Hoooo-nelly… We’re still here. And we’re going to be here a long while yet (she says, eyeballing the again-rising numbers in Ontario and the ongoing dumpster fire that is COVID responses and shenanigans one month from a presidential election south of the border). And winter is coming — insert ubiquitous Game of Thrones graphic here — and shit’s about to get very, very complicated. (Not that COVID wasn’t already complicating everything, so I’m not really sure how much worse it can get… no. I really shouldn’t invite that kind of chaos. It can ALWAYS get worse.)
We’ve cruised over the six-month mark in this current pandemic, and it is taking its god-awful toll on all of us in some way or another. Not too long ago, someone pointed me to this amazing description of “the six month wall” by University of Toronto prof Dr. Aisha Ahmad. For those who prefer not to scroll through Twitter stories, she encapsulated her thoughts in this article, and there’s a decent Forbes article exploring her ideas. Dr. Ahmad’s experience working in disaster relief is, I think, a good parallel for what it’s like for many of us struggling to find footing and balance under the weight of an ongoing pandemic, albeit one a growing number seem inclined to ignore as a threat. She provides a very balanced look at both how tough getting over the six month wall can be and also what has worked to help keep forging ahead when we hit those difficult slumps and ruts.
The idea that in an ongoing, persistent crisis state, we’re all going to hit a slump in our struggles against that state just makes sense. Some people have been struggling with the fear of infection and illness since COVID first started spreading in North America; some are less worried about the virus itself and more concerned about the short- and long-term impacts of protracted social distancing. Others might be most impacted by grief and grieving those they cannot get to under quarantine restrictions and travel embargoes. Long story short, for one reason or another (or many reasons all at once), a great many of us have hit an exhaustion point. We’ve been struggling to adapt to this new scenario in all its implications since March; it’s been at best a challenge and at worst an utter shitshow. We’re breaking down mentally and emotionally stalling out.
As she points out, most of us have already adapted to some degrees of the “new normal”, but winter is going to require us to adapt again to the new challenges of COVID resurgence WITHOUT the benefit of warming weather and outdoor escape options. That we’re hitting the six month wall now, as those seasonal implications begin to really hit home for many, is doubly harsh. I don’t about other mental health workers, but I don’t even know how to predict what my work is going to look like come the holidays under COVID, and the aftermath heading into deep winter. I can’t imagine it’s going to be pretty. Humans are naturally adaptable on an evolutionary scale of things, but a lot of us don’t actually enjoy change when the necessity of it is thrust upon us by factors beyond our control (personally, I get grumpy about change even when it IS 100% in my control, so… there’s that.)
“[T]he wall is real and normal. And frankly, it’s not productive to try to ram your head through it. It will break naturally in about 4-6 weeks if you ride it out.” – Dr. Aisha Ahmad
Aye, there’s the rub… riding this slump out for another four to six WEEKS.
A later Tweet by Dr. Ahmad explores a little more deeply her concept of mental “shore leave” plan to help make it over the six month wall:
Mental shore leave means a psychic retreat. So my task is to get creative about where I can create respite in my life today, just as it is. It also means looking hard at where I can set boundaries, and cut out negativity & noise. The goal is simple: optimize rest and joy. /4
A key factor will be ensuring that my shore leave plan does not depend on anything staying open. If my strategy is about going to a gym or bookstore, it will be vulnerable to collapse. I need my respite to be absolutely untouchable. /5
On the whole, I am deeply onboard with this idea. The idea that we’re allowed to put down the load of “life in wildly-uncertain times” is seductive, if only because sometimes *I* just want someone to give me permission to stop worrying about things for an hour or two. Even half an hour! My only caveat is that, as presented, there is no allowance for those who have spent the last six months sliding down into depressive cycles that make adding ANY extra efforts to their day a difficult challenge, even respite time. As a therapist, in the past week, I’ve been shaping those conversations with clients in this slump as exploring their definitions of “respite”. For some, it has meant finding ways to increase literal rest or looking for ways to reshare/rebalance some of their workloads to provide relief from at least SOME of their stressors. For others, it has meant the deliberate, temporary delay of dealing with all manner of issues and circumstances that might be a lower priority than basics of safety and survival. For many on the depressive spiral, myself included, it has been a discussion about allowing ourselves a respite from some of the less-important things we believe we SHOULD be doing, and giving ourselves permission to make rest and recovery our highest priority as much as our circumstances permit.
The pandemic may be unrelenting, but how we engage with it need not be. I like Dr. Ahmad’s notion of respite breaks, but I would prefer seeing a more grounded approach in introducing that notion to our struggling clients especially. Most importantly, I really appreciated seeing someone outside of the therapeutic/mental health field validating and echoing what I’ve been noticing lately in discussions with my own clients… and experiencing in my own head. The wall is real, the slump is not exactly short-term but it IS temporary, and we DO have options for disengaging from it for whatever periods of time we can muster for respite.
I might just get myself and my clients through the next 4-6 weeks, then, given all of that.
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.
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.
“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.
?You are the Hero of your own Story.?
? Joseph Campbell
Catching up with a colleague over coffee this morning, we were commiserating over a shared experience that seems to hit those of us who are somewhere post-divorce. We’ve moved on, or we’re moving on, and in encounters with The Ex, we suddenly experience an unpleasant sensation of realizing they’re HAPPY, or at least content, or having their own adventures, or… or…
It’s the sharp adjustment of recognizing that, as the heroes in our own stories, we expect that our ex-partners should be miserable, or missing us, or somehow struggling in our absence. And in finding that they’re not at all unhappy with their new status quo, WE are somehow thrust into unexpected or unwelcome re-evaluations–often unfavourable– about where we ourselves are landing. It’s at least a *common* part of a grief-and-recovery process to rewrite our stories around ourselves. Without the presence of the Other, women in particular are often discovering a centred-in-selfness that is new to them: we become Victim, Hero, Adventurer, Martyr, Rescuer–sometimes all of these roles simultaneously, sometimes sequentially, sometimes adopting one and getting mired in it.
