Stop Saying the phrase "JUST for Attention"

I occasionally give a training about how to help people in psychological distress.  The purpose of the training is to coach people who are not mental health providers to actively listen and support those who have suicidal thoughts and/or are in psychological pain.  Inevitably at this training the question comes up “But what do we do if someone is saying they are suicidal just for attention”.  This question always makes me flinch.  Not because the person asking has any bad intentions, but because we live in a culture that can demonize the most basic of human needs—the need to be seen.  I think about people who feel so desperate to be seen and are in so much pain that they disclose suicidal thoughts in the hopes that someone will confirm that their existence matters and that they matter.  I want to be clear that threatening to kill oneself unless someone else behaves or emotes in a certain way is exploitative and can be a form of emotional abuse.  But, people who act in a manipulative way often do so because they feel intensely powerless and don’t know how to be direct, vulnerable, open with their needs, and sturdy enough to take care of themselves if others are not able to meet them.  While I cannot condone the behavior, I can absolutely empathize with the emotional experience.

My five year old daughter loves getting attention, and she will do all kinds of things to get it.  “Mom watch how high I can jump”. “Mom look at me spin in a circle”.  “Mom, here is some grown-ups-love-it stew that I just made for you”.  Since she now has a younger sister, sometimes she asks for it directly “Mom, I need some attention too!”  Sometimes her behaviors in pursuit of attention are less acceptable like when she interrupts a conversation I’m having a million times or starts coloring on a wall.  I tell her that she can’t interrupt and she can’t color on a wall.  I let her know that she has to learn to play on her own sometimes or be her own friend, but I always say that it’s ok to want attention.  I don’t want to shame her for being human.  I think about all of the lessons college students receive from hook up culture—there is nothing more unattractive than someone who is too “needy” so push down everything you want and pretend you’re in a relationship for mere kicks.  I wish we told ourselves as a culture “of course you want to be seen and of course you want attention and intimacy—now here are ways you can communicate that effectively.

I hear this phrase in all kinds of other contexts as well—“She’s dressing that way just for attention”, “He’s making that up just for attention”.  Again I agree that some of these behaviors are absolutely problematic and often keep people from accomplishing the very thing they want most—to have a real connection, to feel loved, to feel validated and seen and valued.  My issue is that if we pretend that we don’t all need attention and love, if we minimize this most basic of needs, then we implicitly tell these people who are in pain that they are less-than.  We end up turning away from the people who are most hungry for some human contact and empathy. 

Meditations and Guided Imagery Exercises for Wellness

Just like specific physical exercises can help you obtain different physical benefits (e.g. cardiovascular health vs. stronger muscles vs. increased flexibility, etc.), different kinds of meditations can help target and build different psychological abilities.  I wanted to take a little bit of time to detail some of my favorite meditations and guided imagery exercises, talk about how they can support mental wellness, and provide some useful links to where you can find more details and audio scripts.  Enjoy!

Focused Attention Meditations (helps reduce anxious and depressive thoughts, reduce addictive behaviors, and improve concentration) - Focused attention meditations involve focusing on your breath, an object, mantra, or visualization for an extended period of time.  When your mind wanders, simply notice it and gently bring it back to the breath/object/manta/etc.  Practicing focused attention meditation over time improves your mind’s ability to be in the present moment and can help reduce the mind’s tendency to wander toward worried thoughts about the past or future.

For an audio script: http://marc.ucla.edu/mpeg/01_Breathing_Meditation.mp3

Loving Kindness Meditations (helps build a strong sense of compassion and non-judgment toward the self and others, can help those struggling to let go of anger) - Loving Kindness Meditations are particularly useful for those with strong negative feelings toward themselves and/or others.  To practice a loving kindness meditation, close your eyes and remember a time when someone was particularly kind towards you.  Focus on that image and feeling until it grows larger and then imagine sharing this same feeling of loving kindness with yourself.  Once you feel comfortable receiving this feeling from yourself, slowly imagine sharing it with close loved ones, acquaintances, and eventually a person or people you’re struggling with.

For an audio script: http://marc.ucla.edu/mpeg/05_Loving_Kindness_Meditation.mp3

Open Monitoring Meditations (helps increase non-reactivity and knowledge of the self and reduce impulsivity) - Open Monitoring involves sitting in meditation and noticing/labeling all of the thoughts, feelings, and sensations that arise with a sense of curiosity, kindness, and detachment.  To practice open monitoring you may want to imagine yourself sitting by a stream and placing any thought, feeling, or sensation on a leaf in the stream and watching it drift by as you wait to place another thought, feeling or sensation on a new leaf.  If you find yourself getting carried away with one thought, simply go back to the original image of sitting by the stream.

For more info: http://www.insightmeditationcenter.org/books-articles/articles/mental-noting/

Body Scan and Progressive Muscle Relaxation (reduces muscle tension and cortisol, increases relaxation)- A body scan involves gentle noticing each part of your body and setting the intention to loosen and relax one’s muscles.  Progressive Muscle Relaxation exercises are very similar but involve first tensing each muscle and then focusing on relaxing them one muscle at a time (this may be particularly necessary if one carries a lot of stress in one’s muscles). 

For an audio script: http://marc.ucla.edu/mpeg/Body-Scan-Meditation.mp3

For an audio script: https://www.nyu.edu/content/dam/nyu/studentHealthServices/audio/shc-progressive-muscle-relaxation.mp3

Guided Relaxation (increases feelings of relaxation, reduces cortisol, can help induce sleep)-  Guided relaxation exercises refer to an array of audio scripts that use relaxing imagery, the movement of the breath, soothing music, and suggestions to trigger strong feelings of relaxation.  While focused attention and open monitoring meditations can make the biggest impact at improving anxiety over time, guided relaxation meditations are often the most helpful at reducing anxiety/stress in the moment. 

For an audio script: http://podcast.momentsofmagic.com/e/countdown-to-relaxation-guided-sleep-meditation/

Inner Child (Increases insight into early childhood needs that may influence current functioning) - An Inner Child Meditation involves sitting comfortably and focusing on one’s breath.  After one feels relaxed in this position, imagine a safe comfortable place and notice all of the sensations (colors, textures, sounds, smells, etc.) present in this space.  Then imagine oneself as a small child approaching you in this space.  Let yourself greet this child in whatever way feels natural.  Listen to how the child feels and what the child wants most in life.  Then, if you can, make a promise to this child—the child part of yourself that we all carry around.  This meditation can be very intense and should be done with a therapist particularly if you have experienced trauma in childhood.

