Coping in a Time of Uncertainty

Thanks to COVID and the election (among other things), we are living in a time of heightened awareness about the uncertainty of our futures. It is this unpredictability that allows for anxiety to develop and spiral. I hear this worry daily and from every direction - from friends, colleagues, patients, even my own brain. So, what are we to do when confronted with the reality that the future is unpredictable and potentially bad?

Unfortunately, there is no magic pill. To some extent, we have to train ourselves to live with all the possible futures. It is easy to get pulled into self-destructive strategies: eating too much, substance use, alcohol use, overspending, or other behaviors. These might help us feel better today, but they fail to acknowledge that we are very likely to have a future in which we might regret those decisions. So be careful. Learn to enjoy today while also being aware of the impact on the future, and in the meantime, try out some of the recommendations in this post.

One of the best strategies is to learn how to effectively pull your thoughts out of the future and back into the present moment. Regular, daily mindfulness is the primary evidence-based strategy for improving your mind’s ability to do this. Some of my favorite activities include: diaphragmatic breathing, progressive muscle relaxation, thought watching, and grounding. Give these a try and work on building at least 5 minutes of mindfulness into your daily routine. It can be done while brushing your teeth or taking a shower - it doesn’t have to be fancy.

Now, I recognize that even with regular practice, this strategy can be incomplete for some. Which brings me to step two: determine and plan for your worst case scenario. First, figure out the worst case scenario that keeps popping up and causing stress. To use a specific and present example, image you get COVID. Where does your brain run to in its anxious state? Let’s just say it’s death. Who will take care of my kids? What happens to my stuff? How will my loved ones cope? (Yes, I know you’re all anxious now reading this.) Slow those thoughts down a little and ask yourself: How might I plan for death such that I feel as prepared as possible for that outcome? This might be updating a will, writing letters, or nothing at all. Maybe you’ve already done those things. Regardless, it might bring you some peace to know you’re as prepared as possible.

Now that you’ve made yourself anxious, come up with a plan that partially calmed you down, and are still breathing a little faster than is healthy, take a moment to come back to the present moment. Look around, what do you see around you? What do you hear? Feel? Smell? Taste? Are you safe now? There - You’ve used a mindfulness skill. If you are still wound up, scroll back up and try out one of the links above.

Good luck everyone - the future is uncertain, as it always is, but now you have some additional skills to tolerate that. Take care, and, as always, if you need extra help, reach out to a trained mental health professional.

COVID-19 and Being Human

I have debated writing a post about coping with life during, and as a result of, the COVID-19 pandemic. Rates of mental health difficulties, most significantly anxiety, depression, and trauma-related symptoms are skyrocketing in conjunction with the spread of COVID-19. Individuals who’ve struggled with their mental health before may be struggling even more and those who’ve never understood the despair that can be caused by psychological distress are learning a hard lesson. Because of this, there are a multitude of excellent available resources on the internet including some from extremely reputable sources like the CDC and, my particular favorite, the University of San Francisco. These sites give you all the right information that therapists around the world are bound to tell you, myself included. So I’m not going to recreate the wheel in this regard. I’ll let the other brilliant and educated psychologists, counselors, and LCSWs take the lead on this.

But, let’s be honest, you can do every single thing right when it comes to taking care of your mental health, you can follow every single recommendation, and the world may still feel like it is crushing in on you. You may feel like everything is out of your control, or you might feel hopeless. No amount of deep breathing, yoga, schedules, or exercise is going to solve that problem. So then what? How do you cope when nothing seems to be working?

This is the dark place nearly everyone tries to avoid - the place of despair. Yet, this is the place where you may have to go to be able to move forward. The place where it seems like there’s nothing left to do but hold on and get through it. This may mean you have to lay in bed and cry, yell at the top of your lungs, brave yet another panic attack. Be gracious with yourself. THIS IS HARD - potentially the hardest thing you’ve ever done. Let it be hard.

It can be hard, and you can survive it at the same time.

It can be hard, and you can wake up tomorrow and make your kids breakfast.

It can be hard, and you can call your best friend to check in on them.

It can be hard, and you can go for a walk around your neighborhood.

It can be hard, and you can do the things that are IMPORTANT TO YOU.

This is the essence of living with factually true negative life events. First, you admit the thing is true and here to stay (at least in the present moment). Then, you FEEL. Then, be kind to yourself about how you feel. Only then do you begin to figure out who you want to be WHILE you are struggling.

