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Appearances Can Be Deceiving

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You know what’s hard about having depression and anxiety? Having to go about your day, looking like you feel fine when you’re not. I know everyone feels this way at times, but it’s something that I have to focus on a lot. Like, perhaps people have to prepare for the possibility of a thunderstorm every now and then, but it is a daily threat for me. So I always have to carry an umbrella and think about what shoes I want to wear. Whether my outfit is appropriate. Whether or not I’m at risk of getting struck by lightning.

But then again, perhaps I underestimate how bad the weather is for everyone. Because when I listen to my clients and read my friends’ Facebook status updates, I am reminded that there are all kinds of people walking around in pain, looking normal on the outside. We all feel broken in one way or another. It’s so convincing, though, when people look like they have it all, isn’t it? So easy to believe that you are alone in your pain.

When people tell me they read my blog, they always say something about how vulnerable I am in it. They mean it as a compliment, but even though I’ve been doing it for over 3 years now, it always makes me feel self-conscious. Have I said too much? Did they read something that makes me look bad? Do they think less of me as a person? As a psychologist?

Still, it has been worth the risk, both because of how much I have helped other people and because of how freeing it has been. Of all of the things that I have done to battle my demons, blogging has been one of my most powerful weapons. And if there are clients who choose not to see me after reading my blog, I am learning to accept that I can’t be all things to all people.

I realized recently that choosing vulnerability is like choosing love: it’s risky, and you’re bound to get hurt, but it’s better than spending a lifetime trying to play it safe. It’s still hard to put myself out there and risk judgment and criticism, but most of the time it results in a meaningful connection with someone–perhaps even a complete stranger. Because now they know they are not alone. And I am reminded that I’m not alone, either.

Wouldn’t it be nice if more people were willing to take the risk of being vulnerable? If instead of seeming like we had it all together, we could be honest about our pain? I know it would be unrealistic to go around telling everyone about the holes in our hearts all the time. Sometimes when someone asks how you are, you just have to say fine or you won’t have time to get a coffee before your first client. But if you want to know the truth about how I’m feeling, I’ll tell you. And if you read my blog, you will definitely find out.

Control What You Can Control

My friends on my tennis teams and in my groups often tell me, in a teasing way, that I am bossy. And I have to admit, it’s true. But it’s sort of necessary if you want to make sure that people show up to matches and for court times, because it’s very bad when people don’t. Which is exactly why people don’t like to captain and be in charge of groups. Who wants all that responsibility? No normal person, that’s for sure. So really, I’m doing everyone a favor.

One of the things that all of the books on compassion emphasize is how little control we actually have over our thoughts, feelings, and behavior. Our genetic makeup, our upbringing, our circumstances in life are not in our control. In some ways, it’s a little disconcerting, given that so much of our culture is focused on the idea that we control our own destiny. This is why people don’t want to take meds (they’re for the weak-minded). Why we blame people who find themselves in less fortunate circumstances than our own (they’re just lazy). Why our failures are our fault.

When I tell people about this aspect of practicing compassion, skeptics are quick to respond with, you’re just letting people off the hook. You’re just giving people excuses for not taking responsibility. Which is not the case at all. Because the one thing that we are in control of is our intentions. To be loving or hateful. Forgiving or vengeful. Accepting or judgmental. And our instinctive response with ourselves and others is to be critical and judgmental. It takes a considerable amount of discipline and practice to counteract these negative responses. It is far more work than controlling, blaming, and shaming ourselves and other people.

I know it’s negative, but as I reflect on this past year, the first thought that comes to mind is that it really sucked. I know people have it worse, that people have harder lives than me, but a lot of it was still sucky. It would be unrealistic to aspire to a normal life, given how predominantly mental illness factors into every aspect of my life, but sometimes I wish it could be a tad easier. Just a little less painful.

I tell myself all kinds of things to try to keep from falling into a pit of despair. The most helpful strategy is a compassionate one. I cannot entertain these thoughts because they cause me suffering, and I don’t have enough energy to spare on unnecessary suffering. I must take care of myself or I won’t be able to function. I remind myself that I’m doing the best that I can. That all I can do is focus on getting through this moment. I need to take advantage of whatever small thing I can do to make myself feel even the tiniest bit better.

