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Category Archives: Psychology

In Transition

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If you’ve been reading my blog for a while, perhaps you remember my inner infant–that part of me that gets anxious for apparently no reason but has no words to tell me what she’s upset about. I am still like a new parent who is getting to know their child for the first time. It is a very slow, painstaking process. But I came to a realization last week that has been helpful in being more compassionate towards this anxious baby, who I will call Amygdala for scientific reasons that are too technical to get into, but if you’re interested, you can check out this article.

Every morning when I’m getting ready to leave for work, Amygdala gets anxious and I have to say my standard mantra to her: It’s OK. Everything’s going to be OK. You’re fine. Everything’s going to be fine. And when I’m frustrated, I add although I have no idea what you’re anxious about!  Which is not very compassionate, and therefore not very effective in soothing her.

For some reason, last week I realized that Amygdala gets anxious when I am in transition–from sleep to wakefulness, getting dressed, getting into the car, getting out of the car, leaving work, going to play tennis. I imagined what it would be like for a baby during these times, and I could see why Amygdala would be anxious.

For example, when I am spending the night in a different place for the first time, I will often wake up and have a split second where I don’t recognize my surroundings and not remember where I am. Then I’ll be like, oh yeah. I’m at districts. But babies don’t have very good memories, because their brains aren’t fully formed. So for them, every time they wake up, they probably don’t recognize their room. Or they could have been moved to a different room while they were sleeping. And they’re probably like, where the hell am I?! (If it were a baby that cursed, that is.) What am I doing here? Where is that person who is supposed to be taking care of me?!

Or like how when my niece was younger she never wanted to go to dance class, even though she loves dancing and always enjoys it once she’s there. I never understood why kids do that, since I’m not a parent. But I do know what it feels like to be all content doing whatever you’re doing and then having to get up, change clothes, drive somewhere, and see people, even if it’s to do something I love, like play tennis. It’s hard to overcome the inertia of doing nothing. So I can see why that might be upsetting.

But since I’ve realized this, I’ve figured out something more compassionate to say. Whenever Amygdala cries because I am in transition, I tell her that it’s OK, she’s just anxious because we’re doing something different, but once we get there, everything will be fine. And it usually is.

So maybe I’m becoming a better parent after all.

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I found this while I was looking for quotes on transitions. My inner infant has no idea what it means but she thinks it’s funny.

Perception is Reality

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In “A Beautiful Mind” John Nash, a Nobel Laureate in Economics, talks about how he learns to cope with his hallucinations by ignoring him. That is a pretty amazing thing to do for someone who has schizophrenia. There are several disorders in which the person’s thoughts are so convincing, despite being false, that it is difficult to cope with them by deciding that you’re not going to listen to them.

For example, someone with anorexia may truly see herself as being fat, even though intellectually she knows that she is not. But her inner critic is so persecutory in its insistence that she not eat, not take up space in the universe, that she ultimately gives in. People with eating disorders often conceptualize their inner critic as having a relationship with ED, and ED is the most abusive partner I have ever met in therapy.

Or someone who is psychotic might be convinced that he is going to win a million dollars because Publisher’s Clearing House has told him that he may have already done so. And despite the fact that the check has not arrived in the mail after several years, he makes outlandish purchases based on the prize money that he is convinced is on the way.

I do not have delusional thoughts, but sometimes my obsessive brain tries to convince me of things that are not as insidious but still cause me to suffer. No one gives a crap about me. I am incompetent. Sometimes I can convince myself otherwise with objective evidence, but sometimes my inner critic is relentless in trying to convince me of the veracity of these assertions. It will repeat them hundreds of times a day. The effort to refute them is exhausting.

My psychiatrist tells me that I should put myself out of my misery at the beginning of this barrage by taking an Ativan as soon as the thoughts begin. But often I don’t because, despite all I’ve said about the importance of taking meds, sometimes I still don’t want to. And because, unlike depression, anxiety feels so normal that sometimes I forget that it is not. The meds definitely help. Most of the time I know that when the thoughts come, they are not true. But sometimes it takes a lot of work to keep them at bay.

Practicing mindfulness helps, too. One of the benefits of practicing is that it helps you understand the nature of the mind. Even for “normal” people, this is how the brain works. Random thoughts will pop up. They may not be based in reality, may not reflect what you actually believe. And in the next moment, the thoughts may be completely different.

