What To Do If Your Spouse Has Depression

You’ve been noticing some changes in your partner.  She has a hard time getting out of bed in the morning.  He’s lost interest in the friends and outings he used to love.  She bursts into tears at the slightest provocation.  He talks about feeling overwhelmed, hopeless, and tired.

When your loved one is going through a season of depression, it can be difficult to know how to respond, especially if you’ve never experienced depression yourself.  When depression is not addressed in relationships, it can create emotional and relational problems that lead to divorce.  Depression affects communication between spouses, creates isolation from friends, and can lead to feelings of depression in the healthy spouse.  Conflict can escalate as your partner experiences irritability and shifts in mood.

How can you actively respond to your spouse’s depression in a way that doesn’t drive you apart, but that draws you closer together?

First, learn about depression.

Understanding the way depression works is the first step to supporting your spouse.  Read books and articles to learn more about depression symptoms.  Identify which symptoms are common for your spouse, and get to know the types of negative thoughts that characterize depression.  Learn about differences in severity and what to do if your spouse struggles with thoughts of suicide.  If you’ve just had children, learn about the symptoms of post-partum depression.  Identify if the depression is related to a situation like a death in the family, or if it’s a more chronic problem.

Reduce the stigma.

You might find that your spouse denies struggling with depression or feels ashamed at having to admit they need help. People with depression can dislike putting that fact about them on display.  They can feel stereotyped and marginalized as others minimize their concerns, saying words like, “It’s no big deal, you’ll cheer up soon.”  Encourage your spouse that what they’re experiencing is normal for depression, they don’t need to feel shame, and help is available.

Build your marital friendship.

John Gottman shares that a top prevention strategy for post-partum depression is building and maintaining friendship in your marriage.  You can foster this friendship in many ways.  Spend time asking each other questions to learn about one another’s worlds.  Go for a walk or exercise together, as exercise offers health benefits for depression and can be a great activity for connection.  Choose a sitcom on Netflix to watch and laugh together.

Talk about how you’re feeling.

Processing and understanding emotions in one another can be a great way to build intimacy and cope with feelings of depression.  Check in every day to find out how each of you are feeling, using a structure like Gottman’s stress reducing conversation.  Seek to understand your spouse, not to fix them. Take time to name the different emotions you experienced today.  Discuss a high and low moment from the day, identify things for which you are grateful, and affirm what you achieved throughout the day.

Create a game plan with your spouse for bad days.

In the ups and downs of depression, there will be days that are worse than others.  On bad days, it can be helpful to have a plan of activities to do to care for your spouse.  Pay attention to the triggers.  Explore ideas on what helps your spouse to feel better on bad days and encourage him or her to do them.  Offer a massage.  Practice gratitude together.  Encourage your spouse to take care of him or herself without pushing.

Be patient.

It can be easy to become angry with a spouse whose actions affect you.  If they have difficulty at work due to their depression, aren’t motivated to do fun things together, or have a hard time caring for children, it can feel like you’re taking on more responsibility.  In this case, share how you feel (gently) and seek to find a compromise or solution.  Be aware that talking about their struggles with depression or making suggestions on what to do might be met with defensiveness, so be mindful of taking a gentle approach. 

Respect and support their work in therapy.

Ultimately, if your spouse is struggling with depression, he or she needs to seek professional help. One way to support this process is to drive them to sessions with their therapist or psychiatrist.  When your spouse is in therapy, expect them to set boundaries and make changes in their life that may affect you, including cutting back on some responsibilities. If their therapist requests you come in for sessions or begin couples therapy, do so.  Request to come in for a session to learn about how you can support your spouse’s work with the therapist.

Prioritize your own self-care, friendships, and therapy.

As depression impacts your partner, you may tend to isolate from others as a couple.  It may be more difficult to have fun together.  It is important for you to cultivate your own relationships with friends and family to help.  Identify safe family members or same-sex friends who can be a support.  Be wary of depending too much on friends of the opposite sex, as that could lead to infidelity.  If needed, pursue your own therapy to learn about how to cope with the emotions and stress you’re experiencing.

Most importantly, if your spouse talks about thoughts of suicide or a plan to harm themselves, seek immediate medical help.  Drive your partner to the nearest ER facility or call 911.

It is important not to minimize this last point: if your spouse is talking about suicide, take action.  If you are unsure about the symptoms of suicidal ideation, call the suicide prevention lifeline (1-800-273-8255) and ask about warning signs.

As the spouse of someone struggling with depression, you have the power to make an impact in their healing.  My hope is that as you learn to care better for both yourself and your spouse, you’ll be able to experience greater intimacy as you fight back against depression together.

Three Dead-End Approaches to Communication (And One Way Out)

One summer in college, I shared a house with eleven other women (and yes, it was as crazy as it sounds).  We had a house meeting early on where we outlined rules and expectations for living together.  One roommate asked that we use direct, verbal communication when we had concerns, rather than leaving notes, which could be seen as passive-aggressive.  While we took her concern seriously, we began to playfully design perfect passive-aggressive comments.  This experience taught me a lot about what not to do, but it also demonstrated the benefits of direct communication. 

Poor communication is the #1 reason why couples come to therapy.  Typically, communication styles between partners clash and lead to conflict, and direct communication is not happening.  Often unhealthy systems of relating are modeled for us in our families growing up, and our adoption of our parents’ styles wreaks havoc in our marriages.

