GRATITUDE: THE ANTIDOTE TO DISSATISFACTION

A theme common to all of my clients is that they are “not good enough”, or that their relationships or other circumstances are “not good enough.” This is a consistent theme, with variations on that theme, depending on the stories my clients tell themselves. As a Buddhist psychotherapist, I understand that this sense of dissatisfaction is the universal cause of suffering in what is called the “human realm” of existence. I also understand that the experience of gratitude is the antidote that allows us to let go of our common dissatisfaction.

In Buddhist cosmology, the human realm is one of the six realms of cyclic existence into which beings are reborn until they reach enlightenment. Being born in the human realm is both the bad news and the good news. The bad news is that one reborn as a human experiences the suffering of the human realm. The good news is that humans are the only beings who can learn the lessons of suffering, thereby overcoming suffering and attaining enlightenment, getting off the cyclic wheel of existence, called samsara.

The human realm is also called the “desire realm.” We desire what we don’t have, cling to the things we like, and try to get rid of the things we don’t like. This constant desire and yearning is the primary cause of our suffering. Here are some steps to ease the suffering caused by believing that who you or what you have is “not good enough”:

• Take at least five minutes each day to sit quietly, focusing in a relaxed way on your breath. Notice your thoughts without following them. You can imagine that your thoughts are like leaves, floating down a stream.

• As you do this on a consistent basis, you will more easily recognize your self-limiting beliefs, what I call the “yeah but’s” or “if only’s” we all have.

• Do not judge your “yeah but’s” and “if only’s”. Instead, notice them as the insubstantial thoughts they are. Allow some space around those “yeah but’s” and “if only’s”, and simply notice, without judging or clinging, how those beliefs of not good enough have kept you stuck and dissatisfied.

• Little by little, let your self-limiting beliefs go, like old friends you have outgrown. Gently tell them thank you and goodbye. This will take time and discipline, so be patient as you work on letting go of these habitual beliefs.

• Take time each day for gratitude. Before you go to bed each night, write down five things you are grateful for that you experienced that day. Many of my clients say “yeah but, it’s hard to feel gratitude for anything when my life is so crummy.” So here are some steps for allowing gratitude and appreciation into your life:

• Start your gratitude exercise by appreciating the life around you: the blue sky, warm sun, sound of a bird, the trees and flowers blooming in spring. Then expand your gratitude to people and animals in your life.

• In addition to the gratitude exercise, write down the things you appreciate about yourself, and especially note the things you did that day that brought you a sense of satisfaction. You may notice the self-doubts creep in. Simply notice them and let them go, like those leaves floating down the stream.

• As you do these gratitude and appreciation exercises, continue to breathe, especially in the area around your heart. You may find at first that your heart space feels tight and constricted. Allow your breath to loosen that tightness around your heart, letting in a sense of lightness and openness. This will further help you experience gratitude and appreciation.

It is important to exercise your gratitude and appreciation “muscles” on a consistent basis. Those thoughts of “not good enough” and “yeah but” or “if only” will undoubtedly creep back in. By doing these exercises daily, your negative and self-limiting beliefs will gradually lose their power, and will be replaced by the sense of satisfaction you deserve. In a sense, enlightenment is nothing more than lightening up, and appreciating what you have, moment by moment. That is your birthright, and the path out of suffering.

© 2016 Beth S. Patterson. www.bethspatterson.com . All rights reserved.

 LIVING WITH A PARTNER WITH DEPRESSION OR BIPOLAR DISORDER

 

The recent suicide of Robin Williams awakened many of us to the toll depression or bipolar disorder takes not only on the afflicted person, but also on those of us who love and live with the person with a mood disorder. As the tragedy of Robin Williams illustrates, there is no such thing as being “just” depressed. Depression and other mood disorders are serious illnesses, and mental illness should be treated as seriously as physical illness. Partners of mentally ill loved ones are often thrust into the role of caregiver, and self-care is paramount.

Here are some tips for caring of yourself while caring for someone with depression, bipolar disorder or other mood disorders.

1. Set healthy boundaries. It is tempting to forget your own needs when living with someone with a mood disorder. Remember that you need to take care of yourself. If you do not, you will become resentful and may suffer burn out and your own depression.

2. Do not isolate yourself. A person with a mood disorder is likely to isolate him or herself. This is a primary symptom of the disorder. It is also often a result of the shame or guilt the depressed person feels. Make sure to maintain your friendships, work life and the activities that give you satisfaction.

3. Learn about the disorder. This will help you understand your partner and give you tools for caring about yourself while caring for your loved one. If he or she suffers from bipolar disorder, learn not to say “he is bipolar.” He or she is not their illness, but someone with an illness. Learning about the disorder will also help you to….

4. Don’t take it personally. A symptom of many mood disorders is irritability and uncontrolled anger. Do not take it personally, as hard as that may seem when your loved one is lashing out and directing his or her anger toward you. Do not argue or defend yourself at those times – it is like trying to be rational with a baby having a temper tantrum. Arguing and expressing your anger at these times will only escalate the situation. If the anger is overly hurtful, disengage, and walk away, as unemotionally as you can, while not suppressing your own feelings. You can say “I know you are hurting right now, but you are also hurting me. We’ll talk after you feel a little better.”

