I am a clinical social worker in private practice specializing in anxiety disorders, trauma treatment and ADHD. My website can be found at www.therapistseattle.net When I'm not helping clients make peace with their past and envision a heartful future or foisting vegetables upon my reluctant children, I like to hang out with friends, move plants around the garden, read fiction and cruise thrift stores for original art and funky hand made ceramics.
Lately I’ve been chewing on the balance between care of self and service to others. I believe we all exist in a web of connection. Consider the underground fungus: it transmits nutrients to tree roots, which keeps the trees alive and in return protects the fungus from drying out. If the fungus gives away too much of its nutrients it dies, and if it gives away too little, it struggles to live.
As humans, we hold this tension of self versus other constantly: Do we check in on our elderly neighbor or take those few extra minutes to savor some time alone?
Too much service to others creates depletion, resentment and
fatigue. Co-dependents are not happy
people. They give and give, and exhaust themselves and wind up indignant and
angry that their needs are never someone else’s top priority.
On the other hand, folks who only care for themselves, who spend their time and energy in sole pursuit of their own betterment suffer from isolation and meaninglessness. Without sustained and reciprocal connection to others, our existence lacks purpose.
I want to live in the intersection, to promote and protect my own well-being without apology while actively supporting the well-being of others. There’s a way to do this, but it takes a spirit of experimentation and willingness to make mistakes and plenty of time to get it right and then have the balance go and shift on you so that what worked at one point no longer works. No matter, its what we’re here for. Share your good stuff. Just make sure you keep some of it for yourself.
I once called a client a “walking vagina.” For real. This was years ago. I’d like to think I’m more delicate with my Sword
of Sarcasm these days; but the truth is I’m not always able to tell the difference
between useful humor which cuts through defenses and damaging humor which just
I know I’m a weirdo and my humor can be fully wrong. I rely
on the quality of the relationship, the trust my clients feel towards me that
they can come back and tell me if something I say lands in a way that hurts
rather than helps or clarifies. This requires trust and courage on the part of
my client and humility and non-defensiveness on my part. And it’s helluva good
practice for IRL—because people (including this therapist) are imperfect and language
is an abstract, approximate tool for building reality.
The backstory of my inappropriate comment was this: my young
adult client was being texted in the middle of the night by a guy who was only
interested in no-strings-attached sex, while she had a huge crush and yearned
for a relationship with this same fellow. This happened enough times that she
knew what was going on, but still found it irresistible when he booty-called
her. I was trying to engage her self-protective anger to increase her ability
to resist him. So, I told her he was treating her like a vagina delivery
service. This worked! She stopped responding to him. Yay! But I also hurt her
When I hear about how many supposedly terrible therapists there
are out there, I wonder what the hell is wrong with my profession?! Then I
wonder: what if there are just these unfortunate moments when the therapist is
trying to say something useful in a unique, therefore noticeable way but they
get it wrong? And if the client feels
hurt but they don’t go back and have a conversation, then the comment becomes
this toxic thing that erodes trust. And that doesn’t even include the
(abundant!) times when the therapist is trying to summarize what is happening
and they just don’t get it.
In real life, like in therapy, we are constantly trying to understand
one another, communicate needs, make meaning, provide care, and feel received.
If you have conflict in your life or in your therapy, try this: call upon your
courage and talk to that person. It
might not work. They might lack humility or willingness to hear your
perspective. They might deny responsibility for hurting you, and when that happens
it really sucks. And it might work: you might feel better understood or better
understand where they were coming from. But no matter how they respond, you will
be operating from a place of courage and willingness to process your pain,
rather than withdraw from connection.
My kids are seventeen now, and share their own car. Each milestone towards their independence feels like a celebration and loss both. Parenting teenagers is categorically different than parenting younger children. For one thing, they have strongly held opinions and great oratory skills. Teenagers are natural born litigators, able to argue a point to (my) exhaustion.
When they were young, my primary job as a parent was exposure: to provide safe and stimulating experiences so that they would experience the world as a large, varied and mostly safe place. All our trips to the parks, aquarium, zoo, swimming and even the grocery store were fun ways to build that understanding.