Determining your own communication style sheds light on ways you can speak more directly and improve your marriage.   Here are three common unhealthy types of communication.

Passive

When you’re faced with conflict, do you run away?  Maybe you don’t speak up about your needs, invalidating your desires.  You may feel anger from time to time, but it’s easy to belittle yourself and make excuses for why you shouldn’t bring it up.

Passive communicators tend to be conflict avoidant, masking their negative emotions through calm or complacency.  Yet they must to deal with their negative emotions somehow and might find themselves turning to addictive behaviors as a coping mechanism.  This is the member of the duo that wants to run away from conflict and stop the conversation as soon as possible.

Beliefs that drive this communication style include unworthiness or low self-esteem.  Passive communicators don’t trust their own judgment and emotions, and they can feel like a doormat.

Aggressive

In contrast to the passive style, aggressive communicators use more intimidation or force with the way they speak.  They might use sarcasm, contempt, yelling, or name-calling in the course of a conflict conversation.  At extremes, this can become verbal abuse, used to gain control.

Aggressive personalities have a low tolerance for emotional distress, and therefore can fly off the handle unexpectedly.  When the passive partner withdraws, the aggressive spouse may become more ramped up and try to continue the conversation.  They want to make sure their point is heard, and therefore act as the pursuer.  Surprisingly, this communication style can also be motivated by low self-esteem.

Passive-Aggressive

Passive-aggressive communication occurs when anger has been pushed down so often that it spills out sideways.  It is often a function of the suppressed anger of the passive style boiling over.  Although the individual tries to ignore the anger as long as possible, like a beach ball that’s being held underwater, it will eventually pop back up unexpectedly, uncontrollably, and with more force than it took to push it down.

Rather than direct communication, passive-aggressive words require your spouse to be able to read between the lines and guess your thoughts and feelings.  It undermines their experience, such as when the passive-aggressive communicator denies being upset when they are bothered.  Often this style is motivated by a fear of what will happen if you communicate directly.  The hope is to find a way around direct communication and still gain control or get your needs met.

Can you tell which of these three communication styles is your go-to?  Maybe you experience more than one, or they change based on circumstances and people.  But if you find yourself stuck in these patterns, what does healthy communication look like?

Assertive

Assertive, or direct, communication is an effective way to have our feelings and needs heard and to hear the same in others without escalating into emotional volatility.  A simple formula, as described in an earlier post, is to say the following: I feel _____ because _____ and what I need is_____.

I encourage my clients to do something I call “speaking the subtext.” Often when we speak with our spouse, we imply something different from what our words are saying on the surface.  For example, when you ask, “what time are you getting home from work today?” are you wondering about a certain time, or are you implying that you’d like your spouse to come home early to help make dinner?

When being assertive, emotions don’t overwhelm and derail conversations as easily.  It is easier to set boundaries and take responsibility.  Assertive communication is motivated by a healthy view of your own value and empathy for others.

What are some steps you could take today to more toward more assertive communication?

Self-Care Saturdays: Treat Yo' Self

Welcome to Self-Care Saturdays, a series of bonus blog posts that will be released on the last Saturday of each month.  In a world where we are constantly faced with demands on our time and energy, it can feel impossible to slow down enough to pay attention to our own needs and take steps to care for them.  These articles are meant to get you thinking about one small step you can take today to practice kindness and care for yourself. 

If you’re familiar at all with the NBC show Parks and Recreation, you’ll be familiar with the phrase (and holiday) that’s gained popularity in our everyday vocabulary: “Treat Yo’ Self!”  The premise, as described by Donna and Tom, is to spend a day shopping, eating delicious food, and generally doing fun things for yourself that you wouldn’t normally do otherwise.

Treating yourself, while inherently fun, also has health benefits that make this practice worth it.  When you practice self-compassion, or being kind to yourself, research shows it can improve your psychological well-being and physical health .  It improves your productivity at school and at work to take occasional breaks.  It can increase your happiness and positive mood, make you more resilient, and help you respond more positively to negative events or beliefs about yourself.  Self-care as a whole has huge benefits for depression, as it directly combats the negative patterns of thinking that so often characterize this disorder.

A huge component of treating yourself is the idea of self-nurture.  It is unfortunately common to grow up without a good understanding of how to nurture ourselves.  We may have had parents who struggled to nurture or care for us, or didn’t have the financial resources to provide that care.  As an adult, however, it is crucially important to practice this self-nurturance to improve your self-worth and self-value.

If you find yourself skimping or depriving yourself often, treating yourself can be a big gift to yourself.  At the same time, it’s important not to go overboard.  If you splurge too much or too impulsively, you can get hit with financial stress or regret afterwards.  If it’s out of a heart of self-indulgence, this can develop into an addiction or unhealthy reliance on that “treat” to cope.  It will leave you feeling like you never really get what you want, or it's not enough.  Avoid this trap by making a specific plan ahead of time to treat yourself, rather than doing so impulsively.  Then if you feel uncomfortable with the treat, you can adjust it to what feels right.

What are some ways you can treat yourself?

Splurge.

Every once in a while, take the opportunity to spend a little extra money on yourself. 

• Get a fancy manicure or pedicure: go a tier up from what you usually get.

• Go out to a nice restaurant that serves your favorite cuisine.

• Purchase something beautiful from your favorite store.