5. Determine if the anger is abusive, and weigh honestly whether to stay or leave. Only you know if the personal attacks are overly abusive and if they outweigh the love and good in the relationship. If you are in danger physically or emotionally, it will likely be best for you to leave the relationship. Abuse is never acceptable. Determine if the angry outbursts and behaviors are simply that or if they cross the line into abuse. If it is only occasional emotional attacks, that may be acceptable, but only you can judge how much it is affecting you and your life.

6. Take care of your own feelings and health. It is important to preserve your own health, both physical and mental, when you are living with a person with mental illness. You need to express your feelings, or you will become depressed yourself. Allow yourself a good cry, take a walk, hit a pillow or stamp your feet to get the feelings out. It is best not to do this in front of your loved one, as this may result in further guilt, shame and depression for him or her. Talk to a trusted friend. Get professional counseling for yourself. Get a massage. Exercise. Stay connected to your spiritual community.

7. Do not try to “cure” or “fix” your loved one. He or she may hope, whether consciously or unconsciously, that you will be a savior/rescuer and cure the illness. Remember that this is not your role or job. Remind your loved one of this gently and firmly, and suggest professional help. This is a big piece in setting a healthy boundary. Do not nag about that, as tempting as that may be.  Make suggestions once, avoiding the word” should.” He or she will hear you, and may just not be ready to take the necessary steps toward healing. Remember that only your loved one can choose to get the help he or she needs, and forcing him or her into therapy or into taking other steps will backfire if he or she is not ready to commit to the process.

8. Do not feel guilty about your loved one’s depression or other mood disorder. Remember that you are not responsible for it. Offer support, understanding and love, and again, don’t take it personally.

9. Do not make excuses for your loved one. Unfortunately, the negative symptoms of a mood disorder, such as undue anger, irritability and self-isolation, often spill over into other areas of your loved one’s and can affect your relationships with others. Let your loved one know that you will not make dishonest excuses, while assuring him or her that you will not divulge confidential information. If we all start saying “We would love to see you, but my partner is dealing with depression and is unable to go out tonight” we will begin to take away the stigma associated with mental illness. We have no problem excusing ourselves when we have a cold – why should it be any different with symptoms of a mental illness?

10. Be willing to engage in activities without your loved one. This goes hand in hand with not isolating yourself. If your loved one’s illness prevents him or her from keeping a social commitment, go yourself, especially if it is a commitment with a friend or community that nurtures you.

11. Have compassion for yourself, and acknowledge the good you are doing. Living with someone with a mental illness is a difficult challenge. Know that staying with your loved one and acting in the best interest of both yourself and your partner are acts of courage and compassion. Remember that you cannot have compassion for another unless you have compassion first and foremost for yourself.

 

 

 

 

HOW UNDERSTANDING IMPERMANENCE CAN HEAL DEPRESSION AND GRIEF

 

One of the most important tenets in Buddhism is that all phenomena are impermanent. All things and all beings are constantly changing. Nothing stays the same, and ultimately everything dies. We tend to consider this bad news. However, accepting impermanence can also be considered good news. If everything stayed the same, there would be no possibility for growth. Also, understanding that nothing stays the same can alleviate feelings of hopelessness, helplessness and overwhelm.

We all struggle to hold on to others and to things, and resist impermanence. This leads to tremendous suffering. The incorrect belief that things are “stuck” and will never change also results in great suffering.   I have observed in my years as a psychotherapist that the struggle to resist impermanence and the belief that things don’t change are universal. It is only through letting go of the resistance to change and impermanence that true healing and growth is possible.

For example, many of my clients with depression feel mired in difficult situations that they believe are permanent. It can take a lot of work for them to give up the beliefs that keep them stuck. I too am prone to depression. My Buddhist practice and study have been invaluable in helping me let go of my negative beliefs. I now know that those beliefs are just insubstantial thoughts that I no longer need to hold on to. Of course, I get thrown back into feelings of hopelessness on occasion. When that happens, I call on a friend to remind me that whatever situation is getting me down is impermanent and will change. My friend’s reminders are just what the doctor ordered at those times, and I feel a tremendous weight lifting and the restoration of hope just from hearing the words “remember that it’s impermanent.”

A big part of my psychotherapy practice is working with grief and loss. I have found that clients who have difficulty acknowledging that everyone dies have a very difficult time processing their grief. Of course, the death of a loved one or beloved pet is never easy. Although death is never easy for those left behind, always remembering impermanence helps ease the way, and despite profound sadness and grief, those who “grieve well” know that death is a natural part of life.

One of the most significant moments in my meditation practice occurred about fifteen years ago. My wonderful cat Andy was “meditating” with me at the time. I recall having a clear realization that Andy would not be with me forever. My emotions went from sadness to acceptance. I was left with a profound sense of the preciousness of life, knowing that the fact that nothing lasts is what makes life so precious. Andy, who died last summer, has ever since been my reminder of both impermanence and the preciousness of life. As the great Buddhist master Dilgo Khyentse Rinpoche said:

                                     Life is fragile, like the dew hanging delicately on the grass,  crystal drops that will be carried away on the first morning breeze.                                

