Why I Should Not Have Become a Psychologist, But Did Anyway

“Help others.” This is my personal mission statement I shared with you when I wrote my first blog Why I Became a Psychologist where I described how I came to be a Psychologist with influences from both social/personal and educational areas of life intersecting. This blog addresses the other side of my development. There are several reasons why I should not have become a Psychologist (but did anyway), and I feel compelled to write and share with you. This is the story of my personal development. If I expect people to open up with me and share information they do not share with anyone else, I should hold myself to the same standard. I hope this piece of writing allows you to know more about me personally, but I also have the goal of inspiring personal development-however this happens to look for you. Because my work is really about helping others develop and overcome some of the obstacles of their past. People are capable of extraordinary change. I am humbled and privileged to be a part of this growth every time I meet with clients. At the same time, I am a living example of change. And, I am just getting started on my personal development. I can hardly wait to see what the future holds for me. I hope you feel the same about your development and growth.

Where I Came From

First, I came from a value system (influenced by culture, family, peers, etc.) which is not consistent with the values and ethics of my profession. Psychology advocates for respect of and an appreciation for diversity in many forms. However, I grew up in a family full of racism, homophobia, and sexism. These forms of bigotry were also a large part of the culture of the time and both family and culture had influences on me before I became educated and experienced in the world. For example, before I began college, I was covertly racist. You may know the kind: the white kid who laughs at racist jokes of others without doing anything to stop these micro-aggressions. Also, I was actively homophobic along with most of my peers. This was easier to get away with because it was much more acceptable in the culture of the time. I was more apt to make homophobic jokes, say the term, “gay” in a derogatory way, and use a ‘safety’ seat between me and a friend in the movie theater. The most acceptable form of discrimination I remember from my childhood was sexism. It was so much a norm that I barely recognized when it was happening. Like trying to explain water to a fish. It did not occur to me how damaging these forms of discrimination were until later in life. I am ashamed of this part of my past.

At the same time I was very limited in my awareness of privilege. I do not know if I missed something (most) everyone else knew about or if privilege was an unpopular concept during my childhood. I grew up in the ‘80’s and as I go back to watch movies from this era (which is the best way to spend a lazy afternoon in my opinion), I am surprised by the amount of racism, misogyny, and homophobia. I was not aware of it back then, and I laughed along in my ignorance. Also, I had very little exposure to most forms of diversity. The high school I attended in DeSoto, Texas (Go Eagles!) was ethnically diverse, but there were few people of different religions or countries of origin, no openly gay students, and individuals with disabilities were teased. Being a white, heterosexual male it was easy to ignore power differences among different groups of people. After all, it did not harm me. I did not suffer. I was in the majority. So, add self-centered to the list of my characteristics. In other words, the opposite of my mission statement about helping others. Being self-centered is common for someone during adolescence, so I have some self-compassion about it, but it also drives me to make up for my past transgressions.

DeSoto High School   Photo Credit: Gregory Henderson

DeSoto High School

Photo Credit: Gregory Henderson

Because of my education and social experiences, I have worked hard to overcome these marginalizing values of my youth. For example, I had a close friend during college (Jeff) with whom I worked. We were restaurant servers together for a summer. When he came out to me as gay, I simplified the issue into two options in my mind: 1) I could hold onto my homophobic values and lose a friend or 2) I could do the more difficult thing of changing my values and keep my friendship with Jeff. Obviously, I chose the latter. I have learned to become aware of and examine my biases, intervene with others when witnessing micro-aggressions, and understand the perspective of others. I have been very intentional about putting myself in situations in which I am a minority to get a taste of this experience while recognizing I could easily get back to my many areas of demographic privilege (e.g., simply driving off campus of the minority institution where I worked). I have become an ally and advocate for others which fuels my passion for social justice issues, and I now have values consistent with my profession of Psychology. This includes leading trainings and presentations on topics such as how to be a supportive ally, heterosexism, and homophobia. I learned how to have conversations with people about these issues in a way which reduces defensiveness (including my own), guilt, and misunderstandings. This growth has been exhilarating and challenging at times. I have lost relationships (including family) over my change in values with absolutely no regrets. Except for one regret: I wish I had made these changes sooner.

Over-controlled Order vs. Unrestricted Chaos

Because of several of my childhood experiences I have a strong preference for order over chaos. I came from a dysfunctional family system which included substance use, poverty, instability, and domestic violence. My childhood and adolescence were chaotic in several different ways. So, I understand and have a lot of self-compassion about why I prefer order over chaos. I like predictability, stability, and consistency because these were missing during the early part of my life. More than once I would come home from school to learn we were unexpectedly moving that day due to being evicted. This preference for order is part of my character and I really appreciate the traits of consistency and stability in other people. Also, this is one of the reasons I really enjoy jigsaw puzzles. It brings order to chaos as every piece has its place.

However, preferring order over chaos is not exactly the best approach to the people I serve. Often their lives are chaotic, so it takes some comfort with and familiarity for a lack of order. While at the same time remaining calm, or at least appearing to remain calm. For example, on the surface a duck swimming looks very serene; but if you looked under-water you would see a lot of movement. This has been hard for me. It would be easier if every client came in and predictably discussed their issues in a rational manner. But, it is unrealistic and so I have had to adjust so I could be mentally present for them. Learning to tolerate ambiguity, irrationality, and chaos while understanding these are not necessarily destructive was something which took time. Chaos is part of the change process and I have learned to trust the process (thanks to a late mentor, Don).

Ducks look very different above or below the water.

Ducks look very different above or below the water.

Related to my increased comfort with chaos is my familiarity with ambiguity. One of the skills of a good therapist is to be able to sit in the space of uncertainty with clients (“betwixt and between”), sometimes never getting to see the decisions or results of the therapy. Another reason I like puzzles: the satisfaction of seeing the final product. I have not always been comfortable nor familiar with ambiguity. Earlier in life I could be described as somewhat compulsive. For example, before we were married my wife stopped by my house to write me a sweet little love note one day. I called her back and immediately asked her where the cap to my pen was. Talk about missing the importance of the moment! But, back then I mistakenly figured there was an answer or place for everything and believed calm and peace would come from putting everything in order. I did not see the value in chaos or ambiguity. Work with clients and my education along with becoming a father have taught me there are not always clear answers for the questions of life and it can be okay to ride a wave of uncertainty. Now I often get feedback about how calm I am (or appear to be) which surprises me when I am freaking out on the inside-which happens more than I would like to admit.

I’m Not Crying, You’re Crying

I did not have the luxury of growing up with empathy role models. When I was hurting emotionally the messages I got were typical masculinity themes of ‘suck it up’ or ‘walk it off’ or ‘boys don’t cry’. No wonder I didn’t understand emotions of others. I could not understand nor receive support for my own emotional experience. I didn’t even quite understand exactly what empathy was until graduate school. But, it is a cornerstone skill to my work. I’m surprised they let me into my graduate program at Texas Tech University (Go Red Raiders!) until I realize they saw potential in me and not a final product. They were prepared to teach me empathy, and I was a willing student.

More generally, Psychology is a woman/female dominated field and influences from traditional masculine value systems taught me anything feminine was to be avoided at all costs. I grew up believing the feminine is weak and the masculine is strong. It is a challenge to overcome this type of limited thinking. Masculinity was a large part of my upbringing with 3 older brothers and a male dominated household. Being the youngest, I was often in the least powerful position of any conflict, and there was a lot of conflict, especially with my next oldest brother, Derrick. Derrick, for whatever reason, enjoyed torturing his younger brother physically and emotionally despite the large age difference. For example, he would convince me of lies which still have a hint of impacting me today. I cringe every time I hear the word, “Volvo” because I was deviously taught at the age of 6 it was the worst swear word imaginable. He would also tease me in front of my peers. A “Welcome Home, Pooh Bear!” sign at our mailbox and every other junior high student on the bus laughing at me as I got off is a memory which comes to mind. And, he often avoided punishment for such abuse! What these experiences taught me was the emotions of others (including hurt) are meaningless and success comes from over-powering another person (even if they are quite a bit younger) mentally and physically. These experiences and culture also taught me to pretend I was right and strong which meant not expressing feelings, unless it was anger. It became physically and emotionally dangerous to share my hurt with others.

I never could admit when I was wrong, man

even when I felt it in my bones.

I always thought it meant I was a strong man.

And, I wondered why I was alone.”

Dawes

So, there is a lot of baggage I had to overcome to become an effective and empathic therapist. Part of this work was done with my own therapy which has been extremely helpful. Another aspect of this growth has been putting distance between myself and toxic, dysfunctional relationships/people while putting more energy in my healthy support system. Not easy things to do, but totally worth it. Again, absolutely no regrets for the changes I have made. As I began to become an empathic person, I would thirst for more knowledge. I read books on the subject including Emotional Intelligence by Daniel Goleman (more on this in the next section). I would ask supervisors and mentors for resources and feedback about my empathy. It became something I worked on all the time. Like any skill, it was difficult and full of challenges in the beginning while becoming easier with practice and experience. I often use momentum analogies with my clients to normalize and prepare them for their change processes. Now I see the world much differently and cannot imagine living or working without empathy.

Add Emotional Intelligence to the List

Michael Scott from The Office

When I was first learning about Psychology during college, I was not very emotionally intelligent. Think Michael Scott from The Office, but much less extreme. Saying things without consideration for the potential responses or feelings of other people. Taking jokes way too far. I wonder where this came from. Not really: it was Derrick. But, I was also sensitive and sincerely loyal to the people I cared about.

Part of emotional intelligence is the ability to be comfortable with yourself and to extend this comfort by being genuine and sincere with others. Since I spent a lot of time not comfortable with myself and being socially anxious for decades, the latter part of this was impossible. I was constantly worried what others thought of me or about the possibility of doing something embarrassing. I would practice what I wanted to say beforehand to get it right even with the most casual of conversations. Part of this was due to a childhood speech impediment which comes out every now and then in the form of mumbling as an adult. I have heard stories about no one understanding anything I said before I attended speech therapy during elementary school, but my brother Derrick ‘interpreted’ for me. I cannot imagine what he described me saying, but I am guessing it was not for my benefit. Also, I did not feel great about my looks and consistently compared myself with other people, often unfavorably. This guy is taller than me. She has a much better fashion sense. I wish I could have hair like them. Anxiety breeds anxiety, partially due to an anxiety-avoidance loop. As an anxious person, I would avoid the things which would make me uncomfortable, like social interaction. This did not improve the situation any. It would make it worse and I would worry even more about my social skills because of my lack of practice.

This has been my most difficult work in personal development: getting to a point where I am comfortable enough with who I am to be myself and not worry how others might react. It took a lot of physical relaxation to get through scary moments for me as well as pushing myself to stop avoiding the uncomfortable interactions. I would put myself out there despite my fear and introduce myself to people. I would put my worries on the back burner and would often fake it until I made it. Also, I would be on the lookout for my tendency to judge others and myself and would actively change those thought patterns. Eventually I would worry less what others thought of me as my social skills grew and I matured which included increased comfort with who I consider myself to be. The book, Self-Esteem by McKay and Fanning, is a great resource to battle self-critical thinking.

Having the ability to be genuine and vulnerable is another step. It was easier to fake confidence and put myself out there. Then, I began being more genuine and sharing what I really thought and felt. Surprise flooded me when some people stuck around and did not treat me any different. I found my ‘tribe’ of friends who accepted me for who I am rather than some fake version of me. So, I owe a lot of credit for my growth to the people around me now-my current friends. Acceptance is a beautiful and empowering experience and I have tried to re-pay this kindness with every opportunity. I am still sensitive to rejection since I have a long-term history of rejection by both myself and others. I, now, simply choose to invest my energy into relationships where there is much more acceptance and this has made a world of difference to me and my self-esteem. Writing and publishing this blog which has some very personal details about me feels very vulnerable. I hope Brené Brown would be proud of me.

My heart’s like an open book for the whole world to read.”

Mötley Crüe

I’m not shy. I promise.

