Just because you are capable of doing something, doesn’t mean you must

By Dr. Shoshana Shea

Simply put, when someone asks us to do something we are capable of doing, we often feel guilty, anxious, and obliged to do it; that doesn’t mean we should though.  Ever notice how being efficient and competent can sometimes feel like a punishment? Or when no one else is taking responsibility for a task, and the task needed to get done two days ago, and that even though you are screaming “No!” inside, you absolutely won’t do it this time, the other side of your brain betrays you, and tells your foot to step forward?

The paradox in all of this is that, in an effort to be helpful and connected, we end up feeling resentful and disconnected.

From an evolutionary biological standpoint, individuals who were able to live in cooperative societies, were able to survive, thrive, and pass on their genes; i.e., our ancestors. So not only is it in our ‘hard wiring’ to say yes without thinking about it, we have many societal and familial reasons to not say no as well. A compliant easy-going child gets praised, and a ‘difficult,’ more independent one often gets punished and shamed.

Don’t get me wrong; I’m not advocating for people to not be helpful and amenable; I’m asking that we pause to consider a few factors before proceeding with an action.

Here are a couple of points to take into account the next time your co-worker, mom, PTA president, the dog groomer, or even the dog asks (or implies that) you should be doing something:

1.     Just because you are able to do something, doesn’t mean you should! Make this your new mantra, “Just because I can, doesn’t mean I should.”

2.     Do you truly have the capacity? Especially in the larger scheme of your life, is the balance tipped all the way towards doing things for others, while there isn’t enough time, energy, and/or space left over for you?

3.     Saying yes is not necessarily always good for the other individual;

4.     Even more important, saying yes is not necessarily good for the RELATIONSHIP.  *See paradox above.  The intention may be that you are saying yes to preserve the relationship, but the outcome may end in you feeling resentful, and ultimately destroy the relationship.

5.     It’s OK to say no. Period. End of story; actually, there is no story; no explanation is needed.

6.     Even extremely kind compassionate leaders say no sometimes.  Saying no clears the path to say yes and build consistency and trust in a relationship.

7.     Check your body; what is it saying? When you get that anxiety drop in your stomach and your thoughts start spinning, your body is trying to get your attention.

8.     Pause next time this comes up; ask yourself if you really want to.

9.     And lastly, and just as important (if not the most important), check to see what emotions are there. Are you feeling anxious, guilty, sad, frustrated?

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

Cognitive Defusion: How Thanking Your Mind for Its Worst Thoughts Can Help You Get Some Distance

By Annabelle Mebane, MA, AMFT

In Acceptance and Commitment Therapy, the overall goal of our work is to help clients increase what we call psychological flexibility, which is basically the ability to do what matters most to you in your life no matter what uncomfortable thoughts and feelings show up.

One of the skills we teach to help people respond more effectively to their thoughts is called “Cognitive Defusion.”

Our default mode is to take our thoughts at face value and to believe that they are true and important. Like a fish doesn’t know it’s in water, we don’t typically notice that we are thinking. We are so accustomed to looking out the lens of our own thoughts that we forget to recognize we’re wearing glasses at all, and that there might be more than one way to see things.

Cognitive defusion is the ability to notice that we are having a thought –

that our mind is “languaging” about our experience. Defusion involves creating a little bit of space that allows us to recognize that just because our mind thought it, doesn’t necessarily make it true or important. Why should we make that space? Because if we can recognize a thought for what it is – words our mind is generating – we can make a choice about how we want to respond to it. Instead of automatically buying into our thoughts or viewing them as directives or imperatives, we can tune in to our values – who and how we most hope to be in a given moment – and decide whether listening to a particular thought and behaving accordingly is going to move us toward or away from our valued direction.

There are a whole bunch of exercises

that we use in ACT to help you learn how to defuse from your thoughts. One of them goes like this. First, you state the thought exactly as your mind has it. For example, “if I go out on this date, I’m going to embarrass myself.” Then you pause, and notice what it’s like to sit with the thought. Next, you preface the thought with “I’m having the thought that…[thought]”, and notice what it’s like to sit with that. Finally, you preface it with “I’m noticing that I’m having the thought that….”, and tune in to what that’s like.

And then you can decide, do you want to listen to that thought, and stay home and avoid the possibility of being embarrassed because it feels more comfortable? Or are you someone who wants to be open, vulnerable, and show up anyways because it’s meaningful to you to try to find a fulfilling connection, even if it’s a risk?

Notice that when we are ‘defusing,’ we aren’t getting caught by the content of the thought, trying to prove or disprove it.

We are simply creating enough distance to allow us to choose how we want to respond.

But here’s the thing, sometimes it feels pretty hard to get that distance and to make a choice based on values.

Why? Because sometimes, or maybe even usually, the stickiest and most painful thoughts our minds have are designed to try to protect us from something painful. And probably, it kind of works. If we continue with the above example, your mind might be trying to protect you from the pain of rejection or disconnection. And yeah, if you stay home, you get the relief of know you can’t embarrass yourself and you can’t get rejected. But the thing is, if you avoid going out on any dates because you might get rejected or feel embarrassed, you are almost certainly also going to miss out on the possibility of a really meaningful connection.

The thing about pain is that it doesn’t show up around stuff that doesn’t matter to us; it shows up around the things that we care most deeply about.

On the flip side of our pain, we can usually find our most cherished values.

Your mind comes up with these painful stories to try to prevent you from feeling pain or loss around the things that matter to you, but a lot of times, when we listen to those stories, that’s what keeps us from accessing the richness of moving toward what really matters.

So for those especially sticky thoughts that seem so powerful and that are really deeply painful, sometimes the best defusion tactic is pretty counterintuitive.

Instead of beating yourself up for having such self-critical thoughts, you can actually thank your mind. You can thank it for trying to help you and for trying to protect you, and then you can let it know that you are going to take it from here.

It sounds nuts to thank your mind for telling you that you are weird or a failure or incompetent or unworthy or too sensitive, but when we meet our pain with compassion, understanding that our minds are just trying their best to do their job and keep us safe, we sometimes can start to take away the power of that really painful story and get just enough space from it to decide to respond based on something other than the avoidance of pain.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

Anxiety Is Like A Metal Detector

By Annabelle Parr

I spend a lot of time reading articles related to enhancing mental health, to highlight and repost relevant pieces, as I value spreading awareness in this area. It’s wonderful that the conversation around mental health and anxiety is more open than it used to be, reminding us that our struggles are deeply human and we are not alone. But one thing I notice is that sometimes the way anxiety is discussed – even with the utmost compassion, can still imply that anxiety is bad. 

Don’t get me wrong; anxiety can lead to problems in our lives. Anxiety can turn into a full blown anxiety disorder, and by definition, anxiety disorders cause significant distress and impairment in a person’s life. And even if we are not in the realm of a full blown anxiety disorder, it can be very uncomfortable. So uncomfortable that sometimes we make choices designed to avoid or get rid of anxiety at the expense of what matters to us.

It’s true that anxiety, and the way that we respond to it, can be a problem.

However, I think when we focus exclusively on the negative parts of anxiety, we are missing a big piece of the picture that can empower us to change how we relate and respond to it. Anxiety – like any feeling – is information. And most of the time, at least part of that information has to do with what is most important to us in our lives.

For example, if someone experiences a lot of social anxiety and fear of judgement, what might that say about what matters to them? It might mean that they deeply value connection and relationships. Maybe it is really important to them to show up in their relationships as kind, compassionate, engaged and authentic, and maybe the anxiety has to do with worrying that something they could say or do will be incongruent with those values.

The problem with anxiety occurs when we take our anxious thoughts at face value,

and when our behavior is driven not by our values, but by trying to avoid the feared outcomes our minds generate. For example, social anxiety might involve thoughts like “I can’t go to that party. What if I make a fool of myself or say something stupid or am too anxious to even talk, and my friends don’t want to hang out with me anymore?” Such thoughts can feel very real and powerful, and our instinct is not usually to get curious about what they might indicate about what is important to us.

Instead, our instinct is often to think that outcome is likely, and to decide to stay home from the party to avoid anxiety and try to prevent rejection. But if instead, we can notice that thought, get curious about why it is visiting us and what it says about what is matters to us, we might recognize that in fact we deeply value connection. So much so that it feels excruciating to risk the possibility of rejection. And yet, in not going to the party, we are certainly missing an opportunity for the connection we so deeply crave.

When we can identify the values underneath the anxiety, we then get a choice about what to do next.

Getting curious about our values and what is really meaningful to us in our lives then allows us to identify actions that would move us in our valued direction. For example, you could choose to go to the party even though you are feeling anxious in service of your value of connection, or you could choose to stay home in order to experience relief from the anxiety.

From an Acceptance and Commitment Therapy perspective, our pain and our values are like two sides of the same coin: if we flip the pain coin over, we find what means the most to us in our lives. Or, as one of my clients said, anxiety is like a metal detector: when it starts beeping and getting loud, it means there is treasure under the surface, and that treasure is your values.

Sometimes it can take some curiosity and creativity to get to the core of what the value is, because anxiety can be sneaky and tricky and it’s not always immediately apparent. But if we can look at anxiety as important information, it can help us change how we relate to it. We don’t need to make it go away, we just need to figure out what really matters to us and make choices toward our values.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

What If Everything You Know About Anxiety Is Wrong?

By Annabelle Parr, MA, AMFT

When we experience anxiety, our minds are really good at coming up with all kinds of “what if” thoughts. And those worried thoughts often deal in extremes and absolutes, like the title of this post.  

Good news: it’s unlikely that everything you know about anxiety is wrong.

If you’ve ever experienced anxiety, at the very least you know what it feels like in your mind and your body. But it is possible that some of what you’ve learned about anxiety is not workable (that is, it doesn’t move you toward the kind of life you want to live).

Anxiety in the information age:

These days, the internet is filled with articles and podcasts discussing stress, anxiety, and self-care. It is so important to make information accessible and to talk openly about the difficult and painful parts of being a human. When we are suffering, knowing that we are not alone in our experience can make all the difference.

As much as it is wonderful that these topics are getting so much air time, the way we talk about them matters.

As anxiety is a rather hot topic these days, we decided to bust some of the common myths that, though well intentioned, can actually keep us stuck.

Myth #1: You can self-care your way out of anxiety.

There is a fair amount of content out there that sends the message that if you just take enough bubble baths, do enough yoga, or drink enough herbal tea, your anxiety will finally go away. Or that if you’re ever going to get a handle on your anxiety, you have to eat healthy, get good sleep, and exercise regularly. None of those activities are bad or wrong, and they can help us feel good.

But when we engage in a behavior (ANY behavior – even “healthy” behaviors) where the purpose is to control or avoid our internal experience, we may paradoxically find ourselves even more stuck. Our anxiety might go away momentarily, but we may find that in the long term (or even in the middle of downward dog) our anxiety actually gets more powerful. And then when anxiety doesn’t go away, we think that we are doing self-care wrong, or worse, that there is something wrong with us since it’s not working. Cue cycle of chugging herbal tea and feeling anxious about the fact that we are still feeling anxious. 

Myth #2: If you just got the hang of positive thinking, you’d be anxiety-free.

If positive thinking works for you, helps you cope, and allows you to be the person you most want to be, carry on. But if it doesn’t, you are not alone. When I am at my most anxious or upset, trying to convince myself to believe a more positive thought often makes me feel worse. I might be able to come up with a more positive thought, but then I just feel frustrated that I can’t make myself believe it. Research supports that trying to suppress our thoughts can actually increase the frequency and intensity of the very thought we are trying to avoid.  