• Put together an outfit at a clothing store (from shoes to shirt to earrings) and buy it.

• Gift yourself a floral bouquet.

• Buy a gift for a friend just because.

• Take a class on a topic you love (cooking, art, music).

Spa.

The most physically relaxing and comforting experience might be giving yourself a day at the spa, whether that’s inside or outside of your home. 

• Soak in a bath with essential oils.

• Give yourself an at-home manicure or pedicure – and don’t skimp on any step! Soaking, buffing, cuticle care, filing…make it as much like a spa nail treatment as you can.

• Wear comfortable clothes, like a fluffy robe or fuzzy slippers.

• Get a massage.

• Care for your skin with a face mask.

Sabbath.

I can’t seem to get enough of talking about how important it is to take a day of rest (likely because it’s the area where I need to grow the most).  Rest can feel countercultural and like a treat in our busy, fast-paced lives.

• Sleep in.

• Indulge in your favorite hobby for an entire morning or afternoon.

• Go to see a new film in theaters or watch an old favorite.

• Plan a vacation using websites like Groupon or LivingSocial.

• Play a game you enjoy.

• Have a dance party!

Snack.

They call it "comfort food" for a reason: having a delicious treat can fire up the feel-good neurochemicals in your brain.  Take care to make this an occasional practice, rather than turning to food every time you need a boost.

• Bake a delicious dessert or craft a savory treat.

• Make a special breakfast or meal that reminds you of your childhood.

• Cook yourself your favorite meal.

• Buy your favorite coffee or tea drink from a coffee shop.

What are the ways you can treat yo’ self this week?

Are You Living Like The Walking Dead?

This Sunday, AMC premiered the 8th season of The Walking Dead with the series’ 100th episode.  It’s fascinating to see how much this show has maintained its popularity through the past 8 years.  Part of the draw in our culture toward TV and movies that focus on zombies is that on some level, we can relate.

Have you ever heard yourself or someone else utter the phrase, “I feel like a zombie”?  Whether it’s because we’re exhausted, stressed, or overwhelmed, we can find ourselves having a hard time functioning.  While feeling exhausted might be remedied by a good night’s sleep, sometimes we feel like zombies caught in the day-to-day of our lives.  We can be emotionless and struggle to make it through each day.  We lose sight of our hopes and dreams for the future, as the fog of everyday stress fills our mind.

One hallmark trait of zombies is their insatiable hunger.  That hunger is what makes them so dangerous.

At the same time, we can relate to the sense of being hungry for something more.

We desire for our lives to have meaning and purpose, to feel content and whole, but we often settle for filling our hunger with things that don’t satisfy.  We can become addicted to alcohol, drugs, sex, shopping, food, or gambling.  We can become entangled in dysfunctional or codependent relationships.  We might fill our lives with things that make us busy so we don’t have time to feel longing for more.  We might spend our money on bigger and better things as an attempt to make us feel happy.  But sadly, none of these satisfy us.

What are you hungry for?

What are the things that you desire?  If you’ve numbed out in any of the above ways, it’s likely that question hasn’t crossed your mind in some time.  Nothing may come to mind for you.  Here are a few questions that might help spark your curiosity:

• If you could change one area in your life that would make it infinitely better, what would it be?

• If you could wave a magic wand and have the life you want, what would it look like?

• What do you daydream about? Why? What will that give you?

• What were the things you loved to do as a child? What did you want to be when you grew up?

As you answer these questions, you may come across desires that aren’t practical or helpful.  For example, if you daydream about having an affair or quitting work to play video games all day, that likely isn’t a desire that will serve you well in life.  However, these daydreams provide clues to your desire.  For example, if you daydream about an affair because your marriage feels like you’re living parallel lives, it can point out a desire for more intimacy in your marriage.  If you desire to play video games all day because you hate your job, that’s a clue that you want something more out of your career.

Keep in mind that this may be a painful process.  Identifying desires breaks the pattern of numbing out and opens us up to feeling longing, sadness, loneliness, anger, and a whole host of other emotions.  But in order for you to feel joy and contentment with your life, you need to be able to move through these negative emotions as well.  I love the book Desire by John Eldredge that outlines how desire is both crucially important and so difficult to engage with.

How do I come back to life?

You’ve identified your desires: now what?  Just identifying desires can lead us back into numbing out if we don’t have a concrete idea on how to move forward into those desires. 

To start, choose one desire you’re feeling in your life.  Typically it’s best to identify the desire that has the most energy or emotion tied to it.   It could be related to your career, your relationships, your spiritual life, or your hobbies.  Next, what is one step you can take to move yourself closer to that desire?  Start with the end goal and trace each step back until you get to a manageable first step.

An example from my own life: I want to be a skilled home baker.  I’m obsessed with watching the Great British Baking Show and Food Network’s Holiday Baking Championship, and I dream about crafting beautiful and delicious desserts.  But the amount of knowledge these bakers have is beyond my competence.  How do I trace it back?.  In order to be a skilled home baker, I need to learn different recipes and methods of baking desserts.  I need understand the chemistry of baking.  I need to practice.  A next step might be to check out a book at the library about baking to read, to sample a new recipe, or to watch a YouTube video about cake decorating.

But what if I don’t know what to do?

