How to Know when Medication is Right for You

How to Know when Medication is Right for You

Note: Always consult with your doctor when making decisions about your options for medication and the severity of your symptoms.

People experience mental health symptoms on a scale, which is to say that the severity of their symptoms vary widely amongst individuals.  For example, most people have a bandwidth of happiness in which they exist regardless of their circumstances.  Think about happiness as being a scale from 1-10, in which 10 is the most happy, joyful, and blissful mood you can experience, and 1 is being so depressed that you are suicidal.  Some people never get to that feeling of 1.  Even when things are really bad, such as experiencing the pain of grief, or significant financial hardships, or experiencing a severe trauma or assault, they still never get to the point at which they are suicidal.  Maybe that person stays within a bandwidth of 5-9, so that when things are really, really, bad, they would rate their happiness around a level 5, and when things are going really, really well, they get pretty close to that 10 on the happiness scale.  There are other people, though, who never ever get to that feeling of 10.  They tend more towards depression, and when things are really, really going well, they experience their happiness around perhaps a 7, but when they are really struggling with things going on in their life, or something pretty bad happens, they can become suicidal and really struggle to cope with their circumstances.

 

All this means is that some individuals may need more interventions depending on where they fall on an overall bandwidth of their symptoms.  The same analogy above can be considered when you are thinking about symptoms of anxiety as well.  Some people tend to have more of an anxious nature, while others may be very laid back in how they handle life’s curveballs, and many of us land somewhere in between.  You can use this analogy to help you determine how severe your symptoms are and whether or not your symptoms are likely to improve with non-medical interventions such as traditional talk therapy, utilizing your coping skills, and reaching out for support from family and friends, or whether you need to seek out medical interventions.

 

I have found in my clinical practice that many people do not want to take medication for depression, anxiety, bipolar disorder, or other diagnoses or symptoms.  This is understandable, because no one wants to feel like they have to have a crutch to help them cope with life.  However, there is no shame in using a medical intervention when needed to help you better manage your mental health.  We use medication all the time to address our physical health needs.  Just as we preserve our physical health by using non-medical interventions such as diet, exercise, and lifestyle changes when necessary, we can use our coping skills, support systems, and lifestyle changes to preserve and promote our mental health.  However, just as we sometimes need an antibiotic or another medication to manage a temporary or chronic physical condition, we may need to use a mental health medication to manage a temporary or chronic mental health condition.

 

If you are wondering whether medication is right for your mental health, consider the following in order to help you make a decision about whether a temporary or long-term mental health medication is something you should discuss with a therapist or doctor.

 

  1. You have been diagnosed with a mental health condition that includes symptoms of psychosis or other features that necessitates medication management.
  • If you have a mental health diagnosis that includes symptoms such as hearing voices, dissociative states, or severe mood swings, medication may be something that needs to be included in your long-term treatment plan. While some diagnoses may be temporary in nature, other conditions such as schizophrenia, dissociative identity disorder, or bipolar disorder require long term treatment and medication is frequently a part of the treatment recommendations.  Understandably, there are many people who resist being on medication long term.  People with these conditions often do benefit from their medication protocols, but they can be susceptible to lapses in medication compliance because they begin to feel better and mistakenly believe that they no longer need the medication.  This can result in a harmful cycle of symptom escalation, which could be avoided with regular compliance with their medication protocols.  If you have a more severe clinical diagnosis, it is important to recognize that medication can an important part of maintaining a good quality of life, with your symptoms being closely monitored by your treatment team and your medications managed by a doctor you trust.
  1. Your symptoms have been ongoing for a month or longer.
  • We all experience temporary struggles in life that can affect our mood and can increase symptoms of depression or anxiety. However, sometimes those feelings become overwhelming and our regular coping skills aren’t cutting it when it comes to managing our mental health.  For example, you may experience a significant loss in your life and grief becomes overwhelming.  Or, you might be going through an extremely stressful life change, and your anxiety starts to escalate to the point at which you begin to experience panic attacks.  While some stress, depression, or anxiety is normal when you experience these major life changes, if you are experiencing significant distress for a month or longer, please consider consulting your doctor or a psychiatrist to help you learn what medical options may help you experience some relief.
  1. You have begun to experience physical manifestations of your mental health symptoms.
  • When your body starts to show physical signs of your mental health stress, it is probably time to consult with a doctor about your symptoms. For example, some anxiety under periods of stress is normal, but when you start to experience panic attacks, tightness in your chest, or hyperventilation, you have crossed a threshold at which medication management may be another tool that you can benefit from to get relief from the distress.  This applies to depression, too.  Many people experience bouts of depression during difficult times in their lives, but when your depression is causing extreme fatigue, disrupted sleep, changes in weight, body aches and pains, or other physical manifestations, you may benefit from trying an anti-depressant under the supervision of a qualified doctor.
  1. You have tried utilizing your coping skills and support system but your symptoms have not improved.
  • I am a big advocate of utilizing non-medical interventions for mental health treatment and building the right skills to help manage symptoms on your own. However, this doesn’t mean that medication can’t be an appropriate tool to use when your other skills are not helping you to feel better.  We all need to develop and use our own coping skills and reach out to our positive support systems when we are distressed.  Yet if you have tried these interventions and you are still suffering, there is no shame in seeking out more help when needed.  This doesn’t mean you have to be on medication forever, but medication can help your brain chemistry a little bit, and help you get back to feeling normal (whatever that is for you) again.
  1. You have had thoughts of wanting to harm yourself or other people, or you have engaged in self-harm behaviors such as cutting to relieve or manage your symptoms.
  • Self-harm behaviors or suicidal ideations are significant indicators that you may need some help with medication management. No one deserves to feel like they need to harm themselves to experience relief from anxiety or depression, and no one deserves to feel like their life is not valuable enough to fight for.  If you have engaged in self-harm behaviors (including disordered eating behaviors like restriction, binging, and purging) or you have thoughts of wanting to harm yourself, you need to talk to a professional about getting your symptoms under control so that you can stop harming yourself and start working towards recovery.  Your life and your mental health are worth fighting for and you should not feel ashamed about seeking medical help.  If you have significant anger issues that result in you having thoughts of wanting to act out in violence or harm others, you also may need to seek medication in addition to traditional therapy in order to prevent an escalation of these impulses.
  1. You are engaging in other forms of self-medication such as overuse of alcohol, marijuana or other substances to get relief from your symptoms.
  • If you find that you are using alcohol or other substances on a regular basis to experience relief from symptoms of depression or anxiety, your efforts may backfire on you. Alcohol is a depressant, and thus it may temporarily make you feel more relaxed or less anxious, but it can ultimately exacerbate your symptoms.  Alcohol also interferes with your sleep, and the lack of quality sleep can also exacerbate your symptoms (hint: passing out is NOT quality sleep!).
  • Substance use functions as a form of escapism for many people, but your problems are still there when you wake up in the morning. If you really want to get a handle on symptoms of depression, anxiety, or other mental health conditions, think about your use of substances and whether it is really helping you improve your life, or if it is just serving as a form of self-medication or causing you to avoid seeking professional help.
  • Alcohol and other substances can interfere with many medications. If you have consulted with your doctor and decided that medication is right for you, be sure to let your doctor know about your drinking or other habits so that they can ensure you are informed about potential interactions or side effects when taking your medication.