Creating a story around our circumstances that offers a “probable hypothesis” for why things happen is what humanity does. We are a race of story tellers who don’t like gaps in our knowledge, so we fill in the blanks with plausible-sounding stories explaining why things happen. It started with the first caveman who had enough language to explain to his clan that lightning striking a nearby tree and setting it afire was the act of angry sky-beings, and continues millennia later in coffee shops all over the world as we tell ourselves stories about who and why we are the people we have become.
In part, the restructured narrative helps us move from one day to the next in the early stages of post-upheaval recovery. Part of grief processing involves the need to understand “Why?”, but lacking direct input from an uncooperative partner in the process of a relationship breakup, we will fill the void in our factual knowledge with semi-informed interpretation and assumption. When those created narratives get invested with emotional weight, they become “like facts”, and the storylines become entrenched. Being shaken out of those entrenchments when later re-encountering our exes (or any Other who played a part in significant life-altering events) generally involves having those internalized “facts” challenged by the living presence of someone behaving nothing like we expect.
If we’re the heroes of our own stories, however, that generally tends to imply that the Other must be the “villain” or antagonist of the piece, right? Our internal heroes implicitly expect that something bad happens to the Other, even if it’s just a desire to know they hurt and pine and regret and lament the pain of our absence from their lives, as we have hurt (or been angered by, or regretted) for their absence from ours. That would just be *fair*, right?
Except… it rarely seems to work that way. Unsurprisingly, people who live outside of our heads, and therefore outside the confines of our carefully-constructed narratives, never conform neatly to the confines of those tight stories. And once they, or we, have exited the relationship, they are even LESS bound by expectations to confirm, so they go off and have happy lives of their own. And when we encounter them in their happiness, it just doesn’t fit for us. (Yes, I’ve been through this process myself; I know exactly how it feels to confront this perception. I am extremely sympathetic and empathetic to friends and clients alike when they run into the same uncomfortable emotional adjustments.)
The awkward truth of this process is that we ARE filling in blanks with presumptive narratives. We do this to make ourselves feel better. How many of us can remember being children, telling ourselves stories to make the world around us seem less scary? Personally, I attribute my becoming a writer to exactly this process; I entrenched my narrative processes so deeply, I made a career out of them! Yay me, right? Up until those processes get in the way of having healthy relationships, sure.
Often times, we find these story-telling activities already exist inside relationships; we don’t have to wait until things fall apart to see them in action, that’s just when we see them take on new lives of their own. We catch the story loops in anxiety and self-esteem crises; we see them in how partners in relationship react to each other, especially when reactions seem disproportionate to the triggering events. We see them when we see reversions in behaviour to traditional patterns when we host or go home to visit our families. We adopt or revert to roles we have played, well-developed personas who fit certain requirements of the systemic storyline, or that feed into our own personal narratives about who we are, what we value (or what we’re supposed to value).
When working with narrative challenges, one of the very first tools we develop is self-observation. It’s a way of both “differentiating from the system” in Bowen Systems language, and also “externalizing the problem” in narrative therapy terms. We learn to look at what’s happening in the system, to recognize the stories spinning around us, as well as our part within them. What am I telling myself? What am I experiencing as I observe what others are doing, and what am I telling myself about those experiences? Turning off the urge to interpret, to filter our experiences into our personal narratives, is a challenge at the best of times. But in doing so, we can also unhook ourselves from a certain amount of default reactive, patterned reactions, including the unconscious urge to want other people to hurt like we have hurt in the wake of relationship breaks, for example. “If I’m unhappy, you certainly don’t deserve to be happy,” is a depressingly common refrain I hear in a lot of post-break conversations, before we get to looking at the narratives entrenching the speaker inside that unhappiness. I get it; I’ve been there, too.
So we work on making the storylines more consciously observable. Then we look at how we are hooked into them by expectations, or by our attachment to different outcomes than we’ve experienced. Breaking those down takes time, and often a lot of “reframing the narratives”; the external perspective of a therapist can be a useful tool for this process. It’s less about playing Devil’s advocate and more about offering insight into our own experiences, helping someone to “consider an idea from a different point of view, taking the evidence as it is but coming to a different conclusion.” We can use perspective-shifting questions that move from (for example) Victim/Marty roles to Hero perspectives by posing the simple question, “If you were the Hero of this story, what would you do next?” (which comes close to one of my fundamentally-important questions, “What kind of person do you CHOOSE to be in this situation?”).
Being the Hero of our own story is something we all desire, but into which we sometimes need a little help casting ourselves. Encountering others’ happiness feels like a check, or even an outright stop, as we adjust to adjacent or outright conflicting storylines that don’t fit neatly with our own. But discomfort doesn’t make it a bad thing, and if it results in us being more mindfully observing of ourselves and our narratives in the world, then we ultimately have a better sense of our Selves as we interact with those other storylines.
Yes, we can ALL be Heroes. (Even if just for one day…)
“I know nothing stays the same, but if you’re willing to play the game, it will be coming around again.”
So, January… I see you have come around again.