For a video script: https://www.youtube.com/watch?v=Mpfl_wAVGBk

Inner Guide (Increases insight into a particular question you may have, helps you tap into your own inner-wisdom) - The beginning of an inner-guide meditation is the same as the inner-child meditation.  Comfortably focus on your breath and when you feel relaxed, imagine a safe place in great detail.  Then wait for an inner-guide to approach the safe space.  Your inner-guide may take the form of a person who is living or dead, a spiritual figure in your life, an animal, or simply some kind of light.  If you feel comfortable with your inner-guide, invite it into your safe space and ask it any questions you may have.  Listen for the answers.  The answers may be simpler than you imagine- perhaps a meaningful facial expression or a nod.  If you don’t feel comfortable with your inner-guide, send it away and wait for a new one to emerge.

For a video script: https://www.youtube.com/watch?v=ruAf6Pez5lw

Container Exercise (Reduces anxiety and worry about a particular issue) - Focus on your breath until you feel very relaxed.  Then imagine a room with a table in the center and a container placed on the table.  Look closely at the container’s tight lid.  Imagine opening the lid and placing all of your worries inside.  When you feel confident that all of your worries are in the lid, close the container tightly.  Remind yourself that all of your worries are safe in the container and simply place any additional worries that may come up throughout the day into the container.  Imagine closing the lid tightly and walking out of the room.

Lessons in Mindfulness from Helen Keller

I recently took a tour of an old mansion in Canandaigua, NY called the Granger Homestead where the Grangers lived from 1816 to 1930.  The mansion was pretty typical of other homes I’ve seen from that time period with high ceilings and interesting woodwork, but upstairs in the last bedroom of the tour was a picture of Helen Keller with the words delicately inscribed with now light brown ink “Dear Miss Granger, With all kind love and mindfulness, Helen Keller”.  I stood looking at the picture with her impeccably written words transfixed by the intentionality in both her handwriting and greeting.  I thought about what it would mean to greet each person with such a strong sense of love and attention.  Helen Keller seemed to capture the mindfulness movement with its message of being in the present moment with kindness 70 years before it infiltrated main stream psychology. 

Since that first visit to the Granger Homestead, I’ve become a little obsessed with Helen Keller, and what she has to teach us about mindfulness and rising above adversity. 

I first wanted to know how often people even used the word “mindfulness” and whether such a greeting was common in the late 1800s.  According to an incredibly fun tool called “Google Ngram” I found out that mindfulness is used today 44 TIMES the amount it was used in the 1890s.  Thus I assumed that Helen Keller was tapping in to something particularly unique and visionary—though I’m certainly no historian. 

After reading Dorothy Herrmann’s biography of Helen Keller I learned that she was close to many influential thinkers of the time, and I wondered if she had any connections to well-known psychologists.  I was surprised to find out that she developed a friendship with the philosopher and psychologist William James who is arguably the first psychologist to promote ideas consistent with mindfulness in the West.    She met James in the 1890s when she was 11 years old and they continued a correspondence until he died in 1910 (Taylor, 2015). 

A thesis by David Jacobs Gordon reads

James claimed that subjective life is composed of that which we attend to; out of “the infinite chaos of movements,” each sense-organ picks out certain objects and ignores the rest as if they did not exist.

In a time when psychologists were advocating “objective” measures of psychological study, James pushed for a view that both valued the subjective experience and allowed one to step back as an observer and view the subjective experience with curiosity (Gordon, 2009).  This valuing of the subjective self and the cultivation of an “observer” who has some distance from the subjective is very consistent with current mindfulness practices.

It’s clear that James and Keller shared their respective ideas about the world and he may have added to her rich understanding of mindfulness, however Keller on her own had a deep grasp of the power of our senses and the importance of attending to the moment.

Below I examine the different components of mindfulness and look to Keller for insight and wisdom.

Attending to the present moment:  In Keller’s autobiography The World I live In, Keller writes about her ability to tell someone’s mood by the way their hand feels, know a storm is coming by quivers in her nose, and distinguish between different kinds of roses.  She savored sensations and could be found hugging trees and enjoying the vibrations produced by the piano.  Reading about the depth by which she experiences smell and touch left me wondering what information I miss all of the time by not attending as intensely to these senses.

Embracing an attitude of loving kindness:  Mark Twain, another one of Keller’s dear friends, wrote “Kindness is the language that the deaf can hear and the blind can see”.  Keller rarely wrote critically of others and often was highly empathic and understanding of why others might have good reasons to act out in different ways.  This was particularly true for her teacher Annie Sullivan who was prone to fits of rage particularly after she married John Macy.  Helen later wrote that she knew Annie had a very difficult past and sometimes felt overwhelmed because of it.  Helen also shows a deep reverence for the power of love.  “What we have once enjoyed we can never lose.  All that we love deeply becomes a part of us” (Helen Keller).

Cultivating an attitude of non-judgment:  As Helen grew up she struggled with coming to terms with what it meant to be deaf and blind knowing that others could see and hear.  She writes in The World I Live In “To the blind child the dark is kindly. . . Not until he weighs his life in the scale of others’ experience does he realize what it is to live forever in the dark.”  Overtime, Helen learns to be accept her unique experience in the present moment without judgment.  She writes, “Everything has its wonders, even darkness and silence, and I learn, whatever state I may be in, therein to be content.” 

Acting with intention:  Helen Keller demonstrated tremendous intentionality in her actions fighting for women’s suffrage, workers’ rights, socialism, and the blind.  She writes, “True happiness... is not attained through self-gratification, but through fidelity to a worthy purpose.”  She also had to be intentional in her day to day actions and bring a tremendous amount of focus to her tasks whether it was going for a walk by herself by holding on to a pre-strung rope or writing a book.  She writes, “I long to accomplish a great and noble task, but it is my chief duty to accomplish small tasks as if they were great and noble.”

An Upstate New York Winter Survival Guide

Rochester, NY is home to a diverse restaurant scene, amazing, warm people, intellectually stimulating universities, interesting cultural activities, and an incredibly long and brutal winter season. 

It’s fair to say that I am not a winter person.  The tips of my fingers get numb on any day the temperature goes below 50 and I cringe at the thought of driving in the snow.  All of this aside, Upstate New York has my heart so I’ve turned to concepts in mindfulness and the “good habits” literature to try to find ways to make winter a little easier to handle.

