RSS Feed

Category Archives: Self-Acceptance

Control What You Can Control

979dae5347bc4abdf9d0f19b72e535eb

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.

If Only…

waiting-for-happiness

It’s that time of year again–after Daylight Savings Time, shortly before Thanksgiving–when I am the most at risk for a depressive episode. But this year I am determined not to have one. Or at least to control whatever is in my control to prevent one. I mean, that is always my goal, but I do have an added incentive this year: I have to be able to take care of my brother, which means I have to take care of myself.

I am happy to say that I have been much better about setting boundaries as a result of this added motivation. I can only help so many people. I can only worry about so many things at once. I can only take on so many responsibilities.

The biggest problem is that, despite all of the blog posts I’ve written about letting go of those illusions of happiness that people cling to– money, beauty, the perfect relationship, extra hours in the day–I still cling to my illusions of happiness. I feel this restlessness that can’t be soothed. I long for something that will take the edge off. I turn to something that will only provide fleeting moments of relief, at best.

Lately I’ve been turning to shopping. I know it’s compulsive. I know that the relief will be temporary. I repeat this to myself as I fill my cart, put in my credit card information, and hover over the order button.

Sometimes I can talk myself out of it for a few days. But during those days I still obsess over it. Would it really be so bad if I bought another pair of boots? Don’t I deserve some indulgence, given the crappiness of my life?

So I give in and hit order. But a few days later, I have the itch to shop again. And then I have to take money out of savings to pay my credit card bill. And then I obsess about not having any money. And then I feel deprived, so I want to buy more stuff.

The problem is, I need something to think about. And if I’m not going to fill my head with all of these illusions of happiness, then what, exactly, am I supposed to think about?  So then I try to remember what all of those mindfulness books say about happiness.

I list all of the things that I can be thankful for. This is tricky, though, because if I see an accident on the side of the road, I think, I’m glad I haven’t gotten injured in a car accident. But then my obsessive brain will be like, oh my God! What if I get in a car accident?!

So then I have to switch to practicing self-compassion and tell myself that we’re not going to focus on car accidents because that stresses you out. We’re trying to focus on things that will make you feel more content. Like, how nice the weather is today, given that it’s the middle of November.

Or I’ll try to be fully present by focusing on whatever it is I’m supposed to be doing in that moment. Like driving. Or listening to my client. Or watching UVA get killed in football. Or I’ll do something that I enjoy, like knit, or read, or write.

But eventually I give in and shop some more. So then I have to switch to practicing self-compassion again and remind myself that I’m doing the best that I can.

It’s a lot of work, quite honestly. But it does occupy my mind with something other than illusions of happiness. So I’ll keep practicing and see if it keeps me from getting depressed.

shoes

Do you think I bought too many shoes?

Being Present, Part 2

presence-and-gratitude

Yesterday I met with a client whose grandmother is coming to the end of her battle with cancer and Alzheimer’s. Of all of the scenarios I can imagine, practicing mindfulness when your loved one has a degenerative disease seems the most challenging. Every day you try to be in the moment, grateful for good days, for what they are still able to do, knowing that eventually they will have fewer good days, fewer things they are able to do. But I guess there is always something to be thankful for–that their suffering is over, the pleasure of having known them, memories that you treasure.

This past month and a half has been tough. Practicing mindfulness and gratitude have become survival mechanisms rather than a choice. Sometimes I think about what my life was like in August, when my primary stressor was going back to work after being off for the summer, and it seems like a luxury. Now, in addition to the usual stressors of work and family crises, I have become a parent.

Ironically, the hardest part is the stuff that “normal” people do every day–meal planning, cooking, grocery shopping. Domestic tasks in general. I hate all of them. Even if I were married, I wouldn’t be as domestic as I am now. But I have no choice while my brother recovers from heart surgery.

In moments of weakness, I think about what my life used to be like. I never thought I’d say this, but I miss my solitude. I miss boredom. I miss the freedom of not having to go to the grocery store and eating a bowl of cereal for dinner instead. Of spending hours reading and writing in my journal, even if it was because I had no one else to talk to.

Likewise, I feel even more saddened by my single state. Before, although I didn’t love it, being single felt more like a choice–even though that was an illusion, since I hadn’t met anyone. Now dating isn’t an option. I barely have time to get ready for bed.