I cannot say you’re going to stop feeling everything complicated, distressing, and messy about this crisis. I am hopeful that you can feel those things, be the person you want to be, and then look back on each moment of successfully holding those two things together and be proud. You are strong. You’ve done hard things before. You can do it again.

New Year, New You?

Well, it’s that time again. The time when the calendar flips over, and a new year begins. Popular culture tells us this is the time to “resolve” to change something about ourselves or our lives. But is this realistic? Or even a good idea?

First of all, if there is a behavior that you’re hoping to change, the new year is as good as any. It’s not any better or any worse than any other time that you feel as if you’re ready to commit to a goal. So if now is the time, go for it! However, if now is NOT the time, please, please do not beat yourself up about this. One thing is for sure, making yourself feel bad about something only makes you feel worse than whatever that “something” is that you think you are supposed to change.

Second, the word “resolution” has a pass/fail connotation to it. Thus, one slip up or mistake is likely to de-rail the whole experience. Rather than “resolving” to do something, think about these changes as “intentions” or “options.” That way, if and when you are not perfect, you can return to the idea of intention and start again.

Third, make sure the goals you set are specific and attainable. For example, if you want to “lose weight,” start with a specific goal like “lose 1 pound per week.” Do some research, find out what is possible for you and your life, and set goals that push you a little but not so much that giving up is easy. A good rule is to increase a behavior by 20%. So if you go to the gym for 100 minutes per week, you would want to shoot for 120 until that feels easy and routine and then increase to 142 minutes, etc.

If you’re having a difficult time building motivation or developing smart goals, take a look at some of the SMART goal worksheets available online (like this one) or talk to a mental health professional.

Good luck to you all in your endeavors! I wish you all the best in the new year.

When Life Gets You Down

Hello everyone! Sorry about the break from posting. I, along with many of you, have had an extremely busy spring and summer and am just settling into the routine of long, hot, humid summer days at home. Recently, I have felt as if my days are filled with "one thing after another," and generally those things are not very exciting (at best) and distressing (at worst). So I wanted to spend a little time talking about how to manage when life just seems to be dealing you a bad hand. Sometimes, this includes big things like family illness or loss. Other times, it can be the found in the minutiae of daily tasks taking longer or being more difficult than expected. Regardless, these experiences can leave you feeling worn out, tired, overwhelmed, discouraged, disappointed, or like there is no point in trying. While it is tempting to throw your hands up, give up, and never leave your house (or your bed), this is the exact opposite of what is recommended.

Believe it or not, negative feelings often pass on their own if you acknowledge them, talk about them, and then allow them to accompany you through your daily activities.I give people a "24-hour" rule. You get to feel miserable for 24 hours, but then you have to get back out there and keep plugging ahead. So, for those of you who are getting dealt a bad hand right now, acknowledge your feelings, get support, and keep plugging ahead. Better times are ahead of you.

**Note: If you experience chronic, persistent depression, anxiety, or other mood problems, you may need additional treatment with a psychologist or psychiatrist.**

Stop Comparing Yourself

Do you ever feel like you're not good enough? Or wish you had what other's have? Do you get jealous or angry when you think about other people? If you answered yes, you're probably falling into a typical thinking trap - comparing yourself to others. 

Our awake brain spends a lot of time doing one of three things: thinking about the future, thinking about the past, or comparing ourselves to others. Each of these patterns drives different emotional patterns, and comparing oneself to others usually leads to jealousy, anger, resentment, or frustration. It can also lead to problematic pride or condescending behavior. When we measure our lives against the lives of others, we are constantly either coming up short or putting other people down. Neither of these helps us feel content and satisfied with our own lives. Yes, I know that many of us were taught to contextualize our problems by thinking about how small our problems are compared to things like world hunger, and for some of us, that's helpful. However, it's generally just invalidating and leads to suppression of valid, real emotions.

So, how do we stop ourselves from falling into the comparison thinking trap? I recommend one of two approaches, both of which require that you first notice what you're doing. Label your comparison to others by saying, "I am comparing myself to others."

Then either:

1. Ask yourself if it's helpful. If it isn't, try to develop a thought about the other person that is more helpful.
2. Alternatively, use a mindfulness or grounding exercise to redirect your thinking to your present environment. Focus on your breathing or a sensory experience (e.g., smell something stinky, touch something with an interesting texture). 