Now that they are older, my job has shifted from creating their experiences to supporting their choices. It’s mostly my job now to affirm their competence, to offer my opinion but to always convey the message “I trust your judgement.” When we are trusted, we feel and are more competent and make better choices.
One of my sons has taken on a heavy load of volunteering and working on top of a demanding academic schedule. He loves his volunteer work and loves the money he makes at work. He doesn’t want to give any of it up. Now his boss is asking him to work both weekend days. I feel protective of his free time and don’t want him to. We discussed why he should limit his working hours and how to respectfully set a boundary. At the end of the conversation, he rehearsed what he would tell his boss and I complimented him on his word choice. It was different than mine. It was better. More succinct. The whole conversation was one of those lovely opportunities where I could still exert some appropriate protection by sharing my ideas and he could then handle the situation on his own entirely.
If you have teenagers in your home, be sure to tell them that you trust their judgement. It’s so important to their emerging independence to feel and to be seen as competent.
As the Equinox draws near, signs of spring are everywhere. Crocuses poke their fragile heads up from the ground, fat buds of future flowers weigh down the tips of rhododendrons and camellias in the garden. The snowfall and rain made the earth heavy and wet. I’ve been swapping around roses and hydrangeas, responding to new light patterns after the weight of the snow broke off tree branches that created shade. The hydrangeas need filtered, indirect light and the roses prefer strong, baking sun.
People are like plants in the garden; different people need different things. Some people thrive best with low levels of stimulation. For these folks, a trip to the market on a Sunday afternoon constitutes all the weekend excitement they need. Others are more stimulation seeking and need social, physical and intellectual pursuits during down time.
The hydrangea is a picky beauty. She needs a lot of water and ample shade. But she’s also a prolific bloomer and one of the only flowers that doesn’t need dead-heading. Worth it! Roses, meanwhile are just as needy. While you don’t have to water them nearly as frequently, they need fertilizer, protection from leaf mold, aphids, deep watering, and plenty of sunlight. You will stab and slice yourself if you keep roses because no matter how careful you are, thorns are sneaky. But a rose in full bloom is the one of the greatest delights. Well, after puppies. And our own children.
In this time of transition, think about your needs. No matter how resilient or tough you are, if you are not taking care of yourself, you will not be able to express your full potential. Like my hydrangeas and roses, you might need a new environment or some other small or large change to be at your best. The cool thing about being human is we have both brains AND mobility. Plants, alas do not. You must cultivate your environment (relationship, home, job, friends, education, activities) to meet your needs. I wish you great success in the garden of your life!
A sense of personal agency—that powerful feeling of having the ability to make your life mostly the way you want it—is a historically unprecedented capacity for women and a luxury that largely belongs mainly to the privileged (Caucasian cis-gender) citizens of the western world.
Context acknowledged, most of my readers are those genetically and geographically and gender-identifying (ha! Try saying that five times in a row, fast!) fortunate Americans, so you have massive capacity for personal agency, but may not quite know it.
What does personal agency have to do with mental health? Only everything! If you feel you can point yourself in the direction you want to go—make a new friend, finish your degree, negotiate a raise, adopt fifteen stray cats,—then you can figure out a strategy to get there—strike up a conversation with your neighbor, research university programs designed for working adults, make a list of job accomplishments and ask for a meeting with your boss, invest in an industrial sized bag of kitty litter.
Without personal agency, life is just happening to us. We are at the mercy of the economy, the whims of our boss, the vicissitudes of life. Like children awaiting dinner and hoping for pasta, we have wants but are passive, and passivity equals powerless.
Girls in particular are raised to deny their needs. In order to be ladylike and nurturing, we are taught to take care of everyone else first and then (only if there is time) to attend to ourselves. Boys meanwhile, are taught to “shake it off” when they are physically injured and shamed “don’t be a baby” when they are emotional. Girls are raised to accommodate everyone except themselves, and boys are raised to dominate everyone including themselves. It’s crappy social programming resulting in massive, unresolved pain and the compulsive need to escape it.
