Current Events, Mental Health, Practice News

So, here’s another truth about being a therapist at this particular moment in human history (last week’s behind the curtain view was a humorous one; this one’s a little more serious). Most therapists work from what’s called a “trauma-informed” perspective, meaning we are “treating a whole person, taking into account past trauma and the resulting coping mechanisms when attempting to understand [current] behaviors and treat the patient.” We also take into account the differences between trauma as a disruptive event, and complex trauma, which is “a psychological disorder that can develop in response to prolonged, repeated experience of interpersonal trauma in a context in which the individual has little or no chance of escape.”. In other words, we’re good at coming in when the client is ready to do the work of unpacking or changing the way past events have, or continue to disrupt their current life.

…AFTER THE FACT.

We sometimes get lucky enough to be available as someone is processing an event in progress, like working to escape an abusive relationship or dealing with a loved one as they are dying. But even in those circumstances, we’re on the outside of the experience looking inward, a stable neutral presence that can help anchor and support clients in distress.

Hard truth time: ain’t none of us trained to deal with global epidemics and crises on this scale AS THEY ARE HAPPENING and AS THEY ARE ALSO HUGELY IMPACTING *US*.

We sometimes get called in very soon or immediately after a crisis event happens, but we’re not usually enmeshed in it ourselves. Right now, however, we’re supporting our clients and colleagues (many of whom are themselves in identical unfamiliar circumstances) in working through virtual channels, working from home, dealing with children and partners underfoot all the time in quarantine… while dealing with exactly those same issues ourselves. As I wrote last week, we’re all in this together, but like medical health professionals, having been determined by the government to be “essential services” therapists are ALSO working long hours to make sure we keep our own shit under wraps enough to be an effective support for our clients right now.

I don’t tell you this to make us seem like superheroes, because I can assure, we’re still pretty human (see last week’s post for proof of that). I tell you this because there’s a need to understand that while we’re doing the best that we can, we’re really not trained for this, either. Many of us are cobbling together what we know of trauma care with what we know of working with high anxiety and (where appropriate) basic CBT tactics to hold the intrusive, fear-laden thoughts at bay. The problem is, when we’re living through an honest-to-god global pandemic, the actual worst-case fears and risks are both absolutely legitimate, and pretty terrible… and the clients aren’t the only ones seeing that. The therapists are living and breathing those concerns and fears right alongside you.

The definition of complex PTSD keeps coming back to me as I watch people adjust to the new normal, including a persistently-high state of stress/worry/concern/anxiety/fear about the what-ifs. When you’re living in a dangerous time, there isn’t any form of escape other than to just “live through it”, no matter how long it takes. And being in that persistent state over the longterm always exacts a toll; it’s not going to be the same for everyone, nor will it manifest in the same timeframe for everyone. But it’s there. And we have to take that into account when we’re dealing with ourselves and our clients, not just in the future and after the fact, but right now. Today. In this moment.

The best tool I’ve got right now is working with people to normalize and validate everything in their maelstrom of feelings; to shorten down their personal event horizons and look specifically, and exclusively, at what is in their power to do TODAY? What will make them feel better TODAY? It’s not that I don’t want to sustain a sense of hope for the future, but we have to keep hope in the context of daily-fluctuating uncertainty. We need to frame it in an understanding that our current heightened state of curve-flattening mitigation tactics will take WEEKS yet, if not MONTHS, to drop the infection rate back to near-zero (because as long as there IS a new-case reporting rate, we ALL remain at risk; that’s just how viral pandemics work). I’m watching friends and clients intellectualize that timetable, but the truth of what their lives will look like is barely just starting to take hold on an emotional level, especially knowing that the pandemic is only the trigger for an economic crisis of equally epic proportions to come. This kind of uncertainty really eats away at a person’s sense of grounding and control.

It eats away at ours, too. Trust me on that.

We’re in a high-stress, high-uncertainty scenario not of our own making and even less under our control. The odds of this crisis *creating* complex trauma responses for a large number of individuals is likely high, because it’s a longterm situation and it’s inescapable. The challenge for us as therapists is that we can’t wait for this scenario to be over before we’re needing to put boots on the ground and be effective. We can’t wait until we get ourselves clear of this scenario before we wade in to offer support to others. When I say, “we’re all in this together”, I mean it quite literally. As therapists, for once we are not apart from your crisis; we may have our own responses to what’s going on, but we are also up to our eyeballs in it. We’re as uncertain, as stressed, as anxious, as terrified, as exhausted as you may be.

And we’re still here. If you need us, we’re keeping the lights on for you as long as we can, and hopefully all the way through.

(Both my home office and Bliss Counselling are still open and seeing clients, BTW. We’re only doing virtual sessions via Zoom or phone for the duration, but WE ARE OPEN!)

Uncategorized

Okay, so we’re all slowly crawling out of what for many is week two of Pandemic Life, though for many of us it’s been varying degrees of “longer”. People who aren’t used to the enforced stillness and introversion of being trapped at home for extended periods, extroverts especially, have already started climbing the walls. Even introverts, suddenly faced with having to spend ALL THIS TIME with their families under the same roof, in the same rooms, even in the same conversations, are struggling.

And frankly, if the data models are to be believed, we’re still only just getting started. It took FIVE MONTHS for China to start seeing declines in the daily new case reports, and they were way ahead of North America when it comes to trying to lock down the exposure vectors. So buckle in folks… we’re in this for the long haul.

Many of you who are clients of therapy have already had the conversation with your therapist about moving to phone or video platforms to continue work. I grew up working in IT so the occasional stint of working from home (WFH) doesn’t phase me, and Webex (phone/video) conferencing is a legitimate way of life for techfolk. But for those of you new to this level of disconnect in your connection channels, it’s going to add a level of strain to work that may already be hard to do for any number of reasons. Trust me when I say, however, that your very-human therapists might be struggling to adapt to the necessity of the times as much as you are.

We’re all trying to find humour and silver linings in a time when so much feels beyond our control, or lost to uncertain, distant end dates (the American President’s staunch insistence that this somehow magically will all be over by Easter notwithstanding). SO I thought I’d share some things that are making things a little lighter from OUR side of the video conferences, just to help keep things in perspective, and assure everyone that we’re all in this together.

It’s a really cool thing to see these slim slices of people’s home lives. I’m learning about my colleagues’ and clients’ pets and children, and which ones will shamelessly fart in front of cameras (the pets and children, NOT the colleagues and clients… so far).

Sometimes your working-from-home therapist’s head is going to look suspiciously like a cat’s head. Possibly like a cat’s butt. This is not an optical illusion.

It’s a perfectly reasonable thing to suspect that your therapist may not be wearing pants in a video session. It might be a tad declass? to ask, though.

Your therapist isn’t ACTUALLY doing therapy from San Fransisco or the bridge of the Enterprise, he just accidentally turned on the backgrounds feature in Zoom Mobile and can’t figure out how to turn it off again.

Why yes, we DO sometimes wear a unicorn onesie to work, why do you ask?

You can mostly trust that’s just coffee. Mostly.

No-one can tell if your therapist wears the same ensemble to work three days in a row. Or four. Or five. We might also have to stop and think about whether we’ve showered today or not.

Therapists with kids at home themselves are going to be SO VERY HAPPY TO SEE YOU AND TALK WITH YOU, ONE ADULT TO ANOTHER. Cut them some slack. They’re in the same boat as many of their parenting-at-home clients, right down to interrupting sessions to tell small people not to set each other, themselves, or the dog on fire.

By the end of next week, some of us might have forgotten how to drive to work. On the upside, in between client sessions and naps, some of us are busy reacquainting ourselves with kitchen and household appliances we didn’t even know we owned.

Naps are totally a thing for adults. Who knew?? (Well, clearly not the adults with children at home, I suspect. Sorry…[not really].) The only thing better than napping on the office sofa is napping in my own bed.