                                                                            

The Importance of Self-Compassion

We throw the word “compassion” around so much that it can seem like a trite cliché.  Yet, the more I listen to my therapy clients, the more I realize that compassion — particularly self-compassion – is the key to healing ourselves and our relationships.

Compassion means “to suffer with.”  The word is generally used to describe empathy toward another.  However, I am clear that one cannot really have true compassion toward another without experiencing his or her own suffering and having kindness and empathy toward him or herself first.

The Sanskrit word maitri has been defined by Tibetan Buddhist master Chogyam Trungpa as unconditional friendliness, particularly toward oneself.  Pema Chodron, a student of Trungpa’s and a master in her own right, observes:  ” I teach about maitri a lot. In fact, sometimes I think it’s the only thing I    teach. I also teach about        compassion a lot, but actually compassion is a form of maitri so this unconditional friendliness to oneself, it seems to be what most of us do not have”  (www.shambhala.org/teachers/pema).

I have made this same observation in my work as a psychotherapist.  Most of my clients come in complaining of depression and low self-esteem.  They think that something “out there”–even something as beneficial as caring for others —  is going to make them “better.”  When I tell them that what will heal their depression is kindness toward themselves, some look at me as if I were speaking a foreign language – the idea of self-compassion is that alien to them!

For many, the messages they received in their families of origin have contributed to their low self-esteem and negative self-talk. Western culture’s emphasis on perfection doesn’t help.  Because of these familial and cultural messages, many believe that’s just the way it is, and their beliefs about themselves can’t be changed.

For example, a client I’ll call “John” recounted in his first session with me his regrets about the breakup of his marriage, and concluded “I’m a failure.”  In my work using the modality of mindfulness-based cognitive therapy, I challenged John’s belief, asking how doing something that he now regrets means he’s a failure.  I told him that he did the best he could at that time, and encouraged him that the key to his healing will be having compassion for himself and his human imperfections and neuroses. My homework for John was to simply notice when he calls himself a failure, what triggers it, and to start to challenge that long-fixed belief.  Changing these thoughts takes time, practice and discipline because they are so habitual and deep-seated, but it certainly can be done

I can challenge and have compassion for John, because I had to do the same work myself.  As I have recounted in other articles, after a period of regular mindfulness meditation practice, I was able to not only notice my negative self-talk, but realize that was just another thought, and that I could relegate those thoughts to my mental trash heap.  In fact, I told myself that if someone could have magically heard the way I talked to myself, they would have to turn me in to the police for abuse!

The Buddhist teachings on buddhanature or basic goodness are very helpful in developing self-compassion.  Those teachings tell us that we all have buddhanature, but due to our habitual tendencies and patterns, it is obscured and we have difficulty experiencing it.  An image I have found helpful is that of the sun in a cloudy sky.  The sun is always there, even on a cloudy day, but we can’t see it.  Imagine being in a plane, and seeing the sun in a clear blue sky after rising to an altitude above the clouds.  Indeed, the sun was there the whole time.

The next time you make a mistake or do something you consider less than “perfect”, take a breath, and try not to go on automatic pilot and start beating yourself up.  Instead, have compassion for yourself and all others who suffer in that way and remember the image of the sun in a cloudy sky.  Yes, you made a mistake and you can feel regret about it, and resolve not to do it again. Remember that your thoughts about your mistakes and imperfections are just fleeting clouds, and the sun of your self-worth is there the whole time.

 

 

 

USING EMDR TO UNCOVER AND HEAL SHAME AND EXISTENTIAL DESPAIR

Shame is one of the most difficult feelings for humans to acknowledge and express.  It becomes a vicious circle:  We feel shame about an event or action in our lives, and then feel shame about our shame.  Shame causes self-doubt, depression and deep suffering and prevents us from living freely, fully and authentically.  Our shame causes us to monitor what we say and do, out of fear of saying or doing the “wrong thing.”

As a humanistic, existential and Buddhist psychotherapist, my primary goal is to help my clients uncover the truth about the cause of their suffering so that they can live full and satisfying lives. Through my work with a client I will call “Bill”, I have discovered the power of EMDR[i] as a tool in this process.

Bill came to see me complaining that he was not able to experience joy or passion in his life, and felt that nothing he was doing had any meaning.  This is an apt description of existential despair. Bill had not suffered any recent crises that would account for his angst, and on the surface, his life looked quite successful:  Bill is a brilliant scientist, in a good marriage and has a high paying job.  He is athletic and is an avid cyclist and skier.  However, Bill was unable to experience any joy, passion or satisfaction from his accomplishments and activities, saying that he had a “nagging feeling that something is missing.”

Bill and I spent many sessions trying to identify the source of his existential despair.  He described growing up in a small mid-western town.  His parents divorced when he was 16 years old, and he and his brother lived with his father.  Bill has been estranged from his mother for over 20 years.  He described his mother as having an “alternate lifestyle” as a Lesbian and artist.  It was clear to me that he was doing what we therapists call “splitting” – seeing his father as all good, and his mother as all bad.  However, my attempts to go there with him were futile.