So this year my New Year’s resolution is to exercise more control over my intentions, which are to be mindful, compassionate, and accepting. Which means that I need to write more blog posts.

Three Years Later…

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Today is my blog’s 3rd birthday! Can you believe it? I’ve written 277 posts and still haven’t run out of things to say!

In those 3 books about God that I read this summer, they all said that we have many rebirths in the course of a lifetime, and the beginning of this blog year definitely feels that way. As you know if you’ve been reading my blog, my baby brother had quadruple bypass surgery less than a month ago. What I did not mention at the time is that I am taking care of him, so his heart attack has been a life-changing experience for both of us. While taking on this new role has presented many challenges, in some ways it has simplified my life. My behavior is more intentional; my motivation for everything I do is clear. Many of the things I have realized in this past month relate to themes I have written about over the past 3 years, so I thought I would share some of them.

1. Self-care. I often tell people to treat self-care as though your life depends on it, because it does. Nevertheless, I still struggle with it. It’s hard to go to bed on time, to cook, to go to the grocery store. I still have trouble saying no. Still push myself to the point of exhaustion. But now that I’m taking care of my brother, self-care really does feel like life or death. I have to go to the grocery store and cook healthy meals because if I don’t, he can’t eat. I have to get out of bed, even if I don’t feel like it, because I have to check on him. I have to set limits, or I won’t have the energy to care for him. Like Romeo said in his last post, sometimes it’s better when you don’t have a choice.

2. Mantras. There are so many new things to worry about now that I often feel overwhelmed. Sometimes I can’t fall asleep. I wake up to anxiety attacks. In rare moments of stillness, I cry, thinking about what he went through, wondering how we will make everything work. But in addition to my usual mantras (e.g., everything is going to be OK; I’m doing the best that I can), I have added 2 more: 1) anything is better than him being dead, and 2) if God saved his life, then he’ll help me find a way. And that helps to calm me down.

3. SolitudeI offered to take care of my brother without really thinking about it. At the time, I didn’t realize it meant that he was going to live with me indefinitely. Not that it would have changed my decision. But it’s sort of like suddenly having a child without the 9 months to mentally prepare for it. There was a moment where I mourned the loss of my space, my freedom, but that quickly faded. And surprisingly, I have gained far more than I have lost. I have someone to watch football with. Someone to talk to when I get home, to share my thoughts with. He cares about how my day went, whether I won my tennis match. I don’t dread days when I have nothing planned now, because they’re not as dreadful when you don’t have to spend them alone.

4. FriendshipsMy friends are so awesome. I am so thankful for them. Even though they don’t know my brother, they call and text to ask how we’re doing. They’ve made meals for us. They say prayers for us. They wished me luck on my first day back to work because I was stressed about it. They’ve listened to me cry. They’ve spent hours putting together shelves so that my brother could have space for his belongings. They are taking good care of me, so that I can take good care of Romeo.

5. GratitudeIn my prayers, when I give thanks for all of my blessings, I always do so with some anxiety, knowing that at some point I will lose the things that I am thankful for. What will I do then? Fortunately, hardship and loss have heightened my awareness of how plentiful my blessings are. I am even more aware of what a gift it is to be able to breathe, to feel your heart beat, to walk. (All mindfulness exercises, by the way.)  I’m thankful that I have a job that has vacation days. I’m thankful that every day my brother gets stronger. That he is happier now than he was before the surgery.

If this period of my life marks a rebirth, then my goal in this lifetime is to be more fully aware of what a gift it is to be alive.

Two Year Progress Report

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Today is my blog’s 2nd birthday. Woo hoo! And I have to say, I’m really proud of myself. I started this blog because I wanted to write a book and this seemed like the best way to force myself to show my writing to other people and to develop content. I also wanted to prove to myself, and to others, that sharing our vulnerabilities is the best way to accept ourselves.

I did not, however, expect to make so many meaningful connections with other people–even though intellectually I knew this is also one of the benefits of sharing our vulnerabilities. And I did not expect my blog to be the best therapy I’ve ever received.

I know a lot of people share tips on how to have a successful blog on their birthdays, but I thought I’d share the things I’ve learned about myself through blogging that have made my life better instead.

1. Self-care is hard work. As a therapist, I preach about self-care all the time. And I thought I was pretty good about taking care of myself. But through blogging, I now realize there have been obstacles to my self-care that I have overlooked because I think I am superhuman.