New year, new month, resolute new beginnings for many. And resolute restarts for many more. But this post isn’t about resolutions, New Year’s or otherwise; the internet is full of advisory posts about resolutions at this time of year, and frankly I’m already exhausted by the idea. Instead, today’s post is about the mentality of “starting over”, specifically from the perspective of a post-relationship breakup.
The holidays can be brutal on the recently-single, but perhaps more so is the aftermath of the holidays, when it seems like *everyone* is staring down the long, dark, cold and dreary months of Winter Proper. Remove the artificial and inflated moods of the holidays, and what’s left? (Those of you who are winter enthusiasts, shush 🙂 )
Depression in the winter months is a well-documented phenomenon, at least in North America, in part because of the darkness and cold. Add in elements of 21st century social insularity, and then consider how that withdrawing almost becomes a norm when someone is grieving a breakup, or grieving the loneliness of ongoing singleness. Grief and pain are a drain on energy and motivation, and the cold snowy outdoors is, for many, already a more than sufficient reason to avoid leaving the house. This is a damnably difficult time of year to face the refrain of “new resolutions!”, or “starting over”; it all just sounds like too much effort and what’s the point?
Starting over at any age is a tough challenge, but I think the older we get, the more we believe we stand to lose when a job or a relationship goes away, for whatever reasons. The more we stand to lose, the more we fear the loss and attach to the idea of hanging onto what we can, and the more strength it seems to take every time one has to pick themselves back up again. There’s very little to say to someone in the depths of that experience that will help them visualize what “starting over” even looks like, or when they will be ready to take a step… in ANY direction other than pain-paralyzed stasis. During rough times in the past ten years, I’ve leaned hard on a mantra that taught me a wisdom in keeping efforts small and simple until I’ve been ready to do more: “One day at a time, one breath at a time; one foot in front of the other.”
I keep this article bookmarked now, because it offers some very practical perspectives on how to start over in general after losses:
learn from failures
leave the old attitudes behind (sometimes this is where a good therapist can be a useful ally)
don’t make grandiose announcements, just do it
leverage what you know DID work previously
take baby steps, and celebrate the small victories as well as the big ones
do things differently
keep moving
spin criticisms, however harsh, into constructive perspective
?I have lived in the shadow of loss?the kind of loss that can paralyze you forever. I have grieved like a professional mourner?in every waking moment, draining every ounce of my life force. I died?without leaving my body. But I came back, and now it?s your turn. I have learned to remember my past?without living in it. I am strong, electric, and alive, because I chose to dance, to laugh, to love, and to live again. I have learned that you can?t re-create the life you once had?you have to reinvent a life for yourself. And that reinvention is a gift, not a curse.” — Christina Rasmussen, Second Firsts: Live Laugh and Love Again
Learning how to remember the past without becoming persistently stuck in it is difficult work, especially when one is still mired in pain. Avoiding entrenching ourselves in our victimhood is also a challenge; it’s more comforting to believe we are the wronged parties, especially when the loss comes about unexpectedly. Too many questions (mostly in the “Why/how did this happen to me?” category) overwhelm us without answers; without answers, we believe we cannot understand, and without understanding of what went wrong, we’re afraid to move forward in case we make the same missteps and mistakes in future… and risk feeling the same pain again. Best to stay put until we KNOW things, right?
Except… some things can’t be known. And even when presented with answers, if we don’t like or don’t believe the information as presented, we engage it in a struggle to prove, disprove, pick apart, analyse, investigate. We stay stuck with the need to COMPREHEND. And if we can’t, there is no way to resolve the struggle, to free ourselves, to choose to act differently.
Starting over after romantic breakups adds some things to the list above, like choosing whether to maintain a hard or soft heart — does grief make us cynical, gun-shy, pragmatic, open-hearted, willing, eager? Starting over involves challenge and opportunity, but especially in romantic contexts also involves emotional risk; like the clich? says, “Love like you’ll never be hurt”, but how hard is that to hear when you’re still in recovery, post-breakup, even months or years later?
Recovery often becomes about the stories we tell ourselves in the aftermath, whether we stay stuck in the stories of grief and pain and loss and allow that stuckness to creep in and also infect our “forward vision”. Do we shape those narratives in negative language, or positive language? For example, consider the difference between, “I don’t ever want to feel (that kind of) pain and grief again,” and “I want to love and be loved again,” in the sense of reinforcing a negative versus positive space. “I don’t want X” only defines a specific or narrow set of experiences, even when the scope of that experience seems (however temporarily) all-encompassing. It works less effectively for crafting a useful, self-directing course TOWARD something. Saying, “I want [Y]”, on the other hand, opens a conversation about what [Y] can look like, what paths might move one from current state towards receptivity and onward toward open reception and acceptance.
Relationship therapists generally hold that intimacy is rooted in vulnerability, and vulnerability is, itself, rooted in risk-taking. Starting over after breakup involves some soul-searching questions about willingness, or potential readiness, to engage in what undoubtedly feel like emotionally-risky behaviours. The last thing most of us want to do when we’ve burned our fingers is too stick them back someplace we’re afraid will result in further burns. This is where my two core tenets, mindfulness and choice, become critical components of any “starting over” mentality. What have I learned, and what do I need to carry forward? What changes to my metrics for satisfaction and happiness do I want to make, and to my communications when things aren’t measuring up to those metrics? How do I want to ask for what I want, even if the entity I’m asking is “the universe at large”?
