Psychotherapy is hard (and meaningful) work. Perhaps it is this realization or the fear of what might be dug up through that process that keeps so many people from seeking out the therapy that might be so beneficial for them. I often find myself perplexed, frustrated, and questioning when people “drop out” of therapy early or do not attend the appointments to which they have been referred and scheduled. National studies have provided many reasons why people do not engage in therapy. Beyond that, research also shows us that one of the most important factors in maintaining therapy and seeing therapeutic success is the client-therapist relationship. Every therapist is likely to have his or her own style, personality, and approach to treatment, which will not necessarily work for every person seeking therapy in the same way. Sometimes it may be helpful or necessary to see a few therapists before finding the “right” one. For this reason, the Moments of Meaning project lists on their blog tips for finding a psychotherapist. Among top considerations, they note ethical practice, training, and the ever-important fit. It can be helpful for both therapist and client to treat the first visit as a consultation, each exploring the concerns to be addressed and expectations for treatment, as well as their interpersonal fit. Approaching therapy in this collaborative way and with an open and curious mind sets the tone for the important work to come.
May is Mental Health Month, and Mental Health America is focusing their campaign this year, B4Stage4, on encouraging screening and early intervention. They propose that with earlier identification and intervention, mental illness can be treated more effectively, preventing its progression and ultimately lowering disease burden and health care costs. Though the USPSTF recommends routine depression screening only in the cases where mental health supports and follow-up are readily available (by having psychologists or other mental health providers integrated into primary care clinics, for example) and doesn’t make a recommendation for routine screening for suicidal thoughts, the MHA campaign promotes a new way of thinking about prevention and treatment of mental illness that is more aligned with how we think about prevention and treatment of physical illnesses such as cancer (though this dichotomy assumes that mental and physical illness are two separate things, when many times they are closely intertwined). With 50 percent of Americans meeting criteria for some mental illness during their lifetime, any prevention and treatment efforts are crucial. Below are two of my favorite Ted talks on mental health.
A Google images search of “resilience” will yield various pictures reflecting the meaning of the word, perhaps most commonly the image above. These images reflect the idea that resilience is about growing despite adversity or the ability to bounce back. As I shoveled snow this morning, something I haven’t done in several years and had dreaded doing upon my move out of the South, I thought that perhaps my personal image of resilience would be something like the red ivy and green berries or glistening blacktop that poked out in patches from under the snow. Or perhaps just me standing triumphantly atop a mound of snow I had shoveled. (I really dislike cold and snowy weather.) What I also noticed is that if I stopped thinking about how much I hate being cold and instead noticed how beautiful the white, powdery snow was, how it looked as though glitter or diamonds had been sprinkled in with it, it actually was kind of nice. If I checked in on my emotions, I really wasn’t terribly upset to be outside. Also, it provided an excellent workout.
Winter weather is not a serious adversity to overcome, but I have learned through other personal and professional experience that mindfulness and a handful of other practices can be helpful in facing stressful conditions and building resilience. The American Psychological Association offers 10 ways to build resilience, including keeping things in perspective (for me this morning, it was the first real snow of the season and much less than people in other parts of the country have had to deal with; also, it was a powdery snow, much easier to shovel than a heavier, wet snow) and maintaining a positive outlook (bonus workout today!). Also important is staying positive about your abilities to deal with the stressor, particularly when based on how you have handled other stressors in the past. When I have experienced professional setbacks, I have taken time to reflect upon the problem-solving skills that I developed through years of school, then used that critical thinking to find solutions to the problem or reframe the stressor (sometimes there is a silver lining to be found). Less focused on reflecting on the past or reframing the present situation, mindfulness also can help cultivate resilience by encouraging acceptance (seeing the situation for what it is, without the emotional baggage), self-compassion, and cognitive flexibility.
People generally are resilient, whether with major life changes or everyday stressors (including snow storms). Keeping our own resilience in mind often is the first step in tapping into our resources to deal with challenges.
Recently, I was talking with someone about running when he asked me if I was a runner. I hesitated, and he quickly replied, “That means no.” For many years, I would have agreed with him. I have never considered myself to be “a runner.” It’s not something I particularly enjoy; I certainly am not setting any records for running. But does that really mean I’m not a runner? What would make me worthy of that label? Because really, in those few minutes on the weekend when I’m running, I am a runner.
Likewise with being an introvert, a characteristic that has been celebrated somewhat more recently. Most psychologists acknowledge that people may fall at different places along the introversion-extraversion continuum in different circumstances, though people tend to be labeled as one or the other. I have always considered myself more of an introvert and fit comfortably into that role. Except that it doesn’t always fit. When I was described once as being outgoing, I was taken aback, but when I paused to reflect on the things that made me outgoing to that person, I realized that my interpersonal style doesn’t always follow the same script.
The stories we tell ourselves about who we are and what we can do are powerful. In reflecting upon the stories I have about myself or the labels I have given myself (or have been given by others), I see that I have been limited at times in trying something that I wanted to do because it didn’t fit the mold. In saying “you’re (I’m) not a runner,” I am excused or inhibited from engaging in a behavior. When we let go of the script that we follow and instead engage mindfully in an activity that may be interesting or important to us, we don’t have to think about what we’re supposed to do; we can simply do.
For more information on building this type of psychological flexibility, read about ACT (Acceptance and Commitment Therapy).
Internet, we need to have a talk.
I’ve had a number of readers ask why I’ve neglected to write about Amanda Bynes this last year. It’s simple, really. I don’t believe that celebrities are “fair game,” and that, when they have very human and very difficult struggles, I should capitalize on those things by writing an article, however well-intentioned. I believe they are deserving of privacy and respect, by virtue of their being people.
