deserving isn’t a new one. But for someone who is not used to feeling deserving or worthy, it can be a difficult concept.

As a black woman, I grew up with conflicting messages from my family telling me that I was capable and deserving of whatever my heart desired. But then I went into the world only to be told directly and indirectly how undeserving I was. Whether I was undeserving of the same respectful treatment my colleagues were given, of being seated at a restaurant, or of the promotion that I’d worked hard for, I was constantly told and reminded how undeserving I was.

For many people, there is a tension between what we come to believe we deserve and what others tell us we deserve. Whether it’s an outsider or ourselves limiting our expectations, though, it makes it more challenging to live a fulfilled life. Perhaps the limitations you experience in life are a result of a deeper belief that you don’t deserve more. Though it doesn’t feel good, it is familiar to stay in a situation that you’re used to.

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But it doesn’t have to be this way. There are steps you can take toward having the life you want and deserve.

First, ask yourself, “Do I deserve good things in my life?” If the answer is no, why not? Why can’t you have the relationship, job, or life that you want? Take the time to write your answers. You may surprise yourself with the thoughts that are unconsciously swirling around your head. Many times, these buried thoughts come from long-ago experiences that hurt us and continue to influence us today. If you don’t uncover them, you can’t change them!

Now that you know where your feelings of being undeserving come from, you have some investigating to do. Are the comments that were made to you 20 years true today? Were they true then? Don’t give yourself an automatic answer; take the time to expose the validity, or lack thereof, of these thoughts.

A true investigation requires more than just your perspective. Gather three people who are honest, who love and encourage you. Ask for their opinion and thoughts about the messages you received when you were younger. Picking the right three people is key. They shouldn’t be people who will agree with you no matter what; otherwise, you won’t believe them. Nor should they be the people who initially conveyed these messages! They need to be people who will be honest with you while loving and supporting you.

Once your investigation is complete, you need to review this new information. Ask yourself again, “Am I deserving?” and “What am I deserving of?” Are your answers any different than the original ones?

What do you want to do with this new information? Do you want to hold onto it and ponder it? Or are you ready to take action and make changes in your life?

If you are ready to make a change, repeat the following daily: “I am worthy and deserving of goodness.”

Imagine the difference on your psyche and in your interactions with others if you move from saying “I’m worthless” day after day to saying “I am worthy and deserving of goodness.” Repeat “I am worthy and deserving of goodness” each time you go outside. Whether you’re leaving for work in the morning, taking a lunch break, or going to the store, say it. In doing so, you will challenge your thinking and your beliefs about your worth. It will lead you to the interactions, relationships, and situations that you are truly deserving of!

What or who makes you feel deserving? Let us know in the comments section below.

For people who define themselves as socially awkward, the perceived risk of being seen in endlessly negative ways—inadequate, ugly, boring, stupid, anxious, depressed, empty, arrogant, fat, pathetic, etc.—is always present. When I think about people in therapy who see themselves as socially awkward, I find little correlation between how I experience each individual as a social person and how they think of themselves. Every one of them seems to have characteristics that I enjoy and admire, and they are often (but not always) in occupations of respectable social status. However, for the “socially awkward” person who supposedly “knows” how little they have to offer to the world, the facts of their occupational status or character are irrelevant.

What I have come to recognize about many people in therapy who feel severely socially awkward is that they share the belief that when they were growing up they missed out on learning the rules of social discourse. As a consequence, they are intensely anxious about how they will be responded to if they are socially off the mark. For example, Robert, an attorney, worries about phone calls and what to do after you say hello. Paula, an information technology manager, panics about being in a social situation and not knowing how to approach someone. Tanya, a college graduate, unemployed for the past year, keeps asking “what are the rules, how long do you talk with someone at a party and how do you get yourself out of a conversation?” Everyone worries about silence and eye contact.

While many of us might experience similar social concerns, a “socially awkward” person believes that their anxiety and inability to navigate these situations will be blatantly evident, and they expect to be responded to with rejection and disgust. Even when there are no evident responses that confirm their fears, such people continue to experience bad feelings about how they behaved and consequently justify their continued self-attacks and self-hate.

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Parental Expectations

A major source of the feelings of social inadequacy and the consequent self-hate that people often express is related to parental expectations. Both Tanya and Robert had parents with very high expectations. Robert talked about his parents pushing him to work harder at all the extracurricular activities they insisted he engage in: “They thought I was a virtuoso and kept pushing me to do more with the violin. My mother kept telling me what a wonderful writer I was and that I should try and get published. But she also insisted on critiquing any creative writing I tried.”