While traditional Cognitive Behavioral Therapy works on helping people to engage in more balanced thinking (NOT unrealistically optimistic positive thinking), Acceptance and Commitment Therapy can help us change our relationship to our thoughts. Our thoughts, after all, are just words. Sometimes they have helpful information to share, but they aren’t always great at communicating it to us. 

Myth #3: You need your anxiety to go away before you can do the things that matter to you.

Anxiety is good at convincing us that we can’t or shouldn’t do things that matter to us until we feel less anxious. But the best antidote to anxiety is doing what matters to you even when anxiety is at its loudest. Because here’s the thing: anxiety typically shows up around the things that you care most about. So if you wait for anxiety to go away before you go after the life you want or before you show up as the kind of person you want to be, you may end up waiting forever.

So is your anxiety coping skills toolkit workable?

Workable simply means: does this behavior help you move in the direction of your values (who and how you want to be in the world) and does it have a cost to you? So if you have a stellar self-care routine that helps you feel more present, engaged and able to show up in your life as the person you want to be, keep doing your thing. And if positive thinking has helped you live a more meaningful, fulfilling life, keep it up.

But if you find that you are trying to control your anxiety and make it go away, and instead it just keeps getting more powerful, more intense, and more uncomfortable as your life gets smaller and more restricted, Acceptance and Commitment Therapy (ACT) may help. ACT is designed to help you change your relationship to anxiety and help you develop psychological flexibility: the ability to do what matters to you no matter what.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

A Lesson on Living Life to Its Fullest

by Shoshana Shea, Ph.D.

“You must defeat your reason before you can start” – Patrick Star

If you want to live life to the fullest, it’s not about forgetting all your troubles and checking out, it’s about slowing down, checking in, and recognizing you have choices. One of the greatest examples of this came from the imagination of Stephen Hillenburg, “SpongeBob Squarepants” show creator, and his writers. The character is Larry the Lobster; the name of the episode, “A Life in a Day.” As I watched that episode for the 100th time, I was thinking more about Larry’s secret to living life to the fullest; he pronounces, “You got to take risks. Live on the edge…by living each day like it was your last.” Larry goes on to say, “By livin’ like, me, Larry!” 

Living life to the fullest does NOT mean that we should try to ignore all our fears and worries.

Patrick The Starfish, states, “This is the moment where we redeem our miserable lives,” and decides that he must live moment to moment and find the most dangerous of feats; then he will truly be living! To Patrick, ‘Living life to the fullest’ seems to mean that we should try to forget reality and just live without regard for the long-term consequences. I think many of us can relate to that idea, that we wish to live completely free of fear and shut off our worries like a faucet. If only it were that easy! Patrick pronounces, “You must defeat your reason before you can start.” This is my absolute favorite line! It can sound so appealing to ignore that voice in our head that urges us to be cautious and go the opposite direction. But as appealing as it might sound to have no fear, as Patrick discovers, this can have pretty big consequences.

Cautious isn’t necessarily the same as stagnant or boring…

While Patrick is out thrill-seeking within inches of his life, Spongebob interprets living a full life to mean not taking any risks at all. He embodies that voice in our head that tells us to stay firmly planted inside our comfort zone. That familiar voice which can paralyze us, and which can make life stagnant, boring, and small.

Moving towards our values is not easy; otherwise we’d all be doing it!

When we are heading in a direction that is deeply meaningful to us (TOWARDS our values), we have to remember that the short-term is usually not easy at all. When we are moving AWAY from our valued direction, the short-term is usually a relief and can be enthralling at first. What we later find out is, ultimately, an AWAY move reveals that the hard stuff is still there and there are usually negative consequences to whatever method of avoidance we chose in the first place: Drinking excessively, overeating, acting impulsively, reckless thrill seeking (like Patrick), or staying well within our comfort zone (like Spongebob), etc. 

Mindfulness is a useful tool to help us move towards are values.

Mindfulness is often misunderstood to mean that we are only “allowed” to be in the present moment, and not think too much, or to not think at all, about the future. Being mindful is about non-judgmentally NOTICING and having awareness of what we are thinking, feeling, and experiencing, while we are in the present moment. For example, if we are aware that we are feeling sad about our work situation, we can notice the physiological sensations that arise, any other emotions that might be present, and any thoughts that emerge. We can make deliberate decisions about the direction of our life based on these observations. Mindfulness helps us stay the course. It can help bring us back if we have strayed or feel stuck. Contrary to Patrick’s version of “living in the moment,” it’s not about making quick, impulsive, reckless decisions and remaining cut off from our thoughts and emotions. After all, our thoughts and feelings can have really important information for us. Opposite of Patrick: Slow down.

Once we recognize thoughts that help us to move towards what’s meaningful, we have choices about our actions.

A mindfulness tool we use in Acceptance and Commitment Therapy (ACT), is to look at whether our thoughts and actions are serving the function of moving us TOWARDS our values or are they moving us AWAY from what’s most meaningful. Often life throws up some curve balls. We can decide how we are going to relate to those barriers and take action. For example, using the example from above, if we notice we are unhappy at work, we might start researching other job opportunities, setting up informational interviews, and continuing to show up to work every day (all examples of TOWARDS moves), rather than quitting the next day (an example of an AWAY move), and putting ourselves in a bad position.

What will you decide?

At the end of the episode, Patrick has convinced Spongebob that really living is about engaging in a series of dangerous acts. As they are heading towards their demise, Larry saves them, but only after they are all severely injured. Larry chides them as they are heading towards the sharp rocks, “Look guys, my advice wasn’t meant to be taken literally, I meant to live life to the fullest; not to maim yourselves!” So what will you decide? To live like Patrick and “defeat your reason before you can start;” to live like Spongebob, and not take any chances or go outside your comfort zone; or to live like Larry…where risk is absolutely encouraged but in a calculated deliberate manner?

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

When What You Fear Is Fear Itself

By Annabelle Parr, MA, AMFT

We’ve all felt anxious at one point or another. Anxiety involves worried thoughts about a possible future threat or unpleasant situation; it is a natural human emotion, evolutionarily wired to help us anticipate and prepare for or avoid danger. Anxiety can be adaptive, but it can also start to become like a smoke alarm that goes off in the absence of a fire…when this occurs, what we refer to as an “anxiety disorder” can develop.

What makes an anxiety disorder?

There are a variety of different anxiety disorders, or ways in which anxiety can take on a life of its own. At the core of each one is worry about an anticipated future scenario perceived to be threatening or uncomfortable, difficulty with uncertainty around whether the feared outcome will occur, and resulting functional impairments (i.e. the anxiety is getting in the way of your ability to function in your work, school, relationships, etc.).

What are panic attacks?

One feature that can occur within or outside the context of any anxiety disorder is panic. Sometimes referred to as “anxiety attacks,” panic attacks involve a handful of distressing physiological symptoms, such as racing heart, shortness of breath, choking sensations, numbness or tingling, sweating, and/or catastrophic thoughts such as “I’m dying” or “I’m going crazy,” as well as possibly feeling detached from one’s body or surroundings. Panic attacks typically peak within about 10 minutes, though it can feel like much longer. They can occur seemingly out of the blue, or they can follow an identifiable trigger. 

If I’ve had a panic attack, does that mean I have panic disorder?

Many people have experienced a panic attack before; anyone who has can tell you that panic attacks are unpleasant to say the least. But what distinguishes a panic attack from panic disorder is how the person responds to the panic. Panic disorder can develop when the person begins to fear panic itself, including intense anxiety about the possibility of subsequent panic attacks, changes in behavior designed to avoid or prevent future attacks, and significant functional impairment, lasting for at least one month.

For example, if you are struggling with panic disorder you may begin to avoid activities that raise your heart rate, such as drinking coffee, exercising, or walking up or downstairs out of fear that an increased heart rate will trigger a panic attack. Avoidance of these activities may make it difficult to leave the house or go to the office, and can get in the way of engaging in your life and relationships in the ways you desire.

Attempts to avoid anxiety are at the core of every anxiety disorder.

It makes sense to want to avoid the intense anxiety that comes with panic attacks. The problem is that when we become so focused on trying to avoid anxiety, our lives can begin to revolve around trying to prevent it. This restricts our behavior and makes our lives smaller; instead of making choices based on what is important to us, we make choices driven by fear. 

What’s the alternative?

The good news is that avoidance is not our only option. Both Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) are evidence based treatments for anxiety disorders, including panic disorder. Each approach typically involves at least some component of exposure work, which essentially involves a therapist working with you to help you begin to learn that anxiety is uncomfortable, but not dangerous. The purpose of exposure is to elicit the feared discomfort and to help you learn more flexible ways to respond to it.

From a CBT perspective, we view anxiety disorders as driven by two main errors in thinking:

1. We overestimate the likelihood of catastrophe or our feared outcome.

2. We underestimate our ability to handle it if the feared outcome were to occur.

Exposure is designed to help you face the things you fear, and generate new learning around these faulty beliefs. From an ACT perspective, the goal is to increase your ability to flexibly respond to uncomfortable experiences so that you can begin to make conscious choices about what to do based on your own personal values, rather than based on a fear of fear itself.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

Feeling Guilty for Having Feelings?

By Annabelle Parr, MA, AMFT 

The past five months have been painful, and as our world has turned upside down, it makes sense that we may have felt some combination of anxiety, fear, sadness, depression, grief, frustration, and/or anger during this time. Despite the fact that we are in the midst of a global pandemic, our minds are really good at dismissing our very legitimate pain by coming up with all kinds of stories about how things “could be worse,” or how we “should be grateful” for what we have when others are struggling or have struggled more than us.

Perhaps the only thing that can make pain hurt more is feeling guilty for having it.

It goes without saying that pain hurts. And our minds, designed to protect us and keep us safe, want to problem solve our way out of emotions that hurt. So our minds begin to tell us these stories about our pain and how we shouldn’t have it, in hopes that it can be avoided or controlled. But do these stories truly help us move through our pain more effectively? Do they help us show up to this moment as the kind of person we want to be in the world?

Let’s start with the “it could be worse” story.

It is probably true that things could be worse.

But pain isn’t meant to be compared. Someone always has a more painful or uncomfortable situation, and if we want to compare our pain to that of others, we will find no shortage of suffering. Just because someone else has it worse, that doesn’t mean our pain is insignificant. 

And here’s the thing: we are in the middle of a PANDEMIC.

That’s really hard. It means we are all dealing with some sort of loss. And yes, some losses are bigger or more painful or permanent, but loss is loss and it hurts no matter how big or seemingly small. So yes, perhaps it could be worse. But that doesn’t mean this isn’t painful. 

What about the “we should be grateful” story? Isn’t it good to be grateful and think positive?

Gratitude is a beautiful thing, but it cannot exist without pain.

Contrary to what our minds may tell us, gratitude and pain are not mutually exclusive. In fact, they are inextricably intertwined. Because in order to experience gratitude, we have to value and care about the person or thing for which we are grateful. And we only feel pain around the things that we care about and value. So when we squelch our pain, we squelch our capacity to care, and we also deny ourselves access to gratitude.

Plus, gratitude loses its goodness when it’s used as a punishment for pain.

