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Tag Archives: Depression

Eye on the Ball

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When I went to that self-compassion retreat a few years ago, one of the teachers told me that she thought I loved tennis because I love practicing mindfulness. As you know, I’m a big advocate for mindfulness, but I was pretty sure I cared more about competition, burning calories, hanging out with friends, and wearing cute outfits than I cared about practicing mindfulness. But I can see her point. Tennis is the only thing I can do that allows me to block everything else out of my mind, and I almost always feel better afterwards.

For example, last Monday I was feeling so depressed that I actually did not want to play. Which almost never happens. But I knew it would make me feel better, and I was playing with a friend, so I forced myself to do it. It was tough, though. I thew up 4 times, which is a record. I’m not that good at singles anymore, so I was losing for most of the match. For the first set and a half I felt like crying.

But then I channeled my inner warrior. I told myself I could cry when I got home. I reminded myself of all of the times I was depressed during matches and played through them. How I’ve had to lie down for several hours after matches because of heat exhaustion–which is not a great thing, I know, but it does demonstrate my mental toughness.

And It worked. I won that night. I even saved a match point. I felt better afterwards, but I still cried when I got home. Still, I was proud of myself for my ability to fight through adversity. If there’s one thing that depression teaches you, it’s how to be resilient. To play my best under pressure. It has made me a stronger person.

The most helpful strategy was to keep my eye on the ball–which is pretty much always my strategy. If you’ve ever played with me, then you know that I often publicly announce that I am going to watch the ball before every point. I told myself that in that moment, I’m just a tennis player. Not a psychologist. Not a sister taking care of her brother. Not a depressed person. It’s just me and the ball. Nothing else exists.

Thich Nhat Hanh says that when you practice mindfulness, happiness is available to you at any moment. I can’t say that I was happy after the match, but I did feel better afterwards. And there were moments when I was in flow. When I was free from all the thoughts and feelings that plague me. And that is a great feeling.

So whatever your equivalent is to keeping your eye on the ball, be sure to call upon that strategy whenever you’re feeling down to help you ground yourself in the present moment. You’re bound to feel better afterwards.

A Compassionate Take on Why Misery Loves Company

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A few years ago I had the pleasure of listening to the the President of Washington and Lee University speak to the parents of the freshman class that year, appraising them of some of the things they could expect to encounter in their child’s first year of college. A frantic call in the middle of the night about something. The transition to being a little fish in a big pond. The Turkey Drop–which happens over this very break, when some poor girlfriend or boyfriend is informed that this long-distance relationship thing just isn’t working out. Hope we can still be friends.

Students in counseling often talk about “losing the breakup.” I like that term, because it so accurately captures that feeling of being left behind with your heart broken, stalking your ex on social media as they post pictures with their new significant other. If I have to suffer, they should have to suffer, gosh darn it! I hope they get what’s coming to them.

It’s true; misery loves company. And sometimes it’s because people who are miserable want other people to be miserable so that we can all feel sucky together. But sometimes it’s not because people are mean and hateful. Sometimes it’s because we don’t want to be left alone in our pain and suffering.

In self-compassion speak, this is called common humanity. It’s one of the things that comforts us in the midst of our pain in suffering. To know that getting your heart broken is an inevitable part of experiencing love. It sucks for everyone. It did not happen to you because you are uniquely unlovable. And it’s not your fault that it hurts so much that your friends are tired of listening to you talk about your ex.

As I mentioned in my last post, it’s that time of year when my inner demon of depression rears its ugly head. It’s better this year. I’ve made it to work every day so far. I have not fallen into a pit of despair. But it’s still painful.

One of the best and most unexpected benefits of having a mental health blog is that, in the midst of my lows, some reader will reach out to me and thank me for sharing my pain because they have known that pain, too, and it’s comforting to know that they are not alone. It is as therapeutic to me as it is to them to know that there are people in the darkness with me, reaching out to me so that I know that they’re there.

Last week, as I was describing to one of my clients the types of obsessive thoughts that often go through people’s heads, she asked me if I knew what this inner dialogue was like because I studied it or from first-hand experience. I was a little taken aback. I’d never had a client ask me directly if I had an anxiety disorder. But I told her the truth. It’s both. I know her pain because I studied it, and I feel her pain because I, too, struggle with it.

I know what it’s like to suffer alone. So I became a therapist. Because misery loves company.

If Only…

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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.

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Do you think I bought too many shoes?

Being Present, Part 2

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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.

Strength and Weakness

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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.

Darkness and Light, Part 3

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Now that I am at the end of my summer break, my sleep cycle is officially fully out of whack. I go to bed at 4 am and often wake up after noon. I’m getting better at not berating myself for this because this luxury is about to end in a few days. And because, since I’m a night owl, I feel the best in the wee hours in the morning. This is when I have my moments of clarity. When my demons lose their power to convince me that I suck. Ironically, for me, seeing the light happens in the darkness of night.