Tanya described how her parents pushed her to succeed in high school so she could get into an Ivy League school: “They would compare me to their best friends’ son and list all his achievements. On the surface, they seemed to be saying they thought I had what it took to be superior. But I never felt I could really be good enough, no matter how well I did. I upset them when I didn’t apply to Harvard, but I couldn’t bear the thought of disappointing them by not getting in.”

Paula also was negatively affected by her parents’ expectations. They wanted her to “be good.” The worst thing she could do was make anyone outside the family think any negative thoughts about her. This would shame and humiliate her parents and result in physical or verbal abuse. The most Paula could hope for from her parents was to avoid anger and criticism. She recalled: “My mother would scream and berate me if I didn’t smile the right way at a neighbor. I remember, when I was about 9, she dragged me from the Thanksgiving table at my aunt’s house because I didn’t say ‘please’ when I asked for the turkey. I was a very scared kid and never knew when I was going to get hit or criticized. I never knew what the right thing to do was. I still don’t know.”

The Importance of the Audience

Robert and Tanya needed to be high achievers so the parents could feel pleasure and ego satisfaction about their parenting. By pushing achievement on their children, the message, consciously and unconsciously, was that you must do more, be better, and shine or you will hurt and disappoint me. For all three people in therapy, the ultimate authority on how they were doing as children was the social audience their parents looked to and empowered. Most importantly, the incredible power of the “audience out there” cast the final judgment on how the parents were doing.

Without audience approval, the parents felt inadequate and humiliated and put the responsibility for these bad feelings onto their child. The parents held the child responsible for their own feelings of inadequacy, which were then attributed (projected) to the child who was designated as inadequate. The child not only felt the shame of insufficiency, but experienced the badness of having socially hurt, disappointed, and shamed the parents. It is no surprise, then, that for the humiliated, “inadequate” child, the social world would feel like a constant source of scrutiny with the mission of detecting and identifying the guilty party.

Developing Feelings of Social Adequacy

These three individuals have great certainty and strong emotional attachments to their belief that they are socially inadequate people. While they typically begin therapy with some hope that they can do something to improve their experiences, feelings of hopelessness often outweigh the hope. The journey to feeling more socially able begins with people becoming aware of the ways in which their social awkwardness has been shaped and confirmed by their early and continuing life experiences. While this provides a rational understanding of how their feelings of social inadequacy developed, it does not alter the strong emotions that arise when they find themselves in social situations.

I often hear about their intense anxiety in social situations and how they become panicked. With intense agitation, they scan faces of others to detect the expected negative reactions. If I wonder how it would be if I helped them to strategize for a social situation, the response is usually negative: “It won’t work; I’m too anxious; it’s useless.” I believe this is an expression not only of hopelessness but of the self-hate that the person feels. If I can help the person reflect about this and put his self-hate into words, it can help break through the paralysis and allow the person to agree to try and practice some new behaviors before a social situation.

Even when a person may bravely go to the party and try out a strategy, it is unusual for the person to feel that he or she has had success. As Robert told me: “It was horrible. I saw a woman standing alone near the bar and I went over to her and introduced myself and asked her name and how she came to be at the party (like we planned). I couldn’t make eye contact very well, but I tried. She did answer my questions, but then this other girl came over and started talking to the first girl and I panicked. I couldn’t say anything and left.”

The example above illustrates how, even with a strategy, it is difficult to succeed with the plan. What is even more difficult is to change the negative feelings about one’s self that influence our social behaviors. With considerable work, repeated experiences of small successes can lead to incremental but steady changes in behavior and self-perceptions.

I am going to list some steps that represent what happens in the therapy process that can help in altering self-defeating behaviors and feelings of self-hate and social inadequacy. To undertake these steps, with or without the help of a therapist, requires commitment to tolerate frustration and painful unwanted, and intolerable feelings. There must be a willingness to fail and try again repeatedly.