But the process of “starting over” must also, by necessity, make space for processing grief and the pain of whatever’s been lost. Starting over, like “moving on”, doesn’t necessarily mean forgetting about what has happened or magically stopping the feelings. Nor does it function on any kind of a set schedule. More accurately, it needs to be a process of learning how to redistribute the weight of those experiences, so that we can move without tripping over the unresolved baggage. Resolution, to me, means a maybe-sometimes-never process by which we gradually shift or improve our relationship to those prior experiences, so some lingering effects may be with us for a long time. But we can either be pinned in place under the weight of those effects, or we find a way to move in spite of them. Grief processing is its own thing, and again, this might be a place in which good therapy is useful. Working through our fears and anxieties around future “what ifs”… well, that’s the work of starting over, right there, in a nutshell.
If it were all as easy as a song lyric, life would be so much simpler, wouldn’t it? We can’t always force a tidy resolution, but we can change our relationship to the weight we carry forward. We pick ourselves up, dust ourselves off, and start… not *quite* all over… again. And again. And again. As often as our hearts can stand it.
Nothing brings out the best and worst of us like this time of year. I don’t know a lot of people who get through the six weeks from December 1 to mid-January without a great deal of stress and anxiety, whether it’s about money, work, family, the increased workloads involved in balancing work + social event schedules + family, weather (especially for those of us in northern climes)… The amount of work most people I know put into trying to get to a point where they CAN relax over the holidays is phenomenal. When I still worked in IT, nothing crushed the heart and soul out of many employees like the workload of trying to clear a project schedule just to afford a couple of days off between Christmas and New Years, and that’s assuming that you have vacation time available, or work some place flexible enough to allow banking lieu time at this time of year. Not everyone has those luxuries.
Client schedules at this time of year become extremely unpredictable. Clients with benefits that renew at the beginning of the calendar year may be gleefully maxxing them out while they can, or they may find themselves eaten by other schedule requirements requiring them to rebook or miss appointments. A lot of seasonal sickness makes the rounds at this time of year, too. For psychotherapists like myself who may not be covered by most benefits, we find (unsurprisingly) that as much as our clients appreciate their work with us, they will often (understandably) choose to pay for Christmas rather than therapy, even when they (ruefully) admit they probably need the therapeutic support more now than other times through the year. We’re pretty understanding of that, though obviously it impacts OUR seasonal income as well. And honestly, there’s generally no good way for us to predict from one year to the next what any given holiday season is going to look like.
We CAN largely expect that many of our conversations with clients will revolve around how holiday stress impacts their relationships at home, or with larger family groups. Nothing seems to spark relational conflict or communications issues like a bucketload of conflicting priorities and obligations packed into the short window of Christmas.
Most therapists will tell you flat out, there’s no magic wand we can wave to take all of that strain away. The holidays really do bring out the best and worst in us. Google will helpfully provide pages and pages of links in response to typing “surviving the holidays” into the Search bar, but at the end of the day, I think the basics of Seasonal Survival Strategies look the same:
1. There should be some place that becomes your “safe space”, a respite from the Holiday Craziness that will, in fact, infect just about every aspect of your world for six weeks. (Even if you’re from a culture that doesn’t celebrate a major holiday at this time of year, if you’re reading this you’re probably living somewhere where most people around you seem to have almost literally Lost Their Minds). Whether this is a place in your home, your workplace, your car if you have one, or some place like a public library, make sure it’s a place you can get to on a regular basis. It should be some place you can keep mostly clear of the trappings and noise of the holidays, or at least have a higher degree of control over said trappings and noise.
2. Spend time in that safe space whenever you can. Make it a deliberate and mindful choice to “leave Christmas at the door” when you enter the space. The lists, the schedules, the noise, the chores, the negotiations, the frustrations… leave them outside. They’ll still be there when you come out (trust me) but for a few minutes or even an hour, give yourself the gift of Not-That-Chaos. It may seem like a luxury, an outrageous demand, to walk away from it all for a while, but honestly, this is nothing more than developing good boundaries, and valuing your own mental health in the mix of temporarily-extraordinary life. Everyone else will tell you that it’s important to be empathetic and compassionate to everyone else, because everyone else is stressed, too… but I can guarantee it will be damned hard to find energy to BE empathetic and hold compassion for others if you DON’T create some protected time and space to recharge yourself along the way.
3. Relax rigid expectations. This is a hard one for many of us, myself included, but absolutely powerful when we manage it. We all love the illusion of having control of situations and people; it brings us a sense of calm, or something. But honestly, this time of year is all about requiring some flexible adaptability. Herding cats never goes like we expect, and trying to muscle everyone’s obligations onto a singular rigid schedule that can then be skewed by weather, who-forgot-to-pack-that-Very-Important-Thing, sudden illness, unexpected upheavals in family politics, and any number of other factors over which we have ZERO control… this is the recipe for disaster we hand down between generations almost as faithfully as we’ve passed on great-grandmother Janette’s fruitcake recipe. If there is one gift I could give all my readers this holiday season, it’s this reminder: SHIT HAPPENS. You can wallow in your outcome attachment and get angry/disappointed/hurt/frustrated/upset, or you can roll with it and just “be there when you get there”. (I write that with a certain amount of personal irony as I am also trying to shore up scheduling with my mother that has my travel time contingent upon how long we need to roast a ham for Christmas Dinner, especially as I’m the one bringing said ham from KW to a city two hours away in GOOD driving conditions…)
4. Remember that “This too shall pass”. The work seems overloading and perpetual when you’re in it, and it never seems like family helps or supports you as much as you might want or hope it will; doubly so if your family life/relationship(s) is in any way already unsettled or contentious. But the holidays are a time-boxed event. January brings its own strains, but worry about those in January. Your job is to just survive December, and know that the holiday efforts will end, as they do every year, eventually.
