Category: Couples Therapy

COVID on Depression

Posted on by systemstherapy

Covid on depression

 

 

        Research has shown us that work, love, and play are critical in our overall fulfillment and happiness. For work, it is not just having a job that would make us happy. We need a sense of worth and value. Many people get this through their job itself or through making money from their job. One man described his value was rooted in his ability to provide financially for his family while another man described his value was rooted in how he helped the community through his job. For love, we deeply desire connection. Our personal relationships generally provide us with this sense of connection with others. For play, leisure and fun provide us with a sense of pleasure in life. This could be with others or alone. Play takes off the heaviness life can create and brings childlike joy.

        The pandemic has affected all three of these areas. Work: For some, it has made their job increasingly more difficult whereas others it has destroyed their business altogether. Love: The social distancing has affected our love and connection with others. We are isolated and often away from our friends and family who make us feel loved and cared for. Play: Our play has been generally hard to do in the midst of this storm and some people feel like how can we play when it seems like the world is on fire. For our sense of value, explore ways you would still feel productive if you are stuck at home. What is in your control that you can accomplish during this time and follow through, it will help in at least a partial sense of productivity. For your sense of connection, take time to reach out to family members via phone or facetime/zoom to stay as connected as possible. If you are stuck at home with your partner, remember that this may be an opportunity to spend more quality time together and realign on your priorities as a couple. For play, we need to lighten the load. Find and give yourself permission to let loose with a game, a hobby, or engaging in whatever makes you laugh.   

        It has seemed to many people that the pandemic has paused life’s timer—feeling as though this year has been especially long. When our ‘busy-ness’ pauses, we lose distractions. We are met with the experience of our experience. This could be positive like the person who feels like 2020 slowed him down and allowed him to focus on what is actually important. For others, this distraction-less season uprooted their fail-safety system. Our fail-safety system is what we have in place in case something goes wrong. We all have some form of this. Defense mechanisms, part of the fail-safe, becomes inadequate if the danger or threat is too large. Once these defenses or fail-safe become unable to help adapt, we are left in a state of vulnerability. This openness to our existence, including its opposite non-existence (death), pries the foundation of our fail-safe system. Be as open as you can throughout this time. Adapting becomes nearly impossible if we are unable or unwilling to find ways to change. No one asked for this but we can use this time to reevaluate what brings us purpose. Our time here is short but we can discover what makes it worth it. It takes courage to confront these questions but the reward is worth it.

        Helplessness and hopelessness are two of the main core features of depression. These two features lead to a sense of isolation and disconnection, lack of motivation, substance abuse, and suicidality. Many people feel helpless due to the reality of this pandemic being ultimately out of our control and in turn we begin to lose hope. Our hope of this turning around quickly has been shattered. The hope of our goals we had for ourselves has either been changed or in some cases been impossible to be accomplished (at least during the timeframe we expected). We will have a video series on motivation where we will talk more at length about how to get unstuck but for now we can leave it at this: our motivation requires a reason (‘why’) (discovering purpose) and it requires action. Don’t wait and hold on until you feel motivated. Action precedes motivation. After we act, we create momentum and the more momentum, the harder it is to get stuck. This year has made it very easy to get stuck so we must be intentional on taking action to create momentum to support ourselves and the one’s we love. 

 

COVID on Anxiety (Part 1)

Posted on by systemstherapy

covid on anxiety

          COVID and the effects of the pandemic have changed our life now and has shifted the future for better or worse. With all the change, the unknown, and the fear of the virus itself, we have been forced to adapt…very quickly.  Some people with anxiety have actually found this pandemic easy to cope with. One woman described her experience as feeling more calm since the pandemic started because as she put it, “I was in an internal pandemic before 2020 began.” For many others, it has been a very difficult year to know how to handle the chaos. What has been the impacts for people with anxiety and what we can do about it?

          2020 has met us with the challenge to adapt quickly and respond to something that was unexpected, life altering, and ultimately out of our control. So much of our anxiety comes from this attempt to control (control people’s judgment, control risk, control our death/finitude). COVID has a blend of all of these (e.g., people judging for certain behaviors during this pandemic, risk from the virus itself, finitude/death being brought to the forefront). Although this time is unique, we can learn from it. This year has shown many of us an important lesson: we can’t control the world’s future or the environment (anything outside of us). But the good news: we are always in control of our response. Life is consistently risky. From turning on the stove to driving in your car, we are always faced with the possibility of something outside of our control meeting us with little to no warning and putting us in a position we never wanted to be. Remember–your responsibility is your response. So when the next unexpected thing happens in your life-breath vs react, plan vs tirelessly worry, and respond to the adversity with courage. Who knows, maybe someone could feed off of your courage and leadership during this time. 