Using gratitude as a way to try to chastise ourselves out of our pain (“You should be grateful! Don’t you know it could be worse?”) is unlikely to be effective. The more we try to control our emotions, the more entrenched they become. Not only does this strategy tend to be ineffective, it also warps gratitude from something beautiful and meaningful to a punishment for having legitimate emotions.

It’s not pain OR gratitude. It’s pain AND gratitude.

Rather than using “it could be worse, you should be grateful” stories to try to guilt ourselves out of having any anxiety, anger, pain, or grief, we can let our pain exist, acknowledging that emotions are not problems to solve. They simply are. AND we can also intentionally choose to pay attention to what is good in our lives.  We can even use our pain to help guide our focus toward what is important to us. For example, if I am grieving the loss of hugging loved ones, I can also connect with gratitude for having family that live near me. It’s both/and, not either/or.

Gratitude is an action, as much as it is a feeling.

When we are in the middle of a wave of sadness or anxiety over this whole situation, we might not feel particularly grateful. However, we can still choose to act in a manner that expresses gratitude to those we love or appreciate. We can write thank you notes to our doctors or healthcare workers, or we can call our parents or grandparents, or we can choose to say thank you to the grocery workers in the checkout line.

None of this erases our pain, nor is it meant to do so.

Instead, it simply connects us with what matters, and helps us to show up in our lives and relationships in a manner consistent with the kind of person we want to be. It helps us be present for the goodness so that the important things don’t pass us by. And it is a reminder that our current emotional state does not control or define who we are, and we do not have to control our emotions in order to choose our actions.

So if you are not feeling grateful (or whatever you think you “should” be feeling), that’s okay.

If you value expressing gratitude, you can choose to take actions consistent with this value whether you feel grateful or not. You get to decide what you do. But you cannot force yourself to feel or not feel something. So give yourself grace, and remind yourself that even if it could be worse, that doesn’t mean this shouldn’t hurt.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

Five Tips to Tackle Perfectionism and Engage with What Really Matters

By Annabelle Parr

Perfection. On the surface, perfection sounds, well…perfect. A worthy aspiration. Perfection is to be without flaw, and reducing flaws sounds like a pretty solid goal. Right? For those of us who have dealt with perfectionism, we know firsthand that it’s not all it’s cracked up to be. Far from making us our best selves, perfectionism can trap us in feelings of shame, guilt, low-self esteem, anxiety, and never ending stories in our minds about how and why we are not good enough. It can cause us to limit our choices and keep our lives small in order to avoid risking failure, and thus the tumult of pain that would follow. Far from making life feel perfect, perfectionism can leave us feeling empty and lonely. 

Filtering Out Flaws and The Trap of Social Comparison

In the age of social media, it is more tempting than ever to look at the perfectly filtered moments of other peoples’ lives and to feel like your life is the only one that is anything less than picture perfect (even during a pandemic!). When you compare your lowest moments to everyone else’s shiniest ones, your biggest flops to everyone else’s top ten hits, your worst failures to everyone else’s greatest achievements, your #nofilter to everyone else at their most coiffed, you are bound to feel like there is something wrong with you.

Social media facilitates an instant internal comparison of you at your very worst to others at their absolute best. When we buy into the idea that life should always look and feel Instagramable, we are setting ourselves us for disappointment. But perfectionism has been around far longer than Facebook, so let’s look at it more closely. Why is it so tempting to compare ourselves to others and pursue perfection as if it were possible?

Perfection = Happiness ?

It’s easy to equate striving for perfection with striving for happiness, something our culture loves to sell to us as the ultimate goal. At every turn, we are told that it is our job to be happy. Quite literally. If you are not a perpetually happy employee, partner, parent, friend, etc. you *must* be doing something wrong. Somewhere along the line, you must have messed up. 

But here’s the rub: happiness is an emotion, and like any other emotion, it is fleeting. No matter how apparently perfect your life is, you will still experience the full range of human emotion, including frustration, anger, anxiety, fear, sadness, grief, joy, excitement, and awe. There is no perfecting our way out of our emotions.

In fact, the more that we believe we must be perfect, the more likely we are to feel that we are failing and the more likely we are to be caught in uncomfortable emotions about how we don’t measure up to our own impossibly high standards. We are less likely to recognize our successes because *spoiler alert* they have not launched us into the untouchable perfect zone. Far from making us perpetually happy, a desire to be perfect is a surefire way to create extra unpleasant feelings.

Perfection = Growth ?

It’s also easy to confuse striving for perfection with striving for growth or improvement. And sure, if you are constantly beating yourself up about all the things that are wrong with you and all the ways that you are screwing up, you and your growing edges might be quite familiar. OR…

Maybe you are so petrified of being imperfect that you can’t actually examine where you have room for growth. You know you’re not perfect, but you have no concrete sense of how you want to grow because it is too excruciating to reflect on where you feel you are not measuring up. 

Scenario number two: you are busting your butt hard every day. You are exhausted and burnt out, yet no matter how much you check off your how-to-be-perfect-to-do-list, somehow the list just keeps growing. No achievement or improvement seems to make a dent towards the elusive end game of perfection.

Scenario number three: you are so paralyzed with fear of imperfection that you can’t make any choices at all. Terrified to make the wrong decision, risk making a mistake or even worse, failing, you choose not to choose. Far from perfect, life feels stagnant.

So if trying to be perfect doesn’t make us happy and doesn’t guarantee us growth, what’s the point?

Before you start beating yourself up for your perfectionistic tendencies, consider why you are so determined to be perfect in the first place. Even if it is a thwarted, misguided attempt, it probably makes some sense or else perfectionism wouldn’t be such a prevalent strategy.

Maybe your desire for perfection is a desire for belonging: somewhere along the way, you developed the belief that in order to be loved and to connect with others, you had to be flawless. Or maybe it is a desire to have a life that is rich with joy: you want a life filled with that which fills up your soul. Or maybe you find it fulfilling to strive to be the best version of yourself that you can possibly be. You have been striving to be perfect because you are trying the best way you know how to fulfill a deep need or desire. In other words, even though the strategy you are using has some pretty big costs, it makes sense.

What are the costs of perfectionism?

In order to redirect our energy toward a more workable strategy for engaging in life, first let’s consider the costs of trying to be perfect. They might include, but are certainly not limited to: missing out on the joy of life’s sweet moments and triumphs; saying no to opportunities for fear of failure; low self-esteem; inauthenticity leading to disconnection in the service of appearing perfect; burnout from taking on too much all the time; perpetual anxiety and shame; stagnation; and/or decreased sense of well-being. We become limited by an unattainable standard and life gets smaller and more restricted as we try to squeeze it into the perfect little box we have constructed in our minds about how it should be.

So what is the alternative?

From an Acceptance and Commitment Therapy perspective, perfectionism is at its core psychological inflexibility. The alternative, then, is to cultivate psychological flexibility. How? 

1. You are not your thoughts.

First, we defuse ourselves from our “not good enough” stories. Every time our mind generates a thought about how we are failing or how we might fail or how we have failed and are now somehow unworthy, we remind ourselves that this is our mind trying to protect us and also that this thought is just a thought. We – at our very core – are more than the contents of our minds in any given moment. Our thoughts are not the whole truth about who we are or about the reality of a situation.

In her new book, Be Mighty: A Woman’s Guide to Liberation from Anxiety, Worry & Stress Using Mindfulness and Acceptance, Dr. Jill Stoddard suggests we give our inner critic a name in order to defuse – get some space from – the judgements it generates. Then, when the Critic pipes up with some new version of the “not good enough” story, we can relate to them as if they were a well-meaning friend. We can thank them for their input and desire to help protect us or motivate us, and then we can connect with what matters in this moment.

2. Pause for presence.

How do we connect with what matters in this moment when we are caught in painful emotions? We get present to what is. As Dr. Shea says, take a breath and tune in to this “painful present moment.” Identify the emotions you are experiencing and get curious about the unmet need or desire underlying your feelings.

3. Let your values guide your choices.

If we look back to the needs or desires beneath our efforts to be perfect, we can start to get a sense for our values. For example, bring to mind an area of your life in which it feels particularly important to be perfect. Now consider what this says about what is important to you. What domains of your life feel most important? If you were your ideal self in each of those contexts, who and how would you be?

For example, if it is important to you to be a perfect parent, that probably means that you value your relationship with your kids. Or if it feels important to be the perfect employee or student, that probably means that your work is important to you. Now what qualities do you want to bring to these areas of your life? Our values aren’t goals that we meet, but they describe the way that we want to be in the world. For example, maybe you want to be a loving, compassionate, present, engaged parent. Or maybe you want to be a hard-working, conscientious, ambitious employee or student.

Here is the wonderful part about connecting with our values: we get to choose on a moment by moment basis what it looks like to act in a way that is consistent with who we want to be. And here is the beautiful thing – there is no end goal. You never achieve your values permanently. They are qualities of being you can bring to any moment. And when you fail to act consistently with your values in one moment (because you will), what matters is what you choose to do in the moment following.

4. If you want to live in line with your values, you have to be willing to have discomfort.

When we are caught in needing to be perfect, it tends to be excruciating to recognize when we fall short (often). This is partially because our desire for perfection shows up in the areas of life that matter to us. Making moment by moment choices in line with our values rather than in line with a goal of perfection does not spare us discomfort. Those areas of life still matter to us and it still will hurt when we fall short of acting in line with our values, even if we have defused from our desire to be perfect.

An important piece of the puzzle is that we must be willing to have uncomfortable feelings. We can’t take away the anxiety, sadness, anger, fear, or pain that are inevitable parts of being human. In fact, those feelings often point directly toward something that we care deeply about, and if we were able to rid ourselves of those emotions we would also have to get rid of the joy, love, happiness, and awe that come from connecting with what and who is important to us.

5. Finally, get present to what is.

One of the biggest costs of perfectionism is that we lose touch with the sweetness of life. We are so caught in wanting it to be perfect all the time, that we miss the bliss of both the big and small moments that come pretty darn close. When our minds are frantically searching for something wrong, we miss out on experiencing everything that might be so right. The point of being mindful and present is not to be happy all the time, but it is to bring nonjudgmental attention to what is in this moment. When we are truly present, we free ourselves up to make more deliberate decisions about how to act. We are more conscious of our thoughts and feelings, and we are more likely to catch the sweet little moments that brighten and enrich our lives.

“And now that you don’t have to be perfect, you can be good.” – John Steinbeck

John Steinbeck said it so well when he said, “and now that you don’t have to be perfect, you can be good.” The ACT perspective would say, and now that you don’t have to be perfect, you can live a life that is guided by what truly matters. You are free to connect with what is important to you and learn to live in line with who you want to be. When we need life to be perfect, we drain it of vitality. When we give ourselves the freedom to be imperfect, we free ourselves up to connect with who we want to be and what truly matters most.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. DR. SHOSHANA SHEA CAN HELP. SHE CAN BE CONTACTED AT 619-269-2377.

Therapy in the Time of COVID-19 and Shelter in Place: What is Teletherapy?

By Annabelle Parr

During this incredibly stressful time of COVID-19, we are having to make major life adjustments.  With the new shelter in place restrictions, you might wonder whether psychotherapy is still an option available to you. The short answer is yes!

Telehealth, also known as video conferencing or online therapy, has been available long before COVID-19, and is an important alternative to in person care.

