pi3: February 2019

Thursday 28 February 2019

Private Practice Inspiration of the day: Traci Lowenthal

“A big thank you to Dr. Traci Lowenthal for sharing her private practice story. Too many therapists feel alone on the journey of starting a private practice. Share your favorite...

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New Phase of Life / Depression, Insight Needed

Hey there! Just to point this out in advance, I am seeing a few professionals about my mental health, I’m on medication and I’ve already been diagnosed with Major Depressive Disorder, PDD-NOS, and potentially ADHD. I do not have the means to explore these further, but I have regular monthly visits with my psychiatrist and therapist.

I’m currently dealing with drug abuse, my anxiety-fueled fight or flight response has led me to self-terminate from several jobs, and I typically carry really low self-esteem and distrust for myself and everyone around me. My social skills are acceptable, but I’ve adopted several toxic behaviors that lead me to manipulate, hurt, and abuse others. This is pretty self-destructive considering I’m also incredibly lonely and have no friends. I spent way too much time obsessing over perfectionism and believed I wouldn’t deserve to be loved otherwise.

Since failing high school, the only things I strived for is daily drug use and sexual stimulation. My therapist theorizes that most of this behavior stems from repeated emotional trauma that we’ve discussed, but thinking about those events doesn’t stir up any emotional response at all which just confuses me and makes me feel worse. I’m 23 now, and a few months ago something happened inside my head and I feel an intense need to fix things and help my life turn for the better, but the more I pursue that the more I stir up bottled emotions, toxic behaviors and self-hate. I struggle with managing my emotions in general and don’t have any support from family or any friends to fall back on, so making changes to my life is a little terrifying.

I still have a lot of questions I’m trying to figure out, trying to quit drugs is difficult when I lose all motivation and drive to change while sober, especially since I was like this long before I started drug use. I don’t know if I’m a good or bad person, or if I’ll ever feel like I’m worth anything. I don’t want to go through all the effort to improve things and still feel the way I feel right now, I’d be utterly hopeless after that. At the same time though, I really don’t want this need for change to disappear, I don’t like feeling this way.
Thoughts?

What’s evident from your letter is your drive to resolve these issues and succeed. You want to change. You want a better life. You are moving in the right direction. Without that motivation, change may not be possible.

It sounds as though you need a possible medication adjustment. Your therapists’ assessment of your situation doesn’t resonate with you. That might be a sign you need a new therapist. Each time you go to therapy, you should feel slight improvement. Overtime, there should be some evidence of progress.

Alternatively, you mentioned that you don’t go to therapy often. You seem to need more help than you’re getting. It’s not clear whether your therapist is the problem or if you’re not attending as much as you should. Once a month is rarely enough.

Another issue may be your use of drugs. Drugs alter brain chemistry. They may be interfering with the medication you have been prescribed. The use of drugs would suggest a lack of coping skills. If you had a healthy way of dealing with stress, you would not be using drugs.

Generally speaking, it seems time to reassess your current treatment situation. As described above, you might need new medication and/or a new therapist. If what you’re doing isn’t working, then you must try something else. Don’t stop until you find something that works or someone who can help. It is worth it. Good luck with your efforts. Please take care.

Dr. Kristina Randle

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Podcast: How to Stay on Track to Make Lasting Change

When it comes to making big changes in our lives, most of us fail. Oh, the change might stick for a while, but eventually we go back to our unchanged selves. Why is that? Why can’t we maintain change for the long-term? In this episode, you’ll learn different reasons for this, but even better, how to make the long-term changes stick.

Subscribe to Our Show!

And Remember to Review Us!

About Our Guest

Eric Zimmer is a dad, serial entrepreneur, podcast host, behavior coach, and author. He is endlessly inspired by the quest for a greater understanding of how our minds work and how to intentionally create the lives we want to live. At 24, Eric was homeless, addicted to heroin, and facing long jail sentences. In the years since, he has found a way to recover from addiction and build a life worth living for himself.

He currently hosts the award-winning podcast, The One You Feed, based on an old parable about two wolves at battle within us. With over 200 episodes and over 10 million downloads, the show features conversations with experts across many fields of study about how to create a life worth living. In addition to producing the show, Eric works as a behavior coach and has done so for the past 20 years. He has coached hundreds of people from around the world to make real, lasting change in their lives.

LASTING CHANGE SHOW TRANSCRIPT

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Narrator 1: Welcome to the Psych Central show, where each episode presents an in-depth look at issues from the field of psychology and mental health – with host Gabe Howard and co-host Vincent M. Wales.

Gabe Howard: Hello everybody and welcome to this week’s episode of the Psych Central Show podcast. My name is Gabe Howard and with me as always is Vincent M. Wales. And this week we are going to be speaking with Eric Zimmer. He’s a dad a serial entrepreneur behavior coach and an author and he’s gonna tell us really about a lot of things and I don’t want to read your bio, Eric. Eric, welcome to the show.

Eric Zimmer: Thank you for having me on.

Gabe Howard: Eric, of course I have your entire bio in front of me but, rather than read it off, can you introduce yourself to our audience please?

Eric Zimmer: Well, what I do these days is I am the host of The One You Feed podcast which has been out for about five years and we we do you know kind of similar to you guys. We talk with lots of different people about what it means to live a good life. And so I’ve been doing that for about five years. We’ve been listened to I think something like 15 million times. And so that’s been good. And then I also do behavioral coaching with people. And before that, I’ve got a long history of various entrepreneurial things like a software startup company. I started a solar energy company. I’ve got a son who is 20 and is at college and as I mentioned to you guys sort of in the beginning, and I’ve also got a mother in law who has Alzheimer’s that we’re taking care of. So that’s a big big part of my life these days. But it’s kind of a brief overview.

Vincent M. Wales: I want to tell you I love the title of your podcast, The One You Feed. Can you share with our listeners where that came from because it’s one of my favorite stories?

Eric Zimmer: Sure. It’s an old parable. Nobody really knows where it comes from. Some people insist it’s an old Cherokee story, other people insist it’s not a Cherokee story, so I don’t I have not been able to find anybody who really can prove one way or the other. But yeah it’s an old parable and in the parable, there’s a grandfather who’s talking with his grandson. He says, in life there are two wolves inside of us that are always a battle. One is a good wolf, which represents things like kindness and bravery and love, and the other’s a bad wolf, which represents things like greed and hatred and fear. And the grandson stops and he thinks about it for a second. He looks up at his grandfather and says, Grandfather< which one wins? And the grandfather says, the one you feed.

Vincent M. Wales: That’s beautiful.

Eric Zimmer: So that’s the parable. And I use it to kick off every episode. I just you know I start off by asking my guests kind of what that parable means to them in their lives and in the work that they do.

Vincent M. Wales: I love that. Awesome.

Gabe Howard: And of course, you’re from Columbus, Ohio, which is awesome because I’m from Columbus, Ohio and usually we’re interviewing people from all over the country and not in my back door. But what’s really cool is many years ago, you had the band Watershed on your podcast and I love the band Watershed. And besides people who know me or who are from Columbus, they’ve never heard of them, so from one watershed fan to the other, it’s great talking to you.

Eric Zimmer: Yep. A local Columbus band that was great and still is when they play sometimes.

Gabe Howard: Yeah they don’t play a lot because they got old and had kids.

Eric Zimmer: Yup, yup, yup.

Gabe Howard: You know, when you say serial entrepreneur, you know I’m very interested in that because you know most people say, I’ve started a business or I’m an entrepreneur, but you say serial entrepreneur because, well you’ve started a lot of businesses. Can you explain what serial entrepreneur means to you?

Vincent M. Wales: It means he can make cereal.

Eric Zimmer: Exactly, yes. You know, off-brand Frosted Flakes and Cocoa Puffs and… No, I think by serial, it just means that yeah it’s I’ve been in one sort of startup business after the other for most of my career. So that’s where most of my career has been spent is in, you know very small startup companies that are very entrepreneurial by the nature of them being pretty new and small, although some of them got big, but they started small.