I have been an introvert for as long as I can remember. I have only recently become more accepting of this in myself. Books like Quiet by Susan Cain and talking with other introverts can go a long way to normalizing this less common personality trait. Psychology is often a social endeavor. In fact, it is classified as a ‘Social Science’. Typically the more introverted psychology students gravitate towards more academic positions filling their time with research, supervising, and teaching. I did not go that route despite encouragement from my mentor. I went the more extraverted route of training and pursuing professional positions in higher education counseling centers. Staff and committee meetings were brutal for me. 20-30 other people forced to be in the same room for hours at a time. I could sense the excitement from some of my extraverted colleagues as I continually checked the clock. In fact, for several semesters I opted to be on-call for emergency and walk-in appointments during staff meeting times just to limit this extraverted activity. Introverts are not un-social (definitely not anti-social which means something else entirely). Introverts receive their energy from within (the world of thoughts and feelings). One-on-one or small group interaction is fine for introverts, while large group situations can be energy draining. Like training hundreds of residential life staff every August: exhausting! Also, introverts abhor small talk. I prefer to get to know someone with a focus on the deeper stuff as soon as I can-even in a first meeting, although I recognize this breaks a social norm.

Through my career I have learned to find opportunities to help people in one-on-one situations mostly but have also increased my comfort with less introverted job duties. When I began teaching Introductory Psychology in graduate school, public speaking would send me into a panic. I would have most of the physical symptoms of panic attacks. Increased pulse-√. Shallow breathing-√. Sweating-√. Feeling like I need to urinate when I don’t-√ + embarrassment. With experience and physical relaxation strategies, I have come to love public speaking. It’s one of my favorite things to do nowadays. Another part of this development has been my social skills and working on social anxiety issues. With awareness, counseling, and support I have been able to conquer my social anxiety, practice social skills, and have become a really social person. In fact, I get questions all the time about my introversion given how social I appear in large and medium group situations. I can be social when I choose to be, but it is still exhausting.

A Little Help From My Friends

As previously mentioned, I did not discover Psychology until college. Back in my day, it was not common for high schools to offer Psychology as a course-at least where I attended. No one I had ever known had been a Psychologist or studied Psychology. Some people are fortunate enough to have a life-long mentor or role model. No such luck for me at first. I found and forged a path myself in the beginning. It would have helped a lot to have someone advise me on steps along the way in the early part of my educational/professional development. Also, I did not have many others pursue higher education in my family. Several of my extended family members were educated, but most were not people I was close enough with to have any real influence on me. My parents were no help in navigating college, both of them had dropped out. My Lubbock aunt thought I had joined a cult during graduate school because of how busy I was-true story. Graduate school was a very rare thing in my family and extended family which made it hard to explain. So, it was tempting to follow the paths of others and stop my education (i.e., stop incurring more student loan debt which I am still paying on) and begin working. I am grateful for my wife and parents for talking me out of such non-sense and continuing with my program.

Luckily, I found some mentors along the way once I got started. Dr. Susan Hendrick at Texas Tech University is amazingly supportive and very wise. Dr. Don Boswell at Oklahoma State University was crass, funny, and genuine. Dr. Pat Darlington in Stillwater is encouraging, assertive, and pushy in the best possible way. She sees potential in people even when they do not see it in themselves. Whatever your path, there are others who have been there before you. Find, collect, and cherish the wisdom, support, and the encouragement of these people along your journey even if you have to put in some extra effort in finding them.

It’s Dr. Sensitive Pants

I am a highly sensitive person. What this means is I experience emotions on a whole different level than most people. This can be an asset in my psychological work with regards to having developed empathy. However, it can also be a hindrance in some respects. I have trouble going out in public sometimes because I can pick up on the emotions of people around me, even if I don’t know them. I have learned over the years to tune them out. I have also learned to take care of myself when my energy level is low (e.g., alone time)-something extraverted family members and friends do not always understand. Additionally, I am very sensitive to criticism. Some people call me Mr. Sensitive Pants to which I correct them by reminding them I am a doctor. This was especially difficult during graduate school and my internship at Texas Woman’s University (not Women’s) as Psychology is a field in which the training involves being put ‘under the microscope’ in terms of have every nuanced action or inaction scrutinized by supervisors, peers, and faculty. This is done by video and audio recordings of sessions, live supervision behind a one way mirror, and co-therapy with others. As you might imagine, being sensitive to feedback and getting a lot of it over the course of several years can be a challenge. This is in addition to teaching evaluations, client satisfaction surveys, and course grades. There was just an overwhelming amount of feedback! I had to learn to use this feedback constructively taking solace in the good while correcting the bad.

Finally, one of my main ‘buttons’ is not being listened to. It’s a wonder I went into the field given I rely daily on the opportunity for people to listen to me or not. I was expecting to be automatically listened to upon my graduation. After all, I was a doctor-how arrogant of me! I figured once I became educated and got the title people would listen to me. I thought this would apply to older family members who never listened to me before and treated me like a child. But, this is not how things happened. Turns out, people tend to avoid advice. My family and friends knew me before graduate school and nothing changed from their perspective. Also, people are not great at listening at times, especially when they are distressed. This was a major source of frustration for me starting out in my career. Luckily, I stuck with it and got used to it by lowering my expectations to a more reasonable level and finding different ways of communicating. I have learned to use my sensitivity as a strength rather than a hindrance and highly value the importance of self-care.

Take Home Points

So, now I have developed these various qualities which make me a Psychologist, but they certainly did not come naturally-at least some of them. I guess the only qualities that came naturally (which I did not address in this blog focused on personal growth and development) were my ease of rapport with people, my inquisitive mind which seeks to know and understand, and how I tend to help others feel comfortable. I also have a pretty dry sense of humor and I am not yet sure how this helps people. Maybe a topic for a future blog. It can be easy for me to get lost in the weeds of all the things I need to think about and consider when I am with a client, but it seems most helpful to simply focus on being with them. Both the natural and developed qualities will come into play as needed, but I do my best work when I am my full self. Fully present. Fully empathic. Fully genuine.

·         You are capable of changing your values and beliefs. It is hard work, but you get to choose what you believe and how this impacts your interactions with others.

Through growth, I have learned to be respectful and appreciative of those who are different from me and to advocate for those in less powerful/majority positions. Clients can expect to feel respect from me and not have the experience of me making assumptions about them. This has come with a lot of perspective taking and has not been easy to change the values and beliefs with which I was raised, but well worth it.

·         If chaos scares you because of past experiences, it can be healing to learn to live with healthy chaos. Avoiding healthy chaos does not work and can lead to stunted growth. Continue avoiding unhealthy, destructive chaos which is a healthy and justified protection mechanism.

I have learned to become comfortable with chaos and a lack of order at times with the message that these are not necessarily destructive but rather a part of the change process. Clients can be in chaos and not have to ‘pull themselves together’ for my benefit. I will accompany them in their pain and disorder in whatever form it occurs while trusting this ‘soul’ work will lead to progress.

·         Empathy is a skill. Just like any skill it is developed with practice. Giving up and saying you are just not an empathic person is a copout.

I have learned empathy. This helps ensure my clients feel heard and understood.

·         Being comfortable with yourself and genuine with others is key to healthy psychological living. If there is something you reject in yourself-deal with it. Have some self-compassion and acceptance about aspects of yourself you are unable or unwilling to change.

Photo Credit: Journal Psyche

Photo Credit: Journal Psyche

Carl Rogers has been an inspiring and challenging icon in the field of Psychology who emulated genuineness and sincerity even at great risk. This sincerity allows my clients to know what I think and feel without having to ask. This also makes it easier for me to connect with others.

·         Introversion is healthy. Learn to manage it and know it does not mean you cannot be social. It is an energy issue, so take care of your needs by having plenty of alone or one-on-one time, especially after a large social event.

I have learned to manage my energy due to being an introvert and valuing this trait rather than judging myself. I can share this appreciation and wisdom with clients who are also introverted and with clients who deal with others’ introversion.

·         Role models are necessary for goals. They can provide support, guidance, and push you to work on areas in yourself you may not even be aware of. Find ones you can trust fully.

I am not sure where I would be without the role models I have had throughout my development, but I am sure I would not be nearly as effective with clients. I know there are times when I needed their help more than I communicated and their presence supported me more than they have known. I plan to return this level of support with others. 

·         Being sensitive is okay, but you might have extra challenges others do not have to deal with. This can be managed so you can function effectively and learn to enjoy your emotional world rather than be in a constant state of hurt or fear.

I have spent a lot of time judging myself for my sensitivity and feeling hurt or rejected by others who had a hard time accepting this aspect of me. This time is over. I have been able to turn this self-perceived ‘weakness’ to a strength and this guides my relationships. It still has its challenges at times, but I feel much more in-control and strengthened by this characteristic. Also, this helps me when I am normalizing to my more sensitive clients (and others). The look on their faces when they hear this trait has a label and is something which can be managed is priceless and well worth the suffering I have experienced in my personal life.

 

References

Aron, Elaine N. (1996). The highly sensitive person: How to thrive when the world overwhelms you. New York, NY: Harmony Books.

Cain, Susan. (2012). Quiet: The power of introverts in a world that can’t stop talking. New York, NY: Broadway Paperbacks.

Goleman, Daniel. (1995). Emotional intelligence. New York, NY: Bantam Books.

McKay, M., & Fanning, P. (2000). Self-esteem (3rd Ed.). Oakland, CA: New Harbinger Publications.

 

13 Ways to Get Your Self-Esteem Back

Have you ever thought back to when you were in college, or high school, or maybe an earlier time in your life and had the thought, “I use to be so confident. What happened?”? Were you really cool or hip or sexy back then? Did you have no problem talking with someone you were interested in dating? Maybe you defied authority with parents, teachers, police, etc.  If you were like me back then you did what you wanted with little concern for what might go wrong. Now you pause to consider the consequences. Somewhere along the way how you feel about yourself has changed and this has impacted how you act. You have matured and grown into the person you are today. You have gone through some pretty significant transitions in life. Some are positive and some are not so great. Some possibilities: education, career, marriage, divorce, children, and grief. There have also been changes going on around you with other people in your family or friendships. Maybe you have moved. Your community has changed, too. Not the least of which have been changes at Oklahoma State University and within Stillwater. You are probably doing a different job than you were back then (and making more money) and you likely think about the world differently as well.

As you experience life, you will likely have times when you focus a little bit more on the negatives than the positives. This is natural and normal. This might apply to self-evaluations as well. Also, life gets a little bit complicated to downright hectic at times. And, it is challenging to be truly confident when going through a difficult situation. Self-esteem lowers to problematic levels when tendencies develop that involve an over-focus on the negatives about ourselves. Also, situational stressors can leave us feeling helpless (maybe we are actually helpless in some situations), which lowers our sense of self-control. Low self-esteem can be a part of a depressive disorder or Social Anxiety Disorder, but is also something that all of us experience at times. Even the most seemingly confident celebrity has self-doubt occasionally. Except for Kanye, but that’s a different story.

If you are concerned about your self-esteem, I offer the following strategies to consider:

1.      Focus on your strengths.

Many people develop subtle patterns of increasing focus on self-perceived weaknesses rather than self-perceived strengths slowly over time. We tend to believe what we focus on. If we focus on our negatives, then we tend to believe that we are not so great. When we shift our focus to what we like in or about ourselves, we feel more confident. Also, negative feelings, statements, and perceptions tend to be much more powerful than positive ones. When working with clients with low self-esteem, I usually get a long list of self-perceived negatives and a short list of strengths that clients feel about themselves. It is all too common, but not surprising, when someone with low self-esteem focuses much more energy and time repeatedly focusing on their own dislikes, which are much more powerful, than their likes.

The good news is that this pattern can be reversed. Like the concept of momentum (think about attempting to reverse the direction of a spinning wheel), it can take some more effort in the beginning. I encourage people to write out a list of strengths and add to it every day. Any little thing can be added. For example, “I held the door open for someone today. That was a nice thing to do. I am nice.” Try to not judge the example as worthy or not worthy. Also, do not worry about whether it is absolutely or always true or not. If it was fitting for that moment, then it counts. Add it to the list. Be generous with yourself here to make up for all of the years that you were not so kind with the over-focus on the negatives. After a while this list of strengths can get pretty long. You can also review your list periodically. This may help during a moment of discouragement to remind yourself of your strengths.