          What about stay at home orders? These stay at home orders had unintended consequences–especially to people with anxiety and depression. It further disconnected people from outlets and supports that relieved intense stress & anxiety. It has enabled or intensified avoidance of fearful things outside of the home. (Although the fear is within us, it is easier to avoid the thoughts/emotions that spontaneously arise from outside of the home). As we know, with increased avoidance comes increased anxiety. To add to it, this increase continues to build hopelessness and helplessness (more about the effects of COVID on depression later).

          Lastly, there is no end in sight. Some talk about going back to normal, some talk about a new normal, but we have no idea what that means (course of the virus, vaccines, stay at home restrictions, masks, etc.). When does this new normal begin, has it already begun?. Our anxiety can have some rest if it is contained in time. For example, maybe you know that crossing a very tall bridge over a large lake will create anxiety but if you are able to put the event in a time frame (e.g., I will feel anxious for 30 seconds as I cross this bridge and it will be over)-we can deal with that much easier. However, having no end in sight doesn’t mean you are doomed to suffer until the end rescues you. Put the day contained in time. The worry of when “this will end” gives us no help. As soon you as wake, you’ve entered a new chapter, each breath a new page. No need to wonder when the book will end, solely write each page with intent and purpose. When you get to the end of the book, you won’t be disappointed in yourself for skipping chapters. You will have written a full and creative story. It may even be a good read for others.

“Contain the anxiety in time, it is only existing now by staying in the future.”

 

Fake it till you make it?

Posted on by systemstherapy

fake it to Make it?

Fake it until you make it. So you fake your smile, feel uncomfortable as well as slightly guilty and ashamed for not being genuine…and voilà–peace. Not exactly. Do we need to fake it until we make it or do we need to transform our energy into something more helpful?

I’d offer the possibility we rarely have to fake it to make it. In my experience, people need value or a purpose to make them feel comfortable with change. If you have a ‘why’ that connects with one of your deeper needs then you’ll have less difficulty with anything in your life. That goes for completing job duties, helping others, going the extra mile, or having a more fulfilling life. 

I was talking to one man who said, “I hate being fake. I don’t like smiling at people when I don’t know them. I don’t know if they’re a good person or if they’re a jerk.” So smiling at a stranger was fake for him because he didn’t “know them”. Another man rarely got threatened by strangers and enjoyed the possibility of brightening someone’s day with a smile. Neither individual is being fake. Both are acting in accordance to their beliefs and values. The only difference was how their belief impacted their enjoyment.

There is an analogy that some people find helpful to understand how to transform fear, anxiety, stress, self-criticism, or negative self-talk. You have red paint and blue paint. The red paint is negative self-talk, fear, etc. The blue paint is positive self-talk, courage, reassurance, empowerment, etc. If you mix them both, you get green-which is neither fully positive nor negative. However, the more blue you continue to mix in, the bluer it becomes. If you start with negativity and intentionally add positive self-talk, you won’t be all of a sudden positive. But if you continue with this process of countering negative thoughts with more positive/helpful self-talk, you’ll find positivity becoming more natural.  (If you’re like many people, your helpful and positive thoughts are more rational!) So if it’s more positive and rational then by definition it is more accurate–less fake. So the green paint at the beginning of the process wasn’t fake–it was the result of the combination of positive/negative forces. 

Is it simple to intentionally counter unhelpful thoughts with helpful thoughts? As simple as running a marathon. It takes gradual practice, time, grace for setbacks, and consistency. Introduce one positive image or one positive movie in your head throughout your day-watch what happens. Some will have resistance-“this won’t work!” “this is elementary” “what a waste of time”. These are unhelpful thoughts. Imagine preparing for a marathon and thinking these thoughts after the first day–not helpful to your goal. Play another positive movie. In time, you will be playing helpful movies that fulfill, energize, and grow more enjoyment. 

