mental health

5 More Tips for Times of Transition

By: Abby Lombardo, LMFT

If you missed part one of this post, head here to read it now

 

6. It’s OK to not be OK.

       The phrase “It’s OK to not be OK” is meant to normalize your experience, whatever the not okayness may be or may stem from. It is sad to me that we need these reminders, because the society we live in, in most of America, subscribes to this toxic positivity, good vibes only, put your best foot forward at all times, filtered social media persona… The messiness of our humanity is often experienced behind closed doors. And when that is the case, we often isolate ourselves further because of the lack of representation or the belief that no one else has moments like these, struggles like these. What I mean when I say it’s okay, is that it is NORMAL. It is part of the range of human experiences. Shit happens. Life happens. It is not a personal failing. You are not failing at life. When things become significantly distressing and cause bigger issues in our life, that’s a sign to address and work on some things, maybe with a therapist. Still, most of my sessions, despite the issue or diagnosis of the client, is about reminding people that what they are experiencing is valid, it makes sense, and it is a normal experience within the realm of human experiences. We often have to start there before we can get anywhere else.

What it’s OK to not be OK looks like:

Being sad.

Grieving.

Crying.

Hugging yourself.

Telling a friend how you’re truly doing.

Being vulnerable with your partner about your needs in the relationship.

Being messy.

Having a bad day.

Not feeling generous towards people.

Not wanting to say yes to things, people, events, invites…

Not wanting to smile.

Not forcing yourself to smile.

Taking a mental health/sick/self care day off from work.

Not liking yourself or how you look.

Feeling anxious

Feeling depressed.

 

7. Know when to take control and when to let go.

This is a common struggle I can highlight in my own life and the life of most of my clients: the struggle to know when to take control and when to just let a thing go. They are two very important skills. One, feeling empowered in your sense of agency and sense of self control in the world. Two, feeling the peace of knowing you’ve done all you can and it is now time to switch course, pivot, regroup, and proceed differently. The third skill is knowing how to discern when the situation calls for one or the other. So, how do you know when it’s time to take control and empower yourself to push through or to relinquish control and graciously surrender?

What taking control and letting go can look like:

Asking yourself:

What is my goal here?

Am I afraid of something happening if I let go of control?

       What do I have the ability to impact in this situation?

       What would accepting the situation do for me?

Realizing the limits of your own control.

Surrendering to the unknown mystery of life that cannot be controlled.

Practicing meditation.

Move your body, which can help regulate your nervous system and the intensity of the situation.

 

8. Connect with yourself.

The world is raging around you. Sometimes, you have nowhere else to go but inward. I encourage you to make a home within yourself. A retreat. A place where you can rest, gain insight, sit with what is, explore a new place through visualization, imagination, reading, curiosity. Cultivate connection with yourself in a way that becomes your best resource when everything around you feels too much or too out of control. In order to do this, we often have to shine a light on all the shadowy corners of our selves we’d really rather not have to face. These are the most important places we can go in order to befriend ourselves. When we can engage the parts of ourselves we deem unworthy, shameful, or unacceptable with curiosity, compassion, and gentleness then we can learn to inhabit ourselves more fully. Embodied people learn to be grateful for their shadows, because they have much to teach us about ourselves.

What connecting with our selves can look like:

Journaling.

Being vulnerable.

Identifying areas where you carry shame.

Identifying parts of yourself you often reject or find intolerable in others.

Sitting with yourself in silence.

Bringing curiosity to your experiences and behaviors.

Validating your own feelings.

Offer yourself compassion, care, and kindness.

Imagine interacting with a younger version of yourself, what would you say or do for the is younger you, that maybe you needed then?

 

9. Remember your values.

When I feel adrift in session with a client, it’s usually because I don’t know what guides them, what matters to them, what they value most. Sometimes they aren’t even aware themselves! Values ground us and transcend us, they give our actions purpose and meaning. They make this existence matter. When we live into our values, we feel aligned and purposeful. We feel satisfied and fulfilled. When we walk away from our values, we often feel dissonance between the person we want to be and the person we are behaving like. The easiest way to close that gap is to 1) be aware of what your values are 2) Find small actionable steps that lead in the direction of your value. We can never “accomplish” a value. Living into a value is never done, it is something we continually must choose to step towards. No one lives into their values 100% of the time. Yet the more mindful we are about our choices lining up with our values, the more direction, purpose, and meaning we derive from life.