But it’s really hard. Maybe if I dedicated my life to meditation like Buddhist monks do, my inner critic would be less effective in undermining my self-worth. Or maybe Buddhist monks don’t suffer from mental illness.

But my psychiatrist supports my mindfulness practice, in addition to my meds. He confirmed that it works, even for people with mental illness. But it takes a long time, and it happens very slowly. I know it works because I remember what I used to be like. And now when I go several days without meditating, in my moments of weakness the thoughts creep in and become more convincing.

So I continue to practice, and in the moment, I feel loved, competent, and worthwhile. So I’m writing this post to remind myself that this is true because, in the next moment, I may feel differently.

Head Games,Part 2: Sportsmanship

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I have always prided myself on not using head games to win. However, this morning, as I started obsessing the moment I became conscious, I realized that this is not completely accurate. If head games are something you use to affect your opponents’ behavior, then I am guilty as charged. But not in the way you might think.

Last month while I was at districts, I played a match in which my partner and I were frustrating our opponents with our game. They tried to make adjustments, but they weren’t working. I could see that they were starting to lose it. They started arguing with one another. A few points later, they went ballistic when I called a ball out. As I have mentioned in previous posts, I tend to be overly generous with line calls because I’m afraid of going to hell. But it was so obvious that this was a ploy to disrupt our concentration that I was uncharacteristically dismissive of their protests. Then, during the changeover, they complained to the official that we were taking too much time. At that point, I actually started laughing, their tactics were so transparent.

In the next game, one of the opponents hit a good shot, and I acknowledged it, because that’s what I always do. My partner said they don’t deserve compliments, but I explained to her that if I let their behavior affect my behavior, they win. Their head games worked. It’s not that I wanted to be nice; I wanted to send the message that there was nothing they could do to disrupt my concentration. That I was mentally tougher than they were.

Interestingly, my good sportsmanship was so disarming that they, too, started acknowledging our good shots. And by the end of the match we shook hands cordially, and our opponents did not show a trace of the animosity they had demonstrated earlier. And I have to say, I was prouder of myself for the way I handled their head games than I was for the way I played. Although the win felt good, too.

What a revolutionary idea. That good sportsmanship can be as contagious as poor sportsmanship. It is the most effective head game you can use. It makes you look foolish if you continue to yell and complain when your opponent is complimenting your shots. It calls attention to your bad behavior. So unless you want to feel like a bad person, there’s nothing left to do but to be fair in return. In social psychology, this is called reciprocity: people give back the kind of behavior they have received from another.

Can you imagine if we applied this strategy in real life? If, whenever someone accused us of doing something that upset them, instead of getting defensive, we say I’m sorry I’ve hurt you. If, when someone tries to pick an argument with us about politics or current events, we say, well that’s an interesting perspective. I can see why you would feel that way. Not because we like them or agree with them, but because we don’t want to give them any more ammunition. Because we want to disarm them. That would be a much more powerful weapon than retaliation.

And when it comes to mental toughness, I’m all about winning.

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Defending Hope

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Guess what the best predictor of suicide is? Here are some possibilities, in multiple choice form, since I used to be a psychology professor.

  1. a diagnosis of depression
  2. a diagnosis of anxiety
  3. feelings of helplessness
  4. feelings of hopelessness
  5. all of the above
  6. none of the above

I just threw in those last 2 options because students hated those. They are a bit sadistic, I have to admit.

The correct answer is…#4. Hopelessness.

I have only recently become aware of Hope. Among the cast of characters in my mind, like the Inner Critic and the Drill Sergeant, you’d think discovering Hope would have been a pleasant surprise. But I was actually annoyed with her. I had been calling her by a different name: Delusions of Grandeur.

In a previous post on optimism, I defended its merits even when it believes in something that is statistically unlikely to happen, like winning that lottery. Or that you’re going to win when you’re down 0-6, 0-5, 0-40 in a tennis match. I don’t feel like I risk too much by being optimistic, because when I lose, it’s really not that devastating. I wasn’t expected to win.

I don’t feel the same way about hope. Hope wants me to believe in things when the stakes are high. She wants me to put my dreams out there, knowing that they may get dashed. To open my heart up, knowing it might get broken. To believe in something, knowing that I might become disillusioned.

I blame a lot of my failed relationships on Hope. I yell at her whenever I think about the pain I’ve endured. How foolish she was. What the hell were you thinking? That was a terrible idea! Why did you not heed the warning signs? Why didn’t you protect me?