Traditionally, therapy is done in person. However, with the emergence of new technologies, there have been an increasing number of telehealth / video conferencing options and platforms emerging and available in the mental health field over the last decade. This means that not only do we have the infrastructure available to offer confidential, HIPAA compliant virtual therapy, but also that there is already plenty of research on telehealth and its efficacy in mental health treatment.

Prior to coronavirus, teletherapy expanded access to care to individuals who were not able to get to a therapist’s office, whether that was due to scheduling difficulties or a lack of mental health care options in their community. Now, shelter in place poses a barrier to accessing in person care for all of us. Thus, telehealth via video conferencing offers convenient access to care for everyone as we are required to stay at home as much as possible.

How effective is telemental health care?

According to the Anxiety and Depression Association of America, “from a large body of research we know that telemental health leads to high patient and provider satisfaction ratings and achieves health outcomes equivalent to in-person care across all diagnostic groups” (Yellowlees, 2020). So as long as the client is willing to engage in therapy virtually and is not an extreme risk to themselves or others, research shows that telemental health is as effective as in person treatment.

How does virtual therapy work?

Typically, telehealth involves video conferencing with your therapist using a secure, HIPAA compliant platform. No extra equipment or complicated applications are required.  Clients can use their smartphones or a laptop computer with a built-in camera. Therapists are able to offer telehealth services to patients located in the state in which they are licensed. So a therapist licensed in and practicing in California is able to offer teletherapy services to patients located in the state of California. Though not all therapists were offering telehealth options prior to COVID-19, given the current situation, many have adjusted their practices to offer video counseling options to patients in need.

What should you look for in a telehealth provider?

The same things you would look for in a therapist you would see in person: you want to ensure that the therapist you choose has expertise in the areas in which you are seeking treatment for, and you want to make sure the therapist feels like a good fit for you personally. One thing we know for sure is that the quality of the therapist-client relationship is the most important factor in producing successful treatment outcomes across settings, in-person or online. This means that in order for therapy to be effective, you have to have a solid trusting rapport with your therapist. Assuming those two conditions are present, telehealth is likely to be just as effective as working with the same therapist in person.

If you find yourself struggling, feeling stuck, and/or could use some help navigating your feelings, you could benefit from Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness, and Telemental Health Services. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.

Navigating Romantic Relationships During COVID-19

by Annabelle Parr

One of the many challenges presented by COVID-19 is the way it has altered how we are permitted to relate to one another. Required to maintain distance between ourselves and others, we are allowed out of our homes only for essential business and errands, or to take walks or runs as long as we keep at least six feet between ourselves and those we pass. Initially this six feet rule was termed “social distancing,” but experts have proposed that we shift our terminology to “physical distancing.” While this may seem like a trivial shift, it speaks to the importance of relational connection and reminds us that we must keep a physical distance from one another, not an emotional one.

Humans are inherently social creatures; we evolved in a context that dictated that connection and cooperation with the group was vital to our survival. So what a strange situation we find ourselves in where, for our collective wellbeing, we must put physical distance between ourselves and others. Paradoxically, you may find that this new paradigm is helping you to reconnect with friends and loved ones you rarely spoke with prior, taking advantage of the technologies that allow us to see one another even when you are not in the same room, city, or even country. You may also be finding that this shift has thrown new, challenging, unprecedented and unexpected variables into your romantic relationship. Whether you are dating, in a committed relationship, or married, COVID-19 has altered our daily lives in such a way that it is bound to impact our relational lives.

Dating during coronavirus

If you were dating prior to the COVID-19 outbreak, it may feel difficult to know how to proceed. With so many options for online dating and dating apps, the dating landscape has changed dramatically over the last decade, even prior to coronavirus. However, while these apps may help you find and connect with people you wouldn’t otherwise meet, typically, the dating itself has still involved actually meeting in person. For the time being, meeting in person is not an option.

But what if you are still interested in dating, meeting new people, and pursuing connection? If it is important to you to continue dating during this time, there are options available to you if you are willing to be flexible and creative. Rather than going out on dates, you can opt for talking on the phone, setting up a video call happy hour, or even a Netflix Party to share in a favorite TV show or movie together.

It’s also important to know that there is no pressure. If meeting for the first time through your computer screen does not sound like something that is in line with your values at this moment in time, that’s okay. Give yourself permission to take a break and know that this is temporary. Tune in to what matters to you and what you need to do to take care of yourself during this time.

Relationships during coronavirus

Maybe you are already in a committed relationship. If you do not live with your partner, you may have found that suddenly it feels like you are in a long distance relationship. Depending on any number of variables (from whether you or your partner lives with others, whether their roommates are still working outside the home, etc.), you may not be able to see each other or connect using any form of physical touch right now.

If, on the other hand, you are living together or have chosen to quarantine together, you are likely now spending near 24/7 in the same space together. This can present its own set of challenges. As much as we love our partners, as relationship expert Esther Perel noted, “our need for togetherness exists alongside our need for separateness.” And it can be hard to find that separateness during shelter in place.

Marriage and/or children during coronavirus

If you are married and/or raising children with your partner, not only are you and your partner now together 24/7, but the kids are home as well. Trying to navigate working from home and homeschooling children on top of everything else presents a lot of new variables to manage as a couple and family.

Tips for tending to your relationship during coronavirus

Whether coronavirus has meant that you and your partner cannot see each other in person, or whether it means that you are now almost constantly together, connection and communication are crucial for navigating this time together. Here are some tips for maintaining a loving, balanced relationship during COVID-19:

1. Acknowledge and have self-compassion for your emotions. Allow yourself to have your feelings. Be gentle with yourself and know that however you are feeling is okay. When we are willing to have our feelings and to be compassionate to ourselves in the midst of pain and struggle, we are able to make deliberate choices about how we communicate and behave that are in line with the type of person and partner we want to be. When we are unwilling to have our feelings, or we are unkind to ourselves, our emotions may find unhelpful ways of leaking out and may come to covertly control our reactions.

2. Clearly state your feelings and your needs. Our partners are not mind readers, nor should they be. We are all individuals with unique feelings and needs, and we can best support each other when we are each clear about what helps us to feel safe and loved. I-statements provide a useful template for communicating your feelings and needs clearly (I feel [x] when [y], and I need [z]).

3. Give your partner space and compassion to process and experience their emotions. Know that it’s totally normal for each of us to feel and think differently about this situation. You and your partner may have different needs, feelings, and opinions, and just as it is important that you allow yourself to have your experience, it’s important that your partner has the space to have their experience as well. In any given moment, one of you may feel anxious about all the uncertainty, while the other may feel grateful for time to slow down; one of you may want to be productive, while the other may be exhausted. One of you may want to be as informed as possible and process the information aloud, while the other may want to watch Netflix and only update as necessary.  

4. Work together to creatively support each other. You may have different needs during all of this, and that can be hard to manage. Carve out time to meet each other’s needs and find ways to compromise. For example, those in long distance scenarios may find one partner is craving a FaceTime date, while the other wants to ditch their screens for a while having been glued to them all day while telecommuting. Plan a time for a screen date to maintain connection, and also plan out some time for a screen detox.  

5. Stay connected with friends and family. Romantic relationships are not meant to function like islands; yet when we are stuck in the same space for weeks on end, it can start to feel like we are literally stuck on an island together. Make sure to reach out for support and connection with friends and family during this time. Having a wider net for support in times of stress is crucial.

6. Strike a balance between connection and separation. If you are in a long distance scenario, you may be craving more connection. If you are quarantining together, you may be craving more separateness. (Though of course the reverse can be true in either scenario as well). It is important to find time to connect, share our emotions, needs, and experiences, and be together, and it is equally important to have some space to ourselves, to read or engage in personally enjoyed activities, or catch up with other loved ones. Being intentional with our time and space, and honoring our own and our partner’s need for both connection and separateness can help us to strike a balance.

7. Laugh together. Humor can be so healing during times of stress. Finding things to laugh about together can help us bond and help defuse some of the tension we may be feeling. Whether this involves watching funny videos or shows together, playing silly games, or just finding the humor in little moments, laughter really is good medicine. It might sound hard to laugh during such a stressful time, but it’s important to seek out something that brings us a little joy and levity.

8. Connect with gratitude. This does not mean you are not allowed to feel anxious or sad or angry or exhausted about this massive upheaval. However, pausing to mindfully appreciate small joys or victories can help shift our perspective, even if just for a moment, and can help us to weather the storm with more resilience. See if you can notice the things that you are grateful for in your partner, the little moments with them that you cherish. Try to connect with something you are grateful for each day, whether it has to do with your relationship or not.

9. Utilize the tools available to you. We are still able to go outside, breathe in fresh air, take walks or go on a run. And thankfully we live in a time in which we have a whole host of technology available to us that allows us to stay connected in ways never before possible. None of this is an ideal situation, but don’t forget to utilize what is available to you to help create balance in your life and relationship where possible.

10. Seek professional support. If you are experiencing stress, anxiety, trauma, or depression that is impacting your ability to function effectively in your relationship (or any other important area of your life), professional support is available. Many therapists, including Dr. Shea, are offering telehealth services to clients during shelter in place. Telehealth or teletherapy typically involves conducting sessions via a videoconferencing platform or over the phone, and studies have shown telehealth to be as effective as in person therapy. It is okay to ask for help, and help is still available to you.

Relationships can be challenging even in the best of times, and as we face this totally unprecedented global stressor, expect that it will present some new challenges to your relationship. As much as it is a time filled with stress, anxiety, and fear, this is also an opportunity to develop resilience and skills to navigate situations full of uncertainty. Rest in the knowledge that this is a period of trial and adjustment for us all, and be gentle with yourself, your partner, and all of your loved ones.

If you find yourself struggling, feeling stuck, and/or could use some help navigating your feelings, you could benefit from Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness, and Telemental Health Services. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.

How To Bring Meaning to Your Work Even When It’s Not Your Passion

Connect with your values and you can find meaning in any moment

by Annabelle Parr

“Choose a job you love, and you will never work a day in your life.”

Pretty good advice, right? Of course this expression doesn’t mean that you will literally never work a day in your life. Rather it implies that when you love your work, it feels like a choice more than a burden. On the whole, it adds value and meaning to your life, and fills your soul rather than saps it of vitality. To love one’s work is a beautiful thing that should absolutely be encouraged.

However, there are several important caveats to note when we discuss the importance of “loving your work.”

First of all, even if you love your job with all your heart, there will inevitably be hard days. Something about the saying above implies a sense of joy, ease, and effortlessness. Like if you love your job enough, you’ll hit some kind of work nirvana and just be blissed out all the time. But there will be days when – despite your love and passion for what you do – you are less than thrilled when your alarm goes off. There will likely be parts of your job that you love a bit less than others. There may be people you butt heads with. And there will be days that are downright crappy. No matter what your job or how much you love it, you will have hard days.

Work is work and it will still be challenging even when you love it.

When we set people up to expect that loving your work means you get to avoid difficult emotions and experiences, we do them a disservice. In fact, if you are looking for something perfect that involves 0% discomfort, it’s pretty much a guarantee that you will fail to notice something that you could or would love. No job is perfect; instead, look for the one that means enough to you that you are willing to suffer some discomfort for it because it is just that important to you. So, caveat number one: love does not imply perfection. However, it does imply purpose and meaning (more on that later).

Caveat number two: there is a certain amount of privilege inherent in prioritizing loving your job.

