Blog - Page 6 of 7 - Kate Gegg, AM, LCSW

May 18, 2021March 27, 2023

The Argument for Distress Tolerance

Often times when we feel intense negative emotion our drive will be to pull towards, so we can do something / say something / solve something to “release” the emotion
Blood actually starts flowing differently in our brains when we are in high distress – it flows away from the parts of our brain that are best at problem solving, and thinking through consequences, pros, cons, priorities, and values.
This means despite that intense desire to lean it, in those moments we actually want to lean away.
Part of coping well is knowing where that line is in ourselves, when we need to step away rather than step towards. Sometimes we can’t problem solve right away, we just have to get through.
When we are feeling our negative feelings very intensely (like an 8 or a 9 out of 10) we need a different set of strategies. In those times we need to work on distracting, calming, soothing, and diverting attention
Distress tolerance skills teach us to try and shift our attention away instead of trying to manage the problem at hand
For these skills to work we *really* need to shift our attention completely and allow ourselves to be completely engaged in something else. This helps the brain “reset”. Sometimes this means we have to shift our attention again and again until our brains cooperate.
Learn more about why we need distress tolerance skills in today’s post. Specific skills to follow another day.

One of the big gripes I hear about distress tolerance skills – skills and techniques that help you get through the moment (like focusing on your breathing, going for a walk, watching a show) – is that we’re not problem solving. These types of skills don’t actually make the situation better or address the problem at hand. They just divert your attention from whatever the problem is.

All of that is true. Those types of coping mechanisms don’t make the situation better or solve the issue at hand.

That is not their purpose.

Distress tolerance skills help YOU feel better so YOU can (eventually) effectively tackle the situation at hand. They help YOU come back “online” so that you can problem solve, think clearly about solutions, consequences, pros, cons, priorities, and values. They help YOU be in the mindset to tackle a concern with all of your facilities – which we have less access to when we are in a panic, or when we are overwhelmed with emotion.

Think about it. Have you ever quickly addressed what felt like a pressing issue at the time only to reflect later (in a less intense state of mind) to realize you could’ve handled it better? When our emotions are running high (and I mean we’re feeling them at an 8 or a 9 on a scale of 1-10) our brains don’t work the same as they do when we are calmer.*

Often, when we feel strong emotions we feel them with urgency and we believe we need to act NOW. But usually that desire to act NOW is more about making the feeling “go away” than it is a response to any true urgency from the situation at hand.

When we use distress tolerance skills we are not trying to change how we feel or the situation we are in. Instead, we are changing where we focus our attention. This gives us a break from a very intense situation so we can return to it later with our full attention and our facilities intact.

The key with distress tolerance skills is to let things settle and then return to the problem or situation at hand when the external circumstances permit and when your internal state of mind is more balanced. If we don’t return to the problem at hand we’re engaging in avoidance, and that creates a whole host of other issues in our life.

Notes:

* Blood flows differently in our brains when we are experiencing intense negative emotion. This is our brain’s way of trying to protect us when we experience a signal of “alarm” from our emotions, so that our bodies can be ready to handle what our emotions are telling us is a major issue. Your frontal lobe (a section of your brain just behind your forehead) has many functions, but one of them is to help you process the signals from your emotional world and weave those with logical decision making and discerning judgment. As Bessel Van Der Kolk describes in his book, “The Body Keeps the Score”, our frontal lobes have less blood flowing to them when we are in intense emotional states, “As long as you are not too upset, your frontal lobes can restore your balance…Neuroimaging Studies of human beings in highly emotional states reveal that intense fear, sadness, and anger, all increase the activation of subcortical brain regions involved in emotions and significantly reduce the activity in various areas in the frontal lobe” (Pages 62-63) (The Subcortical regions of the brain he refers to are the areas of the brain under the frontal lobe). Full citation for the book: Van, . K. B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma.

Unsure how to identify if your brain may not be “online”? See post dated May 11th called The Window of Tolerance. This post covers what it can feel like when we’re in a place where we want to consider using distress tolerance skills.
Sometimes it can take practice, trial, and error to come to recognize when we’re “not really here”. It will get easier with time.
Much of what I pull from in this post regarding classification of “what” a distress tolerance skill is comes from Marsha Linehan’s Skills Training Manual for Treating Borderline Personality Disorder. Full Citation: Linehan, M. (1993). Skills training manual for treating borderline personality disorder. New York: Guilford Press.

May 18, 2021March 27, 2023

The Brain as an “Association Machine”

Think of your brain like one giant association machine
It is constantly looking to learn, make connections from prior experiences, keep you safe, and make sure your needs are met
The majority of associations and connections are made when we are kids, when most development happens
Those associations are our brain trying to make sense of the world in a way that protects us, our relationships, and gets our emotional, physical, and relational needs met.
Sometimes the associations from one phase of life serve us very well in that phase, but then don’t serve us as universally well in others.
If you are stuck and unsure what to do, or if you (or someone in your life) is having reactions that don’t quite make sense consider that your brain may be trying to solve a new problem in the “old” way
We can learn new ways, build new associations, and make genuine changes, but first we have to come to recognize what is hard wired in us from the environments we developed in
It is easier to do that if we can have compassion for our past selves, and accept that what we are doing may have made sense before, but may not (as universally) make sense now
See examples in comments for illustrations which show how our patterns can both serve us and hold us back
The good news is we are working on EXPANDING patterns, not abandoning parts of ourselves. What worked in the past may work again so we can ADD new tools and ways of being.

Think of your brain like a giant association machine that at all times is working on learning and making connections. It’s developing a sense of cause and effect, right and wrong, should and shouldn’t – rules for living and operating; the dos and don’ts of life so you can learn from your mistakes and optimize your successes. Your brain makes the most connections in childhood when most development happens, but throughout adulthood your brain still actively works to keep you safe and protected.