 

So, what if you have been on medication for mental health symptoms, but now you are feeling better and you don’t want to be on medication any longer?  First, recognize that if you are feeling better- this means the medication is working as intended.  Some people want to get off medication as soon as they start to feel better, but understand that you may need to stay on the medication for a while longer, especially if you are getting good results.  Sometimes people stay on an anxiety medication or an anti-depressant for a year or longer.  However, if you have done the work of developing stronger coping skills, or you have had success with traditional therapy and feel as though you are ready to wean off of a medication that you have been utilizing to address your symptoms, you can seek guidance from your providers about your options for your next steps.  A good provider will be honest and frank with you about your progress and the risks and benefits of changing your medication protocol.  However, if you have decided to go off of your medication, make sure that you do so under the guidance of your doctor.  Many medications build up in your body in order to reach a therapeutic level (the dosage at which they are most effective).  It is very important not to wean yourself off of a medication without consulting your doctor, because your doctor may be able to help you get off the medication slowly so that you do not experience harsh side effects or a dramatic return of your symptoms.  You do not have to feel ashamed about pursuing medication when it is right for you.  Think of it as just another tool in your toolbox of coping skills.  Deciding to take a medication doesn’t mean you have to stay on it forever, and it doesn’t mean you don’t still have to do the work of going through therapy or otherwise building your other methods of coping and obtaining support.  Just understand that medication is a tool, not a panacea to resolve your problems.  A medication is not going to magically make your problems go away, but it may just help you get the relief you need to keep moving forward with your life in a healthier and happier way, and there is no shame in that.

How to Take a Compliment

How to Take a Compliment

When someone gives you a compliment, you have a choice about how to receive it.  I will say up front that this is a problem that I have personally struggled with at times in my life, but have worked to change over time.  Most of us intend to be gracious and appreciative when somebody compliments us, yet our responses do not always reflect that intent.  If someone compliments you, and your first instinct is to say “no that’s not true” or something else that minimizes and downplays the recognition, you may want to reflect on whether you are being truly gracious in that situation.

When you minimize, negate, or dismiss a compliment that you have received you are probably trying to convey a sense of humility and avoid looking as though you have been trying to call attention to yourself.  There is a good reason why you are trying to convey that message.  Women in particular have been conditioned by society to be polite, humble, and appreciative in every situation, and not to appear to be braggadocios or self-congratulatory, at the risk of being labeled stuck-up.  Men are not immune to these messages either, but they also are more likely to be conditioned to have confidence in themselves and to take credit for their accomplishments.  Regardless of gender, though, when you regularly dismiss any positive things people say to or about you, you are doing yourself a disservice and you may not be conveying the messages that you truly want to send.

First, consider the position of the person who has paid you a compliment.  They tried to say something nice to you, but you dismissed what they had to say because you were trying to be humble, or maybe just out of habit.  Now they have to spend additional time convincing you to receive the compliment and say “thank you” before the conversation can comfortably end.  Furthermore, if you continue to make self-deprecating statements you can end up coming across as actually fishing for compliments, because the other person is now in the position of having to refute all the negative things you are saying so that s/he does not come across as rude.  A situation in which another person tried to say something nice has now become an exercise in contradicting your negativity.  This isn’t humility, it’s insecurity.

Think also about the impression that you want to give to others.  The inability to receive a compliment graciously can have the effect of making you look insecure and perhaps even incompetent.  When you constantly refute positive things that others say about you, people may start to believe that you don’t want or deserve the accolades.  If other people see something positive in you, don’t try to convince them otherwise! That only ends up reinforcing any negative feelings you may have about yourself in the eyes of others.  It’s okay to take credit for the positive things you have accomplished, or feel good if you happen to be looking fierce that day.

Even small habits like dismissing compliments can have a negative impact on your overall sense of self-esteem and confidence.  However, this also means that making a small change in your habits can be a boon to your confidence.  It can be challenging to graciously receive a compliment when you have been in the habit of dismissing them.  Luckily, practicing this small change is easy and simple once you’ve recognized the problem.   If appropriate, you can give credit to others who may have helped you with whatever the accomplishment was that you have been recognized for.  Do not say it was all somebody else’s doing, though, because that again minimizes your contribution.  Above all, avoid negating what the other person has said, or arguing about whether the compliment was deserved.  The best, and most gracious way to receive a compliment is simply to say “Thank you”.

“Work It Out” Is Here!

“Work It Out” Is Here!