Gabe Howard: And that sort of… you like to do this. I mean that’s like the crux of your career. You like to take small things and help start them, make them bigger, you like to turn ideas into substance. This is what being a behavior coach is. I mean, actually explain that better because I’m just butchering it to hell.

Eric Zimmer: Well I do love, I do love the early stages of a company. You know I love sort of yeah like you said, they’re building something, taking an idea getting it out there. And I love that really, in early stage companies, you do a little bit of everything. So your job description is very broad and very wide. And so that’s always suited me well. I do a fair number of things pretty well. And so that always suited me. And so yeah, I would do one and then the company would get about to the size where it started needing specialization, where it was more operational than it was you know building, and then you know for both the company and me it wasn’t usually the best fit at that point and it would be better for me to go on and do something.

Vincent M. Wales: So, Eric, I understand that you had in your in your history some issues with alcohol and other substances could you talk about that for a bit?

Eric Zimmer: Sure. At the age of 24, I was essentially a homeless heroin addict. I was really sick. I had hepatitis C, I weighed about 100 pounds. I had a lot of potential jail time staring me in the face. And so, at the age of 24, I got sober, recovered from heroin. I stayed sober about eight years and then I drank again for a few years and now I’ve been back sober again for about 13 years, so I’ve got sort of two distinct stories of getting sober.

Gabe Howard: And you also struggled with depression, if I’m not mistaken.

Eric Zimmer: Yeah. And you know I never know whether to say I still struggle with it or not. I don’t really know. It is not the prominent factor of my life like it was for a long time. But you know it’s still sort of there. I think I manage it way way better than I did and it’s far less of a heavy thing in my life. But I think it’s still something that I work with. It’s a feature of my inner landscape.

Gabe Howard: This is a constant discussion in mental health circles. You know I live with bipolar disorder and I say I’m in recovery from bipolar disorder, but I still have bipolar disorder, I still have to manage it. I still spend some part of my day worried about it. So am I in recovery with? Am I in from? Some people are like well there’s no cure or so recovery is the wrong word.

Eric Zimmer: Yeah.

Gabe Howard: It is a difficult thing to try to manage because you don’t want to wander around and tell everybody that you’re depressed because then people might try to render care or aid and you’re just trying to live your life. But by the same token you don’t want to tell people that you’re fine because this is something that you… it’s impacted your life in many ways.

Eric Zimmer: Yeah you know I think for me with the show, you know I’m talking about these kind of topics all the time and I’m pretty open about it on the show and in other shows I go on to just because there’s lots of people out there that also struggle with it and and wrestle with it. And yeah I agree with you. I don’t know, like I said, I don’t know whether it’s am I recovered, am I in recovery, is it gone? And what’s remainder is sort of a natural melancholy temperament. I don’t know any of those answers. But I do know that the things that I’ve done to treat depression, most of them are things that I continue to do today, because they seem to keep depression at bay and they’re just kind of all around good for my mood state.

Gabe Howard: It is a common discussion that people have. Where does mental illness end and my personality begin? When is it a mental health issue versus a mental illness? When is it just an emotion? When is it… you know it’s why podcasts like ours can really exist, because there’s a lot of discussion and varying opinions on the subject. So thank you for lending your voice to the landscape. It’s very much important.

Eric Zimmer: You’re welcome.

Vincent M. Wales: So now Eric, how did your history with alcohol and drugs… how did that lead to what you do today? How did it impact your life and what was the process there?

Eric Zimmer: So like I said originally, I got sober at 24, stayed sober about eight years, got sober again, and I think that in my case, recovery from addiction and alcoholism took sort of a wholesale change in the way I viewed the world and how I moved in it. And it made me take my internal state much more seriously and really pay attention to what’s happening there and then also you know look at how am I interacting with others and connecting with others. And so I’ve kind of always had that. And that drove an interest in me in all things mental health related, spirituality related. And so that was kind of always there. And then about five years ago, five and a half years ago at this point, I had a solar energy company that I eventually just decided I didn’t… I was going to shut it down. And so I shut it down and I was doing some consulting work and I was just kind of bored. You know I didn’t really have like a thing that was, that I was really into and passionate about and love. And so the idea to do this podcast just kind of hit me. And it’s turned out to be wonderful. I started it for a couple reasons. Like I said, I started it because I was bored. I also started it because what I realized was that my mind, when it’s left to its own devices, heads towards less than optimal places. And so I wanted to sort of feed the good wolf in my own life. And I thought you know what if I interview people every week and then I read their book to prepare for the interview like I’ll be immersed in and swimming in these ideas, these concepts,these topics, and it’ll help me just overall do better. And that turned out to be totally true. And my best friend was an audio engineer and I thought that by doing it I get to spend more time with him, which turned out to be very true.

Vincent M. Wales: Well that’s convenient.

Gabe Howard: That is really cool. And you know it’s not unlike it’s not unlike the story of the Psych Central Show. On our hundredth episode, we sort of talked about how this show came to be and there’s a lot of similarities there. I ran my mouth. Next thing you know I thought hey I can spend more time with my good friend, which is Vin. And here we are. And we’re glad that we did because we definitely need to stay out of trouble for sure.

Eric Zimmer: I agree. I understand that that motivation.

Gabe Howard: We’re going to step away for 30 seconds to hear from our sponsor. We’ll be right back.

Narrator 2: This episode is sponsored by BetterHelp.com, secure, convenient and affordable online counselling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face-to-face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. BetterHelp.com/PsychCentral.

Vincent M. Wales: Welcome back everyone. We’re here with Eric Zimmer talking about making lasting change in our lives. So Eric, tell us about how this became your coaching work. You say it’s a behavior coach. Is that correct?

Eric Zimmer: Yeah, you know it started a couple years into the podcast and I started having listeners ask me if I ever did any one-on-one work with people. And I originally you know I initially said no I don’t. You know it’s not really something I’ve done. But I kept getting people asking me and I thought you know what? Let me give this a try. Let me see what it’s like to coach people. And you know about partway through the first call, it hit me that I had done this hundreds of times in recovery by being the sponsor to people. You know I had done that over and over and over and so I really realized it was something that I really felt like I knew how to do. And by behavior coach, what I generally mean by that is that it’s very difficult to… We all know you can’t just change your emotion, you can’t just grab your emotion and move it where you want it to be. And we can certainly work with thoughts, but some thoughts are what they are. But the thing that we seem to have the most control over is our behavior. You know there’s an old line I heard early in my recovery time, which is, sometimes you can’t think your way into right action. You’ve got to act your way in the right thinking. And so I would say that that line sort of underlies the whole idea of behavior coaching, that there are behaviors that we can do. There are activities that we can do that move us in the direction of our goals and our dreams. And also, there are behaviors and actions we can do that help our emotional and mental states of mind also. So that’s really where I focus is on what what behaviors are we going to change and how do we change them? I think we all have some idea like, well you know what? I know exercise is good for my mental and emotional health and I hear that eating right is good and meditation might be good. But a lot of us struggle to make any kind of lasting change with those things or to really stick with them. So that’s a lot of what I focus on with people is how do you make the change in your life you want to make? From things like I just described exercise or eating right to people who are trying to finish a dissertation or I’ve helped people finish novels or people who are trying to start businesses. If there’s a behavior, if there’s something you want to change, that’s kind of what I think I’m an expert at.

Vincent M. Wales: Now a lot of us have experience with making changes, but just not being able to keep at it. You know this is… we’re recording this in late January so recently it was all, you know, New Year’s resolution times, right? People are going to make their insistence on eating better and exercising and yet, come March, they’re not doing it. So what is a way that we can make the change going over the long term?

