self-perception

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, Family Issues, Language, self-perception, Uncategorized

One nebulous advantage of being a Marriage & Family Therapist, trained in family systems theory, is that we have ample opportunity to explore our own origin stories, as well as those of our clients. We gain new perspectives or information that reframes our understanding about where we come from, and how that changes our perception of who and how we are in the world.

In psychotherapy, there are generally some firm boundaries around “safe and effective use of Self” for therapists that are all about understanding and/or mitigating how WHO we are impacts HOW we are in our work with our clients. Understanding the formative and often invisible impacts of our families of origin can be a part of that work, as our early models often influence our values and inter-relational patterns in all kinds of relationships. We don’t use it necessarily as an excuse to talk about ourselves in client sessions, though careful and limited use of personally-relatable anecdotes can be a useful tool for illustrating to clients just how much we do (or don’t) *get them*.

Then again, I’m also a writer by trade long before I was a therapist, and a principle tenet of writing is to “write what you know”. Since people are often curious about how therapists wind up becoming therapists, I thought I’d for once break the silence around personal stories, and share my own origin story. In doing so, it also helps me recognize that a lot of this has the ring of well-honed narrative, meaning that every time I tell some of these stories, I’m (subtly, perhaps) reinforcing those storylines and their underlying values in my head. I’m also giving myself an opportunity, however, to reflect on those storylines a little more and see whether there’s anything to be altered in the current moment, applying years’ worth of reflection to temper something I’ve been telling myself, in many cases, literally all my adult life. As an exercise, I’m going to bold the parts of it that are the internalized scripts, the narrative lines that I’ve carried and polished the longest.

WHO AM I, a story by Karen, age 50 and 3/4

To start with, my family structure itself was odd. My parents met in Toronto in 1965 when my recently-divorced mother and her four-year-old daughter were trying to make a new life for themselves. The mid-60s weren’t exactly hospitable years for divorcees and single mothers, and my mom has admitted that what she was looking for was financial support more than romance. My mother’s first daughter was a handful, however, and sometime just before my parents met, my mom made her daughter a ward of the Crown; in short, voluntarily relinquished her into the fostercare system. Mom had also had a second child out of wedlock after the marriage ended; he was given up for adoption at birth.

My father was working as an industrial architect with a side passion for big-band jazz. I’ve got ancient newsclippings of my dad on an upright base playing with a then-unknown black kid by the name of Oscar Peterson on the piano. My dad was 17 years older than my mom. They connected through unknown-to-me circumstance. Two years later, they had me; I was planned. I grew up knowing about my half-sister, as she came and went from my life on whirlwind visits. I don’t remember how old I was when I discovered the birth documents for my half-brother, probably around 8 or so, but thereafter I know I internalized the idea that “I was the one she/they kept”. I also internalized the idea that if they gave away two other babies, obviously they could give ME away any time they wanted, too.

As a young adult, I took to describing my homelife as a “Cold War zone”. My relationship with each of my parents was okay and as “normal” as one might expect for the 70s and 80s–their relationship with each other was a different story. Of note: my parents were never married; they both commented over the years that having each been burned by previous marital heartaches, there seemed no good reason to go through the motions a second time. The scripted line was, “They lived together for 19 years, and hated each other for 17 of them,” which, while lacking in the accuracy of the minutiae, certainly encompasses the overarching tension of my homelife. My parents never slept in the same bed, and round about the time we moved into a small town when I was 7.5, they didn’t even sleep in the same room on the same floor of the house. Mom always maintained it was because of Dad’s snoring (which was prodigious), but I never believed that was all, or even the bulk of her reasoning.

It’s worth noting: I never knew my dad’s family. His parents were long dead before I was born, as was one of his sisters (Scarlet Fever in her case); what family he had through his remaining sister was scattered on the East Coast. I have a vague memory of meeting a couple of his cousins or nephew/niece when I was very young, but I remember their dog better than I remember them. I also met the daughter of his first wife once in my early teens when she came west to visit, but that once was all the exposure I had until I tracked her down through FB last year to inform her of Dad’s passing. My mother’s family is its own tale of dire dysfunction, including her alcoholic mother with undiagnosed suicidal depression (though some of my mother’s tales ring the bells of Borderline Personality Disorder); my mother tells of the day my grandmother tried to kill herself by driving the family car off the road… with my mother and her younger brother loose in the back seat. My grandfather was unwilling to confront or deal with his wife’s obvious mental health issues, so he didn’t intervene even when she beat her daughter or emotionally terrorized either child. MY mother finally fled as a teenager, as soon as she was old enough to work to support herself. She married young; her first husband was an abusive alcoholic. She was 20 when her first daughter was born.

Both of my parents were high-functioning alcoholics. My mother also suffered from undiagnosed depression. Neither of my parents finished high school. Dad enlisted in the army at 18, which got him to Europe for the last rounds of WWII. His work ethic meant both a workaholic, emotionally-unavailable father-figure, and that my university education was paid for long before I graduated high school, about which I was constantly reminded, and an investment I promptly lost by failing out of my first year of university. I was the first generation of the family to attend university; between my mother’s and her brother’s kids (her 2 daughters, his 2 sons), only two of us completed undergrad. I’m the only one with a post-grad degree. None of us has had a stable, successful marriage (including our parents). Only one of the four of us ever had kids. The eldest in both sets of siblings has significant mental health issues including drug or alcohol issues and numerous run-ins during “troubled youth” with law enforcement. That left myself and my younger cousin to be the “good kids” in a widespread system of familial dysfunction. My running joke for a long time was that David (said cousin) and I were the white sheep of the family, notable for our rarity.

So… that’s the bare-bone systemic model in which I grew up. Even glossing over so many details about the intergenerational and inherited trauma normal to family systems, that’s a lot of self-defining scripting I’m carrying forward into my adult life, the echos of which still occasionally rattle the windows and shake the walls of my current life.

When we dig into the narratives I’ve bolded, there’s an incredible amount of tension touching on several aspects of my core family dynamics:

  • The incredible pressure of growing up as “the one they kept”, believing that if they could give the other children away, I had to be EXTRA GOOD to make sure that didn’t happen to me.
  • The weight of expectation tied to my going to university, even if I proved terribly unready for the responsibility of “being launched”.
  • Being the Adult Child of Alcoholics (OMG, I don’t even know where to start with what I’ve learned about this one, but here’s a good suggestion).
  • The dynamic of seemingly overbonded mother and underbonded father (and let me tell you, THAT dynamic has been a major undermining factor of EVERY heterosexual relationship I have ever had, including both my marriages).
  • Undiagnosed mental health issues galore, up to and including my own until-recently-admitted depression and anxiety.
  • The “Cold War” aspect of my parents’ relationship as the foundational model I took away for “how intimate partnerships should look” (and my own deeply-disconnecting behaviours when stressed in relationship).

It’s not uncommon that “relationship issues” such as faltering intimacy or communications challenges in relationship are what drive an individual or partners into a therapist’s office. One of the reasons the family of origin snapshot is such an integral part of my own intake process is that it shapes for me a picture of the significant early and formative influences on the participants in the current conversation.

Having spent so much time navel-gazing my own origin story, and listening over the years to how I tell my origin story, I’ve learned something about how to listen for those polished-sounding phrases, lines and phrases that crop up time and time again in conversation. I can’t always put my finger on what it is about a particular choice of wording in a client’s story that sets my Spidey-senses tingling, but my accuracy is (in my not-so-humble opinion) better than just average in catching the tones. There’s just something about a precise choice of words; or something about how they all run together like a phrase we haven’t actually had to think about constructing for a long time, dropped in the midst of an otherwise thoughtful conversation.

(I’m not ruling out the idea that I’m just projecting onto my own clients, at least some of the time; on a good day, I’m self-aware enough to be aware that’s a potential inadvertent-thing-wot-therapists do, yo.)