Beliefs create our reality, if what we do doesn’t feel real–we need to reevaluate our beliefs and our corresponding actions. So before you go out and try to “fake it”, get in touch with why you want to do something and make sure it is in line with your beliefs. Not your old beliefs-your current ones. Then intentionally add more helpful thoughts and internal movies throughout fulfilling your why. 

 

Expectations and ‘Shoulds’

Posted on by systemstherapy

what

are

your

shoulds

 

     We all have conscious or unconscious rules for our life. We have rules for ourselves, others, things, places, etc. When we get frustrated or angry, often it is from one of our rules being broken.

     Rules are usually called ‘shoulds‘. Take the example of a person walking into a coffee shop right in front of you. He opens the door for himself and lets the door fall right behind him without keeping it open for you even though you are only a few feet from the door. You get frustrated and say ‘thanks’ in a sarcastic tone. The should or rule broken here is: people hold the door open for others when they’re only a few feet away from the door.

     Easy to understand in the previous example but what about other, more subtle shoulds or rules we have in our relationships. Take Michelle and Tony, a couple who has been married for 5 years. Michelle has an expectation that Tony should ask how her day was. After all, doesn’t he care about how she is doing and how work is going for her? Tony has the same expectation with an additional expectation that Michelle should know he has a lot of stress at his job and should be trying to support him more. Both partners get frustrated when their expectation isn’t fulfilled and begin building resentment for each other.

     Expectations, rules, and ‘shoulds’ can be healthy, they lay out the world in a clear, familiar way. This lay out, ”the way the world works”, is born from our experiences. However, it would help for us to have awareness of our experience and context. Without this awareness, we can consistently lay out the world that sets us up to be let down, disappointed, neglected, frustrated, etc. We need awareness to identify our experience, that is, what is going on for us. And awareness of context–others or things outside of us in a certain time and place.

     The context in the first example of the poor doorman may be that: at that particular time, the man had a very important meeting at the coffee shop and became so extremely preoccupied about planning for it and rehearsing what he was going to say that he didn’t realize there was someone behind him. Imagine the man looking back and giving that context and explanation to you after he realized there was someone right behind him. Our rule/should would still be intact since he apologized and ‘the world would be right again’. Often we’re not so lucky and we must deal with our rules being broken and the frustrations and disgust that comes with it.

     Start with recognizing what you have expectations for throughout your daily life (alarm going off, water running, car starting, people smiling after you smile at them, others responding to your emails and on and on). Then begin putting these expectations into a context–maybe it’s not as personal as it initially feels.

 

Confronting Anxiety?

Posted on by systemstherapy

fear is not outside

 

where to look?

Confronting Anxiety

The term avoidance gets thrown around very often in the mental health field. A lot of people say we shouldn’t avoid, we should confront. Well that is not necessarily helpful and people with severe anxiety know this all too well.

     Take the example of Tom, a teenager in highschool. Tom has a class presentation coming up and he is afraid of messing it up. Tom becomes scared about presenting but “confronts his fear” and presents the topic to the class. During the presentation, Tom’s symptoms become more severe and uncomfortable and afterwards he has a good deal of self-criticism about his performance. So when Tom’s next class presentation comes around, wouldn’t he feel more confident since he already confronted his fear before? Not for many people like Tom. In fact, many people would have more fear of the presentation. The uncomfortable symptoms they experienced during the previous presentation are in their memory. Their criticism of their past performance is still vividly remembered. And add onto that the ongoing fear that Tom initially had–messing up the presentation. The fear for Tom is not the presentation–the fear is messing up, discomfort, criticism, etc. 

     A female client once talked about her experience in this way: “I throw myself into situations I’m afraid of all the time. I am constantly trying to confront my fear and get over it but it doesn’t work. It just makes me feel more afraid and hopeless. There’s people who won’t be brave enough to do the things I do but somehow they get better and I don’t, how is that possible?”

     Many people find that the frequently used phrase ‘confront your fears’ helps in a lot of situations and for various reasons. But for many people, this statements is misused and/or misunderstood. The fear is within us, not in some situation or event. A lot of people are led to believe–‘the more exposure, the less negative symptoms.’ Well if that were true across the board then trauma wouldn’t be possible. We all have a certain zone-a tolerance-where we can be exposed to the fear enough to grow but not too much to stop us.

Some will say “The fear is going out of the house.” So we listen to the bootstrap advice of confront your fears and leave the house several times. But our fear not only persists but increases. What then? Didn’t we confront our fear? No. You went out of the house. That’s outside of the house, not your fear.