Eric Zimmer: So one of the things that happens to a lot of us is we we have this narrative in our head that says you know what? I’m the kind of person that just can’t stick with anything or I’m the kind of person who can never finish anything. So we start to make a change and it’s going along well. And then like I mentioned something knocks this off track, our kids get sick, our dog needs to go to the vet, we get sick, and then all of a sudden that voice in our head starts to say again to us, see? I knew you couldn’t stick with it, I knew you wouldn’t stick with it. And then that becomes a self-fulfilling prophecy. So a lot of it is about really learning how to get back on track quickly. Some of it is learning how to adjust as your life changes. So you might have a routine that’s going really well, but you start traveling for work. So how do you keep the routine going while you travel for work, or you enter a busy season at work or it’s summer and the kids are out of school. It’s about being able to sort of adjust to what you’re doing, how much you’re doing, when you’re doing it, how you’re doing it. All of that to kind of adjust as life changes, because the same routine usually won’t work for people forever and ever and ever. It needs to be adjustable. But what happens is that when life starts to move around in ways we don’t expect, we get off track and we tend to give up. So that’s one really big one is to just get back on track as soon as possible. There’s another one that’s really important that I sort of call… the analogy I make is like don’t kill the plant, right? So if you think of your habit as like a plant, there are times that when you’re at home you can water the plant and you can take good care of it and you talk to it if that’s your thing, right? But then inevitably something happens. You go out of town for a week. When you go out of town for a week, all you’re really after you might ask your mom to come by and water the plant once a week. You just don’t want to kill the plant. And sometimes habits are this way. If you get a really busy week, what we want to do is not kill the habit. So if your routine is to go the gym every day for an hour, but the week just is really really busy, you’re better off to go to the gym every day for 10 minutes. You know reduce the scope, stick to the schedule is what well-known habits person says, because that keeps the habit alive. And that’s really the key is how do you just keep the habit alive so that when circumstances are better you can kind of get back to the full version of the habit? So those are just some of the ways to get through when things change a lot and how to really make a habit stick long term.

Gabe Howard: I really like all of that. I can relate to a lot of it even in my own life and in my own recovery and you know from personal goals to business goals, that all resonates and makes a lot of sense. So I’m about to throw a wrench in it and ask what happens when somebody like me gets off track? Because I know I’m going to get off track. So what are the strategies to get back on track?

Eric Zimmer: I think that the most important is just to almost expect that that’s going to happen. Right? Because if you expect that getting off track is part of the process, if you recognize that that’s going to happen to most everybody at some point or other, then it’s a lot easier to get back on track because you don’t assign a whole lot of moral judgment to it. You don’t think it says something about you. You don’t do what I said just a minute ago, which is you start telling yourself, see I knew I couldn’t do it. You just know like, oh yeah that happens sometimes. I’m going to get back on. The other thing you can do that can be really helpful is if you get off track, is it’s often important to start the habit smaller than it was. So let’s take exercise as an example. Maybe you’re used to exercising for an hour a day, right? And you get off track for a couple of weeks or you get off track even for a month. A lot of times we try and pick right back up where we were and often that is too difficult. And so a lot of times what can be helpful is to start doing something that’s a little bit easier. A smaller version of it and build up to it. And that’s often one of the key ways to start a good habit is start smaller than you think you need to do. Find something that you could do every day and succeed at to build a habit. And so the same thing can happen if you get off track. Often it’s helpful to sort of step back a little bit. So I like to meditate you know 20 to 40 minutes a day, but there have been some times over the last couple of years where I’ll get off track and I’ll miss some days of meditation and what I’ll find is that all of a sudden jumping back up to 40 minutes feels like a lot. So I’ll give myself permission to start back over at 10 minutes a day and build my way back up. So that can be a way to get back on track when it feels really hard to get started again.

Vincent M. Wales: So what if you’ve been off track for say, I dunno, 20 years? How small can I start?

Eric Zimmer: [laughs] Joking aside, as absolutely small as you need to. So let’s… I’ll use meditation again, right? I have been an on again off again meditator since I was 18 years old. That was a long time ago, right? And so I would try and meditate for 30 minutes a day. I pick up a book and it’d say you should meditate for 30 minutes a day. So I would try and meditate for 30 minutes a day. And in my particular case, sitting down to meditate is kind of like inviting the circus to come to town and 30 minutes was too long. It was too hard. So I would manage to gut it out for a few days or a few weeks, but eventually I would stop. And so finally about five years ago, I decided that I was going to meditate for three minutes a day, but I was going to do it every single day. That was the tradeoff. I’m not going to try and do 30 minutes; I’m going to do three, but I’m going to do it every day. And from there, I was able to build to four to five… you know finally up to 20, 30, 40 minutes by slowly slowly building up, but in the beginning you look at three minutes you go, that’s ridiculous. Nobody is going to get any benefit out of three minutes of meditation or you know if you’re trying to get in good shape you know say, well I’m not going to get any benefit out of taking a walk around the block. But what you’re doing is you’re building the habit, you’re beginning to put that structure in place you’re beginning to feel better about yourself and you’re beginning to build some momentum. So seriously, no amount is too small. When I work with a client, if they’re struggling, like if we if we try and build a habit and it’s not taking, we will just keep trying a smaller and smaller amount until they are able to do it. Consistently and frequently. And then we’ll build from there. If we go too far, too fast, it’s often difficult to do. And there’s a really good reason for all this. There’s actual a behavioral model out there that a Stanford professor B.J. Fogg developed, and I’m not going to go into it, but it lays it out in sort of a graphic where you can see very clearly why that principle works.

Gabe Howard: Eric, I like that you use conventional wisdom, facts, and just support in order to help people get to where they’re going. You know, so many people want to focus you know just on the goal or just on the science or just on the hugging and while all of those things are important, they often you know, we kind of need to put them all together. I mean I need somebody to tell me what to do just as much as I need somebody to tell me how I can do it when it comes to certain things in our lives and I think that’s one of the things that has made you a successful coach and no doubt why people listen to your podcast.

Eric Zimmer: Yeah I think you’re absolutely right. I love when I start to see modern science back up something that comes from you know more of an ancient tradition and you sort of see both those things agreeing. I always feel like that’s like… I like that because it’s so he gives me reinforcement from two sources. And I also agree with you, I think that all of us are told over and over and over and over what we need to do, but a lot of the problem is in actually doing it.

Vincent M. Wales: Yes indeed.

Gabe Howard: Hear hear. So Eric, please plug your podcast one more time. I am assuming that it can be found on every single podcast player imaginable, but does it have a web site?

Eric Zimmer: It does. The podcast is called The One You Feed. So like you said, search any podcast player or oneyoufeed.net.

Vincent M. Wales: Eric, thanks for being on the show. This was very informative and we really appreciate you taking the time to be with us.

Eric Zimmer: Thank you so much for having me on. I really enjoy talking with both of you.

Gabe Howard: You’re very welcome and Vin, I think I know what you might be getting for your birthday. Eric sells gift certificates.

Vincent M. Wales: Ahhhh…

Gabe Howard: Thank you Eric for being here and thank you everyone for tuning in. And remember you can get one week of free, convenient, affordable, private, online counselling anytime, anywhere by visiting betterhelp.com/psychcentral. We’ll see everybody next week.

Narrator 1: Thank you for listening to the Psych Central Show. Please rate, review, and subscribe on iTunes or wherever you found this podcast. We encourage you to share our show on social media and with friends and family. Previous episodes can be found at PsychCentral.com/show. PsychCentral.com is the internet’s oldest and largest independent mental health website. Psych Central is overseen by Dr. John Grohol, a mental health expert and one of the pioneering leaders in online mental health. Our host, Gabe Howard, is an award-winning writer and speaker who travels nationally. You can find more information on Gabe at GabeHoward.com. Our co-host, Vincent M. Wales, is a trained suicide prevention crisis counselor and author of several award-winning speculative fiction novels. You can learn more about Vincent at VincentMWales.com. If you have feedback about the show, please email talkback@psychcentral.com.

About The Psych Central Show Podcast Hosts

Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. He is also one of the co-hosts of the popular show, A Bipolar, a Schizophrenic, and a Podcast. As a speaker, he travels nationally and is available to make your event stand out. To work with Gabe, please visit his website, gabehoward.com.

