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Category Archives: Mental Health

How to Predict the Future

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If you’re psychic, this blog post does not apply to you, because you already know how to predict the future. For the rest of us, there are a range of options for predicting the future, each with their pros and cons. In this blog post, I will review the primary strategies so that you can be more informed and mindful about employing whichever one you choose.

  1. Worst-case scenario. This is the most common strategy I see in therapy. It involves things like predicting you will fail your test, and then your class, and then college altogether, and then you’ll end up flipping burgers at McDonald’s. People who use this strategy are not delusional; they know they are picking the worst-case scenario. Their argument is that if things go poorly they will be mentally prepared, and if things go well they will be pleasantly surprised. The problem with this strategy is that it causes unnecessary stress, since the worst-case scenario is not likely to happen. And, if you’re trying to practice self-care, your goal is to eliminate unnecessary stress. Plus, even if the worst-case scenario does happen, you can prepare for it then, just as well as you can prepare for it now, and save some energy.
  2. Optimism. In this strategy, people assume that things will turn out in their favor, even in cases when this might be statistically unlikely. In fact, even if your optimism is not based in reality, there is research to suggest that it is still effective in creating positive outcomes and feelings of happiness. One recommendation for how to capitalize on the benefits of optimism is to write your goals down as though you have already accomplished them. (I’m trying this out for myself and have started writing I’ve lost 10 lbs. every day to see if it works. I’ll let you know.) The downside to this strategy is that, from a mindfulness perspective on happiness, we do not need to rely on any particular outcome to be happy. Well-being can be created by learning to be fully present in this moment, whatever it looks like. Assuming that things will turn out the way we want them to, on the other hand, makes our happiness dependent on a favorable outcome.
  3. No expectations. This strategy is best illustrated in the expression “expect nothing but be prepared for everything,” which presumably came from an ancient samurai warrior, according to Jerry Lynch in The Way of the Champion. With this mindset, you do not assume that you will win, but you expect that you will do your best, regardless of the result, because doing your best is all you can control. And you expect that, whatever happens, you will learn more about yourself and become a better person because of it. This strategy is more consistent with a mindfulness approach because it does not assume that we have more control than we actually do. It also does not assume that a negative outcome is necessarily a bad thing. The biggest drawback to this strategy is that it forces us to live with the anxiety of not knowing what will happen. Our fear of uncertainty is so great that imaging ourselves failing out of school and flipping burgers at McDonald’s seems less anxiety-provoking than the ambiguity of the unknown.

It’s probably obvious what my bias is. I encourage my clients to have no expectations. When making predictions about the future, I encourage them to substitute their negative predictions with the mantra “I don’t know what will happen,” and reassure them that whatever happens, they can have faith that they will be able to figure out a solution when the time comes.

How to Tell if You’re Lazy

lazy cat

I have clients tell me that they’re lazy all the time. Even though they are all high achieving, perfectionistic, over-scheduled students who work more hours in a day than I do. And I work a pretty full day myself. Why is that, you may ask? That doesn’t make any sense. Because that’s how mental illness is; it doesn’t make any sense.

Usually when people beat themselves up for being lazy it’s a telltale sign that they’re probably depressed. A better word for laziness would be something like fatigue. When people are depressed they have no energy, no motivation. Nothing is enjoyable. Getting out of bed is too much effort. But it can’t be depression. That’s just an excuse. I don’t have real problems. I’m just being lazy.

Sometimes being paralyzed with fear can feel like laziness. Because fight or flight aren’t the only possibilities in the face of fear. Sometimes you freeze, like a deer in headlights. This is usually what happens when students have a paper due the next day but they have been staring at a blank screen on their computer for hours without typing a single word.

We do need a certain amount of anxiety to be motivated to do anything, but it doesn’t take much to go from the kind of anxiety that motivates you to the kind of anxiety that paralyzes you. Especially when you try to motivate yourself by saying you suck, you’re disappointing everyone, you’re going to flunk out of school and end up homeless. Not exactly a pep talk. And yet, this is the kind of stuff we say to ourselves all the time.

The ironic thing is, when I was looking for a meme on laziness, I discovered that people who really are lazy don’t feel bad about it. They’re out there looking for hacks to make the most out of their laziness–trying to figure out how to make it seem like they do yoga, or what comfortable clothes they can buy to lounge around in. There’s no shame about it at all. In fact, many of the memes are about wearing their laziness on their shirts like a badge of honor. Literally. Like this one:

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And this one:

Not productive

In case you were too lazy to read the whole blog post, I’ll summarize it for you.

Here are 5 signs that you are not really lazy:

  1. Your therapist tells you that you are depressed.
  2. Your therapist tells you that you are anxious.
  3. You think you’re a loser and a terrible person.
  4. You worry about homelessness.
  5. You feel a strong affinity to deer in headlights.