I know that I am not clairvoyant. I don’t know what the future holds. Things won’t be like this forever. Still, my current situation is a loss of freedom similar to what I experienced when I got divorced. Although I would have never quit my job while I was married, we could survive if I lost my job. Knowing that I had to work after I was divorced made keeping my job a necessity that caused me anxiety.

But as soon as I become aware of these thoughts about my past and future, I have to focus on the present. Not because I am trying to push myself to a higher state of happiness or enlightenment, but because it’s all I can do to get through each day. I would not have chosen my current situation, but hardship is an inevitable part of life, and my life is no exception to the rule. I cannot think about what my future holds because there are so many things to come that are overwhelming. I can only focus on this thing, in this moment.

This week that thing is returning to work full time, in the midst of the period in the semester with the highest volume of clients. Which is often the beginning of my descent into depression. Except this time, I can’t get depressed, because I have to take care of my brother. But since I can’t control whether or not I get depressed, I’m scared.

But I can’t worry about that today. Today I am not depressed. Today I will focus on getting through the day, and that will have to be enough.

One could argue that my life is worse than it was before, but I cannot afford the luxury of entertaining that thought, either. Nor do I feel that way. I just focus on the things that I can be thankful for now. Although they are different things, they are as plentiful as they were before. My brother is alive. He is getting better every day. He is able to help with more domestic tasks as he gets stronger. He is happy and appreciative. He is a football expert.

In fact, he recently informed me that Aaron Rodgers is not a fake State Farm agent. He is actually a really good quarterback. It makes pro football more interesting because now when Green Bay is playing I can cheer for the State Farm guy.

See? I can still find happiness in the little things.

Perception is Reality

cec13ed184a2041487d54b4afdc010ee

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.

No Way Out

Last week I gave you my reflections on my brother’s heart surgery. Today he’s feeling well enough to share what this ordeal was like for him in an effort to share his epiphany: regardless of what you may have to lose in the process, it’s always worth it to choose life.

***

In “The Walking Dead” Season 6 debut, former allies Rick Grimes & Morgan Jones share an uneasy reunion. “I’m sorry for all this,” Rick says to Morgan, shyly apologizing for having to lock his old friend into a cell until he can get the man acclimated to the new community he has just joined. Holding no grudges, Morgan replies: “It’s okay. Sometimes it’s easier when you don’t have a choice.”

18294167-mmmain

Fast forward to August 30, 2016. I’ve missed a couple of days at a new job. Inexplicably, I can never feel fully rested & suffer from painful gas that seems to get stuck in my chest. After weeks of combating my symptoms with sleep, stubborn cardio workouts, & Gas-X—something told me I needed a different approach this time. So I call out sick & plan to see a doctor in order to get an excuse for a couple of days & a prescription for some real medicine. Because of my reference to “chest pains”, the walk-in clinic refused to see me & referred me to the ER instead. “This will be an expensive bottle of Tums,” I thought to myself, the seriousness of my situation not yet setting in. A day later, I’m in a hospital room in my region’s premiere facility for heart surgeries. I’m told I have severe blockage in the arteries feeding my heart. They need to operate on me—TOMORROW. Doctors, nurse practitioners, & everyone who has seen my test results regard me with such astonishment. They wonder aloud how I’d been walking around.

“Oh great,” I think to myself. I’m going to have to call work again. They’re going to think I’m playing hooky.” I must have still been in emotional shock. That night, my stunned older sister calls me & tells me to quit my job—to stop forcing myself through unduly stressful challenges. “They don’t care about you! They don’t appreciate you! They have no idea how valuable you are! You don’t owe them another minute of your time. You hear me? NOT A MINUTE!” She also brought up examples of other people who should have been more concerned with my current crisis than they appeared to be. She wondered why I wasn’t more disappointed.

In hindsight, it was probably because I knew I didn’t have time to be disappointed. It was all happening so fast. I came in for painful gas, maybe some acid reflux, & they offer me open heart surgery instead. My head must have been spinning. But on some level, I knew there was no time to be disappointed or sad—it was time to be strong. Resolved. Focused. That was it. “I’ll be fine,” I reassured the only member of my family who, at that point, seemed to acknowledge the gravity of my current crisis–including me. “I have to go. The nurses just told me I had to take 2 showers with surgical soap; the first one tonight before bed.” It was already past 11 pm. It had been a long day; & the next day would be worse. I rang the nurse to get me unhooked so that I could take this shower with “surgical soap” & about 5 different washcloths intended for different regions of my body.