What remembering your values can look like:

Complete a “Values Sort Exercise” by reading through a list online and organizing the words that stand out to you most.

Investigate past positive experiences where you felt you had a strong sense of self, direction, satisfaction, fulfillment, purpose, or meaning and mine those experiences for clues as to what you might have been valuing or living into at those times.

Break down small, actionable, realistic steps for living into one of your identified values.

Offer yourself compassion for making mistakes or not living up to your goals/values.

Surround yourself with people who share similar values or inspire you to move towards your goals and values.

Be curious about your values, where they originate, how they feel to you, is there a socio-cultural narrative that impacts these values (positively or negatively)?

Make conscious choices about the things you choose to value and how you show you value them.

 

10.  Prioritize what’s most important.

In times of transition, and in general, we only have so much energy. While it is a renewable resource, our energy is also limited per day. Our world is so full of distractions and non-stop media grabbing for our time and attention – also precious resources. We seek entertainment and distraction to soothe our overwhelmed and overstimulated nervous systems, thereby re-starting the whole cycle. Prioritizing what’s important is a skill that helps us cut through the static, narrow our focus, and direct our energy where it matters most. It takes conscious effort and mindful awareness to choose where our energy, time, and attention is invested. But that’s exactly what is happening, no matter what we are doing we are investing it somewhere. We invest it in entertainment and media, we invest it in work for money to live off of, we invest it in our relationships to maintain and enjoy them, we invest it in ourselves to learn and grow. Or you could say: Wherever you spend your time and energy, there your heart and treasure lie also. So be wise with where you allocate your most precious of resources. Ensure that you are investing in the things that truly matter to you, that truly are important.

What prioritizing what’s most important can look like:

Taking stock of your daily routine/agenda

Clarifying your needs and goals for a day/week.

Identifying what is important in your life and ways you show that to yourself and others

Being honest about areas in your life that are important yet have been neglected in terms of “investment” of your time, energy, and attention

Look for small, actionable steps for re-investing in neglected areas

Make a schedule/create a routine/set a reminder in order to continually and intentionally prioritize what’s important

 

 

Remember that these are only suggestions of things to possibly try, things that might help. Please trust yourself to navigate your needs in this time of transition. And when you feel like it’s too hard or you can’t do it much more on your own, please know that we at Riverbank Therapy would love to partner with you in your journey and come alongside to support you.

Empathy 101

by Toni Aswegan, LMHC, NCC

Let’s dig into this massive concept!

What is the difference between sympathy and empathy and compassion?

Sympathy is identifying with someone else’s situation, while empathy involves identifying with what they’re feeling and thinking during that situation. Empathy is harder and more vulnerable because it requires you to identify and experience within yourself the same emotion they are experiencing right now. That’s also what makes it more powerful than sympathy. Compassion is similar to empathy, but the main difference is that compassion is empathy PLUS the desire to help.

A note on terminology: “empathic” and “empathetic” are synonyms.

Is being an empath a real thing?

Maybe! Social scientists seem to have mixed opinions on this topic. For my purposes, I don’t feel the need to know whether it is a “real” thing (by which I’m assuming people mean “an inborn characteristically high level of empathy”). When I’m talking about an “empath” I mean someone who is highly attuned to other’s emotional states. If the label of “empath” is useful for you, great! If it’s not, you don’t have to pick that label up. You can call yourself what you want.

Does everyone have a baseline amount of empathy? Does early attachment wire you for more empathy?

Everyone (arguably, other than psychopaths) are born with the capacity for empathy. It is a trait humans naturally possess. Our experiences can increase our ability to experience and express empathy, or they can stunt our ability to experience and express empathy.