1.       “Radically Accept” the Weather:  I often find myself creating a negative inner monologue around winter weather that refuses to accept that the season is a time when it’s cold and snows a lot.  I’d say things to myself such as “I can’t believe my car is covered in snow again” or “Does it really have to be 20 degrees for the third week in a row?”  There’s a term Marsha Linehan uses in Dialectical and Behavioral Therapy called “radical acceptance”.  She talks about giving up the internal monologue that something “shouldn’t be the way it is” and radically accepting it as it already has shown itself to be.  With that in mind, I try to welcome the weather with as few judgments or comparisons as possible.  One task that has involved has been deleting the weather reports on other areas of the United States from my phone in an effort to quiet thoughts like “Why can’t it be more like the weather in_____”. 

2.       Reward the Bothersome:  Think about what bothers you most about the winter.  Is it when the temperature hits a certain low?  Is it shoveling off your car or driving in the snow at night?  Create a reward for yourself whenever the weather is particularly frustrating.  For example, there’s a really decadent hot chocolate that I choose to drink only when the high of the day is below 20 degrees.  Now there’s a small part of me that gets excited when the weather is particularly cold because I know I get to have my favorite hot drink.  Take some time to think about a reward that fits for you—it could be that you only watch your favorite show when you have to do some shoveling or you only take a hot bath with candles after a particularly icy drive.

3.       Resist the Urge to Hibernate: Unlike bears, we’re not meant to withdraw for months on end.  Set aside time to plan activities during the winter that will get you out of the house and connecting with other people.  There’s a lot of evidence that suggests that novelty is good for romantic relationships and mental health so use winter as an excuse to try new experiences and connect with new people.  Looking for places to start?  Try visiting your local library and asking them for programming options, recreational sports, cooking classes, performances, anything in your community.  Creating novelty can be a powerful way to improve life satisfaction.

4.       Know when to Reach Out: An estimated 5% of the population suffers from Seasonal Affective Disorder which refers to recurrent mood disturbances that are linked to seasonal changes (usually worsening in the fall and winter months).  If you find yourself feeling down most of the time, withdrawing from those you love, feeling disinterested in things you usually enjoy, and/or sleeping more than you typically do, it may make sense to reach out and schedule an appointment to talk with someone.  Current treatments for SAD include psychotherapy, light therapy, and medication. 

Six Podcasts that Will Help You Learn about Yourself

For the past three years I have been enamored with downloading and listening to podcasts. They provide new and interesting perspectives on every topic imaginable and allow me to enjoy learning while I drive to work. I wanted to take time to share some of my favorite podcasts that address mental health with the hope that a few people might feel inspired to add it to their routine. If you’re new to podcasts, they consist of digital audio files that you can stream on any computer or download to your phone or other audio playing device at no cost.

Happier with Gretchen Rubin: http://gretchenrubin.com/podcast/ Happier features Gretchen Rubin and her sister Elizabeth Craft reflecting on ways to add to their overall sense of well-being. They provide research supported advice on simple things to try at home which can boost happiness from setting an alarm to go to bed at night to creating a “shrine” of things that bring you joy. The podcast provides a nice balance of the scientific with their own personal triumphs and fails in their quest to be their best selves. First time listeners might want to check out Episode 25 where interviewee A.J. Jacobs provides his own “try this at home” tips. Podcast 25: Hilarious Tips from A. J. Jacobs: Posture, Brainstorming, and Eat from the Fridge, Not the Pantry.

Invisibilia: http://www.npr.org/programs/invisibilia/ Invisibilia is a collaboration between Lulu Miller and Alix Spiegel which examines intriguing psychological phenomenon by interviewing experts and weaving this information into personal narratives that bring the topics to life. My favorite episode is called “The Secret History of Thoughts” which chronicles psychology’s changing views about thoughts over time and reflects on how these different conceptualizations impact our daily lives and how we see ourselves. You can check out this episode here: http://www.npr.org/programs/invisibilia/375927143/the-secret-history-of-thoughts?showDate=2015-01-09

The Hidden Brain: Shankar Vedantam explores current social psychology research and what it tells us about ourselves in this new podcast by NPR. If you’re a research fan, Shankar’s podcast provides a multitude of results from different psychological studies in a condensed and digestible way. He also brings the research to life by relating it to current tv shows and occasionally asks a friend to sum up the podcast with an original musical composition. New listeners may want to check out “Near Wins and Not Quites, How Almost Winning can be Motivating” http://www.npr.org/2015/09/29/439489290/near-wins-and-not-quites-how-almost-winning-can-be-motivating

The Mental Illness Happy Hour: Paul Gilmartin invites therapists, comedians, and listeners on to his show to talk about their own experience of mental health and their journey toward wellness. His show provides virtually no scientific research, but it sends a strong message about the empowerment that comes with owning one’s flaws and challenging the shameful part of ourselves that feel unworthy of love. If you listen with children present or you’re not a fan of explicit content, you may want to avoid this podcast as some themes are sexual in nature. To look at past episodes you can go to the show’s website here: http://mentalpod.libsyn.com/ .

The Checkup: Carey Goldberg and Rachel Zimmerman bring on experts to discuss a broad range of psychological and medical issues and health news. A recent episode centered around anxiety http://www.slate.com/articles/podcasts/the_checkup/2015/04/the_checkup_on_the_fear_of_flying_parental_anxiety_and_managing_your_relentless.html explores the host’s recovery from plane phobia and a new theory of anxiety based on hormones. The two women talk about health news in a way that is relatable, relevant, and surprisingly funny.

The TED Radio Hour: Guy Raz interviews experts on a broad range of topics encompassing Technology, Entertainment, and Design and destills these interviews into a gripping hour long radio show. I included TED Radio because some of its best programs center around mental health issues and wellbeing including an episode about the importance of quiet moments, interesting theories of emotion, and how we change when we listen to others. First time listeners might want to check out “Simply Happy” which explores ideas such as mindfulness and gratitude in the context of understanding happiness http://www.npr.org/programs/ted-radio-hour/267185371/simply-happy .

When your Partner seems Mad

Here's a link to an article I wrote for Goodtherapy.org: When you think your partner is mad at you, there's nothing wrong with checking in about what he or she is feeling. But be sure to check in with yourself, too.  http://www.goodtherapy.org/blog/what-youre-not-saying-when-you-ask-if-your-partner-is-angry-1116155

Joining the "good Therapy" team

For the past couple of months, I have been following goodtherapy.org's blog, and I've been moved by their mission to destigmatize therapy and promote mental health.  I'm very excited to join their team as a contributing Topic Expert.  You can read my first article for their blog here: http://www.goodtherapy.org/blog/navigate-your-relationship-through-polarization-0916154 .