Steps to Changing Feelings of Social Inadequacy

1. Gain knowledge through self-reflection to hypothesize how your “social awkwardness” has been shaped and confirmed by your life experiences.
2. Self-talk to remind yourself of (1) positive qualities, (2) feelings that seem intolerable, and especially (3) your resilience, i.e., ability to withstand those intolerable feelings. (After all, you are still standing and functioning, and have had many encounters with those feelings, and you’re still here.)
3. Develop strategies to help manage behavior in social situations, e.g., what to say when approaching a stranger at a party or subjects to talk about on a date. (Google your questions if you can’t come up with your own strategies.)
4. Try out behaviors and be prepared to fail.
5. Learn to see failed attempts as success. This means overriding old patterns of self-attack and bad feelings and allowing yourself to feel courageous for trying.
6. Try out behaviors again and be prepared to fail again.
7. Keep trying to feel successful for trying.
8. Repeat steps 1 through 7 as long as necessary until you begin to feel more positively about yourself and more able to tolerate your unwanted feelings.
9. Come up with a new thought which reflects positive feelings about yourself.
10. Come up with a new thought about yourself as someone who is feeling a little more socially adequate.
11. Allow yourself to consider that you can change and be aware of your anxiety about change.
12. Keep repeating steps 1 through 11.
13. Never stop working on developing positive feelings about yourself.
14. Never stop working on your ability to tolerate unwanted feelings, change your behavior, and feel positive about yourself.

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

Thanks so much for your question. Boy, it sounds like you’re going through a really tough time, and I’m sorry to hear about your childhood abuse; I know how intrusive and debilitating posttraumatic stress symptoms can be. What’s kind of a “double whammy” here is the fact therapy doesn’t seem to be helping. What’s interesting to me is that it sounds as though it’s all up to you to make it work, when in fact the therapist is a 50/50 collaborator in the process. It’s sad to me you feel you’re “blindly” fumbling around, as if you have no help finding direction. I always challenge my clients when they take whole blame for any “stuckness.” Therapist and client form a system, like two atoms in a molecule, and every relational system seems to reach a kind of homeostasis, or regular pattern, which on the one hand provides a sense of stability and reliability, but on the other can lead to the sort of stalemate you’re talking about. I would agree with you that you’re not capable of change by yourself; your therapist needs to be an active participant, and the way you describe therapy makes it sound as though there’s tremendous distance between you two.

I’m also curious as to what made you decide to quit at that particular juncture. A sense of boredom? Frustration? Sometimes it takes time to get to a point where change begins, but until then it can feel eternally slow. I’m not saying that’s happening here, but sometimes we hit a wall, and just beyond the wall is a new phase. Always darkest before the dawn, as the cliché goes. Sometimes it’s true.

I want to tell you that—and I have zero doubt about this—your therapist is part of the problem here, and the solution. Therapy is, in part, a business arrangement, and as the customer you are not satisfied and have every right to voice your concerns. I would strongly encourage you to have at least one more session and air your true feelings. Let it all hang out; we’re professionals, but we’re not perfect, and feedback is terribly important. Yes, it’s true that we are “experts” of a kind, but psychology is not medicine (it’s part art/part science, in my view). Everyone is different and comes with his or her own history, perceptions, feelings and interpretations that warrant close exploration so that you and your therapist can co-construct a way of working that you both feel is productive and going somewhere. It’s almost like co-creating a language that exists solely within the “psychic sphere” of therapy, to borrow Freud’s phrase.

On another note: One of the many sad things about trauma is it can challenge us in forming attachments to others, including, of course, to the therapist. He or she may become an authority or parental figure whom we are afraid to confront, but clients often report that it is very healing for them to tell me the truth when something bothers them, and to have me listen and understand each of our contributions so we can work it through. Some of the very best work happens when a client is unhappy with something and we process it. Additionally, there are often beliefs about the self based on past abuse that have to be brought to light. Some may unconsciously feel they “deserve” to suffer because of the belief that they brought the trauma on themselves. To a child, assuming they are the cause is less frightening than no cause at all. I hear a note of this when you ask if you are capable of change. Everyone is capable of change, my friend—in fact, we are changing every second of every day! We are organic, physically and psychologically. It’s the illusion or experience of staying the same that is so painful. (The new gray hairs I saw in the mirror today are testament to this.)

There are even unconscious motives for change not to happen, in some cases. Abuse and mistreatment are often, tragically, the only way some caretakers have ever related to their children; clinging to the symptoms is, symbolically (for some), a way of holding on to Mom or Dad. Some would rather believe they are bad than accept that their caretaker, often idealized, treated them so horribly. It’s like losing a parent, and the underlying grief and loss can create terrible apprehension. All of this needs to be explored in the consulting room.

I’m describing a very psychodynamic way of working, by the way. There are other modalities to employ with these types of injuries, including cognitive behavioral therapy, EMDR, somatic experiencing, neurofeedback, spirituality, peer support, and so forth. I use an eclectic mix, depending on what the client finds helpful. But again, without sustained feedback, I don’t know what’s helpful.

You might also look into a peer support group instead of, or in addition to, individual treatment. Finding a group of people who can relate and accept you as you are, because of (not in spite of) your challenges, can be tremendously healing.