Like the CDC developing a cure for the plague, or The Walking Dead’s Rick Grimes forging a new community, you need a guide who can give you direction on where to go and how to get there.  Often, the process of coming back to life is long and arduous.  Like a trek through a mountain, it can be easy to become discouraged when looking at the summit instead of the next step in front of you.  You might slip back into old patterns in that discouragement.

As a therapist, I function as a guide in areas of your life where you feel stuck.  My role is to help you identify and engage with your desires, break down desire into manageable goals, and walk with you as you make progress on your climb up the mountain.  When I see you slipping back into numbing out through addictive behaviors, it is my role to lead you back to the path to your desire.  In the process, I believe that you’ll see areas of your life slowly become more vibrant and in alignment with what you desire.  Hope will grow and flourish as you begin to see these dreams becoming a reality.

How Recognizing Grace Transforms Counseling

I’ve been a traveling therapist these past few weeks, jetting off around the country for various conferences. Some have been counselor-focused, and others have been for personal growth and healing, because in order to offer the best care I can to my clients, I need experience my own healing.  I sat in on a talk given at a conference by a favorite speaker of mine, Mark McMinn, who taught my graduate school professors and was influential in my educational experience as a result.  He spoke about integrating grace in his counseling sessions and the impact of the message of grace.  This message felt like a personal devotional time of reconnecting with the grace in my own life.

Here were a few reflections I’ve since had from that session.

How do we define grace?

When I first became a Christian, I had no idea what grace meant.  I’m sure I heard sermons about it, read about it in the Bible, and heard other people talk about their experience of grace, but I was clueless as to how it affected me.  It wasn’t until I read The Ragamuffin Gospel by Brennan Manning that the true message of grace sunk in.  I learned that no matter what I did, no matter what mistakes I made, no matter how many times I failed, I could rest in the love that God had for me and know that it was enough.

McMinn talked about grace in this way: Grace is a free gift of love, forgiveness, and God’s favor with no strings attached.  It is above and beyond all we could ever want or need.  There is no hidden agenda or any way we could pay God back for the grace we receive.  It isn’t contingent on how we respond.  It is unconditional and is given to us before we decide to receive it.  It doesn’t make sense.  It changes us.

Ultimately, grace is about believing that I am enough.

In my personal retreat this past week, I engaged with the question of “Am I enough?”  This is a common question we face, and we often answer this question one way or the other based on what we see in our lives.  But what grace tells us is that our actions cannot add to or detract from our fundamental worth and value.  If I am going to experience grace for myself and extend it to my clients, I must rest in the truth that we each have individual and inherent worth and value, and that because of that, we are enough.

Grace allows us to practice acceptance.

As I talked about in an earlier post, there is a surprising freedom that comes as we take stock of our circumstances and give ourselves grace for how we are handling them.  Often we are plagued by the “tyranny of the shoulds,” where we wonder about how we “should” be facing a certain circumstance, or we fret over how our circumstances are not working out as they “should.”  However, the energy spent on “shoulding” all over ourselves and others simply increases our distress.  As a therapist, one of my goals is accept and love you in the middle of your circumstance, offering you grace when you aren’t able to offer it to yourself, with the hope that you will learn the path to offering grace to yourself.

Our values are incredibly important.

While we may accept our circumstances, that doesn’t mean throwing our hands up in defeat.  Accepting our circumstances doesn’t magically fix them. What it does is provide clarity on what actions we can take to move toward our values.  In the urgency of the day-to-day, we can lose sight of the things most important to us.  If you make a list of all the things you value and compare it to your current schedule, you would likely find some inconsistencies.  Identifying and reminding yourself of your values and choosing to act in accordance to them even amidst chaotic circumstances allows you to experience peace.

Addiction treatment is vastly different with an outlook toward grace.

Manning, the author of the Ragamuffin Gospel, suffered from a lifelong pull toward alcoholism.  Alcoholism and addictions of any kind are driven by shame: as the addict feels shame in their life, they will choose to medicate or run away from that shame with addictive behaviors.  However, addressing shame with grace removes the fuel for the fire of addiction.

Resist shame by befriending the thoughts that are plaguing you.  Accept them, normalize them, and allow them to be there while also making decisions based on your values.  Imagine a sex addict feeling the urge to view pornography.  In the moment when she feels that urge, she may experience shame and “should” all over herself, which will lead her to medicate that shame with the most effective tool she has – acting out in her addiction.  With an approach of grace, however, the addict can choose to normalize her urges (“Of course I’m wanting to view pornography, I’m an addict and there’s a chemical imbalance in my brain.”) and then choose to act in a way that is in alignment with her values (“Sobriety is important to me, so I’m going to choose to call my sponsor instead.”)

Grace is humbling and helps us admit we are wrong.

Grace offers us the opportunity to admit that we don’t have it all together.  Over the years, McMinn named that he had adapted his counseling style from one focused more on concrete thoughts and emotions (cognitive behavioral therapy) to a method that involved more mindful awareness and acceptance of the present state of circumstances (acceptance and commitment therapy).  He even wrote a book about the first style of therapy that he admitted to his audience was not in alignment with what he currently practices.  Grace gives us the humility to adapt and change our response.

We develop empathy as we connect with our personal brokenness.  Accepting grace requires us to admit that we are human, that we’ve failed or done wrong or made a mistake.  It makes it easier to forgive others when we see how broken we are ourselves.  Imagine the difference this could make in marriage if couples extended grace to themselves and to one another.  Imagine the effect this forgiveness could have.