The flip side of this strategy is to stop focusing on those negatives. Either change them or accept them, but do not put any more time into feeling bad about yourself because of them. When you catch yourself falling into that pattern of focusing on the negatives, imagine a symbol for ‘Stop!’ (e.g., a stop sign or a red light for visual people; a whistle or buzzer sound for auditory people; grabbing your wrist or popping yourself with a rubber band for kinesthetic types) and shift your focus to your list of strengths. Maybe, this would be a good time to review your list or make the most recent additions.

choose to focus on your strengths rather than weaknesses for healthy self-esteem

These strategies seem straightforward and simple, which they are. Also, they work! Effective does not always involve complicated strategies. No need to take my word for it, though. Try them out and see for yourself. If you are less than satisfied with these strategies there are 12 more categories below.

2.      Stop comparing yourself to others.

How often do you look at someone else and think to yourself that you are better or worse than them on some characteristic? Maybe that other person is in better shape. Possibly you are more stylish in your dress. You wish you had her voice. Even if you ‘win’ most of the comparisons you make, you are setting yourself up to focus too much on compare and contrast. Eventually, you will find someone better than you on something specific. We can always find someone better than us in some regard and we can always find someone worse than us in that same regard. This is psychologically unhealthy compared with self-acceptance when no comparisons are made. We can still appreciate the beauty (or style, or grace, or kindness, or maturity) of someone else without it necessarily reflecting poorly on ourselves.

Social media makes this social comparison tendency worse. The reason being that people are biased in what they post. Are you more likely to post a ton of vacation pics on Instagram or do you consistently report the boring meal you are having for lunch every Tuesday. People tend to post their happier moments. This is not to say that negatives do not come up on social media. They do. Just not in proportion to the positives and within what actual lives are like (except maybe Kanye’s life).

Also, there is an issue of information access. When we compare or contrast ourselves to other people (whether on social media or in-person), we have different types of information access. With ourselves, we know our internal experiences (thoughts, feelings, memories, motivations, desires, etc.) as well as what we choose to display to the external world. However, with other people, we only have access to the external, what they choose to share with the world. Because our external selves tend to be more positive than our whole selves (internal and external), we can mistakenly make the inaccurate assumption that our whole selves do not match up with someone else based only on the external information we have about them which is likely to be positively biased.

If social comparison is a problem for you, consider catching yourself. You can use the same strategy to ‘stop’ yourself mentioned above. Then think about comparing yourself with yourself. Trying to be better than you were yesterday is a psychologically healthier goal than trying to best someone else.

Photo by Jocelyn Lehman

Photo by Jocelyn Lehman

3.      Be aware of your internal self-critic and the purpose it serves.

Do you have a nagging, internal voice that is critical of your actions? Your decisions? Your personality characteristics? Some people can easily identify the source of their internal critic (e.g., a parent, a teacher, a coach, an in-law), but it can be a challenge for others. You do not need to know where your internal self-critic originates to change it. You do, however, need to know what purpose it serves. Sometimes that internal critic is trying to motivate you. This only works when you need to be motivated and often backfires to make you less likely to achieve whatever goal is under consideration. Another example of a purpose of an internal critical voice is to put you down before others do it for you. If you can be down on yourself, then the criticisms of others does not have as much power. Self-critics can protect us from failure or success if these are outcomes that scare us, whether we are aware of these fears or not. If your self-critic limits or prohibits you from interacting with other people, the purpose might be to prevent you from feeling or being rejected.

There are several functions that an internal, critical voice can serve. What is important is to know which purpose(s) yours serve so that you can begin to make some changes so that it no longer has a negative impact on your self-esteem. Is there another way to deal with that fear of failure or rejection? Can you address the need that the critic serves rather than continue to allow the critic to tear you down? Awareness is the first step in making changes to this tendency. Without that nagging, critical voice to weigh you down like an anchor, your self-esteem is free to soar.

4.      Change negative self-talk.

Once you know what purpose your internal self-critic serves, you can begin to make changes to your internal dialogue, the way you talk to yourself. Recall that what you focus on leads to what you believe. So, if you focus on the negatives that your internal self-critic says about you, you are likely to begin believing that. Recognizing this process can be challenging at first and exhausting once you begin to realize just how much you put yourself down. The good news is that with a little bit of effort at first (remember the idea of changing momentum), you can quickly begin to make some changes and feel better about yourself in a relatively short amount of time.

First, I work with people on how to recognize negative self-talk. Paying attention to your thoughts, ask yourself is this something I would say out loud to myself in front of someone who cares about me? If the answer is no because the thought is too critical, then this is the type of thought you want to target for change. Some people benefit from writing out these negative, critical thoughts about themselves. Warning: it can be distressing to see these thoughts written down because we also tend to believe what we see written. Once you begin to recognize negative self-talk, the second step involves getting your attention. This is where imagining a symbol for stop can be helpful (see above for more information). Once you are paying attention, the third step involves replacing the negative thought with another thought that is more positive or neutral. You can still think negatively about your actions, but maybe put some separation between how you feel about your behaviors from how you feel about yourself. Just because you had a lazy moment, does not mean that you are a lazy person. The important thing for the replacement thought is that it has to be believable. Do not change a negative thought about being tone deaf to the unbelievable thought that you are Kanye. That would be delusional!

you can choose to change or stay the same

5.      Realize that feelings and thoughts are not necessarily true.

One of the more difficult steps in getting your self-esteem back is not believing what you think and feel all of the time. We often fall into the trap of convincing ourselves that if we think it or feel it then it must be true. Also, we might falsely believe that what we feel will become permanent. However, ask yourself if you have ever worried about something bad happening only to later find out that you were worried for nothing. This is an example of attaching to a feeling that was not necessarily true. It might have been true. It was possible. It just was not true in that situation. Also, it is tricky because sometimes our feelings and thoughts are true. That is why this section includes the phrase, “not necessarily true”. When we over-attach to our thoughts and feelings, we can make ourselves miserable, especially if these thoughts and feelings are unpleasant. As it applies to self-esteem, we might overly attach to negative thoughts and feelings about ourselves which causes further damage.

“You are the sky. Everything else-it’s just the weather.” Pema Chödrön

“You are the sky. Everything else-it’s just the weather.” Pema Chödrön

One strategy for detaching from your thoughts and feelings is to recognize some important facts. 1) What you think and feel is not necessarily true. It might be true or it might not. Consider that it might be untrue. Think about the probability that it is or is not true. Avoid wasting your time and energy with low probability scenarios. 2) What you think and feel is not permanent. In a moment of distress, it can be difficult to believe that you will not always feel or think what you are feeling and thinking in the moment. However, think back to a difficult time in your life. You probably do not feel exactly the same way about it now or at least not as intensely about it. 3) You are not your thoughts and feelings. You have the option to act as an observer to your thoughts and feelings. These are just symbols for events in our lives. Instead of fighting against unpleasant thoughts or feelings, allow yourself to notice them. This will make them much less powerful and you will likely be able to move on in life in most non-severe circumstances.

6.      Live in the moment.

“The secret of health for both mind and body is not to mourn for the past, worry about the future, or anticipate troubles, but to live in the present moment wisely and earnestly.” Buddha

Focusing on the past, especially negative experiences in the past, can lead to feelings of sadness as we mourn the difference between the way things were and the way we wanted them to be. Focusing on the future, especially with an over-focus on potential negative outcomes, can lead to feelings of fear and anxiety. This impacts low self-esteem when we over-focus on our mistakes from the past (i.e., regret) or expect ourselves to fail in the future (i.e., worry). When we focus on the present, we can live in the moment without regret or worry. We are not judging ourselves as having failed nor expecting ourselves to fail in the future. Think about the last time you felt truly care-free. Was it a time you were living in the moment? Most likely it was. You were probably able to take a break from the sadness of the past or the fears about the future, even if it was for a brief moment.

Also, living in the moment can help us connect and engage with other people. Have you ever had the experience of focusing on some unpleasant thought or emotion while in a crowd? Did you feel lonely? Did it impede you from talking with other people? When we are truly present it is easier to converse, interact, play, and be creative with other people. Humans are social animals and we need social interaction. This includes spending less time on your smart phone or tablet including social media (see above information about the social media bias and how it can affect your self-perceptions). If there are people around you, allow yourself to engage with them.

7.      Know your limits.

It happens often that I hear clients talking about how their low self-esteem comes from taking on too many tasks, roles, and responsibilities while holding themselves accountable when they are less than perfect in each one of them. With our current, fast-paced society and technological ease of communication we face more demands, deal with expectations of urgency from others, and take on multiple roles. It is unfair to expect ourselves to be perfect at all of them and unfair to expect perfection in any one of them. If we hold ourselves to an impossibly high standard and fall short, our self-esteem can suffer. Something has to give!

One option for those with this as a problem is to lower your expectations for yourself. If we expect less and meet the target, we feel better about ourselves. Sometimes the lowered self-esteem that results from judging what we do with what we ‘should’ be doing is a problem with perception. If you are unable to do more to meet your expectation, why not adjust your expectation to meet what you do? This might involve reducing ‘shoulds’ in your vocabulary as well as learning to be more assertive with others. It is important that you make the adjustment for yourself before you communicate to others. Another potential option for some people is to take on fewer roles and responsibilities. This will free up time and energy to put more effort to the tasks that are a priority for you within the roles you choose.

8.      Be appropriately assertive.

If your self-esteem problems result from the expectations of others and your challenges or difficulties (or straight up impossibilities) to meet them then it might be time to confront those expectations. This might involve learning to be appropriate assertive. Easier said than done, especially for someone who has been under-assertive about their needs and wants for long periods of time.

Several of the clients I work with on this issue have the fear of becoming over-assertive (i.e., aggressive), so a brief primer on assertiveness might help. Under-assertiveness means that a person focuses on meeting the needs of others at the sacrifice of their own needs (i.e., meekness). This hurts your self-esteem because it repeatedly reinforces the message that other people’s needs are more important than your own. Over-assertiveness involves meeting one’s own needs at the expense of the needs of other people (i.e., aggressiveness). Appropriate assertiveness occurs when a person is able to meet their own needs without taking advantage of others and meeting the needs of others without sacrificing themselves.

Assertiveness Continuum:

Under-Assertiveness-------------------Appropriate Assertiveness----------------Over-Assertiveness

Notice that to move from under-assertiveness to over-assertiveness, one would have to move through appropriate assertiveness. There is no short-cut between being under-assertive and being over-assertive. Usually once a person makes progress in changes from under-assertiveness to being appropriately assertive, they do not further change to over-assertiveness or aggressiveness.

            One common strategy for learning to be assertive involves using a role model. Think about the most appropriately assertive person you know. Now consider what that person does. What does s/he say to get her/his needs met but not at the expense of others? How do they go about meeting the needs of others while not being self-sacrificing? Most often, assertive behaviors involve saying, ‘No’ to requests from others and/or setting limits in other ways. If you have an example in your own life, consider how your role model would respond. Practice being assertive in front of a mirror or with a trusted friend.

be appropriately assertive

9.      Focus on values and meaning rather than feeling happy.

We often hear about people trying to be happy. I think this is a misguided goal. Don’t get me wrong, I appreciate the times in my life when I have been happy. It is much more pleasant than sadness, fear, anger, and shame. However, there are too many experiences that create temporary happiness and some of these are unhealthy if used in excess (e.g., substance use, video games, etc.). When we live a life of chasing happy experiences, it can lead to a path of meaninglessness. Also, happiness, like other emotions, is temporary. It is short-term, so we keep chasing it. We find new ways of seeking to feel good. But, we are never fully satisfied. So the problem occurs when we attempt to create a permanent state from a temporary emotional experience. Going along this path, we can begin to question ourselves. Are we living the right kind of life? What is wrong with me that I cannot seem to be happy? Or-what is wrong with me that I can’t hold onto feeling happy for longer periods of time? The problem is often not you, but your perception that you can maintain and contain an emotion that is temporary in its nature.

I suggest that people seek meaningfulness rather than happiness. This might result in happiness (in the form of satisfaction with a life well lived) which becomes a consequence rather than a goal. This involves being clear about your values and having actions that support those values. Actions become habits which become tendencies which become your character. Ask yourself what types of experiences would be meaningful to you (rather than creating temporary happiness)? What are your values? How do you live your values through action? When you live a life of meaning where your actions support your values, it becomes easy to feel good about yourself.