Attuned interactions with early caregivers (interactions in which a caregivers helps us name and care for what we feel) helps us develop both a theory of self and other. When we don’t experience attunement regularly as children, we develop a less stable sense of self and less skills to regulate emotions, and thus may have a harder time with empathy later on in life.

On attachment styles:

Those with avoidant attachment tend to experience a lack of attunement in childhood. Their emotional states are often ignored or criticized, so those with avoidant attachment might have a harder time experiencing and expressing empathy. Those with anxious attachment tend to experience enmeshment as children, meaning their emotional states are merged with their caregivers rather than differentiated. Those with anxious attachment might have a harder time stopping empathy and setting boundaries around empathy.

Why do some people struggle with empathy?

There are a ton of possibilities here. It’s possible they didn’t have a lot of attunement in early childhood. It’s possible they are not very in touch with their own emotions and so have a hard time connecting with those of others. Maybe they are easily dysregulated by emotion. Maybe they are stressed or otherwise burned out, which makes it harder to perspective take. Maybe they are judging another person, which blocks empathy.

Humans are generally born with the capacity to experience and express empathy.

Your childhood and attachment experiences can help you become more empathic, but even if you didn't build this skill from a young age, it is a skill you can learn and improve. And it's worthwhile to do so. Empathy will help you feel more connected, happier, and makes the world a better place.

What skills will help me build and practice empathy?

-reading fiction books;

-watching movies;

-going to therapy;

-practicing self-compassion;

-asking yourself questions about other people's inner worlds and behavior (swipe).

All of these actions help you build the muscle of curiosity and imagination about what is going on for another person.

Question to ask yourself to practice empathy for others:

-how might this person be feeling right now?

-how might I feel if I were in their position?

-what might this person have experienced in their past to lead them to this action/feeling/belief?

-even if you disagree with it, how might their behavior make sense?

 

What are some practical ways to express empathy?

There’s no script here. Use your body language and facial expression. Reflect what you think the other person is feeling “I imagine that was really scary” or “You’re feeling really lonely, huh?” with the option for them to correct you (we’re going for accurate empathy here, y’all). Get curious and ask questions, then reflect more.

How to move cognitive empathy to emotional/visceral empathy?

Being able to think through or understand empathy is great, but letting yourself feel it is really what other’s resonate with. Practice feeling your own emotions, this will help you get more comfortable with others. Therapy is a great place to practice this skill.

How do have empathy when I don’t agree with the other person?

This is totally possible! Empathy is not agreement. I can disagree with someone staying with an abusive partner, and empathize with their fear and helplessness about the decision to leave or not. I disagree with their decision, but I know moments where I’ve felt scared and helpless, and I can connect with them on that. Remember, empathy is connecting with the feelings, not the situation.

How to ask for empathy?

“I don’t need solutions right now, I just need you to know and understand how I feel.”

Remember, not everyone who is empathic has the skills to communicate it, so be patient.

 

At what point does experiencing empathy for others become unhealthy?

You’ll notice empathy becoming unhealthy when:

-you have little to no space to feel your own feelings

-You can’t stop thinking about other people

-You can’t sleep, are experiencing depression or anxiety related to other people’s feeling

-You overly adjust your behavior to influence others’ emotions or to take care of them

-You’re feeling burned out, disconnected, and losing your ability to have compassion and empathy (this is a SURE sign for me as a therapist).

How to set boundaries when you’re overly empathic?

-take some time to focus on your own feelings.

-Remind yourself that you’re not in the other person’s situation.

-Remind yourself what IS and IS NOT yours to be responsible for.

-Practice symbolically setting other peoples stuff down (write it down, pick an object to represent it and leave it outside the room).

-Get empathy from other people yourself. Seek support of your own, especially if you are consistently in the position of supporting others.

 

Wow, there’s a lot to say about empathy! It’s almost like its MY JOB! I really believe that empathy and compassion can make the world a better place. That’s why I do what I do.

Want to book with one of our wonderfully empathic therapists? Click here to schedule your free 20 minute consultation!

Thoughts On Why Masks and Phone Calls Are Anxiety-Provoking

Anyone else super anxious when making a phone call? 

