Gratitude

In this country, today is a holiday called Thanksgiving

This is a useful time to re-visit the concept of gratitude, written about in previous posts.

 Here is someone else's offering on the topic:  greatergood.berkeley.edu/topic/gratitude/definition.

How has gratitude touched your life?
 
There are 10 other posts that discuss or mention the topic of gratitude.  Just type the word into the search bar for a list.

When To Call a Therapist

Reason for making use of the therapy resource

What are some of the reasons a person might look into beginning therapy?  Here are some common experiences that people find they want help with:

• Difficulty at work
• Trouble at school
• Social problems (chronic interpersonal issues or social fears or awkwardness)
• Family strife
• Feeling fearful with no apparent reason for it
• Sleep disorder
• Anxiety, nervousness, or shakiness
• Loss of interest in usual activities
• Sense that life is too much of an effort
• Hopelessness about the future
• Feeling blue 
• Eating disorder, often in the form of compulsive overeating

Other general causes for the call may have to do with:

1. how the person views themselves,
2. how well they may or may not be dealing with their problems
3. friendships or lack of support/people they can count on
4. wish to accomplish something and looking for assistance
5. substance abuse or chemical dependency or a close relationship with one who has this issue
6. chronic medical condition and how to handle it

By and large, most people come to therapy with anxiety or depression or both and in varying degrees.  Problems in their primary relationship rank up there with one of the most commonly seen problems by therapists.  Generally, just feeling stuck brings people to the therapy office; they have a dilemma and have not been able to solve it with their usual methods.  It may be a pattern, that is, a problem that has come up repeatedly in their life or it may be a new conundrum that they want help with how to figure out a way through.

Some people still think of therapy as being only there for "psychotic" people or the "certifiably insane" or "nutcases" (I have heard all of these descriptive terms from clients who, obviously changed their opinion or, from members of the general public who have not changed their opinion).  The truth is, the people seen in outpatient therapy offices come from all walks of life, sometimes with more severe disorders but, usually, with the ordinary challenges of life that everyone faces.

Do you have any questions about this list?

"Revisioning Later Life..."

A View to the Future

"The years beyond midlife have the potential for being the most productive and satisfying period in our lives.  Although these years hold many challenges---including health concerns and physical aging---perhaps the most important challenge we face is finding meaning in our lives.  We have many choices:  we can focus on loss, disappointment and perhaps depression or, alternatively, transform this period into a time of profound psychological and spiritual growth.

This transformation requires a rebirth---a new way to live and be in the world.  We need to reassess and prioritize our interests, our passions and ways to pursue meaningful and intimate relationships.  For C.G.Jung, "aging is not a process of inexorable decline, but a time for the progressive refinement of what is essential."

Recent research has shown that the human brain can remain active, creative, and highly functional during our later years.  Too often we forget that mental and spiritual health is less a matter of fate than a matter of choice.  We can either shrink from life or enlarge it by engaging the passions of our soul, mining the richness of our true Self, and living the life we are truly meant to live."

(from the N.Y. Center for Jungian Studies)

Have you figured out how to age positively?  Do you know an elder who is living well?  A role model?  Let us know.

The Inner Resource

 You, at your best

 "...finding the areas of emotional health to improve, access, or develop, I focus on helping the individual to connect to a time or times when they felt healthy emotionally... Even those clients who have had horrific pasts have had moments when they felt good, strong, resilient, happy, safe, etc. Accessing those moments so that they are able to own what they felt, did, had, etc in order to feel good about themselves or their lives gives them a sense of empowerment. All too often when people feel sad, depressed, angry, hopeless , helpless, etc. it stems from not knowing how to access any other feelings...Not because we have to be happy or "up" all the time, but because we all want to know that, just as good times may be fleeting, bad times are also transient as well, and in accessing our feelings of empowerment they can learn to trust in their abilities to cope with the "not so good" feelings and moments in healthy and yes, hopeful ways... In short, to add to the list, I'd put in 1. empowerment, 2.trust in one's ability to cope"  Loren Gelberg-Goff