10.  Avoid ‘should-ing’ all over yourself.

This joke comes from the great Albert Ellis, an eminent American Psychologist who developed his own psychological theory of human behavior and treatment, Rational Emotive Behavior Therapy. He discouraged the use of words like ‘should’ and ‘must’ (calling the use of the latter, ‘musterbation’). The reason being is that these words create a sense of pressure when applied to an expectation. Imagine the difference between, “I must get this project done tonight” versus “It would be nice if I get this project done tonight, but not the end of the world if it is not completed”. Do these two statements feel differently to you? Along the lines of reducing expectations for ourselves (or being assertive in dealing with the expectations others may have for us), reducing the pressure of these expectations involves a simple change in our language for our self-talk. Using ‘should’ or ‘must’ implies that there is something wrong or dire consequences will occur if we fail and this can lead to negative self-interpretations thus further lowering our self-esteem. Being self-compassionate and reducing that pressure can go a long way towards improving self-esteem.

11.  Handle mistakes with grace.

Sometimes the way we handle mistakes impacts how we feel about ourselves. Some people let their blunders roll off of their back with a ‘devil may care’ attitude. Others are eaten up with guilt and shame for days, weeks, even months or years afterwards. What do you notice saying to yourself after something you do does not go the way you wanted it to? Are you overly harsh and critical of yourself? Do you make global personality or character accusations (e.g., “I’m so clumsy”)? Have you spent time at the end of a day thinking about all the ways you would have done things differently if you were granted a ‘do-over’? Pay attention for the next few days and try to understand if you have any of these tendencies. Do you recognize that internal self-critic as the voice of someone in your life (parent, teacher, or coach)? Do you know what purpose that critical voice serves? This is helpful to know if you are going to make changes to improve your self-esteem.

Changing to a more self-compassionate approach with more understanding and grace can have a positive impact on your self-esteem. Try to separate your feelings about the mistake from your feelings about yourself. We all mess up from time to time, but we do not all interpret these experiences in the same way. Those with grace tend to have healthier self-esteem than those who are overly critical. As mistakes occur, ask yourself if you would say the same thing to a loved one who just committed the same error. If you would not say that to someone else, have the same level of grace for yourself (or more).

12.  Accept what you cannot control.

Not just a part of the Alcoholics Anonymous serenity prayer, accepting what you cannot control is psychologically healthy. Many people get caught up over-focusing on things outside of their power, especially negative things, and then blame themselves. Holding yourself responsible for things you have no control over is a surefire way to feel helpless and have low self-esteem. If you find yourself in a difficult situation there are some questions you can ask yourself. Do you have control or power here? You might have power or control (or even influence) over aspects of the situation even if you do not have overall power in a situation. If you have no power in the situation, can you get yourself out of that situation? For things outside of your control, avoid holding yourself responsible (at least in your own mind-you might have to pretend to blame yourself for the benefit of others).

Sometimes people get into a tendency to blame themselves for things outside of their control because the alternative is too difficult to consider. If you acknowledge aspects of your life as outside of your control, then it rationally follows that there are some things you are helpless about. This is a challenging idea for many people in this American culture of independence. Therapy can help people become more comfortable with the helpless feelings associated with aspects of their lives outside of their power and emotion-focused coping is the recommended strategy. I spend a lot of time as a Psychologist encouraging clients to express emotions about the things outside of their control (emotion-focused coping) and deal with the things within their control (problem-focused coping).

See previous blog on  Stress and Coping  for more information.

See previous blog on Stress and Coping for more information.

This helps improve one’s self-esteem when you can reduce or eliminate the self-blame for things outside of your power.

Another approach is to shift your focus to other experiences and situations in your life in which you have more power and control and put your energies towards these pursuits. This can help you feel more empowered and build your self-esteem.

13.  Relax (if time allows).

Last, but not least, relaxation can help with low self-esteem. Giving yourself the gift of relaxation on a regular basis strengthens the message to yourself that you are worthy of self-care. Relaxation can come in many forms from the everyday (e.g., taking a walk, hot shower, favorite food, etc.) to the more intentional (e.g., daily meditation, scheduled massages). Working with clients on issues of anxiety or stress, I often find it helpful to match the treatment strategy within the same category as most of their symptoms:

relax

·         Physical symptoms (e.g., sleep disruption, appetite or weight changes, increased pulse or difficulties breathing with anxiety) and physical relaxation strategies (e.g., deep breathing, stretching, regular exercise, massage)

·         Cognitive symptoms (e.g., concentration difficulties, memory problems, racing thoughts) and cognitive relaxation strategies (e.g., thought replacement, meditation, visualization)

·         Emotional symptoms (e.g., mood swings, crying, irritability) and emotional relaxation strategies (e.g., journaling, social support)

·         Behavioral symptoms (e.g., fidgeting, pacing, avoidance) and behavioral strategies (e.g., taking a walk, leisure activities like sports, painting)

I have found from professional and personal experience that a focus on recognizing and changing negative and pressured thought patterns (e.g., over-focusing on weaknesses, social comparison, negative and critical self-talk, pressured language) to more positive, accepting, and self-compassionate ones; avoiding getting overly attached to thoughts and feelings, living in the moment, setting limits for yourself and others, choosing actions that are meaningful, and being able to relax are all valuable ways to improve self-esteem. I hope this information has been helpful for you to get your self-esteem back.

If it is time for you to regain your self-esteem and you would like some professional assistance, give me a call at 405-614-2846 for a consultation.

References

Brown, B. (2017). Braving the wilderness: The quest for true belonging and the courage to               stand alone. Penguin Random House.

Harris, R. (2008). The happiness trap: How to stop struggling and start living. Boulder, CO:             Trumpeter Books.

McKay M. & Fanning, P. (2000). Self-esteem (3rd ed.). Oakland, CA: New Harbinger                         Publications.

When Do I (or Others) Need Professional Help?

When meeting people at social gatherings, the most common question I get is, “You’re a Psychologist; so, are you analyzing me right now?” I try to be witty and give answers like, “Only if you plan to pay me.” or “No. I’m off the clock right now.” Okay, so maybe these responses are trite and not that funny, but that’s my dry sense of humor. Sometimes, my openness about my career is viewed as an invitation for the sharing of a lot of very personal information. People tend to open up to me, even when the timing or situation is not the most appropriate (e.g., OSU Football games-Go Pokes!). Other times, people walk away with a worried look on their face once I tell them about my profession.

Shocked face when people learn that I am a Psychologist

Shocked face when people learn that I am a Psychologist

All of this is surface level to hide the subtext of the discomfort of being known by someone else, especially when that knowledge is uninvited or unexpected. Some people fear that Psychologists are given or taught these super-powers to read others like a book whether the person wants to be known or not. I must have missed that class in graduate school. Honestly, I do have some keen observational skills, but I will not likely uncover deep, dark secrets about someone I have just met simply by paying attention to body language or facial expression. Or by talking with them for a few minutes. I cannot analyze someone without their permission, and my job is mostly about listening well.

For the same reasons, I tend to avoid reaching out to someone I have never met in my role as a Psychologist. This is something I get asked to do frequently, but it hardly ever goes well. Imagine that you are at work or shopping in Stillwater or whatever you tend to do. You are minding your own business when someone taps you on the shoulder and says, “Hi! I’m a Psychologist and your (friend, spouse, co-worker, etc.) is worried about you. Mind if we talk for a few minutes?” You don’t know me. And, this is how you learn that others are talking about you behind your back? About some difficult topics? Not the best opening for professional treatment. However, people ask me to do this often for people they care about. Mostly because it is hard to have the conversation about seeking professional help.

conversation about seeking professional help

This blog is intended to provide some guidelines for you to consider if you are thinking about seeking professional counseling or if you have concerns about a friend, family member, co-worker, etc. While extremely helpful to many (even life-saving for some), I do not believe that everyone needs counseling, nor do I believe that everyone would benefit from counseling. It is normal to want to deal with a situation yourself, especially in our American “boot-straps” culture. It is also common to worry about opening up to a complete stranger, and paying for it. There are many ways to cope with a situation (see Blog posts on Physical Self-Care and Stress and Coping for more information) and several options for treatment of psychological disorders. Counseling is not for everyone, and it works best for the people that are most open to the process of professional treatment. If you feel like you’re trying to force someone into therapy (including yourself), it will likely be unsuccessful at best. At worst, it could be a waste of time, money, and effort.

For those who are interested in professional help as a possible option, the following list of experiences might be times to consider reaching out to schedule an initial appointment.

  • Symptoms of a psychological condition:

o   Symptoms of anxiety might include worry, feeling overwhelmed, concentration or memory difficulties, muscle tension, panic attacks (including physical symptoms like increased heart rate, difficulties breathing, shakiness, etc.), social avoidance/isolation, restlessness, irritability, sleep disruption, phobias, fear of embarrassment or judgment from others, obsessions, compulsions, and/or trauma reactions like re-experiencing, avoidance behaviors, and hyper-vigilance (American Psychiatric Association, 2013). 

graphicstock-success-creative-concept-pencil-ladder-with-copy-space_H_SgtToDeje.jpg

o   Attention Deficit Hyperactivity Disorder (ADHD) symptoms include inattention, distractibility, difficulties organizing or listening to others, careless mistakes, lacking follow through, losing items, fidgeting, talking excessively, impatience, and/or interrupting others (American Psychiatric Association, 2013).

depression can include sadness and loneliness

o   Symptoms of depression might include sad or depressed mood, crying, lack of motivation or interest, sleep disruption, appetite/weight changes, concentration difficulties, irritability, fatigue, excessive guilt, low self-esteem, indecision, feeling hopeless/helpless, and/or thoughts of death/suicide (American Psychiatric Association, 2013).

·        

  • A transition in life:

o   Job promotion or loss; new job

o   Unfamiliar city; recent move

o   Marriage, divorce, or separation; relationship ending

o   Grief; loss or disconnection in friendship(s)

o   Parenthood or step-parenthood

o   Care-giving to other family members

o   Starting school or returning to school

  • Behavioral changes:

o   Poor grooming or hygiene

o   Sudden appetite/weight changes (increases or decreases)

o   Sleep disruption

o   Increasing alcohol or drug use; substance abuse or dependence

o   Self-injury behavior or suicide attempts

o   Academic or work struggles (e.g., poor grades, procrastination, missing work)

o   Loss of interest in typical behaviors

o   Indecisiveness

o   Bizarre or odd behaviors

o   Disturbed speech or thought process

  • Social signs:
couple fighting and arguing

o   Social isolation or withdrawal

o   Not getting along with others; constant fighting or arguing

o   Dependency on others

o   Poor eye contact; extreme shyness

 

  • Emotional indications:

o   Mood swings

o   Irritability (especially if it seems unrelated to life circumstances)

o   Crying/tearfulness

o   Sadness

o   Anger and aggression

Most people start looking for a therapist when they are going through some challenging life situation(s) and their existing ways of coping or dealing are no longer available, become ineffective, or start causing further difficulties. For example, when someone loses a loved one to whom they have relied on for social support for several years, it can be frightening and lonely to face life without that person. All of us like to ‘escape’ the stress of daily life once in a while. This is why movies, music, television, video games, social media, books, etc. are so popular. However, when someone over-relies on escape strategies for coping with a stressor, it may lead to a worsening of distress rather than relief. Some situations can only be avoided for so long. Use of alcohol or other substances can be an unhealthy form of escape and can lead to further stressors like legal issues, family disruption, missed work/school, physical hangovers, financial losses, etc.

If you recognize some of these signs of distress in yourself or someone you care about, it might be time to consider professional help as an option. This might be talk therapy with a psychologist or counselor, but might also involve medical treatment with a physician. I recommend that clients speak to a physician about medication options when their symptoms are mostly physical in nature, when their symptoms have occurred for long periods of time and seem unrelated to situational stressors or circumstances, and/or when there is a significant family history of similar symptoms. These factors suggest more biological causes for symptoms.

medication is an option for treatment of psychological conditions

Other options including seeking informal social support from family or friends, improving physical self-care,  stress management, and/or making a change in relationships, work, school, etc.

