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Don’t want to go to therapy today? Tell your therapist

Sometimes you’ll dread therapy

This might coincide with the time you decide to stop taking your meds, out of some mixture of not feeling that they’re working anymore, the return of your self-destructive impulses, and your self-reassurance that actually you’re fine.

You will consider not showing up in your counsellor’s office or in the online waiting room.

You’ll try to come up with excuse beyond ‘I don’t have the energy’, ‘I just don’t want to’, and ‘I don’t want to be told that what I’m doing isn’t healthy, because right now I don’t want to be healthy.’

You’ll want to avoid your therapist for all kinds of reasons that you don’t entirely understand.

There will be days when you’re tired of admitting that you’re struggling, tired of being a ‘person in therapy’, and you’ll want to just sack it off and do something fun, ‘normal’.

There’ll be days when you genuinely think you’re doing brilliantly, and really don’t see the point.

There’ll be days when you’re at your lowest, and you can’t stand the idea of having to admit that to the person who’s working hard to help you get better.

These days will come after months on waiting lists, of searching for therapists, of ranting about how much you need some care.

You’ll grumble at yourself for being unappreciative. But the therapy-dread won’t budge.

Sometimes you’ll explain that something came up at the last minute. Other times you’ll push yourself through the dread and get your butt to therapy – usually because you feel too guilty about letting your therapist down rather than any sudden excitement about working on your mental health.

Most of the time, when you do end up going, you’re glad you did afterwards.

Therapy’s a lot like going to the gym.

You know you should go. You know it’s good for you. But you also know it’s bloody hard, and the sweet relief of putting it off and doing something unhealthy instead is brilliant enough to make you think skipping it is a good idea.

But when you do push through, lace up your trainers, and work out, you feel brilliant afterwards.

And it’s the same with therapy.

It’s okay to sometimes dread it. It’s okay to resent having the commitment, especially when you find yourself turning down fun plans because you have an appointment at 6pm.

But it’s the days when you dread it that you likely need therapy the most.

Therapy isn’t easy. It can sometimes feel like a chore, and it’s a weekly reminder that while everyone else seems (emphasis on seems, because it’s rarely the reality) to have everything together and be able to go forth and live without any baggage, you’re reliant on some extra help.

It’s easy to convince yourself not to go.

You focus on the unpleasant bits – the awkwardness, the tears, the frustration of having to put in work when all you want it to just hurry up and be better.

You tell yourself it’s not working. You tell yourself it is working, but you’ve already learnt everything you need.

You bend over backwards to justify not doing therapy, because your brain, as it so often does, tells you not to take care of yourself.

Remember that when this happens, it’s not the logical part of your brain that’s talking, or the part that actually cares about your wellbeing.

It’s the bit you’re working on, the bit with the destructive impulses, and the patterns that you’re trying to break down, and all the negative stuff.

This bit of your brain doesn’t want what’s best for you.

It wants you to sit out therapy so it can step in and make you feel rubbish, uninterrupted. It’ll tell you you’re a mess because you need therapy, and that you should feel guilty because you didn’t go, and that you don’t need therapy all in one spiral of crap thoughts.

That part of your brain can be tricky to ignore. But you have to try to drown it out.

Remind yourself that just like working on your physical health, working on your mental health gets easier as you go – but you have to keep going. Otherwise you don’t get the benefits, and it seems like a massive waste of time.

Know that pre-therapy dread is normal, but remember how much more positive and equipped you feel after a session.

If you find yourself dreading it week in, week out, and end up miserable after every session, that’s a sign you may need to change things up and talk to your doctor about getting a different therapist.

But if it’s just the occasional pre-therapy dread, don’t worry too much – you’re not failing and you’re not being unappreciative, it’s just that natural human impulse we all have to avoid doing something we know is good for us because it requires some effort.

Push through. Force yourself to do therapy even when you’re really not feeling keen, because at the end of the session, you’ll be glad you did.

And hey, feel free to bring all these feelings up in your therapy session. That’s kind of what it’s there for.

This article is part of “Getting Better”, a weekly series about a  journalist, Ellen Scott’s journey through getting help with her mental health. 

Article Published in Metro

 

 

Shame

There is no doubt, seeing the suffering of the depressed clients I work with, that feelings of shame can have huge consequences on wellbeing and sense of self.

Gershen Kaufman summed up many of the consequences of shame in one paragraph of his book on the psychology of shame (Kaufman, Gershen, Shame: The Power of Caring, Rochester, 1992):

“…shame is important because no other affect is more disturbing to the self, none more central for the sense of identity. In the context of normal development, shame is the source of low self-esteem and deficient body-image. In the context of pathological development, shame is central to the emergence of alienation, loneliness and perfectionism”.