And here are signs that you might actually be lazy:

  1. You’re a cat.
  2. You own one of those t-shirts.
  3. You have a Pinterest board about hacks for lazy people.
  4. You don’t read them because you’re too lazy.
  5. Being lazy doesn’t really bother you.

And if you were too lazy to read those signs, then here is the one-sentence moral of this story:

If you’re beating yourself up about being lazy, then you probably aren’t.

50 Shades of Blue

shades of blue

When I was in grad school, clinical depression was described as this discrete period that occurred in episodes with a clear beginning and ending. It was even called the common cold of mental illness. Like you would know when you had caught it, and then you’d get better and be in remission. If you had a genetic predisposition, you could be at risk of recurring depressive episodes, potentially for life.

You could also have this more chronic but less severe form of depression called dysthymia. Sometimes you could be unfortunate enough to have dysthymia and major depression at the same time. Double depression, it was called. As though you could have carefully measured doses of depression, and double depression has 2 cups of symptoms instead of 1. Which is strange, because you can’t have double of any other mental disorder.

Now that I’m a practicing psychologist, I know that the diagnostic categories are not as neat and clean as they were made out to be. As a person who has been depressed for most of my life, I can say that major depression feels distinct, but it is not always clear when I am depression-free vs having dysthymia. There are times when I didn’t think I was depressed in the moment, but when I look back, it’s clear that I was.

Often we tell clients who are on meds that they can begin tapering off once they are in a period of stability. Over the summer, perhaps. Or some time after they have gotten settled in their new job. Maybe the problem for me is that there is never a period of stability. Never some time when there isn’t some family crisis. When there isn’t some problem that I’m dealing with. If anything, I would say there have been episodes of stability that have broken up the more chronic feeling of being depressed.

I don’t to want give the impression that I’m always miserable, because I’m not. Like I said, sometimes I don’t even realize I’m depressed. Sometimes it only lasts a few hours or a few days. And it doesn’t feel the same every time. So at least there’s some variety to it.

Every now and then I get upset about how unfair it all seems. The depression. The anxiety. The family craziness. The stress that comes with thinking I need to save the world. But life isn’t fair, right? And I am blessed and fortunate in other ways. If I had to choose my suffering, at this point I’d choose mental illness, because at least it’s familiar to me. I know what to expect. I know how to manage it.

And the meds do help. So does therapy, self-care, mindfulness, and self-compassion. I think depression has made me wiser. It has made me a better therapist. I’ve learned to accept the ebbs and flows of my mood, and of life in general, without beating myself as much, because I’m doing the best that I can.

This week is finals week. We are all willing ourselves to make it to the break, exhausted from the semester. Despite taking my meds, talking to my therapist, and practicing self-care, mindfulness, and self-compassion, I’ve still had bad days. But I’m determined to get that Perfect Attendance award, so I’ve made it to work when I’m supposed to be here.

Today I would call my mood cornflower. Which is a pretty shade of blue.

Take the One Day Judgment-Free Challenge

Even though I have been practicing and teaching self-compassion for several years now, it is still extraordinarily hard not to judge myself. I’m more aware of when I do it, but I still do it a lot. It is just so deeply rooted in the way we think. So automatic that it’s hard to catch, even when I’m being mindful of my inner dialogue. And so hard to come up with alternative statements. Let me give you some examples of some that I have been struggling with lately.

One thought I’ve been having difficulty with is that I feel fat, because I really have gained weight since my brother moved in with me. I specialize in eating disorders, so I know that fat is not a feeling. Yet it conveys the way I feel better than any feeling words I can think of. Usually my next thought is, I know I shouldn’t be focused on my appearance, but should is a judgment word, too. So now there are 2 sentences I need to change. And need is borderline judgmental. And on and on it goes. It’s hard to even get a sentence out without having to rephrase it.

The should sentence is easier because I practice reframing should statements with students a lot. It could be something like, I feel guilty and ashamed that I still care about how I look. (I would like to end that sentence with, even though I know better, but that’s judgmental, too.) That’s a lot longer to say in my head  than I feel fat, but it doesn’t make me feel like I’ve already failed.

The feeling fat sentence is harder. Maybe it could something like, I’m ashamed of my body in this moment. I kind of feel ashamed for feeling shame, too, but it’s OK to feel whatever we feel. There is no right answer.

Most of the time it is about shame when we judge ourselves or someone else. We think we–or the other person–is a bad person. Maybe they were mean to someone. Maybe they cheated. Maybe they voted for the other party. But I know I’ve done things that I’m ashamed of, and I try not to think of myself as a bad person. So who am I to say that someone else is a bad person? Who am I to say that I am better than anyone else?