We all have these stories, these pieces of personal narrative we just carry with us as shorthand descriptions of things that actually carry an incredible significance to those willing to get past the polish and gleam of scripting. I joke sometimes that my job as a therapist is to be a “professional disruptive influence”, and more often than not, what I’m looking to disrupt is the attachments we invest in those safe scripts. Scripts around our origin stories, like any other experience, in many ways function as cages that contain complex emotional experiences. Language is a tool we use to define and shape experience into something we can wrap our heads around. Dispassionate versus passionate language and delivery, for example, is discernible through listening to word choice as well as tone. Applying language to an experience is, in and of itself, a very cognitive process, and in pushing emotional experience through cognitive filters, we already begin to separate ourselves from the immediacy of the lived and felt experience. Our word choice actually informs our brain how we want to qualify and quantify that experience; we can use language to embrace or distance our selves from the feelings. Our origin stories are the stories we have been practicing and polishing the longest of all our scripts. Sometimes we need to just scrape off the years of accumulated polish to see the actual grain and bones of the experience underneath, to understand what happened in different lights and perspectives, and maybe learn something new about ourselves in the process.

Communication, Relationships, self-perception

There’s an old warhorse of a trope that I first encountered in the poly communities that, thanks to various (sub)cultural overlaps, rears its head in certain monogamous circles these days as well. You may have heard it; it goes something like this: “All your relationship problems will be solved if you just COMMUNICATE, COMMUNICATE, COMMUNICATE!”

Yeah… no, not really.

I mean, as a relationship therapist it’s kind of my job to work with people who come in and say, “I/we want to improve our communications within our relationship,” and it’s work that’s both rewarding and fulfilling, generally (on both sides of the therapy process, even). So it’s not that improving communication DOESN’T solve problems, because improving the articulation and reception process CAN change things significantly.

The epiphany I had a while ago, as I was trying to articulate any one of the many reasons I have come to hate this particular trope (other than its oversimplification of how *easy* it implies communication SHOULD be), is this:

We can only ever be as good at communication in general, as our ability to recognize and understand what it is we’re trying to communicate.

Let me illustrate this with an example from my own life, because this epiphany pretty much encapsulates a big part of the communications failure on my part of my marriage’s collapse.

We can only communicate what we know. If we can communicate that much effectively, that’s great; that can be a LOT of useful information to give and receive and integrate into personal and relational understandings. But when things continue to bamboozle us or upset status quo AND WE DON’T KNOW WHY, then there’s a limit to how much information we can communicate about what’s going on. In my case, I knew I was thrashing emotionally, but I couldn’t say why. I could talk about a lot of things–for all the relationship’s natural flaws, one thing we did well was “talk about our feeeeeeeelings”. But the things I couldn’t talk about were the things even I couldn’t see and therefore didn’t understand… and they were the things I was, unfortunately, highly reactive to in the final stages of the collapse. I didn’t know then what I know now, for example, about attachment theory (especially in the area of early attachment injury) or common issues around being an adult child of alcoholics, let alone the intersectionality between those two topics. I didn’t know then what I know now about self-regulation of anxiety through meditation practices as simple as mindful breathing and body scans. I didn’t know then what I know now about entering into communication attempts with statements of intent for the conversation (or at least, I/we weren’t practicing that consistently).

The point is, there is always so much more TO know that we simply can’t communicate, because we can’t see it (yet). It’s not uncommon to get one or more members of a relationship in the counselling room and have someone own the fact that one or the other is not prone to a lot of self-observation or self-reflection. And therein lies a massive part of the problem. If you’re not looking inward, then what, exactly, do you know about yourself *TO* communicate to a partner? And this doesn’t even begin to cover what happens when someone who is self-observant and self-reflective but far too wrapped up in anxiety to share those thoughts and observations effectively with a partner. Another issue that contributed to capsizing my marriage was an issue from my partner who struggled to disclose information at times.

So:

  1. Just because stuff is happening in our internal landscape, doesn’t mean we’re observing it.
  2. Even if we’re observing it, it doesn’t mean we’re reflecting on it as a way of trying to better understand ourselves and what’s happening inside us.
  3. And even if we’re reflecting on it, we might not feel safe or secure in disclosing those observations and reflections.
  4. And even if we do feel safe and secure in making those vulnerable disclosures, it doesn’t always mean we have the SKILLS to effectively engage in conversation about them.

When clients come into therapy, they’re usually assuming we start with that final point: working on the communications SKILLS to articulate something important about their experiences to a partner. But when the communications skills don’t always fix the problems as presented on intake, the same clients often come back frustrated with the process, with each other, with the therapist. And that’s when we have to start working backwards through the rest of the list to discern whether the things we’re talking about are actually the things needing to be discussed.

Sometimes therapists can observe places where words and nonverbal information seem incongruous, but honestly, the onus needs to be on the clients themselves to up their game when it comes to internal work. And this can be a difficult challenge for a variety of reasons, starting as simply as, “I don’t know how”. Since we can only communicate what we know, this gives us two avenues to start: What do I know about myself because of what I can *observe* about myself, and what do I know about myself because of what I interpret or believe or tell myself? Neither avenue ever presents a full story, because people are generally more complicated than that, especially in times of distress or crisis. However, we can approach both observable behaviours, and the interpretable aspects (motivations, beliefs, scripts, etc.) with an open-minded, non-judgmental curiosity: where does that behaviour or thought come from? What do we feel like it motivates us to do? What feelings or additional thoughts do we observe being associated with, or triggered by, the catalyst? Do we recognize it as being a component of larger patterns? Can we separate out the catalyst thought or action from what we feel are default reactions, to see other potential available options?

An analogy borrowed from the realm of astronomy comes in handy here: there’s a lot of stuff out in the depths of space that we can’t actually *see*. So from an “observable phenomenon” perspective, we can’t actually look at a thing and know it for what it is. But what we CAN observe, is the impact the invisible thing has on objects we CAN see; for example, something exerting a significant gravitic force on bodies in a solar system will cause the orbiting bodies of that system to shift in their transit paths. We may not be able to see what’s causing the shift, but we’ll certainly notice when one or more celestial bodies make relatively sudden, incongruous shifts in their expected movements. In cognitive psychology terms: we may not be able to see what’s causing a reactive behaviour, but the fact that we can see and experience the behaviour will strongly suggest there is something invisible provoking it.

This is where, when luxury of time permits, we can delve deeper into the emotional experience of the moment: does it feel like anything else we remember experiencing? How do we feel now about those earlier experiences, and are we seeing any similarities in our current situation, both in terms of the perceived triggers, and in the perceived reactions? What can we share about those observations? There’s potentially a lot of cognitive and emotional processing that comes as part of the package when learning to develop the self-observation and self-reflection skills; observation means learning to see what’s happening in and to us, and reflection means finding ways to think about/assess/analyze the experience and sort it into something meaningful to us. And we have to do all of that work, ideally, BEFORE we even get to the point of trying to articulate that information to someone living OUTSIDE our own heads.

So far, we’re still just looking at figuring out how to handle the self observation/self-reflection part. We haven’t even begun to tackle the aspect of learning HOW we communicate: how do we know *TO* communicate? How do we decide WHAT to say, how much do we selectively self-edit (and at what cost)? How well do any of us articulate our thoughts and feelings at best of times, never mind at the worst? Do we make effort to effectively shape the INTENT of any communication process we engage?

This sounds like a tremendous amount of work, doesn’t it?

It certainly can be. After the marriage ended, I spent six months intensely, and other year a little less intensely, digging as deeply as I could get on my own and with my own therapist, into what we uncovered about where some of the invisible baggage I was dragging around came from. That was a hugely painful time of confronting a lot of moments of, “How the hell did I not know this about myself??” or “Why the hell couldn’t I have figured this part out BEFORE everything went sideways??” And I watch my clients struggle, time and again, with the same frustrations. The discovered information is never wasted, but it doesn’t always come to light in time to reverse course, either; and when partners, even armed with new perspectives and understanding about themselves, can’t summon enough energy or belief in things being different to mount a new development plan for the relationship, it can be hard to avoid wondering, why bother?