Professional help is not about advice giving. It is more about listening, empathy, and understanding with some mutual problem solving. My clients are always in control over what we talk about (session content) and whether or not to follow through on any suggestions or recommendations that I make. As I work with clients, I put the responsibility on me for session process which is the way we discuss presenting concerns so that it is helpful for symptom relief, self understanding, emotional expression, changing behaviors, and decision making. I guide the session process through listening, questioning, connecting various information points, and infrequent suggestions. Knowing what to expect from professional help options can help you or your loved one make a decision about initiating treatment. Ask questions from people you know who have sought treatment and ask questions of potential treatment providers. What do they specialize in? What is their background and treatment approach? If they give you a bunch of jargon that you do not understand or there is a lack of comfort in talking with them, you might consider moving on to the next potential provider. Do your research online to learn more about which treatment provider might be the best fit for you. PsychologyToday.com is a great resource for finding psychologists and counselors in your area with search features for different specializations, insurances accepted, etc.

If you are concerned about someone else, here are some tips for talking with them about seeking professional help as an option:

·         Talk with the person in private

·         Be fully present and give them your full attention

·         Allow for plenty of time; do not rush

·         Share your concerns in an objective manner

·         Express your feelings of caring for the person

·         Do not guarantee absolute confidentiality

·         Invite them to tell you more about what they are feeling and experiencing

·         Listen without judgment

·         Validate their emotional experience even if you do not understand it

·         Ask if they are having thoughts of suicide 

·         Instill hope for improvement for them

hope can be a powerful ally

·         Inform them about help being available and what it is like

·         Research options for treatment with them

·         Let them make the actual appointment

·         Offer to be available for ongoing support

·         Avoid being overly responsible for them and their distress

·         Follow-up with them afterward

·         Stay connected with the person

social support and ongoing care for loved ones

·         Take care of yourself as well

If you or someone you know is in immediate crisis (e.g., thoughts or plans of suicide or homicide, self-injury behavior, severe alcohol or substance intoxication), seek immediate help by calling 911, going to the nearest emergency room, or contacting a suicide hotline (see previous Blog post on Suicide Prevention for additional information).

If you are wondering if it is time to start counseling or want to know more about my approach, give me a call at 405-614-2846 for a consultation.

Reference

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental                            disorders. (5th ed.). Washington,

Suicide Prevention

Preventing Suicide

            Suicide is the most preventable form of death (QPR Institute) and is an epidemic crisis in this country, especially among younger and older people. With just a little bit of information and a lot of caring, anyone can help another person experiencing a suicidal crisis. You do not have to know the exact right thing to say or do. You also do not need to worry about doing or saying the wrong thing. Almost any indication of caring without judgment will likely be experienced as helpful to someone in crisis. The intention of writing this blog is to present factual information, dispel myths about suicide, teach others to recognize the risk of suicide, highlight some considerations in talking with a suicidal individual, reduce the stigma of talking about suicide, and reassure readers that anyone and everyone can prevent suicide.

hope-despair_zyinq_dd (1).jpg

Suicide Statistics

            National

            Almost 45,000 people die by suicide every year which amounts to 123 deaths per day and 1 death every 12 minutes (Drapeau & McIntosh, 2017).

            White/Caucasian males, Native American males, and Black/African American males are highest risk ethnicity/gender groups (Drapeau & McIntosh, 2017).

            10th leading cause of death in U.S.A. for all age groups and 2nd leading cause of death for young people (15-24 year olds) (Drapeau & McIntosh, 2017).

            3.4 male deaths for every female death and 3 female attempts for every male attempt (Drapeau & McIntosh, 2017). This means that females attempt suicide much more often than males, but with less lethal means (e.g., poisoning or intentional overdose). Men are much more likely to use firearms which is very lethal.

            25 attempts per death on average (Drapeau & McIntosh, 2017). There are several opportunities to intervene and get appropriate help for someone who has survived a suicide attempt.

            Firearms overwhelmingly top method for suicide deaths followed by hanging/suffocation (2nd) and poisoning (3rd; most common method for females) (Drapeau & McIntosh, 2017).

            Suicide costs the US $51 billion annually (American Foundation for Suicide Prevention, 2017a).

            90% of people who die by suicide have a mental disorder at the time (American Foundation for Suicide Prevention, 2017b).

suicide statistics and data.jpg

             State

            Oklahoma is 7th in the nation for highest suicide rate per capita in 2016 behind Alaska (1), Montana (2), Wyoming (3), New Mexico (4), Nevada (5), and Colorado (6) (Drapeau & McIntosh, 2017).

            Lowest rates of suicide are found in the mid-Atlantic and New England areas (Drapeau & McIntosh, 2017).

            Suicide to homicide rate in Oklahoma is 3:1 (B. Woods-Littlejohn, personal communication, May 25, 2017).

            Suicide is 2nd leading cause of death for the following age groups: 10-14, 15-24, and 25-34 (B. Woods-Littlejohn, personal communication, May 25, 2017).

            Firearms is most common method for men (64% of suicides) and women (49%) in Oklahoma (B. Woods-Littlejohn, personal communication, May 25, 2017).

            368 official suicides in Oklahoma between 2011 and 2015 among 18-24 year olds with mean age of 21 and 82% males (B. Woods-Littlejohn, personal communication, May 25, 2017).

Myths about Suicide

1.      Myth: Suicide is unstoppable.

        Truth: Almost any sign of caring can help prevent suicidal action. And, suicide is the most preventable form of death (QPR Institute).

suicide can be stopped.jpg

2.      Myth: Bringing up the idea of suicide might ‘plant the idea’ in someone’s mind and I will become responsible if they attempt or complete suicide.

         Truth: Talking about suicide decreases the risk because a person considering suicide often feels like no one is comfortable or safe enough to discuss suicide with. Also, others are not likely to be considered responsible for suicidal actions except in the most extreme cases (e.g., encouraging suicide).

3.      Myth: Only experts can prevent suicide.

         Truth: Non-experts do more to prevent suicide with signs of caring, recommending professional help, intervening with someone who is considering suicide, and offering hope. Sometimes, a person helps prevent a suicide without ever knowing that the other person was ever considering suicide.

4.      Myth: Suicidal people are secretive about their plans. Suicides happen without warning.

         Truth: Most people consider suicide for weeks, months, even years prior to action and tell people about these thoughts along the way. There are usually many attempts to get help prior to a suicide death. However, most people who attempt and complete suicide do not leave suicide notes, only about 25% of cases.

5.      Myth: Suicidal people want to die or, at least, stop living.

         Truth: A person considering suicide is searching for an escape from their emotional pain and have trouble considering any other options. Many suicidal individuals are ambivalent about death with reasons both for and against living.

6.      Myth: Those who talk about suicide do not take action and should not be taken seriously, especially if they have threatened suicide multiple times.

         Truth: Any indication of suicide, especially a direct verbal statement about suicide, should be taken seriously regardless of one’s history. Not taking suicidal threats seriously can lead to a fatal outcome.

7.      Myth: Suicide is an act of cowardice.

        Truth: Overcoming one’s natural inclination towards living and facing the physical pain of a suicidal act is one of the most challenging things to do. Typically a person makes several attempts before a death by suicide occurs as they build up a tolerance to pain and familiarity with the method. This allows opportunities to intervene and get the person the hope and help needed to prevent further suicidal action.

8.      Myth: Suicide has only one cause.

         Truth: Suicide is complex and has multiple causes that influence each other in unique ways. There is no ‘one’ reason why people attempt or die by suicide.

9.      Myth: People become more suicidal in the winter, especially during the holidays.

         Truth: Suicide is more common in late spring and less common during the holidays. April and May have the highest rates of suicide; November and December have the lowest rates of suicide.

Warning Signs and Risk Factors

            Many people wonder how to recognize that someone else might be distressed to the point of thinking about suicide. Sometimes, this type of information seeking does not occur until a suicide death occurs. When I present on this topic I like to remind audiences that you are only responsible for the actions you take based on the information you have at the time. So, I encourage readers of this blog to not hold themselves responsible for not knowing this information with past incidents of attempting to help someone through a suicidal crisis.  

          Warning signs are more immediate indications that a person is considering taking suicidal action whereas risk factors increase overall chances of suicidal action based on statistics (e.g., being male). Most of these should be taken into account within the context of what you know of a person. However, any direct or indirect verbal indications of suicidal thoughts can be taken seriously regardless of other information. Generally the more warning signs and risk factors that are present or if the more intense/severe warning signs are occurring the more you should be concerned about someone.

warning signs and risk factors of suicide

Warning Signs

·         Verbal statements (either direct or indirect) that indicate thoughts of death or suicide:

o   “I plan to kill myself.”

o   “Sometimes I wonder what it would be like if I was no longer here.”

o   “I can’t stand the pain any longer.”

o   “What if I did not wake up tomorrow?”

·         Behavioral clues:

o   Past suicide attempts, gestures, or plans

o   Researching suicide methods

o   Alcohol or other substance use/abuse

o   Giving away possessions or putting personal affairs in order (e.g., a twenty-something writing a will)

o   Saying ‘goodbyes’ to close others

o   Stockpiling medications or acquiring means of suicide (e.g., a firearm)

o   Poor hygiene or grooming

o   Increasing intensity of physically risky activities (e.g., sports, skydiving, etc.)

o   Low motivation to do things previously enjoyed

o   Drastic changes in religious activity (either greatly increased or greatly decreased interest and participation)

o   Poor sleep habits

·         Emotional indications:

o   Feeling hopeless or in despair

o   Helplessness

o   Sudden anger or irritability (especially when the person did not previously have problems in this area)

o   Extreme mood swings

o   Humiliation

o   Frequent crying and sadness

·         Health factors:

o   Diagnosis of a depressive disorder, a bipolar disorder, an eating disorder, or a trauma disorder

o   Diagnosis of a serious, chronic, or fatal medical condition

o   Constant physical pain or fatigue

o   Alcohol or other substance use disorder

·         Social signs:

o   Social isolation/withdrawal

o   Being bullied or abused

o   Disconnection from previous relationships (e.g., death of a loved one, divorce/separation, job loss)

o   Restrictions due to hospitalizations, incarceration, deportation, etc.

o   Feeling like a burden to others (e.g., financially or with regards to social support/assistance)

·         Situational circumstances:

o   Being fired or laid off from work

o   An unwanted move (e.g., moving to a nursing home or assisted living facility)

o   Death of a loved one, especially if death was by suicide

o   Greatly reduced financial income or loss of financial security

o   Fear of punishment

Risk Factors

·         Being male

·         Being White/Caucasian, Native American, or African American

·         Owning a firearm

·         Living in a rural area, especially the Western part of the country

·         Lacking access to quality health care

·         Physicians and other health care providers

How to Intervene

            Once you have identified someone as potentially suicidal based on their context, warning signs, risk factors, and other information you have about them, it is time to consider how to discuss your concerns with them. It is helpful to talk with someone in private to help them feel more comfortable and safe in opening up. Also, give them your full attention and do not set time limits for the discussion. If you are asking someone about suicide, there is likely no other issue that is more urgent or more important at that time. Express your observations and concerns in the most objective manner possible. For example, you might say something like, “I have noticed that you have missed a lot of work and that you seem disconnected from others since your divorce. I have been concerned about you because I care about you.” Then, as calmly as you can and without any judgment ask the person if they are thinking about suicide. You do not need to know any exactly right words or have any kind of planned response to their answer. Most likely, they will begin doing most of the talking and then your job is to listen patiently and express hope by connecting them with resources. If the person is hesitant to answer, be persistent and ask again. Remember that most suicidal people are worried that no one will understand and that no one is willing to discuss suicide. If you can be the exception to that belief it will bring a lot of relief to the distressed person. Someone considering suicide is often more open than expected. Tell them that you are ready to help and that there are reasons to be hopeful for improvement. Some options for connecting the person with resources regardless of whether they are considering suicide or not:

·         Helping them make a counseling appointment either by phone or in-person

·         Researching treatment providers online to find the best fit

·         Calling or texting one of the crisis hotlines together-see below

·         Providing contact information about treatment options

·         Calling 911 or taking the person to an emergency room

helping someone considering suicide find help

     It is common to be uncomfortable with the topic of suicide, especially when you consider asking someone a very personal question like whether or not they are considering killing themselves. If you are concerned enough about someone to have suicide be a consideration and you are unable to ask the individual, find someone else that can. Preferably this would be someone who has a good relationship with the potentially suicidal person. As with most things, asking about suicide gets more familiar with experience and practice.