Please don’t give up. I recommend that you talk to your therapist or try with another one, and ask for a treatment plan or set of goals that you both agree are obtainable and desirable. Each goal should have specific methods or ways of working that you both, again, feel comfortable with. The technique of therapy shouldn’t be a mystery; there are many unknowns, of course, but this isn’t hocus pocus and there have been some tried-and-true methods shown to work over the past hundred years. The key one appears to be a trusting relationship with your therapist, and I think that even if you decide this one ultimately isn’t for you, you deserve a fair hearing as to why you’re unhappy and the changes you’d really like to see (and what seems to be getting in the way). You don’t and shouldn’t have to go through this alone.

Respectfully,
Darren

At first glance, the injunction to bless and release sounds just beautiful, and so evolved. On reflection, it is missing a crucial component: learning from the experience before you let it go. Jumping right to bless and release without first opening to the lesson is like putting a Band-Aid on a broken leg. You may think you did something helpful, but it’s a superficial solution.

If it were that easy to just bless and release, people would forgive far more readily, and generally move through relationship roadblocks and inner conflicts with ease. As you know, nothing could be further from the truth.

If you take stock of a situation, ask yourself what you could glean from it, and then consciously open your heart, you will be more able to truly bless the people involved and let it go. The psychic lightness you experience as a result comes from true detachment.

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In Buddhism, the concept of detachment is often misunderstood. It does not mean detaching your love and caring from someone; rather, it is detachment from outcome. This requires an understanding of your expectations, even when they are not readily accessible. It’s just another good reason to take time to meditate, as it allows previously buried thoughts and feelings to emerge from your unconscious to your conscious mind.

Once you are aware of your expectations, i.e., your attachment to certain outcomes, you can work to release them. The first step in letting go is acknowledging the hold they have on you. Is there a pattern of thinking, judging, reacting, or expecting that has dogged you in the past? If so, please resist the temptation to blame yourself. Trust that you were doing the best you could, and refuse to enter the cycle of self-criticism, as it will only impede your progress.

Accepting other people’s different ways of being and behaving is a wonderful goal. Like all major cognitive and heart-opening shifts, it does not happen overnight. A good way to start is by being aware of your thought patterns, behaviors, and physical responses to certain people and situations. If you sense a tightness in your chest or abdomen, ask yourself what you might be thinking about someone’s behavior. Are you judging it? Are you being critical of his or her way of handling something? Are you comparing how you would do things differently? Breathe into whatever tightness you feel. Give yourself a cosmic permission slip to have those initial reactions without resorting to self-condemnation. Then ask yourself: “How would I rather think and feel about this person?”Imagine reacting that way. Use all five senses to really feel the difference. Now, notice any changes in your body.

If you like how you think and feel after that exercise, you may be ready to bless. Following the teaching of the Buddha on metta, or loving-kindness meditation, bless yourself first. To Western minds, this may appear selfish, but it sets the stage for opening your heart to others. Once you feel that positive intention toward yourself, you can bless the other person. A classic invocation is: “May you be peaceful, may you be happy, may you be free from suffering.”

If that felt good, let it all go. This is easier said than done, as humans can’t erase memories at will; however, you can let go of any residual negative feelings, such as anger, resentment, or jealousy, especially if you feel yourself joyfully moving forward.

Letting go is powerful psychological medicine when it is done with a truly forgiving heart. Be patient with yourself as you traverse this new territory, and practice self-forgiveness as it paves the way to being more loving and understanding of others.

It is not unusual for people to come to therapy with feelings of confusion about what they want, think, and/or feel. I find that many grew up in families in which one or both parents involved themselves in their children’s lives in ways that interfered with the development of separate, individual thoughts and feelings. Most of these parents were well-intentioned. Their intrusion into their child’s life typically came from a need to protect the child from painful feelings or to assure that the child’s behavior and choices were the “right” ones. As a consequence, these children grew up relying on their parents to define not only what they should feel or how they should behave, but ultimately their identity: who they are as individuals. As adults, these children spend a lot of time in their heads worrying about the choices they make, how they are seen in the world, if they upset their parents by having separate ideas, if they did the right thing, etc. They become confused when the thoughts they have about themselves are different from what they know their parents believe. “What is true and real about me?” becomes the question that these patients bring to therapy.

“Sam” came to see me filled with anxiety. He didn’t know if he should continue in a relationship that was becoming serious. “I think I’m in love with Kara,” he said. “We have a really good time together, and she is very good to me. But then I get confused: Do I really want to spend my life with her? My father thinks she isn’t a good match for me. She’s Italian, and I’m German. I never really thought about things like that, but my father thinks that the cultural differences are too much. He also thinks that Kara’s family is very different than ours and that will be a problem when we have a family.” Sam continued to describe his uncertainty about how he felt and what he should do. I asked him if he thought he would be less unclear about Kara if his father approved. It was striking to me that this question seemed to startle Sam. It hadn’t occurred to him that his father’s opinion about what was good for him had such a profound influence.