Honestly, I look at a list like that and think to myself, “How hard can this be?”, and then I find myself, or at least a little part of the back of my brain, making high-pitched, hysterical giggling noises. And this is a GOOD year: other than Christmas Day at my mum’s since we’re the last of my family, I’m working through the bulk of the holidays. Excepting a small tea date this coming weekend and going out for NYE, I’m not hosting anything, I’m not doing any other travelling, I’m just looking after myself and my geriatric cat. And yet even then I can’t escape a degree of the holiday craziness. I still scrambled a weekend earlier this month to put up my tree and decorations at home; I still have to contend with cranky seasonal crowds almost everywhere I go. I’m definitely at the simple end of the seasonal spectrum, but I still vividly remember the days of travelling to my ex-husband’s family in Ottawa for multiple days, then having to squeeze my late dad in Orillia and my mum in Owen Sound somewhere else around the schedule, plus respective office Christmas events, our hosting massive NYE events, and probably one or the other of us working in between, trying to fit in the gift shopping and groceries and… and… and…
I know what it’s like to lose one’s Self amid the requirements of the Family Obligation World Tours. We lose the quiet moments in our own spaces, we lose the opportunity to just roll the schedule as we see fit, when everyone else’s timetables suddenly seem (or have) to take precedence. We lose sleep. We lose patience. We lose tempers. We lose perspective and equilibrium. I get it, I do. I don’t miss it, but I’m in a weirdly luxurious position of having as much time and space as I want for *my singular self*, and I recognize that. So much empathy for those who don’t have that same luxury. Time and time again, year after year, I find these are the four points that resonate most when talking with people trying to find a sane path through the messier parts of the season. We feel so much pressure to “be of good cheer” and wish “joy to the world” and all of that romantic holiday fiddle-faddle, but we can’t always get there from here when we’re viewing the season through the filters of our own personal stress and anxiety. We can’t even get to the relationship-management skills necessary to get through the season effectively when we’ve lost our personal footings, so I’m not even talking about those today.
Make some space, take some time, practice flexibility, and believe this will all be over in time.
However you celebrate the holidays, I hope you find a degree of peace in the process, moments where you remind yourself WHY you do what you do for these celebrations. Find love and joy where you can, rest when you need to, and please accept warm seasons greetings from my house to yours.
[Please note: the blog is on hiatus next week, as we prove that therapists can, and sometimes do, follow our own suggestions.]
It’s Tuesday morning and I’m sitting in the coffee shop with my colleague, and largely induced by last night’s dose of Nyquil, I’m in a mental fugue state that just Does Not Want To Write. It’s not quite “stomping my little feetsies and howling” levels of resistance, but it’s a big chunk of mental Don’Wannas that just won’t respond to coffee or placatory scones. I’m trying to force myself to go through archived posts to see if there’s anything I can repost for more meaningful content, trying to force myself to write on a difficult topic currently whirling around my hindbrain, I’m trying to force the groove that just resists me at every turn…
Then I go get another coffee from my favourite barrista, Ben, and realize I’m missing a beautiful opportunity right here and now to observe myself in the moment. The heart of mindfulness is the ability to witness ourselves in the moment of whatever experience we’re having, without judgment. We approach our own experiences with a curious mind; it’s an exploratory mindset rather than a harshly manipulative one. In the moment it becomes less about enforcing my own will over my own obvious reluctance, but it’s a chance to observe that reluctance and give space and voice to whatever’s going on right here, right now.
When I set the noise of my own performative expectations aside (Must! Write! Blogpost! Must! Continue! Generating! Original! Value-add! Content! Musn’t! Disappoint! Readership! Must! Drive! Traffic! To! Website! Create! Revenue! PanicpanicpanicEGO!), there’s a whole lot of silence in the ensuing space. It’s silent, because today I am exhausted. Some of that is grogginess from the cough syrup taken before bed last night, but most of it is the drained aftermath of an emotionally tumultuous week on social and inter-relational fronts. It’s a resistance based in wanting to bask in the flexibility of my schedule by NOT doing work today, and resenting the fact that the only reason I got out of bed this morning was a barely-disciplined drive to keep up a habit. (Don’t get me wrong, this weekly workdate is a godsend as far as habits go, for someone like me with a very wibbly-wobbly-timey-wimey relationship to “work ethic”, but it really does happen largely by dint of willpower, rather than an actual love of getting out of bed early on my plausible day off to go write.)
The trick with mindfulness and self-observation at that point, is what happens next. Having observed these feelings running rampant through the room, now what? More importantly, if I’m actually under pressure or deadline to get things done, what can I do with these feelings to accomplish something?
This is a decision point, if we’re aware in the moment to recognize such. Today, I have the luxury of being under no deadline but my own, so I can afford to slack the performance-writing pressure off, and come home to finish the post in my own time. We don’t always have the luxury of time, however, or at least we perceive that we don’t (which is, in part, how the “cult of busyness” has become the implacable force it has for many of us), so we can’t cut much slack into the timetable to sit with our own discomforts. Then what?
I liken this part of the process to the film technique of split-screening, with two or more windows on screen showing different people in different places, talking to each other or others. In a mindfulness exercise of self-observation, we make a space to hold that self-observation in real-time while ALSO doing whatever needs doing outside the realm of our internal experience. I refer to my “observing self” as having a little Zen Master who sits a little above and behind my shoulder, observing the Self in action while the rest of my brain goes about the external business (or busyness) of the moment. We hold space for the in situ observations with a non-judgmental curiosity, and worry about assessing later. This doesn’t always negate the stress or performance pressure in the moment, but it makes space to allow it to happen and flow through us without necessarily being blocked or bottlenecked as we fight it or try to compartmentalize it into some other corner of our mind.