Like, if I play tennis 6 times in a row, I’m too tired to function the next day. And it hurts my knees. Or if I spend all my energy on helping my family and my clients and my romantic partners, I get depressed. And I have a lot of expectations about how much I should be able to do that my body and mind don’t always agree with.

So now I treat taking care of myself as though my life depends on it. And it kind of does.

2. I can have more faith in God. I used to spend a lot of time worrying about the fact that I have very little money in savings. Or that if I were to become disabled, I don’t have anyone else’s income to rely on. Or if I were to fall and couldn’t get up, no one would find me until I didn’t show up for my tennis match. Which is partly why I play so much.

I’m not going to lie and say I don’t worry about those things anymore, but I worry about them less. Because blogging has shown me that somehow, things always work out. Like that time when I had a nail in my tire and my ex just happened to see it and let me know.

So I try to stop worrying so much about how things will work out and just trust that God will take care of me.

3. It pays to be nice to yourself. I used to spend a lot of time motivating myself with shame. Yelling at myself to get out of bed, get off the couch, go to work, and go to the grocery store like a normal person. Other people who have spouses and kids do it. What’s your excuse? But practicing compassion has helped tremendously, and I accomplish much more by motivating myself with kindness than I do with shame.

So now I tell myself things like, I’m doing the best that I can. And I really am.

4. I can be alone and still feel loved. Before I started my blog, I had been in relationships non-stop since I was 14. The thought of not being in one was anxiety-provoking. Now I’ve been single for almost 2 years, and it is the most mentally stable I’ve ever felt. Apparently, relationships make me crazy.  But more importantly, I have become much more aware of how many people are there for me. My family loves me. My friends look out for me. Even readers care about when I’m having a bad day.

Perhaps some day I will find someone who I can add to this list, but in the mean time, I’m pretty happy with things just as they are.

That’s it for this year. Looking forward to seeing the person I become in the next year. And thanks for accompanying me on the journey!

2015 Blog for Mental Health Project

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I pledge my commitment to 2015 Blog for Mental Health Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.

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For the second year in a row, I am participating in the Blog for Mental Health Project. Many of you already know my story, but if you don’t, check out my post on Why I Blog About Mental Illness. You can also check out my post for the 2014 Blog for Mental Health Project.

I wrote my story about depression last month because Sarah Fader from Stigma Fighters asked me to write a 1000 word essay on my experience with mental illness. Since it’s hard to cram 25 years of depression into 1000 words, I basically just stuck with the facts. And yet, it is the post that has resonated the most with people who have struggled with depression.

I guess that’s because when you say things like, I stopped taking my meds because I didn’t want to rely on them to be normal, and then I relapsed 3 months later, they know exactly what you mean. You don’t have to spell out the shame and self-loathing involved in that process.

When I first started my blog, my goal was to model how to practice self-acceptance, because I need all the practice I can get. I was especially proud of that post because it meant I have finally accepted what it means to be someone who has struggled and will continue to struggle with depression, which is the thing I have been the most ashamed of.

But after I wrote my story, I realized that self-acceptance is not enough. Accepting all of the things that I have to do to prevent a relapse is not the same thing as acknowledging how painful it has been to live with depression. How hard it was to feel like a failure. How isolating it was to hide my depression because I knew that some people would minimize my suffering and make me feel worse about myself.

Until I wrote that post, I had never had compassion for my suffering because I didn’t think I deserved it. So now I’ve upped the ante, so to speak. Now I am modeling how to practice self-compassion. Which is why I’m also participating in 1000 Voices of Compassion, in which 1000+ bloggers will publish posts on compassion on February 20.

I will continue to educate people about mental health and do my part to erase stigma, but ultimately I cannot change what people think about me or anyone else with a mental illness. So I will make sure that I treat myself with the love and kindness that I deserve, and I will encourage other people to do the same.

On a final note, if you read my blog, then you know that I am obsessed with being a warrior. So I thought I would leave you with this article on Mental Illness Warriors, some of whom you may recognize.