I am pleased and proud to announce the launch of my new book “Work It Out: A Survival Guide To The Modern Relationship”, out now and available on Amazon.  This has been a project that I have been working on for some time now, and it is based on my work with couples in the clinical setting.  I hope that my readers will find some beneficial information as I discuss the most common themes that I see when couples are seeking help with their primary relationships.  I have compiled some of the insights and strategies that I use to work with couples who are facing problems with issues like communication, partnership, intimacy, and conflict resolution.  While all relationships are unique and have different dynamics and needs, I present the most important skills and considerations that I use to help couples when they are trying to work things out.  I appreciate so very much the people who have supported and encouraged me throughout this process.  The book is available now on Amazon in e-book or paperback form, and I will be working on expanding the availability of the book on other platforms in the coming months.  Click on the link in my About the Author page to purchase!

Suicide Rising

Suicide Rising

In June, news broke of the suicides of both luxury handbag designer Kate Spade and international food celebrity Anthony Bourdain.  Whenever high-profile celebrities complete suicide, we are reminded that depression and mental health conditions touch every class of people and inevitably look for explanations of why anyone, even wealthy, successful people, would take their own lives.  The truth is that suicide rates have been increasing dramatically over the past two decades.  The trends are startling.  Suicide rates have increased among every single age group from 10 to 74 since 1999.  Rates are up 25% overall across the country.  Approximately 300-400 physicians complete suicide every single year.  In fact, physicians are more at risk for suicide than the general population of both males and females.  Over 20 Veterans complete suicide every single day.  Keep digging, and the facts don’t get any better.  2/3rds of firearms related deaths in this country are due to suicide.  Over half of people who complete suicide had no known mental health problems.  1 million Americans lose their doctor to suicide each year.

Why are we seeing this dramatic increase in suicide rates?  The problems are deep and resonating throughout our culture.  Isolation and hopelessness are leading emotional triggers for suicidal ideation and attempts.  We tend to blame suicidal ideation and behaviors on mental health problems, but the conditions that contribute to suicidal ideation go far beyond what is going on in people’s minds.  Emotional circumstances such as grief and loss are certainly a factor, but so are economic circumstances (homelessness and dire financial pressures), relationship circumstances (isolation and rejection both romantically and socially), and employment circumstances (overwhelming stress, abusive management, lack of basic respect, micro-aggressions and discrimination or harassment in the workplace).  Once again, when it comes to suicide, we want to simplistically blame mental health problems and offer medications or treatment to individuals without ever addressing the root causes of the distress in the first place.  To be clear, of course people who have suicidal ideations need treatment and professional care.  However, as with all problems if you continue to live with the circumstances that are the cause of your distress, the relief you experience from individualized treatment is limited.  The alarming statistics with regards to suicide rates are indicative of our broader cultural problems, and we likely will not see remittance in these rates until we truly de-stigmatize mental health treatment, provide increased access without fear of retribution or loss of reputation (a primary concern for impaired professionals), and start to shift our culture of individualistic solutions to systemic cultural problems.

I have worked with countless individuals who are either actively suicidal or have been in the past.  In my clinical observations, most people who verbalize suicidal ideation do not really want to die.  They want their lives to get better and they feel so hopeless that their circumstances will change that they come to the conclusion they would rather die than to continue to live their lives under the current conditions.  This is not to say that there aren’t people who do truly want to die.  Getting at the truth of whether someone really wants to die is a critical component of suicide intervention.  When you can help someone recognize that there is hope for their life to get better, they may become more receptive to getting the help they need to prevent suicidal behaviors.  When someone really and truly desires to die, they may actually avoid seeking help altogether because they do not want the intervention that comes from admitting that truth.

We often call people selfish who complete suicide because of the pain it causes to their friends and family left behind.  For some though, the decision to complete suicide comes after a period of intense contemplation, during which time perhaps the only thing keeping them alive is the desire NOT to hurt their loved ones or cause them more pain.  In reality, some people who complete suicide believe that they are a burden to their loved ones.  They may not want to place a further burden on their friends and family by asking for help.  This is why it is often so hard for people who really want help to come forward, and why we sometimes hear that someone has completed suicide with almost no signs of distress to their friends and family, as was the case with Bourdain from initial reports.

Perhaps in light of the alarming trends we are seeing there will be some increased funding and decreased stigma towards mental health treatment.  That would be an excellent start.  The military is a useful example of how these issues play out in reality though, and I am speaking as someone with a background in clinical counseling with military service members and their families..  Certainly, in the military there has been increased attention to suicide prevention and response, yet actually dedicating the appropriate resources remains a problem.  There may be flyers posted everywhere and mandatory in-services and dozens of pages of written protocols and programs. When it comes to changing the culture of All-Results-All-The-Time-No-Excuses that causes soldiers and sailors to lose hope though, there is no light at the end of the tunnel so to speak.  It’s akin to treating the symptoms of a disease but never addressing the root cause.

We can continue to press for more treatment resources, and more public awareness so that we can foster a compassionate culture that responds to the needs of those contemplating suicide.  However, we must do more than that to foster a culture that allows vulnerability to exist and does not punish people who seek help.  We must seek to change the circumstances that are causing undue distress.  It is not reasonable to expect the intense and rigorous standards required by medical schools to result in people feeling so overwhelmed that they choose to die.  It is not reasonable to expect our military service men and women to behave as though they are robots with no feelings or needs of their own just because they signed a contract to serve their country.  When the needs of individuals cease to have any value to the systems that they work for, we cannot then blame the individuals for turning out to be human, with human limitations and human needs.  Neither can we expect people who are suffering from severe clinical depression to be able to battle the stigma of seeking help by themselves.  We all owe it to each other to listen with compassion when we know someone who is struggling, and advocate in any ways we can towards changing the outcomes of this growing problem.  More than just connecting someone to professional help, which should be done as soon as possible, we need to listen to people in order to discover the root causes of their hopelessness and fix these broader problems as well if we want to truly make a dent in this tragic epidemic.