If you grew up in an ideal environment (and there’s really actually no such thing) your brain would have all the ideal associations. Instead, each of us starts to make connections based on our own personal experiences, our family norms, and lessons from what we see and experience in our culture and community.

These patterns – regardless of how effective they are in a diversity of situations – get hard wired in and become second nature. They are our automatic go-to solutions and ways of thinking about things, responding to ourselves, and responding to others.

Some of those associations serve us forever, and in a diversity of scenarios (like knowing smiling is a signal of friendliness). Some of those associations served us at one point in our life and in one environment (like with the folks that raised us) but then maybe don’t quite make so much sense in other environments (examples in comments).

So, when we have reactions that don’t quite make sense to us, it’s likely your brain is associating the current situation with one from the past. Your brain is trying to apply the old rules to a new situation, and sometimes it doesn’t work out in our favor.

We can learn be more discerning and less automatic with these associations through building insight into what our automatic patterns are, and challenging that automated way of being through the use of mindful and intentional responses, choices, and actions. We can also learn to add in responses that may have been “off limits” in our early environment by observing what works for others that we may not feel is accessible for us (yet). And of course – therapy can help too.

Notes:

Season 1 of the HBO show WestWorld explores this concept through its use of humans and robots. The show explores how humans, like robots, can build such strong associations and patterns that they lose their ability to think critically and respond to individual moments and situations.
Wondering how this applies to you? Ask yourself what feel like your hard and fast rules for how you handle: your feelings, your friendships, saying yes to something, saying no to something, making plans, handling conflict. Bring as much curiosity as you can to what feels “normal” to you and the environment you came from – and then – think about if you’ve seen other examples of how those same scenarios are handled by others. What’s a “rule” or “norm” for you, may not be as universal as you may believe.
I talk about themes related to this in my post from April 15th, “for every action there is an equal and opposite reaction”.
Examples of relational and emotional health related associations made in childhood that may have protected us as children but may not serve us as well as adults are numbered below.
Example 1: Imagine you grew up in a home where you were a pretty emotional kid, and your parents were less emotional people. Or maybe they were emotional, but often preoccupied and not very plugged into you. Once they knew you were upset they would be very comforting and supportive, but it was hard for them to see early (or even mid – cues) that you were in distress and needed support. To get the help you might learn you needed to have BIG reactions. Yelling, crying, screaming – expressing emotions at a high level. We can understand then the association your brain would build – if i need emotional help, I have to be LOUD for the people around me to plug into me. So as an adult you might have BIG reactions, and yes – people would know how you felt, but, it might also be hard for others to tolerate such big reactions. While your sensitive and emotional nature might be very appreciated by others (because empathy may come very naturally to you) your way of handling your big feelings might not work in an environment where people are more plugged into you.
Example 2: Imagine you grew up in a home where you had a parent that needed a lost of positivity from you. Whenever you shared your frustrations or sadness they would find a positive spin to it. If you pushed on expressing your sadness, anger, jealousy etc they would tell you you had a bad attitude and you learned that if you brought your negative emotions to the relationship the parent would push you away. You would probably learn to push away your negative emotions too, and keep things light and positive around yourself and others (because what you’ve learned is these negative emotions just cause issues). In many scenarios in your life having that optimistic attitude would probably serve you – you’d always find a way to see the upside of things. People would probably really like your positive energy and spirit. But, not all situations in life HAVE a positive spin, and part of getting through life is being able to get through the rough times – some of which there just won’t be an upside to. So, some people may think of you as a bit of a “pollyanna’ and people may not talk to you about the REALLY hard stuff, because it could feel dismissive to have you try and find the positive when they are really hurting or struggling with something. Also, you may be more vulnerable to experiencing depression at some point in your life because your most heavily relied upon coping mechanism is to “find the positive’. This is a GREAT coping mechanism, and one we want you to keep, AND we’d want you to learn more ways to manage negative feelings beyond trying to “find the positive”. This would help you build resilience and likely help you connect better and more meaningfully with others in your life.
Example 3: Imagine you lived in a home where your parent became very angry with you when you made a mistake. Maybe you were punished, or shamed, or told you should know better. The parent never acknowledged they might have over-reacted, and so what you learned was that your relationships suffer (and you feel overwhelming feelings you can’t really handle) when you make mistakes. You might become an adult who is very high functioning and proficient (because you rarely make mistakes), but you might carry with you a lot of anxiety about making mistakes for fear of it hurting relationships, or for fear of how it makes you feel. You also might become an adult who hides their mistakes from those around them (for fear that finding out about the mistake would harm the relationship, or bring up those feelings). You might have a hard time with vulnerability. People “catching” you in mistakes might make you defensive (because your brain will go to all kinds of extremes to do what it thinks will protect you from having a problem in your relationship or from feeling those feelings that feel way too big to manage). As you can imagine, though, this might actually CREATE problems in your relationship because a) you have a hard time admitting when you’re wrong and taking accountability and b) you might be spending a lot of time preoccupied with not making mistakes instead of focusing on the big picture. You will also become more avoidant of your feelings which may leave you more vulnerable to anxiety and or depression.
Example 4: Imagine you grew up in a home where your parent would shut down if you challenged them, regardless of whether you were right or wrong. You’d probably learn that it’s best not to be direct with people, regardless of the circumstances. Being more indirect would serve you with your parents, and perhaps in other relationships too. People might see you as non-abrasive and approachable. However, if we don’t EVER feel it’s acceptable to be direct then there are situations where it will be called for (like with someone who may not have strong intuitive skills, or who may need things really laid out for them to “get it”). Because that “directness” feels inaccessible, we’ll be stuck in those moments in part because indirectness feels so essential to us.
Interested in trying to build up that capacity for mindfulness? See this post, “Foundations of Meditation“.
What I discuss in this post is backed by neuroscience. David Wallin’s Attachment in Psychotherapy explains how the work of Daniel Siegel and others shows the associational nature of brain development: “Siegel explains that what registers in the mind and body as ‘experience’ corresponds at the neural level to patterns in the firing or activation of brain cells. These pattern of neuronal firing establish synaptic connections in the brain that determine the nature of its structure and functioning…the architecture of the brain is associational” – Page 69: Wallin, D. J. (2007). Attachment in Psychotherapy. Guilford Press.