That’s why sometimes I am not so kind to her. Especially after I’ve been hurt. Hope must die! I must kill her off! So she hides from me. Slips between the cushions of the couch and throws pillows over herself so I won’t find her. Because I’m really not that thorough in my vacuuming.

Sometimes she tries to placate me. Pretends she agrees with me when I say things like, what’s the point of trying to get a book published? No one will probably read it, anyway. But then she tricks me into writing another blog post. Like tonight. Maybe it will make you feel better, she says. That’s the goal, after all. Not fame and fortune. It’s meant to be for you. Except she still secretly believes I will become a famous writer someday.

The truth is, I need Hope. I mean, she thinks I’m great. How can I kill off a part of myself that thinks I’m great? And she inspires me to do great things. It is because of Hope that I became a therapist. Without her, I would never have been able to help anyone.

And even when she breaks my heart and leaves me disillusioned, she convinces me that things will get better. That is the thing that keeps people alive, even in the midst of depression, after all. The hope that things will get better. So Hope has actually saved my life many times.

So I guess I’ll try to be nicer to her.

 

May We All Accept Things As They Are

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As a part of my compassion practice, I am currently reading Lovingkindness: The Revolutionary Art of Happiness, by Sharon Salzberg. Today’s chapter was on equanimity, which is “a radiant calm that allows us to be present fully with all the different changing experiences that constitute our world and our lives.”

I can definitely use some of that. It’s hard to have a “radiant calm” because I have an anxiety disorder, so I obsess all the time. In my last post where I was describing how happy I was on Sunday, I really did obsess about death and bodily injury later that day. Luckily, I was able to focus my attention back to the present moment, which made me happy again.

And sometimes I get depressed for no apparent reason, which is maddening. Or sometimes there is a reason, but that’s still maddening, because I can’t function. The ups and downs that everyone experiences are a bit steeper when you have a mood disorder. Still, I try to accept whatever it is I’m feeling, whether it makes sense or not. To remind myself that this is the natural ebb and flow of life.

And I take my medication.

The equanimity meditation is actually about accepting that you can’t control other people’s behavior. Like getting mad when people don’t take my advice. Which is ill-advised, but I guess people can make bad decisions if they want to.

Seriously, though, one of the things that brings clients the most suffering is that other people aren’t behaving the way they want them to. If they would just text me back. Or put their dishes away. Or not hook up with anyone until we graduate. Then my life would be better.

Most of the meditations on lovingkindness are about sending yourself and others the hope that they are healthy, happy, safe, and free from suffering. Practicing equanimity means that we send these good intentions without trying to control the outcome. We understand that, no matter how much we want good things for other people, ultimately they have to help themselves; they have to take responsibility for their own happiness.

Salzberg refers to this as the release from codependency in psychological terms. Which is ironic, because I never heard the word codependent once when I was getting my Ph.D. in clinical psychology. You don’t read self-help books for your course work, so I had no idea what people meant when they said I was codependent. But now it’s pretty clear that I am. The whole feeling other people’s feelings thing. And trying to control other people’s behavior.

The words you recite in the equanimity meditation are:

All beings are the owners of their karma. Their happiness and unhappiness depend on their actions, not on my wishes for them.

That’s a lot for me to have to remember to say, so I opted for the shorter version when I did the meditation, which is “may we all accept things as they are.”

When I did the meditation earlier tonight I was feeling sad, and after I did the meditation, I can’t say that I felt significantly better. But then I remembered that I can’t practice the meditation with the intention of controlling my feelings; I just have to accept whatever they are in the moment.

But now that a few hours have passed, I do feel better. Which is a reminder that in the ebb and flow of life, happiness will return to you at some point.

I’m In Between Shoes Right Now

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Today I woke up happy because I had a good day yesterday. My tennis team won, my other team almost won, I got to play, and a bunch of my friends went out to eat afterwards–which is always my favorite part. And even though I lost my match, I played well and we split sets. The last time I played with my partner we had a set point but we blew it, and this time we closed the set out, so this match was an improvement. My friend told me that I am always looking for the silver lining. I know some people don’t believe in small victories, but I think you’re a lot happier if you do.

I was watching this commercial the other day about these athletes who were giving this guy’s daughter advice about life. David Robinson gave her positive advice, but I can’t remember what it was. This other guy who was supposed to be some loser said, “remember–success is just failure that hasn’t happened yet.” Which I thought was freaking hilarious. That’s a good illustration of what life is like when you don’t look for the silver lining.