     Another consideration for a suicidal individual is to remove any items they have considered using for a suicide attempt. This might be relocating a firearm to another location or placing a gun lock. Removing potentially harmful medication, especially large quantities of medication can help. Taking away or hiding car keys is an option. Staying with the individual or arranging others to be with them so that they are not alone is something to consider. Most people will not think about changing one suicide method to another in most situations, so focus on putting as many barriers between them and the method(s) they have considered. Have them commit to not taking suicidal action and to give treatment an honest try.

     Ask them how you can continue supporting them and, then, follow up with them. Check in with them the next day. Ask them how about their first therapy appointment. Offer to help in ways that you feel comfortable about and avoid getting over-involved. Also, consider getting others involved in ongoing support for the individual. Trust them when considering whom to invite. If they say that their parents will likely react negatively and that it is better to involve others, believe them. Any offers of assistance and caring are likely to be received positively from someone distressed whether they are considering suicide or not. Remember that you do not need to be an expert or know the exactly right thing to say or do. Being your genuine, caring, and non-judgmental self is the best thing you can do for someone distressed.

Coping and Support

            There are many things that can help a person considering suicide. These apply to other distressed individuals whether they are suicidal or not. Use the ones that apply to your situation:

·         Hope and positive thinking

·         Anger management

·         Remaining active

·         Staying connected with others

·         Stress management-see prior blog for more information

·         Plans for the future

·         Healthy sleep habits-see prior blog for more information

·         Social support (including talking about suicidal thoughts and talking about other things)

·         Avoiding alcohol or other harmful substances

·         Counseling treatment

·         Medication management of symptoms

·         Support groups

·         Reasons against suicide

hope is one of the most important parts of suicide prevention

Resources      

            If you or someone you know is having thoughts of suicide, help is available and hope is real. Use the following resources to connect with someone immediately:

·         Suicide Prevention Lifeline: (800) 273-TALK (8255)

·         Crisis Text Line: 741741

·         Teenline (Crisis hotline for teenagers): (800) TLC-TEEN (852-8336)

·         Trevor Lifeline (Crisis hotline for LGBTQ youth): (866) 488-7386

·         National Alcohol and Drug Abuse hotline: (877) 437-8422

·         Call 911 or go to the nearest hospital emergency room

For less urgent situations, the following resources have a lot of helpful information about suicide prevention, training options, treatment options, statistics, and more:

·         American Association of Suicidology (www.suicidology.org)

·         American Foundation for Suicide Prevention (afsp.org)

·         ASIST (Applied Suicide Intervention Skills Training) (www.livingworks.net)

·         National Eating Disorder Association (800-931-2237)

·         National Institute of Mental Health (www.nimh.nih.gov)

·         Oklahoma Suicide Prevention Council/Oklahoma Department of Mental Health and Substance Abuse Services (www.odmhsas.org)

·         Psychology Today (www.psychologytoday.com)

·         QPR (Question, Persuade, Refer) Institute (qprinstitute.com)

If you have questions or concerns about someone who is distressed and possibly considering suicide, give me a call at 405-614-2846 for a consultation. Keep in mind that this phone number is not for emergency situations-see above resource information for other options for urgent suicidal crises.

References

American Foundation for Suicide Prevention (2017a). Suicide statistics. Washington, DC:                 American Foundation for Suicide Prevention dated August 31, 2017, downloaded from                 https://afsp.org/about-suicide/suicide-statistics.

American Foundation for Suicide Prevention (2017b). Treatment. Washington, DC: American           Foundation for Suicide Prevention dated August 31, 2017, downloaded from                                 https://afsp.org/about-suicide/preventing-suicide.

Drapeau, C. W., & McIntosh, J. L. (for the American Association of Suicidology). (2017). U.S.A.         suicide 2016: Official final data. Washington, DC: American Association of Suicidology,               dated December 24, 2017, downloaded from www.suicidology.org.

Joiner, T. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.

Joiner, T. (2010). Myths about suicide. Cambridge, MA: Harvard University Press.

Quinnett, P. G. (2000). Counseling suicidal people: A therapy of hope. Spokane, WA: The QPR       Institute Inc.

Quinnett, P. G. (2008). Suicide: The forever decision. New York, NY: The Crossroad Publishing         Company.

Stress and Coping

Stress 

What is stress? Stress is something we talk about and ‘manage’ all of the time, but it can be challenging to precisely define for some people. Stress is simply a challenge to meet either an internal or external demand. Stress can be a painful emotion like sadness or fear when we face the death of a loved one. Stress can also occur when we are running late to an important meeting or have difficulties meeting the demands of our various or conflicting roles. When people discuss ‘stress’ they are typically talking about ‘distress’ or the negative side (or right side of the curve below) of the stress continuum. This is the type of stress that is uncomfortable or painful and leads to worsened performance (e.g., lower grades, decreased productivity, concentration problems, etc.). However, there is another type of stress known as eustress, which receives less attention. This type of stress is motivating and helps us do better. Eustress is recommended for those who are under-motivated or under-performing to their potential. Increases in eustress can lead to improved performance and higher functioning in these situations. Difficulties arise, however, when someone applies pressure to another person to increase performance due to a mistaken belief that they could benefit from eustress. For example, someone with an undisclosed anxiety issue at work might appear to be ‘slacking off’ and their supervisor decides to confront these avoidance behaviors with goal of improving performance only to find that the problems worsen because the employee was actually experiencing distress rather than eustress. See the following curve for a visual representation. Eustress is on the left side incline leading up to optimal performance (green leading to yellow) whereas distress is on the right side decline leading away from optimal performance (yellow leading to blue).

stress and performance curve with eustress and distress.jpg

 

            What are common sources of stress? Many people think of unwanted events in life as stressful. For example, an unwanted job termination or being laid off, a relationship difficulty, or an unexpected financial obligation can be stressful. However, stress is also associated with positive life events and changes. Getting married. Moving to college. Retirement. These are life experiences that many people look forward to for years, yet they come with their fair share of stress. Do you know of anyone who had a stress-free wedding?

            There are several negative impacts of stress. Some are physical like sleep disruption, unwanted appetite and weight changes, medical illness, and fatigue or loss of energy. Other consequences of stress are emotional such as helplessness, hopelessness, irritability, etc. Cognitive symptoms of stress include concentration problems, memory deficits, difficulties talking, and over-focusing on worst case scenarios. Lastly, stress can lead to behavioral indications like social withdrawal, changes in hygiene or appearance, low motivation, or substance use. These indications of stress can lead to decreased functioning at work or school, problems in relationships with close friends or family members, and reduced quality of life overall. However, there are many options to deal with stress to minimize the negative impact.

Coping

When people face stressors and difficult times, there are two basic ways of approaching how to deal with the situation. If the person has some control and power with the issue or outcome, problem-focused coping might be recommended. This is when someone attempts to change the situation and can include problem solving, making a decision, taking action, changing something about their approach, etc. This type of coping is traditionally associated with masculinity, but is something we all engage in regardless of our gender identification. For those socialized in more traditional gender value systems, boys and men might have more opportunities to learn problem-focused coping. Examples of stressors that might benefit from a problem-focused coping strategy include relationship difficulties (where one focuses on what they can do differently to improve the relationship or decide to leave it), job dissatisfaction, under-assertiveness, or goals for self-improvement like exercise, eating healthier, and avoiding harmful substances.

Some clients seek therapy for solutions to their stressors and prefer a problem-focused approach. This often involves a clear definition of the problem and the history of the stressor as well as past problem-solving efforts for similar difficulties. Areas of power/control are assessed in order to understand which options are available. For example, some clients come to therapy for help with their sleep habits when they are ready to make a change. See more about Sleep Hygiene in an earlier blog post. Other clients seek treatment to deal with problems in communication or dissatisfaction with people in their family or with whom they work. These clients might be looking to make a change in these relationships or how they approach communication (e.g., becoming more appropriately assertive). Some common problem-focused coping stress management strategies include:

·         Eating healthier meals consistently

·         Improving sleep habits

·         Exercising

·         Reducing use of harmful substances

For more information on Physical Self-Care-see this earlier blog post.

·         Changing job situations

·         Making new social connections

·         Time management-see more information by clicking here

·         Organization

·         Relaxation strategies

·         Improving communication within relationships

            The other approach to managing stress is emotion-focused coping which often helps a person deal with the associated emotions and thoughts about the stress. This does not change the situation, as some people mistakenly hope, but rather one’s mental approach to the situation. I recommend emotion-focused coping for stressors in which the person has very little or no control of the situation or outcome. Some examples might include the death of a loved one, an unwanted job change, and health/medical concerns. This approach is traditionally associated with femininity especially for those with more traditional socializations, but can apply equally regardless of gender. Traditionally socialized girls and women may default to using emotion-focused coping due to experience and familiarity.

            Many of my clients come to me when their usual problem-focused coping strategy no longer works. This might be the first time they have experienced a stressor in which they had little or no power or control, or they may not be used to emotion focused coping. Instead of trying to change the situation, emotion-focused coping focuses on helping the person deal with the emotional impact of the stressor in healthy ways. I often hear people ask why they should discuss their past experiences, since they are unable to change the past. While this is true about our inability to change the past, it indicates an over-focus on problem-focused strategies. I counter with an explanation about how discussing past experiences within a safe and trusting therapeutic (or other) relationship can reduce the impact and influence (conscious or not) those past experiences have on one’s emotions, thoughts, and functioning.

            Taking emotion-focused coping one step further, I often use a container analogy with my clients. Imagine that everyone has an ‘emotional container’ within them. These containers are different sizes. Some people have rather large containers whereas others have much smaller spaces. As we have experiences and emotional reactions to those experiences we can choose to express that/those emotion(s) and move on with life. On the other hand, we might choose to ‘stuff’ that feeling in our container to deal with it later (healthy in many situations) or ignore it completely (usually unhealthy in the long-term). There can be many reasons to not deal with our in-the-moment emotions. We might be in a situation where it is necessary to appear non-emotional to prevent judgment from others or get through a situation that needs a problem-focused approach. However, when a person repeatedly ‘stuffs’ their feelings in their emotional container without dealing with or processing those feelings later, the container eventually gets full. When a container is full, a couple of things can occur. First, this is when people typically start experiencing symptoms of anxiety or depression that bring them into treatment. Second, there is no more room in the container for new emotions, so a person is forced to begin dealing with their feelings, which can be daunting to those unfamiliar with the process.

like this truck that is too full our emotional containers can get overwhelmingly full.jpg

            In addition to talk therapy, some common emotion-focused coping strategies include:

·         Social support-talking with a trusted and empathic friend or family member

·         Journaling-focus on the process of emotional expression rather than the content of what is written

journaling can be a great way to express emotions.jpg

·         Music-important that the feeling of the music fits the emotion experienced by the person

·         Positive self-talk-changing internal interpretations about one’s self in relation to experiences, especially patterns of repeated experience.

·         Art

·         Dance

I encourage clients to schedule time for emotion-focused coping and to follow it with some form of self-soothing or comfort behavior. Often I will start with helping clients develop new comfort behaviors so that they will have many options to choose from and feel confident in their abilities to relieve themselves emotionally after the fatigue that sometimes comes with emotional expression. This also acts as a reward to help reinforce the use of emotion-focused coping strategies. When clients are unable to think of self-soothing or comfort strategies, I ask them to consider what they do with themselves when sick with a cold or the flu. Another option is to ask clients what they notice other people do to take care of themselves. Common examples of self-soothing and comfort behaviors include:

·         Taking a walk

·         Hot shower/bath

·         Reading

·         Watching television

·         Music that does not fit the emotion expressed

·         Time with friends

·         Petting a dog or another pet

Younger version of Dasher

Younger version of Dasher

Current Dasher

Current Dasher

·         Exercise and sports

·         Comfort items like a soft blanket or a favorite sweater

·         Cooking

·         Video games

·         Family time

·         Some people even enjoy cleaning!