Loving your job is a wonderful goal, but not everyone is afforded the resources and opportunities necessary to attain their “dream job.” Figuring out what you love to do can take a lot of time, energy, and effort that many people do not have. Ultimately, work is a means to paying the bills – it is first and foremost about survival. When survival is on the line and basic needs are barely being met, loving your work is not high on the priority list because it often can’t be. So what about all those people who for one reason or another, are not able to put “love” as a top priority when it comes to their job?

Well, what does it actually mean to love your work?

I imagine that if you truly love your job, if you won the lottery tomorrow, you would choose to continue to work just for the love of the thing. So what if you don’t love your work? If you have the means to try to figure out what it is you do love and to seek that out, go for it! But if you don’t, you might still be able to find love in the midst of work even when the job is just a means to an end.

What if you don’t actually have to love the work that you do to find meaning in it?

What if the meaning isn’t necessarily in the job title or the day to day tasks, but actually in the way that you do it and the reasons you do it for? From an Acceptance and Commitment Therapy (ACT) perspective, life inevitably involves pain and discomfort. The problem isn’t pain, but rather the inflexible ways in which we choose to respond to it. We get stuck in our minds, in stories about how things are or how they should be; we get stuck trying to escape discomfort, but find only that our lives get progressively smaller and more rigid.

The antidote to suffering: psychological flexibility.

That is, being willing to have our experiences inside our skin (thoughts, emotions, sensations); choosing to be present in this moment; recognizing our thoughts for what they are: words generated by our minds rather than inherent truths about the way things are; choosing to see our selves as more complex than our current experience; and identifying what matters to us and deciding to act in the direction of what matters even when we are experiencing discomfort. In ACT, our personally chosen values serve as the compass for our actions in any given moment. And our values are qualities of being that we can bring to any experience at any time.

From an ACT perspective, love might have less to do with the work itself, and more to do with the qualities of being that you bring to it.

There is something about the idea of loving your work that seems somewhat fixed and rigid. Like you either love it or you don’t and that’s that. But when you choose to allow your values to inform your work, you have some sense of agency day to day regarding whether you will find meaning in this moment.

What are your personal values?

Maybe it’s important to you to provide for your family. Maybe it’s important to you to be kind and compassionate, or driven and tenacious, or present and engaged. These are all qualities of being that you can choose to bring to any job, on any given day. When we reconnect with our values – who and how we want to be – we can infuse our day with meaning no matter what we are doing.

Here’s a new saying for you: connect with your values and you can find meaning in any moment.

I think it’s meaning that we’re really after when we encourage people to do what they love. And it’s freeing to know that meaning is up to you. You do not have to find the elusive dream job before you can find meaning in your work. No matter the contextual restrictions on your ability to choose a job you “love,” you can still decide who you want to be when you show up every day to do your job, regardless of what it is.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, AND MINDFULNESS. DR. SHOSHANA SHEA CAN HELP. SHE CAN BE CONTACTED AT 619-269-2377.

Work-Life Balance: On Connecting with Our Values

By Annabelle Parr 

As technology has expanded in the last couple of decades, the workplace has changed significantly. With laptops and smartphones, work can follow you outside of the office and into the hours outside of 9 to 5. While the upside of this shift is that there is now more opportunity for flexibility, the downside is that it can mean pressure to work non-stop. No place is sacred when the smartphone can ping you with an email anytime, anywhere. As a result of both the increased opportunity for flexibility and the increased opportunity for being forever on the clock, work life balance is tricky. How can we create balance between work and other important areas of our lives, like family, fitness, fun, etc.?

When work life balance becomes oppressive…

Though this question is certainly valuable and worth considering, the emphasis on work life balance also has the potential to become oppressive. Are you balanced enough? Have you created the perfect balance between working and spending time with your kids and your partner? Are you doing it all with a smile?

When we fuse with this ideal of work life balance – in other words, when we hold as a literal truth that we must equally balance our time between our work lives and the other aspects of our lives – we can lose sight of the original point behind the concept. We may find ourselves feeling increasingly stretched too thin. Rather than enjoying our so-called balanced lives, we may find ourselves feeling persistently inadequate, unsatisfied, and that we are failing in some regard.

Values-based living offers an alternative approach

So what can we do instead? We can construct our own personal definition of what it means to have a fulfilling, balanced life. Acceptance and Commitment Therapy (ACT) suggests that when we connect with our own personally chosen, deeply held values (rather than values imposed upon us, designed to please culture/other people, or driven by a “should”), we construct a compass which guides our decisions. Values are not the same as goals or outcomes, but are qualities of being, toward which we can strive in each moment. When we are conscious of and connected to our values, we are equipped with a why to drive our actions. 

And once we know what matters to us, we can begin to prioritize the things that truly bring us meaning and fulfillment. We can gauge whether our lives are aligned with our values or out of sync, regardless of whether they live up to the ‘work life balance’ ideal. Then we can consider what (if anything) needs to change in order to better align with what’s really important to us. The beauty of this idea is that there is no one right way to structure our lives. To the extent that you have choices about your work and your time spent outside it, you get to decide what matters to you and what actions you can take in that direction.

How do we connect with our values?

There are a whole host of ways that we can get in touch with our values. ACT relies on experiential exercises and metaphors to teach psychological flexibility skills and to help us connect with what matters.

One exercise that can help you consider what is truly important to you is to try writing a summary of your own autobiography written twenty years from now. What’s the title? How do you hope to be described? What major accomplishments or milestones are noted? What stands out about you in your life story? 

If you’d like to try a similar exercise, imagine what you would want people to say about you in your eulogy. This exercise may sound morbid, but in connecting with the finitude of life, we can reflect on how we want to move forward with our lives and how we want to engage with the present, rather than reflecting back with regret. How do you hope you will be described by the people that matter to you most at the end of your life? How do you want to be remembered? What do you hope you will have accomplished? How do you hope to have spent your time? Who do you hope to be?

If this activity feels too morbid for you, before you decide not to complete it, be present with and honor the feelings that show up when you consider the exercise. Those feelings may have something important to say… 

Once you have done one (or both) of these activities, see what themes emerge. What matters to you? Who and how do you want to be? How do you want to spend your time? What do you want to bring to the world? You may notice some goals you have for your life, but see if you can step back from the goals and identify the qualities of being that you want to embody. These are your personal values. Now, consider how you can apply them to your life today. In what ways is your life consistent with or at odds with your eulogy or your autobiography? These are the areas in which you may want to consider making values-based changes.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, AND MINDFULNESS. DR. SHOSHANA SHEA CAN HELP. SHE CAN BE CONTACTED AT 619-269-2377.

The Way We Use Mindfulness Matters

By Annabelle Parr

It seems like mindfulness is everywhere these days. In recent years, it has exploded on the scene as the seemingly catch-all cure for a whole host of problems, supposedly promising to address mental health concerns, decrease stress, improve performance at work, and make you a better parent. Its benefits are touted across the internet – from business sites like Forbes and Fast Company, to wellness sites like the Huffington Post, to inspirational sites like Upworthy.

It’s true that practicing mindfulness can benefit us in all sorts of ways, showing not only benefits to our mind and our mood, but to our overall physiological health as well. However, when something is subjected to as much hype as mindfulness has been, sometimes in all the air time, it can get watered down and potentially misrepresented. Depending on how we talk about mindfulness and how we choose to apply it to our struggles and our lives, mindfulness can be a huge help or it can become one more well-disguised attempt at avoiding and controlling discomfort.

So what actually is mindfulness?

Mindfulness has a long and rich history rooted in Eastern philosophy traditions, which have acknowledged its benefits for centuries. Jon Kabat-Zinn, professor of medicine at the University of Massachusetts Medical School, was a trail blazer in integrating an understanding of mindfulness into the Western conception of health. He defines mindfulness as “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.” Meditation is an example of a mindful exercise, but mindfulness can be practiced in any moment during any activity – one of the reasons it is so appealing and accessible as a means of promoting wellbeing.

Sounds ideal, right? You can practice it anytime, anywhere! The key to a stress free life is available to you in any moment! Well…not exactly.

 As Steven C. Hayes (2019) pointed out in his new book, A Liberated Mind, “it matters what mindfulness is for.” Why are we choosing to practice mindfulness? Based on any number of headlines and articles you read online, it sounds like practicing mindfulness is about getting rid of discomfort and stress. But thinking about it this way can actually make things worse! As Carl Jung noted, what we resist persists. The more we try to escape, avoid, or control our emotions, the stronger they tend to get. What’s more, when all our energy is devoted to controlling discomfort, our lives become increasingly restricted as our choices are dictated by what we are not willing to feel. When mindfulness becomes one more tool to escape or control uncomfortable experiences, it can end up fueling the same cycle that gets us caught in suffering.

So if it’s not about getting rid of stress, why should we bother being mindful?

From an Acceptance and Commitment Therapy (ACT) perspective, mindfulness helps make our lives richer and more meaningful. It does not guarantee freedom from discomfort. But it does offer us a new way to meet our pain. When we connect to the here and now rather than getting caught in regrets about the past or worries about the future, we are freed to notice what is happening in the moment and then choose to take action toward what is important to us.

The purpose is not to get rid of stress or anxiety or grief or whatever other uncomfortable feeling shows up, but rather to help facilitate awareness so that discomfort does not control our actions and define our lives. In being more present, we are free to notice not only the tough stuff like sadness or fear or frustration, but also the stuff that fills us up, like peace, joy and triumph. When we are not responsible for changing how we feel, we are freed up to change how we behave.

If you are interested in learning more about mindfulness, it can absolutely be helpful! And it can help you with things like stress and anxiety and work performance and being a more engaged parent and partner. But the reason it is helpful matters. A lot.

When you decide to show up to the moment mindfully, remind yourself that this is not a way to escape something difficult or painful. As psychiatrist and Holocaust survivor, Victor Frankl, so poignantly noted, “between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and freedom.” Mindfulness allows us to access that space. It allows us to hold our experience willingly and gently, allows us to notice helpful information that may be present in our experience, and allows us to make a conscious, active choice about how we want to behave. We are freed to choose to act in a way that is consistent with our values, and in so doing, we are invited to experience life as full of vitality and meaning, even when we are faced with discomfort.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, AND MINDFULNESS. DR. SHOSHANA SHEA CAN HELP. SHE CAN BE CONTACTED AT 619-269-2377.

I Get Nervous in Social Situations…Do I Have Social Anxiety Disorder?

By Annabelle Parr

Most of us probably know what it’s like to feel nervous about public speaking or before going on a first date. We might feel anxious before a job interview, or find our palms get sweaty right before we shake hands with someone we’ve just met. But for the 7 percent of US adults that experience social anxiety disorder in a given year, the fear of humiliation and embarrassment can be debilitating (National Institute of Mental Health, 2017).

What is social anxiety disorder?

Getting anxious in a social situation does not mean that you have social anxiety disorder. In order to receive this diagnosis (American Psychiatric Association, 2013), you must experience persistent fear or anxiety about one or more social situations, causing you to either avoid or suffer through the feared situation. In addition, you must also fear that your behavior will reflect your anxiety and that this will lead to negative social repercussions, like humiliation or rejection. Finally, the anxiety must be out of proportion to what might be expected in that context. This fear, anxiety, or avoidance around social situations must last for at least 6 months and it must make it difficult to function in important areas of life, such as work, school, or relationships. 

What are some examples of situations that trigger social anxiety?