Vincent M. Wales is a former suicide prevention counselor who lives with persistent depressive disorder. He is also the author of several award-winning novels and creator of the costumed hero, Dynamistress. Visit his websites at www.vincentmwales.com and www.dynamistress.com.

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New Phase of Life / Depression, Insight Needed

Hey there! Just to point this out in advance, I am seeing a few professionals about my mental health, I’m on medication and I’ve already been diagnosed with Major Depressive Disorder, PDD-NOS, and potentially ADHD. I do not have the means to explore these further, but I have regular monthly visits with my psychiatrist and therapist.

I’m currently dealing with drug abuse, my anxiety-fueled fight or flight response has led me to self-terminate from several jobs, and I typically carry really low self-esteem and distrust for myself and everyone around me. My social skills are acceptable, but I’ve adopted several toxic behaviors that lead me to manipulate, hurt, and abuse others. This is pretty self-destructive considering I’m also incredibly lonely and have no friends. I spent way too much time obsessing over perfectionism and believed I wouldn’t deserve to be loved otherwise.

Since failing high school, the only things I strived for is daily drug use and sexual stimulation. My therapist theorizes that most of this behavior stems from repeated emotional trauma that we’ve discussed, but thinking about those events doesn’t stir up any emotional response at all which just confuses me and makes me feel worse. I’m 23 now, and a few months ago something happened inside my head and I feel an intense need to fix things and help my life turn for the better, but the more I pursue that the more I stir up bottled emotions, toxic behaviors and self-hate. I struggle with managing my emotions in general and don’t have any support from family or any friends to fall back on, so making changes to my life is a little terrifying.

I still have a lot of questions I’m trying to figure out, trying to quit drugs is difficult when I lose all motivation and drive to change while sober, especially since I was like this long before I started drug use. I don’t know if I’m a good or bad person, or if I’ll ever feel like I’m worth anything. I don’t want to go through all the effort to improve things and still feel the way I feel right now, I’d be utterly hopeless after that. At the same time though, I really don’t want this need for change to disappear, I don’t like feeling this way.
Thoughts?

Dr. Kristina Randle

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An Unusual Early Sign of Dementia

Be aware of this unusual sign of dementia.

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Recovery From an Eating Disorder is Possible: An Interview With Heather Hower

Jennifer Rollin speaks with Heather Hower, MSW, LICSW, QCSW, ACSW. Jennifer: Tell me a about your struggle with an eating disorder (please avoid numbers of graphic descriptions of behaviors, so...

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A ketamine inspired nasal spray for depression.

I pass on this New Atlas article link on a nasal spray based on ketamine (the party drug PCP or 'angel dust') that is likely to receive FDA approval soon. From the article (which has a link to a series on that site called Psychedelic medicine 101, describing formerly taboo substances now being found useful, cf. Michael Pollan's recent book "Changing your Mind"):

Originally developed decades ago as a novel anesthetic, ketamine has been undergoing a renaissance in recent years... Of course in the world of Big Pharma there is no money to be made investing in clinical trials for a decades-old drug past its patent. So in comes esketamine, a chemical cousin of ketamine with many similar pharmacological actions. Esketamine is roughly twice as strong as ketamine, eliminated by the body faster, and allegedly presents less negative dissociative symptoms when compared to its relative. For the most part, esketamine acts on the brain in similar ways to ketamine, except it doesn't influence a few key neurological receptors.

Johnson & Johnson has been developing an esketamine-based nasal spray to treat depression for several years. The treatment's development process has been undeniably rocky with two major clinical trials failing to prove the drug is more effective than placebo and some experts questioning its ultimate efficacy.

Ahead of a final FDA decision, expected by early March, an independent advisory committee was recently established to offer a recommendation on the treatment's efficacy. After evaluating a multitude of research submitted by the pharmaceutical company, the committee overwhelmingly voted 14-to-2 in favor of recommending the treatment.

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Am I a Psychopath or Anxious?

From a teen in Canada: I often feel extremely worried on whether I’m a psychopath. I feel empathy and remorse. When I was eight I had done something terrible to an animal and it ended up killing it by accident and I haven’t been able to let this go. I’m not entirely sure if this is guilt I feel, because I feel really bad about this. I have had past childhood trauma too.

I also have major suicidal tendencies and self-harm behaviors. I have thoughts like, (NOT ACTING ON THESE) “What would happen if I killed someone?” is this normal? I all honesty I’m more harmful towards myself then others. But I also hear inner voices and never outside of my head. When I speak to myself its usually negative and in third person. Is this normal?

Because of the thing with the animal I have got myself convinced im a psychopath.

One incident does not define someone as a psychopath. You can probably rule it out since you do feel remorse. Accidents do happen.

However, I’m very concerned about your self-harming and that you are so hard on yourself. I would need more information to know what to make of the inner voices. Since I can’t help you explore this, I hope you will make an appointment to see a mental health counselor who can. The time to interrupt these thoughts is now. You are already anxious about whether you are anxious. This can become a worsening spiral. Talk to someone who can help you understand yourself and give you some peace of mind so you can enjoy your teen years.

I wish you well.

Dr. Marie

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Social Contagion: You Are Unique, Just Like Everyone Else

“If your friends jumped off the Brooklyn Bridge, would you do it too?” That was my mother’s favorite reply when teenage me would say things like “All the other kids are wearing…” or “Nobody else has a curfew” or “My best friend’s mother lets her…”. My mother was unimpressed. She was right. I probably would have jumped off that bridge — at least some of the time. Chances are, I would look at what my friends were doing and follow along.

We may like to see ourselves as individuals, free to follow our own minds and hearts and determinedly able to follow a “different drummer” when our friends are doing something we don’t particularly agree with. But studies show that is more illusion than fact. What everyone else is doing is more seductive than we’d like to think.

Social psychologists call the spread of information, attitudes and behaviors among friends, relatives and communities “social contagion.” There are numerous studies that confirm that people tend to do pretty much what people close to them do.

Little kids often want to dress or behave “just like” their new best friend. In their search for identity, teens start to define themselves by being “different” from their parents. Ironically, they assert their difference by trying to dress, talk, and act like their particular group of friends. They join clubs, develop interests, or even experiment with risky behaviors in line with what the group is doing.

Social contagion doesn’t stop in adulthood. Studies by social psychologists and behavioral economists show that we are more likely to “follow our crowd”. It’s not at all unusual for peers to marry and start families around the same time. Friends often pursue the same level of education or share the same political beliefs. One huge study even showed that we are 75% more likely to divorce if a friend does.

Sometimes the tendency to take the lead of others is helpful and pro-social. One study found that energy customers were more likely to conserve if they were shown that their neighbors’ use of electricity was less than theirs. Sometimes, people get caught up in antisocial behaviors, chanting racist slogans at a rally, for example, even when it violates their personal values. And sometimes we walk in step with arbitrary and even pointless behavior — like when we decide what brands we buy. We’re more likely to purchase what we think is more popular. If everyone else is buying it, it must be the best, right?

The statement “You are unique as everyone else” is on t-shirts, mugs, and bumper stickers. Although meant to be funny, there is truth to it well beyond adolescence.

Why Social Contagion Occurs

We are social creatures. We want to fit in, to be accepted, to be seen as one of us, not one of them. Quite unconsciously, we adopt internal ideas and attitudes and external habits and dress that are in line with the people we want to associate with. Shared experience increases intimacy and support among a social group.
We’re in this together feels much better than going it alone. When everyone else is getting married, joining a gym, buying a new car, having a baby, or getting divorced, we often feel compelled to consider whether we should be doing the same.
Whatever is familiar has a powerful influence on us. We tend to choose friends who are much like others who are close to us, even when it is uncomfortable in some way. Almost everyone knows someone who seems to find the same kind of partner again and again even if on the surface the new love looks different. Chances are any new person in our life is close to similar people. The result? The new people we meet are more of the same.
Our closest associates also model options for our life. An extreme example is that friends of people who suicide are more likely to suicide. It’s not because suicide is “contagious” like a disease. No. It’s thought to be because a friend’s suicide makes the option for doing so more real to friends who may be also struggling with depression or overwhelming setbacks.
On a more positive note, studies show that optimism is also likely to spread in a group. If we hang around with people who are optimistic and who have a problem-solving approach to life, it increases our own resilience. Instead of jumping into despair with us when we are having a hard time, such people listen compassionately, but then provide us with practical help and advice and support for moving forward. We then know how to pass it on.
Empathy may be another factor. When we listen empathetically to a friend’s positivity or negativity, it causes us to think about what is positive or negative about our own situation. Hearing about the romantic high a friend is experiencing may cause us to want to find the same thing. Listening to a friend complain about her spouse may highlight our concerns about our own marriage. It’s why both marriages and divorces seem to happen in friend clusters. Happiness as well as misery loves company.