“Did you sleep well?” The surgeon asked me around the crack of dawn. “Yes I did,” I replied. He was stunned & said so out loud. Truth be told, I didn’t know what I had gotten myself into. And it was probably better that way. Had the details of what was about to happen been revealed earlier, I probably would have escaped! The surgery was nerve-racking. I actually woke up a couple of times after the surgical team had injected me with anasthesia. I saw myself in that horrifying environment under the blue surgical shroud. I had seen things that I had never asked to see. But the aftermath was the worst. I wouldn’t wish my experience on a sworn enemy—not even the Devil himself! I’m sure the Devil deserves punishment; but what kind is not for me to decide. Holed up in bed over the next 3 days in a state of constant discomfort, I realized how the powers both to inflict pain & subdue it are both sacred & require severe checks & balances.

I’m 40. If you saw me on the street, you’d think I look closer to 20. Yet here I was. A “kid” facing “real man” problems. But I’m recovering quickly. My vitals are consistently good. Even in the hospital, the staff seemed surprised at how well I was handling recovery. “If this is what you call ‘good’ I’d hate to see what you call ‘bad.’ “ They’d laugh at me. It was just humbling for me to be so dependent on so many people for so many things.

I always thought of myself as “tough,” but I never really knew for sure. Even after what I went through, I don’t feel tough or brave or strong. In fact, when I think about how severe the pain was & how terrifying everything seemed & how long the discomfort lingered long after the the violent pain had dissipated, I marvel that I got through at all! It took a lot of intervention from my Creator, but also some personal resolve. This wasn’t a challenge that I chose for myself; but once recognized, I was seeing it through. I was strong & brave not because I am all the time, but because I had to be right then.

Like Morgan said, “Sometimes it’s easier when you don’t have a choice.” Yes, well said, Morgan. All life truly is precious. Given everything I’ve had to endure over the last 2 weeks, my life is not only precious, but sacred to me now. That was a choice that I did have to make for myself. But now that I have, I’m as happy on the inside as I’ve been in a long time–maybe ever.

image.jpeg

Strength and Weakness

e9893725853d22f57e33b9eb51b75635

In a previous post, I wrote about how using post-apocalyptic strategies to motivate yourself by turning everything into a crisis is not an effective way to manage your psychological resources. If you use shame and fear to motivate yourself–Get up and go to work, you loser! You’re just being weak and lazy!–it may work, but there’s a high price to pay.

Last week my 40 year old brother, the one who struggles with depression and anxiety, had a mild heart attack and had to undergo quadruple bypass heart surgery. They said it was amazing he was walking around at all, given that his arteries were 99% clogged. The only reason he saw a doctor is because he felt guilty for being too weak to go to work and wanted medical evidence to verify that he wasn’t just being lazy.

In fact, because he thought he was just being weak, he tried to overcome his fatigue by drinking Red Bull and forcing himself to do rigorous cardio workouts.Willing himself to commute 2 hours to and from work, to override his anxiety about his job with drill sergeant self-talk. And it almost killed him.

I’m beginning to think that reincarnation isn’t just about life after death. It’s about the opportunities for rebirth, here on earth. That’s why we celebrate the new year. Birthdays and anniversaries. That’s why people who go through personal tragedies often say that the experience saved their life.

Before the surgery my brother felt like his life wasn’t valuable because his depression and anxiety made it hard for him to hold a job. He’s not married and doesn’t have kids. He hasn’t done anything heroic. The thing that he was the most proud of was his physical strength. But right now plugging in the charger to his phone is challenging and leaves him out of breath.

Apparently it’s common to feel depressed after heart surgery, and given that he’s already prone to depression, I was worried about what his mental state would be. Surprisingly, this is the most at peace I’ve seen him. His goals are different now–to give up stressing about the little things, drill sergeant strategies, and other people’s definitions of success. He is more appreciative of the small things, like being able to sit without being in pain. And, perhaps most importantly, he finally understands how strong he is.