May 18, 2021March 27, 2023

Emotions Are Brief

Often, when we feel difficult feelings for extended periods time it’s because we don’t know how to release them
Our emotions are brief – often times only seconds to minutes
Many of us, however, get stuck in emotional states for far longer periods of time.
This happens because we re-expose ourselves to what sets off our feelings either with our thoughts, our memories, or the moment we are in
As a result, the emotional signal from our brain re-fires again and again stringing together one long experience of feeling an emotion
When this happens it can be time consuming, exhausting, and overwhelming.
We can get wiped out from these experiences of having such lengthy emotional states.
We can start to feel like our feelings are too much, too hard, too disruptive, and we can start to cope by just cutting them off or pushing them away
Or some of us lose hours of our time stuck in feeling states with little ability to truly be present in our lives at those times
We want to feel our emotions long enough to process through them and learn from them. But then we want to be able to move on from them and get on with our lives

Marsha’s Linehan’s research backed treatment, Dialectal Behavior Therapy (DBT) teaches: “Emotions come and go. They are like waves in the sea. Most emotions last from several seconds to minutes”.

When I share this with my clients I hear a lot of “Not mine. Mine last for hours”.
For many of us this is true, we can feel sad, scared, lonely, angry, upset – you name it – for extended periods of time, far beyond a few minutes.

So what’s happening?

DBT addresses this too, “Emotions are also self-perpetuating. Once an emotion starts, it keeps restarting itself”.

This means that when feelings go on and on it’s actually the same brief emotional signal being fired in the brain repeatedly (until something stops the signal). It all connects to feel like one big long feeling, but it’s not. It’s a bunch of very brief emotional signals from our brain strung together.

So why does the signal keep re-firing?

Often it’s because of how we RESPOND to the experience of having the emotion.

Sometimes our thoughts trigger the re-firing: “I can’t believe I did it again”, “I hate it when he does this, “I’m going to put her in her place and tell her…”.

Sometimes our memories trigger the re-firing, like when we play the scene over and over in our heads.

Sometimes the conversation or event that’s triggering the feeling goes on and on (like when you’re sad throughout an entire funeral or angry throughout an entire fight).

Why does this matter?

The crux of being able to cope productively with negative feelings is being able to interrupt that firing process at the appropriate time. When our emotions stick around for extended periods of time it’s because something (internally or externally) repeatedly sets off the emotion. Emotions themselves don’t necessarily HAVE to last so long, and we can learn how to interrupt the re-firing process with coping skills and with processing through the feelings.

There will be more on that to come (look out for distress tolerance and emotion regulation skills) so we can increase our ability to keep emotions with us long enough to make use of them, and then release them (rather than re-start them) once that process is done.

Notes:
1. The DBT quote comes from page 87 of Marsha Linehan’s Skills Training Manual for Treating Borderline Personality Disorder. Full Citation: Linehan, M., M., (1993). Skills Training Manual for Treating Borderline Personality Disorder. New York, NY: The Guilford Press.
2. We can feel more than one feeling at once, and we can have multiple feeling signals firing from the brain around the same topic.
3. Some people struggle to hold on to feelings rather than feel like they stick around too long. There will be another post on the impact of that relationship with your emotional world.
4. See post called Emotions as Traffic Signals for more about why it’s important to be able to feel our whole range of emotions, positive and negative.

May 11, 2021March 27, 2023

The Window of Tolerance

We all have a sweet spot in our ability to cope, manage, process, think, feel, and communicate.
When we are in that sweet spot (also called the window of tolerance) we generally feel calm, able to take on what comes, and able to think and feel at the same time.
When we are outside of that spot we can feel very intense anxiety, rage, or feelings so big we can’t even really identify them – they just fill us to the brim
We may be more likely to ruminate (i.e. not be able to stop thinking about something), become hyper focused on the topic at hand, or lash out our feelings at others.
We may also feel a tremendous degree of urgency to “fix” whatever has pushed us outside of our window.
We can also fall outside of that window in the other direction, to a place of more emptiness, depression, numbness, or avoidance
When we’re on that side of the window we may get sleepy or have a hard time paying attention
Parts of our ability to function are “offline” when we are pushed to either side of this window of tolerance
For us to be successful in our relationships, at work, and in managing our mental health it is essential that we recognize this window exists, and that we respond to it constructively
More to come in a future post about how to widen your window of tolerance, but the first step is recognizing it exists and to identify how it manifests in you.
We can all work to widen our windows of tolerance through therapy, meditation (more on this to come) and learning (and using) coping skills. One of the reasons your therapist can be effective in treatment is because they (likely) have done some work widening their own window to be able to tolerate what their clients bring to treatment.

In the DBT world we would say we know we’re in our window when our “rational” (i.e. thinking or logical) mind and our emotional mind are accessible. As Daniel Siegal says, “If an experience pushes us outside our window…we may fall into rigidity [depression, cut offs, numbness, avoidance] or into chaos [agitation, anxiety, rage, emotions that feel so big we can’t even identify them they just consume us with intensity]”.

He explains, “We [each] have multiple windows of tolerance. And for each of us those windows are different, often specific to certain topics or emotional states. I may have a high tolerance for sadness, continuing to function fairly well even when I or those around me are in deep distress. But even a lesser degree of sadness…may cause you to fall apart. In contrast anger may be relatively intolerable for me…but for you, anger may not be such a big deal”.

