The Storm

Wouldn’t you know it, we are still living in, and therefore thinking, writing, and worrying about Covid. All of this activity is essential. We have big problems to solve, communities to care for, losses to mourn. Writing a blog post seems trite. But here are a few words- just a check in. 

I recently attended a lecture that began with a quote:

And once the storm is over you won’t remember how you made it through, how you managed to survive.  You won’t even be sure whether the storm is really over. But one thing is certain. When you come out of the storm, you won’t be the same person who walked in. 

-Haruki Murakami

What a good quote, for those of us fortunate enough to come out of this pandemic storm. But it also threw me viscerally back into another, personal storm- the big one- surviving Mike’s death. Honestly, after that, a pandemic seems like a surreal cake walk. I know, it’s relative. Pandemic definitely does not equal cake. 

A friend, recently going through an especially hard time, kindly mentioned that I remain one of the most joyful people she knows. And if I can be joyful- after what I have endured- then maybe she can get there too. We talked through how to do it. We settled on “one foot at a time” along with yet another cliché, albeit more elevated and cohesive: mindfulness. 

I realize that word has been slapped on every magazine cover in health food stores for the last 10 years. How many ways can we be reminded, and why do we have to keep talking about it? Because being in the present really is the answer. It doesn’t mean not caring about the future or the past. But it does mean soaking in experience, plugging into our relationships and values, and appreciating this delicate life.  

After surviving an electrocution, I was 13 and amazed be alive. I actually went around thinking, this is so cool! Another day, another year! Let’s do this! 

After surviving Mike’s death, I was numb. I was terrified. I was nowhere near amazed or excited. But I was still grateful for another day, another year. I remained acutely aware of the present, of being in the moment. Mindfulness. It was the only option- can’t look forward, certainly can’t look back- and it saved me. 

These days, I feel cacophonous. There’s concern, realism, heaviness, sadness, and still a fair amount of joy. Wow, ok, another day, holy shit, I guess we are still doing this, ok, let’s go. Not quite optimism. But happy to have health, love, and even more chances to give life a try.

My apparently persistent joyfulness is fueled by awe. I still look to the sky in amazement that it’s still there, that it’s so beautiful, that there is an atmosphere that sustains us. The earth is spinning a thousand miles per hour. What?! Wow. We don’t even notice it. Meanwhile, we are in our own worlds, having been given brains and bodies evolved enough to create synaptic connections that feel and think and care and stress (but not evolved enough to know the answers). That’s why my job remains the coolest, because I get to help people figure out how to make meaning as tiny organisms on a careening planet in this unknown universe. 

On a good day, this can be fun stuff to figure out. But a pandemic throws quite a wrench in it all. Survival is not interesting or recreational. Awe doesn’t pay bills or bring back loved ones. So control what you can. Plan once you can. Stay present when you can. And know that when the storm is over, you will have a new version of yourself and your life to pursue. 

A cloud behind my house. Momentary awe.

Distance Therapy: The New (Ab)normal

Abnormal psychology is one of those rite-of-passage college classes that piques one’s imagination and does not disappoint.  Strange and extreme conditions are pretty intriguing when learning about them from a distance.  But true abnormality, or pathology, is something quite devastating.  There’s no fun in it whatsoever.  I think a global pandemic qualifies. 

Nothing is business as usual and of course, for some, there is no business at all.  Jobs lost, businesses shuttered, hopes dashed. Talents and passion projects and labors of love all on hold.  As we hunker down, tending to ourselves and our families, waiting to forge uncertain futures, I feel especially fortunate to be able to do what I love, to connect to people in this strange new virtual landscape.  

Even before the virus, I had been pleasantly surprised by video formats- telemedicine, videoconferencing, whatever the heck we are all calling the act of sitting awkwardly on our devices, trying to read each other’s body language (upper-body language?) while working through deep stuff.  It’s quirky and glitchy and somehow… human.  