Individuals experiencing social anxiety might find themselves feeling anxious about any number of situations, including making small talk with coworkers, interacting with the cashier at the grocery store, ordering a latte, going on dates, attending parties, eating in public, giving a speech or presentation, or performing in front of an audience. The main fear underlying social anxiety is experiencing rejection or humiliation.

Social anxiety isn’t all bad.

Like all anxiety disorders, social anxiety disorder is an adaptive response gone awry. The reason we all know that heart pounding, cheeks flushing, palms sweating reaction to a nerve-wracking social situation is that we have evolved physiologically to avoid any trace of rejection. Humans are inherently social animals, and our survival has depended upon our ability to function in the context of relationships. Beyond basic survival, relationships also add joy and meaning to our lives. As a result, we are literally neurologically wired to connect with one another. We achieve that social connection by concerning ourselves with what those around us think, need, and feel. Imagine a world where everyone only cared about themselves and paid no attention to the impact they had on others…yikes! So a little anxiety around situations that might result in rejection can be a really healthy, adaptive response. However, if you find yourself so afraid of rejection that you can’t be vulnerable enough to engage in necessary or meaningful social interactions, that’s when social anxiety can become problematic.

Risking rejection is part of the process of having deeper connections.

The paradox here is that in order to seek connection, you are also automatically risking rejection. You cannot get the joy and reward of interacting and bonding with others if you are not also willing to accept that this will sometimes result in pain, embarrassment, or rejection. Social anxiety disorder – unlike manageable anxiety that shows up in any number of vulnerable situations – hinders connection because the desire to avoid rejection overwhelms the impulse to seek connection. In other words, you miss out on both the risks and the rewards.

What are the consequences of social anxiety disorder?

When social anxiety reaches disordered levels, it can make it impossible to focus on anything but anxiety, so you are unable to be truly present in the situation and you white-knuckle your way through. Or it is so overwhelming that you avoid the situation entirely, and life becomes restricted by fear. It can result in isolation, loneliness, and underperformance in areas which you might otherwise excel. The catch is that the anxiety is so strong that it prevents you from learning that a positive outcome is possible. In Acceptance and Commitment Therapy (ACT), this is called experiential avoidance.

Does social anxiety have to rule my life?

No! The good news is that social anxiety is highly treatable. With Cognitive Behavioral Therapy (CBT), clients can learn to reframe their anxious thoughts to be more realistic, as opposed to catastrophic. They can learn that anxiety is not all bad, but how we view it drastically affects how it impacts us. And with the help of a therapist, they can learn to slowly face the things that have come to feel impossible. ACT, the third wave of CBT, can also help clients to get in touch with their values and act in ways that bring meaning to their lives, even when they are experiencing something difficult, like anxiety or fear.

Getting anxious in social situations is a pretty universal experience. It’s hard to find someone who has never been nervous about some kind of vulnerable, human-to-human experience. But when it becomes something that is making it difficult to engage in life in the ways that bring you purpose and joy, it might be worth reaching out for some help.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, AND MINDFULNESS. DR. SHOSHANA SHEA CAN HELP. SHE CAN BE CONTACTED AT 619-269-2377.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

National Institute of Mental Health. (2017). Social anxiety disorder: Statistics [Webpage]. Retrieved from https://www.nimh.nih.gov/health/statistics/social-anxiety-disorder.shtml 

If at first you don’t succeed, try something different

by Shoshana Shea

“The definition of insanity is doing something over and over and expecting different results.”  - Albert Einstein

What do you do when you run out of reasonable (or at least semi-reasonable!) coping strategies, finding that they are just not working to improve your situation? One more conversation with your partner using a respectful tone and making a request they be more mindful of a situation; hoping a person will consider you just once before they act; bending over backwards to make sure someone is OK and getting little to no acknowledgement of your help. Or, do you need to recognize the insanity of trying the same ineffectual “solutions,” perpetually expecting different results, and make some shifts in your behavior, by trying something new instead?

In one of my favorite scenes from the “Bee Movie,” Jerry Seinfeld’s character, Barry the Bee, flies into someone’s home to get out of the rain because, as the movie states, everyone knows that bees can’t fly in the rain (Seinfeld & Smith, 2007)! When he realizes that it’s even more dangerous to be inside a house with humans, he tries to leave out the window he just flew in. So he heads towards the window and crashes into it. You see, the problem is that the humans had closed the window right after he flew in. He proceeds to stand up and continue crashing into the window multiple times reciting the words, “Maybe this time; maybe this time, this time! This time! This time!” only to get shot back down by the cold hard glass. In exasperation he decries, “This is diabolical!” 

I know I can certainly relate to Barry the Bee. How many times have we tried to use a strategy over and over again, only to not have it work, even if it seems perfectly reasonable?! He flew in through the window; why would he not be able to fly back out?!

There is a great metaphor from Acceptance and Commitment Therapy (ACT) of a man who is walking along and drops into a deep, dark hole (Hayes, Stosahl, & Wilson, 1999). At the bottom is a shovel, so he starts digging because there are no other tools around him. He digs and digs, only to discover he has created an even deeper hole than when he started. ‘Digging’ our way out with the only tool at our disposal seems logical at first, but it is ultimately the strategy that is holding us back from successfully moving forward in our lives.  What’s a person (or a bee) to do in these situations?

Consider these 5 ideas to help you exit the house or climb out of the hole:

1)     Acceptance– Acknowledge the reality of the situation. What is the problem or issue at hand? What strategy are we using, and is it helpful or unhelpful in resolving the situation? Have awareness of the fact that everything we’ve tried thus far is not working. Banging our head against the window isn’t going to open it.

2)     Letting go might be the best option – i.e., drop the shovel. Usually the strategy we are using is serving as an avoidance of the present moment. Barry the Bee was in a very precarious situation. I don’t blame him for being reluctant to give up the option of leaving the way he came in. It was all he knew. These situations hurt our heads, metaphorically and literally. We attempt to rationalize using the same ineffective strategy, instead of looking at the ultimate reality. The window is closed and it is not going to work as an exit strategy, whether we like it or not! The best option is to let go of the strategy that is not only not working, but likely making the situation worse! For example, staying in a relationship that we know is not serving us drains more of our energy than most of us are willing to admit. 

3)     “The window” or the solution might be all there inside of us. Sitting quietly and tuning in to our wisdom, we can usually find numerous answers. We just might have a heap of fear because it will likely require venturing out into unchartered territory. Our self-critic usually doesn’t like that…how do we know it will work? We don’t, unless we try.

4)     There might be another window, but we may not have access to it in that very moment.  This is related to the previous idea. As we sit with the present moment rather than running from it, we tune in to our “gut,” our good sense, and we see that the solution has multiple steps and may take a bit of time to get there. For example, if you are unhappy at work and ultimately decide to go back to night school to retrain for a different career, going through the steps to get there may take some time.

5)     We might need to practice what I like to call “trial and adjustment” as opposed to “trial and error”; we have to try out a new solution to see if it works. We won’t know what the outcome will be until we try. If it doesn’t work, that doesn’t make it an error at all. Rather, it’s a behavioral experiment, or a work in progress where we assess the feedback/data collected and make necessary adjustments. For example, look for support from a different source, rather than going to the same friend or family member who continues to be emotionally unavailable or makes most of us feel worse than before. There is no guarantee that whatever avenue we try will ultimately lead to the solution, but we never know until we try. The famous hockey player, Wayne Gretsky, said, “We miss 100% of the shots we never take.”

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, AND MINDFULNESS. DR. SHOSHANA SHEA CAN HELP. SHE CAN BE CONTACTED AT 619-269-2377.

References

Hayes, S.C., Strosahl, K.D., Wilson, K.G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guildford Press.

Seinfeld, J. (Producer), & Smith, S. J. (Director). (2007). Bee Movie [Motion Picture]. United States: DreamWorks Animation.

How did I get stuck in this rabbit hole? Overcoming negative self-talk

by Shoshana Shea

Have you ever fallen down the rabbit hole of negative self-talk and found yourself thinking…

·      “I’m unworthy”

·      “I’m not good enough”

·      “I hate myself”

·      “There’s something wrong with me”

If you said yes to any of these, you are not alone. 

Where does this come from?

These negative thoughts emerge when we are in pain. We want to unfeel our feelings, but we can’t.  We want the pain to end. This is where the self-critic comes in and wants to make sense of our pain so it can stop. When it can’t find an easy fix, it starts saying things like “There must be something wrong with me.” “I hate myself for caring and my (perceived) shortcomings.” “I’m unworthy.” “I’m unlovable.” “I’m not enough.”

If we have enough hard painful events in our lives, which most of us do, we start to have narratives (aka storylines) about who we are and how things are going to go (not well!) in any situation; we stop checking scenarios out for what they are.  Sometimes we even deny that we have emotions at all. An example of this would be if you went out on a date, had a great time, felt like you connected with the other person, and then you never heard a word from your date again. You might think that you are unlovable, hate yourself, and decide that dating isn’t for you. This is not true. Yes, you are having a painful present moment, but your interpretation and the assumptions you make may not be true. In other words, thinking you are unlovable does not equate to actually being unlovable.

Cognitive Fusion: Believing our thoughts, acting on them, and getting stuck in the rabbit hole

In Acceptance and Commitment Therapy (ACT), this is called Cognitive Fusion, which means that we take our thoughts as absolute truths. When we experience cognitive fusion, we feel we have to carry out our thoughts’ directives without question, even if they tell us to make ourselves small or that we are small. When we are completely ‘fused’ i.e., attached, to our thoughts, we get pulled down the rabbit hole.

Cognitive De-Fusion: Unhitching from our thoughts

So if cognitive fusion means unquestioningly believing our thoughts to be absolute truths, cognitive de-fusion means that we are able to notice our thoughts without automatically acting on them. This is where mindfulness comes in. Viktor Frankl has been attributed to have said, “Between stimulus and the response there is a space. In that space is our power to choose a response. In our response lies our growth and our freedom.” When we can de-fuse, or get some space from our thoughts, we are able to see them and understand them better, even though we often might not really want to see the hard stuff in front of us.   

Here are some techniques to consider for getting distance from the self-critic:

1. Give yourself the benefit of the doubt that you are feeling the way you do for good reason. There is ALWAYS a reason why you are feeling the way you do, but it is not because you are worthy of hating yourself! Take the example up above. The reason you might be feeling you hate yourself is because there was a painful present moment that you couldn’t control. You actually have no idea why your date never called back. Perhaps they were already dating someone else. Perhaps they were not in a place to move forward in a serious way in a relationship. You can’t know for sure what the reason is, and your feelings of pain are valid, but they are not an indication that they exist because something is wrong with you.

2. Name the emotion. Once you have given yourself the benefit of the doubt that you are feeling something for good reason, ask yourself what those feelings might be. Emotions are usually one word: Sad, fearful, anxious, hurt, etc. Emotions give us important information.

3. “Am I worthy?” is not necessarily the most helpful question to ask yourself. Instead, ask yourself, “What is the Painful Present Moment?” (Which I call The PPM).  Continuing with the above example, you might be dating because you would like to find a life partner. In this scenario, the PPM is that since your date did not call back, you have not yet found your partner. That, in and of itself, does not feel good and could be quite disheartening. The self-critic may say, “It’s because you are not enough.” The mind is coming up with explanations because you are in pain and it is hard to sit with that. It’s hard to accept that you probably need to keep dating, when it clearly has not been a great experience thus far.