Acceptance of the fact that this window exists, and there are limits in our ability to function based on our presence (or not) in it are crucial to success in managing your mental health, relationships, feelings, and thoughts. We are more likely to be pushed out of our window of tolerance at times when our safety is threatened; we are hungry, in pain, or tired. Some of us may be more inclined to fall to the rigid side (with less emotion) and others may be more inclined to the chaos side (with more emotion).

Daniel goes on to say, “Within our window of tolerance we remain receptive” (this means able to integrate information from our bodies, thinking selves, and feeling selves), “outside of it we become reactive” (this means we’re highly emotionally charged and less able to thoughtfully think through and respond to something with our full capacity to consider consequences, values, and priorities).

Many of us have spent a good chunk of our lives outside our personal windows without awareness that we CAN get to that middle ground place. When we are outside our window of tolerance it is not the time to make important decisions, or have important conversations. It is instead a time to work on coping and “coming back online” so we are out of the reactive place and back that receptive place.

Notes:

This posts combines a mix of the “wise mind” skill from Dialectical Behavioral Therapy, developed by Marsha Linehan with information from Daniel Siegal’s book, Mindsight (pages 137-138). Full Citation: Siegel, Daniel J., Mindsight : The New Science of Personal Transformation. New York: Bantam Books, 2010.
It’s not always obvious when we’re outside our window of tolerance. For some of us it just is our sense of “normal” or “how we’re supposed to feel”. If you often feel the way I’ve described suspect you may regularly be outside of your personal window.
We can learn to recognize when we’re outside our window and we can develop coping and grounding skills to bring us back within our window so we can function and manage well. Those coping skills to follow in another post, try to work on knowing when you’re in and outside of your personal windows based on the cues I described. If you have a partner – heads up – they may have a sense of when this occurs for you better than you do!

May 5, 2021March 27, 2023

Introduction to Relational Trauma

Trauma is more common and varied than most of us realize
Often, when we think of something traumatic we think of a concrete event – a war, a shooting, a life threatening situation, or a situation in which pain was endured
Yes. Those are absolutely traumatic events, we in the therapist world call those “Capital “T” traumatic events”
There is another kind of trauma that is quite common, highly impactful, incredibly painful, and (in my opinion) under-acknowledged
We therapists call that “lower case ’t’ trauma”
That kind of trauma is also called complex, cumulative, or (what I will call it) relational trauma
In short, this trauma occurs when a child is repeatedly left with big overwhelming feelings that make them feel at fault, unsafe, scared, or inadequate without the ability to manage the feelings or recover from the experience
It may not threaten our lives, but it threatens our emotional safety and that has huge effects on our emotions and relationships moving forward
Relational trauma can sometimes only be discovered by the imprints it leaves behind
Effects of relational trauma can include: trouble managing feelings / in relationships / with trust; and chronic anxiety, depression, feelings of inadequacy, or struggles with self-worth.

If there is one thing that I wish was more widely known and understood about trauma, it’s that it is far more common and varied than we give it credit for.

Most of us can intuitively understand Capital T Trauma. If you get in a car accident and it was terrifying, we understand and can offer empathy to you if you’re scared to get in a car again; your terror and discomfort is understandable to us.

Many of us have a more difficult time understanding and offering empathy for relational trauma and its impact. Unlike the accident described above, we don’t have that concrete experience to reference of “where the trauma came from” which can make it confusing to all parties when someone is triggered and responding to prior relational trauma. Instead, we often just think someone is being “crazy” or “ridiculous”*(6).

Usually, we know if we’ve experienced Capital T trauma, but sometimes we don’t know if we’ve experienced relational trauma. It can feel like how problems or feelings are managed or what we known to be normal.

As David Wallin puts it (full citation in comments(7)): relational trauma develops after repeated experiences in childhood of “fear, helplessness, humiliation, shame, and/or [emotional or physical] abandonment” from primary care givers (often parents) who did not help a child recover from intense emotional experiences or manage their overwhelming feelings.

That repeated experience of being alone with big overwhelming feelings without help managing or recovering can leave us scared of our feelings because we don’t know how to manage or recover from them. As a result we can learn to bury or hide feelings away. This inability to be in touch with and process our feelings limits our ability to know ourselves, develop priorities, and can lead to chronic anxiety and / or depression(5)**.

Experiencing relational trauma can also leave us with conflicting feelings about close relationships – we may want relationships but also feel scared or untrusting of them. Intimacy, closeness, connection, trust, and vulnerability can become inaccessible – until we recover from the trauma (which can be done in therapy, or in a series of safe, trusting, and healing relationships).

Notes:

Trauma is an incredibly complex, sensitive, and important topic. Quite frankly, I’m intimidated taking it on in a post because I know I cannot succinctly discuss it in a way that truly represents its scope, impact, and complexity – even over multiple posts. There are incredible books, researchers, therapists, and talks on this topic and I will do my best to be a bridge to those resources so you can learn more about this. If you are interested in getting started now “The Body Keeps the Score” by Bessel Van Der Kolk is an excellent introduction. Though he focuses on Capital T trauma much of what he writes about applies to relational trauma as well.
Sometimes we endure relational trauma from care givers who love us deeply and who we love, and who we may otherwise have good relationships with except for those difficult moments. Those caregivers are often trying their best and well meaning, but are not sure how to handle big feelings or big problems themselves. These are not necessarily “bad” parents or caregivers, though they may not have been able to give us what we needed developmentally in some of these more intense moments. They can be incredibly loving and effective parents in other moments. Sometimes these are caregivers who THEMSELVES experienced relational trauma and have not recovered from it, so are unable to help themselves (or the kids around them) effectively manage these difficult moments. If you endured relational trauma it doesn’t mean your parents were bad parents. If you think you may have inflicted some relational trauma it doesn’t mean you are a bad parent AND there is an opportunity to change patterns and work to heal all involved parties.
For help on parenting in ways that will not create relational trauma look into Big Little Feelings. They offer a $99 course, as well as free tips on their instagram page for parents and caregivers (friendly reminder, I am in no way connected to them or profiting off their course – it’s just plain old helpful material).
Like most everything else in this world relational trauma exists on a spectrum, meaning just a little can effect us a little and more frequent or intense experiences can effect us a lot.
Chronically burying or hiding away feelings can limit our ability to find long term happiness. See “Emotions as Traffic Signals” for more information.
For tips on how to deconstruct moments in which relational trauma may have been stirred up see “for every action there is an equal and opposite reaction”.
The David Wallin book I reference is called “attachment in psychotherapy”. It was published in 2007 by the Guilford Press (NY, NY). The quote is from page 245 and is in reference to chapter five of the book Healing Trauma: attachment, mind, body, and brain”. That chapter was authored by Francine Shapiro and Louise Mayfield, and the book was edited by Marion Solomon and Daniel Seigel and published by Norton (of NY) in 2003. Formal Citation: Wallin, D. J. (2007). Attachment in psychotherapy. New York, NY: Guilford Press.