Here we have  self-esteem expert, Ms Gelberg-Goff making a very useful point.  All of us go through difficult periods in our lives, have problems and are faced with challenges.  We sometimes do a pretty good job of working through these trials.  Those memories are put to good use when we sort through them for our effective coping abilities.  What were they?  Make a list.  Thus, we can learn from our own past, our own prior experiences and how we used our own creative powers of finding a solution.  If you can identify some of these, not only will it help you to be satisfied and proud of yourself but, also, will give you back those resources for current or future problems.

Her main point though is, I think, that  we can remember ourselves when we were in excellent condition and use that to nourish our self-esteem.  I will add that we can put reminiscing  into a practical exercise:  Remember a time in your life when you felt really centered, energetic, hopeful, engaged, and alive!  What were you doing?  What were the circumstances in your life at that time?  What was different then from  now?  When you can actually delineate the personal qualities you had in gear, what you were doing, and what was happening around you, you have the material to duplicate at least some of that in current time.  

At any point in time, we are our own living repertoire. 

We are the sum of all that we have ever been.

Exercise to Lift Your Mood

"...mens sana in corpore sano---a healthy mind goes with a healthy body."

"...physical activity is good for your head...it can improve mood, reduce anxiety and produce a sense of well-being.  "...evidence has been accumulating that exercise can help relieve and possibly even prevent depression.

     Physical effects are easier to measure than emotions, so this is a difficult subject to study.  There have been few...large-scale, controlled studies, but research shows fairy consistently that exercise can improve mood and help reduce depression...

     Why would exercise affect your emotional state?  It can boost various nervous system chemicals---notably dopamine, norepinephrine,and serotonin---that influence mood.  Even...the slight rise in body temperature caused by exercise might have a calming and pleasurable effect, as can the rhythms of the activity.

     Psychology also comes into play.  Any type of exercise can provide a sense of control and accomplishment.  It can serve as a distraction or time-out from daily anxieties and concerns.

     If you are one of the millions suffering from depression, you probably know that there are a variety of approaches to treatment and you may have to try several."  Exercise "...cannot replace therapy and/or medication, however, especially if you are severely depressed.  Keep in mind:

     vPick an activity that gets you out...and into the company of others.  Depressed people tend to isolate themselves, and isolation contributes to depression.

     vAny exercise appears to help, but it has to suit you and you have to do it regularly."

•    jogging
•   weight lifting
•   walking
•   swimming
•   running 
•   hiking
•   playing a sport
•   dancing
•   martial arts
•   aerobics

There's a few suggestions.  Do you feel inclined toward any of these?  If not, think of what you might like.  If it is fun or interesting to you, you are more likely to stick with it.  As children, most of us are active naturally; what do you remember that you liked to do as a child?

     "I can't promise that exercise will lift your mood, let alone cure depression...they're still good for your body and brain in so many ...ways."  It definitely makes sense to include exercise as a component of a mood-supporting program.  I have exercised most of my life and it always makes me feel good.  Sometimes I don't want to do it but, there's where a little self-discipline comes in; I do it anyway.  And I am always glad afterwards!

     Quotes are from an article by J. Swartzberg, M.D. titled Sound Body, sound mind in the WellnessLetter, August 2011

For more specific info on exercise with recommendations:  http://www.alignedandwell.com/?p=3042&option=com_wordpress&Itemid=223 
To read more about the following additional benefits of exercising:
"better sleep, blow off steam, improve sex life, boost energy, lower blood pressure without medication, help children avoid obesity", go to http://www.lef.org/news/LefDailyNews.htm?NewsID=11398&Section=AGING&source=DHB_110723&key=Body+ContinueReading&utm_source=DH

 Have you noticed your mood lift when you exercise?  Share your experience here.