4. Anxiety and sadness are not bad in and of themselves. They are there for good reason (See point #1); it’s UNACKNOWLEDGED anxiety and/or sadness that leads to the problems. For example, walking home at night in a not so safe neighborhood, you have two choices: you have a well-lit street that takes longer, or a short-cut through a dark alley. Which one gives you anxiety? It serves a good purpose in our lives if we examine the cause of that anxiety. So the next time you are feeling anxious, give yourself the benefit of the doubt and try find out why.

5. Have Self-Compassion. If you can’t quite access why the negative self-talk is raining down on you so hard, try to have compassion for yourself. In other words, at least try to make the effort to understand yourself, even if you still feel like the emotions are just there for no apparent cause. Practice statements like, “I get why I’m feeling anxious because...” or “I’m probably feeling this way for good reason, even if I don’t know what that exact reason is right now.” My favorites are, “This stinks” and “No wonder I’m feeling this way.”

6. Practice saying, “My mind is having the thought that (insert self-critical statement)...” For example, “...that I’m overthinking this” or “…that I shouldn’t be taking this so hard.” This helps you to separate your mind from your self, and can help create some space that can allow you to recognize that your thoughts are not necessarily cold hard truths.

7. Try slowing the pace of your words, adjust your intonation, and use a kinder tone of voice. “(Oh no!) I'm anxious!” vs. “I AM anxious, and I don't have to pretend I'm not. It's actually my body telling me that something needs my attention.” This helps with cognitive flexibility and organically shifts your perspective. The function of the mind/self-critic is to alert you that something VALID needs your attention.

8. Talk to a trusted other. If my mind is working overtime to either spin and/or criticize me, I know that important truths are begging to be uncovered and unpacked beneath the storylines my mind is trying to tell. And if I can’t uncover it on my own, I ask a trusted other to help me to create space between myself and my thoughts so I can get that shift in perspective I so desperately need. You may think you have talked and thought about this enough already, so last thing you want to do is talk about it more. Consider this idea: yes, you have been thinking a lot, but you are likely stuck in the rabbit hole, especially if there is little to no relief and the end to your suffering is nowhere in sight. Talking to someone else can allow you to formulate more helpful questions so that you can move forward in a meaningful way.

If you find yourself struggling, feeling stuck, and/or could use some help navigating your feelings, you could benefit from Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Mindfulness. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.

What We Resist Persists

by Shoshana Shea

Have you ever had these thoughts: “Everything REALLY IS fine, so why do I feel so sad?”  Or “I’m unhappy, yet I have nothing to be unhappy about.”  Or “I have a lot of NOISE in my head; I can’t get this nagging feeling to go away, even though I have a ‘good life,’ overall.”  Normally, our first instinct is to rationalize or push away uncomfortable feelings.  We try to think our way out of these painful periods in our lives. And for the most part, that has worked out fine.  On the other hand, we have never fully gotten rid of the thought, “Maybe I could be happier?”  Or perhaps we know we’re not happy, but we feel stuck and don’t know what to do.  Despite trying to push the thoughts away, they can become more intrusive, more frequent, and more oppressive.  In Acceptance and Commitment Therapy (ACT) there is a common saying, originally opined by famous analyst, Carl Jung: “what you resist persists.”  In other words, even our life long strategies of thinking ‘harder,’ or further rationalizing, and/or attempting to ignore our feelings, can become ineffective in pushing pain away.

This is not necessarily a bad place to be in your life.  According to Buddhist nun, author, and world renown teacher, Pema Chodron (1997), “...feelings like disappointment, embarrassment, irritation, resentment, anger, jealousy, and fear, instead of being bad news, are actually very clear moments that teach us where it is that we’re holding back. They teach us to perk up and lean in when we feel we’d rather collapse and back away. They’re like messengers that show us with terrifying clarity, exactly where we’re stuck. This very moment is the perfect teacher, and lucky for us, it’s with us wherever we are.”

I’m fine, but not really.

This “I’m fine, but not really” experience can happen in any situation in our life – in our romantic relationships, friendships, work, family, and inside ourselves.  Consider this scenario: Sally has a decent paying job, but she is overworked. She comes home feeling drained and anxious, sometimes numb. The boss just gave her a cost of living raise, but not a merit one.  She has the thought, “I should just be happy I have a job at all when so many people don’t.”

Why do the thoughts persist?

The thoughts persist because our body is trying to alert us that ‘an important something’ is needing our attention, and we can no longer continue the way we have been doing so.  Our job is to do a deeper investigation in order to generate more effective coping strategies in our lives and ultimately, to move in a more meaningful life direction.  The thoughts will continue as long as we don’t address the underlying causes.

Our brain runs on templates

Another reason these thoughts persist is that our brains will engage in familiar behavioral and thinking patterns that maintain the status quo.  We want a quick fix where relief is readily available.  Having to sit and do a deeper investigation of our feelings and possibly take actions that initially heighten our pain for the purpose of getting the long-term pay-off is not to our brain’s liking.  We will, therefore, look for coping strategies that are readily accessible and that we have utilized in the past. Given that our neural pathways like this familiarity and run on these (often outdated) templates to help us cope and navigate any situation, we will avoid trying something new or unfamiliar; even if that familiarity does not involve a happy outcome, it’s a predictable one. 

Forging a new neural pathway is akin to having to cut down a path through a cornfield

Furthermore, creating a new neural pathway has been compared to walking through an overgrown cornfield, as opposed to a path that is already cut down and well-tread. Forging a new path is akin to taking out a pocket knife and cutting down one stalk at a time.  That can be fairly disheartening and who knows what lies on the other side of the field, so why expend the effort?  An even more unsatisfying work situation or relationship may be at the end of the path.  So we fall back on old “safe” behaviors and continue to feel unsatisfied in our lives.

The paradox in all this is that this built-in mechanism that is meant to protect us is actually keeping us from being more content in our lives.  The Rochester Meditation Center’s Daily Tejaniya for May 2, 2018 captures that idea perfectly: A meditation student said her meditations were deeply unpleasant because she had to face a torrent of random thoughts, distracting fantasies, and harsh self-judgments.  “Do you want it to stop?” Sayadaw asked her.  “Yes!” she said. “That’s the problem,” he said.

So What Can We Do?

1. Stop struggling, as the example with the meditation teacher and student above implies, we have to stop pushing back on the thoughts and telling ourselves we can’t think that way. Remember, what we resist persists!
    
2. Thoughts are not the problem – Acknowledge that the thoughts are there, and know that our brains, albeit exhausting, are trying to find a quick fix to the situation by thinking ‘harder.’ 
    
3. “You can’t control your first thought, but you can [certainly] control the second” (Hendrix & Hunt, 2013.) The first thought is our primal brain (i.e., the part of the brain that we share with many other species) reacting to pain and perceived danger. The second thought has the potential to engage our higher ordered thinking human brains, in a more fully embodied way, to include more information than our initial thoughts. This is our opportunity to look at the larger picture!
    
4. Understand that the thoughts and emotions are there for good reason.  Something does need our attention; however, we need to engage our thoughts in a different way, not by pushing back on them or getting pulled down into their content.
    
5. Sometimes we do have to make some hard choices – Initially, in the short run, we may have to make some difficult decisions and put in some hard work, for the long-term payoff. As in the case of Sally, she may need to find a new job and/or take a pay cut at first, so she can ultimately have more upward mobility.  That will likely involve more pain at first; our brains don’t like that, and will tell us all kinds of stories about why we can’t handle making a change in our lives.
    
6. The body never lies – If we are in pain, our body is only alerting us to that and wants us to move towards a better quality of life.  The body knows making a mindful change will lead us to a better place.  Instead of loneliness and disconnection, if we tune into our “gut,” ultimately, we will come to a more connected fulfilling place.
    
7. Therapy can be helpful to make some changes – A therapist can identify where we are getting stuck and help us relate to our thoughts in a more helpful way. By taking us through a deeper investigation, our wisdom can emerge to help facilitate meaningful changes and action in our life.

If you find yourself struggling, feeling stuck, and/or could use some help navigating your feelings, you could benefit from Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Mindfulness. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.

References:

Chodron, P. (1997). When things fall apart. Heart advice for difficult times. Boston, MA: Shambala Publications, Inc.

Hendrix, H.  & Hunt, H.L. (2013). Making marriage simple. 10 relationship-saving truths. New York, NY: Harmony Books.

The Rochester Meditation Center. (May 2, 2018). The Daily Tejaniya.

Do I Need to be Perfect Before I Can Have a Relationship?

by Shoshana Shea and Annabelle Parr

Have you ever been through a breakup and had your friends or family tell you that being single is good because now you can “work on yourself?” We often hear that the time to focus on ourselves and our own growth is when we are single. While being single can offer us an opportunity for self-development, this message suggests that being in a relationship and working on yourself are mutually exclusive. While this may be true occasionally, it is certainly not the rule. Our personal growth does not end just because we enter a relationship. Arguably, some of our most profound growth will occur within our relationships, not removed from them.

Why do people emphasize being single as the time to work on yourself? 

Theoretically, it’s easier to work on yourself when you are single; it’s primarily you that you need to focus on. In a relationship, the focus in not only on yourself, but also on your partner and the relationship.    

No one can save us from our own personal growing pains.

Additionally, we sometimes end up using the relationship as a substitute for working on ourselves. Motivational speaker, Jungian psychologist, and author, James Hollis, reminds us in his book, Finding Meaning in the Second Half of Life, How to Finally Really Grow Up, that “there is a telling paradox at work here. The more we wish another person to repair our wounds, meet our needs, and protect us from having to grow up, really grow up, the more dissatisfying the relationship will prove over the long haul. It will swamp in stagnation...” (Hollis, 2006).

Our partner may be able to help catalyze our growth, but they cannot do our growing for us.

In the context of a healthy, loving relationship, it is still possible to “work on yourself.” James Hollis (2006) continues, “If, however, we can see that the relationship is a summons to growth, in part by encountering the otherness of our partner, the relationship will support each person risking, stretching, and growing beyond the point where they entered.”

When a relationship ends, how long do you need to “work on yourself” before getting into another relationship? 

If you have recently been through a break up, there may be value in taking some time and space before entering into a new relationship. This single period can give you time to reflect on and process why a relationship didn’t work. There is no set amount of time or magic equation, however, that will tell you when to begin dating again. As long as you are committed to self-growth, you can begin dating whenever you feel compelled to do so.

The most important thing is that you get out there and live your life!

People can spend so much time trying to ‘fix’ themselves before entering a relationship that they don’t engage in their life. Cheryl Strayed (2015) reminds us, “You can’t ride to the fair unless you get on the pony.” People can lose sight of two important things: 1. They can continue to work on themselves and work on (or pursue) a relationship at the same time.  2. They were actually whole to begin with and it’s not about “fixing” anything at all; perhaps the last relationship just wasn’t the right fit. Jeff Foster (2014) reminds us, “...Courage is the willingness to fall to your knees, to feel pain, to get yourself dirty, shake yourself off, and forge ahead with a broken-open heart.”

When we are truly committed to our own growth, we will find opportunities to “work on ourselves” whether we are in a relationship or not.

Consider this question on your journey of self-growth posed by James Hollis (2006), “’Am I made larger, or smaller, by this path, this relationship, this decision?’” Relationships are complicated, and they are not always the right fit. When we are single and unattached, we usually have plenty of time and space to “work on ourselves” and there is no doubt that there is much joy to be found in this part of the journey. But if we have found a partner whom we love and cherish, we can be connected to them and remain connected to ourselves and our own growth all at once.