200 Posts!

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You know what I love about blogging? Unlike birthdays and New Years, I feel different as I reach each landmark. In honor of my 200th post, I thought I would take this opportunity to reflect on what I’ve learned up to this point. Here are the highlights:

1. Vulnerability works. I started this blog in part as an experiment to see if sharing our vulnerabilities really makes people feel more connected to one another. The answer is an emphatic yes. Every time I read posts warning of trollers whose purpose is to write mean comments on your blog, I brace myself for the cruelty. But perhaps it’s harder to be cruel to someone who has already shared their weaknesses with you.

Perhaps there is less of a need to tear someone down when you know they feel just as flawed as you do.

2. Compassion works. You’re not supposed to judge how well you are practicing compassion, so I will just say that at this point, criticism is still my default. However, the more I practice, the more amazed I am at how powerful it is. MLK day was last Monday, and I think about how someone tried to strike down the message of peace and love. But that has only multiplied exponentially the power of Martin Luther King’s message.

Hate might be easier, but love is stronger than hate, so it is well worth the practice.

3. Prayer works. Every time I pray, I throw in a caveat that I totally understand if my prayer isn’t answered, given how trivial my concerns are in the grand scheme of things. And every time, I am surprised that God cares about my problems, big and small. I hate to admit it, but when I’ve heard people say that in the past, I looked down on them. But now I know it’s true. I guess if my parents care about my problems, why wouldn’t God?

It’s good to be reminded that my suffering is never trivial.

4. I love being alone. I have always been one of those people who had to be in a relationship, even if it was a crappy one. Of all my faults and failings, this is the one I have been the most ashamed of. But it turns out that I am happier when I am not in one. I admit, the first year was hard. I imagine it’s sort of how it feels to go through detox. Which gives me a better appreciation of how hard it is to overcome an addiction.

But now that I am “clean,” I have never felt better.

5. I am a writer! Perhaps the biggest philosophical question in the blogosphere is when you can call yourself writer. When you are published? When you receive your first paycheck? When you have declared yourself a writer? For me, it was when I discovered that many writers are night owls. They are always in their heads. They are plagued by demons that tell them that their writing sucks. They write even when they don’t get paid or published. Even when they find out that fame and fortune are unlikely.

I’m not even sure if I care about publishing a book anymore. Or about trying to make my blog popular. I like the freedom of writing about what I want when I want. I write because the joy is in the act of writing itself.

The Gift of Compassion

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Last week I gave a presentation at work on self-compassion, which was perfect timing. I had just posted my story about depression a few days before and was still reeling from all the thoughts and feelings that had exploded inside me as a result.

Blogging is truly a pay it forward kind of gift. I blog to help other people, but as I said in that post, it has turned out to be the best gift I have given myself. I’ve never had so many people thank me for talking about me. It was as though I had expressed compassion for their suffering when all I did was tell my story. When people thank me and tell me their own stories, every comment is another gift to me. So I received a lot of gifts last week, and I thank you if you were one of the gift givers.

One reader in particular, Abby Gardiner (AKA Stress Bubbles) said that she was sorry that I had suffered so much. I was taken aback. Until then, I was happy with the post because I thought it was a thorough and honest account of my depression, which I had never shared. And I was happy that I was in a place where I could accept my depression rather than feel ashamed about it. But I had not thought of it as a story of someone who had struggled with depression most of her life and whose shame kept her from seeking help.

I felt like Neo at the end of the Matrix when he broke open the code and everything suddenly made sense. I saw how impossible it was not to get depressed given my genes. My family members who are always in crisis. My tendency to choose people who need help because I had always played the helping role in my family. How little help I was able to receive from my family and my partners because of their own problems. And from anyone else because I never said how badly I was hurting. How I had cared about functioning more than myself. I had to get good grades. Get a Ph.D. Teach classes and see clients and rescue everyone I met.

Because she expressed compassion for me, I was able to have compassion for myself. Now, when I think about my story, it feels as though something is pressing against my heart. Perhaps the way it feels to someone whose heart has been jump started with a defibrillator. A bit painful and disorienting, I imagine, but you’re alive. What a powerful gift it is, compassion.

Since then, I make a point of thanking anyone who has shown me compassion. And I make it a point to have compassion for myself–even for the small things. Like having to spend a thousand dollars on a water heater. Or having a cold. Or having to cancel tennis when I was looking forward to it all week.

Because, if I’m being compassionate, then all the small things really aren’t small at all.