Time to get Motivated! Tips and Tricks to Tap into your own Ambition

In one of the last classes I took in graduate school, Professor and Psychologist Ed Deci made a proposition.  He stated “I need a volunteer for an interesting class experiment.”  Prone to brevity, Professor Deci paused and waited for hands to go up.  Several long seconds passed when one graduate student raised his hand and agreed to participate.  The rest of the class breathed an audible sigh of relief.  Instead of inviting this lone volunteer to the front of the room, Professor Deci asked us all to close our eyes.  “I want you all to imagine the part of yourself that wanted to volunteer and participate…and now I want you to imagine the part of yourself that kept you from raising your hand.  What did that part look like?  Did it take a certain form or shape?  What was the part of yourself telling you?  What words was it saying?  Now, if you can, see if these two parts of yourself can have a conversation.  What might they say to each other?” 

Sitting in a class with 15 other students, I got in touch with the curious, ambitious part of myself that wants to try new things and take on the world.  This part of me was big and bold and bright.  I also discovered a darker part of myself that feared being seen as incompetent and rejected.  Like a black hole, it sucked up my energy and encouraged me to be invisible. 

There is a lot of power that comes from noticing and tuning in to the thoughts and feelings that hold you back in life and leave you feeling smaller.  Only by noticing and understanding that these thoughts are separate from who you are as a person can you start to distance yourself from them and hand your curiosity and ambition a metaphorical megaphone.

If you also have trouble getting in touch with your own internal motivation, curiosity, and ambition, here are a few things you can try.

Think about what you enjoyed doing when you were a kid:  A year ago I discovered my eighth grade diary.  It was full of ridiculous crushes and petty daily dramas with friends, but it was also crammed with poetry and stories.  I remembered how much I loved to write as a child.  I realized that part of what was holding me back from writing in the present was my own judgments about not being great with grammar or not producing something “good enough”.  Acknowledging these barriers and starting this blog anyway has brought me a tremendous amount of joy.  Thinking back to what you enjoyed before your own and others’ expectations started creeping in, can help you remember the things you naturally feel motivated to do.

Find little ways to get a sense of ownership over your work: Set aside 20 minutes a day to just brain storm.  You can think of different ways you could approach a task, new ideas for a product, or a new occupation you could move into entirely.  Spending time creating ideas of your own leads to a greater sense of ownership over the choices you make and can help stimulate your sense of motivation (Ryan &Deci, 2000).  In addition, your brain is like a muscle and practicing being creative can lead to an increased ability to generate new and interesting ideas (Thompson, 2003).

Get a buddy: Studies show that feeling a sense of connection is vital to stimulating intrinsic motivation (Ryan & Deci, 2000).  We are inherently social creatures and it can be hard to accomplish tasks without sharing our experiences with someone else.  If you feel distant from your coworkers, try hosting an office dinner or inviting someone to team up with you in some way.  If you work by yourself, talk about your projects with friends or loved ones so you can share your passions with others.

Remove barriers: Think about the last time you held yourself back from trying, putting it all out there, or volunteering.  What thoughts and ideas got in your way?  Imagine what you would say to a close friend or family member who was struggling with the same thoughts.  Often times we’re harsher toward ourselves than we are to those we care about.  Give yourself permission to make mistakes, fail, or be rejected, and give yourself credit for taking risks and trying something new.

A Primer on Mindfulness

I gravitated toward the concept of mindfulness because I’m a naturally pretty distracted person—I forget where I park, I’m always looking for my keys, and there have been moments when I’ve caught myself looking at pictures of other people’s children on facebook instead of playing with my own daughter.

Mindfulness is a pretty trendy topic these days, so I thought I’d write down some of my favorite points about mindfulness for those who may be less familiar with the concept.  Mindfulness has been around for thousands of years and thirty years of intense psychological research shows that it helps just about everyone.  People who are anxious are less anxious, people with depression are less likely to experience another depressive episode, people with psoriasis who practice mindfulness have clearer skin, partners who are more mindful tend to be happier in their relationships.  If mindfulness was a little white pill, it would be flying off the shelves.

Mindfulness is about focusing all of your attention and awareness on the present moment with as much non-judgment and intention as possible.  Similar to muscles in our body, mindfulness takes practice.  There’s an old saying that the mind is like a puppy—you tell it to sit and it chews up your pillows and pees on your rug.  Just like a puppy needs training and repetition, it takes effort to learn to focus and attend to the present moment with a more accepting mind.

Many people I talk with struggle with what it means to be non-judgmental in the context of mindfulness—“How can I tell my partner when I’m feeling hurt, avoid people who aren’t healthy for me, and make good decisions if I walk away from judgments?”  I think about two different aspects of non-judgment that Marsha Linehan and Jon Kabat-Zinn describe respectively.  Linehan talks about judgments being important shortcuts that our brain takes to protect us.  We say that a piece of fruit is “bad” when we are trying to describe a consequence- “If I eat that piece of fruit, I’ll get sick”.  This isn’t a big deal when it comes to fruit but it’s incredibly damaging when it comes to ourselves and our relationships.  We tell ourselves that we are “bad”, “stupid”, “worthless” when what we mean is that we made a decision that hurt someone, struggle in some specific subject matter, or have a hard time connecting with some people.  Mindfulness is about noticing these judgments we make about ourselves and others and allowing ourselves to replace them with observations more rooted in reality rather than taking an intellectual and cultural shortcut.

Jon Kabat-Zinn and Linehan also talk about non-judgment in the context of accepting (sometimes radically accepting) whatever is currently happening in the moment.  I remember once running an “anxiety management workshop” for 15 or so college students during my internship and feeling wrecked with anxiety.  My heart was pounding, my hands were shaking and I thought “How am I ever going to teach people skills to manage their anxiety when I’m feeling anxious?  It’s NOT OK that I’m feeling this way”.  The result was that I felt intensely more anxious and led what I’m sure was a challenging class for everyone.  Mindfulness taught me to share with the whole class “You know my heart is beating a little fast, my hands are shaking a little and I’m going to accept these sensations as they are and turn my attention to teaching this class”.  I found that once I accepted rather than judged my anxiety or pretended it wasn’t there, it became far easier to deal with.  I want to clarify that acceptance doesn’t mean that you can’t decide you want to take action to change something you would like to see changed.  You are much more likely to protest injustice if you accept and acknowledge that injustice is taking place. 