Social contagion is not an irresistible force. We are not all robots, marching in step with the people closest to us. The push to maintain individuality is also strong. How we resolve the tension between the two poles, being alike and being different, being true to ourselves vs. doing what wins group approval, this is what in fact makes us unique. The question we all address as we mature is how to retain membership in a social group we like and admire while fostering our independence.

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How Hard Should You Try with Depression?

With depression we are told to “fake it til we make it,” to “act as if,” to go through the motions until we can feel again. But what if doing so sabotages your health? What if you push yourself straight into a wall of debilitating symptoms? Conversely, what if efforts to baby yourself keep you where you are?

This issue of knowing when to push yourself and when to coddle is undoubtedly one of the most challenging aspects of recovery from depression. I ask myself this question a few times a day.

When trying too hard backfires.

It turns out that trying too hard to reverse depressive ruminations can definitely backfire. A study published in August 2007 in The Journal of Neuroscience showed that there was a breakdown in normal patterns of emotional processing that prevented depressed and anxious people from suppressing negative emotions. In fact, the more they tried, the more they activated the fear center of their brain — the amygdala — which fed them more negative messages.

In the study, researchers examined depressed and non-depressed adults. Participants were asked to view a series of emotionally positive and negative images and then specify their reaction to each one. After the presentation of each picture, participants were asked to either increase their emotional response, to decrease it, or simply to continue watching the image. The results showed distinctive patterns of activity in the ventromedial prefrontal cortex (vmPFC) and the right prefrontal cortex (PFC), areas that regulate the emotional output generated from the amygdala.

It’s much like exercise. While regular and moderate exercise can boost longevity, cardiovascular health, and mood, long-term endurance exercise and working out too hard can actually harm our health.

What are your pressure points?

In pushing ourselves with depression, we need always be mindful of our pressure points, or vulnerabilities. For example, I know that when I work more than 50 hours a week for more than a month, my mood becomes fragile and the self-loathing tapes return. Stress is the ultimate pressure point. It compromises almost every biological system in our bodies.

So when deciding if you should push harder or not, evaluate your stress levels and the pressure points triggered (fragility and self-loathing, in my case). Rather than quitting or taking six months of medical leave, I first start with scaling back my hours. You might look for a compromise in your situation, a temporary arrangement that allows you to remain active while giving you the time and care you need.

Why flexibility is key.

Some days you may have the energy and determination to complete your responsibilities as if you don’t have symptoms. And other days you can hardly get out of bed. What’s really difficult is that you don’t know which day you’re getting until you open your eyes. That’s why it is really critical to be as flexible as you can, knowing that even though pushing made sense yesterday it might not today.

Trust yourself as much as possible. Don’t force progress if it doesn’t feel right. Instead, step aside and enjoy the view until you can get back into the race.

A cold or the flu?

Several months ago I attended a mental health conference. I was tempted to cancel, as I was having severe symptoms of depression. Even though I couldn’t quiet my ruminations, I made myself participate and found that the interaction with other people helped me. However, in the hotel room afterward, my symptoms returned. I couldn’t stop crying. I went to the airport seven hours early, hoping to catch an earlier flight. During the cab ride there, I beat myself up mercilessly for not being able to enjoy a new city. Shouldn’t this be a time when I push myself?

As soon as I arrived at the terminal I started to feel physically sick, with flu symptoms. Suddenly the self-bashing stopped, and I was able to be gentle with myself. I then thought about the trying harder versus coddling dilemma. When I have a cold, I push through and go to work. When I’m sick with the flu, I stay in bed and rest. Might it be the same with depression? Once we assess the severity of our symptoms we can determine if we have a cold or the flu.

In everything, self-compassion.

Self-compassion should be the ultimate compass behind your decision to call in sick or press on. In all situations, ask yourself, “What is the kinder act?” For example, some days self-compassion for me means swimming for an hour and other days it means going to the woods to have a good cry. Being kind to yourself can mean tackling the first item on your to-do list, or it could mean slashing that list in half.

Self-compassion is most challenging for me when I decide to rest because I undoubtedly start to obsess about copping out and giving in. That’s when you need to be extra compassionate and remind yourself that you have the flu.

Unfortunately, there’s no set rule on when to try harder and when to go easy with depression. Each situation requires careful discernment, assessing the severity of our symptoms. Sometimes faking it and pushing through delivers us to a better place. Other times trying too hard sabotages our health. One thing is for sure, though. We need always treat ourselves with kindness and compassion.

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Wednesday 27 February 2019

Private Practice Inspiration of the day: Marca Cassity

I remember Marca logging in to the first Bootcamp kickoff group coaching call last year. It has been delightful to coach her through the process of coming back from burn...

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Kratom: A Primer for Clinicians

Kratom (Mitagyna speciose) is a tropical evergreen tree in the coffee family whose leaves have been used for centuries in South Asian countries as a stimulant and pain reliever. Recently,...

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RBT Study Topics: Professional Conduct (Part 1 of 2)

Registered behavior technicians should be familiar with the RBT task list developed by the BACB (Behavior Analyst Certification Board). There are a variety of skills that an RBT should be...

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The Bicycle That Boosts Brain Power (M)

People got a boost to their mental performance and feel better using this type of bike.

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How Do I Get Over This Trust Issue?

I started dating my boyfriend almost 2 years ago. At that time, he was a student living in a student’s house of 6, and two of his housemates are his close friends(a guy and a girl. The girl is around my age while the guy is a lot younger). They liked to hang out together, especially my boyfriend and this girl whose rooms happened to be next to each other.

In the beginning, my relationship with these two friends was ok. The guy welcomed me with open arms to their circles, however, the girl was a bit distant. I noticed that she liked to ask my boyfriend to come to her room whenever she had problems (mostly family and relationship issues) to talk to him. She looked uncomfortable whenever I was around, which happened to be a lot.
After a few months coming there, she finally spoke to my boyfriend that she felt uneasy having us there. Since her room is next to my boyfriend, she could not find peace since we giggled and made jokes a lot in my boyfriend’s room. She also mentioned that it would be nice if I visit the house only a few times a week to give her “space”. I and my boyfriend understood and tried to facilitate the issue.

However, later on, I found from her (we did talk several times), that she actually missed my boyfriend and all the time they used to hang out together “as housemates” This talk, however, started to make me uneasy. I somehow felt that she wanted to maintain their friendship the same way before we dated.

Ok. Back today, now I’m in a long-distance relationship with my boyfriend. Recently, he and this girl made a plan to visit their friend (the guy that I mentioned) in another country together. I got jealous and told my boyfriend my concerns and he tried to figure out the best thing to do. In the end, he chose to go on the trip with her because she might return home and never see him again, also he said it’s good for us. He told me to trust him. I tried, but my concerns came from all the thoughts I have about her all these times. Now my boyfriend is kind of hurt from my response. I start to wonder if I have trust issues. How should I fix this? (From Indonesia)

Thank you for explaining this delicate situation for us. Your reactions are normal and not a “trust issue,” per se. They are, however, a very good reason to continue conversation, negotiation, and compromise with your boyfriend.

Be clear with him that it isn’t so much about trust as it is about her neediness and wanting of his time. This is real, quantifiable, and chronic—which makes it an important topic for discussion. Your uneasiness is about these very real things that demand his time. That isn’t about trust—it is about priority.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

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The Best Diet Plan For Weight Loss

Scientists compared many different types of diets to see which was most effective.