In some ways, the virus is only one side of the social upheaval we’re going to have to manage, and the one therapists are least trained to deal with. It’s helping people observe and mitigate how we react when trapped either in isolation, or together with others in close quarters for indefinite periods of time, getting on each others’ nerves, and lacking the usual recourses and escape mechanisms to cope–THAT’s something we’re already on the alert to catch and mitigate as tempers and tolerances shorten.

We’re doing our best to keep up with the rising challenges of social lockdown and massive life disruptions. Please remember, however, that most of us aren’t trained for this kind of live-rolling, global-level-disruptive crisis, so we’re on a learning curve right alongside our clients. We’re doing our best to provide as much continuity of care to you as we can, so take the technical glitches and challenges in stride and be patient as we all figure out how best to weather what’s happening. Remember that we’re all human, we’re all fallible, we’re all facing fear/uncertainty/doubt in spades, and we’re all probably already feeling some degree of the strain. (Massive shout-out to the medical workers and emergency-response folks on the very front lines of this, BTW. I see you.) So remember to be gentle with yourselves, each other, and us as this situation unfolds.

We’ll take care of each other as best we can, all right?

Current Events, Mental Health, Practice News, Self-care

People keep asking why I’m continuing to see clients in person both uptown and at the home office. It’s simple, really: the therapist’s office is the only safe space some people have. Many who might have used work to escape volatile, toxic, abusive, or outright dangerous home situations are now being told to stay home and not come to work — meaning they are trapped in the very situations that threaten them the most.

It’s unclear what protocols local shelters are enacting in a time of pandemic, but the anxiety levels around exposure and uncertain shelter occupancy arrangements will also serve to keep the vulnerable from getting clear of a dangerous home environment.

It’s the darker side of quarantine, isolation, and the desperately-needed social distancing practices: yes, we’re trying to flatten a curve and spare hospitals and treatment centres from overloading, but we’re also trapping some of the most vulnerable people in their own worst nightmares, caging them with their abusers for an indefinite period of time.

So yes, if my office is the one safe space that remains open to them, then I will take every precaution I can to protect us all for as long as I can. I will disinfect everything I can and keep to a reasonable distance across the room, but come hell or high water, for those that need us — we’ll keep the lights on for you as long as we safely can.

Uncategorized

Hello, world!

The last year’s been something of a wild ride, and I can’t blame L for changing up her client schedule to drop out of our weekly work dates. It’s true I still work best with an accountability partner, but I was doing fine BEFORE she joined me for Tuesday mornings. I just decided to take the opportunity to give myself permission to sleep in on Tuesdays instead of getting up and coming downtown in an attempt to exercise some high-level cognitive function.

Truth be told, I kinda miss it. Apparently enough that in the middle of a Day 2 Migraine I’m squinting through one eye at my laptop trying to amass some thoughts into coherence.

Last year was all about rearranging my life quite drastically in the wake of coming to grips with my own long-term high-functioning depression. I spent the winter taking stock of just about every aspect of my life and decided that, on the assumption that my depression was (likely) largely the result of suppressed emotional Stuff, I needed to find the things about which I used to have Feeeeeeeelings, and find out what happened to them in my life. Work, family of origin, intimate relationships, personal creativity, self-image and self-worth… y’know, all the shit we as therapists challenge our own clients to confront every now and then. To that end, I spent the year working intently with my own therapist of twenty years, especially after the latest wheels-coming-off-wagons in my family of origin last spring, coupled with the arrival of new potential romantic relationships. Then in the spring, I found my long-lost creative muse and took off on what at first seemed like it could only be a manic surge of productivity. Well, that supposedly-manic break has now lasted a solid year, and I just reset the project whiteboard in my revamped Studio for 2020’s endeavours. I’ve retrained myself in languishing skills and taught myself a bunch of new ones along the way. It’s been pretty great.

The depression is still an ever-present part of my life. There are days, even weeks (especially over the winter) where the weight sitting on my mind and body stifles my energy something fierce, and very little beyond the absolute necessity gets done. If there’s one BIG takeaway from observing myself learn to work around the depression in the last year and a half, it’s the necessity of learning to let go of the SHOULDs, those internalized beliefs of what I SHOULD be doing, how I SHOULD be behaving, the efforts I SHOULD be putting into my life, my work, my loves, my job. And somewhere along the way I found the permission I needed to just let go of a lot of that shit. Granted, it’s easier to do when you’re single and have no kids, because you’re not changing the expectations or rules of engagement on people trying to cohabitate with you. You still need to communicate with others around you, but it’s easier when they’re not rooted in the same kinds of dependencies.

I gave myself permission to NOT:

  • worry about keeping my home spotless, so long as the office and transit path for clients remains tidy enough to be not wholly embarrassing.
  • worry about doing dishes daily; my kitchen is now a happy disaster through most of the week until I have time and energy on MY schedule to do my dishes.
  • worry about keeping in touch with everyone all the time; regular contact with my intimates in whatever form those relationships have morphed to, but I don’t try to connect with my entire social tribe all the time now.
  • try to keep up with my own fears; work is the biggest place where this drives me, in that I have long feared the “if I don’t work I don’t get paid” reality of being an hourly contractor. This has lead to taking a lot of time off the uptown schedule over the summer and eventually changing how we handled intakes (a work in progress), paying someone else to take over my bookkeeping, cutting back the hours in my home practice considerably, rejigging my budget hard after a summer of creative (unplanned) expenses, and more recently, increasing fees uptown. I’ve known for years that I work more hours than is generally recommended for people doing the kind of work we do, but I’ve been sticking by the “need to do it anyway” out of financial fear. Giving myself permission to relax that a little bit was probably the most important change of this past year. I’m still far from comfortable with believing “it will all work out in the wash”, but I’m recognizing there’s an unsustainable cost to driving myself as hard as I have been, too.
  • chase after people who don’t show value for *me*, and not just because of what I can do for them. That’s been a huge internal confrontation because it taps into family of origin issues as well as long-held interpersonal ones. Yet I feel SO MUCH BETTER once I finally stop waiting for people’s approval, forgiveness, interest, desire, time, attention…
  • suppress my creative bent because I’m afraid other people won’t like what I make, or won’t like the time I take away from my availability to them to do my own creative “thang”. Nor will I continue to suppress making stuff that makes me happy because I’m afraid I won’t do it well; this past year has been all about learning and relearning and not getting torn up over mistakes. Shit happens. Learn from it. Do differently next time. Learn from THOSE mistakes. Keep going.
  • beat myself up for not reading as much as I *SHOULD*, not doing as much professional development as I *SHOULD*, not building my private practice business as much as I *SHOULD* (comparatively speaking, of course; in truth, I’m doing okay on all fronts but I look at colleagues and constantly wonder about the feeling that I *SHOULD* be doing SO MUCH MORE)

Unsurprisingly, a lot of people, women with Supermom complexes in particular, are coming to their senses and dropping out of the race to keep up with the SHOULDs. This article in particular resonates with me every time I come back to it (for all that I’m not a mom, so some of her “I Don’ts” don’t apply here).

And of course, I realised that I?m part of The Problem. My life, from the outside, looks like I ?do it all?. And from the inside, of course, it feels like I barely do anything. The nature of many women is that we can only see our shortcomings and never our strengths.

But now I can see that what women really need to hear is not how other women ?do it all?, so that we can mimic their to-do lists and add more and more to our cracking plates. No. We need to hear what other women aren?t doing.

Because we all have an ?I Don?t? List. And every one will be different. Most of us don?t have endless choice about what we do and what we don?t. Often there?s simply no one else to bloody well do it, so prioritising gets brutal. Some of us shirk the domestic in favour of the professional. Others choose to let the endless demands of work leap off the bottom of the list in favour of home. Some people love to, say, bake, while for others it feels like an exam they?ll always fail.