Another part of mindfulness that people can struggle with is the idea of doing things with intention.  In a world where we order clothes while we wait in line to buy coffee, it’s hard to recommend doing one thing at a time on purpose.  At the same time, research shows that multi-tasking is less effective then doing things “one mindfully” as Linehan calls it.  I tell clients that if they always have a to-do list running in their head, set aside 15 minutes where all you are supposed to do is focus on planning.  If you are a big worrier, set aside time each day to just worry and then if you start worrying while you are driving or going for a walk you can remind yourself that you already worried today. 

If mindfulness has perked your interest and you would like to improve your own mindfulness, here are a few recommendations:

1.       Meditate—Try focusing on the movement of your breath for 5 minutes, and if your mind wanders, just gently bring it back to the movement of your breath.  You’ll find that the more you practice focusing on something as simple (and boring) as your breath, it’ll be easier to focus on a plethora of things that are far more engaging like a conversation with a friend or co-worker.

2.       Try a Mindfulness Power Hour—Spend one hour a day trying to focus completely on the activity at hand (doing dishes, playing with your kids, driving in the car).  Every time your mind wanders bring it back gently and non-judgmentally to the task.  There’s a saying that if your mind wanders a thousand times, just gently bring it back a thousand times.  It also helps to put away your smart phone!

3.       Explore Your Senses—Mindfulness is about getting in touch with all of your senses in the present moment so get to know some senses you may be paying less attention to.  Admire beautiful works of art and nature, smell all of the bottles of perfume the next time you’re at a department store, eat slowly and see if the food tastes the same with each bite, listen for new kinds of sounds.

4.       Notice—Ellen Langer describes mindfulness as simply the act of noticing.  She talks about the powerful things that can happen the deeper we push ourselves to notice the world around us and particularly the people we care about.  Notice your partner or friends’ smile, their wrinkles, the way it feels when you get a hug.  Studies show that this simple act of noticing can make dramatic improvements to relationship satisfaction.

Our Collective Ambivalence toward Therapists

Whenever I go to a neighborhood block party or some other social event where my usual safety net of friends is absent, I often find myself dreading an inevitable question-- "What is it that you do for a living?" I can’t count the number of times that someone has responded “I hope you’re not analyzing ME!” after I’ve disclosed that I’m a psychologist.  In the moment, I feel shutdown, defensive, and at a loss.  I want to say that my hope in working with clients is that they feel deeply understood, connected with someone else, and not analyzed as some kind of science project.  I want to say that their seeming discomfort with therapy might be adding to the stigma of mental health issues in subtle and potentially toxic ways.  I want to say that I’m also a person and I like to make friends and talk about the latest podcasts and my kid at neighborhood block parties.  What I usually end up saying is something equally if not more inane like “You’d have to pay me for that first!.”  I confirm people’s preexisting beliefs about psychologists as cold money-seekers rather than seizing an opportunity for both of us to leave feeling a little more understood. 

I’ve been sitting on this idea of our collective ambivalence toward therapists for a long time.  It started when I saw a psychologist as a graduate student.  At the time, I was already seeing my own clients, and I was surprised by my conflicting emotions toward my therapist.  I felt grateful for my therapist’s listening ear, his non-judgmental and accepting perspective, his objective advice, but I also kind of hated him.  I resented how he unilaterally got to sit and listen to my darkest thoughts and deepest vulnerabilities.  I felt like implicit in this arrangement was the idea that he was all-knowing and I was “less than”.  Julie Schumacher, author of the Black Box, captured my feelings perfectly when she wrote:   

“Talking to a therapist, I thought, was like taking your clothes off and then taking your skin off, and then having the other person say, "Would you mind opening up your rib cage so that we can start?” 

I wish I had brought up my own ambivalence years ago in therapy so we could name a tension that was assuredly in the room and possibly getting in the way of our work together.  I hope my own clients feel comfortable and bold enough to name challenging feelings that are present in our work together.  I’m sure if you asked my therapist, he would have told you the same thing I tell my own clients—that it’s a deep honor and privilege to be a psychologist and that the therapeutic process is a vehicle toward a client making changes for themselves.  Rather than a therapist being “all knowing” or “mind readers”, we have a specific expertise in helping clients navigate the therapeutic process-- the same therapeutic process therapists seek when they find themselves in crisis. We learn how to ask questions so that people can more deeply understand themselves and in turn be understood by others.  The therapeutic process necessitates a certain one sidedness—the beauty of therapy is that it’s a space to focus only on what the client needs in their own life apart from everyone else’s’ expectations and demands.  Ultimately, allowing myself to be vulnerable in therapy in front of someone else was painful and challenging and deeply rewarding. 

It’s fair to feel ambivalent about psychologists as it speaks to the core of our ambivalence about intimacy and being vulnerable.  We want to be known and accepted for being our flawed selves and at the same time it feels risky and uncomfortable to let the darker parts of ourselves be known by others.  What if I’m judged or rejected for the very things I judge and reject in myself?

The next time I’m told in mildly horrified tones “I hope you’re not analyzing me!!!”, I’ll respond “I hope I’m not analyzing anyone… Now let me tell you about my new favorite podcast”.

How to Improve your Mental Hygiene on Facebook

My relationship with facebook is unsurprisingly complicated.  I feel grateful to have an easy way to follow the joys in the lives of many people that I don’t have the time to talk to every day.  I like having the ability to post a picture of my daughter and know that anyone who cares can see how she’s growing and changing.  I feel excited about the ability to share my blog posts and ideas with a variety of different people with different and interesting perspectives.  I feel a little uncomfortable posting or being tagged in personal photos knowing that I’m “friends” with some people I might not recognize on the street.  I loathe the compulsive part of myself that wants to check it all of the time. 

I also feel like it’s slowly and subtly skewing our expectations for a happy life.  All of the pictures of delicious looking meals, flowers from significant others, happy babies, sleeping babies, and tropical vacations leave me wondering if we’ve sacrificed simple, intimate moments of joy for captured, filtered memories we can share with everyone.  I long for one person to post a picture of an average looking frozen meal eaten by a mildly displeased and tired child on a cluttered table with an overgrown lawn in the background.  I know I am the 12498093850 person to express this sentiment, and I also know that I am equally guilty of showing the best version of myself and my life to my 324 closest friends—it’s risky to be vulnerable in such a public space.    All of this is to say that if you really want to make positive changes in your life, you could probably get a lot more accomplished by taking a break from facebook altogether. 