Sam agreed to begin therapy, and we began to explore how he thought about himself and how he determined what he wanted and needed. It soon became apparent to both of us that Sam’s father had always played a big role in characterizing who Sam was. Sam recalled that he wanted to take guitar lessons when he was about 10. His parents bought him a guitar, and he liked strumming it and learning to play, but he had trouble with dexterity and was not developing into a very good player. After about six months, his father told him, “You’re not very musical. You should find a different hobby. You should try chess; you would be good at that.” Sam recalled: “Even though I enjoyed playing and fooling around on the guitar, I stopped the lessons. My father started to teach me chess. I did get pretty good at it and joined a chess club in middle school. My father always says with great pride how he knew I would love it because I’m such a rational and logical person, that chess is perfect for me.” Sam paused and thought a minute and said, “It’s funny, I never thought about this before. I think of myself as a logical guy, but then I never know what to make of all the feelings that seem to boil up in me. My parents don’t see me as emotional.” Sam paused again, seemed deep in thought, and then sadly said, “Wow, I guess I hide that part of myself from them. They don’t really like emotions.”

As Sam and I continued to talk, he became increasingly upset as he began to discover that much of what he thought about the kind of person he was mirrored his father’s view of him. He also began to realize that there was a judgmental attitude when his father told him what he thought. For example, his father still believed that Kara was not for him. His father had explained, “You’re not someone who can deal with opinionated people. She is too aggressive for you.” Instead of becoming confused and wondering if his father’s idea was true, Sam began to consider his own experience. He was learning to ask himself what was happening in his internal life and to study what went on externally. He thought about Kara and her opinions and realized that many of her ideas were different from those of his parents. But he also saw that she was flexible and, in fact, he often agreed with her. As he was more able to focus on himself and create some space apart from his father’s influence, he could consider how he felt. He didn’t feel conflict with an opinionated Kara. Rather, he was becoming aware that he disagreed with his father. This was not an awareness that he allowed himself to experience very often. It made him anxious, but now he second-guessed his experience less, and he was beginning to make space for his separate feelings and ideas to emerge.

Sam and I still have work to do. He is working on his relationship with Kara. As he develops the ability to know what he wants and feels, he is more able to express himself to Kara and that relationship is getting stronger. Sam continues to work on individuating from his father. After 30 years of relying on him to define and characterize who Sam is, it takes time to develop confidence in his own thoughts and feelings. There is still anxiety for Sam when he asserts his newly found voice with his father. Sam has recognized that his father’s judgmental tone has made it difficult for him to feel that his own perspectives are valid. His memory of his father telling him, “I’m your father and I know what you like and what is best for you” no longer feels just about his father’s love and concern. Sam is beginning to understand that his father is anxious, too, and that it is his anxiety that drives him to try to control Sam and to believe that he knows what’s right. Hopefully, as Sam’s sense of identity becomes more solid, he will be able to negotiate the relationship with his father so there will be room for multiple thoughts, feelings, and perspectives.

Well-intentioned parents who are critical and controlling may promote their child’s reliance on them to determine and define what is good and acceptable about the child. When a loving parent is so certain that he or she knows what is right for the child and does not consider that the child may have valid, different ideas about what he or she wants, needs, and feels, there is no space and no invitation for the child to develop the ability to express his or her own self with separate ideas, feelings, and needs. Over time, as the child grows to adulthood and is exposed to more ways of thinking about things, there is typically a good deal of confusion about identity, thoughts, and feelings. Unless there is an opportunity to develop a separate sense of self, there will likely be a lot of anxious thinking about what is real but little ability to think for oneself in a self-reflective way.

When parents view their child’s “problematic” behavior, attitudes, or troubles as a reflection of them, it can be a terrible blow to the ego. For parents with positive self-feelings, anger, hurt, and disappointment can occur when they don’t see themselves reflected in their children. (“My child should be just like me.”) For parents who do not feel very good about themselves, seeing a child as being “just like me” can feel devastating. Parents who lack self-esteem often feel like their child’s problems are their fault. Their inability to differentiate themselves from their children can also result in guilt and painful feelings of responsibility that are often overstated and inaccurate. Many parents who struggle with the idea that their child is a reflection of them (for better and worse) have not separated from their children. These parents tend to feel some responsibility for their child’s situation. Most often they believe that, either in their early behavior with their children or in their biological contribution (or both), they have profoundly affected their child’s life and character.