Up until I started my own business, I used to have to hand the phone off to someone else to order pizza, make an appointment, etc, because I was too anxious to be on the phone with a stranger. I have heard this over and over again from other people, too. Phone calls are so stressful.

Now that I have some background in how our nervous system functions, I have a theory (emphasis on *theory*, I could be wrong) as to WHY this is the case for so many of us.

It's the same theory for why talking to people with masks on might be creating social stress (other than the obvious stress of living in a pandemic time...P.S. WEAR A MASK).

You've heard about the window of tolerance, also called the social engagement system. (and if you haven't, scroll around my page a bit and you'll find old posts about it). This is governed primarily by the ventral vagal complex (VVC), a big ol' nerve system that runs from the base of your skull all over your face and ears and throat, into your heart and lungs and guts (it's a big one, friends).

The VVC keeps your heart rate regulated. It helps you tune your ears to hear the frequency of human voices over other sounds. It helps you create and appropriately read facial expressions, by noticing the crinkles at the edges of eyes, the shape of someone's mouth, how much teeth are showing, if their nose is moving, crinkled, etc.

When we're able to read facial expressions, we can feel safer knowing whether a person is friendly or aggressive, sad or angry or pleased...in other words--feeling safe is connected to knowing how the other person feels and what their relationship is to us...which is all deeply connected to our ability to see their face. 

Well guess what?! The phone obscures all of the facial expression information. Masks obscure fully two thirds of this information.

We're missing the usual information we would use to help determine safety and how to act in relationship. Anxiety and stress in these situations is NORMAL.**

For those with a history of trauma, this stress might be even more acute and distressing.

Does this resonate with you? Let me know your thoughts!

**WEAR A MASK ANYWAY I'm just validating one potential reason why we might feel more dysregulated lately.

A Love Letter to Meditation (And Mythbusters)

Meditation is not about calming down.

It’s not about clearing your mind. It is not about disconnecting from the world. It is not about relaxing.

It is a practice of just BEING with whatever IS…right now.

Right now is a particularly difficult time to be with what is. Things are scary, overwhelming, downright traumatizing.

So meditation right now is about learning to be with the chaos, sit with the fear, breathe through the uncertainty. Not focusing on making it better or necessarily on feeling better but learning how to feel better. It’s a practice that supports you in learning to tolerate discomfort. It’s a practice of noticing distractions, stressful thoughts, tension in your body, and staying present despite it all.

THIS IS NOT EASY.

I have been meditating almost daily for about 5 years now, and daily for all of 2020. And let me tell you…it is still hard. I still get distracted. I still want to run away internally from discomfort. But you know what? When tension arises in a relationship, or when I get frustrated in traffic, or when a friend is feeling pain…I am way more able to stay present and respond in line with my values. I am less likely to pop off and yell at my husband. I’m less likely to flip the bird at the car tailgating me. I am wayyyy more able to remain calm and regulated when my friend is crying.

It also changes my relationship with myself. Because I meditation when I’m anxious, depressed, angry and fearful, I know what that feels like in my body. I am learning to recognize what those thoughts sound like, and the subtle precursors to emotional changes. This is helpful in preventing deep depressive episodes. It helps me recognize my anxiety earlier and take action to soothe myself. Meditation allows space to get curious about my internal experience, rather than judging, which lets me take more effective action when I need to take care of myself.

In short, meditation helps me get comfortably uncomfortable with pain and discomfort, so that I can sit with it without running away.

Meditation is legit one of the cornerstone skills of my well-being.

I’m not saying it’s the answer to everything, because it certainly isn’t. But it is in my top 5 list of skills to support mental health. (If you’re curious, the others are: exercise/movement, getting good sleep, getting enough nutrition, spending time with other humans.)

Because world events are so scary right now, I find myself valuing my meditation practice more. It’s supporting me in being able to stay present and within my window of tolerance (maybe just for a few more minutes a day) during this trauma.

Again, this isn’t about being calm. It’s about learning to sit with discomfort.

One of my favorite ways to practice this while meditation is with ITCHINESS.

My nose itches.

My back itches.

My head itches.

Don’t scratch. (I know.)