So now that I’m done sharing my uneasiness with facebook in general, I wanted to offer up some facebook suggestions—questions and exercises that I’ve found useful to ask myself and explore with clients as we all get to know ourselves better.

Learn from Envy and then Free Yourself from It- Whose posts fill you with envy and what is it about their lives that cause that feeling?  Use that envy to understand your own goals, wants, and priorities and see if you can work toward meeting some of those wants and needs.  If there are people you envy for reasons that aren’t in anyway in your control or that aren’t motivating for you, unfollow their newsfeeds. 

Express Gratitude- Are there people that you really appreciate who bring you joy on facebook, but you feel too inhibited to communicate that appreciation?  Maybe you like their posts or quietly follow their newsfeed but you haven’t told them how small things they share are impacting you.  Reach out to these people and let them know you’ve been enjoying their pictures, comments, links, etc.  Everyone likes to be appreciated and studies show again and again that practicing gratitude can do a lot to improve your own mental health (Read Emmons and McCullough’s “The Psychology of Gratitude” to learn its wide reaching benefits).

Engage in Random Acts of Facebook Kindness- If you notice bullying on facebook or someone takes the risk to share that they aren’t having a great day, send them some positive thoughts.  A plethora of studies have converged to show that practicing random acts of kindness help people who are depressed feel less depressed and make happy people happier (see Sin & Lyubomirsky, 2009 for a review).

Honor your own Highs- When you’re done reading about everyone else’s high points, write down your own for the day.  Studies have found that writing down in detail 3 things that went well each day for one week can increase happiness and reduce depressive symptoms for up to 6 months (Seligman and Steen, 2005).  Whether you decide to post any of those highs on facebook is up to you.

Increase Intention- Combat the tendency for facebook to become a compulsive monster you have to constantly check in with the moment you feel bored, tense, or (insert uncomfortable feeling here).  If you value using facebook, try to schedule a time each day (or week or month) that you want to engage with it.  Allow yourself to really engage with other people, ideas, feelings, etc. during that time and then log off.

A Psychologist’s Open Letter to College Students

I’ve spent the last eight years working as a psychotherapist at a college counseling center— listening to the pain, worries, anxieties and joys of young adults as they work to figure out who they are on their own and away from home.  Now that I’m leaving to start a full-time private practice, I wanted to take a moment to think about my time in college counseling with the hope that I can crystallize something—distill some message that I can pack with my boxes of books and files and take with me.  

People often ask me if I got bored in college counseling discussing what they assume are banal relationship issues and common test anxieties.    In reality I’ve been privileged to work with dynamic students who each have different stories, different traumas, different defenses and resiliencies.  

While each college student is unique, every day I’m left with a dull jealousy of their complete freedom and a sharp pain in response to the crushing amount of expectations and judgments they place on themselves.  I want to shout, “YOU’RE ENOUGH!  WHO YOU ARE IS ENOUGH!  Try, study, reach out to others, create, love, laugh, but ultimately, who you are is enough and you deserve love even though you are human and flawed.”  If there is one valuable lesson or piece of advice college students (and all of us) could benefit from, that is it.  But I’ll offer up a few more thoughts for good measure.

1.     Pot is not immoral or “bad,” but it is also not the completely benevolent drug so many people think it is.  I can’t tell you how many times I’ve had a student in my office say, “I can’t concentrate, I have no motivation, my relationships are all superficial, I feel anxious all of the time…I think I’m depressed”.  Then when I ask them how frequently they use alcohol and drugs, they casually mention that they smoke pot one to four times a day.  Pot interferes with REM sleep, so if you consistently smoke pot before you go to bed, you’re subjecting yourself to chronic fatigue.  The ironic thing about consistent pot use is that it’s often used to treat anxiety; however, the first symptom of chronic fatigue is anxiety, so it’s common for anxiety symptoms to increase with extended pot use.  In addition, consistent pot use can mirror symptoms of depression and keep people from experiencing emotions necessary to engage in deep, meaningful, intimate relationships.  There are plenty of people who enjoy smoking pot once a week with little or no repercussions, but the idea that pot is completely benign or not addictive is patently false.

2.     Your alcohol use might be causing more problems than you realize.  Most students know that if they’re binge drinking alone, missing classes, or arrested for drinking while driving, their alcohol use may be getting in the way of their goals.  What many students aren’t aware of is the more subtle ways that binge drinking might be harming their relationships.  Do most of your interactions with potential romantic partners begin when both of you are intoxicated?  Do you have an easier time sharing your true feelings when you’re drunk?  Do you crave the excitement and uncertainty that comes with being wasted?  Ask yourself what you’re getting from binge drinking and think about if there are ways you can meet some of those needs when you’re sober (even if you ultimately decide not to make any changes in your drinking habits).

3.     People want to help you, and you should let them.  College is one of the few times in life when you have a plethora of free resources at your disposal.  Now is the time to use them!  Professors often spend office hours hoping that an engaged student stops by.  Psychologists, librarians, tutors, study mentors, health professionals, career counselors, student affairs staff members work at colleges because they actively want to help college students, so take advantage of all of the resources you can!  People often have fears about what it means to ask for help.  Their families or friends taught them that asking for help is a sign of weakness.  I often tell clients that if someone wanted to build a house on their own with their bare hands they could, but it wouldn’t be a particularly great house.  However, if they used all of the tools available and asked for help in acquiring the skills needed to use those tools, they could build a really great house.  We should all approach life in the same way—we need help, tools, skills, resources, and people to be our best selves. 

4.     You’re not the only one who is struggling, and letting others see your pain can be an act of kindness.  Unfortunately, the phrase “no one else is dealing with this but me,” is one that I hear a lot.  First year students feeling homesick and struggling to fit in are sure they are the only ones who can’t make it work at college.  Students who are grieving a parent or a grandparent feel that grief is theirs alone.  People who have been sexually assaulted as a child or in college believe no one else has experienced trauma.  Sometimes there are weeks when four or five clients are all going through similar hardships and are all feeling so alone in their concerns.  One of my biggest suggestions for college students who feel alone in their struggle is to try group therapy.  Most colleges offer unlimited group therapy sessions, and group therapy can be a powerful way to intimately connect with others and feel supported in one’s own painful experiences.  In addition, group therapy acts like a microcosm of the real world, and it can shine light on patterns you have in relationships which may be hindering your friendships both inside and outside of group. 