If you find yourself struggling and could use some help navigating your feelings, you could benefit from Cognitive Behavior Therapy, Acceptance and Commitment Therapy, and mindfulness. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.

References:

Foster, J. [Jeff]. (2014, August 6). Self esteem [Facebook status update]. Retrieved from https://www.facebook.com/LifeWithoutACentre/posts/620343951396550

Hollis, J. (2006). Finding meaning in the second half of life: How to finally, really grow up. New York, NY: Gotham Books.

Strayed, C. (2015). Brave enough. New York, NY: Alfred A. Knopf.

Why It’s Okay to Be Mad

by Annabelle Parr

Humans are wired for connection. Relationships bring us immense joy, but they can also be challenging at times. There will inevitably be moments when we miscommunicate and misunderstand each other, and this can lead to frustration and conflict where both partners feel angry and hurt.

Here’s an example.

Julie and Rob both have busy lives, children they love, and full-time jobs. Julie wants Rob to spend more time with the family. Rob wishes Julie understood the overwhelming pressure his boss puts on him. Julie never “signed up” to be a single parent; and Rob doesn’t seem to understand that she has pressures and responsibilities of her own at work. Julie, unlike Rob, makes time for the family. It is the third night in a row that Rob has called to say he won’t be home before the boys go to bed. Julie is tired and frustrated. She snaps, “You don’t have to come home at all, for all I care.” Rob feels demoralized. It seems like he can’t please anyone no matter what he does. Julie is fuming and can’t seem to make Rob understand how she feels so alone.

Both Rob and Julie’s feelings are valid, but neither one of them is feeling heard. Both of them are now feeling angry. Anger is not a bad thing; there are no “bad” emotions. However, when people get angry, conflict does have the potential to escalate.

We tend to equate anger with aggression, but anger is an emotion while aggression is a behavior.

The problem isn’t anger itself. As Tina Gilbertson notes on her blog, “anger has never hurt anyone.” Emotions, no matter how strong, cannot cause harm. Rather, it is our behavior and our emotional expression has the potential to inflict injury. So, our negative connotation towards anger is due to our lack of understanding surrounding how to express ourselves when we feel mad.

Allowing ourselves to get angry is actually healthy.

While getting aggressive is destructive, allowing ourselves to feel angry is vital. Here’s why.

1. Anger, like any emotion, is information. Ignoring anger is like ignoring your smoke alarm. Approaching the screeching alarm may be uncomfortable, but it’s a sign that something is amiss. When we ignore such a vital piece of information, we invite the underlying problem to turn into a full blown fire.

“…feelings like… anger… instead of being bad news, are actually very clear moments that teach us where it is that we’re holding back…They’re like messengers that show us, with terrifying clarity, exactly where we’re stuck.”
- Pema Chödrön

“Anger is the feeling that says No to opposition, injury, or injustice. It is a signal that something I value is in jeopardy.”
- David Richo

2. Anger is energy that we can use to create change. We can either take this energy out on ourselves and/or others, or we can channel it into positive, constructive change. For example, rather than getting into a yelling match with a family member, you can use your angry energy as courage to set a firm, clear boundary. Or rather than ruminating on all the bad things that happen in the world, you can use your anger as motivation to get involved in volunteering for a cause close to your heart.

“We begin to use our anger as a vehicle for change when we are able to share our reactions without holding the other person responsible for causing our feelings, and without blaming ourselves for the reactions that other people have in response to our choices and actions. We are responsible for our own behavior. But we are not responsible for other peoples’ reactions, nor are they responsible for ours.”
- Harriet Lerner

3. Anger can help protect us, at least for a time. Anger helps us to draw a line between what we will accept in our lives and what we will not. It can also help us ease into pain that we may not be ready to fully experience without a protective layer - anger. Holding on to anger across our lifetime is toxic. But allowing ourselves to be angry for a time may give us the space we need to set boundaries and create room to heal.

“My dictionary defines forgiveness as a ‘letting go of resentment.’ But how do we let go if we believe our anger protects us from further injury or, in some strange way, holds a perpetrator accountable? Resentment and righteous indignation distance us from our own pain, and we need distance to survive. At least initially.”
- Daniel Gottlieb

4. No matter how hard we try to repress our anger, it will eventually find its way out at our expense. We cannot will our emotions away. They’ll simply find other outlets or ways to catch up with us. The only way to get rid of an emotion is to feel it and allow it to move through us.

“Passive anger [passive aggression] is inappropriate and not an adult way of behaving. Strongly expressed anger is called rage. Strongly held anger is called hate. Unexpressed anger is resentment. Anger can be unconsciously repressed and internalized. It then becomes depression, i.e. anger turned inward.”
- David Richo

“Let go of the battle. Breathe quietly and let it be. Let your body relax and your heart soften. Open to whatever you experience without fighting.” 
- Jack Kornfield

So next time you find yourself feeling angry, give yourself grace and permission to feel it. Because, as David Richo (1991) wisely states, “the anger has pointed to where it still hurts.”

How to Handle Anger Constructively:

1. Pause. Take a deep breath and center yourself before trying to communicate.
2. Acknowledge and accept what you are feeling. Give yourself the benefit of the doubt; your feelings exist for good reason. Ask yourself what exactly you are feeling – frustration, pain, fear, rejection. Get curious about what caused that feeling to arise.
    
3. Have compassion for yourself.
    
4. Have compassion for the other person. Give them the benefit of the doubt as well, and recognize that their feelings exist for good reason too. Get curious about their emotions and what has triggered that emotion in them.
    
5. Respond rather than react. Reacting is reflexive; it’s a knee jerk reaction that occurs when someone hits one of our sore spots. Reacting is natural and happens to everyone from time to time. But how you move forward after you react is important. Notice your own reaction and then respond to it. Responding is pausing, communicating without blame, and listening from a place of compassion rather than defensiveness.

If you find yourself struggling with anger and could use some help navigating these feelings, you could benefit from Cognitive Behavior Therapy, Acceptance and Commitment Therapy, and mindfulness. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.

References:

Chodron, P. (1997). When things fall apart: Heart advice for hard times. Boulder, CO: Shambhala Publications, Inc.

Gottlieb, D. (2010). The wisdom of Sam: Observations on life from an uncommon child. Hay House, Inc.

Kornfield, J. (1993). A path with heart: A guide through the perils and promises of spiritual life. New York, NY: Bantam Books.

Lerner, H. (1985). The dance of anger: A woman's guide to changing the patterns of intimate relationships. New York, NY: Harper & Row Publishers. 

Richo, D. (1991). How to be an adult: A handbook on psychological and spiritual integration. Mahwah, NJ: Paulist Press.

When Panic Sneaks Up and Attacks

by Annabelle Parr 

It’s a regular Thursday morning and John is driving to work along the same stretch of freeway that he drives every day. He is having a stressful week, but his mind isn’t dwelling on anything in particular. His thoughts bounce from what to make for dinner to an errand he has to run during lunch to a meeting he has this afternoon. He doesn’t feel particularly anxious.

Suddenly, his heart starts racing and his palms begin sweating. He can’t explain what is happening; it doesn’t make sense to him. First he feels confused, then he begins to worry that something is wrong. He starts to feel short of breath and then he begins to feel as if he is going to faint. Because he is driving, he is afraid that if he passes out, he will crash and die.

John doesn’t know what happened to him. He worries it may have been a heart attack, but when he goes to the doctor, he learns that it was actually a panic attack. He is confused because he didn’t feel afraid or anxious prior to the attack. His doctor explains that you don’t have to feel panic to experience a panic attack.

Our body is built to respond adaptively to danger.

At some point or another, we have all experienced the feeling that our safety is being threatened. We know what it’s like to feel consciously afraid and to feel our body physiologically preparing for danger. Our heart starts racing, our palms start sweating, our breathing gets shallow, and our muscles tense up. Our body goes into fight-flight-or-freeze mode to help us respond adaptively to whatever threat we are facing.

Panic attacks are the body’s way of trying to prepare us for an unconscious perceived threat.

Sometimes, our body responds to a threat that our conscious mind is not aware of. This is what happened in the above example. When we do not feel afraid, the physiological response itself can feel threatening and overwhelming. This exaggerated and unexplained response can result in a panic attack. Panic attacks create the feeling that your body is turning against you rather than working to help you. What may once have been an adaptive response to an external threat has morphed into what feels like a threat coming from within.

What is a panic attack?

A panic attack is defined as the abrupt onset of intense fear or discomfort that peaks within several minutes. Panic attacks can emerge from a calm state or an anxious one, making them difficult to predict. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM V), a panic attack includes at least four of the following symptoms:

1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feelings of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, light-headed or faint
9. Chills or heat sensations
10. Paresthesia (numbness or tingling sensations)
11. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
12. Fear of losing control or “going crazy”
13. Fear of dying

What’s the difference between a panic attack and panic disorder?

Panic disorder can develop when a person experiences recurrent and unexpected panic attacks, and develops a persistent concern or worry about additional panic attacks or their consequences and/or significant maladaptive behavior changes related to the attacks. It is possible to experience panic attacks without having panic disorder.

Are panic attacks dangerous?

People experiencing panic attacks often end up in the Emergency Room worried they are having a heart attack. While uncomfortable and overwhelming, a panic attack itself is not dangerous. But because they can arise unexpectedly, it can feel as if they are. If we have just been on a long run or are about to give a big presentation, we know why our heart is pounding or our palms are sweating. But when our heart begins pounding and we start trembling and we can’t figure out why, these symptoms are frightening. They seem to originate within our body rather than as a response to something external.

Is it all in my head?

Absolutely not. While panic attacks are psychologically rooted, they result in a very real physiological response. And though a panic attack may seem to arise out of the blue, there is always an external trigger. Our minds detect a threat, whether consciously or not, and our body responds accordingly. A feedback loop then ensues as our mind interprets our physiological response as threatening, and our body continues to attempt to prepare us to address a threat.

If you experience a panic attack, there is nothing to be ashamed of. It’s not a sign of weakness or that you are going crazy. It’s not your fault. Though it doesn’t feel this way, a panic attack is your body trying to help protect you.

Are panic attacks permanent?

No, panic attacks do not have to be a permanent fixture in your life. Though you do not cause yourself to have a panic attack, you can learn how to prevent and manage them. Panic disorder is one of the most treatable disorders, and Cognitive Behavioral Therapy has been proven to be a highly effective form of treatment.

Cognitive Behavioral Therapy

Psychoeducation and understanding what is happening in the mind and body during a panic attack is a big part of healing. Treatment also involves examining triggers, teaching clients skills to address the acute symptoms of the attack as well as the overall stress level, and using repeated exposures. Exposure therapy incorporates an experiential piece into treatment, where the client is incrementally exposed to the feared situation and learns that they will survive.

Cognitive Behavioral Therapy can help clients to overcome the fear of panic attacks themselves, and empower them to face the situations that they may have previously avoided in order to try to prevent an attack. Clients can learn that not only will they survive a panic attack, but that they can actually move on and begin to thrive.

If you are experiencing panic attacks, avoiding situations you fear could trigger an attack (driving, crowded spaces, public speaking, etc), or find that your day to day functioning is impacted by anxiety, you could benefit from Cognitive Behavioral Therapy. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.