It’s this complexity that fuels my growing dislike of the “communicate, communicate, communicate” adage. It strikes me as a dangerously reductionist approach to something that is anything but simple for many people, creating an almost caricature-like presentation that leaves some people feeling like failures because “we talk and talk and talk, but nothing gets any better”. Communication as an intimate process has to be effective in and of itself, absolutely; but beyond that, we have to do the work to effectively understand WHAT needs to be communicated. So the next time the phrase crops up (especially if you move in circles where it’s bound to crop up eventually, possibly repeatedly), consider this as a response:

Communicate! = Do we know WHAT to communicate?
Communicate! = Do we know HOW to communicate?
Communicate! = Do we know WHY we communicate? (the *INTENT* or expected outcome)

It’s not just about the talking. It’s as much about saying the useful and needful things, and it’s about how we shape those communications, as it is about simply making the effort to talk in the first place.

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

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”.)

Emotional Intelligence, self-perception, Uncategorized

There’s an interesting trend across a number of conversations I’ve been having lately, predominantly (though not exclusively) with women, or with male clients generally under the age of 30. When they come in to see someone like me because of relationship challenges, or dealing with common personal issues like depression and anxiety, there are often significant factors in their respective backstories that provoke an increasingly common question from me as an outside observer: “How are you not ANGRY about this situation?”

I don’t think I’m super-sensitive but when the one thing I would, personally or professionally, expect to see as a reaction to certain types of situations is notably absent, I’m going to wonder why. And honestly, the situations that will drive someone to seek therapy are OFTEN going to be exactly the types of situations in which it would seem perfectly normal to be angry, even if we’re just angry at circumstances rather than angry at people, including ourselves. Yet when I ask my clients, bluntly, about that absence, sometimes they squirm uncomfortably, and sometimes they return words to me that acknowledge there is negative feeling present, but they use words like “frustration”, or “disappointment”. Okay. It’s not my job to own or correct a client on their experience — their feelings are theirs, not mine — but I will open the door to an “And Also?” kind of exploration that explores whether there’s possibly more going on under the hood, as it were, and also considers whether the feeling label is entirely accurate.

The presence of anger makes a lot of people uncomfortable, so sometimes before we go directly inviting it into conversation, we have to explore more generally at what “anger” as an experience means to the client. Most of us have a reasonable grasp on what outward anger looks like: aggression, hostility, violence. For some people with very low tolerance for emotional experiences, ANY intense emotional expression will read like anger, especially when they believe it to be directed at them personally. And most of us will have some sense of what happens when anger turns inward: self-esteem issues, self-loathing, shame. Unsurprisingly, very few people admit to being comfortable, let alone adept with managing, any of these anger-associated experiences, so culturally we have adopted an unspoken policy around suppressing or denying anger, then being surprised when it refuses to stay quietly in the box, leaks out around the edges, and inevitably comes back to bite us in our collective arses on everything from the interpersonal to the society-wide, endemic tide of hate.

And we, collectively and individually, are left without adequate tools to manage that anger regardless of whether it’s our own or someone else’s.

“You?ll never guess quite how furious the women around you are, until you ask them. Some of the angriest women I know are also the sweetest, the kindest, the most personable and generous. Inside, they might be seething with rage they have been taught never to express, anger they can barely acknowledge even to themselves. They?d probably be surprised to find out how common that feeling is. They have learned that showing their anger is an invitation to mockery, shame, or shunning, so they displace their anger, try to smother it into silence, because they’ve learned that nice girls don’t get cross. Nice girls don’t speak out or stand up for themselves. It?s unladylike. It?s unbecoming. Worst of all, it?s threatening to men. Case in point: period jokes. How many times have you heard people dismiss and belittle a woman who dares to express emotion by telling her she?s probably menstruating? How many times have men in power ? including Donald Trump ? tried to push back and put down women who criticize them by implying that our opinions are nothing more than a mess of dirty, bloody hormones, none of it rational, none of it real? These jokes are never just jokes. They?re a control strategy.

The patriarchy is so scared of women’s anger that eventually we learn to fear it, too. We walk around as if we were bombs about to go off, worried about admitting how livid we really are, even to ourselves. There are real social consequences for coming across as an “angry woman” ? especially if you?re not also white, straight, and cisgender.” — Laurie Penny, writing for Teen Vogue, Aug 2, 2017

One of the reasons my second marriage failed is because I was my own best example of how a failure to acknowledge anger became the corrosive factor undermining safe, intimate connection. My mother, an excellent example of her generation, raised by a mentally-ill mother who was an excellent example of HER generation, instilled in me a set of gender-biased, role-defining values that devalued my own experiences for the sake of care-taking another’s, without any ability to acknowledge that I even had my own needs, let alone a voice to address them adequately, and so as I tried to eat my needs, I got angrier and angrier at the costs of suppression and denial, and would periodically explode in uncontrolled rage at my bewildered (and unfortunately, very conflict-averse) partner. It took a long time to break down that pattern and recognize where most of it was coming from, and how I had become “complicit in my own subjugation” by being at first unable, and then later unwilling, to be more clear about what I was feeling and why, and what needs or expectations were attached, and why. My models did NOT prepare me in the least to be okay with being angry, so the only outlet it had was the explosive, all-eclipsing supernova once the fury was too big to contain.

Even on the lowest heat setting, a pot will eventually boil itself dry and set itself on fire.

So where does this silence come from as a mask for anger?

Largely, it comes from a pervasive cultural message, one especially damaging to women, that anger is a thing to be feared, that it is never anything but inappropriate, that it brings shame on us (for women in particular, anger is seen as a denial of our programmed nurturance and care-giver roles, so we are shamed on many levels for daring to stand up against expectations, for example, or assert our own needs against those of others). Children are often punished from the outset for their anger, though it’s tolerated more in boys than in girls.

Harriet Lerner, author of “The Dance of Anger, introduces anger this way, however:

“Anger is a signal, and one worth listening to. Our anger may be a message that we are being hurt, that our rights are being violated, that our needs or wants are not being adequately met, or simply that something is not right. Our anger may tell us that we are not addressing important emotional issues in our lives, or that too much of our self–our beliefs, values, desires, or ambitions–is being compromised in a relationship. Our anger may be a signal that we are doing more and giving more than we can comfortably o or give. Or our anger may warn us that others are doing too much for us, at the expense of our own competence and growth. Just as physical pain tells us to take our hand off the hot stove, the pain of our anger preserves the very integrity of our self. Our anger can motivate us to say “no” to the ways in which we are defined by others and “yes” to the dictates of our inner self.” — Harriet Lerner, “The Dance of Anger”

Unfortunately, she goes on to describe the cost of anger that many women understand all too well:

“Women who openly express anger at me are especially suspect. even when society is sympathetic to our goals of equality, we all know that “those angry women” turn everyone off. …The taboos against our feeling and expressing anger are so powerful that even knowing when we are angry is not a simple matter. When a woman shows her anger, she is likely dismissed as irrational or worse. …Because the very real possibility that we are angry meets with rejection and disapproval from others, it is no wonder that it is hard for us to know, let alone admit, that we are angry. …Thus, we too learn to fear our own anger, not only because it brings the disapproval of others, but because it signals the necessity for change. [The resulting] questions can be excellent ways of silencing ourselves and shutting off our anger.”

Many of my women clients describe a common scenario: they get angry about something a partner has done, but when they raise the issue with the partner, especially if they are still angry when they do so, the partner dismisses them with some variant of, “You’re crazy.” Setting aside for a moment the entire issue of gaslighting, the sheer commonality of this dismissive response to a partner’s emotional state and area of concern tells me that there is, as of yet, no safe place in relationships for anger. We’re often taught first as children that anger is not allowed unless it abides by specific rules, if it’s allowed at all; we commonly learn about conflict and intensity management or avoidance as patterns of behaviour modeled within our families of origin. We’re taught by partners with differing tolerances for emotional intensity that it may not be tolerated at all in intimate relationships. We’re taught by employers and workplace environments that anger is completely inappropriate in professional settings.