Where do you need grace in your life today?  Are you ready to ask for help?

Why Can't I Feel? Dissociation and Emotional Detachment in Response to Trauma

Back in 2013, a film was released called The Secret Life of Walter Mitty which features Walter, an ordinary man who lived a fairly uneventful life but daydreamed about a fantastical, adventurous life to escape bullying by coworkers and unrequited love.  I loved how this film portrayed Walter’s tendency to do what his mother called “zoning out,” where he would engage in a fantasy that distracted him from the pain he experienced in his daily life.

For Walter, this daydreaming was a form of what we call dissociation.

What is dissociation?

Dissociation, or emotional detachment, is a defense mechanism used to cope with distressing or overwhelming emotions.  It involves disconnection between your thoughts, emotions, and behaviors.  Often it begins as avoidance of past memories of traumatic events or of negative emotions.  While all of us experience this emotional detachment from time to time (have you ever binge-watched an entire Netflix series without knowing where the time has gone?  Or zoned out on the highway and completely missed your exit?), dissociation is particularly common in survivors of trauma. 

With past experiences of abuse or trauma, dissociation serves as a survival tactic that keeps us from becoming overwhelmed by the pain or trauma we are experiencing.  Dissociation is particularly common with sexual abuse or assault, and it is associated with symptoms of post-traumatic stress disorder.  However, as we adopt these patterns of emotional detachment that were helpful in the past, they can become patterns we continue with later in life, putting us in constant survival mode.  Often dissociation is caused by parents who do not teach emotional regulation skills to their children, and therefore children don’t know how to cope with these emotions when they surface and are overwhelmed by them.

In extreme cases with severe trauma, dissociation can transform into a more serious psychological disorder.  However, most often the process of dissociation does not lead to this extreme.  In fact, most people emotionally detach from time to time, and it doesn’t turn into a more severe disorder.  However, it can impact struggles with depression or anxiety as numbness sets and in and replaces healthy experiences of emotion.

How do I know I’m dissociated?

It is incredibly easy to dissociate in our daily life.  We have so many opportunities to be entertained or distracted.  We “check out” and avoid because life is too painful or stressful.  This detachment can be functional and seem like it works to control emotions, but you might find that the dissociation eventually controls you.

Here are some indicators that you might be dissociated:

• numbness

• apathy

• memory gaps

• feeling of being outside of yourself, as an observer of your life

• feeling disconnected from surroundings

• “checking out” or drifting off

• feeling as though the world around you is distorted or not real

• avoiding or “stuffing” emotions

• daydreaming

• difficulty remembering events

How can I change dissociation in my life?

When you notice emotional detachment or dissociation in your life, there are several ways you can choose to re-center yourself and connect to those emotions that you find yourself avoiding.

Practice a grounding exercise.

The first step in getting in touch with your emotions involves slowing down your physiological reaction and paying attention to your body.  This can happen as you practice mindfulness and breathing exercises that allow you to observe the sensations you feel inside yourself.  A particular favorite of mine is the 5-4-3-2-1 senses exercise referenced in this article, which helps you connect with what you see, hear, feel, smell, and taste right in front of you.

Remind yourself that you are safe in the present moment.

In the midst of these grounding exercises, emotions can arise that you didn’t know were there.  In those moments, you might find yourself triggered by a past memory or anxious about an upcoming event. Repeating key phrases during this grounding exercise like, “I am safe now.”  “I can handle what is coming in my life” or any other statement that helps you to feel peace can ease this pain. 

Pay attention to where emotions are centered in your body.

When you begin to identify the emotions that arise, notice where you can feel the sensation most clearly in your body.  Often, when I meet with children, I’ll have them color an outline of their body with colors that represent different emotions, in terms of where they feel that emotion most frequently in their body.  If you aren’t currently feeling any strong emotion, spend some time thinking of the major emotions (happy, sad, angry, afraid) and how you would describe their presence in your body in the past.

Keep an emotions journal.

Often we aren’t aware of our emotions because we are moving too quickly through life, or we’ve never taken the time to identify them.  Instead of rushing through your day without checking in with your emotions, spend a set time each day reflecting on your emotions and how they affect you.  Use a tool like this feelings wheel to answer the following questions:

• What am I feeling right now?

• How do I know I’m feeling that emotion?

• Where does that emotion center in my body?

• What triggered this feeling?

• What do I want to do because I feel this way?

• How do I wish I were feeling?

Look for patterns in your emotions and how you respond to them over time.  Notice if there are certain emotions that lead to dissociation.  Identify if there are times you felt that emotion in the past which may lead you to want to avoid it in the present day.

Self-soothe when you’re experiencing negative emotions.

Our emotions serve as a red flag indicating unmet needs or desires in our lives.  Use these indicators to consider the desires you’re feeling and seek to either care for those needs or self-soothe in ways that calm your emotions.  Feeling angry?  Take some time to exercise to release that pent-up energy.  Feeling sad? Practice good self-care by taking a bath and soaking in the warm water.  Feeling stressed?  Give yourself a day off to relax around the house and do something you love.

As you begin to approach dissociation or emotional attachment differently, you’ll find yourself integrating emotion into your life differently.  While this process may be painful at first, with time you’ll come to appreciate the richness of your ability to access emotions throughout your life.