My life is not perfect. It’s not always happy, it’s often not even on anything resembling an even keel by some external standards. But it’s opened internal doors I haven’t stood in front of for literal years in some cases. And there are feelings behind all those doors that I haven’t invited in for literal years either. The point of this entire exercise was to shift even a little bit out of the depressive flatlining into something that encourages me to be more aware of and engaging in my own emotional landscape. Honestly, I’m still a lot further down the emotional volatility scale than I ever have been, but ultimately I don’t see that as being a bad thing. I’ve come a fair way up from flatline, and I’m a LOT harder to provoke nowadays into something explosive. I don’t have a lot of balance between work and play yet, but that may be the lesson ahead of me in 2020 (it would be a lesson 53 years in the making if I want to be completely honest about that one).

Letting go of the SHOULDS has made space for some valuable things for me. It’s work I intend to keep doing, because it has quite literally been a game-changer for me. It’s also made a lot of things more clear about the process of “becoming” who we’re maybe meant to be as we strip away the dreck and dross of those applied values and narratives. And it’s given me huge compassion for the clients embarking on these kinds of journeys in my office. It’s one powerful thing to be able to say, “I see you”, but something entirely different, yet equally powerful, to say, “I’m right there with you; I GET it.”

So here’s to the journeys of 2020. And maybe to the occasional blog post along the way to capture the thoughts that are a part of said journey. (Probably not weekly; I still vastly prefer sleeping in on my Tuesdays…)

Communication, Emotional Intelligence, Relationships, Uncategorized

There’s an old clich? about people being divided into two types of listeners: those who listen for comprehension, and those who are only drawing breath waiting for their turn to talk again. It’s a truism in relational therapy that when we’re activated by stressful situations, a lot of us take a naturally defensive posture, in the sense of leaping to the defence of our position. As counter-intuitive as it sounds, there’s no defence like a good offence, as the saying goes. It’s not uncommon that people who feel trapped or attacked come out of their corners verbally swinging: jumping on the conversation and interrupting or speaking breathlessly into the barest of breaks after someone else is done talking, taking the ball back and making things immediately about themselves and their experiences or opinions.

Watching this dynamic unfold in conflicted relational communications is a significant portion of what relationship therapists do. We’re looking for places where the power struggle between the participants starts to escalate, where the knives come out, where the retreats and feints occur. And we’re listening for the Four Horsemen so we can divert the worst of the attacks into antidotes. There are many different ways we therapists cleverly divert the energy of those attacks into something that starts to de-escalate the tension. Sometimes it starts with simply calling out the incongruity of attacking someone we claim to love and choose with commitment; if the stated desire is to build love, trust, commitment, then why choose actions that hurt, divide, alienate? What happens when the participants make an effort to choose a different way of engaging?

Enter the principles of active listening and non-violent communication (NVC), something that ties in hard with the practice of emotionally-focused therapy (EFT).

NVC’s describes its core practice of listening as “receiving empathically”:

“Instead of offering empathy, we tend instead to give advice or reassurance and to explain our own position and feeling. Empathy, on the other hand, requires us to focus full attention on the other person’s message. We give the others the time and space they need to express themselves fully and to feel understood. There is a Buddhist saying that aptly describes this ability: “Don’t just do something, stand there.” ” – Marshall Rosenberg, “Non-violent Communication: A Language of Life,” PuddleDancer Press, Encinitas CA, 2003

Active listening, using verbal and non-verbal common reflection tactics creates empathic presence between the parties. One of the simpler ways to do this in the therapy room is to re-orient the clients towards each other. The more intense the topic and potential for conflict, the more likely it is that clients will speak to each other through the neutral third party of the therapist: looking at or facing toward the therapist, speaking to the therapist rather than directly to the partner. We are a point of de-escalation because we are assumed to be neutrally receptive, sympathetic. But *WE* want clients to be practicing these tactics directly with each other. Sometimes this means we have to teach clients how to slow down their own reactive escalation and actually read each other WITHOUT INTERPRETING, or at least without jumping to assumptive and unvalidated conclusions based on the interpretations we all generally make anyway. We can use some reflection to start, by asking each client, in turn, to tell me how they see their partner’s physical presence and encouraging each to explicitly validate their external perceptions with the partner.

EFT folds this empathetic reception into a different style of exchange between partners, following these steps:

  1. reflecting back what the speaker has shared, not as a verbatim report but rather more of a “Here’s what I’m hearing”
  2. validation (sometimes clarified by the therapist until the process clarifies for the clients)
  3. exploration of the speaker’s experience in the form of a Q&A (“evocative responding”)
  4. highlighting, or heightening, the interactions that seem more poignant or significant in the partners’ exchange (for example, reflecting through Gottman’s lens the various points of disengagement or repair attempts)
  5. infering the client’s experience, enabling or assisting the speaker to “extend and clarify that experience so that new meaning can naturally emerge” (Sue Johnson, “The Practice of Emotionally Focused Couple Therapy, 2nd ed.” Brunner Routledge, NY 2004)
  6. therapist self-disclose (if relevant/appropriate)
  7. restructuring or reframing the clients’ interactions based on developing understanding and compassion

The hard part for many clients in interactive crisis is that yielding the defensive battlements feels untenable. Yielding often leaves someone in crisis feeling lost, overpowered, undermined, unheard, at risk, unsafe. For many, the lashing out or refusal to hear each other’s pain is the result of an unconscious, “you hurt me so I want you to know how it feels, asshole,” knee-jerk reaction. Or there might be a shame reaction to recognizing (and not wanting to face the responsibility for) hurt we have caused, so we double-down on defensive entrenchment and find ways to avoid taking ownership for actions with painful consequences for others. By the time we get into that kind of dynamic, however, these patterns are often so deeply entrenched that restoring good faith between partners is work that has to happen before we can re-orient clients toward each other. We can deploy some short-term, strengths-based work here to re-establish some fundamentals of goodwill between the partners, getting them back into recognizing their good things between them. We need that platform brought back into focus if we’re going to have something stable on which to build a sustainable change process in the midst of ongoing crisis.

Yielding defensive stances requires rebuilding, and sometimes developing for the first time, trust; it also requires the tools to self-regulate emotional upheaval, to clarify what needs to be said and to accurately receive and respond to that information. We take each portion of this process as a one-step-at-a-time process until everyone gets a little more of a solid footing on the change processes. We acknowledge and build on baby-step successes, and we try to not let setbacks make mountains out of molehills; old habits do die hard, after all, and for many, these are habits and internal processes that can be VERY deeply rooted (like, Family of Origin deep in some cases…)

But if the clients are in the room because they both intrinsically WANT to work things out, then we use their willingness to tolerate the uncertainty as a springboard towards hope, we reconnect them with the strengths inherent in themselves and their relationship, then we begin to rebuild their relationship house with different tools. Slow but rewarding processes based in genuine empathy and compassion for each other get us the best long-term results, which graduate our couples back OUT of therapy!

Communication, Language, Relationships

[I know. I KNOW. I have been trying to complete and publish something for *MONTHS* and failing. Depression is finally inching its way up and out at least. That’s been the lion’s share of the challenge, paired with ongoing health issues, and just trying to balance all of this with both work AND a spectacular kind of renaissance in my personal life. Now if cancer would just stop robbing me of people I love, that would be just dandy, thanks…]

Noting recurring themes in therapy is often what drives the content for these posts, and lately there has been a couple of big thematic topics cropping up. One of them is observing clients of all genders in relational conversations using something I’ve come to label the “Universal We”. Women in particular are raised in a social context that programs us to consider others more than we consider ourselves; our traditional roles as nurturers and care-givers primes us for this behaviour even when it doesn’t come with the traditional baggage of being homemakers and staty-at-home parents to the sacrificial detriment of our own dreams and desires.

Women have been conditioned for I-don’t-even-know-how-long to employ “softened language”, which takes myriad forms even in modern discussions. We preface our own ideas with, “I think,” “What do you think about,” “I believe,” or “How do you feel about.” For women to be as direct and upfront in what they want, need, intend, or desire, is to be seen as aggressive, even masculine. In corporate culture, forthright women on one hand were seen as being more likely to be noticed for potential recognition and promotion, and on the otherhand reviled for not being soft and collaborative enough. Men in the corporate world don’t generally get punished for being direct; women, on the other hand, get labelled as “bossy” or “bitchy” when they start sentences with, “I want” or “I need”.