For more information and resources on suicide, visit the National Institute of Mental Health here:

www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml

Balancing Internal and External Validation

Balancing Internal and External Validation

Validation is a natural human need that comes from our origins as social beings.  While some species are content to live most of their lives alone, humans have always lived in groups, and thus our need for social acceptance is deeply engrained in our consciousness.  Acceptance from our peer group would have been literally a matter of life and death in early human history, because a person who had to survive on their own had much less probability of survival than those who were enmeshed within a group.  In light of our natural need for acceptance from other human beings, it’s easy to understand why many of us give significant weight to what other people think about us and whether they give us accolades or criticism.  As non-conformist as you think you may be, you still consciously or sub-consciously act or think in ways that reflect a certain value on what others may think of you.  Basic ways we conform include abiding by socially acceptable wardrobe choices, keeping appointments and schedules, showing up to work, paying for things you intend to take, and generally navigating the world without too much trouble.

It’s not a bad thing to care about what others think of you.  In fact, going back to our primitive need for social acceptance, it helps our society function in many important ways.  Our conformity to social norms ensures that we remain out of jail, can function in the culture we live in, and that our basic needs get met.  However, having a healthy mentality also means that you do not overemphasize the importance of other people’s opinions about you.  When you place too much value on what other people think about you, this can become an engrained need for external validation.  External validation means that you are getting your feelings of self-worth based on sources outside of yourself.  Internal validation means that you are gaining your sense of self-worth based on what your own opinions about yourself are.  The problem with an over-reliance on external validation is that when other people inevitably come up with something to criticize about you, you may have a difficult time mentally getting past the critique and dismiss any positive thoughts about yourself you may have had.

Imagine that you have worked very hard on a project for work, and you have to present the information about your project to someone in a supervisory role.  Upon finishing your presentation, you receive a scathing critique of your efforts, and you are told that your quality of work was poor, your efforts were sub-par and your presentation clearly lacks any demonstration of creativity or competence.  Ouch.  In order to process all this information, you need to have a healthy balance of respect for other’s opinions, and belief in the validity of your own efforts.  Having a strong sense of internal validation does not mean that you dismiss any and all criticism you receive, but it does mean that you try to separate out the information you received, with how you feel about that information.  True, you may feel embarrassed, hurt, or angry about the critique.  It may have been unfair, and if it is then you have all the more reason to look to your own internal confidence in order to cope with the situation.  When this happens, recognize that someone else’s opinion is just that, an opinion.  You’re allowed to have opinions too, and your opinion should matter at least as much to you as external opinions.  Some people really do just criticize other people in order to feel better about themselves, and these are the people who often abuse authority when they have it and are a general pain to be around.

Yet there may be times when some valid criticism is given to you, and you need to have a strong sense of internal validation in order to receive that criticism about yourself.    When you value the positive qualities that you know you have, you feel buffered by a strong sense of internal confidence that isn’t going to be destroyed by one critical opinion, or even ten.  That sense of confidence comes from knowing that you are talented and competent in some areas, as are all people, and that you can excel in those areas while knowing you own limitations.  It doesn’t mean that you think you always have the right answers or perspective, and it doesn’t mean that you think everyone who criticizes you is wrong, or out to get you. You are able to receive a valid critique, while dismissing the parts that you know and feel confident are unfair criticisms.  You recognize that other people’s opinions and expertise can help you to grow and get better at what you do.

Receiving criticism is an important skill to master when working on the right balance of internal and external validation, but there are many other times in which we navigate those feelings.  These struggles show up in our relationships, for example, if you constantly seek approval from potential partners because feeling lonely makes you feels unworthy.  Or, if someone make an unflattering comment to you about your appearance and you vow to change something about yourself or burn whatever clothes you were wearing to combat the shame of feeling hurt by their comments.  Sometimes, your opinion is the only one that does matter.  If you feel good about yourself, your work, your appearance, your talents, your future, and/or your value as a human being, there is no reason to allow other people to change your mind.  One of my favorite quotes is “What other people think of me is none of my business”.  The internet tells me it was Gary Oldman who gave us that gem.  It’s a great little mantra to remember, though, when you find yourself stressing over what other people may or may not be thinking about you.  Having a strong sense of internal validation will help you brush off unhelpful criticism and stop worrying so much about what others are thinking or saying.  Another thing to remember if that if you wouldn’t say something to your best friend, then don’t say it to yourself.  You do not have to co-opt the negative opinions that others may have of you.

Work on finding a balanced approach to external and internal validation, in which you can receive what you need from others in order to grown and learn, while not adhering to a need for perfection that requires that others constantly show you attention and praise so that you can feel good about yourself.  Reflect on what you value about yourself, what your strengths are, and how you use those strengths to accomplish your goals.  Then, keep these values and strengths in mind the next time you find yourself over-emphasizing what others think of you.  Frankly, it will make your mind a much more pleasant place to be.

Building Frustration Tolerance

Building Frustration Tolerance

Many of us struggle from time to time with low frustration tolerance.  Perhaps you find yourself fuming at small inconveniences, or a minor infraction by your partner, peers, or children.  When our lives become overly stressful, it can be difficult to keep little things from becoming major annoyances, and it can be hard  to stop yourself from exploding verbally or mentally when one more thing goes wrong, even if it is just a minor thing, like a stubbed toe or being cut off in traffic.  Over time though, when we do not keep our frustration tolerance in check, our moods can start to feel out of control.  We can become angry and resentful in our daily lives, and snap at people we care about, contributing to the overall negativity in our environment.  It’s important to recognize when low frustration tolerance has become a problem, so that you can start to build more resiliency in your life and stop allowing minor frustrations to become overwhelming.

First, ask yourself a few questions to determine if frustration tolerance has become a problem in your life:

  • Do I find myself becoming disproportionately angry at minor inconveniences or mistakes?
  • Do I sometime snap and yell at people I care about (or strangers) when something frustrating happens?
  • Does anger and frustration seem to be impacting my overall mood in my daily life?
  • Do I regret or feel ashamed about my reaction to things when I become frustrated?