Be curious about what you are truly afraid of and try to find your appropriate exposure gauge. Find what is too much and what is too little. Some discomfort is great, it means we’re growing. But at what point does it hinder your experience and stop the growth and learning? We all have a different zone or tolerance level and we need to start where we are. 

 

Control

Posted on by systemstherapy

“Helping others may not be helpful and helping yourself may help others. “

control

                Anxiety and control are seeds grown from the same soil. It is from our fear that we need to control, it is from our helplessness that we attempt to control our fate. Often pain or trauma reminds us that things out of our control are dangerous. If we live too passively we feel as though we are a puppet on a string but if we live too ‘actively’ we try to control what isn’t ours. In either case, our stress spikes, our relationships suffer, and we’re left in a never ending cycle of frustration and pain. Why does this keep happening and what can we do about it: 3 strategies to interrupt this cycle.

                Control is the power to direct or influence. We control to regulate or adapt. This helps us to create a sense of balance or harmony (it’s often described as grounded in many meditative practices or yoga practices). It is the sense that we are back in our skin, things are ok, and now is now. Even though we often (and consistently) influence others and visa versa, we are ultimately ONLY in control of ourselves. We ultimately cannot determine or ensure regulation from others. This is a topic that comes up so much in therapy and people have heard different phrases like ‘control what you can control’ or ‘just be yourself’ but they brush by some really core principles that can be very helpful. We cannot determine or ensure regulation from others, we cannot depend on others to make us happy, and we cannot expect ourselves to make others happy. Pain and trauma often clouds this fact so say that out loud: We cannot depend on others to make us happy and we cannot expect ourselves to make others happy.

                This brings us to the 1st strategy: Leave other’s happiness in their hands. Focus on what makes you happy. But what if helping others is what makes me happy? Isn’t that trying to make them happy? Not necessarily- If helping others makes you happy or fulfilled-then help away! If serving another leaves you feeling used then don’t invest your time or energy into it—you’ll only get back anger and resentment. Typically “serving others” is more specific—some people you get great joy out of it (this is where your “help” is likely helpful) and others you may feel manipulated or that you’re enabling (this is where you “helping” is likely unhelpful for them).

                Here are the areas that others may influence but we are ultimately in control of: our physiological state (body regulation, relaxation, tension, etc.), our behavior (our actions), our cognitive processes (thoughts, beliefs, etc.), emotions (our perceptions of the world). What is outside of these areas may be frustrating and may trigger our past but I would suggest that the frustration comes from your attempt at changing what is not yours to change. Our trauma and anxieties often create a misperception of responsibility-that is, we try to control what is not ultimately ‘us’ and we neglect what is.

                2nd strategy: Pick one of the areas above and become very attuned to it for a whole day. For example, let’s say you pick physiological state. Notice where tension is in your body throughout the day. Or you pick behavior-be very aware of each choice/action you take throughout the day. Emotions-Be very attuned to your emotions and what raises or lowers your emotions throughout the day. Once you become very attuned to these areas-you’ll notice you have much more ability to influence what is happening internally.

              Expectations are intertwined in our frustrations and lead to a great deal of anxiety that turns into fear when things don’t go either ‘as planned’ or ‘as we need them to go’. Our expectations in some philosophies and ideologies is the central point to frustrations and stress. When we expect something that doesn’t occur, we are immediately met with frustration. Our trauma may come from something we expected from someone else (dignity, respect, character, integrity, honesty, etc.) but this expectation was shattered and we’re left feeling hurt, frustrated, angry, sad, or resentful.

             3rd Strategy: Whenever you get frustrated, angry, or hurt ask yourself who am I expecting to do what right now? And then am I in control of that? If not—set your focus on one of the areas above and take the time to acclimate yourself in that area. For example-a coworker does something you don’t appreciate (but isn’t against policy or human rights!). You get annoyed. You then ask yourself-am I in control of what they did or what they will do in the future? No. You then remind yourself to go to the ‘cognitive processes’ area to get very attuned to your thoughts and beliefs and realize you have a belief and thought that others should do what you believe is right. Then you start thinking and realizing “People have different beliefs and values and just because they do something that isn’t what I like (and maybe most people don’t like) doesn’t change anything about my life or my value system and I can still live my life the way I want.”

           These strategies may take time to practice. Be patient and have grace with yourself while remembering that practice leads to mastery.