I warn clients that there are some harmful and unhealthy comfort strategies to be avoided. Spending too much time online, impulse shopping, and harmful substance use are some common examples. Be sure that your comfort strategies are healthy and not over-used.

If you or someone you know has a stressor(s) and need assistance with either problem-focused or emotion-focused coping (followed by self-comfort strategies), give me a call at 405-614-2846 to get started.

The 5 Love Languages

Whether you are currently in a romantic/intimate relationship or not, everyone can benefit from increased insight about how we communicate in relationships. The 5 Love Languages concept was originally written within the context of romantic relationships, but application has been made for many other types of relationships. Friendships. Co-workers and supervisors. Professional relationships. Family members. The idea is simple and straightforward. Basically, we give and receive (or interpret the actions of ourselves and others) within the lenses of 5 different styles called love languages. When we communicate with someone else who speaks our ‘language’ things tend to go smoothly and not much extra effort is required. However, if our ‘languages’ are different, then potential for misinterpretations and misunderstandings occurs, just as when an English speaker is in a Spanish speaking country and has very little comprehension of the Spanish language. This does not prohibit communication, but makes it more complicated and extra effort is needed for a positive relationship. To complicate matters a bit more, some people have 2 or 3 (or 4) love languages that are equally accessible. These people are bilingual or multilingual and may easily get along with a greater number of other people as they switch from one language to another depending on whom they are speaking with.

If you have ever wondered what your love language(s) is/are or that of someone else in your life, online free quizzes are available at: http://www.5lovelanguages.com/. Below is a brief summary of the 5 love languages. In working with clients (especially couples), I encourage people to practice different languages with focus on the language of their significant other (or with someone else to whom they are desiring an improved relationship) and assess the results. This includes not only speaking the other person’s language, but also interpreting their behavior from the perspective of their language. Languages can be learned with awareness, practice, and effort; so don’t give up if you have language differences.

1.      Acts of Service

Actions speak louder than words. When you do a favor for someone, you are engaging in the love language of Acts of Service. This might including taking someone’s chore or errand for them while they are sick or overwhelmed with other demands. It might be going out of your way to do something that benefits them such as buying them their favorite comfort food when they are stressed. Taking your time to teach something to someone is an act of service. Acts of service is the most behavioral of the 5 love languages and may involve an action away from the other individual, and therefore go unnoticed if that other person speaks a different love language. If you have ever been on a committee, the Acts of Service people are easy to spot because they tend to jump right in and volunteer when something needs to be done. People with Acts of Service as their primary love language tend to be upset when others do not offer to help with a task.

Acts of Service.jpg

2.      Gifts

Gifts are tangible, concrete items that have a lot of sentimental or emotional meaning to the receiver. We all know those people who are able to think of the perfect birthday gift for other people in their life. People with this love language pay attention to what others have and what they might benefit from receiving. Gifts is the most tangible of the 5 love languages. People with this love language put a lot of thought into the gifts they purchase or make for someone and tend to expect the same consideration for gifts they receive themselves.

Gifts.jpg

3.      Physical Touch

Physical Touch is the most physical of the 5 love languages and involves affectionate touching above and beyond sexual relations. This includes hand holding, hugs, a pat on the back, shoulder rubs, etc. A person with physical touch as their primary love language is typically not shy about public displays of physical affection. Also, the reduction in stress and feelings of comfort are almost visible when a physical touch person receives the appropriate physical affection, like a long hug at the end of a hard day at work. However, unwanted or inappropriate touch can be very off-putting to a person with this love language (as it is with most people). And, lack of physical touch can feel like a neglected need. Physical touch is the trickiest of the 5 love languages to translate to professional or work relationships because appropriate boundaries can limit the type or amount of touch, so you might refrain from engaging in too much touch at work unless you know the other person is completely comfortable with it.

Physical Touch.jpg

4.      Quality Time  

Quality Time is the most interpersonal of the 5 love languages and involves spending moments of engaged togetherness with one another. This does not mean sitting on the same couch and watching the same television show while both people scroll through social media feeds separately. Quality time is more about giving thoughtful attention to another person and being emotionally present. It might involve an activity of mutual interest like cooking dinner together or playing a sport or video game together or taking walks, etc. Quality time people tend to want more time with their loved ones and can become offended when some barrier gets in the way of that type of engaged togetherness.

Quality Time.jpg

5.      Words of Affirmation

Words of affirmation involves compliments and praise. This is the most verbal of the 5 love languages. Some people need to hear that they have done a good job with some job or task. This reinforces their desire to do the same thing in the future and helps them feel valued when someone provides praise. This can also help with connection in relationship. However, the opposites of affirmative words, either in the forms of negative criticism, insults, or simply lack of positive praise can be experienced as extremely hurtful to people with this as a primary love language. One might wonder why they have worked so hard on something if only to be criticized or at least not recognized by verbal positivity.

Words of Affirmation.jpg

Remember that love languages (just like other languages) can be learned at any age. Pay attention to how you interpret your actions and the actions of other people with special attention to what things help you feel most closely connected with others and what hurts when it is turned into a negative or area of neglect. Also, keep in mind how others tend to fall back into their natural languages and try to appreciate their attempts at connecting rather than assuming that they do not desire or know how to connect in relationships. A lot of relationships are characterized by two people making effort in different ways with their attempts going unnoticed due to language differences.

            If you or someone you know is struggling with relationship issues whether this is a romantic relationship or other types of relationships (friendships, working relationships, etc.), feel free to give me a call to schedule an appointment or for a quick telephone consultation.

Reference

Chapman, G. (2010). The 5 love languages: The secret to love that lasts. Chicago: Northfield     Publishing.

Time Management

“Time is at once the most valuable and the most perishable of all our possessions.”

John Randolph

            In today’s fast paced society and global business culture, it becomes increasingly important to manage one’s time. We all seem to have increasingly more demands on our time and attention as well as the expectation that we are constantly accessible (e.g., social media, email, cell phones). However, we all have the same 24 hours in a day and we do not control the speed of time. So, time management is really about self-management. If you struggle with managing yourself with regards to time, you are not alone. This is a common complaint of many of my clients as well as friends. Improving your time management can free up additional free time for relaxation or anxiety management or help one feel more confident and accomplished in their day. Good time management can help you focus on your most important priorities. If you’re interested in ways to improve your time (self) management skills, here are my tips:

1.      Plan ahead.

Begin with the end in mind. Sounds simple and straightforward, but ask yourself how many times you set out to focus on your main priorities only to make little to no progress because you get side-tracked by less important matters. When we plan ahead and focus on our top 1-3 priorities, we tend to make more room in our schedule for what is important. This helps keep the distractions and unimportant matters at bay. Successful people spend the first few minutes of each day thinking about what they want to get accomplished and making sure detours are minimal.

2.      Keep a schedule.

Once you know your priorities you can begin to map out a weekly schedule. Start with the most important tasks and meetings and include the less flexible, recurring time commitments. As you add to your schedule, add the things that are decreasingly important or more flexible until you have the least prioritized and most ‘movable’ or ‘cancel-able’ plans at the end. Make sure you include some down-time for you to relax and some flexible time where unexpected things could get done. Do not forget about sleep and don’t scrimp on getting at least 7-8 hours per night.

 

Also, schedule in time to eat, exercise, and generally take care of your physical needs.

3.      Use a task list.

After you have a weekly schedule and know approximately when things will happen it is time to keep track of what needs to get done. Using a task list can help with efficiency and it is so gratifying to cross completed tasks off the list as you watch the number of things needing to get done shrink. There are two good options for the order of your task list and one bad option. Some people find it helpful to list the most important tasks up top to keep them focused on their priorities. Others seem to benefit from ordering their task list by time urgency, so they put what is ‘due’ first at the top and move towards what is ‘due’ last or later towards the bottom. Either of these methods are fine so you might try both to see which one is a better fit for you. The order you want to avoid is random order or placing tasks on the list as you think of them. Once you have a task list written down or in electronic format, you free up some mental energy in not having to remember to remember to do something.

keeping a task list can help with time management.jpg

4.      Know what time it is.

“Better three hours too soon, than one minute too late.”

William Shakespeare

How can you manage your time if you do not know what time it is? Keeping track of the time is an important though often overlooked aspect of good time management. This can be done in a number of ways with technology and is more than looking at the clock or a watch. Reminder alarms and timers on smart phones are really helpful to some people, especially those with attention difficulties or passionate people who tend to get ‘lost’ in what they are doing. Also, knowing your bio-rhythms is important. Do you know what part of the day you have the most energy and focus? When do you slump? Organizing your schedule and task plans around the daily changes in your body and energy level is helpful to maximize your productivity.

5.      Do the hard or unpleasant stuff first.

If you are anything like me, you would rather do the fun or more interesting stuff first. The only problem with this for me is that I put off the boring or less interesting tasks over and over again until it causes problems because I never get them done. I have found that doing the unpleasant things initially and rewarding my work with the more interesting or fun tasks can be a way to manage my time more effectively. This is also known as the Premack Principle or Grandmother’s Rule. You must finish your homework before you can go out and play. Grandmother was wise.

6.      Reduce distractions.

“What distracts us will eventually define us.”

Bob Goff

One of the reasons we struggle with time management these days is because there are so many ways we can be distracted. Some of the biggest culprits are cell phones, email, and social media. I jokingly tell my clients that mobile phones have off buttons for when they are working or studying. If you keep your phone on or have a tablet, laptop, or desktop open with windows or applications running, you might consider turning the alert features off to prevent distractions while working on something that takes more focus. Some of the best managers of their times will only check email once or twice per day (at the beginning and possibly end of the work day). This may or may not be feasible depending on your situation, but you might be able to check email less often. Social distractions can be reduced by closing office doors or working on a project away from your usual places. Whatever your distractions are, think about a plan to reduce their interference on your work.

7.      Set deadlines for yourself.

We all know those people that wait until the last possible moment to get things done.  Even with large projects. Maybe you are one of them. There are many reasons for procrastination, but one of the more common explanations is that people get stressed and overwhelmed when there is too much to do. For any large scale projects, it can be stress relieving and reduce overwhelm by breaking the process into steps (and sub-steps as needed) and setting soft deadlines for these steps. Then, simply focus on one step at a time within your set schedule. If your current step still feels overwhelming to you, then break that down smaller to sub-steps until you no longer feel overwhelmed and are ready to take action.

time management can be stressful planning ahead using a calendar and tasks list and other tips .jpg

8.      Have your materials organized.

It can save a lot of time when you do not have to go looking for stuff. Knowing where your materials are and keeping them nearby means that you do not have to spend time gathering them. Also, having something to work on at all times can be helpful if plans get unexpectedly cancelled. For example, working with college students, I will often recommend they have something to read or study in case a class is cancelled and they have unexpected free time while on-campus. When working from office or home, try to have most of the things you need within arm’s reach. If you are traveling, put some extra time into packing your bag with the things you definitely need as well as things you might need. That way you can take advantage of potential time opportunities.

9.      Focus on one thing at a time.

“If you want to make good use of your time, you’ve got to know what’s most important

and then give it all you’ve got.”

Lee Iacocca

When our attention is divided, we are less efficient at any one task. Also, we end up spending a lot of our time trying to re-focus or re-orient on a task. “Now where were we?” “What was I working on again?” The book The One Thing by Gary Keller with Jay Papasan is an excellent and not very time consuming read on this topic. Checking email or returning phone calls only once or twice a day can really help you focus on one thing at a time. Plus, you get to choose the timing rather than being at the mercy of other’s schedules for communication.

10.  Slow down.

This last one may seem counter-intuitive at first. If you are like me, then you hate being in a rush. When time is tight, you make mistakes. This causes you to spend more time ‘cleaning up’ those mistakes. In the long run, it is best to take most things slowly, which helps you be more focused and efficient on the task at hand and reduces mistakes (and time spent fixing those mistakes).

            If you or someone you know is struggling with time management, feel free to give me a call to schedule an appointment or for a quick telephone consultation.