 

If you answered “yes” to any of these questions, recognize that you may want to focus some attention to building more resiliency to frustration, and improve your frustration tolerance.  There are several reasons why having better tolerance to frustration is an important skill.  Most importantly, having better frustration tolerance will help you spend less energy on things that are not worth getting angry about.  Our lives can be busy, complicated, stressful, and exhausting.  Focusing your energy where it will best serve you will help you feel better on a daily basis, and more in control of your emotions.  Having low frustration tolerance is just unpleasant.  Your mood is affected, you may ruminate on unimportant problems, and you waste time and energy reacting to stressors that should really be brushed off.  Of course this all sounds good, but how do you stop letting frustration affect your mood and relationships and keep your energy focused on what’s really important?

First, assess your priorities.  Take stock of your life and identify 5 areas that are most important to you.  This may include your relationships with your family and friends, your success at work, making room for quality down-time in your life, working on special projects you care about, or accomplishing goals that you have set for yourself.  Recognize that these are the areas in which you want to focus the most of your energy.  Everything else is secondary, and thus does not deserve to have too much of your attention and energy.

Next, identify how low frustration tolerance has negatively impacted your life.  Perhaps you have said things you regret when you were frustrated, destroyed property when you were angry, or your overall mood has been soured because you get stuck in a negative mindset.  Recognize how this negativity has taken up space in your life that detracts from your real priorities. Make a commitment to re-focus your energy back on your real priorities, and stop giving energy to the frustrations that drag you down.

Finally, start working on ways to reduce the power that frustration has over your life, and begin to develop the skills you need to minimize that impact.  Some strategies to building better frustration tolerance include:

  • Start your day off with a positive affirmation. This can be as simple as a mental note you make to remind yourself that you are going to have a good day and not let small things affect your mood.  Alternatively, it could be a devotional or prayer that speaks to you and helps you center your priorities for the day.  Another possibility is starting your day with uplifting music that will help you get your mood in the right place for the day.
  • Build an arsenal of coping skills that you can use in the moment when a frustrating experience happens. Deep-breathing exercises, counting practices, worry dolls or a talisman, a personal mantra (“Serenity Now!”), and walking off or removing yourself from an overwhelming situation are all examples of coping skills that will help you deal with frustration in the moment and prevent the situation from taking control of you.
  • Allow yourself a designated amount of time to vent or process your frustrations, and then choose to let them go. It’s fine to give a voice to or acknowledge the things that get you down or cause frustration in your life, but don’t allow this time to go on forever.  If you have a friend, for example, that you talk to or vent to when you feel frustrated, allow yourself to spend no more than half of your time together ruminating or discussing frustrations, and then consciously change topics to more uplifting messages or acknowledge the positives you can identify in your life or day as well.
  • Use humor or comedy to help you build resiliency to negativity and improve your mood when you find yourself stuck in negative mindset or feeling angry too often. Watch comedy programs you enjoy, listen to comedy podcasts or radio shows, read humorous materials or writers you enjoy, and talk to your funniest friends.  Use inside jokes with your friends or family to lighten the mood or remind you about times that were fun or funny.  It’s hard to feel frustrated and angry when you’re laughing.
  • End your day with affirmations of gratitude. If you are partnered you can have a gratitude practice that you engage in right before you go to bed or at another time during the evening, when you identify at least one thing you are grateful for that day.  You could also do this practice with your kids if you have them, or just do them solitary.  You can write your ideas down, or just mentally take stock with intention.  Finding space to recognize what you are grateful for will help you keeps those priorities centered, reducing the power that frustration has over your life.

 

As you incorporate these strategies into your life, you are intentionally giving more energy to positivity and priorities, and taking energy away from the frustrations and negativity that life throws at you sometimes.  Keep practicing and building good habits, and you should begin to build your tolerance to frustration in a way that helps you feel more empowered over your thoughts, emotions, and behaviors.

How to Un-friend and Still Be Friends

How to Un-friend and Still Be Friends

Social media has changed our lives in so many ways, including how we communicate with our friends.  There have been many positive things that have come out of the rise of social media, such as reconnecting with old friends we haven’t seen or spoken to in many years, maintaining ties with people when you’re no longer living in the same area anymore, the ability to quickly connect and communicate with new friends you meet, and even connecting and communicating with people you haven’t met yet.  It’s been a great platform to share information, vocalize your views and opinions, or keep up with new happenings in the lives of people you care about.  However, social media can doubtlessly be problematic too.  With the rise of social media came the rise of cyber-bullying, the spread of fake news, and the virtual version of Un-friending.

In many ways, social media has complicated our friendships and other relationships.  Whereas you used to only have to hear your Uncle Fox ranting about politics once a year at Thanksgiving, now he may be blowing up your newsfeed with fake news every day.  Or worse, your best friend from high school hasn’t grown up much since then and is now engaging in unnecessary mudslinging and stirring up drama online, publicly hashing out her grievances and causing friction and conflict in front of everyone you’ve ever met.  Sometimes it’s easy to know when to un-friend someone online, such as in instances of cyber-bullying or malicious interactions with people you don’t really know that well or care much about.  However, at other times it can be more difficult, because you will still see this person in your real life at least sometimes, or because you actually value your relationship with that person and don’t want to lose them as a friend.

There are a few considerations you can use to determine if you should un-friend someone on your social media pages, and how you can continue to be friends in real life without having to lose a relationship that you value.  Ask yourself a few questions first to find out if you need to restructure your contacts or rethink your online relationships.

1: Do I interact with this person in my real life on a regular basis, or is this someone that I only see sporadically when we happen to be around a mutual acquaintance?