April 29, 2021March 27, 2023

How to Pick a Therapist

The following are tips I would give anyone who is looking to start with a new therapist

Trust your gut. If after 2-4 sessions it doesn’t feel right, move on. One of the most important things for treatment to be successful is for you to feel comfortable opening up and discussing difficult topics. If you feel uncomfortable it probably isn’t a great fit. That doesn’t mean the person you are seeing isn’t high quality, they just may not be right for you – but if you find the next person isn’t a great fit it doesn’t mean it’s you, sometimes it takes a few rounds of trying.

There is not a lot of quality control in the field. Many programs don’t require prospective applicants interview, have their own therapy, or have an analysis of their own mental health / wellbeing. Don’t just assume that “someone knows what they are doing”, there is a huge range in skill sets of therapists out there so if someone seems off, not quite ok themselves, just trust it and move on.

Look out for a therapist that seems reactive (i.e. seems highly emotionally charged) or defensive (preoccupied with rationalizing their perspective at the detriment of understanding, connection, and receiving feedback). Therapists are people too, with emotions of course, but we want you with a therapist who can manage their feelings. Sometimes therapists will have emotions in session that they will discuss with you, but the key is for the sessions to feel like they are largely about YOU.

If you can get a personal recommendation, that’s always the best way to go (ask your doctors, friends or family who you trust to know you’re considering seeking treatment).

If you know someone that is seeing a therapist they love, ask them to ask their therapist for recommendations – high quality therapists often know of other high quality therapists.

It is my opinion (spoken as an LCSW) that the degree (i.e. the letters that come after someone’s name like LCPC, LPC, LCSW, LMFT, PsyD, PhD etc) are less important than that items I mentioned above.

—

Notes:

Note on item (1) after you’ve been in therapy with someone for a while and previously felt like you trusted them / vibed with them / liked them but are no longer feeling as comfortable this is a cue to talk to them about the shift in you from things feeling good / right / helpful to not as good / right / or helpful. This is a time to look our for reactivity or defensiveness from your therapist when having this discussion.

I mention in the post that you want to be weary of a therapist that spends a lot of time talking about themselves. There are therapists that work in what’s called a “relational” framework. This means that they talk about their experiences of you with you to help you better understand how you may impact relationships and people around you. This form of therapy can be incredibly effective when done well. Furthermore, some therapists will share something about themselves as a means to talking about your situation, struggles, or perspective – or as a way to help you feel at ease. It can be a delicate balance, but it’s not that it’s a “bad sign” if a therapist talks about themselves, the key here is the the sessions to feel predominantly focused around you, and to be on the lookout if that’s not your experience.

April 23, 2021March 27, 2023

Emotions as Traffic Signals

While “bad” feelings don’t feel as nice, they are actually incredibly important tools to help us find long term happiness
What if, instead of trying not to have negative emotions, we could learn to embrace them just as we do positive ones?
Negative emotions, like positive emotions, are signals to us about what does and doesn’t work for us
The trouble is sometimes we don’t feel the way we think we “should” feel in a scenario, and so we often want to push our feelings away.
Or, sometimes negative emotions are just plain hard to feel and hold on to because we’ve gotten so used to not feeling them and we don’t like how they feel.
We want to try and work towards connecting with our negative emotions in a sustainable way.
Negative emotions can teach us about what we value (sadness when we experience a loss), when we’ve made a mis-step (guilt), when we feel wronged or betrayed and need to protect ourselves (anger).
Without working on learning how to approach and tolerate these feelings we are vulnerable to missing important cues about what can make our lives better.
See post and comments for how this is different if we are depressed or anxious.

A common request I get in treatment, “You’re going to help me get rid of my bad feelings, right?”. It makes sense. Feeling good feels good and feeling bad feels bad. But, that’s not how it works OR how we want it to work.

Think of your emotions like a traffic signal that help you get to know your authentic self (meaning your personal beliefs, preferences, likes, dislikes, interests, values, and limits. See comments for more).

We are not capable of long-term and sustainable happiness if we are not in touch with our authentic selves, so learning to accept all your feelings is an important step in the process of having more positive feelings overall.

Red light emotions make us stop and signal to us that something isn’t quite right. Those include anger, sadness, guilt, shame, embarrassment – and most other emotions you might lump in the “bad” category.

Green light emotions are a signal to move closer to something. Those include joy, pride, satisfaction, hope, interest – and most other emotions you might lump into the “good” category.

Whenever we feel an emotion we are offered an opportunity to pause, reflect, understand, and learn. Examples of some of those lessons are in today’s comments.

Unfortunately, many of us struggle to tolerate the experience of feeling our negative emotions because they feel bad, we don’t like them, and most of us don’t have practice in accepting them. There is a sweet spot between feeling them “enough” to make sense of them, and stewing in them (or overwhelming ourselves with them). Finding that personal sweet spot can take some practice.