Physical Self-Care

As I drive by a gym on the way home from the office, I notice the parking lot seems fuller than usual. This could be due to the cold weather, but I suspect the crowds has something to do with the new year. How many people do you know that make New Year’s Resolutions to start exercising, eat healthier foods, lose weight, stop or reduce the alcohol, etc.? These are some of the more common goals I hear from people, and there is nothing wrong with having these goals. I have hope for people to stick with them past January every year as it takes approximately 66 days for habits to form.

“People do not decide their futures, they decide their habits and their habits decide their futures.”

F. M. Alexander

This blog is in support of anyone wanting to make improvements in how they take care of their physical body with hope that any changes result in lasting habits.

One of the first places I start with many of the clients I help is asking questions about how they take care of themselves physically. I assess for sleep hygiene (see previous blog), exercise, energy levels, appetite and eating habits, avoidance of harmful substances, and relaxation strategies. The importance of physical self-care becomes evident once clients start making improvements in these areas as there are several overlaps and influences between physical functioning and mental health. Clients will immediately report feeling better with their moods, their anxiety, their depression, and even relationship concerns once they learn to manage their sleep hygiene, start exercising, etc. This is not a cure-all for sure, but it is a great place to start treatment.

            Let’s take a look at each of these areas more specifically.

            Sleep Hygiene

            The parts of your brain responsible for quality sleep are focused on cues, comfort, and consistency. The more consistent your sleep schedule and environment, the better your sleep becomes. If you have a pre-bedtime routine that involves doing the same behaviors in the same order every night (with decreasing levels of stimulation), the more likely you will go to sleep when you want. One of the biggest barriers to quality sleep is engaging your brain while in bed. So, stay off those smart phones/tablets, stop watching your show on Netflix, and do not read while in bed. These wakeful activities should only be done away from bed, preferably in another room. Making your bed as comfortable as possible is another way to help improve sleep. This includes reducing noise or light interference, having the right bedding and pillows, and adjusting the temperature to your preferences. Avoiding caffeine use, especially late in the day is an obvious way to assist with sleep. But, a less obvious strategy is to avoid exercise too close to bedtime. Although exercise tires your muscular and skeletal systems, it stimulates the nervous system. This is the difference between ‘tired’ and ‘sleepy’. Put at least 2 hours between exercise and sleep for optimum benefit. I often hear that sleep problems are caused by racing thoughts. One strategy for dealing with this sleep barrier is to give those pesky thoughts attention earlier in the day. Any form of emotion focused coping like journaling or social support can help with this (look for a future blog post on this subject). Last, but not least, avoid alcohol and other drugs (more on this below). Although some substances, including alcohol, can make you sleepy, they often reduce the quality of sleep and can interfere with long-term sleeping habits.

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            Exercise

            Consistent exercise is one of the best things you can do for your body and mind. The good news is that there are so many options. Running. Weight Training. Yoga. Biking. Swimming. Sports. Even walking or standing are better than a completely sedentary lifestyle. If you have trouble getting started, talk with people you know who exercise or hire a personal trainer. Not only does exercise improve your muscles, joints, energy level, and stamina; it does wonders for one’s mental state of mind. I know that I feel more clear-headed after a long run, especially if the weather is good enough to run outside. Also, exercise and body improvements often lead to increases in self-esteem. Cardiovascular types of exercise (in which the pulse is raised for a specific time period) are the ones I most often recommend to clients. This is especially helpful for reducing baseline heart rate which improves one’s ability to manage stress or anxiety. Finally, it is wise to consult with your medical physician if you have any health concerns that might limit or prevent certain types of exercise.

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            Appetite and Eating Habits

            Do you have a comfort food? Do you feel like your eating habits are out of your control? Let’s face it. Some foods are hard to resist and some stressful situations can trigger unhealthy eating habits. This could be on the sweet or savory side and/or be involved in portion control. There are many print, online, and professional resources that provide information on healthy eating habits, but people typically have a good sense about whether they eat healthy or unhealthy foods and whether they eat healthy portions or not. In working with clients on this issue, I ask them to pay close attention to the times they eat better (including situational stress) and the times they eat worse. There are often hidden emotional triggers to unhealthy eating. The goal is to understand the connection between one’s emotions and eating habits. Other influences include the media and celebrities, family/friend peer influence, finances that might limit food choice options, and culture in general. Once patterns are examined, people can make more informed and in-control decisions about their eating habits.

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            Sudden changes in appetites (either greatly decreased or increased appetite) can be a sign of a mental health or medical condition. It might be important to have your appetite assessed by a professional within context of other signs and symptoms.

            Avoidance of Harmful Substances

            We all know that we shouldn’t drink too much. We shouldn’t smoke. Don’t do drugs. But, what about caffeine? Is too much caffeine harmful? How about prescription medications? It’s important that you are well informed about any chemicals you consume and the impact it has on your body and mind. For example, many prescription ADHD medications are stimulants that help with ADHD, but cause anxiety symptoms to worsen. Caffeine and alcohol can be a cause of sleep disruption. Whatever harmful substances you struggle with reducing or avoiding, consider going longer periods of time between use or decreasing the amount used and assess the results. You could also pair your substance use with discomfort to make it less appealing. Do you feel any better physically or mentally? If you continue to struggle or if your substance use creates legal, work, or relational problems; you might seek professional help.

            Relaxation

            Do you experience recurring muscle tension? Has your dentist talked with you about wearing a night guard on your teeth because of grinding or clinching damage? Your body cannot be relaxed and tense at the same time. So, if you struggle with physical tension, you would probably benefit from physical relaxation. Like exercise, there are many forms. Progressive muscle relaxation. Massage. Deep breathing. Some more common behaviors that are physically relaxing are things people do every day like hot showers, sexual release, and stretching. Pay attention to the tension in your body. Do you have spots that tend to be sore or tense often? What are some methods you could use to relieve some of that tension? Combined with adequate sleep, exercise, healthy eating, and avoiding harmful substances; relaxation can help you feel better physically and mentally. I often prescribe relaxation as a strategy to manage anxiety symptoms, especially if anxiety symptoms are physical in nature.

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Energy Level

            Energy level is an important indicator of how your body and mind are doing physically, mentally, and emotionally. If you find that your energy level is too low it might be due to inadequate or poor quality sleep, lack of exercise, unhealthy foods, substance use, or other causes. Energy problems might also be a sign of a mental health or medical disorder. If your energy level is consistently too low (despite attempts to make above changes to your physical self-care habits) or is consistently too high, you might consider consulting a psychologist or medical physician.

If you or someone you know is struggling in any of these areas of physical self-care, feel free to give me a call at (405) 614-2846 to schedule an appointment or for a quick telephone consultation.

Improve Your Sleep

            Do you have sleep difficulties? Does it take longer than 10-20 minutes to fall asleep most nights? Do you wake in the night and have trouble returning to sleep?  The former is referred to as onset insomnia and the latter is terminal insomnia. Also, some people have erratic sleep schedules that include naps during the day. These can be part of a larger psychological issue such as an anxiety disorder or mood disorder, or they can occur independently. Sleep is a vital physical and mental need for our bodies and our brain. Improving your sleep might be the best thing you can do for yourself. Sleep is often the first issue I address with my clients with regards to improving physical self-care, and is becoming an increasingly common problem. More on that later.

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            Before we address ways to improve sleep habits, I think it is important to discuss the benefits of good sleep. While some of these might seem obvious, there may be others that are helpful to know about. Benefits of good sleep include:

·         Happier, more content mood

·         Increased energy and staying alert

·         Ability to be productive at work or school

·         Less irritability with others

·         Improved concentration and memory

·         Better physical/medical health

·         Reduced stress

·         More creative

·         Physical performance is enhanced

·         Healthier weight

·         Avoid mistakes or accidents

            So, if you’re still reading, you might be interested in ways to improve your sleep hygiene. Here are my 9 tips for improving your sleep:

1.      Have a consistent sleep schedule. The parts of your brain responsible for sleep really, really like consistency. The more structured your sleep schedule is, the less your brain has to adjust to changing demands. Attempting to go to sleep at about the same time every night and waking at about the same time every day puts your brain in a pattern that makes it easier to predict so that your body will prepare for sleep. Try to not change your schedule by more than an hour on weekends and days off work or school to keep that consistent pattern going. Of course, life happens and there will be occasions that prevent us from sticking to the schedule. This is fine occasionally, and the more consistent you become with your schedule in the long-term, the easier it is to return to your sleep routine once your situation allows. It helps to have a pre-bedtime routine too-see next tip for more information.

2.      Have a bedtime routine. Keeping with the consistency of a sleep schedule, your mind will prepare to go to sleep when it is easy to predict. Having a bedtime routine including the same behaviors in the same order every night helps prepare your mind and body for sleep. I recommend this routine include activities that are not too engaging or active. Common parts of this routine can include changing into pajamas or sleepwear, brushing your teeth, drinking a glass of water, reading in a dimly lit room, etc. Avoid noise, light, and too much activity with this routine.

3.      Avoid wakeful activities in bed. Nowadays it seems like I hear everyone talk about their sleep difficulties, and the first question I ask is, “Do your read, watch television, or play on your phone/tablet in bed?” Most of the times the answer is “yes”, which I believe is one of the causes of increasing frequency of sleep disturbances. The mind is very cue oriented when it comes to sleep. If you use your bed for active and engaging activities (especially ones with light or noise-more on that later), your brain thinks you should be awake in that place. If you limit these activities to places other than your bed, then your mind knows that the bed is only for sleep and is likely to reduce any problems you might have.

4.      Reduce noise or light interference. Sometimes the simplest explanation is the right one (see Occam’s Razor). When assessing the origins of sleep problems with clients, some are surprised to learn that a simple and straightforward strategy that solves their difficulties is reducing/removing the light in their sleep area or cutting down on the noise in their home. This might include asking a roommate or neighbor to turn down that television, music, or video game in the next room, using a sound machine or app, buying darker curtains/blinds/shades, or putting insulation around the crack at the bottom of a door. Humans tend to sleep best in the dark and the quiet.

5.      Make your bed comfortable. Issues of comfort can be a culprit and cause of sleep difficulties. Do you need to invest in a new mattress or box springs? Is your bed too small to accommodate you comfortably?  When is the last time you purchased a new pillow? Also, issues of comfort might be temperature related. We sleep best when our heads and faces are a few degrees cooler than the rest of our bodies. Do you have the right covers for the temperature in your bedroom? Are your covers heavy enough to help you feel cozy? These small changes can go a long way in solving some sleep problems.

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6.      Reduce caffeine use. An obvious cause of poor sleep is too much caffeine use, especially late in the day. Can you skip that afternoon latte? Caffeine stimulates the nervous system which is responsible for going to sleep. Even with experienced caffeine consumers who claim to be able to drink a pot of coffee just before bedtime, but complain about having sleep difficulties ‘some times’; I challenge you to reduce your caffeine use or at least consume the soda, energy drink, or coffee beverage earlier in the day and just see what happens. What do you have to lose? Plus, you might save a few bucks.

7.      Do not exercise too close to bedtime. A lot of people make the mistake of thinking that if they tire themselves out just before bedtime, they will be able to go to sleep. Wrong! Exercise tires some systems of the body (e.g., skeletal or muscular), but stimulates the nervous system. This makes sleep more unlikely. Think about the difference between ‘sleepy’ and ‘tired’ and put at least 2 hours between the end of exercise and the start of sleep.

8.      Deal with those racing thoughts. Many of my clients complain about racing thoughts that occur when they lay down to sleep. I point out that some thoughts and feelings try to get our attention during the day, but we tend to be too busy with activities to give these thoughts the attention they require. When is the one time of day that you are sure to not be busy? When you are trying to go to sleep. Your pesky thoughts and emotions know this and demand your attention at that time. Try journaling, social support, or counseling to express these thoughts earlier in the day so that they don’t try to grab your attention at night and sabotage your sleep.

9.      Avoid alcohol and other drugs. Although alcohol is a depressant and helps people get to sleep, it also disrupts normal sleep patterns which lessens the quality of sleep. Also, there is a risk of dependency when a person relies too often on alcohol, sleeping pills, or other drugs to go to sleep. It’s a short-term solution that worsens long-term sleep patterns.

If you need more individualized help with your sleep problems, give me a call at (405) 614-2846 to discuss or set up an appointment.