As my previous post on the inner critic described, we all engage to some degree in a continuous dialogue with our inner critic’s voice. When our critic is very harsh, this is when shame can be felt and depression may follow. Unfortunately, as we tend to listen and believe our critic, we are primed to interpret situations in such a way that provides us with more evidence that our critic is  right. Our inner critic develops as a means of keeping ourselves in line; as mentioned before,  it tries its best to protect us from feeling rejected, left out, alone or abandoned. When it becomes too extreme however, it can become very destructive and increase this feeling of shame.

What can we do about feelings of shame?

Below are nine ways to begin working with your shame:

  1. Know that you were not born feeling shame about yourself. Know that shame is learned. Get curious about where and when and from who you learned your shame.

 

  1. Know that shame is NOT your fault, even though our shame tells us that it is and can be very convincing.

 

  1. Know that as adults, we can learn skills and get help in handling shame like learning to manage rejection. We can gain enough confidence to take chances and come out of hiding. There is always hope.

 

  1. Know that you can surround yourself with friends and partners who accept and love you for you. You can find people to share in your joy and excitement. You can find people who share your interest in being real and authentic.

 

  1. Practice changing your habitual reflex to shrink and hide. Slowly start experimenting with expansive feelings like joy, pride, interest and excitement when they arise by firstly acknowledging them. Notice if you immediately dismiss good feelings about yourself or towards others.

 

  1. Know that arrogance, contempt, perfectionism, pretenses, bullying behavior and aggression in general are often a cover for underlying shame. Notice (non-judgmentally) those defensive behaviours that you recognize in yourself and others.

 

  1. Practice offering compassion to the part(s) of you that feel ashamed or bad in the moments you are suffering most.

 

  1. Practice working with your shamed part(s) by asking it (them) as though it (they) were another person you were talking to “How did you learn to feel ashamed? From whom or where did you get this message?” Then be patient and listen to your shamed part(s). it might tell you something new.

Practice finding and validating the core emotions you have felt as a result of being shamed in the present or the past. (see my previous post on “Change”

Change

Most of us go to therapy because, at some level, to some degree, we recognise we need to change. Things aren’t working as they are. Relationships at home, at work, or more generally aren’t functioning anymore. We can’t go on as things are.

Some of the time, it is external circumstances that need changing but more often than not, it is something within us, internally that we have to get a hold of. We have become out of touch with who we are; we don’t feel “ourselves”. We have been avoiding facing things for a while. We have perhaps been blocking our emotions. 

Most of us block access to our core emotions with a variety of creative defenses originally designed to protect us from emotional pain and discomfort. While offering us emotional protection, defenses block access to our core emotions, which leads to chronic states of anxiety, depression, and other psychological problems. As adults, we need to relearn to experience our core emotions safely. By doing so, anxiety and depression are reduced and we feel much better.

For example, “Joe” was effectively taught by his father, due to being repeatedly ridiculed, not to show sadness and definitely not to cry. His brain learned to thwart sadness using shame, an inhibitory emotion. But we need to experience all our core emotions to feel vital and authentic and to recover from life’s losses. People who cannot experience sadness get “stuck” and develop psychological symptoms, which are in fact cues that something within us needs attention and care. By working to undo the connections between sadness and shame in his brain, Joe learned to experience sadness once again and felt better in a whole host of ways. Moving through our emotions regulates the brain and nervous system. That is why, when we connect to our core emotions and move through them, we feel more confident, calm, and clear.

What are core emotions? They are largely physical sensations that we come to recognize and name as a particular emotionCore emotions inform us about our environment. Am I safe or in danger? What do I need/want and don’t want? Am I sad? Am I hurt? What brings me pleasure? What disgusts me? What excites me? Core emotions are hard-wired in the middle part of our brains, meaning they are NOT subject to conscious control. Triggered by the environment, each core emotion is pre-wired to set off a host of physiological reactions that prime us for action. Core emotions are brilliant: if we get out of their way, their innate programming tells us what to do to live life adaptively. The core emotions are: sadness, fear, anger, joy, excitement, sexual excitement and disgust.

What are inhibitory emotions? Inhibitory emotions block core emotions. Shame, anxiety and guilt, the inhibitory emotions, block core emotions: 1) when they are in conflict with what pleases others whom we need like parents, peers, and partners; 2) when core emotions become too intense and our brain wants to shut them down to protect us from the emotional overwhelm. 