When we we’re depressed we’re often so over-run with negative feelings (they’re on overdrive) that they can be difficult to process through or make sense of. Sometimes we feel numb or don’t really feel anything at all. If either of those describes you that’s a sign to consider professional help from a therapist. See comments for more.

So, although you may be tempted to push away negative emotions, try to work towards seeing them as your teacher and your guide. This is best done once you are out of the throes of the negative emotion – sometimes just getting through is all you can do in the moment.

Notes:

Think about what each emotion signals to you. Some examples below for the purpose of some of our most common emotions.
When we feel anger we’ve received a signal we feel wronged, betrayed, or exploited in some way. We can learn from these situations and work to protect ourselves so we are not repeatedly in situations where we feel taken advantage of.
When we feel sad we’ve received a signal we feel the loss of something important or valued to us. Knowing what we value and working towards finding that in our lives (in other ways beyond the loss we just endured) offers us the opportunity to make more and more meaningful experiences moving forward. Sadness also helps us know and recognize how important something or someone was to us (which means we can sometimes feel surprised when we didn’t realize it until we lost it).
When we feel guilt we’ve received a signal that we’ve made a mistep. This signal helps us know when to make a mends, and helps us protect our sense of integrity and self respect.
When we feel fear we’ve received a signal that there is something to be afraid of. We want to work towards finding safety and security for ourselves.
When we feel joy we’ve found something that brings us pleasure. We want to (responsibly) keep that in our lives in a way that’s sustainable with other goals and priorities.
When we feel pride in ourselves or others we’ve received a signal that we or someone important to us has accomplished something of significance.
I mention your “authentic self” in the post. Many of us are confused about our authentic self because culturally, societally, and sometimes by our families we’ve been given messages about how we “should” feel, what we “should” think, and what “should” be important to us. These messages, some of which are well intentioned can confuse our ability to be in touch with how we actually feel, what we actually think and believe, where our limits actually are, and what is actually important to us. I talk about this further in my post on judgments and in my post on “should’s vs wants”.
Anxiety and depression can heighten emotions, and sometimes we can feel intense guilt, sadness, or fear that is not in proportion to the situation we are in or how we authentically feel about something. Feeling a lot of guilt CAN mean you really did something you feel is wrong, or it can mean your emotion is on over drive. While we can still learn from these emotions, the strength of the emotion does not directly match the strength of the lesson. Often times when we are anxious or depressed it’s not that there’s no reason for the feelings we are having, it’s that we don’t understand the reason – and the process of finding the reason can take a lot of reflecting and professional help. We also may need to learn when to listen to emotions and when to to challenge emotions, and figuring out when to do which is a complex process that is best done with a professional.
The premise of this post is that our emotions serve a function; we have them for a reason. Inside Out, the Pixar Movie is a great introduction to this concept, and explores how all of our emotions (including anger and sadness) serve functional and useful purposes for us. If you’re wrestling with this idea, or looking to introduce it to a child, consider watching the movie.

April 20, 2021March 27, 2023

Understanding “Know your Limits”

“Know your limits”, you’ve been told. But what does that mean?
We are often given this advice without any direction as to how to do this, and many of us are operating outside of our limits without awareness
Signs you might be outside your limits: Irritability, anger, resentment towards others, a desire for someone to rescue you from having to acknowledge a limit you may may not want to be a limit.
Sometimes it’s more like a shutting down where we retreat away. Sometimes you may find yourself avoiding.
Many of us hit limits faster when we are tired, hungry, in pain, or scared for our safety (including both immediate threatening dangers, and more subtle /ongoing / systemic dangers, like feeling unable to provide for our families or feeling unsafe in our communities).
We don’t always get to determine our behavior based on where our limits are, but it’s always helpful to know when you’ve hit a limit so you can take steps to take care of yourself and pause (when possible) important decisions and activities
If you read this post and find that you are in this type of place a lot of the time / most of the time consider getting professional help, you may be struggling with anxiety or depression.

“Know your limits.” An easy piece of advice to give, and often a hard piece of advice to enact, especially if you haven’t had role models who knew and respected their limits, and who taught you how to do the same.

If you are someone who has a hard time with recognizing and respecting your limits (and you may not know this is you until you read further) it may help to consider that they may not be where you want them to be, or believe they “should” be.

Sometimes accepting our limits requires making sacrifices.

We can work towards developing awareness of our personal cues that we’ve passed our limits. It can look at feel different for everyone, so this will have to be a personal journey for each person to identify their particular signs. Here are some tips to help you get started on working towards learning where your limits are.

For many of us we get irritable or “snap”. We might say things we regret or start thinking repeated thoughts that are hard to stop (called ruminating), about how upset we are with ourselves or other people.

For others of us we shut down, fall asleep, zone out, or numb out.

Sometimes we look for someone to rescue us so that we don’t have to acknowledge a limit that we wish were not a limit, “maybe she’ll break up with me so I don’t have to”, “maybe I’ll just get fired so it could be over”, “If only he cleaned all this up then I could take a break”.

Sometimes it looks like tunnel vision where it becomes hard for us to problem solve or see the big picture. We can get fixated on one particular perspective or solution when we’re in this mindset.

If you feel the way I’ve described more often than not this is a cue that you may be depressed or anxious. I’d encourage you to seek out professional help.

We don’t always get to determine our behavior based on our limits, but we can work towards recognizing when we’re “not really here” so that we can hold off on important tasks or decisions, take breaks, ask for help, or at a minimum work on taking a few deep breaths and coaching ourselves through a difficult time.