Although this sounds easy, it's not. It's hard to catch ourselves doing things that occur as part of human nature, and it's even harder to develop alternative thoughts or bring ourselves back into present awareness. Despite this, it's worth a try! Also, it gets easier with practice. And remember, even if you are able to do it 5% of the time, you're spending more time thinking in ways that ease negative emotions than you did before.

Happy practicing!

Living a Value Driven Life

One of the most common things I hear in my practice is a desire to increase happiness. We, myself included, get caught up in the day-to-day of living and wonder if we're really living the lives that we dream about or hope to have. When this comes up, my go-to skill is determining how you can live more of a "value driven life."

Living a value driven (or value based) life is a common intervention for overcoming doubt and increasing life satisfaction. Psychologists have been talking about and researching it for years, and it has recently become more commonplace in corporate employee wellness programs. It has even become part of self-help programs for individuals without any type of mental health disorder. Living a value driven life has shifted from being a skill for individuals with mental health difficulties to being a skill for literally everyone. So then, how do you do this? 

1. Identify 5 values that you want to frame your life around. Ask yourself, how do you want people to describe the way you life your life? Do you want to be remembered as honest, responsible, kind, etc? 
2. Make a plan for how you can better fulfill at least one of those values today and throughout the week.
3. Go do the plan.
4. When faced with choices, remember your values and make the decision that best lines up with those.

Simple, right? Usually, the answer is yes. However, there are inevitably going to be times when two of your values conflict with each other. For example, what if you really don't like someone, and they ask you to spend time together. How do you be both honest and kind if honesty suggests you should tell someone you're not interested and kindness suggests you should spend time with a person who enjoys your company? In these moments, take stock and ask yourself if you can in fact live by both values (perhaps there is a kind way to be honest). If there is truly no way to live out both of your values, then decide which one is more important to you in this moment. In the end, you are hoping to make a decision that you can look back on without regret since you will know that you lived your values the best that you could. 

Bring this practice into your daily life, and you are likely to experience more happiness and less guilt and anxiety about decisions. Enjoy!

Problem Solving 101

I mentioned problem solving in my last post but did not fully outline the steps, so I wanted to do so here. This is a little more of a technical and a little less fun post, but it is important for those of you out there working through difficult choices. I find the use of a whiteboard particularly useful during this activity. Sometimes, I even like to use colored markers. But you can do this with good old fashioned pen and paper as well.

Steps to Problem Solving:

1. Clearly identify the problem that you are trying to solve.
2. Brainstorm every possible solution (even crazy or impossible ones - you may end up coming back to these) to the problem.
3. Make a list of pros and cons next to each one. Be honest with your appraisal of each option.
4. Decide which option makes the most sense based on the balance of pros and cons. Sometimes the path will be clear, but sometimes you'll be faced with many possible good choices.
5. Follow through with whatever action you chose. 
6. Reflect upon how whatever you did worked. Sometimes, it worked great, and you're done with the problem and might know what to do when similar problems arise! Other times, it wasn't that great. If that is the case, go to the next step.
7. Return your original brainstorming list and choose a different option! Carry it out, assess, repeat. 

Now you know the basics of problem solving! Good luck to you all in tackling your decisions!

Self-Compassion

Sometimes, the hardest thing to do is to treat ourselves with the kindness, compassion, and love with which we treat others. We beat ourselves up over small mistakes, miscalculations, or missteps that we would never begrudge another for committing. For many of us, when we realize that we have been hard on ourselves, we are hard on ourselves for being hard on ourselves. Thus, we find ourselves in a vicious cycle of self-degradation. If anyone else then validates our self-criticism, we become even more convinced of our terribleness and continue to chastise ourselves with increased vigor. As you might have guessed, this can make us feel terrible and can even lead to depression, anxiety, or other mental health concerns.  

One of the tenants I teach in my therapy practice is to be compassionate with yourself the way you would be compassionate with others. As a daily tool, I advise to think about what you would tell a loved one, particularly a child. Then, I encourage you to talk to yourself in this same loving yet encouraging way. Many people, myself included, struggle to do this on a regular basis or even at all. In fact, I face a lot of resistance from people who believe that being kind to themselves will lead to laziness or lack of performance. This is just untrue. You can be kind to yourself while also offering a different action. As a general script, you could try, "You did ____, and that is okay. Next time try ___." 

Building the muscle of self-compassion is challenging and often benefits from daily practice. One of my favorite mindfulness meditations is focused on loving-kindness for others but also for yourself. It can be found here. Daily practice can train your brain to be more likely to go to kindness when you make a mistake. This, in turn, may protect you from a vicious cycle of self-criticism.