Why I Blog About Mental Illness

Yesterday someone asked me to write a 1,000 word essay on my personal experience with mental illness. After I wrote it, I realized that I have never told my story to anyone. I have now added it to the menu on my blog, but I thought I’d include it in a post, too. Here it is:

I come from a family with a history of depression and anxiety. My dad and two of my brothers have bipolar disorder. My mom has an undiagnosed anxiety disorder. And I struggle with both mood and anxiety disorders. Because of this familiarity with mental illness, I played the helping role in my family for many years before I chose my profession. So becoming a clinical psychologist almost felt like a calling rather than a choice.

I first became depressed in high school. It’s hard to separate the angst of adolescence from clinical depression, but I had thoughts of suicide by the age of 15, so I’ll say that it started then. At that time, my diagnosis would have been dysthymic disorder—a more chronic, lower grade version of depression.

When I left for college at 18, I crossed over to major depression. However, I didn’t do anything about it for a year. At 19, I had my first therapy session with a psychiatrist who confirmed my diagnosis of depression. At the time, that was enough to make me feel better—to have someone tell me that what I was going through was real.

So I didn’t follow up with therapy until after I graduated from college, when I was 22. I can’t say I thought that therapist was particularly helpful. He never told me his opinion on anything, never gave me homework, never offered me another way to look at things.

The 3rd time I went to therapy was with my boyfriend right before we got engaged. I was 25 at the time. It was clear that she thought that our relationship problems were because of my depression and suggested that I go on meds, which really pissed me off. We didn’t see her for very long.

Still, she planted the seed of meds in my mind, and I started a trial of antidepressants about 6 years after she suggested it. And it did help. But after a year and half, I stopped taking them because I didn’t want to have to rely on meds to feel “normal.” Then I started them again a few years later when my husband and I started talking about separation.

I also went back to therapy. And she is the therapist who I have seen on and off for 13 years now. Her unconditional acceptance and belief in me, over time, has allowed me to accept and believe in myself. Still, I would see her for as little as I could get away with until I became functional, because I didn’t think I deserved to take up more of her time.

My 2nd major depressive episode happened almost 6 years ago when I was 40. I had stopped taking my meds again, and about 3 months later, I got depressed again. And it was even worse than the first time. It probably took me about 9 months to recover completely.

This time I was not able to just restart my meds and return to normal, so I saw a psychiatrist for the second time. Surprisingly, he was more concerned about things like light therapy, sleep hygiene, and supplements (Omega-3, NAC, Folic Acid) than he was about antidepressants. But I had to take those, too. He also added Ativan, because my anxiety had worsened, and lamotrigine for bipolar depression, because of my family history and my hypomanic episodes.

It was difficult to accept that for the rest of my life I would be on a regimen that requires an AM and PM pill box. But I had suffered so much through this last depressive episode that I got over it and was thankful to pharmaceutical companies for coming up with drugs that could make me feel like myself again.

Since that last depressive episode, I have gotten much better at taking care of myself. Mental health professionals have a tendency to put other people’s needs first, usually to their own detriment. I guess it’s sort of like how physicians make terrible patients. However, my determination to avoid a 3rd major depressive episode has motivated me to make my well-being a priority.

I have never shared this detailed of an account of my mental health history with anyone because I was ashamed of my depression. I felt like a failure. I was supposed to have everything under control, but sometimes I was struggling more than my clients were. But then a few years ago I decided to write a book about self-acceptance where I make use of both my personal and professional experience.

I decided to start with a mental health blog where I would be open and honest about all of the things that I ordinarily try to hide as a way to demonstrate how to practice self-acceptance. Because it’s that hard to do. Even when you know what you’re supposed to do.

Surprisingly, readers are more interested in my personal experience than my expertise. Although I think it helps them to know that I am a psychologist, because it’s further proof that everyone struggles. Being an expert doesn’t make you exempt from suffering. From avoiding help. From resisting treatment. It is all a process that slowly improves with time. And as I blog and get feedback from readers, I become increasingly more comfortable with being me.

So even though I started this blog to help other people, it has turned out to be the best gift I have ever given to myself.

I Don’t Want to Talk About It. (But I Really Do.)

I have always considered myself a fairly open person, but maybe I’m really not. Blogging has made me realize how little I have shared of my suffering with others. Even friends and family. Even when they ask me how I’m doing.