Which brings me to the next sentence that I have difficulty coming up with a compassionate alternative for. And that is, I feel pathetic. Like fat, pathetic isn’t a feeling, either. But when I try to come up with other sentences, it’s something like, I feel like a loser, which is equally judgmental. The closest thing I’ve come up with is something like, I feel embarrassed, humiliated that I did that. That’s still painful to admit, but it’s the truth. Whereas being pathetic is not. Hopefully.

When all else fails, I use my favorite mantra: I’m doing the best that I can. Because I know that’s true. And all you can do is all you can do.

Since taking challenges is the in thing to do these days, I’d like to invite you to take a One Day Judgment-Free Day with me. See if you can spend just one day paying attention to whether you use judgmental language. And when you notice that you have, take a few minutes to think about how to rephrase that sentence. It will be tough, and you may find yourself judging yourself for your judgments, but be compassionate about that, too. We all do it. It doesn’t make us bad people.

If you do take on the challenge, let me go how it goes! I’d loved to hear what it was like for you.

The Flip Side of Narcissism

We’ve all heard about the narcissistic epidemic. Students feel entitled to A’s, and if they don’t get them, the teacher may hear from their parents about it. At sporting events, we wear giant foam fingers claiming We’re # 1. Because who wants to be #2? Our selfies must be cropped and filtered to show us in our best light. Our houses must be bigger and better than our neighbors. Our salaries must be higher.

And these are just examples of culturally acceptable narcissism. The next level is the narcissistic personality. You know, that person who brags about their kids, their accomplishments, their possessions to no end. They may even point out how much better they are than you–if not to your face, then at least behind your back. And if you have something that they don’t, they’ll be sure to criticize it and devalue it to make themselves feel better about not having it.

Do these people have abnormally high self-esteem? Not in my experience. People who feel good about themselves don’t feel the need to prove how great they are. And they prefer to make other people feel good about themselves rather than tear someone else down. People who feel worthwhile are content to be average–no better, no worse than anyone else.

On the flip side of believing that one is exceptionally good is the belief that they are exceptionally bad. Undeserving of the things that other people are entitled to. They have to get an A, or be #1, because anything less than perfect is failing. They can’t have problems, or go to therapy. They can’t look bad, grow old, or be wrong. They cannot be human. If you point out their humanity, they may become rageful and attack. Or feel unbearable shame. Sometimes you can feel how fragile they are underneath, so you don’t poke holes in their argument because you can sense that they might fall apart.

While it may seem that narcissists suffer from excessive self-love, the reality is that they don’t believe they are lovable. Hence, the need to be perfect. The best. Enviable. Only then can they believe that other people might want to be around them. But because no one is be perfect, the need to accomplish and impress is endless. There is never enough proof that they are worthy of love.

And even when they come close to their goal of seeming perfect, this does not make other people love them. Or sometimes even like them. They are hard to listen to in casual conversation. Hard to be friends with because they have to compete with you. Hard to be in a relationship with because you can never convince them that you love them. Sure, they may draw you in initially with their charisma, but once you get to know them, you can feel how endless their need for admiration and affirmation is. A bottomless pit that you can never fill, no matter how much you try to convince them that they are enough.

I’ve been in so many relationships with narcissistic people that I’ve become an expert on this subject. I have been made to feel not good enough. I’ve been made to earn people’s love. And I am not without my own narcissistic traits. I know I have made other people feel the same way. But I’m trying to change that. I consider myself a narcissist in recovery, because like people in 12 step programs, I believe it’s something that I can never be cured of completely.

Perhaps you recognize yourself in this post and also aspire to be OK with being you. How does one go about doing that, you might ask. Well, it’s not easy, but it begins with self-love. Self-compassion. You remind yourself repeatedly that you are OK exactly as you are–despite every flaw, every mistake, every failure. You don’t have anything to prove. You don’t have to deserve to be loved. You can accept yourself exactly as you are.

Sometimes when I tell clients this in session, they cry. I am guessing that’s because they’ve never heard anyone tell them that they are OK, just as they are. You can’t make other people tell you this, but you can say it to yourself. If I can learn to accept myself, so can you, because we are ultimately all the same. All trying to figure out how to do this being human thing. So I see who you really are, underneath all that narcissism, and I know that you are enough, just as you are.

Why Try?

ocean with a ladle

So I read that doom and gloom article on the state of the world because of global warming. Since the changes that must occur to save the earth need to happen on a level that I cannot participate in–things at the policymaker level–I wondered whether my obsessive recycling makes a difference. Whether it matters if I recycle the rolls for toilet paper and paper towels. And every receipt and scrap of paper that my to do list is on. One could easily conclude that it’s all pretty hopeless. Or not true. Or irrelevant, since I’ll be dead by then. I don’t even have kids who will have kids who will be affected.

But I believe it’s true. And relevant.