Watch the itch arise, intensify, and fall away. Sit with it and notice how you can actually tolerate how itchy it is. How it goes away. Or you get distracted by a thought and by the time you remember you were itchy, it’s gone, or somewhere else. Notice how things change.

This is how you operationalize “sitting with discomfort”. You find a way to practice. Meditation is a great field for this.

So I recorded a few meditations for you.

The first is a general mindfulness meditation. This can be done sitting, laying down, walking, moving. Eyes open or closed. Modify the practice as needed to suit you.

The second is a meditation to help you connect with your body. Again, modify as needed.

Click here to get these meditations!

I hope these can support you somehow during this time. Take care of yourself. I’m here with ya.

-Toni

Attachment, Resilience and Trauma

Therapists asking about your childhood is a cliché. But…it’s cliché for a reason.

Your childhood has a massive impact on who you are as an adult. In my work as a trauma therapist, I know that your childhood experiences have a huge impact on stress resilience. People who had childhoods that fostered secure attachments (or adult relationship that facilitate an “earned secure” attachment style) are better able to recover from stress, and less likely to develop PTSD after a traumatic event.

Let’s back up. What do I mean by “attachment”? It basically means the way that you receive soothing and connection with your primary caregiver(s) as a child. The quality of these early attachment relationships to a large extent influence everything about you.

“Attachment is part of a 3-part motivational system of fear–attachment-exploration. Fear triggers attachment behaviors. The safe haven of secure attachment soothes the fear of the amygdala, and opens exploration….Exploration eventually bumps us into something that triggers fear again which shuts down exploration and triggers attachment behaviors again which soothe the fear again and open exploration cycle of safety-exploration again.” -Linda Graham

Because we have a need for regulation, and as a baby haven’t yet developed the structures to do this ourselves, we rely on our primary caregivers to help us regulate. This is what our attachment system does for us. Attuned attachment typically leads to a wider window of tolerance, while misattuned attachment typically leads to a narrower one.

If our early attachment relationships are safe and attuned, we develop the ability to trust, accurately assess fear and regulate emotions. We can move more easily between fear, attachment and exploration. When something stressful happens to a person with secure attachment, their fear/anxiety peaks, and then over time returns to baseline in the window of tolerance. This happens more quickly and easily for those with secure attachments.

However, if our early attachment relationships are injurious or traumatic, then we might get stuck in any part of the fear-attachment-exploration cycle. This depends on how our caregiver(s) responded to us when we sought soothing after fear, or when we craved exploration. We may become more likely to seek attachment in response to fear (anxious attachment style), or seek exploration in response to either fear or attachment (avoidant attachment style), or oscillate between both (disorganized attachment).

This has a huge impact on how we respond to stress.

With an insecure attachment style (anxious, avoidant or disorganized), the peak of anxiety/fear may be higher, last longer, and take more to return to baseline. In addition, that baseline may be higher than those with secure attachment as well—meaning anxiety without stressful events idles closer to the edge of the window of tolerance.

Because our early attachment relationships influence our ordinary stress resilience, they also influence resilience to traumatic stress.

Those with insecure attachment styles are more likely to develop PTSD after a trauma than those with a secure attachment.

[This DOES NOT MEAN that everything is predetermined. Our attachment systems are quite amenable to growth and change, as is our stress tolerance. This is simply more information about how our early childhood experiences shape our adult selves.]

About 20% of people who experience trauma go on to develop PTSD. There is not a ton of research on how to prevent the development of PTSD after trauma, but this information is an interesting piece of that puzzle. If we can help kids have more secure attachments, then it follows that less kids and adults will experience PTSD after a trauma.

(I know, it would be great if trauma just didn't happen...but we don’t have control over that. However…I'd also argue that less interpersonally caused trauma would happen if more of us had secure attachment...but that’s a post for another time.)

Attachment security being a resilience factor supports the theory that relational experiences are necessary for healing trauma: developing more secure attachments in and through therapy will help widen your window of tolerance, support your nervous system in becoming more adaptive and flexible, and provide new healing experiences.

Want to explore this with one of our therapists? Click here to schedule your free 20 minute consultation today!