This creates a society of men and women who are completely estranged from their authentic selves, from the internal voice that knows our deepest needs and wants, and therefore has no power to fulfill them. This estrangement and the resulting feelings of emptiness creates enormous resentment and insatiability.
It’s why we have major obesity epidemic in our country: because unmet needs show up in crooked ways and calories are comforting when you work twelve hours a day or stuff your pain down because your life fits like a too-small pair of shoes. Its why pot shops are becoming as common as coffee shops here in the Seattle landscape: because if you are hurting and don’t know how to make the pain stop, you just want to distract yourself from the pain. It’s why so many people can’t hang out alone without a television on in the background or a phone screen in their hand. Distraction is easier than taking responsibility for changing your life, but folks: Taking responsibility is a LOT more powerful, interesting and liberating.
The only way out of this mess is taking time to get to know yourself. There are a million ways to go about it: meditation, journaling, time alone in nature, reflection time over coffee, any creative practice, building things, moving slowly in silence, stillness. You need just three ingredients: curiosity, solitude and quiet. Curiosity is like an opening into the possible, it’s a deeply spiritual state. And we can’t enter into a state of curiosity about ourselves in the midst of other people or distractions of any form.
As we move through autumn, with its slower pace and gorgeous foliage, I wish for you dear reader, protected time to get in touch with yourself so that you can find out what you need deep down, below the incessant and noisy surface wants. Try saying “no” to a few demands on your calendar, and reinvest that time into yourself. Take a candle-lit bath. Go for a slow walk in a beautiful setting.
I wish you great patience with your wants and needs, and faith in your own secret strength and power. I wish you to exercise your personal agency to make your life a beautiful, sturdy, comfortable fit.
When I was a kid I loved magnifying glasses. They seemed like a magical portal to a secret world: like Alice in Wonderland drinking the elixir which made her shrink and grow, magnifying glasses changed everything. Ants went from simple black specks to armored warriors. Grass became a complex, mysterious world of sharp edges and shadows. Sunlight went from general brightness to burning laser. I yearned to someday own an old fashioned, wooden handled magnifying glass.
I’ve come to think of anger as a type of magnifying glass. If that sounds random (and it probably does) bear with me. Anger offers—demands–we pay attention to our core values. We get angry when we believe that something or someone is threatening our core values. Anger magnifies our emotion to get us to pay attention to and protect our values.
Now there are folks out there who get mad at everything and everyone: the weatherman for predicting rain, the government for collecting taxes, the neighbor for taking too long to pull in their trashcans. To these folks I’d say get therapy (but not me, I don’t enjoy your kind). They also are responding to a perceived threat to their value system but like a rescue dog who bites when frightened, they lack the emotional wellbeing to tell when they should and should not feel safe.
I’m addressing this blog to the vast majority of us who are not constantly (and tediously!) angry, but who struggle with recognizing anger as a useful tool in navigating relationships. Typically, we feel angry when we feel duped, taken advantage of, disrespected, or mistreated in some way. Likewise, we feel angry when these things happen to someone we care about. Anger holds in its flaming heart the certain knowledge that we are WORTH something, that we are precious and worth protecting. Healthy anger is the safeguard of self-esteem.
Seen through this lens, anger is a useful reaction to a threat to the safety of connection between people. Anger is fuel propelling us with courage to stand up for ourselves, to set boundaries, to name the thing that we cannot and should not ignore. Anger is a wicked cool sword that cuts through the bullshit of pandering and placating to show us our own raw truths.
Skillful communication of anger protects relationships by protecting boundaries. If I don’t allow myself to be mistreated, I can stay safely connected. If I let myself be mistreated I either have to give up my safety or I have to sever the relationship. Anger is the opposite of apathy, and apathy is the opposite of love. Anger and love are inextricably wound into all of the relationships we treasure because every deep, long term connection involves imperfect people. All of us make mistakes, have blind spots and character flaws, lack complete understanding and inevitably fail one another at different times.