Self-Care Saturdays: Keep it Simple

Welcome to Self-Care Saturdays, a series of bonus blog posts that will be released on the last Saturday of each month.  In a world where we are constantly faced with demands on our time and energy, it can feel impossible to slow down enough to pay attention to our own needs and take steps to care for them.  These articles are meant to get you thinking about one small step you can take today to practice kindness and care for yourself. 

Simplicity has become an increasingly popular concept in our culture.  In a time when technology is advancing faster than we can keep up, multitasking is the norm, and we’re constantly accessible through our phones and emails, we can feel overwhelmed by complexity in our lives.  De-cluttering and minimalism are trends made popular by Marie Kondo and other organization gurus.  We find ourselves reminiscing about “the good old days” where life was just a little bit slower and a whole lot simpler.

This summer I read a childhood favorite book series of mine: Little House on the Prairie.  As I read, I thought about pioneers and felt a longing in my heart to live in the simplicity of that generation.  When I'm overwhelmed by stress and complexity in my life, it is easy to forget how technological advances have made our lives simpler and more automated.  I find a need to balance using technology to create more simplicity in my life without letting it rule over me.

It can feel near impossible to create simplicity in your life.  You may be in a season where simplicity is unrealistic because of the demands of family or career.  Often, as we grow older and gain more responsibilities, simplicity seems like a pipe dream.  We need to begin to create simplicity by eliminating the extras that add unnecessary overwhelm to our lives so that that we can focus on the areas that bring us life and that fit alongside our values.

How can you create more simplicity in your life?

Breathe.

Stop for a moment and notice your breath.  When was the last time you physically felt the breath in your body as you inhale and exhale?  This process is unconscious: we can go for days without actually noticing our breath.  Slow down today and remind yourself to breathe.  Practice mindfulness exercises or meditation throughout your day.  Use a meditation app like Headspace to do a daily meditation or to meditate at various points throughout the day.

Take a Sabbath each week.

I’m a recovering perfectionist.  I have a tendency to overfill my schedule to the point of overwhelm and sometimes even burnout.  When I see this happening in my life, I know that I need to prioritize a day off for myself.  A Sabbath is my go-to way both to recharge myself and to spend time reconnecting in my relationship with God.  Spend one day a week intentionally doing things that refresh you and help you to go back into your work recharged.

Allow yourself to feel bored.

With the easy accessibility of iPhones and media, we are constantly within reach of being entertained.  Because of this, we have become intolerant of boredom.  When we feel bored, we can always find a way to keep our minds occupied and our thoughts entertained.  When you notice yourself becoming bored, allow yourself to sit in that emotion instead of immediately seeking a way to be entertained.  If you’re standing in line, choose not to check your phone.  If you’re waiting for an appointment, choose to sit and wait rather than finding a way to distract yourself.

Get rid of clutter and unnecessary items in your home.

It can be easy to accumulate massive amounts of material things over the years.  Sometimes we don’t even know how we got it, but our home is suddenly full of "stuff".  Often we don’t need or even really want some of these items, but the effort it takes to get rid of them can feel like too much.  Spend a day going through your closet or drawers and clear out anything you don’t love.  As Marie Kondo suggests in her book, save the items that bring you joy and trash or donate all the remaining items.

Say “no” more often.

Simplicity in our schedules is near impossible when we have overcommitted ourselves.  It can be easy to say yes to everything we are asked, especially if we’re people pleasers.  In her book The Best Yes, Lysa Terkeurst talks about learning to say no more often so that we can give our best yes to the commitments that align with our values, bring us life, and fit within our gifting.  Save your yes for those moments, and begin to practice the tough work of saying no.

Uni-task.

Multitasking wears on our brain as we’re trying to focus our limited attention on several different items at once.  Our brains become overloaded by this multiple focus, so we tend to do each task to a lesser quality than we would otherwise.  Choose to focus on one task at a time and spend your energy in that one direction of focus before moving on to the next.

How will you choose to press into simplicity this week?

How to Choose Your Therapist

You’ve finally hit the breaking point.  Whether your sadness and depression are the lowest they’ve ever been, your anxiety has hit a fever pitch, or your marriage feels like it’s crumbling around you, you’ve likely hit rock bottom and are looking for a way out.  The idea of therapy may have popped into your head from time to time, but today you’re at the point where you’re ready to start.

But how do you make a decision about which therapist is the best fit for you?

The process of looking for a therapist is anxiety-inducing by nature. Therapy is stigmatized in the media, and you may only know horror stories of therapists you heard from friends or family.  The hurdle of making the first appointment can feel insurmountable.  Common wisdom says that people wait three to six months after receiving a referral to a therapist before scheduling their first appointment.

Here are a few pointers in your search for a therapist.

Ask for a recommendation.

People you know who have seen therapists are often your best resource for a good counselor.  If your friend has seen a therapist and had a positive experience, this is one of your best indicators that this therapist might click with you.  Ask your family or friends for names of counselors they’ve seen.  Check out the counselor’s website and online presence to get a sense of their voice.  If they have a blog, read some articles to see who they are and if you feel as though you can feel comfortable with this individual.

Look for a therapist who specializes in the issue you’re dealing with.

Often, therapists have a specialty in an area of interest for which they have a unique passion.  For example, my area  of specialty is sex and love addiction, particularly as it relates to women.  Therapists attend events or get additional training in these issues in order to be the best resource for you.  Look at the therapist’s “about” page on their website to learn more about these specialties.