This ordeal has been helpful to me, as well. I still struggle with feeling weak and pathetic because I can’t do the things that other people do. My colleagues are able to handle their case load and responsibilities without becoming depressed and suicidal at the end of the term. Our services are in high demand, which is good for job security but not good for setting limits. I feel pressure to push myself beyond what I know I can handle, and I berate myself when I crash and burn.

But to see the undeniable evidence that my brother was insanely mentally and physically tough when he felt weak and irresponsible reminds me that I am strong, too. I don’t need to prove it by pushing myself to my breaking point. Trying to live up to other people’s expectations isn’t worth dying over. I’m going to accept my limits without being ashamed. I’m going to start standing up for myself. I’m going to say no when I know it’s too much.

One of the most valuable lessons that my brother learned from this experience is that you don’t have to train yourself for every possible crisis to prove that you’re strong. You can just have faith that when you need it, you will have the strength to face whatever comes your way. That you already have everything you need to survive.

Olympic Dreams and Self-Esteem

5d138c6f6fa54d8bd059d029c3966666

I’ve really enjoyed watching the Olympics over the past 2 weeks. During the Winter Olympics 0f 2014 I wrote a post about my dream of being an Olympic athlete. I didn’t so much care about being the greatest athlete of all time, but I wanted to be a part of the opening ceremonies, live in the Olympic Village (without getting stuck in an elevator for 40 minutes like Del Potro), and exchange pins with other athletes.

During this year’s Olympics I was struck by how many stories there were about gold medalists (usually men) who felt lost, depressed, even suicidal after their success. How they turned to drugs, alcohol, got in trouble with the law, wandered around purposeless, sometimes homeless, not knowing what their next goal should be. Michael Phelps’ story is probably the most surprising one of all. What would the greatest Olympian of all time have to feel depressed about?

This is the myth that continues to haunt us in our search for happiness. We believe that achieving greatness will transform us into someone who we will finally like. It will bestow upon us a sense of self-worth and belonging. We will feel purposeful, useful, and lovable.

In a previous post I wrote about how I had a similar experience after I got my Ph.D. I was expected to get an education beyond college. Preferably medical school, but in one of my few acts of rebellion, I chose clinical psychology instead. Even in my first year of grad school I had fantasies about how smart and accomplished I’d feel after getting my doctorate. Only to find out that instead I felt…exactly the same. Actually, maybe even a little worse. Because if having a Ph.D. didn’t make me feel better about myself, I realized that nothing would. I had nothing left to channel my energy into. No fantasies about how I was just one accomplishment away from achieving my dream of not feeling sucky.

There are other versions of the dream of transformation. They involve six figure salaries, weight loss, a youthful appearance. The perfect job, the perfect spouse, the perfect children. Everything we ever wanted is waiting for us…right after we accomplish this one thing. Oops. Not that one. The next one. Or maybe the next one.

Yesterday on the ride home from our annual Cincy Tennis Tournament trip, I was telling my friend that my job in therapy is to tell my clients over and over again that they are OK, just the way they are. Every week they bring in a different set of problems, different flaws, different confessions, and I say those are all OK, too. You’re still fine. On the one hand, that may seem like a strategy that is too simple to be transformative, but you should try it some time. It’s surprisingly difficult to believe we’re fine the way we are. That’s why change takes so long; we need to hear it all the time. We are never fully confident that we are good enough.

It’s clear that Michael Phelps still enjoys winning gold medals. It’s obviously still a thrill to train to be the best, to see that his hard work has paid off, and to know that he’s still the greatest. But he also seems more at peace about retiring. After all, he is not just the greatest Olympic athlete of all time; he is also a father and a soon-to-be husband. Will he come back to the Olympics in 4 years? Maybe. But if he does, it will be because he loves the competition–not because he is nothing without it.

I, too, think about accomplishing goals differently than I used to before my Ph.D. I’m still competitive and I want to win, but now it is more about the process of getting better than the result of any particular match. I do think that competing hard, playing fair, and executing my game plan say something about my character. But win or lose, when I walk off the court, I’m still the same person I was before the match began. I’m still me.

And I’m becoming increasingly comfortable with that.