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Is Video Game Addiction Real?

Joey admitted that he lost interest in his favorite sport. Already a state champion with prospects to be a national star, each day he didn’t practice he was throwing away...

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Losing a Pet Can Be Just as Hard as Losing a Loved One

Losing a pet is not easy for most people. Pets — or what researchers call companion animals — are most often seen as a fellow member of the family today. It is not surprising then to learn that most people grieve a pet’s passing as much, and sometimes even more, than the passing of a human friend or family member.

What makes the passing of a pet so hard? How can we better cope with it?

Some people think that it’s silly to grieve over the loss of a pet. Those people either never had much of an attachment to any pet, never had one growing up as a child, or never really experienced the unconditional love and affection that only an animal can provide.

Whether they died from illness, an accident, or had to be euthanized, losing a cat, dog, or other beloved animal is a traumatic event. Even if the death was expected due to old age, the loss of their constant companionship is hard to put into words. It’s like a large hole is in your heart, and nothing in this world will ever be good enough to fill it as your lost pet did.

Having our companion euthanized can be especially difficult, even when we know it’s time and it’s for the best to end their pain and suffering. In a study conducted by researchers at the University of Pennsylvania (Quackenbush & Glickman, 1984), it was discovered that individuals were at the greatest distress and at greatest risk for experiencing extreme grief when having had to euthanize their pet.

Sadly, many people don’t understand pet loss and the value that pets hold in a person’s life. This can greatly add to a pet owner’s grief. Instead of being comforted and listened to by friends or family (what psychologists refer to as validation), the person is told “It was just a dog (or cat), get over it” or “I’m not sure why you miss that cat (or dog) so much.” These kinds of uninentionally hurtful comments can add to a person’s burden of grief (Messam & Hart, 2019).

The researchers also note:

Feeling guilty often is a component of the grief, especially if the owner is conflicted about a decision for euthanasia, or feels that appropriate care was not provided. Grief for an animal, though becoming more socially accepted, remains somewhat disenfranchised. For example, time off work is typically not an option.

What You Can Do to Feel Better After Pet Loss

The loss of a furry loved one is rarely easy. But there are some things you can do during and after the loss. It appears that having to euthanize our loved one brings special difficulties. Being actively involved in the decision process of ending a pet’s life, however, can often be helpful, allowing a person to take comfort in their passing.

While some people report becoming distressed by reminders of their deceased — such as cat/dog toys, bowls, and leashes — others take comfort in them. If they are causing you additional distress by seeing them, put them away somewhere out of sight for a time. You don’t have to get rid of them just yet, but there’s no point in having them bring reminders of painful memories or sadness.

The Rainbow Bridge is a popular theme in pet loss because it suggests that we will all meet again in the afterlife. This is a source of great comfort, knowing that we can reunite with a loved one after we too have passed.

Feelings of guilt often accompany euthanasia. It is a heavy burden to bear deciding when to end another being’s life. These feelings are perfectly natural. But please know that you ended your pet’s life because it was their time. You put an end to a time where they were suffering and likely in some sort of pain or distress. There was no hope for recovery or further treatment that would provide both quantity of life, and more importantly, quality of life.

Your pet appreciated all that you did for them, and all the love you bestowed upon them. They got as much as they gave, and lived a life full of knowing they were appreciated and cared for by you. It was a relationship that benefited them as much as it did you.

Many pet owners feel as their furry loved ones are like surrogate children. When put into this context, it is completely understandable why the loss of a pet can be so devastating. Losing a source of non-judgmental, unconditional love in a person’s life is usually extremely difficult, no matter the source of that love. While many people don’t understand this, pet owners nearly always do.

Many people find comfort in memorialization of their pet (Messam & Hart, 2019). These kinds of activities can include having a funeral or wake for the pet (either privately, or with close, trusted friends and family). Some like to create an online photo gallery, print photos, or even create a scrapbook or photo collage. Some find comfort in cremating a pet and keeping their ashes in a memorial box with the engraving of their pet’s name on top.

Grief coping strategies for pet loss often starts with reading pet loss bereavement articles (whether it be a book or online)(Messam & Hart, 2019). Additional coping strategies include writing letters or blogs to the pet, interacting with other animals (such as at shelters), joining a pet loss support group online or Facebook, and keeping busy with routines, seeing friends, and volunteering. In extreme cases of loss, it is not uncommon for a person to seek out grief therapy from a mental health professional.

How Long Will My Grief Last?

Nobody can say for certain how long your grief will last. The feelings of loss and sadness are very individualistic, and so can vary widely. In one small study of 82 people who had lost their pet, “25% took between 3 and 12 months to accept the loss of their pet, 50% between 12 and 19 months, and 25% took between 2 and 6 years, to recover” (Messam & Hart, 2019).

As you can see, there is a wide gulf in the range of time it can take to fully recover from losing your pet. This is a reminder that grief takes as long as it takes to fully experience. There is nothing you can do to speed up the process, or feel it more fully. It comes when it comes and lasts as long as it needs to.

You will get over the loss of your pet. But you will never forget the love and times you shared together. Someday, you may even feel ready to open your heart up again to another furry or feathered friend. Our hearts are large enough to welcome much love into our lives, throughout our lives.

I hope your burden during this trying time is not too heavy. Please remember and known, you are not alone and you will get through this.

For further reading…

Grieving the Loss of a Pet

Why We Grieve So Intensely for Our Pets

On Mourning the Death of a Pet

References

Messam, LLM & Hart, LA. (2019). Persons Experiencing Prolonged Grief After the Loss of a Pet. In Clinician’s Guide to Treating Companion Animal Issues, 267-280.

Quackenbush, J. E., & Glickman, L. (1984). Helping people adjust to the death of a pet. Health
and Social Work, 9, 42–48.

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New form of neural communication at a distance.

The branch of parapsychology that claims subtle sensing and psychological action at a distance might be heartened that they are finding a shred of supportive data in recent bizarre findings suggesting a new form of neural communication. It turns out that two pieces of brain tissue in close proximity can still communicate with each other even though they have been completely severed, leaving a gap between them. From Dickson's summary of work by Chiang et al.:

Chiang et al. show that slow periodic activity in a horizontal hippocampal slice preparation occurs through dendritic NMDA receptor‐dependent Ca2+ spiking, which is itself self‐generating and self‐propagating, via ephaptic interactions across neurons. Consistent with purely ephaptic transmission, this activity and its active propagation across the slice were resistant to pharmacological blockers of fast ionotropic chemical neurotransmission, as well as pharmacological blockade of electrical transmission via gap junctions. What is particularly compelling is that the activity could be not only modulated, but also eliminated or even regenerated by imposed electrical fields. Most shockingly, this activity could be transmitted from one side of a surgically severed slice to the other when the two cut edges were simply placed in close proximity. These surprising findings were further supported by a computer model of hippocampal circuitry.

Here are the key points listed in the Chiang et al. (open source) article:

Slow periodic activity can propagate with speeds around 0.1 m s−1 and be modulated by weak electric fields.

Slow periodic activity in the longitudinal hippocampal slice can propagate without chemical synaptic transmission or gap junctions, but can generate electric fields which in turn activate neighbouring cells.

Applying local extracellular electric fields with amplitude in the range of endogenous fields is sufficient to modulate or block the propagation of this activity both in the in silico and in the in vitro models.

Results support the hypothesis that endogenous electric fields, previously thought to be too small to trigger neural activity, play a significant role in the self‐propagation of slow periodic activity in the hippocampus.

Experiments indicate that a neural network can give rise to sustained self‐propagating waves by ephaptic coupling, suggesting a novel propagation mechanism for neural activity under normal physiological conditions.

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The Best Questions to Ask Yourself to Shift Your Perspective

The way you see something can easily keep you stuck and stressed—or it can free you. In other words, your perspective is powerful in creating the life you want to live—or not.