Attend the first session to see if you feel comfortable with the therapist and can grow to trust them.

The first session is a good opportunity to test out your fit with your therapist.  You want to feel connected early on in therapy.  While trust is generally built over time, you can typically get a good sense for the potential to trust in that first session.  If you notice yourself feeling “off” in relationship with your therapist, if you are just staying in therapy to appease them, and especially if you feel as though you are being manipulated by your therapist, then you may want to find someone who is a better fit.

Identify if the counselor has a fundamental curiosity about you and your story.

Therapy is meant to be an exploration of your personal narrative with your counselor acting as a guide to help illuminate additional viewpoints and insights into your life story.  In order for this to happen, your therapist needs to be curious about your story: asking questions, digging deeper, exploring different perspectives on the content you bring to session.

Your therapist should be willing to push your buttons…but not too much.

Your counselor should strive to strike the delicate balance between pushing back against some of the faulty beliefs and behavior patterns in your life in order to encourage you to change, but not doing so until you feel uncomfortable.  You will likely feel slight discomfort as your therapist presses into your issues.  But if you’re feeling too uncomfortable in relationship with your therapist, that may be a sign that they’re not the right fit for you.

Counselors need to make space for their own therapy, practice quality self-care, and set appropriate boundaries.

Many graduate programs require their therapists to be involved in their own personal therapy.  Therapists spend their days hearing the pain and difficulty in others’ stories, and they need a space to receive their own care from a therapist.  You want your therapist to practice what they preach.  They likely won’t be perfect at it, but you want your therapist to set appropriate boundaries and take good care of themselves so that they can be fully present with you and your story.

See if your therapist’s values reflect your own.

As much as therapists try to be neutral, therapists do bring their personalities and their values into their sessions.  If you have a significant role in your identity that feels important to you, look for a therapist who fits with that identity.  For example, if you are a Christian, finding a therapist who is also Christian helps you to connect over those spiritual values.

Ultimately, you want to choose a therapist who is grounded in their own emotions, confident in their practice, and not afraid to refer you to another therapist if needed.

A Dangerous Spiral: The Cycle of Addiction in Sex and Love Addicts

Have you ever found yourself in the middle of a familiar pattern of behavior that you promised you would never do again?  Maybe it was a series of toxic relationships where you felt drained of life.  Maybe you found yourself having one drink too many again, with the raging hangover to prove it.  Perhaps you wonder how you managed to polish off another bag of cookies all by yourself.

For the sex and love addict, finding herself in the middle of behaviors she promised she would never return to again is a common occurrence.  There’s often a distinctive difference where her “addict” self takes over and their true, authentic self disappears.  It seems reminiscent of Dr. Jekyll and Mr. Hyde, where she feels clueless of how the change even happens.

We’ve talked about triggers toward addictive behavior in the past.  While triggers can often be the spark that lights the fire, the fire burns brighter and picks up speed as it starts to move through the cycle of addiction introduced by Patrick Carnes in his book, Out of the Shadows. 

Beginning the Cycle

The cycle starts when events trigger the addict to experience beliefs rooted in shame.  Thoughts like “I am not enough,” “I am too much,” or “There is something wrong with me” can trigger a shame spiral, which leads to painful emotions.  The addict can feel the tension of desire to escape from the pain, creating a void she wants to fill.  These shame statements can be made worse by feeling hungry, angry, lonely, or tired, which are often results of poor self-care.

Stage 1: Preoccupation and Fantasy

As she tries to cope with the shame and beliefs she’s experiencing, the sex and love addict begins to fantasize about her desired sexual behavior.  Sexual behaviors are typically the primary way she has learned to cope with distressing emotions.  Eventually, her obsessive thoughts about sex or relationships can feel intrusive and uncontrollable as they continue to pop into her head uninvited.  Fantasy about past sexual behavior or the potential of future behaviors can flood her brain with dopamine, a neurochemical in the brain that is a driving factor in sexual addiction.

What does preoccupation and fantasy look like for you?

Stage 2: Ritual 

Next, the addict begins to prepare to engage in her sexual behavior.  In this stage, the addict begins to disconnect from the world around her.  Time can pass in a rush, responsibilities can be ignored or forgotten, and she moves in autopilot, energy coursing through her body as a result of the flood of neurochemicals in her brain.  She may prepare to meet sexual partners by dressing up and putting on makeup, driving to a bar, or opening a hookup app on her phone.  If her addictive behavior is based online, even opening a computer can serve as a ritual. The emotional “high” from engaging in these rituals is typically more sexually charged than the sexual behavior itself.

What are your rituals?

Stage 3: Compulsive Sexual Behavior

Stages 1 and 2 set the addict on a crash course toward what is referred to as “acting out behavior,” or the compulsive sexual behavior in which the addict engages.  Once the cycle has started, this behavior can feel inevitable, especially if she isn't aware of the process of ritual and preoccupation.  While to the outsider this stage might look like the goal of the cycle of addiction, in reality it serves as the activity that brings the thrill or high to a halt.  In fact, many addicts look forward to and prolong the ritual stage for as long as possible so they don’t break the high of the behavior.

How would you define this problem behavior in your life?

Stage 4: Despair

When the addict acts out, she then experiences both relief and shame.  The relief comes from masking the distressing emotions she felt that drove the behavior, but it is often quickly followed by shame surrounding the failure to resist acting out.  Sadly, that shame can reinforce the beliefs about herself that initially led the addict to become triggered in the first place.