For the record, I’m not always great at this practice myself, even after almost fifteen years of practicing (with wildly-variable degrees of success) self-observation in my daily life. My biggest pitfall is common: I get trapped in judgmental assessments and harsh critiques of my own internal experiences, rather than simply being curious about what’s happening. Instead of simply observing my resistance this morning, I became frustrated by what I was noting. In being curious about what I was feeling, I critiqued the choices and actions that presumably led to my current state and then passed judgement on myself for being an idiot last night and taking Nyquil later than I should have, knowing I had an early alarm set, blah blah yadda yadda blah.
By learning how to let go of that critical analysis that for many of us leads to inevitable internal name-calling and denigration, we cut ourselves some slack. We let the pressure off. We allow ourselves to recognize that we are thinking, rather than simply feeling, to tell ourselves, “stop”. In most meditation practices, the sitter will invariably get distracted and pulled into thought processes. We can either get wrapped up in those thoughts, or we can recognize “thinking” and permit the process to just drift away. Normally we call attention back to the breath, or something specifically centred in the moment, to help turn mental power away from distracting or disruptive thoughts, and we can do the same thing when trying to simply observe what’s happening in the moment. It’s a simple refocusing choice: “What’s happening right now?” We discipline ourselves to observe only the observable, and to let go of anything that feels like a thought.
When we don’t have the luxury of taking all day to do what we meant to do in a two hour window in the morning, the split-screen approach enables the observations to happen in one window while the forward momentum happens in the other. “What is the next step in what I am doing?” becomes a way of restructuring the need to push forward when half our conscious cognitive power is suddenly rerouted to self-observation. We shift focus to the smallest progressive component in our current task: do the next small thing; when that’s finished, do the next small thing after that. When that’s complete, do the next small thing after *that*, and so on until the self-observation of whatever is happening on the other side of the screen has run its course as best it can.
When we are mindful and self-observant about our own internal experiences, we stand a better chance of making more effective decisions about ourselves and our needs in the moment. It requires being fully present, in the sense of being open to, the feelings themselves; as soon as we start to layer rationalizations, justifications, judgments, or narratives over top of those feelings — in other words, as soon as we start to tell ourselves stories about why we feel what we feel, or where those feelings must/probably come from — then we are trapped in a cognitive process that is more about manipulating our own feelings than it is about simply allowing them to be. That in turn often introduces a great deal of tension or anxiety into the mind, and can in turn create significant dissonance and distress between what we feel and what we do in REACTION to those feelings (or rather, what we’re telling ourselves about those feelings). For example, I spent a relatively lengthy part of this morning beating myself up for failing to function this morning, and for failing to adhere to my own best-practices around managing drowsy-making medications int he evenings. Letting go of my own expectations, all rooted in my ego, around my vaunted prowess for pulling lengthy blog posts outta my arse in two hours or less, meant letting go of that harshly-critical voice in my head and just allowing myself to observe what lay beneath. And when I was able (and willing) to recognize the exhaustion that is more pervasive than a simple late-night dose of cough syrup could explain, it was much easier to release the expectations of ego and say, “Well, okay then… what’s the next small step that I *can* do?”
And so, it’s mid-afternoon on Tuesday and my small steps have included things like, “letting the pressure off myself,” “shut up and enjoy my coffee,” “chat with cafe friends,” “enjoy the mild sunshine on the drive home,” “write some more,” “snuggle my aging cat,” “write some more,” “do some small tidying efforts,” “finish the post,” “publish the post,” then whatever else comes next in line. If I had pushed to write something as I had initially felt compelled to do, I would have been unhappy with the end product and disconnected from myself for the rest of the day because of how I would have failed to just listen to myself. (I also would have cheated myself out of both a great experiential learning opportunity* AND blog content, but that’s neither here nor there 🙂
So, when you’re feeling stressed, anxious, resistant, anything really — cut yourself some slack. Even if it’s only just enough to take a moment and turn the observant eye inward, get curious about your own internal state. Dismiss the negative narratives that may come along for the ride, and just give some space to what you note in your own experience of that moment. If you need to continue being productive because you don’t feel you have the luxury of time, then leave part of the mind on observation mode and let another part of the mind break down the required forward momentum into next-small-step-sized parcels. Let the feelings be just feelings; they may not require action, so just let them run their course. They’ll subside in scope and intensity much fast than if you engage and fight or throttle them. And you’ll hopefully feel considerably more grounded once they do.
(* — Or, as we like to call them in some circles, “Another F***ing Personal Growth Opportunity”.)
[This week’s post is by request. Yes, we take requests! Honestly, anything that gives me some direction more than fifteen seconds before I sit down at the keyboards with the first coffee of the creative day is welcome. Assuming it’s something I actually know something about, of course.]
When I talk about making starting the career change from Hired Pen in IT to Personal Improvement Sherpa, I often use the term, “I hit the wall” as part of the formal narrative explaining what happened. For me, there was probably a large chunk of undiagnosed and probably-not-even-recognized depression already in play, but the biggest factor behind the need to change course lay in a persistent and burgeoning case of burnout. The friend who requested some exploration of this topic is also grappling with something that feels like burnout but with the more pervasive sense that most would more likely associate with depression, in a “absolutely anti-motivated to do anything that is not absolutely mandatory” kind of way; they describe themselves as feeling neither sadness nor despair, nor are they unable to get out of bed. But they do feel “frozen”. There is still a sense of connection to joy and lightness in other aspects of life, but there is no energy to connect with the actions most commonly associated with creating joy and mirth.