“Peter” came to his therapy session in a rage about “Adam,” his 25-year-old son. He had just come from his son’s apartment and was disgusted about the dirt and disarray he encountered: “What is the matter with that kid? He’s such a slob. There is stuff everywhere. It feels so chaotic! I have the same feeling when I think about how he gets drunk with his friends on the weekend. He’s a mess!”

When I asked Peter what made him so angry about this, he began to express remorse about being so enraged. Choking up, he said, “I guess I’m really hurt. I feel like Adam is being disrespectful to me. He knows I hate his messes and his drinking behavior. I feel like he’s on a terrible path of disorganization and disaster. I keep asking myself, ‘How did he turn out this way?’ ”

I asked Peter what he thought about why Adam was like this. “I don’t really know,” Peter said. “But I honestly believe it’s my fault. You know I was a terrible workaholic during Adam’s first 10 years. I neglected him when he was growing up. Then I think, if I was a workaholic, will he be an alcoholic? I know I made him this way. I’m a mess of a father.” Peter was tortured by his painful feelings and disappointment that his son hadn’t turned into the ideal adult that Peter wished he could be.

Over time, as we explored Peter’s feelings, it became apparent that he put all the responsibility for the person Adam was at age 25 on himself. He found it very difficult to see Adam as a separate individual with his own reasons for behaving the way he did. Slowly, Peter was able to consider that his influence hadn’t only been negative and that he wasn’t the only influence on Adam’s development. Adam’s mother was nurturing; Adam had many friends growing up. Peter could even recall some teachers who were influential in Adam’s life. He acknowledged, for example, that a high school teacher had encouraged Adam to stay with his music, and Peter admitted that Adam was a successful musician.

“I guess I haven’t focused enough on Adam’s successes, just on the ways I see him as a failure and blame myself,” Peter said. “Sometimes I still think that maybe Adam is punishing me when he messes up in ways he knows I hate. I guess I really have to admit that it isn’t all about me. Adam is a different person from me. It’s just hard to be OK with that. But I do want to get there. I know that would be best for our relationship.”

Peter is slowly beginning to separate from Adam and experience Adam’s successes and failures as more about Adam than him. He is also beginning to take Adam’s character and behavior less personally. Giving up the idea that “it was all my fault” makes space for Peter to see Adam as a separate individual.

“Rose,” another client, began to talk about her 10-year-old daughter, “Jessica,” in our therapy sessions.  Rose was obsessed with worry that Jessica, who had learning disabilities, would never have a successful life. She said with some sadness: “Her brain is damaged. How will she ever be OK?”

“What do you mean, ‘Her brain is damaged’?” I asked.

“You know that we had her tested and she has so much trouble focusing and organizing her thoughts,” she responded.

“Yes, I know she has some learning disabilities, but seeing her as ‘a person with a damaged brain’ seems a rather extreme way of defining your daughter,” I said.

“I sort of know what you’re saying is true,” she said. “But you know I had learning disabilities as a kid. No one identified them; no one did anything about it. I still struggle at work and in my life in general with being focused and organized. I get so depressed and anxious when I forget things or don’t get stuff done like I promise my husband or my boss. I know my brain is messed up, and Jessica is just like me. Why would I think her fate is going to be any different?”

Rose had a very strong belief that biology was determining her future as well as her daughter’s. She was reluctant to consider that her daughter’s life could take a different path from hers. She had a difficult time thinking about Jessica as a separate person with her own unique characteristics. I reminded her that she and her husband had been addressing Jessica’s learning problems and getting help for her. I also pointed out that this was very different from her own experience growing up. I emphasized that there are many influences other than biology that influence a person’s development. I also asked Rose to tell me anything she could think of about Jessica’s accomplishments. We both listened to the list Rose came up with: “Great piano player, really good artist, hula-hoop champion, kind person, good swimmer, and I guess other stuff, too.” Rose reluctantly acknowledged, “Yes, I suppose her brain works OK in some ways.”

Rose and I spent a lot of time talking not only about Jessica, but also about Rose’s negative sense of self. It was harder for her to take seriously that she has her own accomplishments. It was even more difficult to consider that Jessica was like her in some ways and not others. (Rose is a terrible artist and swimmer!) Our work has centered on Rose’s struggle to experience herself in positive ways and on seeing Jessica as a separate, differentiated individual. We have also been talking about how painful it is to see your child have areas of deficit, and even worse when you feel you are the cause. Helping Rose to talk about her impaired sense of self and its development has allowed her to make distinctions between her own experience and Jessica’s. I have tried to help Rose consider that while there could be some biology at work in regard to Jessica’s learning disabilities, so much more than being “just like me” is involved in what makes Jessica who she is.