She might try to numb out or disengage from those feelings through other addictive behaviors, such as alcohol, drugs, food, cleaning, religious activities, shopping, or focusing on children.  But the easiest way to deal with that guilt and shame that arises is to return to the sexual acting out to mask those feelings once again.  The underlying issues that started the addictive cycle in the first place (the shame and negative core beliefs that started the spiral downward) are left unaddressed.

What do you tend to do to make your despair or shame go away?

Jumping Off the Cycle

You cannot break this cycle by just telling yourself to stop.  It is crucially important to examine how your personal version of the cycle looks so that you’re able to recognize when you’re headed toward a downfall.  The cycle can only be addressed when you start at the root: the underlying core beliefs and triggers that led you there in the first place.

Start noticing the events, thoughts, and emotions you have prior to your fantasy or preoccupation starting.  What do you believe about yourself or about the world around you?  When you notice that shame arising, slow down and practice self-care.  Journal or call up a trusted friend who can help you sort through what you’re experiencing.  Look for alternative behaviors to meet the needs that are driving your desire to act out.  Examine those emotions or experiences in a healthy way with your therapist, and you’ll begin to notice the drive to escape is not as powerful as you once thought.

The Many Faces of Trauma

We’ve talked on this blog before about the various signs and symptoms of trauma you might experience.  In that article, I referenced the difference between what I called “big T” traumas and “small t” traumas.  But how do we categorize those different events?  Maybe you’ve had the experience where something you thought was “normal” ended up having a greater negative impact on you.  What types of events can be defined as traumatic? How do different stressful life events affect how we process and deal with trauma?

“Big T” traumas

A “big T” trauma is a uniquely identifiable and significant distressing event.   You might immediately associate these type of events with post-traumatic stress disorder (PTSD).  PTSD involves a cluster of symptoms that interfere with daily life, including: exposure to a traumatic event, re-experiencing through flashbacks or intrusive thoughts, avoidance of reminders of the traumatic event, negative thoughts about self or others, and heightened reactivity.  Significant traumas such as these can lead to feelings of isolation, due to the distinctive nature of these events.  The individual who experienced this trauma may also feel a greater pull to avoid reminders of the trauma and experience a sense of helplessness over circumstances.

Recently, we’ve been faced with horrendous scenes of destruction in the wake of two major hurricanes that ripped through the southern states of our country.  It is easy to see the effects of these major events as trauma that affects the individuals whose homes were damaged or destroyed and who are now displaced.

Examples of “big T” traumas include:

• Physical or sexual abuse in childhood or adulthood

• Sexual assault

• Natural disasters

• Sudden and unexpected death of a loved one

• Witnessing the death or injury of someone else, particularly a loved one

• Domestic violence

• Robbery

• War

• Military service/combat

• Acts of terrorism

• Car or airplane accidents

“Small t” traumas

“Small t” traumas are distressing events that are smaller in scale than “big T” traumas, but often occur over a more prolonged period of time. These traumas are more persistent and subtle than the “big T” traumas, and can be just as painful as a result.  They are especially impactful for those who experience them in childhood. While typically those who have faced these types of trauma do not have enough criteria to be diagnosed with PTSD, they may experience symptoms of trauma that mimic the characteristics of this disorder.

I imagine this type of trauma like a series of waves in the ocean.  The first time the waves sweep your feet out from under you, it’s relatively easy to recover.  Once you’ve regained your footing and tried to stand, however, you find you've been knocked off your feet again as the current pushes another wave toward you.  Before long, you become exhausted by the process of trying to stand up to the current.  "Small t" traumas are often minimized by the individuals who are facing them because they do not carry the label of a significant trauma, but this persistent nature is just as impactful as the “big T” traumas.

examples of “small t” traumas include:

• Betrayal/infidelity by a spouse

• Emotional abuse in childhood or adulthood

• Non life-threatening injuries

• Family or work conflict

• Bullying or harassment

• Divorce

• Loss of a significant relationship

• Sudden relocation/moving

• Legal issues

• Loss of a job

• Financial distress/poverty

• Being the child/spouse of an addict or individual with mental illness

• Ongoing parental criticism

• Parental disconnection and disengagement

Life Stressors

Sometimes even positive life experiences can create increased stress levels that lead to distress or anxiety and compound the symptoms associated with a more major trauma.  The Holmes and Rahe stress inventory is a measurement used to identify how some stressors (which can be either “small t” traumas or positive events that created a pattern of stress) may be affecting you today.  The interactive survey here helps you to identify how stressful life events have impacted you this past year.

Examples of significant life stressors include:

• Planning a wedding/getting married

• Starting a new job

• Moving across the country

• Having/adopting a child

• Holidays

Each of these traumatic or stressful situations is handled uniquely by different people.  How you respond to trauma is related to your predisposition and personality.  However, one factor that has been shown to affect the experience of traumatic symptoms is avoidance.  The more a person avoids the traumatic experience, the more likely they are to integrate that trauma into their psyche and have a harder time recovering.  Instead of choosing to avoid the pain , allow yourself to feel impacted by it and seek the help you need.  These traumatic events can be painful, and they deserve care and compassion.

What are some of the experiences listed above that have caused trauma in your own life?  How are you coping with that trauma?