Bored To Tears

A way of structuring your thinking that may lead to improved self-esteem

 "Success Cycle:
1. Goal Setting > 2. Goal Achievement > 3. Satisfaction and Pride > 4. Increased Self-Confidence

People who are bored with life or lack enthusiasm and zeal usually have goals that are vague or meager, or else they have none at all.  Most of us make the mistake of thinking that a zest for living is something beyond our control, and so we do nothing to pursue it.  We immobilize ourselves and do not realize that immobilization isn't the result of depression.  Rather it's the cause.  It is difficult, if not impossible to be absorbed in pursuing a meaningful goal and be depressed at the same time.  Just as there is a success cycle, there is a failure cycle and it looks like this:

1. Immobilization > 2. Non-Achievement >3. Boredom, Depression > 4. Feelings of Worthlessness"
Author unknown

I posted this (despite not being in total agreement with everything in the quote) because I think it is a useful way to think about managing your self-esteem.
The italics on the word meaningful are mine because that would make all the difference for most people.  Any old goal will not have the effect of engaging your creative energy and excitement.  It needs must be something important to you.

Also, in reality, undue fatigue and lethargy are, in fact, symptoms of depression, which is possible to suffer from, due only to a chemical imbalance.  Some people who suffer from depression need medication.  But there are certainly many who habitually decline into the doldrums who could use a concept such as the one presented above to alleviate much suffering.  The research shows that for the majority of patients with this diagnosis,  a combination of psychotherapy and medication is the most effective treatment.  When I am presented with a person who has this complaint, I usually try  therapy only, first.  Sometimes counseling alone will suffice.  However, if we just can't get anywhere and the patient doesn't feel any relief, then I consider trying a medication regimen along with the counseling.  Most depression can be relieved.

Reflecting

The value of reviewing your personal history

 "Overcoming childhood woes.  Your childhood affects how you handle conflict, react to authority, and take and give criticism and compliments.  For example, as a child, were you considered stupid?  Made to feel guilty for speaking up?  Expected to live with scarcity?  Disliked by your parents?  Were your role models inadequate; for example, did you have a lazy or short-tempered parent?  Solution:  Every time you feel uncomfortable at work, in a memo pad, write the event, your internal response (if there's one), your external response, and what, if anything, you want to do differently next time."  Author unknown.

Reluctance to review the past

Often patients come to therapy but the one thing they don't want to do is reflect on their childhood.  There can be many reasons for this, such as, not understanding the value of that process, fear of re-experiencing emotional pain, a reluctance to critique their parents or family of origin, and so on.

And a growth process can take place without this aspect being included but it eliminates a richness to the experience.  Reviewing your early experiences from the position of adulthood can help you to understand yourself.  The more you understand how you came to be the way you are, the more confident you will become.  Why?  Because you won't surprise yourself.  Also, you won't be afraid that someone else might see something in you that you don't see.
 The thoughts and memories that come to mind if you allow this can also give you the opportunity to have compassion for yourself.  If you had difficulty with something as a little kid, who can have more mercy and ability to be helpful than you, yourself, as an adult?  I once wrote a post here about a person who, as a child, had parents who paid no attention to his interests, to him as an individual.  In fact, they actively suppressed his individual inclinations. (Title of that post, Depression Prevention)    In therapy now, as he is beginning to come to terms with the effect this has had on his life and his tendency toward depression, we are working to repair the deficit and help him to find his passions.
 A recent post on Addiction brings to mind a simple and common example:  In alcoholic families, the children are often disallowed to have feelings.  Of course, they have them, but they cannot be shown.  So, an adult from this kind of background may find themselves having a lot of trouble expressing their feelings, even when it is welcomed, because deep down inside it is experienced as breaking the rules.

On the other hand, some suffer from being haunted by sad or painful or confusing memories from childhood.  This is the opposite of the repression mentioned above.  In this case, sharing, in a conscious manner, with a trusted therapist, can be a relief.  The result of clarifying and enlightening oneself about what happened can be, ultimately, a sensation of feeling more integrated as a person.