Ergo, we (all genders) learn to suppress or misdirect the emotional intensity. We downplay it, until someone flags the use of descriptive labels that seem out of step with the nonverbal indicators, or simply wonders where the plain anger is. We dismiss it, and pretend we’re not angry even though nonverbally we may be broadcasting rage to the world, or having it leak out like toxic waste through the cracks in our facades. There’s probably not a person reading this who hasn’t had the experience of someone saying to them, “I’m FINE” in tones that clearly convey the speaker is anything BUT. (This one was always my personal downfall.) For many people, suppressed anger leads to depression and anxiety; for others, it leads to toxic and damaging behaviours covering a spectrum from emotional withdrawal to domestic violence. We– many of us–would rather talk about being strained, frustrated, disappointed than admit to outright anger.

Why?

The most-oft-repeating thread in the counselling is that people are afraid of “what happens when I get angry”. In short, it’s less about the feeling itself and more about the thoughts or the actions provoked by those thoughts. But we don’t differentiate well between feelings, thoughts, and actions, so the messy association paints all three components with the same brush. If I fear what I might *DO*, then I should also fear the feeling that drives the action… right?? Well, no… not really.

McKay, Davis, and Fanning, authors of the CBT textbook, “Thoughts and Feelings”, break things down this way:

“Thoughts cause feelings. This is the essential insight of cognitive therapy. All of the cognitive techniques that have been developed and refined in the last half of the twentieth century flow out of this one simple idea: that thoughts cause feelings, and many emotions you feel are preceded and caused by a thought, however abbreviated, fleeting, or unnoticed that thought may be. In other words, events themselves have no emotional content. It is your impression of an event that causes your emotions.”

They go on to describe a feedback loop that we all experience, consciously or otherwise, in which an event triggers a thought that incites an emotional response that triggers another layer of thought process that might trigger further layers of emotional reaction.

In the case of anger, a narrative we hear a lot from our clients is that something happens in the relationship, the triggering event, and in between the trigger and the emotional state, there is an assessment or interpretation that occurs. I sometimes refer to this as “the interpretive dance”, in which we receive the trigger and assign motive or value to it, and then we react to the interpretation, rather than to the original event. And THEN we tell ourselves stories about our reactions, either justifying our stance, or judging ourselves for it, and then we react emotionally to THAT level of thinking. And at some point in that mess, we might find ourselves acting–acting OUT, acting in DEFENCE, etc. It’s often more of a REACTION than a response, a default pattern of behaviour carved over time into a path of least resistance. And this is where communications often break down as the emotional intensity gets stuck in defaulting loops of interpretation and REACTIVE action.

Anger is a notoriously problematic emotion in this context because the default loop is often one of retaliation or punitive measures: we often react in anger when we’ve been hurt and so, reactively, we want the source of our pain to feel what we feel. But on the thinking level, we recognize that “hurting other people is bad”, so we suppress the tendency (or think we suppress the behaviour) by trying to suppress the emotional content completely. “I don’t want to be a bad person who hurts others” is a common cultural narrative, one especially laden with caretaking overtones for women. So we associate “bad” with both the action and the feeling, and accept training that creates aversion to both action and emotion.

So… what the hell do we do with all of that in the therapy office?

CBT provides some very excellent tools for separating out layers of thoughts from emotional reactions, so there are a lot of well-proven avenues for breaking out the components for the reactive feedback loops. Mindfulness and acceptance therapy introduces some very useful language around internal self-reflection and noticing the narratives as distinct from emotional states. But specifically when working with anger and women, I find one of the most important pieces of work we do is simply providing space and permission to name the emotion for what it is. We normalize the impact of the cultural suppression process, but we also allow for exploring the impact of what that suppression has taught us about disavowing and disallowing our own emotional experiences. We work to separate out the feelings from the choices we make about resulting actions, and we create space for clients to learn, as Pema Chodron calls it, to “sit in the fire of our own discomfort” WITHOUT impulsively committing to ACTION. We feel, we process (we learn to think differently), and then at some point we make different, conscious choices about ensuing actions. We create mindful responses, rather than knee-jerk reactions. In allowing clients to learn to sit with the anger and see that simply allowing it to be present without provoking reactive behaviours, we can allow space for the feeling without fear, or at least hopefully reducing the fear of what we might do BECAUSE we’re angry. (I have recognized three stages of angry communication patterns that help with this part of the process when I’m working with high-conflict couples, but I think I need to save that for a future post.)

There has to be space in relationship for each of us to be authentic in our emotional experiences, but because we’re afraid of our emotional expressions, we’re not generally very good at sharing those experiences. We’re afraid of the intense emotions for a variety of reasons, but predominantly because they make us feel unsafe, regardless of whether we’re the ones presenting or receiving the emotional content. We don’t know what to do with it, and at the more intense ends of the spectrum, it can feel like violence to those with low(er) tolerances. So we need to find balance, but we can’t find balance until we allow that everyone has a voice, and has to have space to exercise that voice. Anger is a damnably difficult thing to give voice to, but a hugely important indicator of relational and individual health and attachment. Learning to be present with anger is some of the most challenging work I will do, not just as a therapist, but as a woman, and it is so very necessary.

Emotional Intelligence, Self-Development, self-perception

I’m going to step outside the usual heavy-thinking kinds of posts I normally write to offer a brief glimpse into the entirely-human world of Therapists As Human Beings. (I know most of you cognitively understand that we’re humans, but it’s surprising, in a no-not-really-kinda-way, how often clients in particular expect us to have our shit together in particular ways. Since it’s not often that folks who deal with us professionally get the chance to peek behind the curtain and recognize the foibles that make us just like everyone else, if you’re someone who doesn’t WANT to know that your therapist is human, might I recommend you click THIS LINK instead.)

So, disclosure: I turned 50 in May. I am part of the generation that didn’t grow up with a lot of childhood conveniences we take for granted in this day and age. Sometimes when in our middle aged wisdom and experience we encounter something that a schoolkid takes for granted, we can feel somewhat crushed that we’re not managing the experience as well as someone a tiny fraction of our age.

In preparation for a camping event over the Labour Day weekend, I bought a case of juice boxes at Costco. I have almost never used juice boxes, but a case of small square servings of fruit-sugared liquids is an excellent thing to take camping when you normally run into liquids/convenience issues on primitive sites. In the course of loading out, the case never made it into the vehicle and was, perforce, awaiting my return. Ergo, I’ve been drinking my way through the case of juice boxes for the last week.

And lemme tell you, nothing levels an adult ego like realizing that your “brain the size of a planet” and five decades of developing hand-eye coordination and grad-school-honed intellect and three decades worth of professional problem solving… it’s all for naught when for a week straight your Facebook posts read, “Days Since Last Juice Box Incident: 0”. Even after being scolded and schooled by a seven year old this past weekend on “Juice Box Best Practices”, I have still managed at least once a day to forget how these lethal little liquid grenades work, somehow. Much of this week’s laundry is comprised of Fruit Punch Fatalities.

So what’s going on here?

It’s both everything and nothing, really. From a mindfulness perspective, it’s the observation that I am apparently not in my best moment when it comes to maybe 60% of my juice box encounters; when you don’t pay attention to corporeal, mechanical details, it’s easy to grasp a thing that doesn’t do well when grasped. It’s a humbling reminder of vulnerability and openness to our own internal narratives around who we are and what we believe we *SHOULD* be capable of. It’s easy to feel humiliation when admitting we can’t do something a child can do in their sleep (those of you trying to teach senior parents to program a PVR, use a computer, or manage a smartphone, have almost certainly seen that humiliation in action in your parents, for example). We don’t as a species generally like admitting our failures and weaknesses, and for certain professions, those human weaknesses when exposed feel like nails in the coffins of our professional presentations to our clientele.