Bill tended to describe painful experiences, like the recent death of a friend and his parents’ divorce, intellectually, factually and with little emotion. My attempts to go deeper would be met with the response “I don’t know”.  After several months together, Bill acknowledged a deep fear of expressing his emotions, saying, “what if I express myself and no one accepts it?”  Attempts to explore his fear more deeply were met at that point with more “I don’t knows” and intellectualizing.  I observed how difficult it was for Bill to directly experience his body sensations and emotions.  He acknowledged that he has always relied on his intellect as a way to cope.

In addition to Bill’s fear of rejection if he expresses himself, he came to realize his deeply held belief that “If I were a good enough person, my life would have more meaning and joy.”  We explored what this meant to him, and I asked Bill what unfinished business he might need to complete, and what he would need to accomplish if he had a terminal diagnosis – the big existential question.  It was clear to me that his estrangement from his mother was the elephant in the room, but Bill was unable or unwilling to go there at that point in our therapeutic relationship.  I believed then that EMDR (see footnote 1) would help forward Bill’s journey of self-discovery. Bill agreed to give it a try.

Our first task in preparing Bill for EMDR was to get him to feel safe feeling his body sensations and emotions, and our next task was to identify a target for our EMDR work.  He identified the target as his fear of being emotional, and described the incident representing the worst part of this issue as being rejected by a girl in elementary school after he gave her a gift.  The negative belief he took from that experience was “I will get hurt if I express my feelings”, and the positive belief he wanted to have instead was “I am safe to express myself.”  Bill was able to complete the work on this target in one session.  However, we both came away with the feeling that there was something more.  I encouraged Bill to note any insights and new memories that might arise during the week before I saw him again.

Bill came in the following week saying that after our EMDR session, he started experiencing profound shame about his parents’ divorce and his feelings about his mother’s lifestyle.  We discussed how painful shame is, and I validated his difficulty in acknowledging it.

My experience as a therapist, and as a former client in therapy, has taught me how unbearable the experience of shame can be.  We will do almost anything to avoid it – risky behaviors, blaming others, acting out in any number of ways.  Shame unacknowledged can lead to deep depression as a result of internalizing the negative messages we received earlier in life.  In acting out his shame, Bill made his mother the “bad guy” and was unable to take pleasure in his life, a form of self-punishment.  He had internalized his family rules “don’t air our dirty laundry” and “don’t express your feelings” to such an extent that he was living an inauthentic life, leading to his existential despair.  Bill’s fear of feeling the full panoply of life’s emotions resulted in his dissatisfaction and belief that his life lacked meaning.

Bill’s nascent awareness of his shame placed him in what Naranjo (1993, pp. 52, 63) has called “a limbo where the surface games of the personality have been dropped and self-awareness has not [yet] taken its place.  Shame… [is] not [a] pure experience[] of reality, but the outcome of attitudes in which we stand against that reality, denying or resisting it, fearing to perceive it….Shame  [is a] mind-created curtain that we interpose between ourselves and the world.” [ii] This curtain of shame prevents us, like Bill, from fully and directly experiencing life and all of its riches, whether painful or pleasurable.

Bill asked to do another EMDR session around this issue.  The negative belief he has carried about his shame was “I am insignificant” and the positive belief he wanted to have instead is “I matter.”  The emotions that he felt were grief, despair and shame.  Through the EMDR process, Bill discovered that he has spent an inordinate amount of time trying to avoid his feelings and be “perfect”, and that he projected his shame on his mother and others who he perceived as not good enough.  He also felt tremendous guilt about the way he treated his mother.  After processing the disturbing feelings, Bill discovered that truest positive belief for him was “I forgive myself.”  This was a deeply moving session for both of us.

Bill came in to our next session saying that he felt that our work was complete for the time being.  He said that he had blamed his mother for everything, in his black and white thinking, and was in the process of writing a letter to her to acknowledge this and hopefully begin a relationship with her.  Bill said he had a tremendous sense of relief about this, and he felt more appreciation for his life. I encouraged Bill to use “I forgive myself” as his mantra when he felt the tendency to retreat behind his curtain of shame. Bill knows that he is on the path to continued healing, and, with his newly gained tools, is not afraid or ashamed to meet the challenges that lie ahead.

[i] EMDR is a scientifically proven therapeutic protocol for overcoming trauma and other life difficulties.  EMDR utilizes “bilateral stimulation”, i.e., sensory stimulation alternately on both sides of the spinal cord to release traumatic material from the brain in a way that makes it workable. Trauma that is locked in the brain leads to the “fight, flight or freeze” response. EMDR helps release traumatic images, transforming them into memories that no longer have a deleterious hold on the individual.   In addition to this physiological response to trauma, the traumatized individual also develops negative beliefs about him or herself (such as “I do not deserve love, “I was at fault,” etc). EMDR allows the individual to replace negative cognitions about him or herself with positive ones (such as “I deserve love”, “I did the best I could”, etc.).  EMDR also works on a somatic level, with the therapist guiding the client to feel the traumatic images and negative beliefs in the body, thus further facilitating the transformation of the images into non-intrusive memories, and also transforming the negative beliefs into positive, useful ones. Therapists need to be trained to practice EMDR, and follow a standardized protocol in EMDR work with clients. (The foregoing is a brief summary of EMDR, and is not intended to be a full explanation of the process.)