It got me thinking about all of the good/bad dichotomies. Darkness and light. Angels and demons. Joy and pain. As I mentioned in a previous blog post, I’ve been reading all these books about God, trying to understand what it means to be good, and the answer seems to be to accept everything about ourselves–even our sins and our vices. I write about acceptance all the time, but I guess in my mind self-acceptance was still something more along the lines of, don’t hate this thing about yourself because it’s a part of you. But it’s still bad. I mean, how can you think of something like depression as good? How can I embrace something that causes me so much suffering?

Although lately I have had a better appreciation of my depression. I pride myself on being mentally tough–on being a warrior. My greatest strength in tennis is not my athletic ability but rather my mind. My determination to not let my opponent get in my head. To fight, even when I’m down 0-6, 0-5. To be able to see what I’ve done well in a loss and to learn from my mistakes.

One of the things I take the most pride in is that players on my team appreciate me as a captain, and continue to be on my team even if we lose every match, because they think I’m positive and encouraging. I mean, I award a Player of the Game and Honorable Mention in matches where we’ve lost 0-5. That is really looking on the bright side. But my bright side would not be possible without my dark side. My mental illness has strengthened my character. It has shaped the parts of me that people admire the most.

If boot camp prepares soldiers for war, then depression is the boot camp for hardship. When I look back on each depressive episode, I realize how strong I was, even though I thought I was weak at the time. How hard I was trying, even though I thought I was being lazy. How much hope I had that things would get better, even though a part of me was telling me to give up–that life was not worth living.

Having said all of this, I can’t say that I have fully embraced my depression. I’m not thrilled when it shows up. But I’m trying to accept it in the way people sign up for the military, knowing that it may cost them their life. Or the way that people choose to get married for richer or poorer, in sickness and health. The way parents choose to have children, knowing the heartache that comes from loving so deeply.

Joy and pain. Angels and demons. Darkness and light. I will choose all of these, because I believe our task in this life is to fully embrace what it means to be human.

The Cost-Benefit Analysis of Pain and Suffering

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It was 7 years ago that I had my most severe depressive episode. It began because I decided to try to wean myself off my meds. It was a reasonable thing to try; I had been stable for a while. I got off them very gradually. By the time I was completely off them in January, I could feel the difference immediately. I was a little more easily irritated without them. Things were a little more painful. But I was willing to live with the pain if it meant that I didn’t have to be on meds.

But then things got worse. I remember being on vacation in February and screaming at my husband over fairly insignificant things. I don’t even know how he put up with it. And the last straw was some tennis drama thing in March that would not seem serious enough to make my mind unravel, but that’s how depression is; sometimes it doesn’t make any sense.

It took a long time to get back to “normal,” and I often berated myself for this costly mistake. For sacrificing my mental health so that I didn’t have to take that little pill every day. Now I have to take a bunch of them every day, twice a day, but I do so religiously, because I will do whatever it takes not to feel that way again.

Lately, since I’ve been practicing self-compassion, it strikes me how the road to recovery is complicated by our unwillingness to give up our suffering. Who knows why. Because we don’t believe we are really suffering. Don’t believe we deserve to be free of our suffering. Think we should be able to free ourselves on our own, without help, without drugs.

So taking each of those steps is a long and arduous process. I was depressed in high school but didn’t go to my first therapist until I was 25. The first time I went on antidepressants I was 30. I went back on them when I was 35 and went off them again when I was 39. By the time I was 40, a good 25 years after I first experienced depression, I accepted that I needed to be on meds for good.

Before this last depressive episode, I used to present a more neutral position on medication to my clients. But now I encourage them to give it a shot. I tell them that everyone is willing to tolerate a certain amount of pain in order to be able to say that they are not on meds, but I encourage them to ask themselves at what point this is no longer a good tradeoff.

Had someone phrased the question to me in that way, perhaps I would have taken them sooner. But I did not know how to practice self-compassion back then. I did not understand the concept of being kind to myself because I was in pain. I was not motivated to alleviate whatever suffering was under my control. Because so much of anxiety and depression are not in your control. But asking for help, going to therapy, taking your meds, and learning how to care for yourself are in your control.

I’m not going to lie–depression and anxiety still cause me quite a bit of suffering. Anxiety, in particular, has been kicking my ass today. And being diligent about all of the things that I have to do to strike that delicate balance of mental stability is effortful and time-consuming. But in a cost-benefit analysis, it’s still worth it.

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.

 

On the Road to Enlightenment, Part 2

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So I finished reading “Lovingkindness,” and I’ve concluded that people who dedicate their lives to meditation must not have mental illnesses. This is not to say that I did not get anything out of the book. I loved the book, and I have recommended it to several clients. It’s just that I think you have to have a certain level of mental stability to become enlightened.