Millennials and Gen Zs are so comfortable on screens that, at times, they are more themselves on FaceTime than face to face.  Also, it’s cool to see their bedrooms or houses or dorms.  But only if they want you to… they are expert backdrop curators.  The rest of us old folks are quickly realizing that it’s actually quite easy, downloading a link, inviting or joining a virtual waiting room.  Lighting doesn’t matter in the virtual therapy session, bring yourself just as you are.  

The major downside, obviously, is privacy.  My real-life clients know to slam my office door against the frame to get it to shut- that’s how much soundproofing I have smooshed between the cracks.  Privacy.  The essential function of therapy.  Parents, kids, inadvertent walk-ins or curious onlookers to a virtual therapy session… simply ruinous.  Going for a walk and talking on the phone might be more feasible, but has its own limitations.  

A pandemic is riddled with limitations, and we are getting the hang of them.  Every decision and movement and interaction is a renegotiation of everything we deemed presumable and civilized.  We used to strive for balance: autonomy and privacy and independence on one hand, connection and relationship and interdependence on the other.  Now, there’s a little too much of both.  We miss connecting with the world, but we clamor for space from those at home.  

But even that would be a generalization.  Everyone is faring so differently.  One can read about the apocalyptic advantages of being an introvert (it’s a guilty pleasure during a pandemic, but some like staying at home just fine).  Bonding with immediate family isn’t always such a bad thing, either.  But change is change, and it’s hard.  And, people’s real-life goals and challenges are the same, perhaps amplified.  So, the therapy must go on!

And after it all, I will revere the simple pleasure of seeing you back in my office again.

Homework works!

I am both a therapist and a professor. More often than not, my students are easy to teach.  A syllabus is constructed for them, and it is mandatory.  Clients are different.  Counseling is a delicate practice, and clients don’t need to be taught.  In fact, we know from experience and even from research (like “motivational interviewing”) that we learn the most about ourselves when we discover insights on our own.  So, while a client isn’t always sure what is happening, the therapist is asking questions or making statements that simply promote their own self-discovery.  Advice and even psycho-education are often discouraged in therapy. 

I like to operate in a slightly more flexible realm. Clients often want advice (although that might be precisely when not to give it).  But clients also want- and deserve- to be educated. They want to understand their anxiety, what grief looks like, how trauma might settle into their bodies.  They want to know what to do about it.  Increasingly, psychologists are “allowed” and even encouraged to inform and guide clients, because it often does work.  The best therapy (in my opinion) is delicately balanced between guiding and not-guiding, informing and instilling confidence (and patience) in clients to inform themselves. 

Many clients have the patience to do the work in the therapy room, but they might also want a recommendation for a book or an assignment they can practice on their own.  This is a great goal, and a tricky one to execute.  If I suggest an assignment, a client might fear disappointing me if they don’t complete it.  Luckily, I am not a school teacher, and suggestions are nothing more than offerings.  

Also, what happens in therapy is hard to translate to other formats.  Like this blog, therapy is almost always centered around language and how we make meaning through language.  So it’s important to find “self-help” through the other systems and experiences in our bodies and lives… art, nature, exercise, sleep. When it comes to words, “self-help” occurs spontaneously through song lyrics or the words of a child.  On paper, novels and poems can be the greatest self-help of all.  I like to find out what my clients enjoy reading and what moves them.  I also like for them to explore the meaning of their own words, through journaling and logs.

Of course, my clients inform and enlighten me as much I as I do them, as evidenced by the long, hastily-scribbled list of books and podcast recommendations on my desk. I like the homework, but I’m glad I don’t have to turn it in.

Weed is everywhere.

At least here in Colorado, but really, everywhere. I guess it always has been, and that didn’t seem to be that big of a deal. As a clinician, it comes as a relief if a teenager prefers weed to alcohol; less car accidents, less non-consensual sex, a culture of kind, maybe even philosophical friends.