  •  If you don’t have a relationship with a person in your real life, and your interaction with them is mostly online, you don’t really need them bringing negativity into your online social scene.  It’s usually fine to un-friend this person without further ado and not worry about it, because you’re not really going to see them much anyways, and you both will probably benefit from less interaction with each other.  If you do engage with this person in real life regularly, you may choose to use a different feature to reduce their impact on your page.  On many social pages you can mute or hide the person so that you remain “friends” online, but you aren’t subjected to seeing their posts anymore.  Check your platform’s settings to see how you can utilize those tools.

2: Does this person typically make my day better or worse when I see their posts on my page? 

  • If someone is constantly posting things that annoy, enrage, offend, or otherwise sour your mood, you most likely don’t need them on your page. See the above reference to determine what the best course of action is in this case.  However, even if you don’t interact in-person with someone on a regular basis, if their posts generally make you happy because they are full of positivity, and you like keeping up with them and seeing what they’re doing, then it’s obviously fine to keep them in your feed.

3:  Do I believe this person actually cares about me and/or my family, or are they someone who wouldn’t be there for me in my real life if I needed some support?

  • Needless to say, if someone is making your day worse by being annoying, offensive, negative, or disrespectful, you probably don’t need them in your online life. However, if regardless of those things, you still value the relationship and believe they value it as well, then a careful approach is necessary.  You still have the option to mute or hide their posts.  If it doesn’t seem to be beneficial to have them on your page at all though, and you still want to preserve the friendship after removing them from your page, you can take steps to ensure the relationship isn’t damaged by the change in status.

 

If you want to remain friends with someone after un-friending, un-following, or blocking someone on your social media pages, then in person or phone contact is sometimes necessary afterwards.  This doesn’t mean you have to bring up the subject of un-friending them, but actually seeing each other or hearing other’s voices will reassert that the friendship is still valuable and you want to remain friends.  If there has been some kind of a significant conflict that played out in the social media world, particularly if it was public, then you may want to discuss the conflict and hash things out in person before writing the relationship off for good.  The important thing is that you make the effort to engage with the person after un-friending so that you both can recognize that you still care about the relationship.  If you are one who un-friended, it should be you that reaches out first.

There are times when this is unnecessary.   First, they may not have even noticed that you un-friended them.  There’s no point in making a big deal about something if you didn’t often engage in each other’s posts.  They may just think you haven’t been online much lately or didn’t notice that your posts weren’t showing up in their feed.  If they did notice or they bring it up, try not to make personal attacks.  Make a more general point about why you made that decision.  For example, if it was about politics, you can say “Listen, I just made the decision that it was healthier for me to reduce the political chatter on my feed because it was stressing me out”.  Or, if it was about because there was a public spat online, you can say “Look, I value our friendship and I didn’t want to continue to hash out our problems in front of everyone online, so I’d rather us talk things through in person”.

What if you’ve been un-friended by someone else?  First of all, don’t freak out or get offended.  If the relationship is meaningful to both of you in real life, you can still be friends or acquaintances and you don’t have to run in the other direction or escalate a conflict.  All of the above advise still applies, and sometimes the best way to repair a damaged online relationship is to make more of an effort to get together in person and/or via phone and focus on building real interactions instead of virtual ones.  If it wasn’t a very meaningful relationship in the first place, then it’s no loss and everyone can go about their business feeling better about the online friends they do have.  You can still see your uncle at Thanksgiving and seat yourself at the opposite end of the table like you always do.  Don’t let social media ruin important relationships that you value, but keep in mind that you certainly don’t have to allow people or posts on your newsfeed to make your day worse for no identifiable reason.  Now go adjust those settings!

This is Not a Drill

This is Not a Drill

When I was in about 3rd or 4th grade, my classmates and I had all the standard safety drills in elementary school.  Fire drills, tornado drills, and the like.  There was one drill though, that I remember doing only once, which was the active shooter drill.  I don’t know that they called it exactly that at the time, but I do remember that they made all of us kids run zig-zag from the stairs of the school to the playground down the field and into the woods behind the playground, hiding wherever we could.  I remember it being somewhat odd that we had this new drill, and at some point they explained to us that if someone ever came into the school and started shooting, that this is what we were supposed to do.   I grew up in a suburb of Atlanta in a good school district.  Overall it was a great place to grow up, and felt safe most of the time (though not always).  This drill seemed a bit of an outlier, as though the district had heard about shootings in other schools and thought they should be prepared, just in case.  Never mind that the strategy they adopted was totally wrong and unsafe given our current knowledge of active shooter survival.  I’m sure they were doing the best they could back in the 80’s when this kind of danger was relatively new to the public consciousness.  These days, though, an active shooter with an AR-15 and hundreds of little kids zig-zagging across a playground is a recipe for our next national tragedy.

Fast forward to 1999, and I was a senior in high school.  In April of that year, the Columbine shooting rocked the national news.  Prior to that, news of violence in urban school districts was not unheard of, and discussions about guns in schools and how to keep schools and students safe were certainly in the public discourse.  The Columbine shooting was different, however, for many reasons.  The affluent, mostly white suburban school, the arsenal of weapons, the bombs, the depressed, gun-obsessed teenagers who idolized Timothy McVeigh, the suicides.  It was horrifying.  Not long after the shootings, a copycat began calling in bomb threats to my high school.  It was always around the same time of day on the same days of the week.  I was always in art class, which was located across the hallway from the school nursery, where the babies of students and teachers were.  My fellow art students and I would jet across the hallway and grab a baby before running across the street to a community center, where we stayed with the babies until their parents came to pick them up.  Even as I write this now, it sounds totally insane.  I didn’t go to a hard core inner city urban school. It was in a middle class, diverse, low crime town.  The bomb threats continued for weeks, and to my knowledge, they never caught the person.  It became clear pretty soon that whoever was calling the bomb threats in was pulling a prank to get out of a certain class, but in the aftermath of Columbine it seemed impossible to feel truly safe in that context.  Years later, in college and afterwards, when I would tell people about the drills and the bomb threats, they were horrified.  “What kind of school did you go to?  Oh you’re from Atlanta? That must’ve been so scary! They must have some really bad schools where you lived!”  Well… no, not exactly.   What kind of school did I go to?  A good one, or so I thought.