Working with as many clients, and still having an exceptionally large number of friends working in IT, I can verify that there is a LOT of comorbidity between the symptoms of depression, burnout, and fatigue. It’s one of the major reasons why, when clients come in with a self-diagnosis of depression, I want to explore more of a general context for what’s happening in their lives to see if there are any systemic factors that might suggest more clearly the predominance of any one of these states.
“Depression is one of the most common mental illnesses, and it can be mild, moderate or serious. There are several different types of depression that can be recognised by different signs. Which symptoms of depression occur and how strong and frequent they are vary from person to person. People in any social or age group can be affected, both women and men. If someone has had at least two of the following symptoms for longer than two weeks, it might mean that they are depressed: deep sadness; listlessness; loss of interest in the things they usually care about.” – US National Library of Medicine
“Exhaustion is a normal reaction to stress, and not a sign of disease. So does burnout describe a set of symptoms that is more than a “normal” reaction to stress? And how is it different from other mental health problems?
Experts have not yet agreed on how to define burnout. And strictly speaking, there is no such diagnosis as ?burnout.? This is unlike having ?depression? diagnosed, for example, which is a widely accepted and well-studied condition. That is not the case with burnout. Some experts think that other conditions are behind being ?burned out? ? such as depression or an anxiety disorder. Physical illnesses may also cause burnout-like symptoms. Being diagnosed with ?burnout? too soon might then mean that the real problems aren’t identified and treated appropriately.” — US National Library of Medicine
Fatigue as a general symptom runs through a lot of these kinds of conditions, running the gamut from “I’m a little tired today but I can push through it” to “it’s a Blanket Forts Against the World kind of day”. Fatigue’s commonality is also one of the factors that makes it more difficult to differentiate between situational burnout and deeper depression, because fatigue is a profound thief. So when we’re talking in session about what’s going on, we explore the presence and perceived impacts of fatigue: how long has it been going on, how often does it impact functionality, what else is occurring in the subject’s life that contributes to exorbitant and draining stress? What aspects of their lives DON’T currently feel like a drain on their personal energy resources? What restores them?
From there we look for burnout symptoms: what are the high-demand attention drains currently (or recently) impacting the subject’s life and energy levels? Where is the balance with self-care and/or external support? How much of their day is being dedicated to these high-demand pursuits, and over what length of time? What other aspects of their lives still provoke joy, delight, mirth, wonder, passion, even if at lowered levels than constitute their normal baselines? The likelihood of burnout being the dominant effect rather than depression is often tied to these discernible draining factors over an undefined-but-probably-extensive-or-ongoing period of time. Without such key indicators as work stress, family stress, personal health stress, etc., we consider the scales tipping more in favour of depression. We also look at bigger systemic factors including family histories around mental health issues/Family of Origin relational modeling/parental alcohol or drug abuse, etc. when looking for indicators of depression.
And finally, we ask the question, “As difficult as it might be to imagine right now, if we took away the fatigue, what kinds of feelings would be left?” Self-reporting clients have, at least in my experience, been clear to indicate whether they expect themselves to “bounce back” and be right as rain again, or whether the nihilistic disengagement from the world would still be a part of the picture. (Self-reporting measures are generally problematic at best, but lacking a verifiable clinical diagnosis for depression, as counsellors and psychotherapists, we operate largely at the mercy of what our clients tell us.) The clients’ own hopefulness about their potential future state provides at least some degree of useful information, and can often gives us a platform (however small) on which to start building that sense of hope into some sustainable, hopefully realistic faith in change and progress. Clients stuck in depression often cannot connect with hope; hopelessness is one of the most common lies depression tells us. But burnout, while it may not allow for significant enthusiasm about the future, doesn’t completeley dismiss it so much as waves a hand at anything hopeful and begs, “Come back later, please”.
Typically, burnout is the result of specific and identifiable stressors like occupational burnout, persistent relationships stresses, or ongoing/long-term care practices for ailing or high-demand family members, for example. When facing burnout we look at rebalancing self-care practices in the short term, sometimes involving very deep conversations about the willing (often repetitive) sacrifice of self-care in pursuit of project deadlines or the drive to care-take others. We discuss the values keeping clients potentially stuck in these kinds of patterns, a conversation that comes up a LOT with driven professionals. Often we have to normalize the fact that corporate mindsets and project management pay a degree of lip service to the nebulous “work/life balance”, then expect the superhuman in terms of commitment to near-impossible project deliverable dates. And in the case of those who persist in “taking on too much” and deliberately, repeatedly pushing themselves into burnout states, we have some conversations around what’s their return on investment that makes doing this to themselves over and over, worth the costs of the pattern?
With depression, the work is more complicated, and may often necessitate conversations about clinical diagnostics (that psychotherapists are, unfortunately, not trained to do) and/or medications to help level out the worst of the symptoms. Because the depression may not be cognitive, it’s harder to shape a therapeutic conversation around motivations, and we may have to work more fundamentally with the bodily experience of depression, up to and including normalizing it as a chronic persistent or recurrent medical condition like diabetes, arthritis, MS, and others. We change how we consciously relate to the presence and impact of the illness when we can’t shift the illness itself in significant ways.