This plays out in intimate and familial relational dynamics in very interesting ways as well. When couples in particular come in with “working on our communications” as the presenting issue, these patterns are among the first I start listening for. I also listen for the presence of “We-isms”, those intentionally-inclusive pronouns that carry a weighty IMPLICIT expectation.

When people use the “Universal We,” something very specific is happening in default social programming. The speaker is offering an implicity unity-of-purpose between the parties involved. “We need to set some ground rules around Little Jamie’s bed-time schedule,” “we should make plans for the summer vacation week,” “we really need to sit down and talk about last night’s argument” — these are all examples of ways in which the speaker is putting an implied invitation to discussion in front of a partner. The problem, however, is the that suggestion following the “we” language, *IS*, in fact, a universally-agreed-upon thing (value, intention, plan, whatever).

In truth, however, what’s generally underneath such language is a core need or want on the speaker’s part, either something the speaker wants for themselves, or something the speaker wants to request specifically of the listener. “I want to set some ground rules with you…,” “Do you have time right now to make some plans for summer vacation?,” “I really need to sit down and talk with you about what happened last night.” Such direct statements and explicit invitations are challenging in a culture that has indoctrinated us with the belief that women are meant to be soft and enticing where appropriate, yielding where required. Being direct feels like we are being threatening, and many women fear what happens when they put themselves and their own desires right up front in the clear to been unequivocably seen. To be explicit is to court rejection, and that’s untenable. So we interject the implied “we” in the belief that the softer inclusive language will magically provoke our partners into correctly interpreting our request as something that involves their active participation.

Unfortunately, what I see happening in relational (and often familial) dynamics more often than not, is the speaker is trying to enlist the partner into something that might represent a shift in their usual dynamics, either by engaging in a more collaborative practice than usual, or wanting the *partner* to take on responsibility, for something that has likely traditionally fallen on the speaker to do. And what I see play out is the listener translating the universal “we” as a status quo expectation; they may hear the “we” but the implicit received message is, “Oh, [Speaker] will take care of this; they always do”. So while Speaker says “we” meaning collaborative unity or the You-the-Partner, the listener is translating the vocabulary as we-means-Speaker-because-it-has-always-been-that-way. By the time such couples get to me, the one who most commonly brings up the universal we is frustrated beyond belief by their partner’s perceived lack of engagement, while the receiving partner is baffled by having never received an explicit request or suggestion aimed specifically at THEM personally.

The clarity of communication around needs, want, and related expectations can, and frequently does, get utterly lost in something as simply as pronoun usage. Softened language is endemic in all kinds of relational dynamics, and is a line of contention in corporate dynamics. John Gottman uses the principle of the “soft startup” as a way of easing into potentially challenging topics with a partner, and while this idea has definite value (especially as a practitioner of non-violent communications), it remains problematic from a feminist and feminine agency perspective if it encourages the practice of misdirecting the intensity or urgency of the needs we’re trying to address. Years ago, a very good friend of mine encountered something similar in her partner dynamics that became a clear illustration of the problems inherent in gender-biased communication dynamics. In the course of preparing dinner for her husband and child, she realized she was out of some critical ingredient, so she asked her partner, “Do you want to tgo to the store for [X]?” To which her partner quite truthfully responded, “No.”

My friend, like many of us, was raised in a culture of the “soft ask”, another deflective tool that undermines the clarity of our communications by implying or infering rather than being a clear and explicit statement or request of our own need. Instead of saying, “I need [X], could you please go to the store for me?”, the implicit ask tries to get the listener onside with making our need their need or want, so of COURSE they’ll want to go to the store.

Yeeeeeeeeeeaaaaaaah… except when that runs afoul of someone who does NOT want to go to the store. Or sit down and debrief the most recent argument. Or make time to plan the summer vacation. Or whatever the implicit ask is trying to get them onside with.

And yet women in particular do this to ourselves ALL THE TIME. As a therapist, I’m only starting to catch *myself* when I use universal we-isms with my clients. It’s actually extremely problematic for therapists and any professional in a power dynamic with their clients, because while there are some potential points in which we share experiences, perspectives, feelings with our clients, the universal we isn’t always a great tool for joining them in a therapeutic alliance. I suspect most of us do it to normalize the client’s experience somehow, but I’m also aware that the disproportionate majority of therapists are WOMEN, so now I’m completely suspicious of how WE (delibate usage there) are applying that pronoun.

So what do I do with this once I observe its persistent presence in the room?

First of all, I call attention to it, and explore the speaker’s awareness of the pattern. We then clarify the intentions behind the usage. More often than not, it’s an intent to put a request for something the speaker wants or needs directly onto the listener. Sometimes the speaker is aware of a fear of provoking conflict or rejection, but more often than not it’s simply a learned pattern (as with my friend, this was just the way women in her family in particular had always operated, and to some extent the same pattern was reinforced in her corporate experiences as well). Then we work on deliberately correcting occurences of the pattern in therapeutic conversations, encouraging a movement from the universal we to the “clarified I”. (This is another application of the principle moving from an external locus of control to an internal one, but that one may take a whole ‘nuther post to explain.) We observe the new pattern in the field for a while and see what shifts in partner engagement and/or expectations, and we can adjust the communications around intent and expectation from there.

The dynamic of how we present our ideas and needs in relationship is obscured by strong traditions around these heavily-gendered models, and for many women and non-binary folks, there is an implied safety in assuming we can onside our supporters with inclusive language and implicit, invitational expressions. but we also have to balance out the likelihood of the implied communications going awry on the receiver’s end for reasons we may not be able to see or work around without challenging the receiver’s internal filters, an act that can seem too close to provocation, aggression, threat of conflict and rejection.

Sometimes the neutral third party of the therapist is a key component in shifting dynamics for partners afraid of taking up space in relationships, and sometimes really all we as allies need to do is hold up the observational mirror of to the behaviours and reflect what we’re seeing for clarification purposes. After that, we can unravel and reknit the intentions into something far clearer, stronger (without being aggressive), and more directly engaging.

Attachments, Relationships, Uncategorized

Google inadvertently teaches me some very interesting things. For example, as I sit down this morning to write something undoubtedly brilliant hopefully coherent about Schwartz’s application of Internal Family System’s parts theory in relationships, I type the words “love” and “redeemer” or “redemption” into my trusty search engine… and get pages upon pages of religion and faith-speak in return. Not entirely surprising, but given that the premise of “(romantic) love redeems and completes us” is so pervasive in western culture, I am surprised there wasn’t more content tying redemption tropes to romance and our expectations for romantic partners.

“Everyone is born with vulnerable parts. Most of us, however, learn early–through interactions with caretakers or through traumatic experiences–that being vulnerable is not safe. As a consequence, we lock those childlike parts away inside and make them the inner exiles of our personalities.” – Richard Schwartz, You Are the One You’ve Been Waiting For, Trailheads Publications, 2008, pg. 55

“To all of us drowning in this empty, striving, isolated, and anxious [North] American lifestyle, the media throws the biggest life preserver of all. From watching movies or TV, or listening to songs on the radio, you’ll be convinced that everyone, sooner or later, will find their one, true, happily-ever-after relationship. The person who will heal you, complete you, and keep you afloat is out there. If the person you’re with isn’t doing that, either he or she is the wrong person altogether or you need to change him or her into the right one.