Now, that term has no meaning.  There is no such thing as a “good school.”  There is no school where children can be kept safe from gun violence, from bullying, from racism, from sexual harassment or assault, from exposure to drugs and alcohol, not even from predatory teachers.  As hard as we try to put in policies and security procedures, and codes of conduct and mental health resources, we have been unable to protect our children from the world that we have created.  A world in which violence is glorified and murder makes you a celebrity.  A world in which anger is the most readily accessible emotion and violence an acceptable recourse when you feel provoked.  A world in which we are quick to label violent criminals as part of the mental health crisis, yet refuse to properly fund community mental health centers, or put social workers in every school, or teach basic communication and conflict resolution skills to children.  Teachers are vilified, blamed, and punished for classroom problems that originate in the home, yet we refuse to give teachers the support they need from social workers and school psychologists to help families become successful in the classroom.  I say families, and not just children, on purpose.  Families need to be treated as a whole, to ensure that we see and address all areas in which the family is struggling.  We keep insisting that test scores are the best way to measure a child’s potential and progress, scores which completely ignore a child’s emotional, social, and psychological progress.  While politicians starve our public schools of resources and ignore the needs of the mentally ill and struggling families, we have turned our anger on each other, vilifying our fellow citizens and digging our heels into the culture wars to make up for the lack of a functioning public sphere.

Our schools should not be war zones, yet that’s what many of them have been for decades, and any attempts by parents to get their kids into a “good school” are increasingly fruitless.  There is no panacea to solve the culture of violence that has resulted in the mass shooting epidemic that we are currently suffering through.  It cannot be solved with thoughts and prayers, it cannot be solved by banning bump stocks, or raising the age to purchase certain weapons, or bringing religion into schools.  It cannot be solved by school resource officers, as we so crushingly discovered during the Parkland shooting, and it cannot be solved by instituting more anti-bullying campaigns.  Trying to imagine any of the teachers that I grew up with as pistol-packing renegades seems not only incredibly dangerous and ineffective, but incredibly unfair given the sacrifices and responsibilities that we already expect from teachers and our refusal to pay them properly for the amazing work they are doing every day.   We are way beyond all of those ideas now.  People continue to shout their ideas for solutions, and many of those ideas have merit, while others seem reactionary and insufficient.  I am not going to pretend to know all the answers.  I certainly have my own opinions about what I would like to see happen, but I fear that nothing we can do at this point will be sufficient without an enormous cultural shift that our country seems unprepared for and unwilling to recognize.  The problems that go into the making of an active shooter are deep and resonating throughout our culture.  Lack of empathy, isolationism, misogyny and racism, rampant abuse and violence in our neighborhoods, families, schools, and media, easy access to weapons ranging from hunting weapons to handguns to military style assault rifles, glorified violence on television both fictionalized and reality based: all of this has indoctrinated us to the point where we don’t even try to stop the violence any more, we just try to prepare for it.

I am sick.  I am sick of this culture of violence.  I used to get angry when I would hear people say that they don’t like to watch the news because they don’t like to see all the violence and terrible things going on in the world.  How could they just turn a blind eye and pretend it’s not all happening?  I understand this more now.  It comes from a feeling of abject helplessness in the face of the world we have created.  It comes from a sense of self-protectionism, akin to hiding in a closet while a gunman murders your classmates.  I used to watch Law & Order episodes like a junkie.  Ditto the ID Investigations, and Forensic Files, and other reality based crime shows.  However, after years of working with victims of violence and abuse in my real-life job, I cannot see violence as entertainment anymore.  I don’t ignore it, I can’t ignore it, and my job necessitates that I continue to confront it daily.  Yet I can’t shake the feeling of helplessness and self-protectionism.  So I will continue to battle as I have always done, one life at a time, one client at a time, and one family at a time, which includes my own.  This is the only way I know how to fight back against our cultural sickness.

A few weeks ago, my daughter filled me in on some of the 2nd grade struggles going on in her school that week.  A student did not want to include one of her friends in their games, and was trying to get the other kids to leave the other kid out.  This upset my daughter because she didn’t want her friend to be left out.  We processed this for a while, but she came to her own conclusion: “I’m going to stick up for my friend tomorrow”.   “I think that’s a good idea, I’m proud of you,” I said.  Meanwhile, back at work in my office, we prepared for another annual active shooter drill.  So when the alarm came on via my computer and cell phone, alerting to the fact that there was an active shooter (exercise) on premise, I closed and locked my office door as instructed, and listened as we heard pretend gun shots, people running through the halls, and the first responders practicing their take down in the building.  Back in elementary school, zig-zagging across that field, it seemed silly, remote, and implausible.  Sitting in my office that day, listening to shots fired and the boots running through the hallways, it felt more real than ever before.

It’s on all of us to change the culture that has created this mess that our children are now paying for with their lives.  What each of us can do is going to be different.  Perhaps engaging in the policy battles and protests, perhaps donating to or volunteering with your local school systems or other organizations, perhaps changing your buying or viewing habits to promote more of what you want to see and support, and less of what continues to sicken us.  I can’t come up with a catch-all prescription and say “here’s the solution, this will fix it”.  I just know that most of us can do something, including our feckless leaders, and we all have to be a part of creating the world our children deserve.  I will continue to hope that we can make progress together, despite the political barriers that seem insurmountable at this time.  I can increasingly sense the desperation, the anger, and the futility that is seeping into every area of our society.  I’m not willing to give up, though I understand why people do.  When it feels overwhelming, I try to remember that even though I can’t change everything I want to change about our culture, I can still be responsible for my little corner of the universe.  I know that small scale change leads to bigger changes later on.  If anything is clear to me now, it is that change comes from the bottom up, not the top down.  To me, that means working on myself, on my own family, with my clients, with my friends, and with my community.  I want bigger change, but I can’t single handedly pull it off.  To that end, bottoms up.