Meanwhile, it’s a becoming a huge problem. Edibles, vape pens, dabbing. Marijuana is available in intensely high doses and can be undetectable by parents and teachers. Some teens are high 24/7. Literally. Some use it to self-medicate, saying it helps their anxiety. That might be true, at least at first. But different strains act differently in the brain; most teens are happy to get their hands on any weed and don’t know what they are smoking. One day they feel good, the next they feel paranoid and antisocial. One day, they might take a test high and pull it off. They try to replicate that, and fail the next one. Coming down from being high, people are irritable, tired, and might have rebound depression, anxiety, stress. Some people can’t control how much they eat when they are high, then feel guilty, compounding body image issues. Most people are lethargic on weed, so they exercise less, too. One big problem with marijuana is it seems so versatile; every situation is a reason to get high. Movies, get high. Going out to eat, get high. Boring class, get high. Weekends, high. You get the point.

Regardless of whether marijuana seems to be “working” or not, there is compounding evidence that it’s bad for young brains. As with all drugs, the rule is, wait till you’re 25. This is laughable to teens, who strive to party pretty hard and to plan not to be concerned about their brains for several years. They feel invincible. And apathetic. Oh, did I mention weed makes people more apathetic?! But unfortunately, it doesn’t make them invincible.

What’s the solution? Let’s begin with, who needs to be high 24/7? That’s a clear signal that something is wrong. Real life, sober life, needs to be tolerable, enjoyable. Get to the bottom of that. Smoke less. Way less. Or, just wait. Every day, month, year later a teen starts smoking, the better. If a teen has real anxiety or stress, get professional help. Of course, there are larger policy decisions to be made, including this one. Sorry for the constant NYTimes references, but, hey, it’s a good resource! Read this:

https://www.nytimes.com/2019/06/16/opinion/marijuana-brain-effects.html?smid=nytcore-ios-share

the P word

Oh, Procrastination. So ubiquitous. So simple yet so, not simple. Yet another article to address it, this one from the New York Times:

https://www.nytimes.com/2019/03/25/smarter-living/why-you-procrastinate-it-has-nothing-to-do-with-self-control.html

I liked this one because it reminds me of one of my favorite interventions. To back up: the best known, state-of-the-art treatment for most psychological symptoms is CBT, or Cognitive Behavioral Therapy, which was popularized in the 80s and 90s in response to the stream of consciousness, tell me about your mother, lay on a couch method that just hadn’t helped that many people.  It is so great because, as it turns out, there are things you can DO to change, rather than just wait for you or your therapist to have some revelation about your mother.  One great thing you can do is realize your cognitive distortions or dysfunctional thought patterns that set you up for failure, depression, self-loathing, all that fun stuff your brain automatically manufactures.  You can look up lists of cognitive distortions and get to work on how to replace them with more accurate and effective thoughts.  

One of the lesser known but important cognitive distortions is Emotional Reasoning, or assuming negative emotions reflect the way things really are.  For example, “I feel guilty. I must be a terrible person.” Or “I feel angry. This proves I am being treated unfairly.”  One of the best examples of Emotional Reasoning relates to procrastination and avoidance.  Such as, I feel overwhelmed by how much I have to do, so I guess I can’t do it.  I don’t feel like doing my work, so I will wait until I feel like doing it later.  I don’t feel like I can focus now, therefore I can’t focus now.  

One of the qualities of successful, satisfied people is doing what needs to be done and what you have deemed important to your overall life and goals, even when it’s not what you feel like doing.  And, as your mother has told you so many times before, the things you feel like doing feel especially great when you have gotten the other things out of the way.  See, moms don’t just cause our mental distress, they solve it! (Now if we would just listen to them).  

Two other very relevant, moderately psycho-babble terms that relate to procrastination are frustration tolerance and delay of gratification.  It’s what we aim to teach kids but can be the hardest things to actually teach our kids. We want to give them what they want, and we hate to see them suffer.  They hate it too, but some of it is good for them.  And some kids have a harder time with delaying gratification and tolerating frustration no matter what we set up for them.  It has to do with their nervous systems, temperaments, and subjective levels of distress they truly feel when frustrated, when confronted with negative emotions, and when tempted by impulses.  