For instance, if you think you’ll never find a fulfilling job, you’ll feel demoralized, and you won’t do the very things you need to do to find a fulfilling job. That is, you likely won’t create an effective resume, brush up on your interview skills and write a compelling cover letter.

That’s because, as psychotherapist Megan Gunnell, LMSW, pointed out, our perspective affects our feelings, and these feelings affect our behavior. This also means that if you change your perspective, you’ll change your feelings and then you’ll change your behavior for the better.

For example, you’re starting your day, and you’re already thinking, There’s not enough time! There’s never enough time! I’ll be late! Today is going to be awful. You start feeling anxious and rushed and stressed. “Then you behave in a way that makes you forget things and lose your focus and consequently, you are inefficient, scattered, late and not able to complete what you’re doing,” said Gunnell, also a speaker, writer and international retreat leader in Grosse Pointe, Mich. Your body also starts reacting based on your anxious, overwhelmed thoughts: You release adrenaline and cortisol, she said.

However, if you reframe your perspective—I’ll do my best, one task at a time—then you’ll feel calm and confident. “Your behavior isn’t rushed or erratic, and you find you are efficient and effective in your approach to completing your tasks.”

We adopt all kinds of unhelpful perspectives that keep us stuck. We think we don’t have control over our circumstances and our lives, and we think our ability to grow and accomplish certain goals is limited (when it actually isn’t), said Diane Webb, LMHC, a psychotherapist and self-development coach in private practice in Clifton Park, N.Y. “If you think there are limits, the limits will present themselves.”

We think in terms of “always” and “never.” “You’re unemployed and unhappy today, so you start to think you’ll always be unemployed and sad,” said Ryan Howes, Ph.D, a board-certified psychologist and writer in Pasadena, Calif. “You’ve dated 10 men and haven’t yet found a great fit, so you start to believe that you’ll never find a solid relationship.”

Thankfully, our perspectives aren’t permanent, and sometimes they don’t take much to shift—a simple (and profound) question can alter our viewpoint, and help us create incredible change. These questions can help you see things through a healthier, more effective lens:

Is this perspective an old tape on replay? According to Webb, an old tape is an old way of thinking—about deficits you thought you had but outgrew, or definitions you gave yourself that no longer fit what you’ve become and achieved. For example, an executive still sees herself as inadequate because she struggled with math in school, she said.

What do I want? How do I feel? “Many people get so involved in the needs and wants of others they fail to check in with their own wants and feelings,” Howes said. You still might need to consider others, but your desires are just as important.

Does this perspective prevent me from abundance, happiness and peace? Webb suggested asking this question, which is vital because we regularly think things that don’t serve or support us.

What has this perspective cost me? What have I missed out on because of this perspective? Webb said. These questions speak to whether you’re clinging to negative, limiting perspectives that have led you to decline positive opportunities (or make unhealthy decisions). Because if a perspective is poisoning your life, why are you holding onto it?

If I were twice as strong and twice as confident, what decision would I make? Howes asks his clients this question when it seems like fear is clouding their judgment. “This doesn’t mean it’s always the right choice, but it does show how much power they’re giving to fear.”

What am I grateful for in this moment? According to Gunnell, gratitude moves us from a mentality of scarcity to a mentality of abundance. It moves us from being filled with fear and worry to feeling empowered and maybe even seeing possibilities where before we saw none.

For instance, Gunnell’s client is the breadwinner of her family, while her husband stays home with their young kids. Her job involved long hours, grueling deadlines, demanding expectations and frequent global travel. The stress was sparking significant health issues. For months she dreamed about finding a new job, but she thought she didn’t have the time for a comprehensive search, and felt pressure as the primary earner to stay. Then she was let go—and felt shocked, angry and devastated. However, she quickly shifted to a grateful, hopeful perspective: This gives her “a break to catch her breath, reduce her stress and start a comprehensive job search for a new position in a company [that’s] a better fit for her family, life balance and health.”

Does this perspective belong to someone else? Do I want to adopt it myself? For instance, we often internalize our parents’ perspective about ourselves, who we’d become in the future and their approach to life, Webb said. We also often internalize societal expectations and standards. But, as the latter question illustrates, just because we once took on a perspective doesn’t mean we have to keep it; we have a choice in whether to adopt a viewpoint or not.

What would my mentor or hero do? “We have role models for a reason, to model bravery and character for us,” Howes said. “Sometimes it’s easier to get in touch with their motivations than our own, and this is worth exploring.”

What can I learn from this? You can gain insight even when you feel terribly stuck, Howes said. For example, when you ask this question, you might realize that you should trust your gut, that you need to better control your anger, or that you’ve been pursuing the wrong relationships, he said. “Sometimes just knowing there’s a nugget you’ll take away feels empowering.”

Is this perspective in alignment with what I want in my life? Webb said. Reflect on what you want your life and your days to look like. Does your mindset match these desires and dreams? Does your mindset match these specific images?

How will I want to remember this chapter of my life when I re-tell the story? When you’re feeling paralyzed, it’s hard to see the bigger picture—and to see potential solutions. Which is why Howes suggested imagining yourself “some time in the future telling the story from this time” and wondering how you’d like the narrative to sound. For instance, you might come up with: “I kept pushing until I found a brand-new solution,” Howes said.

“Just imagining this helps you realize you won’t be in this predicament forever, and starts you on the road of problem solving as you write your own story.”

Because, remember, you are the author of your life.

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Uncontrolled Negative Thought Creeps in Even Though I Don’t Want It

I have a mind which pokes me unnecessarily with negative rubbish. I know a negative thought will come – and I say myself DON’T think about it – but, I give in and the thought pokes me and “pulls me down”.

Example, if I am eating peacefully, I will remember a friend who humiliated me for eating too much. If I am talking to a girl, I remember a friend who bullied me because he was jealous. If I am confidently doing something, I remember someone who unnecessarily mocked me and I start losing confidence.

If I look at a girl who is attractively dressed, totally unnecessarily, Iy mind says – ‘u have a daughter, one day even she will wear something like this’, and equally unnecessarily a forceful thought comes up and brings my daughter in such an outfit and I am begging for the thought ‘not to come’. The more I beg, surely, it comes.

If my dad is unwell, out of the blue, my mind says, ‘let him die, there will be no responsibility, u will be free’. And I know it is not true as I love my dad beyond what words can express.

I have a positive mind of reality and a negative counterpart always picking on the positive mind and mocking it and making it fail and lose always.

It makes me such a loser in my mind.

1 – What am I suffering from.
2 – What should I do ?

Two possibilities come to mind. The first is an unquiet mind. People meditate in order to quiet their minds. Meditation is the practice of focusing one’s attention and awareness. You might try meditation to gain control over your thoughts.

A second possibility is obsessive-compulsive disorder (OCD). OCD is an anxiety disorder. People with OCD commonly experience intrusive thoughts. They are thoughts and images that are unwelcome and distressing. People often describe them as “coming out of nowhere” and lack the control to stop them from occurring.

The solution to this problem is counseling. These are exactly the types of problems that psychotherapy is designed to resolve. Contact a local therapist and meet with them in person. They would be in the best position to know what might be wrong and most importantly, how to treat it.

One final thing. You are not a “loser” for struggling with this issue. That type of thinking makes it more difficult to accept treatment. Anxiety is one of the most common conditions in the world and it’s easily rectified with treatment. The sooner you begin treatment, the sooner this issue can be remedied. Good luck and please take care.

Dr. Kristina Randle

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Exercise: Don’t Forget to Make Amends to Your Body

In a world where nothing is in my control and living with a head that constantly tells me I’m not doing enough, exercising every day makes me feel like I’ve checked a box.

Last year, my mom fell and broke her hip. During the surgery, she had a mild heart attack and a pulmonary embolism. Since that fall, she’s become wheelchair bound and has started showing the signs of early dementia. She’s now in assisted living, being bathed by caretakers. On the other hand, my father has a girlfriend, writes screenplays, teaches kids to read, swims, and delivers food to the elderly (even though he is the elderly). My parents are the same age: 81.

What could cause such a difference in their physical states?