So if you want love in your life, be prepared to sometimes be pissed off. Be prepared to piss off the ones you love. Allow the experience to slow you down, just like a magnifying glass in the hands of a curious kid. Anger springs from your deepest values and offers lessons about areas of yourself that you need to refine: your expectations, your boundaries, your capacity to hang in there and stay respectful. It teaches you how to meet the world without being a doormat. Anger gives insight into your own code of fairness. When you or the ones you love are angry, don’t run away, but rather magnify the moment. Be prepared to listen and to speak your truth.
I think most of us have this secret fear lurking in our core: that our needs are too much for the people around us. That our unvarnished self is a black hole of emptiness and nothing can fill us up. We hide our fear of emptiness/neediness in a variety of ways: by developing hyper-independence, or engaging in excessive care-taking of others, or by dissociating with food/alcohol/television/Facebook/tasks.
To understand where this near-universal fear comes from it helps to know two things:
One, the brain is a meaning-maker. It makes meaning by recognizing patterns and generalizing those patterns out to arrive at conclusions to help us navigate life. One major pattern we learn is simple cause and effect tracking: If I do X, Y will happen. This cause and effect pattern-recognition is half the battle of functioning in a given environment. For example: If Harry consistently gets to work late (X), he will lose his job (Y). If I rinse my dishes before putting them in the sink (X), it’s easier to clean them (Y).
Two, just because a pattern is true at one point in time doesn’t make it true in present time. Therein lies 98% of the work of therapy.
If you were born into a compromised environment such as a family system where addiction or mental illness or poverty or disability affected the adult’s capacity to care for you, than your needs were too much. At that time, and in that family system of diminished capacity, a growing child’s constant need for food, love, shelter, attention, explanation, comfort, sanitation, structure, stimulation, and consideration is too much for the parent(s) to meet. The parent, ashamed at their failure to meet the demands of this needy being grows angry at the child for putting them in this position and blames the child. The adults convert their own failure into blame and send the message to the child: Your needs are too much. The child’s meaning making looks like this: If I have needs (x), I make my mother angry (Y). The child then starts to hide his needs, first from his mother and ultimately from himself.
Of course we all have needs, and our adult selves need the very same things that our child selves needed. Some of those needs we can now meet directly (food, shelter, sanitation, structure) while others still must be met via relationship (love, attention, comfort, consideration).
If we are still in that child habit of hiding our needs from ourselves, we don’t know it’s okay to have needs and we don’t know what we really want. We may think we want a Rolex watch or watch ten hours of Netflix.
Here’s a handy way of telling if we are meeting a need or blotting ourselves out: when we meet a need, it goes away. We return to a state of calm. When we are blotting ourselves out, the need gets quiet for a short period of time and then resumes its shrill driving force. When blotting out, we vacillate between distracted and restless. When meeting a need, we feel relief and peace.
My wish for you, dear reader, is that you take the time to know your needs and value yourself enough to meet them.
In the gloom of a Seattle January, it’s vital to keep our inner sun ignited. Seasonal Affective Disorder, with its attendant low levels of energy and flattening of enthusiasm, affects many to some degree.
Do you find yourself hitting the snooze button and rolling over? Do you look out the window and scowl?
People in Seattle, we need a whole battalion plan of fun to battle the winter meh’s. What is fun? I’m talking about tiny bits of delight, not the roller coaster of joy. Fun is subjective, subtle and easily attainable.
Visualize Picturing the golden sun in a clear blue sky is uplifting. Imagine a garden in the late spring; recall the delightful riot of blooming peonies and lily-scented hyacinths. Visualization is not just for woo-woos. I know a clinical social worker working with professional athletes in Chicago. He has injured players picture themselves practicing and playing the game while in their hospital beds. Just by visualizing, these players are able to retain muscle tone and skill level. Think of visualization as the opposite of catastrophic thinking. Instead of using your imagination to freak yourself out, visualization is using your imagination to improve your reality. Conscious use of visualization is effective, free and has no unwanted side effects!