We can do the same with burnout, but burnout needn’t be a persistent issue for people so it’s sometimes less effective to treat it as a persisting condition (though it can be argued that project cycles increase the likelihood of it being recurrent). When burnout becomes a cyclical factor in someone’s life especially, we could really use some increased self-observation to watch for markers of this state sliding into depression. A pervasive sense of inescapability can shift a mindset from the hopeful, “light at the end of the tunnel” coping mechanism to a fatalistic sense that “it will never be any different or any better than this, so why bother?” Losing hope is fundamentally damaging to our mental health:
?Life is never made unbearable by circumstances, but only by lack of meaning and purpose.? ? Viktor E. Frankl
Burnout can leave us with purpose but no energy to engage without a period of recovery and restoration; depression leaves us feeling devoid of meaning or purpose. And fatigue is the river that runs through both states. How we treat any of this depends on our abilities to differentiate between these conditions, and how willingly our subjects can still feel any connection, however tenuous, to hope.
Having been on the run for the better part of a month I can firmly state both that there’s no place like home, and that the concept of respite as self-care is a crucial-if-vastly-under-advertised aspect of our culture. Like many people, I read the articles that suggest a bubble bath and a glass of wine, or a mani/pedi, or a massage, as self-care, and while I don’t dismiss how wonderful these experiences might be, I think they may obscure the fact that what they all point to as the underlying value, is *respite*.
At its simplest, respite means an opportunity to step outside the normal pacing our of lives, to stop and rest for a while. For many people, allowing themselves time to themselves is the LAST thing that fits onto a schedule most likely formed around work obligations, family demands, health issues… responsibilities that always seem to demand putting others ahead of ourselves, sometimes to the detriment of our own peace and well-being. When I work with clients who seem to be running themselves ragged, my first question is always, “Where do you value respite for yourself in your self-care?” (and we often have to talk about what respite looks like for each of them), followed by, “Why is everyone else’s care so much more important to you than your own?”
Culturally, many of us are conditioned to put others ahead of ourselves, and it costs us dearly when that becomes a default stance. I see this in myself more often than I like, because I insisted on doing a two-career dance for so long that I left almost no time for myself, or my self-care. Even now that my own life is calming down considerably, I find giving myself explicit permission to step outside the pace of my obligations is HARD, so I understand it on a personal level when my clients tell me how much of a struggle it is to take time out. Or what a struggle it is to do nothing with that time once they do take it.
Respite is an opportunity to stop, or at least slow down, and listen to ourselves. It’s a chance to listen to what our bodies are telling us they need, or an opportunity to listen through the usual daily cacophony in our minds to hear what’s going on a few layers down that demands attention and care. (This is the emotional signal people often try to avoid looking at until some nasty therapist makes them actually LOOK under the hood at this stuff. Damned therapists.) Sometimes we don’t WANT to take the time to slow down precisely BECAUSE we’re worried about what might happen if we do: what things will fall apart in the obligations/responsibilities spheres when we’re not there to attend everyone else, or what we’re going to hear or discover in ourselves when we allow things to be silent long enough to listen to ourselves.
And so it is that a great many people prefer to maintain breakneck momentum rather than explicitly allow themselves time to rest. “Burning the candle at both ends” becomes a seemingly-valid lifestyle choice when we’re afraid of the consequences, including the cost of lost momentum and having to grind gears to get back up to speed. This is my first blog post in three weeks; I know how hard it is to get back into the stream after you’ve been outside of the pacing for a while. We normalize the pacing we believe we’re supposed to keep, and changing pace is perceived as making things MORE difficult rather than less so. It’s a near-universal level of complaint that the first several days back to work after a holiday or vacation are the worst. We lose momentum and fear the increased efforts involved in returning to our usual pace. But the return can be managed as well as the respite itself; while it’s true that not everyone has the luxury of padding out time away from their obligations with an extra day to get themselves turned back around, sometimes we can find tools and techniques to prepare for the return and integration a little more effectively. (Some of us are just NEVER going to be okay with Monday mornings and the first day[s] after vacations, but that doesn’t mean we can’t find a little room for improvement in our approaches, right…???)
Maintaining momentum is a “path of least resistance” kind of approach to busy lives, but it’s also the most costly in the long run when we consider the amount of energy we burn on physical, mental, emotional levels to sustain that pacing. One of the largest fields of rocket science involves the study fuel economics: how much fuel does a rocket have to carry to power liftoff, sustained navigational ability over unthinkably vast distances, with enough left over for docking and/or re-entry attempts? The more fuel we have to carry, the more energy we have to burn in moving that fuel, so at some point it becomes a critical kind of catch-22. We have to carry a lot of fuel just to move a lot of fuel… never mind the mass of the rest of the rocket or its cargo or crew. So the trick is, thrusters are often simply turned off and the rocket allowed to coast at speed with minimal thrust applied to keep course and speed. This is a good analogy for how we manage respite and momentum in our own lives as well. Sometimes we HAVE to turn the thrusters off and allow the engines a respite, a chance to cool, and give ourselves an opportunity to stop consuming the finite reserves of energy we carry. Which is not to say that respite is rocket science, just to be clear…
Sometimes the break in pacing is the best tool we have for getting a better handle on all the things we feel we need to do on a day-to-day basis. Sometimes the break is a thing we fear or resist out of obligation or anxiety regarding implications of future workloads. But when we don’t make time to stop and listen to ourselves now and then, we eventually atrophy the skill and the muscles will burn out from under us. Gabor Mate’s book, When the Body Says No is a great read about how physical and mental systems break down when we don’t provide respite care to ourselves.
So having said that, I hereby give everyone who needs it permission to find themselves a respite plan that fits what they need, challenges what they fear about self-care, and lets them put themselves outside the madcap pacing of their own lives somehow, now and then. Not all of us can afford luxury vacations, but that doesn’t mean there aren’t ways and places to solve that need within the resources we can access. On that note, I’m giving myself permission to go have a nap; a month running at full throttle is exhausting, and my body says I’m still catching up on *sleep*!