“This is an impossible load for intimate relationships to handle. The striving for money and the isolation from a circle of caring people are enough to do in many marriages–not only because both partners are depleted by the pace of life and the absence of nurturing contact, but also because to work and compete so hard, they each must become dominated by striving parts that don’t lend themselves to vulnerable intimacy. To deal with the stress of this lifestyle, we reach for the many distractions that our culture offers, which are also obstacles to, and surrogates for, intimacy.” – Schwartz, pg. 24-5

Esther Perel also talks about how North American ideals of romance often suffer because we trade the passionate, playful parts of ourselves that initially create intimacy as we explore our chosen Other, for security, stability, and comfort over the longer term of settling down together–needful things that make our exiled parts feel safely attached and protected, but which are about as “sexy” as our oldest, softest, most familiar and comfortable pyjamas and slippers. In Schwartz’s language, we surprise the exiles as they start to manifest once the spontaneous, impetuous excitement has either secured the partnership into more fixed states (living together, engagement/marriage, children, house-purchasing), or burned itself out and been supplanted by the requirements of regular life (work demands, family obligations). There is no space for those playful energies, and while the erosion of the welcome that once existed may be subtle at first, eventually it starts to feel like parts of us are being rejected by our partners, and that hurts, so we shut down the vulnerable parts and return them to their places in exile.

Where the ideals of redemption come into play is the initial expectations we place on our romantic partners to be the people who “will heal you, complete you.” This language is inherently problematic for many reasons:

“[P]artners are cut off from their Selves by being raised in a society that is so concerned with external appearances that authentic inner desires are ignored and feared. Into this nearly impossible arrangement is poured the expectation that your partner should make you happy and that if [they don’t], something is very wrong.

“These messages about your partner play into your exiles’ dreams, keeping the focus of their yearning on an external relationship rather than you. Thus, our culture’s view of romantic love as the ultimate salvation exacerbates an already difficult arrangement. Many writers have blamed the unrealistic expectations our culture heaps on [romantic partnership] as a significant reason for its high rate of collapse. I agree with that indictment to the extent that expectations perpetuate the partner-as-healer/redeemer syndrome.” – Schwartz, pg. 18

When I’m addressing with clients their experiences of dissatisfaction and disappointment in a relationship, we look at things like core needs (that, oftentimes, clients have never directly looked at or attempted to identify/define) and the expectations they have for how those needs are to be addressed by their partner. More often than not, the needs and their attendant expectations have never been explicitly articulated or negotiated with the partner, but we see plenty of evidence of the wounded exiles when those needs and expectations go unmet.

Attachment theory suggests that when we connect with others, especially intimate others in romantic partnership, for many of us it is a way of redressing early attachment injuries. These don’t need to be traumatic injuries, but simply moving to meet a craving for warmth and attention that we may implicitly feel was lacking or inconsistent in our earliest care-giving attachments. We exile those needy, unattended parts of ourselves over time, but then look, consciously or unconsciously, to romantic partners to meet that craving need for us, to redeem our wounded exiles and welcome them back into the fold. (This is generally a decent interpretation, from a parts/system perspective for what it means when a partner “completes us”–they nurture ALL our parts and create safety and welcome for the parts we have thrust out of the spotlight for being “ugly,” “damaged,” “too broken to function,” or “too terrifying to allow to surface.”

Harriet Lerner, in her book “The Dance of Intimacy,” describes a kind of dance in which we desperately want someone to rescue us from our own internal sense of unvalued despair and isolation, but as we get closer and closer to true intimacy (vulnerability), we become increasingly afraid of what happens when a romantic partner sees what we mistakenly believe to be our “true selves”, nasty warts, scars, and all. At that point, fear takes over and we inadvertently push partners back to safer distances, or close ourselves off, or sabotage the relationship in unconscious ways to “hurt you before you can hurt me.” We crave closeness that means someone allowing those wounds to surface and heal for once in our lives, but to closer we let those exiles come to the surface, the more anxious dread at “being truly seen” comes along for the ride.

We WANT to be redeemed, and then fail ourselves at the eleventh hour because we fail to let the redeemer actually make use of the all-access backstage pass we thought we wanted them to have.

When we rely on external Others to redeem those wounded exiles, we create this intricate tension rooted in needing someone else to wade in and do something magical to “fix” those wounds; we create a kind of codependent strategy in which we rely on someone else to “complete” us and accept all our parts. But our fears, those protector/firefighter parts of us that come armed with all kinds of saboteur scripts, get in the way pretty much EVERY TIME. And as soon as we start pushing people away, we are in a loop of self-fulfilling prophecy: we get defensive (sometimes aggressively so), partners retreat from us in fear, confusion, disappointment, frustration… sometimes even disgust; we see their withdrawal as validating our internal, unspoken script about how “everyone who is supposed to love us disappoints us/hurts us/betrays us/abandons us”, and we are validated further in our belief that our exiles MUST stay locked down and far, far away from the light of love and acceptance.

The healing work in a therapeutic context, regardless of whether the focus is on an individual or on a relationship, then becomes all about teaching each party to make space within themselves for welcoming their own exiles. Schwartz describes this as moving from a process of talking FROM our activated exiles (or the messy emotional chaos of exiles and protectors all trying to get air-time control in the middle of a triggering argument with another person) to talking ABOUT them. I do some of this work when I ask clients to, in essence, narrate an emotional reaction WHILE THEY ARE EXPERIENCING IT. We talk ABOUT what it’s like to feel triggered and reactive, the physical sensations, the self-observation of emotion, the scripts they hear being spooled up in their heads, rather than allowing the triggered reaction to unleash itself AT the other person or people in the room. Parts language becomes a useful tool in this narrative process especially when it gives the narrating client a way of adding some observational separation and distance: “One part of me is observing how another part really feels hot and angry, like it’s looking for something to attack. It’s angry because it feels attacked, like there’s another part that’s been hurt and needs to be protected.”

Being able to create this separation allows us to dialogue with both the attacker part and the hurt part separately, given the person who is caught up in this momentous experience a chance to unravel what’s going on for themselves, and to figure out what is necessary for calming themselves and re-centering their sense of balance. All of this can be done in the presence of the Other but doesn’t rely on the Other to sooth or validate those chaotic parts. Sometimes we’ve been able to make massive tectonic shifts just by getting one partner to introduce that self-observing narrative perspective while the Other partner bears silent witness, an abiding, compassionate, non-judgmental presence. Sometimes that’s just the starting point for different ways of being with each other that reintroduce independent security, and space to rebuild trust without the codependent fusion that Esther Perel labels the “death of intimacy”.

When we no longer rely on a partner to redeem and validate our exiled parts–when we become more adept at welcoming and managing those hurts without reliance on an external Other to complete us–it’s not that we no longer WANT to be in partnership. Rather, it becomes more about choosing to be in partnership as coherent, whole people in ourselves. We heal our own wounds, we accept our own warts and scars; we rely primarily on ourselves to soothe our internal chaos rather than forcing romantic partners into salvation roles and expectations most of them don’t expect, or have the capacity, to carry for us.

Emotional Intelligence, Mental Health, Self-care

The problem with not sitting down to write anything since some time in the last half of November is that, of course, I haven’t actually cracked open the tablet I use for such things since some time in the last half of November. Ergo, first thing this morning it was both (a) utterly out of go juice, and (b) way behind in installing operating system updates. Have you ever watched a device simultaneously try to recharge and update itself? Trust me when I say, it’s not pretty. In fact, from an impatient end-user perspective, it’s really fabulously frustrating.

So as I’m sitting in my favourite coffee shop, masticating my toasted bagel and ruminating into whatever coffee Tori poured for me this morning, forcing myself off the precipice of my own impatience, it occurs to me that this simple piece of electronica is reflecting back at me a valuable learning opportunity. Never mind that I hate being schooled by inanimate objects at the best of times, truthfully over the years I’ve learned to be open to “lessons from the universe” whenever, however, and from whomever (or whatever) they originate.

I’ve been sunk in a massive depression for a while, unveiled finally in late November by a series of confluent precipitating events (aka, “a bunch of shit crashed together and crushed me”). Since then, struggling to retain any degree of functionality has meant circling the wagons ’round, pulling in my boundaries, shutting down every gate and ingress to all comers, and just kind of hiding out, entirely to conserve near-depleted energy. In short, my internal batteries are entirely out of go juice.