[ii] Naranjo, C. (1995).  Gestalt Therapy:  The Attitude and Practice of an A-theoretical Experientialism.  Gateways/IDHHB Publishing:  Nevada City, CA.

Using Mindfulness Meditation to Tame Intrusive Thoughts

Intrusive thoughts — those pesky thoughts that can spiral from a simple thought into a full-blown novel — can interfere with our work life, as well as our life in all other areas, interrupting our sleep, intruding in our relationships and in enjoying our lives in the moment. We give so much power to our thoughts. Learning to let them go and not attach importance to them can be tremendously liberating. This is especially so with thoughts that are self-critical.

The first step in dealing with those intrusive thoughts is to be aware of them. Mindfulness meditation can be extremely helpful in dealing with our thoughts. Here are some basic instructions:

• Sit comfortably in a chair or on a cushion, making sure your back is straight yet relaxed, so that your breath can flow freely. If you are sitting in a chair, uncross your legs, feeling both feet on the floor. Unclench your jaw muscles, by resting the tip of your tongue directly in back of your teeth. Have your hands rest comfortably on each thigh, palms down.

• Breathe — notice your in-breath: the rise of your abdomen and chest, the feel of the cool air coming in through your nostrils. Then notice your out-breath — warm air coming out your nostrils, letting go of stress, the fall of your abdomen and chest. Notice the pause before the next in-breath.

• Continue breathing in this fashion. As thoughts arise, simply label them “thinking” and come back to the breath. If you find yourself caught in a story or discursive thinking, simply notice that, without judgment, let it go and come back to the breath.

Practice this for a few minutes each day, slowly increasing the time of each session. The key is to do this every day.  It may be helpful to have an experienced meditation instructor guide you through this practice.

Another technique that I often use with my clients is called “the container”:

• Visualize a container or box with a lid or other top, something you can evoke simply.

• When thoughts arise that are getting in your way, consciously say to yourself, “I do not need these thoughts right now”, and put them in your container, and close the lid or top.

Something else you can do is to visualize your energy going from your head — where all those intrusive thoughts are buzzing around — to your feet. Put both feet firmly on the ground, feeling the floor or ground beneath you, and bring your energy to your feet. This is very grounding as well as a good way to release those pesky thoughts.

It is amazing how much time we spend in our heads, and are not present with whatever it is we are doing or feeling. This is a “curse” of being a thinking human being. With our fast paced world, we are often multi-tasking, on our iPhone, iPad and MacBook all at the same time!. Take a break from your devices.

Another very effective way to slow down those intrusive thoughts is what I call “driving meditation”. The goal of this exercise is to drive when you are driving. Here are the steps:

• When you get in your car, turn off your cellphone and all other devices, including the radio.

• Have the intention to be present with your driving.

• Notice how it feels to put the key in the ignition, then listen to the sound and feel the vibrations as you turn on the car.

• Feel the tires on the road as you drive. When your mind wanders, notice that without judgment, and come back to being present driving, feeling the tires, seeing the road and the flow of the traffic, listening to your car engine and the other cars around you.

• When you get to a stop sign, actually STOP and take a breath, noticing where you are, both inside and out, and then proceed. As my Buddhist teacher says, “Don’t do a California Roll through the stop sign!”

We all have an inner-critic — that voice inside our heads that judges and criticizes ourselves. These mindfulness techniques are so helpful in freeing ourselves from these self-negative thoughts. After meditating for a while, I actually gave that critic a name that was different from my real name, as well as a different voice than my actual voice. After a year or so of meditating, a friend asked me how it helped me. After pondering her question, I answered, “Wow! I no longer mentally beat myself up, and that’s a miracle!”

Using Anger Mindfully

Many of us, especially those on the spiritual path, tend to look at anger as an entirely negative emotion.  However, anger used mindfully can be extremely positive, powerful and ultimately healing.  Anger is simply energy, and we always have a choice as to what to do with it. Dzogchen Ponlop, in his recent book Rebel Buddha (2010) aptly states:

We usually think of anger … as negative.  Ordinarily, our impulse would be either to cut through it and get rid of it or to transform its intense energy into good qualities like clarity and patience….[T]he  direct experience of our unprocessed, raw emotions can generate a direct experience of wakefulness. These emotions are powerful agents in bringing about our freedom, if we can work with them properly (p. 144).

So, what do we do that that energy?  We are often afraid to feel its raw power, and fear that expressing it will make us seem less than the kind compassionate people we are.  However, using anger mindfully will actually awaken our compassion, starting with compassionate lovingkindness toward ourselves.