We are familiar with parents feeling great pride in how they played a role in their children’s successes. But when parents boast incessantly about their children’s accomplishments to the extent it doesn’t feel like typical parental pleasure, we typically consider them to be narcissistic. For Peter and Rose, their great dismay in what they perceived as their children’s deficits, problems, and failures was also narcissistic.

The term narcissism comes from the Greek myth of Narcissus, in which Narcissus falls in love with his own reflection in a pool. The notion of reflection is pertinent to the experiences of Peter and Rose. Rather than experiencing narcissistic pleasure, these distraught parents experienced a narcissistic wound. They couldn’t tolerate the pain of looking into the pool (i.e., at their child who also represents the parent) and seeing something that is not “beautiful” reflected back. When they looked at their children, they saw a reflection of themselves. It was intolerable that the reflection they saw was “a mess” or had a “damaged brain.” It was not “beautiful.”

These parents are responding narcissistically, and they have not differentiated themselves from their children. One has to wonder how parents, who view their children as reflections of themselves, may have influenced their child’s separation/individuation process. As parents become more aware that their beliefs that their children are or are supposed to be “just like them” are assumptions, they will be in a better position to examine those beliefs. As a result, parents will experience less pain, and their children will be helped to develop into separate, unique individuals.

This is the third in a series of articles designed to explore some of the issues and concerns that arise around what is currently called Asperger’s syndrome, which will soon be incorporated into the broader spectrum of autism disorder when the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is published in 2013.

I had a client we’ll call Brian, a man in his mid-thirties with a diagnosis of Asperger’s syndrome who came to me to discuss what he referred to as “issues he was having with people at work.”

It is not an unusual request for a person with Asperger’s to want to work on the confusion that surrounds social interactions in general. Interactions at work often are more challenging because in the office, not only do the normal social protocols apply, but there often is an additional layer of a particular corporate culture overlaid upon this basic structure, invisibly directing everything.

Bryan was a pleasant and engaging man. He held good eye contact, spoke with precision, and demonstrated a light touch with humor. His demeanor changed, though, when I asked him about his colleagues in the office where he worked as a certified public accountant.

A quiet earnestness overcame him. He spoke clearly and without breaking to collect his thoughts or in expectation of response. He discussed one individual after another in great detail, including information about the kind of work they did, their areas of responsibility, and where they stood in the hierarchy. This was precisely the sort of information I expected to get from Brian on the topic of work relationships.

Then, however, he began to speak of his colleagues in more personal terms. He knew who was married and who was single. He knew who had children, their names and ages, and the schools they attended. Brian told me who had recently vacationed and where they had gone; who golfed and who played tennis; who had iPhones and who used Androids. He knew the makes and models of everyone’s cars. He knew the names of spouses. He knew which neighborhoods his coworkers called home. He even knew who had housekeepers and who did not.

It might appear surprising on first glance to read that I was given such detailed and personal information about others from a man with Asperger’s who came into my office with self-identified problems related to interpersonal relationships. But I have seen this before. Once you look at this apparent contradiction in another light, you may recognize it, too.

I’m talking about the illusion of friendship.

Further discussion with Brian demonstrated to me that he had gleaned all this information about his coworkers not from interactions with them over time, the way you or I might imagine getting to know the people we work with. Instead, Brian had developed his extensive knowledge of everyone around him by listening and even eavesdropping on conversations others were having around him, but in which he had not once been involved personally.

And he was having problems with his coworkers when he would make a statement revealing his knowledge about a person, info he had no apparently legitimate way of knowing. People became uncomfortable around him because of this and withdrew from him, which left him utterly confused.

Of course, this became the starting point for our work together. Brian had to learn about the ways that acquaintanceships and friendships develop over time. Importantly, he also had to learn the concept of reciprocity: It is not enough to know things about another person, but one must also share personal information about oneself as well in the give-and-take manner of casual conversation. This is how trust develops between people. This is the foundation from which we can make a statement such as, “Oh, yes, I know Brian,” with legitimacy.

Brian had to learn that knowing confidential or intimate facts about another person without that reciprocity was considered socially gauche, and that it had the potential even to be frightening to some individuals. Brian had to learn the difference between having friends and having the illusion that he had friends.

Once we began to tease this distinction apart, Brian began making progress in his social interactions. We used role-playing techniques and many “what-if” exercises, and Brian’s distress around the topic of his work environment noticeably decreased over time.