Progress The therapeutic value of a feeling of progress cannot be overstated. Sure we are all aging and the mortality rate is a solid hundred percent, but here you are, alive and able, so do something to make your life even a tiny bit better/prettier/healthier/more interesting. Each winter I repaint bits of the ceiling and walls that are marred. This weekend my boyfriend and I spent half a day making a week’s worth of healthy breakfasts and lunches from scratch to save time and money during the work week. Learning anything is a slam dunk for creating a sense of progress. With the internet, learning has never been so abundantly available. As an example, the DuoLingo app offers free daily language lessons that take just five minutes and allow you to choose from all the major world languages. I’m currently working on my Spanish and will learn French next. And you don’t need Wi-Fi to learn: Find someone who knows something you don’t and ask them questions.
Travel Depending on destination and level of luxury, travel costs vary from modest to major. If you can afford it, go to the sun midwinter for a blue sky break. Stay somewhere you can walk outside every day for an hour and get your vitamin D recharged. If that’s too much for your budget, take a weekend getaway with your partner or friends and go somewhere to connect with loved ones and shake up the routine. If you don’t want to commit to a whole weekend, get outside of the city and go east to the mountains for a day of snowshoeing or sledding or skiing. Take in the beauty of snow blanketing the landscape and feel the refreshing chill of high altitude winter air.
Experience Novelty Anything new and different wakes your brain up and makes you feel alive, which happens to be exactly the opposite of how Seasonal Affective Disorder makes you feel. Think of novelty as the umami flavoring that makes life delicious. Again, we’re talking little bits of newness here, not enter the witness protection program and move across the country. Discover a new show on Netflix or Amazon that makes you laugh, cry or think. Throw a party for a truly ridiculous reason (The Winter Olympics watch party! National Pie Day!). Spend an evening listening to a new album, or internet-stalk your favorite musician and listen to their side bands. Make a paper-mache mask. Take a class that you would have loved as a child. I’ve taken classes on hip hop dancing, ceramics building, jewelry-making, mosaics, writing, interior decorating, cooking, and painting. Remember adults take recreational classes for fun, not to create an amazingly impressive product, so dump your perfectionism before you go.
Get Physical Attend to the mammalian needs of your body. The basic three are: sleep, exercise and food. It’s easy to have not enough of the first two and then try to make up for feeling lousy with way too much of the third. Make a plan to get to sleep earlier. Block out time on your schedule to get regular, healthy movement. Do a little prep each weekend by making or buying readymade meals for the work week so you can have food that sustains you without inflating you. Drink more water and less everything else liquid. Have sex. Really! Schedule it if need be. Sexual activity increases both self esteem and dopamine.
Finally, consider this general philosophy: Nibble on as many different sources of self care as you can dream up. Consider emotional nutrition akin to dietary needs for variety and enjoyment.
These days the news is rife with stories about sexual assault and harassment by men in positions of power against girls, women and boys. My clients—many of whom are survivors of sexual abuse—are torn between feelings of relief that their stories are finally in the main stream and despair that they live in a society where sexual exploitation by men in power is so pervasive.
Meanwhile the decent, non-rapey guys out there–the vast majority of men–are grappling with the painful realization that so many men are sexual predators and fear that they too will be painted with this broad brush.
It’s easy to want to turn away from the numbing repetition of this upsetting information. We feel overwhelmed, shocked, and unable to screen out the pain and anger of the victims who are finally coming forth like a tidal force, we are exhausted by determining degrees of wrongness, trying to figure out what should happen next both to individual perpetrators and as social response to this pervasive injustice.
Anger and the fear of anger cause us to retract from each other, to avoid the difficult, useful work of coming together to talk and listen and think about this problem that touches us all. Every man has a woman he loves, be it his mother or sister or daughter or wife. Every woman has a man she loves, be it her partner or parent or child or brother. We cannot get away from the connection, and therefore we cannot get away from the need to have conversations.