In fact, many people who are compassionate toward others do not treat themselves with the same degree of compassion, and are self-critical and often depressed.  It has been said that depression is “anger turned inward.”  One of the major goals in treating depression in psychotherapy and in grief counseling is to help clients feel safe to express their anger, and turn the energy of anger outward.  “Ex-pressing” anger literally means pushing it out, so that it becomes workable and is not a toxic agent against oneself.

Anger in its pure form, without the “additives” of concept and labeling it as a bad thing, is simply energy.  The key is to harness that energy through the use of mindfulness.  Mindfulness enables us to recognize the anger without simply reacting — either spitting it out against another or turning it against ourselves.  By looking at it without reacting, we have the ability to choose to use our anger productively.

The following are some suggestions for using anger mindfully:

  • Notice how anger manifests in your body — is it a burning sensation in your heart?  A cold tight clenching in the pit of your stomach?  A flush of heat in your face or hands?  Become as familiar as you can with your own unique physical “early warning signs” of anger so you can catch its energy without reacting.
  • As soon as you notice the physical sensation of anger, stop and breathe.  Allow the energy of anger to wake you up to what is actually happening at that moment.
  • Give yourself permission to feel hurt, abandoned, scared, frustrated or sad with a sense of compassion for yourself.  Breathe in light, peace and compassion, and breathe out the dark, heavy sensations of anger without judgment, accepting it just as it is.
  • If you notice the anger turning inward against yourself, continue to breathe it out more forcefully.  Use your body to keep the energy of the anger outward — shake it off your hands into the air, stomp it into the ground with your feet  — whatever it takes not to turn that energy against yourself.
  • Be curious.  Ask yourself:  “What is this feeling?  What is it telling me?”
  • Trust your body to tell you the appropriate course of action.  Is there something you need to say to someone who has hurt you, in a way that will forward your own healing and contribute to the growth of the other person and your relationship with him or her?  Is it something you can simply let be, making sure not to turn the anger inward?

As Stephen Levine (1987) eloquently says, “the investigation of anger…leads us directly to the love beneath, to our underlying nature. When we bring anger into the area where we can respond to it, where we can investigate it, where we can embrace it, it emerges into the light of our wholeness….Then anger is no longer a hindrance, but a profound teacher.”

References

Dzogchen Ponlop (2010).   Rebel Buddha: On the Road to Freedom.  Boston:     Shambhala Publications, Inc.

Stephen Levine (1987).  Healing into Life and Death.  New York:  Doubleday, a division of Bantam Doubleday Dell Publishing Group, Inc.

© 2011.  Beth S. Patterson, MA, LPC.  All rights reserved.

Mind the Gap: Living in the Space Between Loss and Healing

One of the most difficult phases in any life transition is the space of the unknown between a loss or change, and healing or new beginning.  All life changes, even positive ones, entail a sense of loss or grief.  For example, there is a sense of loss in giving up addictive behaviors like cigarette smoking, despite the fact that the change is a positive one.  Even the change of getting a better job or promotion entails loss — you might be giving up security, relationships and the comfort of the known in making such a change.  The most difficult changes involve the death of a loved one or death of a relationship.

Our lives are always in transition.  Every breath we take involves a transition, from inhaling to exhaling, to the gap or space before the next inhalation.     After the end of a phase in our lives, we have a tendency to jump into something (or someone) new, because that space of the unknown can be so uncomfortable.  William Bridges (1980) calls this space the “neutral zone.” As Bridges explains (p. 112), “one of the difficulties of being in transition in the modern world is that we have lost our appreciation for this gap in the continuity of existence.  For us, emptiness represents only the absence of something.  So, when the something is as important as relatedness and purpose and reality, we try to find ways of replacing those missing elements as quickly as possible.”

Resting in the space of the neutral zone — feeling the pain of our loss, exploring our options, getting to know ourselves on a deeper level — is the key to transformation and growth.   How can we sit in that space of the unknown that feels anything but neutral, without giving in to the impulse to do something?  The first step is to be rather than do, which sounds much easier than it is, until we develop some friendliness toward ourselves and our anxiety.  Notice the impulse, and instead of acting on it, explore it with curiosity:  Where do you feel it in your body?  What is it telling you?  Breathe into it and let it be without having to change it in any way.

Mindfulness meditation, especially mindful breathing, is very helpful in learning how to be in the gap or neutral zone:  Feel the cool air entering your nostrils on the in-breath.  Pause and then feel the warm air leaving your nostrils on the out-breath.  Notice in particular how the out-breath dissolves and experience the space before your next in-breath.

Journaling can also be helpful in navigating the neutral zone.  Journaling helps us get those swirling emotions out of our bodies and head in a way that is workable and spacious.  We can gain some perspective on the stages of our journey — a major function of the neutral zone, and get to appreciate that time as a time for renewal.

Finding a regular time and place to be alone is also helpful in the neutral zone.  The period after a loss is a natural time to turn inward. This time of year, the barren stillness of winter, is also a natural time to turn inward.  Experience the loss of summer’s richness and the loss of the autumn leaves.  Know the gap before spring comes again as a time for renewal.  Without death, there can be no rebirth.