My tennis partner gives me a hard time because he says I’m setting my sights too low and I don’t have enough faith in myself. And it’s true that I’m happy as long as we don’t get killed, but I prefer to think of it as being easily made happy about the small things. Like hitting a good forehand, since that’s my weakest shot. Or free pie on Wednesdays.

Nevertheless, I still get that sense of foreboding joy that Brene Brown talks about in her book “Daring Greatly.” I still worry about when the other shoe will drop. Sometimes after something good happens I’ll even switch to worrying about death or bodily injury, thanks to my anxiety disorder.

I just looked up the origin of that phrase, because why would it be so terrible to drop a shoe? Apparently it has its origins in NYC. In the late 19th and early 20th century, apartments were built so that the bedrooms were on top of each other, so it was common to hear when your upstairs neighbor took their shoes off. So the phrase refers to that maddening feeling of when you’re waiting for something that is inevitably going to happen. Last night on 60 Minutes they had a feature on this guy on death row who asked to be executed as quickly as possible for that very reason; he just wanted to get it over with, even though he didn’t want to die.

Most of the time I hear people say it after something good has happened and they know this means that something bad is going to happen soon and ruin everything. However, when we are feeling down, we don’t wait for the other shoe to drop; we think we’re going to feel bad forever.

When clients express this fear, I tell them to think about both positive and negative feelings as things that ebb and flow, even if we do nothing. So it’s true that when something good happens, something bad will follow at some point. But it’s equally true that when something bad happens, something good will eventually follow. The key to happiness is to be able to savor that moment, in between shoes, even though you know that at some point you won’t be happy. This works for negative feelings, too; in this moment you may be sad, anxious, or angry, but at some point you will be happy again.

So while I know that the next post you read may well be one in which I say I’m feeling depressed or anxious, in this moment I am happy, and I’m going to let myself enjoy this moment for as long as I can.

Trauma and Resilience

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So I’m at this conference on mindfulness, trauma, and addiction right now. For some reason, I seem to be drawn to these topics. Just like for some reason, I seem to be drawn to guys who’ve been traumatized. And to therapy, in general.

Actually, I think I know why. It occurred to me earlier this year that my interest in trauma may be more than just intellectual curiosity. I am always “jokingly” saying that I was traumatized by my some of my past relationships. I have mini-flashbacks. I shut down when people yell at me. I have an exaggerated startle response.

And I had anxiety attacks during the presentations on trauma at this conference. Yesterday afternoon I had to take an Ativan because I felt like I was drowning. I couldn’t go back to the conference today; two days of listening to examples of my relationship history were all I could tolerate.

Still, like my clients, I look back at the events of my life and think, was it really that bad? There are lots of people who had it worse than me. But the more I learn, the more I realize that everyone has experienced some trauma.

In my case, having a parent with a mental illness was traumatic. Having a spouse with a mental illness was traumatic. And coping with my own mental illness while I tried to help the people I loved with theirs was also traumatic.

I was reminded during this conference that many therapists have experienced trauma. Helping others is a way to have a sense of mastery over our past. That’s why it seems depressing to most people to spend all day listening to other people’s problems, but it isn’t to us.

You would think that realizing that I have been traumatized would make me feel bad about myself, but the opposite is true. Instead of thinking that I’m weak and pathetic because I get overwhelmed easily and shut down and can’t function, now I think, look how awesome I have coped with everything! I kick ass!

In fact, resilience, post-traumatic growth, and grit are the new darlings of positive psychology. Some people thrive in the face of traumatic events. Sometimes they even find a way to turn it into something good–usually by trying to help other people.

For example, the student organization that I supervise, Active Minds, was founded by Alison Malmon, whose brother committed suicide while he was a student at the University of Pennsylvania. He had not told anyone that he was suffering from schizoaffective disorder, including his family. Alison recognized that many students probably lived in secrecy like her brother did, so she created Active Minds, whose goal is to raise awareness and reduce stigma about mental illness on college campuses.

Let me make clear that I am not in any way saying that everyone should be able to overcome traumatic experiences if they try hard enough. Some of it is luck. I have many resources that other people do not, for which I am thankful, but I didn’t do anything to earn them.

Still, for me, finally acknowledging that I have lived through traumatic experiences doesn’t make me feel broken. It actually makes me appreciate how strong I am.