I’m of the (potentially contentious) opinion that embracing humility, on the other hand, is a way of maintaining balance within our sense of authentic presence. Most of us understand there is a difference between humilation and humility, but don’t always have a clear understanding of the difference:

Definition of humiliate:
humiliated; humiliating
transitive verb
:to reduce (someone) to a lower position in one’s own eyes or others’ eyes :to make (someone) ashamed or embarrassed :mortify

Humiliation is a terribly painful and destructive emotional state. It ranks very high among the things that people are afraid of. It is an overwhelming experience of shame and being degraded, usually in the eyes of others. Sometimes a person can be intentionally humiliated by another, in a sadistic attack that is intended to strip away all dignity and self-esteem. —
Michael Jolkovski

Definition of humility:
noun
:freedom from pride or arrogance :the quality or state of being humble

Humility, on the other hand, is a relief. When individuals are able to gracefully accept that there are limits to their power and importance, and to not collapse into despair, shame, or impotent rage, this is a developmental accomplishment. It marks the move from fantasy to reality, from omnipotence to competence. It is a gift at every stage of life ? when a 2-year-old can accept that they are not actually in charge of everything, or when an aged person accepts that they need to a depend on others in a way they haven?t before. There?s a key element of being at peace. Contrary to humiliation, humility gives a person their dignity and equilibrium back. —
Michael Jolkovski

There is a great deal of ego wrapped up in our adult concepts of who we should be, how we should function, what we should be able to do. To have our ego confronted with persistent failures on simple challenges — if a seven year old can wield the juice box so effortlessly, why am *I* awash in apple juice accidents?? — is almost guaranteed to feel like we are lesser, touching on that degradation mentioned under “humiliation”; our incompetence is being judged by others, we feel, and judged harshly. It feels like hot burning shame; “I’m 50 friggin’ years old, I drive a car and work and pay taxes, WHY CAN I NOT OPEN A DAMNED JUICE BOX WITHOUT CATASTROPHIC FAILURE???”

(That may or may not be an actual quote.)

There is a choice we can make when we are awash in the struggle around what we feel we SHOULD be able to manage, and what we actually experience. We’re going to feel what we feel, and if it’s the hot wash of shame and humiliation that hits us first, then so be it. But when that tide recedes, we can choose how to respond to the experience: we can judge ourselves as we imagine others are judging us, and stay bogged down in the peach punch-stained hell of our own humiliation and misery, or… we can sit with a seven year old Subject Matter Expert who probably handles more juice boxes in a month than I will handle in the course of my lifetime, and be open to what this child can teach us. In my case, I was amazed that this child had significantly more patience with me than I had been having for myself. He showed me how to carefully lift the top corners of the juice box and how to hold it so that I had some firmity of grip without grasping the weaker sides and inadvertently squeezing. He showed me twice, once on my juice box, and again on one of his own.

For myself, I could choose to be embarrassed by the necessity of this educational curve ball, or I could hold myself open to the teachings in spite of feeling more than a little ashamed at its necessity. As the definitions above suggest, one of the chiefest tenets of humility is the relief in accepting that one HAS limitations, of letting go of the ego-wrapped expectations and SHOULDS bolstering my flawed self-definition. It’s okay to be embarrassed. But we can choose, to some extent, whether that embarrassment parlays into shame and humiliation, or into humility and vulnerable authenticity.

Being able to own and embrace my own failings is, for many therapists, the largest resource pool from which our working compassion for others comes from. Sometimes we forget that we’re also flawed, and I can guarantee every one of us has flaws we actively WORK TO FORGET, because hey, no-one ever ENJOYS confronting or exposing our secret shames. But sometimes sharing them allows for a bonding experience, an opportunity to let in others who have similar flaws and weaknesses. Sometimes we can exploit our own vulnerabilities for comedic value (this is my own usual modus operandi; Virginia Satir would likely say this is my irreverent/irrelevant stance coming into play, and she’s probably not wrong; I’m okay with allowing many of my flaws to be seen, but I will spin-doctor the hell out of the presentation to increase the chances of my audience joining me in that witnessing in gentler, more tolerable ways.) Being able to separate out humiliation from humility allows us more of an opportunity for reflection; humiliation and shame are reactive default stances that close us down without much recourse for active decision-making. Humility leaves us open and relaxed in our understanding of limitations, and hopefully open to opportunities to learn from those with something to teach us, regardless of our expectations. “See the world through a child’s eyes” is a cliche because it’s true; they see and experience things so much more differently than we do that it’s good to be reminded sometimes they can teach or re-teach us so much.

So I’m going home to do more laundry, and contemplate the remaining juice boxes as a lesson in humility. They are a good reminder, in their own inauspicious, ticking-time-bomb kind of way, that what we expect of ourselves can sometimes be subverted by the simplest of things, and we can either flagellate ourselves mercilessly with shame and humiliation for failing those expectations, or we can be open to the lessons they can teach us with embarrassment rather than shame, and humility rather than humiliation.

(BTW, the Peach Punch is my favourite. Because you needed to know that.)

Attachments, Emotional Intelligence, Relationships, self-perception

The more I work with adult clients raised in environments where parental or caretaker love was NOT present, or was inconsistent at best, the more I come to recognize a stance in many of my clients in which they have learned to substitute “being needed” for authentic love. Substituting need for love can manifest in many different ways, but often embodies a significant portion of care-taking for others as a core practice, as if to say, “If I can prove my value to you through taking care of you, you’ll just love me, right?”

What happens instead, however, is a slippery slope of enablement and reinforcing potential entitlements. How this plays out in a lot of relational dynamics (at least insofar as we therapists see it in the counselling office) looks like this:

A caretaker personality is often hyper-attentive, or hyper-vigilant, to the moods of a partner. At the earliest signs of partner distress, the care-taker is *right in there*, sometimes asking explicitly, “What can I do for you? How can I help you? What do you need from me?” More commonly, however, the care-taker often guesses or tries to anticipate what needs are going unaddressed, to take care of them BEFORE the distressed partner can increase distress (either internally at themselves or outwardly at the care-taker or other vulnerable others). While this care-taking practice seems a noble gesture, the problems it introduces are manifold.

First, it removes responsibility for practicing emotional self awareness and self-regulation from the distressed party; they never learn how to manage themselves or their own needs. Secondly, it creates undue stress on the care-taker, not only because they’ve taken on emotional labour that, truthfully, isn’t theirs to manage, but also because it generally encourages care-takers to compartmentalize or bury their OWN needs, anxieties, or distresses without effectively addressing them. Third, it reinforces the codependent fusion by reinforcing the notion that neither can effectively exist without the other, since a care-taker by definitions must have others to care for in order to feel validated, and they believe the Other cannot exist without them to manage every little detail for them (something those Others may often be too willing to accept if it means less work for them to handle on some front or other).

It may be true that very few of us *LIKE* seeing our partners in distress, but there’s a massive difference between being ready to assist, or simply bearing witness, and moving in to “fix” things for another. When I was a teenager taking swimming lessons up to and including training as a lifeguard, the VERY FIRST lesson they teach us about rescuing drowning swimmers is that it’s a REALLY BAD IDEA to get close enough to the drowning swimmer to make contact. The swimmer in their panic will grab on to the rescue attempt and completely overwhelm the rescuer… and they both drown. So lifeguards are trained to use a “reverse and ready” position that lets them push a flotation device to the swimmer and instruct them to grab and hang on until they are calm enough to be assisted back to safety. This analogy is one of the most powerful ones I can give to care-takers who insist on swimming in after distressed partners, then wonder why they always feel so overwhelmed by their efforts, almost to the point of drowning themselves.