Since early December, I’ve been trying to update the operating system: getting back to my own therapist at least biweekly, starting the game of Russian Roulette with antidepressants, making sure I spent the entirety of the holiday season sleeping as much as I could (which might even have been within spitting distance of as much sleep as I need), reintroducing massage therapy as a more frequent thing (the convenience of having the massage college with an excellent student clinic close by), and as of last week, getting back to my nightly meditation practice. I have a nebulous idea about attending to what and how I eat as the next step, and then at some point, trying to finagle an increase in movement back into my schedule.

It all sounds good, doesn’t it?

Now, imagine what it’s like trying to think about/plan, to implement, and then to SUSTAIN, all of this when, on top of normal day-to-day functionality, there is ZERO POWER in the batteries.

Like the tablet this morning: start an update, power cycle into a shutdown, leave the user wondering if the OS is going to boot up this time or if it needs a kick. Some days, you need to lean a little on the Power button; some days the power cycle reboots on its own, gets a little further into the next update process… and shuts down again. Lather, rinse, swear a lot, repeat.

This is, unfortunately, a really exquisite description of my life for the last several months, but particularly since the November crash. On the upside, I have been finding that it gives me a whole new metaphor for talking with clients about their own experiences of depression (especially those who have some experience with the cyclical frustrations of Reboot Hell). For some, a depressive cycle starts with a crash; things may have been going wrong in the OS for a whole, but as long as it wasn’t BADLY impacting functionality, we could ignore the slow downgrade until it crashed out completely–I don’t know for sure what the depression equivalent of the feared “Blue Screen of Death” is, but I’m betting there is one. For others, the slow cascade of fail is something they see yet cannot stop, even as they throw mitigating efforts at it along the way. The lucky ones are those who have some way of actually rebooting in mid-decline AND HAVE IT STICK. I aspire to be one of those people, even though I have zero idea what that actually entails.

The biggest challenge for deploying this kind of metaphor with high-functioners in particular is getting clients to realize that depression recovery isn’t just about the updates and reboot process, it’s about recognizing the dead battery aspect. Even many depressives who otherwise have no trouble recognizing their own lack of energy as a critical feature of depression, will struggle against the imposed limitations. The desire to push to be “happy” means that, like my poor tablet, any process of updating and rebooting is automatically hampered out of the starting gate because there just isn’t enough energy to do both the regular startup AND the additional implementation of updates. The hardline lesson of learning to live with depression, and I see this reiterated all of the place now, is learning to live WITH it like a recurring but perpetual illness. That means learning to accept that it comes with limitations and discomfort, much like anything from recurring cold sores to arthritis flares or MS relapses, will. It will come with the frustrations of watching your core operating system get stuck in a process you can’t clearly see into, and can’t do much about once the process kicks off. You can only sit by in frustration, waiting impatiently for the cycle to finish. Or you can learn to relax into it, do what you can around it, find other ways of doing what little you CAN find energy to manage. (I’ll give you two guesses which category I fall into, and the first guess doesn’t count.)

The stigma around depression prevents many of us from “being okay” with simply being depressed. Most of us work in situations that leave us feeling like we can’t afford to be physically sick, never mind mentally compromised or incapacitated. The pressure to just grit our teeth and get through depression is enormous… and depletive. Culturally we don’t have any good answers for how best to treat depression beyond recognizing it as a legitimate illness encroaching on epidemic proportions, even as mental health professionals grapple with the notions that depression’s causes are almost as numerous and varied as its manifestations and its impacts. (For example, even as we note that depression can run in families, we still have no surefire way of determining whether it’s a nature or nurture effect, genetic predisposition or learned coping strategy; how is it that I remained high-functioning for 18 months and still continued to work through and after a hardline crash, while my mother was rendered bedridden by her depression for long periods of time? Genetics? Situational necessity? Combinations of the two? Who knows?)

My only good answer remains, as frustrating to many as I’m sure it is: slow down. Realize you’re compromised, and will be for a while. If you can’t accept the limitations depression imposes, for whatever reasons, at least be realistic in your workarounds (see previous note, re: compromised functionality). Consider the fact that you may reach the point where you can EITHER recharge your batteries OR upgrade the operating system somewhow, but attempting both simultaneously may make things more complicated and frustrating than you mean them to be.

Sometimes all we can do is wait something out. Eventually one of the interminable reboots will hopefully get us back to the point where we can do something more like what we expect of ourselves. Be patient. It’s been my unfortunate lesson to learn that sometimes there’s nothing else for it but to hang on and ride the ride until it’s over and you can exit the damn thing safely.

Yeehaw… or something.

Emotional Intelligence, Self-care, self-perception, Uncategorized

“It might be hard to know that your therapist is as crazy as you are.” — Mike Fidler, MSW, RSW

It’s a bit of a truism in the therapeutic world that most of our compassion and no small amount of our ability to relate to our clients stems from our own personal experiences. (Not that we need overtly-relatable personal experience to BE a decent therapist, just that… it certainly helps with the perspective, even if it also risks the complication of personal experiential biases kicking in.)

So in the spirit of full disclosure, here’s a little bit of humanizing back story about Yerz Trooly:

While I have long known that I have depression, I had always thought it was mild, cyclical, and eminently manageable without significant therapeutic or pharmaceutical intervention. It wasn’t until VERY recently that I came back to a question my GP asked me over a year ago that I, to my embarrassment, discounted at the time:

“Do you think maybe you fit the label of “high-functioning depression?” she wondered.

“Yeah, maybe. Probably,” I said. “But as long as I’m functional, that’s good, right? It can’t be all that bad.”

Let me now say: It can, dear readers, be utterly, damnably, catastrophic.


“A recent survey by the British Psychological Society found that 46 percent of psychologists and psycho-therapists suffered from depression and 49.5 percent reported felt they were failures. The overall picture is one of burnout, low morale and high levels of stress (70 percent) and depression in a key workforce that is responsible for improving public mental health.

“Since American psychologists are treating the same general public with the same mental issues, it would not be surprising to find similar high rates of depression and feelings of failure. (The most recent major American survey published in 1994, found 61 percent of psychologists clinically depressed and 29 percent with suicidal thoughts.)” — William L. Mace Ph.D., for Psychology Today, Apr 27, 2016


“High-functioning depression isn?t a true medical diagnosis; you won?t find it listed in the Diagnostic and Statistical Manual of Mental Disorders, the bible of the mental health profession. But it is popping up on treatment center websites and health blogs as a way to characterize people with low mood, low energy, and anxiety, experts say.

“It?s a useful term, says Johnny Williamson, MD, medical director of the Timberline Knolls Residential Treatment Center in Lemont, Illinois, because it?s ?readily understandable? and encompasses people who don?t necessarily fit neatly into traditional diagnostic categories.

“What qualifies as high-functioning depression is somewhat subjective. People often fill three or four main roles in their lives: vocation (meaning work or school); intimate partner or spouse; parent; and friend or community member, explains Michael Thase, MD, professor of psychiatry at the University of Pennsylvania Perelman School of Medicine and co-author of Beating the Blues: New Approaches to Overcoming Dysthymia and Chronic Mild Depression. Assessing how active you are in your roles can help a mental health professional gauge high-functioning depression, he says. ?You may notice that there?s a hole in this person?s extracurricular life.”

“Steven Huprich, PhD, professor of psychology at University of Detroit Mercy, says there may be something in a person?s nature??a particular type of negative self-image??fueling his or her chronic unhappiness. ?If somebody came to me and said, ?I think I have high-functioning depression,? chances are not only would I hear about mood symptoms, but I?d probably hear something about being kind of perfectionistic, feeling guilty a lot, feeling self-critical,? he says.” — Karen Pallarito, for Health, February 07, 2018


“High-functioning depression, or dysthymia, may be harder to detect than major depressive disorder (MDD) because the people living with it are often high achievers who make you think everything is all right all the time.” […]

“For people with high-functioning depression, the ?invisible illness? aspect of the mental state can feel particularly searing. A few years ago, after shoulder surgery, my arm was in a sling. People fell over themselves to cluck with sympathy at my pain?socially sanctioned pain. It felt good to be the object of so much caring.