In at least one theory of therapy, Ego psychology, it is believed that the earlier the damage took place, the more severe will be the expression of it in adulthood.  This also flies in the face of common wisdom:  Most people think that it doesn't matter much what happens to children before they can talk because they don't remember it.  However, if you understand the logic behind this psychological hypothesis, it makes sense:  The younger we are, the fewer defenses and coping mechanisms we have.  We are exquisitely impressionable as very young beings.

Usually the best therapy takes place when the past problems, the present conundrums, the emotions and the thoughts are all woven together.  Often this is where insight occurs.

 

(Posts related to this topic:  The Man In The Mirror & Not A Know-it-All)

Have you discovered a new understanding of yourself through introspection?  Sharing your experience of that here might be encouraging to other readers.

Getting Unstuck

Self-intervention strategies for depression

 What do you do when you are despondent or anxious ("stressed")?  I think it is easy to stay there and wind yourself down even further.  If you ruminate, repeat bad thoughts in your mind, and dwell on the discouraging feelings, you can make yourself worse and worse.  Inertia sets in and you can continue in the same depressed/apprehensive mode or, worse,- keep spiraling down further and further,- if you don't interrupt it.
It's difficult to make that U-turn but once you've felt your emotions, identified them, given yourself some sympathy and checked to see if there's anything to learn from your reaction, it's time, in my opinion to start intervening with yourself.

Of course undesirable things happen---to everybody.  Unfortunate events of this kind are real, they are part of life for all of us.  And we will react.  But, if we hang on to a litany of our bad luck, we do ourselves a disservice.
So how do you help yourself?  It would be fascinating to hear from any of you who would share your ideas and experience with what has helped you.

George Burns, when asked how he lived to be 100 years old, said:  "Nothing bothers me."
Krishnamurti said:  "I don't mind what happens."
Dr. Maoshing Ni says:  "You can expand your emotional elasticity by cultivating tolerance."
These three seem to be on to the same thing.

Personally, I can get to the same place but I have to do things to get there.  Here are some of the things I do:

1.  Find an activity that is completely out of my normal routine and is very engaging (takes me out of myself, displaces my repeated problematic thoughts)-even better if it can be with someone whose companionship I enjoy and if it can be a productive activity (not just entertainment).
2.  Take some time off from work; go to another place, even for a very short stay, a place of peace.  I go to an area that is quiet, slow-paced, and beautiful---usually in nature.
3.  I focus on finding that tranquil place in my own mind that I have in my repertoire; I know I've felt it before, so I try to get there mentally. (especially important before sleep)
4.  I find a sentence or "mantra" that I can repeat to myself that is the exact opposite of whatever bad thing I have been telling myself or am troubled by (cognitive therapy).
5.  Even if yet another unlucky thing happens at this point, I find the part to be grateful for.  For example, a near auto collision with another driver who unexpectedly cut in front of me, let me be grateful for my great brakes, glad to have a car with good steering, able to note my own alertness and quick reaction time and happy to be, rather than in some hospital emergency room, able to go on with my day.
6.  A critical or mean remark from another will be looked upon as their own negativity popping out because they were momentarily unable to control it.
7.  Meditate.
8.  Do yoga.
9.  Get physically active.
Try not to aggravate your stress reaction with what AA calls, "stinkin' thinkin'" and figure out ways to help yourself.  Find a good therapist.

(Other posts pertinent to this topic:   Wise Words From a Long-Term Patient & "Stress Reducing Methods")
Did you try any of these?  Did it help?

Wise Words From a Long-term Patient

The woman who talked to me today about how she has learned to manage, what was once a debilitating depression, has been in on-going weekly treatment for a number of years.  Over time, she has come to know herself and, with some trial and error, has learned how to take care of herself  in a way that is effective and also a relief to her family.