Often people ask me a similar question about therapy. Doesn’t it depress me, working with all these unhappy people? And in my darkest moments, I wonder how much change people are capable of. Not so much my clients. I am narcissistic enough and they are young enough that I feel confident that they can change. But I wonder how much change is possible once you’re middle-aged like me, or older. Is it hopeless at this point? Have all the traumas, the mistakes, and the accumulated stress caused irreparable damage? Like slathering yourself with baby oil all your life rather than sunscreen?

In an article in Men’s Health they say that 50 is the new 20. But maybe they’re just saying that so you’ll keep buying the stuff in their ads.

I go through this cycle of thought many times. What am I doing? Is it worth it? Does it even make a difference to try so hard? It’s like having the goal of being good. Even if you’re earnest about it, it’s hard to feel good enough. Especially if you’re earnest about it, in fact.

So I went on a quest to find out what would be a better goal than trying to be good, and the answers were 1) to be self-aware and 2) to be loving. It’s like that quote about how if you have to choose between being right and being kind, choose kindness. Being good feels like choosing to be right. Being self-aware and loving feels like choosing to be kind.

But I digress. What does this have to do with wondering what good it will do to recycle? Or how much I can really help my loved ones and myself so late in the game?

I guess I treat every decision the same way. I try to choose what makes me feel like a better person, regardless of the result. Regardless of whether it is going to lead to success. Trying to save the earth, myself, and the people I love is choosing to be kind.

Sometimes it feels like trying to empty the ocean one bucket at a time. But I guess being in the water, trying to do something, feels better than standing there on the shore, feeling overwhelmed by the vastness of the problem. If it’s a choice between doing something and doing nothing, I choose to do something.

So I keep recycling. I try to stay hopeful about myself, my brother, and my life in general. Because what is the purpose of life, if it isn’t to try?

The Daily Grind

daily grind

Sometimes I wonder if other people have to will themselves to get through the day like I do. I know it’s not compassionate to compare myself to other people, but sometimes that’s what I do. Like, when my brother and I were living in a one bedroom apartment and we had even less personal space than we did before we moved out of my 1000 sq ft patio home, I told myself that it’s not as bad as being a refugee fleeing to another country from an oppressive government. They probably have to sleep outside somewhere with people all around them. So suck it up!

Or when I have to come home from work and go by the grocery store and cook dinner and do the dishes and do my light therapy and stretch and then start my nightly routine, I feel like a single parent. Because before my brother lived with me, I wouldn’t cook dinner because it requires meal planning, going to the grocery store, cooking, and dishes. I would just fall asleep from exhaustion when I got home and wake up at midnight and get ready for bed.

So then I’ll be like, well it’s not as bad as being a single parent. Think about what that would be like. You think this is bad? People struggle way more than you do!

Or when I have to wake up in the morning and have a full schedule of clients ahead of me today and every day, knowing that I have no vacation or sick days to take and I have to be perfect, I tell myself to think about that guy from the Coast soap commercial from the 70’s. He could barely get out of bed. It wasn’t until he showered with new deodorant Coast, which brings you back to life, that he was able to face his day with enthusiasm. Other people struggle to get out of bed. So get up!

And then at some point I catch myself and remind myself that these are not compassionate ways to motivate myself. My mental illness is real. There are people who have my conditions and can’t hold a job, don’t make it into work, and can’t perform adequately when they do. I read recently that, according to the Centers of Disease Control and Prevention (CDC) depression is the 2nd most common cause of disability in the world. (Heart disease is the first.)

So then I do my compassionate mantras. What you’re doing really is hard. You’re juggling a lot of things. You’re doing the best that you can. Am I really? Yes, of course you are. You always do.

This semester, instead of running scared at the thought of getting sick when I don’t have any days off, I’m trying to use my inner warrior approach. I checked my balance yesterday, thinking that I had at least 2 days of leave, but I have none. And I panicked.

But then I thought, you know what? I got the perfect attendance award once in 6th grade. I didn’t know until 15 years later after I had to go to my high school to get proof of my existence after my purse got stolen on the way to a UVA bowl game (which is a blog for another day). It was still in my file, unclaimed. Clearly I had missed the day they were giving out awards, but still. I didn’t think I had ever gotten perfect attendance.

So instead of running scared, I have decided to think of it as a challenge. Like the kinds of challenges I always do, but this time it’s not just for kicks. It’s for real. I have to make it in. So I’ve added the Perfect Attendance Award to my New Year’s Resolutions, in addition to letting go. At least for this semester. Enough time to build up some days. I can do it! Warrior! RAAH! (That’s my warrior cry.)

My boyfriend thinks that’s unrealistic. I’m working on some other ideas, but so far this is the best one I’ve come up with. I’ll let you know how it goes.