This state of emotional enmeshment, where care-takers deflect or defer their own anxiety by hyper-attentively managing others’ distress is something Murray Bowen identified in (family) systems as “fusion”:

?Fusion or lack of differentiation is where individual choices are set aside in service of achieving harmony in the system? (Brown, 1999)

Fusion is where ?people form intense relationships with others and their actions depend largely on the condition of the relationships at any given time?Decisions depend on what others think and whether the decision will disturb the fusion of the existing relationships.? (Papero, 2000)

Care-takers come by this fusion through their early training; they learn that they cannot be emotional safe, acknowledged and validated for any reason other than a service they can provide. Parentified children, for example, or displaced children, often internalize early on a strong sense that they are valuable for what they DO, rather than simply for being lovable and worthwhile people in their own right. (The displacement may happen within the family system for a variety of reasons, such as parental preference for a first-born or male child over a female child; or one child is perceived as a “problem” child while other children might be left to manage on their own or manage the family while the parents cope with the “problem”; children may also feel ostracized in a variety of ways by their care-takers for not conforming to or complying with both explicit and implicit systemic values.) They learn to fear what happens if they do NOT provide the service they believe is expected of them. Seeing loved ones in emotional distress may trigger intense surges in their own anxiety; perhaps their own early care-takers tended to act out with violence in distress, so any emotional distress in the adult client is intolerable, for fear of such violences returning. Or the adult client may simply not recognize the value of anything other than performing service; if they themselves have no memorable experience of being loved for themselves, they may be unable to distinguish a difference between “being needed” and “being loved”, and the idea of not being needed to take care of someone threatens their very self-definition and sense of self-worth.

It’s a tricky thing to suss out what’s happening with clients who fall into the category of “substituting need for love”, because the patterns are hard to verify in the light of things like Gary Chapman’s Love Languages identifying “acts of service” as a bone fide love language. Where we start to see the substitution becoming problematic is when the underlying attachments themselves become a struggle to manage; care-takers doing this kind of substitution often have anxious attachments in which any failure of the partner to validate the care-takers efforts become a source of significant distress in the care-taker themselves. There is no healthy sense of differentiation between the care-taker and the target when the smallest bump in this “transference of care” can send one or both parties into distress. It’s too easy for the receiving partner to simply become complacent with being cared for, especially if it means they never have to learn to self-manage their own distress when someone else is always there to take care of things for them. And it certainly seems a common social pattern for individuals to gravitate into relationships with complimentary, familiar care-taking patterns. The patterns in and of themselves may not be problematic, but they bring with them a weighty potential for invisible expectations and unspoken needs around reflecting validation. Care-takers will sometimes chase target recipients even if the relationship as a whole is one they recognize on some level as unhealthy for them; that’s certainly a Big Red Flag in the therapy room that we’re dealing with someone who is potentially chasing validation for being needed, and a historical or Family of Origin snapshot will tell us in very short order whether or not the client recognizes the experience of being loved, or if they respond more to being needed.

To be clear, in healthy intimate relationships, there is generally a balance of love and need, and sometimes there is less need than love. When need overshadows love, however, or subsumes it completely, we stand at high risk for having less stable, less satisfactory relationships overall. In therapy we might find that care-takers who only (or predominantly) identify with meeting needs more than recognizing love as their primary avenue of attachment are insecure not only in their relationships, but in themselves. We see a lot of co-morbid symptoms tied to anxiety, depression, low self-esteem, and profound exhaustion, with a potential raft of physical/health issues that often come along for the ride with ANY of these mental health challenges. Unraveling this convoluted self-identity can be a lengthy process; there are no “silver bullet solutions” when countering a lifetime’s worth of programming around a person’s sense of intrinsic sense of worth. We start with the basics of Human Worth, and look at how those lessons may have been twisted early on, reinforced by a lifetime’s worth of relationship practices, and how the errant substitution of need for love is probably sabotaging self and self-in-relationship in the client’s current situations. We can unravel understandings and begin the work of creating a new sense of self, but as with all things, it takes time and patience, and a willingness to self-love that can sometimes be every bit as challenging as loving others

But the work is worthwhile, however difficult. We are all worthy of love, not just because of what we DO for others, but simply because as people we have a value all our own. Sometimes we just need to be reminded of that fact, and taught (as we maybe weren’t in early life) to see that in and for ourselves.

Emotional Intelligence, Family Issues, Relationships, self-perception, Uncategorized

I’m not saying Freud was right to blame everything on our mothers (his misogynistic views on women are well documented), but he did have the root of an idea that Murray Bowen leveraged decades later into Family Systems Theory. Sometimes it’s easy to trace our personal challenges as adults to specific events or traumas tied to our personal histories, but other times it’s a far more subtle, potentially insidious thing to trace the nuanced impact of internalized behavioural models and “invisible values” inherited from our family systems.

Even clients who have no notable red-flag-raising events in their loving, textbook-perfect families can be surprised at just how much of their behaviour *can* be tied directly back to how they were raised, or what they experienced in the home where they grew up. One of the most common examples of this that we see in relationship counselling with individuals, couples, or poly groups, comes from people who present as happy, seemingly-well-adjusted people from families where the parents never fought, who come into counselling because they have issues connecting with their partners, or because they are anxious in their attachments, and they can’t figure out why. “My parents never argued” is probably the single most common indicator that this was likely to be a family with unhealthy coping strategies for tension and conflict, up to and including outright avoidance of contention. Given that kids inherently use their family of origin as models for behavioural development in most things inter-relational and (once they are adults) and intimacy-building, it’s unsurprising that otherwise “happy home” kids grow into adults who don’t do well with emotional intensity or all-out conflict.

I use the family of origin “snapshot” fairly extensively with many of my clients. It helps me create a picture of the client in terms of where they come from, what kinds of models they grew up with, what kinds of default responses might have been programmed in for emotional self- or co-regulation within the family system from a potentially early age. Within the first session or two, we don a verbal sketch of the principle members of the system: mom and dad, siblings, step-parents and blended family members. If there are interesting things in parental histories that seem impactful on the client’s development, we often look at the relationship between parents and grandparents as well. This tells us what family values might have been passed (or shoved) down from that generation onto the parents that potentially informed how the parents raised their own kids, at least one of whom is now sitting in my office in crisis. It’s this part of the process that’s more about the art of reconstruction, interpreting what we can discern about the family behaviours through the lens of Bowen’s System Theory into a narrative that sheds a little light on why my otherwise-happy client can’t now seem to tolerate any kind of disagreement in the relationship, and falls into an anxious fugue at anything even remotely suggesting that conflict is present.

The family of origin snapshot also sheds some light on intersibling dynamics that may impact personal development into adulthood. Looking at where the client falls in a multi-child birth order, for example, might tell us something about issues like “middle child syndrome” (perhaps the client IS the middle child, or was heavily impacted by a middle child’s behaviours), or parentification of an eldest child. Unconscious parental favouritism can have a huge impact on how kids in such a family develop into adults, as can being the “normal” child in a family that also includes a differently-abled, ill, or developmentally-handicapped child.

Sometimes the family of origin snapshot can pinpoint exact historical incidents that manifest as seemingly-disconnected physical trauma much later in life. Sometimes the group portrait makes it very clear up front that there is a systemic behavioural pattern that has produced challenging or toxic patterns in the client’s own adult life and relationships; toxic parenting or corrosive sibling rivalries will also have a profound effect on how the adult client has come to view relationships.

Once we have created the word picture of the family and the set players on the stage, we use that construct to look at how the client perceives both their role in relational drama, and how they are likely to interpret the behaviours of others around them based on what their families taught them. This runs the gamut from uncovering anxious narrative of imperfection to ego-invested narratives of “Of course I’m always right”, to “Love mean we never fight, doesn’t it? So if we’re fighting all the time, why does my partner hate me??” Because this is an interpretation, I make it clear to the clients when we do this work that just because we construct a narrative explanation that resonates with the information as we perceive it, that doesn’t mean it’s the truth, or that it’s the only truth. We put all the pieces on the board: what the client can relay about their own lived experience, what the therapist can bring in terms of clinical education and observational perspective, and we move the pieces of information around on the board until we have a storyline that explains what is known in a way that fits with both shared and unshared information (clients *ALWAYS* have more information in their heads than they share verbally in therapy; that’s just a truism of the work). Theories that don’t fit get tossed and we start again; the therapist’s own flexibility and refusal to get stuck on their own perspectives becomes a key component here, just as the client’s own willingness to see their long-held historical snapshot explained in a new perspective is important.