Are you Parenting your Partner?

Are you Parenting your Partner?

I see a lot of clients for marital/relationship counseling, and one of the most common and frustrating factors that people struggle with when they come to see me is something that I call the Parent/Child Dynamic.  This happens when one partner has taken on the role of the Parent, or Director, in the relationship, and the other partner is stuck in the role of the Child, or Adolescent.  In these relationships, one person is basically in charge of knowing what needs to be done, and they end up having to ask, direct, or otherwise nag their partner to complete responsibilities that need to be handled.  This is an unhealthy relationship pattern for many reasons, but it’s not the fault of one partner of the other.

Honestly, the way I see this dynamic play out most often occurs with a woman in the role of Parent, and a man in the role of Child/Adolescent.  However, this is by no means the only way it happens.  I’m going to use the example of a woman in the Parent role to illustrate my points here, but be aware that these roles can occur in any relationship with either partner taking on these two roles.  In this situation, the woman/Parent is constantly having to tell her partner what chores need to be done, what bills need to be paid, what child-care responsibilities need to be attended to, what planned events or activities need to be prepared for, what needs to be purchased at the store, what pet care duties need to be fulfilled, and on and on and on.  Often, I hear from the partner in the Child/Adolescent role “I don’t mind doing whatever she needs, she just needs to ask me”.  It sounds like cooperation, but it’s really a form of relinquishing duty.  In this example, the woman is in charge of knowing everything that needs to be taken care of, and is in charge of making sure everything gets completed on time and as needed.  The man essentially can say he is helping and cooperating, but he takes no part in being pro-active about responsibilities.  This dynamic is damaging to relationships because the relationship is not functioning as a partnership, but as a Parent/Child relationship.

For the person in the parent role, it’s exhausting.  You didn’t sign up to parent your partner, you wanted someone who would share responsibilities, support you in both tangible and intangible ways, and be, well, your Partner.  For the person in the adolescent role, it’s equally frustrating.  After all, you didn’t sign up to be treated like a child, nagged about your duties, and punished verbally or emotionally when you didn’t do your chores.  It’s infantilizing, and for men, also emasculating.  In most cases, you both came into this relationship looking for a partner, and when it starts to feel like you’re in a Parent/Child relationship, it’s going to start to feel less like a partnership and more like a drag.  No one wants to be treated like a child, and no one wants to have to nag their partner like a parent.  Even worse, sometimes the person in the adolescent role will become resentful about being treated like a child, and will begin “acting out”, by saying they will complete certain tasks and then “forgetting”, or just saying they will do it later and then dragging it out until their partner starts nagging them again, causing more frustration, resentment, and even arguments.

The solution here requires both partners to make some changes.  First, you need to have an open discussion with each other if you feel that this is the kind of dynamic that is developing in your relationship.  You need to both recognize the role that you have been playing and discuss what you really want your partnership to look like.  If you have been in the adolescent role, recognize that it is not your partner’s job to tell you what needs to be done around the house, remind you of the responsibilities that you agreed to, and direct all functions of the household duties.  You’re an adult, so act like it.  Don’t want to be nagged about taking out the trash or helping with dishes or children?  Then start being more pro-active about what needs to be done so your partner doesn’t have to “assign” you chores to do.  In some circumstances you can both agree about what needs to be done and assign who is responsible for doing it.  However, in my opinion, this is not ideal.  Chore lists are for teenagers, not adults.  If you don’t want to be treated like a teenager, then act like an adult.  It’s fine to have some general roles if you both prefer to do certain tasks.  For example, one person may be primarily responsible for mowing the lawn or cooking dinner.  These divisions may occur naturally based on what each partner prefers to do or is more capable of doing well.  That’s not a problem.  But all partnerships require some give and take, and if you notice something needs to be done, just do it.  There’s no point in keeping score.

If you have been in the parent role, you may be in for some frustration as you try to make these changes.  It will be hard to refrain from engaging in your role as director and assigner of duties if you have been used to doing this, because if the pattern continues, you will see things that need to be done and either end up doing them yourself, or feeling secretly insane inside as you wonder when and if your partner is going to step up and do what needs to be done.  This will take some adjusting because while you are used to knowing what needs to be done, and when and how to do it, you will need to allow some space for your previously adolescent partner to step into their new adult role.  Give it some time, because one of the most important parts of fixing this problem is that you refrain from asking multiple times for something to be done, or reminding your partner of the things they said they would do.  If you get frustrated and start asking multiple times or reminding your partner over and over about something they said they would do, the pattern starts to get further engrained.  Sometimes, unpleasant things may happen, like the trash piles up or a bill incurs a late fee.  I know, I know, this shouldn’t happen.  But you are trying to break unhealthy patterns, and you must give your partner some space to feel the consequences of their own inaction rather than you pointing it out to them all the time.  People will not grow up and take responsibility if you always fix everything for them, nor if you criticize how they do everything.  If your partner feels like they can never do anything right, they will likely just stop trying.

These changes are not going to happen if you do not talk openly and frankly about what the problem is beforehand.  For example, if you have, in the past, tried to passively stay silent while the lawn went un-mowed or the dishes piled up, “testing” your partner to see how long it would take them to notice and step up to the work that needs to be done, then continuing that pattern is not going to help.  You have to figure out how to walk the line between direct communication about what you both need and expect from your partnership, and being the director and supervisor of everything.  This means that you may need to let go of some of the things you want to control.  The towels may not be folded the way you like them and you might run out of toilet paper.  Partnership is a growth process.  As individuals, we all have to make adjustments when we choose to become a partner to someone else.  If you want that partnership to develop in a healthy way, you need to recognize that it is not your partner’s responsibility to conform to what you want them to be.   You both need to make adjustments to find the dynamic that works for you both.  But don’t allow an unhealthy dynamic to fester and grow in your relationship.  You both need to be part of the solution, so recognizing and talking about the Parent/Child dynamic and how it is damaging your partnership is a good place to start changing.