What are defenses? Defenses are anything we do to avoid feeling core or inhibitory emotions. Depression is a defense because in that state we are out of touch with our core emotions. There are an infinite number of defenses but some of the other common ones in our culture are: joking, sarcasm, too much “screen time,” criticizing, spacing out, procrastination, preoccupation, negative thinking, misguided aggression, working too much, over-exercising, over-eating, under-eating, cutting, sex, obsession, addiction, etc.

 

The Change Triangle

The Change Triangle, devised by psychotherapist, Hilary Hendel, is intended to help in that immediate moment when something within you, or someone or something in your environment causes you to experience emotional struggle. When you figure out where you are on The Triangle, the idea is that you feel better for two reasons: 1) just from gaining some distance and perspective from your immediate feeling; and 2) from having some direction of what to do to help yourself feel better.

Here are the basic steps:

  1. Identify which corner you most closely find yourself.
  2. Pause, breathe, and calm yourself for a few seconds at least.
  3. Try to identify all the underlying core emotions coming up in the moment. There may be more than one. Name each one you can.
  4. Think through the best way to proceed in the moment.

With a little practice, when you ask, “Where am I on The Change Triangle right now?” you will realize that your emotional state is found at one of three corners of The Triangle:

a) Top left corner – Defense

b) Top right corner – Anxiety, Shame or Guilt

c) Bottom corner – Core Emotion

Or below The Triangle, in a calm state of peace and openheartedness – where we all hope to spend much more time. The state below The Triangle is accessed by “listening” to what the core emotion of the moment is telling us, by honoring what it says and by letting the associated body sensations move through freely until they naturally subside. Core emotions are wavelike in nature: rising then ebbing.

This of course is an alternative way to that of working with parts or sub-personalities (see earlier posts) though it is essentially the same: we identify which part we are acting from (step 1 above), we try and separate from it (step 2), notice it from a place of the witnessing self (step 3) , give it some attention, perhaps ask what it needs and then respond by fulfilling that need from the place of a calm, compassionate self (step 4).

Whichever approach you find fits best, or even if you were to use a combination of both, the key is to identify and then safely process or release the core emotion.

This is what can bring about real change.

Neuroplasticity

9 Quotes on Neuroplasticity

Neuroplasticity refers to the brain’s ability to adapt. Unlike computers, which are built to certain specifications and receive software updates periodically, our brains can actually receive hardware updates in addition to software updates. Different pathways form and fall dormant, are created and are discarded, according to our experiences.

When we learn something new, we create new connections between our neurons. We rewire our brains to adapt to new circumstances. This happens on a daily basis, but it’s also something that we can encourage and stimulate.

9 Quotes on Neuroplasticity

Check out these 9 interesting, engaging, and sometimes entertaining quotes about neuroplasticity.

Andrew Weil:

“Among other things, neuroplasticity means that emotions such as happiness and compassion can be cultivated in much the same way that a person can learn through repetition to play golf and basketball or master a musical instrument, and that such practice changes the activity and physical aspects of specific brain areas.”

Elizabeth Thornton:

“Because of the power of neuroplasticity, you can, in fact, reframe your world and rewire your brain so that you are more objective. You have the power to see things as they are so that you can respond thoughtfully, deliberately, and effectively to everything you experience.”

Santiago Ramón y Cajal:

“Any man could, if he were so inclined, be the sculptor of his own brain.”

Craig Krishna:

“Meditation invokes that which is known in neuroscience as neuroplasticity; which is the loosening of the old nerve cells or hardwiring in the brain, to make space for the new to emerge.”

Norman Doidge:

“Everything having to do with human training and education has to be re-examined in light of neuroplasticity.”

Donald O. Hebb:

“Neurons that fire together wire together.”

Douglas Rushkoff:

“Brains are tricky and adaptable organs. For all the ‘neuroplasticity’ allowing our brains to reconfigure themselves to the biases of our computers, we are just as neuroplastic in our ability to eventually recover and adapt.”

Michael S. Gazzaniga:

“Our brains renew themselves throughout life to an extent previously thought not possible.”

Susannah Cahalan:

“Our minds have the incredible capacity to both alter the strength of connections among neurons, essentially rewiring them, and create entirely new pathways. (It makes a computer, which cannot create new hardware when its system crashes, seem fixed and helpless).”

7 Reasons Why Meditation is Difficult

What is it about something as simple as sitting still and watching our breath that evokes panic, fear, and even hostility? No matter how many reports there are proving the mental, emotional, and physical value of being quiet, there seems to be an even greater number who refuse to give it a try.