This part of shifting perspective is part of the narrative reframing process in which we challenge the client’s understanding of “how things work” on which they have quite likely based their adult values and decision-making models. And if they are coming into therapy because their internal models don’t seem to be influencing or sustaining the kinds of connections they say they want to have in their lives and relationships, the family of origin snapshots will go a long way towards potential roots of the problem. When we change the historical perspective, we also open the opportunity to change how the client relates to both their own history and, perhaps more importantly, the future of their own relationships. For example, a client coming from what they described on intake as, “really close and super-happy home” was struggling with the surprise dissolution of the parental marriage at the same time as the client was facing a power struggle in their own marriage. Because they feel they “turned out just fine” from this “super-happy home”, to the client it was apparent that the parenting strategies that raised them “are obviously the right ones, so if I’m using them to raise *MY* child, I’m obviously right, aren’t I?” But when we circled back around to the dissolution of the parental marriage and all the conflict that was engendering in the family, we had cause to wonder about how it was that the parents were so unhappy for so long that dissolution finally seemed the only option. That led to a conversation about emotional suppression and what that taught my client about emotional suppression and emotional validation, and we began to see how the parental choices had informed my client’s development… and how if we began to see the parental model as potentially deeply flawed in new or still-unseen ways, what did that mean for how my client had internalized that “perfect parenting model” that was at the heart of their own relationship power struggle? Suddenly, simply by looking at the family of origin snapshot from a new angle, we had a whole new perspective on what was happening for the *CLIENT* in terms of attempting to implement a flawed model, or a flawed understanding of an imperfect model.

It’s common for clients to wonder why their families become important to me as a therapist when we’re talking about what they perceive as disconnected issues. I explain about my Systems Theory background, and how it’s part of my job to hold in mid the potential impact these other factors might have on our work. It’s a lot like radio astronomy, I tell them; there are a lot of important objects out in deep space, like black holes, that we can’t see directly, but we can see and measure the effect they have on the things we *CAN* see. Family impacts on client issues work the same way; we can only determine the impact those factors have when we observe the client’s behaviours as an adult. And I freely admit, the times when my clients are most likely to perceive what therapists do as Pure Magictm is when we can put the pieces of their intake story through the Family System Theory filter and feed back to them an enhanced reflection that suddenly “explains so much”. Being able to see light bulbs or couch bombs go off in client’s heads is, I also admit, a big secret part of why we therapists Do What We Do. We love those moments when the revised narrative gains a toehold, and the new vista opens up for the client; it’s one of the things that makes it easier for clients to go forward into the work they’ve come to do. It’s like we’re the mountain sherpas who, by showing them a new understanding of the past, have opened up an unexpected path to go forward from there… and simply catching a glimpse of the path, that new understanding, gives the client tremendous hope that they’re in the right place to do the right work.

Some days, what we do really does seem like a kind of magic 🙂

Self-Development, self-perception

One of the factors that often seems to come with anxiety and depression for many is the experience of poor self-esteem, a distorted vision of ourselves or a devalued sense of worth reflecting what we believe other people think of us. For those individuals dealing with cognitive depression especially, the kind that comes with burdensome negative self-talk narratives, the self-esteem challenges are pretty much a given. Part of the work in therapy with these kinds of clients involves constructing (or reconstructing, if the absence of self-esteem is something that can be traced to a clear source of systemic erosion) a sense of intrinsic value, or unconditional human worth:

Howard?s Laws of Human Worth
Unconditional worth means that you are valuable as a person, important, because your essential core self is unique, eternal, precious, of infinite unchanging value and inherently good. You are as precious as any other person.

  1. All beings have internal, infinite, eternal and unconditional worth as persons.
  2. All have equal worth as people. Worth is not comparative or competitive. Although you might be better at sports, academics, or business, and I might be better in social skills, we both have equal worth as human beings.
  3. Externals neither add to nor diminish worth. Externals include things like money, looks, performance, and achievements. These only increase one?s market or social worth. Worth as a person, however, is infinite and unchanging.
  4. Worth is stable and never in jeopardy (even if someone rejects you). Worth doesn?t have to be earned or proved. It already exists. Just recognize, accept, and appreciate.
  5. Worth doesn?t have to earned or proved. It already exists. Just recognize , accept and appreciate it.

Claudia A. Howard (1992) [as read here]

Low self-esteem generally manifests as narratives along the line of, “I’m not worth anyone’s time [attention/effort/love/desire/respect/etc.]”, and “It’s not worth taking an effort or risk because I won’t get it right, or the results won’t be worth it”, for example. We fear the repercussions of failed efforts because we tie our value, our self-worth, to external events like job or relationship success.

“When worth equals externals, self-esteem rises and falls along with events. […] for adults, the highs may come with promotions, awards […]. The lows may come with criticism, poor performance or when [you or] your team loses. If your worth equals your job or your marriage, how will you feel if you realize you have already gotten your last promotion or if you divorce? Your feelings would probably go beyond the normal and appropriate sadness and disappointment. When worth is in doubt, depression usually follows. If human worth equals market worth, then only the rich and powerful have worth. By this line of thinking, a Donald Trump or a Hitler would have more human worth than a Mother Theresa.”
Glenn Schiraldi, The Self-Esteem Workbook, p. 33

Working through self-esteem narratives with a cognitive-behavioural approach tends to help many, by allowing them space to introduce counterscripting that often starts with awareness and acceptance (we don’t leap immediately to attempting outright self-love, because that’s a difficult pinnacle to reach for people with self-esteem issues, and we try to avoid setting our clients up for failure right off the starting block). We begin with introducing a better understanding of intrinsic human worth, as with Howard’s Laws, above. These tenets become a working mantra to underpin the work that follows; everything points back to this developing understanding of intrinsic value.

We then begin to develop self-observation and reflection: what are the thoughts we’re aware of, and what feelings come along for the ride when we catch ourselves in those thoughts? We separate the thoughts from the feelings and challenge the thoughts: Is this true? What evidence do I have to support it? What evidence might I have to counter it? We introduce the counterscripts, like “I accept myself as being MORE than my weaknesses or mistakes”, and “Criticism is an external force; I can examine it for ways to improve WITHOUT concluding that being criticized makes me less of a human being.”

We also explore the feelings that are tied to these narratives. Sometimes we can get a sense of where they started and what they root in, but most commonly we work simply in the present experience: we feel bad now when we buy into the poor self-esteem narratives, but we assume we will feel worse when we receive other people’s evaluations of our low worth. Poor self-esteem, regardless of where it originates, tells us we are unworthy of love, especially unconditional love; our worth is tied ENTIRELY to our ability to adequately meet or exceed other people’s expectations. We often have a damaged sense of self-love, so we rely on input from others to validate us, and when those reflections are broken or distorted, we believe the worst about ourselves as undeserving beings.

Opening up to a belief that we are intrinsically valuable and worthy of love requires a heady degree of vulnerability. Often self-esteem work will sail or flounder on the individual’s willingness to wade into the weeds of that kind of experience. Trauma survivors, for example, will often find vulnerability exceptionally threatening. Pema Chodron, Buddhist nun, refers to sitting with the discomfort of our own emotional experiences as “leaning into the sharp things”, and this is a metaphor I use a great deal in this kind of work. We walk with the client into those internal places where the early emotional hurts are still festering underneath those “I’m not worthy” narratives. We strap on the armour of, “All humans are intrinsically worthy, therefore I am worthy”, and we face down the demons with a variety of weapons, the biggest of which is a cudgel labelled, “I am worthy of my own love”. And we bear witness while the clients learn how to hold that in themselves, awkwardly at first, and sometimes losing their hold on it completely. We all slip at times; it’s human. We sit with the failure and celebrate the attempt as a counterscript to the client’s default narrative, “I am a failure and therefore not worthy.” We can break down the experience into, “What did I attempt? What did I learn? What do I want to do differently?”, and consider the emotional ties to the answers of each question along the way. Unravelling fear of failure and its ties to external validation is a slow process; we take our time working on stages of self acceptance. We look at the notion of self-love, but in truth, some people will get there while others won’t get much further than an uneasy truce with self-acceptance. We work to the reasonable abilities of our clients, and while we try and expand the comfort zones (by pushing into discomforts as best we can), everyone’s limitations will fall in different places.