The Christian mystics call this gap and time of turning inward the “dark night of the soul.” It is a time to allow ourselves to feel the pain and despair that is a universal part of the human condition in the face of loss and change.  We may feel bereft and spiritually arid, and it is necessary to feel those feelings in order to transform them.  Despair can be seen as the manure from which spiritual growth and personal transformation arise.  As Michael Washburn so beautifully says in the aptly titled article The Paradox of Finding One’s Way by Losing It (1996), “It is only in the depths of despair that genuine spiritual life is found.  It is a paradox that we sometimes have to lose our way in order to find our true self.  We sometimes have to die to the world and to our worldly self before we can discover that our deepest and truest self was within us all the time.”

REFERENCES

Bridges, W. (1980). Transitions:  Making Sense of Life’s Changes. Cambridge, MA:  Perseus Books.

Washburn, M. (1996).  The Paradox of Finding One’s Way by Losing It:  The Dark Night of the Soul and the Emergence of Faith.  In Sacred Sorrows, Nelson, J.E and Nelson, A., eds. New York:  G. Putnam’s Sons.

EMDR as a Healing Tool in Transforming Traumatic Grief

The intense and painful experiences of grief are generally considered “normal.”  However, when those experiences are extremely distressing, unduly interfere with day-to-day functioning or do not subside to a manageable level over time, the bereaved may be experiencing complicated or traumatic grief.  Complicated grief has been proposed as a new diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (DSM), and suggested components of the diagnosis include (1) that sufferers experience bereavement by death; (2) that their reactions include intrusive and distressing symptoms, including yearning, longing and searching for the deceased; and (3) that the bereaved exhibit at least four marked and persistent trauma reactions, which may include:  “avoidance of reminders of the deceased,  purposelessness, feelings of futility, difficulty imagining a life without the deceased, numbness, detachment, feeling stunned, dazed or shocked, feeling that life is empty or meaningless, feeling a part of oneself has died, disbelief, excessive anger or bitterness related to the death, and identification symptoms or harmful behaviors resembling those suffered by the deceased” (Mitchell et al, 2004, p. 13).

Even in cases that do not fit the criteria for complicated grief as described above, the events surrounding the death may be sufficiently traumatic to interfere with daily functioning or result in unrelenting distress.  As a psychotherapist specializing in grief and loss, I have found EMDR (Eye Movement Desensitization and Reprocessing) to be an effective tool for alleviating trauma in grief.  As in grief, trauma affects the whole person — body, mind and spirit, and on a hierarchy of needs, trauma must be dealt with in order for the healing process of grief to proceed in a healthy, and healing, fashion.

What is EMDR?

In brief, EMDR was developed by psychologist Francine Shapiro after making a chance discovery that the lateral movement of her eyes reduced the intensity of disturbing material she was dealing with in her life (Shapiro, 1995, p. 2).  Dr. Shapiro spent several years scientifically studying this phenomenon, and found that bilateral stimulation, i.e., stimulation on both sides of the body — whether in the form of eye movements, tapping, sound or other forms — released traumatic material from the brain in a way that made the material workable. Trauma that is locked in the brain leads to the “fight, flight or freeze” response, and EMDR helps transform traumatic images into memories that no longer have a deleterious hold on the individual.

In addition to this physiological response to trauma, the traumatized individual often develops negative beliefs about him or herself (such as “I do not deserve love, “I was at fault” etc).  The beauty of EMDR is that it works on a cognitive level as well as the physiological level, not only facilitating the transformation of traumatic images in the brain, but also allowing the individual to replace negative cognitions about him or herself with positive ones (such as “I deserve love”, “I did the best I could”, etc.).  EMDR also works on a somatic level, with the therapist guiding the client to feel the traumatic images and negative beliefs in the body, thus further facilitating the transformation of the images into non-intrusive memories, and also transforming the negative beliefs into positive, useful ones. Therapists need to be trained to practice EMDR, and follow a standardized protocol in EMDR work with clients.

Case Studies

Two cases in my practice are illustrative of the effectiveness of EMDR in resolving traumatic grief.  “Carol”, the mother of two small children, came to see me complaining of ongoing distress after the death of her husband nine months before.  “Bill” was in a motorcycle accident, sustaining a broken leg. After being admitted to the hospital, Bill suffered a stroke and brain swelling, and died after being taken off life support two days later.  Carol was concerned about her irritability, particularly toward her children, and her anger toward Bill for dying and leaving her with two small children to raise alone. She also expressed guilt regarding her anger toward Bill, which I spent time validating and normalizing, since anger is often exhibited as a normal grief response.   Carol spent much time telling her story — a useful healing tool for making meaning of a seemingly senseless situation (White, 1995).  She did not exhibit signs of trauma for the first few months that we worked together.  However, as the anniversary of Bill’s death approached, Carol found it difficult to sleep, being awakened by intrusive images of Bill lying in the hospital bed and her shock when she learned of his condition.  We explored Carol’s negative cognitions around these images and Bill’s sudden death. The negative belief that that most impacted Carol was her belief that Bill’s death was her fault because she had a premonition that he would be in an accident, and she did nothing to prevent it.   In describing the images of Bill lying in the ICU and her belief that it was her fault, Carol felt tightness in her chest and had difficulty breathing. After two 90-minute EMDR sessions, Carol was able to replace her negative belief “I was at fault” with the positive belief “I did the best I could.”  She reported that she still, of course, experienced memories of Bill’s death, and reported she was very pleased that that she could feel sadness without guilt.  Carol was thus finally able to process her grief and loss in a healthy way.