During the summer when I was depressed and my dad was depressed and I was contemplating ending my marriage, I was rushing to a tennis league match, barely able to suppress my tears. One of my players noticed and asked me how I was doing. I just said, “Oh, you know….” To which she replied, “No. I don’t know.” But I still didn’t say anything.

A few months before this I confessed to my parents that I was depressed because I was missing so much work and felt ashamed, weak, and irresponsible. My parents never missed work, and they had far more responsibilities than I did. During my dad’s depressive episodes he still went to work every day, even though it took him forever to do his job. I wanted them to help me with my depression, but I guess I also wanted them to tell me that it was OK that I was struggling. That I wasn’t a terrible person.

But I didn’t tell my brothers. Luckily my mom did it for me, and they each reached out to me and asked me how I was doing. I said I was fine, even though I wasn’t. Even though I had to will myself to go to work and to stay at work every day. It’s only because they read my blog and because I’ve been helping one of my brothers who has been struggling with depression that they now know what that time was like for me.

A few weeks ago I had a client make a public declaration to his friends that he wanted them to approach him if he looked like he was not doing well. And if they asked how he was doing and he said he was fine, he wanted them to push a little harder and make him talk. It terrified him to do this, because he has always valued stoicism, and he’d had a ton of traumatic experiences that he might have to talk about now.

I’m not even sure what possessed him to do something so brave. Even now, I’m not sure I would make such a declaration to my friends and family. I’m trying to make myself ask for help when I need it, and I am more honest now when people ask me how I’m doing. But I haven’t gone so far as to tell them to ask and to hold me accountable if I say I’m fine.

I imagine our work together contributed to his decision to ask for help, but it’s still surprising when clients take steps that are more courageous than anything I have done because of therapy. Sometimes I even use them as inspiration to do something courageous. Sometimes I wish I could tell them how much they inspire me to take risks in my own life.

Maybe I can tell them to read my blog. But I’m still not that brave…yet.

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Running My Own Race

I am a terrible runner. That’s why I decided to take up running 16 years ago. I like to challenge myself to do things I suck at. I wanted to prove to myself that I could run for more than 5 minutes. My husband at the time, being the competitive athlete that he was, said he would train with me if we ran a 5K at the end. Which was intimidating, but I liked the idea of having a running partner, so I agreed to do it.

So we started a 10 week program for beginners. By the last week you were supposed to be able to run for 35 minutes. I couldn’t imagine getting to that point, but in the first week you only had to walk for 2 minutes and run for 1 minute for 7 laps, which was totally doable. So I just focused on my goal for that week and trusted that if I did that every week I would be able to run for 35 minutes by the end, whether I could imagine it or not.

We never made it to the last week but we ran the race, anyway. And it was even more embarrassing than I imagined. We were so far behind everyone else that we couldn’t see a single runner ahead of us. We were even behind the police officer who was supposed to follow the last runner, so we missed part of the route and ran past the finish line in the wrong direction. We assumed people were supposed to cheer when you got to the end, but no one did. So we kept running.

The police officer realized his mistake and told us to run around the block to make up for the segment of the route we missed. We came in second to last, and I finished the race in 36 minutes. But I came in 3rd place in my age group because there were only 3 people in it. I love awards, so I was like, woo hoo! When is the next race?

So we ran 5Ks for a few years before I rediscovered tennis. It always hurt, I never got runner’s high, and I hated everything about it except the sense of accomplishment when I crossed the finish line. Sometimes I would place if it were a small race, but I was still always one of the last runners. Women pushing baby carriages would pass me by. Sometimes I was barely in front of the walkers. But I just focused on my goal, which was to run faster than I did in the last race.

I’ve been struggling lately with posts where bloggers say how many followers they have or how many views a particular post has gotten.  It makes me feel like I’m wasting my time. Sometimes it makes me want to give up. But I don’t. Because even if I don’t have a large audience, I know my blog means a great deal to the small group of people who read it. And that small group of people is still larger than the number of clients I see in a week.

Recently I decided that I would use my running mentality whenever I read a post with numbers in it. I will focus on writing and promoting and trust that in the end, I will get to where I want to be. I will focus on my own progress rather than on the people who are passing me by. I will focus on my own race.

So far so good.

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