Exercise. My dad always exercised while mom was very sedentary.

The Dreaded E-Word

I know, the dreaded “E” word. I take after my mom in this area: I’ve never been an athlete, I pretended I was sick for most high school P.E. classes, and I’m extraordinarily uncoordinated. I hate group classes and I loathe tight name-brand exercise gear. Gyms scare the shit out of me and I have no idea what I’m doing.

But two years after my break up, I was still considerably underweight and what little muscle I’d had was long gone. I could pass in clothes as modelesque but naked I could have been a dummy for an osteology class. (“And here, students, you can see the sternum and entire rib cage…”) I was eating, but stress (about work, life, my mom) kept me from putting on any real weight.

And then boom. Out of the blue, I’m contacted by Doug Bopst to ask if I’d like to be interviewed for his new book, The Heart of Recovery, coming out March 12th. Sure, I lied. What does Doug happen to do? He’s a fucking trainer! Doug kicked opioids and lost 50 pounds in jail through—you know it—exercise.

“When we stop using drugs, we have to replace them with healthy coping mechanisms,” Doug says. “Fitness is a great tool and should be a staple in everyone’s recovery.”

He took pity on me and started training me via Skype (he’s in Maryland and I’m in LA). He also sent me a list of foods I should eat. Sometimes deliveries randomly showed up at my door. Over the next year my living room became littered with resistance bands, a stability ball, dumbbells, a yoga mat. I was living in a mini 24-Hour Fitness but with a cat.

At the beginning, I complained. A lot. He ignored me. I constantly wanted to skip days (and we were only training three times a week) because I was “tired” or “depressed.”

“I train machines, not wussies,” he’d say, knowing it would motivate me.

“Fuck you!” I’d text back. “See you at 5!”

It’s almost a year later and now I insist we train everyday…

Find out how Amy is doing now, almost a year after starting her exercise training, in the original article Exercise: Making Amends to Your Body at The Fix.

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The Power of Creativity in Helping Us to (Kind of) Cope

The intensity of Maureen “Marzi” Wilson’s anxiety varies day to day. Some days, it’s a “mild uneasiness,” a nagging feeling that she’s forgotten something important. “Other days, it’s closer to terror, a horrible premonition that something catastrophic is imminent,” she said.

The outward expression varies, too. Sometimes, she fidgets. Other times, she’s “sitting in the corner of a closet wrapped in a blanket.” Because “some days are harder than others,” she said.

Wilson has been struggling with anxiety since she was a teen. Several years ago, she was trying to figure out the best way to cope with her anxiety, which prompted her to start creating illustrations online. She’d also taken a personality quiz, and discovered that she’s an introvert. She wanted to understand more about her introversion and her anxiety.

As she writes in her insightful, inspiring, funny, poignant book Kind of Coping: An Illustrated Look at Life with Anxiety, “I’d assumed that my limited social circle and my preference for solitude were due solely to anxiety. But it turns out I’m an introvert who has anxiety. And I became committed to understanding what that means.”

Wilson created a doodle named “Marzi,” who’s trying to figure out how to navigate life as an introvert who also struggles with anxiety at IntrovertDoodles.com.

For Wilson, creating these illustrations helps her to express her “fears and hopes in a therapeutic way.” “It “enables me to make sense of my feelings. Writing and drawing help to clarify my intentions, and that makes it easier to follow through on my goals,” she said.

That’s the thing about creating and making: It helps us to better understand who we are. It helps us to unravel our many layers, and brings us closer to our core. And, ultimately, it helps us to cope with our struggles, whether those struggles are around having anxiety or depression, losing a loved one, or dealing with a painful situation (or all of the above).

Wilson noted that releasing our thoughts “onto paper or canvas [can keep] them from taking up space in your head.” And that can provide meaningful relief—and insight. When we use creativity as a tool to work through our thoughts, feelings and challenges, we can make sense of our inner turmoil, and even soothe it. We can get to its root. And we acknowledge, name and honor our experience, which is a powerful way to care for and bolster our well-being.

Here are five ways you can use creativity to explore and cope with whatever you’re struggling with.

Describe the details. In Kind of Coping, Wilson illustrates what it’s like to live with anxiety on a regular basis. For instance, in one illustration, she notes that anxiety is problems with prioritizing (“I don’t know what to do first!”), and thinking that every decision you make is wrong. It’s “bodily mutiny,” with headaches, insomnia, muscle tension, nausea, shaking, sweating and exhaustion. It’s irrational thoughts: “Nobody likes me,” “I’m a failure,” “Something terrible is going to happen,” “I’m so stupid,” “I’m not safe.” It’s “messy moods,” such as overwhelmed and irritable and afraid and detached.

Spend some time identifying the details of your struggle. Then draw these details. You might create a comic like Wilson. Or you might think about the different creative outlets you enjoyed as a child—making up stories, drawing animals, keeping a diary, dancing—and use those to explore and name the specifics of your struggle and situation.

Paint the whirl of emotions. Focus solely on your feelings. How are you feeling right now? Channel those feelings into a painting, letting them dictate the colors you use and what you create. Maybe you’re feeling overwhelmed, so you splash paint onto your paper, and move it around with your hands. Maybe you decide to depict what your depression feels like during the course of a day using different shapes. Maybe you decide to paint your grief in its messy, multilayered stages.

Write about the quality of your feelings. It can be hard to put into words precisely what we’re feeling. In Writing for Emotional Balance: A Guided Journal to Help You Manage Overwhelming Emotions, psychologist Beth Jacobs, Ph.D, notes that “Emotions can blend together like watercolors, and a physical sensation such as a knot in your stomach can indicate a variety of feelings ranging from excited anticipation to anxiety to fear or rage.” Which is why she suggests exploring the qualities of our feelings with these sentences:

If this feeling was a color, it would be ….
If this feeling was weather, it would be ….
If this feeling was a landscape, it would be ….
It this feeling was music, it would be ….
It this feeling was one object, it would be ….

Create a conversation. Write out a conversation between you and whatever you’re struggling with. Maybe that’s a conversation between you and your anxiety. Maybe it’s a conversation between you and a mistake you made. Maybe it’s a conversation between you and a trait of yours, which you’ve been disappointed about (e.g., your shyness, your sensitivity, your introversion).

Use your genuine curiosity to delve deeper. What do you want to know about this situation, this illness, this challenge, this trait? You might ask questions like: What do you want to tell me? What are you trying to teach me? Why? What do you need right now? What are you really upset about? What’s on your mind? How can we become a team?

Use creativity for encouragement. At the end of Kind of Coping, Wilson features an illustration of the many reasons to keep going: the blooming of a plant you grew, clean sheets, constellations, the first sip of coffee in the morning and the sparkling of grass with early morning dew.

Consider drawing your own reasons to keep going, seemingly small reasons that put a smile on your face or soothe your soul. Or think of another way you can use your creativity to encourage, support and uplift yourself. Maybe you write yourself a letter or a poem. Maybe you snap photos of everyone and everything you love, and create a collage or a small, tangible album. You can keep it with you, and look through it any time you need some comfort and a reminder of all the beauty and love that surrounds you. Or maybe you create something else that gives you hope, like this other illustration from Wilson’s book:

Creativity is just one way we can cope. For instance, Wilson’s comics complement her other coping strategies: She sees a therapist once a week, takes medication, practices self-care and stress management, and uses cognitive techniques for redirecting anxious thoughts. She also bakes, sews and skates, which are hobbies, she said, that are calming and provide a sense of purpose. Plus, “lots of puppy cuddles” help, too.

Through her illustrations, Wilson said that she’s lucky to have found an incredibly supportive community on Instagram (@introvertdoodles). “The most beautiful part of this journey for me has been realizing that I’m not as alone or as weird as I thought I was…I’m not the only one learning out how to (kind of) cope, and neither are you! It’s something we can figure out together.”

And that’s another powerful benefit of creativity: connecting over our shared humanity. Or, in short, kinship.

All images are from Kind of Coping: An Illustrated Look at Life with Anxiety.

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