After genocide, truth and reconciliation process is primarily about allowing people to tell their stories and be heard by perpetrators and victims alike. This process humanizes both sides, allows them to weep and heal together. It takes enormous courage to tell and to listen. I want to remind every big hearted man out there that if you want to help us heal, this is your job right now; listen to the women in your life. Ask them for their own stories with this experience. If it hurts to hear, remember it hurts a lot more to go through it than it does to hear it. As a therapist, the most important gift I can offer is to bear witness to the experiences of my clients. The simple act of listening is the most overlooked magic.
Every woman I know has experienced at least attempted sexual abuse by a man. There is a portion of this that may be innocent misjudgement: men are charged with sexual initiation in a patriarchal society. I used to joke that if I weren’t a woman I’d still be a virgin because there is no way I’d ever have the courage to initiate sex. So given that in the beginnings of relationships men almost always are the ones to initiate sex, and women consent or refuse it, how do we proceed?
There should be bright, clean lines such as no sexual relationships between people in substantial power disparities (such as boss/employee or perspective boss/employee, or religious leader/follower or famous person in specific field/person wanting to become successful in said field). These bright, clean lines are further delineated by simple questions such as: “Can I kiss you?” “Do you want to have sex?” Consensual sex is fun for both parties and career safe.
For men: if you are so successful that you can’t find someone to sleep with who is in a similar power position as you are, look for someone who has nothing to do with your line of work and doesn’t care about it. This is hard on the ego but great for avoiding sexual harassment accusations. And dude, no matter who you are, don’t sleep with someone who works for you.
How do you avoid being misunderstood if you are man? More bright, clean lines here: Don’t view women in your professional life as sexual beings, no matter how pretty they are. Take a good look at the way you interact with women. Ask yourself, would I say this to a man I worked with? “That dress is pretty,” is fine, just as you might compliment a male on his awesome tie. Comments about a female coworker’s butt, breast size or shape is a hell no, just as complimenting a male coworker on his formidable penis size would not go over super well at the water cooler.
For the women: remember that most men are just like us: decent, imperfect, and trying figure out this incredibly complex thing called life. Most men wouldn’t try to take unfair advantage of a woman even if they could get away with it because it would make them feel disgusting. Avoid the temporary comfort of cynicism which comes with the half life of despair. Tell your story. Claim your equal space. You belong right here, at the grownup table.
One of the best things about being a therapist is also one of the best things about being a mom. This year my teenagers were surprisingly enthusiastic about decorating for Halloween. After several years of their steadily diminishing interest in holiday decor, I had given away the moaning zombie head, the black foam tombstones, the light up snowman, the plywood Santa, and pared down our vast and tacky collection to our favorite things.
But I was wrong because October first, my sons were completely excited about decorating for Halloween. We set about putting up the giant bat, the blinking bat lights, the sparkly spider, the witch, the Frankenstein treat holder, the rubber rats. The boys put things in weird places: The “eye of newt potion” bottle was stuck in the door of the fridge, with the condiments. One of them put a giant rubber rat in the linen closet, just far back enough in the shadows to actually freak me out.
This is one thing I love about both parenting and therapy. It’s the delightful surprise of how people think differently. I think of decorations like art. I put them out where they are easy to see and enjoy. Meanwhile, the boys think of them as thematic: eye of newt would be a witch’s condiment, so it goes in the fridge with condiments. Seeing a rat in a closet is scary, and Halloween is a holiday to scare people.
Years ago, when running a social skills group, participants were developing ground rules for group safety and cohesion. One of the women requested no swear words. She grew up in a religious household and felt uncomfortable with swearing. It was a revelation to me that someone might feel unsafe from salty language. As a result, I had to think about conveying enthusiasm and intensity and spontaneity without swearing which made me a more palatable public speaker.
These separations between how we interpret reality and how others do the same can be incredibly fertile growth areas. Which is therapist-code for “or it can really freakin’ suck.” (See how I didn’t swear there?) As we move into the holiday season my wish for you, dear reader is that you can notice and communicate those differences with compassion both for yourself (we are all works in progress) and others (because ditto).