But on the days when listening to the sorrows of others exacerbates my own and I feel spent, I typically stay silent, not wanting to advertise my own vulnerability. Why is it so much easier to let others in on pain when it?s physical?” — Sherry Amatenstein, LCSW, for PSYCOM, Sep 11, 2018


The problem with the high-function aspect of High-functioning Depression is that it doesn’t look like the debilitating kinds of behaviours most people associate with depression. Or in some cases (like mine) there are physical health conditions (like perimenopause) with symptomology that masks the impact of depression, or makes it impossible to tell the difference between PM symptoms and HFD symptoms. When the health issues mask the psychological ones, especially if the health issues are perceived to be transient, the narrative EASILY slides into one of, “Just ride it out, this is just a temporary thing.” The unfortunate result is a misatribution of cause, and therefore a failure to effectively diagnose and treat the more devastating issue. Eventually, the lack of cope that is the key component of the high-functioning script fails utterly, and in ways that are even more difficult to recover from, than if the depressive aspect had been caught and dealt with from the get-go.

Therapists, really anyone working in the mental health field, are hamstrung in very particular ways by this high-functioning aspect. The staggering numbers of therapists in therapy themselves for depression tells a haunting story if we consider those are just the REPORTED cases. I am my own best example of therapists who are late to the party, in terms of recognizing, acknowledging, and bending to the need for treatment, of their own depression. We are often the WORST people for believing we have to buy into the myth of “having our shit together” to be the support our clients need, and to model more effective mental health practices (individually or within our relationships) for friends and family around us. In short, we buy into our own PR, and we suffer for it in significant numbers.

Imposter Syndrome is another factor that I suspect (based on nothing more than purely observational, anecdotal “evidence”) figures strongly into HFD. Imposter Syndrome occurs across all professions and all walks of life, specifically affecting those in positions of increased or increasing responsibility and authority. The greater the sense of responsibility and authority, the more likely it is that the individual in question will feel anxious about being “found out” or discovered to be less able than others believe them to be. This fear of discovery often drives us (yes, I include myself in this august and populous group) to do everything we can to “be worthy”, to meet the standards we feel are expected of us by those who look to us to perform in our roles… even if we don’t know or haven’t validated what those expectations actually entail. But because we strive so hard to meet that worthiness, we tell ourselves that we cannot fail, we are not ALLOWED to fail, that failure will lead to discovery of our own incompetence… and voila, we’re binding ourselves into the script of “must be high-functioning OR ELSE”, often at the cost of our own equilibrium and mental health.

So what leads to the breaking points? How does someone caught up in the whirlwind of staying functional-at-all-costs finally get around that cycle? As with a lot of depression disorders, there are many things that can pull a sufferer out of the darkness, including, simply time. For me, the epiphany came as the result of a LONG period of draining demands that built inexorably over time well beyond the tolerance point, yet still sustained. There was a singular, precipitating incident that triggered a realization that something that SHOULD have been exceptionally terrifying and upsetting wasn’t producing really any kind of emotional response. I had flatlined, emotionally. More importantly, looking backward, I realized I had been flatlining for a while–able to function in caretaking roles in other relationships (personal and professional), but ultimately seeing those as ways of distracting myself from my own eroding state of health–and doubling-down on the “Just Ride It Out” script. I knew there was a problem, but I didn’t do my own homework to separate out the dogpile, so I didn’t have to admit there was something IN the dogpile that needed to be addressed differently.

In short, it took recognizing that I was NOT responding to stimuli at all (let alone “appropriately”) that forced me to realize just how disconnected I had become, and how much was being locked in a box buried deep below the surface, just so I could function from one day to the next. Like the flipping of a switch, I very clearly had one thought that hit me like a sledgehammer: “Holy shit. I am really VERY NOT OKAY.”

And admitting that was the crucial turning point. (Of course, by the time Pandora realizes what’s in the box, it’s too late to close the lid on that shit, and now we have to actually, y’know, DEAL with it.)


“While “high-functioning depression” isn’t an official term for any of them, and has even been debated on social media, it’s what many like Judge use to describe their condition. Part of the reason is that they don’t fit the stereotypical image of a depressed person, the one put forward in antidepressant ads and TV dramas. They may not be skipping work, withdrawing from social activities, feeling hopeless or crying all the time. In fact, they may be honors students in college, business executives, physicians, journalists, startup employees, or any of a variety of seemingly confident, successful individuals. […]

“On the surface, high-functioning depression may seem like it’s easier to deal with, but it can persist for years, leading to more functional impairment over time than acute episodes of major depression, Craske says. Research has shown that the low self-esteem, lack of energy, irritability, and decrease in productivity that accompanies persistent depression is associated with significant long-term social dysfunction, psychiatric hospitalizations, and high rates of suicide attempts. And, ironically, persistent depression also puts people at a higher risk for major depressive episodes with more severe symptoms.” — Knvul Sheikh, for Tonic, Oct 16 2017


“Because high functioning depression so often flies under the radar, many people either don?t seek help until their condition has progressed to a severe state or their clinician doesn?t recognize the severity of their illness, leading to inadequate treatment. If this is your experience, residential treatment can provide the best path toward recovery.” — Elisabet Kvarnstrom, for Bridges to Recovery, June 6, 2017

Because residential programs are a luxury many of us can’t afford–not just in terms of expense, but also many of us can’t afford to be not working for the length of time any kind of residential or in-patient program demands–we have to consider what intensive treatment options ARE affordable. It might involve revisiting discussions about, or changing up existing prescriptions for, anti-depressant medications. It almost certainly involves getting in with a good therapist. Yes, even therapists have therapists of our own (and yes, sometimes even therapists don’t want to call their own therapists to admit there’s maybe a wee problem and could we please come in at their first available opportunity… I’m pretty sure I’m not alone in that regard. *looks around the room shiftily*). It also seems extremely important to consider one of the comments above, about looking for the “hole in this person?s extracurricular life”, to see what’s missing. High-functioning individuals, whether driven by Imposter Syndrome or not, often lack balance across their various roles. The gaps and places where they are ignoring, subsuming, deflecting, or otherwise compartmentalizing their needs then becomes a place to explore, to consider why those absences have been permitted to occur.

Because HFD is not clinically differentiated from any other depressive disorders, the treatment modalities are likely to be the same. Medication as determined in consultation with medical or psychiatric professionals, psychotherapy, lifestyle shifts if necessary. None of which is going to be easy for those of us who have taken so long to get to the point of even admitting there’s a problem in the first place. This comic comes up as hugely relevant, and highly descriptive, a lot for many of us, frankly:

No, we’re fine. Really. Ignore the fact that we’re on fire.

So be gentle with those of us who are hitting this point, or starting our way back from where we’ve wandered into the weeds. It’s hard enough to make the admission that we’re not healthy, let alone reach out to ask for help with what we’re realizing. People struggling with depression are already likely overwhelmed with where they’re at, and sorting out what feelings need what assistance is just “altogether too much”. When the depressed individual is able to articulate what they can, hopefully they will (Note to Self: take my own damned advice), and maybe they will be able to ask for something specific.

And always consider that just because someone is BEHAVING like they have all their shit together, their internal truth may be very, very different.

Emotional Intelligence, Relationships, Uncategorized

“Sometimes our most intimate space is in the distance between us.”

This is a statement that came out of my mouth with clients not too long ago as we were starting to look at some of the inherent complications that arise when couples become too tightly fused to each other in their quest to build security, trust, comfort into their intimate attachment. I still encounter with terrifying frequency–as much inside the counselling office as outside in cultural mores and media messaging–that we require partnerships to somehow “complete” us. That the height of romantic entanglement is a state in which “I don’t know where I end and you begin”.