When I went to this conference on trauma, Ron Siegel, another mindfulness guru, practically said the same thing. He said that you need to be fairly mentally stable to go on a silent retreat because you realize how much your mood is affected much more by random thoughts than anything that is going on in the external world. When you’re depressed and anxious, those random thoughts can be fairly persecutory, so to be left alone with them without anyone to tell you that they’re not real could be a major mental health hazard.

I’ve been feeling depressed this past week. It shouldn’t come as a surprise, because this is what happens at the end of every term. I should be used to it by now. But how do you get used to the pain? To your brain telling you all of these things that aren’t true? Every time feels like the first time. Maybe that’s why it takes so long for me to admit it’s depression. I keep thinking it’s something else. Something real. Something that might go away if only this thing happens. Or this thing. Why are these things not helping? Oh. It’s because I’m depressed and nothing helps. Nothing stops the pain.

I played tennis today and even that didn’t help. However, it was an unusually frustrating experience because it was so windy. You think you can go out there and do your thing like you always do, but no. The wind has other ideas. The wind is like, you think you have a good serve? See if you can get the ball over the net if I’m in you’re face. You’re not strong enough. I bet you thought that ball was going to be 2 feet out, didn’t you? WRONG! You lose the point. So we ended up stopping early.

I told my friend I needed to write a blog post and she said I should write one about the wind. How it can be a metaphor for something. And the wind actually is a pretty good metaphor for depression. It makes you feel like you suck. Like you don’t know how to play tennis at all. All of your strengths are stripped away from you, and no matter how hard you try to overcome it, you cannot play your game. And during that 2 hours while I was playing in the wind, that’s exactly how I felt about being depressed. I was trying to be in moment, out in the sun, spending time with my friends. I was trying to enjoy myself, be thankful, focus on nothing but the ball. All things that come natural to me when I’m not depressed. But my demons, like the wind, just kept telling me how much I sucked.

There really is so little you can do to stop the pain in the moment when you’re feeling depressed, so I tried to practice self-compassion. To be kind to myself. I ate lunch. I read old journal entries, because I find them hilarious and prophetic. I wrote in my journal. Tried to watch tennis. And then finally I took half an Ativan and took a nap. And now I’m writing a blog post. And I do feel a little better.

I guess if practicing lovingkindness and self-compassion can at least help me battle my demons, that in itself makes it worth the effort.

I Understand Why they Call It Practice

It’s been a year since 1000 Voices Speak for Compassion was created. In honor of its one year anniversary, the topic of the month is to write about what participating in 1000 Voices has meant to us. I love “year in review” posts, and I love writing about compassion, so this topic is right up my alley.

In the past year, I have made a concerted effort to practice self-compassion, and while it continues to be challenging, it is the strategy that has been most effective in battling my demons. I’ve learned from studying compassion, listening to clients in therapy, and observing my own mind, that our instinctive response to coping with pain and suffering is to be unkind to ourselves. To minimize our suffering. To shame ourselves out of our pain. To chastise ourselves for being crazy, selfish, and petty. It’s ironic that, although we all want to be happy and feel good about ourselves, our default is to see ourselves as being flawed and unworthy.

This instinctive response to be self-critical is so strong that it often takes a while for me to come up with a self-compassionate response. Take today, for example. Another day where I’ve slept in and done nothing. Even though other people have probably done things like wake up early, gotten out of bed, tended to their spouses and children, and done some productive things.

I’ve gotten better at not berating myself, which reduces some of my suffering, but I still struggle with coming up with something loving to say to myself. But today I thought of one. Today, I thought that, for someone who struggles with depression, I’m actually a fairly productive person. And this made me feel strong instead of weak. In fact, I’m writing this blog post right now, since I’m feeling better about myself. Granted, I’m still doing it from my bed, but I can have compassion for myself for that, too.

Practicing self-compassion has changed the way I do therapy, because almost every client can identify that self-critical voice. Most of the time it says unkind things about us all day long, and we do nothing to stop it because it seems so natural and it feels true. So I teach clients how to practice mindfulness so that they can become aware of these thoughts without judgment or criticism. And then I teach them to have compassion for their feelings. This is pain; this is suffering. It does not make you crazy or weak; it makes you human. It is not your fault that you have come into the world this way, with this vulnerability; you did not choose it. And given that you are already in pain, let’s focus on whatever is in your control to make yourself feel better.

I understand why you practice self-compassion. There is no finish line. It’s not something that you master and then you can stop doing it. It’s like doing cardio for strengthening your heart, or lifting weights for your muscles. It is a lifetime activity.

The good thing about blogging is that it’s the psychological equivalent of looking in the mirror at the gym and seeing that your workouts are paying off. Hey! I am talking to myself differently! I am kinder to myself! It’s working! So thank you, 1000 Voices of Compassion, for providing me with this opportunity to strengthen my capacity to love.

For more posts on compassion, you can access the link-up here.

You can also find posts on Twitter @1000Speak.