Meditation can certainly be challenging, and even more so if we are uncertain as to why we are doing it. It can seem very odd to sit there just listening to the incessant chatter in our head, and we easily get bored if we do nothing for too long, even if it’s only 10 minutes. After hearing a plethora of reasons why people find it hard to meditate, long term meditators Ed & Deb Shapiro have whittled it down to just a few:

1. I’m too busy, I don’t have the time.

Which can certainly be true if you have young children and a full-time job, and all that these entail. However, we are only talking about maybe 10 minutes a day. Most of us spend more time than that reading the newspaper or idly surfing the web. It only appears like we don’t have the time because we usually fill every moment with activity and never press the pause button.

2. I find it really uncomfortable to sit still for too long.

If you are trying to sit cross-legged on the floor then, yes, it will get uncomfortable. But you can sit upright in a firm and comfortable chair instead. Or, you can do walking meditation, or yoga, or tai chi. Moving meditation can be just as beneficial as sitting.

3. My mind won’t stop thinking: I can’t relax.

“I can’t meditate. I just can’t! My mind will not get quiet; it flies all over the place! My thoughts are driving me mad! I’m trying to get away from myself, not look inside.” Sound familiar? Surprisingly enough, trying to stop your mind from thinking is like trying to stop the wind – it’s impossible. In the Eastern teaching the mind is described as being like a drunken monkey bitten by a scorpion because, just as a monkey leaps from branch to branch, so the mind leaps from one thing to another, constantly distracted and busy. So, when you come to sit still and try to quiet your mind, you find all this manic activity going on and it seems insanely noisy. It is actually nothing new, just that now you are becoming aware of it, whereas before you were immersed in it, unaware that such chatter was so constant. This experience of the mind being so busy is very normal. Someone once estimated that in any one thirty-minute session of meditation we may have upward of three hundred thoughts. Years of busy mind, years of creating and maintaining dramas, years of stresses and confusion and self-centeredness, and the mind has no idea how to be still. Rather, it craves entertainment. It’s not as if you can suddenly turn it off when you meditate, it just means you are like everyone else.

4. There are too many distractions, it’s too noisy.

Gone are the days when we could disappear into a cave and be left undisturbed until we emerged some time later fully enlightened. Instead, we all have to deal with the sounds and impositions of the world around us. But – and it’s a big but – we needn’t let it impose. Cars going by outside? Fine. Let them go by, but just don’t go with them. The quiet you are looking for is inside, not outside. The experience of stillness is accumulative: The more you sit, then slowly, slowly, the mind becomes quieter, more joyful, despite whatever distraction there may be.

5. I don’t see the benefit.

Unfortunately, this is where you have to take long term meditator’s word for it. Some people get how beneficial meditation is after just one session, but most of us take longer – you might notice a difference after a week, or maybe two of daily practice. Which means you have to trust the process enough to hang in there and keep going, even before you get the benefits. Remember, music needs to be played for hours to get the notes right, while in Japan it can take 12 years to learn how to arrange flowers. Being still happens in a moment, but it may take some time before that moment comes—hence the need for patience.

6. I’m no good at this. I never get it right.

Actually, it’s impossible to fail at meditation. Even if you sit for 20 minutes thinking non-stop meaningless thoughts, that’s fine. There is no right or wrong, and there’s no special technique. Deb’s meditation teacher told her there are as many forms of meditation as there are people who practice it. So all you need do is find the way that works for you (even if you prefer to do it standing on your head) and keep at it. The important point is that you make friends with meditation. It’ll be of no help at all if you feel you have to meditate, for instance, and then feel guilty if you miss the allotted time or only do 10 minutes when you had promised to do 30. It is much better to practice for a just a sort time and to enjoy what you are doing than to sit there, teeth gritted, because you’ve been told that only 30 or even 40 minutes will have any affect. Meditation is a companion to have throughout life, like an old friend you turn to when in need of support, inspiration, and clarity. It is to be enjoyed!

7. It’s all just weird New Age hype.

It’s certainly easy to get lost in the array of New Age promises of eternal happiness but meditation itself is as old as the hills. More than 2,500 years ago the Buddha was a dedicated meditator who tried and tested numerous different ways of enabling the mind to be quiet. And that’s just one example. Each religion has its own variation on the theme, and all stretch back over the centuries. So nothing new here, and nothing weird.

In other words, meditation is not about forcing the mind to be absolutely still. Rather, it’s a letting go of resistance, of whatever may arise: doubt, worry, uncertainty and feeling inadequate, the endless dramas, fear and desire. Every time you find your mind is drifting, daydreaming, remembering the past or planning ahead, just come back to now, come back to this moment. All you need do is pay attention and be with what is. Nothing else.