There are many parallels between living with a disability and dealing with an uninvited house guest. If you have ever had an uninvited house guest, I am sure you remember moments when things may have been uncertain and, at times, tense or uncomfortable. At the very least, having an uninvited guest requires some adjustments, much like living with a disability.

An uninvited guest may arrive unannounced, leaving no time to plan or prepare. Likewise, in many cases people living with disability have little or no time to plan for the many changes to come. While there may have been no way to prevent the disability and requisite life changes, having time to prepare—psychologically and literally—can make a huge difference in a person’s ability to adapt and cope.

A period of psychological adjustment is required for a person who has a disability, his or her spouse/partner, parents, and other family members. The adjustment process people frequently talk about resembles the grief process in many ways. Like the grief process, people often experience feelings in what seem to be stages. Similar to the grief process, this adaptation process usually begins with a period of denial.

Denial
In my work with couples and families living with multiple sclerosis, I often hear concerns that one person seems to be “stuck in denial.” To people who have moved through the initial denial stage, it may seem as if their loved one is not progressing as quickly as others. The truth is, different people work through this period of adjustment differently, and it takes as long as it takes. The denial stage usually happens at the time of diagnosis or disability, and may come up again at other times. For example, in a progressive illness, if one begins to lose mobility or other limitations arise, the initial stage of the adjustment process may be triggered again.

It may seem clear to a caregiver/partner or family member who has been helping someone walk even short distances that a mobility device is needed (cane, walker, scooter). For the person who is having mobility difficulty, admitting that it is time to talk to a doctor about a mobility device may affect his or her identity, hope for recovery, or future progress. If so, working through the denial and bargaining, and then later stages of adaptation, may be necessary. It is not unusual to see all members of the family triggered by new developments that start the process over.

Denial is believed to be a protective measure that prevents us from becoming emotionally overwhelmed. Denial slows down the process of coping with traumatic events, giving us more time to psychologically prepare ourselves for the onslaught of feelings. The process of denial, known as a defense mechanism, should not be rushed or sabotaged by well-meaning loved ones who are at a different place in the adaptation process. Doing so can cause the person who needs more time to become emotionally overwhelmed without the necessary skills to cope effectively.

Coping skills: A person with disability and his or her family members should try to be empathetic and understand things from the perspective of others. Be honest, but gentle, about your perceptions. Choose the time to discuss these issues carefully—not when either of you are tired, frustrated, or angry. Always talk to your loved one(s) before bringing up concerns with doctors or other professionals.  Caregivers and family members should keep in mind that their needs are important, too. Take care of yourself and make sure you have plenty of support. When children are involved, be very careful what and how you share information with them. Children need to hear things based on what is appropriate for their age and stage of development. Ask for guidance from a professional if you are unsure how much to tell children or how to talk to them about disability.

Bargaining
The stage that usually follows denial is bargaining. During this time, people often are looking for second opinions, alternative therapies, and other remedies. It can also be a time when we promise the gods that we will turn our lives around if given a second chance without the disability or diagnosis.

It is true that finding the best medical providers, keeping a positive outlook, and staying informed of new research and possibilities is important. However, this can also be a time when people are vulnerable to scams and false promises. Unfortunately, there are a lot of companies and people who offer products and services that guarantee outcomes without doing the necessary research required to back up those assurances.

It is a good idea to check out any new or experimental treatments carefully before trying them—particularly if there is a large commitment of money, resources, or time involved. Check with local and national nonprofit organizations that provide services to people with your specific issue or health challenge. Agencies such as the National MS Society, American Cancer Society, and others often have information about ancillary and alternative therapies. They may be able to send you information or answer your questions.

Coping skills: Make decisions together based on facts. Find local and national organizations that you trust to support you and provide well-researched information. Be sure that any second opinions or ancillary providers have access to all the information you have from other providers. In some cases, taking medications or treatment without being fully aware of how they interact with your other treatment can be life-threatening. Make a commitment to fully investigate any new or experimental treatments before deciding to try it. Ask for and check references when appropriate. Verify the credentials of all providers before visiting them. At some point, you may have to accept a new reality that you had not planned for and do not welcome. If you have prolonged difficulty coping with the diagnosis or prognosis, find support from a professional or support group to help you with the transition.

Over the next few months, I will explore additional aspects of disability, how it affects the lives and relationships of the people involved, and ways of coping with these situations. If you have ideas to share about how you have effectively coped with any of the situations presented, please join the discussion by leaving comments below. Likewise, if you have questions, feel free to ask for input from others who read the blog.