My work with “Mary” was deeply profound and moving.  Mary’s husband “Don” suffered with Lou Gehrig’s disease (ALS) for three years, and Mary witnessed the horrible, inexorable ravaging of Don’s body while his mind stayed strong.  Mary’s expressed purpose for coming to see me was that she was unable to feel Don’s presence in her life.  Mary described Don as her soul mate, and I assured her that because of the strength of their bond, she would find a place for Don in her heart and feel his presence as a support in order to move forward. However, it was clear that she would first have to deal with the traumatic images that prevented her from fulfilling this step in her grief process.  The most disturbing image, and target for our EMDR work, was finding Don lying in a pool of blood on the bathroom floor after falling out of his wheelchair.  I taught Mary the “butterfly” technique, in which the client crosses his or her arms across the chest in a hug and taps alternately below each shoulder, simulating the bilateral stimulation used in formal EMDR sessions. I instructed Mary to use this technique at home as a resource when traumatic images arose.  After two sessions, with Mary working at home with the butterfly hug when disturbing images and emotions arose, Mary reported that those images had receded as mere memories that were no longer unduly disturbing.

Mary came into our next session glowing, and reported that she had felt a tug at the back of her shirt while sitting quietly one day and “knew it was Don, back in my life.”  She reported that she subsequently felt Don’s presence coming to her every night before she fell asleep.  Our trauma work was done, and Mary was well on the way to healing her grief.

Conclusion

My work with both Carol and Mary, as well as many others, has enhanced my confidence in my therapeutic skills in identifying and working with traumatic grief, and has increased my trust and faith in the effectiveness of EMDR as a healing tool in grief.

References

A. Mitchell, Y. Kim, H.G. Prigerson, M.K. Mortimer-Stephens. (2004). Complicated Grief in Survivors of Suicide. Crisis 25(1), 12-18.

F. Shapiro. (1995). Eye Movement Desensitization and Reprocessing:  Basic Principles, Protocols and Procedures. New York:  Guilford Press.

M. White. (1995). Re-authoring lives. Adelaide:  Dulwich Center Publications.

The Use of Narrative Therapy in the Transformative Work of Healing Painful Life Transitions

Helen Keller has said that “the only way to get to the other side is to go through the door.”  This is certainly true in the work of transforming painful emotions, such as those we experience after a divorce, into healing and growth. This process involves allowing ourselves to feel the intense emotions of grief – sadness, anger, despair and other difficult emotions, as well as tapping into our internal strengths and external sources of support.

Narrative therapy and has been used with a wide variety of difficulties and issues, including reactions to a major life transition.  The role of the narrative therapist is as collaborator or co-author with the client.  As such, the narrative therapist partners with the client to explore the stories that give meaning to the client’s life (White, 1995). The The

Narrative therapy is thus an empowering vehicle for “re-authoring lives” (Carr, 1998, p. 468; White, 1995), in which the therapist takes the role of a partner or collaborator with the client, rather than an authority figure (Angell, Dennis & Dumain, 1999).. The narrative therapist partners with the client to create a safe place to feel the emotions of loss and change, and to explore the stories that give meaning to the client’s life. The use of narrative or story is a useful vehicle for making meaning and sense of difficult experiences in our lives, by allowing us to access alternative cognitions and gain self-knowledge.

A narrative therapy tool that is often used in this work is the use of written expression, such as journaling and letter writing.  This can be a powerful vehicle for expressing the emotions of loss and change and accessing the individual’s unique internal strengths and resources.

The collaborative approach of the narrative therapist can be useful for accessing the client’s spiritual strengths by respectful inquiry into the client’s worldviews, including his or her beliefs before the loss, and how they may have changed since the loss, and discussing spiritual and existential issues that arise in this context. (Calhoun & Tedeschi, 2000, p. 167).

As one gets in touch on a deep level with his or her own suffering and resiliency in the face of that suffering, he or she can begin to get a panoramic view of the human condition and tap into his or her spiritual strength. Religious and spiritual beliefs have been observed to be one way in which individuals create meaning and a sense of order and purpose to the human condition and its difficult transitions (Golsworthy & Coyne, 1999; Calhoun & Tedeschi 2000).

Narrative therapy can be an effective tool for working painful emotions and finding new meaning in one’s life.  The process of expression literally takes deep feelings out of the body, externalizing them so that they become workable. Through this process, my clients are able to see that they have some control over their lives, and can tap into their strengths and their inherent wisdom.  With my guidance as a partner on the path of healing painful life transitions, my clients can discover their unique strengths, resources and resiliency, deepen their spiritual beliefs, and enhance the meaning of their lives in the context of the human condition.