Coping with depression:
~When it occurs, I limit myself to 7 days.  If I still feel the same after that time has passed, I will make a life change.  Usually, it has abated by then.
~I don't exacerbate it.  When I feel bad, I don't allow myself to dump more discouraging thoughts upon myself.  So I don't continue to spiral down and feel worse and worse.
~ Continue to function.  ("Fake it 'till you make it")  I fulfill my responsibilities, take care of my child,--- despite feeling somewhat robotlike or, certainly joyless, at times.  Doing this keeps me out in the world, encountering people and new situations, which sometimes helps to change the mood during the 7 days.
~I say to my family what it is that I need at that time.  For example, in that state I am pre-occupied with trying to deal with myself.  So, I don't have much patience nor energy for listening.  I ask them to limit their quests for my attention.
~No externalizing.  For example, when I wake up to find myself depressed, I previously found it convenient to blame men.  However, when I began looking at my history, I realized that I was sometimes visited by depression when I was not even in a relationship with a man.  "I saw that it was not the world shitting on me but how I looked at the world."
~Don't shut out those who care.  I did hurt those close to me before I learned this (when I did do the closing out, that was something else to feel bad about).
~From the movie, Zombieland, I saw that when I learned something I could make a rule and enter it in my journal.  Also, that the rules are not written in stone; they can be amended or changed as needed.

These guidelines came of a long, consistent effort on the part of a person who suffered for years and now is living the majority of her life in a satisfactory state of mind.  When she is visited by depression, she isn't helpless; she has created a personalized program for staying in charge of her life.

Does this woman's story inspire you to try to develop your own self-help list?  What have you come up with?

Depression Prevention

Sometimes the origin is in an early time of life; how we can understand this (in oneself) and possibly prevent it in others.

 A man talked to me today about his inability to motivate himself, specifically, in pursuit of his own interests.  He is willing to do for others and will find the energy to pitch in when presented with a need.  He loves "...being Julie's husband..." is very happy "...being Christopher's dad" but, "...there's a piece missing."
Sean is a responsible man who meets his obligations and tries always to not bother others or infringe on anyone else's activities.  He is noticeably intelligent and has some talents.  He has some wonderful character qualities, such as loyalty and tolerance.
His problem is with himself; he not only doesn't know what he would like to do and what  he wants, but does not even know what he likes.  At one point, he  described an absence of conflict:  How to find time to devote to a favorite hobby, resolving a dilemma about taking money from the family budget for an after-market addition to his vehicle---these kinds of things, some examples of common choice points, simply do not come up for him.  He knows that people struggle with these things (conflict between wish and obligation or, even conflict between two wishes) because he has noticed others debating these issues within themselves.

Can you imagine this?  If you are always chomping at the bit  to get to your next project or feeling frustrated because you can't find enough time for the avocations that interest you, or the opportunity to research an intriguing question eludes you, Sean's difficulty may seem odd.  As a matter of fact, I have seen a number of people, over the years, bring up the complaint that they don't know what they want.

How does this happen?  What do you think?   How does a person find themselves in this condition?

I suspect that in most cases, the seeds for this problem are sown early.  This particular individual, who has been told that he was a sensitive child, was oppressed during childhood.  Neglected.  His basic needs were met, but there was not only little or no attention paid to him emotionally.  He was also discouraged from even asking for what he might want.  The adults in his family found a child asking them for things to be an interference with their conduct of their own lives. There was no adult in his young life who had the capacity to mentor him.  No one was able to pay enough attention to notice what he was drawn to nor to listen to what he expressed an interest in.

As an adult, now with the chance to do the things he likes, he doesn't know where to begin.

If you are a parent, or the relative of a young child, it seems to me that a wonderful gift you can offer is to attend to the child and their unique attributes.  If the child shows  an interest in something, anything, from rock collecting, to pirates, to ballet, try to help the child develop that interest.  You could be contributing something so very important to that person's future; as a result, you will never be forgotten (an adult will one day have fond memories of you), and---you could be saving someone from a future of feeling lost like Sean does.
Did some kind adult help you as a child?  Have you paid attention to a child in your life?