However, I’m making an exception here, because in the midst of the negative and callous press that Bynes has received, I think it’s time we had a chat about it from a different perspective. And then, after we’re done, I think it’s time we stop speculating about it altogether. Deal?
First and foremost, there is no way for us to know what, if anything, Bynes has been diagnosed with. The family has denied schizophrenia and bipolar…
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As a psychologist, I often find myself noticing how the behavior of one person can affect the behavior of another. For example, over the past few weeks while driving to work in the morning, I have noticed that if I leave a space open at an intersection, the car in the lane next to me often will do the same. I tested my theory by sometimes blocking the intersection and sometimes leaving an opening and, without fail, the other driver followed suit. This isn’t ground-breaking science, but it got me thinking about how important is can be for each us to model prosocial behavior. I’m not talking about pay-it-forward, random acts of kindness gestures (though those certainly are nice, too) but rather modeling an awareness that there are other people around us to consider. Huffington Post recently published an article about the habits of considerate people which supposedly include, among other things, anticipating the needs of other people, having good manners, and being empathetic. These are not behaviors that necessarily take a lot of time or other resources; these are things we can be mindful of in daily activities. Perhaps letting someone in in traffic won’t solve all the world’s problems, but it does signal respect and may decrease another person’s frustration by a margin. What could be bad about that?
(TED is on its annual two-week vacation. During the break, we’re posting playlists from the TEDTalks archive. We’ll be back with new talks on August 29th.)
Happiness seems simple, yet the more we look into it, the more layers and complexities we find. Here are five TEDTalks that will transform how you view happiness, and how to achieve it.
1) Dan Gilbert, author of Stumbling on Happiness, challenges the idea that we’ll be miserable if we don’t get what we want. Our “psychological immune system” lets us feel truly happy even when things don’t go as planned.
2) Using examples from vacations to colonoscopies, Nobel laureate and founder of behavioral economics Daniel Kahneman reveals how our “experiencing selves” and our “remembering selves” perceive happiness differently. This new insight has profound implications for economics, public policy — and our own self-awareness.
3) Mihaly Czikszentmihalyi asks, “What makes a life…
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Apparently Americans are just not that into vacation days. This probably comes as no surprise to many people who have looked forward to a vacation only to be bombarded by work e-mails upon arrival (and/or during their time off). Many of us struggle to take a lunch break, let alone an actual vacation. A hardy work ethic is part of the American tradition, right? But have we gone overboard? In the nation of supersizing everything, why have we minimized self-care, and what does it cost us? The chronic stress of overworking can be associated with burnout, heart disease, and decreased productivity. It’s not a great long-term strategy for professional and personal fulfillment. Compare this with other cultures, in which the norm is to take a break for a healthy lunch and a glass of wine, go for a walk, perhaps have an afternoon nap, go on holiday for a few weeks, regularly engage in meaningful social activities- in short, do things that do not revolve around work, and they actually live longer and healthier lives. That sounds heavenly to me. So how do we carve out time for lunches and vacations in a demanding work environment that values results over personal wellness? Unfortunately, I don’t have the answer to that, at least not today. Likely it will take a major cultural shift. But perhaps we can start that shift by communicating to others through our actions the importance of self-care. Block some time in your schedule for lunch and step away from your desk to enjoy it. Make an appointment with yourself for exercise or socializing. Go away for a weekend, maybe even a long weekend if you’re feeling adventurous! Clearly there is more to the formula for longevity than this, involving a lifestyle change. But as one of my favorite sayings goes, you can only start from where you are, not from where you want to be.
Have you made these changes in your life? What did you notice? What have you found that works?
In one of my first posts, I wrote about overcoming self-doubt. I’d like to revisit that topic. I think there is a step between experiencing doubt and overcoming it. I think we first must embrace it. Embrace it because doubt can be a good thing. Our first reaction to negative emotion usually is to try and make it go away, push through it, stop it somehow. We do this because negative emotions hurt, and we believe that if something hurts, it must be bad. But as Lesley Hazleton points out in her TED talk about doubt, sometimes these negative emotions open us up for something far greater. Doubt, for example, allows us to have faith. (If we had all the answers, why would we need faith?) Doubt allows us to feel accomplished when we prove to ourselves or to others that we can do something we (or they) didn’t think possible. I’ve learned that doubt shows us what we want. So maybe we don’t need to overcome it at all. Maybe by opening up to doubt, by moving with it rather than through it, we can experience something new.
I find it’s very easy for my brain to judge. Myself, others, whatever the situation, there always seems to be a judgement statement ready. These judgmental thoughts can put us on alert for threat, causing chronic stress in the body. Various forms of meditation have been shown to be effective for re-centering attention away from negative judgements, cultivating present-moment focus, increasing cognitive flexibility (e.g., being able to think about a situation from different perspectives), and generally enhancing health and well-being.
One form of meditation, compassion meditation (or loving-kindness meditation), involves cultivating acceptance and positive thoughts about ourselves and others. To practice, one is encouraged to visualize a loved person, a neutral person, and a difficult person, offering each of these people well wishes. This warmth is then turned toward ourselves (though some practices begin with an inward focus and then turn compassionate thoughts to others). Often, a series of phrases or mantras are repeated (e.g., “May you be free from pain and sorrow. May you be at peace. May you be well.”). When beginning this practice, it can be helpful to have a guided meditation.
May you all be free from pain and sorrow. May you all be well and happy. May you all be at peace.