Personally, I used to love that enmeshment state of New Relationship Energy. If I’m being honest with myself, I still do. However, I now *ALSO* recognize it as the breeding ground for some exceptionally, enormously-unrealistic, and potentially destructive beliefs and entitlements around boundaries… and the inevitable boundary violations that occur when one is unconscious of, or inconsistent in defending, effective boundaries around their emotional and psychological well-being. Coincidentally, this statement came about a scant 24 hours before I started reading Esther Perel’s “Mating in Captivity” for the first time, a book I’ve been intending to read since it came out in 2006 (her second book, “State of Affairs: Rethinking Infidelity” has also been sitting on my To Be Read pile since *IT* debuted a year ago).

When the universe starts handing me these kinds of seemingly-disparate nuggets, it’s because it wants me to connect the dots on something. So as I am getting into the Esther Perel reading, and watching the ever-amazing Jada Pinkett-Smith discuss her marriage to actor Will Smith in a two-part installment of her web series, “Red Table Talks” (part one is here, part two is here), I’m coming to realize we’re on the brink of a potentially large shift about how we view and pursue intimacy.

Murray Bowen, the father of Family Systems Theory, discusses at length the value of healthy differentiation of Self when any individual within a system finds ways to create space and autonomy within the system by changing how they participate around new, more effective boundaries. In discussing his scale for differentiating Self, he writes,

“This scale is an effort to classify all levels of human functioning, from lowest possible levels to the highest potential level, on a single dimension… It has nothing to do with emotional health or illness or pathology. There are people low on the scale who keep their lives in equilibrium without…symptoms, and there are some higher on the scale who develop symptoms under severe stress… The scale has no correlation with intelligence or socioeconomic levels… The greater the degree of undifferentiation (no-self), the greater the emotional fusion into a common self with others (undifferentiated ego mass). Fusion in the context of a personal or shared relationship with others and it reaches its greatest intensity in the emotional interdependency of marriage.” Murray Bowen, “Family Therapy in Clinical Practice,” New Jersey, 1978, p. 472 [emphasis mine]

This fusion within a relational system takes many forms; looking through an attachment lens, one of the most common dynamics of fusion is the distancer-pursuer dynamic of an anxious-secure or anxious-anxious attachment pair. There is a sense of anxiety when an individual transfers from one system (such as a family of origin) to an intimate relational system. Even if the originating system is busted and dysfunctional, there is a familiarity in certain types of connections that provide comfort and security a la “the Devil we know”. Unsurprisingly, we’ll try to recreate the same sense of closeness and familiarity in our intimate relationships, sometimes employing the same kinds of bonding mechanisms learned in the family of origin. If our bonding attempts are uncomfortable to our partner, the partner withdraws or tries to set up new boundaries around engagement… setting the anxious partner into a spiral that can only be resolved by trying to clutch harder to the separating partner.

The upshot of this “dance of connection” (as per Harriet Lerner’s term for this dynamic) is that modern love seeks to equate intimacy with fusion, the inseparable, potentially insufferable closeness that allows for absolutely no distance between us. There is nothing allowed to be unknown, because in the unknown lies uncertainty, and that is intolerable. We substitute comfort and safety for passion and excitement, then wonder why our relationships over the long term start to feel as provocative and sexy as a pair of worn and comfortable socks. Where has the excitement gone? Where has the playful eroticism that made the early era of the relationship so delicious, gone? How do we get that back??

This is where the Esther Perel reading comes into play. Her contention through “Mating in Captivity” is that in generating these states of fusion, exchanging uncertainty and insecurity for a state of entitlement and absolute entanglement on every level, we destroy the very environment that passion and eroticism require in which to live and flourish:

“The mandate of intimacy, when taken too far, can resemble coercion. In my own work, I see couples who no longer wait for an invitation into their partner’s interiority, but instead demand admittance, as if they are entitled to unrestricted access into the private thoughts of their loved ones. Intimacy becomes intrusion rather than closeness–intimacy with an injunction. […]

“Some couples take this one step further, confusing intimacy with control. What passes for care is actually covert surveillance… This kind of interrogation feigns closeness and confuses insignificant details with a deeper sense of knowledge. I am often amazed at how couples can be up on the minute details of each other’s lives, but haven’t had a meaningful conversation in years. In fact, such transparency can often spell the end of curiosity. It’s as if this stream of questions replaces more thoughtful ans authentically interesting inquiry.
“When the impulse to share become obligatory, when personal boundaries are no longer respected, when only the shared space of togetherness is acknowledged and the private space is denied, fusion replaces intimacy and possession co-opts love. Deprived of enigma, intimacy becomes cruel when it excludes any possibility of discovery. Where there is nothing left to hide, there is nothing left to seek.” (Esther Perel, “Mating in Captivity”, New York 2006, p. 43-4)

“Yet in our efforts to establish intimacy we often seek to eliminate otherness, thereby precluding the space necessary for desire to flourish. We seek intimacy to protect ourselves from feeling alone; and yet, creating the distance essential to eroticism means stepping back from the comfort of our partner and feeling more alone.
“I suggest that our inability to tolerate our separateness–and the fundamental insecurity it engenders–is a precondition for maintaining interest and desire in a relationship. Instead of always striving for closeness, I argue that couples may be better off cultivating their separate selves…There is beauty in an image that highlights a connection to oneself , rather than a distance from one’s partner. In our mutual intimacy we make love, we have children, and we share physical space and interests. Indeed, we blend the essential parts of our lives. But “essential” does not mean “all.” Personal intimacy demarcates a private zone, one that requires tolerance and respect. It is a space–physical, emotional, intellectual–that belongs only to me. […]
“Love enjoys knowing everything about you; desire needs mystery. Love likes to shrink the distance that exists between me and you, while desire is energized by it. If intimacy grows through repetition and familiarity, eroticism is numbed by repetition. It thrives on the mysterious, the novel, and the unexpected. Love is about having; desire is about wanting… But too often, as couples settle into the comforts of love, they cease to fan the flame of desire. They forget that fire needs air.” (p. 36-7)

It’s interesting to watch couples react to the concept of INCREASING the distance between them at a time when their instincts (for at least ONE of them) are screaming, “NOOOOOOOOOOO, WE MUST BE EVEN CLOSER THEN EVER BEFORE TO FIX ALL OUR INTIMACY PROBLEMS! I MUST BE ALL UP IN YOUR BUSINESS AND HAVE YOU SHOW ME YOU WANT TO BE ALL UP IN MINE!!!”

And, of course, this never works.

Whether it’s the unrealistic expectation of a reciprocal desire to live inside each other’s heads 24/7, or the unrealistic expectation of a reciprocal definition of privacy boundaries (which, BTW, are PERFECTLY NORMAL and HEALTHY things to have in *healthy* relationships), or whether we have different expectations for how this eternal fusion actually looks on a day-to-day basis, or one partner breaks down and flees in the night with a desperate cry of, “JUST GIVE ME SOME FUCKING SPACE, WILL YOU??!?”— I really cannot begin to count all the ways in which the insatiable need for fusion as a substitute for legitimate intimacy fails us at each and every turn.

When we smother ourselves, our relationships, our partners out of a fear of the distance, we lose the distinct entities we were when we ignited the energy initially bringing us together. Perel’s stance is that in pursuing security and comfort, we sacrifice passion and eroticism by deny the space required to maintain a degree of mystery and uncertainty. Anxious attachments cannot settle and become secure without eradicating all uncertainties, without seizing the seams and trying to seal all perceived rifts by force of will… until “secure and comfortable” becomes “stabilized… and boring”.

(And before anyone asks, yes, this happens in poly relationships, too; it’s not a question of how MANY partners you have, but what your own attachment style in any of those relationships typically looks like, or how security/anxiety responses get activated.)

So, consider this: smothering a fire with a blanket puts the flames out. On the one hand, that keeps you safe, but on the other hand, you’ve lost a source of heat and light that might have been serving a valuable purpose to those enjoying it. The question is, did you put out the fire because you were afraid it would consume you and everything you love if you didn’t? Could you learn to tolerate the fear if it meant being able to sustainably (non-destructively) enjoy the heat and light that the fire brings? We can have distance, and space, and air, and fire, and heat, and passion… without burning the house down.

But it takes rethinking how we define and pursue intimacy to do it.