Ideally we get to a place where clients can at least make, and connect emotionally (with belief) to positive self-statements. How many statements, and how strong the belief that supports their growing self-esteem, is a very individual outcome. But it’s work that we *can* do to help clients grow out of a sense of being stuck in their own perception of non-value.

Mental Health, self-perception

Something I’ve been thinking about lately:

About a week ago, I was speaking with a client about depression, exploring “the lies that depression tells us”. It’s a standard externalizing narrative framework clinicians use to help clients put a little emotional distance between themselves and whatever’s afflicting them; it’s an approach that works for a lot of different things. But I made a mental note in the back of my head that in my own mind, something had started to ring a little hollowly around that particular narrative construct (not for the client; the client ran with the externalization like it was tailored for them). It’s taken me most of the week to figure out what the mischord is. When we talk about depression and “the lies it tells us’, the implication is there’s something inside us that whispers or talks to us and fills us with narratives that are neither helpful nor healthy. This implies that depression functions as a cognitive process, operating in the part of the brain where language and thought processing occurs. When clients respond well to the idea that “depression lies” or tells us things about ourselves, we’re operating in the cognitive realm. We define the cognitive realm this way:

This domain includes content knowledge and the development of intellectual skills. This includes the recall or recognition of specific facts and concepts that serve developing intellectual abilities and skills. There are six major categories, starting from the simplest behavior (recalling facts) to the most complex (Evaluation)
http://serc.carleton.edu/introgeo/assessment/domains.html

I absolutely believe that this definition of depression as a cognitive dysfunction (with all its standard attendant physical byproducts and related chemical imbalance) rings true for a very great many sufferers.

It is most decidedly not, however, true for me. My depression doesn’t talk to me, and I’m increasingly certain it never has. And the more I work with other depression sufferers, the more convinced I am that there’s an entire constituency for whom there is no (or no signficant) cognitive aspect to the their depression at all. For example, my depression says nothing to me about my worth or value. It says nothing to me about my happiness or misery, nothing about the value of doing anything I would normally do, energy I would normally expend. I increasingly suspect that part of the reason why I failed to recognize depression in myself for what it is for as long as I have is precisely BECAUSE the entire internal “demon narrative” has been conspicuously absent. This suggests some forms of depression might operate predominantly, perhaps exclusively, in an affective state, manifesting physically and exclusively without the cognitive narrations::

The Affective domain includes feelings, values, appreciation, enthusiasms, motivations, and attitudes.
http://serc.carleton.edu/introgeo/assessment/domains.html

What I get is something like a gravity well; a thing I fall into in which the weight on my mind and body just increases until I have no tolerance, no strength to move past it. Emotionally I still feel happiness and joy, though muted; I still feel engagement. I’m still reasonably high-functioning, though compromised in scope and sustainability. It’s like something sits on my chest and weighs me down. It can be hard to breathe sometimes, it’s definitely nigh-unto-impossible to move. It’s easier to just stay still, or better yet, just sleep. There’s no judgment, no scripted storyline about what it means; I don’t know if it was always like that. I know I beat myself up fairly heavily the first spring I failed to get back to walking like I had been the previous fall, but that failure and self-recrimination narrative was as much disappointment over lost momentum and gear investment costs as it was anything else. All things considered, it was easy to let go of that cognitive process once I figured out what was going on.

My depression doesn’t talk to me, and I don’t talk to it. At the deepest points of the gravity well, it doesn’t whisper to me to kill myself, that the world would be better without me or that no-one would notice. I actually like my life; I have a mostly-healthy connection with my world and the place I have made for myself within it ? not without challenges, but hey, I’m still human. At the deepest points, where people start to have urgent conversations about suicidal ideation, the sensation has been more what I imagine drowning swimmers eventually reach when they are too tired to keep struggling up past the weight of the water to the air, too tired to keep pushing their own waterlogged bodies to draw in breath, and they just… succumb. There’s the instinctive urge to breathe and stay alive, but eventually we can’t keep fighting against the weight and resistance of the surrounding elements. It seems to me that there’s not a lot of internal narrative in those moments, beyond “so tired” and “just let go”. I’m reasonably certain the only thing that pulled me through those times was the utterly unconscious, instinctive urge to keep breathing. In those moments it’s not so much that one consciously care much about living or dying; we can’t battle the weight any more, but autonomous bodily functions keep going. It occurs to me, this is likely where a big part of the mantra that has been a core operating principle for the last five years is rooted: “One day at a time, one breath at a time; one foot in front of the other.” Think no further ahead than the next breath; there isn’t enough energy to invest in speculating any further ahead than that.

A clinician friend in Boston this morning pointed me to the works of Edwin Shneidman, an American psychologist and author who wrote extensively on his work with the suicidal mind. Specifically, she was correlating my thoughts on depression as a predominantly non-cognitive, felt experience rather than a mental, narrative one, with Shneidman’s description of suicidality as a “psychache”, language that I suspect may resonate strongly with affective depression sufferers (even those nowhere near the point of suicidal ideation):

“As I near the end of my career in suicidology, I think I can now say what has been on my mind in as few as five words: Suicide is caused by psychache (sik-ak; two syllables). Psychache refers to the hurt, anguish, soreness, aching, psychological pain in the psyche, the mind. It is intrinsically psychological ? the pain of excessively felt shame, or guilt, or humiliation, or whatever. When it occurs, its reality is introspectively undeniable. Suicide occurs when the psychache is deemed by that person to be unbearable. This means that suicide also has to do with different individual thresholds for enduring psychological pain.”
(Shneidman, 1985, 1992a).

Looked at through this lens, we have the option now of language that supports exploring depression as a form of psychache, one with a scope of tolerance for enduring the affective or physiological experience, and how the client is able to function within the threshold of that experience. For clients who get frustrated by trying to use cognitive, narrative process to relate to their depressive experience, we can instead use bodywork language from the likes of Eugene Gendlin or Bessel van der Kolk (whose groundbreaking work on bodily retention of traumatic experiences is a go-to resource for many clinicians). This affective approach also opens up the options of a dialogue with clients around other physiological variables that can impact the physical and affective states. Western psychology sometimes skirts the edge of this holistic understanding when we press clients to consider their sleep/diet/exercise (any energy expenditure) habits in light of their depression, but often stops short of giving legitimacy to depression as potentially being a *wholly* affective state for some people. (The more I recognize this in myself, the easier it becomes to see this as an option for other depressive clients).

So now we can observe when the default cognitive “depression narrative” approach seems to sit badly with clients and others, and offer them this as an alternative to consider. Humans are narrators and interpreters and story-tellers by design, but I think sometimes the words actively get in the way of simply being *IN* an experience, especially if the experience itself is frightening in some way. If we can describe an experience–if we can safely box it up in words and interpreted meanings–then we feel we understand it. We feel we have a handle on it… we feel we have, in that handle, some measure of control, however slim. And therein we find comfort. We’ll invent entire mythologies simply because we experience fear when we don’t know why the sky flashes and rumbles at us.

Sometimes a cognitive, narrative *isn’t* the right approach. Sometimes it *doesn’t* encapsulate the experience. Sometimes it actually distances us from it. Recognizing the physical experience of my depression this week was a massive shift for me. There is no internal discussion or discourse, no whispered threats or seductive emanations. There is simply a force of gravity that is very localized; some days I function at Standard Earth Gravity, and sometimes I am flattened by Jovian Pressure so forceful it feels like it would be easier to stop breathing completely than expand my lungs against my crushing ribs one more time.

Even those words don’t capture the experience. Those are words and narrative elements that only fill in the blanks after the fact, for the most part, when I’m having to describe the experience to someone outside my own head. Most times, it never gets past the sensation of just stopping, letting my eyes close where I sit or lie, and letting sleep take me the rest of the way down into the pressurized deeps of that gravity well.

Now at least I have language to explore that with others as well. See? Even clinicians can learn new (and hopefully useful!) things.