So, procrastination is real. It’s probably why I found that article and am writing about it rather than attending to the other less desirable things on my list.  But I can rationalize it, since I feel like I am helping you and doing something good for the world, and that, obviously, makes me a good person!

Therapists as Clients and Therapists

Lori Gottlieb, a writer and psychotherapist (a writer first, which explains why she writes so much and so intimately about psychotherapy- clients sign a disclosure form allowing her to write about them before beginning therapy), recently published Maybe You Should Talk to Someone about her experiences as a client and a therapist.  I have not and might not read it (single parents don’t get to read a lot, and even then, I gravitate first to more professional texts, then biographies, and in a rare moment of luxury, some delicious fiction).  Sometimes it actually hurts to think of all the books I have not read, and music I have not heard.  So, maybe you can let me know if I really should read this book.  

But I found this Fresh Air interview interesting and I thought you might, too, especially if you have wondered how (some) therapists feel about their clients and the therapeutic process.  I will say, I disagree on a few things.  For example, I never find my clients boring, actually!  

https://www.npr.org/2019/03/28/707652944/a-therapist-goes-to-therapy-and-gets-a-taste-of-her-own-medicine

Also this week, Ms. Gottlieb wrote a follow up article on how much a patient should know about their therapist, and in light of the blog my clients can access due to the extraordinary circumstances of my family’s life, this might also interest some of you. 

https://www.nytimes.com/2019/03/30/opinion/therapy-therapists.html

Psychology Trending!

So great to hear Science Friday nerd out to some positive psychology!  This is Yale’s most popular class, which is offered FREE, online. Listen to the Science Friday episode with Dr. Laurie Santos, professor of Psychology and Head of Silliman College at Yale University.  Here is the segment:

https://www.sciencefriday.com/segments/what-makes-your-brain-happy/ 

And here is the class:

https://www.coursera.org/learn/the-science-of-well-being

But honestly, prepare for some homework and tests, this stuff takes real practice.  And it’s not just for fun, the statistics on depression and anxiety in college students are both depressing and anxiety provoking.  

One of my favorite things about the Dairy Block, Downtown Denver: Happy making.

On Being a Psychologist

I love it.  Some people have asked how I do it now, or if it’s fair or right for me to listen to others and help them when I have suffered this deep, strange loss that I have to face daily.  I understand and respect that question, and it is very kind of others to try to feel what my family might be going through and not to want to burden me.  Or to wonder if I can help them.  Anyone who has been to therapy knows that, as one prepares for their therapy meetings, they think about how their therapist will react, what they will say, maybe even how they will feel about their client’s story.  This is called transference. 

Well, I see that my situation is a real transference dilemma for some people.  But people who know me and work with me know that I know how to focus on each person.  I know how to compartmentalize.  I don’t compare one person’s pain to another, including my own.  I never have. 

Ever since I began my job, I started a ritual where I envision my client and what their week might have been like, the space (like real, physical space) they might have come into the meeting from, the mental space, and the events that might have impacted them.  It’s a mini-meditation that allows me to get into their world.  Honestly, having hourly mini-meditations in the effort of becoming another person, understanding them, and helping them is a very good practice.  At least for me. 

More generally and even spiritually, sometimes I wonder what it means that the tragedy of suicide happened to a psychologist, to his wife, who is also a psychologist, and to his kids, whose parents are both psychologists.  I used to joke... everyone assumes that kids whose parents are psychologists are either totally perfect or destined to be totally pathological.  I have always known that my kids were neither of these extremes.  I wonder what it will mean to them that I am a psychologist, one who specializes in families, development and growth.  It all seems so ironic.  Or, maybe it’s destiny… like, I was going to have to care for these kids and I needed a lot of skills.  Sometimes I think I had twins for that reason, too.  So they can have each other through this terrible tragedy that no one else can understand.  Either that or to help finish each other's math problems.

Anyway, in the meantime, I really like my job.  For some reason, I was destined to be a psychologist, and I am here to reassure people that the work still can and will get done.  It’s sad but true that no one can relate completely to any other person.  What happened to Mike was unique, what happens to all of us is unique, and that’s how I enter every meeting.