—
Notes:

Helpful questions to ask: “Is my behavior and thinking in line with how I genuinely feel, my values, and my priorities?” Do I feel like my emotions are out of control?”
This post has connections to other posts I’ve written, specifically: we hit our limits more easily if our shoulds outweigh our wants, we can look out for increasing internalizing or externalizing when we’ve hit a limit, and we want to offer ourselves compassion as we work towards the process of learning what our limits are and learning how to accept and honor them.
Realizing you’ve hit a limit and aren’t sure what to say to others if you need a moment or to return to an important topic? How about “I need a minute”, “I’m not feeling well, I’m going to need to bow out”, “Can we circle back to this? I’m having trouble thinking through this right now”, “ok, I’m putting myself in a time out, I’ll be back in a bit”.
This is not about perfection. No one can be perfectly “available” at all times, but the idea here is to work towards building that awareness of when we really don’t have it in us to be mostly there in a way that aligns with our values, our priorities, and with capacity to manage our feelings.

April 15, 2021March 27, 2023

How to Unpack a Judgment

When we’ve used a judgment in talking or thinking through a topic that’s either 1) complex or 2) there’s disagreement or confusion those are times we want to “unpack” the judgment
To “unpack” a judgment we want to substitute the judgmental language with descriptive language. *this skill was developed by Marsha Linehan of DBT*
For many of us, judgments are hard wired in by our families or by our cultures, so they can be hidden or hard to find. Look for words like “should, shouldn’t, right, wrong, good, and bad”. There is often a judgment built in.
The new language after we’ve unpacked the judgment will often include a belief, value, preference, opinion, or potential consequence
Then, we want to try saying (or thinking) about that topic using the new language instead of the judgmental language
This will reduce conflict, increase understanding between parties that don’t share a perspective, and open up avenues for problem solving. It may also help build connection by finding shared values and concerns
When we don’t use judgments we start to take ownership of our perspective and that improves communication and relationships too. I can also reduce shame and increase motivation.
Using a judgment when the meaning behind it is understood by all parties, or everyone is on the same page, is a great use of the tool and enables more efficient communication
Judgments are not inherently bad (there’s a judgment!) but they are tool, and one we need to use judiciously, with intention, and with awareness.

Often times it makes more sense to say “The weather’s good” than “I prefer sunshine to rain, and my intuition is you do too. This warm weather is a pleasant and comfortable experience for us both”. You probably just rolled your eyes. I get it. That’s obnoxious. We can’t talk like that.

In previous posts I covered what a judgment is and how they limit us. Today, we’re covering what to when we hit one. Feel free to keep saying things like “the weather is good”, using judgmental language when the sentiments under it can be easily deduced, or when everyone is naturally on the same page saves time and energy.

We want to work on using a different approach when everyone is not on the same page (like when there is a judgment in a conflict) or when the meaning is not as easily deduced (like complex, confusing, or new topics). When we unpack the judgment (as I call it) or work to replace judgmental words with descriptive words (as DBT calls for) we can communicate more clearly, reduce conflict, decrease experiences of shame, increase motivation, increase our ability to problem solve, and

increase connection between parties even if they have different perspectives.
When instructing my clients on this I tell them they’ve got to work on finding a way to express what they are trying to communicate without using an evaluative statement (most common are should, shouldn’t, right, wrong, good, or bad – but there are others). I.e. How can you try and express exactly what you were trying to say with words that are not evaluative statements.

Having a judgment is not the same as having a belief, a preference, a value or an opinion. When we remove the judgmental language and unpack the beliefs and opinions that are under it we can get to the bottom of your experience and what may be working (or not) for you, or what may be important (or not) for you or the other person.

While judgments are not inherently bad (there’s a judgment), they are tool, and one we need to use judiciously and with awareness. We can communicate more effectively with one another by reducing our use of judgments and by building insight into the beliefs, experiences, preferences, and opinions that inform them.

Notes:

1. Substituting language is not a one for one. If you remove the word good you cannot find a single word that will replace is. You often need to find a way to re-state the whole premise.
2. I like to use the visual of a flag post when I think of judgments. Think of the flag as marking a spot you need to drill down into to find the substance under the superficial judgment.
3. Let’s take an example: “I’m not good at this”. If we’re not going to use judgmental language, we need to get to the bottom of what’s being stated. This is when it’s time to ask ourselves what we really mean. Some possible examples: Is what we really mean “this is new to me and I expected to get the hang of this quicker”? Or “this isn’t interesting enough for me to keep trying”? Or what about “I can see that others around me are better than me, and I just don’t think I’ll ever get there ” or maybe we mean “the skills required of this task are just not skills I have naturally at this point in my life”. Maybe it means “I don’t want to do this any more” or “I feel defeated”. Unlike “I’m not good at this” all of these statements have natural solutions or next steps (unlike “I’m not good at this” which is a dead-end). Maybe this means the person needs to build more skills, maybe this means they want to stop, maybe this means they need more encouragement, maybe they are struggling with comparisons and need to work more at focusing on their progress rather than others. Whatever statement (or statements) fit – and they will be person and situation specific – there is a clear next step and sense of direction which enables problem solving, support, and movement through an issue.
4. Example: “Lying is bad” I think nearly all of us can agree that lying is (typically) problematic. It misrepresents the truth, deceives others, and can violate trust which hurts relationships. I would argue that it’s far more important to communicate to someone who lies why lying is problematic to help someone understand the consequences and potentially be motivated to change their behavior than to simply leave it as “lying is bad”. We are limited by the statement “lying is bad” because it doesn’t provide enough context for someone who doesn’t understand the impact of lying on the community around them. This is a scenario where it’s more helpful to get descriptive and talk about consequences so someone understands why lying is problematic.
5. Example: “It’s wrong to play video games all day.”. So clearly the speaker is upset about the other party’s decision to spend time on video games, but there is actually a lot to unpack here. Why does this upset the speaker? Is the other person not contributing enough at home? Are they just relaxing after a long day? Is the speaker someone who has a hard time slowing down and finds themselves resentful when they see someone else slow down? Could the video game player be overwhelmed and numbing out their life? Is the person making the statement angry because they feel an imbalance in the relationship? If we don’t unpack what makes it “wrong” we can’t begin to solve and address the underlying concerns – both the possible issues within the player, and the concerns held by the person speaking the statement.
6. Example: “Don’t take away my guns. Gun control is wrong.”. Alternately, “Guns are bad. We need gun control”. (Yes. I’ve chosen a hot button topic for the sake of example. I want to be clear these are examples and are not representative of my beliefs. I am choosing this to illustrate how judgmental language can limit political discourse). We have so little information from either statement about why gun control is bad, or why guns are bad. It’s unclear if we’re talking about safety issues, self-protection issues, fear of not being able to protect oneself, an emotional attachment to ether side – you name it. It’s very hard to problem solve because the statements don’t appear to have much overlap, and we’re not talking about the actual concerns, priorities, fears, needs, and beliefs from either side. If we’re going to address the issue of guns (or other political issues) we need to be be able to clearly articulate our priorities, needs, concerns, fears, and beliefs around them. Then we can create laws that address those topics. We may also find overlap that we weren’t previously aware existed if we can move away from the judgments and get more descriptive with the concerns at hand.