5.     Take responsibility. You have left home and you might have good reasons for being closed off to others – maybe you feel mistrustful, scared that others might leave or hurt you.  These defenses may have protected you in the past, and it makes sense to honor them. College is a new opportunity, though, to take ownership of what you want your relationships, your family, and your life to look like.  If you decide to engage in therapy, try to focus on your goals and the changes that you want to make with-in.  Therapy is not about “venting,” or talking about what everyone else is doing wrong in your life.  Therapy is an opportunity to think deeply about your own choices, emotions, thoughts, and relationships.  The more work and thought you put into therapy, the more you’ll get out of it. 

Reflections on Anxiety

There is probably no better cohort of people to dive deep into ways to understand and cope with anxiety than a typical group of neurotic clinical psychology PhD students.   While I was awake into the wee hours of the night cramming to learn how cortisol, serotonin and GABA are associated with anxiety disorders, my own cortisol levels were rising.  I had placed such a huge amount of my own self-worth on the approval of others and my academic accomplishments that my digestive system never seemed to work quite right, and it took me hours to fall asleep at night.  In strictly psychological terms, I was a basket case. 

I’m still on the anxious spectrum—my husband will be the first to tell you that I read about escaped murderers before I attempt to go to sleep, spend 45 minutes overthinking a three sentence email to an acquaintance, and google mild physical symptoms in an effort to confirm that I likely have a deadly disease.  I’m far from someone who practices perfect mental hygiene.  However, I no longer feel crushed or owned by anxiety the way I did when I was a doctoral student.  My relationship with Anxiety has gone from that of an abusive relationship in which I was manipulated, criticized, and left feeling paralyzed with fear to that of an amusing if sometimes overwhelming friend. “There goes Anxiety. She always finds ways to make things SO dramatic.  Can someone please make her some tea?”  I wanted to take a few moments to reflect on a some things that led me out of a “I’ll-never-be-good-enough-anxiety-spiral”. 

1. Practicing mindfulness: As a naturally absent-minded person who loses my keys and forgets where I parked, I gravitated toward the idea of mindfulness the moment I learned about it.  While a deeper discussion of mindfulness and the power of meditation is in a previous post, I found that once I tried to deeply attend to the present moment with a sense of radical acceptance, intention and non-judgment, I felt many of my anxiety hang ups float away.  When I was on an airplane, I wished I was at my destination.  Waiting for food at a restaurant left me feeling restless.  Five years of graduate school felt like an opportunity in which I would keep my head down until my diploma was in hand.  I found that when I embraced the present moment and lived in the “here and now” I realized how many positive and beautiful moments I was wishing away.  There’s a Buddhist saying that those who live in the past are depressed, those who live in the future are anxious, and those who live in a fantasy world are psychotic.  Mindfulness taught me to try a little harder to welcome the present moment.

2. Prioritizing a balanced life: In graduate school my primary goal was to complete my dissertation and get a job.  My work was constantly evaluated and a week didn’t go by when I didn’t receive some kind of feedback about how I was doing in the program.  I remember starting my job as a staff psychologist and feeling lost by the lack of something concrete to work towards.  There was no person whose positive evaluation of me felt paramount.  When my goals shifted from being academically successful, to living a meaningful life it felt like tectonic plates were shifting in my body.  I started constantly checking in with myself about how my creative, relational, and professional needs were being met.  I continue to tinker my habits and change my schedule after thinking about what part of myself feels like it needs nourishment.

3.   Therapy and supervision: Therapy and supervision of my clinical work provided me with a rich opportunity to understand my anxiety in the context of biology, my childhood, and my own cognitive mechanisms for accomplishing tasks.  Just like couples therapy provides an opportunity for individuals to gain a deeper understanding of their partners, accept their strengths and flaws, and embrace one another, my own therapy allowed me to get to know my anxiety on a deeper level, understand the ways that it helps and hurts me, and find ways to have a more productive and healthy relationship.  “Oh hi Anxiety, you’re here again.  Thanks for helping me finish that paperwork.  I’ll be with you momentarily.” 

The Rhythm of Therapy

You are in the waiting room anxiously filling out paperwork.  You avoid eye contact with the man in the corner reading magazines because you’re worried you might see all of the judgments you’re having about yourself reflected in his eyes.  Maybe it IS pathetic to ask for help.  You read questions like “Do you have a history of sexual abuse?” and you check yes or no and you wonder whether scheduling an appointment for psychotherapy was really such a great idea. 

I open the door and call your name quietly.  You look up with a combination of relief and terror.  We walk through hallways into a small room with a couch and two chairs and pillows you can cradle or toss aside.  I tell you that it’s all confidential unless you’re going to kill yourself or someone else or kids are being harmed.  I tell you that this session will be different from a lot of sessions because there will be a lot of questions.  There won’t always be so many questions.  I ask “what brings you here today?” and you take a deep breath and you start.  You begin at the very place you need to begin.  At the place or the thought you’ve been sitting on and going over and holding.  You look at my face for judgment or scrutinize my posture to see if I may hold a different world view from your own.  You keep telling your story --about the pain you’re in now and when it all started. 

I ask you to tell me about your family and you wrinkle your forehead and then close your eyes as you try to decide how you can begin to answer a question so sprawling.  Sometimes you talk about how you love your parents and they tried their best, but they left you with some wounds.  You say that you developed ways of being and relating and adapting that you had to at the time but now those ways seem to leave you feeling more alone because things are different now and you might not need all those defenses and walls you needed back then.  Sometimes you get nervous and you say that your family was loving and fine and likely have nothing to do with any of this.  I say that your family sounds loving and fine and absolutely has multitudes to do with who you are and who you were in beautiful and joyful and painful ways.   You remark that it’s not their fault and it’s not their responsibility and you’re right because you’re the one who will change or not change and you’re already changing because you’re here.

I ask you what you want from this whole “therapy thing” and you say that you want to feel better.  I tell you that some acceptance might help and some mindfulness might help and looking at all the mean shit you’re saying to yourself might help and sometimes I say that diving deep into what you learned about emotions before you even had words for them might help.  I try to say that things that happen now are kind of about what’s ha­ppening now and also about what’s already happened and sometimes it can all get very muddled—the old reactions and the new ones.  Sometimes some unmuddling is in order.  I ask you how all of that sounds and you say it sounds fine because I’m the expert and all and you fumble for the check you brought and hesitate as to whether we’re supposed to shake hands after this strange exchange.