7. Not sure if it’s a judgment? See this post.

April 15, 2021March 27, 2023

How Judgments Limit us

Judgements are shortcuts we use instead of taking ownership of our beliefs, values, morals, opinions and perspectives
We can use them instead of acknowledging consequences
We can also use judgments as a way to try and control ourselves or others
Sometimes we use language like “bad” or “wrong” or “shouldn’t” and we can’t articulate why or we don’t understand what we mean by it, we just feel strongly that it “is”
Judgments hugely limits our ability to talk to people who have differing values / opinions / beliefs / perspectives
Judgments also limit our ability to understand ourselves, deal with underlying concerns, and meet underlying needs
When we rely on judgments to communicate or think through something we are more prone to misunderstanding, disconnection, confusion, conflict and overall stuck-ness.
We often time can’t get anywhere productive in the conversation or in our thoughts and get hung up on the same issues again and again. If you find this happening internally or in conversation look for a judgment – it might be hidden.
This is a three part series. See previous post for clarification on how to identify a judgment. Post to come on what to do when we are stuck on a judgment.

Marsha Linehan describes judgments as short-cuts that allow us to hide our values, perspectives, preferences, beliefs, or moral stances behind absolute statements. We don’t have to take ownership when we use a judgment. Something just “is”.

We often use language like “it’s wrong” or “it’s bad” as a substitute for statements like “I don’t like this”, “it has potential consequences”, or “my values differ from this”. We say “It’s good”, but what we may really mean is that we see value in it and/or are willing to treat it as important.

Judgments can also be a way to try and control ourselves or others. After all, it’s It’s not “wrong” to run a red light, but it could be dangerous. This example may feel like a technicality – we all know running red lights is dangerous and that’s what the speaker means. However, this gets much more complicated when we rely on judgments to discuss topics that are not generally agreed upon or where the meaning behind it is not as easily deduced.

When we rely on judgments about what (to us) makes a person or situation good, bad, worthy, unworthy, right, or wrong, we often can’t articulate why we’ve labeled something the way we have. For many of us we stop when we get to a judgment. It becomes a dead end where we lose the capacity for curiosity, exploration, and understanding. We can lose our ability to communicate the reasons behind our perspective, and think through why something works or is problematic for us.

When we use judgments internally about ourselves (as we often do when we are anxious or depressed: “I’m worthless”, “I shouldn’t do that”) or externally about others (which we often do in relationships: “he should know better”, “she’s bad news”). We also end up shaming ourselves or others with negative judgments, and that can lead to intense feelings of inadequacy combined with a lack of understanding about how to change or what the actual issue is. Aka, being stuck.

Notes:

Example: Let’s take an example of how a judgment can limit us: “The Fish is Bad”. You and I both probably understand that to mean that whoever made the statement is not enjoying the fish in front of them. But imagine, that you are a server being told by a patron “the fish is bad”. As someone who is in a position to try and solve a problem for your customer, you’re limited. Does this mean the fish is rancid, too salty, under cooked, over-cooked, too cold, or any one of a number of other potential problems with food? You, as the server, have no way to know unless you dig in and ask the patron what they mean. Lucky for our server, this is probably a scenario where the patron can clearly state the problem with the fish and the server can attend the meal by re-heating, replacing, re-seasoning, etc. But sometimes we use language like “it’s bad” and we can’t articulate why or we don’t necessarily understand what we mean by it, we just feel strongly that it “is”.
Let’s look at a more nuanced example: “I’m not good at this”. I am guessing this is a thought we’ve all had at one point or another, and we are very prone to thoughts like this if we’ve ever struggled with anxiety or depression. This thought is one that’s likely to lead us to stop trying, to give up, and to believe something isn’t for us. We are likely to feel shame and inadequacy when we talk to ourselves (or others) this way. And in addition to all those problems, we aren’t left with any avenues for how to try and help ourselves improve, learn, grow, or even what we can do. We’re just stuck
Example: “Don’t take away my guns. Gun control is wrong.” Alternately, “Guns are bad. We need gun control”. (Yes. I’ve chosen a hot button topic for the sake of example. I want to be clear these are examples and are not representative of my beliefs. I am choosing this to illustrate how judgmental language can limit political discourse). We have so little information from either statement about why gun control is bad, or why guns are bad. It’s unclear if we’re talking about safety issues, self-protection issues, fear of not being able to protect oneself, an emotional attachment to ether side – you name it. Problem solving is made much more complicated because the statements don’t appear to have much overlap in terms of solutions that might address common values, priorities or concerns. ,We also can’t address the, fears, needs, and beliefs from either side. I’ll take this example back on in the next post when I explain how to more constructively communicate when judgements arise.
Positive judgments are problematic too, because they too provide little information about WHY something is good or WHAT we value. Positive judgments don’t have the same shaming effect, but they do limit our ability to clearly share our perspective, values, beliefs, etc.
Not sure how to identify a judgment? see this post.