You arrive the following week and you’re a little more comfortable in the waiting room looking at magazines, but you still avoid eye contact with that same man who’s now on his cell phone because you still aren’t sure what you might see in his eyes.  I open the door and you’re already standing up as I say “Come on back” and we walk past familiar walls and corners.  I remind you that we just scratched the surface when we last met and ask if you have any further thoughts on where you want to dive in to this ocean that is your life.  You bring up the anxiety or the depression that’s present, and I tell you that anxiety and depression are often like bubbles on the top of the water when there are deeper and harder emotions submerged.  You pause at this idea and if you are the bravest and fiercest you let yourself feel— the grief of your losses, the anger of your injustices, the loneliness of being human, and love so inextricably linked to those feelings.  You take off the protection you put on every day to get by and exist and it’s raw, and vulnerable and intense.  And sometimes you apologize for crying and using up tissues and sometimes you apologize for being such a downer and sometimes you apologize for yelling.  I try to say that this is the process of therapy and extricating rocks buried deep within and allowing yourself to walk away from them and free yourself from their weight.  I try to say that I have also sat on a couch feeling old things and new things and cried and usually and hopefully grown and that I will sit on a couch again when life is shaken or I am shaken or worse yet stuck.  We schedule another appointment and you hand me the check and we exchange passing comments about the weather as we transition from the sacred space of the therapy room to the hallway. 

The weeks pass and you stop reading the magazines because they haven’t changed since your first week.  You scroll through old text messages and send some new ones and hope Verizon doesn’t accidentally disclose your location to the recipients.  You glance briefly at the man in the corner who’s now just sitting with his thoughts and he nods ever so slightly as if to say “it’s ok that you’re here”.

I ask where you want to start today and you say that things are going a little better.  You felt like hell when you left but then a little lighter and that was nice.  You say you don’t know what to talk about today with things being better and all and you begin to catalogue the highs and lows of the week and suddenly water comes to your eyes and like archeologists we stumble on another emotion and its deeper and older and your surprised because you thought we were done with that whole emotions business. We look at it together and try to hear any message it’s trying to share and we marvel at the thoughts it brings with it and where it takes up residence in your body.  We ask if there’s anything else the emotion needs to tell us and sometimes we let the emotion know that it’s really quite a beautiful emotion and we honor its beauty, but it doesn’t get to tell us archeologists what to do because we’re on an important mission and in the end it’s just a rock.

Sessions later you find yourself in the waiting room gathering your thoughts.  You ignore the magazines and your cell phone because you finally have a chance to be with yourself and you like yourself.  You smile at this thought as you see an anxious woman enter the waiting room and search desperately through magazines and avoid eye contact.  You sink into the couch in my office and I ask “where do you want to start today” and you really don’t know.  It’s not clear to you or me.  You catch me up on the highs and lows of your week.  You relate them to past highs and lows like the expert on yourself that you are. You feel all kinds of things but the feelings are lighter like leaves drifting down a stream.  You wonder what’s the next step in this whole “therapy” thing and there isn’t one.  We have conversations that are easier and less penetrating and it all means that you are finished and it’s time to end the work for now.  We say goodbye—what’s been accomplished and what’s left over and how we feel about each other.  Because by now there aren’t just feelings in the room but between us.  We care about each other and it’s another loss and another love and for once we get to talk about it.  When we’re all done with words, we sit for a moment lingering in the therapy room, enjoying a quiet appreciation for each other and a moment of reverence for this journey of therapy.  We embrace with handshakes or hugs or words.

As you walk past the waiting room you slip a note that you scrolled into a magazine.  It reads “It’s ok that you’re here.”

A Love Letter to Group Therapy

When I was in graduate school working on my PhD in clinical psychology, I casually signed up for a class called “Gestalt Therapy”.  I had heard that this “class” allowed one to obtain course credit for engaging in an hour and a half of group therapy once a week, so I enthusiastically signed up.  At the time, I was giving myself a mental high five for actively avoiding another course in statistics.  What I wasn’t prepared for was the beautiful way this class would influence my life and the general power of the group therapy process.  

On the first day of group therapy, I walked into a nondescript classroom, sat down among 7 of my peers and listened to the group leader begin. “I want everyone to use this time to pay attention to your own feelings and reactions.  Be curious about your feelings and share them with the group if you can.  Where do you want to start?”  Tentatively people began discussing their anxiety being in group therapy, their fears of being seen for the flawed people they are, and their fears of not being seen at all-- of becoming a trivial or irrelevant part of the group. 

Through group therapy, I connected with people who were vastly different from me.  As a group, we’d often dive into the past or talk about weekly grievances that happened throughout the week, and the group leader would remind us to stay in the present with our current feelings and reactions to each other-- to embrace real intimacy apart from a shared personal, familial, or sexual history.  The group members had different experiences, cultures, and beliefs but we all knew deeply what it meant to feel sad, jealous, embarrassed, and joyful.  This also allowed us to understand our own patterns in relationships when we had the opportunity to access a powerful amount of information—our precise feelings in the moment and feedback from others in real time.

My own revelations in group therapy that semester were small but meaningful.  A group member shared that she was hurt when she gave me a present at Christmas time, and I never wrote a thank you note.  I spent my whole life actively avoiding conflict or voicing negative feelings, and I was suddenly confronted with the things I liked least about myself—the times I’m disorganized, messy, thoughtless, and self-absorbed.  But in that moment in group, I wasn’t told “you’re disorganized, messy, and thoughtless”.  Rather, I was told how my actions impacted someone else—the ways my actions were hurtful and left someone feeling small and invisible.  I remember in that moment a physical sensation of growing—my limbs ached and my body felt exhausted.  I would try harder to let others know that I care about and appreciate them rather than assume that they knew the love I felt for them.  I would try to let this group member know that I care about her and see her. 

During another group session, I confronted my own obsession with timeliness.  I grew irritated that a group member was late and missed something I had shared with the group.  I realized the way my pattern of arriving 15 minutes early to everything was a sad effort to convince people I “had my act together” and was “good enough”.  It left me feeling resentful of people who were less imprisoned by the construct of time. 

Since that time, I’ve led my own psychotherapy groups, and I’ve had the privilege of witnessing members connect and challenge one another.  I continue to carry the lessons from my own group experience with me-- I try to focus on sharing my own feelings rather than judging others as careless or thoughtless or mean.  I remind myself that there is no feeling I can’t handle if I welcome it with the same curiosity and intention of my first group therapist.  Now clients sit in my office as I pitch them the idea of joining a therapy group and try to explain the ways the group therapeutic process can help above and beyond individual therapy alone.  I hold my breath as I see them struggle with their own ambivalence.  I hope they say “yes” to group.